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3. Atazanavir and darunavir in pregnant women with HIV: evaluation of laboratory and clinical outcomes from an observational national study

Author

Floridia, M., Masuelli, G., Ravizza, M., Tassis, B., Cetin, I., Sansone, M., Antoni, A. D., Simonazzi, G., Maccabruni, A., Francisci, D., Frisina, V., Liuzzi, G., Dalzero, S., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., S. Mercurio V., Zanaboni, D., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A. M. D., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Bordonivicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Crupano, F. M., Calabretti, D., Cervi, F., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G. C., Genovese, O., Cafforio, C., Pinnetti, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Parazzini, F., Vella, S., Floridia, M., Masuelli, G., Ravizza, M., Tassis, B., Cetin, I., Sansone, M., Antoni, A. Degli, Simonazzi, G., Maccabruni, A., Francisci, D., Frisina, V., Liuzzi, G., Dalzero, S., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., S.Mercurio, V., Zanaboni, D., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A.M. Degli, Molinari, A., Crisalli, M.P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., BordoniVicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Crupano, F.M., Calabretti, D., Cervi, F., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G.C., Genovese, O., Cafforio, C., Pinnetti, C., Casadei, A.M., Cavaliere, A.F., Cellini, M., Marconi, A.M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M.F., Amici, R., Galluzzo, C.M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Parazzini, F., and Vella, S.

Subjects
Male, 0301 basic medicine, medicine.medical_treatment, HIV Infections, 0302 clinical medicine, Pregnancy, Pharmacology (medical), 030212 general & internal medicine, Pregnancy Complications, Infectious, Darunavir, medicine.diagnostic_test, Obstetrics, Pregnancy Outcome, virus diseases, Alanine Transaminase, Viral Load, Cholesterol, Treatment Outcome, Infectious Diseases, Premature birth, Gestation, Female, Drugs in pregnancy, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, Anti-HIV Agents, Atazanavir Sulfate, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, pharmacology, pharmacology (medical), infectious diseases, medicine, Humans, Caesarean section, Triglycerides, Pharmacology, business.industry, Infant, Newborn, Infant, Bilirubin, medicine.disease, 030112 virology, Atazanavir, azatanavir sulfate, Lipid profile, business
Abstract

Background Atazanavir and darunavir represent the main HIV PIs recommended in pregnancy, but comparative data in pregnant women are limited. We assessed the safety and activity profile of these two drugs in pregnancy using data from a national observational study. Methods Women with atazanavir or darunavir exposure in pregnancy were evaluated for laboratory measures and main pregnancy outcomes (e.g. preterm delivery, low birthweight, non-elective caesarean section and neonatal gestational age-adjusted birthweight Z-score). Results Final analysis included 500 pregnancies with either atazanavir (n = 409) or darunavir (n = 91) exposure. No differences in pregnancy outcomes, weight gain in pregnancy, drug discontinuations, undetectable HIV-RNA, haemoglobin, ALT, total cholesterol, HDL cholesterol and LDL cholesterol were observed between the two groups. At third trimester, exposure to darunavir was associated with higher levels of plasma triglycerides (median 235.5 versus 179 mg/dL; P = 0.032) and a higher total cholesterol/HDL cholesterol ratio (median 4.03 versus 3.27; P = 0.028) and exposure to atazanavir was associated with higher levels of plasma bilirubin (1.54 versus 0.32 mg/dL; P

Published
2017
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4. Amniocentesis and chorionic villus sampling in HIV-infected pregnant women: a multicentre case series

Author

Floridia M, Masuelli G, Meloni A, Cetin I, Tamburrini E, Cavaliere AF, Dalzero S, Sansone M, Alberico S, Guerra B, Spinillo A, Chiadò Fiorio Tin M, Ravizza M, Mori F, Ortolani P, Dalle Nogare ER, Di Lorenzo F, Sterrantino G, Meli M, Polemi S, Nocentini J, Baldini M, Montorzi G, Mazzetti M, Rogasi P, Borchi B, Vichi F, Del Pin B, Pinter E, Anzalone E, Marocco R, Mastroianni C, Mercurio VS, Carocci A, Grilli E, Maccabruni A, Zaramella M, Mariani B, Natalini Raponi G, Guaraldi G, Nardini G, Stentarelli C, Beghetto B, Degli Antoni AM, Molinari A, Crisalli MP, Donisi A, Piepoli M, Cerri V, Zuccotti G, Giacomet V, Coletto S, Di Nello F, Madia C, Placido G, Vivarelli A, Castelli P, Savalli F, Portelli V, Sabbatini F, Francisci D, Bernini L, Grossi P, Rizzi L, Maso G, Airoud M, Soppelsa G, Dedoni M, Cuboni C, Ortu F, Piano P, Citernesi A, Bordoni Vicini I, Luzi K, Roccio M, Vimercati A, Miccolis A, De Gennaro A, Cervi F, Simonazzi G, Margarito E, Capretti MG, Marsico C, Faldella G, Martinelli P, Agangi A, Capone A, Maruotti GM, Tibaldi C, Trentini L, Todros T, Frisina V, Brambilla T, Savasi V, Personeni C, Giaquinto C, Fiscon M, Rubino E, Bucceri A, Matrone R, Scaravelli G, Genovese O, Cafforio C, Pinnetti C, Liuzzi G, Tozzi V, Massetti P, Casadei AM, Cellini M, Castelli Gattinara G, Marconi AM, Sacchi V, Ierardi M, Polizzi C, Mattei A, Pirillo MF, Amici R, Galluzzo CM, Donnini S, Baroncelli S, Villani P, Cusato M, Cerioli A, De Martino M, Mastroiacovo P, Parazzini F, Vella S., Floridia M, Masuelli G, Meloni A, Cetin I, Tamburrini E, Cavaliere AF, Dalzero S, Sansone M, Alberico S, Guerra B, Spinillo A, Chiadò Fiorio Tin M, Ravizza M, and Mori F, Ortolani P, Dalle Nogare ER, Di Lorenzo F, Sterrantino G, Meli M, Polemi S, Nocentini J, Baldini M, Montorzi G, Mazzetti M, Rogasi P, Borchi B, Vichi F, Del Pin B, Pinter E, Anzalone E, Marocco R, Mastroianni C, Mercurio VS, Carocci A, Grilli E, Maccabruni A, Zaramella M, Mariani B, Natalini Raponi G, Guaraldi G, Nardini G, Stentarelli C, Beghetto B, Degli Antoni AM, Molinari A, Crisalli MP, Donisi A, Piepoli M, Cerri V, Zuccotti G, Giacomet V, Coletto S, Di Nello F, Madia C, Placido G, Vivarelli A, Castelli P, Savalli F, Portelli V, Sabbatini F, Francisci D, Bernini L, Grossi P, Rizzi L, Maso G, Airoud M, Soppelsa G, Dedoni M, Cuboni C, Ortu F, Piano P, Citernesi A, Bordoni Vicini I, Luzi K, Roccio M, Vimercati A, Miccolis A, De Gennaro A, Cervi F, Simonazzi G, Margarito E, Capretti MG, Marsico C, Faldella G, Martinelli P, Agangi A, Capone A, Maruotti GM, Tibaldi C, Trentini L, Todros T, Frisina V, Brambilla T, Savasi V, Personeni C, Giaquinto C, Fiscon M, Rubino E, Bucceri A, Matrone R, Scaravelli G, Genovese O, Cafforio C, Pinnetti C, Liuzzi G, Tozzi V, Massetti P, Casadei AM, Cellini M, Castelli Gattinara G, Marconi AM, Sacchi V, Ierardi M, Polizzi C, Mattei A, Pirillo MF, Amici R, Galluzzo CM, Donnini S, Baroncelli S, Villani P, Cusato M, Cerioli A, De Martino M, Mastroiacovo P, Parazzini F, Vella S.

Subjects
Infectious Disease Transmission, Prenatal diagnosis, HIV Infections, 0302 clinical medicine, Birth defect, Pregnancy, Odds Ratio, Vertical, Medicine, 030212 general & internal medicine, Pregnancy Complications, Infectious, education.field_of_study, Amniocentesi, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, Obstetrics, Infectious, Obstetrics and Gynecology, Amniocentesis, birth defects, chorionic villus sampling, HIV, invasive testing, mother-to child HIV transmission, pregnancy, prenatal diagnosis, Birth defects, Chorionic villus sampling, Invasive testing, Mother-to child HIV transmission, Anti-Retroviral Agents, Chorionic Villi Sampling, Female, Adult, medicine.medical_specialty, Prenatal diagnosi, Population, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, Humans, education, Fetal Death, Analysis of Variance, Chi-Square Distribution, business.industry, Infectious Disease Transmission, Vertical, Odds ratio, medicine.disease, Confidence interval, Pregnancy Complications, business, Chi-squared distribution
Abstract

Objectives To assess in pregnant women with HIV the rates of amniocentesis and chorionic villus sampling (CVS), and the outcomes associated with such procedures. Design Observational study. Data from the Italian National Program on Surveillance on Antiretroviral Treatment in Pregnancy were used. Setting University and hospital clinics. Population Pregnant women with HIV. Methods Temporal trends were analysed by analysis of variance and by the Chi-square test for trend. Quantitative variables were compared by Student's t-test and categorical data by the Chi-square test, with odds ratios and 95% confidence intervals calculated. Main outcome measures Rate of invasive testing, intrauterine death, HIV transmission. Results Between 2001 and 2015, among 2065 pregnancies in women with HIV, 113 (5.5%) had invasive tests performed. The procedures were conducted under antiretroviral treatment in 99 cases (87.6%), with a significant increase over time in the proportion of tests performed under highly active antiretroviral therapy (HAART) (100% in 2011–2015). Three intrauterine deaths were observed (2.6%), and 14 pregnancies were terminated because of fetal anomalies. Among 96 live newborns, eight had no information available on HIV status. Among the remaining 88 cases with either amniocentesis (n = 75), CVS (n = 12), or both (n = 1), two HIV transmissions occurred (2.3%). No HIV transmission occurred among the women who were on HAART at the time of invasive testing, and none after 2005. Conclusions The findings reinforce the assumption that invasive prenatal testing does not increase the risk of HIV vertical transmission among pregnant women under suppressive antiretroviral treatment. Tweetable abstract No HIV transmission occurred among women who underwent amniocentesis or CVS under effective anti-HIV regimens.

Published
2016
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6. Vaginal delivery in women with HIV in Italy: results of 5 years of implementation of the national SIGO-HIV protocol

Author

Tibaldi, C., Masuelli, G., Sansone, M., Tassis, B., Cetin, I., Franceschetti, L., Spinillo, A., Simonazzi, G., Vimercati, A., Dalzero, S., Meloni, A., Bernardon, M., Frisina, V., Polizzi, C., Todros, T., Martinelli, P., Floridia, M., Ravizza, M., Trentini, L., Tiso, G., Brambilla, T., Savasi, V., Personeni, C., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Forleo, M. A., Badolato, R., Roccio, M., Zanaboni, D., Sirico, A., Maruotti, G. M., Capone, A., Guerra, B., Cervi, F., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Crupano, F. M., Calabretti, D., Ravizz, M., Marconi, A. M., Galiano, V., Ierardi, S. C. S. M., Chiodo, A., Ortu, F., Piano, P., Dedoni, I. M., Maso, G., Belcaro, C., Rizzante, E., Alberico, S., Citernesi, A., Vicini, I. B., Luzi, K., Tibaldi C, Masuelli G, Sansone M, Tassis B, Cetin I, Franceschetti L, Spinillo A, Simonazzi G, Vimercati A, Dalzero S, Meloni A, Bernardon M, Frisina V, Polizzi C, Todros T, Martinelli P, Floridia M, Ravizza M, and for SIGO-HIV Study Group.

Subjects
0301 basic medicine, Microbiology (medical), Adult, medicine.medical_specialty, 030106 microbiology, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Pregnancy, medicine, Humans, 030212 general & internal medicine, Young adult, Hiv transmission, Delivery complications, Vaginal delivery, business.industry, Obstetrics, Cesarean Section, HIV, Mode of delivery, Delivery, Obstetric, Female, Italy, Viral Load, Obstetric, General Medicine, medicine.disease, Infectious Diseases, Delivery complication, business, Viral load, Delivery
Abstract

PURPOSE: To evaluate the maternal and neonatal safety of vaginal delivery in women with HIV following the implementation of a national protocol in Italy. METHODS: Vaginal delivery was offered to all eligible women who presented antenatally at twelve participating clinical sites. Data collection and definition of outcomes followed the procedures of the National Program on Surveillance on Antiretroviral Treatment in Pregnancy. Pregnancy outcomes were compared according to the mode of delivery, classified as vaginal, elective cesarean (ECS) and non-elective cesarean section (NECS). RESULTS: Among 580 women who delivered between January 2012 and September 2017, 142 (24.5%) had a vaginal delivery, 323 (55.7%) had an ECS and 115 (19.8%) had an NECS. The proportion of vaginal deliveries increased significantly over time, from 18.9% in 2012 to 35.3% in 2017 (p

Published
2019

7. OC.14.3 MULTI-BAND MUCOSECTOMY FOR NEOPLASIA IN PATIENTS WITH BARRETT'S ESOPHAGUS: IN VIVO COMPARISON BETWEEN TWO DIFFERENT DEVICES

Author

Spadaccini, M., primary, Bhandari, P., additional, Maselli, R., additional, Spaggiari, P., additional, Alkandari, A., additional, Di Leo, M., additional, Galtieri, P.A., additional, Ferrara, E.C., additional, Carrara, S., additional, Anderloni, A., additional, Attardo, S., additional, Varytimiadis, L., additional, Lamonaca, L., additional, Craviotto, V., additional, D'Amico, F., additional, Brambilla, T., additional, Sharma, P., additional, Hassan, C., additional, and Repici, A., additional

Published
2019
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9. Abacavir/Lamivudine and Tenofovir/Emtricitabine in Pregnant Women with Hiv: Laboratory and Clinical Outcomes in an Observational National Study

Author

Floridia, M., Pinnetti, C., Ravizza, M., Masuelli, G., Personeni, C., Sansone, M., Antoni, A. D., Guaraldi, G., Spinillo, A., Tassis, B., Dalzero, S., Liuzzi, G., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Maccabruni, A., Zaramella, M., Mariani, B., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Vicini, I. B., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G. C., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., and Baroncelli, S.

Subjects
0301 basic medicine, HIV Infections, Hemoglobins, 0302 clinical medicine, Abacavir, Anemia, Cholesterol, Emtricitabine, HIV-RNA, Lamivudine, Low birthweight, Pregnancy, Preterm delivery, Tenofovir, immune system diseases, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Pregnancy Outcome, virus diseases, Lipoproteins, LDL, Drug Combinations, Infectious Diseases, Hypertension, RNA, Viral, Female, medicine.drug, Adult, medicine.medical_specialty, Anti-HIV Agents, Pregnancy Trimester, Third, 03 medical and health sciences, Internal medicine, medicine, Humans, AIDS-Associated Nephropathy, Cesarean Section, business.industry, Abacavir/Lamivudine, medicine.disease, 030112 virology, Dideoxynucleosides, CD4 Lymphocyte Count, Pregnancy Complications, HIV-1, Observational study, business
Abstract

Abacavir-lamivudine (ABC/3TC) and tenofovir-emtricitabine (TDF/FTC) represent in the guidelines of several countries, including Italy and United States, the preferred nucleoside/nucleotide backbones of antiretroviral regimens. We assessed their profile in pregnancy using data from a national observational study.Laboratory measures (CD4, HIV-RNA, lipid profile, glucose, hemoglobin, and alanine transferase) and pregnancy outcomes (preterm delivery, low birthweight, nonelective cesarean section, birthweight Z-score, congenital defects, HIV transmission, maternal weight gain, and pregnancy complications) were compared after prenatal exposure to ABC/3TC or TDF/FTC.The study evaluated 913 pregnancies (ABC/3TC: 252; TDF/FTC: 661). At entry in pregnancy, women on TDF/FTC were older (33.6 vs. 32.4 years, P = 0.005), less frequently on treatment (66.9% vs. 80.2%, P0.001), and had lower CD4 counts (475/mm vs. 533/mm, P = 0.003) and higher plasma HIV-RNA levels (2.48 vs. 2.22 log10 copies/mL, P = 0.003). Women on ABC/3TC had more commonly hypertension/nephropathy (5.2% vs. 2.0%, P = 0.013). No major differences were observed in the main pregnancy outcomes and in rates of undetectable HIV-RNA at third trimester. In a subgroup analysis that evaluated at third trimester only cases with regular 3-drug treatment during pregnancy, women on TDF/FTC had lower hemoglobin levels (median: 11.1 vs. 11.8 g/dL, P = 0.002) and women on ABC/3TC had higher levels of total cholesterol (median: 230 vs. 216 mg/dL, P = 0.023) and low-density lipoprotein-cholesterol (133 vs. 111 mg/dL, P = 0.030).In this study, use of TDF/FTC and ABC/3TC in pregnancy was associated with similar pregnancy outcomes and with some differences in laboratory measures that might guide physicians' prescriptions in mothers with hematologic or metabolic risk factors.

Published
2018

11. Pregnancy outcomes and cytomegalovirus DNAaemia in HIV-infected pregnant women with CMV

Author

Ravizza, M., Tamburrini, E., Mori, F., Ortolani, P., dalle Nogare, E.R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V.S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A.M., Molinari, A., Crisalli, M.P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Masuelli, G., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Genovese, O., Cafforio, C., Pinnetti, C., Liuzzi, G., Tozzi, V., Massetti, P., Casadei, A.M., Cavaliere, A.F., Cellini, M., Castelli Gattinara, G., Marconi, A.M., Dalzero, S., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M.F., Amici, R., Galluzzo, C.M., Donnini, S., Baroncelli, S., Floridia, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Parazzini, F., Vella, S., and Degli Antoni, A.

Published
2016
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12. Pregnant with HIV before age 25: Data from a large national study in Italy, 2001-2016

Author

Floridia, M., Masuelli, G., Tamburrini, E., Cetin, I., Liuzzi, G., Martinelli, Paolo, Guaraldi, G., Spinillo, A., Vimercati, A., Maso, G., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Maccabruni, A., Zaramella, M., Mariani, Bianca, Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A. M. Degli, Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Angeli, G., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Rizzante, E., Belcaro, C., Meloni, Antonio, Dedoni, M., Ortu, F., Piano, Pierluigi, Citernesi, A., Vicini, I. Bordoni, Luzi, K., Roccio, M., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, Filippo, Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Tassis, B., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, Matteo, Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., DE MARTINO, MARIA CRISTINA, Parazzini, F., and Vella, S.

Subjects
Antiretroviral treatment, HIV diagnosis, HIV testing, pregnancy, women's health, medicine.medical_specialty, Pediatrics, Longitudinal study, Adolescent, Epidemiology, Short Report, HIV Infections, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Pregnancy, medicine, Odds Ratio, Humans, 030212 general & internal medicine, Young adult, 030219 obstetrics & reproductive medicine, business.industry, Odds ratio, medicine.disease, Female, Italy, Infectious Diseases, Confidence interval, Family planning, business, Cohort study
Abstract

SUMMARYYoung pregnant women with HIV may be at significant risk of unplanned pregnancy, lower treatment coverage, and other adverse pregnancy outcomes. In a large cohort of pregnant women with HIV in Italy, among 2979 pregnancies followed in 2001–2016, 9·0% were in women P< 0·001). Younger women had a lower rate of planned pregnancy (23·2%vs.37·7%, odds ratio (OR) 0·50, 95% confidence interval (CI) 0·36–0·69), were more frequently diagnosed with HIV in pregnancy (46·5%vs.20·9%, OR 3·29, 95% CI 2·54–4·25), and, if already diagnosed with HIV before pregnancy, were less frequently on antiretroviral treatment at conception (vs.99·3%), with no differences in rate of HIV viral suppression at third trimester and adverse pregnancy outcomes. The data show that young women represent a growing proportion of pregnant women with HIV, and are significantly more likely to have unplanned pregnancy, undiagnosed HIV infection, and lower treatment coverage at conception. During pregnancy, antiretroviral treatment, HIV suppression, and pregnancy outcomes are similar compared with older women. Earlier intervention strategies may provide additional benefits in the quality of care for women with HIV.

Published
2017

13. Rate, correlates and outcomes of repeat pregnancy in HIV-infected women

Author

Floridia, M., Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., Vimercati, A., Alberico, S., Maccabruni, A., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Grossi, P., Rizzi, L., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Capone, A., Maruotti, M., Tibaldi, C., Trentini, L., Todros, T., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Cellini, M., Castelli Gattinara, G., Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Parazzini, F., Vella, S., Floridia, M, Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., Vimercati, A., Alberico, S., Maccabruni, A., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M. [, Faldella G., and ]

Subjects
0301 basic medicine, Adult, medicine.medical_specialty, HIV RNA, Anti-HIV Agents, birth weight, HIV, pregnancy, preterm delivery, Health Policy, Infectious Diseases, Pharmacology (medical), Birth weight, Emigrants and Immigrants, HIV Infections, Settore MED/17 - MALATTIE INFETTIVE, Pregnancy, Preterm delivery, CD4 Lymphocyte Count, Female, HIV-1, Humans, Premature Birth, Viral Load, Infant, Low Birth Weight, 03 medical and health sciences, medicine, Obstetrics, business.industry, Low Birth Weight, Infant, Odds ratio, medicine.disease, 030112 virology, Confidence interval, Pregnancy rate, Low birth weight, Premature birth, medicine.symptom, business, Viral load
Abstract

Objectives The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. Methods Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. Results The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10–1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35–2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06–1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). Conclusions Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies.

Published
2016

14. Good prenatal detection rate of major birth defects in HIV-infected pregnant women in Italy

Author

Floridia, M, Mastroiacovo, P., Ravizza, M., Todros, T., Chiadò Fiorio Tin, M., Marconi, A. M., Cetin, I., Maruotti, G. M., Liuzzi, G., Pinnetti, C., Degli Antoni, A., Spinillo, A., Guerra, B., Tamburrini, E., Floridia, M., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, Daniela, Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Cervi, F., Puccetti, C., Margarito, E., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Tibaldi, C., Trentini, L., Masuelli, G., Frisina, V., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundarò, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Parazzini, F., and Vella, S.

Subjects
Adult, Infectious, Obstetrics and Gynecology, HIV Infections, Congenital Abnormalities, Pregnancy Complications, Italy, Pregnancy, Humans, Female, Pregnancy Complications, Infectious, Genetics (clinical)
Published
2015

15. Progetto SOPHY: Studio osservazionale sul pH vaginale e sullo stile di vita della donna nelle diverse età e condizioni fisiopatologiche. Parte I

Author

Guaschino, S., Benvenuti, C., Agnello, A., Agnolotti, M., Agostinelli, D., Agrifoglio, V., Albani, F., Alesi, L., Amadori, A., Andresini, R., Anelli, R., Antoniello, M., Arcadia, P., Arduino, S., Atlante, M., Bagnara, M., Balestrucci, G., Barbini, V., Barletta, F., Bassan, M., Bechini, F., Belsan, R., Benatti, G., Beretta, R., Bernardi, F., Bersani, R., Bertocchi, L., Bianchi, M. S., Bianchi, S., Biello, A., Bolelli, E., Bonaccorsi, G., Bonauguri, F., Bondesan, A., Bordignon, D., Bozzo, G., Brambilla, T., Brizio, A. M., Brusa, C., Businco, F., Cadario Preti, E., Calanchini, C., Capodieci, C., Cardinale, A., Carnio, P., Carnuccio, G., Casa, A., Castagna, P., Cazzavacca, R., Chiodi, A., Ciancio, G., Ciccone, E., Cicotti, M. P., Cino, S., Cirri, R., Citterio, S., Colla, F., Colombi, C., Conti, C. S., Corazza, G., Crana, F., Creanza, V., Crisafulli, M. L., Cristiani, P., Cugini, A. M., Curto, G., Cutuli, A., Dal Bò, R., Damone, R., De Majo, D., De Nuzzo, M. A., De Rosa, E., De Valle Vietti, G., Defazio, D. D., Delli Ponti, E. C., Di Bari, I., Di Biase, R., Di Cosmo, E., Di Giovinazzo, L., Di Natale, R., Di Pietro, F., Esposito, E., Fabbrizi, L., Faggionato, I., Fanti, S., Favi, O., Fazio Pellacchio, C., Ferraina, F., Ferrari, D., Ferrentino, A., Fiscella, A., Fischetti, A., Florio, V., Forcella, G., Franzolini, P., Furani, S., Fuschini, G., Gallo, G., Gammi, L., Geda, O., Gianfranceschi, C., Gigante, A., Giolito, M. R., Giordano, A., Giovagnorio, P., Giuliani, L., Gostinicchi, P., Gozeni, M., Guadalupi, E., Guagliarlo, M., Guastaferro, L., Gubbiotti, R., Guernieri, A., Guidi, A., Guzzinati, N., Iannacci, M. C., Iannelli, S., Infante, F. E., Insacco, P., Jannacone, D., Lalanne, A., Lanfranchi, A., Latella, R., Lazzarin, L., Lefosse, M. G., Lemme, E., Lepadatu, C., Levanti, S., Liberio, M. D., Linsalata, I., Lombardi, P., Luchi, C., Lucianetti, M., Luciano, V., Maccarini, U., Maggio, I., Maggiorelli, M., Maietta, A., Mancini, A. C., Mancini, L., Mancini, F., Manni, M. U., Manuzio, D., Manzan, L., Marasca, O., Marchi, M., Marcozzi, S., Maresi, M. P., Mariatti, M., Martinelli, P., Masi, P., Masini, M., Massa, E., Matanã², S., Mattioli, V., Mazzoli, F., Mazzucato, R., Medori, A., Melappioni, S., Mendolicchio, S., Meroni, S., Miliffi, L., Minorini, D., Mirra, P., Mori, R., Moroni, S., Mossetti, M., Motta, N., Mucci, M., Munizza, W., Mura, M., Musconi, M., Mussida, M., Nanni, C., Nardi, E., Nardi, M., Nesi, D., Nirta, A., Nozza, M., Oliva, N., Oliverio, C., Onofri, M. C., Paduano, F., Palombino, K., Papadia, L. S., Parvaneh, H., Pascazio, F., Pasini, T., Pasini, A., Paticchio, M. R., Pellegrinotti, A., Pensabene, I., Perilli, M. L., Perrini, G., Perugini, A., Pessina, M., Petracchi, M., Pieracci, R., Pignata, M., Pisaturo, G., Po, E., Poggi, M. G., Poli, M., Polpatelli, L., Pone, A., Ponticelli, R., Potenza, M. T., Previdi, A. M., Preziuso, M., Quagliarini, V., Quaranta, M., Quattrocchi, G., Ragusa, S., Rainã², M. I., Regge, G. M., Rizzo, S., Roberti, P., Romano, G., Romano, D., Rossi, M., Ruggeri, C., Ruggiero, G., Russo, C., Russotto, C. M., Salmi, P., Salvestroni, C., Salviato, M. G., Sangiorgi, B., Santandrea, V., Santomauro, S., Santoni, S., Sarica, F., Savoca, S., Scandellari, E., Scarpellini, M., Sciarra, M. N., Scibilia, M. R., Scopacasa, P., Serafini, T., Setaccioli, M., Settembrini, L., Sganga, E., Simionato, S., Sommacampagna, P., Spadaro, F., Spettoli, D. A., Speziale, M., Spiga, A. M., Stampone, R., Stefanidou, M., Stefanutti, B., Stolfi, G., Strazzari, G., Tabanelli, S., Tafuri, A., Tamburini, M., Tampucci, S., Tarantini, P., Tempesta, N., Testoni, N., Testori, P., Tomba, D., Toscano, M., Trapassi, L., Tripodi, M., Vadalã , A., Valentino, V., Valieri, M., Valsecchi, L., Vassena, L., Ventimiglia, L., Vicentini, M. T., Volonterio, A. M., Votano, S., Wittemberg, L., Zangara, C., Zecchi, R., ORIGONI, MASSIMO, Guaschino, S., Benvenuti, C., Agnello, A., Agnolotti, M., Agostinelli, D., Agrifoglio, V., Albani, F., Alesi, L., Amadori, A., Andresini, R., Anelli, R., Antoniello, M., Arcadia, P., Arduino, S., Atlante, M., Bagnara, M., Balestrucci, G., Barbini, V., Barletta, F., Bassan, M., Bechini, F., Belsan, R., Benatti, G., Beretta, R., Bernardi, F., Bersani, R., Bertocchi, L., Bianchi, M. S., Bianchi, S., Biello, A., Bolelli, E., Bonaccorsi, G., Bonauguri, F., Bondesan, A., Bordignon, D., Bozzo, G., Brambilla, T., Brizio, A. M., Brusa, C., Businco, F., Cadario Preti, E., Calanchini, C., Capodieci, C., Cardinale, A., Carnio, P., Carnuccio, G., Casa, A., Castagna, P., Cazzavacca, R., Chiodi, A., Ciancio, G., Ciccone, E., Cicotti, M. P., Cino, S., Cirri, R., Citterio, S., Colla, F., Colombi, C., Conti, C. S., Corazza, G., Crana, F., Creanza, V., Crisafulli, M. L., Cristiani, P., Cugini, A. M., Curto, G., Cutuli, A., Dal Bò, R., Damone, R., De Majo, D., De Nuzzo, M. A., De Rosa, E., De Valle Vietti, G., Defazio, D. D., Delli Ponti, E. C., Di Bari, I., Di Biase, R., Di Cosmo, E., Di Giovinazzo, L., Di Natale, R., Di Pietro, F., Esposito, E., Fabbrizi, L., Faggionato, I., Fanti, S., Favi, O., Fazio Pellacchio, C., Ferraina, F., Ferrari, D., Ferrentino, A., Fiscella, A., Fischetti, A., Florio, V., Forcella, G., Franzolini, P., Furani, S., Fuschini, G., Gallo, G., Gammi, L., Geda, O., Gianfranceschi, C., Gigante, A., Giolito, M. R., Giordano, A., Giovagnorio, P., Giuliani, L., Gostinicchi, P., Gozeni, M., Guadalupi, E., Guagliarlo, M., Guastaferro, L., Gubbiotti, R., Guernieri, A., Guidi, A., Guzzinati, N., Iannacci, M. C., Iannelli, S., Infante, F. E., Insacco, P., Jannacone, D., Lalanne, A., Lanfranchi, A., Latella, R., Lazzarin, L., Lefosse, M. G., Lemme, E., Lepadatu, C., Levanti, S., Liberio, M. D., Linsalata, I., Lombardi, P., Luchi, C., Lucianetti, M., Luciano, V., Maccarini, U., Maggio, I., Maggiorelli, M., Maietta, A., Mancini, A. C., Mancini, L., Mancini, F., Manni, M. U., Manuzio, D., Manzan, L., Marasca, O., Marchi, M., Marcozzi, S., Maresi, M. P., Mariatti, M., Martinelli, P., Masi, P., Masini, M., Massa, E., Matanã², S., Mattioli, V., Mazzoli, F., Mazzucato, R., Medori, A., Melappioni, S., Mendolicchio, S., Meroni, S., Miliffi, L., Minorini, D., Mirra, P., Mori, R., Moroni, S., Mossetti, M., Motta, N., Mucci, M., Munizza, W., Mura, M., Musconi, M., Mussida, M., Nanni, C., Nardi, E., Nardi, M., Nesi, D., Nirta, A., Nozza, M., Oliva, N., Oliverio, C., Onofri, M. C., Origoni, Massimo, Paduano, F., Palombino, K., Papadia, L. S., Parvaneh, H., Pascazio, F., Pasini, T., Pasini, A., Paticchio, M. R., Pellegrinotti, A., Pensabene, I., Perilli, M. L., Perrini, G., Perugini, A., Pessina, M., Petracchi, M., Pieracci, R., Pignata, M., Pisaturo, G., Po, E., Poggi, M. G., Poli, M., Polpatelli, L., Pone, A., Ponticelli, R., Potenza, M. T., Previdi, A. M., Preziuso, M., Quagliarini, V., Quaranta, M., Quattrocchi, G., Ragusa, S., Rainã², M. I., Regge, G. M., Rizzo, S., Roberti, P., Romano, G., Romano, D., Rossi, M., Ruggeri, C., Ruggiero, G., Russo, C., Russotto, C. M., Salmi, P., Salvestroni, C., Salviato, M. G., Sangiorgi, B., Santandrea, V., Santomauro, S., Santoni, S., Sarica, F., Savoca, S., Scandellari, E., Scarpellini, M., Sciarra, M. N., Scibilia, M. R., Scopacasa, P., Serafini, T., Setaccioli, M., Settembrini, L., Sganga, E., Simionato, S., Sommacampagna, P., Spadaro, F., Spettoli, D. A., Speziale, M., Spiga, A. M., Stampone, R., Stefanidou, M., Stefanutti, B., Stolfi, G., Strazzari, G., Tabanelli, S., Tafuri, A., Tamburini, M., Tampucci, S., Tarantini, P., Tempesta, N., Testoni, N., Testori, P., Tomba, D., Toscano, M., Trapassi, L., Tripodi, M., Vadalã , A., Valentino, V., Valieri, M., Valsecchi, L., Vassena, L., Ventimiglia, L., Vicentini, M. T., Volonterio, A. M., Votano, S., Wittemberg, L., Zangara, C., and Zecchi, R.

Subjects
Sexual behavior, Vagina, secretion, Vaginosis, bacterial, Obstetrics and Gynecology, Candida
Abstract

Aim. The importance of vaginal pH and vaginal flora in maintaining a well-balanced vaginal ecosystem is well known and has been widely described. However, no systematic nationwide studies have been carried out concerning the correlation between vaginal pH, life style and different physiopathological conditions in women of different ages. Methods. SOPHY (Study on pH and Hygiene) collected data concerning the lifestyle, vaginal pH, and the presence of symptoms, stratified into different subgroups (prepuberal, fertile, pregnancy, postpartum, premenopause and menopause) in a representative sample of the Italian gynecological population (264 gynaecologists for a total of 2 641 women) with the aid of a specific Internet site for data entry. Results. A more acid vaginal pH was related to a better satisfactory sexual activity and to more healthy genital condition. A positive relationship was detected between education level and good perception of sexuality. Certain clothing habits and a higher frequency of candidiasis and bacterial vaginosis was shown. Conclusion. SOPHY revealed some interesting correlations between clothing and the frequency of candidiasis and bacterial vaginosis, between vaginal pH and satisfactory sexual activity, and between education and sexuality. SOPHY had a considerable educational impact, leading the physicians and women to consider vaginal pH as an important aspect of everyday life.

Published
2008

17. Pregnancy outcomes and cytomegalovirus DNAaemia in HIV-infected pregnant women with CMV

Author

Floridia, M., primary, Pirillo, M.F., additional, Degli Antoni, A., additional, Molinari, A., additional, Tamburrini, E., additional, Pinnetti, C., additional, Guaraldi, G., additional, Nardini, G., additional, Masuelli, G., additional, Dalzero, S., additional, Cetin, I., additional, Sansone, M., additional, Amici, R., additional, Ravizza, M., additional, Mori, F., additional, Ortolani, P., additional, dalle Nogare, E.R., additional, Di Lorenzo, F., additional, Sterrantino, G., additional, Meli, M., additional, Polemi, S., additional, Nocentini, J., additional, Baldini, M., additional, Montorzi, G., additional, Mazzetti, M., additional, Rogasi, P., additional, Borchi, B., additional, Vichi, F., additional, Del Pin, B., additional, Pinter, E., additional, Anzalone, E., additional, Marocco, R., additional, Mastroianni, C., additional, Mercurio, V.S., additional, Carocci, A., additional, Grilli, E., additional, Maccabruni, A., additional, Zaramella, M., additional, Mariani, B., additional, Natalini Raponi, G., additional, Stentarelli, C., additional, Beghetto, B., additional, Degli Antoni, A.M., additional, Crisalli, M.P., additional, Donisi, A., additional, Piepoli, M., additional, Cerri, V., additional, Zuccotti, G., additional, Giacomet, V., additional, Coletto, S., additional, Di Nello, F., additional, Madia, C., additional, Placido, G., additional, Vivarelli, A., additional, Castelli, P., additional, Savalli, F., additional, Portelli, V., additional, Sabbatini, F., additional, Francisci, D., additional, Bernini, L., additional, Grossi, P., additional, Rizzi, L., additional, Alberico, S., additional, Maso, G., additional, Airoud, M., additional, Soppelsa, G., additional, Meloni, A., additional, Dedoni, M., additional, Cuboni, C., additional, Ortu, F., additional, Piano, P., additional, Citernesi, A., additional, Bordoni Vicini, I., additional, Luzi, K., additional, Spinillo, A., additional, Roccio, M., additional, Vimercati, A., additional, Miccolis, A., additional, De Gennaro, A., additional, Guerra, B., additional, Cervi, F., additional, Simonazzi, G., additional, Margarito, E., additional, Capretti, M.G., additional, Marsico, C., additional, Faldella, G., additional, Martinelli, P., additional, Agangi, A., additional, Capone, A., additional, Maruotti, G.M., additional, Tibaldi, C., additional, Trentini, L., additional, Todros, T., additional, Frisina, V., additional, Brambilla, T., additional, Savasi, V., additional, Personeni, C., additional, Giaquinto, C., additional, Fiscon, M., additional, Rubino, E., additional, Bucceri, A., additional, Matrone, R., additional, Scaravelli, G., additional, Genovese, O., additional, Cafforio, C., additional, Liuzzi, G., additional, Tozzi, V., additional, Massetti, P., additional, Casadei, A.M., additional, Cavaliere, A.F., additional, Cellini, M., additional, Castelli Gattinara, G., additional, Marconi, A.M., additional, Sacchi, V., additional, Ierardi, M., additional, Polizzi, C., additional, Mattei, A., additional, Galluzzo, C.M., additional, Donnini, S., additional, Baroncelli, S., additional, Floridia, M., additional, Villani, P., additional, Cusato, M., additional, Cerioli, A., additional, De Martino, M., additional, Mastroiacovo, P., additional, Parazzini, F., additional, and Vella, S., additional

Published
2016
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19. Atazanavir and lopinavir profile in pregnant women with HIV: tolerability, activity and pregnancy outcomes in an observational national study

Author

Floridia, M., Ravizza, M., Masuelli, G., Giacomet, V., Martinelli, P., Degli Antoni, A., Spinillo, A., Fiscon, M., Francisci, D., Liuzzi, G., Pinnetti, C., Marconi, A. M., Tamburrini, E., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, Giovanni, Nardini, Giulia, Stentarelli, Chiara, Beghetto, Barbara, Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Fabiano, V., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., Bassi, E., Guerra, B., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Regazzi, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Ravizza, M, Masuelli, G, Giacomet, V, Martinelli, Pasquale, Degli Antoni, A, Spinillo, A, Fiscon, M, Francisci, D, Liuzzi, G, Pinnetti, C, Marconi, Am, Tamburrini, E, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy, Floridia, M1, Italian Group on Surveillance on Antiretroviral Treatment in, P. r. e. g. n. a. n. c. y., Marco Floridia, Marina Ravizza, Giulia Masuelli, Vania Giacomet, Pasquale Martinelli, Anna Degli Antoni, Arsenio Spinillo, Marta Fiscon, Daniela Francisci, Giuseppina Liuzzi, Carmela Pinnetti, Anna Maria Marconi, Enrica Tamburrini, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [.., Capretti, M.G., Marsico, C., Faldella, G., and ].

Subjects
Pyridines, Pyridine, HIV Infections, Triglyceride, Lopinavir, Liver Function Tests, Pregnancy, HIV Infection, Pharmacology (medical), Viral, Pregnancy Complications, Infectious, triglycerides, pre-term delivery, medicine.diagnostic_test, Liver Function Test, Obstetrics, Medicine (all), Pregnancy Outcome, Infectious, virus diseases, HIV, pregnancy, RNA, Lipid, Viral Load, Lipids, Infectious Diseases, Tolerability, Oligopeptide, Population study, RNA, Viral, Female, medicine.symptom, bilirubin, Viral load, Oligopeptides, Human, medicine.drug, Microbiology (medical), Adult, medicine.medical_specialty, HIV RNA, Anti-HIV Agents, Atazanavir Sulfate, Infectious Disease, Bilirubin, Cholesterol, Pre-term delivery, Triglycerides, Pharmacology, cholesterol, Settore MED/17 - MALATTIE INFETTIVE, medicine, Humans, business.industry, Anti-HIV Agent, medicine.disease, Atazanavir, CD4 Lymphocyte Count, Pregnancy Complications, Immunology, Pregnancy Complications, Infectiou, business, Liver function tests, Weight gain
Abstract

BACKGROUND: Atazanavir and lopinavir represent the main HIV protease inhibitors recommended in pregnancy, but comparative data in pregnant women are limited. METHODS: Women from a national observational study, exposed in pregnancy to either atazanavir or lopinavir, were compared for glucose and lipid profiles, liver function tests, CD4 count, HIV RNA and main pregnancy outcomes. Statistical methods included univariate and multivariable analyses. RESULTS: The study population included 428 pregnancies (lopinavir, 322; atazanavir, 106). The lopinavir group was characterized by higher rates of HIV diagnosis in pregnancy and treatment indication for maternal health, lower CD4 counts, higher HIV RNA levels, less frequent antiretroviral treatment at conception and shorter duration of drug exposure during pregnancy. No differences in pregnancy outcomes, glucose metabolism and weight gain were observed. The two groups also showed in a multivariable analysis similar odds for detectable HIV RNA in the third trimester (adjusted OR 0.85, 95% CI 0.35-2.10, P = 0.730). Total lipid levels were significantly higher in the lopinavir group (median values in the third trimester 239 versus 221 mg/dL for total cholesterol and 226 versus 181 mg/dL for triglycerides; P < 0.001 for both comparisons) and bilirubin levels were significantly higher in the atazanavir group (1.53 versus 0.46 mg/dL, P < 0.001). CONCLUSIONS: In this observational study atazanavir and lopinavir showed similar safety and activity in pregnancy, with no differences in the main pregnancy outcomes. Atazanavir use was associated with a better lipid profile and with higher bilirubin levels. Overall, the study findings confirm that these two HIV protease inhibitors represent equally valid alternative options.

Published
2014

20. Body Mass Index and Weight Gain in Pregnant Women With HIV: A National Study in Italy

Author

Floridia, M., Ravizza, M., Masuelli, G., Dalzero, S., Pinnetti, C., Cetin, I., Meloni, A., Spinillo, A., Rubino, E., Francisci, D., Tamburrini, E., Mori, F., Ortolani, P., Dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, Claudio Maria, Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Luzi, K., Nardini, G., Stentarelli, C., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Bernini, L., Alberico, S., Maso, G., Tropea, M., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Vicini, I., Roccio, M., Vimercati, A., Miccolis, A., Bassi, E., Guerra, B., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Tibaldi, C., Trentini, L., Todros, T., Garetto, S., Brambilla, T., Savasi, V., Crepaldi, A., Giaquinto, C., Fiscon, M., Rinaldi, R., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Liuzzi, G., Tozzi, V., Massetti, Anna Paola, Anceschi, M., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Marconi, A. M., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Ravizza, M, Masuelli, G, Dalzero, S, Pinnetti, C, Cetin, I, Meloni, A, Spinillo, A, Rubino, E, Francisci, D, Tamburrini, E, Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy, Martinelli, Pasquale, Floridia M, Ravizza M, Masuelli G, Dalzero S, Pinnetti C, Cetin I, Meloni A, Spinillo A, Rubino E, Francisci D, Tamburrini E, Faldella G, Guerra B, and for the Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy

Subjects
Microbiology (medical), medicine.medical_specialty, antiretroviral therapy, MEDLINE, Human immunodeficiency virus (HIV), HIV Infections, body mass index, medicine.disease_cause, Settore MED/17 - MALATTIE INFETTIVE, Body Mass Index, BMI, weight gain, HIV-1, Pregnancy, Medicine, Humans, HIV infection, pregnancy, Pregnancy Complications, Infectious, business.industry, Obstetrics, Cesarean Section, Infectious, Pregnancy Outcome, HIV, medicine.disease, Pregnancy Complications, Infectious Diseases, Italy, National study, Female, medicine.symptom, business, Weight gain, Body mass index
Abstract

Although most of the women (69.4%) had a normal BMI at start of pregnancy, only 37% had an adequate weight gain during pregnancy. Inadequate body weight gain was more common (44.8%) than excessive weight gain (18.2%), but 40% of overweight women and 50% of obese women had an excessive weight gain in pregnancy, with about 9% of the women in these categories gaining >18 kg during pregnancy (Table 1). Only 1.9% of the women had a vaginal delivery; elective and nonelective cesarean deliveries accounted for 81.3% and 16.7% of deliveries, respectively. Compared to underweight/normal women, overweight/obese women had similar occurrences of preterm delivery (23.4% vs 22.7%, P = .871), significantly lower rates of low birthweight (14.2% vs 24.2%, P = .007) and nonelective cesarean deliveries (11.7% vs 18.3%, P = .042), and a significantly higher occurrence of fasting plasma glucose >92 mg/dL at 20–28 weeks (12.1% vs 6.6%, P = .027), hypertension during pregnancy (6.4% vs 2.7%, P = .019), and gestational age–adjusted birthweight >90th percentile (15.5% vs 5.0%, P < .001). Complications of delivery, major birth defects, and HIV transmission were similar between the 2 groups (7.3% vs 7.6%, P = .881; 2.6% vs 3.5%, P = .589; and 0.8% vs 0.5%, P = .661, respectively). An inadequate weight gain during pregnancy was associated with an increased risk of nonelective cesarean delivery (OR, 1.589 [95% CI, 1.077–2.346], P = .020). Excessive weight gain during pregnancy was not associated with either hypertension (OR, 1.364 [95% CI, .537–3.465], P = .514) or 20–28 week glucose level of >92 mg/dL (OR, 0.841 [95% CI, .399–1.772], P = .648), but was significantly associated with birthweight >90th percentile (OR, 2.271 [95% CI, 1.229–4.195], P = .009), and appeared to be protective against low birthweight (OR, 0.544 [95% CI, .323–.918], P = .023) and birthweight

Published
2013

21. Body Mass Index and Weight Gain in Pregnant Women With HIV: A National Study in Italy

Author

Floridia, M, Ravizza, M, Masuelli, G, Dalzero, S, Pinnetti, C, Cetin, I, Meloni, A, Spinillo, A, Rubino, E, Francisci Dtamburrini, E, Mori, F, Ortolani, P, Dalle Nogare Er, Di Lorenzo, F, Sterrantino, G, Meli, M, Polemi, S, Nocentini, J, Baldini, M, Montorzi, G, Mazzetti, M, Rogasi, P, Borchi, B, Vichi, F, Pinter, E, Anzalone, E, Marocco, R, Mastroianni, C, Mercurio, Vs, Carocci, A, Grilli, E, Maccabruni, A, Zaramella, M, Mariani, B, Natalini Raponi, G, Guaraldi, G, Luzi, K, Nardini, G, Stentarelli, C, Degli Antoni Am, Molinari, A, Crisalli, Mp, Donisi, A, Piepoli, M, Cerri, V, Zuccotti, G, Giacomet, V, Fabiano, V, Placido, G, Vivarelli, A, Castelli, P, Savalli, F, Portelli, V, Sabbatini, F, Francisci, D, Bernini, L, Alberico, S, Maso, G, Tropea, M, Dedoni, M, Cuboni, C, Ortu, F, Piano, P, Citernesi, A, Vicini, I, Roccio, M, Vimercati, A, Miccolis, A, Bassi, E, Guerra, B, Cervi, F, Puccetti, C, Murano, P, Contoli, M, Capretti, Mg, Marsico, C, Faldella, G, Sansone, M, Martinelli, P, Agangi, A, Tibaldi, C, Trentini, L, Todros, T, Garetto, S, Brambilla, T, Savasi, V, Crepaldi, A, Giaquinto, C, Fiscon, M, Rinaldi, R, Bucceri, A, Matrone, R, Scaravelli, G, Fundarò, C, Genovese, O, Cafforio, C, Liuzzi, G, Tozzi, V, Massetti, P, Anceschi, M, Casadei, Am, Cavaliere, Af, Finelli, V, Cellini, M, Castelli Gattinara, G, Marconi, Am, Sacchi, V, De Pirro, A, Polizzi, C, Mattei, A, Pirillo, Mf, Amici, R, Galluzzo, Cm, Donnini, S, Baroncelli, S, Villani, P, Cusato, M, Cerioli, A, De Martino, Maurizio, Mastroiacovo, P, Moroni, M, Parazzini, F, Tamburrini, E, Vella, S, and Martinelli, P.

Subjects
HIV
Published
2013

22. Birth defects in a national cohort of pregnant women with HIV infection in Italy, 2001-2011

Author

Floridia, M., Mastroiacovo, P., Tamburrini, E., Tibaldi, C., Todros, T., Crepaldi, A., Sansone, M., Fiscon, M., Liuzzi, G., Guerra, B., Vimercati, A., Vichi, F., Vicini, I., Pinnetti, C., Marconi, A. M., Ravizza, M., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Luzi, K., Nardini, G., Stentarelli, C., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Coletto, S., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Alberico, S., Maso, G., Tropea, M., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Spinillo, A., Roccio, M., Miccolis, A., Bassi, E., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Trentini, L., Masuelli, G., Garetto, S., Cetin, I., Brambilla, T., Savasi, V., Giaquinto, C., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Anceschi, M., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Regazzi, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Mastroiacovo, P, Tamburrini, E, Tibaldi, C, Todros, T, Crepaldi, A, Sansone, M, Fiscon, M, Liuzzi, G, Guerra, B, Vimercati, A, Vichi, F, Vicini, I, Pinnetti, C, Marconi, A, Ravizza, M, Martinelli, Pasquale, and The Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy

Subjects
Male, HIV Infections, transcriptase inhibitors, Cohort Studies, chemistry.chemical_compound, Pregnancy, Prevalence, Birth Weight, Young adult, Pregnancy Complications, Infectious, education.field_of_study, Obstetrics, Coinfection, Antiretroviral therapy, birth defects, efavirenz, HIV, non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, pregnancy, protease inhibitors, women, Obstetrics and Gynecology, Abnormalities, Drug-Induced, Middle Aged, Italy, Maternal Exposure, Reverse Transcriptase Inhibitors, Female, Cohort study, Adult, medicine.medical_specialty, Efavirenz, Adolescent, Anti-HIV Agents, Birth weight, Population, Antiretroviral Therapy, Birth defects, HIV-1, Young Adult, Hepatitis B, Chronic, medicine, Humans, education, business.industry, Infant, Newborn, Odds ratio, Hepatitis C, Chronic, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, Pregnancy Trimester, First, chemistry, business
Abstract

Objective We used data from a national study of pregnant women with HIV to evaluate the prevalence of congenital abnormalities in newborns from women with HIV infection. Design Observational study. Setting University and hospital clinics. Population Pregnant women with HIV exposed to antiretroviral treatment at any time during pregnancy. Methods The total prevalence of birth defects was assessed on live births, stillbirths, and elective terminations for fetal anomaly. The associations between potentially predictive variables and the occurrence of birth defects were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs) for exposed versus unexposed cases, calculated in univariate and multivariate logistic regression analyses. Main outcome measures Birth defects, defined according to the Antiretroviral Pregnancy Registry criteria. Results A total of 1257 pregnancies with exposure at any time to antiretroviral therapy were evaluated. Forty-two cases with major defects were observed. The total prevalence was 3.2% (95% CI 1.9–4.5) for exposure to any antiretroviral drug during the first trimester (23 cases with defects) and 3.4% (95% CI 1.9–4.9) for no antiretroviral exposure during the first trimester (19 cases). No associations were found between major birth defects and first-trimester exposure to any antiretroviral treatment (OR 0.94, 95% CI 0.51–1.75), main drug classes (nucleoside reverse transcriptase inhibitors, OR 0.95, 95% CI 0.51–1.76; non-nucleoside reverse transcriptase inhibitors, OR 1.20, 95% CI 0.56–2.55; protease inhibitors, OR 0.92, 95% CI 0.43–1.95), and individual drugs, including efavirenz (prevalence for efavirenz, 2.5%). Conclusions This study adds further support to the assumption that first-trimester exposure to antiretroviral treatment does not increase the risk of congenital abnormalities.

Published
2013

30. Consequences of presentation with advanced HIV disease in pregnancy: Data from a national study in Italy

Author

Floridia, M., Tamburrini, E., Masuelli, G., Guaraldi, G., Molinari, A., Cetin, I., Dalzero, S., Spinillo, A., Liuzzi, G., Pinnetti, C., Vicini, I., Castelli, P., Sacchi, V., Ravizza, M., Mori, F., Ortolani, P., Dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Claudio Maria MASTROIANNI, Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Raponi, G. N., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Coletto, S., Di Nello, F., Placido, G., Vivarelli, A., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Vicini, I. B., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., Gennaro, A., Guerra, B., Cervi, F., Puccetti, C., Margarito, E., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundarò, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Gattinara, G. C., Marconi, A. M., Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., and Vella, S.

31. SOPHY project: An observational study of vaginal pH, lifestyle and correct intimate hygiene in women of different ages and in different physiopathological conditions. Part II | Progetto SOPHY: Studio osservazionale su pH vaginak, stile di vita e corretta igiene intima nella donna nelle diverse eta e condizioni fisiopatologiche. Parte II

Author

Guaschino, S., Benvenuti, C., Agnello, A., Agnolotti, M., Agostinelli, D., Agrifoglio, V., Albani, F., Alesi, L., Amadori, A., Andresini, R., Anelli, R., Antoniello, M., Arcadia, P., Arduino, S., Atlante, M., Bagnara, M., Balestrucci, G., Barbini, V., Barletta, F., Bassan, M., Bechini, F., Belsan, R., Benatti, G., Beretta, R., Bernardi, F., Bersani, R., Bertocchi, L., Bianchi, M. S., Bianchi, S., Biello, A., Bolelli, E., Bonaccorsi, G., Bonauguri, F., Bondesan, A., Bordignon, D., Bozzo, G., Brambilla, T., Brizio, A. M., Brusa, C., Businco, F., Cadario Preti, E., Calanchini, C., Capodieci, C., Cardinale, A., Camio, P., Carnuccio, G., Casa, A., Castagna, P., Cazzavacca, R., Chiodi, A., Ciancio, G., Ciccone, E., Cicotti, M. P., Cino, S., Cirri, R., Citterio, S., Colla, F., Colombi, C., Conti, C. S., Corazza, G., Crana, F., Creanza, V., Crisafulli, M. L., Cristiani, P., Cugini, A. M., Curto, G., Cutuli, A., Dal Bo, R., Damone, R., Majo, D., Nuzzo, M. A., Rosa, E., Valle-Vietti, G., Defazio, D. D., Delli Ponti, E. C., Di Bari, I., Di Biase, R., Di Cosmo, E., Di Giovinazzo, L., Di Natale, R., Di Pietro, F., Esposito, E., Fabbrizi, L., Faggionato, I., Fanti, S., Favi, O., Fazio-Pellacchio, C., Ferraina, F., Ferrari, D., Ferrentino, A., Fiscella, A., Fischetti, A., Florio, V., Forcella, G., Franzolini, P., Furani, S., Fuschini, G., Gallo, G., Gammi, L., Geda, O., Gianfranceschi, C., Gigante, A., Giolito, M. R., Giordano, A., Giovagnorio, P., Giuliani, L., Gostinicchi, P., Gozeni, M., Guadalupi, E., Guagliarlo, M., Guastaferro, L., Gubbiotti, R., Guemieri, A., Guidi, A., Guzzinati, N., Iannacci, M. C., Iannelli, S., Infante, F. E., Insacco, P., Jannacone, D., Lalanne, A., Lanfranchi, A., Latella, R., Lazzarin, L., Lefosse, M. G., Lemme, E., Lepadatu, C., Levanti, S., Liberio, M. D., Linsalata, I., Lombardi, P., Luchi, C., Lucianetti, M., Luciano, V., Maccarini, U., Maggio, I., Maggiorelli, M., Maietta, A., Mancini, A. C., Mancini, L., Mancini, F., Manni, M. U., Manuzio, D., Manzan, L., Marasca, O., Marchi, M., marco onofrj, Maresi, M. P., Mariatti, M., Martinelli, P., Masi, P., Masini, M., Massa, E., Malanò, S., Mattioli, V., Mazzoli, F., Mazzucato, R., Medori, A., Melappioni, S., Mendolicchio, S., Meroni, S., Miliffi, L., Minorini, D., Mirra, P., Mori, R., Moroni, S., Mossetti, M., Motta, N., Mucci, M., Munizza, W., Mura, M., Musconi, M., Mussida, M., Nanni, C., Nardi, E., Nardi, M., Nesi, D., Nirta, A., Nozza, M., Oliva, N., Oliverio, C., Onofri, M. C., Origoni, M., Paduano, F., Palombino, K., Papadia, L. S., Parvaneh, H., Pascazio, F., Pasini, T., Pasini, A., Paticchio, M. R., Pellegrinotti, A., Pensabene, I., Perilli, M. L., Perrini, G., Perugini, A., Pessina, M., Petracchi, M., Pieracci, R., Pignata, M., Pisaturo, G., Po, E., Poggi, M. G., Poli, M., Polpatelli, L., Pone, A., Ponticelli, R., Potenza, M. T., Previdi, A. M., Preziuso, M., Quagliarini, V., Quaranta, M., Quattrocchi, G., Ragusa, S., Rainò, M. I., Regge, G. M., Rizzo, S., Roberti, P., Romano, G., Romano, D., Rossi, M., Ruggeri, C., Ruggiero, G., Russo, C., Russotto, C. M., Salmi, P., Salvestroni, C., Salviato, M. G., Sangiorgi, B., Santandrea, V., Santomauro, S., Santoni, S., Sarica, F., Savoca, S., Scandellari, E., Scarpellini, M., Sciarra, M. N., Scibilia, M. R., Scopacasa, P., Serafini, T., Setaccioli, M., Settembrini, L., Sganga, E., Simionato, S., Sommacampagna, P., Spadaro, F., Spettoli, D. A., Speziale, M., Spiga, A. M., Stampone, R., Stefanidou, M., Stefanutti, B., Stolfi, G., Strazzari, G., Tabanelli, S., Tafuri, A., Tamburini, M., Tampucci, S., Tarantini, P., Tempesta, N., Testoni, N., Testori, P., Tomba, D., Toscano, M., Trapassi, L., Tripodi, M., Vadala, A., Valentino, V., Valieri, M., Valsecchi, L., Vassena, L., Ventimiglia, L., Vicentini, M. T., Volonterio, A. M., Votano, S., Wittemberg, L., Zangara, C., and Zecchi, R.

33. Exposure to antiretroviral therapy in utero or early life: the health of uninfected children born to HIV-infected women

Author

European Collaborative Study, Newell, Ml, Giaquinto, C., Ruga, E., Rossi, A., Grosch-Worner, I., Mok, J., Johnstone, F., Jose, I., Bates, I., Salas, S., Guevara, Cl, Pena, Jm, Garcia, Jg, Lopez, Jra, Garcia-Rodriguez, Mc, Asensi-Botet, F., Otero, Mc, Perez-Tamarit, D., Ridaura, S., Gregori, P., La Torre, R., Scherpbier, H., Kreyenbroek, M., Boer, K., Bohlin, Ab, Lindgren, S., Ehrnst, A., Belfrage, E., Lars Naver, Levy, J., Barlow, P., Hainaut, M., Peltier, A., Wibaut, S., Ferrazin, A., Bassetti, D., Maria, A., Gotta, C., Mur, A., Paya, A., Vinolas, M., Lopez-Vilchez, Ma, Rovira, Ma, Carreras, R., Valerius, Nh, Coll, O., Vidal, R., Perez, Jm, Boguna, J., Fortuny, C., Pardi, G., Ravizza, M., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Savasi, V., Vigano, A., Ferrazzi, E., Brambilla, T., Bianchi, L., Maccabruni, A., Taylor, Gp, Lyall, Egh, Penn, Z., Buffolano, W., Martinelli, P., Sansone, M., Tibaldi, C., Marini, C., Masuelli, G., Benedetto, C., Niemiec, T., and Marczynska, M.

34. alpha-Synuclein multiplication analysis in Italian familial Parkinson disease.

Author

Sironi F, Trotta L, Antonini A, Zini M, Ciccone R, Della Mina E, Meucci N, Sacilotto G, Primignani P, Brambilla T, Coviello DA, Pezzoli G, Goldwurm S, Sironi, Francesca, Trotta, Luca, Antonini, Angelo, Zini, Michela, Ciccone, Roberto, Della Mina, Erika, and Meucci, Nicoletta

Abstract

The alpha-synuclein gene (SNCA) multiplication causes autosomal dominant Parkinson Disease (PD): triplication is associated with early-onset rapidly progressing parkinsonism with a strong likelihood of developing dementia, while duplication is associated with a less severe phenotype similar to idiopathic PD. We tested for SNCA multiplication 144 unrelated PD patients with a dominant family history. We identified one patient with SNCA duplication (0.7%). The SNCA-duplicated patient was a woman of 45 years of age with PD onset at 41 years of age. She experienced a rapidly progressive disease with early motor complications (on/off fluctuations and dyskinesias). Medical records confirmed that the proband's mother developed PD at 47 years of age and died at 63 with dementia. She experienced rapid progression in both motor and cognitive symptoms: development of dementia at 54 years of age, 7 years after onset. Although SNCA duplication is an unusual cause of familial PD testing for it is worthwhile. The clinical presentation of duplicated cases may be more aggressive than usual. [ABSTRACT FROM AUTHOR]

Published
2010
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35. Exposure to antiretroviral therapy in utero or early life: the health of uninfected children born to HIV-infected women

Author

Newell, ML, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Mok, J, Johnstone, F, de Jose, I, Bates, I, Salas, S, de Guevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Garcia-Rodriguez, MC, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, GREGORI, PIETRO, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, LEVY, JOHANNA, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Ferrazin, A, Bassetti, D, DE MARIA, ANTONELLA, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Rovira, MA, Carreras, R, Valerius, NH, Coll, O, Vidal, R, PEREZ, JESUS MARIA, Boguna, J, Fortuny, C, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Savasi, V, Vigano, A, Ferrazzi, E, BRAMBILLA, TERESA, Bianchi, L, Maccabruni, A, Taylor, GP, Lyall, EGH, Penn, Z, Buffolano, W, Martinelli, P, Sansone, M, Tibaldi, C, Marini, C, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Newell, ML, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Mok, J, Johnstone, F, de Jose, I, Bates, I, Salas, S, de Guevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Garcia-Rodriguez, MC, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, Gregori, P, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Ferrazin, A, Bassetti, D, De Maria, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Rovira, MA, Carreras, R, Valerius, NH, Coll, O, Vidal, R, Perez, JM, Boguna, J, Fortuny, C, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Savasi, V, Vigano, A, Ferrazzi, E, Brambilla, T, Bianchi, L, Maccabruni, A, Taylor, GP, Lyall, EGH, Penn, Z, Buffolano, W, Martinelli, P, Sansone, M, Tibaldi, C, Marini, C, Masuelli, G, Benedetto, C, Niemiec, T, and Marczynska, M

Subjects
Europe, antiretroviral therapy, HIV, uninfected children, abnormalities
Abstract

Concerns have been raised over possible adverse effects of prophylactic antiretroviral therapy (ART) on the fetus and newborn. We analyzed data relating to uninfected children enrolled in the European Collaborative Study and investigated the association between ART exposure, perinatal problems, and major adverse health events later in life. Median length of follow-up was 2.2 (0-15.9) years. Of the 2414 uninfected children, 687 (28%) were exposed to ART in all three periods (antenatal, intrapartum, and neonatal). Of the 1008 infants exposed to ART at any time, 906 (90%) were exposed antenatally, 840 (83%) neonatally, and 750 (74%) both antenatally and neonatally. ART exposure was not significantly associated with pattern or prevalence of congenital abnormalities or low birth weight. In multivariate analysis, prematurity was associated with exposure to combination therapy without a protease inhibitor (PI) (OR = 2.66; 95% CI: 1.52-4.67) and with a PI (OR = 4.14; 95% CI: 2.36-7.23). ART exposure was associated with anemia in early life (P < .001). There was no evidence of an association with clinical manifestations suggestive of mitochondrial abnormalities. The absence of serious adverse events in this large cohort of uninfected children exposed to prophylactic ART in the short to medium term is reassuring.

Published
2004

36. Myeloid and T-Cell Microenvironment Immune Features Identify Two Prognostic Sub-Groups in High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms.

Author

Centonze G, Lagano V, Sabella G, Mangogna A, Garzone G, Filugelli M, Belmonte B, Cattaneo L, Crisafulli V, Pellegrinelli A, Simbolo M, Scarpa A, Spaggiari P, Brambilla T, Pusceddu S, Prinzi N, Anichini A, Tripodo C, and Milione M

Abstract

High-grade Gastroenteropancreatic Neuroendocrine neoplasms (H-NENs) comprehend well-differentiated tumors (NET G3) and poorly differentiated carcinomas (NEC) with proliferative activity indexes as mitotic count (MC) >20 mitoses/10 HPF and Ki-67 >20%. At present, no specific therapy for H-NENs exists and the several evidences of microenvironment involvement in their pathogenesis pave the way for tailored therapies. Forty-five consecutive cases, with available information about T-cell, immune, and non-immune markers, from surgical pathology and clinical databases of 2 Italian institutions were immunostained for Arginase, CD33, CD163 and CD66 myeloid markers. The association between features was assessed by Spearman's correlation coefficient. A unsupervised K-means algorithm was used to identify clusters of patients according to inputs of microenvironment features and the relationship between clusters and clinicopathological features, including cancer-specific survival (CSS), was analyzed. The H-NEN population was composed of 6 (13.3%) NET G3 and 39 (86.7%) NEC. Overall, significant positive associations were found between myeloid (CD33, CD163 and Arginase) and T/immune markers (CD3, CD4, CD8, PD-1 and HLA-I). Myeloid and T-cell markers CD3 and CD8 identified two clusters of patients from unsupervised K-means analysis. Cases grouped in cluster 1 with more myeloid infiltrates, T cell, HLA and expression of inhibitory receptors and ligands in the stroma (PD-1, PD-L1) had significantly better CSS than patients in cluster 2. Multivariable analysis showed that Ki-67 (>55 vs. <55, HR 8.60, CI 95% 2.61-28.33, p < 0.0001) and cluster (1 vs. 2, HR 0.43, CI 95% 0.20-0.93, p = 0.03) were significantly associated with survival. High grade gastroenteropancreatic neuroendocrine neoplasms can be further classified into two prognostic sub-populations of tumors driven by different tumor microenvironments and immune features able to generate the framework for evaluating new therapeutic strategies.

Published
2021
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37. Digital Pathology During the COVID-19 Outbreak in Italy: Survey Study.

Author

Giaretto S, Renne SL, Rahal D, Bossi P, Colombo P, Spaggiari P, Manara S, Sollai M, Fiamengo B, Brambilla T, Fernandes B, Rao S, Elamin A, Valeri M, De Carlo C, Belsito V, Lancellotti C, Cieri M, Cagini A, Terracciano L, Roncalli M, and Di Tommaso L

Subjects
Bayes Theorem, Disease Outbreaks, Humans, Internship and Residency methods, Internship and Residency standards, Italy epidemiology, Microscopy, Surveys and Questionnaires, COVID-19 epidemiology, Clinical Competence, Diagnostic Imaging methods, Diagnostic Imaging standards, Image Processing, Computer-Assisted methods, Image Processing, Computer-Assisted standards, Pathology, Clinical methods, Pathology, Clinical standards
Abstract

Background: Transition to digital pathology usually takes months or years to be completed. We were familiarizing ourselves with digital pathology solutions at the time when the COVID-19 outbreak forced us to embark on an abrupt transition to digital pathology., Objective: The aim of this study was to quantitatively describe how the abrupt transition to digital pathology might affect the quality of diagnoses, model possible causes by probabilistic modeling, and qualitatively gauge the perception of this abrupt transition., Methods: A total of 17 pathologists and residents participated in this study; these participants reviewed 25 additional test cases from the archives and completed a final psychologic survey. For each case, participants performed several different diagnostic tasks, and their results were recorded and compared with the original diagnoses performed using the gold standard method (ie, conventional microscopy). We performed Bayesian data analysis with probabilistic modeling., Results: The overall analysis, comprising 1345 different items, resulted in a 9% (117/1345) error rate in using digital slides. The task of differentiating a neoplastic process from a nonneoplastic one accounted for an error rate of 10.7% (42/392), whereas the distinction of a malignant process from a benign one accounted for an error rate of 4.2% (11/258). Apart from residents, senior pathologists generated most discrepancies (7.9%, 13/164). Our model showed that these differences among career levels persisted even after adjusting for other factors., Conclusions: Our findings are in line with previous findings, emphasizing that the duration of transition (ie, lengthy or abrupt) might not influence the diagnostic performance. Moreover, our findings highlight that senior pathologists may be limited by a digital gap, which may negatively affect their performance with digital pathology. These results can guide the process of digital transition in the field of pathology., (©Simone Giaretto, Salvatore Lorenzo Renne, Daoud Rahal, Paola Bossi, Piergiuseppe Colombo, Paola Spaggiari, Sofia Manara, Mauro Sollai, Barbara Fiamengo, Tatiana Brambilla, Bethania Fernandes, Stefania Rao, Abubaker Elamin, Marina Valeri, Camilla De Carlo, Vincenzo Belsito, Cesare Lancellotti, Miriam Cieri, Angelo Cagini, Luigi Terracciano, Massimo Roncalli, Luca Di Tommaso. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.02.2021.)

Published
2021
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38. Multi-band mucosectomy for neoplasia in patients with Barrett's esophagus: in vivo comparison between two different devices.

Author

Spadaccini M, Bhandari P, Maselli R, Spaggiari P, Alkandari AA, Varytimiadis L, Semeraro R, Di Leo M, Galtieri PA, Craviotto V, Lamonaca L, D'Amico F, Attardo S, Brambilla T, Sharma P, Hassan C, and Repici A

Subjects
Aged, Case-Control Studies, Digestive System Surgical Procedures adverse effects, Esophagoscopy, Female, Follow-Up Studies, Humans, Male, Neoplasm Recurrence, Local pathology, Retrospective Studies, Barrett Esophagus surgery, Digestive System Surgical Procedures instrumentation, Esophageal Neoplasms surgery
Abstract

Background: Multi-band mucosectomy (MBM) is effective and safe for Barrett's neoplasia. No studies have yet compared the efficacy and safety of the MBM devices commercially available: Duette™ (CookMedical) and Captivator™ (BostonScientific). Our aim is to compare the two devices., Methods: This is a dual-center retrospective case-control study (Rozzano, Portsmouth) comparing efficacy, safety, and histology of resected specimens between Duette™ (DUE) and Captivator™ (CAPT). Efficacy was assessed by R0 and local recurrence (LR) rate. Bleedings, perforations, and strictures were recorded as safety outcomes. Moreover, the specimens were re-examined by two pathologists, blinded about the study group, to assess the maximum thickness of both the whole specimens and the resected submucosal layer., Results: Seventy-six patients (38 per group) were included. The two groups did not differ in terms of baseline characteristics. R0 resection was achieved in 96.7% versus 96.3% (p = ns) and LR were recorded in 4/38 (10.5%) versus 3/38 (7.9%) in DUE and CAPT group, respectively (p = ns). Considering Duette™ versus Captivator™, 2 versus 3 patients developed a symptomatic stricture. Only one post-procedural bleeding occurred (Captivator™). Maximum medium thicknesses of specimens and of resected submucosa did not differ between the groups., Conclusions: MBM is safe and effective for resecting visible lesions using either of the two available devices.

Published
2020
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39. Thrombosis of the dorsal vein of the penis as first clinical presentation of pancreatic cancer metastatic to the penis.

Author

Virdis M, Bonifacio C, Brambilla T, Capretti G, De Nittis P, Uccelli F, and Zerbi A

Subjects
Aged, Biopsy, Combined Modality Therapy, Fatal Outcome, Humans, Male, Neoplasm Staging, Penile Neoplasms therapy, Penis pathology, Symptom Assessment, Tomography, X-Ray Computed, Venous Thrombosis etiology, Pancreatic Neoplasms pathology, Penile Neoplasms diagnosis, Penile Neoplasms secondary, Venous Thrombosis diagnosis
Abstract

Introduction: Though metastatic disease is a common presentation of pancreatic adenocarcinoma, localization to the penis is an extremely rare event despite its abundant vascularization. Primary cancers responsible for penile metastases usually occur in prostate and rectum and are often associated with disseminated malignancy and poor prognosis., Case Description: A 66-year-old man was diagnosed with adenocarcinoma of the tail of the pancreas after the onset of thrombosis of the dorsal vein of the penis; pubis ultrasound and total body computed tomography scan were negative for metastases at other sites. The patient was submitted to distal pancreatectomy with splenectomy for a pT3 N1 G4 pancreatic ductal adenocarcinoma. Three weeks after discharge, the patient returned to the outpatient clinic complaining of a painful permanent turgidity of the penis shaft. Ultrasound revealed a complete replacement of the cavernosal bodies by multiple nodular masses and a penile biopsy confirmed metastases from the primary pancreatic cancer. The patient started chemotherapy with NAB-paclitaxel and gemcitabine, with excellent control of symptoms. However, the disease progressed to bone and liver and the patient died 9 months after surgery., Conclusions: Penile localization is an extremely rare event and a standard of care has not been elaborated. Treatments are palliative and mainly aimed at pain relief and can comprise chemotherapy, radiotherapy, and surgery. Identification of venous thrombosis as an early sign of involvement could potentially offer patients an earlier diagnosis and a better treatment option.

Published
2019
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40. Neuroendocrine Tumors (NETs) of the Minor Papilla/Ampulla: Analysis of 16 Cases Underlines Homology With Major Ampulla NETs and Differences From Extra-Ampullary Duodenal NETs.

Author

Vanoli A, Albarello L, Uncini S, Fassan M, Grillo F, Di Sabatino A, Martino M, Pasquali C, Milanetto AC, Falconi M, Partelli S, Doglioni C, Schiavo-Lena M, Brambilla T, Pietrabissa A, Sessa F, Capella C, Rindi G, La Rosa S, Solcia E, and Paulli M

Subjects
Adult, Aged, Female, Humans, Male, Middle Aged, Biomarkers, Tumor analysis, Italy, Lymphatic Metastasis, Neoplasm Grading, Time Factors, Tumor Burden, Ampulla of Vater chemistry, Ampulla of Vater pathology, Ampulla of Vater surgery, Duodenal Neoplasms chemistry, Duodenal Neoplasms pathology, Duodenal Neoplasms surgery, Neuroendocrine Tumors chemistry, Neuroendocrine Tumors pathology, Neuroendocrine Tumors surgery
Abstract

Neuroendocrine tumors (NETs) of the minor papilla/ampulla (MIPA) are rare and poorly studied. Only individual case reports and no comprehensive analysis are available from the literature. We collected 16 MIPA NETs and investigated their clinicopathologic and immunohistochemical features, including markers such as somatostatin, pancreatic polypeptide, gastrin, serotonin, MUC1, cytokeratin 7, and somatostatin receptors type 2A and 5. The median age at diagnosis was 57.5 years, and the female-to-male ratio was 2.2:1. The median NET size was 1.45 cm, and most (94%) were low-grade (G1) tumors. Similarly to what was observed in the major ampulla, 3 histotypes were found: (i) ampullary-type somatostatin-producing tumors (ASTs, 10 cases), characterized by somatostatin expression in most tumor cells, focal-to-extensive tubulo-acinar structures, often with psammoma bodies, MUC1 reactivity, and no or rare membranous reactivity for somatostatin receptor type 2A; (ii) gangliocytic paragangliomas (3 cases), characterized by the coexistence of 3 tumor cell types: epithelioid, often reactive for pancreatic polypeptide, ganglion-like cells, and S100 reactive sustentacular/stromal cells; and (iii) ordinary nonfunctioning NETs (3 cases), resembling those more commonly observed in the extra-ampullary duodenum. Comparable histotypes could also be recognized among the 30 MIPA NETs from the literature. No NET-related patient death among MIPA cases was observed during a median follow-up of 38 months; however, MIPA ASTs showed lymph node metastases and invasion of the duodenal muscularis propria or beyond in 44% and 40% of cases, respectively. In conclusion, MIPA NETs closely resemble tumors arising in the major ampulla, with predominance of ASTs.

Published
2019
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41. One-Step Nucleic Acid Amplification in Breast Cancer Sentinel Lymph Node: A Single Institutional Experience and a Short Review.

Author

Brambilla T, Fiamengo B, Tinterri C, Testori A, Grassi MM, Sciarra A, Abbate T, Gatzemeier W, Roncalli M, and Di Tommaso L

Abstract

Sentinel lymph node (SLN) examination is a standard in breast cancer patients, with several methods employed along its 20 years history, the last one represented by one-step nucleic acid amplification (OSNA). The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3 years experience with OSNA (1122 patients) showed results overlapping those recorded in the same institution with a morphological evaluation (930 patients) of SLN. In detail, the data of OSNA were almost identical to those observed with standard post-operative procedure in terms of patients with positive SLN (30%) and micrometastatic/macrometastatic involvement of SLN (respectively, 38-45 and 62-55%). By contrast, when OSNA was compared to the standard intraoperatory procedure, it was superior in terms of accuracy, prompting the use of this molecular assay as a very valid, and reproducible for intra-operative evaluation of SLN. Further possibilities prompting the use of OSNA range from adhesion to quality control programs, saving of medical time, ability to predict, during surgery, additional nodal metastasis, and molecular bio-banking.

Published
2015
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42. Unexpected vertical transmission of HIV infection.

Author

Giacomet V, Viganò A, Erba P, Nannini P, Pisanelli S, Zanchetta N, Brambilla T, Ramponi G, and Zuccotti GV

Subjects
Antiretroviral Therapy, Highly Active methods, Female, HIV Infections drug therapy, Humans, Infant, Newborn, Male, Pregnancy, Pregnancy Complications, Infectious drug therapy, Risk Factors, HIV Infections transmission, Infectious Disease Transmission, Vertical, Pregnancy Complications, Infectious virology
Abstract

Mother-to-child transmission of HIV infection occurred in a child born from an HIV-infected mother with HIV-RNA undetectable during pregnancy. She was suffering from gastroenteritis in the last 3 weeks of gestation.

Published
2014
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43. Screening LRRK2 gene mutations in patients with Parkinson's disease in Ghana.

Author

Cilia R, Sironi F, Akpalu A, Cham M, Sarfo FS, Brambilla T, Bonetti A, Amboni M, Goldwurm S, and Pezzoli G

Subjects
Adult, Aged, Aged, 80 and over, Female, Genetic Testing, Ghana epidemiology, Humans, Leucine-Rich Repeat Serine-Threonine Protein Kinase-2, Male, Middle Aged, Parkinson Disease epidemiology, Retrospective Studies, Genetic Predisposition to Disease, Mutation genetics, Parkinson Disease genetics, Protein Serine-Threonine Kinases genetics
Published
2012
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44. Parkin analysis in early onset Parkinson's disease.

Author

Sironi F, Primignani P, Zini M, Tunesi S, Ruffmann C, Ricca S, Brambilla T, Antonini A, Tesei S, Canesi M, Zecchinelli A, Mariani C, Meucci N, Sacilotto G, Cilia R, Isaias IU, Garavaglia B, Ghezzi D, Travi M, Decarli A, Coviello DA, Pezzoli G, and Goldwurm S

Subjects
Adult, Age of Onset, DNA Mutational Analysis, Exons genetics, Female, Gene Dosage, Gene Frequency, Genotype, Humans, Male, Phenotype, Severity of Illness Index, Statistics, Nonparametric, Genetic Predisposition to Disease, Mutation genetics, Parkinson Disease genetics, Ubiquitin-Protein Ligases genetics
Abstract

We analysed the parkin gene in a large consecutive series (146) of unrelated early onset Parkinson's disease (onset ?40 years of age) patients. Twelve cases (8.2%) had homozygous or compound heterozygous point mutations and/or exon rearrangements, while a single mutation was found in four subjects (2.7%). We identified eight exon rearrangements and nine point mutations, two of which were novel: c.735delT (p.C212/X224) and c.815C>G (p.C238W). Genotype-phenotype correlation revealed that parkin carriers had features similar to those of non-carrier early onset Parkinson disease patients.

Published
2008
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45. Histopathological and molecular studies in patients with goiter and hypercalcitoninemia: reactive or neoplastic C-cell hyperplasia?

Author

Verga U, Ferrero S, Vicentini L, Brambilla T, Cirello V, Muzza M, Beck-Peccoz P, and Fugazzola L

Subjects
Adult, Aged, Brain Stem Neoplasms diagnosis, Female, Goiter, Nodular diagnosis, Humans, Hyperplasia diagnosis, Hyperplasia pathology, Male, Middle Aged, Mutation, Proto-Oncogene Proteins c-ret genetics, Thyroid Neoplasms diagnosis, Brain Stem Neoplasms pathology, Calcitonin blood, Goiter, Nodular pathology, Thyroid Neoplasms pathology
Abstract

The cut-off values able to differentiate between reactive or neoplastic C-cell hyperplasia (CCH) or to predict sporadic medullary thyroid cancer (MTC) are still debated both for basal and stimulated calcitonin (bCT and sCT). In the present study, the prevalence and the histological patterns of CCH in 15 patients with multinodular goiter (MNG), bCT>10 pg/ml and sCT levels >50 pg/ml were studied. As controls, 16 patients with MNG and bCT levels <10 pg/ml and 4 patients with familial (FMTC) were included. For each case, calcitonin (CT) immunoreactive cells were counted in 60 consecutive high-power fields (400x) and CCH classified as focal, diffuse, nodular, or neoplastic. RET genetic analyses were performed at the germline and tissue levels in MTC and CCH cases. In patients with MNG, sCT levels >50 pg/ml were associated with CCH or MTC, being the total number of C-cells/60 fields significantly higher than that found in MNG with normal bCT (P = 0.0008) and comparable with that detected in FMTCs. In the group with sCT>50 pg/ml, the C-cells displayed a neoplastic phenotype. Neither germline nor somatic RET mutations were found. In conclusion, sCT levels >50 pg/ml were always associated with CCH, without correlation between CT levels and the number of C-cells or the final diagnosis. The C-cells had a morphology and distribution pattern similar to those observed in FMTC. Thus, sCT levels >50 pg/ml indicate the presence of CCH with a possible preneoplastic potential, suggesting the opportunity to perform a prophylactic surgical treatment.

Published
2007
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