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1. Novelties in Brazilian Tradescantia L. (Commelinaceae)

Author

Marco O. O. Pellegrini, Rafaela C. Forzza, and Cassia M. Sakuragui

Subjects
Botany, QK1-989
Abstract

We present a new record to the Brazilian territory (i.e. Tradescantia boliviana), the rediscovery of a species exclusively known from the cultivated type collection (i.e. T. valida), the description of a new taxon (i.e. T. chrysophylla), synonyms for T. crassula and T. boliviana, correct the typification of T. crassula, and designation of a lectotype for T. ambigua and T. ambigua var. pilosula. Furthermore, we present illustrations, comments, distribution maps, and identification keys for the studied taxa.

Published
2017
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2. Active Brazilian crack cocaine users: nutritional, anthropometric, and drug use profiles

Author

Mariana Escobar, Juliana N. Scherer, Cassia M. Soares, Luciano S.P. Guimarães, Martine E. Hagen, Lisia von Diemen, and Flavio Pechansky

Subjects
Crack cocaine, nutritional assessment, nutritional status, biochemical parameters, Psychiatry, RC435-571
Abstract

Objective: To evaluate the nutritional status of crack users and to analyze its correlation with drug use profiles. Methods: Cross-sectional study with 108 crack users. Anthropometric data were assessed through body mass index (BMI) and bioimpedance (BIA) measurements. A blood test to analyze hematocrit, hemoglobin, glucose, and lipid profiles was also performed. Crack use was determined through a standardized interview. Results: Based on BMI and BIA, most individuals were eutrophic (about 70%). Regarding hematological parameters, we found that hemoglobin and hematocrit levels were below normal for 32.4 and 30.6% of patients, respectively. Considering normal parameters, a large part of the sample (60.2%) had low levels of HDL cholesterol and high levels of triglycerides (38%). There were no significant correlations between drug profile and nutritional variables. Conclusion: This is a pioneering study that examines the nutritional status of crack users. Our results showed that most crack users present normal anthropometric findings and the prevalence of underweight is low. However, blood analysis showed changes and a specific type of malnutrition.

Published
2018
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3. PHYTOCHEMICAL AND PHYLOGENETIC ANALYSIS OF Spondias(Anacardiaceae)

Author

Cristiane Pereira, Letícia L. de Oliveira, Ricardo Gonçalves, Ana Claudia F. Amaral, Ricardo M. Kuster, and Cassia M. Sakuragui

Subjects
Spondias, flavonol 3-O-glycosides, molecular phylogeny, Chemistry, QD1-999
Abstract

This paper describes the correlation between the phenolic composition and the molecular phylogenetic reconstruction of five Spondias species (Anacardiaceae). Two of these species (S. venulosa and Spondias sp.) occur in rainforest areas and the other three are widely distributed in Brazil (S. dulcis, S.mombin, and S. purpurea). The flavonoid enriched fraction of the S. venulosa leaf extract also underwent a chemical study. The results indicate that the presence of flavonol 3-O-glycosides are a synapomorphic character of the studied American Spondias and the production of rhamnetin 3-O-rutinoside is a synapomorphy of the Atlantic forest species. This is the first report of flavonoids in S. venulosa, an endemic species from the Brazilian Atlantic rainforest.

Published
2015
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5. Evaluation of acute administration of natural products with potential diuretic effects, in humans

Author

Sandra M. R. Laranja, Cassia M. Bergamaschi, and Nestor Schor

Subjects
Natural products, diuretics, Elephantopus scaber, Alpinia speciosa, Microbiology, QR1-502, Infectious and parasitic diseases, RC109-216
Abstract

In order to evaluate the potential diuretic effect of two natural products, Elephantopus scaber and Alpinia speciosa, a trial administration was carried out in ten healthy volunteers and the effects compared to the those of a placebo. The substances were given on different days, with a seven day interval between doses. The amount of substance administered to the subjects was five times the usual dose i.e. 7.5 g/100 ml and 0.8 g/100 ml respectively. The following parameters parameteres were measured: urinary and plasma sodium, potassium, uric acid, calcium, phosphate, urea, creatinine. The subjects were also examined clinically and total urinary volume was assessed. The only significant finding (p < 0.05) was a slight diuresis with Alpinia speciosa, which also lowered the diastolic (p < 0.05) and systolic (p < 0.01) blood pressures. No effect on electrolytes or renal function parameters was observed, and this probably excludes any renal tubular or glomerular effect from these substances.

Published
1991
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7. O gênero Philodendron (Araceae) no estado do Paraná

Author

Camila V. Buturi, Lívia G. Temponi, and Cassia M. Sakuragui

Subjects
Floresta Atlântica, filodendro, imbé, levantamento florístico, taxonomia, Biology (General), QH301-705.5, Botany, QK1-989
Abstract

Resumo O trabalho apresenta a flora do gênero Philodendron (Araceae) no estado do Paraná. Foram registradas 13 espécies, incluindo duas espécies recentemente descritas e três novos registros para o estado: P. appendiculatum, P. bipinnatifidum, P. camposportoanum, P. corcovadense, P. crassinervium, P. eximium, P. loefgrenii, P. meridionale, P. missionum, P. obliquifolium, P. propinquum, P. rheophyticum e P. roseopetiolatum. Essas espécies foram encontradas nas três principais formações da Floresta Atlântica do Paraná: na Floresta Estacional Semidecidual cinco espécies, na Floresta Ombrófila Mista sete espécies e na Floresta Ombrófila Densa, com maior representatividade, foram registradas 11 espécies. Além disso, a Floresta Ombrófila Densa apresentou maior endemismo, com quatro espécies exclusivas a essa formação vegetacional. Três espécies foram consideradas criticamente em perigo no estado do Paraná, por apresentarem registro em apenas uma ou duas localidades do estado: P. camposportoanum, P. eximium e P. roseopetiolatum. Esse trabalho apresenta uma chave de identificação, pranchas de fotografias, ilustração dos caracteres diagnósticos e comentários taxonômicos de cada espécie de Philodendron encontrada no Paraná.

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16. Increasing depth reduces macrophyte coverage but increasing transparency promotes composition turnover through environmental thresholds

Author

Yasmin M. Canalli, Bruno E. Soares, and Cassia M. Sakuragui

Subjects
Ecology, Aquatic Science, Oceanography, Ecology, Evolution, Behavior and Systematics
Abstract

Context Environmental filters modify the coverage and frequency patterns of macrophyte communities. Aims We characterised the thresholds in depth and transparency at which the macrophyte distribution shifted in an Atlantic Forested wetland. Methods Macrophyte communities were characterised in 150 plots divided into 6 transects. Key results Threshold indicator taxa analysis (TITAN) indicated that free-floating life forms respond negatively to depth and transparency increase. Rooted-floating species responded negatively to an increase in depth and transparency; by contrast, submerged species responded positively to increased transparency. Conclusion TITAN also highlighted that the entire macrophyte community responded negatively to increased depth but exhibited a synchronous turnover among species responding positively and negatively to transparency. Implications Our results demonstrated that macrophyte responses to increasing depth and transparency are non-linear and depend on species life forms.

Published
2023
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19. Multicriteria optimization to develop cost-effective pes-schemes to restore multiple environmental benefits in the Brazilian Atlantic forest

Author

Lemos, Cassia M. G., Beyer, Hawthorne L., Runting, Rebecca K., Andrade, Pedro R., Aguiar, Ana Paula D., Lemos, Cassia M. G., Beyer, Hawthorne L., Runting, Rebecca K., Andrade, Pedro R., and Aguiar, Ana Paula D.

Abstract

Understanding the cost-effectiveness of restoration initiatives is critical for their successful implementation. In this context, this study presents a new approach to investigating the cost-effectiveness of different forest landscape restoration strategies for achieving multiple restoration goals. The approach is based on an optimization model that allocates forest restoration to maximize three environmental benefits (biodiversity conservation, carbon stock increase, and soil loss reduction) while minimizing the cost. We explore scenarios based on the Brazilian Forest Code and the National Policy for Payment for Ecosystem Services. Our optimization approach simultaneously achieves high levels of multiple environmental benefits - more than 90% of the maximum possible biodiversity, carbon, and soil in a cost-effective manner for all scenarios. Variation among the scenarios in the absolute performance concerning the three objectives was small (within 2.5%) compared to variation in costs (up to 19.4%). These results reinforce the importance of quantifying trade-offs among objectives to a better understanding of the cost-effectiveness of restoration initiatives before their implementation.

Published
2023
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20. Il miele: cibo degli dei, cibo tossico

Author

Cassia, M., Bearzot, Cinzia Susanna, Bearzot, C. (ORCID:0000-0003-4414-7963), Cassia, M., Bearzot, Cinzia Susanna, and Bearzot, C. (ORCID:0000-0003-4414-7963)

Abstract

Il contributo considera il carattere del miele come cibo legato alla civilizzazione e all’uscita dallo stato ferino, come il grano e il vino; prende poi in esame le fonti relative all’esistenza di miele tossico; infine, mette in evidenza l’incongruenza tra l’idea di cibo divino e quella di cibo velenoso., The paper considers the character of honey as a food linked to civilisation and to leaving the feral state, like wheat and wine; it then examines the sources relating to the existence of toxic honey; finally, it highlights the inconsistency between the idea of divine food and that of poisonous food.

Published
2023

21. Turbulence Kinetic Energy Dissipation Rate Estimate for a Low-Level Jet with Doppler Lidar Data: A Case Study

Author

Cassia M. L. Beu and Eduardo Landulfo

Subjects
General Earth and Planetary Sciences
Abstract

Low-level jets are a recurrent feature of our study area in Ipero municipality of southeastern Brazil. They grow very near the surface as shown by this case study. These two aspects increase the needs for a realistic modeling of the low-level jet to simulate the atmospheric dispersion of industrial emissions. In this concern, we applied a recently proposed technique to estimate the turbulence kinetic energy dissipation rate of a low-level jet case with Doppler lidar data. This low-level jet remained for its entire lifetime (around 12 h) within a shallow layer (under 300 m); beyond this, we did not notice a remarkable directional shear as in other studies. Even for a shallow layer as for this study case, we observed strong spatiotemporal variability of the turbulence kinetic energy dissipation rate. We also detected a channel connecting the layers above and below the low-level jet that may be an exchange channel of their properties.

Published
2022
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23. LB2303. Single High-dose of Liposomal Amphotericin B in HIV/AIDS-related Disseminated Histoplasmosis: a Randomized Trial

Author

Alessandro C Pasqualotto, Cassia M Godoy, Daiane Dalla Lana, Terezinha S Leitao, Monica B Bay, Lisandra S Damasceno, Renata B Soares, Diego R Falci, Roger Kist, Larissa R Silva, Marineide Melo, Taiguara F Guimaraes, Marilia R Guimaraes, Hareton T Vechi, Jaco Mesquita, Erianna Y Macedo, Antoine A Adenis, Nathan C Bahr, Andrej Spec, David R Boulware, Dennis Israelski, and Tom M Chiller

Subjects
Infectious Diseases, Oncology
Abstract

Background Histoplasmosis is a major AIDS-defining infection in Latin America. Liposomal amphotericin B (L-AmB) is the drug of choice for treatment, but access is limited. Methods Prospective randomized open-label trial of induction therapy with L-AmB for disseminated histoplasmosis in AIDS, followed by oral itraconazole therapy (started on the day after L-AmB was finished). We conducted this trial at 6 centers in Brazil (2019-2022). We randomized subjects to 3 arms of: Single dose 10 mg/kg of L-AmB;10 mg/kg of L-AmB on D1, and 5 mg/kg of L-AmB on D3;3 mg/kg of L-AmB for 2 weeks (control). As a non-inferiority trial, 80% power could detect > 20% non-inferiority margin for a one-sided alpha=0.05 with a sample size of 29 subjects per arm. Clinical response at day 14 was the primary outcome. Results Of 512 screened patients, 118 subjects were randomized (Arm 1, n=40; Arm 2, n=39; Arm 3, n=39). Median CD4 was 25 cells/µL. Subjects presented with weight loss (70%), pulmonary complaints (67%), fever (66%), abdominal findings (59%), skin lesions (38%), lymphadenopathy (38%), and oral lesions (36%). Clinical and lab findings did not differ among arms. Histoplasmosis diagnosis was predominantly via urine antigen (97%). Infusion-related toxicity on D1 was similar in each arm (p=0.56). Kidney toxicity was similar on D3 (p=0.83), D7 (p=0.10), and D14 (p=0.17) as was frequency of anemia, hypokalemia, hypomagnesemia, and liver toxicity (all p >0.05). No subject withdrew due to drug toxicities. D14 clinical response was 82% for Arm 1, 68% Arm 2, and 72% Arm 3 (p=0.69). Absolute risk difference for Arm 1 was 10.3% (95%CI, -8.3% to 28.8%) vs. Arm 3 controls; Arm 2 was -4.2% (95%CI, -24.9% to 16.4%) to controls. Overall survival on D14 was 89.5% (34/38) for Arm 1, 78.4% (29/37) for Arm 2, and 92.1% (35/38) for Arm 3 (p=0.82); 2 subjects were excluded from efficacy analysis due to meningitis and tuberculosis, and 3 were lost to follow up. Conclusion Induction therapy with 10 mg/kg of L-AmB in AIDS-related histoplasmosis was safe. Although efficacy is likely to be non-inferior to standard L-AmB therapy, a confirmatory phase III trial is needed. Such a strategy would markedly reduce drug-acquisition costs (> 4-fold), therefore improving access to L-AmB across the globe. Disclosures Alessandro C. Pasqualotto, FECMM, Gilead: Grant/Research Support|United Medical: Advisor/Consultant|United Medical: Honoraria Diego R. Falci, MD, United Medical: Advisor/Consultant|United Medical: Honoraria Andrej Spec, MD, MSCI, Astellas: Grant/Research Support Dennis Israelski, MD, Gilead Sciences: Empoyee.

Published
2022
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24. LB2303. Single High-dose of Liposomal Amphotericin B in HIV/AIDS-related Disseminated Histoplasmosis: a Randomized Trial

Author

Pasqualotto, Alessandro C, primary, Godoy, Cassia M, additional, Lana, Daiane Dalla, additional, Leitao, Terezinha S, additional, Bay, Monica B, additional, Damasceno, Lisandra S, additional, Soares, Renata B, additional, Falci, Diego R, additional, Kist, Roger, additional, Silva, Larissa R, additional, Melo, Marineide, additional, Guimaraes, Taiguara F, additional, Guimaraes, Marilia R, additional, Vechi, Hareton T, additional, Mesquita, Jaco, additional, Macedo, Erianna Y, additional, Adenis, Antoine A, additional, Bahr, Nathan C, additional, Spec, Andrej, additional, Boulware, David R, additional, Israelski, Dennis, additional, and Chiller, Tom M, additional

Published
2022
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27. Nemaline Myopathy in Brazilian Patients: Molecular and Clinical Characterization

Author

Gurgel-Giannetti, Juliana, primary, Souza, Lucas Santos, additional, Yamamoto, Guilherme L., additional, Belisario, Marina, additional, Lazar, Monize, additional, Campos, Wilson, additional, Pavanello, Rita de Cassia M., additional, Zatz, Mayana, additional, Reed, Umbertina, additional, Zanoteli, Edmar, additional, Oliveira, Acary Bulle, additional, Lehtokari, Vilma-Lotta, additional, Casella, Erasmo B., additional, Machado-Costa, Marcela C., additional, Wallgren-Pettersson, Carina, additional, Laing, Nigel G., additional, Nigro, Vincenzo, additional, and Vainzof, Mariz, additional

Published
2022
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29. The evolution of antifungal therapy: Traditional agents, current challenges and future perspectives

Author

Cássia Milena de Souza, Bárbara Tavares Bezerra, Daniel Agreda Mellon, and Haroldo Cesar de Oliveira

Subjects
Antifungal therapy, Antifungal drugs, Antifungal drug development, Microbiology, QR1-502, Genetics, QH426-470
Abstract

Fungal infections kill more than 3 million people every year. This high number reflects the significant challenges that treating these diseases worldwide presents. The current arsenal of antifungal drugs is limited and often accompanied by high toxicity to patients, elevated treatment costs, increased frequency of resistance rates, and the emergence of naturally resistant species. These treatment challenges highlight the urgency of developing new antifungal therapies, which could positively impact millions of lives each year globally. Our review offers an overview of the antifungal drugs currently available for treatment, presents the status of new antifungal drugs under clinical study, and explores ahead to future candidates that aim to help address this important global health issue.

Published
2025
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31. Nemaline Myopathy in Brazilian Patients: Molecular and Clinical Characterization

Author

Juliana Gurgel-Giannetti, Lucas Santos Souza, Guilherme L. Yamamoto, Marina Belisario, Monize Lazar, Wilson Campos, Rita de Cassia M. Pavanello, Mayana Zatz, Umbertina Reed, Edmar Zanoteli, Acary Bulle Oliveira, Vilma-Lotta Lehtokari, Erasmo B. Casella, Marcela C. Machado-Costa, Carina Wallgren-Pettersson, Nigel G. Laing, Vincenzo Nigro, Mariz Vainzof, Gurgel-Giannetti, Juliana, Souza, Lucas Santo, Yamamoto, Guilherme L, Belisario, Marina, Lazar, Monize, Campos, Wilson, Pavanello, Rita de Cassia M, Zatz, Mayana, Reed, Umbertina, Zanoteli, Edmar, Oliveira, Acary Bulle, Lehtokari, Vilma-Lotta, Casella, Erasmo B, Machado-Costa, Marcela C, Wallgren-Pettersson, Carina, Laing, Nigel G, Nigro, Vincenzo, and Vainzof, Mariz

Subjects
Myotonia Congenita, Organic Chemistry, Muscle Proteins, acta1, nebulin, General Medicine, Myopathies, Nemaline, Catalysis, Computer Science Applications, Inorganic Chemistry, congenital myopathy, Mutation, Humans, nemaline myopathy, Physical and Theoretical Chemistry, Muscle, Skeletal, Molecular Biology, Brazil, Spectroscopy
Abstract

Nemaline myopathy (NM), a structural congenital myopathy, presents a significant clinical and genetic heterogeneity. Here, we compiled molecular and clinical data of 30 Brazilian patients from 25 unrelated families. Next-generation sequencing was able to genetically classify all patients: sixteen families (64%) with mutation in NEB, five (20%) in ACTA1, two (8%) in KLHL40, and one in TPM2 (4%) and TPM3 (4%). In the NEB-related families, 25 different variants, 11 of them novel, were identified; splice site (10/25) and frame shift (9/25) mutations were the most common. Mutation c.24579 G>C was recurrent in three unrelated patients from the same region, suggesting a common ancestor. Clinically, the “typical” form was the more frequent and caused by mutations in the different NM genes. Phenotypic heterogeneity was observed among patients with mutations in the same gene. Respiratory involvement was very common and often out of proportion with limb weakness. Muscle MRI patterns showed variability within the forms and genes, which was related to the severity of the weakness. Considering the high frequency of NEB mutations and the complexity of this gene, NGS tools should be combined with CNV identification, especially in patients with a likely non-identified second mutation.

Published
2022
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32. A utilização de critérios diagnósticos de sepse na Atenção Primária à Saúde e o impacto nos desfechos clínicos

Author

Cássia Mariz da Silva, Thiago Figueiredo de Castro, Lucas Alves Carvalho, Luana de Oliveira Pires, and Rodolfo Rêgo Deusdará Rodrigues

Subjects
Atenção Primária à Saúde, Emergências, Sepse., Medicine (General), R5-920, Public aspects of medicine, RA1-1270
Abstract

Introdução: O atendimento de urgências e emergências médicas está incluído na carteira de serviços da Atenção Primária à Saúde (APS), abrangendo a sepse entre as urgências. A avaliação do paciente com suspeita de sepse deve, idealmente, incluir história clínica, exame físico, sinais vitais e aplicação de critérios diagnósticos específicos. Objetivo: Sintetizar as evidências sobre a utilização dos critérios diagnósticos de sepse pelos profissionais da APS e sua repercussão nas intervenções realizadas e nos desfechos clínicos. Métodos: Foi realizada uma revisão rápida da literatura disponível nas bases de dados Embase, LILACS e SciELO, utilizando os descritores “sepsis” e “primary care” e o operador booleano AND. Resultados: Foram selecionados 6 artigos, que variaram entre estudos observacionais, projetos de melhoria de qualidade, questionários transversais e coortes retrospectivas. Observou-se que a aplicação dos critérios diagnósticos de sepse na APS influencia o tempo de transporte ao hospital, a chance de atendimento por um médico mais experiente ou especialista, o diagnóstico oportuno de sepse, o tempo de internação hospitalar, a chance de internação em Unidade de Terapia Intensiva (UTI) e a mortalidade. Apenas metade dos profissionais é capaz de definir sepse corretamente e menos de um terço conhece o qSOFA, um dos critérios mais utilizados. Os aspectos mais considerados para a suspeita de sepse foram o estado geral do paciente e a intuição clínica. Conclusões: A APS desempenha um papel crucial no manejo da sepse; contudo, é essencial capacitar os profissionais de saúde sobre os critérios diagnósticos para garantir a identificação oportuna e o manejo adequado dos casos suspeitos.

Published
2024
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34. The Role of Rituximab in Primary Focal Segmental Glomerulosclerosis of the Adult

Author

Tedesco, M, Mescia, F, Pisani, I, Allinovi, M, Casazza, G, Del Vecchio, L, Santostefano, M, Cirillo, L, Ferrario, F, Esposito, C, Esposito, P, Santoro, D, Lazzarin, R, Rossi, G, Fiaccadori, E, Ferrantelli, A, Sinico, R, Cozzolino, M, Gallieni, M, Cirami, L, Scolari, F, Vaglio, A, Alberici, F, Affatato, S, Caroti, L, Mancini, E, Semeraro, L, Siligato, R, Cassia, M, Napodano, P, Calatroni, M, Distratis, C, Campo, A, Tedesco, Martina, Mescia, Federica, Pisani, Isabella, Allinovi, Marco, Casazza, Giovanni, Del Vecchio, Lucia, Santostefano, Marisa, Cirillo, Luigi, Ferrario, Francesca, Esposito, Ciro, Esposito, Pasquale, Santoro, Domenico, Lazzarin, Roberta, Rossi, Giovanni Maria, Fiaccadori, Enrico, Ferrantelli, Angelo, Sinico, Renato Alberto, Cozzolino, Mario, Gallieni, Maurizio, Cirami, Lino, Scolari, Francesco, Vaglio, Augusto, Alberici, Federico, Affatato, Stefania, Caroti, Leonardo, Mancini, Elena, Semeraro, Luca, Siligato, Rossella, Cassia, Matthias Arnaldo, Napodano, Pietro, Calatroni, Marta, Distratis, Cosimo, Campo, Andrea, Tedesco, M, Mescia, F, Pisani, I, Allinovi, M, Casazza, G, Del Vecchio, L, Santostefano, M, Cirillo, L, Ferrario, F, Esposito, C, Esposito, P, Santoro, D, Lazzarin, R, Rossi, G, Fiaccadori, E, Ferrantelli, A, Sinico, R, Cozzolino, M, Gallieni, M, Cirami, L, Scolari, F, Vaglio, A, Alberici, F, Affatato, S, Caroti, L, Mancini, E, Semeraro, L, Siligato, R, Cassia, M, Napodano, P, Calatroni, M, Distratis, C, Campo, A, Tedesco, Martina, Mescia, Federica, Pisani, Isabella, Allinovi, Marco, Casazza, Giovanni, Del Vecchio, Lucia, Santostefano, Marisa, Cirillo, Luigi, Ferrario, Francesca, Esposito, Ciro, Esposito, Pasquale, Santoro, Domenico, Lazzarin, Roberta, Rossi, Giovanni Maria, Fiaccadori, Enrico, Ferrantelli, Angelo, Sinico, Renato Alberto, Cozzolino, Mario, Gallieni, Maurizio, Cirami, Lino, Scolari, Francesco, Vaglio, Augusto, Alberici, Federico, Affatato, Stefania, Caroti, Leonardo, Mancini, Elena, Semeraro, Luca, Siligato, Rossella, Cassia, Matthias Arnaldo, Napodano, Pietro, Calatroni, Marta, Distratis, Cosimo, and Campo, Andrea

Abstract

Introduction: Primary focal segmental glomerular sclerosis (FSGS) is a rare, likely immune-mediated disease. Rituximab (RTX) may play a role in management, although data in adults are scanty. Methods: We collected cases of RTX-treated primary FSGS within the Italian Society of Nephrology Immunopathology Working Group and explored response rate (24-hour proteinuria <3.5 g and <50% compared with baseline, stable estimated glomerular filtration rate). Results: A total of 31 patients were followed for at least 12 months; further follow-up (median 17 months, interquartile range [IQR] 15–33.5) was available for 11. At first RTX administration, median creatinine and 24-hour proteinuria were 1.17 mg/dl (IQR 0.83–1.62) and 5.2 g (IQR 3.3–8.81), respectively. Response rate at 3, 6, and 12 months was 39%, 52%, and 42%, respectively. In the first 12 months, creatinine level remained stable whereas proteinuria and serum albumin level improved, with an increase in the proportion of patients tapering other immunosuppressants. There were 6 patients who were retreated with RTX within 12 months, either for proteinuria increase or refractory disease; only the 2 responders to the first RTX course experienced a further response. At univariate analysis, 6-month response was more frequent in steroid-dependent patients (odds ratio [OR] 7.7 [95% CI 1.16–52.17]) and those with proteinuria <5 g/24 h (OR 8.25 [1.45–46.86]). During long-term follow-up, 4 of 5 responders at 12 months maintained a sustained response, either without further immunosuppression (2 of 4) or with pre-emptive RTX (2 of 4); 1 relapsed and responded to RTX retreatment. Conclusion: RTX may be an option in primary FSGS, especially in steroid-dependent patients, with 24-hour proteinuria <5 g and previously responders to RTX. Optimal long-term management for responders is unclear, with some patients experiencing sustained remission and others requiring RTX retreatment, either preemptive or after rising proteinuria

Published
2022

35. Alcibiade dopo Nozio: deposizione o mancata rielezione?

Author

Arena G., Cassia M., Bearzot, Cinzia Susanna, Bearzot C. (ORCID:0000-0003-4414-7963), Arena G., Cassia M., Bearzot, Cinzia Susanna, and Bearzot C. (ORCID:0000-0003-4414-7963)

Abstract

Il contributo studia la fine della strategia di Alcibiade nel 407/6, interrogandosi sull'aspetto giuridico., This paper studies the end of Alcibiades' strategy in 407/6, questioning the legal aspect..

Published
2022

48. Risk of acute arterial and venous thromboembolic events in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

Author

Bettiol, A., Sinico, R. A., Schiavon, F., Monti, S., Bozzolo, E. P., Franceschini, F., Govoni, M., Lunardi, C., Guida, G., Lopalco, G., Paolazzi, G., Vacca, A., Gregorini, G., Leccese, P., Piga, M., Conti, F., Fraticelli, P., Quartuccio, L., Alberici, F., Salvarani, C., Bettio, S., Negrini, S., Selmi, C., Sciascia, S., Moroni, G., Colla, L., Manno, C., Urban, M. L., Vannacci, A., Pozzi, M. R., Fabbrini, P., Polti, S., Felicetti, M., Marchi, M. R., Padoan, R., Delvino, P., Caporali, R., Montecucco, C., Dagna, L., Cariddi, A., Toniati, P., Tamanini, S., Furini, F., Bortoluzzi, A., Tinazzi, E., Delfino, L., Badiu, I., Rolla, G., Venerito, V., Iannone, F., Berti, A., Bortolotti, R., Racanelli, V., Jeannin, G., Padula, A., Cauli, A., Priori, R., Gabrielli, A., Bond, M., Tedesco, M., Pazzola, G., Tomietto, P., Pellecchio, M., Marvisi, C., Maritati, F., Palmisano, A., Dejaco, C., Willeit, J., Kiechl, S., Olivotto, I., Willeit, P., Prisco, D., Vaglio, A., Emmi, G., Bargagli, E., Becatti, M., Beccalli, M., Bello, F., Bozzao, F., Canti, V., Cassia, M. A., Cassone, G., Catanoso, M., Chieco-Bianchi, F., Clari, R., Coladonato, L., De Santis, M., Di Scala, G., Fagni, F., Fenaroli, P., Fiorillo, C., Floris, A., Fornaro, M., Galli, E., Generali, E., Giliberti, M., Lascaro, N., Leccese, I., Mattioli, I., Olivieri, B., Osti, N., Peyronel, F., Radin, M., Righetti, G., Salvati, S., Silvestri, E., Susca, N., Tamburini, C., Taurisano, G., Trezzi, B., Trivioli, G., Bettiol, A, Sinico, R, Schiavon, F, Monti, S, Bozzolo, E, Franceschini, F, Govoni, M, Lunardi, C, Guida, G, Lopalco, G, Paolazzi, G, Vacca, A, Gregorini, G, Leccese, P, Piga, M, Conti, F, Fraticelli, P, Quartuccio, L, Alberici, F, Salvarani, C, Bettio, S, Negrini, S, Selmi, C, Sciascia, S, Moroni, G, Colla, L, Manno, C, Urban, M, Vannacci, A, Pozzi, M, Fabbrini, P, Polti, S, Felicetti, M, Marchi, M, Padoan, R, Delvino, P, Caporali, R, Montecucco, C, Dagna, L, Cariddi, A, Toniati, P, Tamanini, S, Furini, F, Bortoluzzi, A, Tinazzi, E, Delfino, L, Badiu, I, Rolla, G, Venerito, V, Iannone, F, Berti, A, Bortolotti, R, Racanelli, V, Jeannin, G, Padula, A, Cauli, A, Priori, R, Gabrielli, A, Bond, M, Tedesco, M, Pazzola, G, Tomietto, P, Pellecchio, M, Marvisi, C, Maritati, F, Palmisano, A, Dejaco, C, Willeit, J, Kiechl, S, Olivotto, I, Willeit, P, Prisco, D, Vaglio, A, and Emmi, G

Subjects
Pulmonary and Respiratory Medicine, Burden of disease, Humans, Churg-Strauss Syndrome, Granulomatosis with Polyangiitis, Venous Thromboembolism, Venous Thrombosis, Churg-strauss syndrome, Criminology, NO, 03 medical and health sciences, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Vascular inflammation, business.industry, Conflict of interest, Cytoplasmic antibody, medicine.disease, 030228 respiratory system, Wegener granulomatosis, arterial and venous thromboembolic events, Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss syndrome), Organ involvement, business, Production team
Abstract

Eosinophilic Granulomatosis with Polyangiitis (EGPA, Churg-Strauss syndrome) is a rare anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) characterised by respiratory manifestations and systemic organ involvement [1]. Particularly, cardiac manifestations occur in 40–60% of patients, representing the leading cause of mortality [2]. Recent reports suggest that venous thromboembolic events might also represent a consistent burden of disease [3, 4], as already known for the other AAVs [5–7], possibly due to eosinophil-mediated vascular inflammation [5]. Nevertheless, the occurrence of arterial and venous thrombotic events (AVTE) has never been systematically explored in EGPA. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Alessandra Bettiol Conflict of interest: Renato Alberto Sinico Conflict of interest: Franco Schiavon Conflict of interest: Sara Monti Conflict of interest: Enrica Paola Bozzolo Conflict of interest: Franco Franceschini Conflict of interest: Marcello Govoni Conflict of interest: Claudio Lunardi Conflict of interest: Giuseppe Guida Conflict of interest: Giuseppe Lopalco Conflict of interest: Giuseppe Paolazzi Conflict of interest: Angelo Vacca Conflict of interest: Gina Gregorini Conflict of interest: Pietro Leccese Conflict of interest: Matteo Piga Conflict of interest: Fabrizio Conti Conflict of interest: Paolo Fraticelli Conflict of interest: Luca Quartuccio Conflict of interest: Federico Alberici Conflict of interest: Carlo Salvarani Conflict of interest: Silvano Bettio Conflict of interest: Simone Negrini Conflict of interest: Carlo Selmi Conflict of interest: Savino Sciascia Conflict of interest: Gabriella Moroni Conflict of interest: Loredana Colla Conflict of interest: Carlo Manno Conflict of interest: Maria Letizia Urban Conflict of interest: Alfredo Vannacci Conflict of interest: Maria Rosa Pozzi Conflict of interest: Paolo Fabbrini Conflict of interest: Stefano Polti Conflict of interest: Mara Felicetti Conflict of interest: Maria Rita Marchi Conflict of interest: Roberto Padoan Conflict of interest: Paolo Delvino Conflict of interest: Roberto Caporali Conflict of interest: Carlomaurizio Montecucco Conflict of interest: Lorenzo Dagna Conflict of interest: Adriana Cariddi Conflict of interest: Paola Toniati Conflict of interest: Dr. Tamanini reports other from Glaxo Smith Kline, outside the submitted work. Conflict of interest: Federica Furini Conflict of interest: Alessandra Bortoluzzi Conflict of interest: Elisa Tinazzi Conflict of interest: Lorenzo Delfino Conflict of interest: Iuliana Badiu Conflict of interest: Giovanni Rolla Conflict of interest: Vincenzo Venerito Conflict of interest: Florenzo Iannone Conflict of interest: Alvise Berti Conflict of interest: Roberto Bortolotti Conflict of interest: Vito Racanelli Conflict of interest: Guido Jeannin Conflict of interest: Angela Padula Conflict of interest: Alberto Cauli Conflict of interest: Roberta Priori Conflict of interest: Armando Gabrielli Conflict of interest: Milena Bond Conflict of interest: Martina Tedesco Conflict of interest: Giulia Pazzola Conflict of interest: Paola Tomietto Conflict of interest: Marco Pellecchio Conflict of interest: Chiara Marvisi Conflict of interest: Federica Maritati Conflict of interest: Alessandra Palmisano Conflict of interest: Christian Dejaco Conflict of interest: Johann Willeit Conflict of interest: Stefan Kiechl Conflict of interest: Iacopo Olivotto Conflict of interest: Peter Willeit Conflict of interest: Domenico Prisco Conflict of interest: Augusto Vaglio Conflict of interest: Giacomo Emmi

Published
2020

49. Combining regional to local restoration goals in the Brazilian Atlantic forest

Author

Lemos, Cassia M. G., Andrade, Pedro R., Rodrigues, Ricardo R., Hissa, Leticia, Aguiar, Ana P. D., Lemos, Cassia M. G., Andrade, Pedro R., Rodrigues, Ricardo R., Hissa, Leticia, and Aguiar, Ana P. D.

Abstract

To achieve regional and international large-scale restoration goals with minimum costs, several restoration commitments rely on natural regeneration, a passive and inexpensive strategy. However, natural regeneration potential may vary within the landscape, mainly due to its historical context. In this work, we use spatially explicit restoration scenarios to explore how and where, within a given region, multiple restoration commitments could be combined to achieve cost-effectiveness outcomes. Our goal is to facilitate the elaboration of forest restoration plans at the regional level, taking into consideration the costs for active and passive restoration methods. The approach includes (1) a statistical analysis to estimate the natural regeneration potential for a given area based on alternative sets of biophysical, land cover, and/or socioeconomic factors and (2) the use of a land change allocation model to explore the cost-effectiveness of combining multiple restoration commitments in a given area through alternative scenarios. We test our approach in a strategic region in the Brazilian Atlantic Forest Biome, the Paraiba Valley in São Paulo State. Using the available data for 2011, calibrated for 2015, we build alternative scenarios for allocating natural regeneration until 2025. Our models indicate that the natural regeneration potential of the region is actually very low, and the cost-effectiveness outcomes are similar for all scenarios. We believe our approach can be used to support the regional-level decision-making about the implementation of multiple commitments aiming at the same target area. It can also be combined with other approaches for more refined analysis (e.g., optimization models).

Published
2021
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50. Slowly progressive anti-neutrophil cytoplasmic antibody-associated renal vasculitis: clinico-pathological characterization and outcome

Author

Trivioli, G, Gopaluni, S, Urban, M, Gianfreda, D, Cassia, M, Vercelloni, P, Calatroni, M, Bettiol, A, Esposito, P, Murtas, C, Alberici, F, Maritati, F, Manenti, L, Palmisano, A, Emmi, G, Romagnani, P, Moroni, G, Gregorini, G, Sinico, R, Jayne, D, Vaglio, A, Trivioli, Giorgio, Gopaluni, Seerapani, Urban, Maria L, Gianfreda, Davide, Cassia, Matthias A, Vercelloni, Paolo G, Calatroni, Marta, Bettiol, Alessandra, Esposito, Pasquale, Murtas, Corrado, Alberici, Federico, Maritati, Federica, Manenti, Lucio, Palmisano, Alessandra, Emmi, Giacomo, Romagnani, Paola, Moroni, Gabriella, Gregorini, Gina, Sinico, Renato A, Jayne, David R W, Vaglio, Augusto, Trivioli, G, Gopaluni, S, Urban, M, Gianfreda, D, Cassia, M, Vercelloni, P, Calatroni, M, Bettiol, A, Esposito, P, Murtas, C, Alberici, F, Maritati, F, Manenti, L, Palmisano, A, Emmi, G, Romagnani, P, Moroni, G, Gregorini, G, Sinico, R, Jayne, D, Vaglio, A, Trivioli, Giorgio, Gopaluni, Seerapani, Urban, Maria L, Gianfreda, Davide, Cassia, Matthias A, Vercelloni, Paolo G, Calatroni, Marta, Bettiol, Alessandra, Esposito, Pasquale, Murtas, Corrado, Alberici, Federico, Maritati, Federica, Manenti, Lucio, Palmisano, Alessandra, Emmi, Giacomo, Romagnani, Paola, Moroni, Gabriella, Gregorini, Gina, Sinico, Renato A, Jayne, David R W, and Vaglio, Augusto

Abstract

Background. Although rapidly progressive glomerulonephritis is the main renal phenotype of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), slow renal disease progression is sometimes observed. These forms have been rarely discussed; we analysed their prevalence, clinico-pathological characteristics and outcome. Methods. We screened patients with microscopic polyangiitis (MPA) and granulomatosis with polyangiitis followed at seven referral centres and selected those with estimated glomerular filtration rate (eGFR) reduction [removed]25% as compared with diagnosis, while 4/34 (12%) had started RRT. Conclusions. AAV may present with slow renal disease progression; this subset is hallmarked by advanced age at diagnosis, positive MPO-ANCA, subclinical interstitial lung lesions and chronic damage at kidney biopsy. Partial renal recovery may occur following immunosuppression.

Published
2021

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