J Peripher Nerv Syst
September 2015
Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands.
This study aimed to 'define responder' through the concept of minimum clinically important differences using the individually obtained standard errors (MCID-SE) and a heuristic 'external criterion' responsiveness method in patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). One hundred and fourteen newly diagnosed or relapsing patients (GBS: 55, CIDP: 59) were serially examined (1-year follow-up). The inflammatory Rasch-built overall disability scale (I-RODS), Rasch-transformed MRC sum score (RT-MRC), and Rasch-transformed modified-INCAT-sensory scale (RT-mISS) were assessed.
View Article and Find Full Text PDFJ Peripher Nerv Syst
September 2015
Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
We performed a comparison between Neuropathy Impairment Scale-sensory (NISs) vs. the modified Inflammatory Neuropathy Cause and Treatment sensory scale (mISS), and NIS-motor vs. the Medical Research Council sum score in patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and IgM monoclonal gammopathy of undetermined significance-related polyneuropathy (MGUSP).
View Article and Find Full Text PDFRetina
August 2015
*Department of Neurological and Vision Sciences, Eye Clinic, University of Brescia, Brescia, Italy; †Humanitas Clinical Institute, Milan, Italy; ‡Department of Ophthalmology, Second University of Naples, Naples, Italy; and §Department of Health Sciences, Eye Clinic, University of Molise, Campobasso, Italy.
Purpose: To evaluate whether ketorolac eyedrops plus intravitreal ranibizumab (IVR) or verteporfin photodynamic therapy plus IVR provides additional benefit over IVR monotherapy for treatment of choroidal neovascularization in age-related macular degeneration.
Methods: This was a prospective, randomized, pilot study in 75 patients with naive choroidal neovascularization. Patients were randomized 1:1:1 into 3 groups: ranibizumab monotherapy (RM), ranibizumab plus ketorolac, or ranibizumab plus loading-phase reduced-fluence verteporfin photodynamic therapy (RV) groups.
Int J Endocrinol
January 2015
Endocrinology and Diabetology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Padiglione Granelli, Via F. Sforza 35, 20122 Milan, Italy ; Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
Acromegaly guidelines updated in 2010 revisited criteria of disease control: if applied, it is likely that a percentage of patients previously considered as cured might present postglucose GH nadir levels not adequately suppressed, with potential implications on management. This study explored GH secretion, as well as hormonal, clinical, neuroradiological, metabolic, and comorbid profile in a cohort of 40 acromegalic patients considered cured on the basis of the previous guidelines after a mean follow-up period of 17.2 years from remission, in order to assess the impact of the current criteria.
View Article and Find Full Text PDFJ Thorac Oncol
April 2015
*Istituto Toscano Tumori, Ospedale Civile di Livorno, Livorno, Italy; †Humanitas Cancer Center, Istituto Clinico Humanitas IRCCS, Rozzano, Italy; ‡IRCCS AOU San Martino IST - Istituto Nazionale per la Ricerca sul Cancro, Lung Cancer Unit, Genova, Italy; §San Gerardo Hospital, Monza, Italy; ‖Istituto Oncologico Veneto IRCSS, Padova, Italy; ¶Clinical Research Center, Center of Excellence on Aging, University Foundation, Chieti, Italy; #IRCCS Humanitas Clinical Institute, Rozzano, Milan, Italy; **Boehringer Ingelheim Pharma GmbH & Co. KG, Vienna, Austria; ††Boehringer Ingelheim Italia SpA, Milan, Italy; and ‡‡Boehringer Ingelheim Ltd., Bracknell, UK.
Introduction: Afatinib, an oral irreversible ErbB Family Blocker, has demonstrated efficacy and safety in epidermal growth factor receptor (EGFR) mutation-positive advanced lung adenocarcinoma. It is unknown whether such activity also occurs in patients with EGFR gene overexpression, regardless of mutation status. This phase II study investigated the activity and safety of afatinib in advanced non-small-cell lung cancer with increased EGFR gene copy number and/or gene amplification by fluorescence in situ hybridization (FISH), with or without EGFR mutation.
View Article and Find Full Text PDFInt J Cardiol
November 2014
San Raffaele Scientific Institute, Milan, Italy; EMO-GVM Centro Cuore Columbus, Milan, Italy.
Objectives: INSPIRE-1 (Italian Nobori Stent ProspectIve REgistry-1) was designed and conducted to assess clinical performance of Nobori biolimus A9-eluting stent (BES) implantation in an unrestricted "real-world" cohort of patients.
Methods: Unrestricted consecutive high-risk patients treated with BES with biodegradable polymer (Nobori, Terumo, Tokyo, Japan) between February 2008 and July 2012 were prospectively enrolled in an independent multicenter registry and divided in two groups: complex and non complex lesions.
Results: 1066 patients (1589 lesions) treated with Nobori BES were analyzed.
Sleep Med
January 2015
Centre of Sleep Medicine, Centre for Epilepsy Surgery "C. Munari", Niguarda Hospital, Milan, Italy; Institute of Bioimaging and Molecular Physiology, Genoa Unit, National Research Council, Genoa, Italy. Electronic address:
Background: Sleep disturbances are frequently reported by patients with spinal cord injury (SCI). Studies have shown an increased incidence of sleep-disordered breathing (SDB) and periodic leg movements during sleep (PLMS) in people with stable long-term SCI.
Methods: This was a prospective observational study in order to evaluate the features and possible predisposing factors of SDB and PLMS in a heterogenic population of consecutive SCI patients admitted at the Spinal Unit of the Niguarda Hospital within the first year after injury.
Neurology
December 2014
From the Department of Neurology (T.H.P.D., E.K.V., C.G.F., I.S.J.M.), University Medical Centre Maastricht; Department of Neurology (S.I.v.N., P.A.v.D.), Erasmus Medical Centre Rotterdam, the Netherlands; Department of Neurology (K.C.G.), St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA; Department of Neurology (W.L.V.d.P., N.C.N., L.H.v.d.B.), Rudolf Magnus Institute of Neuroscience University Medical Centre Utrecht, the Netherlands; Department of Neurological Sciences (E.N.-O.), Milan University, Humanitas Clinical Institute, Rozzano, Milan, Italy; Department of Neurology (J.M.L.), Hôpital de la Salpêtrière, Paris, France; Department of Neurology (P.Y.K.V.d.B.), Catholique University of Louvain, Belgium; Department of Clinical Neurosciences (G.L.), 3rd Neurology Unit, Milan, Italy; Department of Neurology (V.B., H.K.), Toronto General Hospital, Canada; Department of Neurology (M.P.T.L.), Centre for Neuromuscular Disease, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK; Department of Neurology (J.P.), Centre de Référence des Maladies Neuromusculaires et de la SLA, Hôpital de La Timone, Marseille, France; Department of Neurology (A.J.v.d.K.), Academic Medical Centre, Amsterdam, the Netherlands; Department of Neurology (A.F.H.), London Health Science Center, London, Canada; Department of Neurology (D.R.C.), Johns Hopkins School of Medicine, Baltimore, MD; and Department of Neurology (I.S.J.M.), Spaarne Hospital, Hoofddorp, the Netherlands.
Objectives: We performed responsiveness comparison between the patient-reported Inflammatory Rasch-built Overall Disability Scale (I-RODS) and the widely used clinician-reported Inflammatory Neuropathy Cause and Treatment-Overall Neuropathy Limitation Scale (INCAT-ONLS) in patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and immunoglobulin M-monoclonal gammopathy of undetermined significance related polyneuropathy (IgM-MGUSP).
Methods: One hundred thirty-seven patients (GBS: 55, CIDP: 59, IgM-MGUSP: 23) with a new diagnosis or clinical relapse assessed both scales. Patients with GBS/CIDP were examined at 0, 1, 3, 6, and 12 months; patients with IgM-MGUSP at 0, 3, and 12.
J Neuroimmunol
November 2014
Department of Neuroscience and Imaging, University "G. d'Annunzio", Chieti-Pescara, Italy.
We tested autoantibodies to neurofascin-186 (NF186) and gliomedin in sera from patients with multifocal motor neuropathy (MMN, n=53) and chronic inflammatory demyelinating polyneuropathy (CIDP, n=95) by ELISA. IgG antibodies to NF186 or gliomedin were found in 62% of MMN and 1% of CIDP sera, and IgM antibodies to the same antigens in 12% of MMN and 1% of CIDP sera. These autoantibodies activated complement.
View Article and Find Full Text PDFHorm Metab Res
November 2014
Endocrine Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Molecular mechanisms underlying resistance of pituitary tumors to somatostatin (SS) and dopamine (DA) analogues treatment are not completely understood. Resistance has been associated with defective expression of functional somatostatin and dopamine receptors SSTR2, SSTR5, and DRD2, respectively. Recently, a role of cytoskeleton protein filamin A (FLNA) in DRD2 and SSTR receptors expression and signaling in PRL- and GH-secreting tumors, respectively, has been demonstrated, first revealing a link between FLNA expression and responsiveness of pituitary tumors to pharmacological therapy.
View Article and Find Full Text PDFMol Cell Endocrinol
March 2014
Endocrine Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy.
In the pituitary the activation of cyclic adenosine 3'-5'-monophosphate (cAMP) dependent pathways generates proliferative signals in somatotrophs, whereas in pituitary cells of other lineages its effect remains uncertain. Moreover, the specific role of the two main cAMP effectors, protein kinase A (PKA) and exchange proteins directly activated by cAMP (Epac), has not been defined. Aim of this study was to investigate the effect of cAMP on pituitary adenomatous cells proliferation and to identify PKA and Epac differential involvement.
View Article and Find Full Text PDFDig Liver Dis
March 2014
Department of Internal Medicine, Endocrinology, Metabolism and Geriatrics, Operative Unit of Internal Medicine and Metabolism, Nuovo Ospedale Civile S. Agostino-Estense, University of Modena and Reggio Emilia, Modena, Italy. Electronic address:
J Urol
May 2014
Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
Purpose: To our knowledge no group has evaluated antimuscarinic efficacy in patients with de novo overactive bladder after mid urethral sling placement. We assessed solifenacin efficacy in women with de novo overactive bladder after obturator tension-free vaginal tape placement compared to a control group.
Materials And Methods: We prospectively considered all women with de novo overactive bladder symptoms at a 3-month followup visit after placement of obturator tension-free vaginal tape.
J Mol Endocrinol
February 2014
Endocrine Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Endocrine Unit, IRCCS Humanitas Clinical Institute, Rozzano, University of Milan, Milan, Italy.
The cyclic nucleotide cAMP is a universal regulator of a variety of cell functions in response to activated G-protein coupled receptors. In particular, cAMP exerts positive or negative effects on cell proliferation in different cell types. As demonstrated by several in vitro studies, in somatotrophs and in other endocrine cells, cAMP is a mitogenic factor.
View Article and Find Full Text PDFHandb Clin Neurol
April 2014
2nd Neurology, Department of Translational Medicine, Milan University, IRCCS Humanitas Clinical Institute, Rozzano, Milan, Italy. Electronic address:
The association of neuropathy with monoclonal gammopathy has been known for several years, even if the clinical and pathogenetic relevance of this association is not completely defined. This is not a marginal problem since monoclonal gammopathy is present in 1-3% of the population above 50 years in whom it is often asymptomatic, and in at least 8% of patients is associated with a symptomatic neuropathy, representing one of the leading causes of neuropathy in aged people. Monoclonal gammopathy may result from malignant lymphoproliferative diseases including multiple myeloma or solitary plasmocytoma, Waldenström's macroglobulinemia (WM), other IgM-secreting lymphoma or chronic lymphocytic leukemia, and primary systemic amyloidosis (AL).
View Article and Find Full Text PDFPurpose: Revision of a shoulder arthroplasty to a reverse arthroplasty is a highly demanding procedure. The aim of this study is to report the clinical results of hemi and total shoulder prosthesis revisions to reverse implants without removal of the humeral stem, using a modular shoulder replacement system (SMR Lima LTD). We retrospectively reviewed 26 patients who underwent an operation from 2004 to 2009.
View Article and Find Full Text PDFDrugs
April 2013
Department of Medical Biotechnology and Translational Medicine (BIOMETRA), 2nd Neurology, Humanitas Clinical and Research Center, IRCCS Humanitas Clinical Institute, Milan University, Via Manzoni 56, Rozzano, 20089 Milan, Italy.
Multifocal motor neuropathy (MMN) is a purely motor mononeuritis multiplex characterized by the presence of conduction block on motor but not on sensory nerves and by the presence of high titers of anti-GM1 antibodies. Several data point to a pathogenetic role of the immune system in this neuropathy, although this has not yet been proved. Several uncontrolled studies and randomized controlled trials have demonstrated the efficacy of therapy with high-dose intravenous immunoglobulin (IVIg) in MMN.
View Article and Find Full Text PDFRev Neurol (Paris)
February 2013
Department of Medical Biotechnology and Translational Medicine (BIOMETRA), University of Milan, 2nd Neurology, IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
Chronic immune-mediated neuropathies represent a heterogeneous group of mostly demyelinating neuropathies thought to be caused by an autoimmune response to peripheral nerve antigens. They include chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and related variants, multifocal motor neuropathy (MMN) and neuropathy associated with an IgM monoclonal gammopathy with antibody activity against myelin-associated glycoprotein (MAG). Most of these neuropathies respond to immune therapy even though their response to therapy may be different, thereby confirming that their distinct characteristics have relevant clinical implications.
View Article and Find Full Text PDFBreast
June 2013
Humanitas Clinical Institute, Breast Unit, Via Manzoni 56, Milan, Italy.
Axillary management has evolved from routine axillary lymph node dissection (ALND) for most patients to a selective approach based on the assessment of the sentinel node (SN). Validation of this approach for staging the axilla is based on observational studies and multiple randomized trials with near general consensus that in case of negative SN completion ALND is not required and if the SN contained metastatic disease, a completion ALND is recommended. Multiple observations have challenged the need for routine completion ALND and growing evidence from institutional series have indicated that selective omission of ALND in patients with positive SN was safe.
View Article and Find Full Text PDFCirc J
December 2012
Invasive Cardiology Department, Humanitas Clinical Institute, Milan, Italy.
Background: Stent thrombosis (ST) is a multi-factorial process involving different mechanisms. The impact of inherited coagulation disorders in the genesis of ST has never been assessed. The aim of the present study was to evaluate the prevalence of G1691A Factor V Leiden mutation, G20210A Factor II (prothrombin) mutation and C677T homozygous methylenetetrahydrofolate reductase (MTHFR) polymorphism in patients with ST.
View Article and Find Full Text PDFLancet Neurol
June 2012
Department of Translational Medicine, Milan University, 2nd Neurology, IRCCS Humanitas Clinical Institute, Rozzano, Milan, Italy.
Background: Intravenous immunoglobulin (IVIg) and corticosteroids are effective as initial treatment in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), but little is known about the comparative risk-benefit profile of their long-term use in this disease. We compared the efficacy and tolerability of 6-month therapy with IVIg versus that with intravenous methylprednisolone.
Methods: We did a multicentre, randomised, double-blind, placebo controlled, parallel-group study in patients with CIDP.
Rev Recent Clin Trials
August 2012
Department of Anesthesia and Intensive Care - IRCCS Humanitas Clinical Institute, Rozzano, Milan (Italy).
We reviewed the comparative trials of the Flotrac/VigileoTM versus the thermodilution method, published in the last five years. The results about the agreement between the two methods measuring cardiac output are contrasting. We also noticed that almost the whole pertinent literature include studies conducted without a correct statistical design, particularly about the sample size.
View Article and Find Full Text PDFMinerva Cardioangiol
April 2012
Humanitas Clinical Institute, IRCCS, Milan, Italy.
Primary percutaneous coronary intervention (PCI) is currently the preferred revascularization strategy in acute trasmural myocardial infarction (AMI). In this setting, about one half of patients will be diagnosed with concomitant multivessel (MV) coronary artery disease, associated with a multitude of negative prognostic factors but also still an independent predictor of adverse cardiac events and increased long-term mortality. Since additional "angiographic" lesions found at primary PCI are not directly responsile for the acute presentation, their treatment represents a difficult decision-making problem in cardiology.
View Article and Find Full Text PDFEur J Surg Oncol
June 2012
Dept. of Gynecology, Cancer Center, IRCCS, Humanitas Clinical Institute, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
Aims: To evaluate the feasibility and safety of robotic radical parametrectomy (RRP) and pelvic lymphadenectomy for the management of occult invasive cervical cancer or local recurrence of endometrial cancer and to compare our outcomes with the evidence available in the literature.
Methods: Starting from 07/2008 consecutive patients submitted to RRP have been included in this study. A comprehensive literature review of published papers about this subject was carried out.
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