Showing papers by "Elena Ricci published in 2013"
TL;DR: Atherosclerosis in HIV infection results from the interaction of multiple factors: an inflammatory and HIV-driven disease could prevail in the absence of therapy; metabolic, non-inflammatory causes may be more important in patients undergoing therapy.
Abstract: Objectives: HIV-infected patients have a greater burden of sub-clinical and clinical atherosclerotic disease compared to the general population. The primary objective of thisstudywastocomparetherelative rolesofinflammation,endothelialalterations,and metabolic factors in the induction and maintenance of atherosclerosis in antiretroviral therapy (ART)-treated or ART-naive patients. Design: Cross-sectional study; 79 HIV-infected patients (55 ART-treated and 24 naive individuals) were consecutively enrolled. In both groups, nearly 50% of the individuals had a high cardiovascular risk (Framingham value >20%). Methods: Echo-Doppler [intima‐media thickness (IMT)], inflammatory, thrombophilic, endothelial, metabolic indexes, and cholesterol efflux molecules were evaluated. Multivariate analysis adjusted for age, CD4 nadir, BMI, and Framingham’s score were used to analyze the results. Results: A complex pathogenesis drives atherogenesis in HIV infection. Thus, whereas inflammation could be responsible for this process in ART-naive individuals, metabolic factors [low-density lipoprotein (LDL), apolipoprotein B (ApoB), lipoprotein A] seem to play a more prevalent role in ART-treated patients. Notably, ABCA-1, an ATP-binding transporter cassette protein involved in cholesterol efflux, which is inhibited by Nef, is up-regulated in ART-treated individuals. Conclusion: Atherosclerosis in HIV infection results from the interaction of multiple factors: an inflammatory and HIV-driven disease could prevail in the absence of therapy; metabolic, non-inflammatory causes may be more important in patients undergoing therapy. Approaches to atherosclerotic disease in HIV infection should consider these differences. 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins AIDS 2013, 27:381‐389
55 citations
TL;DR: There is evidence for an association between alcohol consumption and endometriosis risk, and further studies are needed to clarify whether alcohol consumption may exacerbate an existing disease or could be related to the severity of the disease.
50 citations
TL;DR: Women with a histologically confirmed CC and PS endometrial cancer who underwent primary surgery in five institutions in Lombardy, Italy, were eligible for this study and the 5-year survival from surgery was 72.7 % and the5-year progression-free survival was 59.5 %.
Abstract: Clear cell (CC) and papillary serous carcinoma (PS) are histotypes at high risk of recurrence. We analyse patients’ survival in a retrospective series of 128 CC and PS endometrial cancer cases. All women with a histologically confirmed CC and PS endometrial cancer who underwent primary surgery in five institutions in Lombardy, Italy, were eligible for this study. A total of 77 (60.2 %) were PS endometrial cancer cases, 45 (35.2 %) CC cases and 6 (4.6 %) cases had mixed CC and PS histotype. 54 (42 %) cases were diagnosed at stage I, 10 (8 %) at stage II, 47 (37 %) at stage III and 17 (13 %) at stage IV. Recurrence was observed in 49 cases (38.3 %). The median time at recurrence was 12 months (interquartile range 7–18). The rate of recurrence was 20.3 % in cases at stage I–lI and 56.2 % in cases at stage III–IV (p < 0.0001). With regard to the site of recurrence 24 recurrences were in and 52 outside the pelvis. Finally, the rate of recurrence was 32.6 % (14 cases) in CC cases, 43.1 % (31 cases) in PS cases and 66.7 % (4 cases) in cases with mixed histotype. The 5-year progression-free survival was 59.5 % (67.4 % for CC cases, 55.1 % for PS and mixed cases). In this study including CC and PS endometrial cancers, the 5-year survival from surgery was 72.7 % and the 5-year progression-free survival was 59.5 %.
22 citations
TL;DR: With the innovative addition of an evaluation of CKD events, the model showed a cost-utility value advantage for twice-daily LPV/r over once-daily ATV+r, thus providing evidence for its continued use in the treatment of HIV.
Abstract: There is an error in Table 6. The vales in line 5 "Total cost (€)" should be listed in thousands, not millions. Please view the correct table here: http://plosone.org/corrections/pone.0057777.t006.cn.tif
17 citations
TL;DR: In Lombardy, the PH ratio increased between 1996 and 2010, and in this population, rising frequency of CS and older maternal age may explain this trend.
Abstract: To analyze the temporal trends of peripartum hysterectomy (PH) in the period 1996–2010 in Lombardy, Italy. Using data from the Regional Database, PH ratios/1,000 deliveries were calculated from 1996 to 2010, in strata of age and mode of delivery among women resident in Lombardy, Italy. PH cases were identified searching the database for the ICD-9 and ICD-10 codes for subtotal and total hysterectomy. PH ratios/1,000 deliveries in strata of age, mode of delivery and calendar year were computed. Poisson’s regression analysis was used to test trend over time. A total of 905 PH and 1,289,163 deliveries were recorded between 1996 and 2010. The overall PH ratio was 0.70/1,000 deliveries. The PH ratio/1,000 deliveries increased over time, being 0.57 in 1996 and 0.88/1,000 deliveries in 2010 (P < 0.0001). After including calendar year, mode of delivery and maternal age in the Poisson’s regression equation, no significant linear trend emerged in the PH ratio over time (P = 0.28). Women who underwent cesarean section (CS) (CS vs. vaginal delivery: OR 5.66, 95 % CI 4.91–6.54) and older women were at increased risk of PH (maternal age ≥40 vs. <30 years: OR 5.66, 95 % CI 4.48–7.15). The frequency of intractable peripartum hemorrhage and placenta praevia/accreta, the main indications for PH, significantly increased over the study period. In Lombardy, the PH ratio increased between 1996 and 2010. In our population, rising frequency of CS and older maternal age may explain this trend.
17 citations
TL;DR: In this article, the authors evaluated safety and durability of once-daily and twice-daily darunavir/ritonavir (DRV/r)-based treatment in HIV patients in clinical practice.
15 citations
TL;DR: The age-adjusted EP rate and ratio increased between 1996 and 2010, suggesting that the significance of EP as a public health problem has increased in the last years.
Abstract: Background: In recent years, epidemiological data showed that the incidence of ectopic pregnancies (EP) is decreasing, but few data are available on the time trend in Southern European populations. Methods: Using data from the Lombardy Region Database, we calculated and standardized the EP rates/10,000 resident women and the ratios/1,000 pregnancies. Results: Data regarding 1,777,011 pregnancies and 17,028 cases of EP were recorded among women resident in Lombardy between 1996 and 2010, aged 15-50 years old. The age-adjusted EP rates increased from 4.4 in 1996 to 5.8 in 2010. The age-adjusted EP ratio was 9.4/1,000 pregnancies in 1996 and 9.8 in 2010. Medical treatment increased over the period; the proportion of laparoscopic treatment increased from 25.9% in 1996 to 36.3% in 2010. Conclusion: The age-adjusted EP rate and ratio increased between 1996 and 2010, suggesting that the significance of EP as a public health problem has increased in the last years.
7 citations
TL;DR: There was no difference between groups in terms of total withdrawal, treatment discontinuation was more likely due to therapeutic failure in N RTI-sparing regimen, and NRTI- Sparing regimens should be evaluated in a prospective randomized trial.
Abstract: Despite the relative lack of data, nucleoside/nucleotide reverse transcriptase inhibitor (NRTI)-sparing regimens are increasingly prescribed in clinical practice in treatment-experienced HIV-1 infected patients. We aimed to assess the frequency of NRTI-sparing regimens among these subjects, and to evaluate and compare their safety and tolerability. Patients were included if enrolled in the currently ongoing cohorts (raltegravir and darunavir) of the Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) Project. The duration of treatment with antiretroviral therapy was evaluated using the Kaplan-Meier curve and NRTI-sparing and NRTI-based regimens were compared using the log-rank test. From 2006 to 2011, 689 experienced patients were analyzed, of whom 210 (30.5%) were on NRTI-sparing regimens. Patients on NRTI-sparing regimens were older (p=0.004) and had higher median CD4+ cell counts (p=0.002) than patients on NRTI-based regimens. The most frequent combination regimens were raltegravir plus darunavir/ritonavir (n=65; 30.95%) among patients on NRTI-sparing regimen and tenofovir DF/emtricitabine plus darunavir/ritonavir in the NRTI-containing group (n=102; 21.3%). There was no difference between groups in terms of total withdrawal, treatment discontinuation was more likely due to therapeutic failure in NRTI-sparing regimen. NRTI-sparing regimens should be evaluated in a prospective randomized trial.
6 citations
TL;DR: The overall teenage pregnancy rate has risen in Lombardy and the number of non-native Italian adolescent girls markedly increased over the last two decades, their group – with decreasing, but still higher, birth- and abortion rates – has caused the observed rise in those rates.
Abstract: Objectives Data from southern European countries concerning teenage pregnancy have not been properly analysed so far. We provide the temporal trend of adolescent pregnancy rates in Lombardy, Northern Italy.Methods Using the hospital discharge register (1996–2010), teenage pregnancy-related admission rates per 1000 girls aged 13 to 19 years, residing in Lombardy, were computed. Miscarriage-, induced abortion-, and delivery ratios/100 pregnancies, and caesarean section ratio/100 deliveries, were calculated.Results The pregnancy rate increased from 9.07 in 1996–2000 to 10.20 in 2001–2005, and remained at that level (10.27) in 2006–2010. However, the rates by country of birth (native Italian and non-native Italian) showed a steady decline in 2003–2010, when data about residents in Lombardy, categorised by sex, age and country of birth, were available. The induced abortion rate rose from 5.38/1000 to 5.55/1000, then decreased slightly in 2006–2010. The abortion ratio/100 pregnancies diminished from 59....
2 citations