1
|
Coperchini F, Greco A, Rotondi M. Changing the structure of PFOA and PFOS: a chemical industry strategy or a solution to avoid thyroid-disrupting effects? J Endocrinol Invest 2024:10.1007/s40618-024-02339-w. [PMID: 38522066 DOI: 10.1007/s40618-024-02339-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/12/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND The family of perfluoroalkyl and polyfluoroalkyl substances (PFAS) raised concern for their proven bioaccumulation and persistence in the environment and animals as well as for their hazardous health effects. As a result, new congeners of PFAS have rapidly replaced the so-called "old long-chain PFAS" (mainly PFOA and PFOS), currently out-of-law and banned by most countries. These compounds derive from the original structure of "old long-chain PFAS", by cutting or making little conformational changes to their structure, thus obtaining new molecules with similar industrial applications. The new congeners were designed to obtain "safer" compounds. Indeed, old-long-chain PFAS were reported to exert thyroid disruptive effects in vitro, and in vivo in animals and humans. However, shreds of evidence accumulated so far indicate that the "restyling" of the old PFAS leads to the production of compounds, not only functionally similar to the previous ones but also potentially not free of adverse health effects and bioaccumulation. Studies aimed at characterizing the effects of new-PFAS congeners on thyroid function indicate that some of these new-PFAS congeners showed similar effects. PURPOSE The present review is aimed at providing an overview of recent data regarding the effects of novel PFAS alternatives on thyroid function. RESULTS AND CONCLUSIONS An extensive review of current legislation and of the shreds of evidence obtained from in vitro and in vivo studies evaluating the effects of the exposure to novel PFOA and PFOS alternatives, as well as of PFAS mixture on thyroid function will be provided.
Collapse
Affiliation(s)
- F Coperchini
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, Italy
| | - A Greco
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, Italy
| | - M Rotondi
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, Italy.
- Laboratory for Endocrine Disruptors, Unit of Endocrinology and Metabolism, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, Italy.
| |
Collapse
|
2
|
Messineo D, Massaro F, Izzo P, Milani A, Polimeni R, Iannella G, Marinozzi S, Consorti F, Cocuzza S, Maniaci A, Mucchino A, Nannarelli M, Greco A, Magliulo G, Salducci M, Pace A. Radiomic Application for Head and Neck Squamocellular Tumor: Systematic Review. Clin Ter 2024; 175:153-160. [PMID: 38571474 DOI: 10.7417/ct.2024.5048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Abstract Radiomics represents the convergence of artificial intelligence and radiological data analysis, primarily applied in the diagnosis and treatment of cancer. In the head and neck region, squamous cell carcinoma is the most prevalent type of tumor. Recent radiomics research has revealed that specific bio-imaging characteristics correlate with various molecular features of Head and Neck Squamous Cell Carcinoma (HNSCC), particularly Human Papillomavirus (HPV). These tumors typically present a unique phenotype, often affecting younger patients, and show a favorable response to radiation therapy. This study provides a systematic review of the literature, summarizing the application of radiomics in the head and neck region. It offers a comprehensive analysis of radiomics-based studies on HNSCC, evaluating its potential for tumor evaluation, risk stratification, and outcome prediction in head and neck cancer treatment.
Collapse
Affiliation(s)
- D Messineo
- Radiological, Oncological and Anatomo-Pathological Sciences Department, Sapienza University of Rome, Rome, Italy
| | - F Massaro
- Radiological, Oncological and Anatomo-Pathological Sciences Department, Sapienza University of Rome, Rome, Italy
| | - P Izzo
- Pietro Valdoni" Surgery Department I, Sapienza University of Rome, Rome, Italy
| | - A Milani
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - R Polimeni
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - G Iannella
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - S Marinozzi
- Department of Molecular Medicine, Unit of History of Medicine and Bioethics, Sapienza University of Rome, Rome, Italy
| | - F Consorti
- Scienze Chirurgiche Department, Sapienza University of Rome, Rome, Italy
| | - S Cocuzza
- Otorinolaringoiatria Department, University of Catania, Catania, Italy
| | - A Maniaci
- Otorinolaringoiatria Department, University of Catania, Catania, Italy
| | - A Mucchino
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - M Nannarelli
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - A Greco
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - G Magliulo
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - M Salducci
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - A Pace
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
- Department of Molecular Medicine, Unit of History of Medicine and Bioethics, Sapienza University of Rome, Rome, Italy
- Scienze Chirurgiche Department, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
3
|
Grossini E, De Zanet D, Apostolo D, Mallela VR, La Rocca G, Greco A, Coratza G, Minisini R, Pirisi M. rs1801253 Gly/Gly carriage in the ADRB1 gene leads to unbalanced cardiac sympathetic modulation as assessed by spectral analysis of heart rate variability. Clin Auton Res 2024; 34:205-208. [PMID: 38032435 DOI: 10.1007/s10286-023-01001-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/04/2023] [Indexed: 12/01/2023]
Affiliation(s)
- E Grossini
- Laboratory of Physiology, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy.
| | - D De Zanet
- Laboratory of Physiology, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - D Apostolo
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - V R Mallela
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - G La Rocca
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - A Greco
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - G Coratza
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - R Minisini
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - M Pirisi
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| |
Collapse
|
4
|
Ghio S, Badagliacca R, Acquaro M, Filomena D, Recchioni T, Papa S, Colombo D, Ditali V, Carrozzi C, Greco A, Turco A, Breviario F, Benza R, Vizza D, Scelsi L. Prognostic value of deep echocardiographic phenotyping in pulmonary arterial hypertension. ERJ Open Res 2024; 10:00587-2023. [PMID: 38196894 PMCID: PMC10772897 DOI: 10.1183/23120541.00587-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/22/2023] [Indexed: 01/11/2024] Open
Abstract
Background A novel approach to derive prognostic information from echocardiography in pulmonary arterial hypertension (PAH) is to define a phenotype of right heart function combining standard echocardiographic parameters which describe right ventricular pump function and systemic venous congestion. We tested the hypothesis that the combination of advanced strain imaging parameters could yield high prognostic accuracy. Methods This was a prospective observational study with a single centre derivation cohort and a second centre validation cohort. The derivation cohort included 49 naive PAH patients who underwent right heart catheterisation and echocardiographic evaluation at baseline and 4-12 months after diagnosis. The validation cohort included 83 prevalent PAH patients who underwent the same examinations at 12 months after diagnosis. We stratified the risk of the derivation cohort according to three models: Model 1, based on haemodynamic parameters; Model 2, based on standard echocardiographic parameters; and Model 3, based on advanced echocardiographic parameters. The median follow-up period was 21 months; the end point of the analysis was clinical worsening. Results In the derivation cohort, haemodynamic and echocardiographic parameters obtained at diagnosis were not associated with outcome, whereas a significant association was observed at first reassessment. Model 3 yielded a better predictive accuracy (Harrell's C index 0.832) as compared to Model 2 (Harrell's C index 0.667), and to Model 1 (Harrell's C index 0.713). The validation cohort confirmed the accuracy of Model 3. Conclusions A comprehensive assessment of right heart function using right ventricular strain, right atrial reservoir strain and degree of tricuspid regurgitation provides accurate prognostic information in prevalent PAH patients.
Collapse
Affiliation(s)
- Stefano Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- These authors contributed equally
| | - Roberto Badagliacca
- Department of Clinical, Anesthesiological and Cardiovascular Sciences, I School of Medicine, Sapienza University of Rome, Rome, Italy
- These authors contributed equally
| | - Mauro Acquaro
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- These authors contributed equally
| | - Domenico Filomena
- Department of Clinical, Anesthesiological and Cardiovascular Sciences, I School of Medicine, Sapienza University of Rome, Rome, Italy
| | - Tommaso Recchioni
- Department of Clinical, Anesthesiological and Cardiovascular Sciences, I School of Medicine, Sapienza University of Rome, Rome, Italy
| | - Silvia Papa
- Department of Clinical, Anesthesiological and Cardiovascular Sciences, I School of Medicine, Sapienza University of Rome, Rome, Italy
| | - Davide Colombo
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Ditali
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Chiara Carrozzi
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessandra Greco
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Annalisa Turco
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federico Breviario
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Raymond Benza
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Dario Vizza
- Department of Clinical, Anesthesiological and Cardiovascular Sciences, I School of Medicine, Sapienza University of Rome, Rome, Italy
| | - Laura Scelsi
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
5
|
Meliante PG, Colizza A, Di Stadio A, D'Erme G, Gilardi A, Cambria F, Greco A, Ralli M, De Vincentiis M. Montgomery Salivary Bypass Tube vs Self-Expandable Metal Stents for the treatment of esophageal strictures after total laryngectomy: a crossover study. Clin Ter 2023; 174:478-482. [PMID: 38048108 DOI: 10.7417/ct.2023.5012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Objectives Dysphagia affects 16% of patients undergoing total laryngectomy; of these, a third is due to pharyngoesophageal stenosis. Currently, the treatment is cyclic dilation of the stricture and Montgomery Salivary Bypass Tube (MSBT) application. The aim of this study is to assess whether using Self-Expandable Metal Stent (SEMS) may give better results after a non-durable response to repeated dilatation and application of MSBT. Materials and Methods We verified whether using SEMS after at least 3 cyclic dilations and application of MSBT results in a longer dysphagia-free time in laryngectomized patients with pharyngolesopha-geal stenosis. Secondary outcomes were the duration of the procedures, radiation exposure and complications. Results We enrolled 6 patients with a median age of 65 years (QR 62.5 - 75.75), of which 50% had undergone radiotherapy. Friedman's test for the duration of the dysphagia-free period did not show a statistically significant difference between the two groups (Friedman chi-squared = 2.6667, df = 1, p-value = 0.1025). The time required to implant the MSBT was significantly less than that required to implant the SEMS (Friedman chi-squared = 6, df = 1, p-value = 0.01431). Radiation exposure was absent for MSBT, while SEMS implant required an exposure to X-rays during the procedure and after 48 hours for placement verification. Two patients experienced short-term complications after SEMS implantation and one after two weeks from MSBT implantation; none of them had any health consequences. Conclusion In patients who are already undergoing cyclic dilations and application of MSBT, switching to SEMS is not beneficial. Furthermore, MSBT has a significantly shorter implant procedure, does not expose the patient to X-rays, and, in the absence of complications, has a longer duration before removal.
Collapse
Affiliation(s)
- P G Meliante
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - A Colizza
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - A Di Stadio
- Department G.F Ingrassia, Unit of Otolaryngology, University of Catania, Catania, Italy
| | - G D'Erme
- Integrated Head and Neck Care Department, Policlinico Umberto I, Rome, Italy
| | - A Gilardi
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - F Cambria
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - A Greco
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - M Ralli
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - M De Vincentiis
- Department of Sense Organs, Sapienza University of Rome, Italy
| |
Collapse
|
6
|
Acquaro M, Scelsi L, Pasotti B, Seganti A, Spolverini M, Greco A, Schirinzi S, Turco A, Sanzo A, Savastano S, Rordorf R, Ghio S. Sacubitril/valsartan effects on arrhythmias and left ventricular remodelling in heart failure: An observational study. Vascul Pharmacol 2023; 152:107196. [PMID: 37467909 DOI: 10.1016/j.vph.2023.107196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 07/21/2023]
Abstract
AIMS Conflicting results have been reported in the literature on the potential antiarrhythmic effect of sacubitril/valsartan in heart failure patients with reduced ejection fraction (HFrEF). The objectives of this study were: 1- to evaluate the long term effects of sacubitril/valsartan on arrhythmic burden in HFrEF patients; 2- to evaluate the correlation between the reduction of premature ventricular complexes during f-up and reverse remodelling. METHODS We identified 255 consecutive HFrEF patients treated with sacubitril/valsartan between March 2017 and May 2020 and followed by the Heart Failure and Cardiac Transplant Unit of IRCCS San Matteo Hospital in Pavia (Italy). Within this subgroup, 153 patients underwent 24 h-Holter-ECG or implantable cardioverter defibrillators (ICD) interrogation at baseline, at 12 months (t1) and at 24 months (t2) and transthoracic echocardiography at baseline and after 12 months after the beginning of sacubitril/valsartan. Cardiac-related hospitalizations were analyzed in the 12 months preceding and during 24 months following the drug starting date. RESULTS Global burden of 24-h premature ventricular complexes (PVC) was significantly reduced at 12 months (t1) and at 24 months (t2) as compared to the same period before treatment (1043 [304-3360] vs 768 [82-2784] at t1 vs 114 [9-333] at t2, P = 0.000). In the subgroup of patients implanted with biventricular ICD (n = 30), the percentage of biventricular pacing increased significantly (96% [94-99] vs 98% [96-99] at t1 vs 98%[97-100] at t2; P = 0.027). The burden of non-sustained ventricular tachycardia and sustained ventricular tachycardia did not change from baseline to t1 and t2, but a reduction of patients with at least one ICD appropriate shock was reported. The correlations between reduction in 24 h PVC and reduction in LV-ESVi or improvement in LVEF were not statistically significant (respectively R = 0.144, P = 0.197 and R = -0.190, P = 0.074). Heart failure related hospitalizations decreased during follow up (11.1% in the year before treatment vs 4.6% at t1 and 4.6% at t2; P = 0.040). CONCLUSION Sacubitril/valsartan reduced the number of premature ventricular complexes and increased the percentage of biventricular pacing in a cohort of HFrEF patients already on optimal medical therapy. PVC reduction did not correlate with reverse left ventricular remodelling. Whether sacubitril/valsartan has any direct antiarrhythmic effects is an issue to be better explored in future studies.
Collapse
Affiliation(s)
- Mauro Acquaro
- Department of Molecular Medicine, University of Pavia, Corso Strada Nuova, 65, Pavia, Italy; Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Laura Scelsi
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Beatrice Pasotti
- Department of Molecular Medicine, University of Pavia, Corso Strada Nuova, 65, Pavia, Italy; Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessandro Seganti
- Department of Molecular Medicine, University of Pavia, Corso Strada Nuova, 65, Pavia, Italy; Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marcello Spolverini
- Department of Molecular Medicine, University of Pavia, Corso Strada Nuova, 65, Pavia, Italy; Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessandra Greco
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sandra Schirinzi
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Annalisa Turco
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonio Sanzo
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Arrhythmia and Electrophysiology Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Simone Savastano
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Arrhythmia and Electrophysiology Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Roberto Rordorf
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Arrhythmia and Electrophysiology Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Stefano Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
7
|
Ermini L, Taurone S, Greco A, Artico M. Cancer progression: a single cell perspective. Eur Rev Med Pharmacol Sci 2023; 27:5721-5747. [PMID: 37401310 DOI: 10.26355/eurrev_202306_32812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
Tumor tissues are constituted by a dynamic diversity of malignant and non-malignant cells, which shape a puzzling biological ecosystem affecting cancer biology and response to treatments. Over the course of the tumoral disease, cancer cells acquire genotypic and phenotypic changes, allowing them to improve cellular fitness and overcome environmental and treatment constraints. This progression is depicted by an evolutionary process in which single cells expand as a result of an interaction between single-cell changes and the local microenvironment. Recent technological developments have made it possible to depict the development of cancer at the single-cell level, offering a novel method for understanding the biology of this complex disease. Here, we review those complex interactions from the perspective of single cells and introduce the concept of omics for single-cell studies. This review emphasizes the evolutionary dynamics that control cancer progression and the capacity of single cells to escape the local environment and colonize distant sites. We are assisting a rapid progression of studies carried out at the single-cell level, and we survey relevant single-cell technologies looking at multi-omics studies. These forefront approaches will address the combined contribution of both genetic and non-genetic factors to cancer progression and will pave the path for precision medicine in cancer.
Collapse
Affiliation(s)
- L Ermini
- Department of Cancer Research, NORLUX Neuro-Oncology Laboratory, Luxembourg Institute of Health L-1526, Luxembourg, Luxembourg.
| | | | | | | |
Collapse
|
8
|
Oliveri F, Pepe A, Bongiorno A, Fasolino A, Gentile FR, Schirinzi S, Colombo D, Breviario F, Greco A, Turco A, Acquaro M, Tua L, Scelsi L, Ghio S. Hypertrophic Cardiomyopathy and Atrial Fibrillation: A Systematic Review and Meta-analysis of Anticoagulation Strategy. Am J Cardiovasc Drugs 2023; 23:269-276. [PMID: 37061614 DOI: 10.1007/s40256-023-00580-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) frequently complicates hypertrophic cardiomyopathy (HCM), and anticoagulation significantly decreases the risk of stroke in this population. To date, no randomized controlled trials (RCTs) have compared direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs). The present study aimed to systematically compare the two anticoagulation strategies in terms of effectiveness and safety. METHOD We performed a systematic literature search and meta-analysis in the PubMed, MEDLINE, and EMBASE databases for studies reporting all-cause mortality, major bleeding, or thromboembolic events (TEs). Since no RCTs were available, we included observational studies only. The overall hazard ratio (HR) and 95% confidence interval (CI) for each analyzed parameter were pooled using a random-effects model. RESULTS Five observational studies including 6919 patients were eligible for inclusion. Compared with VKAs, DOACs were associated with statistically significant lower rates of all-cause mortality (HR 0.64, 95% CI 0.35-0.54; p < 0.00001), comparable major bleeding events (HR 0.64, 95% CI 0.40-1.03; p = 0.07), and TEs (HR 0.94, 95% CI 0.73-1.22; p = 0.65). CONCLUSIONS Compared with VKAs, a DOAC-based strategy might represent an effective and safe strategy regarding all-cause mortality, major/life-threatening bleeding complications, and TEs in HCM patients with concomitant AF. However, further prospective studies are necessary to reinforce a DOAC-based anticoagulation strategy in this population.
Collapse
Affiliation(s)
- Federico Oliveri
- Division of Cardiology, Department of Molecular Medicine, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy.
| | - Antonella Pepe
- Division of Cardiology, Department of Molecular Medicine, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy
| | - Andrea Bongiorno
- Division of Cardiology, Department of Molecular Medicine, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy
| | - Alessandro Fasolino
- Division of Cardiology, Department of Molecular Medicine, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy
| | - Francesca Romana Gentile
- Division of Cardiology, Department of Molecular Medicine, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy
| | - Sandra Schirinzi
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Davide Colombo
- Division of Cardiology, Department of Molecular Medicine, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy
| | - Federico Breviario
- Division of Cardiology, Department of Molecular Medicine, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy
| | - Alessandra Greco
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Annalisa Turco
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Mauro Acquaro
- Division of Cardiology, Department of Molecular Medicine, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy
| | - Lorenzo Tua
- Division of Cardiology, Department of Molecular Medicine, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy
| | - Laura Scelsi
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
9
|
Vezzelli A, Verzè S, Morbioli L, Solazzo L, Greco A, Benetti C, Cenacchi V, Breda M. Development and validation of a bioanalytical method for the quantification of CHF6550 and its metabolite (CHF6671) in rat plasma and lung homogenate using LC–MS/MS. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1222:123678. [PMID: 37028170 DOI: 10.1016/j.jchromb.2023.123678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 04/08/2023]
Abstract
A selective and sensitive liquid chromatography-tandem mass spectrometry method was developed and validated for accurate determination of CHF6550 and its main metabolite in rat plasma and lung homogenate samples. All biological samples were prepared by simple protein precipitation method using deuterated internal standards. The analytes were separated on a HSS T3 analytical column with 3.2 min run time at flow rate of 0.5 mL/min. The detection was performed on a triple-quadrupole tandem mass spectrometer equipped with positive-ion electrospray ionization by selected-reaction monitoring of the transitions at m/z 735.3 → 98.0 for CHF6550 and m/z 638.3 → 319.2 and 638.3 → 376.2 for CHF6671. The calibration curves for plasma samples were linear between 50 and 50000 pg/mL for both analytes. The calibration curves for lung homogenate samples were linear within 0.1-100 ng/mL for CHF6550 and 0.3-300 ng/mL for CHF6671. The method was successfully applied to a 4-week toxicity study.
Collapse
Affiliation(s)
- A Vezzelli
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy.
| | - S Verzè
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy
| | - L Morbioli
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy
| | - L Solazzo
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy
| | - A Greco
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy
| | - C Benetti
- Chiesi Farmaceutici S.p.A, Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - V Cenacchi
- Chiesi Farmaceutici S.p.A, Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - M Breda
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy
| |
Collapse
|
10
|
Bravi M, Longo UG, Laurito A, Greco A, Marino M, Maselli M, Sterzi S, Santacaterina F. Supervised versus unsupervised rehabilitation following total knee arthroplasty: A systematic review and meta-analysis. Knee 2023; 40:71-89. [PMID: 36410253 DOI: 10.1016/j.knee.2022.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 09/18/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Outcomes after total knee arthroplasty (TKA) are strongly influenced by the adequacy of rehabilitation and the consequent functional recovery. The economic impact of rehabilitation it is not negligible. Inpatient rehabilitation can be 5 to 26 times more expensive than the home-based rehabilitation. This topic is extremely relevant as the COVID-19 pandemic has highlighted the importance of unsupervised rehabilitation in orthopedic surgery. The aim of this review and meta-analysis is to investigate the scientific evidence regarding the comparison between supervised and unsupervised rehabilitation following TKA. MATERIALS AND METHODS Following PRISMA guideline, a comprehensive search of PubMed, Cochrane and Scopus databases using combinations of keywords and MeSH descriptors: "total "Knee replacement," "Arthroplasty", "Rehabilitation" was performed from inception to December 2021. All relevant articles were retrieved, and their bibliographies were searched for further relevant references. Only English written randomized controlled trials comparing supervised and unsupervised rehabilitation following TKA were included in this systematic review. The outcomes considered were long-term pain, physical function, knee flexion and extension ROM, 6 minute walking test (6MWT) and timed up and go test (TUG). RESULTS 11 studies (2.181 patients in total) were included in this systematic review. The long-term pain outcome showed no significant differences (Std. Mean Difference [SMD] = 0.00, 95 % confidence interval [CI] -0.16, 0.017) between the supervised (n = 397) and unsupervised (n = 255). Physical function showed no significant differences among the two groups (mean difference [MD] = 0.84, 95 % CI = -1.82, 3.50). Non-significant differences were also found for knee ROM flexion (mean difference [MD] = -0.46, 95 % CI = -2.95, 2.04) and for knee extension (mean difference [MD] = 0.54, 95 % CI = -0.89, 1.97). At the 52-week follow-up, the unsupervised group showed significant better results in 6MWT (mean difference [MD] = -26.10, 95 % CI = -47.62, -4.59) and in Timed up and go test (mean difference [MD] = 1.33, 95 % CI = 0.50, 2.15). CONCLUSION This systematic review did not show a significant clinical difference in improving pain, function, and mobility outcomes after TKA between supervised PT and unsupervised PT. Therefore, it would appear that supervised rehabilitation did not had additional benefits compared to unsupervised rehabilitation.
Collapse
Affiliation(s)
- Marco Bravi
- Department of Physical and Rehabilitation Medicine, Campus Bio-Medico University, Rome, Italy
| | - Umile Giuseppe Longo
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy.
| | - Andrea Laurito
- Department of Physical and Rehabilitation Medicine, Campus Bio-Medico University, Rome, Italy
| | - Alessandra Greco
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Martina Marino
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Mirella Maselli
- Department of Physical and Rehabilitation Medicine, Campus Bio-Medico University, Rome, Italy
| | - Silvia Sterzi
- Department of Physical and Rehabilitation Medicine, Campus Bio-Medico University, Rome, Italy
| | - Fabio Santacaterina
- Department of Physical and Rehabilitation Medicine, Campus Bio-Medico University, Rome, Italy
| |
Collapse
|
11
|
Dusi V, Pugliese L, Ruffinazzi M, Guerrera F, Sanzo A, Vicentini A, Savastano S, Greco A, Camporotondo R, Vairo A, Frea S, Proclemer A, Imazio M, Tritto M, Trompeo AC, Belliato M, Ghio S, Raineri C, Rordorf R, De Ferrari GM. 958 IMPACT OF CARDIAC SYMPATHETIC DENERVATION ON ELECTRICAL STORMS IN PATIENTS WITH CARDIOMIOPATHIES. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background
Cardiac Sympathetic Denervation (CSD) has been recently proposed for the treatment of refractory ventricular arrhythmias (VAs) in patients with cardiomyopathy (CMP). A multicentric American and Indian case series suggested a greater efficacy of bilateral denervation (BCSD), compared to the left-side only procedure (LCSD), albeit with the potential prize of an increased need for atrial pacing due to the right-side innervation of the sinus node. The impact of CSD on the risk of electrical storms (ES) in CMP has never been evaluated.
Aim
To describe our multicenter Italian experience with CSD in CMP patients with drug and/or catheter ablation refractory VAs, with a specific focus on ES incidence.
Methods
Thirty patients with CMP and refractory VAs underwent either LCSD or BCSD between April 2016 and June 2022. Among them, one patient received first LCSD and then right-side denervation due to ES recurrence after LCSD: to properly assess the risk of ES after LCSD and BCSD he was included in both groups with the corresponding follow-up, leading to 5 cases of LCSD and 26 cases of BCSD. All patients had a Video–Assisted Thoracoscopic Surgery (VATS), in 8 cases associated with the robotic technique. The main reason (3/5 cases, 60%) to perform LCSD instead of BCSD since the beginning was sinus bradycardia in single ICD lead recipients.
Results
87% of pts were male, the mean age was 56 ± 16 yrs and the mean LVEF 31± 12%; most (n=26, 85%) suffered non-ischemic cardiomyopathy and 37% were in NYHA functional class ≥3. Main indications for CSD were represented by refractory polymorphic/fast VAs (cycle length <250 msec) in 60% of pts and by refractory monomorphic VAs episodes in the rest. Except for 5 patients (17%) with previous thyrotoxicosis, the majority were either on amiodarone (n=19, 63%) or on sotalol (n=3, 10%) before CSD and 53% had previously undergone ≥1 catheter ablation for VAs. The median follow-up (FU) after denervation was 15 months (IQR 5-42 months).
No major complication directly related to the procedure occurred. Overall, 11 patients (37%) either died during FU (n=8, 27%), mostly due to end-stage heart failure, or underwent heart transplant (n=3, 10%). After denervation, the percentage of patients with ES decreased from 77% to 40% (p<0.01), while patients with appropriate shocks decreased from 100% to 60%. The antiarrhythmic benefit was even more pronounced among the 26 patients who received BCSD: ES incidence decreased from 85% to 39% (p<0.01), appropriate shock incidence from 100% to 54% (p<0.01), while no significant changes in ES and ICD shock incidence were observed after the few LCSD procedures (n=5). A NYHA class <3 was associated with a trend toward a better response after BCSD (37% vs 54% incidence of ICD shock, p=0.05).
Conclusions
Our case series of CSD in cardiomyopathies represents the largest reported in Europe and the first ever to specifically evaluate the impact of denervation on electrical storms. The occurrence of electrical storm was more than halved by bilateral CSD confirming the powerful protective effect of BCSD also on this ominous phenomenon. The greater antiarrhythmic benefit observed among patients with better functional class suggests the opportunity to perform this procedure earlier on in the trajectory of patients with progressive heart failure.
Collapse
Affiliation(s)
- Veronica Dusi
- Divisione Di Cardiologia, Dipartimento Cardiovascolare E Toracico, Aou Citta’ Della Salute E Della Scienza. Dipartimento Di Scienze Mediche, Universita’ Di Torino
| | - Luigi Pugliese
- Dipartimento Di Chirurgia, Fondazione Irccs Policlinico San Matteo
| | - Marta Ruffinazzi
- Dipartimento Di Medicina Molecolare, Universita’ Degli Studi Di Pavia
| | - Francesco Guerrera
- Dipartimento Di Chirurgia Toracica, Aou Citta’ Della Salute E Della Scienza, Dipartimento Di Scienze Chirurgiche, Universita’ Degli Studi Di Torino
| | - Antonio Sanzo
- Dipartimento Di Cardiologia, Fondazione Irccs Policlinico San Matteo
| | | | - Simone Savastano
- Dipartimento Di Cardiologia, Fondazione Irccs Policlinico San Matteo
| | - Alessandra Greco
- Dipartimento Di Cardiologia, Fondazione Irccs Policlinico San Matteo
| | - Rita Camporotondo
- Dipartimento Di Cardiologia, Fondazione Irccs Policlinico San Matteo
| | - Alessandro Vairo
- Divisione Di Cardiologia, Dipartimento Cardiovascolare E Toracico , Aou Citta’ Della Salute E Della Scienza
| | - Simone Frea
- Divisione Di Cardiologia, Dipartimento Cardiovascolare E Toracico , Aou Citta’ Della Salute E Della Scienza
| | | | - Massimo Imazio
- Dipartimento Di Cardiologia , Aou Santa Maria Della Misericordia
| | | | - Anna Chiara Trompeo
- Dipartimento Di Anestesia , Terapia Intensiva Ed Emergenza, Aou Citta’ Della Salute E Della Scienza
| | - Mirko Belliato
- Uoc Anestesia E Rianimazione 2, Fondazione Irccs Policlinico San Matteo
| | - Stefano Ghio
- Dipartimento Di Cardiologia, Fondazione Irccs Policlinico San Matteo
| | - Claudia Raineri
- Divisione Di Cardiologia, Dipartimento Cardiovascolare E Toracico , Aou Citta’ Della Salute E Della Scienza
| | - Roberto Rordorf
- Dipartimento Di Cardiologia, Fondazione Irccs Policlinico San Matteo
| | - Gaetano Maria De Ferrari
- Divisione Di Cardiologia, Dipartimento Cardiovascolare E Toracico, Aou Citta’ Della Salute E Della Scienza. Dipartimento Di Scienze Mediche, Universita’ Di Torino
| |
Collapse
|
12
|
Mazzoni M, Todoerti K, Agnelli L, Minna E, Pagliardini S, Di Marco T, Borrello MG, Neri A, Greco A. Transcriptomic landscape of TIMP3 oncosuppressor activity in thyroid carcinoma. Cancer Cell Int 2022; 22:400. [PMID: 36503426 PMCID: PMC9743531 DOI: 10.1186/s12935-022-02811-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Papillary thyroid cancer (PTC) is the most frequent thyroid tumor. The tissue inhibitor of metalloproteinase-3 (TIMP3) gene encodes a matrix metalloproteinases inhibitor that exerts a tumor suppressor role in several tumor types. TIMP3 is frequently downregulated in PTC by promoter methylation. We have previously functionally demonstrated that TIMP3 exerts an oncosuppressor role in PTC: TIMP3 restoration in the PTC-derived NIM1 cell line affects in vitro migration, invasion and adhesive capability, while reduces tumor growth, angiogenesis and macrophage recruitment in vivo. To get a deeper insight on the mediators of TIMP3 oncosuppressor activity in thyroid tumors, here we focused on the TIMP3 related transcriptome. METHODS TCGA database was used for investigating the genes differentially expressed in PTC samples with low and high TIMP3 expression. Genome wide expression analysis of clones NIM1-T23 (expressing a high level of TIMP3 protein) and NIM1-EV (control empty vector) was performed. Gene sets and functional enrichment analysis with clusterProfiler were applied to identify the modulated biological processes and pathways. CIBERSORT was used to evaluate the distribution of different immunological cell types in TCGA-PTC tumor samples with different TIMP3 expression levels. Real time PCR was performed for the validation of selected genes. RESULTS Thyroid tumors with TIMP3-high expression showed a down-modulation of inflammation-related gene sets, along with a reduced protumoral hematopoietic cells fraction; an enrichment of cell adhesion functions was also identified. Similar results were obtained in the TIMP3-overexpessing NIM1 cells in vitro model, where a down-regulation of immune-related function gene sets, some of which also identified in tumor samples, was observed. Interestingly, through enrichment analysis, were also recognized terms related to cell adhesion, extracellular matrix organization, blood vessel maintenance and vascular process functions that have been found modulated in our previous in vitro and in vivo functional studies. CONCLUSIONS Our results highlight the correlation of TIMP3 expression levels with the regulation of inflammatory functions and the immune infiltration composition associated with different PTC prognosis, thus providing a broader view on the oncosuppressor role of TIMP3 in PTC.
Collapse
Affiliation(s)
- M. Mazzoni
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - K. Todoerti
- grid.417893.00000 0001 0807 2568Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - L. Agnelli
- grid.417893.00000 0001 0807 2568Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - E. Minna
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - S. Pagliardini
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - T. Di Marco
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M. G. Borrello
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - A. Neri
- Scientific Directorate, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - A. Greco
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| |
Collapse
|
13
|
Coperchini F, Greco A, Denegri M, Ripepi FA, Grillini B, Bertini J, Calì B, Villani L, Magri F, Croce L, Gaetano C, Cappelli C, Trimboli P, Chiovato L, Rotondi M. Vitamin D and interferon-γ co-operate to increase the ACE-2 receptor expression in primary cultures of human thyroid cells. J Endocrinol Invest 2022; 45:2157-2163. [PMID: 35829990 PMCID: PMC9277975 DOI: 10.1007/s40618-022-01857-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/29/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND A more severe course of COVID-19 was associated with low levels of Vitamin D (VitD). Moreover in vitro data showed that VitD up-regulates the mRNA of the Angiotensin Converting Enzyme 2 (ACE-2), the SARS-COV-2 receptor in different type of cells. ACE-2 is expressed in several type of tissues including thyroid cells, on which its mRNA was shown to be up-regulated by interferon-gamma (IFN-γ). The aim of the present study was to investigate if treatment with VitD alone or in combination with IFN-γ would increase ACE-2 both at mRNA and protein levels in primary cultures of human thyrocytes. MATERIALS AND METHODS Primary thyroid cell cultures were treated with VitD and IFN-γ alone or in combination for 24 h. ACE-2 mRNA levels were measured by Real-time Polymerase Chain Reaction (RT-PCR). The presence of ACE-2 on thyroid cell membrane was assessed by immunocytochemistry basally and after the previous mentioned treatments. RESULTS ACE-2 mRNA levels increased after treatment with VitD and IFN-γ alone. The combination treatment (VitD + IFN-γ) showed an additive increase of ACE-2-mRNA. Immunocytochemistry experiments showed ACE-2 protein on thyroid cells membrane. ACE-2 expression increased after treatment with VitD and IFN-γ alone and further increased by the combination treatment with VitD + IFN-γ. CONCLUSIONS VitD would defend the body by SARS-COV2 both by regulating the host immune defense and by up-regulating of the expression of the ACE-2 receptor. The existence of a co-operation between VitD and IFN-γ demonstrated in other systems is supported also for ACE-2 up-regulation. These observations lead to an increased interest for the potential therapeutic benefits of VitD supplementation in COVID-19.
Collapse
Affiliation(s)
- F Coperchini
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
| | - A Greco
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
| | - M Denegri
- Unit of Molecular Cardiology 27100, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - F A Ripepi
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - B Grillini
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - J Bertini
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - B Calì
- Unit of Pathology, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
| | - L Villani
- Department of General and Minimally Invasive Surgery, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
| | - F Magri
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - L Croce
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - C Gaetano
- Laboratory of Epigenetics, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100, Pavia, Italy
| | - C Cappelli
- Department of Clinical and Experimental Sciences, SSD Medicina Ad Indirizzo Endocrino-Metabolico, University of Brescia, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - P Trimboli
- Clinic for Endocrinology and Diabetology, Lugano Regional Hospital, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana (USI), Lugano, Switzerland
| | - L Chiovato
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - M Rotondi
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy.
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy.
| |
Collapse
|
14
|
Badagliacca R, D'Alto M, Ghio S, Argiento P, Brunetti ND, Casu G, Cedrone N, Confalonieri M, Corda M, Correale M, D'Agostino C, De Michele L, Di Marino S, Filomena D, Galgano G, Greco A, Lombardi C, Manzi G, Mercurio V, Mulè M, Paciocco G, Papa S, Romeo E, Scelsi L, Stolfo D, Vitulo P, Vizza CD. Relevance of comorbidities on initial combination therapy in pulmonary arterial hypertension. ERJ Open Res 2022; 8:00298-2022. [DOI: 10.1183/23120541.00298-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/28/2022] [Indexed: 11/05/2022] Open
Abstract
RationaleDemographic characteristics of pulmonary arterial hypertension (PAH) patients have changed over time, but the effects of cardiovascular risk factors on risk status and pulmonary vascular resistance (PVR) reduction with initial oral combination therapy are not known. Therefore, we tested the relevance of cardiovascular comorbidities in this setting.MethodsThe study enrolled 181 treatment-naive PAH patients with a 6-months (IQR 144–363 days) right heart catheterization and risk assessment after initial oral combination therapy.ResultsGroup-A, 96 (53.0%) patients without cardiac comorbidities; Group-B, 54 (29.8%) patients with one cardiac comorbidity; Group-C, 31 (17.1%) patients with ≥2 cardiac comorbidities. Group-C patients were older with a balanced gender distribution. There was a significant difference in PVR reduction moving from the absence to one or ≥2 cardiac comorbidities, respectively, median −45.0%, −30.3%, −24.3%. A ERS/ESC low-risk status was present at first follow-up in 50 (52.0%) patients in Group-A, 19 (35.1%) in Group-B, and 9 (29.0%) in Group-C; a REVEAL 2.0 low-risk status was present at first follow-up in 41 (42.0%) patients in Group-A, 15 (27.7%) in Group-B, and 7 (22.6%) in Group-C. Group-A patients were 2.3 times more likely to achieve/maintain a low risk status compared with Group-B and -C (OR 2.27, 95% C.I. 1.15–4.54, p=0.02). No significant difference was observed between patients with non-cardiac comorbidities and those without comorbidities.ConclusionInitial oral combination therapy seems associated with a less effective response for patients with cardiovascular comorbidities compared with the others, related to the magnitude of treatment-induced decrease in PVR.
Collapse
|
15
|
Spagnolo M, Laudani C, Occhipinti G, Agnello F, Legnazzi M, Scalia L, Mauro MS, Rochira C, Finocchiaro S, Greco A, Capodanno D. Impact of the ISCHEMIA randomized clinical trial on the management of patients with chronic coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In the ISCHEMIA trial, patients with chronic coronary syndromes (CCS) and moderate or severe ischemia had no significant difference in combined ischemic events with an initial invasive compared with a conservative strategy [1]. Coronary computed tomography angiography (CCTA) was part of the pre-randomization workup of ISCHEMIA and is gaining popularity over ischemia testing or initial invasive coronary angiography (ICA) as the initial diagnostic strategy for CCS [2].
Purpose
To analyse whether the results of the ISCHEMIA trial had a sizeable impact on the diagnostic algorithm for CCS by analysing trends in referral to ICA and/or revascularization.
Methods
ICAs performed in CCS patients between November 2019 and February 2022 at a high-volume centre were analysed. Two groups were defined based on procedure date: i) pre-ISCHEMIA, including ICAs performed before March 2020 (date of trial publication); ii) post-ISCHEMIA, including ICAs performed ≥3 months (i.e., blanking period) after trial publication. The primary outcome was the incidence of referral to ICA by CCTA. Secondary objectives included referral to ICA or revascularization by ischemia testing, referral to revascularization by CCTA, and referral by CCTA to ICA that did not require further intervention.
Results
A total of 2,365 patients qualified for the analysis, of which 487 (20.6%) and 1878 (79.4%) in the pre-ISCHEMIA and post-ISCHEMIA groups, respectively. There were no notable differences in baseline characteristics between groups. The primary outcome occurred more frequently in the post-ISCHEMIA group (73.5% vs 32.5%, p<0.01). Referral to ICA by ischemia testing was lower in the post-ISCHEMIA group (31.6%, vs 52.5% p<0.01), while referral for revascularization by CCTA was more frequent (8.3% vs 12.0% p<0.01). There were no significant differences in referral to revascularization by ischemia testing (3.4% vs 3.0%, p=0.73) and referral by CCTA to ICA that did not require further intervention (60.3% vs 60.8%, p=0.90).
Conclusions
At two years from publication, the ISCHEMIA trial seems to have impacted significantly on the decision-making algorithm for patients with CCS. The frequency of referral to ICA and revascularization by CCTA considerably increased, paralleled by decreased referral to ICA by ischemia testing.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- M Spagnolo
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - C Laudani
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - G Occhipinti
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - F Agnello
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - M Legnazzi
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - L Scalia
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - M S Mauro
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - C Rochira
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - S Finocchiaro
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - A Greco
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - D Capodanno
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| |
Collapse
|
16
|
Sabattini S, Rigillo A, Foiani G, Marconato L, Vascellari M, Greco A, Agnoli C, Annoni M, Melchiotti E, Campigli M, Benali SL, Bettini G. Clinicopathologic features and biologic behavior of canine splenic nodules with stromal, histiocytic and lymphoid components. Front Vet Sci 2022; 9:962685. [PMID: 36032303 PMCID: PMC9411940 DOI: 10.3389/fvets.2022.962685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
The term fibrohistiocytic nodule has been discouraged in favor of specific pathologic entities, including complex nodular hyperplasia, splenic stromal sarcoma and histiocytic sarcoma. Nevertheless, the diagnosis of splenic lesions with mixed stromal, histiocytic and lymphoid components still remains a challenge due to lack of straightforward histologic criteria. Misestimation of the biologic behavior of these lesions may lead to detrimental consequences on the clinical management of patients. In this study, we retrospectively evaluated the clinicopathologic features and outcome of canine splenic nodular lesions with mixed components, to identify prognostic factors and histologic criteria of malignancy. Thirty-seven cases were included. Immunohistochemistry did not allow for further subclassification. Nine (24.3%) dogs died from disease-related causes after a median of 234 days (range, 48–1,247). One-, 2- and 3-year disease-specific survival rates were 80, 60, and 43%, respectively. When considering nodules with stromal cell atypia and at least one of mitotic count ≥9, presence of karyomegaly/multinucleated cells and lymphoid component <40%, half of these dogs died of disease-related causes with a median disease-specific survival time of 548 days (95% CI, 0-1216). In the remaining dogs, no disease-related death was reported (P < 0.001). Canine splenic nodular lesions with mixed stromal, histiocytic and lymphoid components and histologic criteria of malignancy may behave aggressively, leading to distant metastasis and death. In the absence of further criteria aiding their classification, and to better characterize their biologic behavior, we encourage the distinction of these complex splenic tumors from conventional sarcomas and histiocytic sarcomas.
Collapse
Affiliation(s)
- Silvia Sabattini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Bologna, Italy
- *Correspondence: Silvia Sabattini
| | - Antonella Rigillo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - Greta Foiani
- Istituto Zooprofilattico Sperimentale delle Venezie, Padua, Italy
| | - Laura Marconato
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - Marta Vascellari
- Istituto Zooprofilattico Sperimentale delle Venezie, Padua, Italy
| | - Alessandra Greco
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - Chiara Agnoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | | | - Erica Melchiotti
- Istituto Zooprofilattico Sperimentale delle Venezie, Padua, Italy
| | - Michela Campigli
- Oncology Division, San Marco Veterinary Clinic and Laboratory, Padua, Italy
| | | | - Giuliano Bettini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| |
Collapse
|
17
|
Hepting M, Bejas M, Nag A, Yamase H, Coppola N, Betto D, Falter C, Garcia-Fernandez M, Agrestini S, Zhou KJ, Minola M, Sacco C, Maritato L, Orgiani P, Wei HI, Shen KM, Schlom DG, Galdi A, Greco A, Keimer B. Gapped Collective Charge Excitations and Interlayer Hopping in Cuprate Superconductors. Phys Rev Lett 2022; 129:047001. [PMID: 35938998 DOI: 10.1103/physrevlett.129.047001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/29/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
We use resonant inelastic x-ray scattering to probe the propagation of plasmons in the electron-doped cuprate superconductor Sr_{0.9}La_{0.1}CuO_{2}. We detect a plasmon gap of ∼120 meV at the two-dimensional Brillouin zone center, indicating that low-energy plasmons in Sr_{0.9}La_{0.1}CuO_{2} are not strictly acoustic. The plasmon dispersion, including the gap, is accurately captured by layered t-J-V model calculations. A similar analysis performed on recent resonant inelastic x-ray scattering data from other cuprates suggests that the plasmon gap is generic and its size is related to the magnitude of the interlayer hopping t_{z}. Our work signifies the three dimensionality of the charge dynamics in layered cuprates and provides a new method to determine t_{z}.
Collapse
Affiliation(s)
- M Hepting
- Max-Planck-Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
| | - M Bejas
- Facultad de Ciencias Exactas, Ingeniería y Agrimensura and Instituto de Física de Rosario (UNR-CONICET), Avenida Pellegrini 250, 2000 Rosario, Argentina
| | - A Nag
- Diamond Light Source, Harwell Campus, Didcot OX11 0DE, United Kingdom
| | - H Yamase
- International Center of Materials Nanoarchitectonics, National Institute for Materials Science, Tsukuba 305-0047, Japan
- Department of Condensed Matter Physics, Graduate School of Science, Hokkaido University, Sapporo 060-0810, Japan
| | - N Coppola
- Dipartimento di Ingegneria Industriale, Università di Salerno, I-84084 Fisciano (Salerno), Italy
| | - D Betto
- Max-Planck-Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
| | - C Falter
- Institut für Festkörpertheorie, Westfälische Wilhelms-Universität, Wilhelm-Klemm-Straße 10, 48149 Münster, Germany
| | | | - S Agrestini
- Diamond Light Source, Harwell Campus, Didcot OX11 0DE, United Kingdom
| | - Ke-Jin Zhou
- Diamond Light Source, Harwell Campus, Didcot OX11 0DE, United Kingdom
| | - M Minola
- Max-Planck-Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
| | - C Sacco
- Dipartimento di Ingegneria Industriale, Università di Salerno, I-84084 Fisciano (Salerno), Italy
| | - L Maritato
- Dipartimento di Ingegneria Industriale, Università di Salerno, I-84084 Fisciano (Salerno), Italy
- CNR-SPIN Salerno, Università di Salerno, I-84084 Fisciano (Salerno), Italy
| | - P Orgiani
- CNR-SPIN Salerno, Università di Salerno, I-84084 Fisciano (Salerno), Italy
- CNR-IOM, TASC Laboratory in Area Science Park, 34139 Trieste, Italy
| | - H I Wei
- LASSP, Department of Physics, Cornell University, Ithaca, New York 14853, USA
| | - K M Shen
- LASSP, Department of Physics, Cornell University, Ithaca, New York 14853, USA
| | - D G Schlom
- Department of Materials Science and Engineering, Cornell University, Ithaca, New York 14853, USA
- Kavli Institute at Cornell for Nanoscale Science, Ithaca, New York 14853, USA
- Leibniz-Institut für Kristallzüchtung, Max-Born-Straße 2, 12489 Berlin, Germany
| | - A Galdi
- Dipartimento di Ingegneria Industriale, Università di Salerno, I-84084 Fisciano (Salerno), Italy
- Cornell Laboratory for Accelerator Based Sciences and Education, Cornell University, Ithaca, New York 14853, USA
| | - A Greco
- Facultad de Ciencias Exactas, Ingeniería y Agrimensura and Instituto de Física de Rosario (UNR-CONICET), Avenida Pellegrini 250, 2000 Rosario, Argentina
| | - B Keimer
- Max-Planck-Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
| |
Collapse
|
18
|
Manzo R, Listorti I, Colasante A, Scarselli F, Greco P, Arrivi C, Watson L, Greco A, Varricchio M, Pirastu G, Musella M, Barberi M, Uva D, Pristera' A, Greco E. P-267 A continuous culture medium with a lower concentration of lactate has a pronounced effect on the percentage of usable blastocysts on day 5. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Does Continuous Single Culture Medium NX, an embryo culture medium containing 1mM lactate, support increased blastocyst development over high lactate Vitrolife G1/G2 Series sequential culture?
Summary answer
There is a statistically significant increase in day 5 usable blastocysts in low lactate culture medium compared to the one with high lactate medium.
What is known already
Studies have shown that day 5 is the most desirable day to obtain blastocysts that are of an expansion, grade and quality to be utilized for transfer and/or vitrification procedures as those result in the highest success of clinical pregnancy,as compared to day 6/ 7 blastocysts, that do not meet criteria. Moreover, recent studies have indicated that there is an increase in chromosomal correctness of embryos cultured in a 1mM lactate environment as opposed to the higher 6-10mM lactate concentrations that have historically been believed necessary for successful blastocyst culture and resulting pregnancy.
Study design, size, duration
A prospective split sibling oocytes study was performed on 50 ICSI and IMSI cycles from October 2020 through April 2021. Oocytes were divided into the low lactate medium and high lactate gradient medium immediately following ICSI/IMSI and thereafter cultured in those medium until the final day of blastocyst culture. All patient ages were included in the sample population.
Participants/materials, setting, methods
This study was carried out in a private clinic. All patient stimulation protocol information and diagnosis’ were recorded; however, there was no restriction on participation. The endpoint was to analyse the resulting usable blastocyst rates on day 5 and day 6 in both arms of the study, using a denominator of normal 2PN fertilization. If a blastocyst was transferred or cryopreserved on day 5 or day 6, it was determined to be usable.
Main results and the role of chance
The resulting data was stratified not only by day 5 and day 6 usable blastocyst rates but also by patient age. It illustrates a statistically significant improvement in day 5 usable blastocysts for patients <35 in CSCM-NXC vs G1/G2 at 56% and 42%, respectively, a 14% increase (p < .05). The overall day 5 usable blastocyst rate was also statistically significant in CSCM-NXC (47%) as compared to G1/G2 (36%), (p < .05) with all ages considered. Additionally, on day 5, there was a higher percentage of usable blastocysts demonstrated in low lactate vs high in patients aged 35-37 (65% vs 42%, respectively) and 41-42 (41% vs 15%). Statistical significance was reversed in patients <35 on day 6, with G1/G2 having 24% usable blasts and CSCM-NXC 10% (p < .05). Interestingly, though not significant, G1/G2 had an increase in usable blastocyst percentage on day 5 in patients >42 (20% vs 11%), but overall, CSCM-NXC saw an increase in that same age group by 16%.
Limitations, reasons for caution
Though statistical significance was found in this study, a greater number will help to bolster the statistical power of the observations. Additionally, more studies are needed in order to ascertain if low lactate has an effect on the development prior to ICSI and resulting culture.
Wider implications of the findings
The mechanism of action that leads to the successful embryo development in low lactate embryo culture medium is vastly unknown, so further studies are required in order to understand the complexities and the impact of the observations provided.
Trial registration number
not applicable.
Collapse
Affiliation(s)
- R Manzo
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - I Listorti
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - A Colasante
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - F Scarselli
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - P Greco
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - C Arrivi
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - L Watson
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - A Greco
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | | | - G Pirastu
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - M Musella
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - M Barberi
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - D Uva
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - A Pristera'
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - E Greco
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| |
Collapse
|
19
|
Pirastu G, Listorti I, Manzo R, Barberi M, Musella M, Zazzaro V, Colasante A, Varricchio M, Scarselli F, Mencacci C, Arrivi C, Litwicka K, Greco P, Greco A, Greco E. P-260 Study of kinetic parameters using KIDscoreTMDay5 version 3.0 in euploid, mosaic and aneuploid blastocysts. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Do kinetic parameters change among euploid, mosaic and aneuploid blastocysts? Is the KIDscoreTMDay5 version 3.0 (KS-5.3) correlated to preimplantation genetic testing for aneuploidies (PGT-A) results?
Summary answer
The KS-5.3 differs in embryo ploidy classes. The analysis of the kinetic variables showed that the aneuploid embryos were significantly slower than euploid and mosaic.
What is known already
Chromosomal abnormalities affect more than 50% of embryos in women with >35 years of age and PGT-A is the best way to predict embryo’s ploidy status decreasing implantation failure and miscarriage. However, this procedure is not always possible due to social or moral issues. So, the use of the non-invasive time lapse monitoring could be helpful to determine the morphokinetic characteristics in the different ploidy classes. KS-5.3 (vitrolife,Sweden) is a scoring model based on morphokinetic data, developed to predict the pregnancy rate of day-5 blastocysts. Recent publications showed differences in kinetic parameters between euploid and aneuploid embryos.
Study design, size, duration
This retrospective study analyzed 728 blastocysts with PGT-A results obtained at Villa Mafalda Clinic from May 2020 to June 2021. Embryos were cultured in EmbryoScope+ time-lapse system (Vitrolife) at 37 °C, 6%CO2, and 5% O2. The PGT-A was performed using next-generation sequence (NGS) technology on the trophectoderm biopsy sample on day 5/6/7. Automatic annotations for division times and quality gradings were performed by senior embryologists and all kinetic values were reported in hours post microinjection.
Participants/materials, setting, methods
728 blastocysts were classified in: (E) euploid (n = 172), (M) mosaicism (n = 171) and (A) aneuploid (n = 385). In this study, they were considered KS-5.3 and the following kinetic variables: the time to reach 2 cells (t2), 3 cells (t3), 4 cells (t4), 5 cells (t5), and the blastocyst formation (TB). Continuous variables were reported as the median and interquartile range (IQR). For the statistical analysis, nonparametric tests were performed and p < 0.05 was considered statistically significant.
Main results and the role of chance
KS5.3 was significantly different between groups [E = 6.6(4.6-7.9) vs M = 5.3(2.9-7.2) vs A = 4.0(2.5-6.6), p < 0.0001]. It was significantly higher in euploid than in mosaic and aneuploid (EvsM p = 0.0007, EvsA p <0.0001, MvsA p = 0.0077). A significant delay in t2,t3,t4 and tb was showed in aneuploid embryos compared to euploid and mosaic, whereas there was no significant difference between euploid and mosaic: [t2: E = 25.80 (24.56-28.09), M = 25.99 (24.49-28.91), A = 27.02 (25.30-29.47), EvsA p <0.0001, AvsM p = 0.03, EvsM p = 0.32]; [t3: E = 37.08 (34.74-39.34), M = 36.69 (34.55-40.02), E = 38.45 (35.93-41.14), EvsA p = 0.0003, MvsA p = 0.002, EvsM p >0.99]; [t4: E = 38.28 (35.63-41.19), M = 38.49 (35.47-42.13), A 39.72 (37.25-43.31), EvsA p = 0.0001, MvsA p = 0.02, EvsM p = 0.65]; [tb: E = 107.70 (102.20-114.30), M = 110.10 (103.60-116.80), A = 113.7 (106.80-122.70), EvsA p <0.0001, MvsA p <0.0001, EvsM p = 0.42]. As for t5, there were no differences among the groups. Longer cell cycles in aneuploid embryos could be associated with activated DNA repair mechanism or during chromosome segregation. Instead, regarding the mosaics, there was a significant difference with euploid embryos only in KS5.3. The age was similar between euploid and mosaic [E = 36.29 (33.42-39.00) vs M = 36.71 (34.00-39.33) p = 0.99], whereas that was significantly higher in aneuploid embryos [A = 39.11(36.01-42.27), EvsA/EvsM p <0.0001].
Limitations, reasons for caution
All these findings have to be validated in a larger sample size. Furthermore, for the retrospective nature of this study, there were some confounding factors, such as protocol of stimulation, female age, and malefactor. This research did not consider the importance of every single kinetic parameter.
Wider implications of the findings
A further study is needed to verify if there is a correlation between morphology and ploidy status. This could clarify the difference in KS-5.3 between euploid and mosaic. In order to decrease age bias, we should enlarge the sample size to analyze a subgroup of patients with higher maternal age.
Trial registration number
not applicable
Collapse
Affiliation(s)
- G Pirastu
- Villa Mafalda, fertility clinic , Roma, Italy
| | - I Listorti
- Villa Mafalda, fertility clinic , Roma, Italy
| | - R Manzo
- Villa Mafalda, fertility clinic , Roma, Italy
| | - M Barberi
- Villa Mafalda, fertility clinic , Roma, Italy
| | - M Musella
- Villa Mafalda, fertility clinic , Roma, Italy
| | - V Zazzaro
- Villa Mafalda, fertility clinic , Roma, Italy
| | - A Colasante
- Villa Mafalda, fertility clinic , Roma, Italy
| | | | - F Scarselli
- Villa Mafalda, fertility clinic , Roma, Italy
| | - C Mencacci
- Villa Mafalda, fertility clinic , Roma, Italy
| | - C Arrivi
- Villa Mafalda, fertility clinic , Roma, Italy
| | - K Litwicka
- Villa Mafalda, fertility clinic , Roma, Italy
| | - P Greco
- Villa Mafalda, fertility clinic , Roma, Italy
| | - A Greco
- Villa Mafalda, fertility clinic , Roma, Italy
| | - E Greco
- Villa Mafalda, fertility clinic , Roma, Italy
| |
Collapse
|
20
|
Donno V, Greco E, Greco A, Miniasi M, Pristerà A, Pirastu G, Varricchio M, Litwicka K, Arrivi C, Mencacci C, Greco P. P-165 Which are the determining factors influencing the success rate of egg donation programs with imported vitrified oocytes? Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Which are the determining factors influencing the success rate of egg donation programs with imported vitrified oocytes?
Summary answer
Number of oocytes available after warming, male BMI and semen characteristics are critical parameters influencing reproductive results of oocyte donation programs with imported vitrified oocytes
What is known already
The use of vitrified oocytes from foreign banks and the performance of ICSI using fresh sperm from the recipient's partner is a widely used method of heterologous fertilisation. Recent evidence has questioned the overall effectiveness of this approach: vitrification and warming may reduce the number of oocytes available for insemination, resulting in a lower rate of live births per cycle. Recent studies have attempted to define the right clinical strategy to improve the effectiveness of oocyte vitrification cycles, stressing the importance of the number of imported oocytes (8-9 oocytes) and transfer to the blastocyst stage.
Study design, size, duration
Observational longitudinal cohort study of 431 cycles of oocyte donation conducted between January 2015 and February 2019. A total of 398 couples (mean female age: 43.2 ± 3.5, 28-50 years; mean male age: 44.7 ± 6.1, 28-73 years) underwent an IVF cycle with imported donated vitrified oocytes (mean donor age: 25.2 ± 3.5, 19-34 years). All consecutive oocyte donation cycles conducted at the centre for Reproductive Medicine of the European Hospital in Rome were included.
Participants/materials, setting, methods
In order to assess which factors are associated with the various outcomes, uni-and multi-variable analyses were conducted. In the multivariable analyses, variables that showed a p value<0.1 in the univariable analyses were included in the final model. The results were presented as Odds Ratio (OR). The corresponding 95% Confidence Interval (95% CI) was also exposed. A p value <0.05 was considered statistically significant. All analyses were performed with STATA v16.1 statistical software.
Main results and the role of chance
A univariate analysis was carried out showing that among the demographic characteristics studied, the only one that proved significantly able to influence the outcome of the pregnancy test was male BMI. In 49% of unsuccessful cycles, the male BMI was above 25 (p = 0.03). The correlation is confirmed when comparing cycle outcomes in couples with normal/underweight vs overweight/obese men (p = 0.03). The relationship between female or donor BMI and treatment outcome, however, was not statistically significant. The day on which embryo transfer is performed affects the outcome of the cycle: transferring on day 2 compared to day 5 reduces the probability of clinical pregnancy (ET in day 2= positive clinical pregnancy in 4/16 (25%); ET in day 3= 158/307 (51.4%); ET in day 5=40/67 (59.7%). The relationship between male BMI classes and sperm parameters was studied: the distribution of concentration is different in the 3 BMI groups (p = 0.011); in particular, obese men have a significantly lower concentration than normal-weight men (p = 0.006 after Bonferroni correction). There were no statistically significant differences in volume (P = 0.722), morphology (p = 0.100) and motility (p = 0.179), although there was a downward trend in motility, with a reduction in obese subjects compared to normal weight.
Limitations, reasons for caution
This is an observational study and our findings are in contrast with previous studies which do not show any correlation between male partner BMI categories and reproductive outcomes in egg donation programs.
Wider implications of the findings
Our study shows that the number of oocytes available after warming, male BMI, semen characteristics and blastocyst transfer are critical parameters able to influence the reproductive outcomes of egg donation programs with imported vitrified oocytes.
Trial registration number
Not applicable
Collapse
Affiliation(s)
- V Donno
- University of Modena and Reggio Emilia, Department of Medical and Surgical Sciences of the Mother- Children and Adults , Modena, Italy
| | - E Greco
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - A Greco
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - M.G Miniasi
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - A Pristerà
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - G Pirastu
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - M.T Varricchio
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - K Litwicka
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - C Arrivi
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - C Mencacci
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - P Greco
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| |
Collapse
|
21
|
Colizza A, Ralli M, Turchetta R, Minni A, Greco A, de Vincentiis M. Otolaryngology adverse events following COVID-19 vaccines. Eur Rev Med Pharmacol Sci 2022; 26:4113-4116. [PMID: 35731083 DOI: 10.26355/eurrev_202206_28981] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Since the outbreak of COVID-19 pandemic, the international scientific community aimed at developing a vaccine to protect against the infection and prevent serious forms of the disease. To date, various adverse events of COVID-19 vaccines have been reported, mostly mild to moderate. MATERIALS AND METHODS In this short communication, we reviewed available literature and described the most frequent otolaryngology adverse events reported after COVID-19 vaccination. RESULTS The most frequent adverse events following COVID-19 vaccine described in the literature are represented by audiovestibular symptoms, such as tinnitus, sudden sensorineural hearing loss, vertigo, and dizziness. Other side effects include facial nerve palsy, epistaxis, and oral manifestations (lichen planus, bleeding, ulcers, and vesicles). CONCLUSIONS COVID-19 vaccine is of utmost importance in limiting the spread of SARS-CoV-2. Otolaryngology-related side effects have been described, but none was severe or life threatening. The mechanisms underlying these effects are still mostly unknown.
Collapse
Affiliation(s)
- A Colizza
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
| | | | | | | | | | | |
Collapse
|
22
|
D'Angelo A, Petrella C, Greco A, Ralli M, Vitali M, Giovagnoli R, De Persis S, Fiore M, Ceccanti M, Messina MP. Acute alcohol intoxication: a clinical overview. Clin Ter 2022; 173:280-291. [PMID: 35612344 DOI: 10.7417/ct.2022.2432] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract Alcohol is a legal and yet detrimental psychoactive substance, capable of establishing addiction and impacting the physical, mental, social, and economic health of people. Alcohol intake causes a large variety of tissue damages severely impacting the nervous system, digestive and cardiovascular systems and causing oral cavity, oropharyngeal, hypopharyngeal, esophageal, colon-rectal, laryngeal, liver and intrahepatic bile duct, and breast cancers. Alcohol can also play a role in the pathogenesis of diabetes mellitus, cardiomyopathy and hemorrhagic strokes. When drunk during pregnancy it is proved to be responsible for serious damage to fetuses causing a wide range of pathological conditions from miscarriage to Fetal Alcoholic Spectrum Disorder (FASD). Acute ethanol intoxication happens when the amount of alcohol consumed is greater than the disposal capacity of the liver, causing an accumulation of its metabolites displayed by initial dysphoria and disinhibition. Nausea, vomiting, memory loss could happen. Although, it can lead to more serious conditions like impaired speaking, impaired coordination, unstable gait, nystagmus, stupor, or coma. Respiratory depression and death could also happen in such cases. Unfortunately, diagnosis of acute alcohol intoxication is difficult because most of the drinkers deny or minimize their assumption. It is dramatically important to assess when the last intake happened to avoid withdrawal syndrome. Alcohol acute intoxication can be considered a serious harm to health and a relevant issue for healthcare provid-ers working in emergency rooms. Differential diagnosis is crucial to avoid serious outcomes. There is no consensus about therapies for acute intoxication, but supportive and symptomatic treatments were proved effective. The repercussions of alcohol misuse over drinkers' social, familiar, economical and working life enhance the importance of a multidisciplinary approach in such cases.
Collapse
Affiliation(s)
- A D'Angelo
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Italy
| | - C Petrella
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome, Italy
| | - A Greco
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - M Ralli
- Department of Sense Organs, Sapienza University of Rome, Italy
| | | | - R Giovagnoli
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Italy
| | | | - M Fiore
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome, Italy
| | - M Ceccanti
- SITAC, Società Italiana per il Trattamento dell'Alcolismo e le sue Complicanze, Rome, Italy
| | - M P Messina
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Italy
| |
Collapse
|
23
|
De Salvatore S, Ruzzini L, Longo UG, Marino M, Greco A, Piergentili I, Costici PF, Denaro V. Exploring the association between specific genes and the onset of idiopathic scoliosis: a systematic review. BMC Med Genomics 2022; 15:115. [PMID: 35590413 PMCID: PMC9118580 DOI: 10.1186/s12920-022-01272-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022] Open
Abstract
Background Idiopathic Scoliosis (IS) is the most common spinal deformity in adolescents, accounting for 80% of all spinal deformities. However, the etiology remains uncertain in most cases, being identified as Adolescent Idiopathic Scoliosis (AIS). IS treatments range from observation and sport to bracing or surgery. Several risk factors including sex and familiarity, have been linked with IS. Although there are still many uncertainties regarding the cause of this pathology, several studies report a greater incidence of the defect in families in which at least one other first degree relative is affected. This study systematically reviews the available literature to identify the most significant genes or variants related to the development and onset of IS. Methods The research question was formulated using a PIOS approach on the following databases: Medline, Embase, Cinahl, Scopus, Web of Science and Google Scholar. The search was performed from July to August 2021, and articles from the inception of the database to August 2021 were searched. Results 24 of the 919 initially identified studies were included in the present review. The 24 included studies observed a total of 16,316 cases and 81,567 controls. All the considered studies stated either the affected gene and/or specific SNPs. CHD7, SH2B1, ESR, CALM1, LBX1, MATN1, CHL1, FBN1 and FBN2 genes were associated with IS development. Conclusions Although association can be found in some candidate genes the field of research regarding genetic association with the onset of IS still requires more information.
Collapse
Affiliation(s)
- Sergio De Salvatore
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Laura Ruzzini
- Department of Orthopedics, Children's Hospital Bambino Gesù, 00165, Palidoro, Rome, Italy
| | - Umile Giuseppe Longo
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy. .,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
| | - Martina Marino
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Alessandra Greco
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Ilaria Piergentili
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Pier Francesco Costici
- Department of Orthopedics, Children's Hospital Bambino Gesù, 00165, Palidoro, Rome, Italy
| | - Vincenzo Denaro
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| |
Collapse
|
24
|
Scelsi L, Lanzillo G, Arbustini E, Armini AD, Greco A, Meloni F, Turco A, Valentini A, Visconti LO, Ghio S. When you hear hoofbeats, think zebras ‐ pulmonary veno‐occlusive disease: a case report. Pulm Circ 2022; 12:e12095. [PMID: 35958437 PMCID: PMC9361796 DOI: 10.1002/pul2.12095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/14/2022] [Accepted: 05/15/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Laura Scelsi
- Fondazione IRCCS Policlinico San Matteo Division of Cardiology Pavia IT
| | - Giuseppe Lanzillo
- Fondazione IRCCS Policlinico San Matteo Division of Cardiology Pavia IT
| | - Eloisa Arbustini
- Fondazione IRCCS Policlinico San Matteo Center for Inherited Cardiovascular Diseases Pavia IT
| | - Andrea D Armini
- Fondazione IRCCS Policlinico San Matteo, Department of Cardio‐Thoracic and Vascular Surgery Heart and Lung Transplantation and Pulmonary Hypertension Unit Pavia IT
| | - Alessandra Greco
- Fondazione IRCCS Policlinico San Matteo Division of Cardiology Pavia IT
| | - Federica Meloni
- Fondazione IRCCS Policlinico San Matteo, Respiratory Disease Unit Department of Internal Medicine and Pharmacology Pavia IT
| | - Annalisa Turco
- Fondazione IRCCS Policlinico San Matteo Division of Cardiology Pavia IT
| | - Adele Valentini
- Fondazione IRCCS Policlinico San Matteo Department of Radiology Pavia IT
| | | | - Stefano Ghio
- Fondazione IRCCS Policlinico San Matteo Division of Cardiology Pavia IT
| |
Collapse
|
25
|
Dammassa V, Greco A, Totaro R, Colombo CNJ, Raineri C, Camporotondo R, De Ferrari GM, Mojoli F, Arbustini E, Oltrona Visconti L, Tavazzi G. Bortezomib-induced cardiogenic shock in a multiple myeloma patient with K light-chain cardiac amyloidosis. Ann Hematol 2022; 101:2087-2088. [PMID: 35538262 DOI: 10.1007/s00277-022-04858-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 04/23/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Valentino Dammassa
- PhD in Experimental Medicine, University of Pavia, Pavia, Italy. .,Adult Intensive Care Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
| | - Alessandra Greco
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rossana Totaro
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Claudia Raineri
- Division of Cardiology, AOU Città Della Salute e Della Scienza Di Torino, Torino, Italy
| | - Rita Camporotondo
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, AOU Città Della Salute e Della Scienza Di Torino, Torino, Italy.,Section of Cardiology, Department of Medical Sciences, University of Turin, Torino, Italy
| | - Francesco Mojoli
- Anesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Fondazione IRCCS Policlinico San Matteo, Unit of Anesthesia and Intensive Care, University of Pavia, Pavia, Italy
| | - Eloisa Arbustini
- Centre for Inherited Cardiovascular Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Guido Tavazzi
- Anesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Fondazione IRCCS Policlinico San Matteo, Unit of Anesthesia and Intensive Care, University of Pavia, Pavia, Italy
| |
Collapse
|
26
|
Mameli M, Franchi J, Calusi G, Deken M, Johnson Z, van der Veen L, Lahn M, Vezzelli A, Cardin R, Greco A, Breda M. Validation of an LC–MS/MS method for the quantification IOA-289 in human plasma and its application in a first-in-human clinical trial. J Pharm Biomed Anal 2022; 217:114829. [DOI: 10.1016/j.jpba.2022.114829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/25/2022]
|
27
|
Borgonovo G, Vettus E, Greco A, Leo LA, Faletra FF, Klersy C, Curti M, Valli M. Early Detection of Cardiotoxicity From Systemic and Radiation Therapy in Patients With Breast Cancer: Protocol for a Multi-Institutional Prospective Study. JMIR Res Protoc 2022; 11:e31887. [PMID: 35451989 PMCID: PMC9073600 DOI: 10.2196/31887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/08/2021] [Accepted: 11/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background The incidence of breast cancer is rising worldwide. Recent advances in systemic and local treatments have significantly improved survival rates of patients having early breast cancer. In the last decade, great attention has been paid to the prevention and early detection of cardiotoxicity induced by breast cancer treatments. Systemic therapy-related cardiac toxicities have been extensively studied. Radiotherapy, an essential component of breast cancer treatment, can also increase the risk of heart diseases. Consequently, it is important to balance the expected benefits of cancer treatment with cardiovascular risk and to identify strategies to prevent cardiotoxicity and improve long-term outcomes and quality of life for these patients. Objective This CardioTox Breast study aims to investigate the use of cardiac imaging, based on cardiac magnetic resonance and echocardiography, and to identify associated circulating biomarkers to assess early tissue changes in chemo-induced and radiation-induced cardiotoxicity in the time window of 12 months after the end of radiotherapy in patients with breast cancer. Methods The CardioTox Breast trial is a multicenter observational prospective longitudinal study. We aim to enroll 150 women with stage I-III unilateral breast cancer, treated with breast conserving surgery, who planned to receive radiotherapy with or without systemic therapy. Baseline and follow-up data include cardiac measurements based on cardiac magnetic resonance imaging, echocardiography, and circulating biomarkers of cardiac toxicity. Results This study details the protocol of the CardioTox Breast trial. Recruitment started in September 2020. The results of this study will not be published until data are mature for the final analysis of the primary study end point. Conclusions The CardioTox Breast study is designed to investigate the effects of systemic and radiation therapy on myocardial function and structure, thus providing additional evidence on whether cardiac magnetic resonance is the optimal screening imaging for cardiotoxicity. Trial Registration ClinicalTrials.gov NCT04790266; https://clinicaltrials.gov/ct2/show/NCT04790266 International Registered Report Identifier (IRRID) DERR1-10.2196/31887
Collapse
Affiliation(s)
- Giulia Borgonovo
- Clinic of Radiation Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Elen Vettus
- Department of Oncology, East Tallinn Central Hospital, Tallinn, Estonia
| | - Alessandra Greco
- Division of Cardiology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Laura Anna Leo
- Department of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | | | - Catherine Klersy
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Moreno Curti
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Mariacarla Valli
- Clinic of Radiation Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| |
Collapse
|
28
|
Sidoli C, Zambon A, Tassistro E, Rossi E, Mossello E, Inzitari M, Cherubini A, Marengoni A, Morandi A, Bellelli G, Tarasconi A, Sella M, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Porcella L, Nardiello I, Chimenti E, Zeni M, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, Pietrogrande L, Mosca M, Corazzin I, Rossi P, Nunziata V, D’Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell’Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Borghi C, Bianchetti A, Crucitti A, DiFrancesco V, Fontana G, Geriatria A, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cassadonte F, Vatrano M, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Seneci F, Fimognari F, Bambar V, Saitta A, Corica F, Braga M, Servi, Ettorre E, Camellini Bellelli CG, Annoni G, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Formilan M, Patrizia G, Santuar L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl’Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Alessandro M, Calogero P, Corvalli G, Di F, Pezzoni D, Platto C, D’Ambrosio V, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Bonetto M, Grasso M, Troisi E, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Faraci B, Bertoletti E, Vannucci M, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D’Amico F, Grippa A, Mazzone A, Cottino M, Vezzadini G, Avanzi S, Brambilla C, Orini S, Sgrilli F, Mello A, Lombardi Muti LE, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D’Amico F, D’Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Cortegiani A, Pistidda L, D’Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study. Aging Clin Exp Res 2022; 34:1827-1835. [PMID: 35396698 DOI: 10.1007/s40520-022-02099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. AIM We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the "Delirium Day project". METHODS We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the "Delirium Day project" (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. RESULTS Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17-1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08-2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62-2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10-1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02-1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68-3.36, p value < 0.0001). CONCLUSION This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.
Collapse
|
29
|
Badagliacca R, Papa S, D'Alto M, Ghio S, Agostoni P, Ameri P, Argiento P, Brunetti ND, Casamassima V, Casu G, Cedrone N, Confalonieri M, Corda M, Correale M, D'Agostino C, De Michele L, Famoso G, Galgano G, Greco A, Lombardi CM, Manzi G, Madonna R, Mercurio V, Mulè M, Paciocco G, Romaniello A, Romeo E, Scelsi L, Serra W, Stolfo D, Toma M, Vatrano M, Vitulo P, Vizza CD. The paradox of pulmonary arterial hypertension in Italy in the COVID-19 era: is risk of disease progression around the corner? Eur Respir J 2022; 60:13993003.02276-2021. [PMID: 35301247 PMCID: PMC9535117 DOI: 10.1183/13993003.02276-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/09/2022] [Indexed: 01/01/2023]
Abstract
Objective The coronavirus disease 2019 (COVID-19) outbreak has led to significant restrictions on routine medical care. We conducted a multicentre nationwide survey of patients with pulmonary arterial hypertension (PAH) to determine the consequences of governance measures on PAH management and risk of poor outcome in patients with COVID-19. Materials and methods The present study, which included 25 Italian centres, considered demographic data, the number of in-person visits, 6-min walk and echocardiographic test results, brain natriuretic peptide/N-terminal pro-brain natriuretic peptide test results, World Health Organization functional class assessment, presence of elective and non-elective hospitalisation, need for treatment escalation/initiation, newly diagnosed PAH, incidence of COVID-19 and mortality rates. Data were collected, double-checked and tracked by institutional records between March 1 and May 1, 2020, to coincide with the first peak of COVID-19 and compared with the same time period in 2019. Results Among 1922 PAH patients, the incidences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 were 1.0% and 0.46%, respectively, with the latter comparable to that in the overall Italian population (0.34%) but associated with 100% mortality. Less systematic activities were converted into more effective remote interfacing between clinicians and PAH patients, resulting in lower rates of hospitalisation (1.2% versus 1.9%) and related death (0.3% versus 0.5%) compared with 2019 (p<0.001). A high level of attention is needed to avoid the potential risk of disease progression related to less aggressive escalation of treatment and the reduction in new PAH diagnoses compared with 2019. Conclusion A cohesive partnership between healthcare providers and regional public health officials is needed to prioritise PAH patients for remote monitoring by dedicated tools. COVID-19 showed low incidence among PAH patients, but high mortality rates. A high level of attention is needed to avoid the potential risk of disease progression in the near future.https://bit.ly/3s1lEYM
Collapse
Affiliation(s)
- Roberto Badagliacca
- Department of Cardiovascular and Respiratory Sciences, Sapienza University of Rome, Rome, Italy
| | - Silvia Papa
- Department of Cardiovascular and Respiratory Sciences, Sapienza University of Rome, Rome, Italy
| | - Michele D'Alto
- Department of Cardiology, Monaldi Hospital - University "L. Vanvitelli", Naples, Italy
| | - Stefano Ghio
- Fondazione IRCCS Policlinico S Matteo, Pavia, Italy
| | - Piergiuseppe Agostoni
- Departement of Clinical and Community Sciences, University of Milan, Milan, Italy.,Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Pietro Ameri
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Paola Argiento
- Department of Cardiology, Monaldi Hospital - University "L. Vanvitelli", Naples, Italy
| | | | - Vito Casamassima
- Department of Cardiology, "F.Miulli" Hospital, Acquaviva delle Fonti, Bari, Italy
| | - Gavino Casu
- ATS Sardegna-ASSL Nuoro, San Francesco Hospital Nuoro, Nuoro, Italy.,University of Sassari, Sassari, Italy
| | - Nadia Cedrone
- Unità di Medicina Interna, Ospedale S. Pertini, Rome, Italy
| | - Marco Confalonieri
- Pulmonology Unit, Heart-Thorax-Vessels Department, University Hospital of Cattinara, Trieste, Italy
| | - Marco Corda
- Cardiology Unit, Azienda Ospedaliera "G. Brotzu" San Michele, Cagliari, Italy
| | - Michele Correale
- Cardiology Department, Ospedali Riuniti University Hospital, Foggia, Italy
| | - Carlo D'Agostino
- Cardiology Department, University Hospital Policlinico Consorziale Bari, Bari, Italy
| | - Lucrezia De Michele
- Cardiology Department, University Hospital Policlinico Consorziale Bari, Bari, Italy
| | - Giulia Famoso
- Department of Cardiac Thoracic Vascular Sciences and Public Health Padua, Padua, Italy
| | | | | | | | - Giovanna Manzi
- Department of Cardiovascular and Respiratory Sciences, Sapienza University of Rome, Rome, Italy
| | - Rosalinda Madonna
- Cardiology Unit, Department of Surgical, Medical and Molecular Pathology and of Critical Sciences, University of Pisa - UNIPI, Pisa, Italy
| | - Valentina Mercurio
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | | | - Giuseppe Paciocco
- Dipartimento Cardio-Toraco-Vascolare, Clinica Pneumologica, Azienda Ospedaliera San Gerardo, Monza, Italy
| | | | - Emanuele Romeo
- Department of Cardiology, Monaldi Hospital - University "L. Vanvitelli", Naples, Italy
| | - Laura Scelsi
- Fondazione IRCCS Policlinico S Matteo, Pavia, Italy
| | - Walter Serra
- Cardiology Unit, University Hospital of Parma, Italy
| | - Davide Stolfo
- Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Matteo Toma
- Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino and Department of Internal Medicine, Univeristy of Genova, Genova, Italy
| | - Marco Vatrano
- Azienda Ospedaliera Pugliese - Ciaccio di Catanzaro, Catanzaro, Italy
| | - Patrizio Vitulo
- Pulmonology Unit, IRCCS - Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione (ISMETT), Palermo, Italy
| | - Carmine Dario Vizza
- Department of Cardiovascular and Respiratory Sciences, Sapienza University of Rome, Rome, Italy
| | | |
Collapse
|
30
|
Rizzo MI, Fallico N, Beneduce N, Ruoppolo G, Ciofalo A, Vagnoni S, Palmieri A, De Virgilio A, Greco A, Zama M. Objective and subjective evaluation of Velopharyngeal Dysfunction (VPD) following surgical repair of the cleft palate using the furlow palatoplasty - A new tool. J Plast Reconstr Aesthet Surg 2022; 75:3448-3456. [PMID: 35768288 DOI: 10.1016/j.bjps.2022.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 02/12/2022] [Indexed: 11/30/2022]
Abstract
Velopharyngeal dysfunction (VPD) diagnosis and speech surgery outcomes are currently based solely on subjective evaluation criteria consisting of perceptual speech assessment and functional imaging. This study describes an objective and comparable method in VPD assessment and investigates the concurrence between the objective and subjective evaluations. The present study included 20 paediatric patients presenting with VPD after primary repair (intravelar veloplasty) of cleft palate. Our protocol was based on computerized analysis of voice parameters by means of an objective tool, spectrography integrated with Multi-Dimensional Voice Program (MDVP). The protocol also included perceptual evaluation by speech therapist and phoniatrician (consensus listening), and parents. This is a single surgeon, single centre experience and all patients underwent a secondary Furlow's palatoplasty. Assessments were performed pre- and postoperatively and upon completion of speech therapy. Results were compared using the two-tailed t student test for paired data. Statistical significance was set for p-values <0.05. Data analysis confirmed an improvement in velopharyngeal closure after surgery and speech therapy consistently with the results of perceptual evaluations. The results of the study confirmed the availability and reliability of an objective method for VPD evaluation based on the analysis of voice parameters with investigations that are simple and easily available in a hospital setting.
Collapse
Affiliation(s)
- M I Rizzo
- Ospedale Pediatrico Bambino Gesù, Department of Plastic and Maxillo-facial surgery, Piazza di Sant'Onofrio 4, 00165 Roma, Italy
| | - N Fallico
- Spires Cleft Centre, Salisbury Oxford, UK
| | - N Beneduce
- Sapienza University, Department of Maxillofacial surgery, Viale del policlinico 155, 00161 Roma, Italy.
| | - G Ruoppolo
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - A Ciofalo
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - S Vagnoni
- Ospedale Pediatrico Bambino Gesù, Department of Plastic and Maxillo-facial surgery, Piazza di Sant'Onofrio 4, 00165 Roma, Italy
| | - A Palmieri
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - A De Virgilio
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - A Greco
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - M Zama
- Ospedale Pediatrico Bambino Gesù, Department of Plastic and Maxillo-facial surgery, Piazza di Sant'Onofrio 4, 00165 Roma, Italy
| |
Collapse
|
31
|
De Giorgio F, Ricci E, Arena E, Greco A, Ralli M. COVID-19 pandemic and days of absence from work in workers with flu-like symptoms in the City of Rome, Italy. Clin Ter 2022; 173:64-66. [PMID: 35147649 DOI: 10.7417/ct.2022.2394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
ABSTRACT COVID-19 has dramatically affected working forces. We aim to report our occupational medicine service's experience in managing suspected COVID-19 cases during the pandemic through a retrospec-tive observational study. We compared the number of days employees were absent from work due to flu-like symptoms from March 2020 to February 2021 to the same period the previous year (2019-2020). Two hundred thirty-four patients (+47.2% compared to the previous year) who tested negative for SARS-CoV-2 reported flu-like symp-toms; the number of days of absence from work was 2812 (+190.2% compared to the previous year). On average, employees with flu-like symptoms lost 12.07 working days compared to 6.12 in the previous year (p<0.0001). In conclusion, in our sample COVID-19 has increased the number of working day loss. However, our approach proved to be important, especially during the first months of the pandemic, to limit SARS-CoV-2 spread in workplaces.
Collapse
Affiliation(s)
- F De Giorgio
- Department of Health Care Surveillance and Bioethics, section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.,ondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - E Ricci
- Department of Health Care Surveillance and Bioethics, section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - E Arena
- Department of Health Care Surveillance and Bioethics, section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Greco
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - M Ralli
- Department of Sense Organs, Sapienza University of Rome, Italy
| |
Collapse
|
32
|
Zucchelli A, Manzoni F, Morandi A, Di Santo S, Rossi E, Valsecchi MG, Inzitari M, Cherubini A, Bo M, Mossello E, Marengoni A, Bellelli G, Tarasconi A, Sella M, Auriemma S, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Margola A, Porcella L, Nardiello I, Chimenti E, Zeni M, Giani A, Famularo S, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Ballestrero A, Minaglia C, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, De F, Pietrogrande L, De B, Mosca M, Corazzin I, Rossi P, Nunziata V, D‘Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell‘Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Bianchetti A, Crucitti A, Di Francesco V, Fontana G, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cannistrà U, Cassadonte F, Vatrano M, Cassandonte F, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Fimognari F, Bambara V, Saitta A, Corica F, Braga M, Ettorre E, Camellini C, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Patrizia G, Santuari L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl‘Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Calogero P, Corvalli G, Pezzoni D, Gentile S, Morandi A, Platto C, D‘Ambrosio V, Faraci B, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Confente S, Bonetto M, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Bertoletti E, Vannucci M, Tesi F, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D‘Amico F, Grippa A, Mazzone A, Riva E, Dell‘Acqua D, Cottino M, Vezzadini G, Avanzi S, Orini S, Sgrilli F, Mello A, Lombardi L, Muti E, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, De F, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D‘Amico F, D‘Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Scapigliati A, Cortegiani A, Vitale F, Pistidda L, D‘Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017. Aging Clin Exp Res 2022; 34:349-357. [PMID: 34417734 PMCID: PMC8847195 DOI: 10.1007/s40520-021-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/31/2021] [Indexed: 01/22/2023]
Abstract
Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric
syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01950-8.
Collapse
|
33
|
Bianco MR, Ralli M, Minni A, Greco A, de Vincentiis M, Allegra E. Evaluation of olfactory dysfunction persistence after COVID-19: a prospective study. Eur Rev Med Pharmacol Sci 2022; 26:1042-1048. [PMID: 35179771 DOI: 10.26355/eurrev_202202_28014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Alterations of the olfactory function in patients affected by COVID-19 often have an early onset and a variable duration ranging from a few weeks to months. The aim of this study was to evaluate olfactory dysfunction persistence after recovery from COVID-19, and potential related clinical-demographic conditions. PATIENTS AND METHODS A total of 76 patients recovered from COVID-19 from at least 20 days with olfactory dysfunction during the infection were included in the study. For the subjective evaluation of olfactory function, a visual analogic scale (VAS) was used. The objective evaluation was performed with the use of the Sniffin' Sticks test. RESULTS Objective assessment of olfactory function revealed that 48 (63.16%) patients were found to be normosmic (TDI ≥ 30.5), 26 (34.21%) were hyposmic (TDI from 30.5 to 16.5) and two (2.63%) were anosmic (TDI ≤ 16.5) at the time of the evaluation. These results did not show a significant difference between subjective and objective tests (p = 0.45). Most patients recovered their sense of smell within the first two months after recovery while a portion (22.2%) still experienced olfactory alterations 4-6 months after SARS-CoV-2 infection. Patients who had not recovered their sense of smell had a significantly longer period of SARS-CoV-2 positivity compared to patients that fully recovered (36.07 ± 7.78 days vs. 29 ± 7.89 days; p = 0.04). CONCLUSIONS Our results suggest that the duration of the infection negatively correlates with the recovery of olfactory function.
Collapse
Affiliation(s)
- M R Bianco
- Otolaryngology Unit, Department of Health Science, University of Catanzaro, Catanzaro, Italy.
| | | | | | | | | | | |
Collapse
|
34
|
Ralli M, Colizza A, Cambria F, Gilardi A, Meliante P, Cavalcanti L, Minni A, Greco A, de Vincentiis M. Effects of COVID-19 pandemic on head and neck oncology activity: the experience of our University Hospital. Eur Rev Med Pharmacol Sci 2021; 25:7268-7271. [PMID: 34919225 DOI: 10.26355/eurrev_202112_27419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has severely affected otolaryngology and head and neck activities, also involving diagnosis and treatment of patients with oncology diseases with consequent delays and tumor upstaging. The aim of this study was to describe the experience of our otolaryngology unit during the pandemic on patients with cancer of the head and neck, comparing data on anatomical site of origin and preferred treatment with pre-pandemic data. PATIENTS AND METHODS This study retrospectively analyzed the clinical records of patients treated for oncology disorders of the head and neck in the Otolaryngology Unit of the Policlinico Umberto I, Sapienza University of Rome, between March 10, 2020, and March 9, 2021. Data were compared with the same period of the previous year (March 10, 2019 - March 9, 2020). RESULTS During the pandemic, we treated 92 patients with malignant tumor of the head and neck, compared to 101 patients treated during the same period of 2019 (-8.91%). The most common anatomical sites of origin of the neoplasms were larynx, oral cavity, and oropharynx. Surgical approach was preferred in 57 patients (61.95%); non-surgical treatments were performed in 35 cases (38.05%). Compared to the same period of the previous year, we found a 12.90% decrease in the number of oncology patients undergoing surgery, while patients treated exclusively with non-surgical approaches increased by 18.42%. CONCLUSIONS Despite the impact of COVID-19 on the activity of our otolaryngology unit and on the whole healthcare system, diagnostic and therapeutic procedures for patients affected by malignancy of head and neck region were only minimally impacted.
Collapse
Affiliation(s)
- M Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Scelsi L, Greco A, Acquaro M, Olivieri C, Sobrero M, Turco A, Cappelletti D, Visconti LO, Ghio S. BMPR2 mutations and response to inhaled or parenteral prostanoids: a case series. Pulm Circ 2021; 11:20458940211037275. [PMID: 34900222 PMCID: PMC8652182 DOI: 10.1177/20458940211037275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022] Open
Abstract
Whether mutations in the BMPR2 gene may influence the response to PAH-specific therapies has not yet been investigated. In this study, in 13 idiopathic, heritable or anorexigen-associated PAH patients, in whom treatment escalation was performed by adding a prostanoid, a greater haemodynamic improvement was observed in BMPR2-negative than in BMPR2-positive patients.
Collapse
Affiliation(s)
- Laura Scelsi
- Divisione di Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessandra Greco
- Divisione di Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Mauro Acquaro
- Divisione di Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Facoltà Di Medicina e Chirurgia, Università di Pavia, Pavia, Italy
| | - Carla Olivieri
- U.O.C. di Biologia Generale e Genetica Medica, Dipartimento di Medicina Molecolare, Università di Pavia, Pavia, Italy
| | - Matteo Sobrero
- Divisione di Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Annalisa Turco
- Divisione di Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Donata Cappelletti
- U.O.C. Anatomia Patologica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Stefano Ghio
- Divisione di Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
36
|
Ruzzini L, De Salvatore S, Longo UG, Marino M, Greco A, Piergentili I, Costici PF, Denaro V. Prenatal Diagnosis of Clubfoot: Where Are We Now? Systematic Review and Meta-Analysis. Diagnostics (Basel) 2021; 11:diagnostics11122235. [PMID: 34943470 PMCID: PMC8700252 DOI: 10.3390/diagnostics11122235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/23/2021] [Accepted: 11/28/2021] [Indexed: 12/28/2022] Open
Abstract
The primary methods for prenatal diagnosis of Clubfoot are ultrasound (US) and magnetic resonance imaging (MRI). An ultrasound is performed between the 1st trimester and the 28th week of pregnancy and it is reported to be used as a diagnostic method alone or in combination with MRI. So far, an international consensus on the most effective screening method has not been reached. This systematic review and meta-analysis were performed to establish the most effective and reliable exam for prenatal diagnosis of Clubfoot. The literature search was conducted using a PIOS-approach from May 2021 to June 2021. Studies reporting cases of prenatal diagnosis of Clubfoot made through US and MRI conducted from January 2010 to June 2021 were included in the study and reviewed by 2 authors. The 23 selected studies included 2318 patients. A total of 11 of the studies included details on the accuracy, while the rest were used to obtain information about the primary methodology utilized. In all the selected studies, US was used as the primary diagnostic instrument. Thirteen of the studies used the US exclusively, while three used MRI in addition to US and seven performed karyotyping after US diagnosis. The US has been shown to be the instrument of choice for the prenatal diagnosis of Clubfoot. International guidelines for an ultrasonography classification of congenital clubfoot are required to reduce the inter-variability accuracy of this procedure.
Collapse
Affiliation(s)
- Laura Ruzzini
- Department of Orthopedics, Children’s Hospital Bambino Gesù, Palidoro, 00165 Rome, Italy; (L.R.); (P.F.C.)
| | - Sergio De Salvatore
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy; (S.D.S.); (M.M.); (A.G.); (I.P.); (V.D.)
| | - Umile Giuseppe Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy; (S.D.S.); (M.M.); (A.G.); (I.P.); (V.D.)
- Correspondence: ; Tel.: +39-06-225-411-613
| | - Martina Marino
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy; (S.D.S.); (M.M.); (A.G.); (I.P.); (V.D.)
| | - Alessandra Greco
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy; (S.D.S.); (M.M.); (A.G.); (I.P.); (V.D.)
| | - Ilaria Piergentili
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy; (S.D.S.); (M.M.); (A.G.); (I.P.); (V.D.)
| | - Pier Francesco Costici
- Department of Orthopedics, Children’s Hospital Bambino Gesù, Palidoro, 00165 Rome, Italy; (L.R.); (P.F.C.)
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy; (S.D.S.); (M.M.); (A.G.); (I.P.); (V.D.)
| |
Collapse
|
37
|
Ghiasi S, Dell'Acqua C, Benvenuti SM, Scilingo EP, Gentili C, Valenza G, Greco A. Classifying subclinical depression using EEG spectral and connectivity measures. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:2050-2053. [PMID: 34891691 DOI: 10.1109/embc46164.2021.9630044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Detecting depression on its early stages helps preventing the onset of severe depressive episodes. In this study, we propose an automatic classification pipeline to detect subclinical depression (i.e., dysphoria) through the electroencephalography (EEG) signal. To this aim, we recorded the EEG signals in resting condition from 26 female participants with dysphoria and 38 female controls. The EEG signals were processed to extract several spectral and functional connectivity features to feed a nonlinear Support Vector Machine (SVM) classifier embedded with a Recursive Feature Elimination (RFE) algorithm. Our recognition pipeline obtained a maximum classification accuracy of 83.91% in recognizing dysphoria patients with a combination of connectivity and spectral measures. Moreover, an accuracy of 76.11% was achieved with only the 4 most informative functional connections, suggesting a central role of cortical connectivity in the theta band for early depression recognition. The present study can facilitate the diagnosis of subclinical conditions of depression and may provide reliable indicators of depression for the clinical community.
Collapse
|
38
|
Acquaro M, Breviario F, Greco A, Ghio S. Acute pericarditis, Graves' disease, and thymic hyperplasia: a case report. Eur Heart J Case Rep 2021; 5:ytab392. [PMID: 34676356 PMCID: PMC8526917 DOI: 10.1093/ehjcr/ytab392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/09/2021] [Accepted: 09/27/2021] [Indexed: 12/11/2022]
Abstract
Background Acute pericarditis as a sign of mediastinal mass is rare and aetiological diagnosis can be challenging without adequate imaging. Case summary An 18-year-old woman came to our attention describing acute sharp chest pain radiated to the left arm, exacerbated with supine positioning and attenuated while sitting or leaning forward. The electrocardiogram showed diffuse ST elevation and PR depression, with sinus tachycardia. Cardiac biomarkers and D-dimer were negative; echocardiography showed no abnormalities and the absence of pericardial effusion. Her blood work revealed no sign of inflammation or bacterial infection (PCR and procalcitonin were normal); thyroid-stimulating hormone plasma levels were suppressed, showing decompensated thyrotoxicosis. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Epstein-Barr virus, human immunodeficiency virus, hepatitis C virus, Enterovirus, Parvovirus B19, and Adenovirus tests were normal. Her past medical history was silent, apart from Grave's disease on treatment with methimazole. Chest computed tomography (CT) was performed and showed the presence of slightly increased density pericardial effusion, with a maximum thickness of 15 mm in the upper mediastinum. Finally, cardiac magnetic resonance (MR) identified a mass of 73 × 51 mm located in the upper mediastinum. The mass was subsequently biopsed with video-assisted thoracoscopic surgery and the histological analysis showed thymic hyperplasia. Discussion This case shows the importance of an adequate clinical suspicion of thymic hyperplasia in the context of acute pericarditis symptoms and known Graves' disease. In this case, a negative chest CT finding may not be sufficient to rule out the diagnosis and cardiac MR imaging is necessary.
Collapse
Affiliation(s)
- Mauro Acquaro
- Divisione di Cardiologia, Fondazione IRCCS San Matteo Hospital, Viale Golgi 19, 27100 Pavia, Italy
| | - Federico Breviario
- Divisione di Cardiologia, Fondazione IRCCS San Matteo Hospital, Viale Golgi 19, 27100 Pavia, Italy
| | - Alessandra Greco
- Divisione di Cardiologia, Fondazione IRCCS San Matteo Hospital, Viale Golgi 19, 27100 Pavia, Italy
| | - Stefano Ghio
- Divisione di Cardiologia, Fondazione IRCCS San Matteo Hospital, Viale Golgi 19, 27100 Pavia, Italy
| |
Collapse
|
39
|
Calderone D, Mauro MS, Greco A, Capodanno D, Tamburino C. Characterization of actionable bleeding and thrombotic risk trade-offs in patients undergoing percutaneous coronary intervention. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients undergoing percutaneous coronary intervention (PCI) are at risk of developing bleeding and/or thrombotic complications. Bleeding and thrombotic risk characteristics may overlap in some patients, which makes decision-making for dual antiplatelet therapy duration a clinical challenge. The actual proportion of PCI patients who have an increased bleeding risk and/or an increased thrombotic risk is unclear.
Purpose
Aim of this study is to identify sizeable and actionable proportions of patients at high bleeding risk (HBR) and/or at high thrombotic risk (HTR) in a contemporary cohort of PCI patients.
Methods
We retrospectively included all patients undergoing PCI at our Institution from November 2019 to April 2020 and identified those at HBR or HTR based on criteria from the Academic Research Consortium for High Bleeding Risk (ARC-HBR) or criteria from Giustino and colleagues, respectively. Since belonging to the HBR and HTR groups was non-mutually exclusive, patients were further stratified into 4 mutually exclusive subgroups: 1) HBR/HTR; 2) HBR, non-HTR; 3) non-HBR, HTR; and 4) non-HBR, non-HTR. In addition, the new ARC-HBR trade-off model (integrating patients' characteristics to define the individual risks of bleeding and thrombotic events) was applied to rank patients based on their computed risk scores for bleeding and thrombosis. Patients were categorized based on the ratio between the ARC-HBR thrombotic and the bleeding risk scores (i.e., high [1.5], intermediate [0.75–1.5], low [<0.75]).
Results
A total of 312 patients were included, of which 93 (30%) presented with HBR and 116 (37%) with HTR. Among patients with HBR, 41% presented with HTR. Among patients with HTR, 33% presented with HBR. Overall, 12.2% of patients had HBR/HTR, 17.6% had HBR, non-HTR, 25.0% had non-HBR, HTR, and 45.2% had non-HBR, non-HTR. Based on the ARC-HBR trade off score, 16.3% of patients had a higher risk of thrombosis than the risk of bleeding, 45.9% had similar risks, and 37.8% had a higher risk of bleeding than the risk of thrombosis. Among patients who had HBR/HTR, the trade-off model identified 8% as having a higher risk of thrombosis than the risk of bleeding and 18.4% as having a higher risk of bleeding than the risk of thrombosis.
Conclusions
Characterizing the risk of bleeding and thrombotic complications is an important prerequisite for tailoring strategies to individual patients, hence minimizing the risks and improving the outcome of PCI. More than half of patients undergoing PCI presented with HBR, HTR, or both. About 40% of patients presented with characteristics of high risk, which make them actionable (e.g., by using shorter durations of dual antiplatelet therapy in patients at HBR and non-HTR or using longer durations in patients at non-HBR and HTR). The ARC-HBR trade off model score is an additional useful tool that may be used to identify an additional quarter of actionable patients in the HBR/HTR category.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- D Calderone
- Azienda Ospedaliero Universitaria “G.Rodolico - S. Marco”, Cardiology Unit, Catania, Italy
| | - M S Mauro
- Azienda Ospedaliero Universitaria “G.Rodolico - S. Marco”, Cardiology Unit, Catania, Italy
| | - A Greco
- Azienda Ospedaliero Universitaria “G.Rodolico - S. Marco”, Cardiology Unit, Catania, Italy
| | - D Capodanno
- Azienda Ospedaliero Universitaria “G.Rodolico - S. Marco”, Cardiology Unit, Catania, Italy
| | - C Tamburino
- Azienda Ospedaliero Universitaria “G.Rodolico - S. Marco”, Cardiology Unit, Catania, Italy
| |
Collapse
|
40
|
Dusi V, Barcellini A, Greco A, Vitolo V, Vai A, Mirandola A, Zambrino D, Roccio M, Coccia M, Turco A, Sanzo A, Vicentini A, Ghio S, Orlandi E, Rordorf R. Hadrontherapy for intra- or para-cardiac tumors: evaluation of cardiac radiation dose distribution and acute cardiac effects. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There is growing interest in the possibility of using X-rays and hadrons (protons and carbon ions) for antiarrhythmic purposes both at the ventricular and the atrial level, but knowledge about the effects on cardiac tissue outside the target is still limited. Hadron therapy has the dosimetric advantage over photons of a greater ability to concentrate high doses on the target while minimizing the off-target dose. Oncological studies have shown a linear relationship between the mean total heart dose (Dm-heart) of X-rays and the long-term risk of heart damage, particularly when the Dm-heart is>5 Gray (Gy).
Objectives
We designed a prospective study aimed at investigating the effect of heavy particles on cardiac structure and function and on cardiac rhythm in patients undergoing hadrontherapy for intra or para-cardiac tumors.
Methods
Patients candidates to hadrontherapy with a mean predicted cardiac dose grather than zero underwent close cardiological monitoring including blood pressure detection, 12-lead ECG, 12-lead Holter ECG (including time-domain indices of heart rate variability in all cases and Brugada leads in selected cases), cardiac US and cardiac (troponin and natriuretic peptides) and inflammatory biomarkers. These assessments were obtained at baseline, during (ECG and biomarkers only) and at the end of the hadrontherapy cycle, and then every 3–6 months as appropriate. Physicists and radiotherapists collaborated to implement a robust optimization of the treatment plan aimed at minimizing cardiac dose. We present the results of the monitoring up to the end of the hadrontherapy.
Results
17 consecutive patients (56±18 years, range 20–77 years, 59% male) have been enrolled to date, including 3 cases (18%) of intra-cardiac tumors (2 primary and 1 metastatic), who have undergone to 16±6 sessions of radiotherapy each, in 71% of cases with respiratory gating during delivery. Most patients (76%) were treated with carbon ions, the remaining with protons (mean total dose on the neoplastic target 51.8±10.7 Gy, from 2 to 4.2 Gy per fraction). Sixty-one percent of patients had ≥1 cardiovascular risk factor, 6% had a known heart disease (valvular cardiomyopathy despite aortic valve replacement with biological prosthesis and post-surgical pericarditis). The mean dose on the whole heart was 3.58±2.05 Gy, the maximum dose was 33.78±23.99 Gy, with a very variable dose distribution on cardiac substructures depending on the tumor site (table). At the end of the scheduled radiotherapy sessions (24±9 days), no significant changes were observed in cardiac function, cardiac rhythm, ventricular repolarization, biomarkers and autonomic indices.
Conclusions
Hadrontherapy with protons and carbon ions aimed at the treatment of para-cardiac or intra-cardiac tumors allowed to maintain a low heart Dm and showed no signs of acute cardiac toxicity. The collection of potential cardiac effects in the medium and long term is ongoing.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- V Dusi
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - A Barcellini
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - A Greco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - V Vitolo
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - A Vai
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - A Mirandola
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - D Zambrino
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - M Roccio
- Policlinic Foundation San Matteo IRCCS, Department of Gynecology, Pavia, Italy
| | - M Coccia
- University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Turco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Sanzo
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - A Vicentini
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - E Orlandi
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - R Rordorf
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| |
Collapse
|
41
|
Dusi V, Masiello L, Vicentini A, Savastano S, Petracci B, Sanzo A, Baldi E, Greco A, Turco A, Raineri C, Scelsi L, Ghio S, Serio A, Arbustini E, Rordorf R. Long-term outcome of patients with cardiolaminopathy undergoing defibrillator implantation: single-center experience. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Mutations in the LMNA gene are associated with a high arrhythmic risk. The history of the disease in patients undergoing ICD implantation is poorly characterized.
Purpose
To evaluate the phenotype of patients with cardiolaminopathy at the time of first ICD implantation, the incidence, characteristics and timing of ventricular arrhythmias (VAs) during follow up and the predictive value of the European score (that assigns a point each to non-sustained VT (NSVT), left ventricular ejection fraction (LVEF)<45% at first contact, male sex and non-missense mutations) and of the Wahbi score (that also includes conduction disturbances) for both VAs and heart failure (HF) related outcomes.
Methods
Patients were identified retrospectively. Clinical and device data were collected at baseline and during follow-up.
Results
We identified 26 patients (54% male, 42±8 years, 31% with familial history of sudden cardiac death, 31% with non-missense mutation) undergoing ICD implantation, 96% in primary prevention, 47% with single chamber ICD, 38% with dual chamber ICD. At the time of implantation, 30% had skeletal muscle involvement, 15% history of syncope, 4% of cardiac arrest, 62% previous NSVT. Also, 38% had a history of supraventricular arrhythmias and 61% had AV conduction disturbances. LVEF was 41±11%, 35% were in NYHA class ≥2, the mean European and Wahbi scores were 2.1±0.8 and 18.2±8.9, respectively. During 8.3±5 years, 15% were transplanted, 8% died due to HF, 4% underwent LVAD implantation, despite 31% having received an upgrade to CRT-D. Appropriate device interventions occurred in 46% of patients with a median time to first event of 29 months (IQR 13–93), for a total of 137 ATP, 51% of which effective (median 3ATP/patient, IQR 1–8) and of 26 shocks, 96% of which effective (median 2 shocks/patient, IQR 1–3); 12% had an arrhythmic storm. The first treated arrhythmia was a polymorphic VT/VF in 17%, a monomorphic VT in the others (medium cycle length 293±37 msec). Survival free from appropriate ICD interventions at 1 and at 5 years was 75% and 19% respectively in case of a European score ≥3 vs 94% and 82% in case of a score <3 (Logrank test p<0.01), 72% and 46% in case of Wahbi score ≥30 vs 100% and 86% with score <30 (p<0.01), with no differences in terms of death/transplant (figure). At last follow-up, 92% of patients a were taking beta-blocker, 42% amiodarone, 8% sotalol, 4% flecainide, 8% mexiletine. Also, 4% had undergone invasive VT ablation, 8% bilateral cardiac sympathetic denervation.
Conclusions
Patients with cardiolaminopathy are at a high risk of both arrhythmic and heart failure progression over the first decade after implantation of the first ICD. A European score ≥3 identifies patients with 5-year shock/ATP free survival of less than 20% but does not predict death/transplantation. The first arrhythmic event in these patients is more frequently a rapid monomorphic VT with modest ATP efficacy.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- V Dusi
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - L.C Masiello
- University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Vicentini
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - S Savastano
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - B Petracci
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - A Sanzo
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - E Baldi
- University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Greco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Turco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - C Raineri
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - L Scelsi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Serio
- Policlinic Foundation San Matteo IRCCS, Center for Cardiovascular Genetic Diseases, Pavia, Italy
| | - E Arbustini
- Policlinic Foundation San Matteo IRCCS, Center for Cardiovascular Genetic Diseases, Pavia, Italy
| | - R Rordorf
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| |
Collapse
|
42
|
Gentile FR, Compagnoni S, Baldi E, Ghio S, Scelsi L, Greco A, Turco A, Oltrona Visconti L, Savastano S. Out-of-hospital cardiac arrest in patients with heart disease from family members' perspective: high perception of risk, low sense of adequacy and the importance of training. J Cardiovasc Med (Hagerstown) 2021; 22:790-791. [PMID: 33851938 DOI: 10.2459/jcm.0000000000001149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
43
|
Sepe R, Greco A, De Luca A, Caputo F, Berto F. Influence of thermo-mechanical material properties on the structural response of a welded butt-joint by FEM simulation and experimental tests. Forces in Mechanics 2021. [DOI: 10.1016/j.finmec.2021.100018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
44
|
Dammassa V, Colombo CNJ, Greco A, Guida S, Boffi A, Mojoli F, Ghio S, Price S, Tavazzi G. Right ventricular time intervals - Comparison between pulsed wave Doppler and tissue Doppler imaging. Echocardiography 2021; 38:1762-1768. [PMID: 34555214 DOI: 10.1111/echo.15209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/22/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Cardiac time intervals are used as indices of systolic and diastolic function. Echocardiographic assessment of these intervals is based on either pulsed wave Doppler (PWD) or tissue Doppler imaging (TDI). We investigated the agreement between the two techniques in the evaluation of right ventricular (RV) time intervals in healthy adults. METHODS In 123 healthy volunteers we used both PWD and TDI to assess RV time intervals (filling time - RVFT, ejection time - RVET), heart rate-corrected intervals (total filling time - t-FT, total ejection time - t-ET) and RV performance indices (total isovolumic time - t-IVT, myocardial performance index - MPI). Intraclass correlation coefficient (ICC) and Pearson analysis (r coefficient) were used to evaluate the agreement and correlation between the two techniques. RESULTS PWD and TDI had excellent agreement and correlation in measuring RVFT (ICC 0.94 [95% CI 0.85 - 0.97], r 0.91) whereas a good agreement was found for RVET (ICC 0.63[95% CI - 0.14 - 0.84]; r 0.68). Good agreement and strong correlation were found for both t-FT (ICC 0.67 [95% CI 0.36 - 0.82]; r 0.59) and t-ET (ICC 0.71 [95% CI - 0.06-0.88]; r 0.74). The two methods had lower agreement in assessing RV t-IVT (ICC 0.52 [95% CI 0.3187-0.6622]; r 0.57) and MPI (ICC 0.36 [95% CI - 0.05-0.43]; r 0.50). CONCLUSION In healthy adults, PWD and TDI are interchangeable in measuring RVFT, RVET, RV t-FT and RV t-ET. Lower agreement between the two techniques was found for RV t-IVT and MPI.
Collapse
Affiliation(s)
- Valentino Dammassa
- Anesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Alessandra Greco
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefania Guida
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Boffi
- Service de Medecine Inetnsive Adulte, Centre Hospitalier Universitaire Vadouis, Lausanne, Switzerland
| | - Francesco Mojoli
- Anesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Unit of anesthesia and intensive care, University of Pavia, Pavia, Italy
| | - Stefano Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Susanna Price
- Royal Brompton & Harefield NHS Foundation Trust, Royal Brompton Hospital, London, UK
| | - Guido Tavazzi
- Anesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Unit of anesthesia and intensive care, University of Pavia, Pavia, Italy
| |
Collapse
|
45
|
Ruoppolo G, Mariani L, Quaglieri S, Longo L, Pescerelli P, Cilfone A, Cocchi C, Marcotullio D, Greco A, De Vincentiis M. Unilateral vocal fold paralysis post-thyroidectomy: does early intervention allow for better voice recovery? Eur Rev Med Pharmacol Sci 2021; 25:1177-1184. [PMID: 33629287 DOI: 10.26355/eurrev_202102_24820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Thyroidectomy is the primary cause of unilateral vocal fold paralysis (UVFP). A delay in rehabilitation may cause dysfunctional phenomena and worsen dysphonia. The main aim is to investigate the impact of early Speech Therapy (ST) on voice recovery in UVFP post-thyroidectomy and propose an appropriate treatment schedule. PATIENTS AND METHODS 93 patients with UVFP were analysed. 72 presented transient paralysis and 21 permanent ones. Individuals with permanent paralysis were retrospectively divided in two groups. Group A was composed of 11 patients (8 F, 3 M; mean age: 50.5 ± 8.6) who received ST within 8 weeks; Group B comprised 10 patients (7 F, 3 M; mean age: 57 ± 11.5) treated after more than 8 weeks. Videolaryngostroboscopy (VLS) was assessed and both objective and subjective voice parameters were collected. The non-parametric Wilcoxon test was applied to the sample. RESULTS The resolution of supraglottic compensations was observed in 91% of cases in Group A, whereas in only 40% of cases in Group B. A functional glottal closure occurred in 73% of patients in group A, while it was completely absent in group B. Group A showed a statistically significant difference between the values of Jitter, NHR, TMF and VHI collected pre-ST compared to that collected after 1 year. Conversely, a statistically significant difference was found only for VHI values in group B. CONCLUSIONS Early ST brings benefits to patients with permanent UVFP, both on voice recovery and on quality of life. A ST protocol should be applied both before and after thyroidectomy. The ST treatment should start early after surgery.
Collapse
Affiliation(s)
- G Ruoppolo
- Department of Sensorial Organs, Sapienza University of Rome, Rome, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Barbato C, Di Certo MG, Gabanella F, Petrella C, Fiore M, Passananti C, Colizza A, Cavalcanti L, Ralli M, Greco A, De Vincentiis M, Minni A. Staying tuned for post-COVID-19 syndrome: looking for new research to sniff out. Eur Rev Med Pharmacol Sci 2021; 25:5318-5321. [PMID: 34486708 DOI: 10.26355/eurrev_202108_26553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Post-COVID-19 syndrome was defined as a persistent and protracted illness, which follows acute COVID-19 infection. This condition continues for more than 12 weeks and cannot be attributed to other clinical situations. Researchers and clinicians are allied in unraveling the molecular pathogenetic mechanisms and the clinical development of this unexpected SARS-CoV-2 infectious evolution. Anosmia, dysgeusia, fatigue, dyspnea, and 'brain fog' are common symptoms observed in the Post-COVID-19 syndrome, depicting a multiorgan involvement associated with injuries involving mainly cardiovascular, pulmonary, musculoskeletal, and neuropsychiatric systems. This commentary analyzes the state of the art of Post-COVID-19 interdisciplinary studies, confirming that we are facing a truly intricate biomedicine story.
Collapse
Affiliation(s)
- C Barbato
- Institute of Biochemistry and Cell Biology (IBBC), Consiglio Nazionale delle Ricerche (CNR), Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Iovine E, Zazzaro V, Pirastu G, Scarselli F, Ruberti A, Paccagnini D, Colasante A, Greco P, Pristerà A, Varricchio MT, Caragia A, Greco A, Minasi MG, Greco E. P–566 Advanced paternal age can influence aneuploidy rate in egg donation cycles with poor sperm quality. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Could advanced paternal age influences the embryos aneuploidy rate in eggs donation cycles with poor sperm quality?
Summary answer
In case of severe male factors increased paternal age can affect embryos aneuploidy rate in egg donation cycles.
What is known already
While the impact of advanced maternal age on reproductive is well understood, the effect of paternal age on reproductive function is controversial. Many studies have shown that Advanced Paternal Age (APA) could impact on male fertility potential affecting testicular function and sperm quality. Moreover, APA also has been associated with increased epigenetics changes and DNA mutations. Increased paternal age could be associated with different types of disorders such as autism, schizopherenia and bipolar disorders. Egg donation cycles, controlling female variables, represent the ideal model for the study of the impact of paternal age on reproductive outcomes.
Study design, size, duration
We retrospectively analyzed 43 egg donation cycles (October 2014-January 2020) with ≥ 50% survival rate of vitrified/warmed oocyte. Only cycles with poor sperm quality were considered. Cycles were divided in two GROUPS: group–1 included male paternal age ≤ 45 while group–2 included male paternal age >45. Data, shown as avarage±SD, were analyzed with Chi square or Student-t test.
Participants/materials, setting, methods
Group–1 included 20 cycles and 219 oocytes, male age was 40,89 ±6.12; Group–2 included 17 cycles and 173 oocytes, male age was 51±6.06. Respectively, in Group 1 and in Group 2, donor age were 22.4±2.65 and 24.8±3.88 (NS). All oocytes were injected with abnormal sperm samples according to WHO 2010. Embryos were cultured in time-lapse system until blastocyst stage. Trophectoderm biopsy and PGT-A analysis were performed according to standardized laboratory protocols.
Main results and the role of chance
Oocytes survival rates in Group1 and 2 were 86% (188/219) and 90.7% (157/173) (NS), respectively. Fertilization rates in Group1 and –2 were 71.42 (135/189) and 73.45% (119/162) (NS), respectively. The total number of obtained embryos (transferred + frozen) were 81 and 801 in Group–1 and –2, respectively. The rates of obtained embryos per reiceved occytes were 37% (81/219) and 46.24% (80/173) in Group–1 and –2 (p < 0.7), respectively. The PGT-A analysis showed 38.7% (31/80) and 31.17% (24/77) of euploid (NS) and 25% (20/80)and 42.85% (33/77) of aneuploid embryos (P < 0.05) in Group–1 and –2, respectively. Mosaic embryos were 33.5% (26/80) and 27.27%(21/77), in Group–1 and –2, respectively. (NS). These results indicate that in presence of severe male factor, advanced paternal age could increase embryos aneuploidy rate raising incidence of chromosomal abnormalities.
Limitations, reasons for caution
Each donor was stimulated with different protocols according to her history and hormones levels. Nothing is known about which type of sperm parameters (semen amount, morphology or motility) have a major impact when focusing on the embryos genetic outcome.
Wider implications of the findings: To better known the effect of APA, it could be necessary identify embryos chromosomal abnormalities and the correlation with specific sperm parameters. Further studies should be done to confirm the APA effect in patients with severe male factors and define a cut-off male age where PGT-A should be recommended.
Trial registration number
Not applicable
Collapse
Affiliation(s)
- E Iovine
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - V Zazzaro
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - G Pirastu
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - F Scarselli
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - A Ruberti
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - D Paccagnini
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - A Colasante
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - P Greco
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - A Pristerà
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | | | - A Caragia
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - A Greco
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - M G Minasi
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - E Greco
- Villa Mafalda, medicina della riproduzione, roma, Italy
| |
Collapse
|
48
|
Scarselli F, Cursio E, Colasante A, Zazzaro V, Andrea P, Gatti S, Paccagnini D, Uva D, Cerquetti C, Greco P, Greco A, Mencacci C, Litwicka K, Minasi MG, Greco E. P–091 Magnetic Activated Cell Sorting (MACS) improves euploid blastocysts rate in pre-implantation genetic testing cycles with high levels of sperm DNA fragmentation and advanced paternal age. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Can MACS increase euploid blastocyst rate in Pre-implantation Genetic Testing (PGT) cycles for AMA-APA (Advanced Maternal-Paternal Age) in patients with high sperm DNA fragmentation (SDF)?
Summary answer
A slight increase in euploid blastocyst rate was found using MACS in infertile patients with high SDF undergoing PGT cycles compared to the control group.
What is known already
Many authors have shown a close correlation between the presence of apoptotic markers on spermatozoa and the failure of assisted reproduction treatments. In normal physiological conditions, apoptotic spermatozoa with phosphatidylserine (PS) residues externalized on the plasma membrane, are eliminated along female genital tract, preventing oocyte fertilization. MACS eliminates apoptotic sperm whit PS residues using superparamagnetic microbeads conjugated with annexin V. This technique reduces the proportion of sperm with high rates of SDF and can be used to maximize ART procedures results. MACS application improves sperm quality, fertilization, cleavage and pregnancy rates reducing miscarriage rate.
Study design, size, duration
From June to November 2020, 10 couples in which MACS was applied to select non-apoptotic spermatozoa, were randomly enrolled in our study (MACS group) and 8 couples without MACS were considered as controls (No-MACS Group). All couples in both groups underwent a PGT cycle and had high sperm DNA Fragmentation (> 20%). A higher rate of euploid and diploid-euploid mosaic blastocysts were obtained in the MACS group compared to the control group.
Participants/materials, setting, methods
Patients with severe oligoastenoteratozoospermia were excluded. MACS protocol was performed as follows: semen sample was analyzed (WHO 2010) and washed with buffered medium; pellet was removed and a swim-up was performed. Retrieved spermatozoa were washed with a binding buffer (Miltenyi Biotec), centrifuged (400 g x 4 minutes) and supernatant discarded. Pellet was covered with Annexin-V and re-suspended. After 15 minutes incubation at room temperature, the sample was eluted through the column and collected for ICSI.
Main results and the role of chance
In MACS group, female and male mean age ± SD were 41.6 ± 2.1 and 43.5 ± 7.3, respectively. Female and male mean age ± SD were 41.7 ± 2.8 and 44.6 ± 8.1 in the No-MACS group, respectively. In MACS and No-MACS groups, injected oocytes were 44 and 35, fertilized oocytes were 32 (72.3%) and 27 (77.1%) (NS), blastocyst formation rates were 71.8% (23/32) and 48.1% (13/27) (NS), respectively. In No-MACS group, only 1 euploid and 1 diploid-euploid mosaic blastocysts were obtained (1/13 = 8%) (NS). In MACS group, 4 euploid blastocysts were formed (4/23 = 17.4%) whereas mosaic diploid-euploid blastocysts were 3/23 (13.0%) (NS). Aneuploid blastocysts were 16/23 (69.6%) in MACS group and 11/13 (84.6%) in No-MACS group (NS).
Limitations, reasons for caution
AMA and APA of couples enrolled should be considered as a limit of the study. A larger number of patients and biopsied blastocysts are needed to analyze clinical results and perform a robust statistical analysis establishing if MACS is useful to improve transferable blastocyst rate in patients with high SDF.
Wider implications of the findings: MACS is useful to select non apoptotic sperms; although fertilization, cleavage and blastocyst rates are not improved, aneuploid blastocysts rate slightly decreases using MACS. It I possible that, selecting spermatozoa free from PS residues, MACS allows to choose spermatozoa with a better DNA packaging, thus affecting the embryo ploidy.
Trial registration number
non applicable
Collapse
Affiliation(s)
- F Scarselli
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - E Cursio
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - A Colasante
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - V Zazzaro
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - P Andrea
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - S Gatti
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - D Paccagnini
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - D Uva
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - C Cerquetti
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - P Greco
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - A Greco
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - C Mencacci
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - K Litwicka
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - M G Minasi
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - E Greco
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| |
Collapse
|
49
|
Greco A, Garoffolo G, Chiesa E, Riva F, Dorati R, Modena T, Conti B, Pesce M, Genta I. Nanotechnology, a booster for the multitarget drug verteporfin. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
50
|
Scuderi L, Anselmi G, Greco A, Abdolrahimzadeh B, Costa MC, Scuderi G. Early identification of keratoconus using pachymetric indexes obtained with spectral domain optical coherence tomography. Clin Ter 2021; 172:347-357. [PMID: 34247218 DOI: 10.7417/ct.2021.2339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose To evaluate the diagnostic ability of pachymetric indexes obtained with Spectral Domain Optical Coherence Tomography (SD-OCT) for early detection of keratoconus (Kc). Methods 64 patients with Kc in at least one eye (95 eyes, 46 men and 18 women, average age 27.84 ±13.50), 59 healthy control subjects (100 eyes, 28 men and 31 women, average age 27.15 ±16.14). All patients underwent detailed clinical examination, topography and anterior segment OCT. 37 subjects (37 eyes, 27 men and 10 women, average age 24.23 ± 14.24) having one eye with manifest Kc and the fellow eye without clinical signs of Kc were identified. We studied two groups of pachymetric indexes: C1-C2, M1-M2, pCLMI, Pmin-P2 (Group 1 indexes) and PPD, PSD, PSSD and PASD (Group 2 indexes). A ROC (Receiver Operating Characteristic) curve was developed to compare the diagnostic accuracy, relative sensitivity and specificity for each index. Results In manifest keratoconus, C1-C2, M1-M2, and pCLMI are significantly higher compared to the control group (P<0.0001); for suspect keratoconus, all Group 1 indexes are significantly higher compared to healthy subjects (P<0.0001) excluding M1-M2 obtained using a constant area circle (P = 0.02). Furthermore, for manifest and suspect keratoconus, PPD, PSD, PSSD and PASD are significantly higher compared to the control group (P <0.0001). Conclusion The studied pachymetric indexes in patients with Kc have high diagnostic accuracy and are statistically significant when compared with healthy subjects (p<0.0001) and can provide a useful tool for keratoconus screening.
Collapse
Affiliation(s)
- L Scuderi
- Ophthalmology Unit, Department of Sense Organs, Policlinico Umberto I, Rome, Italy
| | - G Anselmi
- Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Faculty of Medicine and Psychology "Sapienza" University of Rome, Rome, Italy
| | - A Greco
- Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Faculty of Medicine and Psychology "Sapienza" University of Rome, Rome, Italy
| | | | | | - G Scuderi
- Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Faculty of Medicine and Psychology "Sapienza" University of Rome, Rome, Italy
| |
Collapse
|