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1. Acute Pupillary Disorders in Children: A 10-Year Retrospective Study of 101 Patients

Author

Giacomo Garone, Marco Roversi, Mara Pisani, Francesco La Penna, Antonio Musolino, Sebastian Cristaldi, Anna Maria Musolino, Amanda Roberto, Gianni Petrocelli, Antonino Reale, Fabio Midulla, Alberto Villani, and Umberto Raucci

Subjects
pupillary motility, mydriasis, miosis, children, pediatrics, Pediatrics, RJ1-570
Abstract

Background: To date, no study has specifically examined children with acute-onset pupillary motility disorders (APMD). Especially in the Emergency Department (ED), it is crucial to distinguish benign and transient conditions from life-threatening or urgent conditions (UCs). The aim of the study is to describe the clinical characteristics of children with APMD and their association with an increased risk of UCs. Methods: We conducted a pediatric retrospective study of APMD referred to ED over a 10-year period. We described the characteristics in the overall sample and in two subgroups divided according to urgency of the underlying condition. Furthermore, we applied a logistic regression model to identify the variables predictive of LT condition. Results: We analyzed 101 patients. In 59.4%, the APMD was isolated. In patients with extra-ocular involvement, the most frequently associated features were altered consciousness, headache, and vomiting. Exposure to toxic agents was reported in 48.5%. Urgent conditions occurred significantly more frequently in older children, presenting bilateral APMD and/or other ocular or extra-ocular manifestations. Conclusions: Our study shows that UCs most commonly occur in patients presenting with bilateral APMD and other associated features. In unilateral/isolated APMD ophthalmological examination, exclusion of toxic exposure and observation until resolution of symptoms should be recommended.

Published
2023
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2. Lenalidomide for myelodysplastic syndromes with del(5q): how long should it last?

Author

Federico Vozella, Roberto Latagliata, Ida Carmosino, Paola Volpicelli, Chiara Montagna, Angela Romano, Amanda Roberto, Paola Finsinger, Marco Mancini, Massimo Breccia, Esther Oliva, and Giuliana Alimena

Subjects
Oncology, Cancer Research, medicine.medical_specialty, business.industry, Myelodysplastic syndromes, Hematology, General Medicine, Pharmacology, medicine.disease, Cytogenetic Response, Discontinuation, Internal medicine, Cohort, medicine, In patient, medicine.symptom, business, Bone pain, Complete Hematologic Response, Lenalidomide, medicine.drug
Abstract

Lenalidomide induces in patients with myelodysplastic syndrome (MDS) and del(5q) erythroid and cytogenetic response rates as high as 75% and 50%, respectively. It is still unclear, however, how long lenalidomide treatment should be continued and whether or not the drug could be interrupted. To assess the feasibility of lenalidomide discontinuation, we revised a cohort of 16 low-risk MDS patients with del(5q) treated at our institute in a phase II multicentric Italian study. Among the 12 responding patients, four discontinued lenalidomide while in complete response. All four patients needed during treatment a permanent lenalidomide reduction from 10 to 5 mg/day because of haematological toxicity (three patients) or grade 3 muscular and bone pain (one patient). At lenalidomide discontinuation after 16, 20, 27 and 20 months from the start, respectively, all four patients were in complete hematologic response and three forth in complete cytogenetic response. Three patients are still in response after 36, 30 and 20 months from lenalidomide discontinuation, respectively: The remaining patient relapsed after 20 months, and she is now receiving a new course of lenalidomide. In conclusion, long-lasting remissions are achievable in MDS patients with del(5q) in complete response after lenalidomide discontinuation. Copyright © 2014 John Wiley & Sons, Ltd.

Published
2014

3. Lenalidomide for myelodysplastic syndromes with del(5q): how long should it last?

Author

Federico, Vozella, Roberto, Latagliata, Ida, Carmosino, Paola, Volpicelli, Chiara, Montagna, Angela, Romano, Amanda, Roberto, Paola, Finsinger, Marco, Mancini, Massimo, Breccia, and Esther, Oliva

Subjects
Time Factors, Remission Induction, Pain, Angiogenesis Inhibitors, Middle Aged, Hematologic Diseases, Thalidomide, Treatment Outcome, Myelodysplastic Syndromes, Chromosomes, Human, Pair 5, Humans, Female, Chromosome Deletion, Lenalidomide, Aged
Abstract

Lenalidomide induces in patients with myelodysplastic syndrome (MDS) and del(5q) erythroid and cytogenetic response rates as high as 75% and 50%, respectively. It is still unclear, however, how long lenalidomide treatment should be continued and whether or not the drug could be interrupted. To assess the feasibility of lenalidomide discontinuation, we revised a cohort of 16 low-risk MDS patients with del(5q) treated at our institute in a phase II multicentric Italian study. Among the 12 responding patients, four discontinued lenalidomide while in complete response. All four patients needed during treatment a permanent lenalidomide reduction from 10 to 5 mg/day because of haematological toxicity (three patients) or grade 3 muscular and bone pain (one patient). At lenalidomide discontinuation after 16, 20, 27 and 20 months from the start, respectively, all four patients were in complete hematologic response and three forth in complete cytogenetic response. Three patients are still in response after 36, 30 and 20 months from lenalidomide discontinuation, respectively: The remaining patient relapsed after 20 months, and she is now receiving a new course of lenalidomide. In conclusion, long-lasting remissions are achievable in MDS patients with del(5q) in complete response after lenalidomide discontinuation.

Published
2015

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