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Explaining the increased mortality in type 1 diabetes

World Journal of Diabetes 2015年第7期6卷 889-895页

作者： Chiara Mameli Sara Mazzantini Moufida Ben Nasr paolo fiorina Andrea E Scaramuzza Gian Vincenzo Zuccotti Department of Pediatrics "Ospedale dei Bambini V.Buzzi"University of Milan Division of Nephrology Boston Children’s HospitalHarvard Medical School Transplant Medicine Ospedale San Raffaele20132 MilanoItaly Department of Pediatrics Azienda Ospedaliera Luigi SaccoUniversity of Milan

Despite large improvements in the management of glucose levels and in the treatment of cardiovascular risk factors,the mortality rate in individuals with type 1 diabetes(T1D) is still ***,Lind et al found that T1 D individuals with glycated hemoglobin levels of 6.9% or lower had a risk of death from any cause or from cardiovascular causes that is twice as high as the risk for matched controls.T1 D is a chronic disease with an early onset(e.g.,pediatric age) and thus in order to establish a clear correlation between death rate and the glycometabolic control,the whole history of glycemic control should be considered; particularly in the early years of *** switch from a normoto hyperglycemic milieu in an individual with T1 D in the pediatric age,represents a stressful event that may impact outcomes and death rate many years *** this paper we will discuss the aforementioned issues,and offer our view on these findings,paying a particular attention to the several alterations occurring in the earliest phases of T1 D and to the many factors that may be associated with the chronic history of T1 *** may help us to better understand the recently published death rate data and to develop future innovative and effective preventive strategies.

关键词： Type 1 diabetes Hyperglycemia Deathrates Adolescence Autonomic neuropathy Children Endothelial dysfunction Exercise Metabolic memory

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Impact of severe left ventricular dysfunction on mid-term mortality in elderly patients undergoing transcatheter aortic valve implantation

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Journal of Geriatric Cardiology 2016年第4期13卷 290-298页

作者： Giuseppe Ferrante Patrizia Presbitero paolo Pagnotta Anna Sonia Petronio Nedy Brambilla Federico De Marco Claudia fiorina Cristina Giannini Fabrizio D'Ascenzo Silvio Klugmann Marco L Rossi Federica Ettori Francesco Bedogni Luca Testa Department of Cardiovascular Medicine Humanitas Research Hospital Rozzano Italy Cardiothoracic and Vascular Department Azienda Ospedaliero-Universitaria Pisana Pisa Italy Department of Cardiology IRCCS Pol. S. Donato S. Donato Milanese Milan Italy Department of lnterventional Cardiology Niguarda Ca' Granda Hospital Milan Italy Cardiothoracic Department Spedali Civili di Brescia Brescia Italy Cardiothoracic Department Ospedale Molinette Torino Italy

Background Whether patients with reduced left ventricular function present worse outcome after transcatheter aortic valve implantation （TAVI） is controversial. The aim of this study was to assess the impact of baseline severe impairment of left ventricular ejection fraction （LVEF） on mortality after TAVI. Methods Six-hundred-forty-nine patients with aortic stenosis underwent TAVI with the CoreValve system （92.8%） or the Edwards SAPIEN valve system （7.2%）. Baseline LVEF was measured by the echocardiographic Simpson method. The impact of LVEF 〈 30% on mortality was assessed by Cox regression. Results Patients with LVEF 〈 30% （n = 63）, as compared to those with LVEF 〉 30% （n = 586）, had a higher prevalence of NHYA class 〉 2 （P 〈 0.001） and presented with a higher Euroscore （P 〈 0.001）. Procedural success was similar in both groups （98.4% vs. 97.2%, P = 1）. After a median follow-up of 436 days （25^-75th percentile, 357-737 days）, all-cause mortality [23.8% vs. 23.7%, P = 0.87, hazard ratios （HR）： 0.96, 95% confidence intervals （CI）： 0.56-1.63] and cardiac mortality （19.1% vs. 17.6%, P = 0.89, HR： 1.04, 95% CI： 0.57-1.90） were similar in patients with LVEF 〈 30% as compared to those with LVEF 〉 30%. Thirty-day all-cause mortality was not significantly different between the two groups （11.1% vs. 6.3%, P = 0.14, HR： 1.81, 95% CI： 0.814.06）. Patients with LVEF 〈 30% had a trend toward higher risk of 30-day cardiac mortality （11.1% vs. 5.3%; P = 0.06, HR： 2.16, 95% CI： 0.95-4.90）, which disappeared after multivariable adjustment （P = 0.22）. Conclusions Baseline severe impairment of LVEF is not a predictor of increased short-term and mid-term mortality after TAVI. Selected patients with severe impairment of left ventricular function should not be denied TAVI.

关键词： Left ventricular ejection fraction Mortality Transcatheter aortic valve implantation

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Epilepsy associated tumors: Review article

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World Journal of Clinical Cases 2014年第11期2卷 623-641页

作者： Marco Giulioni Gianluca Marucci Matteo Martinoni Anna Federica Marliani Francesco Toni fiorina Bartiromo Lilia Volpi Patrizia Riguzzi Francesca Bisulli Ilaria Naldi Roberto Michelucci Agostino Baruzzi paolo Tinuper Guido Rubboli IRCCS Institute of Neurological Sciences of Bologna Division of Neurosurgery Bellaria Hospital 40139 Bologna Italy Department of Biomedical and Neuromotor Sciences (DiBiNeM) Section of Pathology "M.Malpighi" Bellaria Hospital University of Bologna 40139 Bologna Italy IRCCS Institute of Neurological Sciences of Bologna Section of Neuroradiology Bellaria Hospital 40139 Bologna Italy Department of Specialistic Diagnostic and Experimental Medicine (DIMES) Section of NeuroradiologyUniversity of Bologna 40139 Bologna Italy IRCCS Institute of Neurological Sciences of Bologna Division of Neurology Bellaria Hospital 40139 Bologna Italy IRCCS Institute of Neurological Sciences of Bologna Bellaria Hospital 40139 Bologna Italy Department of Biomedical and Neuromotor Sciences University of Bologna 40139 Bologna Italy Danish Epilepsy Centre Epilepsi hospitalet4293 Dianalund Denmark

Long-term epilepsy associated tumors(LEAT) represent a well known cause of focal epilepsies. Glioneuronaltumors are the most frequent histological type consisting of a mixture of glial and neuronal elements and most commonly ariseing in the temporal lobe. Cortical dysplasia or other neuronal migration abnormalities often coexist. Epilepsy associated with LEAT is generally poorly controlled by antiepileptic drugs while, on the other hand, it is high responsive to surgical treatment. However the best management strategy of tumor-related focal epilepsies remains controversial representing a contemporary issues in epilepsy surgery. Temporo-mesial LEAT have a widespread epileptic networkwith complex epileptogenic mechanisms. By using an epilepsy surgery oriented strategy LEAT may have an excellent seizure outcome therefore surgical treatment should be offered early, irrespective of pharmacoresistance, avoiding both the consequences of uncontrolled seizures as well as the side effects of prolonged pharmacological therapy and the rare risk of malignant transformation.

关键词： Epilepsy Low grade tumors Long-term epilepsy associated tumors Glioneuronal tumors Ganglioglioma Dysembryoplastic neuroepithelial tumor Lesionectomy Epilepsy surgery

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Targeted molecular therapy (modified RIST regimen) in relapsed high risk stage Ⅳ neuroblastoma: two cases report

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Theory and Clinical Practice in Pediatrics 2018年第1期2卷 2-4页

作者： paolo Indolfi Selim Corbacioglu Silverio Perrotta Francesca Rossi Antonio Marte Elvira Pota Martina Di Martino Daniela Di Pinto Cristiana Indolfi fiorina Casale Unit of Pediatric Oncology Pediatric DepartmentSecond University of Naplesvia Luigi De Crecchio 280138 NaplesItaly Department of Pediatrics and Adolescent Medicine University of RegensburgRegensburgGermany Unit of Pediatric Oncology Department of Women-Children and General and Specialistic SurgeryUniversity of Campania “Luigi Vanvitelli”NaplesItaly Department of Pediatric Surgery University of Campania “Luigi Vanvitelli”NaplesItaly

The prognosis for children with recurrent or refractory neuroblastoma remains a significant clinical challenge,and currently there are no known curative salvage *** this paper we investigated the effect of imatinib with rapamycin and the chemotherapeutic agents temozolomide and *** treated two children with recurrent neuroblastoma with this so called RIST *** patients,off therapy for 15 and 31 months,respectively are well,and developing normally,without any *** findings suggest that a combination regimen of RIST may provide a therapeutic benefit with a favorable toxicity profile to a unfortunate subset of patients with neuroblastoma.

关键词： RIST therapy Neuroblastoma Pediatric cancer

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