Author: "Saccullo, G" / Database: OpenAIRE - Searchworks@Jio Institute Digital Library Search Results

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46 results on '"Saccullo, G"'

1. Caution in Using the Activated Partial Thromboplastin Time to Monitor Argatroban in COVID-19 and Vaccine-Induced Immune Thrombocytopenia and Thrombosis (VITT)

Author: Guy, S., Kitchen, S., Makris, M., Maclean, R.M., Saccullo, G., and Vanveen, J.J.
Subjects: Male, Sulfonamides, SARS-CoV-2, VITT, COVID-19, APTT, Thrombosis, Original Manuscript, Hematology, General Medicine, Middle Aged, Arginine, Thrombocytopenia, COVID-19 Drug Treatment, RC666-701, Pipecolic Acids, Diseases of the circulatory (Cardiovascular) system, Humans, argatroban, Female, Partial Thromboplastin Time, dilute thrombin time, Platelet Aggregation Inhibitors, circulatory and respiratory physiology, Aged
Abstract: Introduction Argatroban is licensed for patients with heparin-induced thrombocytopenia and is conventionally monitored by activated partial thromboplastin time (APTT) ratio. The target range is 1.5 to 3.0 times the patients’ baseline APTT and not exceeding 100 s, however this baseline is not always known. APTT is known to plateau at higher levels of argatroban, and is influenced by coagulopathies, lupus anticoagulant and raised FVIII levels. It has been used as a treatment for COVID-19 and Vaccine-induced Immune Thrombocytopenia and Thrombosis (VITT). Some recent publications have favored the use of anti-IIa methods to determine the plasma drug concentration of argatroban. Methods Plasma of 60 samples from 3 COVID-19 patients and 54 samples from 5 VITT patients were tested by APTT ratio and anti-IIa method (dilute thrombin time dTT). Actin FS APTT ratios were derived from the baseline APTT of the patient and the mean normal APTT. Results Mean APTT ratio derived from baseline was 1.71 (COVID-19), 1.33 (VITT) compared to APTT ratio by mean normal 1.65 (COVID-19), 1.48 (VITT). dTT mean concentration was 0.64 µg/ml (COVID-19) 0.53 µg/ml (VITT) with poor correlations to COVID-19 baseline APTT ratio r2 = 0.1526 p 2 = 0.2188 p 2 = 0.04 p 2 = 0.0064 p Conclusions We believe that dTT is a superior method to monitor the concentration of argatroban, we have demonstrated significant differences between APTT ratios and dTT levels, which could have clinical impact. This is especially so in COVID-19 and VITT.
Published: 2021

2. Platelet cut-off for anticoagulant therapy in thrombocytopenic patients with blood cancer and venous thromboembolism: an expert consensus

Author: Napolitano, M, Saccullo, G, Marietta, M, Carpenedo, M, Castaman, G, Cerchiara, E, Chistolini, A, Contino, L, De Stefano, V, Falanga, A, Federici, AB, Rossi, E, Santoro, R, Siragusa, S, Napolitano, Mariasanta, Saccullo, Giorgia, Marietta, Marco, Carpenedo, Monica, Castaman, Giancarlo, Cerchiara, Elisabetta, Chistolini, Antonio, Contino, Laura, De Stefano, Valerio, Falanga, Anna, Federici, Augusto B, Rossi, Elena, Santoro, Rita, Siragusa, Sergio, Napolitano, M, Saccullo, G, Marietta, M, Carpenedo, M, Castaman, G, Cerchiara, E, Chistolini, A, Contino, L, De Stefano, V, Falanga, A, Federici, A, Rossi, E, Santoro, R, and Siragusa, S
Subjects: venous thrombosis, thrombocytopenia, blood cancer, anticoagulant treatment, consensus, anticoagulants, blood cancer, blood platelets, venous thromboembolism, thrombocytopenia, Heparin, Low-Molecular-Weight, heparin, platelet count, anticoagulant treatment, Settore MED/15 - MALATTIE DEL SANGUE, Venous thromboembolism, haematological malignancy,thrombocytopenia, consensus, low-molecular-weight, Original Article, hematologic neoplasms, cardiovascular diseases, venous thrombosis, humans, heparin, low-molecular-weight, Anticoagulant treatment, Blood cancer, Consensus, Thrombocytopenia, Venous thrombosis
Abstract: Background. Management of venous thromboembolism (VTE) in patients with haematologic malignancies and thrombocytopenia is clinically challenging due to the related risks. No prospective studies or clinical trials have been carried out and, therefore, no solid evidence on this compelling issue is available. Methods. Given this, an expert panel endorsed by the Gruppo Italiano Malattie Ematologiche dell'Adulto Working Party on Thrombosis and Haemostasis was set up to produce a formal consensus, according to the RAND method, in order to issue clinical recommendations about the platelet (PLT) cut-off for safe administration of low molecular weight heparin (LMWH) in thrombocytopenic (PLT
Published: 2019

3. The management of acute venous thromboembolism in clinical practice - study rationale and protocol of the European PREFER in VTE Registry

Author: Agnelli, G., Gitt, A. K., Bauersachs, R., Fronk, E. -M., Laeis, P., Mismetti, P., Monreal, M., Willich, S. N., Wolf, W. -P., Cohen, A. T., Brodmann, M., Rief, P., Eischer, L., Stoshikj, S., Hirschl, M., Weinmann, S., Marschang, P., Abbadie, F., Achkar, A., Addala, A., Adnet, F., Alexandra, J. -F., Aquilanti, S., Belhassane, A., Benaroya, A., Berremili, T., Grenot, M. C., Birr, V., Holtea, D., Bonnin, C., Bosler, F., Durand, M. -G. B., Brisot, D., Brousse, C., De La Fuente, T., Cayman, R., Cazaubon, M., Champion, O., Chanut, M., Chevalet, P., Connault, J., Durant, C., Constans, J., Cordeanu, M., Couturaud, F., Lacut, K., De Dedker, L., Decoulx, E., Derrien, B., Diamand, J. -M., Diard, A., Douadi, Y., Dupas, S., Remond, S. S. M., Sevestre, M. -A., Edhery, S., Falvo, N., Taralunga, C. F., Ferrari, E., Gaillard, C., Garrigues, D., Gillet, J. L., Giordana, P., Grange, C., Vital-Durand, D., Grare, F., Henni, A. H., Heuser, S., Schmidt, J., Hidden-Henic, V., Hottin, D., Imbert, B., Pernod, G., Jakob, D., Jacquinandi, V., Jurus, C., Lacoste, A., Laroche, J. -P., Martin, M., Mazollier, C., Mersel, T., Miserey, G., Nedey, C., Nou, M., Quere, I., Ouvry, P., Peuch, B., Pichot, O., Poulain, V., Ray, P., Rifai, A., Roy, P. -M., Saby, J. -C., Simon, F., Simonot-Lalandec, E., Stephan, D., Tissot, A., Vodoungnon, H., Adamczyk, A., Schnabl, S., Ahmad, W. A., Weber, H., Axthelm, C., Bergmann, K., Beschorner, U., Knittel, M., Binias, K. -H., Pasligh, M., Boral, M., Friederike, G., Bratsch, H., Brauer, G., Burghard, S., Demann, C., Rennebaum, C., Demmig, A., Eberlein, U., Enger, F., Eschenburg, J., Forkmann, L., Frank, J., Freischmidt, H., Gassauer, M., Fritsche, I., Kubicek-Hofmann, C., Goebels, M. -C., Guggenbichler, S., Hartel, D., Hartmann, K., Heilberger, P., Heinsius, A., Held, M., Schnupp, S., Herman, G., Herold, J., Hertrich, F., Hommel, H., Hutte, G., Kalka, C., Jungandreas, K., Ramthor, M., Karcher, J., Werner, N., Karl-Wollweber, S., Keilhau, D. -A., Kittel, K., Knolinski, T., Kohler, C., Werth, S., Kopplin, U., Korner, I., Wittig, K., Kroger, K., Moysidis, T., Kroschel, U., Leschke, M., zur Nieden, T., Lubbert, G., Lutz, A., Wucherpfennig, P., Marencke, G. -H., Mortensen, K., Reppel, M., Nelles, H., Nestler, K., Neumeister, A., Schlosser, A., Oettler, W., Ott, I., Otto, A., Pertermann, A., Pfister, R., Pindur, L., Pourhassan, S., Predel, D., Pudollek, T., Reimer, D., Richter, C., Rieker, E., Rothenbucher, G., Rothhagen, B., Rudolff, S., Stucker, M., Schafer, A., Sonnenschein, K., Schafnitzl, W., Schellong, S., Voigts, B., Schiller, M., Schmeink, T., Schneider, H., Schon, N., Schulze, M., Sechtem, U., Sedl, S., Werno, H. S., Stachowitz, J., Thieme, M., Tiefenbacher, C., Tsantilas, D., Vieth, P., vom Dahl, J., Grun-Himmelmann, K., von Bilderling, P., von Maltik, T., Weinrich, K., Weyer, M., Koln, E. K., Wirtz, P., Wittig, I., Zierock, P., Ageno, W., Caprioli, M., Rancan, E., Guercini, F., Mommi, V., Amitrano, M., Cannavacciuolo, F., Amore, M., D'Antoni, S., Angelini, E., Forgia, S. L., Antignani, P. L., Calandra, G., Arone, A., Perticone, F., Sciacqua, A., Asaro, G., Bellisi, M., Attanzio, M. T., Pinto, A., Attinasi, V., Cillari, E., Sorvillo, S., Balbarini, A., Santini, C., Violo, C., Banfi, E., Lodigiani, C., Barcellona, D., Delpin, S., Marongiu, S., Barillari, G., Pasca, S, Bartolini, C., Verdecchia, P., Bartone, M., Mancuso, G., Bellanuova, I., Felis, S., Bellizzi, A., Masotti, L., Bianchi, M., Carugati, A., Bianchini, G., Guarnera, G., Boari, B., Gallerani, M., Pasin, M., Bortoluzzi, C., Parisi, R., Brucoli, C., Palasciano, G., Camporese, G., Tonello, C., Canafoglia, L., Rupoli, S., Cancellieri, E., Paoletti, O., Testa, S., Carlizza, A., Carnovali, M., Sada, S., Samaden, A., Casarsa, C., Mearelli, F., Pivetti, G., Catalini, R., Zingaretti, O., Vascolare, M., Cavazza, S., Cosmi, B., Cenci, C., Prisco, D., Silvestri, E., Ceresa, F., Patane, F., Ciampa, A., Siniscalchi, V., Ciarambino, T., De Bartolomeo, G., Clemente, M., Conti, F., Paiella, L., D'Avino, M., D'Alessandro, A., Placentino, M., Sollazzo, V., D'Angelo, A., Vigano, S., De Campora, P., Sangiuolo, R., De Franciscis, S., Serra, R., De Gaudenzi, E., De Santis, F., Piccinni, G. C., De Tommaso, I. D., Di Francesco, L., Vincentelli, G. M., Di Maggio, R., Saccullo, G., Siragusa, S., Di Micco, P., Fontanella, A., Di Michele, D., Di Minno, G., Tufano, A., Di Nisio, M., Porreca, E., Donadio, F., Imberti, D., Enea, I., Fabbian, F., Manfredini, R., Pala, M., Falanga, A., Milesi, V., Fiore, V., Franco, E., Giudice, G., Frausini, G., Rovinelli, M., Fuorlo, M., Landolfi, R., Morretti, T., Gamberini, S., Salmi, R., Ghirarduzzi, A., Veropalumbo, M. R., Ghizzi, M., Pepe, C., Gianniello, F., Martinelli, I., Iosub, D. I., Piovella, F., Iozzi, E., Talerico, A., Regina, M. L., Orlandini, F., Marconi, L., Palla, A., Marcucci, R., Poli, D., Margheriti, R., Sala, G., Marra, A., Marrocco, F., Montagna, E. S., Silvestris, F., Vallarelli, S., Mos, L., Rossetto, V., Mugno, F., Di Salvo, M., Nitti, C., Pennacchioni, M., Salvi, A., Olivieri, O., Tosi, F., Zorzi, F., Onesta, M., Pagliara, V., Villalta, S., Paolucci, G., Severino, S., Pierri, F., Russo, V., Pizzini, A. M., Quintavalla, R., Rubino, P., Ria, L., Schenone, A., Strafino, C., Tropeano, P., Vetrano, A., Zanatta, N., Cansino, M. D. A., Gutierrez, J. A., de las Revillas, F. A., Fernandez, C. A., Mijares, N. C., Blanco-Molina, M. A., Garcia, M. A., Seijo, D. J., Blazquez, R. A., Lopez-Saez, J. -B., Rodrigo, E. A., Blanch, J. V., Arxe, A. A., Dalmau, F. G. -B., Quincoces, A. B., Loizaga, A. G., Perez, J. L. B., Diaz, P. B., Loaiza, A. Q., Castellote, M. C., Alcantara, I. C., Padierna, M. L., Exposito, M. C., Mas, A. C., Castro, F. C., Sanz, R. C., de Saracho, J. O., de la Fuente, E. C., de Ancos Aracil, C., Ruiz, J. R., de Daborenea Gonzalez, M. D., Iglesias, A. F., de la Fuente Aguado, J., Gonzalez, L. G., del Carmen Fernandez-Capitan, M., Hernandez, A. L., del Toro Cervera, J., Rus, G. P., Bregel, J. L. D., Fernandez, F. D., Teresa Elias Hernandez, Palomares, L. J., Bataler, R. F., Rodriguez, J. A. N., Garcia, J. M. G., Porras, J. R. G., Garcia, M. G., Lopez, E. H., Lazaro, A. R., Jaras, M. J., Castro, D. J., Madridejos, R. J. -R., Navas, J. M. P., Lecumberri, R., Martinez, N., Castellanos, G. T. L., Espinosa, L. M., Jimenez, L. L., Cobo, O. M., Saiz, C. M., Pizarro, Y. R., Yglesias, P. J. M., Martin del Pozo, M., Melibovsky, L., Altarriba, E. S., Bosch, M. M., Secades, R. M., Lujan, J. M. M., Mestre, A. R., Moral, P. M., Parra, J. A. T., Flores, A. M., Munoz-Torrero, J. F. S., Rodriguez, F. J. M., Fernandez, M. J. N., Sibajas, E. O., de Sedas, M. V., Caballero, P. P., del Campo, I. P. M., Sanchez, J. P., Gallego, A. R., Alvarez, I. V., Beltran, E. M. R., Fuentes, D. S., Schilling, V. R., Alvarez, J. S., Lopez, G. T., Caralt, J. M. S., Miranda, R. T., de Antonio, E. U., Banyai, M., Frank, U., Gian Reto Jorg, Jeanneret, C., Staub, D., Ackroyd, S., Agarwal, G., Mearns, B., Alikhan, R., Allameddine, A., Al-Refaie, F., Arden, C., Austin, A., Bakhai, A., Barton, T., Ewad, H., Body, R., Thachil, J., Chacko, J., Chandra, D., Charters, F., Church, A., Mcgrane, F., Clements, J., Clifford, P., Cox, D., Crouch, M., Crowther, M., Davies, E., Davies, M., Dimitri, S., Drebes, A., Franklin, S., George, J., Irvine, N., Gerofke, H., Gibbs, C., Goh, T., Gupta, S., Holmes, J., Jackson-Voyzey, E., Jones, N., Kallat, A., Kerr, P., Kesteven, P., Lench, T., Lester, W., Lowe, G., Lewis, M., Mccormack, T., Mccoye, A., Moriarty, A., Morris, W., Myers, B., Narayanan, M., Oo, N., Reed, M., Rose, P., Saja, K., Sivakumaran, M., Sohal, M., Solomons, G., Sultanzadeh, S. J., Venton, T., Wakeling, J., Walby, C., Waldron, M., Watt, S., Willcock, W., Agnelli, G., Gitt, A. K., Bauersachs, R., Fronk, E. -M., Laeis, P., Mismetti, P., Monreal, M., Willich, S. N., Wolf, W. -P., Cohen, A. T., Brodmann, M., Rief, P., Eischer, L., Stoshikj, S., Hirschl, M., Weinmann, S., Marschang, P., Abbadie, F., Achkar, A., Addala, A., Adnet, F., Alexandra, J. -F., Aquilanti, S., Belhassane, A., Benaroya, A., Berremili, T., Grenot, M. C., Birr, V., Holtea, D., Bonnin, C., Bosler, F., Durand, M. -G. B., Brisot, D., Brousse, C., De La Fuente, T., Cayman, R., Cazaubon, M., Champion, O., Chanut, M., Chevalet, P., Connault, J., Durant, C., Constans, J., Cordeanu, M., Couturaud, F., Lacut, K., De Dedker, L., Decoulx, E., Derrien, B., Diamand, J. -M., Diard, A., Douadi, Y., Dupas, S., Remond, S. S. M., Sevestre, M. -A., Edhery, S., Falvo, N., Taralunga, C. F., Ferrari, E., Gaillard, C., Garrigues, D., Gillet, J. L., Giordana, P., Grange, C., Vital-Durand, D., Grare, F., Henni, A. H., Heuser, S., Schmidt, J., Hidden-Henic, V., Hottin, D., Imbert, B., Pernod, G., Jakob, D., Jacquinandi, V., Jurus, C., Lacoste, A., Laroche, J. -P., Martin, M., Mazollier, C., Mersel, T., Miserey, G., Nedey, C., Nou, M., Quere, I., Ouvry, P., Peuch, B., Pichot, O., Poulain, V., Ray, P., Rifai, A., Roy, P. -M., Saby, J. -C., Simon, F., Simonot-Lalandec, E., Stephan, D., Tissot, A., Vodoungnon, H., Adamczyk, A., Schnabl, S., Ahmad, W. A., Weber, H., Axthelm, C., Bergmann, K., Beschorner, U., Knittel, M., Binias, K. -H., Pasligh, M., Boral, M., Friederike, G., Bratsch, H., Brauer, G., Burghard, S., Demann, C., Rennebaum, C., Demmig, A., Eberlein, U., Enger, F., Eschenburg, J., Forkmann, L., Frank, J., Freischmidt, H., Gassauer, M., Fritsche, I., Kubicek-Hofmann, C., Goebels, M. -C., Guggenbichler, S., Hartel, D., Hartmann, K., Heilberger, P., Heinsius, A., Held, M., Schnupp, S., Herman, G., Herold, J., Hertrich, F., Hommel, H., Hutte, G., Kalka, C., Jungandreas, K., Ramthor, M., Karcher, J., Werner, N., Karl-Wollweber, S., Keilhau, D. -A., Kittel, K., Knolinski, T., Kohler, C., Werth, S., Kopplin, U., Korner, I., Wittig, K., Kroger, K., Moysidis, T., Kroschel, U., Leschke, M., zur Nieden, T., Lubbert, G., Lutz, A., Wucherpfennig, P., Marencke, G. -H., Mortensen, K., Reppel, M., Nelles, H., Nestler, K., Neumeister, A., Schlosser, A., Oettler, W., Ott, I., Otto, A., Pertermann, A., Pfister, R., Pindur, L., Pourhassan, S., Predel, D., Pudollek, T., Reimer, D., Richter, C., Rieker, E., Rothenbucher, G., Rothhagen, B., Rudolff, S., Stucker, M., Schafer, A., Sonnenschein, K., Schafnitzl, W., Schellong, S., Voigts, B., Schiller, M., Schmeink, T., Schneider, H., Schon, N., Schulze, M., Sechtem, U., Sedl, S., Werno, H. S., Stachowitz, J., Thieme, M., Tiefenbacher, C., Tsantilas, D., Vieth, P., vom Dahl, J., Grun-Himmelmann, K., von Bilderling, P., von Maltik, T., Weinrich, K., Weyer, M., Koln, E. K., Wirtz, P., Wittig, I., Zierock, P., Ageno, W., Caprioli, M., Rancan, E., Guercini, F., Mommi, V., Amitrano, M., Cannavacciuolo, F., Amore, M., D'Antoni, S., Angelini, E., Forgia, S. L., Antignani, P. L., Calandra, G., Arone, A., Perticone, F., Sciacqua, A., Asaro, G., Bellisi, M., Attanzio, M. T., Pinto, A., Attinasi, V., Cillari, E., Sorvillo, S., Balbarini, A., Santini, C., Violo, C., Banfi, E., Lodigiani, C., Barcellona, D., Delpin, S., Marongiu, S., Barillari, G., Pasca, S., Bartolini, C., Verdecchia, P., Bartone, M., Mancuso, G., Bellanuova, I., Felis, S., Bellizzi, A., Masotti, L., Bianchi, M., Carugati, A., Bianchini, G., Guarnera, G., Boari, B., Gallerani, M., Pasin, M., Bortoluzzi, C., Parisi, R., Brucoli, C., Palasciano, G., Camporese, G., Tonello, C., Canafoglia, L., Rupoli, S., Cancellieri, E., Paoletti, O., Testa, S., Carlizza, A., Carnovali, M., Sada, S., Samaden, A., Casarsa, C., Mearelli, F., Pivetti, G., Catalini, R., Zingaretti, O., Vascolare, M., Cavazza, S., Cosmi, B., Cenci, C., Prisco, D., Silvestri, E., Ceresa, F., Patane, F., Ciampa, A., Siniscalchi, V., Ciarambino, T., De Bartolomeo, G., Clemente, M., Conti, F., Paiella, L., D'Avino, M., D'Alessandro, A., Placentino, M., Sollazzo, V., D'Angelo, A., Vigano, S., De Campora, P., Sangiuolo, R., De Franciscis, S., Serra, R., De Gaudenzi, E., De Santis, F., Piccinni, G. C., De Tommaso, I. D., Di Francesco, L., Vincentelli, G. M., Di Maggio, R., Saccullo, G., Siragusa, S., Di Micco, P., Fontanella, A., Di Michele, D., Di Minno, G., Tufano, A., Di Nisio, M., Porreca, E., Donadio, F., Imberti, D., Enea, I., Fabbian, F., Manfredini, R., Pala, M., Falanga, A., Milesi, V., Fiore, V., Franco, E., Giudice, G., Frausini, G., Rovinelli, M., Fuorlo, M., Landolfi, R., Morretti, T., Gamberini, S., Salmi, R., Ghirarduzzi, A., Veropalumbo, M. R., Ghizzi, M., Pepe, C., Gianniello, F., Martinelli, I., Iosub, D. I., Piovella, F., Iozzi, E., Talerico, A., Regina, M. L., Orlandini, F., Marconi, L., Palla, A., Marcucci, R., Poli, D., Margheriti, R., Sala, G., Marra, A., Marrocco, F., Montagna, E. S., Silvestris, F., Vallarelli, S., Mos, L., Rossetto, V., Mugno, F., Di Salvo, M., Nitti, C., Pennacchioni, M., Salvi, A., Olivieri, O., Tosi, F., Zorzi, F., Onesta, M., Pagliara, V., Villalta, S., Paolucci, G., Severino, S., Pierri, F., Russo, V., Pizzini, A. M., Quintavalla, R., Rubino, P., Ria, L., Schenone, A., Strafino, C., Tropeano, P., Vetrano, A., Zanatta, N., Cansino, M. D. A., Gutierrez, J. A., de las Revillas, F. A., Fernandez, C. A., Mijares, N. C., Blanco-Molina, M. A., Garcia, M. A., Seijo, D. J., Blazquez, R. A., Lopez-Saez, J. -B., Rodrigo, E. A., Blanch, J. V., Arxe, A. A., Dalmau, F. G. -B., Quincoces, A. B., Loizaga, A. G., Perez, J. L. B., Diaz, P. B., Loaiza, A. Q., Castellote, M. C., Alcantara, I. C., Padierna, M. L., Exposito, M. C., Mas, A. C., Castro, F. C., Sanz, R. C., de Saracho, J. O., de la Fuente, E. C., de Ancos Aracil, C., Ruiz, J. R., de Daborenea Gonzalez, M. D., Iglesias, A. F., de la Fuente Aguado, J., Gonzalez, L. G., del Carmen Fernandez-Capitan, M., Hernandez, A. L., del Toro Cervera, J., Rus, G. P., Bregel, J. L. D., Fernandez, F. D., Teresa Elias, Hernandez, Palomares, L. J., Bataler, R. F., Rodriguez, J. A. N., Garcia, J. M. G., Porras, J. R. G., Garcia, M. G., Lopez, E. H., Lazaro, A. R., Jaras, M. J., Castro, D. J., Madridejos, R. J. -R., Navas, J. M. P., Lecumberri, R., Martinez, N., Castellanos, G. T. L., Espinosa, L. M., Jimenez, L. L., Cobo, O. M., Saiz, C. M., Pizarro, Y. R., Yglesias, P. J. M., Martin del Pozo, M., Melibovsky, L., Altarriba, E. S., Bosch, M. M., Secades, R. M., Lujan, J. M. M., Mestre, A. R., Moral, P. M., Parra, J. A. T., Flores, A. M., Munoz-Torrero, J. F. S., Rodriguez, F. J. M., Fernandez, M. J. N., Sibajas, E. O., de Sedas, M. V., Caballero, P. P., del Campo, I. P. M., Sanchez, J. P., Gallego, A. R., Alvarez, I. V., Beltran, E. M. R., Fuentes, D. S., Schilling, V. R., Alvarez, J. S., Lopez, G. T., Caralt, J. M. S., Miranda, R. T., de Antonio, E. U., Banyai, M., Frank, U., Gian Reto, Jorg, Jeanneret, C., Staub, D., Ackroyd, S., Agarwal, G., Mearns, B., Alikhan, R., Allameddine, A., Al-Refaie, F., Arden, C., Austin, A., Bakhai, A., Barton, T., Ewad, H., Body, R., Thachil, J., Chacko, J., Chandra, D., Charters, F., Church, A., Mcgrane, F., Clements, J., Clifford, P., Cox, D., Crouch, M., Crowther, M., Davies, E., Davies, M., Dimitri, S., Drebes, A., Franklin, S., George, J., Irvine, N., Gerofke, H., Gibbs, C., Goh, T., Gupta, S., Holmes, J., Jackson-Voyzey, E., Jones, N., Kallat, A., Kerr, P., Kesteven, P., Lench, T., Lester, W., Lowe, G., Lewis, M., Mccormack, T., Mccoye, A., Moriarty, A., Morris, W., Myers, B., Narayanan, M., Oo, N., Reed, M., Rose, P., Saja, K., Sivakumaran, M., Sohal, M., Solomons, G., Sultanzadeh, S. J., Venton, T., Wakeling, J., Walby, C., Waldron, M., Watt, S., Willcock, W., Zafar, A., Agnelli, G, Gitt, A, Bauersachs, R, Fronk, E, Laeis, P, Mismetti, P, Monreal, M, Willich, S, Wolf, W, Cohen, A, Brodmann, M, Rief, P, Eischer, L, Stoshikj, S, Hirschl, M, Weinmann, S, Marschang, P, Abbadie, F, Achkar, A, Addala, A, Adnet, F, Alexandra, J, Aquilanti, S, Belhassane, A, Benaroya, A, Berremili, T, Grenot, M, Birr, V, Holtea, D, Bonnin, C, Bosler, F, Durand, M, Brisot, D, Brousse, C, De La Fuente, T, Cayman, R, Cazaubon, M, Champion, O, Chanut, M, Chevalet, P, Connault, J, Durant, C, Constans, J, Cordeanu, M, Couturaud, F, Lacut, K, De Dedker, L, Decoulx, E, Derrien, B, Diamand, J, Diard, A, Douadi, Y, Dupas, S, Remond, S, Sevestre, M, Edhery, S, Falvo, N, Taralunga, C, Ferrari, E, Gaillard, C, Garrigues, D, Gillet, J, Giordana, P, Grange, C, Vital-Durand, D, Grare, F, Henni, A, Heuser, S, Schmidt, J, Hidden-Henic, V, Hottin, D, Imbert, B, Pernod, G, Jakob, D, Jacquinandi, V, Jurus, C, Lacoste, A, Laroche, J, Martin, M, Mazollier, C, Mersel, T, Miserey, G, Nedey, C, Nou, M, Quere, I, Ouvry, P, Peuch, B, Pichot, O, Poulain, V, Ray, P, Rifai, A, Roy, P, Saby, J, Simon, F, Simonot-Lalandec, E, Stephan, D, Tissot, A, Vodoungnon, H, Adamczyk, A, Schnabl, S, Ahmad, W, Weber, H, Axthelm, C, Bergmann, K, Beschorner, U, Knittel, M, Binias, K, Pasligh, M, Boral, M, Friederike, G, Bratsch, H, Brauer, G, Burghard, S, Demann, C, Rennebaum, C, Demmig, A, Eberlein, U, Enger, F, Eschenburg, J, Forkmann, L, Frank, J, Freischmidt, H, Gassauer, M, Fritsche, I, Kubicek-Hofmann, C, Goebels, M, Guggenbichler, S, Hartel, D, Hartmann, K, Heilberger, P, Heinsius, A, Held, M, Schnupp, S, Herman, G, Herold, J, Hertrich, F, Hommel, H, Hutte, G, Kalka, C, Jungandreas, K, Ramthor, M, Karcher, J, Werner, N, Karl-Wollweber, S, Keilhau, D, Kittel, K, Knolinski, T, Kohler, C, Werth, S, Kopplin, U, Korner, I, Wittig, K, Kroger, K, Moysidis, T, Kroschel, U, Leschke, M, zur Nieden, T, Lubbert, G, Lutz, A, Wucherpfennig, P, Marencke, G, Mortensen, K, Reppel, M, Nelles, H, Nestler, K, Neumeister, A, Schlosser, A, Oettler, W, Ott, I, Otto, A, Pertermann, A, Pfister, R, Pindur, L, Pourhassan, S, Predel, D, Pudollek, T, Reimer, D, Richter, C, Rieker, E, Rothenbucher, G, Rothhagen, B, Rudolff, S, Stucker, M, Schafer, A, Sonnenschein, K, Schafnitzl, W, Schellong, S, Voigts, B, Schiller, M, Schmeink, T, Schneider, H, Schon, N, Schulze, M, Sechtem, U, Sedl, S, Werno, H, Stachowitz, J, Thieme, M, Tiefenbacher, C, Tsantilas, D, Vieth, P, vom Dahl, J, Grun-Himmelmann, K, von Bilderling, P, von Maltik, T, Weinrich, K, Weyer, M, Koln, E, Wirtz, P, Wittig, I, Zierock, P, Ageno, W, Caprioli, M, Rancan, E, Guercini, F, Mommi, V, Amitrano, M, Cannavacciuolo, F, Amore, M, D'Antoni, S, Angelini, E, Forgia, S, Antignani, P, Calandra, G, Arone, A, Perticone, F, Sciacqua, A, Asaro, G, Bellisi, M, Attanzio, M, Pinto, A, Attinasi, V, Cillari, E, Sorvillo, S, Balbarini, A, Santini, C, Violo, C, Banfi, E, Lodigiani, C, Barcellona, D, Delpin, S, Marongiu, S, Barillari, G, Pasca, S, Bartolini, C, Verdecchia, P, Bartone, M, Mancuso, G, Bellanuova, I, Felis, S, Bellizzi, A, Masotti, L, Bianchi, M, Carugati, A, Bianchini, G, Guarnera, G, Boari, B, Gallerani, M, Pasin, M, Bortoluzzi, C, Parisi, R, Brucoli, C, Palasciano, G, Camporese, G, Tonello, C, Canafoglia, L, Rupoli, S, Cancellieri, E, Paoletti, O, Testa, S, Carlizza, A, Carnovali, M, Sada, S, Samaden, A, Casarsa, C, Mearelli, F, Pivetti, G, Catalini, R, Zingaretti, O, Vascolare, M, Cavazza, S, Cosmi, B, Cenci, C, Prisco, D, Silvestri, E, Ceresa, F, Patane, F, Ciampa, A, Siniscalchi, V, Ciarambino, T, De Bartolomeo, G, Clemente, M, Conti, F, Paiella, L, D'Avino, M, D'Alessandro, A, Placentino, M, Sollazzo, V, D'Angelo, A, Vigano, S, De Campora, P, Sangiuolo, R, De Franciscis, S, Serra, R, De Gaudenzi, E, De Santis, F, Piccinni, G, De Tommaso, I, Di Francesco, L, Vincentelli, G, Di Maggio, R, Saccullo, G, Siragusa, S, Di Micco, P, Fontanella, A, Di Michele, D, Di Minno, G, Tufano, A, Di Nisio, M, Porreca, E, Donadio, F, Imberti, D, Enea, I, Fabbian, F, Manfredini, R, Pala, M, Falanga, A, Milesi, V, Fiore, V, Franco, E, Giudice, G, Frausini, G, Rovinelli, M, Fuorlo, M, Landolfi, R, Morretti, T, Gamberini, S, Salmi, R, Ghirarduzzi, A, Veropalumbo, M, Ghizzi, M, Pepe, C, Gianniello, F, Martinelli, I, Iosub, D, Piovella, F, Iozzi, E, Talerico, A, Regina, M, Orlandini, F, Marconi, L, Palla, A, Marcucci, R, Poli, D, Margheriti, R, Sala, G, Marra, A, Marrocco, F, Montagna, E, Silvestris, F, Vallarelli, S, Mos, L, Rossetto, V, Mugno, F, Di Salvo, M, Nitti, C, Pennacchioni, M, Salvi, A, Olivieri, O, Tosi, F, Zorzi, F, Onesta, M, Pagliara, V, Villalta, S, Paolucci, G, Severino, S, Pierri, F, Russo, V, Pizzini, A, Quintavalla, R, Rubino, P, Ria, L, Schenone, A, Strafino, C, Tropeano, P, Vetrano, A, Zanatta, N, Cansino, M, Gutierrez, J, de las Revillas, F, Fernandez, C, Mijares, N, Blanco-Molina, M, Garcia, M, Seijo, D, Blazquez, R, Lopez-Saez, J, Rodrigo, E, Blanch, J, Arxe, A, Dalmau, F, Quincoces, A, Loizaga, A, Perez, J, Diaz, P, Loaiza, A, Castellote, M, Alcantara, I, Padierna, M, Exposito, M, Mas, A, Castro, F, Sanz, R, de Saracho, J, de la Fuente, E, de Ancos Aracil, C, Ruiz, J, de Daborenea Gonzalez, M, Iglesias, A, de la Fuente Aguado, J, Gonzalez, L, del Carmen Fernandez-Capitan, M, Hernandez, A, del Toro Cervera, J, Rus, G, Bregel, J, Fernandez, F, Teresa Elias, H, Palomares, L, Bataler, R, Rodriguez, J, Garcia, J, Porras, J, Lopez, E, Lazaro, A, Jaras, M, Castro, D, Madridejos, R, Navas, J, Lecumberri, R, Martinez, N, Castellanos, G, Espinosa, L, Jimenez, L, Cobo, O, Saiz, C, Pizarro, Y, Yglesias, P, Martin del Pozo, M, Melibovsky, L, Altarriba, E, Bosch, M, Secades, R, Lujan, J, Mestre, A, Moral, P, Parra, J, Flores, A, Munoz-Torrero, J, Rodriguez, F, Fernandez, M, Sibajas, E, de Sedas, M, Caballero, P, del Campo, I, Sanchez, J, Gallego, A, Alvarez, I, Beltran, E, Fuentes, D, Schilling, V, Alvarez, J, Lopez, G, Caralt, J, Miranda, R, de Antonio, E, Banyai, M, Frank, U, Gian Reto, J, Jeanneret, C, Staub, D, Ackroyd, S, Agarwal, G, Mearns, B, Alikhan, R, Allameddine, A, Al-Refaie, F, Arden, C, Austin, A, Bakhai, A, Barton, T, Ewad, H, Body, R, Thachil, J, Chacko, J, Chandra, D, Charters, F, Church, A, Mcgrane, F, Clements, J, Clifford, P, Cox, D, Crouch, M, Crowther, M, Davies, E, Davies, M, Dimitri, S, Drebes, A, Franklin, S, George, J, Irvine, N, Gerofke, H, Gibbs, C, Goh, T, Gupta, S, Holmes, J, Jackson-Voyzey, E, Jones, N, Kallat, A, Kerr, P, Kesteven, P, Lench, T, Lester, W, Lowe, G, Lewis, M, Mccormack, T, Mccoye, A, Moriarty, A, Morris, W, Myers, B, Narayanan, M, Oo, N, Reed, M, Rose, P, Saja, K, Sivakumaran, M, Sohal, M, Solomons, G, Sultanzadeh, S, Venton, T, Wakeling, J, Walby, C, Waldron, M, Watt, S, Willcock, W, and Zafar, A
Subjects: Drug Utilization, Pediatrics, medicine.medical_specialty, Novel Oral Anticoagulants, Registry, Deep vein, Alternative medicine, Anticoagulation, Patient satisfaction, Quality of life, Health care, medicine, Anticoagulation, Novel Oral Anticoagulants, Prevention, Registry, Venous Thromboembolism, Vitamin K antagonists, cardiovascular diseases, business.industry, Prevention, Venous Thromboembolism, Vitamin K antagonists, Hematology, Novel Oral Anticoagulant, medicine.disease, equipment and supplies, Pulmonary embolism, medicine.anatomical_structure, Emergency medicine, Original Clinical Investigation, Observational study, business
Abstract: Background: Venous thromboembolism (VTE) is a major health problem, with over one million events every year in Europe. However, there is a paucity of data on the current management in real life, including factors influencing treatment pathways, patient satisfaction, quality of life (QoL), and utilization of health care resources and the corresponding costs. The PREFER in VTE registry has been designed to address this and to understand medical care and needs as well as potential gaps for improvement. Methods/design: The PREFER in VTE registry was a prospective, observational, multicenter study conducted in seven European countries including Austria, France Germany, Italy, Spain, Switzerland, and the UK to assess the characteristics and the management of patients with VTE, the use of health care resources, and to provide data to estimate the costs for 12 months treatment following a first-time and/or recurrent VTE diagnosed in hospitals or specialized or primary care centers. In addition, existing anticoagulant treatment patterns, patient pathways, clinical outcomes, treatment satisfaction, and health related QoL were documented. The centers were chosen to reflect the care environment in which patients with VTE are managed in each of the participating countries. Patients were eligible to be enrolled into the registry if they were at least 18 years old, had a symptomatic, objectively confirmed first time or recurrent acute VTE defined as either distal or proximal deep vein thrombosis, pulmonary embolism or both. After the baseline visit at the time of the acute VTE event, further follow-up documentations occurred at 1, 3, 6 and 12 months. Follow-up data was collected by either routinely scheduled visits or by telephone calls. Results: Overall, 381 centers participated, which enrolled 3,545 patients during an observational period of 1 year. Conclusion: The PREFER in VTE registry will provide valuable insights into the characteristics of patients with VTE and their acute and mid-term management, as well as into drug utilization and the use of health care resources in acute first-time and/or recurrent VTE across Europe in clinical practice. Trial registration: Registered in DRKS register, ID number: DRKS00004795
Published: 2015

4. Thigh-length versus below-knee compression elastic stockings for prevention of the postthrombotic syndrome in patients with proximal-venous thrombosis: a randomized trial

Author: Prandoni P, Noventa F, Quintavalla R, Bova C, Siragusa S, Bucherini E, Astorri F, Cuppini S, Dalla Valle F, Lensing AW, Prins MH, Villalta S, Canano Investigators Collaborators […, Vedovetto V, Barbar S, Campello E, Milan M, Filippi L, Rocci A, Chiappetta P, Pellegrini R, Fiaschi E, Vallone G, D'Amico E, Noto A, Pili C, Costantini E, Gasperon M, Palareti G, Malato A, Saccullo G, Brini C, Bitti G, Marzolo M, Ramazzina E, Zamboni S., COSMI, BENILDE, Epidemiologie, MUMC+: KIO Kemta (9), RS: CAPHRI School for Public Health and Primary Care, Prandoni P, Noventa F, Quintavalla R, Bova C, Cosmi B, Siragusa S, Bucherini E, Astorri F, Cuppini S, Dalla Valle F, Lensing AW, Prins MH, Villalta S, Canano Investigators Collaborators […, Vedovetto V, Barbar S, Campello E, Milan M, Filippi L, Rocci A, Chiappetta P, Pellegrini R, Fiaschi E, Vallone G, D'Amico E, Noto A, Pili C, Costantini E, Gasperon M, Palareti G, Malato A, Saccullo G, Brini C, Bitti G, Marzolo M, Ramazzina E, Zamboni S., …], Prandoni, P, Noventa, F, Quintavalla, R, Bova, C, Cosmi, B, Siragusa, S, Bucherini, E, Astorri, F, Cuppini, S, Dalla Valle, F, Lensing, A, Prins, M, and Villalta, S
Subjects: Adult, Male, musculoskeletal diseases, medicine.medical_specialty, Time Factors, Immunology, Thigh, behavioral disciplines and activities, Biochemistry, Postthrombotic Syndrome, Settore MED/15 - Malattie Del Sangue, law.invention, POST-THROMBOTIC SYNDROME, Young Adult, Randomized controlled trial, law, medicine, Humans, Knee, Aged, Aged, 80 and over, Venous Thrombosis, First episode, VENOUS THROMBOEMBOLISM, business.industry, Pruritus, Hazard ratio, Cell Biology, Hematology, Middle Aged, musculoskeletal system, medicine.disease, Thrombosis, humanities, Confidence interval, Discontinuation, Surgery, Venous thrombosis, Treatment Outcome, medicine.anatomical_structure, Erythema, Patient Compliance, Female, venous thrombosis, business, Stockings, Compression, Follow-Up Studies
Abstract: Although below-knee compression elastic stockings (CES) are effective for the prevention of the postthrombotic syndrome (PTS), a substantial number of patients with deep venous thrombosis still develop PTS. In the present open-label, randomized clinical trial, we compared thigh-length with below-knee CES for the prevention of PTS. A total of 267 patients with the first episode of proximal deep venous thrombosis were randomized to wear either thigh-length or below-knee CES for 2 years. After 3, 6, 12, 18, 24, and 36 months, they were assessed for PTS manifestations according to the Villalta scale. PTS developed in 44 (32.6%) of the 135 patients randomized to thigh-length CES and in 47 (35.6%) of the 132 allocated to below-knee CES, for an adjusted hazard ratio of 0.93 (95% confidence interval, 0.62-1.41). Severe PTS developed in 3 patients in each group. CES-related side effects developed in 55 (40.7%) of the 135 patients allocated to thigh-length CES and in 36 (27.3%) of those randomized to the below-knee group (P = .017), and led to premature discontinuation of their use in 29 (21.5%) and 18 (13.6%) patients, respectively. We conclude that thigh-length CES do not offer a better protection against PTS than below-knee CES and are less well tolerated. This study is registered as Clinical Trial number NCT00426075.
Published: 2012

5. The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Author: Cohen, At, Gitt, Ak, Bauersachs, R, Fronk, Em, Laeis, P, Mismetti, P, Monreal, M, Willich, Sn, Bramlage, P, Agnelli, G, Brodmann, M, Rief, P, Eischer, L, Stoshikj, S, Hirschl, M, Weinmann, S, Peter Marschang, P, Abbadie, F, Achkar, A, Addala, A, Reynaldo, P, Adnet, F, Alexandra, Jf, Aquilanti, S, Belhassane, A, Benaroya, B, Berremili, T, Grenot, Mc, Birr, V, Holtea, D, Bonnin, C, Bosler, F, Bresin Durand MG, Brisot, D, Brousse, C, De La Fuente, T, Cayman, C, Cazaubon, M, Champion, O, Chanut, M, Chevalet, P, Connault, J, Durant, C, Constans, J, Cordeanu, M, Couturaud, F, Lacut, K, De Dedker, L, Piloquet, Fx, Decoulx, E, Derrien, B, Diamand, Jm, Diard, A, Douadi, Y, Dupas, S, Modeliar Remond SS, Sevestre, Ma, Edhery, S, Falvo, N, Farcas Taralunga, C, Ferrari, E, Gaillard, C, Garrigues, D, Gillet, Jl, Giordana, P, Grange, C, Vital-Durand, D, Grare, F, Hadj Henni, A, Heuser, S, Schmidt, J, Hidden-Henic, V, Hottin, D, Imbert, B, Pernod, G, Jakob, D, Jacquinandi, V, Jurus, C, Lacoste, A, Laroche, Jp, Martin, M, Mazollier, C, Mersel, T, Miserey, G, Nedey, C, Nou, M, Quere, I, Ouvry, P, Peuch, B, Pichot, O, Poulain, V, Ray, P, Rifai, A, Roy, Pm, Saby, Jc, Simon, F, Simonot-Lalandec, E, Stephan, D, Tissot, A, Vodoungnon, H, Adamczyk, A, Schnabl, S, Al Ahmad, W, Weber, H, Axthelm, C, Axthelm, P, Bergmann, K, Beschorner, U, Knittel, M, Binias, Kh, Pasligh, M, Boral, M, Girke, F, Bratsch, H, Brauer, G, Burghard, S, Demann, C, Rennebaum, C, Emter, E, Demmig, A, Eberlein, U, Enger, F, Eschenburg, J, Eschenburg, Ju, Forkmann, L, Frank, J, Freischmidt, H, Gassauer, M, Fritsche, I, Kubicek–hofmann, C, Goebels, Mc, Guggenbichler, S, Härtel, D, Hartmann, K, Heilberger, P, Heinsius, A, Held, M, Schnupp, S, Herman, G, Herold, J, Hertrich, F, Hommel, H, Hütte, G, Kalka, C, Jungandreas, K, Ramthor, M, Karcher, J, Werner, N, Karl-Wollweber, S, Keilhau, Da, Kittel, K, Knolinski, T, Köhler, C, Werth, S, Kopplin, U, Körner, I, Wittig, K, Dres, P, Kröger, K, Moysidis, T, Kroschel, U, Leschke, M, zur Nieden, T, Lübbert, G, Lutz, A, Wucherpfennig, P, Marencke, Gh, Mortensen, K, Reppel, M, Nelles, H, Nestler, K, Neumeister, A, Schlosser, A, Oettler, W, Ott, I, Otto, A, Pertermann, A, Pfister, R, Pindur, P, Pourhassan, S, Predel, D, Pudollek, T, Reimer, D, Richter, R, Eberhad Rieker, E, Rothenbücher, G, Rothhagen, B, Rudolff, S, Stücker, M, Schäfer, A, Sonnenschein, K, Schafnitzl, W, Schellong, S, Voigts, B, Schiller, M, Schmeink, T, Schmeink, P, Schneider, H, Schön, N, Schulze, M, Sechtem, U, Sedl, S, Werno, Hs, Stachowitz, J, Thieme, M, Tiefenbacher, C, Tsantilas, D, Vieth, P, vom Dahl, J, Grün-Himmelmann, K, von Bilderling, P, von Maltik, T, Weinrich, K, Weyer, M, Wirtz, P, Wittig, I, Zierock, P, Ageno, W, Caprioli, C, Rancan, E, Guercini, F, Mommi, V, Amitrano, M, Cannavacciuolo, F, Amore, M, D'Antoni, S, Angelini, E, La Forgia, S, Antignani, Pl, Calandra, G, Arone, A, Perticone, F, Sciacqua, A, Asaro, G, Bellisi, M, Attanzio, Mt, Pinto, A, Attinasi, V, Cillari, E, Sorvillo, S, Balbarini, A, Santini, C, Violo, C, Banfi, E, Lodigiani, C, Barcellona, D, Delpin, S, Marongiu, S, Barillari, G, Pasca, S, Bartolini, C, Verdecchia, P, Bartone, M, Mancuso, G, Bellanuova, I, Felis, S, Bellizzi, A, Masotti, L, Bianchi, M, Carugati, A, Bianchini, G, Guarnera, G, Boari, B, Gallerani, M, Pasin, M, Bortoluzzi, C, Parisi, R, Brucoli, C, Palasciano, G, Camporese, G, Tonello, C, Canafoglia, L, Rupoli, S, Cancellieri, E, Paoletti, O, Testa, S, Carlizza, A, Carnovali, M, Sada, S, Samaden, A, Casarsa, C, Mearelli, F, Pivetti, G, Catalini, R, Zingaretti, O, Cavazza, S, Cosmi, B, Cenci, C, Prisco, D, Silvestri, E, Ceresa, F, Patanè, F, Ciampa, A, Siniscalchi, V, Ciarambino, T, De Bartolomeo, G, Clemente, M, Conti, F, Paiella, L, D’Avino, M, D'Alessandro, A, Placentino, M, Sollazzo, V, D'Angelo, A, Viganò, S, De Campora, P, Sangiuolo, R, De Franciscis, S, Serra, R, De Gaudenzi, E, De Santis, F, Piccinni, Gc, De Tommaso, I, Di Francesco, L, Vincentelli, Gm, Di Maggio, R, Saccullo, G, Siragusa, S, Di Micco, P, Fontanella, A, Di Michele, D, Di Minno, G, Tufano, A, Di Nisio, M, Porreca, E, Donadio, F, Imberti, D, Enea, I, Fabbian, F, Manfredini, R, Pala, P, Falanga, A, Milesi, V, Fiore, V, Signorelli, Ss, Franco, E, Giudice, G, Frausini, G, Rovinelli, M, Fuorlo, M, Landolfi, R, Morretti, T, Gamberini, S, Salmi, R, Ghirarduzzi, A, Ghizzi, G, Pepe, C, Gianniello, F, Martinelli, I, Iosub, Di, Piovella, F, Iozzi, E, Talerico, A, La Regina, M, Orlandini, F, Marconi, L, Palla, A, Marcucci, R, Poli, D, Margheriti, R, Sala, G, Marra, A, Marrocco, F, Montagna, Es, Silvestris, F, Vallarelli, S, Mos, L, Rossetto, V, Mugno, F, Di Salvo, M, Nitti, C, Pennacchioni, M, Salvi, A, Olivieri, O, Tosi, F, Zorzi, F, Onesta, M, Pagliara, V, Villalta, S, Paolucci, G, Severino, S, Pierri, F, Russo, V, Pizzini, Am, Quintavalla, R, Rubino, P, Ria, L, Schenone, A, Strafino, C, Tropeano, P, Vetrano, V, Zanatta, N, Adarraga Cansino MD, Gutierrez, Ja, de las Revillas FA, Amado Fernández, C, Calvo Mijares, N, Blanco-Molina, Ma, Garcia, Ma, Joya Seijo, D, Aranda Blazquez, R, López-Sáez, Jb, Arellano Rodrigo, E, Villalta Blanch, J, Armengou Arxe, A, García-Bragado Dalmau, F, Ballaz Quincoces, A, García Loizaga, A, Beato Pérez JL, Bedate Díaz, P, Quezada Loaiza, A, Castellote, Mc, Cañas Alcántara, I, Lluís Padierna, M, Carrasco Expósito, M, Millón Caño JA, Carrasco Mas, A, Cereto Castro, F, Castrodeza Sanz, R, Ortiz de Saracho, J, Cisneros de la Fuente, E, de Ancos Aracil, C, Ruiz, J, de Daborenea González MD, Fernández Iglesias, A, de la Fuente Aguado, J, González, Lg, del Carmen Fernández-Capitán, M, Lorenzo Hernández, A, del Toro Cervera, J, Pérez Rus, G, Delgado Bregel JL, Díez Fernández, F, Santalla Valle EA, Elias Hernández, T, Jara Palomares, L, Ferri Bataler, R, Nieto Rodríguez JA, García García JM, Villanueva Montes MA, González Porras JR, Guil García, M, San Román Terán CM, Hernando López, E, Roncero Lázaro, A, Jaras, Mj, Jiménez Castro, D, Jiménez-Rodríguez Madridejos, R, Pedrajas Navas JM, Lecumberri, R, Martínez, N, López Castellanos GT, Manzano Espinosa, L, López Jiménez, L, Madridano Cobo, O, Mainez Saiz, C, Romero Pizarro, Y, Marchena Yglesias PJ, Martín del Pozo, M, Melibovsky, L, Altarriba, Es, Monreal Bosch, M, Monte Secades, R, Mora Luján JM, Riera Mestre, A, Moral Moral, P, Todolí Parra JA, Moreno Flores, A, Sánchez Muñoz-Torrero JF, Muñoz Rodríguez FJ, Núñez Fernández MJ, Oncala Sibajas, E, Vaquero de Sedas, M, Parra Caballero, P, Pons Martín del Campo, I, Portillo Sánchez, J, Rivera Gallego, A, Villaverde Álvarez, I, Rodríguez Beltrán EM, Sánchez Fuentes, D, Roldán Schilling, V, Sánchez Álvarez, J, López, Gt, Suriñach Caralt JM, Tirado Miranda, R, Usandizaga de Antonio, E, Banyai, M, Frank, U, Jörg, Gr, Jeanneret, C, Staub, D, Ackroyd, A, Agarwal, G, Mearns, B, Alikhan, R, Allameddine, A, Al-Refaie, F, Arden, C, Austin, A, Bakhai, A, Barton, T, Ewad, H, Body, R, Thachil, J, Chacko, J, Chandra, D, Charters, F, Church, A, Mcgrane, F, Clements, J, Clifford, P, Cox, D, Crouch, M, Crowther, M, Davies, E, Davies, M, Dimitri, S, Drebes, A, Franklin, S, George, J, Irvine, N, Gerofke, H, Gibbs, C, Goh, T, Gupta, S, Holmes, J, Jackson-Voyzey, E, Jones, N, Kallat, A, Kerr, P, Kesteven, P, Lench, T, Lester, W, Lowe, G, Lewis, M, Mccormack, T, Mccoye, A, Moriarty, A, Morris, W, Narayanan, M, Oo, N, Reed, M, Rose, P, Saja, K, Sivakumaran, M, Sohal, M, Solomons, G, Sultanzadeh, Sj, Venton, T, Wakeling, J, Walby, C, Waldron, M, Watt, S, Willcock, W, and Zafar, A.
Subjects: Male, Time Factors, Databases, Factual, Administration, Oral, Disease, Comorbidity, 030204 cardiovascular system & hematology, registry, Direct oral anticoagulants, 0302 clinical medicine, Recurrence, Risk Factors, Epidemiology, 030212 general & internal medicine, Prospective Studies, Registries, anticoagulation, LS4_7, Venous Thrombosis, Hematology, Venous Thromboembolism, Vitamin K antagonist, Middle Aged, Thrombosis, Pulmonary embolism, Europe, vitamin K antagonists, Treatment Outcome, Administration, Female, Coagulation and Fibrinolysis, Venous thromboembolism, Oral, Adult, medicine.medical_specialty, Registry, medicine.drug_class, Socio-culturale, Hemorrhage, direct oral anticoagulants, Venous thromboembolism, anticoagulation, direct oral anticoagulants, registry, vitamin K antagonists, Anticoagulation, Vitamin K antagonists, Aged, Anticoagulants, Humans, Pulmonary Embolism, 03 medical and health sciences, Databases, Disease registry, Internal medicine, medicine, cardiovascular diseases, Intensive care medicine, Factual, business.industry, medicine.disease, equipment and supplies, Clinical trial, business
Abstract: SummaryVenous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0% were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5%). The diagnosis was deep-vein thrombosis (DVT) in 59.5% and pulmonary embolism (PE) in 40.5%. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5%), hypertension (42.3%) and dyslipidaemia (21.1%). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2%), almost half received a vitamin K antagonist (48.7%) and nearly a quarter received a DOAC (24.5%). Almost a quarter of all presentations were for recurrent VTE, with >80% of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes.
Published: 2016

6. RECYCLABLE BIOBASED THERMOSET MATRIX FOR ADVANCED NATURAL FIBER REINFORCED COMPOSITES PROCESSED BY HIGH PRESSURE RESIN TRANSFER MOLDING

Author: Cicala, Gianluca, Latteri, Alberta, Mannino, S, Saccullo, G, La Rosa AD, and Scarpa, F.
Subjects: recycling, Natural fibres, epoxy
Published: 2016

7. POLYCLONAL SERUM IGM AS A PROGNOSTIC MARKER IN NEWLY DIAGNOSED MULTIPLE MYELOMA

Author: Napolitano, M., Montante, C., Saccullo, G., Mancuso, S., Cariccio, M. R. Lanza, Malato, A., Fabbiano, F., Alessandro Lucchesi, Pagan, F., Conticello, C., Mannina, D., Di Raimondo, F., and Siragusa, S.
Published: 2016

8. ABSOLUTE LYMPHOCYTE COUNT IS NOT A PREDICTOR FOR SURVIVAL IN NEWLY DIAGNOSED ELDERLY PATIENTS WITH MULTIPLE MYELOMA

Author: Saccullo, G, Bono, R, Branca, A, Cangialosi, C, Raso, S, Quintini, G, Lipari, M, Fabbiano, F, Specchia, G, Di Raimondo, F, MANCUSO, Salvatrice, ABBADESSA, Vincenzo, SIRAGUSA, Sergio, Saccullo, G, Bono, R, Branca, A, Cangialosi, C, Mancuso, S, Raso, S, Quintini, G, Lipari, M, Fabbiano, F, Abbadessa, V, Specchia, G, Di Raimondo, F, and Siragusa, S
Subjects: multiple myeloma, lymphocyte count
Published: 2012

9. Rituximab for managing relapsing or refractory patients with idiopathic thrombotic thrombocytopenic purpura – haemolytic uraemic syndrome

Author: Caramazza, D., Quintini, G., Abbene, I., Lo Coco, L., Malato, A., Di Trapani, R., Saccullo, G., Pizzo, G., Palazzolo, R., Barone, R., Mazzola, G., Rizzo, S., Ragonese, P., Aridon, P., Abbadessa, V., Siragusa, S., Caramazza, D, Quintini, G, Abbene, I, Lo Coco, L, Malato, A, Di Trapani, R, Saccullo, G, Pizzo, G, Palazzolo, R, Barone, R, Mazzola, G, Rizzo, S, Ragonese, P, Aridon, P, Abbadessa, V, and Siragusa, S
Subjects: Adult, Male, Salvage Therapy, Adolescent, Purpura, Thrombotic Thrombocytopenic, ADAMTS13 Protein, Case Report, Middle Aged, ADAM Proteins, Antibodies, Monoclonal, Murine-Derived, Treatment Outcome, Humans, Immunologic Factors, Female, Rituximab, refractory thrombotic thrombocytopenic purpura
Published: 2010

10. Relapsing or refractory idiopathic thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: the role of rituximab

Author: Caramazza, D., Quintini, G., Abbene, I., Malato, A., Saccullo, G., lo Coco, L., Di Trapani, R., Palazzolo, R., Barone, R., Mazzola, G., Rizzo, S., Ragonese, P., Aridon, P., Abbadessa, V., Siragusa, S., Caramazza, D, Quintini, G, Abbene, I, Malato, A, Saccullo, G, lo Coco, L, Di Trapani, R, Palazzolo, R, Barone, R, Mazzola, G, Rizzo, S, Ragonese, P, Aridon, P, Abbadessa, V, and Siragusa, S
Subjects: thrombotic thrombocytopenic purpura, rituximab
Published: 2010

11. Evidence-based recommendations on the treatment of von Willebrand disease in Italy

Author: Mannucci, Pm, Franchini, M, Castaman, G, Federici, Ab, Contino, L, Accorsi, A, Ciavarella, N, Schiavoni, M, Scaraggi, Fa, Rodorigo, G, Valdre, L, Targhetta, R, Tagariello, G, Radossi, P, Musso, R, Cultrera, D, Muleo, G, Iannacaro, P, Biasioli, C, Testa, S, Alatri, A, Vincenzi, D, Scapoli, G, Morfini, M, Molinari, Ac, Boeri, E, Caprino, D, Delios, G, Girotto, M, Mariani, G, Lapecorella, M, Carloni, Mt, Cantori, I, Santagostino, E, Gringeri, A, Marietta, M, Pedrazzoli, P, Di Minno, G, Coppola, A, Perricone, C, Schiavulli, M, Rocino, A, Berrettini, M, Zanon, E, Mancuso, G, Siragusa, S, Malato, A, Saccullo, G, Tagliaferri, A, Rivolta, F, Iorio, A, Oliovecchio, E, Ferrante, F, Dragani, A, Rossi, A, Mancino, A, Albertini, P, Macchi, S, D'Incà, M, De Rossi, G, Luciani, M, Landolfi, R, Mazzucconi, Maria Gabriella, Santoro, Cristina, Piseddu, G, Schinco, Pc, Rossetti, G, Barillari, G, Feola, G, Gandini, G., Mannucci, Pm, Franchini, M, Castaman, G, Federici, Ab, Contino, L, Accorsi, A, Ciavarella, N, Schiavoni, M, Scaraggi, Fa, Rodorigo, G, Valdre, L, Targhetta, R, Tagariello, G, Radossi, P, Musso, R, Cultrera, D, Muleo, G, Iannacaro, P, Biasioli, C, Testa, S, Alatri, A, Vincenzi, D, Scapoli, G, Morfini, M, Molinari, Ac, Boeri, E, Caprino, D, Delios, G, Girotto, M, Mariani, G, Lapecorella, M, Carloni, Mt, Cantori, I, Santagostino, E, Gringeri, A, Marietta, M, Pedrazzoli, P, DI MINNO, Giovanni, Coppola, A, Perricone, C, Schiavulli, M, Rocino, A, Berrettini, M, Zanon, E, Mancuso, G, Siragusa, S, Malato, A, Saccullo, G, Tagliaferri, A, Rivolta, F, Iorio, A, Oliovecchio, E, Ferrante, F, Dragani, A, Rossi, A, Mancino, A, Albertini, P, Macchi, S, D'Incà, M, De Rossi, G, Luciani, M, Landolfi, R, Mazzucconi, Mg, Santoro, C, Piseddu, G, Schinco, Pc, Rossetti, G, Barillari, G, Feola, G, and Gandini, G.
Subjects: Male, desmopressin, Evidence-Based Medicine, Factor VIII, Hemostatics, von willebrand disease, von Willebrand Diseases, von willebrand factor, Treatment Outcome, Italy, von Willebrand Factor, Humans, Deamino Arginine Vasopressin, Drug Therapy, Combination, Female, Original Article
Abstract: von Willebrand disease (VWD) is the most common hereditary bleeding disorder affecting both males and females. It arises from quantitative or qualitative defects of von Willebrand factor (VWF) and causes bleeding of mucous membranes and soft tissues. The aim of treatment is to correct the dual defect of haemostasis caused by the abnormal/reduced VWF and the concomitant deficiency of factor VIII (FVIII).This document contains evidence-based recommendations for the management of VWD compiled by AICE (the Italian Association of Haemophilia Centres). All the evidence supporting these recommendations are based on non-randomised comparative studies or case series, because randomised controlled clinical trials or meta-analyses are not available for this disease.Desmopressin (DDAVP) is the treatment of choice for patients with type 1 VWD with FVIII and VWF levels of 10 U/dL or more, while VWF/FVIII concentrates are indicated for those who are unresponsive or insufficiently responsive to DDAVP (severe type 1, type 2 and 3 VWD). VWF concentrates devoid of FVIII, not yet licensed in Italy, may be considered for short-term prophylaxis in elective surgery or for long-term secondary prophylaxis.
Published: 2009

12. 4. Absolute Lymphocyte Count Is Unrelated to Overall Survival in Newly Diagnosed Elderly Patients with Multiple Myeloma Treated with Immunomodulatory Drugs

Author: Napolitano, M., Saccullo, G., Bono, R., Branca, A., Cangialosi, C., Mancuso, S., Raso, S., Quintini, G., Lipari, M., Fabbiano, F., Specchia, G., Dolce, A., Di Raimondo, F., and Siragusa, S.
Subjects: Absolute lymphocyte count, multiple meyolma
Published: 2014

13. Italian Registry of Haemophilia and Allied Disorders. Objectives, methodology and data analysis

Author: Iorio, A, Oliovecchio, E, Morfini, M, Mannucci, Pm, Contino, L, Accorsi, A, Ciavarella, N, Schiavoni, M, Scaraggi, Fa, Rodorigo, G, Valdré, L, Targhetta, R, Tagariello, G, Radossi, P, Musso, R, Cultrera, D, Muleo, G, Iannacaro, P, Biasioli, C, Testa, S, Alatri, A, Vincenzi, D, Scapoli, G, Molinari, Ac, Boeri, E, Caprino, D, Mariani, G, Lapecorella, M, Carloni, Mt, Cantori, I, Santagostino, E, Gringeri, A, Federici, Ab, Marietta, M, Pedrazzoli, P, Di Minno, G, Coppola, A, Perricone, C, Schiavulli, M, Rocino, A, Berrettini, M, Zanon, E, Mancuso, G, Siragusa, S, Malato, A, Saccullo, G, Tagliaferri, A, Rivolta, F, Ferrante, F, Dragani, A, Rossi, A, Mancino, A, Albertini, P, Macchi, S, Hassan, J, D'Inca, M, De Rossi, G, Luciani, M, Landolfi, R, Mazzucconi, Maria Gabriella, Santoro, Cristina, Piseddu, G, Carla Schinco, P, Rossetti, G, Barillari, G, Feola, G, Gandini, G, Franchini, M, Castaman, G., Iorio, A, Oliovecchio, E, Morfini, M, Mannucci, Pm, Contino, L, Accorsi, A, Ciavarella, N, Schiavoni, M, Scaraggi, Fa, Rodorigo, G, Valdré, L, Targhetta, R, Tagariello, G, Radossi, P, Musso, R, Cultrera, D, Muleo, G, Iannacaro, P, Biasioli, C, Testa, S, Alatri, A, Vincenzi, D, Scapoli, G, Molinari, Ac, Boeri, E, Caprino, D, Mariani, G, Lapecorella, M, Carloni, Mt, Cantori, I, Santagostino, E, Gringeri, A, Federici, Ab, Marietta, M, Pedrazzoli, P, DI MINNO, Giovanni, Coppola, A, Perricone, C, Schiavulli, M, Rocino, A, Berrettini, M, Zanon, E, Mancuso, G, Siragusa, S, Malato, A, Saccullo, G, Tagliaferri, A, Rivolta, F, Ferrante, F, Dragani, A, Rossi, A, Mancino, A, Albertini, P, Macchi, S, Hassan, J, D'Inca, M, De Rossi, G, Luciani, M, Landolfi, R, Mazzucconi, Mg, Santoro, C, Piseddu, G, Carla Schinco, P, Rossetti, G, Barillari, G, Feola, G, Gandini, G, Franchini, M, and Castaman, G.
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Adolescent, Haemophilia A, MEDLINE, Haemophilia, Severity of Illness Index, haemophilia, registry, von willebrand's disease, von willebrand’s disease, Blood Coagulation Disorders, Inherited, Von willebrand, Severity of illness, Health care, Computer software, medicine, Humans, Haemophilia B, Registries, Age of Onset, Child, Genetics (clinical), Societies, Medical, Aged, business.industry, Infant, Hematology, General Medicine, Middle Aged, medicine.disease, Databases as Topic, Italy, Child, Preschool, Data Interpretation, Statistical, Female, Medical emergency, business
Abstract: National haemophilia registries are powerful instruments to support health care and research. A national registry was established in Italy by the Ministry of Health until 1999. Since 2003 the Italian Association of Haemophilia Centres (AICE) started a new programme aiming at building up the Italian Registry of Haemophilia and Allied Disorders. The AICE identified an expert panel to steer the registry. A computer software to assist patient management was developed and all the AICE-affiliated haemophilia treatment centres (HTC) were prompted to adopt it. Twice a year a predefined set of anonymized data is centralized and merged into a national database. Duplicated entries are managed through a confidentiality sparing mechanism. The database covers sociodemographic, clinical, laboratory and treatment data. A subset of data are shared with the Ministry of Health (Istituto Superiore di Sanita,ISS).Overall, data were collected six times by 43 of 49 HTC; 41 centres updated their patients' records up to December 2006. The database contains 6632 unique records, 442 of them referring to dead patients. Database growth and missing data clearance showed a constantly positive trend over time. The database has collected records of the following alive patients - haemophilia A: 1364 severe, 398 moderate and 935 mild; haemophilia B: 231 severe, 138 moderate and 204 mild; von Willebrand's disease: 1208 type 1, 346 type 2 and 96 type 3. Inhibitor patients were 296 (of which 194 high responders and 65 low responders).The Italian registry run by AICE adds to the list of the available national haemophilia registries and is intended to establish treatment guidelines and foster research projects in Italy.
Published: 2008

14. Cardiovascular events and intensity of treatment in polycythemia vera

Author: Marchioli, R, Finazzi, G, Specchia, G, Cacciola, R, Cavazzina, R, Cilloni, D, De Stefano, V, Elli, E, Iurlo, A, Latagliata, R, Lunghi, F, Lunghi, M, Marfisi, Rm, Musto, P, Masciulli, A, Musolino, C, Cascavilla, N, Quarta, G, Randi, M. L., Rapezzi, D, Ruggeri, M, Rumi, E, Scortechini, Ar, Santini, S, Scarano, M, Siragusa, S, Spadea, A, Tieghi, A, Angelucci, E, Visani, G, Vannucchi, Am, Specchia G, Barbui T., D'Amico, A, Ferri, B, Guido, C, Marfisi, L, Pera, C, Polidoro, A, Sacco, M, Levantesi, G, Tognoni, G, Barosi, G, Carobbio, A, Leoni, P, Mulattieri, S, Tomassetti, S, Honorati, E, Ricco, A, Albano, F, Pastore, D, Carluccio, P, Mazzone, Am, Rossi, Ar, Finazzi, Mc, Delaini, F, Falanga, A, Rambaldi, A, Guaragna, G, Giannotta, A, Usala, E, Simula, Mp, Pilo, F, Cacciola, E, Pezzella, F, Seria, E, Di Francesco, E, Gallamini, A, Bertolotti, L, Antonioli, E, Guglielmelli, P, Pieri, L, Susini, Mc, Bartalucci, N, Bosi, A, D'Angelo, A, Centorrino, R, Gerace, D, Allegra, A, Cortelezzi, A, De Philippis, C, Ferretti, E, Ciceri, F, Claudiani, S, Malato, S, Trinca, S, Pogliani, Em, Belotti, A, Lanzi, E, Elli, Em, Gaidano, G, Deambrogi, C, Rossi, D, Saglio, G, Rotolo, A, Zanone, C, Bertozzi, I, Tezza, F, Aneloni, V, Quintini, G, Saccullo, G, Caracciolo, C, Cazzola, M, Casetti, I, Elena, C, Landini, B, Barulli, S, Guiducci, B, Lucesole, M, Malerba, L, Isidori, A, Grossi, A, De Stefanis, M, Biagioni, C, Merli, F, Imovilli, A, Codeluppi, K, Rubagotti, S, Romano, N, Bonini, A, Bellesia, E, Martorelli, Mc, Villani, O, Zifarone, E, Zonno, A, Santopietro, V, Za, T, Rossi, E, Ciminello, Am, Betti, S, Alimena, G, Tafuri, A, Breccia, M, Carmosino, I, Pisani, F, Romano, A, D'Andrea, M, Nobile, M, Mantuano, Fs, Rossi, G, Tricarico, M, Rodeghiero, F, Bedin, F, Lissandrini, L, Finotto, S., Marchioli, R, Finazzi, G, Specchia, G, Cacciola, R, Cavazzina, R, Cilloni, D, De Stefano, V, Elli, E, Iurlo, A, Latagliata, R, Lunghi, F, Lunghi, M, Marfisi, RM, Musto, P, Masciulli, A, Musolino, C, Cascavilla, N, Quarta, G, Randi, ML, Rapezzi, D, Ruggeri, M, Rumi, E, Scortechini, AR, Santini, S, Scarano, M, Siragusa, S, Spadea, A, Tieghi, A, Angelucci, E, Visani, G, Vannucchi, AM, Barbui, T, and CYTO-PV Collaborative Group.
Subjects: Male, Hematocrit, RECURRENT THROMBOSIS, law.invention, Aged, Antineoplastic Agents, Cardiovascular Diseases, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Hydroxyurea, Janus Kinase 2, Middle Aged, Polycythemia Vera, Thrombosis, Phlebotomy, Medicine (all), LEUKOCYTOSIS, Polycythemia vera, Randomized controlled trial, law, hemic and lymphatic diseases, ESSENTIAL THROMBOCYTHEMIA, Clinical endpoint, Polycythemia Vera, Secondary Prophylaxis, ESSENTIAL THROMBOCYTHEMIA, RECURRENT THROMBOSIS, RISK-FACTOR, HEMATOCRIT, MANAGEMENT, LEUKOCYTOSIS, PREVENTION, DIAGNOSIS, EFFICACY, WARFARIN, medicine.diagnostic_test, Hazard ratio, General Medicine, medicine.medical_specialty, randomized trial, polycythemia vera, Cardiovascular event, DIAGNOSIS, WARFARIN, RISK-FACTOR, Internal medicine, MANAGEMENT, medicine, Myelofibrosis, Adverse effect, business.industry, EFFICACY, medicine.disease, PREVENTION, Surgery, Polycythemia Vera, Cardiovascular event, hematocrit, Settore MED/15 - MALATTIE DEL SANGUE, business
Abstract: A b s t r ac t Background Current treatment recommendations for patients with polycythemia vera call for maintaining a hematocrit of less than 45%, but this therapeutic strategy has not been tested in a randomized clinical trial. Methods We randomly assigned 365 adults with JAK2-positive polycythemia vera who were being treated with phlebotomy, hydroxyurea, or both to receive either more intensive treatment (target hematocrit
Published: 2013

15. Correlation between leukocytosis and thrombosis in Philadelphia-negative chronic myeloproliferative neoplasms

Author: Caramazza, D, Caracciolo, C, Barone, R, Malato, A, Saccullo, G, Cigna, V, Berretta, S, Schinocca, L, Quintini, G, Abbadessa, V, DI RAIMONDO, Francesco, Siragusa, S, and Oct, ANN H. E. M. A. T. O. L.
Published: 2009

16. Haemophilia of the third age

Author: Harrison, C., Saccullo, G., and Makris, M.
Subjects: InformationSystems_GENERAL, MathematicsofComputing_GENERAL, GeneralLiterature_MISCELLANEOUS
Abstract: Editorial\ud

17. Management of venous thromboembolism in patients with acute leukemia at high bleeding risk: a multi-center study

Author: Francesco Fabbiano, Mariasanta Napolitano, Sergio Siragusa, Calogero Vetro, Maria Ilaria Del Principe, Alessandro Lucchesi, Giorgia Saccullo, Alessandra Casuccio, Luca Valore, Maria Enza Mitra, Anna Candoni, Alessandra Malato, Donato Mannina, Francesco Di Raimondo, Napolitano, M., Valore, L., Malato, A., Saccullo, G., Vetro, C., Enza Mitra, M., Fabbiano, F., Mannina, D., Casuccio, A., Lucchesi, A., Del Principe, M., Candoni, A., Di Raimondo, F., and Siragusa, S.
Subjects: Adult, Male, Cancer Research, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Population, Low molecular weight heparin, Hemorrhage, 030204 cardiovascular system & hematology, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Venous thrombosis, Low Molecular Weight Heparin, Humans, Medicine, acute leukemia, cardiovascular diseases, education, Aged, Aged, 80 and over, Venous Thrombosis, Acute leukemia, education.field_of_study, Chemotherapy, Leukemia, business.industry, low molecular weight heparin, Incidence, Incidence (epidemiology), Disease Management, Venous Thromboembolism, Hematology, Middle Aged, medicine.disease, Pulmonary embolism, Surgery, Oncology, 030220 oncology & carcinogenesis, Acute Disease, Female, business, Settore MED/15 - Malattie del Sangue, Venous thromboembolism
Abstract: In the last decades, evaluation of clinically relevant thrombotic complications in patients with acute leukemia (AL) has been poorly investigated. The authors performed a multi-center study to evaluate the management of symptomatic venous thromboembolism (VTE) in adult patients with AL. The intention was to find as clinically relevant the following: symptomatic Venous Thrombosis (VT) occurred in typical (lower limbs) and atypical (cerebral, upper limbs, abdominal, etc) sites with or without pulmonary embolism (PE). Over a population of 1461 patients with AL, 22 cases of symptomatic VTE were recorded in hospitalized patients with a mean age of 54.6 years. The absolute incidence of VTE was 1.5%. VTE occurred during chemotherapy in 17/22 (77.2%) cases, mainly (14/17, 82.3%) during the induction phase. Treatment of acute VTE was based on Low Molecular Weight Heparin (LMWH) at full dosage for the first month from diagnosis and reduced dosage (75%) for the following months.
Published: 2015

18. Abdominal aortic thrombosis secondary to reactive thrombocytosis in a patient with iron deficiency anemia

Author: Mariasanta Napolitano, Sergio Siragusa, Giorgia Saccullo, Simona Raso, Raso, S., Napolitano, M., Saccullo, G., and Siragusa, S.
Subjects: Adult, medicine.medical_specialty, Anemia, Microcytic anemia, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Celiac artery, medicine.artery, Internal medicine, medicine, Aorta, Abdominal, Aorta, Hematology, Thrombocytosis, Anemia, Iron-Deficiency, business.industry, General Medicine, medicine.disease, Thrombosis, Iron-deficiency anemia, 030220 oncology & carcinogenesis, Thrombosi, Cardiology, Thrombocytosi, Female, business, Human
Published: 2016

19. Cancer patients requiring interruption of long-term warfarin because of surgery or chemotherapy induced thrombocytopenia: The use of fixed sub-therapeutic doses of low-molecular weight heparin

Author: Valentina Zammit, Marco Santoro, Alessandra Casuccio, Simona Raso, Sergio Siragusa, Giorgia Saccullo, Alessandra Malato, Saccullo, G, Malato, A, Raso, S, Santoro, M, Zammit, V, Casuccio A, and Siragusa, S
Subjects: Adult, Male, Risk, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Low molecular weight heparin, Antineoplastic Agents, Hemorrhage, low-molecular weight heparin (LMWH), long-term vitamin-K antagonist (VKA) therapy, cancer patients, Settore MED/15 - Malattie Del Sangue, Postoperative Complications, Neoplasms, Thromboembolism, Atrial Fibrillation, Humans, Thrombophilia, Medicine, cancer, thrombocytopenia, low molecular weight heparin, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, Chemotherapy, business.industry, Incidence, Warfarin, Anticoagulants, Cancer, Hematology, Heparin, Heparin, Low-Molecular-Weight, Middle Aged, medicine.disease, Thrombocytopenia, Thrombosis, Surgery, Clinical trial, Heart Valve Prosthesis, Anesthesia, Female, business, medicine.drug
Abstract: No data are available regarding the management of cancer patients requiring interruption of long-term vitamin-K antagonist (VKA) therapy. For this purpose, we tested the efficacy and safety of fixed doses of low-molecular weight heparin (LMWH) in substitution of VKA because of invasive procedures or chemotherapy-induced thrombocytopenia. In cancer patients on VKA, therapy was discontinued 5 ± 1 days before surgery or chemotherapy. Heparin was given at prophylactic dosage in patients at low risk and at fixed subtherapeutic doses (3,800 or 4,000 UI anti-FXa, b.i.d.) in those at high-risk for thrombosis. LMWH was reinitiated 12 hr after surgery and VKA the day after. In patients receiving chemotherapy, LMWH was reinitiated 12/24 hr after obtaining a stable platelet count ≥ 30,000 mmc(3) and VKA after a stable platelet count ≥ 50,000 mmc(3) . Thromboembolism and major bleeding events were recorded from the time of VKA suspension to 30 ± 2 days postprocedure or until the next chemotherapy. Overall, 156 patients (56.4% at low risk and 43.5% at high risk for thrombosis) were enrolled; 34.6% underwent major surgery, 40.4% nonmajor surgery, and 25% chemotherapy. Thrombotic events occurred in five patients [3.2%, 95% confidence interval (CI): 1.41-7.27], four belonging to the high-risk and one to the low-risk group. Major bleeding occurred in five patients (3.2%, 95 CI: 1.41-7.27), all belonging to the high-risk group (three during major surgery and two during chemotherapy). In conclusion, LMWH given at fixed subtherapeutic is a feasible and relatively safe approach for bridging therapy in cancer patients on long-term VKA.
Published: 2012

20. Cryopreserved platelets: from in vitro thrombin generation potential to in vivo safety

Author: Amalia Reina, Piera Stefania Arfò, Giorgia Saccullo, Giuseppe Tarantino, Ivan Noel Sciortino, Claudia Di Gesù, Mariasanta Napolitano, Rosalia Agliastro, Sergio Siragusa, Lucio Lo Coco, Giovanni De Francisci, Napolitano, M., Lo Coco, L., Saccullo, G., Arfò, P., Gesù, C., Sciortino, I., Francisci, G., Reina, A., Tarantino, G., Agliastro, R., and Siragusa, S.
Subjects: medicine.diagnostic_test, P-selectin, business.industry, Immunology, Cell Biology, Hematology, Buffy coat, Biochemistry, Thromboelastography, Cryopreservation, Andrology, Tissue factor, Thrombin, In vivo, medicine, thrombin generation, cryopreserved platelets, DMSO, Platelet, business, medicine.drug
Abstract: Background: Cryopreservation of platelets (PLTs) at -80°C with dimethyl sulfoxide (DMSO) can extend their shelf life up to 2 years. Cryopreserved PLTs (CRY-PLTs) are reported to have a greater in vivo hemostatic effect than liquid-stored PLTs. Aims of this study were: i. to evaluate the thrombin generation potential of buffy coat derived cryopreserved PLTs (CRY- BC PLT) in comparison with fresh buffy coat derived platelets concentrates; ii. to determine the efficacy and safety of CRY-PLTs transfusion in hematological patients with severe thrombocytopenia. Materials and methods: BC PLTs were obtained from 5 buffy coats and pooled. The final PLTs concentrates were leukoreduced by filtration and transferred to a 650 mL patented cryopreservation kit (Promedical ®) which allowed mixing with DMSO 25% in a closed system and following removal of supernatant without further manipulations. BC-PLTs were washed prior freezing, suspended in homologous plasma from 1 of the 5 donors to a final concentration of 200 mL and frozen at - 80°. CRY- BC PLTs were preserved at -80°C with 6% DMSO. A system of 3 accessory bags directly connected to the mother bag was adopted for the in vitro study, to avoid repeated freezing/thawing of samples. In vitro assays were performed before freezing and at 3,6 and 9 months after thawing. Before assay, CRY-BC PLT were thawed at 37°C and diluted in plasma to adjust to 300× 109/L PLTs. Fresh BC PLTs underwent the same dilution to adjust to 300 ×109/L PLTs. Thrombin generation (TGA) was tested in CRY BC-PLTs and compared to TG potential of fresh BC PLTs. TGA was triggered by the addition of 0.5 pmol/L of recombinant human tissue factor. Endogenous thrombin potential (ETP) and peak height (PH) were determined. Flow Cytometry assays for PLTs activation markers and thromboelastography were also determined on each sample. CRY-BC PLTs, separately prepared according to the above described method for in vivo study, were infused in five hematological patients with acute leukemia (AL) and severe thrombocytopenia (PLTs Results Fourty nine BC-PLTs from 245 healthy volunteer donors (145 males and 100 females, mean age: 48.16.±18.91) were prepared, cryopreserved and analyzed up to 9 months after storage. Cryopreserved PLTs show a good thrombin generation potential that is stably maintained up to 9 months after cryopreservation [ETP (nM min): 529.25±98.64 at T0, 558.82±114.67 at T3, at 548.57±93.38 T6 and 533.04±103.15 at T9 months, respectively; PH(nM): 132.77±44.9 at T0, 103.4±44.9 at T3, 108.0±36.7 at T6 and 132.0±44.6 at T9 months, respectively]. At TGA, fresh BC-PLTs (n=35) had a mean ETP of 760.13±130.11, PH was 138.9±40.2. Thrombin generation of CRY-BC PLTs is comparable to fresh BC-PLTs, even if slightly decreased. Infusion of CRY-BC PLT (1U) was effective in controlling mucosal bleeding (epistaxis) in two patients with AL and severe thrombocytopenia. CRY-PLT were also effective when administered for prophylaxis in 3 patients with very low platelets count secondary to chemotherapy. In vivo, thrombin generation is stably maintained up to 24 hours after infusion of 1 Unit of CRY-BC PLTs, without any adverse effect (mean ETP pre-treatment was: 414.13±160.60, 24 hours after transfusion: 326.95±152.54). CRY-BC PLTs were safe and they did not determine any thrombotic event. At flow-cytometry, CRY-BC PLTs expressed higher activation markers (CD62P,CD63) than fresh BC PLTs. CRY-BC PLTs are able to significantly decrease the time to clot formation and clot strength, as measured also by thromboelastography. CRY-BCPLTs activation/deterioration is accompanied by an effective hemostatic in vivo function. Conclusions: Cryopreserved PLTs have an enhanced hemostatic activity and a good thrombin generation potential. They are effective and safe in preventing and controlling bleeding, being available in emergency/urgency settings also for patients with acute leukemia and severe thrombocytopenia. Disclosures Reina: Promedical: Consultancy.
Published: 2015

21. Absolute lymphocyte count is unrelated to overall survival in newly diagnosed elderly patients with multiple myeloma treated with immunomodulatory drugs

Author: Clotilde Cangialosi, Giorgia Saccullo, Salvatrice Mancuso, Gerlando Quintini, Maria Grazia Lipari, Francesco Di Raimondo, Sergio Siragusa, Antonio Branca, Alberto Dolce, Giorgina Specchia, Mariasanta Napolitano, Francesco Fabbiano, Simona Raso, R Bono, Napolitano, M, Saccullo, G, Bono, R, Branca, A, Cangialosi, C, Mancuso, S, Raso, S, Quintini, G, Lipari, MG, Fabbiano, F, Specchia, G, Dolce, A, Di Raimondo, F, and Siragusa, S
Subjects: Aged, 80 and over, Male, Cancer Research, Antitumor immunity, business.industry, Absolute lymphocyte count, Antineoplastic Agents, Hematology, Newly diagnosed, Middle Aged, Prognosis, medicine.disease, Oncology, Immunology, Overall survival, Humans, Immunologic Factors, Medicine, Female, Lymphocyte Count, Absolute lymphocyte count, multiple meyolma, Multiple Myeloma, business, Multiple myeloma, Aged
Abstract: The absolute lymphocyte count (ALC) has been widely studied in hematologic and solid malignancies as a marker of host antitumor immunity. Its significance has been evaluated in multiple myeloma (MM...
Published: 2014

22. Absence of residual vein thrombosis after an episode of idiopatic deep vein thrombosis: short-term anticoagulation is safe. The extended DACUS Study

Author: Bellisi M, Alessandra Malato, Guido Bajardi, Glauco Milio, Domenica Caramazza, Valeria Cigna, Lucio Lo Coco, Sergio Siragusa, Maria Teresa Attanzio, SIRAGUSA S, ALESSANDRA MALATO, MARIO BELLISI, MARIA TERESA ATTANZIO, VALERIA CIGNA, DOMENICA CARAMAZZA, LUCIO LO COCO, GLAUCO MILIO, AND GUIDO BAJARDI, Siragusa, S, Malato, A, Saccullo, G, Pizzo, G, Caramazza, D, Lo Coco, L, Bajardi, G, Milio, G, Pinto, A, Siragusa S, Malato A, Saccullo G, Pizzo G, Caramazza D, Lo Coco L, Bajardi G, Milio G, and Pinto A.
Subjects: medicine.medical_specialty, Deep vein, Immunology, Population, Thrombophilia, Biochemistry, deep vein thombosis, anticoagulation, Settore MED/15 - Malattie Del Sangue, medicine, Vein, education, First episode, education.field_of_study, residual vein thrombosis, business.industry, deep vein thrombosi, Cell Biology, Hematology, medicine.disease, Settore MED/11 - Malattie Dell'Apparato Cardiovascolare, Thrombosis, Surgery, Pulmonary embolism, Venous thrombosis, medicine.anatomical_structure, business
Abstract: Background. The optimal duration of Oral Anticoagulant Therapy (OAT) for Deep Vein Thrombosis (DVT) can be tailored by Residual Vein Thrombosis (RVT) (Siragusa S et al. Blood2003;102(11):OC183), a marker able to assess the individual risk for recurrent thrombosis. However, in patients with idiopathic DVT the safety of early interruption of OAT, because of absence of RVT, is still debated. Objective of the study. In the present study, we evaluated the safety of withholding OAT, in patients with idiopathic DVT and without RVT, three months after the index thrombotic episode. Study design. Prospective controlled study with two groups: patients without RVT stopped OAT after 3 months while those with RVT continued for additional 3 months. Materials and Methods. Consecutive patients with a first episode of idiopathic DVT of the lower limbs; patients with cancer or known thrombophilia were excluded. At the third months of OAT, RVT was assessed as previously described; briefly, RVT was considered absent when a clot occupying less than 40% of the vein lumen was detected by compression ultrasonography. Events, classified as recurrent DVT and/or Pulmonary Embolism (PE) and/or major and minor bleeding were evaluated; all patients were followed-up for at least 12 months after OAT discontinuation. Results. During the period 1999–2006, 518 patients were included in the study. In 206 (39.7%) RVT was considered absent (RVT negative group) and they stopped OAT; the remaining 312 patients continued anticoagulants for additional 3 months (RVT positive group). Total duration of follow-up (FU) was 184.7 years for RVT negative group (with a mean FU of 3.0 ± 0.83 years) and 191.3 years for RVT positive group (with a mean FU of 3.1 ± 0.89 years). The rate and type of events during FU is reported in table and figure. Conclusions. This investigation shows that in patients without RVT, three months of OAT are safe even after an episode of idiopathic DVT. This hold for at least 30% of the entire DVT population and has an important clinical impact; in fact, it is possible to select a group of patients with a very low risk for recurrences over a period of 3 years. This approach carries also a negligible risk for bleeding. Events between RVT Negative and Positive Groups Outcomes RVT Neg. group (206) RVT Pos. group (312) "p" value *After OAT discontinuation, **During OAT Recurrences, n/total (%)* 2/206 (0.9) 63/312 (20.2)

23. Safety of plasma-derived protein C for treating disseminated intravascular coagulation in adult patients with active cancer

Author: Simona Raso, Valentina Zammit, Marco Santoro, Giorgia Saccullo, Clementina Caracciolo, Alessandra Malato, Sergio Siragusa, Lucio Lo Coco, Malato, A, Saccullo, G, Coco, L, Caracciolo, C, Raso, S, Santoro, M, Zammit, V, and Siragusa, S
Subjects: Adult, Male, medicine.medical_specialty, Gastroenterology, Settore MED/15 - Malattie Del Sangue, Neoplasms, Internal medicine, Coagulopathy, medicine, Humans, Blood Coagulation, disseminated intravascular coagulation, Survival analysis, Aged, Aged, 80 and over, Disseminated intravascular coagulation, Hematologic Tests, business.industry, Plasma derived, Anticoagulants, Cancer, Hematology, Middle Aged, medicine.disease, Survival Analysis, Thrombosis, Surgery, Coagulation, Female, business, Protein C, medicine.drug
Abstract: Cancer-related disseminated intravascular coagulation (DIC) is a life-threatening condition for which no effective treatment is currently available. Protein C (PC), a modulator of coagulation as well as the inflammatory system, has been successfully tested (in its activated recombinant form [a-rPC]) in sepsis-related coagulopathy, but with an increased risk for major bleeding. Plasma-derived PC (pd-PC) is more suitable than a-rPC in patients at high risk from bleeding due to its self-limiting process. We carried out a single-arm study evaluating the role of pd-PC in adult cancer patients with overt DIC. Over a period of 3 years, we treated 19 patients with overt DIC and a PC plasma concentration
Published: 2012

24. Prognostic significance of residual venous obstruction in patients with treated unprovoked deep vein thrombosis A patient-level meta-analysis

Author: Benilde Cosmi, Monica Caprioli, Laura Young, Daniela Poli, Alfonso Iorio, Grégoire Le Gal, Walter Ageno, Paolo Prandoni, Giorgia Saccullo, Emilia Antonucci, Matteo Bonzini, Marc A. Rodger, Sergio Siragusa, Francesco Dentali, Marco P. Donadini, Paul Ockelford, Michael J. Kovacs, James D. Douketis, Donadini, M.P., Ageno, W., Antonucci, E., Cosmi, B., Kovacs, M.J., Le Gal, G., Ockelford, P., Poli, D., Prandoni, P., Rodger, M., Saccullo, G., Siragusa, S., Young, L., Bonzini, M., Caprioli, M., Dentali, F., Iorio, A., Douketis, J.D., Department of Clinical and Experimental Medicine (VARESE - Thrombosis Center), Universitá degli Studi dell’Insubria, Department of Medical-Surgical Critical Area (FLORENCE - Thrombosis Center), Azienda Ospedaliero-Universitaria, Department of Angiology and Blood Coagulation (DABC), University Hospital S Orsola-Malpighi, Division of Hematology (MJK), University of Western Ontario (UWO), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Haematology (AUCKLAND - Haematology), Auckland City Hospital, Department of Cardiothoracic and Vascular Sciences (PADUA - Thromboembolism Unit), Universita degli Studi di Padova, Thrombosis Program, University of Ottawa [Ottawa], Clinical Epidemiology Unit, Ottawa-The Ottawa Hospital, Department of Internal Medicine (PALERME - Med Int), Università degli studi di Palermo - University of Palermo, Department of Internal Medicine (PARLERME - Med Int), Department of Molecular Medicine (AUCKLAND - Molecular Medicine), University of Auckland [Auckland], Department of Clinical and Experimental Medicine (VARESE - DCEM), Department of Clinical Epidemiology and Biostatistics (HAMILTON - DCEB), McMaster University [Hamilton, Ontario], and Department of Medicine (DM - McMaster)
Subjects: Male, medicine.medical_specialty, Deep vein, [SDV]Life Sciences [q-bio], Unprovoked deep vein thrombosis, Patient-level meta-analysis, 030204 cardiovascular system & hematology, Sensitivity and Specificity, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Internal medicine, Residual venous obstruction, medicine, Humans, 030212 general & internal medicine, cardiovascular diseases, Prospective cohort study, Aged, Proportional Hazards Models, Randomized Controlled Trials as Topic, Thrombectomy, Ultrasonography, Venous Thrombosis, Proportional hazards model, business.industry, Hazard ratio, Anticoagulants, Reproducibility of Results, Thrombosis, Hematology, Venous Thromboembolism, Middle Aged, medicine.disease, Venous Obstruction, Confidence interval, Surgery, medicine.anatomical_structure, Meta-analysis, Multivariate Analysis, Female, Recurrent venous thromboembolism, deep vein thrombosis, residual thrombosis, ultrasonography, vitamin K antagonsists, business
Abstract: SummaryResidual venous obstruction (RVO) could improve the stratification of the risk of recurrence after unprovoked deep vein thrombosis (DVT), but results from clinical studies and study-level meta-analyses are conflicting. It was the objective of this analysis to determine if RVO is a valid predictor of recurrent venous thromboembolism (VTE) in patients with a first unprovoked DVT who had received at least three months of anticoagulant therapy. Individual patient data were obtained from the datasets of original studies, after a systematic search of electronic databases (Medline, Embase, Cochrane Library), supplemented by manual reviewing of the reference lists and contacting content experts. A multivariate, shared-frailty Cox model was used to calculate hazard ratios (HRs) for recurrent VTE, including, as covariates: RVO; age; sex; anticoagulation duration before RVO assessment; and anticoagulation continuation after RVO assessment. A total of 2,527 patients from 10 prospective studies were included. RVO was found in 1,380 patients (55.1%) after a median of six months from a first unprovoked DVT. Recurrent VTE occurred in 399 patients (15.8%) during a median follow-up of 23.3 months. After multivariate Cox analysis, RVO was independently associated with recurrent VTE (HR = 1.32, 95% confidence interval [CI]: 1.06–1.65). The association was stronger if RVO was detected early, i.e. at three months after DVT (HR = 2.17; 95% CI: 1.11–4.25), but non-significant if detected later, i.e. >6 months (HR = 1.19; 95% CI: 0.87–1.61). In conclusion, after a first unprovoked DVT, RVO is a weak overall predictor of recurrent VTE. The association is stronger if RVO is detected at an earlier time (3 months) after thrombosis.
Published: 2014

25. Optimal duration of low molecular weight heparin for the treatment of cancer-related deep vein thrombosis. The 'CANCER DACUS' study

Author: Doris Mascheroni, Pierpaolo Di Micco, Stefano Rotondo, Walter Ageno, Tullia Prantera, Lucio Lo Coco, Andrea D'Alessio, Salvatrice Mancuso, Angelo Ghirarduzzi, Giovam Battista Rini, Davide Imberti, Sergio Siragusa, Alessandra Malato, Giorgia Saccullo, Pina Gallucci, Oreste Urbano, Mariasanta Napolitano, Delia Sprini, Alessandra Casuccio, Vincenzo Oriana, Eugenio Bucherini, Francesco Recchia, Pietro Spadaro, Napolitano, M, Saccullo, G, Malato, A, Sprini, D, Ageno,W, Imberti, D, Mascheroni, D, Bucherini, E, Gallucci, P, D'Alessio, A, Prantera, T, Spadaro, P, Rotondo, S, Di Micco, P, Oriana, V, Urbano, O, Recchia, F, Ghirarduzzi, A, Lo Coco, L, Mancuso, S, Casuccio, A, Rini, GB, and Siragusa, S
Subjects: Cancer Research, medicine.medical_specialty, medicine.drug_class, Deep vein, Population, Low molecular weight heparin, Settore MED/42 - Igiene Generale E Applicata, Group B, Settore MED/15 - Malattie Del Sangue, Internal medicine, residual vein thrombosis, low molecular weight heparin, cancer patients, medicine, education, First episode, education.field_of_study, business.industry, low molecular weight heparin, Hazard ratio, antivitamin K, nadroparin, Cancer, medicine.disease, Thrombosis, Surgery, medicine.anatomical_structure, Oncology, business
Abstract: Purpose We evaluated the role of residual vein thrombosis (RVT) to assess the optimal duration of anticoagulants in patients with cancer who have deep vein thrombosis (DVT) of the lower limbs. Patients and Methods Patients with active cancer and a first episode of DVT treated with low molecular weight heparin (LMWH) for 6 months were eligible. Patients were managed according to RVT findings: those with RVT were randomly assigned to continue LMWH for an additional 6 months (group A1) or to discontinue it (group A2), and patients without RVT stopped LMWH (group B). The primary end point was recurrent venous thromboembolism (VTE) during the 1 year after disconinuation of LMWH, and the secondary end point was major bleeding. Analyses are from the time of random assignment. Results Between October 2005 and April 2010, 347 patients were enrolled. RVT was detected in 242 patients (69.7%); recurrence occurred in 22 of the 119 patients in group A1compared with 27 of 123 patients in group A2. The adjusted hazard ratio (HR) for group A2 versus A1 was 1.37 (95% CI, 0.7 to 2.5; P = .311). Three of the 105 patients in group B developed recurrent VTE; adjusted HR for group A1 versus B was 6.0 (95% CI, 1.7 to 21.2; P = .005). Three major bleeding events occurred in group A1, and two events each occurred in groups A2 and B. The HR for major bleeding in group A1 versus group A2 was 3.78 (95% CI, 0.77 to 18.58; P = .102). Overall, 42 patients (12.1%) died during follow-up as a result of cancer progression. Conclusion In patients with cancer with a first DVT, treated for 6 months with LMWH, absence of RVT identifies a population at low risk for recurrent thrombotic events. Continuation of LMWH in patients with RVT up to 1 year did not reduce recurrent VTE.
Published: 2014

26. Incidence and Management Of Venous Thrombosis In Acute Leukemia: A Multicenter Study

Author: Mariasanta Napolitano, Luca Valore, Giorgia Saccullo, Alessandra Malato, Calogero Vetro, Maria Enza Mitra, Alessandro Lucchesi, Francesco Fabbiano, Donato Mannina, Alessandra Casuccio, Francesco Di Raimondo, Sergio Siragusa, Napolitano,M, Valore,L, Saccullo,G, Malato,A, Vetro,C, Mitra,ME, Lucchesi,A, Fabbiano,F, Mannina,D, Casuccio,A, Di Raimondo,F, and Siragusa,S.
Subjects: medicine.medical_specialty, education.field_of_study, Acute leukemia, medicine.drug_class, business.industry, Immunology, Anticoagulant, Population, Low molecular weight heparin, Cell Biology, Hematology, medicine.disease, Biochemistry, Gastroenterology, Thrombosis, Surgery, Pulmonary embolism, Venous thrombosis, Internal medicine, medicine, Factor V Leiden, business, education, Venous Thromboembolism, Acute Leukemia, A Multicenter Study
Abstract: Background Venous thrombosis (VT) frequently complicates the clinical course of cancer. Reported incidence of VT in many hematological neoplasms is up to 10%, a value comparable to that of solid tumors. Available data on the incidence and management of VT in Acute Leukemia (AL) are scanty and quite discordant. We have performed a multicenter retrospective study with the primary objective to evaluate the incidence of venous thrombotic complications in a population of patients with AL. Secondary objective was to evaluate the management of these complications in patients with AL. Materials and Methods Available clinical records of out and in-patients diagnosed with AL from January 2008 to June 2013 in 4 Regional Reference Hospitals were analyzed. Cases of venous thrombosis (VT), including thrombosis in atypical sites [Retinal occlusion (RO) and Cerebral Sinus Thrombosis (CST)], were reported in the current study. All data were recorded in a dedicated database. Available laboratory tests at diagnosis of VT included complete blood cells count (CBC), basal coagulation tests (PT, aPTT, fibrinogen), Antithrombin, anticoagulant Protein S and C and D-dimer. Instrumental Diagnosis of deep vein thrombosis (DVT), pulmonary embolism (PE) and RO and CST was performed according to ACCP guidelines. In the statistical analysis, logistic regression model was applied. Fisher’s exact test was used to determine relationships between categorical variables. All P-values represented were two-sided, and statistical significance was declared when P< 0.05. Results Over a population of 831 patients with AL, 37 cases of VT were recorded, mainly (34/37 cases) in hospitalized patients: 24 cases were associated with Acute Myeloid Leukemia (AML) and 13 with Acute Lymphoblastic Leukemia (ALL). In the cohort of patients with VT, 23 were males (14 with AML, 9 with ALL) and 14 females (4 with AML, 10 with ALL), with a mean age of 46 ± 13,1 years; mean age of patients with AML and VT was 49 ± 12,8 years; mean age of patients with ALL and VT was 40,2 ± 12,2 years. Twelve patients presented at least a concomitant chronic disease; no one was receiving anticoagulant prophylactic treatment with low molecular weight heparin (LMWH) during hospitalization. There were 23 cases of DVT of upper arms, 9 cases of proximal DVT of limbs (one complicated with PE), 2 cases of RO, 1 of CST and 1 case of intracardiac clot. In 28/37 (75,6%) cases of recorded VT, a central venous catheter (CVC) was placed (Figure 1); moreover, 21/23 events of DVT of upper arms were significantly associated with a CVC insertion (p< 0.01). In the other 2 cases, one patient had a bulky mediastinal disease and 1 was diagnosed with promyelocytic AML. VT occurred during chemotherapy (CHT) in 32/37 (86.4%) cases, the remaining 5 cases were diagnosed in concomitance with leukemia: in 20 cases, VT occurred at induction, in 7 at consolidation and in 5 during salvage CHT. In both subgroups with VT, there was no statistical significant difference between time at diagnosis of VT and time at diagnosis of AL. At CBC, thrombocytopenia was the most frequently observed laboratory abnormality. Basal coagulation tests and anticoagulant levels were normal in all cases. Inherited prothrombotic mutations were available only for 9/37 cases, 1 case was heterozygous for Factor V Leiden and 1 for Factor II (G20210A) mutation. Most VT episodes (32/37) were treated with LMWH at therapeutic doses for the first month after diagnosis, a dose reduction was recorded in the following months, mainly related to severe thrombocytopenia after CHT ; 1 case was treated with unfractioned heparin; four cases did not receive any treatment due to severe thrombocytopenia. No cases of VT–related deaths nor fatal complications during treatment for VT were recorded. Treatments with LMWH lasted from 3 to 6 months. All patients clinically recovered from VT, only 2 late recurrences (PEs) were observed. Conclusions The incidence (4.5%) of VT in the analyzed cohort of patients with AL is almost similar to only one previous report, even if the involved sites distribution appears quite different. In particular, RO has never been reported. Atypical sites VT must be suspected to be correctly diagnosed and treated. Anticoagulant treatment schedules and duration in patients with AL is influenced by many factors, mainly related to CHT and severe thrombocytopenia. The optimal management of VT in patients with AL requires further, prospective studies. Disclosures: No relevant conflicts of interest to declare.
Published: 2013

27. Ultrasonography-guided central venous catheterisation in haematological patients with severe thrombocytopenia

Author: Mariasanta, Napolitano, Alessandra, Malato, Francesco, Raffaele, Manuela, Palazzolo, Giorgio, Lo Iacono, Roberto, Pinna, Girolamo, Geraci, Giuseppe, Modica, Giorgia, Saccullo, Sergio, Siragusa, Massimo, Cajozzo, Napolitano, M, Malato, A, Raffaele, F, Palazzolo, M, Iacono, GL, Pinna, R, Geraci, G, Modica, G, Saccullo, G, Siragusa, S, and Cajozzo, M.
Subjects: Adult, Aged, 80 and over, Male, Catheterization, Central Venous, Adolescent, Original Articles, Middle Aged, Severity of Illness Index, Thrombocytopenia, Settore MED/15 - Malattie Del Sangue, Settore MED/18 - Chirurgia Generale, central venous catheterisation, ultrasound, Seldinger technique, low platelet count, haematological malignancy, Humans, Female, Aged, Retrospective Studies, Ultrasonography
Abstract: BACKGROUND: Cannulation of the internal jugular vein (CVC) is a blind surface landmark-guided technique that could be potentially dangerous in patients with very low platelet counts. In such patients, ultrasonography (US)-guided CVC may be a valid approach. There is a lack of published data on the efficacy and safety of urgent US-guided CVC performed in haematological patients with severe thrombocytopenia. MATERIALS AND METHODS: We retrospectively studied the safety of urgent CVC procedures in haematological patients including those with severe thrombocytopenia (platelet count
Published: 2013

28. Functional In Vitro Studies Of Buffy Coat Pooled Platelets Cryopreserved In Dimethyl-Sulphoxide With a New System

Author: Lucio Lo Coco, Amalia Reina, Debora Allegro, Salvatrice Mancuso, Diana Di Liberto, Sergio Siragusa, Francesco Dieli, Mariasanta Napolitano, Giovanni De Francisci, Gianpaolo Vaccarella, Luca Valore, Raffaella Fadda, Giorgia Saccullo, Rosalia Agliastro, Napolitano, M, Lo Coco, L, Saccullo, G, De Francisci, G, Reina, A, Allegro, D, Fadda, F, Di Liberto, D, Mancuso, S, Valore, G, Vaccarella, G, Agliastro, R, Dieli,F, and Siragusa, S
Subjects: medicine.diagnostic_test, Cryopreserved platelets, DMSO, Immunology, Cell Biology, Hematology, Buffy coat, Biology, Biochemistry, Thromboelastography, Cryopreservation, Andrology, In vivo, Hemostasis, medicine, Platelet, Mean platelet volume, Annexin A5
Abstract: Introduction Cryopreservation for long term storage of platelets (PLTs) represents a clinical useful method for avoiding platelet shortage. Many studies have tried to define, in vitro and in vivo, the entity and weight of storage-related PLTs lesions with discordant results related to different methods. We have performed an in vitro prospective study to evaluate PLTs count, viability and function of buffy coat derived pooled platelet concentrates (BC-PLTs) treated with dimethyl-sulphoxide (DMSO) and cryopreserved at -80°C with an innovative patented system not requiring laminal flow hoods and external manipulations. Materials and methods Each BC-PLTs was obtained from 5 buffy coats and pooled according to standard procedures. The final PLTs concentrates were leukoreduced by filtration and transferred to a 650 mL cryopreservation kit (Promedical ®) which allowed mixing with DMSO 25% in a closed system and following removal of supernatant without further manipulations. BC-PLTs were washed prior freezing with removal of at least 84% supernatant solution, suspended in homologous plasma from 1 of the 5 donors to a final concentration of 200 mL and frozen at – 80°.Selection criteria to make BC-PLTs available for this study was pooled PLTs concentration > 1250 x 109/L and a blood units collection time duration shorter than 6 minutes. All the 245 donors were healthy volunteers and they did not take any medication affecting PLTs function. BC-PLTs were analyzed immediately pre-freezing (T0) and 3 months after cryopreservation ( CRY BC-PLTs). The following parameters were assayed: PLTs count (PC), mean platelet volume (MPV), pH, flow cytometry (FACS) expression of CD41a, CD42b, CD61a, CD62p, PAC-1, Annexin V PLTs surface antigens and thromboelastography (TEG). All samples were analyzed also after dilution (1:4) with homologous plasma to approximately 400 x109/L PLTs (data not shown) and for bacterial contamination (BC). CRY BC-PLTs samples were thawed in a bath at 37°C for 5 minutes and evaluated promptly. All the tests were performed according to current European recommendations. PLTs swirl was furthermore visually assessed. Results were expressed as mean +/- standard deviation (SD). Results obtained at T0 and after 3 months were compared by paired sample t-test. Differences were considered as significant at p values Results In vitro cell parameters were measured on 49 BC-PLTs and 15 CRY BC-PLTs as reported in Table1. PC was only slightly reduced in CRY BC-PLTs while MPV was significantly increased in CRY BC-PLTs. There were no differences between the 2 groups in CD41a, CD61a, CD62p and Annexin V expression while a significant reduction in CD 42b, PAC-1 for CRY BC-PLTs was observed. TEG parameters were all significantly reduced in CRY BC-PLTs samples without affecting hemostasis. PLTs swirl was observed in all samples and BC was absent. Conclusions The preliminary results of our investigation confirm the potential of a new system to overcome limits to PLTs storage. In fact, this method guarantees sterility and avoids excessive manipulations thanks to a closed system. Our method avoids PLTs apoptosis, as shown by absent expression of Annexin V. The adequate hemostasis achieved at TEG in both groups supports the hypothesis that in vitro PLTs activation/deterioration doesn’t necessarily mirror an impaired hemostatic in vivo function of CRY BC-PLTs. The next step of current study will be to evaluate the influence of the observed in vitro activation changes on PLTs recovery and survival in vivo. Disclosures: De Francisci: Promedical: Consultancy. Reina:PROMEDICAL: Consultancy. Allegro:Promedical: Employment.
Published: 2013

29. CD200 ANTIGEN IN B-CELL DERIVED NEOPLASMS: EXPRESSION AND CLINICAL IMPACT IN 77 CONSECUTIVE PATIENTS OF A SINGLE ISTITUTION

Author: MANCUSO, Salvatrice, SACCULLO, Giorgia, ABBADESSA, Vincenzo, SIRAGUSA, Sergio, Fadda, R, Bono, R, Mancuso, S, Fadda, R, Bono, R, Saccullo, G, Abbadessa, V, and Siragusa, S
Subjects: cytofluorimetry, lymphoprolyferative disease
Published: 2012

30. PREDICTORS OF RESIDUAL VEIN THROMBOSIS AFTER CANCER-RELATED DEEP VEIN THROMBOSIS OF THE LOWER LIMBS

Author: SACCULLO, Giorgia, MANCUSO, Salvatrice, ABBADESSA, Vincenzo, SIRAGUSA, Sergio, Raso, S, Zammit, V, Santoro, M, Malato, A, Lo Coco, L, Russo, A, Saccullo, G, Raso, S, Zammit, V, Santoro, M, Malato, A, Lo Coco, L, Mancuso, S, Abbadessa, V, Russo, A, and Siragusa, S
Subjects: Thrombosi, cancer
Published: 2012

31. ABSOLUTE LYMPHOCYTE COUNT IS NOT A PREDICTOR FOR SURVIVAL IN NEWLY DIAGNOSED ELDERLY PATIENTS WITH MULTIPLE MYELOMA. FINAL RESULTS OF A MULTICENTER STUDY

Author: SACCULLO, Giorgia, MANCUSO, Salvatrice, ABBADESSA, Vincenzo, SIRAGUSA, Sergio, Bono, R, Branca, A, Cangialosi, C, Raso, S, Quintini, G, Lipari, MG, Fabbiano, F, Specchia, G, Di Raimondo, F, Saccullo, G, Bono, R, Branca, A, Cangialosi, C, Mancuso, S, Raso, S, Quintini, G, Lipari, MG, Fabbiano, F, Abbadessa, V, Specchia, G, Di Raimondo, F, and Siragusa, S
Subjects: multiple myeoloma, lymphocite count, prognostic factors, Settore MED/15 - Malattie Del Sangue
Published: 2012

32. PNEUMOCYSTIS JIROVECI PNEUMONIA IN HEMATOLOGICAL PATIENTS: A SINGLE INSTITUTION EXPERIENCE

Author: MANCUSO, Salvatrice, FRANCO, Giovanni, SACCULLO, Giorgia, ABBADESSA, Vincenzo, SIRAGUSA, Sergio, Augello, A, Iovine, G, Mancuso, S, Franco, G, Augello, A, Iovine, G, Saccullo, G, Abbadessa, V, and Siragusa, S
Subjects: PJP infection, Haematological neoplasms, Settore MED/15 - Malattie Del Sangue
Published: 2012

33. CANCER AS A PREDICTOR FOR INCREASED PERIPROCEDURAL BLEEDING DURING SURGERY OR PLATELET-INDUCED CHEMOTHERAPY IN CHRONICALLY ANTICOAGULATED PATIENTS

Author: SACCULLO, Giorgia, MANCUSO, Salvatrice, ABBADESSA, Vincenzo, SIRAGUSA, Sergio, Malato, A, Lo Coco, L, Saccullo, G, Malato, A, Lo Coco, L, Mancuso, S, Abbadessa, V, and Siragusa, S
Subjects: Anticoagulation, bleeding, Settore MED/15 - Malattie Del Sangue
Published: 2012

34. Thrombotic complications in paroxysmal nocturnal haemoglobinuria: a literature review

Author: Malato, Alessandra, Saccullo, Giorgia, Coco, Lucio Lo, Mancuso, Salvatrice, Santoro, Marco, Martino, Samuela, Zammit, Valentina, Sprini, Delia, Siragusa, Sergio, Malato, A, Saccullo, G, Lo Coco, L, Mancuso, S, Santoro, M, Martino, S, Zammit, V, Sprini, D, and Siragusa, S
Subjects: Male, Mutation, Hemoglobinuria, Paroxysmal, Humans, Membrane Proteins, Female, Thrombosis, Review, EPN, Settore MED/15 - Malattie Del Sangue
Published: 2012

35. Residual vein thrombosis for assessing duration of anticoagulation after unprovoked deep vein thrombosis of the lower limbs: the extended DACUS study

Author: Vincenzo Abbadessa, Giuseppe Licata, Francesco Paolo Guarneri, Gaetana Di Fede, Antonino Tuttolomondo, Lucio Lo Coco, Antonio Pinto, Iliana Pepe, G. Mariani, Giorgia Saccullo, Giovan Battista Rini, Alessandra Casuccio, Mauro Di Ianni, Sergio Siragusa, Simona Raso, Alessandra Malato, Alfonso Iorio, Clementina Caracciolo, Marco Santoro, Siragusa, S, Malato, A, Saccullo, G, Iorio, A, Di Ianni, M, Caracciolo, C, Lo Coco, L, Raso, S, Santoro, M, Guarneri, F, Tuttolomondo, A, Pinto, A, Pepe, I, Casuccio, A, Abbadessa, V, Licata, G, Rini, GB, Mariani, G, and Di Fede, G
Subjects: Adult, Male, medicine.medical_specialty, Vitamin K, medicine.drug_class, Deep vein, Hemorrhage, Drug Administration Schedule, Settore MED/15 - Malattie Del Sangue, Recurrence, Risk Factors, deep vein thrombosis (DVT), Residual vein thrombosis, medicine, Humans, Prospective Studies, vitamin K antagonist (VKA) therapy, Prospective cohort study, Aged, Ultrasonography, Venous Thrombosis, business.industry, Acenocoumarol, Anticoagulants, Hematology, Venous Thromboembolism, Vitamin K antagonist, Middle Aged, medicine.disease, Thrombosis, Confidence interval, Surgery, Clinical trial, Vein thrombosis, medicine.anatomical_structure, Lower Extremity, Relative risk, Female, Warfarin, business
Abstract: The safest duration of anticoagulation after idiopathic deep vein thrombosis (DVT) is unknown. We conducted a prospective study to assess the optimal duration of vitamin K antagonist (VKA) therapy considering the risk of recurrence of thrombosis according to residual vein thrombosis (RVT). Patients with a first unprovoked DVT were evaluated for the presence of RVT after 3 months of VKA administration; those without RVT suspended VKA, while those with RVT continued oral anticoagulation for up to 2 years. Recurrent thrombosis and/or bleeding events were recorded during treatment (RVT group) and 1 year after VKA withdrawal (both groups). Among 409 patients evaluated for unprovoked DVT, 33.2% (136 of 409 patients) did not have RVT and VKA was stopped. The remaining 273 (66.8%) patients with RVT received anticoagulants for an additional 21 months; during this period of treatment, recurrent venous thromboembolism and major bleeding occurred in 4.7% and 1.1% of patients, respectively. After VKA suspension, the rates of recurrent thrombotic events were 1.4% and 10.4% in the no-RVT and RVT groups, respectively (relative risk = 7.4; 95% confidence interval = 4.9-9.9). These results indicate that in patients without RVT, a short period of treatment with a VKA is sufficient; in those with persistent RVT, treatment extended to 2 years substantially reduces, but does not eliminate, the risk of recurrent thrombosis.
Published: 2011

36. ABSOLUTE LYMPHOCYTE COUNT AS PREDICTOR FOR SURVIVAL IN NEWLY DIAGNOSED ELDERLY PATIENTS WITH MULTIPLE MYELOMA

Author: SACCULLO, Giorgia, MANCUSO, Salvatrice, CASUCCIO, Alessandra, ABBADESSA, Vincenzo, SIRAGUSA, Sergio, Raso, S, Branca, A, Cangialosi, C, Bono, R, Quintini, G, Lipari, MG, Augello, A, Fabbiano, F, Di Raimondo, F, Saccullo, G, Raso, S, Branca, A, Cangialosi, C, Bono, R, Quintini, G, Lipari, MG, Mancuso, S, Augello, A, Casuccio, A, Fabbiano, F, Abbadessa, V, Di Raimondo, F, and Siragusa, S
Subjects: multiple myeloma, Settore MED/15 - Malattie Del Sangue
Published: 2011

37. Drug-related cardiotoxicity for the treatment of haematological malignancies in elderly

Author: Giorgia Saccullo, Antonio Russo, Giovanni Paolo Guarneri, Alessandra Malato, Simona Raso, Beatrice Vergara, Vincenzo Abbadessa, Giovanni Fazio, Sergio Siragusa, Malato, A, Saccullo, G, Fazio, G, Vergara, B, Raso, S, Guarneri, GP, Russo, A, Abbadessa, V, and Siragusa, S
Subjects: Drug, medicine.medical_specialty, Heart disease, Heart Diseases, medicine.medical_treatment, media_common.quotation_subject, Cardiomyopathy, Antineoplastic Agents, Pharmacology, Cardiotoxins, Drug Delivery Systems, Drug Discovery, medicine, Animals, Humans, Intensive care medicine, drug cardiotoxicity, haematological malignancies, media_common, Aged, Cardiotoxicity, Chemotherapy, business.industry, Age Factors, Cancer, Imatinib, medicine.disease, Hematologic Neoplasms, Rituximab, business, medicine.drug
Abstract: Several publications have focused on the cardiotoxicity of specific classes of haematological therapeutic agents such as antracyclines and cyclofosfamide. Cardiotoxicity of cancer chemotherapeutics is a problem for patients of all ages, but it increases with age. Toxicity can also be developed months after the last chemotherapy dose, and late reactions can be seen years later when they present new-onset cardiomyopathy. No data are available about the cardiotoxicity of non-chemotherapy agents currently used as preferred therapy for haematological malignancy in elderly. In this review we have provided a summary of the cardiovascular toxic effects produced by different drugs and therapeutic agents. Early identification of patients who are at risk for cardiotoxicity should be a primary goal for haematologists in the development of personalised antineoplastic therapeutic strategies or interventions. Thus, the discovery of new biomarkers to identify patients at a high risk for the development of these complications is a high priority. Although targeted therapies such as imatinib and anti-CD20 antibody, such as rituximab, are considered less toxic and better tolerated by patients compared with classic chemotherapy drugs, certain cardiological complications can be very serious as these agents have been in use for a limited period of time.
Published: 2010

38. Patients requiring interruption of long-term oral anticoagulant therapy: the use of fixed sub-therapeutic doses of low-molecular weight heparin

Author: Giorgia Saccullo, Lucio Lo Coco, Alessandra Casuccio, Domenica Caramazza, Sergio Siragusa, Ignazio Abbene, Alessandra Malato, G. Pizzo, Malato, A, Saccullo, G, Lo Coco, L, Caramazza, D, Abbene, I, Pizzo, G, Casuccio, A, and Siragusa, S
Subjects: Adult, Male, medicine.medical_specialty, Bridging, low molecular weight heparin, Time Factors, Vitamin K, medicine.drug_class, Low molecular weight heparin, Administration, Oral, Postoperative Hemorrhage, Risk Assessment, Drug Administration Schedule, Settore MED/15 - Malattie Del Sangue, Risk Factors, Thromboembolism, medicine, Humans, Prospective Studies, Enoxaparin, Prospective cohort study, Aged, Aged, 80 and over, business.industry, Incidence (epidemiology), Warfarin, Anticoagulants, Nadroparin, Hematology, Heparin, Heparin, Low-Molecular-Weight, Middle Aged, medicine.disease, Thrombosis, Confidence interval, Surgery, Low Molecular Weight Heparin, Fixed doses, Chronic oral anticoagulation, perioperative bridging, Anesthesia, Surgical Procedures, Operative, Feasibility Studies, Female, business, medicine.drug, Factor Xa Inhibitors
Abstract: Introduction: We tested the efficacy and safety of fixed doses of Low-Molecular Weight Heparin (LMWH) in patients requiring interruption of Vitamin-k Antagonist (VKA) because of invasive procedures Methodology: Pre-operatively, patients discontinued VKA 5 +/- 1days; in those at low-risk for thrombosis, LMWH was given at a prophylactic dosage of 3.800 U.I. (nadroparin) or 4.000 U.I. (enoxaparin) anti-FXa once daily the night before the procedure. In patients at high-risk for thrombosis, LMWH was started early after VKA cessation and given at fixed sub-therapeutic doses (3.800 or 4.000 UI anti-FXa twice daily) until surgery. Post-operatively, LMWH was reinitiated 12 hours after procedure while VKA the day after. Heparin was continued until a therapeutic INR value was reached. The primary efficacy endpoints were the incidence of thromboembolism and major bleeding from VKA suspension (because of surgery) to 30 +/- 2 days post-procedure. Results: A total of 328 patients (55.4% at low-risk and 44.6% at high-risk for thrombosis) were enrolled; 103 (31.4%) underwent major surgery and 225 (68.6%) non major invasive procedures. Overall, thromboembolic events occurred in 6 patients (1.8%, 95% confidence intervals 0.4 to 3.2), 5 belonging to high-risk and 1 to low-risk group. Overall, major bleeding occurred in 7 patients (2.1%, 95 CI 0.6 to 3.6), 6 patients belonged to high-risk and 1 to low-risk group; most of events occurred in high-risk group during major surgery. Conclusion: LMWH given at fixed sub-therapeutic doses appears to be a feasible and safe approach for bridging therapy in chronic anticoagulated patients. Summary. Introduction: We tested the efficacy and safety of fixed doses of low-molecular-weight heparin (LMWH) in patients requiring interruption of vitamin-K antagonist (VKA) because of invasive procedures. Methodology: Preoperatively, patients discontinued VKA for 5 +/- 1 days; in those at low risk for thrombosis, LMWH was given at a prophylactic dosage of 3800 UI (nadroparin) or 4000 UI (enoxaparin) anti-factor (F) Xa once daily the night before the procedure. In patients at high risk for thrombosis, LMWH was started early after VKA cessation and given at fixed sub-therapeutic doses (3800 or 4000 UI anti-FXa twice daily) until surgery. Postoperatively, LMWH was reinitiated 12 h after procedure while VKA was reinitiated the day after. Heparin was continued until a therapeutic INR value was reached. The primary efficacy endpoints were the incidence of thromboembolism and major bleeding from VKA suspension (because of surgery) up to 30 +/- 2 days postprocedure. Results: A total of 328 patients (55.4% at low risk and 44.6% at high risk for thrombosis) were enrolled; 103 (31.4%) underwent major surgery and 225 (68.6%) non-major invasive procedures. Overall, thromboembolic events occurred in six patients (1.8%, 95% confidence interval 0.4-3.2), five belonging to the high-risk group and one belonging to the low-risk group. Overall, major bleeding occurred in seven patients (2.1%, 95 confidence interval 0.6-3.6), six patients belonged to the high-risk group and one belonged to the low-risk group; most of the events occurred in the high-risk group during major surgery. Conclusion: LMWH given at fixed sub-therapeutic doses appears to be a feasible and safe approach for bridging therapy in chronic anticoagulated patients
Published: 2010

39. The Impact of Venous Thromboembolism In Critically Ill Patients: A Meta-Analysis of Major Clinical outcomes

Author: Giorgia Saccullo, Francesco Fabbiano, Francesco Dentali, Vincenzo Abbadessa, Sergio Siragusa, Alessandra Malato, Malato, A, Dentali, F, Fabbiano, F, Saccullo, G, Abbadessa, V, and Siragusa, SM
Subjects: Mechanical ventilation, medicine.medical_specialty, business.industry, medicine.medical_treatment, Deep vein, Immunology, Cell Biology, Hematology, Biochemistry, Intensive care unit, Confidence interval, law.invention, Study heterogeneity, medicine.anatomical_structure, law, Relative risk, Meta-analysis, Emergency medicine, medicine, Venous thrombosis, metaanalysis, business, Intensive care medicine, Prospective cohort study
Abstract: Abstract 3327 Background: Critically ill patients are at high risk of developing venous thromboembolism (VTE) during their stay in the intensive care unit (ICU) because of premorbid medical and surgical conditions. The clinical consequences of Deep Vein Thrombosis (DVT) have the potential to be serious yet are frequently unrecognized in the Intensive Care Unit (ICU). In contrast to the extensive documentation on the short and long–term outcomes of patients with DVT evaluated in other clinical settings, little is known about the clinical course of this disease in the ICU setting. We hypothesized that both undetected and clinically evident VTE would affect the prognosis of critically ill patients. Purpose: To systematically review whether a diagnosis of DVT in critically ill patients affects clinically important outcomes including length of stay, duration of mechanical ventilation and mortality. Material and Methods: MEDLINE and EMBASE databases were searched up to June 2010. Two reviewers performed study selection independently. Studies were selected if evaluate one or more of the following outcomes: hospital and ICU mortality, duration of patient stay in hospital and in ICU, and duration of mechanical ventilation. Two investigators independently extracted and reviewed data from each study; including study and patient characteristics and outcomes. Association between DVT and hospital and ICU mortality, and the mean difference of duration of patient stay in hospital and in ICU, and duration of mechanical ventilation in patients with and without DVT were calculated using a random-effects model (DerSimionan and Laird method). Pooled results are reported as relative risk (RR) and mean difference and are presented with 95% confidence interval (CI) and with 2-sided P values. A P value of .05 or less was considered statistically significant. Statistical heterogeneity was evaluated using the I2 statistic, which assesses the appropriateness of pooling the individual study results [22]. The I2 value provides an estimate of the amount of variance across studies due to heterogeneity rather than chance. Cohen's Kappa for inter-rater agreement was used to assess inter-rater reliability. Results: Six studies for a total of 1518 patients were included in the systematic review. Patients diagnosed with DVT compared to those without DVT had increased ICU and hospital stay (7.3 days (95% CI 1.4 to 13.2; P= 0.02) and 16.5 days (95% CI 1.51 to 30.59; P= 0.03), respectively. Duration of mechanical ventilation appeared to be increased in patients with DVT although this difference was not statistically significant (weighted mean difference: 3.41 days 95 % CI –1.12 to 7.94; P=0.14). Patients diagnosed with DVT also had a marginally significant increase in the RR of hospital mortality (RR 1.31 95%CI,0.99 to 1.74,P=0.06), and a non statistically significant increase in the RR of ICU mortality (RR 1.96; 95% CI 0.74 to 5.19; P = 0.17). Conclusions: A diagnosis of DVT upon ICU admission appears to affect clinically important outcomes including length of ICU and hospital stay and hospital mortality. Further research involving larger prospective study designs are warranted. Disclosures: No relevant conflicts of interest to declare.
Published: 2010

40. Residual vein thrombosis and D-dimer for optimizing duration of anticoagulation in idiopathic deep vein thrombosis

Author: Giorgia Saccullo, Alessandra Malato, Alfonso Iorio, Sergio Siragusa, Walter Ageno, Malato, A, Saccullo, G, Iorio, A, Ageno, W, and Siragusa, S
Subjects: medicine.medical_specialty, Vitamin K, medicine.drug_class, Deep vein, Drug Administration Schedule, Fibrin Fibrinogen Degradation Products, Risk Factors, Neoplasms, Drug Discovery, D-dimer, Secondary Prevention, Humans, Medicine, Ultrasonography, Venous Thrombosis, Pharmacology, First episode, business.industry, Vascular disease, Anticoagulant, Anticoagulants, residual vein thrombosis, anticoagulant therapy, medicine.disease, Thrombosis, Surgery, Vein thrombosis, Venous thrombosis, medicine.anatomical_structure, business
Abstract: Long-term anticoagulant treatment is highly effective in preventing recurrent Venous Thrombo-Embolism (VTE) in patients with idiopathic Deep Vein Thrombosis (DVT) of the lower limbs, though associated with an increased risk for major bleeding that may offset the benefits of anticoagulation. Accordingly to recent guidelines, patients with idiopathic DVT should be treated for at least 3 months and then should be evaluated for the risk-benefit ratio of long-term therapy. However, such ‘time for decision’ is often unclear and the optimal duration of VKA remains debatable. In recent studies, markers for the assessment of the individual risk for recurrent thrombosis have been proposed, which can be of help to establish the optimal duration of VKA treatment; among them, the D-dimer (D-d) assay and the Residual Vein Thrombosis (RVT) assessment by Compression Ultra-Sonography (CUS) were shown to be the most suitable. Studies results showed that negative results of these parameters after 3 to 6 months of therapy, identify a group of patients at low-risk for recurrent thrombosis in whom VKA treatment can be withheld. In the present review we will discuss advantages and potential limits of using these individual markers for the management of patients with a first episode of DVT of the lower limbs.
Published: 2010

41. Correlation between leukocytosis and thrombosis in Philadelphia-negative chronic myeloproliferative neoplasms

Author: Rita Barone, Valeria Cigna, Clementina Caracciolo, Giorgia Saccullo, Luciana Schinocca, Domenica Caramazza, Gerlando Quintini, Vincenzo Abbadessa, Alessandra Malato, Salvatore Berretta, Sergio Siragusa, Francesco Di Raimondo, Caramazza, D, Caracciolo, C, Barone, R, Malato, A, Saccullo, G, Cigna, V, Berretta, S, Schinocca, L, Quintini, G, Abbadessa, V, Di Raimondo, F, and Siragusa, S
Subjects: Male, medicine.medical_specialty, Pathology, Leukocytosis, myeloproliferative neoplasm, thrombosis, jak2, Gastroenterology, Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative, Settore MED/15 - Malattie Del Sangue, Leukocyte Count, Polycythemia vera, hemic and lymphatic diseases, Internal medicine, medicine, Humans, Hydroxyurea, Risk factor, Prospective cohort study, Polycythemia Vera, Myeloproliferative neoplasm, Aged, business.industry, Essential thrombocythemia, Hazard ratio, Thrombosis, Hematology, General Medicine, Janus Kinase 2, Middle Aged, medicine.disease, Multivariate Analysis, Female, medicine.symptom, business, Thrombocythemia, Essential
Abstract: The evidence that leukocytes may contribute to the pathogenesis of thrombosis in Chronic Myeloproliferative Neoplasms is increasing but not definitive. To further enforces whether an increased leukocyte count is associated with thrombosis and whether this effect can be modulated by cytoreductive therapy, we analyzed the clinical course of 187 patients with Polycythemia Vera (PV) and Essential Thrombocythemia (ET) followed at two Italian Institutions over a period of 7 years. The association was measured at diagnosis or before thrombotic events: a multivariable analysis was carried out using data at baseline and time-dependent covariates. We found that white blood cells (WBC) count above 9.5 x 10(9)/L at diagnosis (baseline analysis) was associated with thrombosis during the follow-up (Hazard Ratio [HR] of 1.8, p 0.03). At the time-dependent analysis, therapy with hydroxyurea (HU), lowering by 35% the baseline WBC level, reduced such strength of association giving a HR of 1.3 (p value non significant). We found a trend between WBC level and thrombosis in untreated low-risk patients (RR of 1.9, 95% CI 0.9 to 3.1); in high-risk patients treated with HU this correlation was clearly lost (RR 1.1, 95% CI 0.2 to 2.7). Finally, we could not identify the presence of JAK2 (V617F) as a risk factor for thrombosis. Properly designed prospective studies should corroborate such results. The evidence that leukocytes may contribute to the pathogenesis of thrombosis in Chronic Myeloproliferative Neoplasms is increasing but not definitive. To further enforces whether an increased leukocyte count is associated with thrombosis and whether this effect can be modulated by cytoreductive therapy, we analyzed the clinical course of 187 patients with Polycythemia Vera (PV) and Essential Thrombocythemia (ET) followed at two Italian Institutions over a period of 7 years. The association was measured at diagnosis or before thrombotic events: a multivariable analysis was carried out using data at baseline and time-dependent covariates. We found that white blood cells (WBC) count above 9.5 x 10(9)/L at diagnosis (baseline analysis) was associated with thrombosis during the follow-up (Hazard Ratio [HR] of 1.8, p 0.03). At the time-dependent analysis, therapy with hydroxyurea (HU), lowering by 35% the baseline WBC level, reduced such strength of association giving a HR of 1.3 (p value non significant). We found a trend between WBC level and thrombosis in untreated low-risk patients (RR of 1.9, 95% CI 0.9 to 3.1); in high-risk patients treated with HU this correlation was clearly lost (RR 1.1, 95% CI 0.2 to 2.7). Finally, we could not identify the presence of JAK2 (V617F) as a risk factor for thrombosis. Properly designed prospective studies should corroborate such results.
Published: 2009

42. Incidence of thromboembolic complications in patients with mechanical heart valves with a subtherapeutic international normalized ratio

Author: Sergio Siragusa, Francesco Dentali, Walter Ageno, Giorgia Saccullo, Nicoletta Riva, Alessandra Malato, Dentali, F, Riva, N, Malato, A, Saccullo, G, Siragusa, S, and Ageno, W
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.drug_class, Low molecular weight heparin, Prosthesis Design, Risk Assessment, Settore MED/15 - Malattie Del Sangue, Cohort Studies, Young Adult, Thromboembolism, Antithrombotic, medicine, Humans, International Normalized Ratio, INR, anticoagulant, mechanical heart valves, Aged, Retrospective Studies, business.industry, Incidence, Incidence (epidemiology), Retrospective cohort study, Middle Aged, Vitamin K antagonist, Confidence interval, Surgery, Heart Valve Prosthesis, Female, Risk assessment, business, Cardiology and Cardiovascular Medicine, Cohort study
Abstract: Objective Subtherapeutic international normalized ratios are frequently encountered in clinical practice, and patients with mechanical heart valves with inadequate anticoagulation may be exposed to an increased risk of thromboembolic events. There are no data on thromboembolic event risk for these patients. Methods We assessed the current practice patterns in the management of patients with mechanical heart valves with subtherapeutic international normalized ratios and assessed the risk of thromboembolic complications in this setting. The charts of patients with mechanical heart valves followed up in two anticoagulation clinics were reviewed. Patients with a history of stable, therapeutic anticoagulation but with a subtherapeutic international normalized ratio were included. Patients who underwent invasive procedures requiring temporary suspension of antithrombotic therapy were excluded. Data on use and dose of low–molecular weight heparin bridging therapy were collected. Results The incidence of objectively confirmed thromboembolic events within 90 days after obtaining the index international normalized ratio was assessed. Two hundred ninety-four patients with mechanical heart valves were included (mean age 63.3 years, 47.3% male). Low–molecular weight heparin was prescribed in 14 cases (4.8%). At 90 days, 1 patient had a thromboembolic complication (0.3%, 95% confidence interval 0%–1.9%). Conclusion Patients with previously stable, therapeutic anticoagulation with a subtherapeutic international normalized ratio have a low risk of thromboembolic events. Withholding low–molecular weight heparin bridging therapy is a reasonable therapeutic option in these cases.
Published: 2009

43. Residual Vein Thrombosis Improves Screening for Occult Cancer: Results On 537 Patients with Idiopathic Deep Vein Thrombosis

Author: Giusy Pizzo, Domenica Caramazza, Giorgia Saccullo, Nicola Gebbia, Alessandra Malato, Sergio Siragusa, Fabio Fulfaro, Lucio Lo Coco, Siragusa, SM, Malato, A, Fulfaro, F, Saccullo, G, Caramazza, D, Pizzo, G, Lo Coco, L, and Gebbia, N
Subjects: First episode, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Deep vein, Immunology, Cancer, Colonoscopy, Cell Biology, Hematology, medicine.disease, Biochemistry, Occult, Surgery, cancer, residual vein thrombosis, Settore MED/15 - Malattie Del Sangue, medicine.anatomical_structure, Internal medicine, Cohort, Cancer screening, medicine, Prospective cohort study, business
Abstract: Abstract 3999 Poster Board III-935 Background Clinical advantage of extensive screening for occult cancer in patients with idiopathic Deep Vein Thrombosis (DVT) is unknown. We have demonstrated that the Residual Vein Thrombosis (RVT)-based screening for occult cancer improves early detection as well as cancer-related mortality (Siragusa S et al. Blood 2007;110(699):OC). Here we report on final analysis of 537 patients over a period of 8 years. Objective of the study We conducted a prospective study evaluating whether a RVT-based screening for cancer is sensitive and influences cancer-related mortality. Study design Prospective with two cohorts of DVT patients: the first cohort was monitored for clinical overt cancer only (Group A), while the second (Group B) received complete screening for occult neoplasm and subsequent surveillance. Materials and methods Consecutive patients with a first episode of DVT who presented RVT after 3 month of anticoagulation and without signs and/or symptoms for overt cancer. Screening for occult cancer was based on: ultrasound and/or CT scan of the abdomen and pelvis, gastroscopy, colonoscopy or sigmoidoscopy, hemoccult, sputum cytology and tumor markers. These tests were extended with mammography and Pap smear for women and ultrasound of the prostate and total specific prostatic antigen (PSA) for men. All investigations had to be completed within four-weeks from the assessment of RVT. All patients were followed-up for at least 2 years. Incidence and cancer-related mortality was compared between the two groups by survival curves (Kaplan-Mayer) and related Breslow test for statistics. Results Over a period of 8 years, 537 patients were included in the analysis: first cohort included 346 patients (Group A), second cohort 191 (Group B). Clinical characteristics between groups were homogenous. During the follow-up, 8.3% of patients developed overt cancer in group A; in group B, 7.8% of patients had diagnosed cancer at the moment of extensive screening while 2 new cases (0.7%) occurred during the follow-up (Table). The sensitivity of this approach was 92.1% (95% confidence intervals 75.2-104.2). Cancer-related mortality was 7.5% in group A and 3.6% in group B (p< 0.001). Conclusions The RVT-based screening for occult cancer is highly effective for improving early detection as well as cancer-related mortality in a cohort of 537 patient with DVT of the lower limbs. Disclosures: Off Label Use: Hydroxyurea use in myelofibrosis.
Published: 2009

44. Italian Registry of Haemophilia and Allied Disorders. Objectives, methodology and data analysis

Author: IORIO A, OLIOVECCHIO E, MORFINI M, MANNUCCI PM, CONTINO L, ACCORSI A, CIAVARELLA N, SCHIAVONI M, SCARAGGI FA, RODORIGO G, VALDRÉ L, TARGHETTA R, TAGARIELLO G, RADOSSI P, MUSSO R, CULTRERA D, MULEO G, IANNACARO P, BIASIOLI C, TESTA S, ALATRI A, VINCENZI D, SCAPOLI G, MOLINARI AC, BOERI E, CAPRINO D, MARIANI G, LAPECORELLA M, CARLONI MT, CANTORI I, SANTAGOSTINO E, GRINGERI A, FEDERICI AB, MARIETTA M, PEDRAZZOLI P, DI MINNO G, PERRICONE C, SCHIAVULLI M, ROCINO A, BERRETTINI M, ZANON E, MANCUSO G, TAGLIAFERRI A, RIVOLTA F, FERRANTE F, DRAGANI A, ROSSI A, ALBERTINI P, MACCHI S, D'INCA M, DE ROSSI G, LUCIANI M, LANDOLFI R, MAZZUCCONI MG, SANTORO C, PISEDDU G, CARLA SCHINCO P, ROSSETTI G, BARILLARI G, FEOLA G, GANDINI G, FRANCHINI M, CASTAMAN G., COPPOLA, Antonino, SIRAGUSA, Sergio, MALATO, Alessandra, SACCULLO, Giorgia, MANCINO, Antonio, IORIO A, OLIOVECCHIO E, MORFINI M, MANNUCCI PM, CONTINO L, ACCORSI A, CIAVARELLA N, SCHIAVONI M, SCARAGGI FA, RODORIGO G, VALDRÉ L, TARGHETTA R, TAGARIELLO G, RADOSSI P, MUSSO R, CULTRERA D, MULEO G, IANNACARO P, BIASIOLI C, TESTA S, ALATRI A, VINCENZI D, SCAPOLI G, MOLINARI AC, BOERI E, CAPRINO D, MARIANI G, LAPECORELLA M, CARLONI MT, CANTORI I, SANTAGOSTINO E, GRINGERI A, FEDERICI AB, MARIETTA M, PEDRAZZOLI P, DI MINNO G, COPPOLA A, PERRICONE C, SCHIAVULLI M, ROCINO A, BERRETTINI M, ZANON E, MANCUSO G, SIRAGUSA S, MALATO A, SACCULLO G, TAGLIAFERRI A, RIVOLTA F, FERRANTE F, DRAGANI A, ROSSI A, MANCINO A, ALBERTINI P, MACCHI S, D'INCA M, DE ROSSI G, LUCIANI M, LANDOLFI R, MAZZUCCONI MG, SANTORO C, PISEDDU G, CARLA SCHINCO P, ROSSETTI G, BARILLARI G, FEOLA G, GANDINI G, FRANCHINI M, and CASTAMAN G
Subjects: methodology, haemophilia, Settore MED/15 - Malattie Del Sangue
Published: 2008

45. The persistence of residual vein thrombosis, after an episode of deep vein thrombosis, and the risk of new overt cancer

Author: SIRAGUSA, Sergio, MALATO, Alessandra, ANASTASIO, Raffaela, SACCULLO, Giorgia, ABBENE, Ignazio, LO COCO, Lucio, CASUCCIO, Alessandra, CIGNA V, FULFARO F, SIRAGUSA S, MALATO A, CIGNA V, FULFARO F, ANASTASIO R, SACCULLO G, ABBENE I, LO COCO L, and CASUCCIO A
Published: 2007

46. Peri-operative bridgning therapy with low molecular weight heparin in patients requiring interruption of long-term oral anticoagulant therapy

Author: SACCULLO, Giorgia, MALATO, Alessandra, ANASTASIO, Raffaela, ABBENE, Ignazio, LO COCO, Lucio, SIRAGUSA, Sergio, CIGNA V, SCIACCA M, SACCULLO G, MALATO A, ANASTASIO R, CIGNA V, SCIACCA M, ABBENE I, LO COCO L, and SIRAGUSA S
Published: 2006

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