0000000000286504
AUTHOR
G. Salemi
Acute myeloid leukemia in Italian patients with multiple sclerosis treated with mitoxantrone
none 25 no Abstract OBJECTIVES: To evaluate the incidence and dose-dependency of mitoxantrone (MTX)-associated acute myelocytic leukemia (AML) in the network of Italian multiple sclerosis (MS) clinics. METHODS: We performed a multicenter retrospective cohort study of patients treated with MTX in MS centers under the Italian national health care system between 1998 and 2008. Demographic, disease, treatment, and follow-up information were collected using hospital records. RESULTS: Data were available for 3,220 patients (63% women) from 40 Italian centers. Follow-up (mean ± SD) was 49 ± 29 months (range 12-140 months). We observed 30 cases of AML (incidence 0.93% [95% confidence interval 0.60%…
Extracellular vesicles from CS fluid are possible biomarkers of multiple sclerosis disease status
Multiple sclerosis (MS) is an autoimmune disease and several researches have been focused on identifying molecular biomarkers that could reflect its heterogeneous clinical course and determine the best treatment option for patients. Some studies identified extracellular vesicles (EVs) in both the cerebrospinal fluid (CSF) and also in blood samples of patients affected by inflammatory neurodegenerative diseases and multiple sclerosis. To monitor the disease onset and its progression we compared the amount of CSF-EVs and their surface markers in subjects affected by either MS or other neurological disorders correlating the EVs with clinical indicators of MS disease severity. EVs isolated by u…
Multiple sclerosis in twins from continental Italy and Sardinia: a nationwide study.
Knowledge about the balance between heritable and nonheritable risk in multiple sclerosis (MS) is based on twin studies in high-prevalence areas. In a study that avoided ascertainment limitations and directly compared continental Italy (medium-prevalence) and Sardinia (high-prevalence), we ascertained 216 pairs from 34,549 patients. This gives a twinning rate of 0.62% among MS patients, significantly less than that of the general population. In continental Italy, probandwise concordance was 14.5% (95% confidence interval, 5.1-23.8) for monozygotic and 4.0% (95% confidence interval, 0.8-7.1) for dizygotic twins. Results in Sardinia resemble those in northern populations but in limited number…
Real-life impact of early interferon beta therapy in relapsing multiple sclerosis.
OBJECTIVE: Recent findings support greater efficacy of early vs. delayed interferon beta (IFNbeta) treatment in patients with a first clinical event suggestive of multiple sclerosis (MS). We aimed to evaluate the effectiveness of early IFNbeta treatment in definite relapsing-remitting MS (RRMS) and to assess the optimal time to initiate IFNbeta treatment with regard to the greatest benefits on disability progression. METHODS: A cohort of 2,570 IFNbeta-treated RRMS patients was prospectively followed for up to 7 years in 15 Italian MS Centers. A Cox proportional hazards regression model adjusted for propensity score (PS) quintiles was used to assess differences between groups of patients wit…
Energy and environmental impacts of energy related products: the case study of a device for reducing natural gas consumption in the production of sanitary hot water
The European Commission identified the Energy related Products (ErP) as products that account for a large share of the European energy and natural resources consumption. In order to reduce the energy and environmental impacts of ErP, the European Commission published the Directive 2009/125/EC, which establishes a framework for setting the eco-design requirements for these products. The above Directive represents a key component of the European policy for improving the energy and environmental performance of products on the market. In this context, it is of paramount importance to develop scientific researches aimed to assess the energy and environmental performances of the current products …
Life Cycle Assessment and eco-design of building materials: the case study of a Sicilian cement plaster
Buildings in the European Union (EU) account for the largest share of the total EU final energy consumption (42%), and greenhouse gas emissions (35%). Therefore, the reduction of energy use, the development of quality-oriented processes and the improvement of energy performance in the building sector are important measures needed to reduce greenhouse gas emissions and the energy dependency of the European Union from foreign countries. In this context, it is necessary to develop sustainable building products, with low energy and environmental impacts during their life cycle, from the extraction of raw material to the manufacturing, use and end-of-life. The main goal of the study is to define…
Quality of life, depression and fatigue in mildly disabled patients with relapsing–remitting multiple sclerosis receiving subcutaneous interferon beta-1a: 3-year results from the COGIMUS (COGnitive Impairment in MUltiple Sclerosis) study
Background: The precise relationships among quality of life, depression, fatigue and cognitive impairment in multiple sclerosis (MS) are complex and poorly understood. Objective: To assess the effects of subcutaneous interferon beta-1a on quality of life, depression and fatigue over 3 years in the COGIMUS study, and to examine the relationship between these outcomes and baseline cognitive status. Methods: COGIMUS was an observational 3-year trial assessing cognitive function in 459 patients with relapsing–remitting MS treated with subcutaneous interferon beta-1a. Results: In total, 331 patients completed the study (168 received interferon beta-1a, 44 µg subcutaneously three times weekly, a…
La Life Cycle Assessment come strumento di supporto per le piccole e medie imprese: un caso studio siciliano
L’Unione Europea mira ad orientare il mercato verso una crescente domanda di prodotti e servizi ecoefficienti ed eco-sostenibili. Le PMI, per essere competitive sul mercato, hanno la necessità di superare il gap tecnologico e di competenze che spesso le caratterizza ed avviare processi produttivi eco-orientati. In tale contesto nasce il Centro di Ricerca Italo-Maltese per la Sostenibilità Ambientale e le Fonti Rinnovabili (CRIM-SAFRI), che si propone di offrire una significativa opportunità di crescita e sviluppo per il tessuto produttivo dell’area del Mediterraneo, contribuire a ridurre i consumi energetici, le emissioni di gas serra e di altre sostanze inquinanti connessi ai processi prod…
NEURODEGENERATION IN MULTIPLE SCLEROSIS: COMPARISON BETWEEN CLINICAL, NEUROPSYCHOLOGICAL, MRI,AND OPTICAL COHERENCE TOMOGRAPHY PARAMETERS
BACKGROUND AND OBJECTIVE Optical Coherence Tomography (OCT) enables rapid, non-invasive in vivo measurement of retinal nerve fiber layer (RNFL) thickness, reflecting axonal density within the optic nerve. There is still lack of concordance about the use of OCT in clinical routine as a surrogate measure of brain atrophy. Objective: To investigate the role of OCT as possible predictor of disability, cognitive impairment and neurodegeneration in Multiple Sclerosis (MS). MATERIAL AND METHODS We recruited patients affected by MS according to validated criteria at the Neurological Department of the University of Palermo. Patients performed Stratus OCT- 3 Zeiss to assess RNFL and GCS measurements.…
Changes in magnetic resonance imaging disease measures over 3 years in mildly disabled patients with relapsing-remitting multiple sclerosis receiving interferon β-1a in the COGnitive Impairment in MUltiple Sclerosis (COGIMUS) study.
Abstract Background Conventional magnetic resonance imaging (MRI) has improved the diagnosis and monitoring of multiple sclerosis (MS). In clinical trials, MRI has been found to detect treatment effects with greater sensitivity than clinical measures; however, clinical and MRI outcomes tend to correlate poorly. Methods In this observational study, patients (n = 550; 18-50 years; relapsing-remitting MS [Expanded Disability Status Scale score ≤4.0]) receiving interferon (IFN) β-1a therapy (44 or 22 µg subcutaneously [sc] three times weekly [tiw]) underwent standardized MRI, neuropsychological and quality-of-life (QoL) assessments over 3 years. In this post hoc analysis, MRI outcomes and corre…
Quantitative EEG differentiates multiple sclerosis with and without cognitive impairment from healthy controls at the beginning of the disease: preliminary data
Background and aims: The present study aims to assess possible qEEG differences between newly diagnosed multiple sclerosis (MS) patients with or without cognitive impairment (CI). Methods: We enrolled 22 patients (18-55-years-old) treated with first-line drugs for <6 months, and 11 healthy controls. All subjects underwent neuropsychological assessment including BICAMS and BDI. EEG recordings were performed during a cognitive task (computerised “SDMT” subtest of BICAMS) and at rest. Based on neuropsychological assessment, patients were considered as affected (MSCI group) or not (MS group) by cognitive impairment. We analysed data comparing MSCI patients matched by sex, age (±5years) and e…
Effects of immunomodulatory treatment with subcutaneous interferon beta-1a on cognitive decline in mildly disabled patients with relapsing-remitting multiple sclerosis
The objective of this study was to assess the effects of subcutaneous (sc) interferon beta-1a (IFNβ-1a) on cognition in mildly disabled patients with relapsing—remitting multiple sclerosis (RRMS). Patients aged 18—50 years with RRMS (McDonald criteria; Expanded Disability Status Scale score ≤4.0) were assigned IFNβ therapy at the physician’s discretion and underwent standardized magnetic resonance imaging, neurological examination and neuropsychological testing at the baseline and regular intervals for up to three years. This analysis included 459 patients who received sc IFNβ-1a (44 mcg: n = 236; 22 mcg: n = 223; three-year follow up was available for 318 patients). The hazard ratio for c…