University of Milan

About: University of Milan is a education organization based out in Milan, Italy. It is known for research contribution in the topics: Population & Transplantation. The organization has 58413 authors who have published 139784 publications receiving 4636354 citations. The organization is also known as: Università degli Studi di Milano & Statale.

Neuroendocrine Control of Growth Hormone Secretion

Abstract: The secretion of growth hormone (GH) is regulated through a complex neuroendocrine control system, especially by the functional interplay of two hypothalamic hypophysiotropic hormones, GH-releasing hormone (GHRH) and somatostatin (SS), exerting stimulatory and inhibitory influences, respectively, on the somatotrope. The two hypothalamic neurohormones are subject to modulation by a host of neurotransmitters, especially the noradrenergic and cholinergic ones and other hypothalamic neuropeptides, and are the final mediators of metabolic, endocrine, neural, and immune influences for the secretion of GH. Since the identification of the GHRH peptide, recombinant DNA procedures have been used to characterize the corresponding cDNA and to clone GHRH receptor isoforms in rodent and human pituitaries. Parallel to research into the effects of SS and its analogs on endocrine and exocrine secretions, investigations into their mechanism of action have led to the discovery of five separate SS receptor genes encoding a f...

2010 International consensus algorithm for the diagnosis, therapy and management of hereditary angioedema

Abstract: C1 inhibitor deficiency (hereditary angioedema [HAE]) is a rare disorder for which there is a lack of consensus concerning diagnosis, therapy, and management, particularly in Canada. European initiatives have driven the approach to managing HAE with 3 C1-INH Deficiency Workshops held every 2 years in Hungary starting in 1999, with the third Workshop having recently been held in May 2003. The European Contact Board has established a European HAE Registry that will hopefully advance our knowledge of this disorder. The Canadian Hereditary Angioedema Society/Societe d'Angioedeme Hereditaire du Canada organized a Canadian International Consensus Conference held in Toronto, Ontario, Canada, on October 24 to 26, 2003, to foster consensus between major European and North American HAE treatment centers. Papers were presented by investigators from Europe and North America, and this consensus algorithm approach was discussed. There is a paucity of double-blind placebo-controlled trials in the treatment of HAE, making levels of evidence to support the algorithm less than optimal. Enclosed is the consensus algorithm approach recommended for the diagnosis, therapy, and management of HAE and agreed to by the authors of this article. This document is only a consensus algorithm approach and requires validation. As such, participants agreed to make this a living 2003 algorithm (ie, a work in progress) and agreed to review its content at future international HAE meetings. The consensus, however, has strength in that it was arrived at by the meeting of patient-care providers along with patient group representatives and individual patients reviewing information available to date and reaching agreement on how to approach the diagnosis, therapy, and management of HAE circa 2003. Hopefully evidence to support approaches to the management of HAE will approach the level of meta-analysis of randomized controlled trials in the near future.

Insights into the reasons for discontinuation of the first highly active antiretroviral therapy (HAART) regimen in a cohort of antiretroviral naïve patients.

Abstract: Objective: To evaluate the frequency of discontinuation of the first highly active antiretroviral regimen (HAART) and the factors predictive of discontinuing for toxicity and failure in a population-based cohort of HIV-positive individuals in Italy, naive from antiretrovirals at enrolmentMethods: The study population consisted of individuals who initiated HAART and had at least one follow-up visit The primary end-points were discontinuation of any component of HAART for drug toxicity and discontinuation for failure Survival analyses were performed to identify predictive factors for reaching the two end pointsResults: Eight hundred and sixty-two individuals initialed HAART; in 727 of them (843%) this consisted of two nucleoside reverse transcriptase inhibitors (NRTI) and one protease inhibitor (PI) Over a median follow-up of 45 weeks, 312 patients (362%) discontinued therapy: 182 (211%) discontinued due to toxicity, 44 (51%) due to failure The probability of discontinuing HAART at 1 year was 255% [95% confidence interval (Cl), 219-289] due to toxicity and 76% (95% Cl, 49-103) due to failure Independent factors associated with discontinuation for toxicity were: gender [relative hazard (RH) = 051; 95% Cl, 032-080 for men versus women], type of treatment (indinavir-containing regimens, RH = 194; 95% Cl, 110-341 and ritonavir-containing regimens, RH = 383; 95% Cl, 209-703 versus hard-gell saquinavir) and time spent on treatment (RH = 089; 95% Cl, 080-098 for each additional month) Discontinuation due to failure was independently associated with the most recent HIV-RNA (RH = 320; 959/0 Cl, 174-588 for log(10) copies/ml higher), and with type of treatment (indinavir-containing regimens, RH = 021; 95% Cl, 006-078 and ritonavir-containing regimens, RH = 023; 95% Cl, 004-126 Versus hard-gell saquinavir)Conclusions: If the current HAART regimen caused no toxicity, less than 10% of naive patients discontinue their first HAART regimen because of failure after 1 year from starting therapy (C) 2000 Lippincatt Williams & Wilkins

The Yin-Yang of tumor-associated macrophages in neoplastic progression and immune surveillance.

Abstract: An intrinsic (oncogene-driven) pathway and an extrinsic (microenvironment-driven) pathway connect inflammatory reactions and cancer. M2-polarized tumor-associated macrophages and the related myeloid-derived suppressor cells are key prototypic components of smoldering inflammation driving neoplastic progression. However, mononuclear phagocytes can exert anti-tumor activity by killing tumor cells and eliciting tissue disruptive reactions (M1), a likely scenario in the early phases of carcinogenesis of immunogenic tumors and following therapeutic intervention. Shifting the macrophage balance represents a viable therapeutic target. Herein, the 'macrophage balance' is discussed in the context of the apparent paradox of tumor promotion by innate immunity-driven inflammation and the seemingly opposed tumor surveillance by adaptive immune responses.