87,706 research outputs found
TPO – Teatro Polivalente Occupato. Intervista con Bettina Cottone
No full textIntervista con Bettina Cottone, co-fondatrice del TPO – Teatro Polivalente Occupato (f. 1995
UNRESECTABLE HEPATOCELLULAR CARCINOMA:META-ANALYSIS OD ARTERIAL EMBOLIZATION
No full text. Radiology. 2002 Jul;224(1):47-54.
Transarterial chemoembolization for unresectable hepatocellular carcinoma:
meta-analysis of randomized controlled trials.
Cammà C, Schepis F, Orlando A, Albanese M, Shahied L, Trevisani F, Andreone P,
Craxì A, Cottone M.
National Council of Research, Istituto Metodologie Diagnostiche Avanzate,
Palermo, Italy. [email protected]
Comment in
Radiology. 2003 May;227(2):611-2; author reply 612-3.
Radiology. 2004 Jan;230(1):300-1; author reply 301-2.
PURPOSE: To review the available evidence of chemoembolization for unresectable
hepatocellular carcinoma (HCC).
MATERIALS AND METHODS: Computerized bibliographic searches with MEDLINE and
CANCERLIT databases from 1980 through 2000 were supplemented with manual
searches, with the keywords "hepatocellular carcinoma," "liver cell carcinoma,"
"randomized controlled trial [RCT]," and "chemoembolization." Studies were
included if patients with unresectable HCC were enrolled and if they were RCTs in
which chemoembolization was compared with nonactive treatment (five RCTs) or if
different transarterial modalities of therapy (13 RCTs) were compared. Data were
extracted from each RCT according to the intention-to-treat method. Five of the
RCTs with a nonactive treatment arm were combined by using the random-effects
model, whereas all 18 RCTs were pooled from meta-regression analysis.
RESULTS: Chemoembolization significantly reduced the overall 2-year mortality
rate (odds ratio, 0.54; 95% CI: 0.33, 0.89; P =.015) compared with nonactive
treatment. Analysis of comparative RCTs helped to predict that overall mortality
was significantly lower in patients treated with transarterial embolization (TAE)
than in those treated with transarterial chemotherapy (odds ratio, 0.72; 95% CI:
0.53, 0.98; P =.039) and that there is no evidence that transarterial
chemoembolization is more effective than TAE (odds ratio, 1.007; 95% CI: 0.79,
1.27; P =.95), which suggests that the addition of an anticancer drug did not
improve the therapeutic benefit.
CONCLUSION: In patients with unresectable HCC, chemoembolization significantly
improved the overall 2-year survival compared with nonactive treatment, but the
magnitude of the benefit is relatively small
Meta-analysis: remission and response from control arms of randomized trials of biological therapies for active luminal Crohn's disease.
No full text1. Aliment Pharmacol Ther. 2008 Jun;27(12):1210-23. Epub 2008 Mar 14.
Meta-analysis: remission and response from control arms of randomized trials of
biological therapies for active luminal Crohn's disease.
Tinè F, Rossi F, Sferrazza A, Orlando A, Mocciaro F, Scimeca D, Olivo M, Cottone
M.
Divisione di Gastroenterologia, Azienda Ospedaliera V. Cervello, Palermo, Italy.
[email protected]
BACKGROUND: Remission and response are the main outcomes to evaluate the efficacy
of new treatments for Crohn's disease (CD).
AIM: To explain variation of remission and response rates in active luminal CD.
METHODS: We studied control patients from trials of biological therapies through
articles retrieved by MEDLINE search (from 1997 to 2007) and by bibliography
review. Thousand nine hundred and thirteen control patients from 28 trials were
identified; data were extracted by three independent observers and pooled by
DerSimonian and Laird random effect model; factors influencing remission and
clinical response were explored by metaregression for aggregated data.
RESULTS: The pooled control rates of remission and response were 17% and 33%,
respectively, both with significant heterogeneity among studies (P < 0.0001). At
metaregression, the time of primary outcome evaluation was associated with
remission, whereas the trial's criteria for defining response and publication
year were predictors of response. CDAI score, CRP levels or other clinical
variables related with disease activity or concomitant medications were not
significant factors.
CONCLUSIONS: Populations used as 'add-on' treatment comparator in trials of
biological therapies for active luminal CD are poorly characterized and outcomes
are heterogeneous. Planning of future trials will require better description of
patients and concomitant therapies, blinding of outcome assessors and homogeneous
criteria of outcome definition
Clinical course of ulcerative colitis
No full text. Dig Liver Dis. 2008 Jul;40 Suppl 2:S247-52.
Clinical course of ulcerative colitis.
Cottone M, Scimeca D, Mocciaro F, Civitavecchia G, Perricone G, Orlando A.
Department of Medicine, Pneumology and Nutrition Clinic, V. Cervello Hospital,
University of Palermo, Palermo, Italy.
AIM: To provide a review of studies on prognosis in ulcerative colitis by
reviewing the relevant population-based cohort studies. On the basis of incidence
and population studies, ulcerative colitis has a favourable clinical course, with
good quality of life, a chronic course characterized by at least one relapse, and
a surgery rate of 30% after 10 years from diagnosis. Patients affected by severe
ulcerative colitis have a higher risk of colectomy, and some clinical variables
may predict the disease's clinical course. Most patients respond to steroids and
only a low percentage become dependent, or non-responders to steroids. Patients
who have a long-lasting ulcerative colitis (>10 years) or are affected by an
extensive disease have an increased risk of developing colorectal cancer, while
those treated with immunosuppressants for long period of time may have an
increased risk of developing lymphomas. Data on mortality in ulcerative colitis
patients are not homogeneous, but if a real risk exists it is in patients with
extensive or severe disease. The evidence that patients with severe ulcerative
colitis are often non-smokers may explain why in one study the mortality rate was
lower
Antibiotic treatment of Crohn's disease:results of a multicentre double blind randomized placebo controlled trial with Rifamixin
No full text1. Aliment Pharmacol Ther. 2006 Apr 15;23(8):1117-25.
Antibiotic treatment of Crohn's disease: results of a multicentre, double blind,
randomized, placebo-controlled trial with rifaximin.
Prantera C, Lochs H, Campieri M, Scribano ML, Sturniolo GC, Castiglione F,
Cottone M.
Operative Unit of Gastroenterology, St Camillo-Forlanini Hospital, Rome, Italy.
[email protected]
BACKGROUND: Clinicians often employ antibiotics in Crohn's disease. Rifaximin is
active against bacteria frequently found in the intestinal mucosa of Crohn's
disease patients.
AIM: To evaluate the difference in efficacy between once and twice/daily oral
administration of rifaximin and placebo in the treatment of active Crohn's
disease.
METHODS: We enrolled 83 patients with mild-to-moderate Crohn's disease and
randomized to three treatments for 12 weeks: Group A (rifaximin 800 mg o.d. +
placebo), Group B (rifaximin 800 mg b.d.) and Group C (placebo b.d.).
RESULTS: Clinical remission was achieved by 52% of Group B, 32% (A) and 33% (C).
Clinical response was seen in 67% (B), 48% (A) and 41% (C), without reaching a
statistically significant difference. Treatment failures were: 4% (B), 12% (A)
and 33% (C), (P = 0.010). Remission and response rates of rifaximin 800 mg b.d.
were significantly higher than those of placebo and rifaximin 800 mg o.d. in
patients with elevated C reactive protein values (P < 0.05).
CONCLUSIONS: Rifaximin 800 mg b.d. was superior to placebo in inducing clinical
remission of active Crohn's disease. Although this difference was not
statistically significant, the number of the failures in the placebo group was
significantly higher than those who received rifaximin 800 mg b.d.
PMID: 16611272 [PubMed - indexed for MEDLINE
Partecipazione pubblica e accettabilità sociale nel cambiamento del sistema energetico: un’analisi socio-psicologica
No full textInfliximab and ulcerative colitis
No full textExpert Opin Biol Ther. 2006 Apr;6(4):401-8.
Infliximab and ulcerative colitis.
Cottone M, Mocciaro F, Modesto I.
Università di Palermo, Istituto di Medicina Generale e Pneumologia, Via Trabucco
180, Palermo, Italy. [email protected]
Tumour necrosis factor (TNF)-alpha is an inflammatory cytokine that plays a main
role in the inflammatory process underlying inflammatory bowel disease (IBD).
Despite the fact that the cytokine profiles associated with ulcerative colitis
(UC) and Crohn's disease (CD) are classically considered different (a Th2 pattern
in UC and a Th1 pattern in CD), there are several evidences in vitro and in vivo
that TNF-alpha has an important role in UC. For this reason, infliximab, the
chimeric monoclonal antibody to TNF-alpha, has been evaluated in the therapy of
UC. The drug has been evaluated in different clinical settings both in adults and
in children: in moderate-severe steroid-dependent UC, in severe refractory UC as
rescue therapy, in active non-steroid-refractory UC, in resistant pouchitis and
in maintenance of moderate-severe UC responsive to infliximab. On the basis of
the randomised controlled trials (RCTs), it is possible to draw the following
conclusions for adults: infliximab seems active in severe steroid-refractory UC,
allowing colectomy to be spared even if further controlled trials are needed with
a larger sample of patients adopting strict and well-defined inclusion criteria.
The drug seems active in inducing remission after 8 weeks in steroid-refractory
patients, in patients taking steroids (even if it is not clear at which dosage of
steroid dependence the drug is more active) and also in patients failing
aminosalicylates therapy. The long-term response of infliximab in comparison to
placebo in these subgroups of patients is not clinically impressive even if it is
statistically significant. Further trials are warranted in order to establish the
role of infliximab in steroid-dependent UC (defined with clear criteria), in
maintaining remission after severe UC, in non-steroid-dependent moderate-severe
UC and in refractory pouchitis. For children it is not possible to draw the same
conclusions, due to a lack of RCTs, despite the encouraging data coming from open
studies, mainly in steroid-refractory UC.
PMID: 16548766 [PubMed - indexed for MEDLINE
Leaving home, family support and intergenerational ties in Italy: Some regional differences
No full textIn Italy conditions at leaving home are characterized by high age at exit, high proximity with parents and widespread intergenerational support, showing important regional differences. According to the "familistic" approach such conditions spread from strong intergenerational ties. Proximity and support are considered proxies of ties’ strength so that different regional proximity and support correspond to different ties’ intensities. The study aims at analyzing similarities and differences about parent-child ties, proximity and support in selected Italian regions, Liguria, Umbria, Sicily and Sardinia. Results show important differences among regions with respect to proximity and support, suggesting different intensity of intergenerational ties.family ties, intergenerational proximity, intergenerational support, regional comparison
- …
