Valeria Ramundo
University of Naples Federico II
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Featured researches published by Valeria Ramundo.
Thyroid | 2009
Stefano Spiezia; Roberto Garberoglio; Francesco Milone; Valeria Ramundo; Corrado Caiazzo; Angelo Pio Assanti; Maurilio Deandrea; Paolo Limone; Paolo Emidio Macchia; Gaetano Lombardi; Annamaria Colao; Antongiulio Faggiano
BACKGROUND Percutaneous radiofrequency thermal ablation (RTA) is a promising new therapeutic approach to manage thyroid nodules (TNs). The aim of this study was to investigate the long-term effectiveness of RTA in inducing shrinkage of TNs as well as in controlling compressive symptoms and thyroid hyperfunction in a large series of elderly subjects with solid or mainly solid benign TNs. METHODS Ninety-four elderly patients with cytologically benign compressive TNs were prospectively enrolled in the study; 66 of them had nontoxic goiter and 28 had toxic or pretoxic goiter. RTA was performed by using a RITA StarBurst Talon hook-umbrella needle inserted in every single TN under ultrasonographic real-time guidance. TN volume, TN-related compressive symptoms and thyroid function were evaluated at baseline and 12 to 24 months after RTA. RESULTS All TNs significantly decreased in size after RTA. The mean decrease in TN volume 12 months after RTA was from 24.5 +/- 2.1 to 7.5 +/- 1.2 mL (p < 0.001), with a mean percent decrease of 78.6 +/- 2.0%. Two years after RTA, a 79.4 +/- 2.5% decrease of TNs size was observed. Compressive symptoms improved in all patients and completely disappeared in 83 of 94 (88%) patients. Hyperthyroidism resolved in most patients allowing methimazole therapy to be completely withdrawn in 79% of patients with pretoxic and toxic TNs (100% with pretoxic TNs and 53% with toxic TNs). The treatment was well tolerated by all patients. No patient needed hospitalization after RTA and no major complications were observed. CONCLUSIONS RTA is an effective and simple procedure for obtaining lasting shrinkage of TNs, controlling compressive symptoms, and treating thyroid hyperfunction. When performed in experienced medical centers, RTA may be a valid alternative to conventional treatments for nontoxic and pretoxic TNs. It is particularly attractive for elderly people for whom surgery and radioiodine therapy are often contraindicated or ineffective.
The Journal of Clinical Endocrinology and Metabolism | 2012
Antongiulio Faggiano; Valeria Ramundo; Angelo Pio Assanti; Francesco Fonderico; Paolo Emidio Macchia; C. Misso; Francesca Marciello; Vincenzo Marotta; M. Del Prete; Enrico Papini; Gaetano Lombardi; A. Colao; Stefano Spiezia
PURPOSE Percutaneous radiofrequency thermal ablation (RTA) was reported as an effective tool for the management of thyroid nodules (TNs). The aim of this study was to investigate the effects of RTA and to establish whether they were treatment-related by comparison with a matched, untreated control group. PATIENTS AND METHODS The study population included 40 patients with compressive TNs: 22 had nontoxic TNs, and 18 had toxic TNs and were treated with methimazole. In all patients, a fine-needle aspiration cytology was performed to exclude a thyroid malignancy. STUDY DESIGN Twenty patients were treated with RTA (group A), and 20 others did not receive any treatment (group B). At baseline, age, gender, and TN features did not differ significantly between groups. All patients were clinically, biochemically, and morphologically evaluated at baseline and after 1, 3, 6, and 12 months. RESULTS TN volume significantly decreased in group A (1.8 ± 0.3 ml at 12 months vs. 13.3 ± 1.8 ml at baseline; P < 0.0001) and remained stable in group B [11.7 ± 1.5 ml at 12 months vs. 11.2 ± 1.5 ml at baseline; P = not significant (NS)]. At 3-, 6-, and 12-month evaluations, TN volume was significantly lower in group A than in group B (P < 0.005). At the end of the follow-up, pressure symptoms were improved in all patients in group A but persisted unchanged in group B. In group A, hyperthyroidism completely recovered in 40% and improved in 40% of patients with toxic TNs, whereas it persisted in all patients with toxic TNs in group B. RTA was safe and well tolerated in all patients. CONCLUSIONS RTA induced a marked TN volume shrinkage resulting in parallel improvement of pressure symptoms. In most patients with toxic TNs, hyperthyroidism significantly improved as well. RTA may represent a valid therapeutic approach in patients with TNs not receiving conventional treatments.
Clinical Endocrinology | 2013
Vincenzo Marotta; Valeria Ramundo; Luigi Camera; Michela Del Prete; Rosa Fonti; Raffaella Esposito; Giovannella Palmieri; Marco Salvatore; Mario Vitale; Annamaria Colao; Antongiulio Faggiano
Radioactive iodine is a crucial tool for treatment of differentiated thyroid cancer (DTC). In 5% of cases, DTCs lose I‐131 avidity and assume an aggressive behaviour. Treatment options for iodine‐refractory DTC are limited. We report the experience of off‐label use of the tyrosine kinase inhibitor sorafenib for treatment of advanced iodine‐refractory DTC.
Journal of Cellular and Molecular Medicine | 2012
Antongiulio Faggiano; Valeria Ramundo; A. Dicitore; S. Castiglioni; M. O. Borghi; R. Severino; Piero Ferolla; Lucio Crinò; Alberto Abbruzzese; P. Sperlongano; Michele Caraglia; Diego Ferone; Leo J. Hofland; A. Colao; Giovanni Vitale
Everolimus, an mTOR inhibitor, which has been demonstrated to induce anti‐tumour effects in different types of neuroendocrine tumours, has never been evaluated in patients with medullary thyroid cancer (MTC). The aim of this study was to evaluate the in vitro and in vivo effects of everolimus in combination with octreotide in MTC. Two patients with progressive metastatic MTC and high calcitonin levels were treated with everolimus 5–10 mg/day. Both patients were under treatment with octreotide LAR at the study entry. An in vitro study was also performed to assess everolimus effects on MTC cell lines (TT and MZ‐CRC‐1 cells). A tumour response was observed in both patients. Serum calcitonin decreased by 86% in patient 1 and by 42% in patient 2. In TT and MZ‐CRC‐1 cells, everolimus induced a significant dose‐dependent inhibition in cell proliferation. This effect seems to be related to a cell cycle arrest in G0/G1 phase in both cell lines and to the induction of cellular senescence in TT cells. Everolimus in combination with octreotide may be active as anti‐tumour therapy in patients with progressive metastatic MTC, suggesting to further evaluate this agent in MTC patients in a large prospective study.
Journal of the American Geriatrics Society | 2007
Stefano Spiezia; Roberto Garberoglio; Carolina Di Somma; Maurilio Deandrea; Edoardo Basso; Paolo Limone; Francesco Milone; Valeria Ramundo; Paolo Emidio Macchia; Bernadette Biondi; Gaetano Lombardi; Annamaria Colao; Antongiulio Faggiano
1. Castellanos A, Interian A, Myerburg RJ. The resting electrocardiogram. In Fuster V, Alexander RW, O’Rourke RA, eds. Hurst’s The Heart [on-line], 11th Ed. Available at www.accessmedicine.com Accessed March 8, 2007. 2. Bathia L, Turner DR. Parkinson’s tremor mimicking ventricular tachycardia. Age Ageing 2005;34:410–411. 3. Samaniego NC, Morris F, Brady WJ. Electrocardiographic artefact mimicking arrhythmic change on the ECG. Emerg Med J 2003;20:356–357. 4. Chase C, Brady WJ. Artifactual electrocardiographic change mimicking clinical abnormality on the ECG. Am J Emerg Med 2000;18:312–316. 5. Llinas R, Henderson GV. Tremor as a cause of pseudo-ventricular tachycardia. N Engl J Med 1999;341:1275. 6. Knight BP, Pelosi F, Michaud GF et al. Clinical consequences of electrocardiographic artifact mimicking ventricular tachycardia. N Engl J Med 1999; 341:1270–1274. 7. Huang CY, Shan DE, Lai CH et al. An accurate electrocardiographic algorithm for differentiation of tremor-induced pseudo-ventricular tachycardia and true ventricular tachycardia. Int J Cardiol 2006;111:163–165. 8. Freedman B. Tremor-induced ECG artifact mimicking ventricular tachycardia. Circulation 2001;103:E111–E112. 9. Michaels AD, Frances CD. Tremor on the electrocardiogram. Circulation 1998;98:184–185. 10. Finsterer J, Stollberger C, Gatterer E. Oral anticoagulation for ECG tremor artifact simulating atrial fibrillation. Acta Cardiol 2003;58:425–429.
Journal of Endocrinological Investigation | 2011
Piero Ferolla; Antongiulio Faggiano; Franco Grimaldi; Diego Ferone; G. Scarpelli; Valeria Ramundo; R. Severino; M. C. Bellucci; Luigi Camera; Gaetano Lombardi; Gabriella Angeletti; A. Colao
Background: In patients with well-differentiated (WD) neuroendocrine tumors (NET), long-acting octreotide (LAR), conventionally administered at a dose of 30 mg every 28 days, has well-documented anti-secretive but limited antiproliferative effects. Aim: The objective of this study was to evaluate a different schedule of LAR treatment consistent with a shorter interval between administrations (21 days) in WD-NET patients with progressive disease at standard-dose interval. Subjects and methods: Twenty-eight patients followed for diagnosis and therapy of WDNET who had tumor progression during therapy with LAR 30 mg every 28 days were enrolled. Clinical, biological, and objective tumor response was evaluated after LAR 30 mg every 21 days. Time to progression was also evaluated after LAR 30 mg every 21 days and compared to LAR 30 mg every 28 days. Results: The treatment with LAR 30 mg every 21 days resulted in complete and partial control of clinical symptoms in 40% and 60% of cases, respectively. Circulating neuroendocrine markers were significantly decreased in 30% of cases. A stabilization of disease was obtained in 93% and objective response in 7%. The median time to progression was significantly longer by using the shortened interval of LAR administration as compared to the standard one (30 vs 9 months, p<0.0001). The treatment was safe and well tolerated. Conclusions: The shortened schedule of LAR administration was able to re-institute control of clinical symptoms, to decrease level of circulating neuroendocrine markers and to increase time to progression in patients previously escaping from a standard schedule treatment.
Biomarkers | 2012
Vincenzo Marotta; Vincenzo Nuzzo; Teresa Ferrara; Alfonso Zuccoli; Milena Masone; Lorenzo Nocerino; Michela Del Prete; Francesca Marciello; Valeria Ramundo; Gaetano Lombardi; Mario Vitale; Annamaria Colao; Antongiulio Faggiano
Context: Usefulness of circulating Chromogranin A (CgA) for the diagnosis of neuroendocrine tumors (NEN) is controversial. The aim of the present study was to assess the actual role of this marker as diagnostic tool. Methods: Serum blood samples were obtained from 42 subjects affected with NEN, 120 subjects affected with non-endocrine neoplasias (non-NEN) and 100 non-neoplastic subjects affected with benign nodular goitre (NNG). Determination of CgA was performed by means of immunoradiometric assay. Results: The CgA levels among NEN-patients were not significantly different from NNG and non-NEN subjects. The Receiver operating characteristic (ROC) curves analysis failed to identify a feasible cut-off value for the differential diagnosis between NEN and the other conditions. Conclusion: Serum CgA is not helpful for the first-line diagnosis of NEN.
Journal of Experimental & Clinical Cancer Research | 2014
Michela Del Prete; Francesco Fiore; Roberta Modica; Vincenzo Marotta; Francesca Marciello; Valeria Ramundo; Antonella Di Sarno; Annachiara Carratù; Chiara de Luca di Roseto; Salvatore Tafuto; Fabiana Tatangelo; Robero Baldelli; Annamaria Colao; Antongiulio Faggiano
Liver metastases occur in 46-93% of patients with neuroendocrine neoplasms (NENs). Presence and extension of liver metastases are considered important prognostic factors, as they may significantly impair the patient’s quality of life, because of either tumor bulk or hormonal hypersecretion. Therapies for NEN liver metastases include surgical resection, liver transplantation, chemotherapy and biotherapy. Surgery is the gold standard for curative therapy, but in most of NEN patients with liver metastases, when surgery can not be applied, minimally invasive therapeutic approaches are adopted. They include trans-arterial embolization (TAE), trans-arterial chemoembolization (TACE), radiofrequency thermal ablation and new emerging techniques.TAE is based on selective infusion of particles in the branch of the hepatic artery supplying the tumor lesions. The goal of TAE is to occlude tumor blood vessels resulting in ischemia and necrosis. Many reports have shown that TAE can reduce tumor size and hormone output, resulting in palliation of symptoms without the use of cytotoxic drugs, resulting in better tolerability. This review will focus on TAE performance and safety in NEN patients with liver metastases.
Clinical Endocrinology | 2008
Antongiulio Faggiano; Lidice Tavares; Libuse Tauchmanovà; Francesco Milone; Gelsomina Mansueto; Valeria Ramundo; Marialaura Del Basso De Caro; Gaetano Lombardi; Gaetano De Rosa; Annamaria Colao
Background In patients with multiple endocrine neoplasia type 1 (MEN1), expression of somatostatin receptor (SST) in parathyroid adenomas and effectiveness of therapy with somatostatin analogues on primary hyperparathyroidism (PHP) have been scarcely investigated.
Clinical Endocrinology | 2014
Valeria Ramundo; M. Del Prete; Vincenzo Marotta; Francesca Marciello; Luigi Camera; V. Napolitano; L. De Luca; Luisa Circelli; Vittorio Colantuoni; A. Di Sarno; Annachiara Carratù; C. de Luca di Roseto; A. Colao; Antongiulio Faggiano
Somatostatin analogues (SSA) represent one of the main therapeutic option in patients affected with functioning well‐differentiated neuroendocrine tumours (NETs). There are no studies specifically focusing on NETs associated with Multiple Endocrine Neoplasia type 1 (MEN1).