0000000000479632
AUTHOR
P. D'angelo
TUMORI a CELLULE GERMINALIin ETA' PEDIATRICA: FATTORI PROGNOSTICI del PROTOCOLLO AIEOP TCG 91.
CIRCA IL 20% DEI PAZIENTI CON TUMORI A CELLULE GERMINALI (tcg) SONO RESISTENTI AL TRATTAMENTO. GLI aUTORI HANNO EFFETTUATO UNO STUDIO POLICENTRICO AL FINE DI RILEVARE CORRELAZIONI TRA PARAMETRI CLINOCO/LABORATORISTICI E LA PROGNOSI
Predictors of early discontinuation of dapagliflozin versus other glucose-lowering medications: a retrospective multicenter real-world study
Background and aims: In routine clinical practice, early discontinuation of newly initiated glucose-lowering medications (GLM) is relatively common. We herein evaluated if the clinical characteristics associated with early discontinuation of dapagliflozin were different from those associated with early discontinuation of other GLM. Methods: The DARWIN-T2D was a multicenter retrospective study conducted at diabetes specialist outpatient clinics in Italy. We included 2484 patients who were initiated on dapagliflozin in 2015–2016 and 14,801 patients who were initiated on other GLM (DPP-4 inhibitors, GLP-1 receptor agonists, or gliclazide) in the same period. After excluding patients who had no…
Similar effectiveness of dapagliflozin and GLP-1 receptor agonists concerning combined endpoints in routine clinical practice: A multicentre retrospective study
Abstract Aims According to cardiovascular outcome trials, some sodium‐glucose contransporter‐2 inhibitors (SGLT2i) and glucagon‐like peptide‐1 receptor agonists (GLP‐1RA) are recommended for secondary cardiovascular prevention in type 2 diabetes (T2D). In this real‐world study, we compared the simultaneous reductions in HbA1c, body weight and systolic blood pressure after initiation of dapagliflozin or GLP‐1RA as second or a more advanced line of therapy. Materials and methods DARWIN‐T2D was a retrospective multi‐centre study conducted at diabetes specialist clinics in Italy that compared T2D patients who initiated dapagliflozin or GLP‐1RA (exenatide once weekly or liraglutide). Data were c…
STAGE I GONADAL CELL TUMORS (GGCT): OUTCOME AFETR THE SURVEILLANCE STRATEGY AS APPLIED IN THE ASSOCIAZIONE ITALIANA EMATOLOGIA ONCOLOGIA PEDIATRICA (aieop) 2004 PROTOCOL
Suveillance strategy is a standerd option in stage 1° testicular GCT and suggested for ovarian GCT too. Worries regarding the relapse risk in ovarian are emerging. We here report on our series of stage 1° GGCT
FAILURE of TERATMENT in CHILDHOOD EXTRACRANIAL and EXTRATESTICULAR MALIGNANT GERM CELL TUMOURS (mgct)
Platinum based chemptherapy improves the cure rate of patients with MGCT to over 80 poer cent, but tumour recurrence is associated with an unfavourable prognosis. We sought to identify factors predicitive of poor outcome following relapse.
Mature and immature teratoma: A report from the second Italian pediatric study
Background. Teratomas demonstrate a benign clinical behavior, however they may recur with malignant components or as teratoma, and in a small group of patients prognosis could be fatal. After the ®rst Italian study, we collected cases of teratoma, alongside the protocol for malignant germ cell tumors. Procedure. Patients with teratoma were collected from 2004 to 2014. Teratomas were classi®ed according to the WHO classi®cations, as mature and immature. Patients with pathological aFP and/or bHCG, and those with a malignant germ cell component were not included. Results. The study enrolled 219 patients (150 mature, 69 immature teratomas) with a median age at diagnosis of 42 months. The primar…
Transfusional Hemochromatosis: Quantitative Relation of MR Imaging Pituitary Signal Intensity Reduction to Hypogonadotropic Hypogonadism
To assess the relationship between magnetic resonance (MR) imaging pituitary signal intensity reduction in patients with transfusional hemochromatosis and the clinical manifestation of hypogonadotropic hypogonadism.Pituitary MR imaging at 0.5 T was performed in 38 consecutive patients affected by secondary hemochromatosis and in 20 healthy volunteers. Serum ferritin levels were estimated in the affected population. Twenty (53%) of the 38 patients had hypogonadotropic hypogonadism diagnosed. Pituitary-to-fat signal intensity ratios were calculated from coronal gradient-echo (GRE) T2*-weighted MR images. The relationship between the quantitative reduction of the pituitary-to-fat signal intens…
MALIGNANT GERM CELL TUMOURS in CHILDHOOD: the Italian Experience
Malignant Germ Cell Tumours (MGCT) account approximately 3% of all malignancies in the paediatric age group. Although many of them are curable, their natural history, staging, systems and optimal treatment still need to be better defined. Tha data of an Italian co-operative study are reported here
Well-being of physicians who work in oncology unit and in BMT unit: analysis of protective factors from work stress
Background. Recently a great deal of attention has been given on doctors' work related stress and possibility of improving their quality of life. Several studies report that oncologists are overloaded psychologically. Contact with serious diseases, excessive working pressure, structural weaknesses, are some of the factors that predispose oncologists to stress. In 2008, at the ASPHO annual meeting, pediatric hematologists/oncologists noted burnout (considered as a result of protracted stress at work) was a significant challenge in their lives. To date, no studies have extensively ruled out on protective factors from work stress among pediatric oncologists. Aims. Our research investigates the…
Serum and fecal pancreatic enzymes in beta-thalassemia major
This study, using indirect tests, demonstrated that exocrine pancreatic function is impaired in a proportion of patients with beta-thalassemia major (TM), though this impairment is generally mild or moderate.Impaired structure and function of the exocrine pancreas has been reported in patients with Beta-thalassemia major.In this study we measured fecal fats and serum and fecal pancreatic enzymes in 30 patients (13 M, 17 F) with TM, mean age 22.1 yr (range 14-39) and compared them with those of a matched group of healthy controls. Results were correlated with age, serum ferritin, blood transfusion, and various nutritional parameters. Enzymes assays included: serum pancreatic amylase (PA), li…
SURGERY IN PATIENTS WITH TESTICULAR MALIGNANT GERM CELL TUMORS: COMPLIANCE TO SURGICAL GUIDELINES AND RESULTS IN THE ITALIAN COOPERATIVE STUDY
Purpose: Surgery represents a main and often the only treatment in patients with testicular Malignant Germ Cell Tumors (MGCT). We analyzed the compliance to surgical guidelines and the results in a series of patients with testicular MGCT -/+ retroperitoneal node involvement, without distant metastases. Method: 42 patients, observed in 15 Centers were enrolled in the Italian Cooperative Study on MGCT (January2004–December2010). 14/42 were younger than 2 y. of age, 28/42 between 13–18 y. Treatment was delivered according to COG-Staging-System: St.I patients (complete excision with inguinal orchifunicolectomy+decrease of markers, +hemiscrotectomy if scrotal involvement) did not receive further…
Magnetic resonance imaging of the pituitary gland in patients with secondary hypogonadism due to transfusional hemochromatosis
To identify pituitary iron overload in patients with transfusional hemochromatosis causing secondary hypogonadism, we prospectively evaluated signal intensity abnormalities of the anterior lobe of the pituitary gland of 18 patients affected by transfusion-dependent thalassemia major and secondary hypogonadism. Magnetic resonance (MR) imaging is useful to assess pituitary iron overload in patients with transfusional hemochromatosis and secondary hypogonadism by detection of a significant decreased signal intensity of the anterior lobe of the pituitary gland on GRE T2*-weighted images. The decreased signal intensity of the anterior lobe of the pituitary gland on GRE T2*-weighted images was co…
EXTRAGONADAL GERM CELL TUMORS: Results of AIEOP TCG 91/98 Protocols
The aim of the Study: To analyze the outcome of patirnts with extragonadal (eg) GCT teated with TCG 91/98 Protocols. 45 pts were enrolled: 34 were females, 11 males; median age 17 months (range: 1-137 months)
MR imaging of pancreatic changes in patients with transfusion-dependent beta-thalassemia major.
The aim of this study was to evaluate MR imaging changes of the pancreas in patients with transfusion-dependent beta-thalassemia major.Twenty patients with transfusion-dependent beta-thalassemia major were examined using MR imaging at 0.5 T, with spin-echo T1-weighted, fast spin-echo T2-weighted, and gradient-echo T2*-weighted sequences. Image analysis was performed to assess pancreas-to-fat signal intensity ratios for all pulse sequences. Pancreatic exocrine and endocrine function and serum ferritin levels were assessed. Twenty healthy volunteers underwent MR imaging with the same three sequences and served as a control group.The pancreas-to-fat signal intensity ratio was significantly dec…
PLEUROPULMONARY BLASTOMA: A DIFFERENTIAL DIAGNOSIS OF CHRONIC COUGH. LONG TERM SURVIVALAFTER MULTIMODAL AGGRESSIVE THERAPY
ITAL J PEDIATR 2006;32:122-125 CASE REPORT CASO CLINICO Pleuropulmonary blastoma: a differential diagnosis of chronic cough. Long-term survival after multimodal aggressive therapy Blastoma pleuro-polmonare: rara diagnosi differenziale da tosse cronica. Remissione a lungo termine dopo aggressiva terapia multimodale P. D''ANGELO, V. MANZO*, S. VENEZIA*, R. ALAGGIO", E SIRACUSA*, M. LO CURTO* Unità Operativa di Oncoematologia Pediatrica, Ospedale dei Bambini " G . Di Cristina", Palermo; * Dipartimento Materno Infantile, Università di Palermo; ** Istituto di Anatomia Patologica, Università di Padova Summary Pleuropulmonary blastoma (PPB) in childhood is a rare clinicopathologic entity distinct …
Hypogonadotrophic Pituitary Insufficiency in Transfusional Hemochromatosis Complicating Thalassemia Major: MR Imaging
To identify pituitary iron overload in patients with transfusion-dependent thalassemia major causing secondary hypogonadism, we prospectively evaluated signal intensity abnormalities of the anterior lobe of the pituitary gland of 30 patients comparing spin-echo, gradient-echo imaging and pituitary T2 relaxation times measurement. We found that pituitary iron overload can best be assessed by MR imaging using gradient-echo T2*-weighted technique to establish signal reduction in the anterior lobe of the pituitary gland. This finding is correlated to increasing serum ferritin level — a parameter that reflects the severity of iron overload, and is more evident in patients with secondary hypogon…
MALATTIA DI KAWASAKI E MAS INDOTTA DA INFEZIONE DA EBV IN PAZIENTE CON LINFOISTIOCITOSI EMOFAGOCITICA DI TIPO 2
L’HLH, rara patologia da alterata risposta infiammatoria sistemica, presenta elevata mortalità, se non diagnosticata e trattata tempestivamente. Il quadro clinico è caratterizzato da febbre elevata persistente, epatosplenomegalia, citopenia di almeno due linee cellulari, linfoadenopatia generalizzata, rash, iperferritinemia, ipertrigliceridemia, ipofibrinogenemia, ipertransaminasemia e alterazioni della coagulazione. La HLH è divisa in primaria o familiare (autosomica recessiva) e secondaria (S. Autoinfiammatorie, infezioni, trapianti, ecc). La terapia si basa su chemioterapia (protocollo HLH94 e HLH2004) e, per le HLH familiari, e trapianto di midollo osseo. Fra le forme familiari, il tipo…