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Grandinetti M, Locorotondo G, Leccisotti L, Guarneri A, Bruno P, Marcolini A, Farina P, Gaudino MF, Lanza GA, Crea F, Giordano A, Massetti M. Quantitative analysis of myocardial blood flow in surgically revascularized and not revascularized myocardial segments. A pilot PET study. Eur J Nucl Med Mol Imaging 2024; 51:1632-1638. [PMID: 38105304 DOI: 10.1007/s00259-023-06563-z] [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: 09/20/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE To prospectively compare changes in myocardial blood flow (MBF) and myocardial flow reserve (MFR) in multivessel coronary artery disease (MVCAD) patients undergoing incomplete revascularization (IR) versus complete revascularization (CR) by coronary artery bypass grafting (CABG). METHODS Seven male patients (age 68 ± 9 years) with MVCAD underwent myocardial perfusion PET/CT with [13N]ammonia before and at least 4 months after CABG. Segmental resting and stress MBF as well as MFR were measured. Resting and during stress left ventricle ejection fraction (LVEF) were also calculated. RESULTS Three patients (43%) underwent CR and four (57%) IR. Among 119 myocardial segments, 101 (85%) were revascularized, and 18 (15%) were not. After CABG, stress MBF (mL/min/gr) and MFR are significantly increased in all myocardial segments, with a greater increase in the revascularized segments (p = 0.013). In both groups, LVEF significantly decreased during stress at baseline PET (p = 0.04), but not after CABG. CONCLUSION Stress MBF and MFR significantly improve after CABG in both revascularized and not directly revascularized myocardial segments. IR strategy may be considered in patients with high surgical risk for CR.
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Affiliation(s)
- M Grandinetti
- Cardiac Surgery Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Locorotondo
- Non Invasive Cardiac Diagnostics Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - L Leccisotti
- Section of Nuclear Medicine, Department of Radiological and Haematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, Radiation Oncology and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
| | - A Guarneri
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, Radiation Oncology and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - P Bruno
- Cardiac Surgery Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Marcolini
- Cardiac Surgery Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - P Farina
- Cardiac Surgery Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M F Gaudino
- Department of Cardio-Thoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - G A Lanza
- Non Invasive Cardiac Diagnostics Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Unit of Cardiology, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F Crea
- Unit of Cardiology, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Giordano
- Section of Nuclear Medicine, Department of Radiological and Haematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, Radiation Oncology and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - M Massetti
- Cardiac Surgery Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
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Sarno G, Iacone B, Tedesco A, Gargiulo A, Ranieri A, Giordano A, Tramontano S, Bracale U. End-colostomy parastomal hernia repair: a systematic review on laparoscopic and robotic approaches. Hernia 2024:10.1007/s10029-024-03026-8. [PMID: 38625435 DOI: 10.1007/s10029-024-03026-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/08/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION Parastomal hernia (PSH) is the most common and challenging complication after stoma creation, with an estimated 50% incidence 2 years after the index surgery. Mesh repair is the treatment of choice. Laparoscopic and/or robotic approaches allow acceptable outcomes. MATERIALS AND METHODS A systematic literature review from January 2012 to November 2023 was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Embase, PubMed, and Scopus search were performed to select articles dealing with minimally invasive surgical treatment for PSH after end colostomy. RESULTS 603 studies were found, and 24 were chosen. When compared to open surgery, laparoscopy showed decreased postoperative complications and recurrence. The main laparoscopic approaches are the keyhole (KH), the Sugarbaker (SB), and the sandwich technique. Continuous improvement in surgery, mesh technology, and surgeons' expertise led to an amelioration of surgical outcome and recurrence rate after repair. Recent studies showed comparable outcomes for SB and KH techniques, while novel surgical approaches have been proposed in an attempt to further increase the operative and long-term results. Reports on PSH robotic repairs are scarce and describe small series results, suggesting a role of the initial learning curve as a risk factor for complications. CONCLUSION End-colostomy PSH surgical repair still represents a challenge for surgeons. Recent evidence has not shown a significant advantage in postoperative complications and recurrence with a specific repair among SB, KH, and sandwich technique. The paucity of data on robotic surgery does not allow to draw definitive conclusion. Further primary, multicentric, and larger cohort studies are needed.
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Affiliation(s)
- G Sarno
- General and Emergency Surgery Unit, Department of Medicine, Surgery and Dentistry, "Salerno Medical School", San Giovanni di Dio e Ruggi d'Aragona University Hospital, Scuola Medica Salernitana, University of Salerno, Faculty of Medicine and Surgery, Campus di Baronissi (SA), "Gaetano Fucito" Facility, Mercato San Severino (SA), Salerno, Italy.
| | - B Iacone
- General and Emergency Surgery Unit, Department of Medicine, Surgery and Dentistry, "Salerno Medical School", San Giovanni di Dio e Ruggi d'Aragona University Hospital, Scuola Medica Salernitana, University of Salerno, Faculty of Medicine and Surgery, Campus di Baronissi (SA), "Gaetano Fucito" Facility, Mercato San Severino (SA), Salerno, Italy
| | - A Tedesco
- General and Emergency Surgery Unit, Department of Medicine, Surgery and Dentistry, "Salerno Medical School", San Giovanni di Dio e Ruggi d'Aragona University Hospital, Scuola Medica Salernitana, University of Salerno, Faculty of Medicine and Surgery, Campus di Baronissi (SA), "Gaetano Fucito" Facility, Mercato San Severino (SA), Salerno, Italy
| | - A Gargiulo
- General and Emergency Surgery Unit, Department of Medicine, Surgery and Dentistry, "Salerno Medical School", San Giovanni di Dio e Ruggi d'Aragona University Hospital, Scuola Medica Salernitana, University of Salerno, Faculty of Medicine and Surgery, Campus di Baronissi (SA), "Gaetano Fucito" Facility, Mercato San Severino (SA), Salerno, Italy
| | - A Ranieri
- General and Emergency Surgery Unit, Department of Medicine, Surgery and Dentistry, "Salerno Medical School", San Giovanni di Dio e Ruggi d'Aragona University Hospital, Scuola Medica Salernitana, University of Salerno, Faculty of Medicine and Surgery, Campus di Baronissi (SA), "Gaetano Fucito" Facility, Mercato San Severino (SA), Salerno, Italy
| | - A Giordano
- General and Emergency Surgery Unit, Department of Medicine, Surgery and Dentistry, "Salerno Medical School", San Giovanni di Dio e Ruggi d'Aragona University Hospital, Scuola Medica Salernitana, University of Salerno, Faculty of Medicine and Surgery, Campus di Baronissi (SA), "Gaetano Fucito" Facility, Mercato San Severino (SA), Salerno, Italy
| | - S Tramontano
- General and Emergency Surgery Unit, Department of Medicine, Surgery and Dentistry, "Salerno Medical School", San Giovanni di Dio e Ruggi d'Aragona University Hospital, Scuola Medica Salernitana, University of Salerno, Faculty of Medicine and Surgery, Campus di Baronissi (SA), "Gaetano Fucito" Facility, Mercato San Severino (SA), Salerno, Italy
| | - U Bracale
- General and Emergency Surgery Unit, Department of Medicine, Surgery and Dentistry, "Salerno Medical School", San Giovanni di Dio e Ruggi d'Aragona University Hospital, Scuola Medica Salernitana, University of Salerno, Faculty of Medicine and Surgery, Campus di Baronissi (SA), "Gaetano Fucito" Facility, Mercato San Severino (SA), Salerno, Italy
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Montera MC, Giordano A, Asperti C, Aruanno A, Barzaghi CE, Bignardi D, Borrelli P, Bommarito L, Busa M, Calafiore P, Carusi V, Cinquini M, Cortellini G, Cocchi R, D'Auria F, De Caro F, Demonte A, Di Leo E, Di Lizia M, Di Rienzo A, Fumagalli F, Kihlgren P, Lodi Rizzini F, Macchia D, Manzotti G, Marra AM, Mileto P, Mietta S, Montagni M, Nettis E, Nucera E, Peveri S, Pivetta D, Pirisi M, Ramirez GA, Rivolta F, Rizzi A, Savoia A, Pedicini A, Scarpa A, Zambito M, Zisa G, Yacoub MR. The role of skin tests with polyethylene glycol and polysorbate 80 in the vaccination campaign for COVID-19: results from an Italian multicenter survey. Eur Ann Allergy Clin Immunol 2024; 56:17-25. [PMID: 36927838 DOI: 10.23822/eurannaci.1764-1489.291] [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] [Indexed: 03/18/2023]
Abstract
Summary Background. International guidelines suggested skin tests with Polyethylene-glycol (PEG) and polysorbate 80 (PS-80), to investigate a possible hypersensitivity to these excipients either to identify subjects at risk of developing allergic reactions to Covid-19 vaccines, or in patients with suspected IgE mediated hypersensitivity reactions (HR) to the Covid-19 vaccine. The main purpose of this study was to investigate the prevalence of PEG and PS sensitization in patients with a clinical history of HR to drugs containing PEG/PS and in patients with a suspected Covid-19 vaccine immediate HR. Methods. This was a multicenter retrospective study conducted by allergists belonging to 20 Italian medical centers. Skin testing was performed in 531 patients with either a clinical history of suspected hypersensitivity reaction (HR) to drugs containing PEG and/or PS-80 (group 1:362 patient) or a suspected HR to Covid-19 vaccines (group 2: 169 patient), as suggested by the AAIITO/SIAAIC guidelines for the "management of patients at risk of allergic reactions to Covid-19 vaccines" [1]. Results. 10/362 (0.02%) had positive skin test to one or both excipients in group 1, 12/169 (7.1%) in group 2 (p less than 0.01). In group 2 HRs to Covid-19 vaccines were immediate in 10/12 of cases and anaphylaxis occurred in 4/12 of patients. Conclusions. The positivity of skin test with PEG and or PS before vaccination is extremely rare and mostly replaceable by an accurate clinical history. Sensitization to PEG and PS has to be investigated in patients with a previous immediate HR to a Covid-19 vaccine, in particular in patients with anaphylaxis.
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Affiliation(s)
- M C Montera
- University Hospital "O.O.R.R. San Giovanni di Dio and Ruggi d'Aragona", Salerno, Italy
| | - A Giordano
- UO University Hospital "O.O.R.R. San Giovanni di Dio and Ruggi d'Aragona", Salerno, Italy
| | - C Asperti
- Unit of Immunology, Rheumatology, Allergology and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - A Aruanno
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - D Bignardi
- Allergology Unit, IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| | - P Borrelli
- SSD Dermatology, Beauregard Hospital, Valle d'Aosta, Italy
| | - L Bommarito
- Turin Local Health Authority 4, Turin, Italy
| | - M Busa
- UOS Dermatology Hospital of Mirano, Venice, Italy
| | | | - V Carusi
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | - M Cinquini
- SSVD Allergology, Spedali Civili, Brescia, Italy
| | - G Cortellini
- SSI Allergology Romagna Health Authority, Rimini Hospital, Italy
| | - R Cocchi
- Pneumology Unit, Busto Arsizio Hospital, Varese, Italy
| | | | - F De Caro
- UO University Hospital "O.O.R.R. San Giovanni di Dio and Ruggi d'Aragona", Salerno, Italy
| | - A Demonte
- Simple Operating Unit of Allergology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - E Di Leo
- Section of Allergy and Clinical Immunology, Unit of Internal Medicine- "F. Miulli" Hospital, Acquaviva delle Fonti, Bari, Italy
| | - M Di Lizia
- UOSD. Allergology Giulianova, Teramo, Italy
| | - A Di Rienzo
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | | | | | - F Lodi Rizzini
- SSVD Allergology, Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences (DSCS), University of Brescia, Brescia, Italy
| | - D Macchia
- SOS Allergology Clinical Immunology, San Giovanni di Dio Hospital, Florence, Italy
| | - G Manzotti
- Allergology Clinic, Casa di Cura Palazzolo, Bergamo, Italy
| | - A M Marra
- ASST Rhodense, Rho Hospital, Milan, Italy
| | - P Mileto
- SSVD Allergology, Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences (DSCS), University of Brescia, Brescia, Italy
| | - S Mietta
- Turin Local Health Authority 4, Turin, Italy
| | | | - E Nettis
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
| | - E Nucera
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Peveri
- ASST Bergamo Ovest, Bergamo, Italy
| | - D Pivetta
- SSVD Allergology, Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences (DSCS), University of Brescia, Brescia, Italy
| | - M Pirisi
- Division of Internal Medicine, Ospedale Maggiore della Carità, Novara, Italy
| | - G A Ramirez
- Unit of Immunology, Rheumatology, Allergology and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - F Rivolta
- UOC General Medicine, Immunology and Allergology, IRCCS Cà Granda Foundation, Maggiore Policlinico Hospital, Milan, Italy
| | - A Rizzi
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Savoia
- Ospedale del Sacro Cuore di Gesù - Fatebenefratelli, Benevento, Italy
| | - A Pedicini
- Ospedale del Sacro Cuore di Gesù - Fatebenefratelli, Benevento, Italy
| | - A Scarpa
- UOS Dermatology Hospital of Mirano, Venice, Italy
| | - M Zambito
- Specialist Outpatient Allergy Unit, ASP 6 Palermo, Palermo, Italy
| | - G Zisa
- SS Allergology and Clinical Immunology, Maggiore della Carità Hospital, Novara, Italy
| | - M-R Yacoub
- Unit of Immunology, Rheumatology, Allergology and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy
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Giordano A, Lin NU, Tolaney SM, Mayer EL. Is there a role for continuation of CDK4/6 inhibition after progression on a prior CDK4/6 inhibitor in HR+/HER2- metastatic breast cancer? Ann Oncol 2024; 35:10-14. [PMID: 37952893 DOI: 10.1016/j.annonc.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/17/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023] Open
Affiliation(s)
- A Giordano
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston; Harvard Medical School, Boston, USA
| | - N U Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston; Harvard Medical School, Boston, USA
| | - S M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston; Harvard Medical School, Boston, USA
| | - E L Mayer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston; Harvard Medical School, Boston, USA.
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Sica M, Piazzolla P, Amparore D, Verri P, De Cillis S, Piramide F, Volpi G, Piana A, Di Dio M, Alba S, Gatti C, Burgio M, Busacca G, Giordano A, Fiori C, Porpiglia F, Checcucci E. 3D Model Artificial Intelligence-Guided Automatic Augmented Reality Images during Robotic Partial Nephrectomy. Diagnostics (Basel) 2023; 13:3454. [PMID: 37998590 PMCID: PMC10670293 DOI: 10.3390/diagnostics13223454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
More than ever, precision surgery is making its way into modern surgery for functional organ preservation. This is possible mainly due to the increasing number of technologies available, including 3D models, virtual reality, augmented reality, and artificial intelligence. Intraoperative surgical navigation represents an interesting application of these technologies, allowing to understand in detail the surgical anatomy, planning a patient-tailored approach. Automatic superimposition comes into this context to optimally perform surgery as accurately as possible. Through a dedicated software (the first version) called iKidney, it is possible to superimpose the images using 3D models and live endoscopic images during partial nephrectomy, targeting the renal mass only. The patient is 31 years old with a 28 mm totally endophytic right-sided renal mass, with a PADUA score of 9. Thanks to the automatic superimposition and selective clamping, an enucleoresection of the renal mass alone was performed with no major postoperative complication (i.e., Clavien-Dindo < 2). iKidney-guided partial nephrectomy is safe, feasible, and yields excellent results in terms of organ preservation and functional outcomes. Further validation studies are needed to improve the prototype software, particularly to improve the rotational axes and avoid human help. Furthermore, it is important to reduce the costs associated with these technologies to increase its use in smaller hospitals.
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Affiliation(s)
- Michele Sica
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
| | - Pietro Piazzolla
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (P.P.); (G.V.); (C.G.)
| | - Daniele Amparore
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
| | - Paolo Verri
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
| | - Sabrina De Cillis
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
| | - Federico Piramide
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
| | - Gabriele Volpi
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (P.P.); (G.V.); (C.G.)
| | - Alberto Piana
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
| | - Michele Di Dio
- Division of Urology, Department of Surgery, SS Annunziata Hospital, 87100 Cosenza, Italy;
| | | | - Cecilia Gatti
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (P.P.); (G.V.); (C.G.)
| | - Mariano Burgio
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
| | - Giovanni Busacca
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
| | - Angelo Giordano
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
| | - Cristian Fiori
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
| | - Francesco Porpiglia
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
| | - Enrico Checcucci
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (D.A.); (P.V.); (S.D.C.); (F.P.); (A.P.); (M.B.); (G.B.); (A.G.); (C.F.); (F.P.); (E.C.)
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (P.P.); (G.V.); (C.G.)
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Tagliaferri L, Alemanno G, Fionda B, Alitto AR, Frascino V, Cellini F, Lancellotta V, Placidi E, Morganti AG, Kovács G, Giordano A, Manfredi R, Valentini V. Multiparametric imaging guided HDR interventional radiotherapy (brachytherapy) boost in localized prostate cancer: a multidisciplinary experience. Eur Rev Med Pharmacol Sci 2023; 27:4175-4184. [PMID: 37203844 DOI: 10.26355/eurrev_202305_32327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVE The aim of this study was to report a monoinstitutional multidisciplinary experience about the use of multiparametric imaging to identify the areas with higher risk of relapse in localized prostate cancer, with the purpose of allowing a biologically planned target dose escalation. PATIENTS AND METHODS We performed a retrospective evaluation of patients diagnosed with prostate cancer who received treatments at our Interventional Oncology Center with interstitial interventional radiotherapy from 2014 to 2022. Inclusion criteria were histologically confirmed localized prostate cancer; and National Comprehensive Cancer Network (NCCN) risk class unfavorable intermediate or high/very high risk. The diagnostic work-up included multiparametric Magnetic resonance imaging (MRI), multiparametric Transrectal ultrasound (TRUS), Positron Emission Tomography Computed Tomography (PET-CT) with choline or PSMA (or alternatively bone scan). All patients were assessed and received one treatment with interstitial high-dose-rate interventional radiotherapy (brachytherapy) delivering external beam radiotherapy (46 Gy). All procedures were performed using transrectal ultrasound guidance under general anesthesia and the prescribed doses were 10 Gy to the whole prostate, 12 Gy to the peripheral zone and 15 Gy to the areas at risk. RESULTS We report the data of 21 patients who were considered for the statistical analysis with a mean age of 62.5 years. The mean PSA nadir was 0.03 ng/ml (range 0-0.09). So far, no biochemical nor radiological recurrences have been recorded in our series. Regarding acute toxicity, the most commonly reported side effects were G1 urinary in 28.5% of patients and G2 urinary in 9.5%; all recorded acute toxicities resolved spontaneously. CONCLUSIONS We present a real-life experience of biologically planned local dose escalation by interventional radiotherapy (brachytherapy) boost, followed by external beam radiotherapy in patients with intermediate unfavorable- or high/very high risk. The local control and the biochemical control rates are proved to be excellent and the toxicity profile tolerable.
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Affiliation(s)
- L Tagliaferri
- Dipartimento di Diagnostica per Immagini, U.O.C. Radioterapia Oncologica, Radioterapia Oncologica Ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
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Mirabelli R, Morganti S, Cartoni A, De Simoni M, Faccini R, Fischetti M, Giordano A, Scotognella T, Solfaroli-Camillocci E, Collamati F. Characterization and optimization of a β detector for 18F radio-guided surgery. Phys Med 2023; 108:102545. [PMID: 37021607 DOI: 10.1016/j.ejmp.2023.102545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/26/2023] [Accepted: 02/09/2023] [Indexed: 03/11/2023] Open
Abstract
Radio-Guided Surgery (RGS) is a nuclear medicine technique to support the surgeon during surgery towards a complete tumor resection. It is based on intraoperative detection of radiation emitted by a radio-pharmaceutical that bounds selectively to tumoral cells. In the past years, an approach that exploits β- emitting radiotracers has been pursued to overtake some limitations of the traditional RGS based on γ emission. A particle detector dedicated to this application, demonstrating very high efficiency to β- particles and remarkable transparency to photons, has been thus developed. As a by-product, its characteristics suggested the possibility to utilize it with β+ emitting sources, more commonly in use in nuclear medicine. In this paper, performances of such detector on 18F liquid sources are estimated by means of Monte Carlo simulations (MC) and laboratory measurements. The experimental setup with a 18F saline solution comprised a "positron signal" spot (a 7 × 10 mm cylinder representing the tumor residual), and a surrounding "far background" volume, that represented for the detector an almost isotropic source of annihilation photons. Experimental results show good agreement with MC predictions, thus confirming the expected performances of the detector with 18F, and the validity of the developed MC simulation as a tool to predict the gamma background determined by a diffuse source of annihilation photons.
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Affiliation(s)
- R Mirabelli
- Department of Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Rome, Italy; Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy
| | - S Morganti
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy
| | - A Cartoni
- Department of Chemistry, Sapienza Università di Roma, Rome, Italy
| | - M De Simoni
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy; Department of Medical Physics Ludwig-Maximilians- Universität München (LMU) Munich, Germany
| | - R Faccini
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy; Department of Physics, Sapienza Università di Roma, Rome, Italy
| | - M Fischetti
- Department of Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Rome, Italy
| | - A Giordano
- Unit of Nuclear Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Istitute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - T Scotognella
- Unit of Nuclear Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - F Collamati
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma, Rome, Italy.
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8
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Sannia A, Giordano A, Gullo NL, Mastroianni C, Plastina F. A hybrid classical-quantum approach to speed-up Q-learning. Sci Rep 2023; 13:3913. [PMID: 36890198 PMCID: PMC9995512 DOI: 10.1038/s41598-023-30990-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/06/2023] [Indexed: 03/10/2023] Open
Abstract
We introduce a classical-quantum hybrid approach to computation, allowing for a quadratic performance improvement in the decision process of a learning agent. Using the paradigm of quantum accelerators, we introduce a routine that runs on a quantum computer, which allows for the encoding of probability distributions. This quantum routine is then employed, in a reinforcement learning set-up, to encode the distributions that drive action choices. Our routine is well-suited in the case of a large, although finite, number of actions and can be employed in any scenario where a probability distribution with a large support is needed. We describe the routine and assess its performance in terms of computational complexity, needed quantum resource, and accuracy. Finally, we design an algorithm showing how to exploit it in the context of Q-learning.
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Affiliation(s)
- A Sannia
- Dipartimento di Fisica, Università della Calabria, 87036, Arcavacata di Rende, (CS), Italy.,Institute for Cross-Disciplinary Physics and Complex Systems (IFISC) UIB-CSIC, Campus Universitat Illes Balears, 07122, Palma de Mallorca, Spain
| | | | - N Lo Gullo
- Dipartimento di Fisica, Università della Calabria, 87036, Arcavacata di Rende, (CS), Italy.,INFN, gruppo collegato di Cosenza, Cosenza, Italy.,Quantum Algorithms and Software, VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | | | - F Plastina
- Dipartimento di Fisica, Università della Calabria, 87036, Arcavacata di Rende, (CS), Italy. .,INFN, gruppo collegato di Cosenza, Cosenza, Italy.
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9
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Volpi G, Checcucci E, Amparore D, De Cillis S, Piramide F, Piana A, Sica M, Verri P, Burgio M, Zamengo D, Meziere J, Cisero E, Della Corte M, Mesterca A, Mandaletti M, Giordano A, Pini F, Sterrantino A, Manfredi M, Fiori C, Porpiglia F. The application of artificial intelligence guided 3D automatic augmented-reality biopsy allows to improve the oncological safety of the nerve sparing phase during robotic prostatectomy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00524-9] [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: 02/12/2023]
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10
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Giordano A, Dalmasso E, Alessandria E, Chiapello G, Oppezzi G, Aimar R, Violino P, Morra I. Multiparametric MRI of the bladder as a predictive factor of histopathology at reTUR in T1GH with presence of detrusor muscle: Could it have a role? Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00643-7] [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: 02/12/2023]
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11
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Giordano A, Alessandria E, Dalmasso E, Bernardi D, Carbonaro B, Violino P, Morra I. Multiparametric MRI in differentiation between muscle invasive and non-muscle invasive urinary bladder cancer with vesical imaging reporting and data system (VI-RADS) application: Our initial experience. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01101-6] [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: 02/12/2023]
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12
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Salvio G, Petrelli M, Paolini S, Baldini V, Sbaffi C, Basili S, Giordano A, Balercia G, Cinti S. Gender-specific effects of capsiate supplementation on body weight and bone mineral density: a randomized, double-blind, placebo-controlled study in slightly overweight women. J Endocrinol Invest 2023:10.1007/s40618-022-01999-w. [PMID: 36609773 DOI: 10.1007/s40618-022-01999-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Overweight and obesity are highly prevalent conditions associated with premature morbidity and mortality worldwide. Capsiate, a nonpungent analogue of capsaicin, binds to TRP vanilloid 1 (TRPV1) receptor, which is involved in adipogenesis, and could be effective as a weight-lowering agent. METHODS Eighteen slightly overweight women were enrolled in this randomized, double-blind, placebo-controlled study. Nine patients were included in the capsiate intervention group and received 9 mg/day of capsinoids and 9 patients received placebo for 8 weeks. All patients underwent weight and waist circumference assessment before and after treatment. Body composition and bone mineral density (BMD) were also detected by dual-energy X-ray absorptiometry (DXA). RESULTS Fourteen patients completed the study. The treatment with capsiate or placebo for 8 weeks was not associated with significant changes in weight or waist circumference. After treatment, there was a significant improvement in BMD values measured at the spine in the capsiate group (1.158 vs 1.106 g/cm2, + 4.7%; p = 0.04), but not in the group treated with placebo. Similarly, the capsiate group showed a 9.1% increase (p = 0.05) in the adipose tissue and an 8.5% decrease in lean mass measured at the supraclavicular level, whereas these changes were not statistically significant in the placebo group. CONCLUSIONS Treatment with capsiate for 8 weeks led to negligible changes in body weight in a small sample of slightly overweight women, but our findings suggest a potential effect of capsaicin on bone metabolism in humans.
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Affiliation(s)
- G Salvio
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - M Petrelli
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - S Paolini
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - V Baldini
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - C Sbaffi
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - S Basili
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - A Giordano
- Center of Obesity, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - G Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - S Cinti
- Center of Obesity, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.
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13
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D'Amario D, Leccisotti L, Cinti F, Sorice GP, Lorusso M, Guzzardi MA, Mezza T, Cocchi C, Capece U, Indovina L, Ferraro PM, Iozzo P, Giordano A, Giaccari A, Crea F. Dapagliflozin improves Myocardial Flow Reserve in patients with Type 2 Diabetes: the DAPAHEART Trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Cardiovascular (CV) outcome trials have shown that in patients with type 2 diabetes (T2D), treatment with sodium-glucose cotransporter-2 inhibitors (SGLT-2i) reduces CV mortality and admission rates for heart failure (HF). However, the mechanisms behind these benefits are not fully understood. This study was performed to investigate the effects of the SGLT-2i dapagliflozin on whole body insulin sensitivity, myocardial perfusion, and metabolism in patients with T2D without HF.
Research design and methods
This was a single-center, prospective, randomized, double-blind controlled clinical trial including 16 patients with T2D randomized to SGLT-2i dapagliflozin (10 mg) or placebo. Whole body glucose uptake (WBGU) and myocardial glucose uptake (MGU) were measured with PET/CT with FDG during euglycemic hyperinsulinemic clamp. Stress (i.v. adenosine infusion) and resting myocardial blood flow (MBF) and myocardial flow reserve (MFR) were calculated by PET/CT with 13N-ammonia.
Results
16 patients were randomized (8 dapagliflozin; 8 placebo). The groups were well-matched for baseline characteristics (age, diabetes duration, HbA1c, renal and heart function). Dapagliflozin significantly improved MFR (2.56±0.26 vs 3.59±0.35) compared with placebo group (2.34±0.21 vs 2.38±0.24; p for interaction =0.001) and was associated to a reduction of resting MBF corrected for cardiac workload (p=0.045). A trend toward an increase in stress MBF was also detected (p=0.058). Moreover, in dapagliflozin group we observed an increase of WBGU of borderline statistical significance (p=0.06) and no effects on MGU (p=0.41).
Conclusions
At the best of our knowledge, our study, for the first time, demonstrated that SGLT-2 inhibition increases MFR in T2D patients. The data presented provide a new potential explanation of cardiovascular benefits with SGLT-2i as they make patients more tolerant to the detrimental impact of obstructive coronary atherosclerosis on MFR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D D'Amario
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - L Leccisotti
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - F Cinti
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - G P Sorice
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - M Lorusso
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - M A Guzzardi
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - T Mezza
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - C Cocchi
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - U Capece
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - L Indovina
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - P M Ferraro
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - P Iozzo
- CNR – National Research Council , Pisa , Italy
| | - A Giordano
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - A Giaccari
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - F Crea
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
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14
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Amparore D, Piramide F, Checcucci E, De Cillis S, Piana A, Volpi G, Verri P, Piscitello S, Meziere J, Zamengo D, Quarà A, Cisero E, Busacca G, Pini F, Ortenzi M, Giordano A, Bellin A, Cossu M, Mesterca G, Manfredi M, Fiori C, Porpiglia F. The role of the intraoperative touchless interaction with 3D Virtual models performing laparoscopic partial nephrectomy: our preliminary experience with ICON3D. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01052-7] [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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15
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De Cillis S, De Luca S, Amparore D, Checcucci E, Piana A, Piramide F, Volpi G, Sica M, Verri P, Piscitello S, Burgio M, Quarà A, Pini F, Mandaletti M, Giordano A, Cidda D, Mesterca A, Manfredi M, Fiori C, Porpiglia F. Salvage robot-assisted radical prostatectomy in patient underwent primary HIFU: A tertiary care center experience. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02145-0] [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: 11/06/2022] Open
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16
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Piramide F, De Luca S, Checcucci E, Amparore D, Volpi G, De Cillis S, Piana A, Verri P, Piscitello S, Zamengo D, Meziere J, Busacca G, Colombo M, Pini F, Sterrantino A, Ortenzi M, Giordano A, Manfredi M, Fiori C, Porpiglia F. Results from our prospective comparative and functional analysis after different ablative techniques for MRI/real-time ultrasound image fusion guided high intensity focused ultrasound (HIFU). EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01245-9] [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: 11/06/2022] Open
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17
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Checcucci E, Alladio E, Manfredi M, Amparore D, De Cillis S, Piramide F, Volpi G, Piana A, Sica M, Verri P, Piscitello S, Ola L, Zamengo D, Cisero E, Della Corte M, Pini F, Giordano A, Fiori C, De Luca S, Porpiglia F. Standard prostate biopsy combined with target biopsy in biopsy naïve patients: does it has an additional role when compared with radical prostatectomy specimens? results of a prospective randomized clinical trial. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01175-2] [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: 11/06/2022] Open
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18
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Manfredi M, Sica M, Checcucci E, Amparore D, Silvestri T, Piramide F, De Cillis S, Piana A, Volpi G, Granato S, Ola L, Zamengo D, Meziere J, Cisero E, Poggio M, Cidda D, Giordano A, Fiori C, Celia A, Porpiglia F. Y-pouch ileal neobladder after robot-assisted radical cystectomy: preliminary results of two italian tertiary centers. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01117-x] [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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19
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Giordano A, Cinti F, Canese R, Carpinelli G, Colleluori G, Di Vincenzo A, Palombelli G, Severi I, Moretti M, Redaelli C, Partridge J, Zingaretti MC, Agostini A, Sternardi F, Giovagnoni A, Castorina S, Cinti S. The Adipose Organ Is a Unitary Structure in Mice and Humans. Biomedicines 2022; 10:biomedicines10092275. [PMID: 36140375 PMCID: PMC9496043 DOI: 10.3390/biomedicines10092275] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/03/2022] [Accepted: 09/08/2022] [Indexed: 12/03/2022] Open
Abstract
Obesity is the fifth leading cause of death worldwide. In mice and humans with obesity, the adipose organ undergoes remarkable morpho-functional alterations. The comprehension of the adipose organ function and organization is of paramount importance to understand its pathology and formulate future therapeutic strategies. In the present study, we performed anatomical dissections, magnetic resonance imaging, computed axial tomography and histological and immunohistochemical assessments of humans and mouse adipose tissues. We demonstrate that most of the two types of adipose tissues (white, WAT and brown, BAT) form a large unitary structure fulfilling all the requirements necessary to be considered as a true organ in both species. A detailed analysis of the gross anatomy of mouse adipose organs in different pathophysiological conditions (normal, cold, pregnancy, obesity) shows that the organ consists of a unitary structure composed of different tissues: WAT, BAT, and glands (pregnancy). Data from autoptic dissection of 8 cadavers, 2 females and 6 males (Age: 37.5 ± 9.7, BMI: 23 ± 2.7 kg/m2) and from detailed digital dissection of 4 digitalized cadavers, 2 females and 2 males (Age: 39 ± 14.2 years, BMI: 22.8 ± 4.3 kg/m2) confirmed the mixed (WAT and BAT) composition and the unitary structure of the adipose organ also in humans. Considering the remarkable endocrine roles of WAT and BAT, the definition of the endocrine adipose organ would be even more appropriate in mice and humans.
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Affiliation(s)
- A. Giordano
- Department of Experimental and Clinical Medicine, Center for the Study of Obesity, Marche Polytechnic University, 60126 Ancona, Italy
| | - F. Cinti
- UOS Centro Malattie Endocrine e Metaboliche, UOC Endocrinologia e Diabetologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - R. Canese
- MRI Unit-Core Facilities, Istituto Superiore di Sanità, 00161 Roma, Italy
| | - G. Carpinelli
- MRI Unit-Core Facilities, Istituto Superiore di Sanità, 00161 Roma, Italy
| | - G. Colleluori
- Department of Experimental and Clinical Medicine, Center for the Study of Obesity, Marche Polytechnic University, 60126 Ancona, Italy
| | - A. Di Vincenzo
- Department of Experimental and Clinical Medicine, Center for the Study of Obesity, Marche Polytechnic University, 60126 Ancona, Italy
| | - G. Palombelli
- MRI Unit-Core Facilities, Istituto Superiore di Sanità, 00161 Roma, Italy
| | - I. Severi
- Department of Experimental and Clinical Medicine, Center for the Study of Obesity, Marche Polytechnic University, 60126 Ancona, Italy
| | - M. Moretti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | | | | | - M. C. Zingaretti
- Department of Experimental and Clinical Medicine, Center for the Study of Obesity, Marche Polytechnic University, 60126 Ancona, Italy
| | - A. Agostini
- Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy
| | - F. Sternardi
- Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy
| | - A. Giovagnoni
- Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy
| | - S. Castorina
- Department of Medical and Surgical Sciences and Advanced Technologies G.F. Ingrassia, University of Catania, 95121 Catania, Italy
| | - S. Cinti
- Department of Experimental and Clinical Medicine, Center for the Study of Obesity, Marche Polytechnic University, 60126 Ancona, Italy
- Correspondence:
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20
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Tarantino P, Niman S, Erick T, Priedigkeit N, Harrison B, Giordano A, Nakhlis F, Bellon J, Parker T, Strauss S, Jin Q, King T, Overmoyer B, Curigliano G, Regan M, Tolaney S, Lynce F. 206P HER2-low inflammatory breast cancer (IBC): Clinicopathologic features and prognostic implications. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.240] [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: 11/16/2022] Open
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21
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Di Girolamo R, Cicolella A, Talarico G, Scoti M, De Stefano F, Giordano A, Malafronte A, De Rosa C. Structure and Morphology of Crystalline Syndiotactic Polypropylene-Polyethylene Block Copolymers. Polymers (Basel) 2022; 14:polym14081534. [PMID: 35458284 PMCID: PMC9031856 DOI: 10.3390/polym14081534] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 02/05/2023] Open
Abstract
A study of the structure and morphology of diblock copolymers composed of crystallizable blocks of polyethylene (PE) and syndiotactic polypropylene (sPP) having different lengths is reported. In both analyzed samples, the PE block crystallizes first by cooling from the melt (at 130 °C) and the sPP block crystallizes after at a lower temperature. Small angle X-ray scattering (SAXS) recorded during cooling showed three correlation peaks at values of the scattering vector, q1 = 0.12 nm−1, q2 = 0.24 nm−1 and q3 = 0.4 nm−1, indicating development of a lamellar morphology, where lamellar domains of PE and sPP alternate, each domain containing stacks of crystalline lamellae of PE or sPP sandwiched by their own amorphous phase of PE or sPP. At temperatures higher than 120 °C, when only PE crystals are formed, the morphology is defined by the formation of stacks of PE lamellae (17 nm thick) alternating with amorphous layers and with a long period of nearly 52 nm. At lower temperatures, when crystals of sPP are also well-formed, the morphology is more complex. A model of the morphology at room temperature is proposed based on the correlation distances determined from the self-correlation functions extracted from the SAXS data. Lamellar domains of PE (41.5 nm thick) and sPP (8.2 nm thick) alternate, each domain containing stacks of crystalline lamellae sandwiched by their own amorphous phase, forming a global morphology having a total lamellar periodicity of 49.7 nm, characterized by alternating amorphous and crystalline layers, where the crystalline layers are alternatively made of stacks of PE lamellae (22 nm thick) and thinner sPP lamellae (only 3.5 nm thick).
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22
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Giordano A, Hunninck L, Sheriff MJ. Prey responses to predation risk under chronic road noise. J Zool (1987) 2022. [DOI: 10.1111/jzo.12968] [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] [Indexed: 11/28/2022]
Affiliation(s)
- A. Giordano
- Biology Department University of Massachusetts Dartmouth North Dartmouth MA USA
| | - L. Hunninck
- Department of Natural Resources and Environmental Sciences University of Illinois Urbana‐Champaign Urbana IL USA
| | - M. J. Sheriff
- Biology Department University of Massachusetts Dartmouth North Dartmouth MA USA
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23
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Morganti S, Bianchini G, Giordano A, Giuliano M, Curigliano G, Criscitiello C. How I treat HER2-positive early breast cancer: how long adjuvant trastuzumab is needed? ESMO Open 2022; 7:100428. [PMID: 35272131 PMCID: PMC8908056 DOI: 10.1016/j.esmoop.2022.100428] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 01/03/2023] Open
Abstract
Since its first approval in 2006, 1 year of adjuvant trastuzumab has been the standard of care for early-stage HER2-positive breast cancer. Nevertheless, the optimal duration of adjuvant trastuzumab was uncertain, and the standard 12-month duration has been questioned by a number of different trials. Although most of these studies were formally negative, a patient-level meta-analysis presented at the 2021 European Society for Medical Oncology (ESMO) meeting first showed the non-inferiority of 6-month trastuzumab. Through this review, we sought to take a closer look at the meta-analysis and the included trials to explain why we believe that non-inferiority should be interpreted with caution. Indeed, here we underline how the meta-analysis’ results were mainly driven by the PERSEPHONE study, an old trial that tested non-standard chemo-trastuzumab regimens in a relatively low-risk population with doubtful endpoints. In summary, considering all the limitations of this analysis and the increasing use of effective anthracycline-free de-escalation strategies, we are convinced that 1-year trastuzumab should remain the standard of care. The standard 1-year duration of adjuvant trastuzumab has been questioned by a number of trials. At ESMO 2021, the meta-analysis by Earl et al. showed that 6-month adjuvant trastuzumab is not inferior to 12-month. The PERSEPHONE trial was the main driver of the meta-analysis’ results, but it has several limitations. Alternative anthracycline-free de-escalation strategies proved to be effective for HER2+ early breast cancer patients. 12-month adjuvant trastuzumab should remain the standard of care.
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Affiliation(s)
- S Morganti
- Division of Early Drug Development, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hematology, University of Milan, Milan, Italy; Dana-Farber Cancer Institute, Boston, USA
| | - G Bianchini
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy. https://twitter.com/BianchiniGP
| | - A Giordano
- Dana-Farber Cancer Institute, Boston, USA. https://twitter.com/antgiorda
| | - M Giuliano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - G Curigliano
- Division of Early Drug Development, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hematology, University of Milan, Milan, Italy. https://twitter.com/curijoey
| | - C Criscitiello
- Division of Early Drug Development, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hematology, University of Milan, Milan, Italy.
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Velásquez P, Montenegro G, Valenzuela L, Giordano A, Cabrera-Barjas G, Martin-Belloso O. k-carrageenan edible films for beef: Honey and bee pollen phenolic compounds improve their antioxidant capacity. Food Hydrocoll 2022. [DOI: 10.1016/j.foodhyd.2021.107250] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Marra G, Agnello M, Giordano A, Peretti F, Soria F, Oderda M, Dariane C, Timsit M, Branchereau J, Hedli O, Mesnard B, Tilki D, Olsburgh J, Kulkarni M, Kasivisvanathan V, Lebacle C, Breda A, Biancone L, Gontero P. Robotic radical prostatectomy for prostate cancer in renal transplant recipients: Results from a multicenter series. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01312-4] [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: 11/04/2022]
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26
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Soria F, Allasia M, Marquis A, Calleris G, Agnello M, Giordano A, Mazzoli S, De Bellis M, Rosazza M, Livoti S, Lillaz B, Gontero P. Radical cystectomy in renal transplant recipients: The advantages of the robotic approach. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01343-4] [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: 11/17/2022]
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27
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Nahass RG, Giordano A, McManus EJ. 615. A Year with COVID19 – Experience from the Front Line in a Large Infectious Disease (ID) Clinical Practice. Open Forum Infect Dis 2021. [PMCID: PMC8644621 DOI: 10.1093/ofid/ofab466.813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
ID Care (IDC) is a large, 43 physician, 74 provider, practice that treats patients in 16 acute care hospitals (ACH) and 120 skilled nursing facilities (SNF) in NJ. March 4, 2021 was the first day a patient with COVID19 seen by IDC. Over the subsequent year IDC evaluated, treated, and tested over 23,000 persons for COVID19. Patients were seen in 2 distinct times - wave 1 (W1) March 5-August 31 and wave 2 (W2) September 1 to March 4. We compare the experience of these 2 waves and report on the year of COVID19 at IDC.
Methods
The administrative data base for IDC was queried for demographic, visit and testing information. A survey of providers was performed to capture incidence of COVID19 and vaccination rates. Daily census logs were used to create epi curves. Comparisons between waves were performed using student T Test or X2.
Results
Table 1 provides the comparisons between waves. More patients were seen in W2, however, the number of visits per patient was less, consistent with a shorter length of stay. Fewer patients were seen in SNF in W2 compared to W1. The age and sex distribution between the waves were the same. A total of 8741 molecular tests were performed. Test positivity peaked the week of December 31 at 6.99% and dropped to 0% by May 1 consistent with vaccination and the NJ epidemic curve. During the year of COVID19, 6/74 (8%) clinicians were infected with SARSCoV2. All recovered. Infections in providers were not clearly work-related exposures. 73/74 clinicians were vaccinated.
Table 1. Demographics For the Year in COVID19 at ID Care
Figure 1. Test Positivity Rate for ID Care
Conclusion
The year of COVID19 occurred in 2 distinct waves. W1 was short and intense. The age and gender distributions were the same between the waves. Even though wave 2 was numerically greater, the cases in SNF were statistically less than the first wave likely from improved IP practice initiated in W1. The numbers of visits per patient, a surrogate for LOS, was statistically less in W2. The decline in test positivity paralleled deployment of vaccination. Despite an intensity of exposure of 158 patients/provider or 1198 visits/provider to SARSCoV2 infected persons only 8% of the clinician staff were infected. ID clinical practice can use electronic databases to help describe regional outbreaks of transmissible disease giving additional perspective across the care continuum. A more usable standard tool would enhance this capacity.
Disclosures
Ronald G. Nahass, MD, Abbvie (Grant/Research Support, Speaker's Bureau)Alkermes (Grant/Research Support)Gilead (Grant/Research Support, Speaker's Bureau)Merck (Grant/Research Support, Speaker's Bureau)
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Tarro Genta F, Marcassa C, Ceresa M, Scalvini S, Dalla Vecchia LA, Bussotti M, Iannuzzi GL, Rizzo C, Pedretti RFE, Giordano A, La Rovere MT. Predictors of long-term survival in patients undergoing residential cardiac rehabilitation (rCR) after transcatheter aortic valve replacement (TAVR): a multicenter retrospective study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Purpose
To evaluate exercise-based rCR derived outcome predictors in patients referred after TAVR.
Methods
Data of 232 patients (aged 82±6 years, 45%males) admitted to an average 3-week rCR program after TAVR (walking, up to 30 minutes of cycling or treadmill session twice daily, respiratory and calisthenic training) from January 2009 to December 2017 and home discharged, were retrospectively collected at 10 rCR Divisions of Istituti Clinici Scientifici Maugeri. Comorbidity (cumulative illness rated state-comorbidity index) (CIRS-CI) score, echocardiography on admission, disability (Barthel Index) (BI) score at discharge, six minutes walking test distance (6MWT) on discharge and maximal training session intensity (MTSI expressed in METs per minutes) were collected. All-cause mortality was assessed up to 3 years after rCR discharge.
Results
During a 3-year follow-up, there were 74 (32%) deaths. At univariate analysis, at discharge non survivors compared to survivors had significantly higher comorbidity rate (CIRS-ICC 5.2±2.3 vs 4.1±1.9, p=0.000) and disability level (BI 80.4±24 vs 88.8±17, p=0.000). Moreover, they had worse renal function (creatinine 1.6±0.9mg/dl vs 1.2±0.4, p=0.000), were more often on diuretic therapy (73% vs 53.2%, p=0.003) and on beta-blocker therapy (73% vs 57,6%, p=0.042) and had a markedly reduced functional capacity (6MWTD 221±100m vs 265±105m, p=0.001). At multivariate logistic stepwise analysis a lower comorbidity (CIRS-ICC), a more preserved renal function (creatinine level), a reduced use of diuretic therapy and 6MWT at discharge confirmed their power as independent predictors of survival at follow up (Table, Harrel's C = 0.707)
Conclusions
Patients attending rCR after TAVR are very old with significant comorbidity; overall mortality at 3-year follow-up after CR discharge is substantial. Our results suggest the need to implement ad-hoc long-term care strategies based on residual exercise capacity, comorbidity score and renal function for tailoring follow-up in patients discharged from rCR after TAVR.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- F Tarro Genta
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Turin, Italy
| | - C Marcassa
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Veruno (NO), Italy
| | - M Ceresa
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Pavia, Italy
| | - S Scalvini
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Lumezzane, Italy
| | - L A Dalla Vecchia
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Milan, Italy
| | - M Bussotti
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Milan, Italy
| | - G L Iannuzzi
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Telese Terme (BN), Italy
| | - C Rizzo
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Bari, Italy
| | - R F E Pedretti
- IRCCS MultiMedica, Cardiology Department, Sesto San Giovanni (MI), Italy
| | - A Giordano
- Istituti Clinici Scientifici Maugeri Spa SB, Service of Bioengineering, Veruno (NO), Italy
| | - M T La Rovere
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Montescano (Pv), Italy
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Soria F, Barale M, D’Andrea D, Gust K, Giordano A, Pizzuto G, Mazzoli S, De Bellis M, Lillaz B, Shariat S, Gontero P. Skeletal muscle loss predicts oncological outcomes in T1HG patients treated with adjuvant intravesical BCG: Implications for decision-making? Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01107-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liccardi G, Milanese M, Bilò MB, Liccardi MV, Gargano D, Giordano A, Habetswallner F, Lo Schiavo M, Madonna F, Montera MC, Pane G, Papa A, Pedicini A, Rogliani P. Lessons from peculiar cases of anaphylaxis: why allergists should be prepared for the unexpected. Eur Ann Allergy Clin Immunol 2021; 54:99-106. [PMID: 33939345 DOI: 10.23822/eurannaci.1764-1489.198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Anaphylaxis is the most severe systemic hypersensitivity reaction, it can be caused by a number of well identified triggers such as foods, drugs, stinging insects and facilitated by predisposing clinical conditions. However, sometimes anaphylaxis shows up with uncommon or peculiar characteristics which could delay diagnosis and therapeutic treatment. In this report we aimed to describe less accounted / difficult-to-approach shapes of anaphylaxis to facilitate clinicians to suspect these severe reactions even in uncommon conditions. We choose to present data on anaphylaxis regarding simulation, mode of exposure to sensitizing agents, pregnancy, exposure to animals, intimate behaviour, psychological stress and other situations.
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Affiliation(s)
- G Liccardi
- Department of Experimental Medicine, Postgraduate School of Respiratory Medicine, Tor Vergata University of Rome, Rome, Italy
| | - M Milanese
- Division of Pulmonology, S. Corona Hospital, Pietra Ligure, Italy
| | - M B Bilò
- Department of Clinical and Molecular Sciences, Marche Polytechnic University, Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti, Ancona, Italy
| | | | - D Gargano
- Allergy Unit, High Speciality San Giuseppe Moscati Hospital, Avellino, Italy
| | - A Giordano
- Postgraduate School of Internal Medicine, University of Salerno, Salerno, Italy
| | - F Habetswallner
- Division of Neurophysiology A. Cardarelli Hospital, Naples, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District n°12), Caserta, Italy
| | - M C Montera
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - G Pane
- Department of Experimental Medicine, Unit of Respiratory Medicine, Tor Vergata University of Rome, Rome, Italy
| | - A Papa
- ASL (Sanitary District), Avellino, Italy
| | - A Pedicini
- Unit of Allergology, Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy
| | - P Rogliani
- Department of Experimental Medicine, Postgraduate School of Respiratory Medicine, Tor Vergata University of Rome, Rome, Italy.,Department of Experimental Medicine, Unit of Respiratory Medicine, Tor Vergata University of Rome, Rome, Italy
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31
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Meazzi S, Paltrinieri S, Lauzi S, Stranieri A, Brentali I, Ferriani R, Rossi G, Giordano A. Role of paraoxonase-1 as a diagnostic marker for feline infectious peritonitis. Vet J 2021; 272:105661. [PMID: 33941336 DOI: 10.1016/j.tvjl.2021.105661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/24/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
Feline infectious peritonitis (FIP) is characterised by the presence of systemic inflammation accompanied by oxidative stress. Paraoxonase-1 (PON-1) is a negative acute phase reactant produced by the liver. A paraoxon-based method has been validated to measure PON-1 activity in feline serum. The aim of this study was to investigate the usefulness of PON-1 activity as a biomarker to discriminate FIP from other diseases with similar clinical signs. Of 159 cats enrolled, 71 were healthy, 34 had FIP and 54 had another disease but presented with clinical signs that could be consistent with FIP. PON-1 activity was lower (P <0.0001) in cats with FIP (median, 26.55 U/L; range, 5.40-78.20 U/L) compared to healthy (median, 87.5 U/L; range, 46.60-215.50 U/L) and Non-FIP Sick group cats (median, 57.90 U/L; range, 3.80-122.60 U/L). Two receiver operating characteristic curves were used to determine the thresholds that maximised the performance of PON-1 activity in predicting FIP both from a screening and diagnostic point of view. A threshold of 78.30 U/L yielded a sensitivity of 100%, a specificity of 50.4%, and a negative likelihood ratio of 0.00 (screening curve). While a threshold of 24.90 U/L maximised specificity (94.4%), had a sensitivity of 44.1%, and increased the likelihood ratio to 7.94, making PON-1 activity a good confirmatory test for FIP (diagnostic curve). Using these thresholds, serum PON-1 activity showed good diagnostic performance in discriminating FIP affected cats from cats with other inflammatory conditions.
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Affiliation(s)
- S Meazzi
- Department of Veterinary Medicine, University of Milan, Via dell'Università, 6, 26900 Lodi, LO, Italy; Veterinary Teaching Hospital, University of Milan, Via dell'Università, 6, 26900 Lodi, LO, Italy
| | - S Paltrinieri
- Department of Veterinary Medicine, University of Milan, Via dell'Università, 6, 26900 Lodi, LO, Italy; Veterinary Teaching Hospital, University of Milan, Via dell'Università, 6, 26900 Lodi, LO, Italy
| | - S Lauzi
- Department of Veterinary Medicine, University of Milan, Via dell'Università, 6, 26900 Lodi, LO, Italy; Veterinary Teaching Hospital, University of Milan, Via dell'Università, 6, 26900 Lodi, LO, Italy
| | - A Stranieri
- Department of Veterinary Medicine, University of Milan, Via dell'Università, 6, 26900 Lodi, LO, Italy; Veterinary Teaching Hospital, University of Milan, Via dell'Università, 6, 26900 Lodi, LO, Italy.
| | - I Brentali
- Department of Veterinary Medicine, University of Milan, Via dell'Università, 6, 26900 Lodi, LO, Italy
| | - R Ferriani
- Ospedale Veterinario San Francesco, Via Isaac Newton 6, 20148, Milano, MI, Italy
| | - G Rossi
- College of Veterinary Medicine, School of Veterinary and Life Science, Murdoch University, 90 South Street, 6150 Murdoch, Western Australia, Australia
| | - A Giordano
- Department of Veterinary Medicine, University of Milan, Via dell'Università, 6, 26900 Lodi, LO, Italy; Veterinary Teaching Hospital, University of Milan, Via dell'Università, 6, 26900 Lodi, LO, Italy
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32
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Liccardi G, Calzetta L, Milanese M, Bilò MB, Liccardi MV, Baiardini I, Gargano D, Lo Schiavo M, Madonna F, Montera MC, Papa A, Pedicini A, Habetswallner F, Giordano A, Rogliani P. Can placebo challenge test (inducing a "nocebo effect") be a suitable model to assess stress-induced bronchial obstruction? Suggestions from the multidisciplinary Working Groups "Stress-Asthma" and "AAIITO Regione Campania". Eur Ann Allergy Clin Immunol 2021; 53:284-287. [PMID: 33728834 DOI: 10.23822/eurannaci.1764-1489.192] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- G Liccardi
- Department of Experimental Medicine, Postgraduate School of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy
| | - L Calzetta
- Department of Experimental Medicine, Postgraduate School of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine, Unit of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy
| | - M Milanese
- Division of Pulmonology, S. Corona Hospital, Pietra Ligure, Savona, Italy
| | - M B Bilò
- Department of Internal Medicine, Allergy Unit, University Hospital Ospedali Riuniti - Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | | | - I Baiardini
- Department of Biomedical Science, Humanitas University, Milan, Italy
| | - D Gargano
- High Speciality San Giuseppe Moscati Hospital, Allergy Unit, Avellino, Italy
| | - M Lo Schiavo
- Departiment of Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- ASL (Sanitary District n. 12), Allergy Unit, Caserta, Italy
| | - M C Montera
- Departiment of Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - A Papa
- ASL (Sanitary District), Avellino, Italy
| | - A Pedicini
- Division of Internal Medicine, Unit of Allergology, Fatebenefratelli Hospital, Benevento, Italy
| | - F Habetswallner
- Division of Neurophysiology, A. Cardarelli Hospital, Naples, Italy
| | - A Giordano
- Postgraduate School of Internal Medicine, University of Salerno, Salerno, Italy
| | - P Rogliani
- Department of Experimental Medicine, Postgraduate School of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine, Unit of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy
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Gaudieri V, Zampella E, Nappi C, Assante R, Mannarino T, D"antonio A, Giordano A, Buongiorno P, Petretta M, Acampa W, Arumugam P, Cuocolo A. Prognostic value of pericoronary adipose tissue and coronary vascular function by cardiac 82Rb PET/CT imaging in patients with suspected coronary artery disease and normal myocardial perfusion imaging. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Pericoronary adipose tissue, due to its proximity to coronary arteries, has been proposed contribute to the progression of coronary atherosclerosis.
Purpose
The aim of this study was to evaluate the prognostic value of pericoronary fat thickness (PCFT), coronary artery calcium (CAC) score and myocardial perfusion reserve (MPR) by hybrid 82Rubidium (82Rb) PET/CT imaging in patients with suspected coronary artery disease (CAD) and normal myocardial perfusion imaging (MPI).
Methods
A total of 640 patients without overt CAD and with normal rest-stress 82Rb PET/CT MPI were studied. PCFT was calculated on CT images as the maximum fat thickness (mm) between heart surface and visceral epicardium surrounding the main coronary arteries. CAC score was categorized as 0, <400 or ≥400. MPR was considered reduced when <2. Endpoints events were cardiac death, nonfatal myocardial infarction and coronary revascularization.
Results
During a follow-up of 42 ± 13 months, 29 events occurred (cumulative event rate 5%). Patients with events were older (66 ± 13 vs. 60 ± 13 years, p < 0.01), had higher PCFT (13 ± 2 vs 11 ± 2 mm, p < 0.001), higher prevalence of CAC score ≥400 (48% vs. 21%, p < 0.01), and lower MPR (2.1 ± 0.7 vs. 2.7 ± 0.7, p < 0.001) compared to those without. A higher prevalence of MPR <2 was observed in patients with events (48% vs. 18, p < 0.001) compared to those without. Patients with reduced MPR had higher PCFT compared to those with normal MPR (12 ± 2 vs. 11 ± 1 mm, p < 0.01). A PCFT value of 11.2 mm was the best trade-off between sensitivity and specificity to detect a reduced MPR. Event rate was higher in patients above this threshold compared to those below (8% vs. 1.5%, p < 0.001). At Cox univariate analysis, age (p < 0.05), PCFT >11.2 mm (p < 0.001), CAC score ≥400 (p < 0.01), and MPR <2 (p < 0.001) were predictors of events. At multivariate analysis, only PCFT >11.2 mm and MPR <2 were independent predictors of events (both p < 0.01). At incremental analysis, adding PCFT >11.2 to a model including clinical data and MPR <2 increased the global chi-square from 26 to 35 (p < 0.01). Classification tree analysis produced 3 terminal groups. For patients with MPR <2, no further split was needed (event rate 12% vs. 3%, p < 0.001). On the contrary, patients with MPR ≥2 were further stratified by PCFT (event rate 7% in patients with and 0.3% in those without (p < 0.001) PCFT >11.2.
Conclusions
In patients with suspected CAD and normal stress MPI, coronary vascular dysfunction and high PCFT are associated with increased cardiac risk. PCFT could help in identifying patients at higher risk of events. Combined evaluation of anatomical and functional vascular abnormalities by 82Rb PET/CT might allow a better risk stratification.
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Affiliation(s)
- V Gaudieri
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - E Zampella
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - C Nappi
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - R Assante
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - T Mannarino
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A D"antonio
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A Giordano
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - P Buongiorno
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - M Petretta
- Federico II University of Naples, Department of Translational Medical Sciences, Naples, Italy
| | - W Acampa
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - P Arumugam
- Central Manchester University Hospitals NHS Foundation Trust, Department of Nuclear Medicine, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - A Cuocolo
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
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Scoti M, Di Girolamo R, De Stefano F, Giordano A, Malafronte A, Talarico G, Cipullo R, De Rosa C. Synthesis, structure and properties of copolymers of syndiotactic polypropylene with 1-hexene and 1-octene. Polym Chem 2021. [DOI: 10.1039/d1py00975c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Incorporation of long branches, such as 1-hexene or 1-octene, in syndiotactic polypropylene gives novel elastomeric materials, whose crystallization behavior and elastic properties can be easily tailored through tuning of the branches concentration.
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Affiliation(s)
- Miriam Scoti
- Dipartimento di Scienze Chimiche, Università di Napoli Federico II, Complesso Monte S. Angelo, Via Cintia, 80126 Napoli, Italy
| | - Rocco Di Girolamo
- Dipartimento di Scienze Chimiche, Università di Napoli Federico II, Complesso Monte S. Angelo, Via Cintia, 80126 Napoli, Italy
| | - Fabio De Stefano
- Dipartimento di Scienze Chimiche, Università di Napoli Federico II, Complesso Monte S. Angelo, Via Cintia, 80126 Napoli, Italy
| | - Angelo Giordano
- Dipartimento di Scienze Chimiche, Università di Napoli Federico II, Complesso Monte S. Angelo, Via Cintia, 80126 Napoli, Italy
| | - Anna Malafronte
- Dipartimento di Scienze Chimiche, Università di Napoli Federico II, Complesso Monte S. Angelo, Via Cintia, 80126 Napoli, Italy
| | - Giovanni Talarico
- Dipartimento di Scienze Chimiche, Università di Napoli Federico II, Complesso Monte S. Angelo, Via Cintia, 80126 Napoli, Italy
| | - Roberta Cipullo
- Dipartimento di Scienze Chimiche, Università di Napoli Federico II, Complesso Monte S. Angelo, Via Cintia, 80126 Napoli, Italy
| | - Claudio De Rosa
- Dipartimento di Scienze Chimiche, Università di Napoli Federico II, Complesso Monte S. Angelo, Via Cintia, 80126 Napoli, Italy
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Di Francia R, De Lucia V, Giordano A, Benincasa G, Mignano M, Berretta M. Pharmacogenomics as a tool to prevent drug-related hospitalization of elderly cardiology-oncology patients receiving chemotherapeutic agents and multiple symptomatic treatments: a pilot study planned for the Italian health system. Eur Rev Med Pharmacol Sci 2020; 23:8695-8701. [PMID: 31646604 DOI: 10.26355/eurrev_201910_19187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Current precision medicine approaches offer powerful tools to optimize medication regimens; however, the potential impact of these tools in cancer patients with multiple drug treatments has not fully appreciated yet. Here we describe a planning project scheduled to start in the next six months. PATIENTS AND METHODS The overall endpoint of this project is to explore the potential association between the presence of individual genetic profile and severe toxicity rates in so-called "frail" cancer patients, using a nested case-control study design. The pilot study includes the detection of the individual pharmacogenetic profile of 150 (cases), prospect enrolled cancer "frail" patients, and 150 (control) retrospectively paired enrolled individuals. Methods for addressing the primary endpoint include: (a) Evaluation of cost-effectiveness analysis by recording QALY criteria; (b) Data recording by a brief self-administered questionnaire used to evaluate the adherence of a patient's tests and the impact of this genotyping on the patient's adverse drug reactions (ADR); (c) A sample size of paired (for age, gender, education, social status, geriatric syndromes, number of medications and comorbidities) 150 (cases) and 150 (controls); (d) Genotyping method choice by current widely diffuse platforms. RESULTS The investigators believe that genotype screening and the management of the overall cost of health care personalized therapy has the potential to reduce the health care costs of the Italian national health system (SSN). CONCLUSIONS Finally, the innovative issue of this project is to advocate the creation of a new model of the co-operative team (Physicians, pharmacist, geneticist and lab manager) that join for planning the most appropriated personalized therapy for their patient.
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Affiliation(s)
- R Di Francia
- Italian Association of Pharmacogenomics and Molecular Diagnostics (IAPharmagen), Ancona, Italy.
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Patterson EI, Elia G, Grassi A, Giordano A, Desario C, Medardo M, Smith SL, Anderson ER, Prince T, Patterson GT, Lorusso E, Lucente MS, Lanave G, Lauzi S, Bonfanti U, Stranieri A, Martella V, Solari Basano F, Barrs VR, Radford AD, Agrimi U, Hughes GL, Paltrinieri S, Decaro N. Evidence of exposure to SARS-CoV-2 in cats and dogs from households in Italy. Nat Commun 2020; 11:6231. [PMID: 33277505 PMCID: PMC7718263 DOI: 10.1038/s41467-020-20097-0] [Citation(s) in RCA: 237] [Impact Index Per Article: 59.3] [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: 08/04/2020] [Accepted: 11/13/2020] [Indexed: 01/20/2023] Open
Abstract
SARS-CoV-2 emerged from animals and is now easily transmitted between people. Sporadic detection of natural cases in animals alongside successful experimental infections of pets, such as cats, ferrets and dogs, raises questions about the susceptibility of animals under natural conditions of pet ownership. Here, we report a large-scale study to assess SARS-CoV-2 infection in 919 companion animals living in northern Italy, sampled at a time of frequent human infection. No animals tested PCR positive. However, 3.3% of dogs and 5.8% of cats had measurable SARS-CoV-2 neutralizing antibody titers, with dogs from COVID-19 positive households being significantly more likely to test positive than those from COVID-19 negative households. Understanding risk factors associated with this and their potential to infect other species requires urgent investigation.
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Affiliation(s)
- E I Patterson
- Centre for Neglected Tropical Disease, Departments of Vector Biology and Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - G Elia
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - A Grassi
- I-VET srl, Laboratorio di Analisi Veterinarie, Via Ettore Majorana, 10 - 25020, Flero, BS, Italy
| | - A Giordano
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - C Desario
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - M Medardo
- La Vallonèa Veterinary Diagnostic Laboratory, via G. Sirtori 9, 20017, Passirana di Rho, MI, Italy
| | - S L Smith
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - E R Anderson
- Centre for Neglected Tropical Disease, Departments of Vector Biology and Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - T Prince
- NIHR Health Protection Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
| | - G T Patterson
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - E Lorusso
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - M S Lucente
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - G Lanave
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - S Lauzi
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - U Bonfanti
- La Vallonèa Veterinary Diagnostic Laboratory, via G. Sirtori 9, 20017, Passirana di Rho, MI, Italy
| | - A Stranieri
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - V Martella
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - F Solari Basano
- Arcoblu s.r.l., via Alessandro Milesi 5, 20133, Milan, Italy
| | - V R Barrs
- City University's Jockey Club College of Veterinary Medicine and Life Sciences, 5/F, Block 1A, To Yuen Building, 31 To Yuen Street, Kowloon, Hong Kong
| | - A D Radford
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - U Agrimi
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - G L Hughes
- Centre for Neglected Tropical Disease, Departments of Vector Biology and Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - S Paltrinieri
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - N Decaro
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy.
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Tarro Genta F, Dalla Vecchia L, Scalvini S, Sarzi Braga S, Iannuzzi G, Bussotti M, Ceresa M, Rizzo C, Riboni G, Marcassa C, Giordano A, Pedretti R. Residential cardiac rehabilitation (rCR) derived survival predictors in patients after transcatheter aortic valve replacement (TAVR): a retrospective multicenter study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose
To evaluate exercise-based rCR derived outcome predictors in patients referred after TAVR.
Methods
Data of 434 patients (aged 81±6 years) admitted to an average 3-week rCR program after TAVR (walking, up to 30 minutes of cycling or treadmill session twice daily, respiratory and calistenic training) from January 2009 to December 2017 and home discharged, were retrospectively collected at 10 Italian rCR Division of Istituti Clinici Maugeri SpA. Comorbidity (cumulative illness rated state-comorbidity index) (CIRS-CI) score, echocardiography on admission, Disability (Barthel Index) (BI) score, Morse Fall Scale score (MFS), six minutes walking test distance (6MWT) on admission and discharge and maximal training session intensity (MTSI expressed in METs per minutes) were collected. The mortality was assessed up to 3 years after rCR discharge.
Results
During a 3-years follow up there were 120 (28%) deaths. At t-test analysis non survivors compared to survivors had significantly higher CIRS CI (p=0.000), MFS score on admission (p=0.008) and discharge (p=0.017), serum creatinine level on admission (p=0.000) and discharge (p=0.000); moreover they had significantly lower BI score on admission (p=0.000) and discharge (P=0.000), left ventricle ejection fraction (p=0.008),6MWT on admission (p=0.001) and discharge (p=0.000) and MTSI (p=0.022) in comparison to survivors.
At multivariate logistic stepwise analysis, BI score on admission and serum creatinine level at discharge were the only independent predictors of mortality (Table 1); the AUC of the final logistic model was 0.72.
Conclusions
Patients attending rCR after TAVR seem to be very old; overall mortality at 3 years follow up in patients discharged home after rCR is substantial. Disability profile on admission (measured by Barthel Index) and impaired renal function on discharge (measured by creatinine levels) are independently correlated to death at long term follow up.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- F Tarro Genta
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Turin, Italy
| | - L Dalla Vecchia
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Milan, Italy
| | - S Scalvini
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Lumezzane, Italy
| | - S Sarzi Braga
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Tradate, Italy
| | - G.L Iannuzzi
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Telese Terme, Italy
| | - M Bussotti
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Milan, Italy
| | - M Ceresa
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Pavia, Italy
| | - C Rizzo
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Bari, Italy
| | - G Riboni
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Montescano (Pv), Italy
| | - C Marcassa
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Veruno, Italy
| | - A Giordano
- Istituti Clinici Scientifici Maugeri Spa SB, Service of Bioengineering, Veruno, Italy
| | - R.F.E Pedretti
- IRCCS MultiMedica, Cardiology Department, Sesto San Giovanni (MI), Italy
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Soria F, Giordano A, Black P, Fairey A, Cookson M, Yu E, Kassouf W, Dall’Era M, Sridhar S, McGrath J, Wright J, Thorpe A, Morgan T, Daneshmand S, Holzbeierlein J, Bivalacqua T, North S, Barocas D, Lotan Y, Grivas P, Stephenson A, Shah J, van Rhijn B, Spiess P, Shariat S, Gontero P. Neoadjuvant chemotherapy plus radical cystectomy versus radical cystectomy alone in clinical T2 bladder cancer patients without hydronephrosis: results from a large multicenter cohort study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35401-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Siciliano M, Trojano L, De Micco R, Giordano A, Russo A, Tedeschi G, Chiorri C, Tessitore A. Predictors of fatigue severity in early, de novo Parkinson disease patients: A 1-year longitudinal study. Parkinsonism Relat Disord 2020; 79:3-8. [PMID: 32853825 DOI: 10.1016/j.parkreldis.2020.08.019] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/17/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Fatigue is one of the most common and disabling nonmotor symptom in Parkinson's disease (PD). The aim of the present study was to investigate the 1-year course of fatigue in a consecutive sample of de novo drug-naïve patients with PD, and at systematically searching for baseline motor and nonmotor predictors associated with fatigue severity over time. METHODS Fifty-five consecutive de novo PD patients (age: 64.71 ± 7.74 years) underwent a comprehensive examination, including Parkinson Fatigue Scale, Epworth Sleepiness Scale, Parkinson's Disease Sleep Scale, Beck Depression Inventory, Parkinson's Anxiety Scale, Apathy Evaluation Scale, and an extensive neuropsychological evaluation. Bivariate and multiple regression analyses were performed to identify baseline predictors independently related to fatigue severity at 1-year follow-up. RESULTS Prevalence rate of fatigue (defined by PFS cut-off) increased from 22% at baseline to 38% at 1-year follow-up. A similar increase in prevalence was observed for excessive daytime sleepiness, and apathy. Among patients with fatigue at baseline, 91% had fatigue at follow-up too (i.e., persistent fatigue). Multivariate regression analysis identified fatigue (p < 0.01), daytime sleepiness (p < 0.01), and emotional apathy (p < 0.01) as the main baseline variables significantly predicting fatigue severity at 1-year follow-up. CONCLUSION In early PD, fatigue increases and persists over time, and its severity is related to higher baseline levels of fatigue, excessive daytime sleepiness, and emotional apathy. These results warrant to monitor fatigue since the early stage of disease, and suggest that treating excessive daytime sleepiness and emotional apathy might prevent its worsening.
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Affiliation(s)
- M Siciliano
- Department of Advanced Medical and Surgical Sciences - MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy; Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100, Caserta, Italy
| | - L Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100, Caserta, Italy
| | - R De Micco
- Department of Advanced Medical and Surgical Sciences - MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy
| | - A Giordano
- Department of Advanced Medical and Surgical Sciences - MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy
| | - A Russo
- Department of Advanced Medical and Surgical Sciences - MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy
| | - G Tedeschi
- Department of Advanced Medical and Surgical Sciences - MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy
| | - C Chiorri
- Department of Educational Sciences, University of Genova, Genova, Italy
| | - A Tessitore
- Department of Advanced Medical and Surgical Sciences - MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy.
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Migliara G, Di Paolo C, Barbato D, Baccolini V, Salerno C, Nardi A, Alessandri F, Giordano A, Tufi D, Marinelli L, Cottarelli A, De Giusti M, Marzuillo C, De Vito C, Antonelli G, Venditti M, Tellan G, Ranieri MV, Villari P. Multimodal surveillance of healthcare associated infections in an intensive care unit of a large teaching hospital. Ann Ig 2020; 31:399-413. [PMID: 31304521 DOI: 10.7416/ai.2019.2302] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Healthcare-associated infections (HAIs), or nosocomial infections, represent a significant burden in terms of mortality, morbidity, length of stay and costs for patients hospitalized in intensive care units (ICUs). Surveillance systems are recommended by national and international institutions to gather data on HAIs in order to develop and evaluate interventions that reduce the risk of HAIs. STUDY DESIGN Here we describe the methodology and the results of the surveillance system implemented in the ICU of the Policlinico Umberto I, a large teaching hospital in Rome, from April 2016 to October 2018. METHODS The multimodal infection surveillance system integrates four different approaches: i) active surveillance of inpatients; ii) environmental microbiological surveillance; iii) surveillance of isolated microorganisms; and iv) behavioral surveillance of healthcare personnel. Data were collected on catheter-related bloodstream infections, ventilation-associated pneumonia, catheter-associated urinary tract infections and primary bloodstream infections that developed in patients after 48 h in the ICU. For environmental surveillance 14 points were selected for sampling (i.e. bed edges, medication carts, PC keyboards, sink faucets). The system of active surveillance of HAIs also included surveillance of microorganisms, consisting of the molecular genotyping of bacterial isolates by pulsed-field gel electrophoresis (PFGE). From 1 November 2016, monitoring of compliance with guidelines for hand hygiene (HH) and proper glove or gown use by healthcare personnel was included in the surveillance system. After the first six months (baseline phase), a multimodal intervention to improve adherence to guidelines by healthcare personnel was conducted with the ICU staff. RESULTS Overall, 773 patients were included in the active surveillance. The overall incidence rate of device-related HAIs was 14.1 (95% CI: 12.2-16.3) per 1000 patient-days. The monthly device-related HAI incident rate showed a decreasing trend over time, with peaks of incidence becoming progressively lower. The most common bacterial isolates were Klebsiella pneumoniae (20.7%), Acinetobacter baumannii (17.2%), Pseudomonas aeruginosa (13.4%) and Staphylococcus aureus (5.4%). Acinetobacter baumannii and Klebsiella pneumoniae showed the highest proportion of isolates with a multidrug-resistant profile. A total of 819 environmental samples were collected, from which 305 bacterial isolates were retrieved. The most frequent bacterial isolates were Acinetobacter baumannii (27.2%), Staphylococcus aureus (12.1%), Enterococcus faecalis (11.1%), Klebsiella pneumoniae (5.2%) and Pseudomonas aeruginosa (4.7%). All Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae environmental isolates were at least multidrug-resistant. Genotyping showed a limited number of major PFGE patterns for both clinical and environmental isolates of Klebsiella pneumoniae and Acinetobacter baumannii. Behavioral compliance rates significantly improved from baseline to post-intervention phase. CONCLUSIONS By integrating information gathered from active surveillance, environmental microbiological surveillance, surveillance of bacterial isolates and behavioral surveillance of healthcare personnel, the multimodal infection surveillance system returned a precise and detailed view of the infectious risk and microbial ecology of the ICU.
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Affiliation(s)
- G Migliara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Di Paolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - D Barbato
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - V Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Salerno
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Nardi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - F Alessandri
- Department of Anesthesiology and Critical Care, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - A Giordano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - D Tufi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - L Marinelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Cottarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - M De Giusti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - G Antonelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - G Tellan
- Department of Anesthesiology and Critical Care, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - M V Ranieri
- Anesthesia and Intensive Care Medicine, Policlinico di Sant'Orsola, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Patterson EI, Elia G, Grassi A, Giordano A, Desario C, Medardo M, Smith SL, Anderson ER, Prince T, Patterson GT, Lorusso E, Lucente MS, Lanave G, Lauzi S, Bonfanti U, Stranieri A, Martella V, Basano FS, Barrs VR, Radford AD, Agrimi U, Hughes GL, Paltrinieri S, Decaro N. Evidence of exposure to SARS-CoV-2 in cats and dogs from households in Italy. bioRxiv 2020. [PMID: 32743588 DOI: 10.1101/2020.07.21.214346] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
SARS-CoV-2 originated in animals and is now easily transmitted between people. Sporadic detection of natural cases in animals alongside successful experimental infections of pets, such as cats, ferrets and dogs, raises questions about the susceptibility of animals under natural conditions of pet ownership. Here we report a large-scale study to assess SARS-CoV-2 infection in 817 companion animals living in northern Italy, sampled at a time of frequent human infection. No animals tested PCR positive. However, 3.4% of dogs and 3.9% of cats had measurable SARS-CoV-2 neutralizing antibody titers, with dogs from COVID-19 positive households being significantly more likely to test positive than those from COVID-19 negative households. Understanding risk factors associated with this and their potential to infect other species requires urgent investigation. One Sentence Summary SARS-CoV-2 antibodies in pets from Italy.
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Calleris G, Marra G, Zhuang J, Beltrami M, Zhao X, Marquis A, Kan Y, Oderda M, Greco A, Zitella A, Bisconti A, Huang H, Faletti R, Zhang Q, Molinaro L, Falcone M, Cappuccelli S, Wang W, Barale M, Giordano A, Agnello M, Guo H, Gontero P. Transperineal free-hand mpMRI targeted prostate biopsies under local anesthesia: A preliminary analysis of learning curves. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34179-3] [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: 11/17/2022] Open
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Muilwijk T, Akand M, Soria F, Giordano A, Milenkovic U, Moris L, Demaegd L, Devos G, Roussel E, Gevaert T, Van Poppel H, Albersen M, Gontero P, Joniau S. The Cancer Of the Bladder Risk Assessment (COBRA) score for estimating cancer-specific survival after radical cystectomy: External validation in a large bi-institutional European cohort. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33685-5] [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: 10/23/2022] Open
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Oderda M, Rosazza M, Agnello M, Barale M, Calleris G, Ceruti C, Daniele L, Delsedime L, Falcone M, Faletti R, Filippini C, Giordano A, Marquis A, Marra G, Pacchioni D, Gontero P. Natural history of widespread high grade prostatic intraepithelial neoplasia and atypical small acinar proliferation: Should we rebiopsy them all? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32664-1] [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: 11/28/2022] Open
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Soria F, D’Andrea D, Barale M, Moschini M, Abufaraj M, Giordano A, Pizzuto G, Mazzoli S, Debellis M, Shariat S, Gontero P. Skeletal muscle loss predicts oncological outcomes in T1HG patients treated with adjuvant intravesical BCG: Implications for decision-making? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33543-6] [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: 11/28/2022] Open
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Gigante L, Bruno D, Feudo V, Bosello SL, Leccisotti L, Musto A, Cerasuolo PG, Zoli A, Giordano A, Gremese E. THU0306 ROLE OF 18-FDG PET/CT IN DIAGNOSIS AND FOLLOW UP OF LARGE VESSELS VASCULITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:18-FDG PET/CT is a functional imaging method which allows to identify inflammation of vessel walls. The use of PET in large vessels vasculitis(LVV) at disease onset and during follow up is still debate either to confirm clinical remission either to drive the therapy choice. American Society of Nuclear Cardiology (ASNC) recently advanced recommendations aimed to standardize the application of PET in LVV(1).Objectives:The aim of our study was to assess the clinical role of PET performed in patients affected by LVV at the diagnosis and during the follow up.Methods:We retrospectively evaluated PET/CT of 49 patients affected by clinically active LVV according to LVV visual grading (LVG, grading 0-3) and measured the standardized uptake value(SUV) of large vessels. 38 (77,6%) patients were affected by Giant Cells Arteritis and 11(22,4%) by Takayasu Arteritis. 32(65.3%) patients repeated the imaging after a mean follow-up of 11.5±5.4 months.All baseline (T0) and follow up (T1) clinical data of disease activity were collected. Patients were treated according to EULAR LVV management recommendations(2). T0 PET/CT study was performed in patients with a clinically active disease defined by suggestive symptoms/signs and/or high inflammatory markers. The mean disease duration before T1 PET/CT examination was 4 months. T0 PET was performed in 25/49 patients(52%) at the diagnosis of LVV, whereas in 24/49(48%) patients with already diagnosed but active LVV disease.Results:Baseline PET was positive in 21 patients(42.9%). According to ASNC recommendations, 19 patients (38.8%) presented a LVG=3, 2(4.0%) a LVG=2, 6(12.2%) LVG=1 and 22 (44.9%) LVG=0. Patients performing PET at disease onset(75%) had higher LVG score than patients performing PET during the disease course (25%),p=0,002. At T0, aortic, carotid, axillary and subclavian SUV did not correlate with inflammatory markers.Follow up PET/CT studies were performed in 32 patients, 13 (40.6%) with a clinically active disease despite therapy, while 19(59.4%) in clinical remission.Follow up PET was still positive in 8 patients (25%) with a LVG=3, 10 (31.2%) patients presented LVG=1 and 14 (43.8%) LVG=0. T1 PET/CT study showed a significant reduction of SUV values in descending aorta, left and right subclavian arteries, and left and right axillary arteries when compared with first PET/CT study. According to LVG, 12 patients with active PET/CT study at T0 (19 pts) presented a reduction of LVG from score 2 and 3 to grade 1 or 0 (64.2%) at second PET/CT study. Only 3 patients presented an increased LVG score at T1, while in the other 17 patients T1 PET confirmed the previous score. No significant difference was found between LVG scores according with clinical characteristics, but among 8 patients presenting an active T1 PET, 4(50%) were in clinical remission.Conclusion:The use of ASNC recommendations for FDG PET/CT in LVV enables to confirm a metabolically active disease in 40% of patients and in 75% of patients at disease onset, suggesting that post-posing the exam could lead to underrate the real extension of disease. Our data, even if limited, suggest that PET/CT could be crucial in management of patients in clinical remission, detecting patients with still metabolically active LVV. Further prospective studies are necessary to evaluate the role of PET/CT in driving therapeutic strategies.References:[1]Slart R et all - Eur J Nucl Med Mol Imaging, 2018[2]Hellmich et all – Ann Rheum Dis 2018Disclosure of Interests:Laura Gigante: None declared, Dario Bruno: None declared, Vanessa Feudo: None declared, Silvia Laura Bosello Speakers bureau: Abbvie, Pfizer, Boehringer, Lucia Leccisotti: None declared, Alessia Musto: None declared, Pier Giacomo Cerasuolo: None declared, Angelo Zoli: None declared, Alessandro Giordano: None declared, Elisa Gremese Speakers bureau: Abbvie, BMS, Celgene, Jannsen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB
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Solari A, Giordano A, Sastre-Garriga J, Köpke S, Rahn AC, Kleiter I, Aleksovska K, Battaglia MA, Bay J, Copetti M, Drulovic J, Kooij L, Mens J, Meza Murillo ER, Milanov I, Milo R, Pekmezovic T, Vosburgh J, Silber E, Veronese S, Patti F, Voltz R, Oliver D. EAN guideline on palliative care of people with severe, progressive multiple sclerosis. Eur J Neurol 2020; 27:1510-1529. [PMID: 32469447 DOI: 10.1111/ene.14248] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 03/25/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND PURPOSE Patients with severe, progressive multiple sclerosis (MS) have complex physical and psychosocial needs, typically over several years. Few treatment options are available to prevent or delay further clinical worsening in this population. The objective was to develop an evidence-based clinical practice guideline for the palliative care of patients with severe, progressive MS. METHODS This guideline was developed using the Grading of Recommendations Assessment, Development and Evaluation methodology. Formulation of the clinical questions was performed in the Patients-Intervention-Comparator-Outcome format, involving patients, carers and healthcare professionals (HPs). No uniform definition of severe MS exists: in this guideline, constant bilateral support required to walk 20 m without resting (Expanded Disability Status Scale score > 6.0) or higher disability is referred to. When evidence was lacking for this population, recommendations were formulated using indirect evidence or good practice statements were devised. RESULTS Ten clinical questions were formulated. They encompassed general and specialist palliative care, advance care planning, discussing with HPs the patient's wish to hasten death, symptom management, multidisciplinary rehabilitation, interventions for caregivers and interventions for HPs. A total of 34 recommendations (33 weak, 1 strong) and seven good practice statements were devised. CONCLUSIONS The provision of home-based palliative care (either general or specialist) is recommended with weak strength for patients with severe, progressive MS. Further research on the integration of palliative care and MS care is needed. Areas that currently lack evidence of efficacy in this population include advance care planning, the management of symptoms such as fatigue and mood problems, and interventions for caregivers and HPs.
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Affiliation(s)
- A Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A Giordano
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.,Department of Psychology, University of Turin, Turin, Italy
| | - J Sastre-Garriga
- Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Köpke
- Institute of Clinical Nursing Science, University of Cologne, Cologne, Germany.,Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A C Rahn
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - I Kleiter
- Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke gGmbH, Berg, Germany
| | | | - M A Battaglia
- Department of Life Sciences, University of Siena, Siena, Italy
| | - J Bay
- Multiple Sclerosis International Federation, People with MS Advisory Committee, Copenhagen, Denmark
| | - M Copetti
- Unit of Biostatistics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - J Drulovic
- Clinic of Neurology, CCS, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - L Kooij
- Nieuw Unicum, Zandvoort, The Netherlands
| | - J Mens
- Nieuw Unicum, Zandvoort, The Netherlands
| | - E R Meza Murillo
- Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Milanov
- Medical University of Sofia, Sofia, Bulgaria
| | - R Milo
- Department of Neurology, Barzilai Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - T Pekmezovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - J Vosburgh
- Israel Multiple Sclerosis Society, Tel-Aviv, Israel
| | - E Silber
- Department of Neurology, King's College Hospital NHS Foundation Trust, London, UK
| | - S Veronese
- FARO Charitable Foundation, Turin, Italy
| | - F Patti
- Neurology Clinic, Multiple Sclerosis Centre, University Hospital Policlinico Vittorio Emanuele, Catania, Italy
| | - R Voltz
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.,Center for Health Services Research (ZVFK), Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - D Oliver
- The Tizard Centre, University of Kent, Canterbury, UK
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Costamagna P, Giordano A, Lazzarini Y, Delucchi M, Busca G. Process of ammonia removal from anaerobic digestion and associated ammonium sulphate production: Pilot plant demonstration. J Environ Manage 2020; 259:109841. [PMID: 32072955 DOI: 10.1016/j.jenvman.2019.109841] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/25/2019] [Accepted: 11/06/2019] [Indexed: 06/10/2023]
Abstract
A process for the continuous extraction of ammonia from anaerobic digesters is proposed. In this process, a portion of the sludge treated in the digesters is continuously withdrawn and transferred to a thin film evaporator (TFE) unit, where the ammonia is stripped through a biogas stream. The ammonia-rich biogas is treated with a sulfuric acid/water solution in a reactive absorption unit, with production of ammonium sulphate. The chemistry of a CH4/CO2/NH3 gas phase in thermodynamic equilibrium with a liquid sulfuric acid/water solution is investigated theoretically, with focus on the simultaneous absorption of CO2 and NH3 into the liquid phase. Pilot plant experimental data confirm the theoretical results. Further pilot plant experimental results obtained during on-off cycles of the stripping equipment demonstrate that, when the TFE unit is off, ammonia concentration in the digestate rises quickly, while, when the stripping equipment is turned on again, ammonia concentration drops down. On average, during the 180 days of pilot plant experimentation, 4.1 g N-NH4 per kg of sludge fed to the digester, i.e. 19.3 g N-NH4 per kg of total solids (TS) fed to the digester, are stripped from digestate and recovered as ammonium sulphate, demonstrating the feasibility of the proposed concept.
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Affiliation(s)
- P Costamagna
- DCCI, Department of Chemistry and Industrial Chemistry, University of Genoa, Via Dodecaneso 31, 16146 Genoa, Italy.
| | - A Giordano
- Acqua & Sole S.r.l., Via Giulio Natta s.n.c., 27010 Vellezzo Bellini (PV), Italy
| | - Y Lazzarini
- Acqua & Sole S.r.l., Via Giulio Natta s.n.c., 27010 Vellezzo Bellini (PV), Italy
| | - M Delucchi
- DICCA, Department of Civil, Chemical and Environmental Engineering, University of Genoa, Via Opera Pia 15, 16145 Genoa, Italy
| | - G Busca
- DICCA, Department of Civil, Chemical and Environmental Engineering, University of Genoa, Via Opera Pia 15, 16145 Genoa, Italy
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Pisa M, Chieffo R, Giordano A, Gelibter S, Comola M, Comi G, Leocani L. Upper limb motor evoked potentials as outcome measure in progressive multiple sclerosis. Clin Neurophysiol 2020; 131:401-405. [DOI: 10.1016/j.clinph.2019.11.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 10/29/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
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Laffon E, Calcagni ML, Galli G, Giordano A, Capotosti A, Marthan R, Indovina L. Correction to: Comparison of three-parameter kinetic model analysis to standard Patlak’s analysis in 18F-FDG PET imaging of lung cancer patients. EJNMMI Res 2019; 9:30. [PMID: 30915583 PMCID: PMC6435769 DOI: 10.1186/s13550-019-0495-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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