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  1. Article: Innovative Combinations, Cellular Therapies and Bispecific Antibodies for Chronic Lymphocytic Leukemia: A Narrative Review.

    Visentin, Andrea / Frazzetto, Sara / Trentin, Livio / Chiarenza, Annalisa

    Cancers

    2024  Volume 16, Issue 7

    Abstract: In the last few years, several agents targeting molecules that sustain the survival and the proliferation of chronic lymphocytic leukemia (CLL) cells have become clinically available. Most of these drugs target surface proteins, such as CD19 or CD20, via ...

    Abstract In the last few years, several agents targeting molecules that sustain the survival and the proliferation of chronic lymphocytic leukemia (CLL) cells have become clinically available. Most of these drugs target surface proteins, such as CD19 or CD20, via monoclonal or bispecific monoclonal antibodies (BsAbs), CAR T cells, intracellular proteins like BTK by using covalent or non-covalent inhibitors or BCL2 with first or second generation BH3-mimetics. Since the management of CLL is evolving quickly, in this review we highlighted the most important innovative treatments including novel double and triple combination therapies, CAR T cells and BsAbs for CLL. Recently, a large number of studies on novel combinations and newer strategic options for CLL therapy have been published or presented at international conferences, which were summarized and linked together. Although the management of treatment with a single continuous agent is easier, the emergence of protein mutations, long-term toxicities and costs are important concerns that favor the use of a fixed duration therapy. In the future, a measurable residual disease (MRD)-guided treatment cessation and MRD-based re-initiation of targeted therapy seems to be a more feasible approach, allowing identification of the patients who might benefit from continuous therapy or who might need a consolidation with BsAbs or CAR T cells to clear the neoplastic clone.
    Language English
    Publishing date 2024-03-26
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers16071290
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Controls and therapy tests of some cases of cutaneous tuberculosis with rabies vaccine.

    CHIARENZA, A

    Il Dermosifilografo

    2014  Volume 24, Issue 11, Page(s) 456–478

    Title translation Controlli e saggi di terapia di alcuni casi di tubercolosi cutanea con vaccino antirabbico.
    MeSH term(s) Humans ; Rabies ; Rabies Vaccines ; Skin
    Chemical Substances Rabies Vaccines
    Language Italian
    Publishing date 2014-01-04
    Publishing country Italy
    Document type Journal Article
    ISSN 0366-886X
    ISSN 0366-886X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Baseline IgM Amounts Can Identify Patients with Poor Outcomes: Results from a Real-Life Single-Center Study on Classical Hodgkin Lymphoma.

    Duminuco, Andrea / Santuccio, Gabriella / Chiarenza, Annalisa / Figuera, Amalia / Motta, Giovanna / Caruso, Anastasia Laura / Petronaci, Alessandro / Ippolito, Massimo / Cerchione, Claudio / Di Raimondo, Francesco / Romano, Alessandra

    Cancers

    2024  Volume 16, Issue 4

    Abstract: Hodgkin Lymphoma (HL) is characterized by an inflammatory background in which the reactive myeloid cells may exert an immune-suppressive effect related to the progression of the disease. Immunoglobulin M is the first antibody isotype produced during an ... ...

    Abstract Hodgkin Lymphoma (HL) is characterized by an inflammatory background in which the reactive myeloid cells may exert an immune-suppressive effect related to the progression of the disease. Immunoglobulin M is the first antibody isotype produced during an immune response, which also plays an immunoregulatory role. Therefore, we investigated if, as a surrogate of defective B cell function, it could have any clinical impact on prognosis. In this retrospective, observational, single-center study, we evaluated 212 newly diagnosed HL patients, including 132 advanced-stage. A 50 mg/dL level of IgM at baseline resulted in 84.1% sensitivity and 45.5% specificity for predicting a complete response in the whole cohort (area under curve (AUC) = 0.62,
    Language English
    Publishing date 2024-02-18
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers16040826
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Health records for migrants and refugees: A systematic review.

    Chiesa, Valentina / Chiarenza, Antonio / Mosca, Davide / Rechel, Bernd

    Health policy (Amsterdam, Netherlands)

    2019  Volume 123, Issue 9, Page(s) 888–900

    Abstract: Introduction: One of the challenges facing migrants and refugees is access to medical records. The aim of this study was to identify Health Records (HRs) developed specifically for migrants and refugees, describe their characteristics, and discuss their ...

    Abstract Introduction: One of the challenges facing migrants and refugees is access to medical records. The aim of this study was to identify Health Records (HRs) developed specifically for migrants and refugees, describe their characteristics, and discuss their reported strengths and weaknesses.
    Materials and methods: A systematic review of articles focusing on HRs implemented exclusively for migrants and refugees was undertaken. Publications were identified by searching the scientific databases Embase, Medline, Scopus and Cochrane, the grey literature and by checking the reference lists of articles.
    Results: The literature search yielded an initial list of 1432 records, with 58 articles remaining after screening of title and abstract. Following full-text screening, 33 articles were retained. Among the 33 articles reviewed, 20 different HRs were identified.
    Discussion: Our findings suggest that HRs, especially electronic ones, might be efficient and effective tools for registering, monitoring and improving the health of migrants and refugees. However, some of the evidence base is narrative or institutional and needs to be backed up by scientific studies.
    Conclusions: Health records, implemented specifically for migrants and refugees, seem to have the potential to address some of the challenges that they face in accessing health care, in particular in strategic hotspots, cross-border settings and for migrants on the move.
    MeSH term(s) Electronic Health Records ; Emigrants and Immigrants ; Humans ; Medical Records ; Refugees
    Language English
    Publishing date 2019-07-30
    Publishing country Ireland
    Document type Journal Article ; Systematic Review
    ZDB-ID 605805-x
    ISSN 1872-6054 ; 0168-8510
    ISSN (online) 1872-6054
    ISSN 0168-8510
    DOI 10.1016/j.healthpol.2019.07.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Monocyte-to-platelets ratio (MPR) at diagnosis is associated with inferior progression-free survival in patients with mantle cell lymphoma: a multi-center real-life survey.

    Duminuco, Andrea / Romano, Alessandra / Ferrarini, Isacco / Santuccio, Gabriella / Chiarenza, Annalisa / Figuera, Amalia / Caruso, Laura Anastasia / Motta, Giovanna / Palumbo, Giuseppe Alberto / Mogno, Carlo / Moioli, Alessia / Di Raimondo, Francesco / Visco, Carlo

    Annals of hematology

    2024  

    Abstract: Mantle cell lymphoma (MCL) pathogenesis is strongly related to the role of the tumor immune microenvironment (TIME) in which MCL cells proliferate. TIME cells can produce growth signals influencing MCL cells' survival and exert an antitumoral immune ... ...

    Abstract Mantle cell lymphoma (MCL) pathogenesis is strongly related to the role of the tumor immune microenvironment (TIME) in which MCL cells proliferate. TIME cells can produce growth signals influencing MCL cells' survival and exert an antitumoral immune response suppression. The activity of TIME cells might be mirrored by some ratios of peripheral blood cell subpopulations, such as the monocyte-to-platelet ratio (MPR). We reviewed the clinical features of 165 consecutive MCL patients newly diagnosed and not eligible for autologous stem cell transplantation (both for age or comorbidities) who accessed two Italian Centers between 2006 and 2020. MPR was calculated using data obtained from the complete blood cell count at diagnosis before any cytotoxic treatment and correlated with PFS. Univariate analysis showed that MPR ≥ 3 was associated with inferior PFS (p = 0.02). Multivariate analysis confirmed that MPR ≥ 3, LDH > 2.5 ULN, and bone marrow involvement were significant independent variables in predicting PFS. For these reasons, MPR ≥ 3 seems the most promising prognostic factor in patients with MCL, and it could be considered a variable in new predictive models.
    Language English
    Publishing date 2024-04-17
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1064950-5
    ISSN 1432-0584 ; 0939-5555 ; 0945-8077
    ISSN (online) 1432-0584
    ISSN 0939-5555 ; 0945-8077
    DOI 10.1007/s00277-024-05752-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Migration, ethnicity, racism and the COVID-19 pandemic: A conference marking the launch of a new Global Society.

    Gruer, Laurence / Agyemang, Charles / Bhopal, Raj / Chiarenza, Antonio / Krasnik, Allan / Kumar, Bernadette

    Public health in practice (Oxford, England)

    2021  Volume 2, Page(s) 100088

    Abstract: The inaugural conference of the Global Society on Migration, Ethnicity, Race and Health COVID-19 examined the impact of the COVID-19 pandemic on migrants and ethnic minorities and the role of racism. Migrants everywhere have faced tightening immigration ... ...

    Abstract The inaugural conference of the Global Society on Migration, Ethnicity, Race and Health COVID-19 examined the impact of the COVID-19 pandemic on migrants and ethnic minorities and the role of racism. Migrants everywhere have faced tightening immigration restrictions, more obstacles to healthcare, increased racism and worsening poverty. Higher COVID-19 mortality rates have been otbserved in ethnic/racial minorities in the United Kingdom and the United States. Structural racism has been implicated, operating, for example, through more crowded living conditions and higher-risk occupations. In Brazil, good data are lacking but a seroprevalence survey suggested higher rates of infection among ethnic minorities and slum dwellers. Considerable disruption of services for migrants at the border with Venezuela have occurred. National policy responses to protect vulnerable groups have been lacking. In Australia, with strict COVID-19 control metrtrun 0asures and inclusive policies, there have been few cases and deaths reported in Indigenous communities so far. In most countries, the lack of COVID-19 data by ethnic/racial group or migrant status should be addressed. Otherwise, racism and consequent inequalities will go undetected.
    Language English
    Publishing date 2021-02-10
    Publishing country England
    Document type Journal Article
    ISSN 2666-5352
    ISSN (online) 2666-5352
    DOI 10.1016/j.puhip.2021.100088
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Previous therapy with immune checkpoint inhibitor as a cause of hypothyroidism, myositis, and renal insufficiency in a candidate for allogeneic hematopoietic transplantation.

    Duminuco, Andrea / Cupri, Alessandra / Milone, Giulio A / Marcantoni, Carmelita / Leotta, Salvatore / Esposito, Benedetta / Garibaldi, Bruno / Chiarenza, Annalisa / Milone, Giuseppe

    Transplant immunology

    2022  Volume 75, Page(s) 101705

    Abstract: Treatment of neoplastic diseases resistant to conventional chemotherapies is still an open challenge. The increasing development of chemical molecules or monoclonal antibodies able to recognize precise molecular targets of cancer disease has played an ... ...

    Abstract Treatment of neoplastic diseases resistant to conventional chemotherapies is still an open challenge. The increasing development of chemical molecules or monoclonal antibodies able to recognize precise molecular targets of cancer disease has played an increasingly important role in treating patients suffering from solid or hematological tumors, and constitutes the basis of so-called 'targeted therapy'. Immunotherapy has become a cornerstone for treating refractory or relapsed cancer disease patients after standard chemotherapies. Immune checkpoint (including PD-1) inhibitors are essential drugs that significantly improve the therapeutic possibilities for neoplastic patients. Still, foreseeable or unpredictable adverse effects can potentially arise during or after the end of therapy. Specifically, toxicity involving several organs is capable of delaying or preventing the continuation of programmed treatment, as described in this case, where we will discuss the possibility of toxicity affecting various organs (kidney, muscle tissue, and thyroid) attributed to nivolumab and which resulted in temporary ineligibility for allogeneic transplantation.
    MeSH term(s) Humans ; Immune Checkpoint Inhibitors ; Programmed Cell Death 1 Receptor ; Hodgkin Disease/drug therapy ; Hodgkin Disease/pathology ; Transplantation, Homologous ; Hematopoietic Stem Cell Transplantation ; Myositis/drug therapy ; Renal Insufficiency/drug therapy ; Hypothyroidism/drug therapy
    Chemical Substances Immune Checkpoint Inhibitors ; Programmed Cell Death 1 Receptor
    Language English
    Publishing date 2022-08-30
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 1160846-8
    ISSN 1878-5492 ; 0966-3274
    ISSN (online) 1878-5492
    ISSN 0966-3274
    DOI 10.1016/j.trim.2022.101705
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Safety of fexofenadine and other second-generation oral antihistamines before and after the removal of the prescription requirement in Italy and other European countries: A real-world evidence study and systematic

    Carnovale, Carla / Battini, Vera / Gringeri, Michele / Volonté, Marina / Uboldi, Maria Chiara / Chiarenza, Andrea / Passalacqua, Giovanni

    The World Allergy Organization journal

    2022  Volume 15, Issue 7, Page(s) 100658

    Abstract: Background: The change from prescription to over-the-counter (OTC) status of oral antihistamines may raise concerns about drug safety due to the possibility of misuse/abuse. In most European countries, oral antihistamines are available without ... ...

    Abstract Background: The change from prescription to over-the-counter (OTC) status of oral antihistamines may raise concerns about drug safety due to the possibility of misuse/abuse. In most European countries, oral antihistamines are available without prescription, whereas in Italy, only <10-tablet packs are available OTC.
    Objectives: To evaluate the safety profile of fexofenadine after OTC switch in Italy in a real-world setting, and to compare its safety profile to that of other European countries where larger pack sizes are available. To compare the safety of fexofenadine, cetirizine, and loratadine in Italy. To examine safety/efficacy across Europe with a systematic review.
    Methods: This case-by-case analysis used the US Food and Drug Administration (FDA) adverse event reporting system (FAERS) to extract data of the adverse events (AEs) related to fexofenadine, loratadine and cetirizine in Italy January 2010-June 2020. The year 2016 was taken as the index date (removal of prescription requirement) for evaluation of the reporting trend of AEs of fexofenadine in Italy and make a comparison pre/post-OTC switch. A comparison of AEs with other European countries where fexofenadine is sold OTC in large packs >20 tablets (Belgium, Portugal, Switzerland, Finland, Hungary) was made. The rate at which an AE related to oral antihistamines occurred was estimated by calculation of the reporting rate (number of cases/[defined daily dose/1000 inhabitants per day]) on the basis of IQVIA sales data using the Italian Institute of Statistics database. A systematic review of the literature was also performed.
    Results: There were 3760 reports of AEs with a suspected association with fexofenadine; of these, eight were reported from Italy. There was a slightly increasing trend per year, in line with a general reporting trend of other drugs. In European countries where fexofenadine is available, the impact of OTC switch on AE reporting activity was negligible: from 2016, the reporting rate increased slightly and then normalized at 3.01, an incidence value similar to that recorded before the OTC switch (3.7 in 2015). Of 22 studies included in the systematic review, 18 (82%) positively evaluated the OTC use of oral antihistamines, confirming an acceptable safety/tolerability profile.
    Conclusion: There was no difference in number of AEs reported for fexofenadine pre/post-OTC switch, indicating a similar safety profile. Spontaneous reporting systems are a valuable source of real-world data and support the OTC provision of oral antihistamines in Europe and fexofenadine in Italy, in addition to supporting the use of larger pack sizes in Italy.
    Language English
    Publishing date 2022-07-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2581968-9
    ISSN 1939-4551
    ISSN 1939-4551
    DOI 10.1016/j.waojou.2022.100658
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Supporting access to healthcare for refugees and migrants in European countries under particular migratory pressure.

    Chiarenza, Antonio / Dauvrin, Marie / Chiesa, Valentina / Baatout, Sonia / Verrept, Hans

    BMC health services research

    2019  Volume 19, Issue 1, Page(s) 513

    Abstract: Background: In 2015 the increased migratory pressure in Europe posed additional challenges for healthcare providers. The aim of this study was to inform the development of a "Resource Package" to support European Union (EU) member states in improving ... ...

    Abstract Background: In 2015 the increased migratory pressure in Europe posed additional challenges for healthcare providers. The aim of this study was to inform the development of a "Resource Package" to support European Union (EU) member states in improving access to healthcare for refugees, asylum seekers and other migrants.
    Methods: A mixed method approach was adopted: i) interviews and focus groups were carried out to gather up-to-date information on the challenges the different healthcare providers were facing related to the refugee crisis; ii) to complement the results of the FGs, a literature review was conducted to collect available evidence on barriers and solutions related to access to healthcare for refugees and migrants.
    Results: The different actors providing healthcare for refugees and migrants faced challenges related to the phases of the migration trajectory: arrival, transit and destination. These challenges impacted on the accessibility of healthcare services due to legislative, financial and administrative barriers; lack of interpretation and cultural mediation services; lack of reliable information on the illness and health history of migrant patients; lack of knowledge of entitlements and available services; lack of organisation and coordination between services. These barriers proved particularly problematic for access to specific services: mental health, sexual and reproductive care, child & adolescent care and victim of violence care.
    Conclusions: The findings of this study show that solutions that are aimed only at responding to emergencies often lead to fragmented and chaotic interventions, devolving attention from the need to develop structural changes in the EU health systems.
    MeSH term(s) Adolescent ; Adult ; Europe ; Female ; Focus Groups ; Health Personnel ; Health Services Accessibility/organization & administration ; Humans ; Interviews as Topic ; Middle Aged ; Qualitative Research ; Refugees ; Transients and Migrants ; Young Adult
    Language English
    Publishing date 2019-07-23
    Publishing country England
    Document type Journal Article
    ISSN 1472-6963
    ISSN (online) 1472-6963
    DOI 10.1186/s12913-019-4353-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Coinvolgere i clinici per identificare e dare priorità alle opportunità di disinvestimento nel trattamento delle malattie neurodegenerative: uno studio qualitativo.

    Ciannameo, Anna / Chiarenza, Antonio / Filippini, Graziella / D'Amico, Roberto / Grilli, Roberto

    Recenti progressi in medicina

    2020  Volume 111, Issue 9, Page(s) 503–514

    Abstract: Introduction: The overuse of health care interventions is a problem which has clinical and economic implications. On a clinical level this means that ineffective interventions or effective interventions in inappropriate clinical indications are used. On ...

    Title translation Engaging clinicians to identify and prioritize disinvestment opportunities in the treatment of neurodegenerative diseases: a qualitative study.
    Abstract Introduction: The overuse of health care interventions is a problem which has clinical and economic implications. On a clinical level this means that ineffective interventions or effective interventions in inappropriate clinical indications are used. On an economic level it refers to allocative inefficiency which implies that these resources could possibly be used for interventions of major clinical utility. The contribution of health professionals in the context of reallocation disinvestment policies is still little investigated. This study involved 25 neurologists in the process of identifying low value interventions in the management of stroke, dementia, Parkinson's disease, amyotrophic lateral sclerosis and multiple sclerosis.
    Methods: The Nominal Group Technique was applied in the context of 5 Focus Groups (FG) in order to reach a consensus to identify and prioritize disinvestment opportunities in the treatment of the 5 neurodegenerative diseases. Qualitative data were coded, categorised, and analysed, applying the six-phase approach to thematic analysis, with the support of Atlas Ti7.
    Results: Within 5 categories of "low value intervention", 25 clinical interventions were identified: 6 pharmacological, 16 diagnostic, 3 clinical-therapeutic. FG findings describe: how clinicians view the issue of disinvestment, both in absolute and relative terms; the factors which contribute to the use of low-value interventions; the explicit link between the disinvestment process and the reallocation of resources.
    Discussion: This study revealed that factors that hinder the disinvestment of inappropriate practices involve elements that are not only technical or clinical, but also relational and care-related contexts.
    MeSH term(s) Delivery of Health Care ; Humans ; Neurodegenerative Diseases/diagnosis ; Neurodegenerative Diseases/therapy ; Qualitative Research
    Language Italian
    Publishing date 2020-09-11
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 138266-4
    ISSN 2038-1840 ; 0034-1193
    ISSN (online) 2038-1840
    ISSN 0034-1193
    DOI 10.1701/3421.34063
    Database MEDical Literature Analysis and Retrieval System OnLINE

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