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1. Economic evaluation alongside the Probiotics to Prevent Severe Pneumonia and Endotracheal Colonization Trial (E-PROSPECT): study protocol

Author

Katie Ross, Dimitra Fleming, John Marshall, Najib Ayas, François Lellouche, Justin Lys, Ryan Zarychanski, Timothy Karachi, Deborah J Cook, Marie-Claude Tremblay, Jeremy Grushka, Dan Deckelbaum, Kosar Khwaja, Tarek Razek, Donald Griesdale, John Muscedere, David Maslove, Roupen Hatzakorzian, Patrick Archambault, Feng Xie, François Lauzier, Heather Smith, David Williamson, Emmanuel Charbonney, John Granton, Alyson Takaoka, Kwadwo Kyeremanteng, Miranda Hunt, Ian Ball, Victoria McCredie, Michaël Chasse, Jennifer LY Tsang, Jordi Mancebo, Peter Dodek, Emilie Belley-Cote, Neala Hoad, Melissa Shears, Mark Soth, Tracy Campbell, Geeta Mehta, Daniel Chen, Shane English, Maureen Meade, John Kim, Jie Meng, Richard Johnston, Jennie Johnstone, Norman Dewhurst, Panagiota Giannakouros, Laura García, John Ma, Dev Jayaraman, Pierre Cardinal, Vincent Issac Lau, John C Marshall, John Basmaji, Deborah Cook, Erick Duan, France Clarke, Mary Copland, Marnie Jakab, Nicole Zytaruk, Christa Connolly, Denise Davis, Catherine Eaton, Tracy Gallinas, Jean Lee-Yoo, Connie Lukinuk, Leia Musielak, Nancy Pavunkovic, Joy Pelayo, Kaitlyn Phillips, Catherine Pracsovics, Julia Raimondo, Vida Stankus, Christine Wallace, Angela Wright, Crystal Young, Katrina Fimiani, Lori Hand, Harjot Jagdey, Lisa Klotz, Alexana Sabev, Nevena Savija, Deanne Cosentino, Diane Lourenco, Julie Misina, Gita Sobhi, Mashari Alghuroba, Alia Khaled, Lauren Locco, Tina Millen, Ryan Vaisler, Maya Biljan, Brittany Marriott, Jan Frieich, Jennifer Hodder, Imrana Khalid, Julie Lee, Yoon Lee, Pragma Roy, Kurtis Salway, Gyan Sandhu, Marlene Santos, Orla Smith, Melissa Wang, Ann Dowbenka, Ann Kosinski, Terri Norrie, Ranjit Parhar, Laura Parsons, Johanna Proceviat, Gitana Ramonas, Mae Yuen, Maria Agda, Victoria Alcuaz, Betty Jean Ashley, Kelsey Brewer, Janice Palmer, Glen Brown, Mara Pavan, Stephen Lapinsky, Laveena Munshi, Maedean Brown, Brittany Giacomino, Alan Kraguljac, Sumesh Shah, Erik Tamberg, Laura Vergeer, Doret Cheng, Gagan Grewal, Anew Han, Holly Leung, Ioanna Mantas, Hilary Roigues, Anew Wyllie, Alexis Turgeon, Danny Barriault, David Bellemare, Anick Boivin, Sarah-Judith Breton, Eve Cloutier, Marjorie Daigle, Charles Delisle-Thibeault, Stéphanie Grenier, Gabrielle Guilbault, Caroline Léger, Catherine Ouellet, Élisabeth Gagne, Julie Gaueau, Claire Grégoire, Véronique Labbé, Ariane Laprise-Rochette, Caroline Ouellet, Mélanie Samson, Marie-David Simoneau, Virginie Turcotte, Tuong-Vi Tran, Lauralyn McIntyre, Joe Pagilarello, Gianni D’Egidio, Mike Hartwick, Jonathon Hooper, Gwynne Jones, Dal Kubelik, Hilary Meggison, Sherissa Microys, Dave Neiliovitz, Guiseppe Pagliarello, Rakesh Patel, Jo Po, Peter Reardon, Erin Rosenberg, Aimee Sarti, Anew Seely, Shelley Acres, Brigette Gomes, Heather Langlois, Liane Leclair, Sydney Miezitis, Kaitlyn Montroy, Rebecca Porteous, Shawna Reddie, Amanda Van Beinum, Allyshia Van Tol, Irene Watpool, Wendy Aikens, Marianne Cox, Anne-Marie Dugal, Susan Fetzer, Kathy Fraser, Jennifer Kuhn, Rob MacLeod, Susanne Richard, Dawn Rose, Sherry Weir, Bill Henderson, Mypinder Sekhon, Denise Foster, Suzie Logie, Judy Yip, Margaret Herridge, s Alberto Goffi, Eyal Golan, Elizabeth Wilcox, Jaimie Archer, Paulina Farias, Brooke Fraser, Cheryl Geen-Smith, Barbara Kosky, Anea Matte, Christina Pugliese, Priscila Robles, Lia Stenyk, Cristian Urrea, Karolina Walczak, Kyung Ae, Jane Ascroft, Fatima Haji, Rajvinder Kaur, Jane Lui, Sophia Mateo, Nga Pham, Tam Pham, Matthew Suen, Jennifer Teng, Gordon Wood, Daniel Ovakim, Fiona Auld, Gayle Camey, Ralph Fleming, Jennifer Good, Mandeep Manhas, Karin Boyd, Jane Dheere, Priscilia Robles, Muhammad Walid, Jill Westlund, Yoan Lamarche, Soazig Leguillan, Karim Serri, Colin Verdant, Yanick Beaulieu, Patrick Bellemare, Philippe Bernard, Marc Giasson, Véronique Brunette, Alexanos Cavayas, Émilie Lévesque, Halina Labikova, Julia Lainer Palacios, Marie-Ève Langlois, Virginie Williams, Thuy Anh Nguyen, Valérie Phaneuf, Frédérick D’Aragon, Charles St-Arnaud, Hector Quiroz, Virginie Bolduc, Elaine Carbonneau, Joannie Marchand, Marie-Hélène Masse, Sylvie Cloutier, Marianne Guay, Line Morin, Jessie Nicolson, Isabelle Paquette, Patricia Roy, France Théberge, Arnold S Kristof, Peter Goldberg, Sheldon Magder, Jason Shahin, Salman Qureshi, Josie Campisi, Vasilica Botan, Anissa Capilnean, Alyssa Corey, Annick Gagné, Jasmine Mian, Kathleen Normandin, Ash Gursahaney, David Hornstein, Robert Salasidis, Patrizia Zanelli, Norine Alam, Tonia Doerksen, Ariane Lessard, Gilbert Matte, Marie-France Robert, Martin Girard, Pierre Aslanian, Sylvain Belisle, François-Martin Carrier, Ané Denault, Jean-Gilles Guimond, Antoine Halwagi, Paul Hébert, Christopher Kolan, Nicholas Robillard, Fatna Benettaib, Dounia Boumahni, Casey Bourdeau Caporuscio, Marie-Ève Cantin, Virginy Côté-Gravel, Ali Ghamraoui, Martine Lebrasseur, Lancelot Legene Courville, Stéphanie Lorio, Maria Trinidad Maid, Nicole Poitras, Romain Rigal, Maya Salame, Valérie Tran, Katie Bacon, Nathalie Boueau, Cecilia Carvajal, Lyne Gauthier, Julie Genon, Karine Jean, Louise Laforest, Antonietta Lembo, Sothun Lim, Jennifer Morrissette, France Pagé, Lucie Pelletier, Marie-Christine Roigue, Jim Kutsiogiannis, Raiyan Chowdhury, Jon Davidow, Curt Johnston, Kim Macala, Sam Marcushamer, Darren Markland, Doug Matheson, Damian Paton-Gay, David Zygun, Nadine Grant, Tayne Hewer, Pat Thompson, Maggie Ge, Janny Hall, Sharon Matenchuk, Osama Loubani, Rick Hall, Robert Green, Diana Gillis, Lisa Julien, Laura Lee Magennis, Tamara Mitterer, Joanna Arsenault, Kim Bruce-Payne, Patti Gallant, Gord Boyd, Christine D’Arsigny, John Over, Jason Erb, Chris Parker, Stephanie Sibley, Tracy Boyd, Ilinca Georgescu, Danielle Muscedere, Cathy Baker, Jennifer Engel, Jennifer Fleming, Lisa Roderick, Shelley Silk, Marcy Spencer, Michelle Tryon, Marcus Blouw, Kendiss Olafson, Bojan Paunovic, Oliver Gutieror, Nicole Marten, Sherri Lynn Wingfield, Marnie Boyle, Halyna Ferens, Debbie Hrabi, Beata Kozak, Chantal MacDonald, Julie Muise, Eileen Campbell, Susie Imerovski, Athena Ovsenek, Rebecca Rondinelli, Teresa Longfield, Amy Moyer, Faith Norris, Janice Sumpton, Karina Teterycz, Brenda Reeve, Karen Bento, Megan Davis, Will Dechert, Krista Gallo, Barbara Longo, Courtney Mullen, Elysia Skrzypek, Laurenne Wierenga, Wesam Abuzaiter, Lynda Amorim, Rosemarie Bauer, Rachel Damota, Thoa Ho, Nicole Macdougall, Mary Thornewell, Lara Pe, Jennifer Visocchi, Auey Bhairo, Halyna Ferenes, Debra Kubin, Dawn-Lee McLaughlin, Maria Valente, Steve Reynolds, Suzette Willems, Tina Sekhon, Sebastien Trop, Alexana Binnie, Ronald Heslegrave, Kim Sharman, Zaynab Panchbhaya, Rakhi Goel, Kim Kozluk, Julianne Labelle, Hina Marsonia, Cecillia Scott, Dave Nagpal, Tracey Bentall, Jessica Sturt-Smith, Michelle Alexander, Tammy Ellis, Mindy Muylaert, Cindy Paczkowski, Wendy Sligl, Sean Bagshaw, Nadia Baig, Lorena McCoshen, Katrina Alexanopoulos, Sherri Bain, Michelle Brandt, Cathy Constable, Kari Douglas, Shaleen Maharaj, Sabrina Travers, Tom Stelfox, Philippe Couillard, Christopher Doig, Ken Parhar, Joshua Booth, Cassidy Codan, Stacy Ruddell, Candice Cameron, Rhonda Edison, Anne Martin, Breanna Mina, Dan Niven, Luc Berthiaume, Jonathan Gaudet, Gina Fleming, Mercedes Carmargo, Beverly Hoekstra, Rita Caporuscio, Rachel Kressner Falvo, Carmelina Maxwell, Karmen Plantic, François Marquis, Han Tin Wang, Francis Toupin, Stephane Ahern, Brian Laufer, Marc Brosseau, Pauline Dul, Johanne Harvey, Lotthida Inthanavong, Danae Tassy, Helen Assayag, Maude Bachand, Marysa Betournay, Karine Daoust, Kristine Goyette, Marceline Quach, Paul Hosek, Bill Plaxton, Catherine Armstrong, Rhonda Barber, William Dechert, Janelle Ellis, Kayla Fisk, Melissa Gabnouri, Emilie Gordon, Rebecca Haegens, Lisa Halford, Brooklynn Hillis, Rebecca Jesso, Jenn McLaren, Elliot McMillan, Mariska Pelkmans, Matthew Rekman, Sylvia Sinkovitis, Monica Truong, Michelle White, Noah Bates, Susan Bryden-Cromwell, Lisa Cha, Colleen Cameron, Aminah Deen, Sheri DiGiovanni, Anders Foss, Esther Lee, Heidi MacGregor, Esther Galbraith, Robyn McArthur, Julie McGregor, Keith Miller, Sharon Morris, Shelley Parker, Candice Smith, Joanna Stoglow, Jennifer Tung, Melissa Vos, Neill Adhikari, Ane Amaral, Ane Carlos, Brian Cuthbertson, Rob Fowler, Damon Scales, Navjot Kaur, Nicole Marinoff, Adic Perez, Jane Wang, Katrina Hatzifilalithis, John Iazzetta, Chrys Kolos, Ingrid Quinton, Paul Lysecki, Joseph Berlingieri, Sameer Shaikh, Steven Skitch, Hala Basheer, Kathy Bruder, Jane Cheng, Kaiser Qureshi, Celeste Thibault, Ying Tung Sia, Mathieu Simon, Pierre-Alexane Bouchard, Patricia Lizotte, Nathalie Chateauvert, Thérèse Grenier, Jean-François Bellemare, Simon Bordeleau, Christine Ouin, Benoît Duhaime, Ann Laberge, Philippe Lachance, Mélanie Constantin, Estel Deblois, Maude Dionne, Lise Lavoie, Isabelle Michel, Alexane Pépin, Sanine Poulin, Sarah Anctil, Amélie Chouinard, Louis-Étienne Marchand, Robin Roy, Roigo Cartin-Ceba, Richard Oeckler, Brenda Anderson, Lavonne Liedl, Laurie Meade, Sueanne Weist, Anna Bartoo, Debbie Bauer, Vince Brickley, Shaun Bridges, Greg Brunn, Jennifer Eickstaedt, Jill Randolph, Sandy Showalter, Melissa Wendling, Robert Taylor, Margaret Cytron, Kim Fowler, Katie Krause, Jackie O’Brien, Marianne Tow, Kaitlin Stassi, Abdulaziz Al-Dawood, Haytham Tlayjeh, Alaaeldien Ghanem, Ahmad Hassanien, Mohamed Hegazy, Ashraf El Sharkawi, Felwa Bin Humaid, Hala Alanizi, Nadyah Alanizy, Njoud Al Bogami, Mohammed Muhaidib, Jawaher Gramish, Randa Alsomali, Nora Devera, and Marjane Villafranca

Subjects
Medicine
Abstract

Introduction Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in the intensive care unit (ICU). Probiotics are defined as live microorganisms that may confer health benefits when ingested. Prior randomised trials suggest that probiotics may prevent infections such as VAP and Clostridioides difficile–associated diarrhoea (CDAD). PROSPECT (Probiotics to Prevent Severe Pneumonia and Endotracheal Colonization Trial) is a multicentre, double-blinded, randomised controlled trial comparing the efficacy of the probiotic Lactobacillus rhamnosus GG with usual care versus usual care without probiotics in preventing VAP and other clinically important outcomes in critically ill patients admitted to the ICU.Methods and analysis The objective of E-PROSPECT is to determine the incremental cost-effectiveness of L. rhamnosus GG plus usual care versus usual care without probiotics in critically ill patients. E-PROSPECT will be performed from the public healthcare payer’s perspective over a time horizon from ICU admission to hospital discharge.We will determine probabilities of in-ICU and in-hospital events from all patients alongside PROSPECT. We will retrieve unit costs for each resource use item using jurisdiction-specific public databases, supplemented by individual site unit costs if such databases are unavailable. Direct costs will include medications, personnel costs, radiology/laboratory testing, operative/non-operative procedures and per-day hospital ‘hoteling’ costs not otherwise encompassed. The primary outcome is the incremental cost per VAP prevented between the two treatment groups. Other clinical events such as CDAD, antibiotic-associated diarrhoea and in-hospital mortality will be included as secondary outcomes. We will perform pre-specified subgroup analyses (medical/surgical/trauma; age; frailty status; antibiotic use; prevalent vs no prevalent pneumonia) and probabilistic sensitivity analyses for VAP, then generate confidence intervals using the non-parametric bootstrapping approach.Ethics and dissemination Study approval for E-PROSPECT was granted by the Hamilton Integrated Research Ethics Board of McMaster University on 29 July 2019. Informed consent was obtained from the patient or substitute decision-maker in PROSPECT. The findings of this study will be published in peer-reviewed journals.Trial registration number NCT01782755; Pre-results.

Published
2020
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2. Stomach and duodenum dose–volume constraints for locally advanced pancreatic cancer patients treated in 15 fractions in combination with chemotherapy

Author

Sara Broggi, Paolo Passoni, Paolo Tiberio, Alessandro Cicchetti, Giovanni Mauro Cattaneo, Barbara Longobardi, Martina Mori, Michele Reni, Najla Slim, Antonella Del Vecchio, Nadia G. Di Muzio, and Claudio Fiorino

Subjects
pancreatic cancer, radiotherapy, gastric toxicity, duodenum, dose-volume effects, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

PurposeTo assess dosimetry predictors of gastric and duodenal toxicities for locally advanced pancreatic cancer (LAPC) patients treated with chemo-radiotherapy in 15 fractions.MethodsData from 204 LAPC patients treated with induction+concurrent chemotherapy and radiotherapy (44.25 Gy in 15 fractions) were available. Forty-three patients received a simultaneous integrated boost of 48–58 Gy. Gastric/duodenal Common Terminology Criteria for Adverse Events v. 5 (CTCAEv5) Grade ≥2 toxicities were analyzed. Absolute/% duodenal and stomach dose–volume histograms (DVHs) of patients with/without toxicities were compared: the most predictive DVH points were identified, and their association with toxicity was tested in univariate and multivariate logistic regressions together with near-maximum dose (D0.03) and selected clinical variables.ResultsToxicity occurred in 18 patients: 3 duodenal (ulcer and duodenitis) and 10 gastric (ulcer and stomatitis); 5/18 experienced both. At univariate analysis, V44cc (duodenum: p = 0.02, OR = 1.07; stomach: p = 0.01, OR = 1.12) and D0.03 (p = 0.07, OR = 1.19; p = 0.008, OR = 1.12) were found to be the most predictive parameters. Stomach/duodenum V44Gy and stomach D0.03 were confirmed at multivariate analysis and found to be sufficiently robust at internal, bootstrap-based validation; the results regarding duodenum D0.03 were less robust. No clinical variables or %DVH was significantly associated with toxicity. The best duodenum cutoff values were V44Gy < 9.1 cc (and D0.03 < 47.6 Gy); concerning the stomach, they were V44Gy < 2 cc and D0.03 < 45 Gy. The identified predictors showed a high negative predictive value (>94%).ConclusionIn a large cohort treated with hypofractionated radiotherapy for LAPC, the risk of duodenal/gastric toxicities was associated with duodenum/stomach DVH. Constraining duodenum V44Gy < 9.1 cc, stomach V44Gy < 2 cc, and stomach D0.03 < 45 Gy should keep the toxicity rate at approximately or below 5%. The association with duodenum D0.03 was not sufficiently robust due to the limited number of events, although results suggest that a limit of 45–46 Gy should be safe.

Published
2023
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3. Long-term treatment with the ace inhibitor captopril, alone or in combination with hydrochlorothiazide, in elderly hypertensives: Effects on blood pressure and quality of life

Author

Barbara Longo, Maurizio Liquori, M. G. Abrignani, Salvatore Novo, and Strano A

Subjects
Pharmacology, medicine.medical_specialty, biology, business.industry, Urology, Hemodynamics, Angiotensin-converting enzyme, Captopril, Endocrinology, Blood pressure, Hydrochlorothiazide, Tolerability, Internal medicine, ACE inhibitor, medicine, biology.protein, Pharmacology (medical), business, Thiazide, medicine.drug
Abstract

The efficacy and tolerability of long-term treatment with the angiotensin converting enzyme inhibitor captopril was evaluated in elderly hypertensive subjects. One hundred thirty patients were studied (61 men and 69 women; mean age, 68.33 ± 5.49 years), all with mild to moderate arterial hypertension (mild = 90–105 mmHg; moderate = 105–115 mmHg). Patients with secondary hypertension were excluded from the study. After a 2-week drug washout, patients were given captopril 25 to 100 mg/day alone or in combination with hydrochlorothiazide (HCTZ) 25 mg/day for 15 weeks. After 2 weeks of treatment, significant decreases in systolic and diastolic blood pressures were observed (P

Published
1993
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4. [Results of a study on formaldehyde pollution as a cause of discomfort in public sector office workers]

Author

Lidia, Proietti, Rosalba, Fantauzzo, Stefania, Gulino, Maurizio, Trizzino, Barbara, Longo, and Domenica, Duscio

Subjects
Occupational Diseases, Public Sector, Italy, Air Pollution, Indoor, Formaldehyde, Humans
Abstract

Medical surveillance of Catania public sector employees who use video display terminals (VDTs) revealed complaints of eye and upper respiratory tract irritation, skin rash, headache, mental fatigue and reduced concentration in some of the workers. These were employed in three recently renovated offices and showed the above symptoms while at work. Investigations were performed to verify whether contaminants that may cause the above symptoms were present in the indoor air. In particular, levels of formaldehyde and CO2 were continuously monitored. CO2 levels were found to be higher in offices open to the general public as compared to other offices (including the three renovated ones). However, CO2 levels were never above 1,000 ppm. Formaldehyde was found in the indoor air of all three renovated offices in approximately equal concentrations, ranging from a minimum of 0,07 - 0,09 ppm to a maximum of 0,3 -0,4 ppm. In addition, a strong pungent odor typical of this substance was present in all three renovated offices but not in the others. Formaldehyde pollution must always be considered and assessed whenever new furnishings that may have required the use of glues that emit formaldehyde are brought into an indoor environment.

Published
2004

5. [Viral hepatitis B among the health care workers. Experience at a health facility in Eastern Sicily]

Author

Lidia, Proietti, Rosalba, Fantauzzo, Barbara, Longo, Mario, Malaguarnera, Maurizio, Trizzino, and Domenica, Duscio

Subjects
Adult, Occupational Diseases, Italy, Risk Factors, Health Personnel, Prevalence, Humans, Hepatitis B
Abstract

to estimate the prevalence of HBV positivity considering the qualifications of workers exposed to biological risk in a hospital in Eastern Sicily.1800 people exposed to biological risk: surgeons, physicians, laboratory workers, rehabilitation therapists, midwives, biologists and technicians underwent a test for HBV.25 workers resulted positive to HBsAg, that is 1.3 % of the total population examined; the professional categories mostly resulting positive were the auxiliaries with a 2% prevalence, and professional nurses with 1.5%, followed by surgeons resulting 1% positive. In the positive group of HBsAg, 16 workers, equal to 64%, were also positive to the viral replication test. Regarding the antibody coverage, the distribution among workers evidenced that 30.4% of the nurses was vaccinated, against 15% of the surgeons and 11.7% of the physicians. 6.4% of the total population studied had a natural immunity, with an absolute prevalence in the auxiliary group-OTA: 9.3%, followed by the professional nurses with a 7.8% positivity.it is shown that the health care workers do not have a sufficient perception of the biological risk, so it is necessary to adopt new strategies to promote the vaccination and increase formation activities and general information.

Published
2004

6. Impact of molecular subtype on 1325 early-stage breast cancer patients homogeneously treated with hypofractionated radiotherapy without boost: Should the indications for radiotherapy be more personalized?

Author

Andrei Fodor, Chiara Brombin, Paola Mangili, Fulvio Borroni, Marcella Pasetti, Roberta Tummineri, Flavia Zerbetto, Barbara Longobardi, Lucia Perna, Italo Dell’Oca, Chiara L. Deantoni, Aniko M. Deli, Anna Chiara, Sara Broggi, Roberta Castriconi, Pier Giorgio Esposito, Najla Slim, Paolo Passoni, Simone Baroni, Stefano L. Villa, Paola M.V. Rancoita, Claudio Fiorino, Antonella Del Vecchio, Giampaolo Bianchini, Oreste D. Gentilini, Mariaclelia S. Di Serio, and N.G. Di Muzio

Subjects
Early stage breast cancer, Breast cancer conservative treatment, Hypofractionated whole breast radiotherapy, Tumor bed boost, Breast cancer molecular subtypes, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Aim: We report molecular subtype impact on 1325 early breast cancer (BCa) patients treated with whole breast hypofractionated (WBH) adjuvant forward-planned intensity modulated radiotherapy (F-IMRT) without boost. Methods and materials: From 02/2009-05/2017 1325 patients with pTis-pT3, pNx-N1aM0 BCa who underwent breast conservation surgery were treated with WBHF-IMRT in our institute, to a total dose of 40 Gy/15 fractions, without boost. Median age: 62 (interquartile range-IQR-:51.14–70.53) years. Histology: 8% in situ carcinoma (ISC), 92% invasive tumors. Molecular subtypes (invasive tumors): 49.9% Luminal A, 33.1% Luminal B Her2 negative (−), 6.2% Luminal B Her2 positive (+), 3.6% Hormone Receptor (HR)- Her2+, 7.1% Triple negative (TNBC), and 0.2% HR+. Chemotherapy (CT) was prescribed in 28% of patients, hormonal therapy in 80.3%, monoclonal antibodies (MAb) in 86.8% of Luminal B Her2+ and 97.7% of HR- Her2+ patients. Results: Median follow up was 72.43 (IQR: 44.63–104.13) months. The 5-year Kaplan-Meier estimates of local relapse-free survival (LRFS) was 97.8%, regional-(RRFS) 98.6%, loco-regional- (LRRFS) 96.9%, distant- (DRFS) 96.6%, disease-free survival (DFS) 94.8% and overall survival (OS) 95.5%. Considering molecular subtypes, 5-year LRFS was: 99.8% for Luminal A, 96.7% for Luminal B Her2-, 94.1% for Luminal B Her2+, 87.9% for HR- Her2+, 95.1% for TNBC and 99.1% for in situ carcinoma. Conclusion: While the overall estimated probability of LR within 5 years after WBHF-IMRT without boost is good (2.2%), molecular subtypes have a strong impact, despite MAb therapy in Her2+ patients, and CT for TNBC patients, and could be used as a parameter in deciding the boost prescription.

Published
2021
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7. Increased prevalence of cardiac arrhythmias and transient episodes of myocardial ischemia in hypertensives with left ventricular hypertrophy but without clinical history of coronary heart disease

Author

Mario Barbagallo, M. G. Abrignani, Antonino Mistretta, Salvatore Novo, Strano A, Emilio Nardi, Barbara Longo, and Giuseppe Di Maria

Subjects
Adult, Male, medicine.medical_specialty, Ambulatory blood pressure, Heart disease, Premature atrial contraction, Myocardial Ischemia, Blood Pressure, Coronary Disease, Ventricular tachycardia, Left ventricular hypertrophy, Electrocardiography, Heart Rate, Internal medicine, Heart rate, Internal Medicine, medicine, Humans, cardiovascular diseases, Aged, business.industry, Arrhythmias, Cardiac, Blood Pressure Monitoring, Ambulatory, Middle Aged, medicine.disease, Echocardiography, Doppler, Circadian Rhythm, Blood pressure, Hypertension, cardiovascular system, Cardiology, Female, Hypertrophy, Left Ventricular, Supraventricular tachycardia, business
Abstract

To evaluate the behavior of cardiac arrhythmias (CA) and transient episodes of myocardial ischemia (TEMI), in relation to the circadian pattern of blood pressure in patients suffering from arterial hypertension, with or without echocardiographically ascertained left ventricular hypertrophy (LVH), we studied 128 patients, 87 men (M) and 41 women (F), aging from 21 to 76 years, subdivided into two groups: Group I, including 66 patients with LVH (45 M and 21 F; mean age of 53.7 ± 9.1 years; Group II, including 62 patients without LVH ( 42 M and 20 F; mean age of 49.7 ± 9.5 years). Office blood pressure (OBP) as well as nighttime ambulatory blood pressure (ABP) were higher in patients with LVH (P < .05 and P < .01). CA were present in a higher number of patients of Group I (P < .001): premature supraventricular beats (PSVB) 22.7 v 4.8%, supraventricular couplets (SVC) 36.4 v 16.1%, supraventricular tachycardia runs (SVT runs) 27.3 v 12.9%, ventricular ectopic beats (VEB) 25.6 v 8.0%, ventricular couplets (VC) 30.3 v 12.9%, ventricular tachycardia runs (VT runs) 12.1 v 3.2%. The absolute number of ectopic beats was also significantly higher in patients of Group I. Ventricular arrhythmias were significantly related to ASBP (r = 0.83, P < .01), to ADBP (r = 0.74, P < .01) and to heart rate (r = 0.87, P < .01) in patients of Group I. TEMI were more frequent in patients of Group I (73 v 41 episodes, 39.39% v 25.8% of patients, P < .01) and were related to ABP peaks. In fact, in both groups of patients all TEMI without heart rate increase and most TEMI with heart rate increase were registered between 6:00 and midnight, hours in which ABP values were higher. We conclude that hypertensives with LVH, but without clinical history of coronary heart disease, have a higher prevalence of ventricular arrhythmias and of transient episodes of myocardial ischemia in relation to the circadian pattern of ABP.

Published
1997

8. Replacing Manual Planning of Whole Breast Irradiation With Knowledge-Based Automatic Optimization by Virtual Tangential-Fields Arc Therapy

Author

Roberta Castriconi, Pier Giorgio Esposito, Alessia Tudda, Paola Mangili, Sara Broggi, Andrei Fodor, Chiara L. Deantoni, Barbara Longobardi, Marcella Pasetti, Lucia Perna, Antonella del Vecchio, Nadia Gisella Di Muzio, and Claudio Fiorino

Subjects
breast cancer, radiation oncology, automation, plan optimization, tangential field, knowledge-based, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

PurposeTo implement Knowledge Based (KB) automatic planning for right and left-sided whole breast treatment through a new volumetric technique (ViTAT, Virtual Tangential-fields Arc Therapy) mimicking conventional tangential fields (TF) irradiation.Materials and MethodA total of 193 clinical plans delivering TF with wedged or field-in-field beams were selected to train two KB-models for right(R) and left(L) sided breast cancer patients using the RapidPlan (RP) tool implemented in the Varian Eclipse system. Then, a template for ViTAT optimization, incorporating individual KB-optimized constraints, was interactively fine-tuned. ViTAT plans consisted of four arcs (6 MV) with start/stop angles consistent with the TF geometry variability within our population; the delivery was completely blocked along the arcs, apart from the first and last 20° of rotation for each arc. Optimized fine-tuned KB templates for automatic plan optimization were generated. Validation tests were performed on 60 new patients equally divided in R and L breast treatment: KB automatic ViTAT-plans (KB-ViTAT) were compared against the original TF plans in terms of OARs/PTVs dose-volume parameters. Wilcoxon-tests were used to assess the statistically significant differences.ResultsKB models were successfully generated for both L and R sides. Overall, 1(3%) and 7(23%) out of 30 automatic KB-ViTAT plans were unacceptable compared to TF for R and L side, respectively. After the manual refinement of the start/stop angles, KB-ViTAT plans well fitted TF-performances for these patients as well. PTV coverage was comparable, while PTV D1% was improved with KB-ViTAT by R:0.4/L:0.2 Gy (p < 0.05); ipsilateral OARs Dmean were similar with a slight (i.e., few % volume) improvement/worsening in the 15–35 Gy/2–15 Gy range, respectively. KB-ViTAT better spared contralateral OARs: Dmean of contralateral OARs was 0.1 Gy lower (p < 0.05); integral dose was R:5%/L:8% lower (p < 0.05) than TF. The overall time for the automatic plan optimization and final dose calculation was 12 ± 2 minutes.ConclusionsFully automatic KB-optimization of ViTAT can efficiently replace manually optimized TF planning for whole breast irradiation. This approach was clinically implemented in our institute and may be suggested as a large-scale strategy for efficiently replacing manual planning with large sparing of time, elimination of inter-planner variability and of, seldomly occurring, sub-optimal manual plans.

Published
2021
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10. Effects of chronic antihypertensive treatment on left ventricular mass (LVM), ventricular arrhythmias (VA) abd transient episodes of myocardial ischemia (TEI) in hypertensive patients

Author

A. Strano, Emilio Nardi, Maurizio Giuseppe Abrignani, G. Pavone, I. Parrino, Geraci Am, Novo S, and Barbara Longo

Subjects
Pharmacology, Left ventricular mass, medicine.medical_specialty, Myocardial ischemia, business.industry, Internal medicine, Anesthesia, Cardiology, Electrocardiography in myocardial infarction, Medicine, business
Published
1995
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11. Noninvasive blood pressure monitoring evaluation of verapamil slow-release 240-mg antihypertensive effectiveness

Author

Maurizio Giuseppe Abrignani, Salvatore Novo, Gaetano Alaimo, Giuseppe Muratore, Strano A, and Barbara Longo

Subjects
Male, Time Factors, Blood Pressure, Placebo, Essential hypertension, Heart Rate, Heart rate, medicine, Humans, Circadian rhythm, Monitoring, Physiologic, Pharmacology, business.industry, Washout, Blood Pressure Determination, Middle Aged, medicine.disease, Circadian Rhythm, Blood pressure, Verapamil, Evaluation Studies as Topic, Delayed-Action Preparations, Anesthesia, Hypertension, Ambulatory, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

The aim of our study was to evaluate the antihypertensive effectiveness of verapamil slow-release (SR), administered once a day. We studied 11 patients, 7 male and 4 female, with an average age of 53.6 +/- 12.86 years, who had essential hypertension. After a drug washout period of at least 15 days, placebo was administered (one tablet per day), and then patients received verapamil SR 240 mg/day at 8:00 a.m. for at least 2 weeks. At the end of the washout, placebo, and active drug treatment periods we performed ambulatory intermittent blood pressure monitoring for 24 h using a Squibb Spacelabs pressurometer. After verapamil treatment, in comparison to placebo, a significant reduction of systolic (SBP) and diastolic blood pressure (DBP) (154.91 +/- 13.34/94.29 +/- 9.48 vs. 143.73 +/- 11.39/84.6 +/- 7.99 mm Hg; p less than 0.005), was observed without significant changes of the circadian blood pressure pattern. Moreover, we observed a significant reduction of SBP and DBP variability mainly during daytime, whereas this behavior was not evident for heart rate. In conclusion, verapamil SR seems useful to obtain a constant and significant reduction of 24-h blood pressure values with a significant reduction of SBP and DBP variability.

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