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1. Oxidant lung injury in cystic fibrosis

Author

Chmiel James, Ciabattoni G, Davi G, Collura M, Iapichino L, Pardo F, Ganci A, Romagnoli R, Maclouf J, and Patrono C

Subjects
Cystic fibrosis, eicosanoids, isoprostanes, oxidants, peroxidation, prostaglandins, vitamin E, Diseases of the respiratory system, RC705-779
Published
2000
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2. RENEB inter-laboratory comparison 2021 : inter-assay comparison of eight dosimetry assays

Author

Port, M, Barquinero, J-F, Endesfelder, D, Moquet, J, Oestreicher, U, Terzoudi, G, Trompier, F, Vral, Anne, Abe, Y, Ainsbury, L, Alkebsi, L, Amundson, S A, Badie, C, Baeyens, Ans, Balajee, A S, Balazs, K, Barnard, S, Bassinet, C, Beaton-Green, L A, Beinke, C, Bobyk, L, Brochard, P, Brzoska, K, Bucher, M, Ciesielski, B, Cuceu, C, Discher, M, D Oca, M C, Dominguez, I, Doucha-Senf, S, Dumitrescu, A, Duy, P N, Finot, F, Garty, G, Ghandhi, S A, Gregoire, E, Goh, V S T, Guclu, I, Hadjiiska, L, Hargitai, R, Hristova, R, Ishii, K, Kis, E, Juniewicz, M, Kriehuber, R, Lacombe, J, Lee, Y, Lopez Riego, M, Lumniczky, K, Mai, T T, Maltar-Strmecki, N, Marrale, M, Martinez, J S, Marciniak, A, Maznyk, N, McKeever, S W S, Meher, P K, Milanova, M, Miura, T, Monteiro Gil, O, Montoro, A, Moreno Domene, M, Mrozik, A, Nakayama, R, O'Brien, G, Oskamp, D, Ostheim, P, Pajic, J, Pastor, N, Patrono, C, Pujol-Canadell, M, Prieto Rodriguez, M J, Repin, M, Romanyukha, A, RoSSler, U, Sabatier, L, Sakai, A, Scherthan, H, Schule, S, Seong, K M, Sevriukova, O, Sholom, S, Sommer, S, Suto, Y, Sypko, T, Szatmari, T, Takahashi-Sugai, M, Takebayashi, K, Testa, A, Testard, I, Tichy, A, Triantopoulou, S, Tsuyama, N, Unverricht-Yeboah, M, Valente, M, Van Hoey, O, Wilkins, R C, Wojcik, A, Wojewodzka, M, Younghyun, Lee, Zafiropoulos, D, and Abend, M

Subjects
Medicine and Health Sciences
Abstract

Tools for radiation exposure reconstruction are required to support the medical management of radiation victims in radiological or nuclear incidents. Different biological and physical dosimetry assays can be used for various exposure scenarios to estimate the dose of ionizing radiation a person has absorbed. Regular validation of the techniques through inter-laboratory comparisons (ILC) is essential to guarantee high quality results. In the current RENEB inter-laboratory comparison, the performance quality of established cytogenetic assays [dicentric chromosome assay (DCA), cytokinesis-block micronucleus assay (CBMN), stable chromosomal translocation assay (FISH) and premature chromosome condensation assay (PCC)] was tested in comparison to molecular biological assays [gamma-H2AX foci (gH2AX), gene expression (GE)] and physical dosimetry-based assays [electron paramagnetic resonance (EPR), optically or thermally stimulated luminescence (LUM)]. Three blinded coded samples (e.g., blood, enamel or mobiles) were exposed to 0, 1.2 or 3.5 Gy X-ray reference doses (240 kVp, 1 Gy/min). These doses roughly correspond to clinically relevant groups of unexposed to low exposed (0-1 Gy), moderately exposed (1-2 Gy, no severe acute health effects expected) and highly exposed individuals (>2 Gy, requiring early intensive medical care). In the frame of the current RENEB inter-laboratory comparison, samples were sent to 86 specialized teams in 46 organizations from 27 nations for dose estimation and identification of three clinically relevant groups. The time for sending early crude reports and more precise reports was documented for each laboratory and assay where possible. The quality of dose estimates was analyzed with three different levels of granularity, 1. by calculating the frequency of correctly reported clinically relevant dose categories, 2. by determining the number of dose estimates within the uncertainty intervals recommended for triage dosimetry (±0.5 Gy or ±1.0 Gy for doses 2.5 Gy), and 3. by calculating the absolute difference (AD) of estimated doses relative to the reference doses. In total, 554 dose estimates were submitted within the 6-week period given before the exercise was closed. For samples processed with the highest priority, earliest dose estimates/categories were reported within 5-10 h of receipt for GE, gH2AX, LUM, EPR, 2-3 days for DCA, CBMN and within 6-7 days for the FISH assay. For the unirradiated control sample, the categorization in the correct clinically relevant group (0-1 Gy) as well as the allocation to the triage uncertainty interval was, with the exception of a few outliers, successfully performed for all assays. For the 3.5 Gy sample the percentage of correct classifications to the clinically relevant group (≥2 Gy) was between 89-100% for all assays, with the exception of gH2AX. For the 1.2 Gy sample, an exact allocation to the clinically relevant group was more difficult and 0-50% or 0-48% of the estimates were wrongly classified into the lowest or highest dose categories, respectively. For the irradiated samples, the correct allocation to the triage uncertainty intervals varied considerably between assays for the 1.2 Gy (29-76%) and 3.5 Gy (17-100%) samples. While a systematic shift towards higher doses was observed for the cytogenetic-based assays, extreme outliers exceeding the reference doses 2-6 fold were observed for EPR, FISH and GE assays. These outliers were related to a particular material examined (tooth enamel for EPR assay, reported as kerma in enamel, but when converted into the proper quantity, i.e. to kerma in air, expected dose estimates could be recalculated in most cases), the level of experience of the teams (FISH) and methodological uncertainties (GE). This was the first RENEB ILC where everything, from blood sampling to irradiation and shipment of the samples, was organized and realized at the same institution, for several biological and physical retrospective dosimetry assays. Almost all assays appeared comparably applicable for the identification of unexposed and highly exposed individuals and the allocation of medical relevant groups, with the latter requiring medical support for the acute radiation scenario simulated in this exercise. However, extreme outliers or a systematic shift of dose estimates have been observed for some assays. Possible reasons will be discussed in the assay specific papers of this special issue. In summary, this ILC clearly demonstrates the need to conduct regular exercises to identify research needs, but also to identify technical problems and to optimize the design of future ILCs.

Published
2023

6. RENEB Inter-Laboratory Comparison 2021: The Cytokinesis-Block Micronucleus Assay.

Author

Vral, A., Endesfelder, D., Balázs, J., Beinke, C., Cuceu Petrenci, C., Finot, F., Garty, G., Hadjiiska, L., Hristova, R., Ivanova, I., Lee, Y., Lumniczky, K., Milanova, M., Monteiro Gil, O., Oestreicher, U., Pajic, J., Patrono, C., Pham, N.D., Perletti, G., and Seong, K.M.

Subjects
NUCLEOLUS, RADIATION dosimetry, EXPOSURE dose, RADIATION doses, CONFIDENCE intervals, MEDICAL triage
Abstract

The goal of the RENEB inter-laboratory comparison 2021 exercise was to simulate a large-scale radiation accident involving a network of biodosimetry labs. Labs were required to perform their analyses using different biodosimetric assays in triage mode scoring and to rapidly report estimated radiation doses to the organizing institution. This article reports the results obtained with the cytokinesis-block micronucleus assay. Three test samples were exposed to blinded doses of 0, 1.2 and 3.5 Gy X-ray doses (240 kVp, 13 mA, ∼75 keV, 1 Gy/min). These doses belong to 3 triage categories of clinical relevance: a low dose category, for no exposure or exposures inferior to 1 Gy, requiring no direct treatment of subjects; a medium dose category, with doses ranging from 1 to 2 Gy, and a high dose category, after exposure to doses higher than 2 Gy, with the two latter requiring increasing medical attention. After irradiation the test samples (no. 1, no. 2 and no. 3) were sent by the organizing laboratory to 14 centers participating in the micronucleus assay exercise. Laboratories were asked to setup micronucleus cultures and to perform the micronucleus assay in triage mode, scoring 500 binucleated cells manually, or 1,000 binucleated cells in automated/semi-automated mode. One laboratory received no blood samples, but scored pictures from another lab. Based on their calibration curves, laboratories had to provide estimates of the administered doses. The accuracy of the reported dose estimates was further analyzed by the micronucleus assay lead. The micronucleus assay allowed classification of samples in the corresponding clinical triage categories (low, medium, high dose category) in 88% of cases (manual scoring, 88%; semi-automated scoring, 100%; automated scoring, 73%). Agreement between scoring laboratories, assessed by calculating the Fleiss' kappa, was excellent (100%) for semi-automated scoring, good (83%) for manual scoring and poor (53%) for fully automated scoring. Correct classification into triage scoring dose intervals (reference dose ±0.5 Gy for doses ≤2.5 Gy, or reference dose ±1 Gy for doses >2.5 Gy), recommended for triage biodosimetry, was obtained in 79% of cases (manual scoring, 73%; semi-automated scoring, 100%; automated scoring, 67%). The percentage of dose estimates whose 95% confidence intervals included the reference dose was 58% (manual scoring, 48%; semiautomated scoring, 72%; automated scoring, 60%). For the irradiated samples no. 2 and no. 3, a systematic shift towards higher dose estimations was observed. This was also noticed with the other cytogenetic assays in this intercomparison exercise. Accuracy of the rapid triage modality could be maintained when the number of manually scored cells was scaled down to 200 binucleated cells. In conclusion, the micronucleus assay, preferably performed in a semi-automated or manual scoring mode, is a reliable technique to perform rapid biodosimetry analysis in large-scale radiation emergencies. [ABSTRACT FROM AUTHOR]

Published
2023
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7. NATO Science for Peace and Security (SPS) Project 'BioPhyMeTRE' 'Novel biological and physical methods for triage in radiological and nuclear (R/N) emergencies'

Author

Testa, A., Patrono, C., Palma, V., Kenzhina, L., Mamyrbayeva, A., Biyakhmetova, D., Zhamaldinov, F., Della Monaca, S., Fattibene, P., Quattrini, M.C., Maltar-Strmečki, Nadica, Erceg, Ina, Vojnič- Kortmiš, Maja, Vidotto, Monica, Bortolin, E., Swartz, S., and Toyoda, S.

Subjects
Retrospective dosimetry, fortuitous dosimeters, photo-stimulated luminescence, radiation triage
Abstract

The BioPhyMeTRE project (2020-2023) focuses on the use of innovative biological and physical methods for a fast evaluation of the radiation exposure level of people involved in a radiological mass casualty incident. The proposed biological method combines the two standardized Dicentric and Micronuclei assays into a single one, which allows the simultaneous scoring of chromosome aberrations and micronuclei on the same slide [1]. The physical method is based on the use of a low-cost, portable photo-stimulated luminescence (PSL) reader for the individual dose assessment by using personal items that people can have in their pockets or bags [2]. Both methods can be applied for a quick screening of the potential victims by using user-friendly analytical procedures. The multi-parametric approach by different techniques provides complementary information useful to overcome the limits (low radiation sensitivity, signal instability, etc.) that each method has, since the “ideal” dosimeter does not exist. From the beginning of the project (April 2020) important progress has been made to optimize and automate the biological procedure and very satisfactory results have been obtained with the PSL technique applied to salty crackers and beach sand. Interlaboratory exercises for the validation of the analytical procedures are planned in the coming months. Next to the work for the improvement of the methods, other important activities have been carried out: online training for the transfer of knowledge and skills among the partners and disseminations of the results through the participation to several international conferences. The project, fully funded by the NATO Science for Peace and Security Programme (Grant G5684), is coordinated by the Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA) of Italy and involves the Institute of Radiation Safety and Ecology (IRSE) of National Nuclear Center of Kazakhstan, the National Health Institute (ISS) of Italy and the Ruđer Bošković Institute (RBI) of Croatia.

Published
2022

12. Status and development of the TOP-IMPLART Project

Author

Picardi, L., Ampollini, A., Anello, P., Balduzzi, M., Bazzano, G., Borgognoni, F., Cisbani, E., DAndrea, M., De Angelis, C., De Angelis, G., Della Monaca, S., Esposito, G., Ghio, F., Giuliani, F., Lucentini, M., Marino, C., Montereali, R. M., Nenzi, P., Notaro, C., Patrono, C., Placido, C., Piccinini, M., Ronsivalle, C., Santavenere, F., Spurio, A., Strigari, L., Surrenti, V., Tabocchini, A., Trinca, E., and Vadrucci, M.

Subjects
FOS: Physical sciences, Medical Physics (physics.med-ph), Applied Physics (physics.app-ph), Physics - Applied Physics, Physics - Medical Physics
Abstract

The TOP-IMPLART project consists of the design and implementation of a linear proton accelerator, its control and monitoring systems for the treatment of superficial and semi-deep tumors. The energy of 150 MeV (corresponding to a penetration in tissue of about 15 cm) is a milestone in design being useful for the proton therapy treatment of almost 50% of tumors based on their position and depth (including ocular melanoma, head-neck tumors, pediatric tumors, and more superficial tumors). The capability to vary the intensity on a pulse-to-pulse basis combined with an electronic feedback system allows to get the required dose uniformity (2.5%) reducing the number of re-paintings. In this paper the state of the art and the objectives of the TOP-IMPLART project are described within the framework of the progress of Protontherapy.

Published
2020

13. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes

Author

Knuuti, Juhani, Wijns, William, Saraste, Antti, Capodanno, Davide, Barbato, Emanuele, Funck-Brentano, Christian, Prescott, Eva, Storey, Robert F, Deaton, Christi, Cuisset, Thomas, Agewall, Stefan, Dickstein, Kenneth, Edvardsen, Thor, Escaned, Javier, Gersh, Bernard J, Svitil, Pavel, Gilard, Martine, Hasdai, David, Hatala, Robert, Mahfoud, Felix, Masip, Josep, Muneretto, Claudio, Valgimigli, Marco, Achenbach, Stephan, Bax, Jeroen J, Neumann FJ, Sechtem U, Banning AP, Bonaros N, Bueno H, Bugiardini R, Chieffo A, Crea F, Czerny M, Delgado V, Dendale P, Flachskampf FA, Gohlke H, Grove EL, James S, Katritsis D, Landmesser U, Lettino M, Matter CM, Nathoe H, Niessner A, Patrono C, Petronio AS, Pettersen SE, Piccolo R, Piepoli MF, Popescu BA, Räber L, Richter DJ, Roffi M, Roithinger FX, Shlyakhto E, Sibbing D, Silber S, Simpson IA, Sousa-Uva M, Vardas P, Witkowski A, Zamorano JL, Achenbach S, Agewall S, Barbato E, Bax JJ, Capodanno D, Cuisset T, Deaton C, Dickstein K, Edvardsen T, Escaned J, Funck-Brentano C, Gersh BJ, Gilard M, Hasdai D, Hatala R, Mahfoud F, Masip J, Muneretto C, Prescott E, Saraste A, Storey RF, Svitil P, Valgimigli M, Windecker S, Aboyans V, Baigent C, Collet JP, Dean V, Fitzsimons D, Gale CP, Grobbee D, Halvorsen S, Hindricks G, Iung B, Jüni P, Katus HA, Leclercq C, Lewis BS, Merkely B, Mueller C, Petersen S, Touyz RM, Benkhedda S, Metzler B, Sujayeva V, Cosyns B, Kusljugic Z, Velchev V, Panayi G, Kala P, Haahr-Pedersen SA, Kabil H, Ainla T, Kaukonen T, Cayla G, Pagava Z, Woehrle J, Kanakakis J, Tóth K, Gudnason T, Peace A, Aronson D, Riccio C, Elezi S, Mirrakhimov E, Hansone S, Sarkis A, Babarskiene R, Beissel J, Maempel AJC, Revenco V, de Grooth GJ, Pejkov H, Juliebø V, Lipiec P, Santos J, Chioncel O, Duplyakov D, Bertelli L, Dikic AD, Studenčan M, Bunc M, Alfonso F, Bäck M, Zellweger M, Addad F, Yildirir A, Sirenko Y, Clapp B, Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de pharmacologie médicale [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Knuuti, Juhani, Wijns, William, Saraste, Antti, Capodanno, Davide, Barbato, Emanuele, Funck-Brentano, Christian, Prescott, Eva, Storey, Robert F, Deaton, Christi, Cuisset, Thoma, Agewall, Stefan, Dickstein, Kenneth, Edvardsen, Thor, Escaned, Javier, Gersh, Bernard J, Svitil, Pavel, Gilard, Martine, Hasdai, David, Hatala, Robert, Mahfoud, Felix, Masip, Josep, Muneretto, Claudio, Valgimigli, Marco, Achenbach, Stephan, Bax, Jeroen J, Neumann FJ, Sechtem U, Banning AP, Bonaros N, Bueno H, Bugiardini R, Chieffo A, Crea F, Czerny M, Delgado V, Dendale P, Flachskampf FA, Gohlke H, Grove EL, James S, Katritsis D, Landmesser U, Lettino M, Matter CM, Nathoe H, Niessner A, Patrono C, Petronio AS, Pettersen SE, Piccolo R, Piepoli MF, Popescu BA, Räber L, Richter DJ, Roffi M, Roithinger FX, Shlyakhto E, Sibbing D, Silber S, Simpson IA, Sousa-Uva M, Vardas P, Witkowski A, Zamorano JL, Achenbach S, Agewall S, Barbato E, Bax JJ, Capodanno D, Cuisset T, Deaton C, Dickstein K, Edvardsen T, Escaned J, Funck-Brentano C, Gersh BJ, Gilard M, Hasdai D, Hatala R, Mahfoud F, Masip J, Muneretto C, Prescott E, Saraste A, Storey RF, Svitil P, Valgimigli M, Windecker S, Aboyans V, Baigent C, Collet JP, Dean V, Delgado V, Fitzsimons D, Gale CP, Grobbee D, Halvorsen S, Hindricks G, Iung B, Jüni P, Katus HA, Landmesser U, Leclercq C, Lettino M, Lewis BS, Merkely B, Mueller C, Petersen S, Petronio AS, Richter DJ, Roffi M, Shlyakhto E, Simpson IA, Sousa-Uva M, Touyz RM, Benkhedda S, Metzler B, Sujayeva V, Cosyns B, Kusljugic Z, Velchev V, Panayi G, Kala P, Haahr-Pedersen SA, Kabil H, Ainla T, Kaukonen T, Cayla G, Pagava Z, Woehrle J, Kanakakis J, Tóth K, Gudnason T, Peace A, Aronson D, Riccio C, Elezi S, Mirrakhimov E, Hansone S, Sarkis A, Babarskiene R, Beissel J, Maempel AJC, Revenco V, de Grooth GJ, Pejkov H, Juliebø V, Lipiec P, Santos J, Chioncel O, Duplyakov D, Bertelli L, Dikic AD, Studenčan M, Bunc M, Alfonso F, Bäck M, Zellweger M, Addad F, Yildirir A, Sirenko Y, Clapp B, Clinical sciences, Cardio-vascular diseases, Cardiology, Knuuti, Juhani [0000-0003-3156-9593], Apollo - University of Cambridge Repository, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), University of Zurich, Knuuti, J., Wijns, W., Achenbach, S., Agewall, S., Barbato, E., Bax, J. J., Capodanno, D., Cuisset, T., Deaton, C., Dickstein, K., Edvardsen, T., Escaned, J., Funck-Brentano, C., Gersh, B. J., Gilard, M., Hasdai, D., Hatala, R., Mahfoud, F., Masip, J., Muneretto, C., Prescott, E., Saraste, A., Storey, R. F., Svitil, P., Valgimigli, M., Windecker, S., Aboyans, V., Baigent, C., Collet, J. -P., Dean, V., Delgado, V., Fitzsimons, D., Gale, C. P., Grobbee, D. E., Halvorsen, S., Hindricks, G., Iung, B., Juni, P., Katus, H. A., Landmesser, U., Leclercq, C., Lettino, M., Lewis, B. S., Merkely, B., Mueller, C., Petersen, S., Petronio, A. S., Richter, D. J., Roffi, M., Shlyakhto, E., Simpson, I. A., Sousa-Uva, M., Touyz, R. M., Benkhedda, S., Metzler, B., Sujayeva, V., Cosyns, B., Kusljugic, Z., Velchev, V., Panayi, G., Kala, P., Haahr-Pedersen, S. A., Kabil, H., Ainla, T., Kaukonen, T., Cayla, G., Pagava, Z., Woehrle, J., Kanakakis, J., Toth, K., Gudnason, T., Peace, A., Aronson, D., Riccio, C., Elezi, S., Mirrakhimov, E., Hansone, S., Sarkis, A., Babarskiene, R., Beissel, J., Cassar Maempel, A. J., Revenco, V., de Grooth, G. J., Pejkov, H., Juliebo, V., Lipiec, P., Santos, J., Chioncel, O., Duplyakov, D., Bertelli, L., Dikic, A. D., Studencan, M., Bunc, M., Alfonso, F., Back, M., Zellweger, M., Addad, F., Yildirir, A., Sirenko, Y., and Clapp, B.

Subjects
anti-ischaemic drug, chronic coronary syndromes, medicine.medical_treatment, [SDV]Life Sciences [q-bio], lipid-lowering drugs, Diagnostic Techniques, Cardiovascular, antithrombotic therapy, Disease, 030204 cardiovascular system & hematology, Guideline, Coronary artery disease, 0302 clinical medicine, Disease management (health), Societies, Medical, ComputingMilieux_MISCELLANEOUS, chronic coronary syndrome, angina pectori, Disease Management, food and beverages, imaging, risk assessment, Syndrome, 3. Good health, Natural history, Europe, Cardiology, Cardiology and Cardiovascular Medicine, coronary artery disease, medicine.medical_specialty, lifestyle modifications, anti-ischaemic drugs, Ischemia, 610 Medicine & health, vasospastic angina, Guidelines, Revascularization, diagnostic testing, 11171 Cardiocentro Ticino, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, angina pectoris, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Journal Article, Humans, business.industry, screening, fungi, 030229 sport sciences, medicine.disease, lipid-lowering drug, Angina pectoris, Anti-ischaemic drugs, Antithrombotic therapy, Chronic coronary syndromes, Diagnostic testing, Imaging, Lifestyle modifications, Lipid-lowering drugs, Microvascular angina, Myocardial ischaemia, Myocardial revascularization, Risk assessment, Screening, Vasospastic angina, myocardial ischaemia, myocardial revascularization, Heart failure, microvascular angina, Chronic Disease, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, lifestyle modification, Coronary Artery Disease/diagnosis, business, Fibrinolytic agent
Abstract

Coronary artery disease (CAD) is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries, whether obstructive or non-obstructive. This process can be modified by lifestyle adjustments, pharmacological therapies, and invasive interventions designed to achieve disease stabilization or regression. The disease can have long, stable periods but can also become unstable at any time, typically due to an acute atherothrombotic event caused by plaque rupture or erosion. However, the disease is chronic, most often progressive, and hence serious, even in clinically apparently silent periods. The dynamic nature of the CAD process results in various clinical presentations, which can be conveniently categorized as either acute coronary syndromes (ACS) or chronic coronary syndromes (CCS). The Guidelines presented here refer to the management of patients with CCS. The natural history of CCS is illustrated in Figure 1.

Published
2019

26. RENEB–Running the European Network of biological dosimetry and physical retrospective dosimetry

Author

Kulka, U., Abend, M., Ainsbury, E., Badie, C., Barquinero, J.F., Barrios, L., Beinke, C., Bortolin, E., Cucu, A., De Amicis, A., Domínguez, I., Fattibene, P., Frøvig, A.M., Gregoire, E., Guogyte, K., Hadjidekova, V., Jaworska, A., Kriehuber, R., Lindholm, C., Lloyd, D., Lumniczky, K., Lyng, F., Meschini, R., Mörtl, S., Della Monaca, S., Monteiro Gil, O., Montoro, A., Moquet, J., Moreno, M., Oestreicher, U., Palitti, F., Pantelias, G., Patrono, C., Piqueret-Stephan, L., Port, M., Prieto, M.J., Quintens, R., Ricoul, M., Romm, H., Roy, L., Sáfrány, G., Sabatier, L., Sebastià, N., Sommer, S., Terzoudi, G., Testa, A., Thierens, H., Turai, I., Trompier, F., Valente, M., Vaz, P., Voisin, P., Vral, A., Woda, C., Zafiropoulos, D., Wojcik, A., Bundesamt für Strahlenschutz (BfS), Bundeswehr Institute of Radiobiology, Universität Ulm - Ulm University [Ulm, Allemagne], Centre for Radiation, Chemical and Environmental Hazards, Public Health England [London], Universitat Autònoma de Barcelona (UAB), Istituto Superiore di Sanita` (ISS), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Radiation and Nuclear Safety Authority [Helsinki] (STUK), National center for public health [Hungary], Hospital Universitario y Politécnico La Fe, University of Tuscia, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Agenzia Nazionale per le nuove Tecnologie, l’energia e lo sviluppo economico sostenibile (ENEA), Universiteit Gent = Ghent University [Belgium] (UGENT), Helmholtz-Zentrum München (HZM), Stockholm University, Seventh Framework Programme, Bundesamt für Strahlenschutz - Federal Office for Radiation Protection (BfS), Istituto Superiore di Sanità (ISS), Hospital Universitari i Politècnic La Fe = University and Polytechnic Hospital La Fe, Università degli studi della Tuscia [Viterbo], Agenzia Nazionale per le nuove Tecnologie, l’energia e lo sviluppo economico sostenibile = Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Universiteit Gent = Ghent University (UGENT), and Helmholtz Zentrum München = German Research Center for Environmental Health

Subjects
[SDV]Life Sciences [q-bio]
Abstract

International audience; Purpose: A European network was initiated in 2012 by 23 partners from 16 European countries with the aim to significantly increase individualized dose reconstruction in case of large-scale radiological emergency scenarios. Results: The network was built on three complementary pillars: (1) an operational basis with seven biological and physical dosimetric assays in ready-to-use mode, (2) a basis for education, training and quality assurance, and (3) a basis for further network development regarding new techniques and members. Techniques for individual dose estimation based on biological samples and/or inert personalized devices as mobile phones or smart phones were optimized to support rapid categorization of many potential victims according to the received dose to the blood or personal devices. Communication and cross-border collaboration were also standardized. To assure long-term sustainability of the network, cooperation with national and international emergency preparedness organizations was initiated and links to radiation protection and research platforms have been developed. A legal framework, based on a Memorandum of Understanding, was established and signed by 27 organizations by the end of 2015. Conclusions: RENEB is a European Network of biological and physical-retrospective dosimetry, with the capacity and capability to perform large-scale rapid individualized dose estimation. Specialized to handle large numbers of samples, RENEB is able to contribute to radiological emergency preparedness and wider large-scale research projects. © 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Published
2017

27. RENEB accident simulation exercise

Author

Brzozowska, B., Ainsbury, E., Baert, A.E., Beaton-Green, L., Barrios, L., Barquinero, J.F., Bassinet, C., Beinke, C., Benedek, A., Beukes, P., Bortolin, E., Buraczewska, I., Burbidge, C.I., de Amicis, A., de Angelis, C., Della Monaca, S., Depuydt, J., de Sanctis, S., Dobos, K., Domene, M.M., Domínguez, I., Facco, E., Fattibene, P., Frenzel, M., Monteiro Gil, O., Gonon, G., Gregoire, E., Gruel, G., Hadjidekova, V., Hatzi, V.I., Hristova, R., Jaworska, A., Kis, E., Kowalska, M., Kulka, U., Lista, F., Lumniczky, K., Martínez-López, W., Meschini, R., Mörtl, S., Moquet, J., Noditi, M., Oestreicher, U., Orta Vázquez, M.L., Palma, V., Pantelias, G., Montoro Pastor, A., Patrono, C., Piqueret-Stephan, L., Quattrini, M.C., Regalbuto, E., Ricoul, M., Roch-Lefevre, S., Roy, L., Sabatier, L., Sarchiapone, L., Sebastià, N., Sommer, S., Sun, M., Suto, Y., Terzoudi, G., Trompier, F., Vral, A., Wilkins, R., Zafiropoulos, D., Wieser, A., Woda, C., Wojcik, A., Istituto Superiore di Sanita` (ISS), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Bundesamt für Strahlenschutz (BfS), National center for public health [Hungary], Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Hospital Universitario y Politécnico La Fe, Public Health England [London], Universiteit Gent = Ghent University [Belgium] (UGENT), Helmholtz-Zentrum München (HZM), Stockholm University, University of Warsaw (UW), Universitat Autònoma de Barcelona (UAB), Bundeswehr Institute of Radiobiology, Universität Ulm - Ulm University [Ulm, Allemagne], Seventh Framework Programme, Istituto Superiore di Sanità (ISS), Bundesamt für Strahlenschutz - Federal Office for Radiation Protection (BfS), Hospital Universitari i Politècnic La Fe = University and Polytechnic Hospital La Fe, Universiteit Gent = Ghent University (UGENT), and Helmholtz Zentrum München = German Research Center for Environmental Health

Subjects
RENEB network, Safety Management, [SDV]Life Sciences [q-bio], Radiobiology, Biology and Life Sciences, Disaster Planning, Reneb Network, Accident Simulation, Radiobiological Event, Europe, radiobiological event, Radiation Monitoring, Medicine and Health Sciences, accident simulation, Triage, Radioactive Hazard Release
Abstract

International audience; Purpose: The RENEB accident exercise was carried out in order to train the RENEB participants in coordinating and managing potentially large data sets that would be generated in case of a major radiological event. Materials and methods: Each participant was offered the possibility to activate the network by sending an alerting email about a simulated radiation emergency. The same participant had to collect, compile and report capacity, triage categorization and exposure scenario results obtained from all other participants. The exercise was performed over 27 weeks and involved the network consisting of 28 institutes: 21 RENEB members, four candidates and three non-RENEB partners. Results: The duration of a single exercise never exceeded 10 days, while the response from the assisting laboratories never came later than within half a day. During each week of the exercise, around 4500 samples were reported by all service laboratories (SL) to be examined and 54 scenarios were coherently estimated by all laboratories (the standard deviation from the mean of all SL answers for a given scenario category and a set of data was not larger than 3 patient codes). Conclusions: Each participant received training in both the role of a reference laboratory (activating the network) and of a service laboratory (responding to an activation request). The procedures in the case of radiological event were successfully established and tested. © 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Published
2017

28. Expert consensus document on the use of antiplatelet agents. The task force on the use of antiplatelet agents in patients with atherosclerotic cardiovascular disease of the European society of cardiology

Author

Patrono, C, Bachmann, F, Baigent, C, Bode, C, De Caterina, R, Charbonnier, B, Fitzgerald, D, Hirsh, J, Husted, S, Kvasnicka, J, Montalescot, G, García Rodríguez, LA, Verheugt, F, Vermylen, J, Wallentin, L, Priori, SG, Alonso Garcia, MA, Blanc, JJ, Budaj, A, Cowie, M, Dean, V, Deckers, J, Fernández Burgos, E, Lekakis, J, Lindahl, B, Mazzotta, G, Morais, J, Oto, A, Smiseth, OA, Ferreira, R, Steg, PG, Teixeira, F, Wilcox, R, and Cardiology

Subjects
Blood Platelets, medicine.medical_specialty, Process (engineering), media_common.quotation_subject, Alternative medicine, Coronary Artery Disease, Risk Assessment, Task (project management), SDG 3 - Good Health and Well-being, Risk Factors, Internal medicine, medicine, Humans, In patient, Quality (business), Heart, lung and circulation [UMCN 2.1], media_common, Clinical Trials as Topic, Atherosclerotic cardiovascular disease, business.industry, Patient Selection, Expert consensus, Clinical trial, Cardiology, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors
Abstract

Guidelines and Expert Consensus Documents aim to present all the relevant evidence on a particular issue in order to help physicians to weigh the benefits and risks of a particular diagnostic or therapeutic procedure. They should be helpful in everyday clinical decision-making. A great number of Guidelines and Expert Consensus Documents have been issued in recent years by different organizations, the European Society of Cardiology (ESC) and by other related societies. By means of links to web sites of National Societies several hundred guidelines are available. This profusion can put at stake the authority and validity of guidelines, which can only be guaranteed if they have been developed by an unquestionable decision-making process. This is one of the reasons why the ESC and others have issued recommendations for formulating and issuing Guidelines and Expert Consensus Documents. In spite of the fact that standards for issuing good quality Guidelines and Expert Consensus Documents are well defined, recent surveys of Guidelines and Expert Consensus Documents published in peer-reviewed journals between 1985 and 1998 have shown that methodological standards were not complied within the vast majority of cases. It is therefore of great importance that guidelines and recommendations are presented in formats that are easily interpreted. Subsequently, their implementation programmes must also be well conducted. Attempts have been made to determine whether guidelines improve the quality of clinical practice and the utilization of health resources. The ESC Committee for Practice Guidelines ( CPG ) supervises and coordinates the preparation of new Guidelines and Expert Consensus Documents produced by Task Forces, expert groups or consensus panels. The Committee is also responsible for the endorsement of these Guidelines and Expert Consensus Documents or statements. The role of aspirin and other platelet-active drugs in the treatment and prevention of atherothrombosis has been reviewed recently by the Sixth American …

Published
2016

30. Coxibs and traditional NSAIDs for pain relief - Authors' reply

Author

Bhala, N., Jonathan Emberson, Patrono, C., Baigent, C., and Cnt, Collaborators

Subjects
medicine.medical_specialty, business.industry, Gastrointestinal Diseases, Anti-Inflammatory Agents, Non-Steroidal, Pain relief, MEDLINE, Physical therapy, Medicine, Humans, General Medicine, Vascular Diseases, business
Published
2014

32. A NOVEL BIOLOGICAL DOSIMETRY ASSAY AS A POTENTIAL TOOL FOR TRIAGE DOSE ASSESSMENT IN CASE OF LARGE-SCALE RADIOLOGICAL EMERGENCY.

Author

Testa, A, Palma, V, and Patrono, C

Subjects
BIOLOGICAL assay, CHROMOSOME abnormalities, AUTOMATION software, NUCLEOLUS, BIOLOGICAL laboratories
Abstract

In case of mass radiological emergencies, new strategies involving biological and clinical endpoints are requested for an efficient triage classification of casualties. For this purpose, we developed a novel protocol combining the two most established cytogenetic methods used in biological dosimetry (dicentric and micronucleus assays) into a single one, in order to have a time-saving, inexpensive and potentially automatable instrument to be used for triage purposes in case of large-scale radiological events. This method could be considered as a 'three in one' assay allowing the simultaneous scoring of chromosome aberrations and micronuclei on a single slide, and also enabling to discriminate between metaphases in first and second cell division without the Fluorescence plus Giemsa staining. This method needs further validation through inter-comparisons involving biological dosimetry laboratories, to verify its reproducibility. Moreover, the possibility to apply the already existing software for automation for dicentric and micronucleus assays could be also verified. [ABSTRACT FROM AUTHOR]

Published
2019
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35. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials

Author

Baigent, Colin, Bhala, N., Emberson, J., Merhi, A., Abramson, S., Arber, N., Baron, J. A., Bombardier, C., Cannon, C., Farkouh, M. E., Fitzgerald, G. A., Goss, P., Halls, H., Hawk, E., Hawkey, C., Hennekens, C., Hochberg, M., Holland, L. E., Kearney, P. M., Laine, L., Lanas, A., Lance, P., Laupacis, A., Oates, J., Patrono, C., Schnitzer, T. J., Solomon, S., Tugwell, P., Wilson, K., Wittes, J., Adelowo, O., Aisen, P., Al Quorain, A., Altman, R., Bakris, G., Baumgartner, H., Bresee, C., Carducci, M., Chang, D. M., Chou, C. T., Clegg, D., Cudkowicz, M., Doody, L., Miedany, Y. E. l., Falandry, C., Farley, J., Ford, L., Garcia Losa, M., Gonzalez Ortiz, M., Haghighi, M., Hala, M., Iwama, T., Jajic, Z., Kerr, D., Kim, H. S., Kohne, C., Koo, B. K., Martin, B., Meinert, C., Muller, N., Myklebust, G., Neustadt, D., Omdal, R., Ozgocmen, S., Papas, A., Patrignani, P., Pelliccia, Francesco, Roy, V., Schlegelmilch, I., Umar, A., Wahlstrom, O., Wollheim, F., Yocum, S., Zhang, X. Y., Hall, E., Mcgettigan, P., Midgley, R., Moore, R. A., Philipson, R., Curtis, S., Reicin, A., Bond, J., Moore, A., Essex, M., Fabule, J., Morrison, B., Tive, L., Davies, K., and Yau, F.

Subjects
medicine.medical_specialty, Gastrointestinal Diseases, Perforation (oil well), coronary disease, Placebo, anti-inflammatory agents, non-steroidal, blood vessels, Diclofenac, vascular, Internal medicine, medicine, naproxen, Humans, Myocardial infarction, Vascular Diseases, medicine (all), Stroke, ibuprofen, anti-inflammatory, business.industry, Vascular disease, Anti-Inflammatory Agents, Non-Steroidal, General Medicine, Articles, Ibuprofen, medicine.disease, stroke, gastrointestinal, diclofenac, myocardial infarction, cyclooxygenase 2 inhibitors, Heart failure, Anesthesia, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, gastrointestinal tract, business, anti-inflammatory agents, non-steroidal, gastrointestinal diseases, humans, vascular diseases, medicine.drug
Abstract

BACKGROUND: The vascular and gastrointestinal effects of non-steroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors (coxibs) and traditional non-steroidal anti-inflammatory drugs (tNSAIDs), are not well characterised, particularly in patients at increased risk of vascular disease. We aimed to provide such information through meta-analyses of randomised trials. METHODS: We undertook meta-analyses of 280 trials of NSAIDs versus placebo (124,513 participants, 68,342 person-years) and 474 trials of one NSAID versus another NSAID (229,296 participants, 165,456 person-years). The main outcomes were major vascular events (non-fatal myocardial infarction, non-fatal stroke, or vascular death); major coronary events (non-fatal myocardial infarction or coronary death); stroke; mortality; heart failure; and upper gastrointestinal complications (perforation, obstruction, or bleed). FINDINGS: Major vascular events were increased by about a third by a coxib (rate ratio [RR] 1·37, 95% CI 1·14-1·66; p=0·0009) or diclofenac (1·41, 1·12-1·78; p=0·0036), chiefly due to an increase in major coronary events (coxibs 1·76, 1·31-2·37; p=0·0001; diclofenac 1·70, 1·19-2·41; p=0·0032). Ibuprofen also significantly increased major coronary events (2·22, 1·10-4·48; p=0·0253), but not major vascular events (1·44, 0·89-2·33). Compared with placebo, of 1000 patients allocated to a coxib or diclofenac for a year, three more had major vascular events, one of which was fatal. Naproxen did not significantly increase major vascular events (0·93, 0·69-1·27). Vascular death was increased significantly by coxibs (1·58, 99% CI 1·00-2·49; p=0·0103) and diclofenac (1·65, 0·95-2·85, p=0·0187), non-significantly by ibuprofen (1·90, 0·56-6·41; p=0·17), but not by naproxen (1·08, 0·48-2·47, p=0·80). The proportional effects on major vascular events were independent of baseline characteristics, including vascular risk. Heart failure risk was roughly doubled by all NSAIDs. All NSAID regimens increased upper gastrointestinal complications (coxibs 1·81, 1·17-2·81, p=0·0070; diclofenac 1·89, 1·16-3·09, p=0·0106; ibuprofen 3·97, 2·22-7·10, p

Published
2013

37. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD - Summary

Author

Ryden, L., Grant, P. J., Anker, S. D., Berne, C., Cosentino, Francesco, Danchin, N., Deaton, C., Escaned, J., Hammes, H. P., Huikuri, H., Marre, M., Marx, N., Mellbin, L., Ostergren, J., Patrono, C., Seferovic, P., Uva, M. S., Taskinen, M. R., Tendera, M., Tuomilehto, J., Valensi, P., Zamorano, J. L., Achenbach, S., Baumgartner, H., Bax, J. J., Bueno, H., Dean, V., Erol, C., Fagard, R., Ferrari, R., Hasdai, D., Hoes, A. W., Kirchhof, P., Knuuti, J., Kolh, P., Lancellotti, P., Linhart, A., Nihoyannopoulos, P., Piepoli, M. F., Ponikowski, P., Sirnes, P. A., Tamargo, J. L., Torbicki, A., Wijns, W., Windecker, S., De Backer, G., Ezquerra, E. A., Avogaro, A., Badimon, L., Baranova, E., Betteridge, J., Ceriello, A., Funck Brentano, C., Gulba, D. C., Kjekshus, J. K., Lev, E., Mueller, C., Neyses, L., Nilsson, P. M., Perk, J., Reiner, Z., Sattar, N., Schachinger, V., Scheen, A., Schirmer, H., Stromberg, A., Sudzhaeva, S., Viigimaa, M., Vlachopoulos, C., Xuereb, R. G., Authors/task Force Members, Committee For Practice Guidelines, E. S. C., and Reviewers, Document

Published
2013

38. Oxidative stress and plateletactivation in homozygous homocystinuria

Author

Davì G, DI MINNO, GIOVANNI, Coppola A, Cerbone AM, Madonna P, Tufano A, Falco A, Marchesani P, Ciabattoni G, Patrono C., ANDRIA, GENEROSO, Davì, G, DI MINNO, Giovanni, Coppola, A, Andria, Generoso, Cerbone, Am, Madonna, P, Tufano, A, Falco, A, Marchesani, P, Ciabattoni, G, and Patrono, C.

Subjects
homozygous homocystinuria, Oxidative stre
Published
2001

39. ANTIPLATELET AGENTS

Author

Gresele, Paolo, Born, G. V. R., Patrono, C., and Page, C. P.

Published
2012

46. ALS phenotypes with mutations in SPG11

Author

Orlacchio, A, Babalini, C, Patrono, C, Montieri, P, Varlese, Ml, Borreca, A, Moschella, V, Mercuri, Nb, Bernardi, G, and Kawarai, T

Published
2009

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