Publications by authors named "Vieri Boddi"

46 Publications

Concordance and clinical significance of uncommon variants of bladder urothelial carcinoma in transurethral resection and radical cystectomy specimens.

Urology 2014 Nov 18;84(5):1141-6. Epub 2014 Sep 18.

Department of Urology, Santa Maria Annunziata Hospital, University of Florence, Florence, Italy.

Objective: To evaluate the concordance and prognostic role of histologic variants of bladder urothelial carcinoma in transurethral resection of bladder tumor (TURBT) and radical cystectomy (RC) specimens.

Methods: Clinicopathologic information available at the time of RC and follow-up data from 4110 RC specimens, collected between January 2000 and December 2009 at 17 tertiary referral centers were retrospectively analyzed and evaluated for the presence or absence of uncommon variants of bladder urothelial carcinoma. The presence or absence of uncommon variants of bladder urothelial carcinoma was evaluated on previous TURBT specimens of patients undergoing RC. Cox regression was used to assess the impact of these parameters on cancer-specific survival, and the Kaplan-Meier test for disease-free survival was plotted for survival estimate.

Results: Of 4110 patients, 579 were found to have uncommon variants of bladder urothelial carcinoma at RC (14.1%), whereas 266 (6.4%) at TURBT. A lack of agreement about uncommon variants was observed between TURBT and RC specimens in the entire population (P <.001). The presence of uncommon variants at TURBT was associated with an increased risk of pathologic upstage (hazard ratio, 3.24; confidence interval, 1.19-6.37; P <.003) and significant decrease in cancer-specific survival and recurrence-free survival (P <.001).

Conclusion: Although the concordance of presence of uncommon histologic variants of urothelial bladder carcinoma between TURBT and RC is low, the presence of uncommon histologic variants of urothelial bladder carcinoma at TURBT is associated with a less favorable clinical outcome.
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http://dx.doi.org/10.1016/j.urology.2014.06.032DOI Listing
November 2014

Altered proteolysis in fibroblasts of Alzheimer patients with predictive implications for subjects at risk of disease.

Int J Alzheimers Dis 2014 18;2014:520152. Epub 2014 May 18.

Section of Experimental Pathology and Oncology, Department of Biomedical Experimental and Clinical Sciences, University of Florence, 50134 Florence, Italy.

There is great interest in developing reliable biomarkers to support antemortem diagnosis of late-onset Alzheimer's disease (AD). Early prediction and diagnosis of AD might be improved by the detection of a proteolytic dysfunction in extracts from cultured AD fibroblasts, producing altered isoelectrophoretic forms of the enzyme transketolase (TK-alkaline bands). The TK profile and apolipoprotein E (APOE) genotype were examined in fibroblasts from 36 clinically diagnosed probable late-onset sporadic AD patients and 38 of their asymptomatic relatives, 29 elderly healthy individuals, 12 neurological non-AD patients, and 5 early-onset AD patients. TK alterations occurred in (i) several probable AD patients regardless of age-of-onset and severity of disease; (ii) all early-onset AD patients and APOE ε 4/4 carriers; and (iii) nearly half of asymptomatic AD relatives. Normal subjects and non-AD patients were all negative. Notably, culture conditions promoting TK alterations were also effective in increasing active BACE1 levels. Overall, the TK assay might represent a low-cost laboratory tool useful for supporting AD differential diagnosis and identifying asymptomatic subjects who are at greater risk of AD and who should enter a follow-up study. Moreover, the cultured fibroblasts were confirmed as a useful in vitro model for further studies on the pathogenetic process of AD.
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http://dx.doi.org/10.1155/2014/520152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052202PMC
June 2014

Apple consumption is related to better sexual quality of life in young women.

Arch Gynecol Obstet 2014 Jul 12;290(1):93-8. Epub 2014 Feb 12.

Department of Urology, Santa Chiara Regional Hospital, Largo Medaglie d'Oro, 9, Trento, Italy,

Introduction: Even if some evidence exists of a positive correlation between regular intake of phytoestrogens, polyphenols, antioxidants and women's sexual health, there is not a study addressing the potential correlation between daily apple consumption and women's sexual function. We aim to assess whether there is a tie between daily apple intake and sexual function in a sample of healthy young sexually active Italian women, not complaining of any sexual disorders.

Materials And Methods: Seven hundred and thirty-one women (mean age 31.9, range 18-43) were enrolled in this cross-sectional study (from September 2011 to April 2012). All participants completed anonymously the Female Sexual Function Index (FSFI) and were asked to report on their amount of daily apple consumption and their eating habits. On the basis of apple consumption all women were split into two groups: Group A--regular daily apple consumption, Group B--no regular apple consumption (<1 apple/day). The main outcome measure was the FSFI questionnaire result.

Results: Three hundred and forty-three women reported a regular daily apple intake and were classified in Group A, while 388 were included in Group B. Group A had a significantly higher total (p = 0.001; Cohen's d = 3.39) and lubrication domain (p = 0.001; Cohen's d = 3.02) FSFI scores than participants in Group B. Multivariate analysis demonstrated that daily apple intake must be considered as an independent parameter (p = 0.002) in predicting a better score at questionnaire examination.

Discussion: This study suggests a potential relationship between regular daily apple consumption and better sexuality in our young women population.
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http://dx.doi.org/10.1007/s00404-014-3168-xDOI Listing
July 2014

COUP-TFII in pancreatic adenocarcinoma: clinical implication for patient survival and tumor progression.

Int J Cancer 2014 Apr 15;134(7):1648-58. Epub 2013 Oct 15.

Department of Experimental and Clinical Biomedical Sciences, University of Florence, Firenze, Italy.

Despite the accumulating knowledge of alterations in pancreatic cancer molecular pathways, no substantial improvements in the clinical prognosis have been made and this malignancy continues to be a leading cause of cancer death in the Western World. The orphan nuclear receptor COUP-TFII is a regulator of a wide range of biological processes and it may exert a pro-oncogenic role in cancer cells; interestingly, indirect evidences suggest that the receptor could be involved in pancreatic cancer. The aim of this study was to evaluate the expression of COUP-TFII in human pancreatic tumors and to unveil its role in the regulation of pancreatic tumor growth. We evaluated COUP-TFII expression by immunohistochemistry on primary samples. We analyzed the effect of the nuclear receptor silencing in human pancreatic cancer cells by means of shRNA expressing cell lines. We finally confirmed the in vitro results by in vivo experiments on nude mice. COUP-TFII is expressed in 69% of tested primary samples and correlates with the N1 and M1 status and clinical stage; Kaplan-Meier and Cox regression analysis show that it may be an independent prognostic factor of worst outcome. In vitro silencing of COUP-TFII reduces the cell growth and invasiveness and it strongly inhibits angiogenesis, an effect mediated by the regulation of VEGF-C. In nude mice, COUP-TFII silencing reduces tumor growth by 40%. Our results suggest that COUP-TFII might be an important regulator of the behavior of pancreatic adenocarcinoma, thus representing a possible new target for pancreatic cancer therapy.
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http://dx.doi.org/10.1002/ijc.28502DOI Listing
April 2014

The role of asymptomatic bacteriuria in young women with recurrent urinary tract infections: to treat or not to treat?

Clin Infect Dis 2012 Sep 7;55(6):771-7. Epub 2012 Jun 7.

Department of Urology, Santa Chiara Hospital, Trento, Italy.

Background: Little is known about the role of asymptomatic bacteriuria (AB) treatment in young women affected by recurrent urinary tract infection (UTI). We aimed to evaluate the impact of AB treatment on the recurrence rate among young women affected by recurrent UTI.

Methods: A total of 673 consecutive asymptomatic young women with demonstrated bacteriuria from January 2005 to December 2009 were prospectively enrolled. Patients were split into 2 groups: not treated (group A, n = 312) and treated (group B, n = 361). Microbiological and clinical evaluations were performed at 3, 6, and 12 months. Quality of life was also measured. Recurrence-free rate at the end of the entire study period was the main outcome measure.

Results: At baseline, the 2 most commonly isolated pathogens were Escherichia coli (group A, 38.4%; group B, 39.3%) and Enterococcus faecalis (group A, 32.7%; group B, 33.2%). At the first follow-up visit, there was no difference between the 2 groups (relative risk [RR], 1.05; 95% confidence interval [CI], 1.01-1.10), whereas after 6 months, 23 (7.6%) in group A and 98 (29.7%) in group B showed recurrence with a statistically significant difference (RR, 1.31; 95% CI, 1.21-1.42; P < .0001). At the last follow-up, 41 (13.1%) in group A and 169 (46.8%) in group B showed recurrence (RR, 3.17; 95% CI, 2.55-3.90; P < .0001). One patient in group A and 2 patients in group B were found to have pyelonephritis.

Conclusions: This study shows that AB should not be treated in young women affected by UTI, suggesting it may play a protective role in preventing symptomatic recurrence.
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http://dx.doi.org/10.1093/cid/cis534DOI Listing
September 2012

Epidemiological features and resistance pattern in uropathogens isolated from chronic bacterial prostatitis.

J Microbiol 2011 Jun 30;49(3):448-54. Epub 2011 Jun 30.

Department of Urology, Santa Chiara Hospital, Trento, 38123, Italy.

Chronic bacterial prostatitis (CBP) is, usually, caused by uropathogens, especially gram-negative bacilli, although infection is sometimes due to Gram-positive and atypical microorganisms. A recent increasing in prevalence of Gram-positive strains has been reported. The aim of this study was to explore the epidemiological features and resistance rates in uropathogens isolated from CBP outpatients in last 10 years. All consecutive outpatients with demonstrated CBP attending a single Sexually Transmitted Disease centre from January 1997 and December 2008, were enrolled and underwent microbiological cultures in first void early morning urine, midstream urine, expressed prostatic secretion, and post prostate massage urine. Prevalence of different bacterial strains was stratified in four different periods: 1997-1999, 2000-2002, 2003-2005, 2006-2008. Any changes observed in epidemiological features and resistance rates in uropathogens over the whole study period have been analyzed. The present study has been planned, thus, as in vitro study. From 6,221 patients, 4,601 Gram-positive and 1,620 Gram-negative bacterial strains have been isolated. Enterococcus faecalis and Escherichia coli strains are the first and second frequent pathogens found, respectively. Significant differences between E. faecalis prevalence in the 1997-1999 and 2006-2008 periods were found. E. coli showed a significant difference between prevalence in 1997-1999 and 2006-2008 periods. Gram-positive organisms showed a decreasing of susceptibility to ciprofloxacin as well as Gram-negative strains, while a good susceptibility to the levofloxacin was evidenced. E. faecalis prevalence seemed to be raised in 2006-2008 periods. Moreover, a decreasing of activity of ciprofloxacin and a good activity profile of levofloxacin have been reported.
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http://dx.doi.org/10.1007/s12275-011-0391-zDOI Listing
June 2011

Genital Chlamydia trachomatis infection is related to poor sexual quality of life in young sexually active women.

J Sex Med 2011 Apr 26;8(4):1131-7. Epub 2011 Jan 26.

Department of Urology, Santa Chiara Hospital, Trento, Italy.

Introduction: Chlamydia trachomatis (Ct) genital infection has been related to several diseases in young sexually active women. It could be related to their sexual quality of life.

Aim: To assess whether genital Ct infection can induce sexual function alterations in women.

Methods: Nine hundred ninety-eight women (mean age 29.4, range 18-43) attending our Sexually Transmitted Disease Centre were enrolled in this observational case-control study. All participants were clinically and microbiologically investigated due to their sexual relationships with a subject affected by chronic bacterial prostatitis. All participants underwent microbiological cultures, DNA and antibodies evaluation for common bacteria and Ct on vaginal swab and urine samples. They completed the Female Sexual Function Index [FSFI] questionnaire. On the basis of microbiological investigation results, all patients were split into three groups: Group A-genital Ct infection, Group B-genital common bacteria/yeast infection, and Group C-negative for Ct and bacteria/yeast infection.

Main Outcome Measures: FSFI questionnaire.

Results: Two hundred ninety-one women were classified in Group A, 276 in Group B, and 431 in Group C. Group A patients were statistically, significantly different from Group B and Group C patients in terms of pain during sexual intercourse and sexual satisfaction. Group C patients had significantly higher FSFI scores (27.1 ± 1.3) (P < 0.001) for both desire (4.9 ± 1.0) and lubrication domain (3.8 ± 1.1) (P < 0.001, P < 0.003, respectively) when compared with Group A patients. Multivariate analysis demonstrated that negative Ct infection marker in female patients must be considered as an independent prognostic factor in predicting a subsequent optimal FSFI questionnaire score (P = 0.002).

Conclusions: Positive values of Ct infection markers are associated with lower FSFI scores for sexual desire, lubrication, and overall sexual function. Genital Ct infection could induce pain during sexual intercourse, reducing sexual satisfaction and sexual quality of life in young sexually active women.
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http://dx.doi.org/10.1111/j.1743-6109.2010.02194.xDOI Listing
April 2011

[Oral vitamin B12: Efficacy and safety data in 31 patients with pernicious anemia and food-cobalamin malabsorption].

Presse Med 2010 Dec 12;39(12):e273-9. Epub 2010 Aug 12.

Hôpitaux universitaires de Strasbourg, service médecine interne, diabète et maladies métaboliques, clinique médicale B, 67091 Strasbourg cedex, France.

Objective: The aim of this study is to validate the efficacy and safety of oral cobalamin therapy in the treatment of cobalamin deficiency related to various causes.

Patient And Method: It's a retrospective study, including 31 patients with documented cobalamin deficiency related to food-cobalamin malabsorption (n=20) and pernicious anemia (n=11). These patients were treated at least for 3 months with oral cyanocobalamin, between 125 to 1000microg per day. Serum cobalamin levels and hematological parameters were compared before and after the therapy and in relation with the nature of cobalamin deficiency. Safety data were also recorded.

Results: After 3 months of therapy, the serum cobalamin levels have significantly increased in all the patients, with a mean of +161.6±79.3pg/mL in the food-cobalamin malabsorption group (P<0,00005) and +136.7±67.4pg/mL in the pernicious anemia group (P<0,0001). Hematological parameters have been normalized in 90 % of the patients, independently of the cause of the cobalamin deficiency. Only 1 patient presented an urticarial reaction.

Conclusion: This study confirms the efficacy and safety of oral cobalamin therapy in food-cobalamin malabsorption and also in case of pernicious anemia.
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http://dx.doi.org/10.1016/j.lpm.2010.03.027DOI Listing
December 2010

Fast-track surgery after laparoscopic colorectal surgery: is it feasible in a general surgery unit?

Surgery 2010 Feb 5;147(2):219-26. Epub 2009 Nov 5.

General Surgery Unit, Misericordia e Dolce Hospital, Prato, Italy.

Background: The aim of the "fast-track surgery" program is to decrease the peri-operative stress response to surgical trauma and thus to a decrease in complication rates after elective surgery. Critics of fast-track (FT) rehabilitation may argue that all reports of successful programs came from major specialized hospital units and that implementation in smaller or less specialized units may be difficult if not impossible.

Methods: We retrospectively studied 101 patients who, from November 2004 to October 2007, underwent laparoscopic colorectal surgery in our institute. A detailed FT surgery protocol had been prepared and given to patients, physicians and nurses, with the aim to create a standard treatment. Data about demographics, ASA score, pre-operative complicating diseases, diagnosis, type of surgery, and postoperative clinical data were analyzed. Univariate analysis of the relationship between all factors (patient characteristics, intervention characteristics, protocol compliance and presence of complications) described here and length of hospital stay was performed.

Results: We compared our results to published major trials and observed no substantial differences in morbidity, mortality and length of postoperative hospital stay between the 2. Univariate analysis showed that compliance to the elements of the FT protocol influences the length of postoperative period more significantly than patient characteristics or surgical procedure.

Conclusion: Based on 6 comparative single-center studies, the FT program was found to reduce length of hospital stay, and was deemed safe for major abdominal surgeries. Present study shows that enhanced recovery or FT program can also be implemented safely in a general surgery unit.
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http://dx.doi.org/10.1016/j.surg.2009.09.035DOI Listing
February 2010

Regular moderate intake of red wine is linked to a better women's sexual health.

J Sex Med 2009 Oct 21;6(10):2772-7. Epub 2009 Jul 21.

Urology Unit, Santa Maria Annunziata Hospital, University of Florence, Via Dell'Antella, 50011 Antella, Florence, Italy.

Introduction: While some evidence does exist for a positive correlation between moderate wine intake and men's sexual health, there is no study addressing the potential correlation between red wine intake and women's sexual function.

Aim: The aim of our study was to assess whether there is a tie between daily red wine intake and sexual function in a sample of healthy Italian women, living in the Chianti area (Tuscany) not complaining of any sexual disorders.

Methods: We recruited 798 women (age 18-50), living in the Chianti area (Tuscany), not complaining of any sexual disorders. We divided the participants into three groups: daily moderate (one to two glasses) red wine intake (group 1); teetotallers (group 2); and daily intake of more than two glasses of red wine and/or other types of alcoholic drinks (including white wine), as well as of those reporting occasional drinking (group 3).

Main Outcome Measures: All participants completed anonymously the Female Sexual Function Index (FSFI) questionnaire and were asked to report on their amount and type of alcohol consumption.

Results: Group 1 had significantly higher total (P = 0.001), as well as desire and lubrication domain (P = 0.001 and P = 0.001, respectively) FSFI scores than participants in groups 2 and 3. No significant differences between the groups were observed concerning sexual arousal, satisfaction, pain, and orgasm. Univariate analysis showed a significant correlation between age, alcohol consumption (P = 0.009), and a better score at questionnaire examination. During multivariate analysis, alcohol consumption was identified as an independent prognostic parameter (P = 0.002) in predicting the better score at questionnaire examination.

Conclusions: The finding that regular moderate intake of red wine is associated with higher FSFI scores for both sexual desire, lubrication, and overall sexual function as compared to the teetotaller status is intriguing. While this finding needs to be interpreted with some caution, because of the small sample size, self-reported data, and the lack of support from laboratory exams, it nevertheless suggests a potential relationship between red wine consumption and better sexuality.
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http://dx.doi.org/10.1111/j.1743-6109.2009.01393.xDOI Listing
October 2009

Psychomotor, cognitive and social interactions in elderly and old Italians. Preliminary report.

Anthropol Anz 2008 Dec;66(4):395-400

Department of Anatomy, Histology and Forensic Medicine, University of Florence, Florence, Italy.

It was the aim of this pilot study to investigate effects of motor activity on psychosocial and functional-physical conditions (using an assisted multidimensional questionnaire) of 53 (39 female, 14 male) free living elderly and old subjects in Florence, Italy. In addition, ADL (test of Activities of Daily Living) and Pfeiffer test (short portable mental status questionnaire) were applied to test autonomy of everyday life and presence of intellectual disturbance of organic origin. Motor activity appeared to influence significantly psychosocial and functional-physical conditions, i. e. motor activity was significantly correlated with subjective feeling of autonomy and independence, and with the variable to have hobbies, as well as with good posture and walking. From ADL and Pfeiffer tests resulted absence of respective pathologies.
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December 2008

Estrogen receptor expression in cutaneous melanoma: a real-time reverse transcriptase-polymerase chain reaction and immunohistochemical study.

Arch Dermatol 2009 Jan;145(1):30-6

Department of Dermatology, University of Florence, Via della Pergola 60, 50121 Florence, Italy.

Objective: To evaluate estrogen receptor (ER) expression in human melanoma tissues and in the adjacent healthy skin with the aim of explaining whether the ERalpha:ERbeta expression ratio has a role in neoplastic progression.

Design: Prospective study.

Setting: Department of Dermatology, University of Florence, Florence, Italy. Patients Fourteen patients, 12 with cutaneous melanoma (6 women and 6 men) and 2 with melanocytic nevi (1 woman and 1 man).

Main Outcome Measures: Using quantitative reverse transcriptase-polymerase chain reaction and immunohistochemical analysis, we analyzed ERalpha and ERbeta messenger RNA (mRNA) and ERbeta protein expression in cutaneous melanoma and in the healthy skin surrounding the lesions.

Results: All melanocytic lesions expressed detectable levels of ERalpha and ERbeta mRNA as well as ERbeta protein. Dividing melanoma cases into 2 groups according to Breslow thickness, we found lower ERalpha and ERbeta mRNA levels and lower ERbeta protein levels in thicker, more invasive tumors.

Conclusions: These observations suggest a role for ERs in the metastatic process of melanoma cells, pointing at the possibility of using ERbeta expression as a prognostic indicator of melanoma. The possibility of distinguishing proliferative melanomas, which are associated with dismal prognosis, from the so-called dormant melanomas opens up novel avenues in tailoring individual treatments, as already happens for other tumors.
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http://dx.doi.org/10.1001/archdermatol.2008.537DOI Listing
January 2009

Pathology of the thoracic aorta: a morphologic review of 338 surgical specimens over a 7-year period.

Cardiovasc Pathol 2009 May-Jun;18(3):134-9. Epub 2008 Jun 3.

Department of Pathology, University of Florence, Florence, Italy.

A total of 338 surgical specimens of the thoracic aorta were studied morphologically. These were obtained from patients (238 males, 100 females) operated on for aortic aneurysm or dissection at the Careggi Hospital, Florence, Italy, between January 1999 and June 2005. Medial degeneration was diagnosed in 299 cases (138 aneurysms, 161 dissections), atherosclerosis with extensive medial destruction was seen in 32 cases (26 aneurysms, 6 dissections), and giant cell arteritis (GCA) was found in 7 cases (all aneurysms). These data show that medial degeneration was a common nonspecific histologic diagnosis in aortic resection after the occurrence of aneurysm or dissection. Considering that this diagnosis was made in as many as 118 patients over 70 years of age and in 175 patients over 65, normal advancing age would appear as the most frequent correlation with these aortic events. Ageing is also associated with the increasing number of cases of GCA with aortic involvement. Angiogenesis, always observed next to areas of medial damage whatever the underlying pathology, may contribute to the pathogenesis of aortic dissection and aneurysm.
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http://dx.doi.org/10.1016/j.carpath.2008.04.001DOI Listing
June 2009

Vitamin D receptor alleles and C-reactive protein in hemodialysis patients.

Ital J Anat Embryol 2008 Jan-Mar;113(1):55-62

Department of Anatomy, Histology and Forensic Medicine, University of Firenze, Italy.

Cardiovascular disease due to atherosclerosis is the major determinant of morbidity and mortality in uremic patients. Inflammation is essential in the development of atherosclerosis and markers of inflammation, in particular C-reactive protein, predict the cardiovascular risk. Vitamin D exerts its effects through the Vitamin D Receptor, coded for by a gene showing several polymorphisms associated with a variety of diseases and differential responses to Vitamin D. We evaluated the association between four Vitamin D Receptor polymorphisms (i.e. those identified by the restriction enzymes BsmI, ApaI, TaqI and FokI) and serum level of C-reactive protein in 88 hemodialysis patients routinely treated with active Vitamin D (calcitriol). Absence or presence of the BsmI, ApaI, TaqI, and FokI restriction sites were denominated B and b, A and a, T and t, F and f respectively. Our results show that the b, a, T, alleles were more frequent in patients with elevated serum level of C-reactive protein compared with patients with normal C-reactive protein level. The differences were statistically significant (p < 0.05). These results suggest that the Vitamin D Receptor alleles b, a, T could be considered novel risk factors in the pathogenesis of inflammation-related, atherosclerosis-dependent cardiovascular disease risk in uremic patients.
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July 2008

Can early single dose instillation of epirubicin improve bacillus Calmette-Guerin efficacy in patients with nonmuscle invasive high risk bladder cancer? Results from a prospective, randomized, double-blind controlled study.

J Urol 2008 Jul 15;180(1):110-5. Epub 2008 May 15.

Department of Urology, University of Florence, Florence, Italy.

Purpose: We evaluated the impact of epirubicin perioperative instillation in improving subsequent bacillus Calmette-Guerin instillation efficacy in high risk patients with nonmuscle invasive bladder cancer.

Materials And Methods: Between January 2005 and June 2007, 161 patients affected by high risk nonmuscle invasive bladder cancer were enrolled in this prospective, randomized, controlled, double-blind study. A total of 80 patients were assigned to group A (perioperative epirubicin 80 mg/50 ml normal saline) plus delayed bacillus Calmette-Guerin instillations (5 x 108 colony-forming units in 50 ml saline) and 81 to group B (delayed bacillus Calmette-Guerin alone). The main outcome measures were time to first recurrence and recurrence rate. All data obtained from a median followup of 15.3 months in group A and 14.8 months in group B, were analyzed.

Results: At the end of followup 46 of 80 patients in group A (57.5%) had no evidence of disease, just like 41 of 81 in group B (50.6%). No statistical difference was observed between the 2 groups in terms of recurrence rate (p = 0.82) or time to first recurrence (p = 0.095). Kaplan-Meier analysis of recurrence showed no significant differences between group A and group B (p = 0.0952). On multivariate analysis the early single dose instillation of epirubicin was not indicated as an independent prognostic factor (HR 0.50, 95% CI 0.32-1.18).

Conclusions: The present study showed no statistically significant differences in terms of disease-free time and recurrence rate between high risk patients with nonmuscle invasive bladder cancer who had undergone perioperative epirubicin instillation plus delayed bacillus Calmette-Guerin and those who had undergone delayed bacillus Calmette-Guerin alone.
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http://dx.doi.org/10.1016/j.juro.2008.03.038DOI Listing
July 2008

Acute viral hepatitis increases liver stiffness values measured by transient elastography.

Hepatology 2008 Feb;47(2):380-4

Dipartimento di Medicina Interna, Università degli Studi di Firenze/Azienda Ospedaliero Universitaria Careggi Firenze, Italy.

Liver tissue alterations other than fibrosis may have an impact on liver stiffness measurement. In this study we evaluated 18 patients without a previous clinical history of liver disease, consecutively admitted for acute viral hepatitis. In each patient, aminotransferase determination and liver stiffness measurement were performed on the same study day, at 3 different points: (1) peak increase in aminotransferase; (2) aminotransferase 50% or less of the peak; (3) aminotransferase levels
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http://dx.doi.org/10.1002/hep.22007DOI Listing
February 2008

Prevalence, incidence estimation, risk factors and characterization of chronic prostatitis/chronic pelvic pain syndrome in urological hospital outpatients in Italy: results of a multicenter case-control observational study.

J Urol 2007 Dec 15;178(6):2411-5; discussion 2415. Epub 2007 Oct 15.

Department of Urology, University of Florence, Florence, Italy.

Purpose: We evaluated the prevalence and estimated the incidence and risk factors of chronic prostatitis/chronic pelvic pain syndrome in urological hospital outpatients in Italy.

Materials And Methods: From January to June 2006 patients from 28 Italian urological centers who were between 25 and 50 years old with symptoms of chronic prostatitis/chronic pelvic pain syndrome were consecutively enrolled in this prospective epidemiological case-control study. A total of 152 subjects of similar age, race and area of origin who were investigated for infertile couples but were otherwise healthy served as controls. All subjects provided a medical history and underwent different symptom scorings, clinical evaluation and microbiological tests.

Results: Of 5,540 male urological outpatients 764 with chronic prostatitis/chronic pelvic pain syndrome were enrolled, including 225 (29.4%) at the first presentation and 539 (70.6%) who underwent previous treatment. Thus, the prevalence of the syndrome was 13.8%, while the estimated incidence was 4.5%. Cigarette smoking, a high caloric diet with low fruit and vegetable consumption, constipation, meteorism, slow digestion, a sexual relationship with more than 1 partner and coitus interruptus were more likely in patients with chronic prostatitis/chronic pelvic pain syndrome than in controls (each p <0.001). The syndrome had a negative influence on sexual desire, erectile dysfunction and premature ejaculation (p <0.001). The Meares and Stamey test was positive in 13.3% of patients and in 2.9% of controls. Urethral swabs in patients with a negative Meares and Stamey test were positive for sexually transmitted pathogens in 6%.

Conclusions: The prevalence and estimated incidence of chronic prostatitis/chronic pelvic pain syndrome in urological hospital outpatients in Italy are high. The syndrome is closely related to lifestyle, diet, smoking, gastrointestinal or anorectal disease and impaired sexual function.
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http://dx.doi.org/10.1016/j.juro.2007.08.046DOI Listing
December 2007

Liquid-based endometrial cytology in the management of sonographically thickened endometrium.

Diagn Cytopathol 2007 Jul;35(7):398-402

Department of Human Pathology and Oncology, University of Florence, Florence, Italy.

Liquid-based cytology represents an opportunity to re-evaluate endometrial cytology. We evaluated the accuracy of liquid-based endometrial cytology as compared to biopsy in 670 women scheduled for histeroscopy because of thickened endometrium (>4 mm), as evaluated by transvaginal sonography. Endometrial biopsy detected pathology in 41 (6%) of cases (21 of which were adenocarcinomas). Cytologic study found pathology in 62 (9%) cases (19 of which were adenocarcinomas). Two hundred ninety-one biopsies (43%) and 28 (4%) cytologies were inadequate. The sensitivity and the specificity were estimated, respectively, at 95% and 98%; the positive and negative predictive values were estimated, respectively, at 83% and 99%. Cytology provided sufficient material more often than biopsy (P < 0.01). We consider endometrial cytology an efficacious diagnostic opportunity. It could be usefully applied in association with transvaginal sonography. The combination of these procedures might reduce more invasive and expensive diagnostic procedures.
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http://dx.doi.org/10.1002/dc.20655DOI Listing
July 2007

Pathologic determinants of survival after resection of T3N0 (Stage IIA) colorectal cancer: proposal for a new prognostic model.

Dis Colon Rectum 2007 Sep;50(9):1332-41

Department of General Surgery, University of Florence, Florence, Italy.

Purpose: There is an increasing need for accurate prognostic stratification of patients with Stage II colorectal cancer to identify a subgroup of high-risk patients who may benefit from adjuvant therapies. This study was designed to evaluate the prognostic impact of a wide spectrum of pathologic parameters in a consecutive series of homogenously treated and well-characterized patients with Stage IIA (T3N0M0) colorectal cancer.

Methods: The study included 238 patients operated on by a single surgeon for Stage IIA colorectal tumors. The median postoperative follow-up was 110 (range, 96-120) months. At least 12 lymph nodes were harvested and examined in all the resection specimens. The prognostic value of 13 pathologic parameters, including lymph node occult disease (micrometastases) detected by immunohistochemistry, was investigated.

Results: Multivariate analysis identified tumor growth pattern (expanding or infiltrating; P = 0.01) and extent of tumor spread beyond muscularis propria (< or =5 mm or >5 mm; P = 0.04) as the only factors having independent prognostic value. The combination of these two easily determined parameters allowed us to identify two groups of patients at low risk or high risk of tumor recurrence. The eight-year survival rates were 83.3 and 53.4 percent for the two groups, respectively. The high-risk group comprised those patients with infiltrating tumors and extramural tumor spread > 5 mm.

Conclusions: We propose a new and simple prognostic model to identify patients with high-risk Stage IIA colorectal cancer for whom adjuvant therapies may be justified and effective.
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http://dx.doi.org/10.1007/s10350-007-0222-9DOI Listing
September 2007

VEGFR-1 (FLT-1), beta1 integrin, and hERG K+ channel for a macromolecular signaling complex in acute myeloid leukemia: role in cell migration and clinical outcome.

Blood 2007 Aug 9;110(4):1238-50. Epub 2007 Apr 9.

Department of Experimental Pathology and Oncology, University of Firenze, Firenze, Italy.

Leukemia cell motility and transendothelial migration into extramedullary sites are regulated by angiogenic factors and are considered unfavorable prognostic factors in acute leukemias. We have studied cross talk among (1) the vascular endothelial growth factor receptor-1, FLT-1; (2) the human eag-related gene 1 (hERG1) K(+) channels; and (3) integrin receptors in acute myeloid leukemia (AML) cells. FLT-1, hERG1, and the beta(1) integrin were found to form a macromolecular signaling complex. The latter mostly recruited the hERG1B isoform of hERG1 channels, and its assembly was necessary for FLT-1 signaling activation and AML cell migration. Both effects were inhibited when hERG1 channels were specifically blocked. A FLT-1/hERG1/beta(1) complex was also observed in primary AML blasts, obtained from a population of human patients. The co-expression of FLT-1 and hERG1 conferred a pro-migratory phenotype to AML blasts. Such a phenotype was also observed in vivo. The hERG1-positive blasts were more efficient in invading the peripheral circulation and the extramedullary sites after engraftment into immunodeficient mice. Moreover, hERG1 expression in leukemia patients correlated with a higher probability of relapse and shorter survival periods. We conclude that in AML, hERG1 channels mediate the FLT-1-dependent cell migration and invasion, and hence confer a greater malignancy.
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http://dx.doi.org/10.1182/blood-2006-02-003772DOI Listing
August 2007

Impact of surgical treatment on nocturia in men with benign prostatic obstruction.

BJU Int 2006 Oct;98(4):799-805

Department of Urology, University of Florence, Florence, Italy.

Objectives: To validate the International Consultation on Incontinence Nocturia Quality-of-life (NQoL) questionnaire in Italian (IT-NQoL) and use it to evaluate the impact of surgical treatment on nocturia in men with lower urinary tract symptoms related to benign prostatic obstruction (LUTS/BPO).

Patients And Methods: All men attending one urological unit between November 2004 and April 2005 were enrolled in the study. They were assessed in two groups; those with and with no LUTS/BPO. An Italian translation of the NQoL was devised, and patients then completed this and validated Italian versions of the International Prostate System Score (IPSS), the Pittsburg Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Clinical, laboratory and instrumental data from each patient were recorded. The patients with LUTS/BPO then had surgical treatment, and 6 months later those with LUTS/BPO were asked to complete all the questionnaires again to evaluate the test sensitivity to change.

Results: Of the 109 patients enrolled in the study, 61 were affected by LUTS/BPO and 48 were not. Cronbach's alpha for the IT-NQoL was 0.943 (95% confidence interval, CI, 0.922-0.959; P < 0.001) and the intra-class correlation coefficient was 0.999 (95% CI 0.998-0.999; P < 0.001) for the total IT-NQoL score. The correlation between the test and the re-test was statistically significant (P < 0.001; r = 0.999) for all items. The mean (sd) IT-NQoL score showed an improvement in QoL from before, at 23.4 (10.1), to after treatment, at 3.09 (2.48) (P < 0.001). In the LUTS/BPO group, the IT-NQoL correlated with the number of times when waking to urinate (Pearson's coefficient 0.80, P < 0.001). There was also a correlation for ESS (0.796) and for the seven PSQI subscales (0.614, both P < 0.001). The decrease in sleep quality, duration and efficiency resulted in an increase in daytime sleepiness (r = 0.639, 0.642). At the 6-month follow-up, all questionnaire results were statistically different from those before treatment.

Conclusions: The IT-NQoL is the first validated translation of the primary instrument into another language. This version is easy to use and has the same characteristic validity as the English version. Using the IT-NQoL showed that surgical treatment determines a decrease in the nocturia rate and an increase in QoL. There was also a significant increase in QoL after treatment as assessed by all the other questionnaires.
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http://dx.doi.org/10.1111/j.1464-410X.2006.06380.xDOI Listing
October 2006

Prognostic role of the tumor-associated tissue inflammatory reaction in transitional bladder cell carcinoma.

Oncol Rep 2006 Aug;16(2):329-34

Department of Urology, University of Florence, Florence, Italy.

Many authors have indicated that the presence of an inflammatory response within the tumor may predict not only recurrence and progression but also survival in several tumors, including transitional cell carcinoma (TCC) of the urinary bladder. Several studies have been performed with a mean follow-up period that is often too limited for predicting patient outcome. The aim of the present study was to define the influence of inflammatory cell infiltrate on recurrence, progression and survival in TCC of the bladder over a long follow-up period. Between January and December 1995, 410 consecutive patients, who had undergone transurethral or open surgery for bladder tumors at the same urologic center, were selected for the study. All cases were reviewed to assess histotype, stage and grade of the tumor and presence or absence of tumor-associated inflammatory reaction. To better evaluate the prognostic role of each single factor in TCC, a follow-up of 10 years after surgery was performed. Pathologic evaluation showed superficial TCC in 312 patients, while 98 had an invasive bladder tumor. Three among 410 bladder tumors were squamous cell carcinomas. Out of 407 TCCs, 119 (29.23%) presented inflammation within the tumor or the lamina propria. At 10 years follow-up, a statistically significant association was shown between the presence of inflammation within the tumor or lamina propria and the number of recurrences (p<0.0001). Moreover, the absence of inflammatory infiltrate in the tumor established the relative risk of suffering more than one recurrence at 2.287 (95% CI 1.180-3.346). The Mann-Whitney test confirmed a statistically significant difference between superficial bladder tumors with inflammation and those without (26.3 vs 11.5 months, p<0.001). In terms of survival rate, a statistically significant difference was reported between carcinomas with and without inflammation (p=0.0261). On multivariate analysis, the presence of inflammation within the tumor was found to be an independent predictor of survival in patients with TCC of the bladder (p=0.027). Survival analysis by means of the Kaplan-Meier curves showed a statistically significant difference between patients with tumor-associated inflammatory reaction and those without (p=0.0098). These results confirm that the presence of inflammatory reaction has a good prognostic value in transitional bladder cell carcinoma. However, to better define its prognostic significance, the characterization of inflammatory cells in tumor-associated tissue reaction must be accomplished.
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August 2006

Multiplex polymerase chain reaction for microsatellite analysis of urine sediment cells: a rapid and inexpensive method for diagnosing and monitoring superficial transitional bladder cell carcinoma.

J Urol 2006 Jun;175(6):2032-7; discussion 2037

Department of Urology, University of Florence, Florence, Italy.

Purpose: Several urinary markers have been recently introduced in clinical practice for improving the noninvasive diagnosis of transitional cell carcinoma. Although microsatellite analysis must be considered the best method in terms of results, its cost and method time are unacceptable for daily use. We validated a more rapid and inexpensive method of determination using rapid DNA extraction and automatic multiplex polymerase chain reaction amplification.

Materials And Methods: A total of 120 patients who presented consecutively to a urological office, including 73 with transitional cell carcinoma and 43 who served as controls, were selected for study. Microsatellite analysis was performed in the blood/urine pair using 3 multiplex polymerase chain reactions per patient. Urine sediment inflammatory cells were assessed by urine dipstick test. Ten microsatellite loci were investigated. Numerical data collected during electrophoresis of the amplified segment in an ABI Prism 310 Genetic Analyzer were used to calculate the cutoff for allelic imbalance. Method sensitivity, specificity, and positive and negative predictive values were calculated.

Results: A total of 66 patients had microsatellite analysis alterations in urine sediment, of whom 59 had transitional cell carcinoma, while 7 had other urological diseases. Test sensitivity and specificity were 80.8% and 85.1%, respectively. Statistical analysis did not indicate any significant influence of inflammatory status on microsatellite analysis diagnostic performance. In the control group the allelic imbalance on chromosome 9 was significantly lower than on other chromosomes (p = 0.0143). This could confirm that chromosome 9 has a specific role in transitional cell carcinoma. The multiplex microsatellite analysis method was low cost and not time-consuming.

Conclusions: Multiplex microsatellite analysis is a noninvasive, rapid, inexpensive and reproducible method for screening for and monitoring superficial transitional cell carcinoma. It should be considered an alternative method to urinary cytology and it should also be considered in the presence of urine sediment inflammatory cells.
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http://dx.doi.org/10.1016/S0022-5347(06)00283-7DOI Listing
June 2006

COX-2 and preoperative CA-125 level are strongly correlated with survival and clinical responsiveness to chemotherapy in ovarian cancer.

Acta Obstet Gynecol Scand 2006 ;85(4):493-8

Department of Human Pathology and Oncology, School of Medicine, University of Florence, Italy.

Background: CA-125 is elevated in the serum of the majority of ovarian carcinoma patients. Cyclooxygenase-2 is an enzyme whose synthesis is upgraded by several cytokines, growth factors, and tumor promoters.

Methods: We analyzed cyclooxygenase-2, preoperative CA-125 levels, and CA-125 levels during chemotherapy in 41 FIGO stage III, grade 3, ovarian serous carcinoma patients in relation to survival with a logistic regression. The correlation of cyclooxygenase-2 expression and CA-125 preoperative level with clinical responsiveness to chemotherapy was studied according to Fisher's exact test. We compared 23 patients living with no evident disease five years after primary treatment to 18 patients who had died of progression of disease no later than two years after primary treatment.

Results: Cyclooxygenase-2 overexpression (p = 0.014 and p = 0.036) and preoperative CA-125 level (p = 0.012 and p = 0.029) were found to be independent predictors of survival in univariate and multivariate analyses. Cyclooxygenase-2 and CA-125 level were correlated to responsiveness to chemotherapy (p = 0.003 and p = 0.036, respectively; Fisher's exact test). The patients with a CA-125 level <35 U/ml after two cycles of chemotherapy showed a longer survival (p = 0.008). The median preoperative CA-125 was 195 in high survival patients and 650 in low survival patients (p= 0.004, Wilcoxon Mann-Whitney test).

Conclusions: Cyclooxygenase-2 overexpression and CA-125 levels may help the management of ovarian cancer patients, permitting the selection of more aggressive and tailored first-line therapy.
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http://dx.doi.org/10.1080/00016340500438173DOI Listing
May 2006

Long-term albumin infusion improves survival in patients with cirrhosis and ascites: an unblinded randomized trial.

World J Gastroenterol 2006 Mar;12(9):1403-7

Department of Internal Medicine, University of Florence School of Medicine, Viale Morgagni, 85-I-50134 Florence, Italy.

Aim: To investigate the effects of long-term albumin administration on survival, recurrence of ascites and onset of other complications.

Methods: One hundred consecutive patients admitted for first-onset ascites were randomized to receive diuretics plus human albumin 25 g/wk in the first year and 25 g every two wk thereafter (group 1) or diuretics alone (group 2). The primary endpoint was survival without liver transplantation. Secondary endpoints were recurrence of ascites and occurrence of other complications.

Results: Median follow-up was 84 (2-120) mo. Albumin-treated patients had significantly greater cumulative survival rate (Breslow test=7.05, P=0.0078) and lower probability of ascites recurrence (51% versus 94%, P<0.0001). Chronic albumin infusion resulted in a mean increase in survival of 16 mo.

Conclusion: Long-term albumin administration after first-onset ascites significantly improves patients' survival and decreases the risk of ascites recurrence.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4124318PMC
http://dx.doi.org/10.3748/wjg.v12.i9.1403DOI Listing
March 2006

Active and passive smoking and lifestyle determinants of 8-oxo-7,8-dihydro-2'-deoxyguanosine levels in human leukocyte DNA.

Cancer Epidemiol Biomarkers Prev 2005 Dec;14(12):2975-7

Department of Pharmacology, Viale Pieraccini 6, 50134 Florence, Italy.

We investigated the effects of smoking and exposure to environmental tobacco smoke (ETS) on oxidative DNA damage by measuring 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGuo) levels in DNA of leukocytes of healthy donors (30 smokers, 29 nonsmokers, and 28 ETS-exposed subjects). Nonsmokers had lower 8-oxodGuo levels compared with smokers (5.94 +/- 0.87 x 10(-6) and 19.85 +/- 4.75 x 10(-6) 2-deoxyguanosine, respectively, means +/- SE, P = 0.00007). Subjects exposed to ETS had higher mean value of 8-oxodGuo compared with nonsmokers (9.18 +/- 1.53 x 10(-6) 2-deoxyguanosine, mean +/- SE), nonsignificant by univariate analysis (P = 0.074). Multiregression analysis indicated that the increase of 8-oxodGuo levels induced by ETS was significant (P = 0.045) and that coffee and tea consumption reduced DNA oxidation (P = 0.0053). Oxidative leukocyte DNA damage was positively correlated with plasma cotinine levels in ETS-exposed subjects (r = 0.47, P < 0.01, n = 28) and was increased by age in nonsmokers and ETS-exposed subjects (P = 0.049). The results seem to confirm that ETS exposure is capable of inducing some oxidative DNA damage in circulating leukocytes and that coffee and tea consumption might partially protect against smoking-induced oxidation damage.
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http://dx.doi.org/10.1158/1055-9965.EPI-04-0906DOI Listing
December 2005

Moon orientation in adult and young sandhoppers under artificial light.

Proc Biol Sci 2005 Oct;272(1577):2189-94

Dipartimento di Biologia Animale e Genetica, Università di Firenze, Via Romana 17, 50125 Firenze, Italy.

Our experiments, carried out at night and during the day on adults and laboratory-born young of the sandhopper Talitrus saltator, deal with the identification and use of the moon as an orientating factor. Sandhoppers were released in an apparatus (a Plexiglas dome) that produced a scenario similar to the natural one (with artificial sky, moon or sun illuminated at different intensities). When tested at night, the adult and young sandhoppers used the artificial moon like the natural one, independently of the intensity of illumination of the artificial sky and moon. In other words, sandhoppers tested at night always identified the artificial moon as the moon and never as the sun. In daytime releases, the seaward orientation failed at low intensities of artificial sky and sun illumination (3.07 and 1.55 microW cm2, respectively), whereas the sun compass was used effectively at higher levels of artificial sun and sky illumination. The innate ability of moon compass orientation in inexpert young sandhoppers was demonstrated even under artificial light.
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http://dx.doi.org/10.1098/rspb.2005.3199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1559952PMC
October 2005

Relationships between promoter polymorphisms in the thymidylate synthase gene and mRNA levels in colorectal cancers.

Eur J Cancer 2005 Sep;41(14):2176-83

Dipartimento di Farmacologia, Unità di Chemioterapia, Università degli Studi di Firenze, viale Pieraccini, 6, 50139, Firenze, Italy.

Thymidylate synthase (TS) intratumoural expression may be a prognostic marker and predict outcome of 5-fluorouracil (5-FU)-based chemotherapy in colorectal cancer patients. The TS gene promoter enhancer region contains two different polymorphisms which can influence TS mRNA transcriptional and translational efficiency: a polymorphic tandem repeat sequence (2 or 3 repeats; 2R and 3R) and a single nucleotide polymorphism (SNP), G > C, within the second repeat of the 3R alleles. We studied the relationship between tumoural TS mRNA expression levels and TS gene polymorphisms in the colonic mucosa of 48 colorectal cancer patients. The 3R/3R genotype was characterised by higher TS mRNA levels in the tumour than the 2R/2R-2R/3R genotypes (P = 0.071). Regarding the relationship with the SNP polymorphism, a statistically significant difference in TS gene expression between the 3RG/3RG genotype and 2R/2R-2R/3RC-2R/3RG genotype subset was observed (P = 0.017). No statistically significant correlation was observed between experimental data and baseline clinical-pathological characteristics as well as clinical outcome in the relatively small patient series investigated. This is the first study reporting an association between the TS intra-repeat SNP and gene expression levels in colorectal cancer patients. These results suggest that in 3R/3R patients, the G > C polymorphism may be an important factor in determining TS mRNA expression levels, and warrant further investigation of the role of TS promoter polymorphisms as predictors of sensitivity to 5-FU-based chemotherapy in larger case series.
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http://dx.doi.org/10.1016/j.ejca.2005.06.016DOI Listing
September 2005

Seasonal variations of DNA damage in human lymphocytes: correlation with different environmental variables.

Mutat Res 2006 Jan 10;593(1-2):143-52. Epub 2005 Aug 10.

Dipartimento di Farmacologia Preclinica e Clinica, Università di Firenze, Viale Pieraccini 6, 50139 Firenze, Italy.

Several types of DNA damage, including DNA breaks and DNA base oxidation, display a seasonal trend. In the present work, a sample of 79 healthy subjects living in the city of Florence, Italy, was used to analyse this effect. Three possible causative agents were taken into consideration: solar radiation, air temperature and air ozone level. DNA damage was measured in isolated human lymphocytes at different times during the year and the observed damage was correlated with the levels of these three agents in the days preceding blood sampling. Three time windows were chosen: 3, 7 and 30 days before blood sampling. DNA strand breaks and the oxidized purinic bases cleaved by the formamidopyrimidine glycosylase (FPG sites) were measured by means of the comet assay. The results of multivariate regression analysis showed a positive correlation between lymphocyte DNA damage and air temperature, and a less strong correlation with global solar radiation and air ozone levels.
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http://dx.doi.org/10.1016/j.mrfmmm.2005.07.002DOI Listing
January 2006

Correlation of epidermal growth factor receptor expression with tumor microdensity vessels and with vascular endothelial growth factor expression in ovarian carcinoma.

Int J Surg Pathol 2005 Apr;13(2):135-42

Department of Human Pathology and Oncology, University of Florence, School of Medicine, Florence, Italy.

We analyzed in advanced ovarian serous G3 carcinoma the correlation between epidermal growth factor receptor (EGFR) overexpression and tumor angiogenesis and their relation with clinical outcome. Microvessel density (MVD) and vascular endothelial growth factor (VEGF) were statistically correlated with disease-free interval and death from disease both in univariate and multivariate analyses while EGFR expression was not correlated with clinical outcome. MVD was significantly associated with progression of disease during chemotherapy while VEGF and EGFR expression were not correlated with responsiveness to chemotherapy (Fisher's exact test). VEGF expression was correlated with MVD (Fisher's exact test). EGFR showed a trend to correlation with MVD. Further studies focusing on the use of angiogenesis inhibitors in addition to EGFR inhibitors on ovarian carcinoma cells may produce therapeutic strategies in the selection of tailored therapies in ovarian cancer patients.
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http://dx.doi.org/10.1177/106689690501300202DOI Listing
April 2005