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Ghio S, Corsico A, Rapagnani A, Borrelli E, Alloni A, Valentini A, Piloni D, Scelsi L, Klersy C, D'Armini AM. Does pulmonary endarterectomy improve the clinical conditions of patients with chronic thromboembolic pulmonary disease without pulmonary hypertension? J Heart Lung Transplant 2024; 43:681-685. [PMID: 38184125 DOI: 10.1016/j.healun.2023.12.015] [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: 10/31/2023] [Revised: 12/24/2023] [Accepted: 12/27/2023] [Indexed: 01/08/2024] Open
Abstract
To verify whether the new hemodynamic definition of pulmonary hypertension (PH) has any implication in treatment of Chronic Thrombo-Embolic Pulmonary Disease (CTEPD) patients without PH, we retrospectively analysed the clinical and functional changes determined by pulmonary endarterectomy (PEA) in 63 CTEPD patients without PH who underwent surgery at our center, comparing those in whom the hemodynamic diagnosis of PH met recent guideline recommendations versus those in whom the diagnosis only met previous hemodynamic thresholds. The results show that the vast majority of CTEPD patients without PH operated at our center would now be defined as chronic thromboembolic pulmonary hypertension (CTEPH) patients. PEA did not result in any improvement in exercise capacity nor in right ventricular function or lung function test in patients with mean pulmonary artery pressure (mPAP) ≤ 20 mm Hg and pulmonary vascular resistance (PVR) ≤ 2 WU; on the contrary, hemodynamic parameters, exercise capacity, right ventricular function and lung function significantly improved in patients with mPAP between 21 and 24 mm Hg.
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Affiliation(s)
- Stefano Ghio
- Division of Cardiology, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, Foundation IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, University of Pavia School of Medicine, Italy
| | - Andrea Rapagnani
- Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, University of Pavia School of Medicine, Italy
| | - Ermelinda Borrelli
- Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, University of Pavia School of Medicine, Italy
| | - Alessia Alloni
- Division of Cardiac Surgery 2 and Pulmonary Hypertension Center, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Adele Valentini
- Institut of Radiology, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Davide Piloni
- Division of Respiratory Diseases, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Laura Scelsi
- Division of Cardiology, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Catherine Klersy
- Service of Clinical Epidemiology and Biometry, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Maria D'Armini
- Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, University of Pavia School of Medicine, Italy; Division of Cardiac Surgery 2 and Pulmonary Hypertension Center, Foundation IRCCS Policlinico San Matteo, Pavia, Italy.
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2
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Catalano M, Bortolotto C, Nicora G, Achilli MF, Consonni A, Ruongo L, Callea G, Lo Tito A, Biasibetti C, Donatelli A, Cutti S, Comotto F, Stella GM, Corsico A, Perlini S, Bellazzi R, Bruno R, Filippi A, Preda L. Performance of an AI algorithm during the different phases of the COVID pandemics: what can we learn from the AI and vice versa. Eur J Radiol Open 2023; 11:100497. [PMID: 37360770 PMCID: PMC10278371 DOI: 10.1016/j.ejro.2023.100497] [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: 05/06/2023] [Revised: 06/02/2023] [Accepted: 06/04/2023] [Indexed: 06/28/2023] Open
Abstract
Background Artificial intelligence (AI) has proved to be of great value in diagnosing and managing Sars-Cov-2 infection. ALFABETO (ALL-FAster-BEtter-TOgether) is a tool created to support healthcare professionals in the triage, mainly in optimizing hospital admissions. Methods The AI was trained during the pandemic's "first wave" (February-April 2020). Our aim was to assess the performance during the "third wave" of the pandemics (February-April 2021) and evaluate its evolution. The neural network proposed behavior (hospitalization vs home care) was compared with what was actually done. If there were discrepancies between ALFABETO's predictions and clinicians' decisions, the disease's progression was monitored. Clinical course was defined as "favorable/mild" if patients could be managed at home or in spoke centers and "unfavorable/severe" if patients need to be managed in a hub center. Results ALFABETO showed accuracy of 76%, AUROC of 83%; specificity was 78% and recall 74%. ALFABETO also showed high precision (88%). 81 hospitalized patients were incorrectly predicted to be in "home care" class. Among those "home-cared" by the AI and "hospitalized" by the clinicians, 3 out of 4 misclassified patients (76.5%) showed a favorable/mild clinical course. ALFABETO's performance matched the reports in literature. Conclusions The discrepancies mostly occurred when the AI predicted patients could stay at home but clinicians hospitalized them; these cases could be handled in spoke centers rather than hubs, and the discrepancies may aid clinicians in patient selection. The interaction between AI and human experience has the potential to improve both AI performance and our comprehension of pandemic management.
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Affiliation(s)
- Michele Catalano
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy and Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Chandra Bortolotto
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy and Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giovanna Nicora
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Marina Francesca Achilli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy and Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessio Consonni
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy and Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lidia Ruongo
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy and Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giovanni Callea
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy and Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonio Lo Tito
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy and Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carla Biasibetti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy and Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonella Donatelli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy and Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sara Cutti
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Giulia Maria Stella
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy and Dept. of Respiratory Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Angelo Corsico
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy and Dept. of Respiratory Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Perlini
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy and Dept. of Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Riccardo Bellazzi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy and Infectious Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Filippi
- Radiation Oncology Unit, University of Pavia, Pavia, Italy and Infectious Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lorenzo Preda
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy and Radiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Locatelli F, Murgia N, Baldacci S, Battaglia S, Bilò MB, Calciano L, Squillacioti G, Corsico A, Gariazzo C, Marchetti P, Massari S, Pirina P, Spiteri G, Torroni L, Viegi G, Verlato G, Marcon A, Maio S. [The role of exposure to airborne pollutants in the workplace on the prevalence and severity of chronic respiratory disease in Italy]. Epidemiol Prev 2023; 47:56-66. [PMID: 38639301 DOI: 10.19191/ep23.6.s3.008] [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: 04/20/2024]
Abstract
OBJECTIVES occupational exposure to vapours, gases, dusts and fumes (VGDF) plays an important role in the development and exacerbation of respiratory diseases. The aim of this study is to evaluate the possible association of occupational exposure to airborne pollutants and chronic respiratory diseases. DESIGN multicase-control study. SETTING AND PARTICIPANTS cases of chronic respiratory diseases and controls from the Italian multicentric study Gene Environment Interaction in Respiratory Diseases (GEIRD). MAIN OUTCOME MEASURES the occurrence of rhinitis, asthma, chronic bronchitis/chronic obstructive pulmonary disease (COPD), asthma severity, spirometry data, exhaled nitric oxide (FeNO) were examined in relation to chronic and acute occupational exposures to airborne pollutants using multiple regression models. RESULTS 2,943 subjects were enrolled in the study. Regularm exposure to VGDF was associated with a higher prevalence of chronic bronchitis/COPD (OR 1.40, 95%CI 0.98-1.99), especially in those also having asthma (OR 1.80, 95%CI 1.14-2.85), a lower prevalence of remittent asthma (OR 0.53, 95%CI 0.29-0.96) and, in those with asthma, an increased activity of the disease (severity score) (OR 1.77, 95%CI 1.20-2.60). No associations were observed between occupational exposure and prevalence of rhinitis, spirometry and FeNO data. Finally, an association was found between acute exposure to airborne pollutants (occupational and non-occupational) and the respiratory diseases investigated, in particular active asthma and asthma associated chronic bronchitis/BPCO. CONCLUSIONS these data confirm a significant role of occupational exposure to airborne pollutants on respiratory health, underlying the importance of workplace exposure prevention, in particular for more susceptible subjects, as those with respiratory diseases.
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Affiliation(s)
- Francesca Locatelli
- Sezione di epidemiologia e statistica medica, Dipartimento di diagnostica e sanità pubblica, Università di Verona, Verona
- Da considerare entrambi come primo autore
| | - Nicola Murgia
- Dipartimento di scienze dell'ambiente e della prevenzione, Università di Ferrara, Ferrara
- Da considerare entrambi come primo autore
| | - Sandra Baldacci
- Istituto di fisiologia clinica, Consiglio nazionale delle ricerche (CNR), Pisa
| | - Salvatore Battaglia
- Dipartimento di promozione della salute, materno-infantile, di medicina interna e specialistica di eccellenza "G. D'Alessandro" (PROMISE), Università di Palermo, Palermo
| | - Maria Beatrice Bilò
- Dipartimento di scienze cliniche e molecolari (DISCLIMO), Università Politecnica delle Marche, Ancona
- Struttura organizzativa semplice dipartimentale (SOSD), Allergologia, Azienda Ospedaliero-universitaria delle Marche, Ancona
| | - Lucia Calciano
- Sezione di epidemiologia e statistica medica, Dipartimento di diagnostica e sanità pubblica, Università di Verona, Verona
| | - Giulia Squillacioti
- Dipartimento di scienze della sanità pubblica e pediatriche, Università di Torino, Torino
| | - Angelo Corsico
- Dipartimento di medicina interna e terapia medica, Università di Pavia
- Struttura complessa di pneumologia, IRCSS S. Matteo di Pavia, Università di Pavia, Pavia
| | - Claudio Gariazzo
- Dipartimento di medicina, epidemiologia, igiene del lavoro e ambientale (INAIL), Roma
| | - Pierpaolo Marchetti
- Sezione di epidemiologia e statistica medica, Dipartimento di diagnostica e sanità pubblica, Università di Verona, Verona
| | - Stefania Massari
- Dipartimento di medicina, epidemiologia, igiene del lavoro e ambientale (INAIL), Roma
| | - Pietro Pirina
- Pneumologia clinica e interventistica, AOU Sassari, Università di Sassari, Sassari
| | - Gianluca Spiteri
- Unità operativa complessa di medicina del lavoro, Azienda ospedaliera universitaria integrata Verona, Verona
| | - Lorena Torroni
- Sezione di epidemiologia e statistica medica, Dipartimento di diagnostica e sanità pubblica, Università di Verona, Verona
| | - Giovanni Viegi
- Istituto di fisiologia clinica, Consiglio nazionale delle ricerche (CNR), Pisa
| | - Giuseppe Verlato
- Sezione di epidemiologia e statistica medica, Dipartimento di diagnostica e sanità pubblica, Università di Verona, Verona
| | - Alessandro Marcon
- Sezione di epidemiologia e statistica medica, Dipartimento di diagnostica e sanità pubblica, Università di Verona, Verona
- Da considerare entrambi come ultimo autore
| | - Sara Maio
- Istituto di fisiologia clinica, Consiglio nazionale delle ricerche (CNR), Pisa
- Da considerare entrambi come ultimo autore
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Marchetti P, Miotti J, Locatelli F, Antonicelli L, Baldacci S, Battaglia S, Bono R, Corsico A, Gariazzo C, Maio S, Murgia N, Pirina P, Silibello C, Stafoggia M, Torroni L, Viegi G, Verlato G, Marcon A. Long-term residential exposure to air pollution and risk of chronic respiratory diseases in Italy: The BIGEPI study. Sci Total Environ 2023; 884:163802. [PMID: 37127163 DOI: 10.1016/j.scitotenv.2023.163802] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/03/2023]
Abstract
Long-term exposure to air pollution has adverse respiratory health effects. We investigated the cross-sectional relationship between residential exposure to air pollutants and the risk of suffering from chronic respiratory diseases in some Italian cities. In the BIGEPI project, we harmonised questionnaire data from two population-based studies conducted in 2007-2014. By combining self-reported diagnoses, symptoms and medication use, we identified cases of rhinitis (n = 965), asthma (n = 328), chronic bronchitis/chronic obstructive pulmonary disease (CB/COPD, n = 469), and controls (n = 2380) belonging to 13 cohorts from 8 Italian cities (Pavia, Turin, Verona, Terni, Pisa, Ancona, Palermo, Sassari). We derived mean residential concentrations of fine particulate matter (PM10, PM2.5), nitrogen dioxide (NO2), and summer ozone (O3) for the period 2013-2015 using spatiotemporal models at a 1 km resolution. We fitted logistic regression models with controls as reference category, a random-intercept for cohort, and adjusting for sex, age, education, BMI, smoking, and climate. Mean ± SD exposures were 28.7 ± 6.0 μg/m3 (PM10), 20.1 ± 5.6 μg/m3 (PM2.5), 27.2 ± 9.7 μg/m3 (NO2), and 70.8 ± 4.2 μg/m3 (summer O3). The concentrations of PM10, PM2.5, and NO2 were higher in Northern Italian cities. We found associations between PM exposure and rhinitis (PM10: OR 1.62, 95%CI: 1.19-2.20 and PM2.5: OR 1.80, 95%CI: 1.16-2.81, per 10 μg/m3) and between NO2 exposure and CB/COPD (OR 1.22, 95%CI: 1.07-1.38 per 10 μg/m3), whereas asthma was not related to environmental exposures. Results remained consistent using different adjustment sets, including bi-pollutant models, and after excluding subjects who had changed residential address in the last 5 years. We found novel evidence of association between long-term PM exposure and increased risk of rhinitis, the chronic respiratory disease with the highest prevalence in the general population. Exposure to NO2, a pollutant characterised by strong oxidative properties, seems to affect mainly CB/COPD.
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Affiliation(s)
- Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Jessica Miotti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesca Locatelli
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Sandra Baldacci
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | | | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Torino, Italy
| | - Angelo Corsico
- Respiratory Diseases Division, IRCCS Policlinico San Matteo Foundation, Pavia, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Claudio Gariazzo
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Sara Maio
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Italy
| | - Pietro Pirina
- Respiratory Unit, Sassari University, Sassari, Italy
| | | | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service ASL Roma 1, Roma, Italy
| | - Lorena Torroni
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
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5
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Miravitlles M, Turner AM, Torres-Duran M, Tanash H, Rodríguez-García C, López-Campos JL, Chlumsky J, Guimaraes C, Rodríguez-Hermosa JL, Corsico A, Martinez-González C, Hernández-Pérez JM, Bustamante A, Parr DG, Casas-Maldonado F, Hecimovic A, Janssens W, Lara B, Barrecheguren M, González C, Stolk J, Esquinas C, Clarenbach CF. Characteristics of individuals with alpha-1 antitrypsin deficiency from Northern and Southern European countries: EARCO international registry. Eur Respir J 2023; 61:13993003.01949-2022. [PMID: 36997232 DOI: 10.1183/13993003.01949-2022] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/10/2023] [Indexed: 04/01/2023]
Affiliation(s)
- Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Alice M Turner
- Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - María Torres-Duran
- Servicio de Neumología, Hospital Álvaro Cunqueiro, NeumoVigo I+i Research Group, IIS Galicia Sur, Vigo, Spain
| | - Hanan Tanash
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Carlota Rodríguez-García
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - José Luis López-Campos
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain
| | - Jan Chlumsky
- Department of Pneumology, Thomayer Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Catarina Guimaraes
- Pulmonology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - Juan Luis Rodríguez-Hermosa
- Servicio de Neumología, Hospital Clínico de San Carlos, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- Research Institute of Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Angelo Corsico
- Pneumology Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Cristina Martinez-González
- Pneumology Department, Hospital Universitario Central de Asturias, Instituto de Investigacion Sanitaria del Principado de Asturias, Oviedo, Spain
| | - José María Hernández-Pérez
- Pneumology Department, Hospital Universitario Nuestra Señora de La Candelaria, Santa Cruz de Tenerife, Spain
| | - Ana Bustamante
- Pneumology Section, Hospital Sierrallana-TresMares, Cantabria, Spain
| | - David G Parr
- Department of Respiratory Medicine, University Hospitals of Coventry and Warwickshire, Coventry, UK
| | - Francisco Casas-Maldonado
- Servicio de Neumología, Hospital Clínico Universitario San Cecilio, Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - Ana Hecimovic
- University Hospital Center Zagreb, Clinic for Respiratory Diseases, Zagreb, Croatia
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Wim Janssens
- Katholieke Universiteit (KU) Leuven, Laboratory of Respiratory Diseases, Department of Chronic Disease, Metabolism and Ageing, Leuven, Belgium
- University Hospitals Leuven, Department of Respiratory Diseases, Leuven, Belgium
| | - Beatriz Lara
- Department of Respiratory Medicine, University Hospitals of Coventry and Warwickshire, Coventry, UK
| | - Miriam Barrecheguren
- Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Cruz González
- Servicio de Neumología, Hospital Clínico Universitario, Instituto de Investigación INCLIVA, Valencia, Spain
| | - Jan Stolk
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Cristina Esquinas
- Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
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6
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Miravitlles M, Turner AM, Torres-Duran M, Tanash H, Rodríguez-García C, López-Campos JL, Chlumsky J, Guimaraes C, Rodríguez-Hermosa JL, Corsico A, Martinez-González C, Hernández-Pérez JM, Bustamante A, Parr DG, Casas-Maldonado F, Hecimovic A, Janssens W, Lara B, Barrecheguren M, González C, Stolk J, Esquinas C, Clarenbach CF. Correction: Clinical and functional characteristics of individuals with alpha-1 antitrypsin deficiency: EARCO international registry. Respir Res 2023; 24:57. [PMID: 36800958 PMCID: PMC9938555 DOI: 10.1186/s12931-023-02340-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Affiliation(s)
- Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron; Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
| | - Alice M. Turner
- grid.412563.70000 0004 0376 6589Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK ,grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - María Torres-Duran
- grid.411855.c0000 0004 1757 0405Servicio de Neumología. Hospital Álvaro Cunqueiro. NeumoVigo I+I Research Group, IIS Galicia Sur, Vigo, Spain
| | - Hanan Tanash
- grid.4514.40000 0001 0930 2361Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Carlota Rodríguez-García
- grid.11794.3a0000000109410645Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - José Luis López-Campos
- grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain ,grid.411109.c0000 0000 9542 1158Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, Spain
| | - Jan Chlumsky
- grid.4491.80000 0004 1937 116XDepartment of Pneumology, Thomayer Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Catarina Guimaraes
- grid.465290.cPulmonology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - Juan Luis Rodríguez-Hermosa
- grid.4795.f0000 0001 2157 7667Servicio de Neumología. Hospital Clínico de San Carlos. Departamento de Medicina, Facultad de Medicina,, Universidad Complutense de Madrid, Madrid, Spain ,grid.411068.a0000 0001 0671 5785Research Institute of Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Angelo Corsico
- grid.419425.f0000 0004 1760 3027Pneumology Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy ,grid.8982.b0000 0004 1762 5736Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Cristina Martinez-González
- grid.411052.30000 0001 2176 9028Pneumology Department, Hospital Universitario Central de Asturias, Instituto de Investigacion Sanitaria del Principado de Asturias, Oviedo, Spain
| | - José María Hernández-Pérez
- grid.411331.50000 0004 1771 1220Pneumology Department, Hospital Universitario Nuestra Señora de La Candelaria, Santa Cruz de Tenerife, Spain
| | - Ana Bustamante
- grid.413444.20000 0004 1763 6195Pneumology Section, Hospital Sierrallana-TresMares, Cantabria, Spain
| | - David G. Parr
- grid.412570.50000 0004 0400 5079Department of Respiratory Medicine, University Hospitals of Coventry and Warwickshire, Clifford Bridge Road, Coventry, UK
| | - Francisco Casas-Maldonado
- grid.4489.10000000121678994Servicio de Neumología. Hospital Clínico Universitario San Cecilio. Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - Ana Hecimovic
- grid.412688.10000 0004 0397 9648Clinic for Respiratory Diseases, University Hospital Center Zagreb, Zagreb, Croatia ,grid.4808.40000 0001 0657 4636School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Wim Janssens
- grid.5596.f0000 0001 0668 7884Laboratory of Respiratory Diseases, Department of Chronic Disease, Metabolism and Ageing, Katholieke Universiteit (KU) Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Beatriz Lara
- grid.412570.50000 0004 0400 5079Department of Respiratory Medicine, University Hospitals of Coventry and Warwickshire, Clifford Bridge Road, Coventry, UK
| | - Miriam Barrecheguren
- grid.411083.f0000 0001 0675 8654Pneumology Department, Hospital Universitari Vall d’Hebron; Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Cruz González
- grid.411308.fServicio de Neumología, Hospital Clínico Universitario de Valencia. Instituto de Investigación INCLIVA, Valencia, Spain
| | - Jan Stolk
- grid.10419.3d0000000089452978Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Cristina Esquinas
- grid.411083.f0000 0001 0675 8654Pneumology Department, Hospital Universitari Vall d’Hebron; Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Christian F. Clarenbach
- grid.412004.30000 0004 0478 9977Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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Aliberti S, Gramegna A, Zucchetti S, Simonetta E, Amati F, Castelli D, Cavallero A, Franceschi E, Conio V, Grosso A, Faverio P, Radovanovic D, Terraneo S, Di Marco F, Pesci A, Airoldi C, Valenti V, Corsico A, Santus P, Centanni S, Sotgiu G, Blasi F. Respiratory viruses in stable bronchiectasis: A multicenter evaluation in Northern Italy. Respir Med 2022; 205:107056. [PMID: 36423458 DOI: 10.1016/j.rmed.2022.107056] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/10/2022] [Accepted: 11/17/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Stefano Aliberti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Respiratory Unit, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Andrea Gramegna
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy; Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Stefano Zucchetti
- Clinica Pneumologica, Università degli Studi Milano-Bicocca, ASST Monza, Italy
| | - Edoardo Simonetta
- IRCCS Humanitas Research Hospital, Respiratory Unit, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Francesco Amati
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Respiratory Unit, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Daniele Castelli
- Microbiology Unit, ASST Monza - S. Gerardo Hospital, Monza, Italy
| | | | - Elisa Franceschi
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, Division of Pulmonary Diseases, Ospedale L. Sacco, ASST Fatebenfratelli-Sacco, Milan, Italy
| | - Valentina Conio
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Amelia Grosso
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Paola Faverio
- Clinica Pneumologica, Università degli Studi Milano-Bicocca, ASST Monza, Italy
| | - Dejan Radovanovic
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, Division of Pulmonary Diseases, Ospedale L. Sacco, ASST Fatebenfratelli-Sacco, Milan, Italy
| | - Silvia Terraneo
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Fabiano Di Marco
- Respiratory Unit, Papa Giovanni XXIII Hospital, Bergamo, University of Milan, Italy
| | - Alberto Pesci
- Clinica Pneumologica, Università degli Studi Milano-Bicocca, ASST Monza, Italy
| | - Cristina Airoldi
- Department of Biotechnology and Biosciences, University of Milano - Bicocca, P.zza della Scienza 2, 20126, Milan, Italy
| | - Vincenzo Valenti
- Department of Health Bioscience, University of Milan - Respiratory Unit, Policlinico di San Donato, IRCCS - San Donato Milanese, Milan, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Pierachille Santus
- Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, Division of Pulmonary Diseases, Ospedale L. Sacco, ASST Fatebenfratelli-Sacco, Milan, Italy
| | - Stefano Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Sotgiu
- Department of Medical, Surgical and Experimental Sciences, Clinical Epidemiology and Medical Statistics Unit, University of Sassari, Sassari, Italy
| | - Francesco Blasi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy; Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy
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8
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Parr DG, Chorostowska-Wynimko J, Corsico A, Esquinas C, McElvaney GN, Sark AD, Sucena M, Tanash H, Turner AM, Miravitlles M. IMpact of COVID-19 in Patients With Severe Alpha-1 Antitrypsin Deficiency: The IMCA1 Study of the EARCO Clinical Research Collaboration. Arch Bronconeumol 2022; 58:840-842. [PMID: 35879122 PMCID: PMC9272568 DOI: 10.1016/j.arbres.2022.07.002] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 11/20/2022]
Affiliation(s)
- David G Parr
- Department of Respiratory Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
| | - Joanna Chorostowska-Wynimko
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Disease, Warsaw, Poland
| | - Angelo Corsico
- Respiratory Diseases Division, IRCCS Policlinico San Matteo Foundation and University of Pavia, Italy
| | - Cristina Esquinas
- Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Gerard N McElvaney
- Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Annelot D Sark
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Maria Sucena
- Pulmonology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Hanan Tanash
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Sweden
| | - Alice M Turner
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
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9
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Rizzi D, Asperges E, Rovati A, Bigoni F, Pistillo E, Corsico A, Mojoli F, Perlini S, Bruno R. Psychological Support in a COVID-19 Hospital: A Community Case Study. Front Psychol 2022; 12:820074. [PMID: 35250697 PMCID: PMC8893142 DOI: 10.3389/fpsyg.2021.820074] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/31/2021] [Indexed: 01/08/2023] Open
Abstract
Burnout is a well-documented entity in Care Workers population, affecting up to 50% of physicians, just as it is equally well established that managing an infectious disease outbreaks, such as confirmed in the COVID-19 pandemic, increases Post-Traumatic Stress Disorder (PTSD) and the psychological burden. Mental health support, in the form of formal or remote sessions, has been shown to be helpful to health care staff, despite the organizational difficulties in an emergency. During the first emergence of COVID-19 in Italy, the Scientific Institute for Research, Hospitalization and Health Care Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo Foundation (Pavia, Lombardy), the Italian hospital that treated “patient 1,” has activated an agreement with the Soleterre Foundation, an international Non-Governmental Organization (NGO) that manages health emergency projects, to provide psychological support. A task force of psychologists was created with the aim of designing and administering a Therapeutic Mental Health Assessment for COVID-19 Care Workers (TMHA COVID-19 CWs) to evaluate and support health care workers’ mental health. The assessment battery was developed to evaluate symptoms and behaviors associated with trauma and the corresponding maladaptive behaviors (the National Stressful Events Survey for PTSD-Short Scale “NSESSS” and the Diagnostic and Statistical Manual of Mental Disorders “DSM-5” Self-Rated Level 1 transversal Symptom Measure—Adult). Once the TMHA COVID-19 CWs had been developed, the team of psychologists regularly visited healthcare staff in the ward to administer it. One hundred seven care workers (44 males, mean age 40 ± 15) across Intensive Care Units (ICUs), the emergency room and medical ward were administered the TMHA COVID-19 CWs. PTSD symptoms were reported as severe by 13% of the population. Depressive symptoms as severe for 7% and Anxiety symptoms as severe for 14%. Severe psychotic symptoms were experienced by 2% and severe suicidal thoughts by 1% of the population. The possibility of acting upon the results of the TMHA COVID-19 CWs allowed an early intervention through individual session beyond the cut-off level (moderate and severe symptoms) for PTSD in NSESSS. In fact, 280 individual support sessions were offered. Therefore, we considered our project a protective and support factor for healthcare workers’ mental well-being and we recommend implementing a mental health screening program in ward involved in COVID-19 patients’ care.
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Affiliation(s)
- Damiano Rizzi
- Fondazione Soleterre Strategie di Pace ONLUS, Milan, Italy.,Unit of Emergency Medicine, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Erika Asperges
- Unit of Infectious Disease, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Anna Rovati
- Fondazione Soleterre Strategie di Pace ONLUS, Milan, Italy.,Unit of Emergency Medicine, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Francesca Bigoni
- Fondazione Soleterre Strategie di Pace ONLUS, Milan, Italy.,Unit of Emergency Medicine, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Elena Pistillo
- Fondazione Soleterre Strategie di Pace ONLUS, Milan, Italy
| | - Angelo Corsico
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation, University of Pavia, Milan, Italy
| | - Francesco Mojoli
- Unit of Anaesthesia and Intensive Care, Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Stefano Perlini
- Unit of Emergency Medicine, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Unit of Infectious Disease, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
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10
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Balbi B, Benini F, Corda L, Corsico A, Ferrarotti I, Gatta N. An Italian expert consensus on the management of alpha1-antitrypsin deficiency: a comprehensive set of algorithms. Panminerva Med 2022; 64:215-227. [PMID: 35146988 DOI: 10.23736/s0031-0808.22.04592-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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Alpha1-antitrypin deficiency (AATD) is a genetic-based risk condition, mainly affecting the lungs and liver. Despite its wide distribution, it is largely underdiagnosed, thus being considered a rare disease, and is consequently managed in ad hoc reference centers. Unfortunately, an easy-to-use algorithm for managing such a complex disease is still lacking. METHODS An expert consensus meeting was conducted among experts in the management of AATD to build a comprehensive algorithm, including diagnosis, monitoring, AAT therapy, rehabilitation and lung transplantation, and liver disease, that could serve as a guide for physicians and treating centers. A panel of AATD specialists evaluated the results of their work. RESULTS Diagnosis is the most delicate phase, and awareness about this condition should be raised among GPs. A set of recommendations has been written about the most suitable follow-up visits. Augmentation therapy with AAT may be useful to reduce the progression of emphysema and lung function decline in selected patients. Exercise capacity may be improved by pulmonary rehabilitation and, in selected cases, by lung volume reduction or lung transplantation. Support therapies are needed for those who develop liver disease, and, in selected cases, liver transplantation may be considered. Patients should be carefully educated about their lifestyle, including smoking cessation, body weight control, and reduced alcohol intake. CONCLUSIONS The proposed algorithm obtained the endorsement of the Italian Society of Pneumology (SIP). However, further studies and additional clinical data are required to confirm the validity of these recommendations.
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Affiliation(s)
- Bruno Balbi
- Pulmonary Rehabilitation of the Institute of Veruno, Istituti Clinici Scientifici Maugeri IRCCS, Novara, Italy -
| | - Federica Benini
- Center for diagnosis, monitoring and therapy of alpha1-antitrypsin deficiency, Gastroenterology Unit, Department of Medicine, Spedali Civili, Brescia, Italy
| | - Luciano Corda
- Center for diagnosis, monitoring and therapy of alpha1-antitrypsin deficiency. Respiratory, Medicine Unit, Department of Internal Medicine, Spedali Civili, Brescia, Italy
| | - Angelo Corsico
- Center for diagnosis of alpha1-antitrypsin hereditary deficiency, Chest Medicine Unit. I.R.C.C.S. Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Ilaria Ferrarotti
- Center for diagnosis of alpha1-antitrypsin hereditary deficiency, Chest Medicine Unit. I.R.C.C.S. Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Nuccia Gatta
- Patients' association Associazione Nazionale Alfa1-At per la tutela dei pazienti con Deficit di Alfa1-antitripsina, Sarezzo, Brescia, Italy
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11
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Colaneri M, De Filippo M, Licari A, Marseglia A, Maiocchi L, Ricciardi A, Corsico A, Marseglia G, Mondelli MU, Bruno R. COVID vaccination and asthma exacerbation: might there be a link? Int J Infect Dis 2021; 112:243-246. [PMID: 34547487 PMCID: PMC8450144 DOI: 10.1016/j.ijid.2021.09.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/15/2021] [Accepted: 09/15/2021] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION There is ongoing debate regarding the role of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in asthma exacerbation, and its long-term impact on the lung function of individuals with asthma. In contrast, the potential impact of coronavirus disease 2019 (COVID-19) vaccination on asthma is entirely unexplored. CASE STUDY This study examined a challenging case of severe asthma exacerbation in a 28-year-old female following two doses of the mRNA-based vaccine BNT162b2 (Pfizer-BioNTech) at IRCCS Policlinico San Matteo in Pavia, Italy. The patient, a fourth-year resident at the hospital, was vaccinated in early 2021. She was an occasional smoker with a 10-year history of asthma and seasonal allergic rhinitis. She tested negative for SARS-CoV-2 on several molecular swabs and serology tests. RESULTS After receiving the second dose of vaccine, the patient started to experience worsening of respiratory symptoms. Following several episodes and a severe asthma attack, the patient required treatment with mepolizumab, a biologic drug (interleukin-5) antagonist monoclonal antibody. CONCLUSION This single case study is insufficient to draw conclusions about the association between asthma exacerbation and the COVID-19 vaccine. While the cause-effect link between vaccination against SARS-CoV-2 and worsening of asthmatic disease might only be suggested at present, this case is a valuable prompt for further investigation. This is particularly true from the perspective of mass vaccination of adolescents and children currently underway across the globe.
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Affiliation(s)
- Marta Colaneri
- Infectious Diseases I Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy.
| | - Maria De Filippo
- Paediatric Clinic, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Amelia Licari
- Paediatric Clinic, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Alessia Marseglia
- Paediatric Clinic, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Laura Maiocchi
- Infectious Diseases I Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Alessandra Ricciardi
- Infectious Diseases I Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Angelo Corsico
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy; Chest Medicine Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Gianluigi Marseglia
- Paediatric Clinic, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Mario Umberto Mondelli
- Infectious Diseases I Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy; Divisions of Infectious Diseases II and Immunology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Infectious Diseases I Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
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12
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Cazzoletti L, Zanolin ME, Antonicelli L, Battaglia S, Bono R, Corsico A, Murgia N, Olivieri M, Pirina P, Verlato G, Ferrari M. Relationship status and respiratory diseases: an analysis on a general population sample. Epidemiology 2021. [DOI: 10.1183/13993003.congress-2021.pa3514] [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: 11/05/2022]
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13
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Melazzini F, Colaneri M, Fumoso F, Freddi G, Lenti MV, Pieri TC, Piloni D, Noris P, Pieresca C, Preti PS, Russo M, Corsico A, Tavazzi G, Baldanti F, Triarico A, Mojoli F, Bruno R, Di Sabatino A. Correction to: Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy. Intern Emerg Med 2021; 16:1153. [PMID: 33400165 PMCID: PMC7782560 DOI: 10.1007/s11739-020-02613-8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Federica Melazzini
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Marta Colaneri
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Federica Fumoso
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Giulia Freddi
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Teresa Chiara Pieri
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Davide Piloni
- Department of Respiratory Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Patrizia Noris
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Carla Pieresca
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Paola Stefania Preti
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Mariaconcetta Russo
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Angelo Corsico
- Department of Respiratory Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Guido Tavazzi
- Department of Intensive Care, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Antonio Triarico
- Chief Medical Direction, San Matteo Hospital Foundation, Pavia, Italy
| | - Francesco Mojoli
- Department of Intensive Care, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
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14
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Melazzini F, Colaneri M, Fumoso F, Freddi G, Lenti MV, Pieri TC, Piloni D, Noris P, Pieresca C, Preti PS, Russo M, Corsico A, Tavazzi G, Baldanti F, Triarico A, Mojoli F, Bruno R, Di Sabatino A. Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy. Intern Emerg Med 2021; 16:1141-1152. [PMID: 33161478 PMCID: PMC7648897 DOI: 10.1007/s11739-020-02550-6] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023]
Abstract
Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p < 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p < 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p < 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in D-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.
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Affiliation(s)
- Federica Melazzini
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Marta Colaneri
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Federica Fumoso
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Giulia Freddi
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Teresa Chiara Pieri
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Davide Piloni
- Department of Respiratory Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Patrizia Noris
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Carla Pieresca
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Paola Stefania Preti
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Mariaconcetta Russo
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Angelo Corsico
- Department of Respiratory Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Guido Tavazzi
- Department of Intensive Care, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Antonio Triarico
- Chief Medical Direction, San Matteo Hospital Foundation, Pavia, Italy
| | - Francesco Mojoli
- Department of Intensive Care, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
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15
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Marcon A, Locatelli F, Dharmage SC, Svanes C, Heinrich J, Leynaert B, Burney P, Corsico A, Caliskan G, Calciano L, Gislason T, Janson C, Jarvis D, Jõgi R, Lytras T, Malinovschi A, Probst-Hensch N, Toren K, Casas L, Verlato G, Garcia-Aymerich J, Accordini S. The coexistence of asthma and COPD: risk factors, clinical history and lung function trajectories. Eur Respir J 2021; 58:13993003.04656-2020. [PMID: 33863744 PMCID: PMC8613837 DOI: 10.1183/13993003.04656-2020] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/06/2021] [Indexed: 11/05/2022]
Abstract
RATIONALE Patients with concomitant features of asthma and chronic obstructive pulmonary disease (COPD) have a heavy disease burden. OBJECTIVES Using data collected prospectively in the European Community Respiratory Health Survey, we compared the risk factors, clinical history, and lung function trajectories from early adulthood to the late sixties of middle aged subjects having asthma+COPD (n=179), past (n=263) or current (n=808) asthma alone, COPD alone (n=111), or none of these (n=3477). METHODS Interview data and prebronchodilator FEV1 and FVC were obtained during three clinical examinations in 1991-1993, 1999-2002, and 2010-2013. Disease status was classified in 2010-2013, when the subjects were aged 40-68, according to the presence of fixed airflow obstruction (postbronchodilator FEV1/FVC below the lower limit of normal), a lifetime history of asthma, and cumulative exposure to tobacco or occupational inhalants. Previous lung function trajectories, clinical characteristics, and risk factors of these phenotypes were estimated. MAIN RESULTS Subjects with asthma+COPD reported maternal smoking (28.2%) and respiratory infections in childhood (19.1%) more frequently than subjects with COPD alone (20.9 and 14.0%, respectively). Subjects with asthma+COPD had an impairment of lung function at age 20 that tracked over adulthood, and more than half of them had asthma onset in childhood. Subjects with COPD alone had the highest lifelong exposure to tobacco smoking and occupational inhalants, and they showed accelerated lung function decline during adult life. CONCLUSIONS The coexistence between asthma and COPD seems to have its origins earlier in life compared to COPD alone. These findings suggest that prevention of this severe condition, which is typical at older ages, should start in childhood.
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Affiliation(s)
- Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesca Locatelli
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Joachim Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Ludwig Maximilians University, Munich; Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Muenchen, Germany
| | - Bénédicte Leynaert
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, , Villejuif, France
| | - Peter Burney
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.,MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation - Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Gulser Caliskan
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lucia Calciano
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Thorarinn Gislason
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland.,Medical Faculty, University of Iceland, Reykjavik, Iceland
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.,MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Rain Jõgi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Theodore Lytras
- Institute for Global Health (ISGlobal), Barcelona, Spain.,Present institution: School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Nicole Probst-Hensch
- Department Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Kjell Toren
- Occupational and Environmental Medicine, School of Public Health, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lidia Casas
- Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Judith Garcia-Aymerich
- Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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16
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Ghio S, Klersy C, Corsico A, Gamba SL, Monterosso C, Masiglat J, Borrelli E, Scelsi L, Greco A, Piloni D, Visconti LO, D'Armini AM. Risk stratification in patients with residual pulmonary hypertension after pulmonary endarterectomy. Int J Cardiol 2021; 334:116-122. [PMID: 33823214 DOI: 10.1016/j.ijcard.2021.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/06/2021] [Accepted: 04/02/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Few studies addressed the issue of risk stratification in patients with residual pulmonary hypertension (PH) after pulmonary endarterectomy (PEA). This study tested the potential added value of parameters that have not been included in existing risk models. METHODS We evaluated 546 consecutive patients with chronic thromboembolic pulmonary hypertension who underwent PEA and were followed-up for a median period of 58 months. RESULTS Among the 242 with residual PH, 27 died and had 127 a clinical worsening event. At univariable analysis, the parameters associated with poor survival were pulmonary vascular resistance (PVR) ≥425 dyn·s·cm-5 (p ≤ 0.001), mean pulmonary artery pressure (mPAP) ≥38 mmHg (p = 0.003) and pulmonary artery compliance (CPA) ≤1.8 ml/mmHg (p = 0.014). In the bivariable models including either PVR or mPAP as first parameter, the addition of CPA was not statistically significant. The parameters associated with poor clinical worsening were CPA ≤1.8 ml/mmHg (p < 0.001), PVR ≥425 dyn·s·cm-5 (p = 0.002), arterial oxygen tension (PaO2) ≤ 75 mmHg (p = 0.003), mPAP ≥38 mmHg (p = 0.008). In a multivariable analysis which included PVR ≥425 as the first parameter, the addition of both CPA ≤1.8 ml/mmHg and of PaO2 ≤ 75 mmHg significantly improved prognostic stratification (Harrel's C of the model = 0.64, p < 0.001). Noticeably, the lower tertile of the model's predictor index identified a subgroup of 91 patients who had an event rate numerically similar to that of patients without residual PH. CONCLUSIONS Risk stratification in residual PH can be refined if CPA and PaO2 are considered in association with standard hemodynamic parameters.
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Affiliation(s)
- Stefano Ghio
- Division of Cardiology, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy.
| | - Catherine Klersy
- Service of Clinical Epidemiology & Biometry, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Sofia Lucia Gamba
- Division of Cardiac Surgery, Cardiopulmonary Surgery and Pulmonary Hypertension, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Cristian Monterosso
- Division of Cardiac Surgery, Cardiopulmonary Surgery and Pulmonary Hypertension, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Joice Masiglat
- Department of Surgical, Clinical, Diagnostic and Pediatric Sciences, University of Pavia School of Medicine, Pavia, Italy
| | - Ermelinda Borrelli
- Department of Surgical, Clinical, Diagnostic and Pediatric Sciences, University of Pavia School of Medicine, Pavia, Italy
| | - Laura Scelsi
- Division of Cardiology, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Alessandra Greco
- Division of Cardiology, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Davide Piloni
- Division of Respiratory Diseases, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | | | - Andrea Maria D'Armini
- Division of Cardiac Surgery, Cardiopulmonary Surgery and Pulmonary Hypertension, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy; Department of Surgical, Clinical, Diagnostic and Pediatric Sciences, University of Pavia School of Medicine, Pavia, Italy
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17
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Ghio S, Baldi E, Vicentini A, Lenti MV, Di Sabatino A, Di Matteo A, Zuccaro V, Foglia D, Corsico A, Gnecchi M, Speciale F, Sabena A, Oltrona Visconti L, Perlini S. Correction to: Cardiac involvement at presentation in patients hospitalized with COVID-19 and their outcome in a tertiary referral hospital in Northern Italy. Intern Emerg Med 2021; 16:807. [PMID: 33475974 PMCID: PMC7817763 DOI: 10.1007/s11739-020-02604-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Stefano Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy.
| | - Enrico Baldi
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology, Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Cardiology Unit, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Alessandro Vicentini
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology, Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Angela Di Matteo
- Division of Infectious Disease, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Valentina Zuccaro
- Division of Infectious Disease, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Davide Foglia
- Division of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Massimiliano Gnecchi
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology, Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Cardiology Unit, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Francesco Speciale
- Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Pavia, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Anna Sabena
- Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Pavia, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Luigi Oltrona Visconti
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy
| | - Stefano Perlini
- Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Pavia, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
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18
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Benazzo M, Leonardi S, Corsico A, Licari A, Miraglia del Giudice M, Peroni DG, Salpietro C, Marseglia GL, Ciprandi G. Cetirizine modifies quality of life and symptoms in children with seasonal allergic rhinitis: a pilot study. Acta Biomed 2021; 92:e2021003. [PMID: 33682837 PMCID: PMC7975941 DOI: 10.23750/abm.v92i1.9948] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/17/2020] [Indexed: 11/16/2022]
Abstract
Background and aim Seasonal allergic rhinitis (SAR) is a common disease in childhood that is characterized by bothersome symptoms and impaired quality of life (QoL). As histamine is the pivotal pathogenic mediator in SAR, antihistamines are the first-line option in the treatment. Cetirizine is a well-known effective antihistamine. This real-life pilot study aimed to investigate the effectiveness of a 4-week continuous cetirizine treatment in a group of Italian children with SAR. Methods Total symptom score (TSS) and the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) were assessed at baseline and the end of the treatment. Results Cetirizine significantly improved QoL (in all domains) and symptom severity (p<0.001 for both). Conclusions The present preliminary study showed that a 4-week cetirizine treatment was able to improve QoL significantly. Cetirizine treatment also significantly reduced symptom severity in Italian children with SAR and was safe.
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Affiliation(s)
- Marco Benazzo
- Department of Otorhinolaryngology, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Salvatore Leonardi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Amelia Licari
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Michele Miraglia del Giudice
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Diego G Peroni
- U.O. Pediatria, Azienda Ospedaliero-Universitaria Pisana, Scuola di Specializzazione in Pediatria, University of Pisa, Pisa, Italy
| | - Carmelo Salpietro
- Department of Pediatrics, Unit of Pediatric Genetics and Immunology, University of Messina, Messina, Italy
| | - Gian Luigi Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
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19
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Solerte SB, D'Addio F, Trevisan R, Lovati E, Rossi A, Pastore I, Dell'Acqua M, Ippolito E, Scaranna C, Bellante R, Galliani S, Dodesini AR, Lepore G, Geni F, Fiorina RM, Catena E, Corsico A, Colombo R, Mirani M, De Riva C, Oleandri SE, Abdi R, Bonventre JV, Rusconi S, Folli F, Di Sabatino A, Zuccotti G, Galli M, Fiorina P. Sitagliptin Treatment at the Time of Hospitalization Was Associated With Reduced Mortality in Patients With Type 2 Diabetes and COVID-19: A Multicenter, Case-Control, Retrospective, Observational Study. Diabetes Care 2020; 43:2999-3006. [PMID: 32994187 PMCID: PMC7770266 DOI: 10.2337/dc20-1521] [Citation(s) in RCA: 169] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/01/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Poor outcomes have been reported in patients with type 2 diabetes and coronavirus disease 2019 (COVID-19); thus, it is mandatory to explore novel therapeutic approaches for this population. RESEARCH DESIGN AND METHODS In a multicenter, case-control, retrospective, observational study, sitagliptin, an oral and highly selective dipeptidyl peptidase 4 inhibitor, was added to standard of care (e.g., insulin administration) at the time of hospitalization in patients with type 2 diabetes who were hospitalized with COVID-19. Every center also recruited at a 1:1 ratio untreated control subjects matched for age and sex. All patients had pneumonia and exhibited oxygen saturation <95% when breathing ambient air or when receiving oxygen support. The primary end points were discharge from the hospital/death and improvement of clinical outcomes, defined as an increase in at least two points on a seven-category modified ordinal scale. Data were collected retrospectively from patients receiving sitagliptin from 1 March through 30 April 2020. RESULTS Of the 338 consecutive patients with type 2 diabetes and COVID-19 admitted in Northern Italy hospitals included in this study, 169 were on sitagliptin, while 169 were on standard of care. Treatment with sitagliptin at the time of hospitalization was associated with reduced mortality (18% vs. 37% of deceased patients; hazard ratio 0.44 [95% CI 0.29-0.66]; P = 0.0001), with an improvement in clinical outcomes (60% vs. 38% of improved patients; P = 0.0001) and with a greater number of hospital discharges (120 vs. 89 of discharged patients; P = 0.0008) compared with patients receiving standard of care, respectively. CONCLUSIONS In this multicenter, case-control, retrospective, observational study of patients with type 2 diabetes admitted to the hospital for COVID-19, sitagliptin treatment at the time of hospitalization was associated with reduced mortality and improved clinical outcomes as compared with standard-of-care treatment. The effects of sitagliptin in patients with type 2 diabetes and COVID-19 should be confirmed in an ongoing randomized, placebo-controlled trial.
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Affiliation(s)
- Sebastiano Bruno Solerte
- Department of Internal Medicine, Geriatric and Diabetology Unit, University of Pavia, Italy.,School of Geriatrics, University of Pavia Azienda di Servizi alla Persona-Pavia, Pavia, Italy
| | - Francesca D'Addio
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Roberto Trevisan
- Unità Operativa Complessa Malattie Endocrine 1-Diabetologia, Ospedale Papa Giovanni XXIII Azienda Socio Sanitaria Territoriale-PG XXIII, Bergamo, Italy
| | - Elisabetta Lovati
- Internal Medicine Unit, University of Pavia and IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonio Rossi
- Division of Endocrinology, Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco, Milan, Italy
| | - Ida Pastore
- Division of Endocrinology, Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco, Milan, Italy
| | - Marco Dell'Acqua
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy.,Division of Endocrinology, Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco, Milan, Italy
| | - Elio Ippolito
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Cristiana Scaranna
- Unità Operativa Complessa Malattie Endocrine 1-Diabetologia, Ospedale Papa Giovanni XXIII Azienda Socio Sanitaria Territoriale-PG XXIII, Bergamo, Italy
| | - Rosalia Bellante
- Unità Operativa Complessa Malattie Endocrine 1-Diabetologia, Ospedale Papa Giovanni XXIII Azienda Socio Sanitaria Territoriale-PG XXIII, Bergamo, Italy
| | - Silvia Galliani
- Unità Operativa Complessa Malattie Endocrine 1-Diabetologia, Ospedale Papa Giovanni XXIII Azienda Socio Sanitaria Territoriale-PG XXIII, Bergamo, Italy
| | - Alessandro Roberto Dodesini
- Unità Operativa Complessa Malattie Endocrine 1-Diabetologia, Ospedale Papa Giovanni XXIII Azienda Socio Sanitaria Territoriale-PG XXIII, Bergamo, Italy
| | - Giuseppe Lepore
- Unità Operativa Complessa Malattie Endocrine 1-Diabetologia, Ospedale Papa Giovanni XXIII Azienda Socio Sanitaria Territoriale-PG XXIII, Bergamo, Italy
| | - Francesca Geni
- Department of Internal Medicine, Geriatric and Diabetology Unit, University of Pavia, Italy.,School of Geriatrics, University of Pavia Azienda di Servizi alla Persona-Pavia, Pavia, Italy
| | - Roberta Maria Fiorina
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy
| | - Emanuele Catena
- Department of Anesthesia and Intensive Care Unit, Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco, Luigi Sacco Hospital, Università di Milano, Milan, Italy
| | - Angelo Corsico
- Pneumology Unit, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Riccardo Colombo
- Department of Anesthesia and Intensive Care Unit, Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco, Luigi Sacco Hospital, Università di Milano, Milan, Italy
| | - Marco Mirani
- Endocrinology and Diabetology Unit, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Carlo De Riva
- Unità Operativa di Malattie Endocrine ULSS3-Ospedale dell'Angelo Mestre, Mestre, Italy
| | | | - Reza Abdi
- Renal Division, Brigham and Women's Hospital, Boston, MA
| | | | - Stefano Rusconi
- Department of Biomedical and Clinical Sciences "Luigi Sacco," Univeristà di Milano, Milan, Italy.,III Division of Infectious Diseases, Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Franco Folli
- Endocrinology and Metabolism, Department of Health Science, Università di Milano, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Antonio Di Sabatino
- Internal Medicine Unit, University of Pavia and IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche, Università di Milano, Milan, Italy.,Department of Pediatrics, "V. Buzzi" Children's Hospital, Milan, Italy
| | - Massimo Galli
- Department of Biomedical and Clinical Sciences "Luigi Sacco," Univeristà di Milano, Milan, Italy.,III Division of Infectious Diseases, Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Paolo Fiorina
- International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Milan, Italy .,Division of Endocrinology, Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco, Milan, Italy.,Division of Nephrology, Boston Children's Hospital, Harvard Medical School, Boston, MA
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20
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Vicentini A, Masiello L, D’Amore S, Baldi E, Ghio S, Savastano S, Sanzo A, Di Matteo A, Seminari EM, Lenti MV, Bosio M, Petracci B, Frigerio L, Sabena A, Tavazzi G, Oltrona Visconti L, Rordorf R, Gnecchi M, Totaro R, Ferlini M, Greco A, Magrini G, Scelsi L, Acquaro M, Coccia M, Digiacomo S, Foglia D, Jeva F, Montalto C, Moschella M, Pezza L, Perlini S, Alfano C, Bonzano M, Briganti F, Crescenzi G, Falchi AG, Maggi E, Guarnone R, Guglielmana B, Martino IF, Pioli Di Marco MS, Pettenazza P, Quaglia F, Salinaro F, Speciale F, Zunino I, Sturniolo G, Bracchi F, Lago E, Corsico A, Piloni D, Accordino G, Burattini C, Di Sabatino A, Pellegrino I, Soriano S, Santacroce G, Parodi A, de Andreis FB, Bruno R, Zuccaro V, Moioli F, Dammassi V, Albertini R. QTc Interval and Mortality in a Population of SARS-2-CoV Infected Patients. Circ Arrhythm Electrophysiol 2020; 13:e008890. [DOI: 10.1161/circep.120.008890] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Alessandro Vicentini
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lucrezia Masiello
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, Cardiology Unit (L.M., S.D., E.B.), University of Pavia, Italy
| | - Sabato D’Amore
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, Cardiology Unit (L.M., S.D., E.B.), University of Pavia, Italy
| | - Enrico Baldi
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, Cardiology Unit (L.M., S.D., E.B.), University of Pavia, Italy
| | - Stefano Ghio
- Division of Cardiology (S.G., S.S., L.O.V.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Simone Savastano
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonio Sanzo
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Emergency Department (A.S.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine (A.S.), University of Pavia, Italy
| | - Angela Di Matteo
- Division of Infectious Disease (A.D.M., E.M.S.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Maria Seminari
- Division of Infectious Disease (A.D.M., E.M.S.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine (M.V.L.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Matteo Bosio
- Division of Respiratory Diseases (M.B.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Barbara Petracci
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Laura Frigerio
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Anna Sabena
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Guido Tavazzi
- Anaesthesia and Intensive Care (G.T.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Unit of Anesthesia and Intensive Care (G.T.), University of Pavia, Italy
| | - Luigi Oltrona Visconti
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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21
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Parisi G, Leonardi S, Ciprandi G, Corsico A, Licari A, Miraglia del Giudice M, Peroni D, Salpietro C, Marseglia G. Antihistamines in children and adolescents: A practical update. Allergol Immunopathol (Madr) 2020; 48:753-762. [PMID: 32448753 DOI: 10.1016/j.aller.2020.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/22/2020] [Accepted: 02/24/2020] [Indexed: 01/01/2023]
Abstract
Histamine is a chemical mediator, released predominantly by tissue mast cells, circulating basophils, and neurons, which are activated in response to various immunological and non-immunological stimuli. Histamine has to bind to specific receptors to exert its physiological and pathophysiological functions. Endogenous histamine is the main mediator of the immediate allergic response, which moreover, performs other multiple functions, including regulation of gastric secretion, neurotransmission in the central nervous system, and immunomodulatory activity. The involvement of histamine in various disorders and the importance of receptors in the clinical features have relevant implications in clinical practice. Anti-H1 antihistamines contrast the histamine-dependent effects, mainly concerning nasal symptoms and cutaneous itching and wheal. Antihistamines are among the most prescribed drugs in pediatric care. This review updates the practical use of antihistamines in children and adolescents.
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22
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Ghio S, Baldi E, Vicentini A, Lenti MV, Di Sabatino A, Di Matteo A, Zuccaro V, Piloni D, Corsico A, Gnecchi M, Speciale F, Sabena A, Oltrona Visconti L, Perlini S. Cardiac involvement at presentation in patients hospitalized with COVID-19 and their outcome in a tertiary referral hospital in Northern Italy. Intern Emerg Med 2020; 15:1457-1465. [PMID: 32960429 PMCID: PMC7505942 DOI: 10.1007/s11739-020-02493-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 06/13/2020] [Accepted: 09/04/2020] [Indexed: 12/15/2022]
Abstract
The correlation between myocardial injury and clinical outcome in COVID-19 patients is gaining attention in the literature. The aim of the present study was to evaluate the role of cardiac involvement and of respiratory failure in a cohort of COVID-19 patients hospitalized in an academic hospital in Lombardy, one of the most affected Italian (and worldwide) regions by the epidemic. The study included 405 consecutive patients with confirmed COVID-19 admitted to a medical ward from February 25th to March 31st, 2020. Follow-up of surviving patients ended either at hospital discharge or by July 30th, 2020. Myocardial injury was defined on the basis of the presence of blood levels of hs-TnI above the 99th percentile upper reference limit. Respiratory function was assessed as PaO2/FiO2 (P/F) ratio. The primary end-point was death for any cause. During hospitalization, 124 patients died. Death rate increased from 7.9% in patients with normal hs-TnI plasma levels and no cardiac comorbidity to 61.5% in patients with elevated hs-TnI and cardiac involvement (p < 0.001). At multivariable analysis, older age, P/F ratio < 200 (both p < 0.001) and hs-TnI plasma levels were independent predictors of death. However, it must be emphasized that the median values of hs-TnI were within normal range in non-survivors. Cardiac involvement at presentation was associated with poor prognosis in COVID-19 patients, but, even in a population of COVID-19 patients who did not require invasive ventilation at hospital admission, mortality was mainly driven by older age and respiratory failure.
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Affiliation(s)
- Stefano Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy.
| | - Enrico Baldi
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology, Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Cardiology Unit, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Alessandro Vicentini
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology, Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Angela Di Matteo
- Division of Infectious Disease, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Valentina Zuccaro
- Division of Infectious Disease, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Davide Piloni
- Division of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Massimiliano Gnecchi
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology, Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Cardiology Unit, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Francesco Speciale
- Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Pavia, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Anna Sabena
- Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Pavia, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Luigi Oltrona Visconti
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy
| | - Stefano Perlini
- Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Pavia, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
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23
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Sposato B, Scalese M, Camiciottoli G, Carpagnano GE, Pelaia C, Santus P, Maniscalco M, Corsico A, Grosso A, Baglioni S, Murgia N, Folletti I, Pelaia G, Masieri S, Cavaliere C, Musarra A, Bargagli E, Ricci A, Latorre M, Paggiaro P, Rogliani P. Mepolizumab Effectiveness and Allergic Status in Real Life. Int Arch Allergy Immunol 2020; 182:311-318. [PMID: 33113532 DOI: 10.1159/000511147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND It is not clear whether mepolizumab is differently effective in allergic and nonallergic severe eosinophilic asthmatics (SEA) in real life. OBJECTIVE We tested mepolizumab effectiveness in allergic/nonallergic SEA in real life. A strict criterion to identify the 2 phenotypes was used. METHOD We retrospectively considered 134 consecutive patients divided into allergic, with a positivity to at least 1 allergen to prick tests and/or IgE values ≥100 UI/mL (severe allergic eosinophilic asthma [SAEA]; n: 97-72.4%), and nonallergic, with no prick test results and normal IgE levels <100 UI/mL (severe nonallergic eosinophilic asthma [SNAEA]; n: 37-27.6%). They had taken mepolizumab for at least 6 months. RESULTS After 10.9 ± 3.7 months, improvements in FEV1%, FEF25-75%, exacerbation numbers, blood eosinophil (BE) counts, fractional exhaled nitric oxide (FENO) (ppb), percentages of patients that stopped/reduced short-acting β2-agonists (SABAs) or oral corticosteroid (OC), observed after treatment, were similar in both groups. Only Asthma Control Test (ACT) increases were higher in SNAEA (8 [5-9]) than in SAEA (5 [2.5-8.5]; p = 0.016). However, no differences were found after treatment in percentages of subjects with ACT ≥20, as well as with FEV1 >80%, FEF25-75 >65%, exacerbations ≤2, BE <300 cells/µL, and FENO <25 ppb between SAEA and SNAEA. Besides, no significant relationships were found, comparing SNAEA with SAEA, for FEV1% (β = -0.110; p = 0.266), FEF25-75% (β = -0.228; p = 0.06), BE counts (β = -0.012; p = 0.918), FENO (β = 0.234; p = 0.085), ACT (β = 0.046; p = 0.660), and exacerbations (β = -0.070; p = 0.437). No different associations between lung function and SNAEA occurrence when compared to SAEA condition (FEV1 >80%: OR = 1.04 [95% CI: 0.43-2.55], p = 0.923; FEF25-75 >65%: OR = 0.41 [95% CI: 0.08-2.03], p = 0.272) were detected. Neither all other parameters, such as ACT >20 (OR = 0.73 [95% CI: 0.32-1.63], p = 0.440), presence of exacerbations (OR = 1.35 [95% CI: 0.55-3.27], p = 0.512), SABA discontinuation (OR = 1.16 [95% CI: 0.40-3.39], p = 0.790), and OC cessation/reduction (OR = 3.44 [95% CI: 0.40-29.27], p = 0.258), were differently associated with 1 or the other phenotype. CONCLUSION Mepolizumab can be considered as a valid therapeutic choice for either allergic or nonallergic SEA in real life.
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Affiliation(s)
- Bruno Sposato
- Azienda USL Toscana Sud-Est Pneumology Department, "Misericordia" Hospital, Grosseto, Italy, .,Experimental Medicine and Systems, "PhD Program" Department of Systems Medicine University of Rome "Tor Vergata", Rome, Italy,
| | - Marco Scalese
- Clinic Physiology Institute, National Research Centre, Pisa, Italy
| | - Gianna Camiciottoli
- Section of Respiratory Medicine, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | - Giovanna Elisiana Carpagnano
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, University of Foggia, Foggia, Italy
| | - Corrado Pelaia
- Section of Respiratory Diseases, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Pierachille Santus
- Division of Pulmonary Diseases, Department of Biomedical and Clinical Sciences (DIBIC), Università Degli Studi di Milano, Ospedale L. Sacco, ASST Fatebenfratelli-Sacco, Milan, Italy
| | - Mauro Maniscalco
- Institute Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Telese, Telese Terme, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - Amelia Grosso
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | | | - Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy
| | - Ilenia Folletti
- Occupational Medicine, Terni Hospital, University of Perugia, Perugia, Italy
| | - Girolamo Pelaia
- Section of Respiratory Diseases, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Simonetta Masieri
- Department of Sense Organs, Otorhinolaryngology Clinic, Policlinico Umberto I, "Sapienza" University, Rome, Italy
| | - Carlo Cavaliere
- Department of Sense Organs, Otorhinolaryngology Clinic, Policlinico Umberto I, "Sapienza" University, Rome, Italy
| | - Antonino Musarra
- Allergology Department, Casa della Salute di Scilla, Scilla, Italy
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplant Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Alberto Ricci
- Division of Pneumology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, AOU Sant'Andrea, Rome, Italy
| | - Manuela Latorre
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy
| | - Pierluigi Paggiaro
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy
| | - Paola Rogliani
- Experimental Medicine and Systems, "PhD Program" Department of Systems Medicine University of Rome "Tor Vergata", Rome, Italy.,Respiratory Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
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24
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Mondoni M, Sferrazza Papa GF, Rinaldo R, Faverio P, Marruchella A, D'Arcangelo F, Pesci A, Pasini S, Henchi S, Cipolla G, Tarantini F, Giuliani L, Di Marco F, Saracino L, Tomaselli S, Corsico A, Gasparini S, Bonifazi M, Zuccatosta L, Saderi L, Pellegrino G, Davì M, Carlucci P, Centanni S, Sotgiu G. Utility and safety of bronchoscopy during the SARS-CoV-2 outbreak in Italy: a retrospective, multicentre study. Eur Respir J 2020; 56:13993003.02767-2020. [PMID: 32859682 PMCID: PMC7453732 DOI: 10.1183/13993003.02767-2020] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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: 06/05/2020] [Accepted: 08/06/2020] [Indexed: 12/14/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the related disease (coronavirus disease 2019; COVID-19) has been notified throughout Italy since February 2020. Intensive care unit (ICU) admission rate increased following the high incidence of pneumonia-related respiratory failure [1]. Utility and safety of bronchoscopy during the SARS-CoV-2 outbreakhttps://bit.ly/3ish52k
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Affiliation(s)
- Michele Mondoni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Francesco Sferrazza Papa
- Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Rocco Rinaldo
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Paola Faverio
- School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Almerico Marruchella
- School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Francesca D'Arcangelo
- School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Alberto Pesci
- School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | | | | | | | | | - Lisa Giuliani
- Respiratory Unit, Papa Giovanni XXIII Hospital, Dept of Health Sciences, Università degli Studi di Milano, Bergamo, Italy
| | - Fabiano Di Marco
- Respiratory Unit, Papa Giovanni XXIII Hospital, Dept of Health Sciences, Università degli Studi di Milano, Bergamo, Italy
| | - Laura Saracino
- Respiratory Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Tomaselli
- Respiratory Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Angelo Corsico
- Respiratory Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Dept of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Stefano Gasparini
- Pulmonary Disease Unit, Dept of Internal Medicine, Azienda Ospedali Riuniti, Dept of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Martina Bonifazi
- Pulmonary Disease Unit, Dept of Internal Medicine, Azienda Ospedali Riuniti, Dept of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Lina Zuccatosta
- Pulmonary Disease Unit, Dept of Internal Medicine, Azienda Ospedali Riuniti, Dept of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Dept of Medical, Surgical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Giulia Pellegrino
- Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Matteo Davì
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Paolo Carlucci
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Stefano Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Medical, Surgical and Experimental Medicine, University of Sassari, Sassari, Italy
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25
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Sposato B, Scalese M, Camiciottoli G, Carpagnano GE, Pelaia C, Santus P, Maniscalco M, Corsico A, Grosso A, Baglioni S, Murgia N, Folletti I, Pelaia G, Masieri S, Cavaliere C, Musarra A, Bargagli E, Ricci A, Latorre M, Rogliani P, Paggiaro P. Real-life Mepolizumab effectiveness in severe eosinophilic asthmatics with nasal polyposis. Respir Med Res 2020; 78:100791. [PMID: 33039948 DOI: 10.1016/j.resmer.2020.100791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022]
Affiliation(s)
- B Sposato
- Azienda USL Toscana Sud-Est Pneumology Department, "Misericordia" Hospital, Grosseto, Italy; Experimental Medicine and Systems, "PhD program" Department of Systems Medicine University of Rome "Tor Vergata", Rome, Italy.
| | - M Scalese
- Clinic Physiology Institute, National Research Centre, Pisa, Italy
| | - G Camiciottoli
- Section of Respiratory Medicine, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Largo A Brambilla 3, 50134, Florence, Italy
| | - G E Carpagnano
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - C Pelaia
- Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - P Santus
- Department of Biomedical and Clinical Sciences (DIBIC), Università Degli Studi di Milano, Division of Pulmonary Diseases, Ospedale L. Sacco, ASST Fatebenfratelli-Sacco, Milan, Italy
| | - M Maniscalco
- Institute Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Istitute of Telese, 82037 Telese Terme (BN), Italy
| | - A Corsico
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - A Grosso
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - S Baglioni
- Pneumology Department, Perugia Hospital, Perugia, Italy
| | - N Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy
| | - I Folletti
- Occupational Medicine, Terni Hospital, University of Perugia, Perugia, Italy
| | - G Pelaia
- Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - S Masieri
- Department of Sense Organs, Otorhinolaryngology Clinic, Policlinico Umberto I, "Sapienza" University, Rome, Italy
| | - C Cavaliere
- Department of Sense Organs, Otorhinolaryngology Clinic, Policlinico Umberto I, "Sapienza" University, Rome, Italy
| | - A Musarra
- Allergology Department, Casa della Salute di Scilla, Scilla, RC, Italy
| | - E Bargagli
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplant Unit, University of Siena, Siena, Italy
| | - A Ricci
- Division of Pneumology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, AOU Sant'Andrea, Rome, Italy
| | - M Latorre
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy
| | - P Rogliani
- Experimental Medicine and Systems, "PhD program" Department of Systems Medicine University of Rome "Tor Vergata", Rome, Italy; Respiratory Unit, department of Experimental Medicine, University of Rome "Tor Vergata" Rome, Rome, Italy
| | - P Paggiaro
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy
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26
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Scichilone N, Barnes PJ, Battaglia S, Benfante A, Brown R, Canonica GW, Caramori G, Cazzola M, Centanni S, Cianferoni A, Corsico A, De Carlo G, Di Marco F, Gaga M, Hawrylowicz C, Heffler E, Matera MG, Matucci A, Paggiaro P, Papi A, Popov T, Rogliani P, Santus P, Solidoro P, Togias A, Boulet LP. The Hidden Burden of Severe Asthma: From Patient Perspective to New Opportunities for Clinicians. J Clin Med 2020; 9:jcm9082397. [PMID: 32727032 PMCID: PMC7463666 DOI: 10.3390/jcm9082397] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/15/2020] [Accepted: 07/20/2020] [Indexed: 12/17/2022] Open
Abstract
Severe asthma is an important topic in respiratory diseases, due to its high impact on morbidity and mortality as well as on health-care resources. The many challenges that still exist in the management of the most difficult-to-treat forms of the disease, and the acknowledgement of the existence of unexplored areas in the pathophysiological mechanisms and the therapeutic targets represent an opportunity to gather experts in the field with the immediate goals to summarize current understanding about the natural history of severe asthma and to identify gaps in knowledge and research opportunities, with the aim to contribute to improved medical care and health outcomes. This article is a consensus document from the “International Course on Severe Asthma” that took place in Palermo, Italy, on May 10–11, 2019. Emerging topics in severe asthma were addressed and discussed among experts, with special focus on patient’s needs and research opportunities, with the aim to highlight the unanswered questions in the diagnostic process and therapeutic approach.
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Affiliation(s)
- Nicola Scichilone
- Division of Respiratory Diseases, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche 2, 90143 Palermo, Italy; (S.B.); (A.B.)
- Correspondence: ; Tel.: +39-091-655-2146
| | - Peter John Barnes
- Airway Disease Section, National Heart & Lung Institute, Imperial College London, Dovehouse Street, London SW3 6LY, UK;
| | - Salvatore Battaglia
- Division of Respiratory Diseases, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche 2, 90143 Palermo, Italy; (S.B.); (A.B.)
| | - Alida Benfante
- Division of Respiratory Diseases, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche 2, 90143 Palermo, Italy; (S.B.); (A.B.)
| | - Robert Brown
- Department of Anesthesiology and Critical Care Medicine, Medicine, Department of Medicine, Division of Pulmonary Medicine, Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD 21287, USA;
| | - Giorgio Walter Canonica
- Personalised Medicine Clinic Asthma & Allergy, Humanitas University, Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (G.W.C.); (E.H.)
| | - Gaetano Caramori
- Respiratory Medicine Unit, Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging (BIOMORF), University of Messina, 98122 Messina, Italy;
| | - Mario Cazzola
- Unit of Respiratory Medicine, Dept. Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.C.); (P.R.)
| | - Stefano Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, University of Milan, 20142 Milan, Italy;
| | - Antonella Cianferoni
- Pediatrics Department, Perlman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and Department of Internal Medicine and Therapeutics – University of Pavia, 27100 Pavia, Italy;
| | - Giuseppe De Carlo
- The European Federation of Allergy and Airways Diseases Patients Associations (EFA), 1000 Brussels, Belgium;
| | - Fabiano Di Marco
- Respiratory Unit, ASST - Papa Giovanni XXIII Hospital, Bergamo, University of Milan, 24127 Milan, Italy;
| | - Mina Gaga
- 7th Respiratory Medicine Dept, Asthma Cen, Athens Chest Hospital, 11527 Athens, Greece;
| | - Catherine Hawrylowicz
- Division of Asthma, Allergy and Lung Biology, King’s College London, Guy’s Hospital, London SE1 9RT, UK;
| | - Enrico Heffler
- Personalised Medicine Clinic Asthma & Allergy, Humanitas University, Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (G.W.C.); (E.H.)
| | - Maria Gabriella Matera
- Unit of Pharmacology, Dept. Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Andrea Matucci
- Immunoallergology Unit, Careggi University Hospital, 50139 Florence, Italy;
| | - Pierluigi Paggiaro
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, 56126 Pisa, Italy;
| | - Alberto Papi
- Research Center on Asthma and COPD, Dept of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Todor Popov
- Clinic of Occupational Diseases, University Hospital Sv. Ivan Rilski, 1431 Sofia, Bulgaria;
| | - Paola Rogliani
- Unit of Respiratory Medicine, Dept. Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.C.); (P.R.)
| | - Pierachille Santus
- Division of Respiratory Diseases, Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy;
| | - Paolo Solidoro
- Pneumology Unit U, Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy;
| | - Alkis Togias
- National Institute of Allergy and Infectious Diseases, Bethesda, MD 20814, USA;
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27
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Cavagna L, Seminari E, Zanframundo G, Gregorini M, Di Matteo A, Rampino T, Montecucco C, Pelenghi S, Cattadori B, Pattonieri EF, Vitulo P, Bertani A, Sambataro G, Vancheri C, Biglia A, Bozzalla-Cassione E, Bonetto V, Monti MC, Ticozzelli E, Turco A, Oggionni T, Corsico A, Bertuccio F, Zuccaro V, Codullo V, Morosini M, Marena C, Gnecchi M, Pellegrini C, Meloni F. Calcineurin Inhibitor-Based Immunosuppression and COVID-19: Results from a Multidisciplinary Cohort of Patients in Northern Italy. Microorganisms 2020; 8:E977. [PMID: 32629788 PMCID: PMC7409165 DOI: 10.3390/microorganisms8070977] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/27/2020] [Accepted: 06/28/2020] [Indexed: 12/23/2022] Open
Abstract
The role of immunosuppression in SARS-CoV-2-related disease (COVID-19) is a matter of debate. We here describe the course and the outcome of COVID-19 in a cohort of patients undergoing treatment with calcineurin inhibitors. In this monocentric cohort study, data were collected from the COVID-19 outbreak in Italy up to April 28th 2020. Patients were followed at our hospital for solid organ transplantation or systemic rheumatic disorders (RMDs) and were on calcineurin inhibitor (CNI)-based therapy. Selected patients were referred from the North of Italy. The aim of our study was to evaluate the clinical course of COVID-19 in this setting. We evaluated 385 consecutive patients (220 males, 57%; median age 61 years, IQR 48-69); 331 (86%) received solid organ transplantation and 54 (14%) had a RMD. CNIs were the only immunosuppressant administered in 47 patients (12%). We identified 14 (4%) COVID-19 patients, all transplanted, mainly presenting with fever (86%) and diarrhea (71%). Twelve patients were hospitalized and two of them died, both with severe comorbidities. No patients developed acute respiratory distress syndrome or infectious complications. The surviving 10 patients are now fully recovered. The clinical course of COVID-19 patients on CNIs is generally mild, and the risk of superinfection seems low.
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Affiliation(s)
- Lorenzo Cavagna
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (G.Z.); (C.M.); (A.B.); (E.B.-C.); (V.C.)
| | - Elena Seminari
- Infectious Diseases Clinic, University of Pavia and IRCCS Policlinico S. Matteo Foundation, 27100 Pavia, Italy; (E.S.); (A.D.M.); (V.Z.)
| | - Giovanni Zanframundo
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (G.Z.); (C.M.); (A.B.); (E.B.-C.); (V.C.)
| | - Marilena Gregorini
- Nephrology, Dialysis and Transplantation Unit, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (M.G.); (T.R.); (E.F.P.)
| | - Angela Di Matteo
- Infectious Diseases Clinic, University of Pavia and IRCCS Policlinico S. Matteo Foundation, 27100 Pavia, Italy; (E.S.); (A.D.M.); (V.Z.)
| | - Teresa Rampino
- Nephrology, Dialysis and Transplantation Unit, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (M.G.); (T.R.); (E.F.P.)
| | - Carlomaurizio Montecucco
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (G.Z.); (C.M.); (A.B.); (E.B.-C.); (V.C.)
| | - Stefano Pelenghi
- Division of Cardiac Surgery, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (S.P.); (B.C.); (C.P.)
| | - Barbara Cattadori
- Division of Cardiac Surgery, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (S.P.); (B.C.); (C.P.)
| | - Eleonora Francesca Pattonieri
- Nephrology, Dialysis and Transplantation Unit, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (M.G.); (T.R.); (E.F.P.)
| | - Patrizio Vitulo
- Pulmonology Unit, IRCCS Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione (ISMETT), 90100 Palermo, Italy;
| | - Alessandro Bertani
- Thoracic Surgery Unit, IRCCS Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione (ISMETT), 90100 Palermo, Italy;
| | - Gianluca Sambataro
- Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy; (G.S.); (C.V.)
| | - Carlo Vancheri
- Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy; (G.S.); (C.V.)
| | - Alessandro Biglia
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (G.Z.); (C.M.); (A.B.); (E.B.-C.); (V.C.)
| | - Emanuele Bozzalla-Cassione
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (G.Z.); (C.M.); (A.B.); (E.B.-C.); (V.C.)
| | - Valentina Bonetto
- Department of Biochemistry and Molecular Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy;
| | - Maria Cristina Monti
- Department of Public Health, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, 27100 Pavia, Italy;
| | - Elena Ticozzelli
- General Surgery Unit, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy;
| | - Annalisa Turco
- Cardiology Department, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy;
| | - Tiberio Oggionni
- Department of Respiratory Diseases, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (T.O.); (A.C.); (F.B.); (M.M.); (F.M.)
| | - Angelo Corsico
- Department of Respiratory Diseases, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (T.O.); (A.C.); (F.B.); (M.M.); (F.M.)
| | - Francesco Bertuccio
- Department of Respiratory Diseases, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (T.O.); (A.C.); (F.B.); (M.M.); (F.M.)
| | - Valentina Zuccaro
- Infectious Diseases Clinic, University of Pavia and IRCCS Policlinico S. Matteo Foundation, 27100 Pavia, Italy; (E.S.); (A.D.M.); (V.Z.)
| | - Veronica Codullo
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (G.Z.); (C.M.); (A.B.); (E.B.-C.); (V.C.)
| | - Monica Morosini
- Department of Respiratory Diseases, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (T.O.); (A.C.); (F.B.); (M.M.); (F.M.)
| | - Carlo Marena
- SC Direzione Medica di Presidio, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy;
| | - Massimiliano Gnecchi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Department of Medical Sciences and Infectious Disease, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy;
- Department of Molecular Medicine, Cardiology Unit, University of Pavia, 27100 Pavia, Italy
| | - Carlo Pellegrini
- Division of Cardiac Surgery, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (S.P.); (B.C.); (C.P.)
| | - Federica Meloni
- Department of Respiratory Diseases, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (T.O.); (A.C.); (F.B.); (M.M.); (F.M.)
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28
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Bonini M, Di Paolo M, Bagnasco D, Baiardini I, Braido F, Caminati M, Carpagnano E, Contoli M, Corsico A, Del Giacco S, Heffler E, Lombardi C, Menichini I, Milanese M, Scichilone N, Senna G, Canonica GW. Minimal clinically important difference for asthma endpoints: an expert consensus report. Eur Respir Rev 2020; 29:29/156/190137. [PMID: 32499305 PMCID: PMC9488652 DOI: 10.1183/16000617.0137-2019] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/09/2020] [Indexed: 02/02/2023] Open
Abstract
Minimal clinically important difference (MCID) can be defined as the smallest change or difference in an outcome measure that is perceived as beneficial and would lead to a change in the patient's medical management. The aim of the current expert consensus report is to provide a “state-of-the-art” review of the currently available literature evidence about MCID for end-points to monitor asthma control, in order to facilitate optimal disease management and identify unmet needs in the field to guide future research. A series of MCID cut-offs are currently available in literature and validated among populations of asthmatic patients, with most of the evidence focusing on outcomes as patient reported outcomes, lung function and exercise tolerance. On the contrary, only scant and partial data are available for inflammatory biomarkers. These clearly represent the most interesting target for future development in diagnosis and clinical management of asthma, particularly in view of the several biologic drugs in the pipeline, for which regulatory agencies will soon require personalised proof of efficacy and treatment response predictors. Minimal clinically important difference (MCID) cut-offs in asthma are validated for patient reported outcomes and lung function, but not for inflammatory biomarkers. MCID represents a key target for future development in asthma management. http://bit.ly/33hcWIe
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Affiliation(s)
- Matteo Bonini
- National Heart and Lung Institute, Royal Brompton Hospital & Imperial College London, London, UK.,UOC Pneumologia, Istituto di Medicina Interna, F. Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marcello Di Paolo
- National Heart and Lung Institute, Royal Brompton Hospital & Imperial College London, London, UK
| | - Diego Bagnasco
- Allergy and Respiratory diseases, University of Genoa, Dept of Internal Medicine (DiMI), Ospedale Policlinico San Martino, Genoa, Italy
| | - Ilaria Baiardini
- Dept of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Fulvio Braido
- Allergy and Respiratory diseases, University of Genoa, Dept of Internal Medicine (DiMI), Ospedale Policlinico San Martino, Genoa, Italy
| | - Marco Caminati
- Dept of Medicine, University of Verona, Verona, Italy.,Asthma Center and Allergy Unit, Verona University Hospital, Verona, Italy
| | - Elisiana Carpagnano
- Division of Respiratory Diseases, Dept of Medical and Surgical Sciences, University of Foggia, Italy
| | - Marco Contoli
- Section of Internal and Cardiorespiratory Medicine, Dept of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation - Dept of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Stefano Del Giacco
- Dept of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Enrico Heffler
- Personalized Medicine, Asthma and Allergy - Humanitas Research Hospital, Rozzano, Italy
| | - Carlo Lombardi
- Departmental Unit of Pneumology & Allergology, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy
| | - Ilaria Menichini
- Dept of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Science, "Sapienza" University, Rome, Italy
| | | | - Nicola Scichilone
- AOUP Policlinico Universitario, DIBIMIS, Università di Palermo, Palermo, Italy
| | - Gianenrico Senna
- Dept of Medicine, University of Verona, Verona, Italy.,Asthma Center and Allergy Unit, Verona University Hospital, Verona, Italy
| | - Giorgio W Canonica
- Personalized Medicine, Asthma and Allergy - Humanitas Research Hospital, Rozzano, Italy
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29
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Peralta GP, Marcon A, Carsin AE, Abramson MJ, Accordini S, Amaral AF, Antó JM, Bowatte G, Burney P, Corsico A, Demoly P, Dharmage S, Forsberg B, Fuertes E, Garcia-Larsen V, Gíslason T, Gullón JA, Heinrich J, Holm M, Jarvis DL, Janson C, Jogi R, Johannessen A, Leynaert B, Rovira JMM, Nowak D, Probst-Hensch N, Raherison C, Sánchez-Ramos JL, Sigsgaard T, Siroux V, Squillacioti G, Urrutia I, Weyler J, Zock JP, Garcia-Aymerich J. Body mass index and weight change are associated with adult lung function trajectories: the prospective ECRHS study. Thorax 2020; 75:313-320. [PMID: 32098862 PMCID: PMC7231449 DOI: 10.1136/thoraxjnl-2019-213880] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/19/2019] [Accepted: 12/16/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Previous studies have reported an association between weight increase and excess lung function decline in young adults followed for short periods. We aimed to estimate lung function trajectories during adulthood from 20-year weight change profiles using data from the population-based European Community Respiratory Health Survey (ECRHS). METHODS We included 3673 participants recruited at age 20-44 years with repeated measurements of weight and lung function (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1)) in three study waves (1991-93, 1999-2003, 2010-14) until they were 39-67 years of age. We classified subjects into weight change profiles according to baseline body mass index (BMI) categories and weight change over 20 years. We estimated trajectories of lung function over time as a function of weight change profiles using population-averaged generalised estimating equations. RESULTS In individuals with normal BMI, overweight and obesity at baseline, moderate (0.25-1 kg/year) and high weight gain (>1 kg/year) during follow-up were associated with accelerated FVC and FEV1 declines. Compared with participants with baseline normal BMI and stable weight (±0.25 kg/year), obese individuals with high weight gain during follow-up had -1011 mL (95% CI -1.259 to -763) lower estimated FVC at 65 years despite similar estimated FVC levels at 25 years. Obese individuals at baseline who lost weight (<-0.25 kg/year) exhibited an attenuation of FVC and FEV1 declines. We found no association between weight change profiles and FEV1/FVC decline. CONCLUSION Moderate and high weight gain over 20 years was associated with accelerated lung function decline, while weight loss was related to its attenuation. Control of weight gain is important for maintaining good lung function in adult life.
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Affiliation(s)
- Gabriela P Peralta
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Anne-Elie Carsin
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - André Fs Amaral
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Josep M Antó
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Gayan Bowatte
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population & Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- National Institute of Fundamental Studies, Kandy, Sri Lanka
| | - Peter Burney
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS 'San Matteo' Hospital Foundation-University of Pavia, Pavia, Italy
| | - Pascal Demoly
- Département de Pneumologie et Addictologie, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
- UMr-S 1136 inSerM, iPleSP, UPMc, Sorbonne Universités, Paris, France
| | - Shyamali Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population & Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Bertil Forsberg
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Elaine Fuertes
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Vanessa Garcia-Larsen
- Program in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Thorarinn Gíslason
- Department of Sleep, Landspitali University Hospital Reykjavik, Reykjavik, Iceland
- Medical Faculty University of Iceland, Reykjavik, Iceland
| | | | - Joachim Heinrich
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population & Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Deborah L Jarvis
- National Heart and Lung Institute, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Rain Jogi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Bénédicte Leynaert
- INSERM U1168, VIMA (Aging and Chronic Diseases. Epidemiological and Public Health Approaches), Villejuif, France
- UMR-S 1168, Univ Versailles St-Quentin-en-Yvelines, St-Quentin-en-Yvelines, France
| | | | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- Department of Public Health, University of Basel, Basel, Switzerland
| | - Chantal Raherison
- INSERM U897, Institute of Public Health and Epidemiology, Bordeaux University, Bordeaux, France
| | | | - Torben Sigsgaard
- Department of Public Health, Section for Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Valérie Siroux
- Institute for Advanced Biosciences, UGA-Inserm U1209-CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France
| | - Giulia Squillacioti
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Isabel Urrutia
- Department of Respiratory, Galdakao Hospital, Galdakao, Spain
| | - Joost Weyler
- Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
| | - Jan-Paul Zock
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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30
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Squillacioti G, Bellisario V, Grosso A, Ghelli F, Piccioni P, Grignani E, Corsico A, Bono R. Formaldehyde, Oxidative Stress, and FeNO in Traffic Police Officers Working in Two Cities of Northern Italy. Int J Environ Res Public Health 2020; 17:ijerph17051655. [PMID: 32143339 PMCID: PMC7084911 DOI: 10.3390/ijerph17051655] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/25/2020] [Accepted: 03/02/2020] [Indexed: 02/01/2023]
Abstract
Personal air formaldehyde (air-FA) was measured as risk factor of airways inflammation and oxidative stress (SO) induction. Overall, 154 police officers were enrolled from two differently urbanised Italian cities, Turin and Pavia. Urinary F2t-isoprostane (15-F2t-IsoP), a prostaglandin-like compound, was quantified as a biomarker of general OS in vivo and fractional exhaled nitric oxide (FeNO) was measured for monitoring local inflammatory processes. Urinary cotinine was quantified as a biomarker of tobacco smoking exposure. Traffic police officers living in Turin showed an increased level of log air-FA (p < 0.001), equal to +53.6% (p < 0.001). Log air-(FA) mean values were 3.38 (C.I. 95% 3.33–3.43) and 2.84 (C.I. 95% 2.77–2.92) in Turin and Pavia, respectively. Log (air-FA) was higher in “outdoor workers” (3.18, C.I. 95% 3.13–3.24, p = 0.035) compared to “indoor workers”, showing an increase of +9.3%, even controlling for sex and city. The analyses on 15-F2t-IsoP and FeNO, both adjusted for log air-FA, highlighted that OS and inflammation were higher (+66.8%, p < 0.001 and +75%, p < 0.001, respectively) in Turin traffic police officers compared to those from Pavia. Our findings suggest that even low exposures to traffic-related emissions and urbanisation may influence both general oxidative stress levels and local inflammation.
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Affiliation(s)
- Giulia Squillacioti
- Department of Public Health and Pediatrics, University of Torino, 10121 Torino, Italy; (G.S.); (V.B.); (F.G.)
| | - Valeria Bellisario
- Department of Public Health and Pediatrics, University of Torino, 10121 Torino, Italy; (G.S.); (V.B.); (F.G.)
| | - Amelia Grosso
- Division of Respiratory Diseases, S. Matteo Foundation–University of Pavia, 5001 Pavia, Italy; (A.G.); (A.C.)
| | - Federica Ghelli
- Department of Public Health and Pediatrics, University of Torino, 10121 Torino, Italy; (G.S.); (V.B.); (F.G.)
| | - Pavilio Piccioni
- Unit of Respiratory Medicine, National Health Service, ASL TO2, 10121 Torino, Italy;
| | - Elena Grignani
- Maugeri Scientific Clinical Institutes, 5001 Pavia, Italy;
| | - Angelo Corsico
- Division of Respiratory Diseases, S. Matteo Foundation–University of Pavia, 5001 Pavia, Italy; (A.G.); (A.C.)
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Torino, 10121 Torino, Italy; (G.S.); (V.B.); (F.G.)
- Correspondence: ; Tel.: +39-011-670-5818; Fax: +39-011-236-5818
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31
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Parisi GF, Leonardi S, Ciprandi G, Corsico A, Licari A, Miraglia Del Giudice M, Peroni D, Salpietro C, Marseglia GL. Cetirizine use in childhood: an update of a friendly 30-year drug. Clin Mol Allergy 2020; 18:2. [PMID: 32127782 PMCID: PMC7043022 DOI: 10.1186/s12948-020-00118-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 02/17/2020] [Indexed: 01/08/2023] Open
Abstract
Cetirizine is a second-generation antihistamine, derived from the metabolism of hydroxyzine, highly specific for the H1 receptors, and with marked antiallergic properties. Although its history began more than 30 years ago, it remains one of the most used drugs in children with a leading role in the medical care of children with allergic diseases. Cetirizine use is licensed for paediatric patients for the treatment of allergic rhinitis, and chronic spontaneous urticaria, in Europe in children older than 2 years old and in the USA in children older than 6 months old. This review provides a practical update on the use of cetirizine in children and adolescents.
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Affiliation(s)
- Giuseppe Fabio Parisi
- 1Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia, 78, 95123 Catania, Italy
| | - Salvatore Leonardi
- 1Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia, 78, 95123 Catania, Italy
| | | | - Angelo Corsico
- 3Pulmonology Clinic, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Amelia Licari
- 4Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Michele Miraglia Del Giudice
- 5Department of Woman, Child and of General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Diego Peroni
- 6U.O. Pediatria, Azienda Ospedaliero-Universitaria Pisana, Scuola di Specializzazione in Pediatria, University of Pisa, Pisa, Italy
| | - Carmelo Salpietro
- 7Unit of Pediatric Genetics and Immunology, Department of Pediatrics, University of Messina, Messina, Italy
| | - Gian Luigi Marseglia
- 4Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
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Sposato B, Camiciottoli G, Bacci E, Scalese M, Carpagnano GE, Pelaia C, Santus P, Maniscalco M, Masieri S, Corsico A, Scichilone N, Baglioni S, Murgia N, Folletti I, Bardi G, Grosso A, Cameli P, Latorre M, Musarra A, Bargagli E, Ricci A, Pelaia G, Paggiaro P, Rogliani P. Mepolizumab effectiveness on small airway obstruction, corticosteroid sparing and maintenance therapy step-down in real life. Pulm Pharmacol Ther 2020; 61:101899. [PMID: 31972327 DOI: 10.1016/j.pupt.2020.101899] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Mepolizumab (MEP) has been recently introduced to treat severe eosinophilic asthma. Trials have demonstrated a significant effectiveness in this asthma phenotype. We evaluated MEP efficacy on lung function, symptoms, asthma exacerbations, biologic markers, steroid dependence and controller treatment level in real-life. METHODS We retrospectively analyzed 134 severe asthmatics (61 males; mean age 58.3 ± 11; mean FEV1%:72 ± 21), treated with MEP for at least 6 months (mean duration:10.9 ± 3.7 months). RESULTS FEV1% improved significantly after MEP. Mean FEF25-75 also increased from 37.4 ± 25.4% to 47.2 ± 27.2% (p < 0.0001). Mean baseline blood eosinophil level was 712 ± 731/μL (8.4 ± 5.2%) decreasing to 151 ± 384/μL (1.6 ± 1.6%) (p < 0.0001), FENO levels decreased likewise. MEP treatment also led to a significant ACT improvement (mean pre:14.2 ± 4.4; mean post:20.5 ± 28) and exacerbations significantly fell from 3.8 ± 1.9 to 0.8 ± 1.1 (p < 0.0001). 74% of patients were steroid-dependent before MEP. 45.4% and 46.4% of them showed a suspension and dose reduction respectively (p < 0.0001). A significant number reduced also ICS doses. Only 67% of subjects used SABA as needed before MEP, falling to 20% after MEP. About 40% of patients highlighted a maintenance therapy step-down. Subjects showing an omalizumab treatment failure before MEP had a similar positive response when compared with omalizumab untreated patients. CONCLUSION In real-life, MEP improved significantly all outcomes even small airway obstruction, suggesting its possible role also in distal lung region treatment. Furthermore, it demonstrated its high effectiveness in OC/ICS-sparing, in reducing SABA as needed and in stepping-down maintenance therapy. MEP is a valid alternative for patients with previous omalizumab treatment failure.
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Affiliation(s)
- Bruno Sposato
- Azienda USL Toscana Sud-Est Pneumology Department, "Misericordia" Hospital, Grosseto, Italy; Experimental Medicine and Systems, "PhD Program" Department of Systems Medicine University of Rome "Tor Vergata", Italy.
| | - Gianna Camiciottoli
- Section of Respiratory Medicine, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Largo A Brambilla 3, 50134, Florence, Italy
| | - Elena Bacci
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy
| | - Marco Scalese
- Clinic Physiology Institute, National Research Centre, Pisa, Italy
| | | | - Corrado Pelaia
- Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Pierachille Santus
- Department of Biomedical and Clinical Sciences (DIBIC), Università Degli Studi di Milano, Division of Pulmonary Diseases, Ospedale L. Sacco, ASST Fatebenfratelli-Sacco, Milan, Italy
| | - Mauro Maniscalco
- Institute Clinic Scientific Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Telese, 82037, Telese Terme, BN, Italy
| | - Simonetta Masieri
- Department of Sense Organs, Otorhinolaryngology Clinic, Policlinico Umberto I, "Sapienza" University, Rome, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Italy
| | - Nicola Scichilone
- Biomedical Department of Internal Medicine and Medical Specialties (DIBIMIS), University of Palermo, Palermo, Italy
| | | | - Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy
| | - Ilenia Folletti
- Occupational Medicine, Terni Hospital, University of Perugia, Perugia, Italy
| | - Giulio Bardi
- Internal Medicine Department, Azienda USL 6 Livorno, Piombino Hospital, Italy
| | - Amelia Grosso
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Italy
| | - Paolo Cameli
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplant Unit, University of Siena, Siena, Italy
| | - Manuela Latorre
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy
| | - Antonino Musarra
- Allergology Department, Casa della Salute di Scilla, Scilla, RC, Italy
| | - Elena Bargagli
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplant Unit, University of Siena, Siena, Italy
| | - Alberto Ricci
- Division of Pneumology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, AOU Sant 'Andrea, Rome, Italy
| | - Girolamo Pelaia
- Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Pierluigi Paggiaro
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy
| | - Paola Rogliani
- Experimental Medicine and Systems, "PhD Program" Department of Systems Medicine University of Rome "Tor Vergata", Italy; Respiratory Unit, Department of Experimental Medicine, University of Rome "Tor Vergata" Rome, Italy
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Polverino F, Stern DA, Ruocco G, Balestro E, Bassetti M, Candelli M, Cirillo B, Contoli M, Corsico A, D'Amico F, D'Elia E, Falco G, Gasparini S, Guerra S, Harari S, Kraft M, Mennella L, Papi A, Parrella R, Pelosi P, Poletti V, Polverino M, Tana C, Terribile R, Woods JC, Di Marco F, Martinez FD. Comorbidities, Cardiovascular Therapies, and COVID-19 Mortality: A Nationwide, Italian Observational Study (ItaliCO). Front Cardiovasc Med 2020; 7:585866. [PMID: 33195473 PMCID: PMC7583635 DOI: 10.3389/fcvm.2020.585866] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/19/2020] [Indexed: 02/05/2023] Open
Abstract
Background: Italy has one of the world's oldest populations, and suffered one the highest death tolls from Coronavirus disease 2019 (COVID-19) worldwide. Older people with cardiovascular diseases (CVDs), and in particular hypertension, are at higher risk of hospitalization and death for COVID-19. Whether hypertension medications may increase the risk for death in older COVID 19 inpatients at the highest risk for the disease is currently unknown. Methods: Data from 5,625 COVID-19 inpatients were manually extracted from medical charts from 61 hospitals across Italy. From the initial 5,625 patients, 3,179 were included in the study as they were either discharged or deceased at the time of the data analysis. Primary outcome was inpatient death or recovery. Mixed effects logistic regression models were adjusted for sex, age, and number of comorbidities, with a random effect for site. Results: A large proportion of participating inpatients were ≥65 years old (58%), male (68%), non-smokers (93%) with comorbidities (66%). Each additional comorbidity increased the risk of death by 35% [adjOR = 1.35 (1.2, 1.5) p < 0.001]. Use of ACE inhibitors, ARBs, beta-blockers or Ca-antagonists was not associated with significantly increased risk of death. There was a marginal negative association between ARB use and death, and a marginal positive association between diuretic use and death. Conclusions: This Italian nationwide observational study of COVID-19 inpatients, the majority of which ≥65 years old, indicates that there is a linear direct relationship between the number of comorbidities and the risk of death. Among CVDs, hypertension and pre-existing cardiomyopathy were significantly associated with risk of death. The use of hypertension medications reported to be safe in younger cohorts, do not contribute significantly to increased COVID-19 related deaths in an older population that suffered one of the highest death tolls worldwide.
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Affiliation(s)
- Francesca Polverino
- University of Arizona, Tucson, AZ, United States
- Lovelace Respiratroy Research Institute, Albuquerque, NM, United States
- *Correspondence: Francesca Polverino
| | | | | | | | - Matteo Bassetti
- San Martino Hospital Istituto di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
| | - Marcello Candelli
- Agostino Gemelli University Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
| | | | | | | | - Filippo D'Amico
- Azienda Socio Sanitaria Territoriale Bergamo EST, Seriate, Italy
| | | | - Giuseppe Falco
- Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico di Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Sergio Harari
- Department of Medical Sciences, San Giuseppe Hospital MultiMedica IRCCS, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Monica Kraft
- University of Arizona, Tucson, AZ, United States
| | | | | | - Roberto Parrella
- Department of Infectious Diseases, Colli Hospital, Naples, Italy
| | - Paolo Pelosi
- San Martino Hospital Istituto di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
| | | | - Mario Polverino
- Mauro Scarlato Hospital, Azienda Sanitaria Locale Salerno, Scafati, Italy
| | | | | | - Jason C. Woods
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | | | | | - The ItaliCO study groupPolverinoF.MD, PhDSternD.MSPolverinoM.MDD'AmicoF.MDD'EliaE.MD, PhDAgarossiA.MDAgatiS.MDAgosteoE.MDAndo'F.MDAndreoniM.MDAngelilloIF.DDS, MPHArcoleoG.MDArenaC.MDBaiamonteP.MDBalestroE.MDBallL.MD, PhDBanfiP.MDBartolettiG.MDBartolottaR.RNBassettiM.MD, PhDBattagliniD.MDBellanM.MD, PhDBenzoniI.MD, PhDBertoliniR.MDBevilacquaM.MDBezziM.MDBiancoA.MDBisbanoA.MDBobbioF.MDBocchialiniG.MDBonettiF.MDBoniF.MDBonifaziM.MDBorgonovoG.MDBorre'S.MDBosioM.MDBrachiniG.MDBrunettiI.MDCalagnaL.CalòF.CandelliM.MD, PhDCapuozzoA.MDCarrT.MDCastellaniA.MDCatalanoF.MD, PhDCataniaG.MDCatenaE.MDCattaneoM.CattelanA.MDCerutiV.MDChiumientoF.MDCicchittoG.MDCirilloB.MDConfalonieriM.MDConfalonieriP.MDContoliM.MD, PhDCoppolaN.MD, PhDCorsicoA.MDCosentinaR.MDCostantinoR.MDCrimiC.MD, PhDCurràA.MDD'AbbraccioM.MDDalbeniA.MDDaleffeF.MDDavideR.MDDel DonnoM.MDDi MarcoF.MD, PhDDi PastenaF.MDDi PernaF.MDDi RosaZ.MDDi SabatinoA.MDElesbaniO.MDEliaD.MDEspositoV.MD, PhDFabianiL.MDFalcoG.MDFaloG.MDFanelliC.MDFantinA.MDFerrignoF.MDFiorentinoG.MDFranceschiF.MD, PhDFronzaM.MDGardini GardenghiG.MDGaspariniS.MDGiacobbeD.R.MDGiannottiC.MDGiannottiG.MDGidariA.MDGiovanardiF.MD, PhDGnerreP.MDGonnelliF.MDGrazianoM.MDGrecoS.MDGrossoA.PhDGuarinoS.MDGuerraS.MD, PhDHarariS.MDIannarelliA.MDImitazioneP.MDIngleseF.MDIodiceV.MDIzzoA.MDLa GrecaC.MDKraftM.MDLaxA.MDLegittimoF.MDLeoA.MDLeoneS.MDLepidiniV.MDLetoM.RNLicataF.MDLocatiF.MDLoriniL.MDLucchettiB.MDMaidaI.MDMaceraM.MDManzilloE.MDMarchA.MDMascheroniD.MDMastroianniA.MDMauroI.MDMazzitelliM.MDMazzucaE.MDMennellaL.MDMichelettoC.MDMingoliA.MDMinuzP.MDMoioliM.MDMontiL.MDMorgagniR.MD, PhDMucciL.MDMuselliM.MDNegriS.MDNobileC.G.A.MDOldaniS.MDOlivieriC.MDPapiA.MDParatiG.MDParodiL.MDParrellaR.MD, PhDPastorelliE.MDPatrunoV.MDPellegrinoF.MDPelosiP.MD, FERSPengoM.F.MD, PhDPepeD.MDPerottiA.MDPetrinoR.MDPetrucciM.MDPianeR.M.MDPignataroG.MD, PhDPinoM.MDPirisiM.MDPolettiV.MDPorruF.MDPuglieseF.MDPunziR.MDRamaroliD.A.MDRobbaC.MD, PhDRostagnoR.MDRuoccoG.MDSabatiniU.MDSainaghiP.P.MD, PhDSaltonF.MDSalzanoC.MDSanduzziA.MDSanduzzi ZamparelliS.MDSangiovanniV.MDSantopuoliD.MDSapienzaP.MDSarmatiL.MDSchiaroliE.MDScienzaF.MDSenniM.MDSerchisuL.PhDSgherziS.MDSodduD.MDSorannaD.MDSorinoC.MD, PhDSpadaroS.MDStirpeE.MDTanaC.MDTardivoS.MDTartagliaS.MDTeopompiE.MDTerribileR.MDTomchaneyM.TorelliE.MDTorlascoC.MDTortiC.MDTupputiE.MDUgolinelliC.MDVatrellaA.MDVersaceA.G.MDVillaniM.MDVincenzoL.MDVoltaC.A.MDVoraphaniN.MDWoodsJ.C.PhDZekajE.MDZoppellariR.MDMartinezF.D.MD
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Marcon A, Marchetti P, Antó JM, Cazzoletti L, Cerveri I, Corsico A, Ferreira DS, Garcia-Aymerich J, Gislason D, Heinrich J, Jõgi R, Johannessen A, Leynaert B, Malinovschi A, Pin I, Probst-Hensch N, Weyler J, Janson C, Jarvis D, Accordini S. Atopy Modifies the Association Between Inhaled Corticosteroid Use and Lung Function Decline in Patients with Asthma. J Allergy Clin Immunol Pract 2019; 8:980-988.e10. [PMID: 31704441 DOI: 10.1016/j.jaip.2019.10.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Inhaled corticosteroids (ICSs) are the mainstay of asthma treatment, but response to medication is variable. Patients with allergic inflammation generally show a better short-term response to ICSs; however, studies on predictors of long-term response are few. OBJECTIVE To assess whether allergic sensitization can modify the association between ICS use and lung function decline over 20 years in adult asthma. METHODS We used data from the 3 clinical examinations of the European Community Respiratory Health Survey. We measured ICS use (no use, and use for <1.3, 1.3-8, and >8 years) and FEV1 decline among subjects with asthma over the 2 periods between consecutive examinations. We conducted a cohort study combining data of the 2 periods (906 observations from 745 subjects) to assess whether the association between ICS use and FEV1 decline was modified by allergic sensitization (IgE > 0.35 kU/L for any of house-dust mite, timothy grass, cat, or Cladosporium). RESULTS FEV1 decline was similar for non-ICS users, as well as ICS users for less than 1.3 years, with and without allergic sensitization. However, among subjects on ICSs for a longer period, sensitization was associated with an attenuated decline (Pinteraction = .006): in the group treated for more than 8 years, FEV1 decline was on average 27 mL/y (95% CIBonferroni-adjusted, 11-42) lower for subjects with sensitization compared with nonsensitized subjects. CONCLUSIONS Our study suggests that biomarkers of atopy can predict a more favorable long-term response to ICSs. Randomized controlled studies are needed to confirm these findings.
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Affiliation(s)
- Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Josep M Antó
- Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Isa Cerveri
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Diogenes Seraphim Ferreira
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Alergia e Imunologia, Complexo Hospital de Clinicas, Universidade Federal do Parana, Curitiba, Brazil
| | - Judith Garcia-Aymerich
- Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - David Gislason
- Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Joachim Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Ludwig, Maximilians University, Munich, Germany; Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Rain Jõgi
- Department of Pneumology, University of Tartu, Tartu, Estonia
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bénédicte Leynaert
- Inserm-U1168, VIMA (Aging and Chronic Diseases. Epidemiological and Public Health Approaches), Villejuif, France; UMR-S 1168, UVSQ, Univ Versailles St-Quentin-en-Yvelines, St-Quentin-en-Yvelines, France
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Isabelle Pin
- Pediatrics, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France; INSERM, Institut for Advanced Biosciences, Grenoble, France; Université Grenoble Alpes, Grenoble, France
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Joost Weyler
- Epidemiology and Social Medicine, StatUA Statistics Center, University of Antwerp, Antwerp, Belgium
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep research, Uppsala University, Uppsala, Sweden
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Seebacher C, Ferrarotti I, Ottaviani S, Bonazza L, Corsico A. Testing for Alfa1-antitrypsin deficiency: is phenotyping enough? Epidemiology 2019. [DOI: 10.1183/13993003.congress-2019.pa4411] [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: 11/05/2022]
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Marcon A, Locatelli F, Corsico A, Antó JM, Burney P, Dharmage SC, Gislason T, Heinrich J, Janson C, Jõgi R, Leynaert B, Lytras T, Probst-Hensch N, Svanes C, Toren K, Weyler J, Garcia-Aymerich J, Jarvis D, Accordini S. A 20-year population-based study of the asthma-COPD overlap (ACO). Epidemiology 2019. [DOI: 10.1183/13993003.congress-2019.oa1939] [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: 11/05/2022]
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Balbi B, Sangiorgi C, Gnemmi I, Ferrarotti I, Vallese D, Paracchini E, Delle Donne L, Corda L, Baderna P, Corsico A, Carone M, Brun P, Cappello F, Ricciardolo FL, Ruggeri P, Mumby S, Adcock IM, Caramori G, Di Stefano A. Bacterial load and inflammatory response in sputum of alpha-1 antitrypsin deficiency patients with COPD. Int J Chron Obstruct Pulmon Dis 2019; 14:1879-1893. [PMID: 31686800 PMCID: PMC6709647 DOI: 10.2147/copd.s207203] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 02/28/2019] [Accepted: 07/10/2019] [Indexed: 01/18/2023] Open
Abstract
Background Airway inflammation may drive the progression of chronic obstructive pulmonary disease (COPD) associated with alpha-1 antitrypsin deficiency (AATD), but the relationship between airway microbiota and inflammation has not been investigated. Methods We studied 21 non-treated AATD (AATD-noT) patients, 20 AATD-COPD patients under augmentation therapy (AATD-AT), 20 cigarette smoke-associated COPD patients, 20 control healthy smokers (CS) and 21 non-smokers (CON) with normal lung function. We quantified sputum inflammatory cells and inflammatory markers (IL-27, CCL3, CCL5, CXCL8, LTB4, MPO) by ELISA, total bacterial load (16S) and pathogenic bacteria by qRT-PCR. Results AATD-AT patients were younger but had similar spirometric and DLCO values compared to cigarette smoke-associated COPD, despite a lower burden of smoking history. Compared to cigarette smoke-associated COPD, AATD-noT and AATD-AT patients had lower sputum neutrophil levels (p=0.0446, p=0.0135), total bacterial load (16S) (p=0.0081, p=0.0223), M. catarrhalis (p=0.0115, p=0.0127) and S. pneumoniae (p=0.0013, p=0.0001). Sputum IL-27 was significantly elevated in CS and cigarette smoke-associated COPD. AATD-AT, but not AATD-noT patients, had IL-27 sputum levels (pg/ml) significantly lower than COPD (p=0.0297) and these positively correlated with FEV1% predicted values (r=0.578, p=0.0307). Conclusions Compared to cigarette smoke-associated COPD, AATD-AT (COPD) patients have a distinct airway inflammatory and microbiological profile. The decreased sputum bacterial load and IL-27 levels in AATD-AT patients suggests that augmentation therapy play a role in these changes.
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Affiliation(s)
- Bruno Balbi
- Istituti Clinici Scientifici Maugeri, IRCCS, Division of Pneumology and Laboratory of Cytoimmunopathology of the Heart and Lung, Veruno, Italy
| | - Claudia Sangiorgi
- Istituti Clinici Scientifici Maugeri, IRCCS, Division of Pneumology and Laboratory of Cytoimmunopathology of the Heart and Lung, Veruno, Italy
| | - Isabella Gnemmi
- Istituti Clinici Scientifici Maugeri, IRCCS, Division of Pneumology and Laboratory of Cytoimmunopathology of the Heart and Lung, Veruno, Italy
| | - Ilaria Ferrarotti
- Department of Internal Medicine and Medical Therapy, University of Pavia , Pavia, Italy
| | - Davide Vallese
- Istituti Clinici Scientifici Maugeri, IRCCS, Division of Pneumology and Laboratory of Cytoimmunopathology of the Heart and Lung, Veruno, Italy
| | - Elena Paracchini
- Istituti Clinici Scientifici Maugeri, IRCCS, Division of Pneumology and Laboratory of Cytoimmunopathology of the Heart and Lung, Veruno, Italy
| | - Lorena Delle Donne
- Istituti Clinici Scientifici Maugeri, IRCCS, Division of Pneumology and Laboratory of Cytoimmunopathology of the Heart and Lung, Veruno, Italy
| | - Luciano Corda
- Medicina Respiratoria, Seconda Medicina Interna, Spedali Civili , Brescia, Italy
| | - Paolo Baderna
- Division of Pneumology, Aosta Hospital , Aosta, Italy
| | - Angelo Corsico
- Department of Internal Medicine and Medical Therapy, University of Pavia , Pavia, Italy
| | - Mauro Carone
- Istituti Clinici Scientifici Maugeri, IRCCS, Division of Pneumology and Laboratory of Cytoimmunopathology of the Heart and Lung, Veruno, Italy
| | - Paola Brun
- Department of Molecular Medicine, University of Padova , Padova, Italy
| | - Francesco Cappello
- Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, Sezione di Anatomia Umana, Università di Palermo, Palermo, Italy.,Euro-mediterranean Institute of Science and Technology (IEMEST) , Palermo, Italy
| | - Fabio Lm Ricciardolo
- Department of Clinical and Biological Sciences, A.O.U., San Luigi Gonzaga, Orbassano, University of Turin , Turin, Italy
| | - Paolo Ruggeri
- UOC Di Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e Delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy
| | - Sharon Mumby
- Airways Disease Section, National Heart and Lung Institute, Imperial College London , UK
| | - Ian M Adcock
- Airways Disease Section, National Heart and Lung Institute, Imperial College London , UK
| | - Gaetano Caramori
- UOC Di Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e Delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy
| | - Antonino Di Stefano
- Istituti Clinici Scientifici Maugeri, IRCCS, Division of Pneumology and Laboratory of Cytoimmunopathology of the Heart and Lung, Veruno, Italy
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Milanese M, Terraneo S, Baiardini I, Di Marco F, Corsico A, Molino A, Scichilone N. Effects of a structured educational intervention in moderate-to-severe elderly asthmatic subjects. World Allergy Organ J 2019; 12:100040. [PMID: 31316712 PMCID: PMC6593309 DOI: 10.1016/j.waojou.2019.100040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/04/2019] [Accepted: 05/13/2019] [Indexed: 11/18/2022] Open
Abstract
Background Adherence to inhaled drugs is linked to patients’ satisfaction with their device, and an incorrect use can negatively affect the outcomes of asthma treatment. We speculated that this is particularly true in elderly asthmatic subjects. Aim We performed a national pre-post interventional multicentre study, enrolling moderate-to-severe asthmatic subjects aged ≥65 years treated with fixed inhaled combination drugs by dry powder inhaler (DPI) or pressurized metered dose inhaler (pMDI). Adherence and critical errors were evaluated by means of validated questionnaires at first visit (V1) and after 3–6 months (V2). At V1, subjects underwent intensive training on the correct use of their device by physical demonstration. Results A total of 411 asthmatics (F/M: 238/173, mean age±SD: 72 ± 5 years) participated to the study. At V1, 50% of the study subjects showed an Asthma Control Test (ACT) score ≤19 despite GINA step 3 and 4 treatment, and 40% had experienced at least one severe asthma exacerbation in the previous year. Poor adherence to treatment was recorded in 43% of subjects, and at least one error in using the device was registered in 56% of subjects. At V2, available for 318 patients, both the percentage of individuals with poor adherence and with at least one critical error significantly decreased (from 46% to 25%, and from 49% to 25%, respectively; p < 0.001 for both comparisons) with a significant increase of the ACT score (from 19 ± 4.9 to 20 ± 4.0, p < 0.001). Conclusions Asthma in the elderly is characterized by low levels of symptom control. Educational interventions are strongly advocated in this age group in order to increase adherence to treatment and inhaler techniques.
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Key Words
- ACT, asthma control test
- AHDS, hospital anxiety depression scale
- Asthma
- CFC, chlorofluorocarbons
- Device misuse
- EDUCA, elderly and device use in chronic asthma
- Education
- Elderly
- FEV1, forced expiratory volume 1s second
- FVC, forced vital capacity
- ICS, inhaled corticosteroids
- LABA, long-acting β2 agonist
- LAMA, long-acting muscarinic antagonists
- MCS, mental health composite score
- PCS, physical health composite score
- PROs, patient-reported outcomes
- SAE, severe asthma exacerbation
- SF12, short form health survey
- mMRC, modified medical research council
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Affiliation(s)
- M. Milanese
- Department of Medicine, Respiratory Unit, ASL2 Savonese, Savona, Italy
- Corresponding author.
| | - S. Terraneo
- Respiratory Unit, ASST Santi Paolo e Carlo, Milan, Italy
| | - I. Baiardini
- Department of Internal Medicine, Respiratory Diseases and Allergy Clinic, University of Genova, Azienda Policlinico IRCCS San Martino, Genoa, Italy
| | - F. Di Marco
- Department of Health Sciences, Università degli Studi di Milano, Respiratory Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - A. Corsico
- Department of Internal Medicine and Therapeutics, Pneumology Unit, IRCCS Policlinico S. Matteo Foundation, University of Pavia, Pavia, Italy
| | - A. Molino
- Department of Respiratory Diseases, Division of Pneumology, University of Naples Federico II, Napoli, Italy
| | - N. Scichilone
- Department of Biomedicine and Internal and Specialistic Medicine (DIBIMIS), University of Palermo, Palermo, Italy
| | - EDUCA GroupAlbiciniF.hBenfanteA.iBraidoF.jCaminatiM.kCostantinoM.T.lCottiniM.mCrivellaroM.nDe TullioR.oGiniE.pGrossoA.pGuarnieriG.qLombardiC.rPatellaV.sPirinaP.tPolverinoM.uRaccanelliR.vRidoloE.wRollaG.xSteinhilberG.yVianelloA.zDepartment of Internal Medicine and Therapeutics, Pneumology Unit, IRCCS Policlinico S. Matteo Foundation, University of Pavia, Pavia, ItalyDepartment of Biomedicine and Internal and Specialistic Medicine (DIBIMIS), University of Palermo, Palermo, ItalyDepartment of Internal Medicine, Respiratory Diseases and Allergy Clinic, University of Genova, Azienda Policlinico IRCCS San Martino, Genoa, ItalyUnità Operativa di Allergologia Azienda Ospedaliero-Universitaria Integrata di Verona, Verona, ItalyInternal Medicine and Rheumatology Department, Azienda Sanitaria Romagna, Rimini, ItalyAllergy and Pneumology Outpatient Clinic, Bergamo, ItalyDepartment of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, ItalyOspedale consorziale Policlinico di Bari, Unità di Pneumologia, Bari, ItalyDepartment of Internal Medicine and Therapeutics, Pneumology Unit, IRCCS Policlinico S. Matteo Foundation, University of Pavia, Pavia, ItalyDepartment of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, ItalyDepartmental Unit of Allergology and Respiratory Diseases, Fondazione Poliambulanza, Brescia, ItalyUnità Operativa di Allergologia ed Immunologia, Dipartimento di Discipline Mediche, Battipaglia SA, ItalyDepartment of Clinical and Experimental Medicine, University of Sassari, Sassari, ItalyDepartment of Pneumology and Endoscopic Unit, Ospedale Scarlato, Scafati SA, ItalyFondazione Salvatore Maugeri, Istituto Scientifico di Milano, IRCCS, MilanoDepartment of Medicine and Surgery, University of Parma, Parma, ItalyAllergy and Immunology, AO Mauriziano Hospital, University of Turin, Turin, ItalyAO Spedali Civili di Brescia, Divisione di Pneumologia, Brescia, ItalyDepartment of Cardiologic, Thoracic, and Vascular Science, University of Padua, Padua, Italy
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Nerpin E, Olivieri M, Gislason T, Olin AC, Nielsen R, Johannessen A, Ferreira DS, Marcon A, Cazzoletti L, Accordini S, Pin I, Corsico A, Demoly P, Weyler J, Nowak D, Jõgi R, Forsberg B, Zock JP, Sigsgaard T, Heinric J, Bono R, Leynaert B, Jarvis D, Janson C, Malinovschi A. Determinants of fractional exhaled nitric oxide in healthy men and women from the European Community Respiratory Health Survey III. Clin Exp Allergy 2019; 49:969-979. [PMID: 30934155 DOI: 10.1111/cea.13394] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 03/18/2019] [Accepted: 03/28/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The fractional exhaled nitric oxide (FE NO) is a marker for type 2 inflammation used in diagnostics and management of asthma. In order to use FE NO as a reliable biomarker, it is important to investigate factors that influence FE NO in healthy individuals. Men have higher levels of FE NO than women, but it is unclear whether determinants of FE NO differ by sex. OBJECTIVE To identify determinants of FE NO in men and women without lung diseases. METHOD Fractional exhaled nitric oxide was validly measured in 3881 healthy subjects that had answered the main questionnaire of the European Community Respiratory Health Survey III without airways or lung disease. RESULTS Exhaled NO levels were 21.3% higher in men compared with women P < 0.001. Being in the upper age quartile (60.3-67.6 years), men had 19.2 ppb (95% CI: 18.3, 20.2) higher FE NO than subjects in the lowest age quartile (39.7-48.3 years) P = 0.02. Women in the two highest age quartiles (54.6-60.2 and 60.3-67.6 years) had 15.4 ppb (14.7, 16.2), P = 0.03 and 16.4 ppb (15.6, 17.1), P = <0.001 higher FE NO, compared with the lowest age quartile. Height was related to 8% higher FE NO level in men (P < 0.001) and 5% higher FE NO levels in women (P = 0.008). Men who smoked had 37% lower FE NO levels and women had 30% lower levels compared with never-smokers (P < 0.001 for both). Men and women sensitized to both grass and perennial allergens had higher FE NO levels compared with non-sensitized subjects 26% and 29%, P < 0.001 for both. CONCLUSION AND CLINICAL RELEVANCE Fractional exhaled nitric oxide levels were higher in men than women. Similar effects of current smoking, height, and IgE sensitization were found in both sexes. FE NO started increasing at lower age in women than in men, suggesting that interpretation of FE NO levels in adults aged over 50 years should take into account age and sex.
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Affiliation(s)
- Elisabet Nerpin
- Department of Medical Sciences, Respiratory Medicine, Allergy and Sleep, Uppsala University, Uppsala, Sweden.,Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden.,Department of Medicine, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Mario Olivieri
- Unit of Occupational Medicine, University of Verona, Verona, Italy
| | - Thorainn Gislason
- Department of Sleep, Landspítali University Hospital, Reykjavík, Iceland.,Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Anna C Olin
- Section of Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Rune Nielsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Diogenes S Ferreira
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Alergia e Imunologia, Complexo Hospital de Clinicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Isabelle Pin
- Department of Pediatrics, CHU Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences, Inserm, Grenoble, France.,Université Grenoble Alpes, Grenoble, France
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.,Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Pascal Demoly
- Département de Pneumologie et Addictologie, Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud-de-Villeneuve, univ Montpellier, Montpellier, France.,Institut Pierre-Louis D'épidémiologie et de Santé Publique, Équipe EPAR, Sorbonne Université, INSERM, Paris, France
| | - Joost Weyler
- Epidemiology and Social Medicine, University of Antwerp StatUA Statistics Center, University of Antwerp, Antwerp, Belgium
| | - Dennis Nowak
- Hospital of the Ludwig-Maximilian University Munich, LMU Munich, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany
| | - Rain Jõgi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Jan P Zock
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Joachim Heinric
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig Maximilians University Munich, Munich, Germany.,Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Bénédicte Leynaert
- INSERM, UMR1152, Paris, France.,DHU FIRE, Université Paris-Diderot, Paris, France
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College, London, UK
| | - Christer Janson
- Department of Medical Sciences, Respiratory Medicine, Allergy and Sleep, Uppsala University, Uppsala, Sweden
| | - Anderi Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
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Janson C, Accordini S, Cazzoletti L, Cerveri I, Chanoine S, Corsico A, Ferreira DS, Garcia-Aymerich J, Gislason D, Nielsen R, Johannessen A, Jogi R, Malinovschi A, Martinez-Moratalla Rovira J, Marcon A, Pin I, Quint J, Siroux V, Almar E, Bellisario V, Franklin KA, Gullón JA, Holm M, Heinrich J, Nowak D, Sánchez-Ramos JL, Weyler JJ, Jarvis D. Pharmacological treatment of asthma in a cohort of adults during a 20-year period: results from the European Community Respiratory Health Survey I, II and III. ERJ Open Res 2019; 5:00073-2018. [PMID: 30723731 PMCID: PMC6355980 DOI: 10.1183/23120541.00073-2018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 11/28/2018] [Indexed: 11/17/2022] Open
Abstract
Asthma often remains uncontrolled, despite the fact that the pharmacological treatment has undergone large changes. We studied changes in the treatment of asthma over a 20-year period and identified factors associated with the regular use of inhaled corticosteroid (ICS) treatment. Changes in the use of medication were determined in 4617 randomly selected subjects, while changes in adults with persistent asthma were analysed in 369 participants. The study compares data from three surveys in 24 centres in 11 countries. The use of ICSs increased from 1.7% to 5.9% in the general population and the regular use of ICSs increased from 19% to 34% among persistent asthmatic subjects. The proportion of asthmatic subjects reporting asthma attacks in the last 12 months decreased, while the proportion that had seen a doctor in the last 12 months remained unchanged (42%). Subjects with asthma who had experienced attacks or had seen a doctor were more likely to use ICSs on a regular basis. Although ICS use has increased, only one-third of subjects with persistent asthma take ICSs on a regular basis. Less than half had seen a doctor during the last year. This indicates that underuse of ICSs and lack of regular healthcare contacts remains a problem in the management of asthma. Despite increased ICS use, only 34% of subjects with persistent asthma take ICSs on a regular basis; <50% have seen a doctor in the last year. Underuse of ICSs and lack of regular healthcare contacts remains a problem in asthma.http://ow.ly/GUZ630mZkVN
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Affiliation(s)
- Christer Janson
- Respiratory, Allergy and Sleep Research, Dept of Medical Sciences, Uppsala University, Uppsala, Sweden.,Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Dept of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Dept of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Isa Cerveri
- Division of Respiratory Diseases, IRCCS, Policlinico San Matteo Foundation, Dept of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Sebastien Chanoine
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Inserm, Université Grenoble Alpes, Grenoble, France.,Pôle Pharmacie, CHU Grenoble Alpes, Grenoble, France
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS, Policlinico San Matteo Foundation, Dept of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Diogenes Seraphim Ferreira
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Alergia e Imunologia, Complexo Hospital de Clinicas, Universidade Federal do Parana, Curitiba, Brazil
| | - Judith Garcia-Aymerich
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - David Gislason
- Dept of Respiratory Medicine and Sleep, Landspitali, Reykjavik, Iceland
| | - Rune Nielsen
- Dept of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.,Dept of Clinical Science, University of Bergen, Bergen, Norway
| | - Ane Johannessen
- Centre for International Health, Dept of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Rain Jogi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Andrei Malinovschi
- Clinical Physiology, Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Jesús Martinez-Moratalla Rovira
- Servicio de Neumología, Complejo Hospitalario Universitario, Albacete, Spain.,Facultad de Medicina Albacete, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Dept of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Isabelle Pin
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Inserm, Université Grenoble Alpes, Grenoble, France.,Dept of Paediatrics, CHU Grenoble Alpes, Grenoble, France
| | - Jennifer Quint
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Valerie Siroux
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Enrique Almar
- Facultad de Medicina Albacete, University of Castilla-La Mancha, Ciudad Real, Spain.,Service of the Health Delegation of Albacete, Albacete, Spain
| | - Valeria Bellisario
- Dept of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - Karl A Franklin
- Dept of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - José A Gullón
- Dept of Pneumology, Universitary Hospital San Agustín, Avilés, Spain
| | - Mathias Holm
- Dept of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center (CPC) Munich, Member German Center for Lung Research (DZL), Munich, Germany.,Institute of Epidemiology, Helmholtz Zentrum München - German Research Centre for Environmental Health, Neuherberg, Germany.,Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center (CPC) Munich, Member German Center for Lung Research (DZL), Munich, Germany.,Comprehensive Pneumology Center (CPC) Munich, Member German Center for Lung Research (DZL), Munich, Germany
| | | | - Joost J Weyler
- StatUA Statistics Center, University of Antwerp, Antwerp, Belgium
| | - Deborah Jarvis
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
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Gramegna A, Aliberti S, Confalonieri M, Corsico A, Richeldi L, Vancheri C, Blasi F. Alpha-1 antitrypsin deficiency as a common treatable mechanism in chronic respiratory disorders and for conditions different from pulmonary emphysema? A commentary on the new European Respiratory Society statement. Multidiscip Respir Med 2018; 13:39. [PMID: 30338069 PMCID: PMC6174569 DOI: 10.1186/s40248-018-0153-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 07/30/2018] [Accepted: 09/25/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The European Respiratory Society recently published an important statement reviewing available evidence on diagnosis and treatment of lung disease associated to alpha-1 antitrypsin deficiency (AATD). Several issues on this topic still remain unresolved and subject of interpretation according to different standard procedures and healthcare systems worldwide. The purpose of this commentary is to offer a critical contribution to most of these controversial issues in light of an Italian perspective for the management of this disease. MAIN BODY The clinical spectrum of AATD lung disease might include different manifestations and the traditional paradigm of a younger emphysematous patient has been revealing insufficient. Targeting with appropriate testing only COPD patients might be considered a limited approach leading to underestimation of the real prevalence of the disease. Several reports have suggested the association between AATD and other chronic respiratory conditions, as asthma and bronchiectasis. A deeper evaluation of clinical, radiological, microbiological and functional variables is, therefore, needed in order to investigate different phenotypes in AATD patients. In addition, a new line of translational research in AATD might focus on the development of personalized therapeutic regimens taking into account the patient clinical profile and needs. CONCLUSIONS Over the past years, AATD has been interpreted as a common mechanism of inflammatory disequilibrium and tissue damage across different conditions. Future research is gradually pointing toward this new paradigm by expanding the evidence of the role of AAT as a potent immunomodulatory and anti-inflammatory drug in conditions different from pulmonary emphysema.
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Affiliation(s)
- Andrea Gramegna
- Department of Pathophysiology and Transplantation, University of Milano; Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Stefano Aliberti
- Department of Pathophysiology and Transplantation, University of Milano; Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Marco Confalonieri
- Department of Medical Sciences, Respiratory Diseases Unit, University Hospital of Cattinara, Trieste, Italy
| | - Angelo Corsico
- Department of Internal Medicine and therapeutics, Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Luca Richeldi
- Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Carlo Vancheri
- Regional Referral Centre for Rare Lung Diseases, Department of Clinical and Experimental Medicine, University of Catania, University–Hospital Policlinico “G. Rodolico”, Catania, Italy
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, University of Milano; Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
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Aliberti S, Gramegna A, Confalonieri M, Corsico A, Richeldi L, Vancheri C, Blasi F. Alpha-1 antitrypsin deficiency as a common treatable mechanism in chronic respiratory disorders and for conditions different from pulmonary emphysema? A commentary on the new European Respiratory Society statement. Multidiscip Respir Med 2018. [DOI: 10.4081/mrm.2018.200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: The European Respiratory Society recently published an important statement reviewing available evidence on diagnosis and treatment of lung disease associated to alpha-1 antitrypsin deficiency (AATD). Several issues on this topic still remain unresolved and subject of interpretation according to different standard procedures and healthcare systems worldwide. The purpose of this commentary is to offer a critical contribution to most of these controversial issues in light of an Italian perspective for the management of this disease. Main body: The clinical spectrum of AATD lung disease might include different manifestations and the traditional paradigm of a younger emphysematous patient has been revealing insufficient. Targeting with appropriate testing only COPD patients might be considered a limited approach leading to underestimation of the real prevalence of the disease. Several reports have suggested the association between AATD and other chronic respiratory conditions, as asthma and bronchiectasis. A deeper evaluation of clinical, radiological, microbiological and functional variables is, therefore, needed in order to investigate different phenotypes in AATD patients. In addition, a new line of translational research in AATD might focus on the development of personalized therapeutic regimens taking into account the patient clinical profile and needs. Conclusions: Over the past years, AATD has been interpreted as a common mechanism of inflammatory disequilibrium and tissue damage across different conditions. Future research is gradually pointing toward this new paradigm by expanding the evidence of the role of AAT as a potent immunomodulatory and anti-inflammatory drug in conditions different from pulmonary emphysema.
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Accordini S, Cazzoletti L, Antó J, Cerveri I, Corsico A, Garcia-Aymerich J, Heinrich J, Gislason D, Jõgi R, Johannessen A, Leynaert B, Malinovschi A, Pin I, Portas L, Weyler J, Janson C, Marcon A, Jarvis D. Asthma control and decline in FEV1/FVC ratio over 10 years in adults. Epidemiology 2018. [DOI: 10.1183/13993003.congress-2018.oa296] [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: 11/05/2022]
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44
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Marcon A, Marchetti P, Antó JM, Cazzoletti L, Cerveri I, Corsico A, Garcia-Aymerich J, Heinrich J, Gislason D, Jõgi R, Johannessen A, Leynaert B, Malinovschi A, Pin I, Weyler J, Janson C, Accordini S, Jarvis D. Inhaled corticosteroids and FEV1 decline in asthma: an international cohort study. Epidemiology 2018. [DOI: 10.1183/13993003.congress-2018.oa295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Rigobello C, Baraldo S, Tinè M, Ferrarotti I, Corsico A, Biondini D, Lacedonia D, Carpagnano GE, Foschino Barbaro MP, Valle G, Saetta M, Cosio M. Exome sequencing reveals immune genes as susceptibility modifiers in a1-antitrypsin deficiency. Genes Environ 2018. [DOI: 10.1183/13993003.congress-2018.pa1267] [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: 11/05/2022] Open
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Accordini S, Calciano L, Marcon A, Pesce G, Antó J, Beckmeyer-Borowko A, Corsico A, Imboden M, Janson C, Keidel D, Locatelli F, Svanes C, Jarvis D, Probst-Hensch N, Minelli C. Incidence of airflow obstruction over 20 years in Europe. Epidemiology 2018. [DOI: 10.1183/13993003.congress-2018.pa2267] [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: 11/05/2022]
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Lønnebotn M, Svanes C, Igland J, Franklin KA, Accordini S, Benediktsdóttir B, Bentouhami H, Blanco JAG, Bono R, Corsico A, Demoly P, Dharmage S, Dorado Arenas S, Garcia J, Heinrich J, Holm M, Janson C, Jarvis D, Leynaert B, Martinez-Moratalla J, Nowak D, Pin I, Raherison-Semjen C, Sánchez-Ramos JL, Schlünssen V, Skulstad SM, Dratva J, Gómez Real F. Body silhouettes as a tool to reflect obesity in the past. PLoS One 2018; 13:e0195697. [PMID: 29694359 PMCID: PMC5918897 DOI: 10.1371/journal.pone.0195697] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/27/2018] [Indexed: 01/10/2023] Open
Abstract
Life course data on obesity may enrich the quality of epidemiologic studies analysing health consequences of obesity. However, achieving such data may require substantial resources. We investigated the use of body silhouettes in adults as a tool to reflect obesity in the past. We used large population-based samples to analyse to what extent self-reported body silhouettes correlated with the previously measured (9–23 years) body mass index (BMI) from both measured (European Community Respiratory Health Survey, N = 3 041) and self-reported (Respiratory Health In Northern Europe study, N = 3 410) height and weight. We calculated Spearman correlation between BMI and body silhouettes and ROC-curve analyses for identifying obesity (BMI ≥30) at ages 30 and 45 years. Spearman correlations between measured BMI age 30 (±2y) or 45 (±2y) and body silhouettes in women and men were between 0.62–0.66 and correlations for self-reported BMI were between 0.58–0.70. The area under the curve for identification of obesity at age 30 using body silhouettes vs previously measured BMI at age 30 (±2y) was 0.92 (95% CI 0.87, 0.97) and 0.85 (95% CI 0.75, 0.95) in women and men, respectively; for previously self-reported BMI, 0.92 (95% CI 0.88, 0.95) and 0.90 (95% CI 0.85, 0.96). Our study suggests that body silhouettes are a useful epidemiological tool, enabling retrospective differentiation of obesity and non-obesity in adult women and men.
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Affiliation(s)
- Marianne Lønnebotn
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
- * E-mail:
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Karl A. Franklin
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Bryndís Benediktsdóttir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Hayat Bentouhami
- Epidemiology and Social Medicine, University of Antwerp, Wilrijk, Belgium
| | - José A. G. Blanco
- Department of Pulmonology, Universitary Hospital San Agustín, Avilés, Spain
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation - Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Pascal Demoly
- Department of Pulmonology, Division of Allergy, Hospital Arnaud de Villeneuve, University of Montpellier, Montpellier, France
- Sorbonne université, INSERM, institute Pierre-Louis d’épidémiologie et de santé publique, équipe EPAR, Paris, France
| | - Shyamali Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | | | - Judith Garcia
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Joachim Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, LMU München, German Center for Lung Research, München, Germany
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy & Sleep Research, Uppsala University, Uppsala, Sweden
| | - Debbie Jarvis
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Bénédicte Leynaert
- Inserm U1152, Pathophysiology and Epidemiology of Respiratory Diseases, Epidemiology Team, Paris, France
- University Paris Diderot Paris 7, UMR 1152, Paris, France
| | - Jesús Martinez-Moratalla
- Servicio de Neumología del Complejo, Servicio de Salud de Castilla - La Mancha, Castilla-La Mancha, Spain
- Facultad de Medicina de Albacete, Albacete, Universidad de Castilla - La Mancha, Castilla-La Mancha, Spain
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, LMU München, German Center for Lung Research, München, Germany
| | | | - Chantal Raherison-Semjen
- Inserm, Bordeaux Population Health Research Center, team EPICENE, UMR 1219, University Bordeaux, Bordeaux, France
| | | | - Vivi Schlünssen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Svein Magne Skulstad
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Julia Dratva
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- ZHAW, School of health professions, Winterthur, Switzerland
| | - Francisco Gómez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
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48
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Zhumagaliyeva A, Ottaviani S, Greulich T, Gorrini M, Vogelmeier C, Karazhanova L, Nurgazina G, DeSilvestri A, Kotke V, Barzon V, Zorzetto M, Corsico A, Ferrarotti I. Case-finding for alpha1-antitrypsin deficiency in Kazakh patients with COPD. Multidiscip Respir Med 2017; 12:23. [PMID: 29090095 PMCID: PMC5655868 DOI: 10.1186/s40248-017-0104-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 06/15/2017] [Accepted: 08/24/2017] [Indexed: 11/19/2022] Open
Abstract
Background Alpha-1-antitrypsin deficiency (AATD) is an under-diagnosed condition in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to screen for AATD in Kazakh patients with COPD using dried blood spot specimens. Methods The alpha1-antitrypsin (AAT) concentration was determined by nephelometry, PCR was used to detect PiS and PiZ alleles; and isoelectric focusing was used to confirm questionable genotype results and detect rare AAT variants. Results To this aim, 187 Kazakh subjects with COPD were recruited. Blood samples were collected as dried blood spot. Genotyping of 187 samples revealed 3 (1.6%) PI*MZ and 1 (0.53%) PI*MS, Phenotyping identified also two sample (1.1%) with phenotype PiMI. Allelic frequencies of pathological mutations Z, S and I resulted 0.8%, 0.3%, 0.5%, respectively, in COPD Kazakh population. Conclusion This study proved that AATD is present in the Kazakh population. These results support the general concept of targeted screening for AAT deficiency in countries like Kazakhstan, with a large population of COPD patients and low awareness among care-givers about this genetic condition.
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Affiliation(s)
| | - Stefania Ottaviani
- Center for Diagnosis of Inherited Alpha1-antitrypsin Deficiency, Dept of Internal Medicine and Therapeutics Pneumology Unit, IRCCS San Matteo Hospital Foundation University of Pavia, Piazza Golgi 1, 27100 Pavia, Italy
| | - Timm Greulich
- University Clinic of Marburg and Gissen, Center for Research alpha-1-antitrypsin deficiency, Marburg, Germany
| | - Marina Gorrini
- Center for Diagnosis of Inherited Alpha1-antitrypsin Deficiency, Dept of Internal Medicine and Therapeutics Pneumology Unit, IRCCS San Matteo Hospital Foundation University of Pavia, Piazza Golgi 1, 27100 Pavia, Italy
| | - Claus Vogelmeier
- University Clinic of Marburg and Gissen, Center for Research alpha-1-antitrypsin deficiency, Marburg, Germany
| | | | - Gulmira Nurgazina
- Kazakh Medical University of Continuing Education, Almaty, Kazakhstan
| | | | - Victor Kotke
- University Clinic of Marburg and Gissen, Center for Research alpha-1-antitrypsin deficiency, Marburg, Germany
| | - Valentina Barzon
- Center for Diagnosis of Inherited Alpha1-antitrypsin Deficiency, Dept of Internal Medicine and Therapeutics Pneumology Unit, IRCCS San Matteo Hospital Foundation University of Pavia, Piazza Golgi 1, 27100 Pavia, Italy
| | - Michele Zorzetto
- Center for Diagnosis of Inherited Alpha1-antitrypsin Deficiency, Dept of Internal Medicine and Therapeutics Pneumology Unit, IRCCS San Matteo Hospital Foundation University of Pavia, Piazza Golgi 1, 27100 Pavia, Italy
| | - Angelo Corsico
- Center for Diagnosis of Inherited Alpha1-antitrypsin Deficiency, Dept of Internal Medicine and Therapeutics Pneumology Unit, IRCCS San Matteo Hospital Foundation University of Pavia, Piazza Golgi 1, 27100 Pavia, Italy.,Dept of Internal Medicine and Therapeutics, Pneumology Unit, University of Pavia, Pavia, Italy
| | - Ilaria Ferrarotti
- Semey State Medical University, Semey, Kazakhstan.,Dept of Internal Medicine and Therapeutics, Pneumology Unit, University of Pavia, Pavia, Italy
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49
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Jarvis D, Newson R, Janson C, Corsico A, Heinrich J, Anto JM, Abramson MJ, Kirsten AM, Zock JP, Bono R, Demoly P, Leynaert B, Raherison C, Pin I, Gislason T, Jogi R, Schlunssen V, Svanes C, Watkins J, Weyler J, Pereira-Vega A, Urrutia I, Gullón JA, Forsberg B, Probst-Hensch N, Boezen HM, Martinez-Moratalla Rovira J, Accordini S, de Marco R, Burney P. Prevalence of asthma-like symptoms with ageing. Thorax 2017; 73:37-48. [PMID: 28974648 PMCID: PMC5738606 DOI: 10.1136/thoraxjnl-2016-209596] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 06/15/2017] [Accepted: 06/19/2017] [Indexed: 11/24/2022]
Abstract
Background Change in the prevalence of asthma-like symptoms in populations of ageing adults is likely to be influenced by smoking, asthma treatment and atopy. Methods The European Community Respiratory Health Survey collected information on prevalent asthma-like symptoms from representative samples of adults aged 20–44 years (29 centres in 13 European countries and Australia) at baseline and 10 and 20 years later (n=7844). Net changes in symptom prevalence were determined using generalised estimating equations (accounting for non-response through inverse probability weighting), followed by meta-analysis of centre level estimates. Findings Over 20 years the prevalence of ‘wheeze’ and ‘wheeze in the absence of a cold’ decreased (−2.4%, 95% CI −3.5 to −1.3%; −1.5%, 95% CI −2.4 to −0.6%, respectively) but the prevalence of asthma attacks, use of asthma medication and hay fever/nasal allergies increased (0.6%, 95% CI 0.1 to 1.11; 3.6%, 95% CI 3.0 to 4.2; 2.7%, 95% CI 1.7 to 3.7). Changes were similar in the first 10 years compared with the second 10 years, except for hay fever/nasal allergies (increase seen in the first 10 years only). Decreases in these wheeze-related symptoms were largely seen in the group who gave up smoking, and were seen in those who reported hay fever/nasal allergies at baseline. Interpretation European adults born between 1946 and 1970 have, over the last 20 years, experienced less wheeze, although they were more likely to report asthma attacks, use of asthma medication and hay fever. Decrease in wheeze is largely attributable to smoking cessation, rather than improved treatment of asthma. It may also be influenced by reductions in atopy with ageing.
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Affiliation(s)
- Debbie Jarvis
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College, London, UK.,MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Roger Newson
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Joachim Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Center, Ludwig Maximilian University, Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Muenchen, Germany
| | - Josep M Anto
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anne-Marie Kirsten
- Pulmonary Research Institute at Lung Clinic Grosshansdorf, Grosshansdorf, Germany
| | - Jan Paul Zock
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Pascal Demoly
- University Hospital of Montpellier, Montpellier, France.,Sorbonne Universités, Paris, France
| | - Bénédicte Leynaert
- Inserm UMR 1152-Equipe Epidémiologie, Université Paris Diderot, Paris, France
| | - Chantal Raherison
- Inserm-U1219 Bordeaux Population Health Research Center, Bordeaux University, Bordeaux, France
| | - Isabelle Pin
- INSERM, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.,Department of Pédiatrie, CHU de Grenoble Alpes, Grenoble, France
| | - Thorarinn Gislason
- Department of Respiratory Medicine and Sleep, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Rain Jogi
- Tartu University Hospital, Lung Clinic, Estonia, Europe
| | - Vivi Schlunssen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - John Watkins
- Public Health Wales, Cardiff, Wales.,University of Cardiff, Cardiff, Wales
| | - Joost Weyler
- Department of Epidemiology and Social Medicine (ESOC), Faculty of Medicine and Health Sciences, StatUA Statistics Centre, University of Antwerp, Antwerp, Belgium
| | - Antonio Pereira-Vega
- Respiratory and Allergy Clinical Unit, Universitary Hospitalary Complex, Huelva, Spain
| | - Isabel Urrutia
- Department of Respiratory, Galdakao Hospital, Galdakao, Spain
| | - Jose A Gullón
- Servicio Neumología, Hospital Universitario San Agustín, Avilés, Spain
| | - Bertil Forsberg
- Public Health and Clinical Medicine, Occupational and Environmental Medicine, University of Umea, Umea, Sweden
| | - Nicole Probst-Hensch
- Department Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - H Marike Boezen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jesús Martinez-Moratalla Rovira
- Servicio de Neumología, Complejo Hospitalario Universitario, Albacete, Spain.,Facultad de Medicina Albacete, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Roberto de Marco
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Peter Burney
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College, London, UK.,MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
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50
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Pesce G, Grataroli D, Marchetti P, Marcon A, Ferrari M, Fois A, Verlato G, Battaglia S, Corsico A, Piccioni P. Depression in asthma and rhinitis: preliminary results from the GEIRD study. Epidemiology 2017. [DOI: 10.1183/1393003.congress-2017.pa3510] [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: 11/05/2022]
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