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105. Dissociation between carotid artery lesions and lipid parameters in recipients of successful kidney graft

Author

Giannarelli, R., Coppelli, A., Aragona, M., Boggi, U., Napoli, V., Donadio, F., Paleologo, G., Tregnaghi, C., Rizzo, G., Mosca, F., Del Prato, F., and Piero Marchetti

Subjects
Adult, Carotid Artery Diseases, Male, Arteriosclerosis, Cholesterol, HDL, Cholesterol, LDL, Middle Aged, Kidney Transplantation, Lipids, Body Mass Index, Carotid Arteries, Cholesterol, Cyclosporine, Humans, Female, Immunosuppressive Agents, Triglycerides, Ultrasonography
Abstract

The relationships between lipid levels and atherosclerotic lesions of carotid arteries in kidney graft recipients are still unclear.We evaluated carotid morphology in 53 recipients of functioning renal transplantation, and studied the relationship of carotid artery wall lesions with relevant clinical and laboratory risk factors for cardiovascular disease. The patients were on stable, cyclosporine-based immunosuppressive therapy.The main clinical characteristics of patients were: age, 46.5 +/- 10.1 years; males/females, 40/13; body mass index, 25.8 +/- 4.4 kg/m2; duration of transplantation, 43 +/- 52 months. Ultrasonographic scanning of carotid arteries showed the presence of lesions (intimal-media thickness and/or plaque) in 28 patients (52.8%). These recipients differed from patients without carotid lesions in terms of age (50.4 +/- 9.0 vs 42.2 +/- 9.7 years, p0.01) and duration of pre-transplant dialysis (4.6 +/- 3.4 vs 2.3 +/- 1.9 years, p0.01), whereas no statistically significant difference was observed as for total cholesterol (230 +/- 44 vs 235 +/- 35 mg/dl), LDL-cholesterol (142 +/- 32 vs 143 +/- 30 mg/dl), HDL-cholesterol (52 +/- 12 vs 58 +/- 20 mg/dl) and triglycerides (178 +/- 94 vs 167 +/- 89 mg/dl). The percentage of post-transplant diabetes was 3-fold higher in patients with carotid lesions (25 vs 8%). No difference was observed as for the following parameters: body mass index, duration of transplantation, fibrinogen levels, DDimer concentrations, reactive C-protein values, prevalence of hypertension, percentage of smokers vs non-smokers.The present study supports the view that carotid artery lesions in kidney graft recipients on stable, cyclosporine-based immunosuppressive therapy may not be related to circulating lipid values.

Published
2004

109. ESPERIENZA PISANA NEL TRAPIANTO DI PANCREAS: 1996-2004

Author

UGO BOGGI, FABIO VISTOLI, Del Chiaro, M., Pietrabissa, A., Signori, S., Vanadia Bartolo, T., Marchetti, P., Coppelli, A., Giannarelli, R., Aragona, M., Barsotti, M., Stefano Del Prato, Rizzo, G., and Mosca, F.

Published
2004

133. In Brief

Author

John A. Libertino, Santi Aragona M, Aileen Caceres, Richard A. Prinz, Frank J. Schaberg, Dennis S. Chi, Chad Wotkowicz, Thomas Ng, Emery L. Chen, and Beth A. Ryder

Subjects
medicine.medical_specialty, Frozen section procedure, Text mining, Neoplasms diagnosis, business.industry, General surgery, medicine, MEDLINE, Surgery, General Medicine, Surgical procedures, Neoplasms surgery, business
Published
2008
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139. Prognostic accuracy of an artificial neural network in patients undergoing radical cystectomy for bladder cancer: A comparison with logistic regression analysis

Author

Bassi, Pierfrancesco, Sacco, Emilio, De Marco, V., Aragona, M., Volpe, A., Bassi P. (ORCID:0000-0002-4313-8427), Sacco E. (ORCID:0000-0003-4640-8354), Bassi, Pierfrancesco, Sacco, Emilio, De Marco, V., Aragona, M., Volpe, A., Bassi P. (ORCID:0000-0002-4313-8427), and Sacco E. (ORCID:0000-0003-4640-8354)

Abstract

OBJECTIVE: To compare the prognostic performance of an artificial neural network (ANN) with that of standard logistic regression (LR), in patients undergoing radical cystectomy for bladder cancer. PATIENTS AND METHODS: From February 1982 to February 1994, 369 evaluable patients with non-metastatic bladder cancer had pelvic lymph node dissection and radical cystectomy for either stage Ta-T1 (any grade) tumour not responding to intravesical therapy, with or with no carcinoma in situ, or stage T2-T4 tumour. LR analysis based on 12 variables was used to identify predictors of overall 5-year survival, and the ANN model was developed to predict the same outcome. The LR analysis, based on statistically significant predictors, and the ANN model were the compared for their accuracy in predicting survival. RESULTS: The median age of the patients was 63 years, and overall 201 of them died. The tumour stage and nodal involvement (both P < 0.001) were the only statistically independent predictors of overall 5-year survival on LR analysis. Based on these variables, LR had a sensitivity and specificity for predicting survival of 68.4% and 82.8%, respectively; corresponding values for the ANN were 62.7% and 86.1%. For LR and ANN, the positive predictive values were 78.6% and 76.2%, and the negative predictive values were 73.9% and 76.5%, respectively. The index of diagnostic accuracy was 75.9% for LR and 76.4% for ANN. CONCLUSIONS: The ANN accurately predicted the survival of patients undergoing radical cystectomy for bladder cancer and had a prognostic performance comparable with that of LR. As ANNs are based on easy-to-use software that can identify nonlinear interactions between variables, they might become the preferred tool for predicting outcome. © 2007 The Authors.

Published
2007

142. Lymphocyte number and stress parameter modifications in untreated breast cancer patients with depressive mood and previous life stress

Author

Aragona, M., Maria Rosaria Anna Muscatello, Losi, E., Panetta, S., La Torre, F., Pastura, G., Bertolani, S., and Mesiti, M.

Subjects
Psychiatric Status Rating Scales, Catecholamines, Hydrocortisone, Depression, Humans, Breast Neoplasms, Female, Lymphocyte Count, Middle Aged, Lymphocyte Subsets, Stress, Psychological, Diuresis
Abstract

Depressive mood disorders and severe, chronic stressful life events (DSM-III-R criteria) were more frequently diagnosed in 106 breast cancer patients with respect to 37 patients with benign breast diseases (control group) (p0.001), during a stressful period such as hospital admission, diagnosis uncertainty, and when awaiting surgery. The study was performed 5 +/- 3 days before histological diagnosis had been done. Controls showed reduced 24-h diuresis and low catecholamine excretion (norepinephrine, NE; and epinephrine, E) that positively correlated with 24-h diuresis (p0.001) and CD3+ lymphocytes (p = 0.056), as during a normal stress response. In contrast, breast cancer patients showed increased 24-h diuresis (with respect to controls p0.001) and catecholamine values (p0.05). Patients' 24-h diuresis correlated positively with NE (p = 0.02) and 17-ketosteroids (p = 0.004); blood cortisol correlated positively with CD3+ (p = 0.01), CD4+ (p = 0.02), CD8+ (p0.01), CD16+ (p = 0.01) lymphocytes and negatively with E (p0.03); catecholamines correlated negatively with CD8+ (p = 0.006). These preliminary data are discussed in relation to upregulation of the adrenergic system and the different mechanisms of immune system regulation involved in breast cancer patients, compared with those in subjects with benign breast disease. The differences in these mechanisms may be a result of an imbalance of the bi-directional regulatory circuit of the psycho-neuro-endocrine-immune system, caused by previous life stress or the presence of the tumor mass.

Published
1996

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