Search

Your search keyword '"Cavuto S"' showing total 161 results
Start Over Author "Cavuto S"
161 results on '"Cavuto S"'

3. Intravenous methylprednisolone pulses in hospitalised patients with severe COVID-19 pneumonia, A double-blind, randomised, placebo-controlled trial

Author

Salvarani, C, Massari, M, Costantini, M, Franco Merlo, D, Lucia Mariani, G, Viale, P, Nava, S, Guaraldi, G, Dolci, G, Boni, L, Savoldi, L, Bruzzi, P, Turrà, C, Catanoso, M, Maria Marata, A, Barbieri, C, Valcavi, A, Franzoni, F, Cavuto, S, Mazzi, G, Corsini, R, Trapani, F, Bartoloni, A, Barisione, E, Jole Burastero, G, Pan, A, Inojosa, W, Scala, R, Burattini, C, Luppi, F, Codeluppi, M, Eldin Tarek, K, Cenderello, G, Salio, M, Foti, G, Dongilli, R, Bajocchi, G, Alberto Negri, E, Ciusa, G, Fornaro, G, Bassi, I, Zammarchi, L, Aloè, T, Facciolongo, N, Salvarani, Carlo, Massari, Marco, Costantini, Massimo, Franco Merlo, Domenico, Lucia Mariani, Gabriella, Viale, Pierluigi, Nava, Stefano, Guaraldi, Giovanni, Dolci, Giovanni, Boni, Luca, Savoldi, Luisa, Bruzzi, Paolo, Turrà, Caterina, Catanoso, Mariagrazia, Maria Marata, Anna, Barbieri, Chiara, Valcavi, Annamaria, Franzoni, Francesca, Cavuto, Silvio, Mazzi, Giorgio, Corsini, Romina, Trapani, Fabio, Bartoloni, Alessandro, Barisione, Emanuela, Jole Burastero, Giulia, Pan, Angelo, Inojosa, Walter, Scala, Raffaele, Burattini, Cecilia, Luppi, Fabrizio, Codeluppi, Mauro, Eldin Tarek, Kamal, Cenderello, Giovanni, Salio, Mario, Foti, Giuseppe, Dongilli, Roberto, Bajocchi, Gianluigi, Alberto Negri, Emanuele, Ciusa, Giacomo, Fornaro, Giacomo, Bassi, Ilaria, Zammarchi, Lorenzo, Aloè, Teresita, Facciolongo, Nicola, Salvarani, C, Massari, M, Costantini, M, Franco Merlo, D, Lucia Mariani, G, Viale, P, Nava, S, Guaraldi, G, Dolci, G, Boni, L, Savoldi, L, Bruzzi, P, Turrà, C, Catanoso, M, Maria Marata, A, Barbieri, C, Valcavi, A, Franzoni, F, Cavuto, S, Mazzi, G, Corsini, R, Trapani, F, Bartoloni, A, Barisione, E, Jole Burastero, G, Pan, A, Inojosa, W, Scala, R, Burattini, C, Luppi, F, Codeluppi, M, Eldin Tarek, K, Cenderello, G, Salio, M, Foti, G, Dongilli, R, Bajocchi, G, Alberto Negri, E, Ciusa, G, Fornaro, G, Bassi, I, Zammarchi, L, Aloè, T, Facciolongo, N, Salvarani, Carlo, Massari, Marco, Costantini, Massimo, Franco Merlo, Domenico, Lucia Mariani, Gabriella, Viale, Pierluigi, Nava, Stefano, Guaraldi, Giovanni, Dolci, Giovanni, Boni, Luca, Savoldi, Luisa, Bruzzi, Paolo, Turrà, Caterina, Catanoso, Mariagrazia, Maria Marata, Anna, Barbieri, Chiara, Valcavi, Annamaria, Franzoni, Francesca, Cavuto, Silvio, Mazzi, Giorgio, Corsini, Romina, Trapani, Fabio, Bartoloni, Alessandro, Barisione, Emanuela, Jole Burastero, Giulia, Pan, Angelo, Inojosa, Walter, Scala, Raffaele, Burattini, Cecilia, Luppi, Fabrizio, Codeluppi, Mauro, Eldin Tarek, Kamal, Cenderello, Giovanni, Salio, Mario, Foti, Giuseppe, Dongilli, Roberto, Bajocchi, Gianluigi, Alberto Negri, Emanuele, Ciusa, Giacomo, Fornaro, Giacomo, Bassi, Ilaria, Zammarchi, Lorenzo, Aloè, Teresita, and Facciolongo, Nicola

Abstract

Rationale Pulse glucocorticoid therapy is used in hyperinflammation related to coronavirus disease 2019 (COVID-19). We evaluated the efficacy and safety of pulse intravenous methylprednisolone in addition to standard treatment in COVID-19 pneumonia. Methods In this multicentre, randomised, double-blind, placebo-controlled trial, 304 hospitalised patients with COVID-19 pneumonia were randomised to receive 1 g of methylprednisolone intravenously for three consecutive days or placebo in addition to standard dexamethasone. The primary outcome was the duration of patient hospitalisation, calculated as the time interval between randomisation and hospital discharge without the need for supplementary oxygen. The key secondary outcomes were survival free from invasive ventilation with orotracheal intubation and overall survival. Results Overall, 112 (75.4%) out of 151 patients in the pulse methylprednisolone arm and 111 (75.2%) of 150 in the placebo arm were discharged from hospital without oxygen within 30 days from randomisation. Median time to discharge was similar in both groups (15 days, 95% CI 13.0–17.0 days and 16 days, 95% CI 13.8–18.2 days, respectively; hazard ratio (HR) 0.92, 95% CI 0.71–1.20; p=0.528). No significant differences between pulse methylprednisolone and placebo arms were observed in terms of admission to intensive care unit with orotracheal intubation or death (20.0% versus 16.1%; HR 1.26, 95% CI 0.74–2.16; p=0.176) or overall mortality (10.0% versus 12.2%; HR 0.83, 95% CI 0.42–1.64; p=0.584). Serious adverse events occurred with similar frequency in the two groups. Conclusions Methylprenisolone pulse therapy added to dexamethasone was not of benefit in patients with COVID-19 pneumonia.

Published
2022

4. Psychedelic‐assisted therapy for palliative care within a home treatment setting: A case report

Author

Seragnoli Federico, Martignoni Geo, Martignoni Entela, Silke Bachmann, Rabitti Elisa, Cavuto Silvio, Dubus Zoë, Penzenstadler Louise, Thorens Gabriel, Billieux Joël, and Zullino Daniele

Subjects
home treatment, palliative care, psychedelic, psychedelic‐assisted therapy, throat cancer, Medicine, Medicine (General), R5-920
Abstract

Key Clinical Message This case study describes the feasibility and safety of psychedelic‐assisted therapy (PAT) as a home‐based intervention for a patient with throat cancer experiencing significant existential distress. The patient tolerated the intervention well. This case supports the feasibility and safety of PAT for patients with life‐threatening conditions in a home setting. Abstract Psychedelic‐assisted therapy (PAT), as it is practiced today, merges traditional psychotherapeutic techniques with the use of psychedelics such as LSD, psilocybin, or MDMA with the aim of unlocking deeper insights in patients and treating mental conditions that are resistant to other forms of therapy. The present case study describes the safety of PAT as a home‐based intervention for a patient with throat cancer experiencing significant existential distress. The patient tolerated the intervention well and was asked to report on measures of anxiety, depression, and distress related to his somatic condition. The observations provided by this clinical case report align with previous findings, suggesting that PAT can be safely applied to potentially provide relief from existential distress in patients with life‐threatening conditions. As this is a single‐case study, generalizations should be made cautiously. Moreover, placebo effects, expectancy effects, and the natural course of the disease may influence outcomes. Future research should consider controlled trials to ascertain the efficacy and safety of such interventions in diverse settings.

Published
2024
Full Text
View/download PDF

5. [Descriptive analytical study on patient mobilization of the Internal Medicine Department of the USL - IRCCS of Reggio Emilia (MOBINT)]

Author

Vezzani, E., Mecugni, D., Silba Cardoso, J., Coriani, S., Boccia Zoboli, A., Ricco, R., Cavuto, S., Savoldi, L., and Amaducci, G.

Subjects
Hospitalization, Internal Medicine, Humans, Prospective Studies, Length of Stay, Aged, Delivery of Health Care
Abstract

Hospitalisation represents a significant risk factor for the decline in the general conditions of the elderly. Loss of autonomy in elderly inpatients, together with immobilisation, has been defined as 'Hospital-Acquired Disability' and affects 65% of this class of patients. Less than half of them will regain independent mobilisation. Included among the negative effects are: falls, increased percentage of admission to nursing homes, longer hospital admissions, increased mortality and morbitity. Despite these facts, elderly patients remain in bed for 83-95% of their hospital stay; they rarely walk or are mobilised. Only on an international level has this issue been analysed OBJECTIVES: To analyse active mobilisation in inpatients.Prospective analytical and descriptive study performed from December 2018 - May 2019 in the Clinical Medicine department of the AUSL of Reggio Emilia. Descriptive analysis of the data has been performed.A total of 1725 patients were screened for the study. After applying the inclusion criteria, 295 patients were enrolled in the study, 9 of which were then excluded for failure to be mobilised. 66.4% of these patients were mobilized the morning during hygiene-rounds. According to the nurse, they appeared in a stable state, alert and oriented (88.1%) and used a variety of aids (from 1 to 3) (57.3%). The frequency of mobilisations were: 44.4% once a day, 31.2% twice, 24.4% three times or more.This study highlighted that mobilisation is strictly correlated to first assistance, frequently relying on health care assistants, and is mostly applied to oriented patients who only need one assistant. Further studies are required to investigate connections between patient's features and mobilisation.L’ospedalizzazione rappresenta un fattore di rischio per il declino delle condizioni generali dell’anziano. La perdita di autonomia dei pazienti anziani ricoverati, associata alla mancata mobilizzazione, è stata definita come una Disabilità Acquisita in Ospedale e colpisce fino al 65% di essi. Meno della metà degli anziani recuperano la mobilizzazione indipendente. Tra gli esiti negativi associati abbiamo: cadute, aumento delle istituzionalizzazioni e dei tempi di degenza, aumentata mortalità, sviluppo di complicanze. Nonostante ciò, gli anziani rimangono allettati per il 83-95% della degenza, solo raramente deambulano o vengono mobilizzati. Solo a livello internazionale è stata indagata questa problematica.Descrivere la mobilizzazione attiva dei pazienti internistici.Studio analitico descrittivo prospettico. Dicembre 2018 - Maggio 2019. Sono stati inclusi i reparti internistici dell’AUSL di Reggio Emilia. È stata eseguita un’analisi descrittiva dei dati.Sono stati screenati 1725 pazienti, applicando i criteri d’inclusione reclutati 295, di cui 9 esclusi perché non mobilizzabili. Il 66,4% dei pazienti viene mobilizzato al mattino durante l’igiene. Essi sono in condizioni stabili secondo l’infermiere, lucidi ed orientati (88,1%) e portatori di vari presidi (da 1 a 3) (57,3%). La frequenza di mobilizzazione è di: una volta al giorno per il 44,4% dei pazienti, due volte al giorno per il 31,2% e più di due volte al giorno per il 24,4%.Lo studio ha evidenziato che la mobilizzazione è strettamente associata all’assistenza di base, nella quale ha un ruolo rilevante l’OSS. Essa riguarda prevalentemente pazienti lucidi orientati e che richiedono un solo operatore. Sarebbero auspicabili studi successivi per indagare correlazioni fra caratteristiche dei pazienti e mobilizzazione.

Published
2021

7. Diagnostic performances of [ 18 F]fluorocholine positron emission tomography in brain tumors

Author

Sollini, M, Sghedoni, R, Erba, P, Cavuto, S, Froio, A, De Berti, G, Pisanello, A, Fraternali, A, Iori, M, Iaccarino, C, Asti, M, Filice, A, Versari, A, Sollini M., Sghedoni R., Erba P. A., Cavuto S., Froio A., De Berti G., Pisanello A., Fraternali A., Iori M., Iaccarino C., Asti M., Filice A., Versari A., Sollini, M, Sghedoni, R, Erba, P, Cavuto, S, Froio, A, De Berti, G, Pisanello, A, Fraternali, A, Iori, M, Iaccarino, C, Asti, M, Filice, A, Versari, A, Sollini M., Sghedoni R., Erba P. A., Cavuto S., Froio A., De Berti G., Pisanello A., Fraternali A., Iori M., Iaccarino C., Asti M., Filice A., and Versari A.

Abstract

BACKGROUND: Brain tumors characterization by molecular imaging that allows the depiction of brain lesions metabolic pattern is crucial. Our study aimed to: 1) to evaluate the diagnostic performances of [ 18 F]fluoroethylcholine positron emission tomography/computed tomography ([ 18 F]FECH PET/CT), and 2) correlate PET imaging derived parameters of [ 18 F]FECH to survival in brain tumors. METHODS: From 2009 to 2012, we enrolled 30 patients who underwent [ 18 F]FECH PET/CT. Final diagnosis was established by clinical and radiological follow-up. RESULTS: Final diagnosis was consistent with tumor disease in 27/30 cases. In 3/30 cases tumor disease was ruled out. [ 18 F]FECH PET/CT resulted true positive and negative in 21/30 and 9/30 patients, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of [ 18 F]FECH PET/CT were 78%, 100%, 100%, 33%, and 80%, respectively. Mean and maximum standardized uptake value (SUV mean and SUV max ) resulted statistically correlated to histology (P=0.0255 and P=0.0222, respectively). Using a SUV max cut-off of 2.0 or 3.2, we distinguished between low- and high-grade gliomas with a good specificity (70% and 80%, respectively). SUV max and histology resulted correlated to overall survival and disease related survival at multivariate analysis. CONCLUSIONS: Our results, worthy of further investigations, show high diagnostic performances of [ 18 F]FECH PET/CT, and a correlation between PET imaging derived parameters and survival.

Published
2018

9. Comparing two visualization protocols for tomosynthesis in screening: specificity and sensitivity of slabs versus planes plus slabs

Author

Iotti, V., Giorgi Rossi, P., Nitrosi, A., Ravaioli, S., Vacondio, R., Campari, C., Marchesi, V., Ragazzi, M., Bertolini, M., Besutti, G., Mori, C. A., Pattacini, P., Coriani, C., Pescarolo, M., Stefanelli, G., Tondelli, G., Beretti, F., Caffarri, S., Paterlini, L., Canovi, L., Colli, M., Boschini, M., Cavuto, S., and Braglia, L.

Subjects
medicine.medical_specialty, Digital mammography, Breast Neoplasms, 030218 nuclear medicine & medical imaging, Breast neoplasms, Mammography, Mass screening, Sensitivity and specificity, Workflow, Aged, Carcinoma, Intraductal, Noninfiltrating, Early Detection of Cancer, Female, Humans, Mass Screening, Middle Aged, Reproducibility of Results, Retrospective Studies, 03 medical and health sciences, 0302 clinical medicine, False positive paradox, medicine, Radiology, Nuclear Medicine and imaging, Protocol (science), medicine.diagnostic_test, business.industry, Repeated measures design, General Medicine, Confidence interval, Tomosynthesis, 030220 oncology & carcinogenesis, Radiology, business
Abstract

Tomosynthesis (DBT) has proven to be more sensitive than digital mammography, but it requires longer reading time. We retrospectively compared accuracy and reading times of a simplified protocol with 1-cm-thick slabs versus a standard protocol of slabs + 1-mm-spaced planes, both integrated with synthetic 2D. We randomly selected 894 DBTs (including 12 cancers) from the experimental arm of the RETomo trial. DBTs were read by two radiologists to estimate specificity. A second set of 24 cancers (8 also present in the first set) mixed within 276 negative DBTs was read by two radiologists. In total, 28 cancers with 64 readings were used to estimate sensitivity. Radiologists read with both protocols separated by a 3-month washout. Only women that were positive at the screening reading were assessed. Variance was estimated taking into account repeated measures. Sensitivity was 82.8% (53/64, 95% confidence interval (95% CI) 67.2–92.2) and 90.6% (95% CI 80.2–95.8) with simplified and standard protocols, respectively. In the random screening setting, specificity was 97.9% (1727/1764, 95% CI 97.1–98.5) and 96.3% (95% CI 95.3–97.1), respectively. Inter-reader agreement was 0.68 and 0.54 with simplified and standard protocols, respectively. Median reading times with simplified protocol were 20% to 30% shorter than with standard protocol. A simplified protocol reduced reading time and false positives but may have a negative impact on sensitivity. • The adoption of digital breast tomosynthesis (DBT) in screening, more sensitive than mammography, could be limited by its potential effect on the radiologists’ workload, i.e., increased reading time and fatigue. • A DBT simplified protocol with slab only, compared to a standard protocol (slab plus planes) both integrated with synthetic 2D, reduced time and false positives but had a negative impact on sensitivity.

Published
2019

10. Whose ‘wish bias’?

Author

Fossati, R., Confalonieri, C., Apolone, G., Cavuto, S., and Garattini, S.

Published
2003

13. EP-1397: Dose painting guided by diffusion-weighted MRI applied to recurrent glioblastoma: a phase I protocol

Author

Iori, M., primary, Galeandro, M., additional, Botti, A., additional, Sghedoni, R., additional, Ciammella, P., additional, Orlandi, M., additional, Napoli, M., additional, Tanzi, S., additional, Pascarella, R., additional, Cavuto, S., additional, Pisanello, A., additional, Russo, M., additional, Cagni, E., additional, Chiari, D.E., additional, Campioli, M., additional, and Iotti, C., additional

Published
2017
Full Text
View/download PDF

14. Dose painting by numbers (DPBN) guided by diffusion-weighted MRI applied to recurrent glioblastoma (GBM): An experimental protocol of phase I/II

Author

Iori, M., primary, Ciammella, P., additional, Orlandi, M., additional, Chiari, D.E., additional, Campioli, M., additional, Orsingher, L., additional, Botti, A., additional, Sghedoni, R., additional, Cagni, E., additional, Cavuto, S., additional, Pascarella, R., additional, Pisanello, A., additional, and Iotti, C., additional

Published
2016
Full Text
View/download PDF

15. Preliminary evidence on the diagnostic and molecular role of circulating soluble EGFR in non-small cell lung cancer

Author

Lococo, F, Paci, M, Rapicetta, C, Rossi, T, Sancisi, V, Braglia, L, Cavuto, S, Bisagni, A, Bongarzone, I, Noonan, D, Albini, A, Maramotti, S, Lococo, Filippo, Paci, Massimiliano, Rapicetta, Cristian, Rossi, Teresa, Sancisi, Valentina, Braglia, Luca, Cavuto, Silvio, Bisagni, Alessandra, Bongarzone, Italia, Noonan, Douglas M., Albini, Adriana, Maramotti, Sally, Lococo, F, Paci, M, Rapicetta, C, Rossi, T, Sancisi, V, Braglia, L, Cavuto, S, Bisagni, A, Bongarzone, I, Noonan, D, Albini, A, Maramotti, S, Lococo, Filippo, Paci, Massimiliano, Rapicetta, Cristian, Rossi, Teresa, Sancisi, Valentina, Braglia, Luca, Cavuto, Silvio, Bisagni, Alessandra, Bongarzone, Italia, Noonan, Douglas M., Albini, Adriana, and Maramotti, Sally

Abstract

Assessment of biological diagnostic factors providing clinically-relevant information to guide physician decision-making are still needed for diseases with poor outcomes, such as non-small cell lung cancer (NSCLC). Epidermal growth factor receptor (EGFR) is a promising molecule in the clinical management of NSCLC. While the EGFR transmembrane form has been extensively investigated in large clinical trials, the soluble, circulating EGFR isoform (sEGFR), which may have a potential clinical use, has rarely been considered. This study investigates the use of sEGFR as a potential diagnostic biomarker for NSCLC and also characterizes the biological function of sEGFR to clarify the molecular mechanisms involved in the course of action of this protein. Plasma sEGFR levels from a heterogeneous cohort of 37 non-advanced NSCLC patients and 54 healthy subjects were analyzed by using an enzyme-linked immunosorbent assay. The biological function of sEGFR was analyzed in vitro using NSCLC cell lines, investigating effects on cell proliferation and migration. We found that plasma sEGFR was significantly decreased in the NSCLC patient group as compared to the control group (median value: 48.6 vs. 55.6 ng/mL respectively; p = 0.0002). Moreover, we demonstrated that sEGFR inhibits growth and migration of NSCLC cells in vitro through molecular mechanisms that included perturbation of EGF/EGFR cell signaling and holoreceptor internalization. These data show that sEGFR is a potential circulating biomarker with a physiological protective role, providing a first approach to the functional role of the soluble isoform of EGFR. However, the impact of these data on daily clinical practice needs to be further investigated in larger prospective studies.

Published
2015

16. Strategies to Prevent 'bad Luck' in Cancer

Author

Albini, A, Cavuto, S, Apolone, G, Noonan, D, Albini, Adriana, Cavuto, Silvio, Apolone, Giovanni, Noonan, Douglas M., Albini, A, Cavuto, S, Apolone, G, Noonan, D, Albini, Adriana, Cavuto, Silvio, Apolone, Giovanni, and Noonan, Douglas M.

Abstract

It is impossible to predict exactly who will develop a cancer and who will not. We know that several "risk factors" may increase the chance of getting cancer and that risk increases with age. However, even with that in mind we seem to be able to explain only a certain number of cancers. Recently, Tomasetti and Vogelstein published a provocative article in Science stating that a large percentage of cancers may be due to "bad luck" (stochastic mutation events during DNA replication) and only a few to carcinogens, pathogens, or inherited genes and that this should impact public health policies. However, their intriguing analysis has numerous limitations, some of which have already been commented upon, including the likely biased subset of cancers and that finding a correlation does not signify a cause-effect mechanism. Here, we point out that there may also be an alternative explanation for the data, the cancer stem cell hypothesis, which postulates that cancers are derived from tissue stem cells and not from somatic differentiated cells. We also highlight the importance of the tissue microenvironment in the growth of transformed cells and outline a table of concurrent factors for several cancers. The message communicated to the public should not be one of helplessness in avoiding cancers, particularly given the now extensive knowledge of known risk factors and several agents/behaviors that can lower risk for specific cancers. While some tumors will still be due to chance, prevention should still be a primary goal for public health policies.

Published
2015

17. Preliminary evidence on the diagnostic and molecular role of circulating soluble EGFR in non-small cell lung cancer

Author

Lococo, Filippo, Paci, M., Rapicetta, C., Rossi, T., Sancisi, V., Braglia, L., Cavuto, S., Bisagni, A., Bongarzone, I., Noonan, D. M., Albini, A., Maramotti, S., Lococo F. (ORCID:0000-0002-9383-5554), Lococo, Filippo, Paci, M., Rapicetta, C., Rossi, T., Sancisi, V., Braglia, L., Cavuto, S., Bisagni, A., Bongarzone, I., Noonan, D. M., Albini, A., Maramotti, S., and Lococo F. (ORCID:0000-0002-9383-5554)

Abstract

Assessment of biological diagnostic factors providing clinically-relevant information to guide physician decision-making are still needed for diseases with poor outcomes, such as non-small cell lung cancer (NSCLC). Epidermal growth factor receptor (EGFR) is a promising molecule in the clinical management of NSCLC. While the EGFR transmembrane form has been extensively investigated in large clinical trials, the soluble, circulating EGFR isoform (sEGFR), which may have a potential clinical use, has rarely been considered. This study investigates the use of sEGFR as a potential diagnostic biomarker for NSCLC and also characterizes the biological function of sEGFR to clarify the molecular mechanisms involved in the course of action of this protein. Plasma sEGFR levels from a heterogeneous cohort of 37 non-advanced NSCLC patients and 54 healthy subjects were analyzed by using an enzyme-linked immunosorbent assay. The biological function of sEGFR was analyzed in vitro using NSCLC cell lines, investigating effects on cell proliferation and migration. We found that plasma sEGFR was significantly decreased in the NSCLC patient group as compared to the control group (median value: 48.6 vs. 55.6 ng/mL respectively; p = 0.0002). Moreover, we demonstrated that sEGFR inhibits growth and migration of NSCLC cells in vitro through molecular mechanisms that included perturbation of EGF/EGFR cell signaling and holoreceptor internalization. These data show that sEGFR is a potential circulating biomarker with a physiological protective role, providing a first approach to the functional role of the soluble isoform of EGFR. However, the impact of these data on daily clinical practice needs to be further investigated in larger prospective studies.

Published
2015

18. Italian cancer figures, report 2011: Survival of cancer patients in Italy

Author

Fusco, M, Buzzoni, C, Coviello, E, Rashid, I, Bianconi, F, Cuccaro, F, Castaing, M, De Angelis, R, Giacomin, A, Guzzinati, S, Mosso, Ml, Pisani, P, Quaglia, A, Randi, G, Ramazzotti, V, Russo, A, Senatore, G, Stracci, F, Traina, A, Vercelli, M, Zarcone, M, Ferretti, S, Mazzoleni, G, Bellú, F, Tschugguel, B, De Valiere, E, Facchinelli, G, Falk, M, Dal Cappello, T, Vercellino, Pc, Andreone, S, Busato, A, Marzola, L, Migliari, E, Carletti, N, Nenci, I, Crocetti, E, Caldarella, A, Corbinelli, A, Giusti, F, Intrieri, T, Manneschi, G, Nemcova, L, Romeo, G, Sacchettini, C, Zappa, M, Paci, E, Serraino, D, Angelin, T, Bidoli, E, Dal Maso, L, de Dottori, M, De Paoli, A, De Santis, E, Forgiarini, O, Lise, M, Zucchetto, A, Zanier, L, Orengo, Ma, Casella, C, Marani, E, Puppo, A, Celesia, Mv, Cogno, R, Manenti, S, Garrone, E, Pannozzo, F, Busco, S, Cercato, Mc, Battisti, W, Sperduti, I, Macci, L, Bugliarello, E, Bernazza, E, Tamburo, L, Rossi, M, Curatella, S, De Francesco, C, Tamburrino, S, Bisanti, L, Autelitano, M, Ghilardi, S, Leone, R, Filipazzi, L, Bonini, A, Giubelli, C, Federico, M, Artioli, Me, Valla, K, Braghiroli, B, Cirilli, C, Luminari, S, Pirani, M, Ferrari, L, Bellatalla, C, Panico, M, Perrotta, C, Vassante, B, Vitale, Mf, Michiara, M, Bozzani, F, Sgargi, P, Tumino, R, La Rosa MG, Cascone, G, Frasca, G, Giurdanella, Mc, Martorana, C, Morana, G, Nicita, C, Rollo, Pc, Ruggeri, Mg, Sigona, A, Spata, E, Vacirca, S, Mangone, L, Di Felice, E, Pezzarossi, A, Caroli, S, Pellegri, C, Vicentini, M, Storchi, C, Cavuto, S, Costa, J, Falcini, F, Colamartini, A, Bucchi, L, Balducci, C, Ravegnani, M, Vitali, B, Cordaro, C, Caprara, L, Giuliani, O, Giorgetti, S, Salvatore, S, Palumbo, M, Vattiato, R, Ravaioli, A, Foca, F, Rinaldi, E, Mancini, S, Tonelli, C, Amadori, M, Cremone, L, Iannelli, A, Zevola, A, Budroni, M, Cesaraccio, R, Pirino, D, Carboni, D, Fiori, G, Soddu, M, Mameli, G, Mura, F, Contrino, Ml, Madeddu, A, Tisano, F, Sciacca, S, Muni, A, Mizzi, M, Russo, M, Sacco, G, Aletta, P, Colanino Ziino, A, Tessandori, R, Fanetti, Ac, Maspero, S, Annulli, Ml, Moroni, E, Sanoja Gonzalez ME, Zanetti, R, Rosso, S, Patriarca, S, Prandi, R, Sobrato, I, Gilardi, F, Busso, P, Piffer, S, Gentilini, Ma, Battisti, L, Rizzello, R, Cappelletti, M, Moser, M, La Rosa, F, D'Alò, D, Scheibel, M, Costarelli, D, Spano, F, Rossini, S, Santucci, C, Petrinelli, Am, Solimene, C, Brunori, V, Crosignani, P, Tagliabue, G, Contiero, P, Preto, L, Tittarelli, A, Maghini, A, Codazzi, T, Frassoldi, E, Gada, D, Costa, E, di Grazia, L, Zambon, P, Baracco, M, Bovo, E, Dal Cin, A, Fiore, Ar, Greco, A, Monetti, D, Rosano, A, Stocco, C, Tognazzo, S, Donato, Francesco, Limina, Rosa Maria, Adorni, A, Andreis, P, Zani, G, Piovani, F, Salvi, O, Puleio, M, Vitarelli, S, Antonini, S, Candela, G, Pappalardo, G, Scuderi, T, Lottero, B, Ribaudo, M, Ricci, P, Guarda, L, Gatti, L, Bozzeda, A, Dall'Acqua, M, Pironi, V, Sutera Sardo, A, Mazzei, A, Sirianni, N, Lavecchia, Am, Mancuso, P, Usala, M, Pala, F, Sini, Gm, Pintori, N, Canu, L, Demurtas, G, Doa, N, Ponz de Leon, M, Domati, F, Rossi, G, Goldoni, Ca, Rossi, F, De Gaetani, C, Benatti, P, Roncucci, L, Di Gregorio, C, Pedroni, M, Pezzi, A, Maffei, S, Mariani, F, Borsi, E, Carruba, G, Cusimano, R, Amodio, R, Dolcemascolo, C, Staiti, R, Pastore, G, Magnani, C, Terracini, B, Cena, T, Alessi, D, Baussano, I, Merletti, F, Maule, M, Macerata, V, Cocchioni, M, Pascucci, C, Gennaro, V, Lazzarotto, A, Benfatto, L, Mazzucco, G, and Montanaro, F.

Subjects
Survival, Italy, cancer patients
Published
2011

19. I tumori in Italia. Rapporto 2011: La sopravvivenza dei pazienti oncologici in Italia

Author

Fusco M, Airtum Working G. R. O. U. P., Buzzoni, C., Coviello, E., Rashid, I., Bianconi, F., Cuccaro, F., Castaing, M., Angelis, R., Giacomin, A., Guzzinati, S., Mosso, Ml, Pisani, P., Quaglia, A., Randi, G., Ramazzotti, V., Russo, A., Senatore, G., Stracci, F., Traina, A., Vercelli, M., Zarcone, M., Ferretti, S., Mazzoleni, G., Bellú, F., Tschugguel, B., Valiere, E., Facchinelli, G., Falk, M., Dal Cappello, T., Vercellino, Pc, Andreone, S., Busato, A., Marzola, L., Migliari, E., Carletti, N., Nenci, I., Crocetti, E., Caldarella, A., Corbinelli, A., Giusti, F., Intrieri, T., Manneschi, G., Nemcova, L., Romeo, G., Sacchettini, C., Zappa, M., Paci, E., Serraino, D., Angelin, T., Bidoli, E., Dal Maso, L., Dottori, M., Paoli, A., Santis, E., Forgiarini, O., Lise, M., Zucchetto, A., Zanier, L., Orengo, Ma, Casella, C., Marani, E., Puppo, A., Celesia, Mv, Cogno, R., Manenti, S., Garrone, E., Pannozzo, F., Busco, S., Cercato, Mc, Battisti, W., Sperduti, I., Macci, L., Bugliarello, E., Bernazza, E., Tamburo, L., Rossi, M., Curatella, S., Francesco, C., Tamburrino, S., Bisanti, L., Autelitano, M., Ghilardi, S., Leone, R., Filipazzi, L., Bonini, A., Giubelli, C., Federico, Massimo, Artioli, Me, Valla, K., Braghiroli, B., Cirilli, C., stefano luminari, Pirani, M., Ferrari, L., Bellatalla, C., Fusco, M., Panico, M., Perrotta, C., Vassante, B., Vitale, Mf, Michiara, M., Bozzani, F., Sgargi, P., Tumino, R., La Rosa MG, Cascone, G., Frasca, G., Giurdanella, Mc, Martorana, C., Morana, G., Nicita, C., Rollo, Pc, Ruggeri, Mg, Sigona, A., Spata, E., Vacirca, S., Mangone, L., Di Felice, E., Pezzarossi, A., Caroli, S., Pellegri, C., Vicentini, M., Storchi, C., Cavuto, S., Costa, J., Falcini, F., Colamartini, A., Bucchi, L., Balducci, C., Ravegnani, M., Vitali, B., Cordaro, C., Caprara, L., Giuliani, O., Giorgetti, S., Salvatore, S., Palumbo, M., Vattiato, R., Ravaioli, A., Foca, F., Rinaldi, E., Mancini, S., Tonelli, C., Amadori, M., Cremone, L., Iannelli, A., Zevola, A., Budroni, M., Cesaraccio, R., Pirino, D., Carboni, D., Fiori, G., Soddu, M., Mameli, G., Mura, F., Contrino, Ml, Madeddu, A., Tisano, F., Sciacca, S., Muni, A., Mizzi, M., Russo, M., Sacco, G., Aletta, P., Colanino Ziino, A., Tessandori, R., Fanetti, Ac, Maspero, S., Annulli, Ml, Moroni, E., Sanoja Gonzalez ME, Zanetti, R., Rosso, S., Patriarca, S., Prandi, R., Sobrato, I., Gilardi, F., Busso, P., Piffer, S., Gentilini, Ma, Battisti, L., Rizzello, R., Cappelletti, M., Moser, M., La Rosa, F., D Alò, D., Scheibel, M., Costarelli, D., Spano, F., Rossini, S., Santucci, C., Petrinelli, Am, Solimene, C., Brunori, V., Crosignani, P., Tagliabue, G., Contiero, P., Preto, L., Tittarelli, A., Maghini, A., Codazzi, T., Frassoldi, E., Gada, D., Costa, E., Di Grazia, L., Zambon, P., Baracco, M., Bovo, E., Dal Cin, A., Fiore, Ar, Greco, A., Monetti, D., Rosano, A., Stocco, C., Tognazzo, S., Donato, F., Limina, Rm, Adorni, A., Andreis, P., Zani, G., Piovani, F., Salvi, O., Puleio, M., Vitarelli, S., Antonini, S., Candela, G., Pappalardo, G., Scuderi, T., Lottero, B., Ribaudo, M., Ricci, P., Guarda, L., Gatti, L., Bozzeda, A., Dall Acqua, M., Pironi, V., Sutera Sardo, A., Mazzei, A., Sirianni, N., Lavecchia, Am, Mancuso, P., Usala, M., Pala, F., Sini, Gm, Pintori, N., Canu, L., Demurtas, G., Doa, N., Maurizio Ponz de Leon, Domati, Federica, Rossi, Giuseppina, Goldoni, Ca, Rossi, F., Gaetani, C., Piero Benatti, Luca Roncucci, Di Gregorio, C., Pedroni, Monica, Pezzi, A., Maffei, Stefania, Mariani, Francesco, Borsi, E., Carruba, G., Cusimano, R., Amodio, R., Dolcemascolo, C., Staiti, R., Pastore, G., Magnani, C., Terracini, B., Cena, T., Alessi, D., Baussano, I., Merletti, F., Maule, M., Macerata, V., Cocchioni, M., Pascucci, C., Gennaro, V., Lazzarotto, A., Benfatto, L., Mazzucco, G., and Montanaro, F.

Subjects
Survival, cancer
Published
2011

20. Small (

Author

Golfieri R., Marini E., Bazzocchi A., Fusco F., Trevisani F., Sama C., Mazzella G., Cavuto S., Piscaglia F., and Bolondi L.

Subjects
RMI, MDTC, HCC
Abstract

PURPOSE: We prospectively compared gadoliniumenhanced magnetic resonance imaging (dynamic MRI), superparamagnetic iron oxide (SPIO) (ferucarbotran) MRI and multidetector-row computed tomography (MDCT) and the combination of dynamic MRI plus MDCT vs. dynamic MRI plus SPIO-MRI (double-contrast MRI: DC-MRI) forthe detection of small (1 cm and the highest specificity (83.3%) superior to dynamic MRI (p1 cm. Furthermore its per-patient negative predictive value was the highest (100%), and significantly higher than all the other methods. CONCLUSIONS: DC-MRI is the most sensitive and accurate method and can be confidently used as a single-step procedure for the detection of small HCCs, with the exception of lesions

Published
2009

21. Un sistema di monitoraggio per i tumori di origine professionale

Author

Crosignani, P., Nesti, M., Audisio, R., Amendola, P., Cavuto, S., Scaburri, A., Zambon, P., Nedoclan, Giovanni, Stracci, F., Pannelli, F., Miligi, L., Vercelli, M., P., Crosignani, M., Nesti, R., Audisio, P., Amendola, S., Cavuto, A., Scaburri, P., Zambon, Nedoclan, Giovanni, F., Stracci, F., Pannelli, L., Miligi, and M., Vercelli

Published
2005

25. Comparison between colour duplex sonography findings and different histological patterns of temporal artery

Author

Muratore, F., primary, Boiardi, L., additional, Restuccia, G., additional, Macchioni, P., additional, Pazzola, G., additional, Nicolini, A., additional, Germano, G., additional, Possemato, N., additional, Cavazza, A., additional, Cavuto, S., additional, Cimino, L., additional, Pipitone, N., additional, Catanoso, M., additional, Addimanda, O., additional, and Salvarani, C., additional

Published
2013
Full Text
View/download PDF

27. Results of blood pressure screening in a population of school-aged children in the province of Milan: role of overweight

Author

Genovesi, S, Giussani, M, Pieruzzi, F, Vigorita, F, Arcovio, C, Cavuto, S, Stella, A, GENOVESI, SIMONETTA CARLA, PIERUZZI, FEDERICO UMBERTO EMILIO GUGLIE, STELLA, ANDREA, Genovesi, S, Giussani, M, Pieruzzi, F, Vigorita, F, Arcovio, C, Cavuto, S, Stella, A, GENOVESI, SIMONETTA CARLA, PIERUZZI, FEDERICO UMBERTO EMILIO GUGLIE, and STELLA, ANDREA

Abstract

OBJECTIVES: To study the prevalence of high blood pressure (BP) in an Italian paediatric population, and to verify whether in this population elevated BP values are associated with overweight (OW). STUDY DESIGN: Children (1206 males, 1210 females) from the lower-grade public schools (ages 6-11 years) were studied. Body weight, height and BP were measured in each child. Elevated BP was defined if resting systolic and/or diastolic BP values equalled or exceeded the 95th percentile according to gender, age and height, based on the US normative BP tables. Overweight children were identified using four different methods: (1) the classification based on the relative body weight; (2) the French references by Rolland-Cachera et al. (Am J Clin Nutr 1982; 36:178-184); (3) the International Obesity Task Force charts; and (4) the Italian charts defined by Cacciari et al. (Eur J Clin Nutr 2002; 56:171-180). RESULTS: The prevalence of high BP in our population was 4.2% and was significantly higher in females (65/1210 = 5.4%) than in males (37/1206 = 3.1%), P = 0.005. The different methods used to define OW provide different estimates of OW prevalence (from 17.0 to 38.6%). The percentage of high BP subjects was significantly higher in OW than in normal-weight children regardless of the method used for the definition of the weight class (P < 0.0001), in both genders. In addition, for each age range, absolute systolic and diastolic BP values were higher in OW as compared to normal-weight children both in males and in females (P < 0.0001). CONCLUSIONS: Our study indicates the importance of performing BP screenings in the paediatric population, and to promote interventions that may reduce the prevalence of OW in children.

Published
2005

29. Differential diagnosis and management of focal ground-glass opacities

Author

Infante, M., primary, Lutman, R. F., additional, Imparato, S., additional, Di Rocco, M., additional, Ceresoli, G. L., additional, Torri, V., additional, Morenghi, E., additional, Minuti, F., additional, Cavuto, S., additional, Bottoni, E., additional, Inzirillo, F., additional, Cariboni, U., additional, Errico, V., additional, Incarbone, M. A., additional, Ferraroli, G., additional, Brambilla, G., additional, Alloisio, M., additional, and Ravasi, G., additional

Published
2009
Full Text
View/download PDF

35. Time-trend analysis of the pulmonary function after surgical treatment for esophageal cancer.

Author

LOCOCO, F., CESARIO, A., MARGARITORA, S., APOLONE, G., CAVUTO, S., LEUZZI, G., PASQUA, F., CARDACI, V., CIAVARELLA, L. PETRACCA, and GRANONE, P.

Abstract

OBJECTIVE: To evaluate, in function of time, the modification of pulmonary function after radical esophagectomy with the aim of identifying clinical and/or surgical predictors of functional worsening. PATIENTS AND METHODS: Data of 57 patients operated from 01/06 to 06/11 were retrospectively reviewed. Thirty-eight patients (67%) underwent transhiatal cervico-laparotomic (CL-Group) and 19 (33%) a Mc-Keown cervico-thoraco-laparotomic esophagectomy (CTL-Group). The pulmonary function has been evaluated before and one month after surgery. The outcome has been benchmarked with demographic/clinical characteristics, the type of operation and the presence of post-operative pulmonary complications (POPCs). RESULTS: Mean age and male/female distribution were 66.6±10.6 yrs and 39/18, respectively. A total of 14 (24% of total sample) POPCs occurred with a significantly higher occurrence in the CTL-Group (71% vs 28%, p < 0.001) and in those patients with a pre-operative concurrent pathological condition (64% in COPD patients vs 36% in patients without COPD, p = 0.021). A global worsening of the spirometric parameters (expressed as the baseline percentage change, Δ) emerged, but this decrease was significantly higher in the CTLGroup in terms of Δ-FVC (p = 0.005) and Δ-FEV1 (p = 0.005). Similarly, those patients who have experienced a POPC, showed a higher reduction of the pulmonary function regardless of the surgical approach when compared with those who did not (Δ-FVC: p = 0.053 and Δ-FEV1%: p = 0.015). CONCLUSIONS: In the context of a global reduction of pulmonary function, patients who underwent trans-thoracic esophagectomy or experienced a POPC showed a significantly worse pattern. These patients could be the "best target" for therapeutic rehabilitative strategies in the pre-operative and/or post-operative setting. This assumption is to be proven through prospective clinical trials. [ABSTRACT FROM AUTHOR]

Published
2014

37. Comparative efficiency of contrast-enhanced colour Doppler ultrasound targeted versus systematic biopsy for prostate cancer detection.

Author

Mitterberger MJ, Aigner F, Horninger W, Ulmer H, Cavuto S, Halpern EJ, Frauscher F, Mitterberger, Michael Josef, Aigner, Friedrich, Horninger, Wolfgang, Ulmer, Hanno, Cavuto, Silvio, Halpern, Ethan J, and Frauscher, Ferdinand

Abstract

Objective: To compare the efficiency of contrast-enhanced colour Doppler ultrasound (CECD-US) targeted biopsy versus systematic biopsy (SB) for PCa detection in 1,776 men.Methods: Retrospective, single-centre, diagnostic accuracy study from 2002 until 2006 in 1,776 male volunteers with a serum total PSA of 1.25 ng/ml or greater. In each patient five CECD-US targeted biopsies were performed in hypervascular areas in the peripheral zone during intravenous injection of a second-generation microbubble US contrast agent. Subsequently, another examiner performed ten SBs. The PCa detection rates for the two techniques were compared.Results: Of 1,776 patients, cancer was detected in 559 patients (31%), including 476 of the 1,776 patients (27%) with CECD-US and 410 (23%) with SB (p < 0.001). The detection rate for CECD-US targeted biopsy cores (10.8% or 961 of 8,880 cores) was significantly better than for SB cores (5.1% or 910 of 17,760 cores, p < 0.001). Among patients with a positive biopsy for PCa, cancer was detected by CECD-US alone in 149 patients (27%) and by SB alone in 83 (15%) (p < 0.001).Conclusion: This study represents the largest clinical trial to date, demonstrating a significant benefit of CECD-US targeted biopsy relative to SB. [ABSTRACT FROM AUTHOR]

Published
2010
Full Text
View/download PDF

38. A randomized study of lung cancer screening with spiral computed tomography: three-year results from the DANTE trial.

Author

Infante M, Cavuto S, Lutman FR, Brambilla G, Chiesa G, Ceresoli G, Passera E, Angeli E, Chiarenza M, Aranzulla G, Cariboni U, Errico V, Inzirillo F, Bottoni E, Voulaz E, Alloisio M, Destro A, Roncalli M, Santoro A, and Ravasi G

Abstract

Rationale: Screening for lung cancer with modern imaging technology may decrease lung cancer mortality, but encouraging results have only been obtained in uncontrolled studies. Objectives: To explore the effect of screening with low-dose spiral computed tomography (LDCT) on lung cancer mortality. Secondary endpoints are incidence, stage at diagnosis, and resectability. Methods: Male subjects, aged 60 to 75 years, smokers of 20 or more pack-years, were randomized to screening with LDCT or control groups. All participants underwent a baseline, once-only chest X-ray and sputum cytology examination. Screening-arm subjects had LDCT upon accrual to be repeated every year for 4 years, whereas controls had a yearly medical examination only. Measurements and Main Results: A total of 2,811 subjects were randomized and 2,472 were enrolled (LDCT, 1,276; control, 1,196). After a median follow-up of 33 months, lung cancer was detected in 60 (4.7%) patients receiving LDCT and 34 (2.8%) control subjects (P = 0.016). Resectability rates were similar in both groups. More patients with stage I disease were detected by LDCT (54 vs. 34%; P = 0.06) and fewer cases were detected in the screening arm due to intercurrent symptoms. However, the number of advanced lung cancer cases was the same as in the control arm. Twenty patients in the LDCT group (1.6%) and 20 controls (1.7%) died of lung cancer, whereas 26 and 25 died of other causes, respectively. Conclusions: The mortality benefit from lung cancer screening by LDCT might be far smaller than anticipated. [ABSTRACT FROM AUTHOR]

Published
2009
Full Text
View/download PDF

48. Intravenous methylprednisolone pulses in hospitalised patients with severe COVID-19 pneumonia, A double-blind, randomised, placebo-controlled trial

Author

Carlo Salvarani, Marco Massari, Massimo Costantini, Domenico Franco Merlo, Gabriella Lucia Mariani, Pierluigi Viale, Stefano Nava, Giovanni Guaraldi, Giovanni Dolci, Luca Boni, Luisa Savoldi, Paolo Bruzzi, Caterina Turrà, Mariagrazia Catanoso, Anna Maria Marata, Chiara Barbieri, Annamaria Valcavi, Francesca Franzoni, Silvio Cavuto, Giorgio Mazzi, Romina Corsini, Fabio Trapani, Alessandro Bartoloni, Emanuela Barisione, Giulia Jole Burastero, Angelo Pan, Walter Inojosa, Raffaele Scala, Cecilia Burattini, Fabrizio Luppi, Mauro Codeluppi, Kamal Eldin Tarek, Giovanni Cenderello, Mario Salio, Giuseppe Foti, Roberto Dongilli, Gianluigi Bajocchi, Emanuele Alberto Negri, Giacomo Ciusa, Giacomo Fornaro, Ilaria Bassi, Lorenzo Zammarchi, Teresita Aloè, Nicola Facciolongo, Salvarani, C, Massari, M, Costantini, M, Franco Merlo, D, Lucia Mariani, G, Viale, P, Nava, S, Guaraldi, G, Dolci, G, Boni, L, Savoldi, L, Bruzzi, P, Turrà, C, Catanoso, M, Maria Marata, A, Barbieri, C, Valcavi, A, Franzoni, F, Cavuto, S, Mazzi, G, Corsini, R, Trapani, F, Bartoloni, A, Barisione, E, Jole Burastero, G, Pan, A, Inojosa, W, Scala, R, Burattini, C, Luppi, F, Codeluppi, M, Eldin Tarek, K, Cenderello, G, Salio, M, Foti, G, Dongilli, R, Bajocchi, G, Alberto Negri, E, Ciusa, G, Fornaro, G, Bassi, I, Zammarchi, L, Aloè, T, and Facciolongo, N

Subjects
Oxygen, Pulmonary and Respiratory Medicine, Treatment Outcome, Double-Blind Method, SARS-CoV-2, Humans, COVID-19, methylprednisolone, steroids, pneumonia, Methylprednisolone, Glucocorticoids, COVID-19 Drug Treatment
Abstract

RationalePulse glucocorticoid therapy is used in hyperinflammation related to coronavirus disease 2019 (COVID-19). We evaluated the efficacy and safety of pulse intravenous methylprednisolone in addition to standard treatment in COVID-19 pneumonia.MethodsIn this multicentre, randomised, double-blind, placebo-controlled trial, 304 hospitalised patients with COVID-19 pneumonia were randomised to receive 1 g of methylprednisolone intravenously for three consecutive days or placebo in addition to standard dexamethasone. The primary outcome was the duration of patient hospitalisation, calculated as the time interval between randomisation and hospital discharge without the need for supplementary oxygen. The key secondary outcomes were survival free from invasive ventilation with orotracheal intubation and overall survival.ResultsOverall, 112 (75.4%) out of 151 patients in the pulse methylprednisolone arm and 111 (75.2%) of 150 in the placebo arm were discharged from hospital without oxygen within 30 days from randomisation. Median time to discharge was similar in both groups (15 days, 95% CI 13.0–17.0 days and 16 days, 95% CI 13.8–18.2 days, respectively; hazard ratio (HR) 0.92, 95% CI 0.71–1.20; p=0.528). No significant differences between pulse methylprednisolone and placebo arms were observed in terms of admission to intensive care unit with orotracheal intubation or death (20.0%versus16.1%; HR 1.26, 95% CI 0.74–2.16; p=0.176) or overall mortality (10.0%versus12.2%; HR 0.83, 95% CI 0.42–1.64; p=0.584). Serious adverse events occurred with similar frequency in the two groups.ConclusionsMethylprenisolone pulse therapy added to dexamethasone was not of benefit in patients with COVID-19 pneumonia.

Published
2022

49. Antihypertensive treatment guided by genetics: PEARL-HT, the randomized proof-of-concept trial comparing rostafuroxin with losartan

Author

Mara Ferrandi, Daniele Cusi, Tzung-Dau Wang, Patrizia Ferrari, Roberto Bigazzi, Jan A. Staessen, Lit Fui Lau, Kang Ling Wang, Chern En Chiang, Giuseppe A. Scioli, Giuseppe Bianchi, Nicola Glorioso, Li Xiaoyi, Chiara Lanzani, Silvio Cavuto, Paolo Manunta, Lorena Citterio, Citterio, L., Bianchi, G., Scioli, G. A., Glorioso, N., Bigazzi, R., Cusi, D., Staessen, J. A., Cavuto, S., Ferrandi, M., Lanzani, C., Li, X., Lau, L. -F., Chiang, C. -E., Wang, T. -D., Wang, K. -L., Ferrari, P., and Manunta, P.

Subjects
0301 basic medicine, Male, Blood Pressure, 030204 cardiovascular system & hematology, 0302 clinical medicine, Clinical endpoint, Pharmacology & Pharmacy, Ouabain, Genetics & Heredity, Genetics, Disease genetics, Middle Aged, Asians, Losartan, ADD1, Cardiovascular diseases, Treatment Outcome, Italy, ADD3, Hypertension, Molecular Medicine, Female, Life Sciences & Biomedicine, medicine.drug, Adult, Taiwan, Predictive markers, White People, Article, 03 medical and health sciences, Asian People, Double-Blind Method, medicine, Humans, Androstanols, Genetic Testing, OSBP, Antihypertensive Agents, Genetic association study, Pharmacology, Science & Technology, Genetic heterogeneity, business.industry, Whites, Gene Expression Profiling, 030104 developmental biology, Blood pressure, Pharmacogenetics, Pharmacogenomics, business
Abstract

We compared a standard antihypertensive losartan treatment with a pharmacogenomics-guided rostafuroxin treatment in never-treated Caucasian and Chinese patients with primary hypertension. Rostafuroxin is a digitoxigenin derivative that selectively disrupts the binding to the cSrc-SH2 domain of mutant α-adducin and of the ouabain-activated Na-K pump at 10–11 M. Of 902 patients screened, 172 were enrolled in Italy and 107 in Taiwan. After stratification for country and genetic background, patients were randomized to rostafuroxin or losartan, being the difference in the fall in office systolic blood pressure (OSBP) after 2-month treatment the primary endpoint. Three pharmacogenomic profiles (P) were examined, considering: P1, adding to the gene variants included in the subsequent P2, the variants detected by post-hoc analysis of a previous trial; P2, variants of genes encoding enzymes for endogenous ouabain (EO) synthesis (LSS and HSD3B1), EO transport (MDR1/ABCB1), adducin (ADD1 and ADD3); P3, variants of the LSS gene only. In Caucasians, the group differences (rostafuroxin 50 μg minus losartan 50 mg in OSBP mmHg) were significant both in P2 adjusted for genetic heterogeneity (P2a) and P3 LSS rs2254524 AA [9.8 (0.6–19.0), P = 0.038 and 13.4 (25.4–2.5), P = 0.031, respectively]. In human H295R cells transfected with LSS A and LSS C variants, the EO production was greater in the former (P = 0.038); this difference was abolished by rostafuroxin at 10–11 M. Chinese patients had a similar drop in OSBP to Caucasians with losartan but no change in OSBP with rostafuroxin. These results show that genetics may guide drug treatment for primary hypertension in Caucasians.

Published
2021

50. Effect of Tocilizumab vs Standard Care on Clinical Worsening in Patients Hospitalized With COVID-19 Pneumonia: A Randomized Clinical Trial

Author

Valerio Del Bono, Massimo Costantini, Andrea Angheben, Lorenzo Zammarchi, Luisa Savoldi, Caterina Turrà, Elisabetta Teopompi, Renato Pascale, Carlo Salvarani, Paolo Luigi Colombelli, Silvio Cavuto, Marco Massari, Luca Braglia, Mario Salio, Giovanni Dolci, Giovanni Secondo, Angelina Passaro, Nicola Duccio Salerno, Walter O Inojosa, Lorenzo Donghi, Giovanni Cenderello, Ombretta Para, Domenico Franco Merlo, Fabrizio Boni, Mauro Codeluppi, Pier Ferruccio Ballerini, Norbiato Claudio, Nicola Facciolongo, Paolo Bruzzi, Marco Falcone, Ilaria Piazza, Alessandro Brignone, Pier Paolo Sainaghi, Pier Giorgio Scotton, Viviana Ravagnani, Roberto Sciascia, Maurizio Milesi, Perla Bertomoro, Salvarani C., Dolci G., Massari M., Merlo D.F., Cavuto S., Savoldi L., Bruzzi P., Boni F., Braglia L., Turra C., Ballerini P.F., Sciascia R., Zammarchi L., Para O., Scotton P.G., Inojosa W.O., Ravagnani V., Salerno N.D., Sainaghi P.P., Brignone A., Codeluppi M., Teopompi E., Milesi M., Bertomoro P., Claudio N., Salio M., Falcone M., Cenderello G., Donghi L., Del Bono V., Colombelli P.L., Angheben A., Passaro A., Secondo G., Pascale R., Piazza I., Facciolongo N., and Costantini M.

Subjects
Male, Blood Gas Analysi, 01 natural sciences, law.invention, chemistry.chemical_compound, Economica, 0302 clinical medicine, Randomized controlled trial, law, Interquartile range, Fraction of inspired oxygen, Monoclonal, Receptors, Medicine, 030212 general & internal medicine, Hospital Mortality, Humanized, Original Investigation, Respiration, Aged, Antibodies, Monoclonal, Humanized, Blood Gas Analysis, C-Reactive Protein, COVID-19, Disease Progression, Early Termination of Clinical Trials, Female, Fever, Hospitalization, Humans, Intensive Care Units, Italy, Medical Futility, Middle Aged, Receptors, Interleukin-6, Respiration, Artificial, Respiratory Insufficiency, SARS-CoV-2, Intensive care unit, Artificial, Human, medicine.medical_specialty, Randomization, Intensive Care Unit, Socio-culturale, Antibodies, Early Termination of Clinical Trial, 03 medical and health sciences, Tocilizumab, Internal medicine, Internal Medicine, 0101 mathematics, Interleukin-6, business.industry, 010102 general mathematics, medicine.disease, Interim analysis, COVID-19 Drug Treatment, Pneumonia, chemistry, business
Abstract

IMPORTANCE: The coronavirus disease 2019 (COVID-19) pandemic is threatening billions of people worldwide. Tocilizumab has shown promising results in retrospective studies in patients with COVID-19 pneumonia with a good safety profile. OBJECTIVE: To evaluate the effect of early tocilizumab administration vs standard therapy in preventing clinical worsening in patients hospitalized with COVID-19 pneumonia. DESIGN, SETTING, AND PARTICIPANTS: Prospective, open-label, randomized clinical trial that randomized patients hospitalized between March 31 and June 11, 2020, with COVID-19 pneumonia to receive tocilizumab or standard of care in 24 hospitals in Italy. Cases of COVID-19 were confirmed by polymerase chain reaction method with nasopharyngeal swab. Eligibility criteria included COVID-19 pneumonia documented by radiologic imaging, partial pressure of arterial oxygen to fraction of inspired oxygen (Pao(2)/Fio(2)) ratio between 200 and 300 mm Hg, and an inflammatory phenotype defined by fever and elevated C-reactive protein. INTERVENTIONS: Patients in the experimental arm received intravenous tocilizumab within 8 hours from randomization (8 mg/kg up to a maximum of 800 mg), followed by a second dose after 12 hours. Patients in the control arm received supportive care following the protocols of each clinical center until clinical worsening and then could receive tocilizumab as a rescue therapy. MAIN OUTCOME AND MEASURES: The primary composite outcome was defined as entry into the intensive care unit with invasive mechanical ventilation, death from all causes, or clinical aggravation documented by the finding of a Pao(2)/Fio(2) ratio less than 150 mm Hg, whichever came first. RESULTS: A total of 126 patients were randomized (60 to the tocilizumab group; 66 to the control group). The median (interquartile range) age was 60.0 (53.0-72.0) years, and the majority of patients were male (77 of 126, 61.1%). Three patients withdrew from the study, leaving 123 patients available for the intention-to-treat analyses. Seventeen patients of 60 (28.3%) in the tocilizumab arm and 17 of 63 (27.0%) in the standard care group showed clinical worsening within 14 days since randomization (rate ratio, 1.05; 95% CI, 0.59-1.86). Two patients in the experimental group and 1 in the control group died before 30 days from randomization, and 6 and 5 patients were intubated in the 2 groups, respectively. The trial was prematurely interrupted after an interim analysis for futility. CONCLUSIONS AND RELEVANCE: In this randomized clinical trial of hospitalized adult patients with COVID-19 pneumonia and Pao(2)/Fio(2) ratio between 200 and 300 mm Hg who received tocilizumab, no benefit on disease progression was observed compared with standard care. Further blinded, placebo-controlled randomized clinical trials are needed to confirm the results and to evaluate possible applications of tocilizumab in different stages of the disease. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04346355; EudraCT Identifier: 2020-001386-37

Published
2020

Catalog

Books, media, physical & digital resources
See catalog results