Dr. Riccardo Pampena

Dr. Riccardo Pampena

Dr. Riccardo Pampena

Dr. Riccardo Pampena
Skin Cancer Unit of the Arcispedale Santa Maria Nuova of Reggio Emilia, Italia

Pediatric melanoma: a systematic review and individual patient meta-analysis
Author: Riccardo Pampena

The clinical and dermoscopic features of the vast majority of uncommon variants of cutaneous melanoma have been rarely reported, leading to difficulty in making accurate diagnoses.
We conducted A 2-step systematic review of the literature was performed (from inception to November 2018) using PubMed, Embase, and Cochrane Central Register of Controlled Trials databases. The first step identified those uncommon variants of melanoma for which at least 1 case reporting dermoscopy was described in the literature. In the second step, each previously identified uncommon variant was searched for in the same databases.
In total, 62 articles met the inclusion criteria, reporting 433 melanoma cases. An additional 56 cases of uncommon melanoma variants were retrieved from the institution’s database for a total of 489 cases: 283 cases of amelanotic superficial spreading melanoma, 18 cases of animal-type and pigmented epithelioid melanocytoma, 7 cases of balloon cell melanoma, 71 cases of desmoplastic melanoma, 3 cases of follicular melanoma, 10 cases of nested melanoma, 33 cases of nevoid melanoma, 2 cases of primary dermal melanoma, 57 cases of spitzoid melanoma, and 5 cases of verrucous melanoma. Clinically, these tumors were mainly palpable or amelanotic lesions that could resemble other benign or malignant skin conditions; dermoscopy typically revealed a homogeneous pinkish background, white structures, and polymorphic vessels. Uncommon melanoma variants may resemble both inflammatory disorders and other cutaneous neoplasms, representing a diagnostic pitfall even for the most experienced dermatologist.

Scurt CV

Dr. Riccardo Pampena is a board-certified Dermatologist specialized in the diagnosis and treatment of skin cancers.
He obtained his degree in Surgery and Medicine (MD) from the Medicine University of the Sacred Heart of Rome in 2011 with full mark; then, he trained and became a board Certified Dermatologist (full mark) of the Department of Dermatology and Venereology of the Sapienza University of Rome, in 2016 defending a thesis on the role of Dermoscopy in predicting the efficacy of ingenol mebutate therapy for actinic keratosis.
Since 2011 he practices research mainly in the field of psoriasis and non-invasive diagnosis in dermato-oncology, paying particular attention to the study of melanoma and pigmented skin lesions by means of non-invasive methods, such as dermoscopy and confocal microscopy for the in vivo and ex vivo study of cytological and architectural aspects of pigmented skin lesions, in correlation with histopathology.
Since November 2016, Dr. Pampena has been working at the Skin Cancer Unit of the Arcispedale Santa Maria Nuova of Reggio Emilia, which is a third-level referral center for skin tumors diagnosis and management and recently became a Board Member of the International Dermoscopy Society. The collaboration of Dr. Pampena with the Skin Cancer Unit of Reggio Emilia started in January 2015 with a 2-month fellowship performed during his residency in Dermatology and Venereology.
Furthermore, he’s actively involved, as a researcher and statistician, in scientific studies. He also attended specific courses in Biostatistics and Cochrane Systematic Reviews and Meta-analysis.

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Conf. Dr. Endres Laura

Conf. Dr. Endres Laura

Conf. Dr. Endres Laura

Conf. Dr. Laura Endres
Universitatea din Oradea, Facultatea de Medicină și Farmacie, România

Dermatita atopica de la diagnostic la un tratament de calitate – Prezentare de caz
Autor: Conf. Univ. Dr. Laura Endres

Facultatea de Medicină și Farmacie, Universitatea din Oradea

Dermatita atopică a adultului reprezintă în continuare o problemă de interes major pentru dermatologi, fiind de multe ori neglijată sau ignorată de alte specialitati. Conform criteriilor actuale de diagnostic Hanifin & Rajika, dermatita atopică este o boală foarte frecvent întâlnită în ultimii ani dar nediagnosticată.
Prezentam cazul unui barbat 44 ani mediu urban, fara antecedente patologice semnificative, care se prezintă în martie 2020 cu : leziuni lichenificate, cruste, leziuni postgrataj ( axile, plica cotului), veziculizație, zemuire, cruste, descuamare mâini bilateral; cheilită angulară; papule, cruste, eritem gambe bilateral, prurit generalizat, insomnii severe apărute de aproximativ 2 ani și investigate de diverse specialități medicale (medicină internă, alergologie, gastroenterologie, chiurgie generală șamd). Pacientul iși administreaza zilnic Medrol de 8mg sau de 16 mg pentru prurit, cu ameliorare de scurta durata, insotit de alcool. De asemenea pacientul pezinta anxietate, depresie severa și o stare generală ușor influențată.
Tratamentul DA este unul complex și de multe ori cu rezultate minime, recăderile fiind frecvente. Terapiile biologice au o eficacitate și siguranță bună în studiile desfășurate până în prezent, venind in completarea tratamentelor actuale, iar beneficiile administrarii lor arată imbunatatirea simptomelor si calitatii vietii pacientilor la care acestea s-a administrat.

Atopic dermatitis from diagnosis to quality treatment – Case presentation

Author: Associate Professor Dr. Laura Endres

Adult atopic dermatitis is still a major concern for dermatologists, often being overlooked or ignored by other specialities. According to current Hanifin & Rajika diagnostic criteria, atopic dermatitis is a very common disease in recent years but it is undiagnosed.
We present the case of a 44-year old man, with no significant pathological history, who presented in March 2020 with : lichenified lesions, crusts, post-scratch lesions (armpits, elbow fold), blistering, crusts, bilateral hand descuamation; angular cheilitis; papules, crusts, leg erythema, generalized pruritus, severe insomnia occurred about 2 years ago and investigated by various medical specialities (internal medicine, allergology, gastroenterology, general surgery, etc.). The patient takes 8 mg or 16 mg of Medrol daily for pruritus, with short-term relief, accompanied by alcohol. The patient also experienced anxiety, severe depression, and slightly affected general condition.
The treatment of DA is complex and often with minimal results, having frequent relapses. Biological terapies have a good efficiency and they proved to be safe in studies conducted so far, complementing current treatments, the benefits of their administration improve the symptoms and quality of life for the patients.

Scurt CV

Conferențiar universitar, CoordonatorDisciplina Dermatologie, Universitatea din Oradea, Facultatea de Medicina si Farmacie.
Medic primar dermatovenerolog, Spital Clinic Pelican Oradea; înființarea și organizarea secției și ambulatorului de Dermatologie a Spitalului Clinic Pelican Oradea din anul 2010.
Licențiată a doua facultăți : Medicină Generală (1999) si Farmacie (2006).
Atestat de Lector în cadrul programului de studii complementare în dermatocosmetologie.
Membru in societati stiintifice internationale și naționale: Societatea Româna de Dermatologie(SRD); Asociația Dermatologilor Transilvani ; Asociația Dermatologilor Români de Sud-Vest; Societatea Româna de Medicina Estetica (SRME); Societatea de Dermato-Oncologie (SRDO); Societatea Româna de Dermato-Patologie (SRDPAT); European Academy of Dermatology and Venereology(EADV); International Dermoscopy Society (IDS); Societatea Româna de Biochimie.
Autor și coautor: 14 articole în extenso în reviste cotate ISI Thomson Reuters, 15 articole în extenso BDI și recunoscute CNCSIS categoria B+, 64 articole publicate in extenso in reviste de specialitate sau la coferinte nationale (indice Hirsh 6). Peste 100 de participări la congrese, simpozioane, master class, workshopuri de pregatire în vederea îmbunătățirii și perfecționării continue a activității didactice și medicale.
Premii UEFISCDI: 3 premii 2018-2020 (articole Q1 5,583 – Journal of Clinical Medicine ; Q1 5,589 – Science of the Total Environment; Q2 4,936 – Oxidative Medicine and Cellular Longevity).
Domenii de interes: oncologie dermatologică, depistarea precoce a neoplaziilor cutanate, studiul patogenezei melanomului, dermatoscopie, prevenția bolilor dermatologice, îmbunătățirea calității vieții la pacienții cu afecțiuni dermatologice cronice, dermatocosmetologie, dematologie estetică, dermatopediatrie, laser vascular; abordări noi ale metodelor analitice în identificarea și determinarea unor substanțe farmaceutice și fitochimice, cercetări farmacologice asupra unor substanțe farmaceutice și fitochimice.

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Prof. Dr. Ancuța Codrina

Prof. Dr. Ancuța Codrina

Prof. Dr. Ancuța Codrina

Prof. Dr. Ancuța Codrina
Universitatea de Medicină și Farmacie “Grigore T. Popa” Iași

Simpozion NOVARTIS

Cosentyx – It’s all about the patient
 Moderator
Prof Univ Dr Daciana Elena Brănișteanu
Lectori
Prof Univ Dr Codrina Ancuța
Dr Georgiana Mihăilă

Boala psoriazică este o afecțiune sistemică inflamatorie, mediată imun, progresivă, care afectează întreg organismul, trecând dincolo de piele. Pentru pacienții cu boală psoriazică, pielea este doar unul dintre aspectele bolii.

Pacienții își doresc un tratament cu eficiență dovedită și profil favorabil de siguranță, care să țintească toate manifestările bolii psoriazice:
-Vindecarea leziunilor cutanate
-Remisiunea susținută a artritei psoriazice
-Tratamentul complet al tuturor manifestarilor bolii, inclusiv al formelor „dificil de tratat”
-Controlul comorbidităților prezente și prevenirea aparitiei altor comorbidități
-Îmbunătățirea calității vieții , atât fizic cât și psihic
Îndeplinirea acestor deziderate presupune diagnosticul, și implicit, tratamentul precoce al bolii.

Date din literatura de specialitate relevă că, în medie, există o întârziere a diagnosticului de psoriazis de aproximativ 2,6 ani de la debutul bolii, în timp ce pentru diagnosticul de artrită psoriazică această întârziere este în medie de 1,8 ani de la debutul simptomelor.

Cu atât mai importantă devine cunoașterea de către pacient a semnelor și simptomelor bolii psoriazice încă din stadiul inițial.

Un studiu recent derulat a scos în evidență faptul că numeroși pacienți cu boală psoriazică nu realizează complexitatea acestei afecțiuni și nici relația între diferitele manifestări ale bolii și comorbiditățile asociate.

Din același studiu reiese că, în ceea ce privește calitatea vieții, 73% dintre pacienți raportează un impact moderat până la foarte mare sau extrem de mare al bolii psoriazice.

Tratamentul eficient și complet al manifestărilor multiple ale bolii psoriazice este esențial pentru îmbunătățirea calității vieții pacienților.

Utilizat la nivel mondial la peste 500.000 pacienți, în indicațiile aprobate, și fără evidențierea de noi semnale privind siguranța de-a lungul a 5 ani, Cosentyx asigură tratamentul complet pentru boala psoriazică.

Începând din timp tratamentul bolii psoriazice și țintind direct cauza bolii, inflamația sistemică, cu Cosentyx, obținem în timp scurt o eficacitate înaltă care este susținută pe termen lung, nu doar la nivelul pieli, dar și la nivel articular, în condițiile unui profil de siguranță favorabil și menținut în timp.

Scurt CV

Profesor universitar, Disciplina Reumatologie, Recuperare, Medicina Fizica si Balneologie, Universitatea de Medicina si Farmacie “Grigore T. Popa” Iasi.
Medic primar reumatologie si reabilitare, sef clinica Reumatologie 2, Spitalul Clinic Recuperare Iasi
Coordonator Centru EUSTAR 162, afiliat retelei EUSTAR (European Scleroderma Trials and Research Group),
Coordonator Centru Capilaroscopie – Network of imaging training center 2016-2021 (EULAR)
Training in capilaroscopie (Paris, Franta 2004), ecografie musculoscheletala (Paris, Franta, 2004; Barcelona, Spania, 2008); osteodensitometrie DXA (Bucuresti, Romania, 2006).
Membru in societati stiintifice internationale: EUSTAR, IASP (International Association for the Study of Pain) si Special Interest Group Musculoskeletal Pain, SLEuro (European Lupus Society)
Domenii de interes: terapia biologica in patologia reumatismala imun mediata, orphan disease (Sclerodermia sistemica, miopatii inflamatorii idiopatice), sarcina si patologia reumatismala imun mediata

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Prof. Dr. Nicolaides Andrew

Prof. Dr. Nicolaides Andrew

Prof. Dr. Nicolaides Andrew

COVID-19: Pathophysiology, Adverse Vascular Effects and Venous Thromboembolism
Autor: Andrew Nicolaides

The SARS-CoV-2 genome encodes approximately 25 proteins needed by the virus to infect humans and to replicate. It enters the human cell via the ACE2-receptor which is expressed on vascular endothelium, respiratory epithelium, alveolar monocytes, macrophages, heart, kidney and GI tract.
Initially, it was considered as an infective-inflammatory disease producing pneumonia, acute respiratory distress syndrome (ARDS), sepsis and eventually multiorgan failure. It was soon realised that it also produces cardiovascular thrombotic events: Deep vein thrombosis (DVT) and pulmonary embolism (PE), arterial thrombosis (stroke and limb gangrene), myocardial infarction, liver and renal failure.
The virus produces direct damage to the vascular endothelium and activates coagulation.
In addition, there is viral inhibition of haem and iron metabolism by binding to the beta chains of the haemoglobin. Circulating free haemoglobin released from red cells impairs NO bioavailability.
Studies from China have reported 20-40% incidence of venous thromboembolism (VTE) in ICU in the absence of pharmacological prophylaxis. In European studies, the incidence of VTE is approximately 30% despite pharmacological prophylaxis. The incidence of VTE is higher in ITU (45%) than in the ward (3%).
Routine CT pulmonary angiography performed in 137 patients (in 63 outpatients to differentiate between pneumonia and PE and in 72 patients in hospital because of worsening symptoms) demonstrated a PE incidence of 24%.
It is well established that in ICU ventilated patients there is a reduced venous blood flow (stasis). This is in addition to activated coagulation and venous endothelial damage. Thus, the whole of Virchow’s triad is involved and may explain why LMWH is relatively ineffective.
The pleiotropic effect by the virus suggests that therapy with medications having a pleiotropic effect is needed such as unfractionated heparin that binds on many proteins and sulodexide which protects the endothelium) in combination with intermittent pneumatic compression that increases venous blood velocity.
A trial of combined methods is urgently required.

Scurt CV

Professor Andrew Nicolaides is a graduate of the Pancyprian Gymnasium (Nicosia) and Guy’s Hospital Medical School (London University 1962), and a fellow of the Royal College of Surgeons England, and the Royal College of Surgeons Edinburgh (1967).
His higher surgical training was in Oxford University, Kings College Hospital Medical School and St Mary’s Hospital Medical School, London. He was awarded the Jacksonian prize by the Royal College of Surgeons England in 1972 for his work on the prevention of venous thromboembolism and obtained the degree of M.S. (Master of Surgery) in 1976.
He was the Professor of Vascular Surgery at the Imperial College School of Medicine (St Mary’s Hospital) and Consultant Vascular Surgeon at St Mary’s Hospital from 1983–2000 and Medical Director of the Cyprus Institute of Neurology and Genetics from 2001-2004. His research group is known internationally in several areas which include noninvasive vascular screening and diagnostic investigation, early detection and prevention of cardiovascular and venous disease. His research is now directed towards the genetic risk factors for cardiovascular disease, identification of individuals at risk and the development of effective methods of prevention, especially stroke.
He is Past-President of the International Union of Angiology and Past-President of the Section of Measurement in Medicine of the Royal Society of Medicine.
He has received many awards and honorary memberships from many scientific societies. He is Editor-in-Chief of International Angiology and is on the Editorial Board of many vascular journals. He is Professor Emeritus at Imperial College and an examiner for MS and PhD degrees for London University. He is currently the Chairman of the Board of European Venous Forum and Foundation. He is Chairman of the Cyprus Cardiovascular Disease Educational and Research Trust (CCDERT) and Medical Director of the Vascular Screening and Diagnostic Centre in London and in Cyprus. He is Honorary Professor of Surgery at the University of Nicosia Medical School and President of the newly formed Cyprus Atherosclerosis Society. He has trained over 200 vascular surgeons who are practicing all over the world; fifteen of them are holding prestigious Chairs as professors in vascular surgery.
He is co-author of over 900 original papers and editor of 14 books.

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Prof. Dr. Popescu Iulia

Prof. Dr. Popescu Iulia

Prof. Dr. Popescu Iulia

Prof. Univ. Dr. Iulia Popescu
Allergy and Critical Care Division, Department Medicine, University of Pittsburgh, Pittsburgh, PA

Infliximab therapies targeting TNF- may be beneficial of CD4+ T cell dysfunction in severe COVID-19

Author: Iulia Popescu

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine; Pittsburgh, PA, 15213, USA

Rationale: Lymphopenia is common in severe COVID-19 disease, yet the immune mechanisms are poorly understood. As inflammatory cytokines are increased in severe SARS-CoV-2 infection, we hypothesized a role in contributing to reduced T-cell numbers. Objectives: We sought to characterize the functional SARS-CoV-2 T-cell responses in severe versus recovered, mild COVID-19 patients to determine whether differences were detectable. Methods: Using flow cytometry and single cell RNA sequence analyses we assessed SARS-CoV-2-specific responses in our cohort. Measurements/Main Results: Here we show it is associated with worse survival and is CD4+ T-cell predominant. We further demonstrate that Spike-1(S1) induces high levels of in vitro TNF- in CD4+ T-cells from severe COVID-19 patients but demonstrate impaired T-cell proliferation and increased susceptibility to activation-induced cell death (AICD). In 148 patients with severe COVID-19, we found lymphopenia was associated with worse survival. CD4+ lymphopenia predominated, with lower CD4+/CD8+ ratios in severe COVID-19 compared to patients with mild disease (p<0.0001). In severe disease, immunodominant CD4+ T-cell responses to Spike-1(S1) produced increased in vitro TNF-, but demonstrated impaired S1-specific proliferation and increased susceptibility to activation-induced cell-death (AICD) following antigen exposure. CD4+TNF-+ T-cell responses inversely correlated with absolute CD4+ counts from severe COVID-19 patients (n=76; R=-0.797, P<0.0001). In vitro TNF- blockade including infliximab or anti-TNFRI antibodies strikingly rescued S1-specific CD4+ T-cell proliferation and abrogated S1-specific AICD in PBMC from severe COVID-19 patients (P<0.001). Single-cell RNAseq demonstrated downregulation of Type-1 cytokines and NFB signaling in S1-stimulated CD4+ cells with infliximab treatment. We also evaluated bronchoalveolar lavage (BAL) and lung explant CD4+ T-cells recovered from severe COVID-19 patients and observed that lung T-cells produced higher TNF- compared to PBMC.
Conclusions: Together, our findings show CD4+ dysfunction in severe COVID-19 is TNF-/TNFRI-dependent through immune mechanisms that may contribute to lymphopenia. TNF- blockade may be beneficial in severe COVID-19.

Short CV

I am a Associate Professor in the Division of Pulmonary, Allergy, and Critical Care Medicine at the University of Pittsburgh in Dr. John McDyer’s laboratory. I have significant experience in transplant and viral immunology. My work has focused on T cell mechanisms of rejection, tolerance, and host immunity to viruses such as CMV, EBV and HIV, including the measurement of lung mucosal responses. I have focused on CMV-specific T cell immunity in lung transplant recipients in a leading clinical transplant program. I am CO-I on a U01 award (AI125050-Dr. McDyer) to perform a novel clinical trial to perform tandem lung and bone marrow transplantation in select individuals with primary immunodeficiencies and end-stage lung disease, and to perform mechanistic pathogen-specific and alloimmune tolerance studies in these study participants. In U01AI125050 I measure systemic and lung pathogen-specific immune responses. As immunologist my focuses are on mechanisms of CMV-specific lung mucosal/systemic immunity and viral control, demonstrating an important role for the Type-1 transcription factor T-bet and other immune parameters. I also study immune mechanisms of allograft rejection/tolerance in lung transplantation with an established divisional research group performing studies in the human studies. I also perform work on Dr. McDyer and Dr. Kirks’ collaborative U01 award (HL121814) to study immune mechanisms of HIV-associated COPD. I am the Co-I on an R01 award HL133184-01 (Dr. McDyer), “Role of F-box Proteins in Lung Transplantation.” In addition, common to these experimental systems above, Dr. McDyer’s laboratory is highly proficient in measuring lung mucosal and systemic viral-specific and allospecific multifunctional T cell immunity and phenotyping in lung transplant recipients. I have a good track record of training medical students and fellows and junior faculty in Dr. McDyer’s lab. the field of lung transplant immunology. Pertinent to this proposal I also have significant experience assessing human alloimmunity, using flow cytometry, in addition to viral immunity, and evaluate the phenotype of T cells, proliferation and effector multifunction. In addition, I am very experienced in ELISA and ELISPOT assays to measure inflammatory responses. Recently, we showed that IPF lung transplant recipients with short telomeres have impaired CMV T cell immunity. Here at Pitt, Dr. Alder, Dr. Snyder, Dr. Chen, Dr. Iasella and Dr. Popescu have a track record of working closely together. Therefore, based on my established and current role in Dr. McDyer’s laboratory and my expertise in transplant immunology in the field of lung transplantation makes me well-suited to fulfill my role as Co-I on this project R01 project, “The Role of Telomeres in Lung Transplant Recipient Immunity and Outcomes”.

Positions and Employment
2020-pres. Research Associate Professor, Pulmonary, Allergy and Critical Care Division, Department Medicine, University of Pittsburgh, Pittsburgh, PA
2014-2020 Research Assistant Professor, Pulmonary, Allergy and Critical Care Division, Department Medicine, University of Pittsburgh, Pittsburgh, PA
2019-pres. Member – International Society of Heart and Lung Transplantation
2012-2014 Research Associate/Manager Flow Cytometry Core, Pulmonary, Allergy and Critical Care Division, Department Medicine, University of Pittsburgh, Pittsburgh, PA
2010-2011 Senior Scientist/Technical Application Specialist, Cellular Technology Limited, Shaker Heights, OH
2006-2010 Faculty Research Instructor, Dept of Surgery Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA
2006-pres. Member – American Society of Transplantation (AST)
2007-pres. Member – American Immunology Association (AIA)
2001-2006 Postdoctoral Research Associate, Dept of Surgery Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA
2000-2001 Research Scientist, Dept. of Cellular Immunology and Signal Transduction, Center of Immunology, Institute of Virology Bucharest, Romania
1997- 2000 Junior Research Scientist, Department Clinical Immunology, Center for Immunology, Bucharest, Romania
1998-pres. Member – European Association for Cancer Research (EACR)
1997 3 months Visiting Research PhD, Doctoral Scientist, Cancer Institute, University of Pittsburgh, Pittsburgh, PA.
1994-1997 Research Associate – Dept. of Cellular Immunology and Signal Transduction, Center of Immunology, Institute of Virology, Bucharest, Romania
1991-1994 Resident Scientist- Department Clinical Immunology, Center for Immunology, Bucharest, Romania
1986-1991 Research Assistant, Department of Interferon Research / Immune-modulators, V. Babes Institute, Bucharest, Romania
1990-pres. Member – Federation of European Biochemical Societies (FEBS)
1986-pres. Member – Romanian Society of Immunology (SNI)
Memberships
Member – American Society of Transplantation (AST) 2006-present
Member – American Immunology Association (AIA) 2007-present
Member – European Association for Cancer Research (EACR) 1998-present
Member – Federation of European Biochemical Societies (FEBS) 1990-present
Member – Romanian Society of Immunology (SNI) 1986-present
Member – International Society of Heart and Lung Transplantation 2019-present

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