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1.
Child Care Health Dev ; 50(1): e13217, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38265140

RESUMO

BACKGROUND: Little is known about bullying experienced by internationally adopted teens residing in Europe. OBJECTIVES: Within the framework of an international research effort involving several European countries, the main goal of this study was to explore the experiences of bullying victimization suffered by adopted adolescents, as well as its impact on their psychological adjustment. METHODS: The sample consisted of 199 adolescents born in Eastern European countries and adopted in France (n = 50), Italy (n = 59), Norway (n = 25) and Spain (n = 65). RESULTS: More than half of the adopted adolescents had been exposed to some form of peer victimization in the previous 2 months, with verbal harassment and social exclusion being the most common forms of victimization. Differences between receiving countries were not statistically significant, suggesting a common pattern for Eastern European adopted adolescents living in Western Europe. More frequent experiences of peer victimization were associated with more psychological difficulties among the adopted adolescents. CONCLUSIONS: Findings highlight that adopted adolescents might have considerable difficulties in social integration with peers; these experiences of peer victimization might play an important role hindering their psychosocial adjustment. The socioemotional development of adopted people is not only linked to their pre-adoptive experiences; factors in their daily lives (i.e., peer relationships) may also be associated with their psychological adjustment later in life. Interventions are needed to promote the real inclusion of these groups of children in their social and educational contexts.


Assuntos
Bullying , Criança , Adolescente , Humanos , Europa (Continente) , Itália , Espanha , Instituições Acadêmicas
2.
Int J Mol Sci ; 25(11)2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38892164

RESUMO

Thymic stromal lymphopoietin (TSLP), is a protein belonging to a class of epithelial cytokines commonly called alarmins, which also includes IL-25 and IL-33. Functionally, TSLP is a key player in the immune response to environmental insults, initiating a number of downstream inflammatory pathways. TSLP performs its role by binding to a high-affinity heteromeric complex composed of the thymic stromal lymphopoietin receptor (TSLPR) chain and IL-7Rα. In recent years, the important role of proinflammatory cytokines in the etiopathogenesis of various chronic diseases such as asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), chronic obstructive pulmonary diseases (COPDs), and chronic spontaneous urticaria has been studied. Although alarmins have been found to be mainly implicated in the mechanisms of type 2 inflammation, studies on monoclonal antibodies against TSLP demonstrate partial efficacy even in patients whose inflammation is not definable as T2 and the so-called low T2. Tezepelumab is a human anti-TSLP antibody that prevents TSLP-TSLPR interactions. Several clinical trials are evaluating the safety and efficacy of Tezepelumab in various inflammatory disorders. In this review, we will highlight major recent advances in understanding the functional role of TSLP, its involvement in Th2-related diseases, and its suitability as a target for biological therapies.


Assuntos
Anticorpos Monoclonais Humanizados , Citocinas , Linfopoietina do Estroma do Timo , Humanos , Citocinas/metabolismo , Anticorpos Monoclonais Humanizados/uso terapêutico , Animais , Receptores de Citocinas/metabolismo , Receptores de Citocinas/antagonistas & inibidores , Terapia de Alvo Molecular , Doenças Respiratórias/tratamento farmacológico , Doenças Respiratórias/metabolismo , Asma/tratamento farmacológico , Asma/metabolismo
3.
Health Promot Int ; 38(3)2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-37279472

RESUMO

Research has been focussing on protective and resistance-related factors that may help people face the long-lasting psychological challenges of the COVID-19 pandemic. Sense of coherence allows to remain healthy and to recover after stressful or traumatic life experiences. We aimed at investigating whether, and the extent to which, social support, in terms of both family and friends support, mediated the well-established link between sense of coherence and mental health as well as that between sense of coherence and COVID-19-related Post-Traumatic Stress Disorder (PTSD) symptoms. In May 2021, 3048 Italian respondents (51.5% women) aged between 18 and 91 (Mage = 48.33, SD = 14.04) filled in a self-report questionnaire. The mediation analyses we carried out on their responses showed a difference between focussing on mental health or on a psychological disorder. Indeed, despite the respectively positive and negative relation between sense of coherence and mental health and PTSD symptoms, this confirming the protective role of sense of coherence more than 1 year after the beginning of the pandemic, social support only mediated, partially, the former link. We also discuss practical implications and further expansion of the study.


Assuntos
COVID-19 , Senso de Coerência , Transtornos de Estresse Pós-Traumáticos , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Masculino , Pandemias , Saúde Mental , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia
4.
Fam J Alex Va ; 31(3): 454-463, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38603286

RESUMO

Despite an increasing interest in how adoptive parents deal with situations appraised as stressful, there is a lack of research regarding adoptive parents' adjustment to the challenges posed by the prolonged COVID-19 pandemic. The current study explores similarities and differences between adoptive and non-adoptive mothers in terms of risks (i.e., COVID-19-related stress) and individual (i.e., sense of coherence [SOC]), couple (i.e., partner's support), parent-child (i.e., parent-child relationship satisfaction), and social (i.e., friends' support) resources in the face of the prolonged COVID-19 pandemic. Specifically, the present study was aimed at predicting which variables discriminate more effectively between the two groups. Participants were 445 Italian mothers (40.9% adoptive mothers), who were asked to fill in an anonymous online survey between May 2021 and October 2021. Results showed that adoptive and non-adoptive mothers reported different resilience resources to face the stressors posed by the health emergency. Specifically, COVID-19 traumatic stress symptoms, parent-child relationship satisfaction, and SOC were found to contribute most in discriminating between the two groups. Findings are discussed in relation to future research developments and practical implications.

5.
Circ Res ; 127(8): 1056-1073, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32673519

RESUMO

RATIONALE: Intercellular tight junctions are crucial for correct regulation of the endothelial barrier. Their composition and integrity are affected in pathological contexts, such as inflammation and tumor growth. JAM-A (junctional adhesion molecule A) is a transmembrane component of tight junctions with a role in maintenance of endothelial barrier function, although how this is accomplished remains elusive. OBJECTIVE: We aimed to understand the molecular mechanisms through which JAM-A expression regulates tight junction organization to control endothelial permeability, with potential implications under pathological conditions. METHODS AND RESULTS: Genetic deletion of JAM-A in mice significantly increased vascular permeability. This was associated with significantly decreased expression of claudin-5 in the vasculature of various tissues, including brain and lung. We observed that C/EBP-α (CCAAT/enhancer-binding protein-α) can act as a transcription factor to trigger the expression of claudin-5 downstream of JAM-A, to thus enhance vascular barrier function. Accordingly, gain-of-function for C/EBP-α increased claudin-5 expression and decreased endothelial permeability, as measured by the passage of fluorescein isothiocyanate (FITC)-dextran through endothelial monolayers. Conversely, C/EBP-α loss-of-function showed the opposite effects of decreased claudin-5 levels and increased endothelial permeability. Mechanistically, JAM-A promoted C/EBP-α expression through suppression of ß-catenin transcriptional activity, and also through activation of EPAC (exchange protein directly activated by cAMP). C/EBP-α then directly binds the promoter of claudin-5 to thereby promote its transcription. Finally, JAM-A-C/EBP-α-mediated regulation of claudin-5 was lost in blood vessels from tissue biopsies from patients with glioblastoma and ovarian cancer. CONCLUSIONS: We describe here a novel role for the transcription factor C/EBP-α that is positively modulated by JAM-A, a component of tight junctions that acts through EPAC to up-regulate the expression of claudin-5, to thus decrease endothelial permeability. Overall, these data unravel a regulatory molecular pathway through which tight junctions limit vascular permeability. This will help in the identification of further therapeutic targets for diseases associated with endothelial barrier dysfunction. Graphic Abstract: An graphic abstract is available for this article.


Assuntos
Proteínas Estimuladoras de Ligação a CCAAT/metabolismo , Permeabilidade Capilar , Moléculas de Adesão Celular/metabolismo , Claudina-5/metabolismo , Células Endoteliais/metabolismo , Receptores de Superfície Celular/metabolismo , Junções Íntimas/metabolismo , Adulto , Idoso , Animais , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/patologia , Proteínas Estimuladoras de Ligação a CCAAT/genética , Moléculas de Adesão Celular/genética , Linhagem Celular , Claudina-5/genética , Feminino , Glioblastoma/metabolismo , Glioblastoma/patologia , Humanos , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , Pessoa de Meia-Idade , Neovascularização Patológica , Neoplasias Ovarianas/metabolismo , Neoplasias Ovarianas/patologia , Receptores de Superfície Celular/genética , Transdução de Sinais , Junções Íntimas/genética , Regulação para Cima
6.
Cultur Divers Ethnic Minor Psychol ; 28(1): 72-79, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34780234

RESUMO

OBJECTIVE: In the present study, we adapted and validated the Bicultural Identity Integration Scale for Children (BIIS-C). METHOD: 259 bicultural children (119 males, 140 females; Mage = 11.07, SD = 1.24) were provided with a questionnaire. Based on adult versions of the scale, we tested the factorial structure of a set of 11 nonreversed items tapping into harmony (vs. conflict; six items) and blendedness (vs. compartmentalization; five items) dimensions. RESULTS: A two-factor model was compared with a one-factor model. In line with research on adults, results showed that the two-factor model (with nine items) fitted the data better than the one-factor model. The two dimensions yielded reliable scores and were correlated in the expected direction with personality variables, acculturation attitudes, and perceived discrimination. CONCLUSIONS: The BIIS-C provides valid and reliable scores for research on biculturalism in childhood. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Aculturação , Discriminação Percebida , Adulto , Criança , Feminino , Humanos , Masculino , Inquéritos e Questionários
7.
J Adolesc ; 89: 10-17, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33838575

RESUMO

INTRODUCTION: In accordance with the "resilience paradigm", this study was aimed at exploring the role of the parent-child relationship in supporting internationally adopted adolescents' ability to develop a strong adoptive identity and a feeling of satisfaction with their own life. METHODS: Participants were 105 Italian adopted adolescents (13-17 years) asked to complete a self-report questionnaire. RESULTS: Results showed that adolescents generally feel fairly comfortable discussing adoption-related issues (especially with their mothers), have a medium-high level of adoptive identity, and appear to be quite satisfied with their life. Moreover, while adoptive identity mediates the association between openness in communication regarding adoption and adoptees' well-being with mothers, father-child communication openness has a direct influence on well-being. CONCLUSIONS: Findings highlighted that the quality of mother-child and father-child relationship plays a crucial role in guiding the process of adoptees' identity formation and influencing their well-being. Recommendations for professionals working with adoptive families were discussed.


Assuntos
Adoção , Relações Pais-Filho , Adolescente , Comunicação , Feminino , Humanos , Mães , Satisfação Pessoal
8.
J Cell Physiol ; 234(6): 7708-7717, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30536609

RESUMO

Data from 423 human epidermal growth factor receptor 2-negative (HER2-), hormone receptor-positive (HR+) advanced breast cancer (aBC) patients treated with palbociclib and endocrine therapy (ET) were provided by 35 Italian cancer centers and analyzed for treatment outcomes. Overall, 158 patients were treated in first line and 265 in second/later lines. We observed 19 complete responses and 112 partial responses. The overall response rate (ORR) was 31% (95% confidence interval [CI], 26.6-35.4) and clinical benefit was 52.7% (95% CI, 48-57.5). ORR was negatively affected by prior exposure to everolimus/exemestane ( p = 0.002) and favorably influenced by early line-treatment ( p < 0.0001). At 6 months, median progression-free survival was 12 months (95% CI, 8-16) and median overall survival was 24 months (95% CI, 17-30). More favorable outcomes were associated with palbociclib in early lines, no visceral metastases and no prior everolimus/exemestane. The main toxicity reported was neutropenia. Our results provide further support to the use of palbociclib with ET in HER2-, HR+ aBC. Differences in outcomes across patients subsets remain largely unexplained.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/patologia , Piperazinas/farmacologia , Piridinas/farmacologia , Receptor ErbB-2/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/metabolismo , Mama/patologia , Neoplasias da Mama/metabolismo , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Receptores de Estrogênio/efeitos dos fármacos , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/efeitos dos fármacos , Resultado do Tratamento
9.
Oncologist ; 24(3): 385-393, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30606884

RESUMO

BACKGROUND: Type 2 diabetes mellitus (T2DM) is associated with increased risk of colon cancer (CC), whereas metformin use seems to be protective. However, the impact of metformin use on the risk of death or disease recurrence after radical surgery for CC remains uncertain. MATERIALS AND METHODS: This is a substudy conducted in patients with high-risk stage II or stage III CC randomized in the TOSCA trial, which compared 3 versus 6 months of fluoropyrimidine-oxaliplatin adjuvant chemotherapy. Objective of the study was to investigate the impact of metformin exposure during adjuvant chemotherapy on overall survival (OS) and relapse-free survival (RFS). We also evaluated the impact of T2DM or metformin dosage on clinical outcomes. RESULTS: Out of 3,759 patients enrolled in the TOSCA trial, 133 patients with diabetes (9.2%) and 1,319 without diabetes (90.8%) were recruited in this study. After excluding 13 patients with diabetes without information on metformin exposure, 76 patients with T2DM (63.3%) were defined as metformin users and 44 (36.7%) as metformin nonusers. After a median follow-up of 60.4 months, 26 (21.7%) patients relapsed and 16 (13.3%) died. Metformin use was neither associated with OS (adjusted hazard ratio [HR], 1.51; 95% confidence interval [CI], 0.48-4.77; p = .4781) nor with RFS (HR, 1.56; 95% CI, 0.69-3.54; p = .2881). Similarly, we found no association between T2DM or metformin dosage and OS or RFS. CONCLUSIONS: Metformin use and T2DM did not impact on OS or RFS in patients with resected CC treated with adjuvant fluoropyrimidine-oxaliplatin chemotherapy. Larger studies and longer follow-up are required to clarify the potential efficacy of metformin in improving the prognosis of patients with CC. IMPLICATIONS FOR PRACTICE: The role of the antidiabetic drug metformin in colon cancer prevention and treatment is highly debated. While low-dose metformin reduced the incidence of colorectal adenomas in two prospective studies, its effect in patients with already established colon cancer remains unclear. In this study, the potential impact of metformin on the survival of resected colon cancer patients who received adjuvant chemotherapy was investigated in the context of the TOSCA study. We did not find any association between metformin use or dosages and patient survival. Prospective studies are required to draw definitive conclusions about metformin impact on colon cancer recurrence and survival.


Assuntos
Antineoplásicos/uso terapêutico , Quimioterapia Adjuvante/métodos , Neoplasias do Colo/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Fluoruracila/análogos & derivados , Fluoruracila/uso terapêutico , Hipoglicemiantes/uso terapêutico , Metformina/uso terapêutico , Oxaliplatina/uso terapêutico , Idoso , Antineoplásicos/farmacologia , Neoplasias do Colo/patologia , Diabetes Mellitus Tipo 2/patologia , Feminino , Fluoruracila/farmacologia , Humanos , Hipoglicemiantes/farmacologia , Masculino , Metformina/farmacologia , Pessoa de Meia-Idade , Oxaliplatina/farmacologia , Fatores de Risco
10.
Haematologica ; 104(7): 1332-1341, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30630974

RESUMO

The nucleophosmin 1 gene (NPM1) is the most frequently mutated gene in acute myeloid leukemia. Notably, NPM1 mutations are always accompanied by additional mutations such as those in cohesin genes RAD21, SMC1A, SMC3, and STAG2 but not in the cohesin regulator, nipped B-like (NIPBL). In this work, we analyzed a cohort of adult patients with acute myeloid leukemia and NPM1 mutation and observed a specific reduction in the expression of NIPBL but not in other cohesin genes. In our zebrafish model, overexpression of the mutated form of NPM1 also induced downregulation of nipblb, the zebrafish ortholog of human NIPBL To investigate the hematopoietic phenotype and the interaction between mutated NPM1 and nipblb, we generated a zebrafish model with nipblb downregulation which showed an increased number of myeloid progenitors. This phenotype was due to hyper-activation of the canonical Wnt pathway: myeloid cells blocked in an undifferentiated state could be rescued when the Wnt pathway was inhibited by dkk1b mRNA injection or indomethacin administration. Our results reveal, for the first time, a role for NIPBL during zebrafish hematopoiesis and suggest that an interplay between NIPBL/NPM1 may regulate myeloid differentiation in zebrafish and humans through the canonical Wnt pathway and that dysregulation of these interactions may drive leukemic transformation.


Assuntos
Proteínas de Ciclo Celular/metabolismo , Diferenciação Celular , Proteínas Cromossômicas não Histona/metabolismo , Regulação Neoplásica da Expressão Gênica , Leucemia Mieloide Aguda/patologia , Mutação , Proteínas Nucleares/genética , Adulto , Animais , Proteínas de Ciclo Celular/genética , Proteínas Cromossômicas não Histona/genética , Embrião não Mamífero/metabolismo , Embrião não Mamífero/patologia , Hematopoese , Humanos , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/metabolismo , Nucleofosmina , Fenótipo , Via de Sinalização Wnt , Peixe-Zebra , Coesinas
11.
Breast J ; 25(2): 237-242, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30810258

RESUMO

The efficacy of anthracycline- and taxane-based chemotherapy for perioperative treatment of breast cancer (BC) has been established. No superiority of a cytotoxic regimen has been demonstrated, provided that administration of an anthracycline and a taxane is warranted. The ASTER study was designed to investigate the safety of 6 months of perioperative chemotherapy with Doxorubicin and Paclitaxel, followed by Cyclophosphamide, Methotrexate, and 5-Fluorouracil. ASTER enrolled patients with cT2-3 N0-1 or pT1-2 N1-3 BC, from November 2008 to August 2011. Treatment consisted of Doxorubicin 60 mg/sm, Paclitaxel 200 mg/sm q21 (AT) for three cycles followed by Cyclophosphamide 600 mg/sm, Methotrexate 40 mg/sm, 5-Fluorouracil 600 mg/sm d1,8 q28 (CMF) for three cycles, in either neo-adjuvant or adjuvant setting. All HER-positive patients received targeted therapy with Trastuzumab for 1 year. Disease-free and overall survival (DFS and OS, respectively) were estimated according to Kaplan-Meier method. Three hundred and thirty patients were enrolled, where 77.9% of cases were treated in an adjuvant setting; 65.5% received breast conservative surgery, 72.4% axillary dissection. 75.5% of cases presented estrogen receptor positivity, 66.7% progesterone receptor positivity; 18.5% of patients presented HER2-positive BC, 16.1% triple negative disease. Twenty-eight (8.5%) developed grade III-IV hematologic toxicity; nine patients (2.7%) developed grade III neurological toxicity. Loco-regional DFS was 99.6% at 1 year, 97.1% at 5 years, 95.9% at 7 years. Corresponding distant DFS was 98.4%, 90.2%, and 88.8%. One, 5, and 7-year OS was 99.6%, 94.9%, and 91.2%, respectively. Chemotherapy with ATx3→CMFx3 is confirmed safe and effective at 6.7 years follow-up. These results appear comparable to those reported in regulatory trials of most commonly prescribed anthracycline and taxane-based regimens.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/cirurgia , Adulto , Idoso , Antraciclinas/administração & dosagem , Neoplasias da Mama/mortalidade , Ciclofosfamida/administração & dosagem , Intervalo Livre de Doença , Feminino , Fluoruracila/administração & dosagem , Seguimentos , Humanos , Pessoa de Meia-Idade , Taxoides/administração & dosagem
12.
Oncologist ; 22(12): 1463-1469, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28860412

RESUMO

BACKGROUND: Second-line therapy has consistently demonstrated survival benefit if compared with best supportive care; however, there is limited evidence whether further lines of treatment may improve the prognosis of advanced gastric cancer (AGC) patients. MATERIALS AND METHODS: Starting from a real-world cohort of 868 AGC patients, we retrospectively analyzed baseline parameters, tumor characteristics, and treatment data of those treated with at least three lines. Categorical features were described through cross-tables and chi-square test. We explored the impact of treatment intensity and progression-free survival (PFS) experienced in previous lines on PFS and overall survival in third-line by uni- and multivariate Cox regression models and described by Kaplan-Meier estimator plot with log-rank test. RESULTS: Overall, 300 patients were included in the analysis. The most common site of primary tumor was gastric body; 45.3% of cancers had an intestinal histotype, 14% were human epidermal growth receptor 2 positive. In third-line, 45.7% of patients received a single-agent chemotherapy, 49.7% a combination regimen. Patients who had experienced a first-line PFS ≥6.9 months had a better prognosis compared with those who had achieved a shorter one. Consistently, a second-line PFS ≥3.5 months positively influenced the prognosis. Patients receiving a third-line combination regimen had better outcomes compared with those treated with a single-agent chemotherapy. CONCLUSION: Our real-world study confirms that selected AGC patients may receive third-line treatment. Longer PFS in previous lines or a more intense third-line treatment positively influenced prognosis. Further efforts are warranted to define the best therapeutic sequences, and to identify the optimal candidate for treatment beyond second-line. IMPLICATIONS FOR PRACTICE: The benefit of third-line treatment to advanced gastric cancer patients is controversial. This study depicts a real scenario of the clinical practice in Italy, confirming that a non-negligible proportion of patients receive a third-line therapy. Longer progression-free survival in previous treatment lines or higher third-line treatment intensity positively influenced prognosis. Including a large number of real-world patients, this study provides information on third-line treatment from the daily clinical practice; moreover, its results help in defining the best therapeutic sequence and offer some hints to select the optimal candidate for treatment beyond second-line.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Prognóstico , Neoplasias Gástricas/tratamento farmacológico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Humanos , Itália/epidemiologia , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/patologia , Resultado do Tratamento
13.
Br J Cancer ; 114(1): 30-6, 2016 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-26575603

RESUMO

BACKGROUND: In metastatic colorectal cancer (mCRC), BRAFV600E mutation has been variously associated to specific clinico-pathological features. METHODS: Two large retrospective series of mCRC patients from two Italian Institutions were used as training-set (TS) and validation-set (VS) for developing a nomogram predictive of BRAFV600E status. The model was internally and externally validated. RESULTS: In the TS, data from 596 mCRC patients were gathered (RAS wild-type (wt) 281 (47.1%); BRAFV600E mutated 54 (9.1%)); RAS and BRAFV600E mutations were mutually exclusive. In the RAS-wt population, right-sided primary (odds ratio (OR): 7.80, 95% confidence interval (CI) 3.05-19.92), female gender (OR: 2.90, 95% CI 1.14-7.37) and mucinous histology (OR: 4.95, 95% CI 1.90-12.90) were independent predictors of BRAFV600E mutation, with high replication at internal validation (100%, 93% and 98%, respectively). A predictive nomogram was calculated: patients with the highest score (right-sided primary, female and mucinous) had a 81% chance to bear a BRAFV600E-mutant tumour; accuracy measures: AUC=0.812, SE:0.034, sensitivity:81.2%; specificity:72.1%. In the VS (508 pts, RAS wt: 262 (51.6%), BRAFV600E mutated: 49 (9.6%)), right-sided primary, female gender and mucinous histology were confirmed as independent predictors of BRAFV600E mutation with high accuracy. CONCLUSIONS: Three simple and easy-to-collect characteristics define a useful nomogram for predicting BRAF status in mCRC with high specificity and sensitivity.


Assuntos
Neoplasias Colorretais/patologia , Mutação , Nomogramas , Proteínas Proto-Oncogênicas B-raf/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/genética , Neoplasias Colorretais/mortalidade , Feminino , Genes ras , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estudos Retrospectivos
14.
Eur J Nucl Med Mol Imaging ; 43(3): 499-508, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26341365

RESUMO

PURPOSE: The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). METHODS: We evaluated the supportive role of CSF Aß42, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. RESULTS: Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aß42 ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. CONCLUSION: In this clinical setting, FDG PET SPM t-maps and the p-tau/Aß42 ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role.


Assuntos
Doença de Alzheimer/diagnóstico , Biomarcadores/líquido cefalorraquidiano , Idoso , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Disfunção Cognitiva/diagnóstico , Diagnóstico Diferencial , Progressão da Doença , Feminino , Fluordesoxiglucose F18/química , Degeneração Lobar Frontotemporal/diagnóstico , Humanos , Doença por Corpos de Lewy/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/líquido cefalorraquidiano , Tomografia por Emissão de Pósitrons , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Proteínas tau/líquido cefalorraquidiano
15.
Clin Chem Lab Med ; 54(11): 1705-1714, 2016 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-26985687

RESUMO

Precision medicine (PM) can be defined as a structural model aimed at customizing healthcare, with medical decisions/products tailored on an individual patient at a highly detailed level. In this sense, allergy diagnostics based on molecular allergen components allows to accurately define the patient's IgE repertoire. The availability of highly specialized singleplexed and multiplexed platforms support allergists with an advanced diagnostic armamentarium. The therapeutic intervention, driven by the standard diagnostic approach, but further supported by these innovative tools may result, for instance, in a more appropriate prescription of allergen immunotherapy (AIT). Also, the phenotyping of patients, which may have relevant effects on the treatment strategy, could be take advantage by the molecular allergy diagnosis.


Assuntos
Dessensibilização Imunológica , Hipersensibilidade/diagnóstico , Hipersensibilidade/terapia , Medicina de Precisão , Humanos
17.
Clin Mol Allergy ; 13: 20, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26430389

RESUMO

Severe asthma (SA) is a clinically and etiologically heterogeneous respiratory disease which affects among 5-10 % of asthmatic patients. Despite high-dose therapy, a large patients percentage is not fully controlled and has a poor quality of life. In this review, we describe the biomarkers actually known in scientific literature and used in clinical practice for SA assessment and management: neutrophils, eosinophils, periostin, fractional exhaled nitric oxide, exhaled breath condensate and galectins. Moreover, we give an overview on clinical and biological features characterizing severe asthma, paying special attention to the potential use of these ones as reliable markers. We finally underline the need to define different biomarkers panels to select patients affected by severe asthma for specific and personalized therapeutic approach.

18.
Int J Psychol ; 50(6): 413-21, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26264672

RESUMO

Transracial adoptees represent a specific group of immigrants who experience unique immigration processes that bring them face-to-face with two cultural backgrounds: that of their heritage culture on one hand and that of their national culture on the other hand. However, there is a scarcity of studies focused on the way these processes unfold within adoptive families. This study was aimed at exploring how transracial adoptees cope with the construction of their ethnic identity. Administering a self-report questionnaire to 127 transracial adoptees and their mothers, for a total of 254 participants, we first investigated the association between mothers' cultural socialisation (enculturation and preparation for bias strategies) and adoptees' ethnic identity (i.e. ethnic identity exploration and ethnic identity affirmation dimensions). We then investigated whether ethnic identity affects self-esteem by testing the hypothesis that national identity moderates the relationship between ethnic identity and self-esteem. Results revealed that mothers' enculturation (but not their preparation for bias) supported adoptees' ethnic identity exploration, which in turn was positively associated with ethnic identity affirmation. Moreover, we confirmed the moderation effect: ethnic identity affirmation enhanced the level of self-esteem, but only for those adoptees who perceived a higher degree of national identity affirmation.


Assuntos
Características Culturais , Emigrantes e Imigrantes , Pais , Autoimagem , Identificação Social , Socialização , Adulto , Emigração e Imigração , Etnicidade , Feminino , Humanos , Masculino , Mães , Inquéritos e Questionários , Adulto Jovem
19.
New Dir Child Adolesc Dev ; 2015(150): 63-76, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26650809

RESUMO

The ethnic identity development plays a crucial role in adolescence and emerging adulthood and may be more complex for adoptees who do not share their ethnic identity with their adoptive families. Evidence from the studies was mixed, with strong ethnic identity not always found to be indicative of improved psychological adjustment. Recently research carried out on ethnic minorities has highlighted that the relation between ethnic identity and well-being could be influenced by Bicultural Identity Integration (BII) (Benet-Martínez et al., 2002): It reflects how individuals who experience more than one culture organize and combine their dual cultural backgrounds. These results are consistent also among adoptees (Manzi, Ferrari, Rosnati, & Benet-Martínez, 2013) but need to be further explored. A longitudinal study was conducted to investigate whether and the extent to which ethnic identity, national identity, and BII are protective factors for adoptees' psychological well-being. A self-report questionnaire was administered to 79 Italian transracial adoptees, aged between 15 and 25, at two time points, one year apart. In line with predictions, longitudinal analyses showed the crucial role of BII that turned out to increase higher levels of well-being one year later. Results are discussed in relation to implications for intervention with adoptive parents and children.

20.
Int J Cancer ; 134(10): 2269-77, 2014 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-23784914

RESUMO

Arterial hypertension and cancer are two of the most important causes of mortality in the world; correlations between these two clinical entities are complex and various. Cancer therapy using old (e.g., mitotic spindle poisons) as well as new (e.g., monoclonal antibody) drugs may cause arterial hypertension through different mechanisms; sometimes the increase of blood pressure levels may be responsible for chemotherapy withdrawal. Among newer cancer therapies, drugs interacting with the VEGF (vascular endothelial growth factors) pathways are the most frequently involved in hypertension development. However, many retrospective studies have suggested a relationship between antihypertensive treatment and risk of cancer, raising vast public concern. The purposes of this brief review have then been to analyse the role of chemotherapy in the pathogenesis of hypertension, to summarize the general rules of arterial hypertension management in this field and finally to evaluate the effects of antihypertensive therapy on cancer disease.


Assuntos
Anti-Hipertensivos/uso terapêutico , Antineoplásicos/uso terapêutico , Hipertensão/tratamento farmacológico , Neoplasias/tratamento farmacológico , Anti-Hipertensivos/efeitos adversos , Antineoplásicos/efeitos adversos , Humanos , Hipertensão/induzido quimicamente , Neoplasias/induzido quimicamente , Medição de Risco , Fatores de Risco
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