Publications by authors named "Presa J"
Background: The morbidity and mortality associated with influenza viruses are a significant public health challenge. Annual vaccination against circulating influenza strains reduces hospitalisations and increases survival rates but requires a yearly redesign of vaccines against prevalent subtypes. The complex genetics of influenza viruses with high antigenic drift create an ongoing challenge in vaccine development to address dynamic influenza epidemiology.
View Article and Find Full Text PDFIntroduction: The most frequently used first-line treatment in patients with advanced hepatocellular carcinoma (HCC) is atezolizumab plus bevacizumab. Upon progression after this treatment, the standard of care in many countries is sorafenib, due to the lack of reimbursement for other drugs. Several randomized trials are currently underway to clarify the best second-line therapy in patients with HCC.
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- Researchers aimed to evaluate spleen stiffness measurement (SSM) as a standalone non-invasive test for clinically significant portal hypertension (CSPH) in patients with compensated advanced chronic liver disease (cACLD) and compare it to the existing ANTICIPATE±NASH model.
- The study involved 407 patients recruited from 16 expert centers in Europe, utilizing various non-invasive tests alongside hepatic venous pressure gradient measurements to assess CSPH probability.
- The findings indicated the potential for SSM to enhance diagnostic capabilities, as models were created to evaluate its effectiveness and discriminative ability compared to existing methods using binary logistic regression analysis.
Article Synopsis
- * A retrospective analysis of 885 HCC patients showed no significant differences in overall survival, time to progression, or disease control rates between viral and nonviral patients treated with the combination therapy.
- * Common prognostic factors were identified across both groups, but there might be some stronger associations between immunological factors and outcomes specifically in viral patients, while treatment-related toxicities and second-line treatments showed nearly identical results for both etiology subgroups.
Article Synopsis
- Low Vaccination Rates
- : The text discusses the low uptake of meningococcal vaccines in the US and emphasizes the importance of understanding factors influencing vaccination preferences to potentially increase these rates.
- Study Design and Findings
- : A study was conducted with adolescents and their guardians to assess their willingness to vaccinate based on various vaccine attributes, highlighting that 59.5% of participants favored vaccination regardless of the attributes presented.
- Key Influencing Factors
- : The findings revealed that the key factors affecting vaccination choice were the vaccine's level of protection and the likelihood of mild-to-moderate side effects, with a new pentavalent vaccine option further boosting willingness among specific demographics.
Article Synopsis
- * Patients taking metformin had significantly shorter OS (HR 1.9) and PFS (HR 1.6) compared to those not using the medication, while no such differences were found in the Lenvatinib cohort.
- * The findings suggest a negative impact of metformin usage on patient outcomes specifically in the context of Atezolizumab plus Bevacizumab treatment for HCC, highlighting the need for
Background: In the United States (US), three types of vaccines are available to prevent invasive meningococcal disease (IMD), a severe and potentially fatal infection: quadrivalent conjugate vaccines against serogroups A, C, W, Y (MenACWY), and monovalent vaccines against serogroup B (MenB) as well as a newly licensed pentavalent vaccine (MenABCWY) protecting against serogroup A, B, C, W, and Y. The CDC's Advisory Committee on Immunization Practices (ACIP) routinely recommends MenACWY vaccine for all 11- to 12-year-olds with a booster dose at 16 years. MenB vaccination is recommended based on shared clinical decision-making (SCDM) for 16- to 23-year-olds.
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- The study focused on creating a scoring system called the OCA response score (ORS) to predict how individuals with primary biliary cholangitis (PBC) will respond to the treatment using obeticholic acid (OCA).
- Data were collected from two large cohorts in Italy to derive and validate the score, which includes various clinical factors both before and after six months of treatment.
- The scoring system demonstrated good predictive ability for treatment response, which could help healthcare providers customize therapies for patients with PBC more effectively.
Background: Suboptimal response to ursodeoxycholic acid occurs in 40% of primary biliary cholangitis (PBC) patients, affecting survival. Achieving a deep response (normalisation of alkaline phosphatase [ALP] and bilirubin ≤0.6 upper limit of normal) improves survival.
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- * The research identified independent prognostic factors affecting overall survival and progression-free survival, notably the severity of decreased appetite, immunotoxicity, diarrhea, fatigue, arterial hypertension, and proteinuria.
- * The findings underscore a significant relationship between the occurrence of AEs and therapy outcomes in HCC patients, similar to what has been observed in other treatment contexts, highlighting the importance of monitoring AEs for prognosis.
Article Synopsis
- - The study examines the impact of Body Mass Index (BMI) on survival among patients with advanced liver cancer (HCC) undergoing first-line treatment with either atezolizumab plus bevacizumab or lenvatinib, focusing on underweight, normal-weight, and overweight classifications.
- - In a cohort of 1,292 patients, results indicated that underweight individuals had significantly shorter overall survival (OS) compared to normal-weight patients, while no significant differences in OS were observed between normal and overweight patients.
- - The research highlights the differing prognostic implications of BMI in cancer treatment, suggesting that underweight patients may require more focused clinical considerations in advanced HCC therapy.
Invasive meningococcal disease (IMD) is a rare but serious illness, and adolescents and young adults in the United States are at increased risk. Here, we discuss US IMD history and how successful disease prevention through routine vaccination against the most common disease-causing serogroups (A, B, C, W, and Y) can inform future recommendations. Before the introduction of quadrivalent meningococcal conjugate (MenACWY) vaccines, most US cases of IMD were caused by serogroups B, C, and Y.
View Article and Find Full Text PDFIntroduction: Wilson's disease (WD) is associated with a variety of movement disorders and progressive neurological dysfunction. The aim of this study was to correlate baseline brain magnetic resonance imaging (MRI) features with clinical phenotype and long-term outcomes in chronically treated WD patients.
Methods: Patients were retrospectively selected from an institutional database.
Background: Data concerning the use of lenvatinib in very old patients (≥ 80 years) are limited, although the incidence of hepatocellular carcinoma (HCC) in this patient population is constantly increasing.
Objective: This analysis aimed to evaluate the efficacy and safety of lenvatinib in a large cohort of very old patients (≥ 80 years) with unresectable HCC.
Patients And Methods: The study was conducted on a cohort of 1325 patients from 46 centers in four Western and Eastern countries (Italy, Germany, Japan, and the Republic of Korea) who were undergoing first-line treatment with lenvatinib between July 2010 and February 2022.
Alzheimer's disease (AD) is characterized by the accumulation of aggregated amyloid peptides in the brain parenchyma and within the walls of cerebral vessels. The hippocampus-a complex brain structure with a pivotal role in learning and memory-is implicated in this disease. However, there is limited data on vascular changes during AD pathological degeneration in this susceptible structure, which has distinctive vascular traits.
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- Influenza virus infection impacts both lung and gut bacteria, but most studies only look at the composition of these microbiota.
- During influenza A virus (IAV) infection, the gut microbiome decreases and loses the ability to metabolize certain nutrients in oxygen-rich environments.
- There is also an increase in resistance to important antibiotics, which could complicate treatment strategies for infections involving multiple bacteria.
Atezolizumab plus bevacizumab (AB) and lenvatinib can be alternatively used as first-line systemic treatment of unresectable hepatocellular carcinoma (HCC). However, no direct comparison of the two regimens has been performed in randomized clinical trials, making the identification of baseline differential predictors of response of major relevance to tailor the best therapeutic option to each patient. Baseline clinical and laboratory characteristics of real-world AB-treated HCC patients were analyzed in uni- and multivariate analyses to find potential prognostic factors of overall survival (OS).
View Article and Find Full Text PDFIntroduction: The aim of this retrospective proof-of-concept study was to compare different second-line treatments for patients with hepatocellular carcinoma and progressive disease (PD) after first-line lenvatinib or atezolizumab plus bevacizumab.
Materials And Methods: A total of 1381 patients had PD at first-line therapy. 917 patients received lenvatinib as first-line treatment, and 464 patients atezolizumab plus bevacizumab as first-line.
Invasive meningococcal disease (IMD) is rare but associated with high morbidity and mortality. In the United States, the most vulnerable age groups are infants and adolescents/young adults, and the most common type of IMD is caused by serogroup B (MenB). MenB is preventable among adolescents and young adults with the use of two licensed vaccines, MenB-FHbp (Trumenba®, bivalent rLP2086; Pfizer Inc, Collegeville, PA) and MenB-4C (Bexsero®; GSK Vaccines, Srl, Italy).
View Article and Find Full Text PDFBackground: The clinical burden of influenza is increasing worldwide. Aging, immunosuppression, and underlying respiratory illness are determinants of poor clinical outcomes, including greater mortality. Bacterial infections seem to be the main reason.
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- The study investigates the effectiveness of two treatments, atezolizumab plus bevacizumab versus Lenvatinib, for advanced hepatocellular carcinoma (HCC) patients classified as Child-Pugh B.
- A total of 217 patients were studied, with Lenvatinib showing a median overall survival of 13.8 months, compared to 8.2 months for the combination treatment (p = 0.0050).
- The findings indicate that Lenvatinib significantly improves overall survival compared to atezolizumab plus bevacizumab in this patient group, suggesting it may be a better first-line treatment option.
Background/aim: The purpose of this study was to ascertain a novel prognostic index via recursive partitioning analysis (RPA) in hepatocellular carcinoma (HCC) patients being treated with the combination of atezolizumab plus bevacizumab (ABE) in first-line setting.
Patients And Methods: A total of 784 patients with HCC were included in the analysis.
Results: RPA identified three groups of patients: high-risk [Child-Pugh B (CP-B) patients; CP-A and Albumin-Bilirubin (ALBI)-2 patients; CP-A and ALBI-1 patients with macrovascular invasion (MVI), and alpha-fetoprotein (α-FP) ≥400 ng/ml]; intermediate-risk [CP-A and ALBI-1 patients with aspartate aminotransferase (AST) normal value (NV), and αFP ≥400 ng/ml, but without MVI; CP-A and ALBI-1 patients with AST increased value (IV), and neutrophil-lymphocyte ratio (NLR) ≥3, but without MVI]; low-risk (CP-A and ALBI-1 patients with AST NV, and αFP <400 ng/ml, but without MVI; CP-A and ALBI-1 patients with AST IV, and NLR <3, but without MVI; CP-A and ALBI-1 patients with MVI, and αFP <400 ng/ml).
Article Synopsis
- Atezolizumab plus bevacizumab has been established as a new first-line treatment for patients with unresectable hepatocellular carcinoma (HCC).
- A real-world study was conducted to examine how the original inclusion criteria from the IMbrave150 trial influence patient outcomes outside of clinical trials.
- The analysis included 766 patients, revealing that those meeting the trial criteria ('IMbrave150-in') had significantly better overall survival and progression-free survival compared to those who did not ('IMbrave150-out').
Vaccines remain a fundamental intervention for preventing illness and death. In the United States, suboptimal vaccine uptake in adolescents and young adults has been observed for meningococcal conjugate (MenACWY) and serogroup B meningococcal (MenB) vaccines, particularly among marginalized communities, despite current recommendations by the Advisory Committee on Immunization Practices. A systematic literature search was conducted in the MEDLINE and MEDLINE In-Process, Embase, Cochrane, PsychInfo, and CINAHL databases to identify both drivers of, and barriers to, MenACWY and MenB vaccine uptake in adolescents and young adults.
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- Current prognostic scores for acutely decompensated cirrhosis patients, especially those with acute-on-chronic liver failure, often underestimate mortality risk due to not accounting for systemic inflammation's impact.
- A study used serum metabolomics from two large European cohorts to identify key metabolites linked to short-term mortality, leading to the creation of two new predictive models.
- Both models significantly outperformed the existing MELDNa score in predicting death within 28 days of hospital admission, demonstrating better accuracy in patients with acute-on-chronic liver failure.