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Lépy MC, Thiam C, Anagnostakis M, Cosar C, de Blas A, Dikmen H, Duch MA, Galea R, Ganea ML, Hurtado S, Karfopoulos K, Luca A, Lutter G, Mitsios I, Persson H, Potiriadis C, Röttger S, Salpadimos N, Savva MI, Sima O, Thanh TT, Townson RW, Vargas A, Vasilopoulou T, Verheyen L, Vidmar T. A benchmark for Monte Carlo simulations in gamma-ray spectrometry Part II: True coincidence summing correction factors. Appl Radiat Isot 2024; 204:111109. [PMID: 38029636 DOI: 10.1016/j.apradiso.2023.111109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023]
Abstract
The goal of this study is to provide a benchmark for the use of Monte Carlo simulation when applied to coincidence summing corrections. The examples are based on simple geometries: two types of germanium detectors and four kinds of sources, to mimic eight typical measurement conditions. The coincidence corrective factors are computed for four radionuclides. The exercise input files and calculation results with practical recommendations are made available for new users on a dedicated webpage.
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Affiliation(s)
- M-C Lépy
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), F-91120, Palaiseau, France.
| | - C Thiam
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), F-91120, Palaiseau, France
| | - M Anagnostakis
- Nuclear Engineering Department, School of Mechanical Engineering, National Technical University of Athens, Iroon Polytechniou 9, 15780, Zografou, Athens, Greece
| | - C Cosar
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 30 Reactorului Street, PO Box MG-6, Magurele, Ilfov County, RO-077125, Romania; Physics Department, University of Bucharest, 405 Atomistilor Str., Magurele, Ilfov County, RO-077125, Romania
| | - A de Blas
- Universitat Politècnica de Catalunya (UPC), Avda. Diagonal, 647, 08028, Barcelona, Spain
| | - H Dikmen
- TENMAK-NUKEN, Nuclear Energy Research Institute, Saray Mahallesi Atom Caddesi No:27, 06980 Kahramankazan, Ankara, Turkey
| | - M A Duch
- Universitat Politècnica de Catalunya (UPC), Avda. Diagonal, 647, 08028, Barcelona, Spain
| | - R Galea
- National Research Council of Canada, 1200 Montreal Road, Ottawa, ON, K1A0R6, Canada
| | - M L Ganea
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 30 Reactorului Street, PO Box MG-6, Magurele, Ilfov County, RO-077125, Romania
| | - S Hurtado
- Dpto. Física Aplicada II, ETSA, Universidad de Sevilla, Avda. Reina Mercedes 2, 41012, Seville, Spain
| | - K Karfopoulos
- Greek Atomic Energy Commission (EEAE), Environmental Radioactivity Monitoring Unit, P.O. Box 60092, 153 10, Agia Paraskevi, Athens, Greece
| | - A Luca
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 30 Reactorului Street, PO Box MG-6, Magurele, Ilfov County, RO-077125, Romania
| | - G Lutter
- European Commission, Joint Research Centre, Retieseweg 111, 2440, Geel, Belgium; Belgium and Department of Environmental Engineering, Technical University of Denmark, DTU, Risø Campus, 4000, Roskilde, Denmark
| | - I Mitsios
- Nuclear Engineering Department, School of Mechanical Engineering, National Technical University of Athens, Iroon Polytechniou 9, 15780, Zografou, Athens, Greece
| | - H Persson
- Mirion Technologies, Inc, 800 Research Parkway, Meriden, CT, 06450, USA
| | - C Potiriadis
- Greek Atomic Energy Commission (EEAE), Environmental Radioactivity Monitoring Unit, P.O. Box 60092, 153 10, Agia Paraskevi, Athens, Greece
| | - S Röttger
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, 38116, Braunschweig, Germany
| | - N Salpadimos
- Greek Atomic Energy Commission (EEAE), Environmental Radioactivity Monitoring Unit, P.O. Box 60092, 153 10, Agia Paraskevi, Athens, Greece
| | - M I Savva
- INRASTES, NCSR "Demokritos", P.O. Box 60037, 15310 Agia Paraskevi, Greece
| | - O Sima
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 30 Reactorului Street, PO Box MG-6, Magurele, Ilfov County, RO-077125, Romania; Physics Department, University of Bucharest, 405 Atomistilor Str., Magurele, Ilfov County, RO-077125, Romania
| | - T T Thanh
- VNUHCM-University of Science, 227, Nguyen Van Cu Street, District 5, Ho Chi Minh City, Viet Nam
| | - R W Townson
- National Research Council of Canada, 1200 Montreal Road, Ottawa, ON, K1A0R6, Canada
| | - A Vargas
- Universitat Politècnica de Catalunya (UPC), Avda. Diagonal, 647, 08028, Barcelona, Spain
| | - T Vasilopoulou
- INRASTES, NCSR "Demokritos", P.O. Box 60037, 15310 Agia Paraskevi, Greece
| | - L Verheyen
- SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, 2400, Mol, Belgium
| | - T Vidmar
- SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, 2400, Mol, Belgium
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Ragonese B, Mularoni A, Valeri A, Campanella M, Corso B, Fazzina ML, Barone MA, Arena G, Lombardo R, Luca A. Reducing Carbapenem-Resistant Enterobacteriaceae Using the Targeted Solution Tool: A Quality Improvement Project. J Nurs Care Qual 2023; 38:47-54. [PMID: 36066885 DOI: 10.1097/ncq.0000000000000651] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Carbapenem-resistant Enterobacteriaceae (CRE) is a worldwide urgent health problem. Hand hygiene (HH) is an effective intervention to reduce the spread of CRE. LOCAL PROBLEM In 2017, an increase in the rate of health care-associated (HA) CRE colonization was observed in a large multiorgan transplant center in Italy. This study aimed to reduce the HA-CRE colonization rates by improving HH compliance. METHODS A pre-/post-intervention project was conducted from November 2017 through December 2020. INTERVENTIONS The DMAIC (Define, Measure, Analyze, Improve, and Control) framework was used to implement the HH Targeted Solution Tool (TST). RESULTS Hand hygiene compliance increased from 49% to 76.9% after the Improve phase ( P = .0001), and to 81.9% after the second Control phase ( P = .0001). The rate of HA-CRE decreased from 24.9% to 5.6% ( P = .0001). CONCLUSIONS Using the DMAIC framework to implement the TST can result in significant improvements in HH compliance and HA-CRE colonization rates.
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Affiliation(s)
- Barbara Ragonese
- Quality and Accreditation Department (Mss Ragonese, Corso, Fazzina, and Barone), Department of Infectious Diseases (Dr Mularoni), and Department of Diagnostic and Therapeutic Services (Dr Luca), Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy; Quality and Accreditation Department, University of Pittsburgh Medical Centre (UPMC), Rome, Italy (Mr Valeri); Infection Control and Infectious Diseases, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy (Ms Campanella); and Corporate Nursing, Technical, and Rehabilitation Services, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy (Messrs Arena and Lombardo)
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Pagano D, Bosch J, Tuzzolino F, Oliva E, Ekser B, Zito G, Cintorino D, di Francesco F, Li Petri S, Ricotta C, Bonsignore P, Calamia S, Magro B, Trifirò G, Alduino R, Barbara M, Conaldi PG, Gallo A, Venuti F, Luca A, Gruttadauria S. Donor Simvastatin Treatment Is Safe and Might Improve Outcomes After Liver Transplantation: A Randomized Clinical Trial. Transplantation 2022; 106:2379-2390. [PMID: 35862782 PMCID: PMC9698118 DOI: 10.1097/tp.0000000000004220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/14/2022] [Accepted: 05/09/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The current curative approaches for ischemia/reperfusion injury on liver transplantation are still under debate for their safety and efficacy in patients with end-stage liver disease. We present the SIMVA statin donor treatment before Liver Transplants study. METHODS SIMVA statin donor treatment before Liver Transplants is a monocentric, double-blind, randomized, prospective tial aiming to compare the safety and efficacy of preoperative brain-dead donors' treatment with the intragastric administration of 80 mg of simvastatin on liver transplant recipient outcomes in a real-life setting. Primary aim was incidence of patient and graft survival at 90 and 180 d posttransplant; secondary end-points were severe complications. RESULTS The trial enrolled 58 adult patients (18-65 y old). The minimum follow-up was 6 mo. No patient or graft was lost at 90 or 180 d in the experimental group (n = 28), whereas patient/graft survival were 93.1% ( P = 0.016) and 89.66% ( P = 0.080) at 90 d and 86.21% ( P = 0.041) and 86.2% ( P = 0.041) at 180 d in the control group (n = 29). The percentage of patients with severe complications (Clavien-Dindo ≥IIIb) was higher in the control group, 55.2% versus 25.0% in the experimental group ( P = 0.0307). The only significant difference in liver tests was a significantly higher gamma-glutamyl transferase and alkaline phosphatase at 15 d ( P = 0.017), ( P = 0.015) in the simvastatin group. CONCLUSIONS Donor simvastatin treatment is safe, and may significantly improve early graft and patient survival after liver transplantation, although further research is mandatory.
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Affiliation(s)
- Duilio Pagano
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center (UPMC) Italy, Palermo, Italy
| | - Jaime Bosch
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fabio Tuzzolino
- Department of Research, IRCCS-ISMETT, UPMC Italy, Palermo, Italy
| | | | - Burcin Ekser
- Division of Transplant Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Giovanni Zito
- Department of Research, IRCCS-ISMETT, UPMC Italy, Palermo, Italy
| | - Davide Cintorino
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center (UPMC) Italy, Palermo, Italy
| | - Fabrizio di Francesco
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center (UPMC) Italy, Palermo, Italy
| | - Sergio Li Petri
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center (UPMC) Italy, Palermo, Italy
| | - Calogero Ricotta
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center (UPMC) Italy, Palermo, Italy
| | - Pasquale Bonsignore
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center (UPMC) Italy, Palermo, Italy
| | - Sergio Calamia
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center (UPMC) Italy, Palermo, Italy
| | - Bianca Magro
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center (UPMC) Italy, Palermo, Italy
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health – University of Verona, Verona, Italy
| | - Rossella Alduino
- Department of Research, IRCCS-ISMETT, UPMC Italy, Palermo, Italy
| | - Marco Barbara
- Department of Research, IRCCS-ISMETT, UPMC Italy, Palermo, Italy
| | | | - Alessia Gallo
- Department of Research, IRCCS-ISMETT, UPMC Italy, Palermo, Italy
| | - Francesca Venuti
- Department of Research, IRCCS-ISMETT, UPMC Italy, Palermo, Italy
| | - Angelo Luca
- Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, UPMC Italy, Palermo, Italy
| | - Salvatore Gruttadauria
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center (UPMC) Italy, Palermo, Italy
- Department of Surgery and Surgical and Medical Specialties, University of Catania, Catania, Italy
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Priola E, Giordana A, Luca A, Eliano D, Lorenza O, Godrath M, Antonio F. The dicyanoaurate supramolecular chemistry: a plethora of opportunities. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322090532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Ragonese B, Denotti V, Re VL, Vizzini G, Corso B, Arena G, Girgenti R, Fazzina ML, Tuzzolino F, Pilato M, Luca A. How to Improve Patients' Perceived Quality of Sleep During Hospitalization Through a Multicomponent "Good Sleep Bundle": A Prospective Before and After Controlled Study. Glob J Qual Saf Healthc 2022; 5:56-64. [PMID: 37261208 PMCID: PMC10228997 DOI: 10.36401/jqsh-22-1] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/26/2022] [Accepted: 06/07/2022] [Indexed: 06/02/2023]
Abstract
Introduction Despite sound evidence on the importance of sleep for human beings and its role in healing, hospitalized patients still experience sleep disruption with deleterious effects. Many factors affecting patients' sleep can be removed or minimized. We evaluated the efficacy of a multicomponent Good Sleep Bundle (GSB) developed to improve patients' perceived quality of sleep, through which we modified environmental factors, timing of nighttime clinical interventions, and actively involved patients in order to positively influence their experience during hospitalization. Methods In a prospective, before and after controlled study, two different groups of 65 patients each were admitted to a cardiothoracic unit in two different periods, receiving the usual care (control group) and the GSB (GSB group), respectively. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) at the admission, discharge, and 30 days after discharge in all patients enrolled. Comparisons between the two groups evaluated changes in PSQI score from admission to discharge (primary endpoint), and from admission to 30 days after discharge (secondary endpoint). Results The mean PSQI score difference between admission and discharge was 4.54 (SD 4.11) in the control group, and 2.05 (SD 4.25) in the GSB group. The mean difference in PSQI score change between the two groups, which was the primary endpoint, was 2.49 (SD 4.19). This difference was highly significant (p = 0.0009). Conclusion The GSB was associated with a highly significant reduction of the negative effects that hospitalization produces on patients' perceived quality of sleep compared with the usual care group.
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Affiliation(s)
- Barbara Ragonese
- Quality and Patient Safety Department, Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione (IRCCS-ISMETT), Palermo, Italy
| | - Valeria Denotti
- Quality and Patient Safety Department, University of Pittsburgh Medical Center (UPMC) Italy, Rome, Italy
| | - Vincenzina Lo Re
- Neurology Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, Palermo, Italy
| | | | - Brigida Corso
- Quality and Patient Safety Department, Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione (IRCCS-ISMETT), Palermo, Italy
| | - Giuseppe Arena
- Corporate Nursing, Technical, and Rehabilitation Services, IRCCS-ISMETT, Palermo, Italy
| | - Rosario Girgenti
- Psychology Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, Palermo, Italy
| | - Maria Luisa Fazzina
- Quality and Patient Safety Department, Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione (IRCCS-ISMETT), Palermo, Italy
| | | | - Michele Pilato
- Cardiac Surgery and Heart Transplantation Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Angelo Luca
- Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, Palermo, Italy
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al 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Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, 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Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Mularoni A, Mikulska M, Barbera F, Graziano E, Medaglia AA, Di Carlo D, Monaco F, Bellavia D, Cascio A, Raffa G, Sciacca S, Luca A, Pilato M, Conaldi PG. Molecular Analysis With 16S rRNA PCR/Sanger Sequencing and Molecular Antibiogram Performed on DNA Extracted From Valve Improve Diagnosis and Targeted Therapy of Infective Endocarditis: A Prospective Study. Clin Infect Dis 2022; 76:e1484-e1491. [PMID: 35686318 PMCID: PMC9907470 DOI: 10.1093/cid/ciac452] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/25/2022] [Accepted: 06/01/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Molecular analysis (MA) on heart valve (HV) improves the microbiologic diagnosis of infectious endocarditis (IE). The main drawback of MA is the lack of antimicrobial susceptibility information. METHODS We conducted a prospective cohort observational study of consecutive adult patients from April 2012 to May 2021 who underwent valve surgery at our hospital. The performance of MA, blood cultures (BC) and valve cultures (VC), and the diagnostic and therapeutic impact of MA were evaluated. Molecular antibiogram results were compared to culture-based antimicrobial susceptibility testing (AST). RESULTS A total of 137 patients with definite IE and 52 patients with no IE were enrolled in the study. Among IE cases BC, VC, and MA were positive in 75 (55%), 30 (22%), and 120 (88%) of IE cases, respectively. Among 62 cases of BC-negative IE (BCNE), 57 achieved diagnosis with MA. MA led to a change of antimicrobial therapy in 92% of BCNE. MA was negative in 100% of patients with no IE. Molecular antibiogram performed on 17 valve specimens that resulted positive for pathogens potential carrier of genes encoding for multidrug resistant mechanisms showed 100% concordance with AST. CONCLUSIONS MA showed a high specificity and sensitivity in etiological diagnosis of IE. Molecular antibiogram could overcome the major limitation of MA that is the lack of susceptibility testing. We advocate for the inclusion of MA among diagnostic criteria for IE and for a more extensive use of molecular antibiogram when the culture result is negative, and MA is the only positive test.
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Affiliation(s)
- Alessandra Mularoni
- Correspondence: A. Mularoni, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Via Ernesto Tricomi 5, 90100, Palermo, Italy ()
| | - Malgorzata Mikulska
- Division of Infectious Diseases, University of Genoa (DISSAL), Genova, Italy,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Floriana Barbera
- Pathology Unit, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy
| | - Elena Graziano
- Infectious Diseases Unit, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy,Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria, ASST-Sette Laghi, Varese, Italy
| | | | - Daniele Di Carlo
- Pathology Unit, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy
| | - Francesco Monaco
- Pathology Unit, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy
| | - Diego Bellavia
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy
| | - Giuseppe Raffa
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy
| | - Sergio Sciacca
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy
| | - Angelo Luca
- Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy
| | - Michele Pilato
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy
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Schlageter V, Badertscher P, Krisai P, Spies F, Luca A, Osswald S, Vesin JM, Kuehne M, Sticherling C, Knecht S. An automatic single beat algorithm to discriminate farfield from nearfield bipolar voltage electrograms from the pulmonary veins. Europace 2022. [DOI: 10.1093/europace/euac053.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): “Stiftung für Herzschrittmacher und Elektrophysiologie” Basel, Switzerland
Background
Confirmation of pulmonary vein (PV) isolation (PVI) during ablation of atrial fibrillation can be challenging due to superimposition of nearfield (NF) PV and farfield (FF) atrial bipolar voltage electrograms (BVE).
Purpose
To develop an automatic algorithm allowing to discriminate PV nearfield (PV-NF) from atrial farfield (atrial-FF) BVE from a circular mapping catheter during cryoballoon (CB) PVI based on a single-heartbeat analysis.
Methods
BVEs from a decapolar inner-lumen diagnostic catheter (Achieve, Medtronic) during CB PVI were manually classified as PV-NF, atrial-FF and combined FF-NF signal based on the characteristics and disappearance of the PV signal during isolation (Figure, upper row). BVE power spectra were computed using the fast Fourier transform (FFT) and the automatic classification of PV-NF, atrial-FF and combined FF-NF signals was performed using the power in different frequency bands (Figure, lower row). Support vector machine classifier was used to identify PV-NF BVE due to its highest predictive accuracy for the two classes PV-NF+ (PV-NF only and combined FF-NF) and PV-NF- (atrial-FF only). Validation of the approach was performed by comparison of a subset of 80 random samples, which were classified in addition by five experienced electrophysiologists.
Results
We analysed a dataset of 355 BVEs from 57 patients. The examples were balanced between the two classes PV-NF+ and PV-NF-. The mean duration (95% CI) of the BVE was 58 ms (26 to 86), 70 ms (50 to 100) and 94 ms (71 to 139) for PV NF, atrial-FF and combined FF-NF, respectively. The overall balanced accuracy including BVE from all PVs was 82.7% (95% CI: 80.3% to 85.1%). The analysis on individual PVs showed an accuracy of 96.6%, 85.2%, 80.8%, and 76.9% for the right inferior, right superior, left inferior and left superior PV, respectively. Validation of the algorithm in the subset of 80 patients showed a comparable accuracy, sensitivity and specificity in PV-NF detection between the automatic algorithm and the experienced electrophysiologists (82.8%, 89.2%, and 76.3%, compared to 85.2%, 91.9%, and 78.5%, respectively).
Conclusion
A reliable automatic based classification algorithm to identify PV-NF BVE could be developed based on a single-beat analysis. Real-time applications as well as using other electrode configurations may improve local signal interpretation.
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Affiliation(s)
- V Schlageter
- University Hospital Basel, Department of Cardiology, Basel, Switzerland
| | - P Badertscher
- University Hospital Basel, Department of Cardiology, Basel, Switzerland
| | - P Krisai
- University Hospital Basel, Department of Cardiology, Basel, Switzerland
| | - F Spies
- University Hospital Basel, Department of Cardiology, Basel, Switzerland
| | - A Luca
- Swiss Federal Institute of Technology of Lausanne, Applied Signal Processing Group, Lausanne, Switzerland
| | - S Osswald
- University Hospital Basel, Department of Cardiology, Basel, Switzerland
| | - JM Vesin
- Swiss Federal Institute of Technology of Lausanne, Applied Signal Processing Group, Lausanne, Switzerland
| | - M Kuehne
- University Hospital Basel, Department of Cardiology, Basel, Switzerland
| | - C Sticherling
- University Hospital Basel, Department of Cardiology, Basel, Switzerland
| | - S Knecht
- University Hospital Basel, Department of Cardiology, Basel, Switzerland
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Luca A, Baskaralingam A, Mccann A, Vesin JM, Pascale P, Le Bloa M, Herrera C, Roten L, Kuhne M, Spies F, Knecht S, Sticherling C, Pruvot E. Amplitude of fibrillatory wave correlates with long-term maintenance of sinus rhythm after ablation in persistent atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Commission for Technology and Innovation (CTI), Switzerland
Background
Amplitude of fibrillatory wave (fWA) on surface ECG is regarded as a predictor of ablation outcome for atrial fibrillation (AF).
Purpose
We sought to investigate whether fWA and its changes during ablation predicts long-term maintenance of sinus rhythm (SR) after wide circumferential isolation of pulmonary veins (WPVI) in persistent AF (peAF).
Methods
41 patients (63±10 y, sustained AF 11±7 months) underwent a de-novo WPVI. A second WPVI was performed in patients with recurrent AF in order to provide complete PV disconnection. We defined "success" as patients who remained in SR after one or two procedures, and "failure" otherwise. 60-sec ECG signals devoid of QRST waves were recorded during the index ablation at baseline and at the end of ablation (end_WPVI, before cardioversion or conversion of AF into SR). fWA was computed on leads V1 and V6b (placed on the pts’ back) as the average difference between the upper and lower envelope of atrial ECG signals.
Results
Over a mean follow-up of 33±9 months, 30 patients remained free from AF (success group), while 11 patients had AF recurrence after 2 WPVIs (failure group). The clinical characteristics (e.g. age, body mass index, left atrial volume or duration in sustained AF) were similar between groups (p > 0.05). The success group displayed significantly higher fWA values at baseline and end_WPVI than that of the failure group (p<0.05, Panel A and B). No significant difference was found between baseline fWA values and those measured at end_WPVI (p > 0.05).
Conclusion
As fWA is independent of PVs contribution, it is a marker of atrial body remodelling. Low fWA values identify patients with peAF unresponsive to WPVI.
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Affiliation(s)
- A Luca
- University Hospital of Lausanne, Lausanne, Switzerland
| | | | - A Mccann
- Swiss Federal Institute of Technology of Lausanne, Lausanne, Switzerland
| | - J-M Vesin
- Swiss Federal Institute of Technology of Lausanne, Lausanne, Switzerland
| | - P Pascale
- University Hospital of Lausanne, Lausanne, Switzerland
| | - M Le Bloa
- University Hospital of Lausanne, Lausanne, Switzerland
| | - C Herrera
- University Hospital of Lausanne, Lausanne, Switzerland
| | - L Roten
- Inselspital - University of Bern, Bern, Switzerland
| | - M Kuhne
- University Hospital Basel, Basel, Switzerland
| | - F Spies
- University Hospital Basel, Basel, Switzerland
| | - S Knecht
- University Hospital Basel, Basel, Switzerland
| | | | - E Pruvot
- University Hospital of Lausanne, Lausanne, Switzerland
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Conoscenti E, Campanella M, Sala A, Di Stefano MC, Vinci D, Lombardo R, Arena G, Ginestra A, Fiolo R, Tuzzolino F, Ippolito A, Martucci G, Enea G, Luca A. Impact of the Organizational Model Adopted during the COVID-19 Pandemic on the Perceived Safety of Intensive Care Unit Staff. J Clin Med 2022; 11:1487. [PMID: 35329813 PMCID: PMC8955264 DOI: 10.3390/jcm11061487] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic had a devastating health, social, and economic effect on the population. Organizational, technical and structural operations aimed at protecting staff, outpatients and inpatients were implemented in an Italian hospital with a COVID-19 dedicated intensive care unit. The impact of the organizational model adopted on the perceived safety among staff was evaluated. METHODS Descriptive, structured and voluntary, anonymous, non-funded, self-administered cross-sectional surveys on the impact of the organizational model adopted during COVID-19 on the perceived safety among staff. RESULTS Response rate to the survey was 67.4% (153 completed surveys). A total of 91 (59%) of respondents had more than three years of ICU experience, while 16 (10%) were employed for less than one year. Group stratification according to profession: 74 nurses (48%); 12 medical-doctors (7%); 11 physiotherapists (7%); 35 nurses-aides (22%); 5 radiology-technicians (3%); 3 housekeeping (1%); 13 other (8%). The organizational model implemented at ISMETT made them feel safe during their workday. A total of 113 (84%) agreed or strongly agreed with the sense of security resulting from the implemented measures. A vast majority of respondents perceived COVID-19 as a dangerous and deadly disease (94%) not only for themselves but even more as vectors towards their families (79%). A total of 55% of staff took isolation measures and moved away from their home by changing personal habits. The organizational model was perceived overall as appropriate (91%) to guarantee their health. CONCLUSION The vast majority of respondents perceived the overall model applied during an unexpected, emergency situation as appropriate.
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Affiliation(s)
- Elena Conoscenti
- Direzione delle Professioni Sanitarie, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy; (E.C.); (M.C.); (R.L.); (G.A.); (A.I.); (G.E.)
| | - Maria Campanella
- Direzione delle Professioni Sanitarie, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy; (E.C.); (M.C.); (R.L.); (G.A.); (A.I.); (G.E.)
| | - Antonino Sala
- Direzione Generale, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy; (A.S.); (F.T.); (A.L.)
| | - Maria Cristina Di Stefano
- Direzione Sanitaria, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy; (M.C.D.S.); (D.V.)
| | - Dario Vinci
- Direzione Sanitaria, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy; (M.C.D.S.); (D.V.)
| | - Rosario Lombardo
- Direzione delle Professioni Sanitarie, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy; (E.C.); (M.C.); (R.L.); (G.A.); (A.I.); (G.E.)
| | - Giuseppe Arena
- Direzione delle Professioni Sanitarie, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy; (E.C.); (M.C.); (R.L.); (G.A.); (A.I.); (G.E.)
| | - Angelo Ginestra
- Ospedale Civico, Via C. Lazzaro 2, 90127 Palermo, Sicily, Italy;
| | - Rosario Fiolo
- Dipartimento BIND, Scuola di Medicina e Chirurgia, Università degli Studi di Palermo, Via del Vespro, 129, 90127 Palermo, Sicily, Italy;
| | - Fabio Tuzzolino
- Direzione Generale, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy; (A.S.); (F.T.); (A.L.)
| | - Alessia Ippolito
- Direzione delle Professioni Sanitarie, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy; (E.C.); (M.C.); (R.L.); (G.A.); (A.I.); (G.E.)
| | - Gennaro Martucci
- Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy
| | - Giuseppe Enea
- Direzione delle Professioni Sanitarie, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy; (E.C.); (M.C.); (R.L.); (G.A.); (A.I.); (G.E.)
| | - Angelo Luca
- Direzione Generale, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti E Terapie Ad Alta Specializzazione), Via E. Tricomi 5, 90127 Palermo, Sicily, Italy; (A.S.); (F.T.); (A.L.)
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Stanga D, Gurau D, Done L, Luca A. A novel virtual point detector model for high purity germanium detectors. Appl Radiat Isot 2022; 181:110107. [DOI: 10.1016/j.apradiso.2022.110107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/14/2021] [Accepted: 01/10/2022] [Indexed: 12/01/2022]
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D'Amico G, Maruzzelli L, Airoldi A, Petridis I, Tosetti G, Rampoldi A, D'Amico M, Miraglia R, De Nicola S, La Mura V, Solcia M, Volpes R, Perricone G, Sgrazzutti C, Vanzulli A, Primignani M, Luca A, Malizia G, Federico A, Dallio M, Andriulli A, Iacobellis A, Addario L, Garcovich M, Gasbarrini A, Chessa L, Salerno F, Gobbo G, Merli M, Ridola L, Baroni GS, Tarantino G, Caporaso N, Morisco F, Pozzoni P, Colli A, Belli LS. Performance of the model for end-stage liver disease score for mortality prediction and the potential role of etiology. J Hepatol 2021; 75:1355-1366. [PMID: 34333100 DOI: 10.1016/j.jhep.2021.07.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/17/2021] [Revised: 07/02/2021] [Accepted: 07/16/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS Although the discriminative ability of the model for end-stage liver disease (MELD) score is generally considered acceptable, its calibration is still unclear. In a validation study, we assessed the discriminative performance and calibration of 3 versions of the model: original MELD-TIPS, used to predict survival after transjugular intrahepatic portosystemic shunt (TIPS); classic MELD-Mayo; and MELD-UNOS, used by the United Network for Organ Sharing (UNOS). We also explored recalibrating and updating the model. METHODS In total, 776 patients who underwent elective TIPS (TIPS cohort) and 445 unselected patients (non-TIPS cohort) were included. Three, 6 and 12-month mortality predictions were calculated by the 3 MELD versions: discrimination was assessed by c-statistics and calibration by comparing deciles of predicted and observed risks. Cox and Fine and Grey models were used for recalibration and prognostic analyses. RESULTS In the TIPS/non-TIPS cohorts, the etiology of liver disease was viral in 402/188, alcoholic in 185/130, and non-alcoholic steatohepatitis in 65/33; mean follow-up±SD was 25±9/19±21 months; and the number of deaths at 3-6-12 months was 57-102-142/31-47-99, respectively. C-statistics ranged from 0.66 to 0.72 in TIPS and 0.66 to 0.76 in non-TIPS cohorts across prediction times and scores. A post hoc analysis revealed worse c-statistics in non-viral cirrhosis with more pronounced and significant worsening in the non-TIPS cohort. Calibration was acceptable with MELD-TIPS but largely unsatisfactory with MELD-Mayo and -UNOS whose performance improved much after recalibration. A prognostic analysis showed that age, albumin, and TIPS indication might be used to update the MELD. CONCLUSIONS In this validation study, the performance of the MELD score was largely unsatisfactory, particularly in non-viral cirrhosis. MELD recalibration and candidate variables for an update to the MELD score are proposed. LAY SUMMARY While the discriminative performance of the model for end-stage liver disease (MELD) score is credited to be fair to good, its calibration, the correspondence of observed to predicted mortality, is still unsettled. We found that application of 3 different versions of the MELD in 2 independent cirrhosis cohorts yielded largely imprecise mortality predictions particularly in non-viral cirrhosis. Thus, we propose a recalibration and suggest candidate variables for an update to the model.
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Affiliation(s)
- Gennaro D'Amico
- Gatroenterology Unit, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy; Gastroenterology Unit, Clinica La Maddalena, Palermo, Italy.
| | - Luigi Maruzzelli
- Radiology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Aldo Airoldi
- Hepatology and Gastroenterology Unit, ASST GOM Niguarda, Milan, Italy
| | - Ioannis Petridis
- Hepatology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Giulia Tosetti
- Gastroenterology and Hepatology Unit Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, Milan, Italy
| | | | - Mario D'Amico
- Radiology Unit, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy; Radiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Miraglia
- Radiology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Stella De Nicola
- Hepatology and Gastroenterology Unit, ASST GOM Niguarda, Milan, Italy
| | - Vincenzo La Mura
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione Luigi Villa, Milan, Italy
| | - Marco Solcia
- Interventional Radiology Unit, ASST GOM Niguarda, Milan, Italy
| | - Riccardo Volpes
- Hepatology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | | | - Cristiano Sgrazzutti
- University of Milan, Department of Oncology and Hemato-oncology and Radiology, Department ASST Niguarda, Milan, Italy
| | - Angelo Vanzulli
- University of Milan, Department of Oncology and Hemato-oncology and Radiology, Department ASST Niguarda, Milan, Italy
| | - Massimo Primignani
- Gastroenterology and Hepatology Unit Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, Milan, Italy
| | - Angelo Luca
- Radiology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Giuseppe Malizia
- Gatroenterology Unit, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Alessandro Federico
- Hepato-Gastroenterology Unit, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Marcello Dallio
- Hepato-Gastroenterology Unit, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Angelo Andriulli
- Department of Gastroenterology and Endoscopy, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Angelo Iacobellis
- Department of Gastroenterology and Endoscopy, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Matteo Garcovich
- Department of Internal Medicine and Gastroenterology, Policlinico Gemelli, Rome, Italy
| | - Antonio Gasbarrini
- Department of Internal Medicine and Gastroenterology, Policlinico Gemelli, Rome, Italy
| | - Luchino Chessa
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Giulia Gobbo
- Internal Medicine Unit, IRCCS Policlinico San Donato, Milano, Italy
| | - Manuela Merli
- Gastroenterology and Hepatology Unit, Department of Translational and Precision Medicine, Università Sapienza, Roma, Italy
| | - Lorenzo Ridola
- Gastroenterology Unit, ASL Latina, Department of Translational and Precision Medicine, "Sapienza" University of Rome, Italy
| | | | - Giuseppe Tarantino
- Liver Injury and Transplant Unit, Polytechnic University of Marche, Ancona, Italy
| | - Nicola Caporaso
- Gastroenterology Unit, Federico II University, Naples, Italy
| | | | - Pietro Pozzoni
- General Medicine Unit,Presidio Ospedaliero, Azienda Socio Sanitaria Territoriale di Lecco, Lecco, Italy
| | - Agostino Colli
- General Medicine Unit,Presidio Ospedaliero, Azienda Socio Sanitaria Territoriale di Lecco, Lecco, Italy
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Romagnoli R, Gruttadauria S, Tisone G, Maria Ettorre G, De Carlis L, Martini S, Tandoi F, Trapani S, Saracco M, Luca A, Manzia TM, Visco Comandini U, De Carlis R, Ghisetti V, Cavallo R, Cardillo M, Grossi PA. Liver transplantation from active COVID-19 donors: A lifesaving opportunity worth grasping? Am J Transplant 2021; 21:3919-3925. [PMID: 34467627 PMCID: PMC8653300 DOI: 10.1111/ajt.16823] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/29/2021] [Accepted: 08/29/2021] [Indexed: 01/25/2023]
Abstract
COVID-19 pandemic dramatically impacted transplantation landscape. Scientific societies recommend against the use of donors with active SARS-CoV-2 infection. Italian Transplant Authority recommended to test recipients/donors for SARS-CoV-2-RNA immediately before liver transplant (LT) and, starting from November 2020, grafts from deceased donors with active SARS-CoV-2 infection were allowed to be considered for urgent-need transplant candidates with active/resolved COVID-19. We present the results of the first 10 LTs with active COVID-19 donors within an Italian multicenter series. Only two recipients had a positive molecular test at LT and one of them remained positive up to 21 days post-LT. None of the other eight recipients was found to be SARS-CoV-2 positive during follow-up. IgG against SARS-CoV-2 at LT were positive in 80% (8/10) of recipients, and 71% (5/7) showed neutralizing antibodies, expression of protective immunity related to recent COVID-19. In addition, testing for SARS-CoV-2 RNA on donors' liver biopsy at transplantation was negative in 100% (9/9), suggesting a very low risk of transmission with LT. Immunosuppression regimen remained unchanged, according to standard protocol. Despite the small number of cases, these data suggest that transplanting livers from donors with active COVID-19 in informed candidates with SARS-CoV-2 immunity, might contribute to safely increase the donor pool.
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Affiliation(s)
- Renato Romagnoli
- Liver Transplant Center -General Surgery 2U, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Giuseppe Tisone
- Surgical Sciences and Medical Sciences, University of Rome-Tor Vergata, Rome, Italy
| | - Giuseppe Maria Ettorre
- POIT Transplant Department, San Camillo Hospital and National Institute for Infectious Diseases L. Spallanzani, Rome, Italy
| | - Luciano De Carlis
- General Surgery and Abdominal Transplantation Unit, Hepatology, University of Milano-Bicocca and Niguarda-Cà Granda Hospital, Milan, Italy
| | - Silvia Martini
- Gastrohepatology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Francesco Tandoi
- Liver Transplant Center -General Surgery 2U, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Silvia Trapani
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
| | - Margherita Saracco
- Gastrohepatology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Angelo Luca
- Abdominal Surgery and Organ Transplantation Unit, ISMETT, Palermo, Italy
| | - Tommaso Maria Manzia
- Surgical Sciences and Medical Sciences, University of Rome-Tor Vergata, Rome, Italy
| | - Ubaldo Visco Comandini
- POIT Transplant Department, San Camillo Hospital and National Institute for Infectious Diseases L. Spallanzani, Rome, Italy
| | - Riccardo De Carlis
- General Surgery and Abdominal Transplantation Unit, Hepatology, University of Milano-Bicocca and Niguarda-Cà Granda Hospital, Milan, Italy
| | - Valeria Ghisetti
- Laboratory of Microbiology and Virology, Ospedale Amedeo di Savoia, ASL “Città di Torino”, Turin, Italy
| | - Rossana Cavallo
- Microbiology and Virology Unit, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Massimo Cardillo
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
| | - Paolo Antonio Grossi
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy,Correspondence Paolo A. Grossi, Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy.
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Mularoni A, Mezzatesta ML, Pilato M, Medaglia AA, Cervo A, Bongiorno D, Aprile A, Luca A, Stefani S, Grossi P. Combination of aztreonam, ceftazidime-avibactam and amikacin in the treatment of VIM-1 Pseudomonas aeruginosa ST235 osteomyelitis. Int J Infect Dis 2021; 108:510-512. [PMID: 34091004 DOI: 10.1016/j.ijid.2021.05.085] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/25/2021] [Accepted: 05/31/2021] [Indexed: 12/27/2022] Open
Abstract
We describe a challenging case of patient with metallo-beta-lactamase-producing Pseudomonas aeruginosa sternal osteomyelitis following aortic valve replacement with biological prosthesis. The strain exhibited a multidrug-resistance phenotype carrying the blaVIM-1 gene and belonged to the high-risk clone sequence type ST235. The patient was successfully treated with surgical debridement plus antibiotic therapy with ceftazidime/avibactam, aztreonam, and amikacin. Time-kill curves showed that this triple antibiotic combination at 1 × MIC was strongly synergic after 8 h, achieving 99.9% killing and maintaining this until 48 h.
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Affiliation(s)
- Alessandra Mularoni
- Department of Infectious Diseases and Infection Control, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy.
| | - Maria Lina Mezzatesta
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, Italy
| | - Michele Pilato
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Alice Annalisa Medaglia
- Department of Infectious Diseases and Infection Control, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Italy
| | - Adriana Cervo
- Department of Infectious Diseases and Infection Control, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Dafne Bongiorno
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, Italy
| | - Ausilia Aprile
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, Italy
| | - Angelo Luca
- Radiology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies, IRCCS-ISMETT, Palermo, Italy
| | - Stefania Stefani
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, Italy
| | - Paolo Grossi
- Infectious Diseases Section, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Conoscenti E, Blot S, Lombardo R, Campanella M, Luca A. Good habits from the pandemic age to bring home: Effective communication and briefing tools. Intensive Crit Care Nurs 2021; 65:103056. [PMID: 33875342 PMCID: PMC8052518 DOI: 10.1016/j.iccn.2021.103056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/15/2021] [Accepted: 03/20/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Elena Conoscenti
- Infectious Disease and Infection Control Service, ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Stijn Blot
- Internal Medicine Department, Ghent University, Belgium
| | | | - Maria Campanella
- Infectious Disease and Infection Control Service, ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Angelo Luca
- IRCCS ISMETT Direttore, Servizi Diagnostici e Terapeutici, IRCCS ISMETT, Italy
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16
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D'Amico G, Perricone G, Morabito A, Latteri F, Filì D, Affronti A, Pietrosi G, Maida M, Rizzo GEM, Bronte F, Petridis I, Bavetta MG, Volpes R, Malizia G, Luca A. Model for end stage liver disease for prediction of mortality in people with cirrhosis. Hippokratia 2021. [DOI: 10.1002/14651858.cd013849] [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: 11/10/2022]
Affiliation(s)
| | - Giovanni Perricone
- S.C. Epatologia e Gastroenterologia; Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda; Milan Italy
| | - Alberto Morabito
- Istituto di Statistica Medica e Biometria; Universita di Milano; Milano Italy
| | | | | | | | | | - Marcello Maida
- Gastroenterology and Endoscopy Unit; S Elia - Raimondi Hospital - Caltanissetta; Caltanissetta Italy
| | | | | | | | | | | | | | - Angelo Luca
- Hepatology; CEO, IRCCS-ISMETT; Palermo Italy
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17
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Nicoară-Farcău O, Han G, Rudler M, Angrisani D, Monescillo A, Torres F, Casanovas G, Bosch J, Lv Y, Thabut D, Fan D, Hernández-Gea V, García-Pagán JC, Abraldes JG, Nevens F, Caca K, Laleman W, Appenrodt B, Luca A, Vinel JP, Mössner J, Di Pascoli M, Zipprich A, Sauerbruch T, Martinez-Lagares F, Ruiz-del-Arbol L, Sierra A, Guevara C, Jimenez E, Marrero JM, Buceta E, Sanchez J, Castellot A, Penate M, Cruz A, Pena E, Procopeț B, Giráldez Á, Amitrano L, Villanueva C, Ibañez-Samaniego L, Silva-Junior G, Martinez J, Genescà J, Trebicka J, Llop E, Palazon JM, Castellote J, Rodrigues S, Gluud LL, Ferreira CN, Barcelo R, Cañete N, Rodríguez M, Ferlitsch A, Mundi JL, Gronbaek H, Hernández-Guerra M, Sassatelli R, Dell’Era A, Senzolo M, Romero-Gómez M, Casas M, Masnou H, Primignani M, Krag A, Calleja JL, Jansen C, Robic MA, Conejo I, Catalina MV, Albillos A, Alvarado E, Guardascione MA, Tanțău M, Zuo L, Zhu X, Zhao J, Xue H, Jiang Z, Zhuge Y, Zhang C, Sun J, Ding P, Ren W, Li Y, Zhang K, Zhang W, He C, Zhong J, Peng Q, Ma F, Luo J, Zhang M, Wang G, Sun M, Dong J, Bai W, Guo W, Wang Q, Yuan X, Wang Z, Yu T, Luo B, Li X, Yuan J, Han N, Zhu Y, Niu J, Li K, Yin Z, Nie Y, Fischer P, Horia Ștefănescu, Pop A, Laursen SB, Turon F, Baiges A, Ferrusquía-Acosta J, Magaz M, Cerda E, Tellez L, Allegretti G, Macedo G, Haldrup D, Santos P, Moura M, Reis D, Meireles L, Sousa P, Alexandrino P, Navascues C, Augustin S, La Mura V, Bañares R, Diaz R, Gómez ML, Ripoll C. Effects of Early Placement of Transjugular Portosystemic Shunts in Patients With High-Risk Acute Variceal Bleeding: a Meta-analysis of Individual Patient Data. Gastroenterology 2021; 160:193-205.e10. [PMID: 32980344 DOI: 10.1053/j.gastro.2020.09.026] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [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: 02/04/2020] [Revised: 08/25/2020] [Accepted: 09/17/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND & AIMS Compared with drugs plus endoscopy, placement of transjugular portosystemic shunt within 72 hours of admission to the hospital (early or preventive transjugular intrahepatic portosystemic shunt [TIPS], also called preemptive TIPS) increases the proportion of high-risk patients with cirrhosis and acute variceal bleeding who survive for 1 year. However, the benefit of preemptive TIPS is less clear for patients with a Child-Pugh score of B and active bleeding (CP-B+AB). We performed an individual data meta-analysis to assess the efficacy of preemptive TIPS in these patients and identify factors associated with reduced survival of patients receiving preemptive TIPS. METHODS We searched publication databases for randomized controlled trials and observational studies comparing the effects of preemptive TIPS versus endoscopy plus nonselective beta-blockers in the specific population of high-risk patients with cirrhosis and acute variceal bleeding (CP-B+AB or Child-Pugh C, below 14 points), through December 31, 2019. We performed a meta-analysis of data from 7 studies (3 randomized controlled trials and 4 observational studies), comprising 1327 patients (310 received preemptive TIPS and 1017 received drugs plus endoscopy). We built adjusted models to evaluate risk using propensity score for baseline covariates. Multivariate Cox regression models were used to assess the factors associated with survival time. The primary endpoint was effects of preemptive TIPS versus drugs plus endoscopy on 1-year survival in the overall population as well as CP-B+AB and Child-Pugh C patients. RESULTS Overall, preemptive TIPS significantly increased the proportion of high-risk patients with cirrhosis and acute variceal bleeding who survived for 1 year, compared with drugs plus endoscopy (hazard ratio [HR] 0.443; 95% CI 0.323-0.607; P < .001). This effect was observed in CP-B+AB patients (HR 0.524; 95% CI 0.307-0.896; P = .018) and in patients with Child-Pugh C scores below 14 points (HR 0.374; 95% CI 0.253-0.553; P < .001). Preemptive TIPS significantly improved control of bleeding and ascites without increasing risk of hepatic encephalopathy in Child-Pugh C and CP-B+AB patients, compared with drugs plus endoscopy. Cox analysis of patients who received preemptive TIPS showed that patients could be classified into 3 categories for risk of death, based on age, serum level of creatinine, and Child-Pugh score. In each of these risk categories, preemptive TIPS increased the proportion of patients who survived for 1 year, compared with drugs plus endoscopy. CONCLUSIONS In a meta-analysis of data from 1327 patients with cirrhosis, acute variceal bleeding, and Child-Pugh score between 10 and 13 points or CP-B+AB, preemptive TIPS increased the proportion who survived for 1 year, in both subgroups separately, compared with drugs plus endoscopy.
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Affiliation(s)
- Oana Nicoară-Farcău
- Regional Institute of Gastroenterology and Hepatology "Octavian Fodor", Hepatology Department and "Iuliu Hatieganu" University of Medicine and Pharmacy, 3rd Medical Clinic, Cluj-Napoca, Romania; Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Barcelona, Spain
| | - Guohong Han
- Department of Liver Diseases and Digestive Interventional Radiology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China
| | - Marika Rudler
- Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Sorbonne University, Paris, France
| | - Debora Angrisani
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Barcelona, Spain
| | - Alberto Monescillo
- Digestive Disease Department, Hospital Universitario Insular de Gran Canaria, Canary Islands
| | - Ferran Torres
- Medical Statistics Core Facility, Institut D'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Barcelona, Spain; Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Georgina Casanovas
- Medical Statistics Core Facility, Institut D'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Barcelona, Spain
| | - Jaime Bosch
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Barcelona, Spain; Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain; Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, Bern University, Bern, Switzerland
| | - Yong Lv
- Department of Liver Diseases and Digestive Interventional Radiology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China
| | - Dominique Thabut
- Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Sorbonne University, Paris, France
| | - Daiming Fan
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China
| | - Virginia Hernández-Gea
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Barcelona, Spain; Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Juan Carlos García-Pagán
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Barcelona, Spain; Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
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Conoscenti E, Martucci G, Piazza M, Tuzzolino F, Ragonese B, Burgio G, Arena G, Blot S, Luca A, Arcadipane A, Chiaramonte G. Post-crisis debriefing: A tool for improving quality in the medical emergency team system. Intensive Crit Care Nurs 2020; 63:102977. [PMID: 33358133 DOI: 10.1016/j.iccn.2020.102977] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To examine clinicians' perception of quality of technical and non-technical response to emergencies and application of post crisis debriefing. DESIGN Descriptive, anonymous, self-reporting survey on the needs and perception of a post-crisis debriefing implementation. SETTING Multi-specialist medical institute in Italy focused on solid organ transplantation and organ failure support. MAIN OUTCOMES Perception of application of guidelines and evaluation of debriefing implementation during in-hospital emergencies. RESULTS Response rate to the survey was 25% (148 health care workers). Of all respondents, 86% were employed >10 years, 75% were involved in ≤5 emergencies over the previous year. Resuscitation guidelines were considered fully applied by 55%; 64% of respondents considered the teaching programme as sufficient. Of all participants, 97% were aware of the importance of teamwork dynamics, 79% were aware of the importance of the personal performance, and 52% considered emergencies as valid opportunities for professional growth. Leadership was considered important by 45% of respondents; debriefing implemented by 41%, and considered a potentially useful tool by 85%. CONCLUSION Post-crisis debriefing is a way to diffuse self-reflective and life-long learning culture; it is perceived as a powerful tool for improving quality of the rapid response system by the vast majority of those surveyed.
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Affiliation(s)
- Elena Conoscenti
- Infectious Disease and Infection Control Service, ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Gennaro Martucci
- Department of Anesthesia and Intensive Care, ISMETT, Palermo, Italy
| | - Marcello Piazza
- Department of Anesthesia and Intensive Care, ISMETT, Palermo, Italy
| | | | | | - Gaetano Burgio
- Department of Anesthesia and Intensive Care, ISMETT, Palermo, Italy
| | - Giuseppe Arena
- Department of Nursing and Healthcare Professionals, ISMETT, Palermo, Italy
| | - Stijn Blot
- Internal Medicine Department, Ghent University, Belgium
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Martucci G, Volpes R, Panarello G, Tuzzolino F, Di Carlo D, Ricotta C, Gruttadauria S, Conaldi PG, Luca A, Amrein K, Arcadipane A. Vitamin D levels in liver transplantation recipients and early postoperative outcomes: Prospective observational DLiverX study. Clin Nutr 2020; 40:2355-2363. [PMID: 33158589 DOI: 10.1016/j.clnu.2020.10.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/16/2020] [Accepted: 10/17/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS In critically ill patients with liver disease, vitamin D deficiency is associated with higher disease severity, increased frequency of infections, and worse outcomes. This study sought to describe the trend of vitamin D in orthotopic liver transplantation (OLT) recipients and its association with outcomes. METHODS Prospective observational study of 67 consecutive OLT recipients enrolled between September, 2016 and August, 2017 at IRCCS-ISMETT, Palermo (Italy). Trend of vitamin D levels and potential factors influencing it levels were evaluated through a generalized linear mixed regression model. RESULTS Sixty-four (95.5%) recipients were vitamin D deficient (<20 ng/ml), with a median value of 8.8 ng/ml [6.2-12.9], and forty-seven of these (70.1%) showed severe deficiency (<12 ng/ml) at baseline, 7.9 ng/ml [5.4-8.9]. The baseline vitamin D showed an inverse correlation with liver disease severity: Child-Pugh, MELD score, bilirubin, INR, and organ failure (p < 0.01) at baseline. Vitamin D increased on postoperative day (POD) 28 compared with POD1: +4.5 ng/ml, C.I. 95% 3.6-5.3 ng/ml, p < 0.01. Lower baseline vitamin D, donor age, transfusion of fresh frozen plasma (negative impact, all p < 0.05), and intra-operative bypass (positive impact at POD 28, p < 0.01) were associated with variation of vitamin D levels after transplantation. Incomplete graft recovery was associated with lower vitamin D on POD28: 8.2 ± 4.4 versus 13.8 ± 9.4 ng/ml, p < 0.01; the odds ratio (OR) was 0.84; CI 95% 0.73-0.97, p = 0.014. The OR for infections within POD 28 was inversely associated with baseline vitamin D: 0.87; CI 95% 0.79-0.98, p = 0.02, and with vitamin D level at baseline <12 ng/ml: OR 6.44; CI 95% 1.66-24.94; p < 0.01. CONCLUSIONS Preoperative Vitamin D is correlated with disease severity, and was highly associated with invasive infection in the first 28 PODs. After OLT, the value on POD 28 had a strong association with graft function.
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Affiliation(s)
- Gennaro Martucci
- Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy.
| | - Riccardo Volpes
- Hepatology and Gastroenterology Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Giovanna Panarello
- Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Fabio Tuzzolino
- Research Office, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Daniele Di Carlo
- Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Calogero Ricotta
- Abdominal Surgery and Organ Transplantation Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Salvatore Gruttadauria
- Abdominal Surgery and Organ Transplantation Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Pier Giulio Conaldi
- CEO, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Angelo Luca
- CEO, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Karin Amrein
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Antonio Arcadipane
- Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
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Pietrosi G, Fernández-Iglesias A, Pampalone M, Ortega-Ribera M, Lozano JJ, García-Calderó H, Abad-Jordà L, Conaldi PG, Parolini O, Vizzini G, Luca A, Bosch J, Gracia-Sancho J. Human amniotic stem cells improve hepatic microvascular dysfunction and portal hypertension in cirrhotic rats. Liver Int 2020; 40:2500-2514. [PMID: 32996708 DOI: 10.1111/liv.14610] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 04/24/2020] [Revised: 07/07/2020] [Accepted: 07/10/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Portal hypertension is the main consequence of cirrhosis, responsible for the complications defining clinical decompensation. The only cure for decompensated cirrhosis is liver transplantation, but it is a limited resource and opens the possibility of regenerative therapy. We investigated the potential of primary human amniotic membrane-derived mesenchymal stromal (hAMSCs) and epithelial (hAECs) stem cells for the treatment of portal hypertension and decompensated cirrhosis. METHODS In vitro: Primary liver sinusoidal endothelial cells (LSECs) and hepatic stellate cells (HSCs) from cirrhotic rats (chronic CCl4 inhalation) were co-cultured with hAMSCs, hAECs or vehicle for 24 hours, and their RNA profile was analysed. In vivo: CCl4-cirrhotic rats received 4x106 hAMSCs, 4x106 hAECs, or vehicle (NaCl 0.9%) (intraperitoneal). At 2-weeks we analysed: a) portal pressure (PP) and hepatic microvascular function; b) LSECs and HSCs phenotype; c) hepatic fibrosis and inflammation. RESULTS In vitro experiments revealed sinusoidal cell phenotype amelioration when co-cultured with stem cells. Cirrhotic rats receiving stem cells, particularly hAMSCs, had significantly lower PP than vehicle-treated animals, together with improved liver microcirculatory function. This hemodynamic amelioration was associated with improvement in LSECs capillarization and HSCs de-activation, though hepatic collagen was not reduced. Rats that received amnion derived stem cells had markedly reduced hepatic inflammation and oxidative stress. Finally, liver function tests significantly improved in rats receiving hAMSCs. CONCLUSIONS This preclinical study shows that infusion of human amniotic stem cells effectively decreases PP by ameliorating liver microcirculation, suggesting that it may represent a new treatment option for advanced cirrhosis with portal hypertension.
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Affiliation(s)
- Giada Pietrosi
- Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione, IRCCS-ISMETT, Palermo, Italy
| | - Anabel Fernández-Iglesias
- Liver Vascular Biology Research Group, Hepatic Hemodynamic Lab. IDIBAPS-Hospital Clínic, CIBEREHD, Barcelona, Spain
| | | | - Martí Ortega-Ribera
- Liver Vascular Biology Research Group, Hepatic Hemodynamic Lab. IDIBAPS-Hospital Clínic, CIBEREHD, Barcelona, Spain
| | - Juan J Lozano
- Liver Vascular Biology Research Group, Hepatic Hemodynamic Lab. IDIBAPS-Hospital Clínic, CIBEREHD, Barcelona, Spain
| | - Héctor García-Calderó
- Liver Vascular Biology Research Group, Hepatic Hemodynamic Lab. IDIBAPS-Hospital Clínic, CIBEREHD, Barcelona, Spain
| | - Laia Abad-Jordà
- Liver Vascular Biology Research Group, Hepatic Hemodynamic Lab. IDIBAPS-Hospital Clínic, CIBEREHD, Barcelona, Spain
| | - Pier G Conaldi
- Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione, IRCCS-ISMETT, Palermo, Italy
| | - Ornella Parolini
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo A. Gemelli, Rome, Italy.,Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Vizzini
- Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione, IRCCS-ISMETT, Palermo, Italy
| | - Angelo Luca
- Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione, IRCCS-ISMETT, Palermo, Italy
| | - Jaime Bosch
- Liver Vascular Biology Research Group, Hepatic Hemodynamic Lab. IDIBAPS-Hospital Clínic, CIBEREHD, Barcelona, Spain.,Hepatology, Department for Biomedical Research, University of Bern, Bern, Switzerland
| | - Jordi Gracia-Sancho
- Liver Vascular Biology Research Group, Hepatic Hemodynamic Lab. IDIBAPS-Hospital Clínic, CIBEREHD, Barcelona, Spain.,Hepatology, Department for Biomedical Research, University of Bern, Bern, Switzerland
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Maccora S, Smorlesi G, Volpes R, Sparacia G, Marrone G, Gruttadauria S, Luca A, Lo Re V. Acute and reversible Pisa syndrome as unusual presentation of portosystemic encephalopathy. Clin Neurol Neurosurg 2020; 196:106040. [PMID: 32629329 DOI: 10.1016/j.clineuro.2020.106040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/24/2022]
Affiliation(s)
- S Maccora
- Neurology Service, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT) Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - G Smorlesi
- Neurology Service, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT) Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - R Volpes
- Hepatology Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
| | - G Sparacia
- Radiology Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
| | - G Marrone
- Radiology Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
| | - S Gruttadauria
- Abdominal Surgery and Organ Transplantation Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - A Luca
- Radiology Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
| | - V Lo Re
- Neurology Service, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT) Via Ernesto Tricomi 5, 90127, Palermo, Italy.
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22
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Mularoni A, Adamoli L, Polidori P, Ragonese B, Gioè SM, Pietrosi A, Tuzzolino F, Guadagnino G, Monaco F, Grossi PA, Conaldi PG, Luca A, Mikulska M. How can we optimise antifungal use in a solid organ transplant centre? Local epidemiology and antifungal stewardship implementation: A single-centre study. Mycoses 2020; 63:746-754. [PMID: 32358860 DOI: 10.1111/myc.13098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/15/2020] [Accepted: 04/27/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE We aimed to implement and to assess the impact of the antifungal stewardship programme (AFSp) on prescription appropriateness of antifungals, management and outcomes of candidaemia patients, and antifungal consumption and costs at our solid organ transplant (SOT) institute. METHODS Local epidemiology of invasive fungal infections (IFIs) from 2009 to 2017 was analysed in order to prepare an effective AFSp, implemented in January 2018. It included suspension of empirical antifungal prescriptions after 72 hours (antifungal time-out), automated alert and infectious disease (ID) consult for empirical prescriptions and for every patient with IFI, and indication for step-down to oral fluconazole when possible. We used process measures and results measures to assess the effects of the implemented programme. RESULTS The ASFp led to significant improvements in selection of the appropriate antifungal (40.5% in pre-AFS vs 78.6% in post-AFS), correct dosing (51.2% vs 79.8%), correct length of treatment (55.9% vs 75%) and better management of patients with candidaemia. Analysis of prescribed empirical antifungal revealed that defined daily doses (DDDs) per 100 patient days decreased by 36.7% in 2018 compared to the average of pre-AFSp period, with important savings in costs. CONCLUSION This AFSp led to a better use of antifungal drugs in terms of appropriateness and consumption, with stable clinical and microbiological outcomes in patients with IFI.
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Affiliation(s)
- Alessandra Mularoni
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Lucia Adamoli
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Piera Polidori
- Clinical Pharmacy Service, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Barbara Ragonese
- Department of Accreditation and Quality, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Santi Mauro Gioè
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Astrid Pietrosi
- Department of Management Control and Decision Support, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Fabio Tuzzolino
- Research Office, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Giuliana Guadagnino
- Department of Infectious and Tropical Diseases, St. Annunziata Hospital, Cosenza, Italy
| | - Francesco Monaco
- Laboratory of Clinical Pathology, Microbiology, and Virology, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Paolo Antonio Grossi
- Clinica delle Malattie Infettive e Tropicali, Università degli Studi dell'Insubria, Varese, Italy
| | - Pier Giulio Conaldi
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Angelo Luca
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - Malgorzata Mikulska
- Division of Infectious Diseases, University of Genoa (DISSAL) and Ospedale Policlinico San Martino, Genoa, Italy
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23
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Ricotta C, Cintorino D, Pagano D, Bonsignore P, Piazza S, di Francesco F, Li Petri S, Tropea A, Calamia S, Salis P, Luca A, Gruttadauria S. Enhanced Recovery after Implementation of Surgery Protocol in Living Kidney Donors: The ISMETT Experience. Transplant Proc 2019; 51:2910-2913. [DOI: 10.1016/j.transproceed.2019.04.089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/15/2019] [Accepted: 04/03/2019] [Indexed: 01/26/2023]
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24
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Sima O, De Vismes Ott A, Dias MS, Dryak P, Ferreux L, Gurau D, Hurtado S, Jodlowski P, Karfopoulos K, Koskinas MF, Laubenstein M, Lee YK, Lépy MC, Luca A, Menezes MO, Moreira DS, Nikolič J, Peyres V, Saganowski P, Savva MI, Semmler R, Solc J, Thanh TT, Tyminska K, Tyminski Z, Vidmar T, Vukanac I, Yucel H. Consistency test of coincidence-summing calculation methods for extended sources. Appl Radiat Isot 2019; 155:108921. [PMID: 31629294 DOI: 10.1016/j.apradiso.2019.108921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/08/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022]
Abstract
An internal consistency test of the calculation of coincidence-summing correction factors FC for volume sources is presented. The test is based on exact equations relating the values of FC calculated for three ideal measurement configurations. The test is applied to a number of 33 sets of FC values sent by 21 teams. Most sets passed the test, but not the results obtained using the quasi-point source approximation; in the latter case the test qualitatively indicated the magnitude of the bias of FC.
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Affiliation(s)
- O Sima
- Physics Department, University of Bucharest, Bucharest-Magurele, Romania; Horia Hulubei National Institute for R & D in Physics and Nuclear Engineering (IFIN-HH), Bucharest-Magurele, Romania.
| | | | - M S Dias
- Nuclear Metrology Laboratory, Nuclear and Energy Research Institute - IPEN-CNEN/SP, São Paulo, Brazil
| | - P Dryak
- Czech Metrology Institute, Brno, Czech Republic
| | - L Ferreux
- IRSN / PSE-ENV / SAME / LMN, Vésinet, France
| | - D Gurau
- Horia Hulubei National Institute for R & D in Physics and Nuclear Engineering (IFIN-HH), Bucharest-Magurele, Romania
| | - S Hurtado
- University of Sevilla, Sevilla, Spain
| | - P Jodlowski
- Faculty of Physics and Applied Computer Science, AGH University of Science and Technology, Cracow, Poland
| | - K Karfopoulos
- Greek Atomic Energy Commission, Environmental Radioactivity Monitoring Department, Athens, Greece
| | - M F Koskinas
- Nuclear Metrology Laboratory, Nuclear and Energy Research Institute - IPEN-CNEN/SP, São Paulo, Brazil
| | - M Laubenstein
- Laboratori Nazionali del Gran Sasso, Istituto Nazionale di Fisica Nucleare, Assergi, Italy
| | - Y K Lee
- DEN/DANS/DM2S/SERMA, CEA-Saclay, France
| | - M C Lépy
- Laboratoire National Henri Becquerel, CEA Saclay, France
| | - A Luca
- Horia Hulubei National Institute for R & D in Physics and Nuclear Engineering (IFIN-HH), Bucharest-Magurele, Romania
| | - M O Menezes
- Nuclear Metrology Laboratory, Nuclear and Energy Research Institute - IPEN-CNEN/SP, São Paulo, Brazil
| | - D S Moreira
- Nuclear Metrology Laboratory, Nuclear and Energy Research Institute - IPEN-CNEN/SP, São Paulo, Brazil
| | - J Nikolič
- Laboratory for Radiation Measurements, Department of Radiation and Environmental Protection, Vinča Institute of Nuclear Sciences, Belgrade, Serbia
| | - V Peyres
- Laboratorio de Metrología de Radiaciones Ionizantes, CIEMAT, Madrid, Spain
| | | | - M I Savva
- INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - R Semmler
- Nuclear Metrology Laboratory, Nuclear and Energy Research Institute - IPEN-CNEN/SP, São Paulo, Brazil
| | - J Solc
- Czech Metrology Institute, Brno, Czech Republic
| | - T T Thanh
- University of Science, VNU-HCM, Faculty of Physics & Engineering Physics, Department of Nuclear Physics, Ho Chi Minh City, Viet Nam
| | - K Tyminska
- Radioisotope Centre, POLATOM, NCBJ, Poland
| | - Z Tyminski
- Radioisotope Centre, POLATOM, NCBJ, Poland
| | - T Vidmar
- SCK•CEN, Belgian Nuclear Research Centre, Boeretang 200, 2400, Mol, Belgium
| | - I Vukanac
- Laboratory for Radiation Measurements, Department of Radiation and Environmental Protection, Vinča Institute of Nuclear Sciences, Belgrade, Serbia
| | - H Yucel
- Ankara University, Institute of Nuclear Sciences, Ankara, Turkey
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25
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Pithon A, Luca A, Buttu A, Vesin JM, Roten L, Kuhne M, Spiess F, Knecht S, Sticherling C, Park CI, Pascale P, Le Bloa M, Herrera C, Pruvot E. P979Persistent atrial fibrillation terminated within the left atrium without recurrence at follow-up demonstrates a gradual intracardiac organization during stepwise ablation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0572] [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
Introduction
We previously reported that patients (pts) with recurrence (Rec) after stepwise catheter ablation (step-CA) of persistent atrial fibrillation (pAF) exhibit high bi-atrial intracardiac dominant frequencies (DF) values before ablation, indicative of a severe bi-atrial electro-anatomical remodeling.
Purpose
Herein, we hypothesized that a gradual decrease in DF values during step-CA is associated with pAF termination and maintenance of sinus rhythm (SR) on the long term.
Method
In 40 consecutive pts (61±8 yo, sustained AF duration 19±11 months), pulmonary vein isolation (PVI) and left atrium (LA) ablation were performed until pAF termination or cardioversion. 10-sec intracardiac electrograms (EGMs) epochs were recorded before ablation (BL), during PVI and during complex fractionated atrial electrograms (CFAEs) and linear ablation (post_PVI) in the right atrial (RAA) and left atrial (LAA) appendages and in the coronary sinus (CS). DF was defined as the highest peak within the [3–15] Hz EGM spectrum. Rec was defined as any atrial arrhythmia lasting >30 sec during follow-up (FU).
Results
pAF was terminated within the LA in 70% (28/40, LT) of the pts, while 30% (12/40, NLT) were not. After a mean FU of 34±14 months, all NLT pts had a Rec, while LT pts presented a Rec in 71% (20/28, LT_rec) and remained in SR in 29% (8/28, LT_norec). Figure 1 shows: 1) a gradient in DF values measured in the LAA (panel A), RAA (panel B) and CS (panel C) with the highest values in NLT pts (red), intermediate values in LT_rec pts (yellow) and lowest DF values in LT_norec pts (green); 2) all three groups displayed a gradual intracardiac organization during LA ablation as shown by decreasing DF values (p<0.05, BL vs post_PVI), but the LT_norec pts (green) exhibited the highest relative changes in DF from BL (p<0.05, LT_norec vs NLT, Δ range: −5.31 to −9.69%).
Figure 1. Effect of ablation on DF
Conclusion
Low DF values before ablation and gradual intracardiac organization until pAF termination are associated with maintenance of SR on the long term.
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Affiliation(s)
- A Pithon
- University Hospital Centre Vaudois (CHUV), Service of Cardiology, Lausanne, Switzerland
| | - A Luca
- University Hospital Centre Vaudois (CHUV), Service of Cardiology, Lausanne, Switzerland
| | - A Buttu
- Swiss Federal Institute of Technology of Lausanne, ASPG, Lausanne, Switzerland
| | - J M Vesin
- Swiss Federal Institute of Technology of Lausanne, ASPG, Lausanne, Switzerland
| | - L Roten
- Bern University Hospital, Service of Cardiology, Bern, Switzerland
| | - M Kuhne
- University Hospital Basel, Service of Cardiology, Basel, Switzerland
| | - F Spiess
- University Hospital Basel, Service of Cardiology, Basel, Switzerland
| | - S Knecht
- University Hospital Basel, Service of Cardiology, Basel, Switzerland
| | - C Sticherling
- University Hospital Basel, Service of Cardiology, Basel, Switzerland
| | - C I Park
- La Tour Hospital, Department of Cardiology, Geneva, Switzerland
| | - P Pascale
- University Hospital Centre Vaudois (CHUV), Service of Cardiology, Lausanne, Switzerland
| | - M Le Bloa
- University Hospital Centre Vaudois (CHUV), Service of Cardiology, Lausanne, Switzerland
| | - C Herrera
- University Hospital Centre Vaudois (CHUV), Service of Cardiology, Lausanne, Switzerland
| | - E Pruvot
- University Hospital Centre Vaudois (CHUV), Service of Cardiology, Lausanne, Switzerland
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26
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Lépy MC, Thiam C, Anagnostakis M, Galea R, Gurau D, Hurtado S, Karfopoulos K, Liang J, Liu H, Luca A, Mitsios I, Potiriadis C, Savva MI, Thanh TT, Thomas V, Townson RW, Vasilopoulou T, Zhang M. A benchmark for Monte Carlo simulation in gamma-ray spectrometry. Appl Radiat Isot 2019; 154:108850. [PMID: 31476556 DOI: 10.1016/j.apradiso.2019.108850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 04/12/2019] [Revised: 07/04/2019] [Accepted: 08/08/2019] [Indexed: 10/26/2022]
Abstract
Monte Carlo (MC) simulation is widely used in gamma-ray spectrometry, however, its implementation is not always easy and can provide erroneous results. The present action provides a benchmark for several MC software for selected cases. The examples are based on simple geometries, two types of germanium detectors and four kinds of sources, to mimic eight typical measurement conditions. The action outputs (input files and efficiency calculation results, including practical recommendations for new users) are made available on a dedicated webpage.
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Affiliation(s)
- M C Lépy
- CEA, LIST, Laboratoire National Henri Becquerel (LNE-LNHB), Bât. 602 PC 111, CEA-Saclay 91191 Gif-sur-Yvette Cedex, France.
| | - C Thiam
- CEA, LIST, Laboratoire National Henri Becquerel (LNE-LNHB), Bât. 602 PC 111, CEA-Saclay 91191 Gif-sur-Yvette Cedex, France
| | - M Anagnostakis
- Nuclear Engineering Department, National Technical University of Athens, 15870 Athens, Greece
| | - R Galea
- National Research Council of Canada - 1200 Montreal Road - Ottawa ON, K1A0R6, Canada
| | - D Gurau
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 30 Reactorului Street, PO Box MG-6, Magurele, Ilfov County, RO, 077125, Romania
| | - S Hurtado
- Universidad de Sevilla, Servicio de Radioisotopos, CITIUS, Avda. Reina Mercedes 4, SP-41012, Sevilla, Spain
| | - K Karfopoulos
- Greek Atomic Energy Commission EEAE- Patriarchou Grigorio & Neapoleos - P.O. Box 60092- P.C. 15341, Agia Paraskevi, Athens, Greece
| | - J Liang
- Ionizing Radiation Devision National Institute of Metrology, No.18, Bei San Huan Dong Lu, Chao Yang District, Beijing, China
| | - H Liu
- Ionizing Radiation Devision National Institute of Metrology, No.18, Bei San Huan Dong Lu, Chao Yang District, Beijing, China
| | - A Luca
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 30 Reactorului Street, PO Box MG-6, Magurele, Ilfov County, RO, 077125, Romania
| | - I Mitsios
- Nuclear Engineering Department, National Technical University of Athens, 15870 Athens, Greece
| | - C Potiriadis
- Greek Atomic Energy Commission EEAE- Patriarchou Grigorio & Neapoleos - P.O. Box 60092- P.C. 15341, Agia Paraskevi, Athens, Greece
| | - M I Savva
- INRASTES, NCSR "DEMOKRITOS" - Terma Patriarchou Grigoriou & Neapoleos - 153 10 Ag. Paraskevi, Athens, Greece
| | - T T Thanh
- University of Science, VNU-HCM, Faculty of Physics & Engineering Physics, Department of Nuclear Physics-Nuclear Engineering, 227, Nguyen Van Cu Street, Ward 4, District 5, Ho Chi Minh City, Viet Nam
| | - V Thomas
- CEA, DAM, DIF, F-91297, Arpajon, France
| | - R W Townson
- National Research Council of Canada - 1200 Montreal Road - Ottawa ON, K1A0R6, Canada
| | - T Vasilopoulou
- INRASTES, NCSR "DEMOKRITOS" - Terma Patriarchou Grigoriou & Neapoleos - 153 10 Ag. Paraskevi, Athens, Greece
| | - M Zhang
- Ionizing Radiation Devision National Institute of Metrology, No.18, Bei San Huan Dong Lu, Chao Yang District, Beijing, China
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27
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Mularoni A, Martucci G, Douradinha B, Campanella O, Hazen B, Medaglia A, Arena G, Gruttadauria S, Tuzzolino F, Arcadipane A, Gioè S, Luca A, Conaldi PG, Grossi P, Gridelli B. Epidemiology and successful containment of a carbapenem-resistant Enterobacteriaceae outbreak in a Southern Italian Transplant Institute. Transpl Infect Dis 2019; 21:e13119. [PMID: 31112353 DOI: 10.1111/tid.13119] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 01/24/2019] [Revised: 04/29/2019] [Accepted: 05/12/2019] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Carbapenem-resistant enterobacteriaceae (CRE) infections are difficult to treat and pose a serious threat to solid organ transplant (SOT) recipients. At our institute we observed an infection burden in 2012. METHODS In order to contain the spread of CRE infections, we established a taskforce to implement guidelines suggested by the Centers for Disease Control and Prevention (CDC) for this type of outbreak. Here, we describe the epidemiology of the outbreak in our SOT population, and the effectiveness of such interventions, by comparing levels of CRE hospital-acquired infection (HAI) pre- and post-task force intervention (from January 2009 to December 2012, and from September 2013 to December 2016, respectively) through a linear regression model. RESULTS In this study, we included 933 patients who underwent a total of 1017 SOT procedures, 286 of whom had a CRE-positive culture (28.8%), of which 65 (22.7% of CRE positive) developed infection. One-year mortality post-SOT was significantly higher in patients with CRE infection. After the taskforce intervention, the CRE HAI rate in SOT showed a significant inverse trend (event rate: -1.28, CI -1.70 to 0.86; P < 0.01). CONCLUSION In the paucity of treatment options, the application of CDC measures in our SOT institute contributed significantly to containing CRE infections.
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Affiliation(s)
| | | | | | | | - Benjamin Hazen
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
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28
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Miraglia R, Maruzzelli L, Mamone G, Luca A. Percutaneous recanalization of a segmental inferior vena cava occlusion in a patient with situs viscerum inversus and symptomatic Budd-Chiari syndrome. Dig Liver Dis 2019; 51:909. [PMID: 30885534 DOI: 10.1016/j.dld.2019.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/11/2019] [Accepted: 02/13/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Roberto Miraglia
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy.
| | - Luigi Maruzzelli
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Giuseppe Mamone
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Angelo Luca
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
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Pagano D, Barbera F, Conaldi PG, Seidita A, Di Francesco F, Di Carlo D, Bàrbara M, Tuzzolino F, Luca A, Gruttadauria S. Role of Allelic Imbalance in Predicting Hepatocellular Carcinoma (HCC) Recurrence Risk After Liver Transplant. Ann Transplant 2019; 24:223-233. [PMID: 31015392 PMCID: PMC6500106 DOI: 10.12659/aot.913692] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 12/15/2022] Open
Abstract
Background One of the most controversial problems for liver transplantation in patients affected by hepatocellular carcinoma (HCC) remains the lack of an oncologic staging system to predict cancer recurrence after liver transplantation (LT). We analyzed allelic imbalance (AI) in 19 microsatellites, and assessed the post-LT HCC recurrence risk. Material/Methods Seventy-one patients were included; 18 had tumor recurrence within 5 years post-transplant. Molecular analysis was done in the primary HCC and peripheral blood samples: a total of 19 microsatellites was used to assess AI. Specific AI was evaluated when outside of range value between 0.66 and 1.5. Based on data in the literature, we grouped the 19 microsatellites into 4 panels. We calculated the fractional allelic imbalance (FAI) to make comparisons between different panels including different subsets of microsatellites. Results We report that AI was associated with HCC recurrence in 3 main loci (D3S2303, D9S251, and D9S254). Tumor recurrence was associated only with 2 specific panels with 9 microsatellites previously reported to be associated with high risk for HCC recurrence. Our data show that fractional allelic imbalance (FAI) index has good negative ability to predict HCC recurrence (Panel 2: negative predictive value of 95%). Conclusions AI analysis could have prognostic value in risk management of HCC recurrence after LT, especially for early recurrence.
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Affiliation(s)
- Duilio Pagano
- Department for Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and High Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Floriana Barbera
- Department of Laboratory Medicine and Advanced Biotechnologies, Mediterranean Institute for Transplantation and High Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Pier Giulio Conaldi
- Department of Laboratory Medicine and Advanced Biotechnologies, Mediterranean Institute for Transplantation and High Specialization Therapies (IRCCS-ISMETT), Palermo, Italy.,Ri.MED Foundation, Palermo, Italy
| | - Aurelio Seidita
- Department for Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and High Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Fabrizio Di Francesco
- Department for Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and High Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Daniele Di Carlo
- Department for Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and High Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Marco Bàrbara
- Department for Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and High Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Fabio Tuzzolino
- Research Office, Mediterranean Institute for Transplantation and High Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Angelo Luca
- Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and High Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Salvatore Gruttadauria
- Department for Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and High Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
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Raffa GM, Agnello F, Occhipinti G, Miraglia R, Lo Re V, Marrone G, Tuzzolino F, Arcadipane A, Pilato M, Luca A. Neurological complications after cardiac surgery: a retrospective case-control study of risk factors and outcome. J Cardiothorac Surg 2019; 14:23. [PMID: 30683130 PMCID: PMC6347812 DOI: 10.1186/s13019-019-0844-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/14/2019] [Indexed: 11/14/2022] Open
Abstract
Background To evaluate incidence, risk factors, and outcomes of postoperative neurological complications in patients undergoing cardiac surgery. Methods A total of 2121 patients underwent cardiac surgery between August, 2008 and December, 2013; 91/2121 (4.3%) underwent brain computed tomography (70/91, 77%) or magnetic resonance imaging (21/91, 23%) scan because of major stroke (37/2121, 1.7%) and a spectrum of transient neurological episodes as well as transient ischemic attacks and delirium /psychosis/seizures (54/2121, 2.5%). The mean age was 65.3 ± 12.1 years and 60 (65.9%) were male. Variables were compared among study- and matched-patients (n = 113) without neurological deficits. Results A total of 37/2121 (1.7%) patients had imaging evidence of stroke. Radiological examinations were done 5.72 ± 3.6 days after surgery. Patients with and without imaging evidence of stroke had longer intensive care unit length of stay (LOS) (13.8 ± 14.7 and 12.9 ± 15 days vs. 5.7 ± 12.1 days, respectively (p < 0.001) and hospital LOS (53 ± 72.8 and 35.5 ± 29.8 days vs. 18.4 ± 29.2 days, respectively (p < 0.001) than the control group. The hospital mortality of patients with and without imaging evidence of stroke was higher than the control group (7/37 patients [19%], and 12/54 patients [22%] vs. 4/115 patients [3%], respectively (p < 0.001). Multivariate analysis showed that bilateral internal carotid artery stenosis of any grade (p < .001), and re-do operations (p = .013) increased the risk of postoperative neurological complications. Conclusions Neurological complications after cardiac surgery increase hospitalization and mortality even in patients without radiologic evidence of stroke. Bilateral internal carotid artery stenosis of any grade, suggesting a diffuse patient propensity toward atherosclerosis, and re-do operations increase the risk of postoperative neurological complications.
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Affiliation(s)
- Giuseppe Maria Raffa
- Cardiac Surgery and Heart Transplantation Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127, Palermo, Italy.
| | - Francesco Agnello
- Diagnostic and Therapeutic Services, Radiology Unit, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), via Tricomi 5, Palermo, 90127, Italy
| | - Giovanna Occhipinti
- Department of Anesthesia and Critical Care, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), via Tricomi 5, Palermo, 90127, Italy
| | - Roberto Miraglia
- Diagnostic and Therapeutic Services, Radiology Unit, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), via Tricomi 5, Palermo, 90127, Italy
| | - Vincenzina Lo Re
- Neurology Service, Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT, via Tricomi 5, Palermo, 90127, Italy
| | - Gianluca Marrone
- Diagnostic and Therapeutic Services, Radiology Unit, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), via Tricomi 5, Palermo, 90127, Italy
| | - Fabio Tuzzolino
- Statistician, Research Office, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Via Tricomi 5, 90127, Palermo, Italy
| | - Antonio Arcadipane
- Department of Anesthesia and Critical Care, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), via Tricomi 5, Palermo, 90127, Italy
| | - Michele Pilato
- Cardiac Surgery and Heart Transplantation Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127, Palermo, Italy
| | - Angelo Luca
- Diagnostic and Therapeutic Services, Radiology Unit, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), via Tricomi 5, Palermo, 90127, Italy
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Tárkányi FT, Ignatyuk AV, Hermanne A, Capote R, Carlson BV, Engle JW, Kellett MA, Kibédi T, Kim GN, Kondev FG, Hussain M, Lebeda O, Luca A, Nagai Y, Naik H, Nichols AL, Nortier FM, Suryanarayana SV, Takács S, Verpelli M. Recommended nuclear data for medical radioisotope production: diagnostic positron emitters. J Radioanal Nucl Chem 2019. [DOI: 10.1007/s10967-018-6380-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Pagano D, Oliva E, Khouzam S, Tuzzolino F, Cintorino D, Li Petri S, di Francesco F, Ricotta C, Bonsignore P, Tropea A, Calamia S, Costanzo F, Luca A, Gruttadauria S. The addition of simvastatin administration to cold storage solution of explanted whole liver grafts for facing ischemia/reperfusion injury in an area with a low rate of deceased donation: a monocentric randomized controlled double-blinded phase 2 study. BMC Surg 2018; 18:122. [PMID: 30587165 PMCID: PMC6307270 DOI: 10.1186/s12893-018-0455-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 08/14/2018] [Accepted: 12/07/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Liver transplantation is the best treatment for end-stage liver disease. The interruption of the blood supply to the donor liver during cold storage damages the liver, affecting how well the liver will function after transplant. The drug Simvastatin may help to protect donor livers against this damage and improve outcomes for transplant recipients. The aim of this study is to evaluate the benefits of treating the donor liver with Simvastatin compared with the standard transplant procedure. PATIENT AND METHODS We propose a prospective, double-blinded, randomized phase 2 study of 2 parallel groups of eligible adult patients. We will compare 3-month, 6-month, and 12-month graft survival after LT, in order to identify a significant relation between the two homogenous groups of LT patients. The two groups only differ by the Simvastatin or placebo administration regimen while following the same procedure, with identical surgical instruments, and medical and nursing skilled staff. To reach these goals, we determined that we needed to recruit 106 patients. This sample size achieves 90% power to detect a difference of 14.6% between the two groups survival using a one-sided binomial test. DISCUSSION This trial is designed to confirm the effectiveness of Simvastatin to protect healthy and steatotic livers undergoing cold storage and warm reperfusion before transplantation and to evaluate if the addition of Simvastatin translates into improved graft outcomes. TRIAL REGISTRATION ISRCTN27083228 .
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Affiliation(s)
- Duilio Pagano
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center) Italy, Via E. Tricomi 5, 90127 Palermo, Italy
| | | | - Simone Khouzam
- Sidney Kimmel Medical College - Thomas Jefferson University, Philadelphia, PA USA
| | | | - Davide Cintorino
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center) Italy, Via E. Tricomi 5, 90127 Palermo, Italy
| | - Sergio Li Petri
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center) Italy, Via E. Tricomi 5, 90127 Palermo, Italy
| | - Fabrizio di Francesco
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center) Italy, Via E. Tricomi 5, 90127 Palermo, Italy
| | - Calogero Ricotta
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center) Italy, Via E. Tricomi 5, 90127 Palermo, Italy
| | - Pasquale Bonsignore
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center) Italy, Via E. Tricomi 5, 90127 Palermo, Italy
| | - Alessandro Tropea
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center) Italy, Via E. Tricomi 5, 90127 Palermo, Italy
| | - Sergio Calamia
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center) Italy, Via E. Tricomi 5, 90127 Palermo, Italy
| | - Federico Costanzo
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center) Italy, Via E. Tricomi 5, 90127 Palermo, Italy
| | - Angelo Luca
- Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, UPMC Italy, Palermo, Italy
| | - Salvatore Gruttadauria
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center) Italy, Via E. Tricomi 5, 90127 Palermo, Italy
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Alexa-Stratulat T, Gafton B, Marinca M, Paduraru M, Luca A, Afrasanie V, Miron L. P1.12-16 Management of Elderly Small-Cell Lung Cancer Patients in a Romanian Tertiary Care Center. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.851] [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: 11/25/2022]
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Lo Re V, Petridis I, Živković S, Burgio G, Mularoni A, Milazzo M, Sparacia G, Volpes R, Luca A, Gruttadauria S. Guillain-Barré syndrome after orthotopic liver transplantation: A clinical manifestation of immune reconstitution inflammatory syndrome? Clin Neurol Neurosurg 2018; 173:140-143. [PMID: 30125836 DOI: 10.1016/j.clineuro.2018.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/27/2018] [Accepted: 07/29/2018] [Indexed: 11/18/2022]
Abstract
Guillain-Barrè Syndrome, as part of the spectrum of dysimmune neuropathies, is unexpected to occur in immunocompromised hosts. We describe a clinical case of Guillain-Barrè syndrome, occurred a few weeks after a liver transplant, and we postulate that our case would satisfy all requirements to explain this peripheral nervous system complication as a clinical manifestation of an Immune reconstitution inflammatory syndrome. In this setting of liver transplantation, complicated by potentially multiple infective triggers, reduction of immunosuppression and reversal of pathogen-induced immunosuppression, through antimicrobial therapy, may have led to pro-inflammatory response. The pro-inflammatory pattern would have sustained the pathophysiologic mechanism of this immune neuropathy.
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Affiliation(s)
- Vincenzina Lo Re
- Neurology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
| | - Ioannis Petridis
- Hepatology Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - Saša Živković
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA
| | - Gaetano Burgio
- Department of Anesthesia and Intensive Care, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - Alessandra Mularoni
- Infectious Disease and Infection Control Service, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - Mariapina Milazzo
- Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - Gianvincenzo Sparacia
- Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - Riccardo Volpes
- Hepatology Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - Angelo Luca
- Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - Salvatore Gruttadauria
- Abdominal Surgery and Organ Transplantation Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
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Vella S, Conaldi PG, Cova E, Meloni F, Liotta R, Cuzzocrea S, Martino L, Bertani A, Luca A, Vitulo P. Lung resident mesenchymal cells isolated from patients with the Bronchiolitis Obliterans Syndrome display a deregulated epigenetic profile. Sci Rep 2018; 8:11167. [PMID: 30042393 PMCID: PMC6057887 DOI: 10.1038/s41598-018-29504-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 07/09/2018] [Indexed: 12/13/2022] Open
Abstract
Bronchiolitis Obliterans Syndrome is the major determinant of the graft function loss after lung transplantation, but its pathogenesis is still incompletely understood and currently available therapeutic strategies are poorly effective. A deeper understanding of its pathogenic mechanisms is crucial for the development of new strategies to prevent and treat this devastating complication. In this study, we focused on the mesenchymal stromal cells, recently recognized as BOS key effectors, and our primary aim was to identify their epigenetic determinants, such as histone modifications and non-coding RNA regulation, which could contribute to their differentiation in myofibroblasts. Interestingly, we identified a deregulated expression of histone deacetylases and methyltransferases, and a microRNA-epigenetic regulatory network, which could represent novel targets for anti-fibrotic therapy. We validated our results in vitro, in a cell model of fibrogenesis, confirming the epigenetic involvement in this process and paving the way for a new application for epigenetic drugs.
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Affiliation(s)
- Serena Vella
- Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy.
- Anemocyte S.r.l, Gerenzano, Italy.
| | - Pier Giulio Conaldi
- Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Emanuela Cova
- Department of Respiratory Diseases, IRCCS San Matteo Foundation and University of Pavia, Pavia, Italy
| | - Federica Meloni
- Department of Respiratory Diseases, IRCCS San Matteo Foundation and University of Pavia, Pavia, Italy
| | - Rosa Liotta
- Department of Diagnostic and Therapeutic Services, Pathology Service, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Lavinia Martino
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Alessandro Bertani
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Angelo Luca
- Department of Diagnostic and Therapeutic Services, Radiology Service, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Patrizio Vitulo
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
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Pagano D, Panarello G, Tuzzolino F, Barbara M, Cintorino D, Tropea A, Luca A, Gruttadauria S. Impact of Basiliximab Induction in Adult Recipient Survival at 60 Months after Liver Retransplantation Procedure. Transplantation 2018. [DOI: 10.1097/01.tp.0000544014.55148.81] [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: 11/25/2022]
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Sciacca G, Nicoletti A, Mostile G, Luca A, Raciti L, Dibilio V, Drago F, Salomone S, Zappia M. Blink reflex recovery cycle to differentiate progressive supranuclear palsy from corticobasal syndrome. Eur J Neurol 2018; 25:1100-e85. [PMID: 29754397 DOI: 10.1111/ene.13673] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 05/03/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) may share similar clinical findings and tests to distinguish between the two disorders could be useful. We evaluated the blink reflex and R2 blink reflex recovery cycle (R2BRRC), determining diagnostic sensitivity, specificity and positive and negative predictive value of R2BRRC in differentiating patients with PSP from those with CBS. METHODS This was a prospective data collection study investigating blink reflex and R2BRRC at interstimulus intervals (ISIs) of 100, 150, 200, 300, 400, 500 and 750 ms in 12 patients with PSP, eight patients with CBS and 10 controls. RESULTS Patients with PSP have earlier recruitment of R2BRRC as compared with patients with CBS (ISI: 100 ms, P = 0.002; 150 ms, P < 0.001; 200 ms, P < 0.001; 300 ms, P = 0.02) and controls (ISI: 100 ms, P < 0.001; 150 ms, P < 0.001; 200 ms, P < 0.001; 300 ms, P = 0.004). The presence of an early recovery of the R2 differentiated PSP from CBS with a specificity and sensitivity of 87.5% and 91.7%, respectively. CONCLUSIONS The R2BRRC curve might be considered to be a useful tool in differentiating patients with PSP from those with CBS.
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Affiliation(s)
- G Sciacca
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - A Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - G Mostile
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - A Luca
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - L Raciti
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - V Dibilio
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - F Drago
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
| | - S Salomone
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
| | - M Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
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Cessna JT, Fitzgerald R, Zimmerman BE, Laureano-Pérez L, Bergeron DE, van Wyngaardt F, Smith M, Jackson T, Howe B, da Silva CJ, Iwahara A, da Cruz PAL, Zhang M, Liu H, Liang J, Fréchou C, Bobin C, Cassette P, Kossert K, Nähle O, Marganiec-Gałązka J, Joseph L, Ravindra A, Kulkarni DN, Yunoki A, Sato Y, Lee KB, Lee JM, Agung, Dziel T, Listkowska A, Tymiński Z, Sahagia M, Antohe A, Ioan MR, Luca A, Krivosek M, Ometakova J, Javornik A, Zalesakova M, García-Toraño Martinez E, Roteta M, Mejuto M, Nedjadi Y, Juget F, Yuan MC, Yeh CY, Yeltepe E, Dirican A, Keightley J, Pearce A. Results of an international comparison of activity measurements of 68Ge. Appl Radiat Isot 2018; 134:385-390. [PMID: 29248210 PMCID: PMC10996930 DOI: 10.1016/j.apradiso.2017.10.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/30/2017] [Accepted: 10/30/2017] [Indexed: 11/25/2022]
Abstract
An international key comparison, identifier CCRI(II)-K2.Ge-68, has been performed. The National Institute of Standards and Technology (NIST) served as the pilot laboratory, distributing aliquots of a 68Ge/68Ga solution. Results for the activity concentration, CA, of 68Ge at a reference date of 12h00 UTC 14 November 2014 were submitted by 17 laboratories, encompassing many variants of coincidence methods and liquid-scintillation counting methods. The first use of 4π(Cherenkov)β-γ coincidence and anticoincidence methods in an international comparison is reported. One participant reported results by secondary methods only. Two results, both utilizing pure liquid-scintillation methods, were identified as outliers. Evaluation using the Power-Moderated Mean method results in a proposed Comparison Reference Value (CRV) of 621.7(11)kBqg-1, based on 14 results. The degrees of equivalence and their associated uncertainties are evaluated for each participant. Several participants submitted 3.6mL ampoules to the BIPM to link the comparison to the International Reference System (SIR) which may lead to the evaluation of a Key Comparison Reference Value and associated degrees of equivalence.
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Affiliation(s)
- J T Cessna
- Physical Measurements Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA.
| | - R Fitzgerald
- Physical Measurements Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - B E Zimmerman
- Physical Measurements Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - L Laureano-Pérez
- Physical Measurements Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - D E Bergeron
- Physical Measurements Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - F van Wyngaardt
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
| | - M Smith
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
| | - T Jackson
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
| | - B Howe
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
| | - C J da Silva
- Laboratório Nacional de Metrologia das Radiações Ionizantes, Instituto de Radioproteção e Dosimetria, Rio de Janeiro, Brazil
| | - A Iwahara
- Laboratório Nacional de Metrologia das Radiações Ionizantes, Instituto de Radioproteção e Dosimetria, Rio de Janeiro, Brazil
| | - P A L da Cruz
- Laboratório Nacional de Metrologia das Radiações Ionizantes, Instituto de Radioproteção e Dosimetria, Rio de Janeiro, Brazil
| | - M Zhang
- National Institute of Metrology, Beijing, China
| | - H Liu
- National Institute of Metrology, Beijing, China
| | - J Liang
- National Institute of Metrology, Beijing, China
| | - C Fréchou
- Laboratoire national de métrologie et d'essais - Laboratoire national Henri Becquerel, Gif-sur-Yvette cedex, France
| | - C Bobin
- Laboratoire national de métrologie et d'essais - Laboratoire national Henri Becquerel, Gif-sur-Yvette cedex, France
| | - P Cassette
- Laboratoire national de métrologie et d'essais - Laboratoire national Henri Becquerel, Gif-sur-Yvette cedex, France
| | - K Kossert
- Physikalisch-Technische Bundesanstalt, Braunschweig, Germany
| | - O Nähle
- Physikalisch-Technische Bundesanstalt, Braunschweig, Germany
| | | | - L Joseph
- Bhabha Atomic Research Centre, Mumbai, India
| | - A Ravindra
- Bhabha Atomic Research Centre, Mumbai, India
| | | | - A Yunoki
- National Metrology Institute of Japan, AIST, Tsukuba, Japan
| | - Y Sato
- National Metrology Institute of Japan, AIST, Tsukuba, Japan
| | - K B Lee
- Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
| | - J M Lee
- Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
| | - Agung
- Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
| | - T Dziel
- National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock, Poland
| | - A Listkowska
- National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock, Poland
| | - Z Tymiński
- National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock, Poland
| | - M Sahagia
- National Institute of Research and Development for Physics and Nuclear Engineering "Horia Hulubei", Bucarest - Magurele, Romania
| | - A Antohe
- National Institute of Research and Development for Physics and Nuclear Engineering "Horia Hulubei", Bucarest - Magurele, Romania
| | - M-R Ioan
- National Institute of Research and Development for Physics and Nuclear Engineering "Horia Hulubei", Bucarest - Magurele, Romania
| | - A Luca
- National Institute of Research and Development for Physics and Nuclear Engineering "Horia Hulubei", Bucarest - Magurele, Romania
| | - M Krivosek
- Slovenský Metrologický Ústav, Bratislava, Slovakia
| | - J Ometakova
- Slovenský Metrologický Ústav, Bratislava, Slovakia
| | - A Javornik
- Slovenský Metrologický Ústav, Bratislava, Slovakia
| | - M Zalesakova
- Slovenský Metrologický Ústav, Bratislava, Slovakia
| | | | - M Roteta
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid, Spain
| | - M Mejuto
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid, Spain
| | - Y Nedjadi
- Institut Universitaire de Radiophysique Appliquée, Lausanne, Switzerland
| | - F Juget
- Institut Universitaire de Radiophysique Appliquée, Lausanne, Switzerland
| | - M-C Yuan
- Institute of Nuclear Energy Research, Taoyuan County, Taiwan
| | - C Y Yeh
- Institute of Nuclear Energy Research, Taoyuan County, Taiwan
| | - E Yeltepe
- Turkish Atomic Energy Authority, Lodumlu - Ankara, Turkey
| | - A Dirican
- Turkish Atomic Energy Authority, Lodumlu - Ankara, Turkey
| | - J Keightley
- National Physical Laboratory, Teddington, United Kingdom
| | - A Pearce
- National Physical Laboratory, Teddington, United Kingdom
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Degiorgio S, Gerasia R, Liotta F, Maruzzelli L, Cortis K, Miraglia R, Luca A. Radiation Doses to Operators in Hepatobiliary Interventional Procedures. Cardiovasc Intervent Radiol 2018; 41:772-780. [PMID: 29344710 DOI: 10.1007/s00270-017-1870-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 04/27/2017] [Accepted: 12/29/2017] [Indexed: 01/18/2023]
Abstract
PURPOSE The primary aim of this study is to provide a summary of operators' radiation doses during hepatobiliary fluoroscopic guided procedures. In addition, patient dose in these procedures was also documented. MATERIALS AND METHODS A total of 283 transarterial chemoembolisation (TACE) and 302 biliary procedures, including 52 percutaneous transhepatic cholangiogram (PTC), 36 bilioplasty and 214 biliary catheter changes (BCC) performed over 14 months, were included. Electronic personal dosimeters were used to measure operator radiation doses. Effective dose (E) was calculated using modified Niklason algorithm. Patient dose was measured as dose area product (DAP) and fluoroscopy time (FT). RESULTS For TACE, E for radiologist ranged between 0 and 9.96 µSv, for radiographer 0-0.99 µSv and for nurse 0-4.65 µSv. The patient DAP and FT ranged between 1.5 and 421.9 Gy cm2 and 1.91-67.25 min. For PTC, E for the radiologist ranged between 0.33 and 55.89 µSv, for radiographer 0-38.61 µSv and for nurse 0-3.18 µSv. Patient DAP and FT ranged between 1.7 and 218.4 Gy cm2 and 2.07-71.53 min. For bilioplasty, E ranged between 0.09 and 9.24 µSv for radiologist, 0-0.84 µSv for radiographer and 0-1.38 µSv for nurse. The patients' DAP and FT ranged from 0.7 to 52.54 Gy cm2 and 1.13-24.47 min. For BCC, E ranged from 0 to 12.78 µSv for radiologist, 0-8.43 µSv for radiographer and 0-4.05 µSv for nurse. Patient DAP and FT ranged between 0.12 and 117.3 Gy cm2 and 0.57-15.83 min. CONCLUSIONS This study shows that doses to all operators performing hepatobiliary interventional procedures can be very low.
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Affiliation(s)
- Sarah Degiorgio
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy.,Medical Imaging Department, Mater Dei Hospital, Triq Dun Karm, Birkirkara, Malta
| | - Roberta Gerasia
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - Ferdinanda Liotta
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - Luigi Maruzzelli
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - Kelvin Cortis
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy.,Medical Imaging Department, Mater Dei Hospital, Triq Dun Karm, Birkirkara, Malta
| | - Roberto Miraglia
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
| | - Angelo Luca
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
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40
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Miraglia R, Maruzzelli L, Degiorgio S, Luca A. Transjugular intrahepatic portosystemic shunt in a patient with Caroli's disease and portal cavernoma. Dig Liver Dis 2017; 49:1375. [PMID: 28606758 DOI: 10.1016/j.dld.2017.05.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 05/16/2017] [Accepted: 05/17/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Roberto Miraglia
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy.
| | - Luigi Maruzzelli
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy
| | - Sarah Degiorgio
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy
| | - Angelo Luca
- Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy
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41
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Mularoni A, Gallo A, Riva G, Barozzi P, Miele M, Cardinale G, Vizzini G, Volpes R, Grossi P, Di Carlo D, Luca A, Trenti T, Luppi M, Conaldi PG. Successful Treatment of Kaposi Sarcoma-Associated Herpesvirus Inflammatory Cytokine Syndrome After Kidney-Liver Transplant: Correlations With the Human Herpesvirus 8 miRNome and Specific T Cell Response. Am J Transplant 2017; 17:2963-2969. [PMID: 28489271 DOI: 10.1111/ajt.14346] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 04/20/2017] [Accepted: 04/27/2017] [Indexed: 01/25/2023]
Abstract
After transplant, patient infection with human herpesvirus 8 (HHV-8) and Kaposi sarcoma-associated herpesvirus (KSHV) is known to cause aggressive tumors and severe nonneoplastic complications. These latter syndromes are driven by HHV-8/KSHV lytic reactivations and related hyperinflammatory host responses typically characterized by high viral loads, elevated levels of cytokines and other inflammation biomarkers, cytopenia, organ failure, high fever, and worsening conditions (with no evidence of B cell neoplasias). These disorders are associated with a high mortality rate, often due to lack of prompt diagnosis, effective therapeutic approaches, and adequate follow-up. These features resemble most of those defining the so-called KSHV-associated inflammatory cytokine syndrome (KICS), which was recently recognized in patients positive for human immunodeficiency virus (HIV). In this report, we describe-for the first time-a case of a KICS-like nonneoplastic recurrent complication occurring after transplant in an HIV-negative patient that was successfully treated by a combination of anti-CD20 monoclonal therapy, antivirals, and modification of the immunosuppressive regimen. In addition to clinical and laboratory findings collected during 3-year follow-up, we report novel experimental data on HHV-8-specific T cell dynamics and circulating microRNA profile, showing correlations with clinical course and other laboratory markers (including viral load, C-reactive protein, and cytokine levels), providing useful information about abnormal cellular and cytokine dynamics underlying HHV-8-associated inflammatory disorders in posttransplant patients.
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Affiliation(s)
- A Mularoni
- Infectious Disease and Infection Control Service, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - A Gallo
- Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - G Riva
- Section of Hematology, Department of Surgical and Medical Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy.,Department of Laboratory Medicine and Pathology USL, Modena, Italy
| | - P Barozzi
- Section of Hematology, Department of Surgical and Medical Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - M Miele
- Fondazione Ri.MED, Palermo, Italy
| | - G Cardinale
- Division of Hematology, Department of Oncology, A.R.NA.S. Civico-Benfratelli, G. Di Cristina e M. Ascoli, Palermo, Italy
| | - G Vizzini
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - R Volpes
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - P Grossi
- Infectious Disease and Infection Control Service, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.,Department of Infectious and Tropical Diseases, University of Insubria, University Hopital Ospedale di Circolo-Fondazioni Macchi, Varese, Italy
| | - D Di Carlo
- Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - A Luca
- Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - T Trenti
- Department of Laboratory Medicine and Pathology USL, Modena, Italy
| | - M Luppi
- Section of Hematology, Department of Surgical and Medical Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - P G Conaldi
- Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.,Fondazione Ri.MED, Palermo, Italy
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Alexa-Stratulat T, Paduraru M, Afrasanie V, Hordila A, Luca A, Miron L. PUB078 Lung Cancer in the Elderly - Histology, Localization and Gender Distribution in North Romania. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1941] [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: 11/15/2022]
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Pagano D, Seidida A, Tropea A, Pietrosi G, di Francesco F, Vizzini GB, Luca A, Gruttadauria S. Use of Hepatitis C-Positive Deceased Liver Donors in Response to the Organ Shortage in an Endemic Area. Ann Transplant 2017; 22:598-601. [PMID: 28983074 DOI: 10.12659/aot.905677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The region of Sicily, Italy, is witnessing a chronic organ shortage. Thus, to face this critical issue, the use of marginal donors has increased over time. An example of marginal donor expansion is the use of liver donors who are positive for the hepatitis C antibody (HCV+) for HCV+ patients requiring liver transplantation (LT). In view of new advances in HCV therapy, including direct-acting agents (DAAs) to treat HCV in the post-transplant setting, our study focused on a monocentric experience in a series of consecutive LTs performed in adult patients receiving HCV+ liver donor allografts. From 2003 to 2016 at our institute we performed 10 LT using HCV+ deceased donors. In particular, the pre-LT histological examination in 1 case showed a framework of moderate steatosis (35% microvesicular and 10% macrovesicular) with micro/macrovesicular steatosis <10% in all the other cases. A fibrous framework of 1/6 according to the Ishak score in a single case, and 2/6 in 2 cases, were highlighted, while there was no fibrosis in the other 7 cases. A picture of periportal inflammation was still detected in 4 cases, with no evidence of inflammatory lesions in the remaining cases. The patient survival was 100% at 1 and 3 years, and 85.7% at 5 years post-LT. One-, three- and five-year graft survivals were 100.0%, 88.9%, and 71.4%, respectively. Only 1 patient underwent re-LT after 2 years, because of chronic rejection. Based on our experience using HCV+ deceased liver donors with a moderate degree of fibrosis, we believe that accepting marginal donors is a feasible therapeutic option when facing a liver donor shortage.
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Affiliation(s)
- Duilio Pagano
- Abdominal Surgery and Organ Transplant Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Aurelio Seidida
- Hepatology Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Alessandro Tropea
- Abdominal Surgery and Organ Transplant Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Giada Pietrosi
- Hepatology Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Fabrizio di Francesco
- Abdominal Surgery and Organ Transplant Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Giovanni Battista Vizzini
- Hepatology Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Angelo Luca
- Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Salvatore Gruttadauria
- Abdominal Surgery and Organ Transplant Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
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Sciacca G, Nicoletti A, Mostile G, Luca A, Raciti L, Dibilio V, Salomone S, Drago F, Zappia M. R2 recovery cycle for neurophysiological differential diagnosis of Corticobasal Degeneration from Progressive Supranuclear palsy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.247] [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: 10/18/2022]
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Schmelzer E, Foka HG, Thompson RL, Luca A, Gridelli B, Gerlach JC. Response of Human Fetal Liver Progenitor Cell Types to Temperature and pH Stresses In Vitro. Rejuvenation Res 2017; 21:257-269. [PMID: 28891399 DOI: 10.1089/rej.2016.1890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Prolonged physiological stresses, including abnormal pH and temperature, are deleterious. However, human hepatic progenitors have been shown to be quite tolerant of temporary temperature stress such as in cold ischemia. We aimed at identifying how various stresses affect liver progenitors, and at determining whether distinct effects exist on different progenitor cells of the human liver. Total fetal liver cells were exposed to low (25°C), normal (37°C), or high (40°C) temperatures, or low (6.76), normal (7.35), or high (7.88) pH in vitro. Culture at 25°C increased cell numbers and percentages of proliferation marker Ki67+ total cells. In total cell cultures, percentages of CD326+ hepatic progenitors co-expressing DLK1 (delta-like 1 homolog), SSEA4, or CD90 increased, as well as proliferation of SSEA4+ and CD235a+ progenitors. Analyses of presorted hepatic progenitors revealed that culture at 25°C increased cell numbers of CD326+ hepatic stem/progenitor cells but not DLK+ hepatoblasts. The expression of several mesenchymal genes was reduced, and distinct hepatic stem/progenitor cell colonies emerged. At 40°C, numbers of adherent hepatic cells decreased but those of hematopoietic nonadherent cells increased. High pH did not cause major effects. Acidic pH resulted in decreased total cell numbers and affected hematopoietic cells. Percentages of DLK1+ hepatoblasts were increased, but those of hematopoietic mature CD45+ cells were decreased. In particular, proliferation of adherent hepatic CD326+, SSEA4+ progenitors, and hematopoietic CD45+ cells and CD235a+ erythroblasts was reduced. Conclusively, our data indicate that low-temperature stress stimulates hepatic progenitor and erythroblast proliferation, whereas acidic pH promotes hepatic maturation and reduces hematopoietic cells.
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Affiliation(s)
- Eva Schmelzer
- 1 Department of Surgery, McGowan Institute for Regenerative Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Hubert G Foka
- 2 University of Pittsburgh Medical Center, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Robert L Thompson
- 2 University of Pittsburgh Medical Center, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Angelo Luca
- 3 Department of Surgery, ISMETT-Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione , UPMC Italy, Palermo, Italy
| | - Bruno Gridelli
- 2 University of Pittsburgh Medical Center, University of Pittsburgh , Pittsburgh, Pennsylvania.,3 Department of Surgery, ISMETT-Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione , UPMC Italy, Palermo, Italy
| | - Jörg C Gerlach
- 1 Department of Surgery, McGowan Institute for Regenerative Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania.,4 Department of Bioengineering, McGowan Institute for Regenerative Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
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Pasta S, Gentile G, Raffa G, Bellavia D, Chiarello G, Liotta R, Luca A, Scardulla C, Pilato M. In Silico Shear and Intramural Stresses are Linked to Aortic Valve Morphology in Dilated Ascending Aorta. Eur J Vasc Endovasc Surg 2017; 54:254-263. [DOI: 10.1016/j.ejvs.2017.05.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 05/25/2017] [Indexed: 10/19/2022]
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47
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Bruggeman M, Collins SM, Done L, Đurašević M, Duch MA, Gudelis A, Hyža M, Jevremović A, Kandić A, Korun M, Ilie S, Lee JM, Lee KB, Luca A, Margineanu RM, Pantelica A, Serrano I, Šešlak B, Tugulan LC, Verheyen L, Vodenik B, Vukanac I, Zeng Z, Zorko B. Systematic influences on the areas of peaks in gamma-ray spectra that have a large statistical uncertainty. Appl Radiat Isot 2017; 134:51-55. [PMID: 28673731 DOI: 10.1016/j.apradiso.2017.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/23/2017] [Accepted: 06/13/2017] [Indexed: 10/19/2022]
Abstract
A method is presented for calculating the expected number of counts in peaks that have a large relative peak-area uncertainty and appear in measured gamma-ray spectra. The method was applied to calculations of the correction factors for peaks occurring in the spectra of radon daughters. It was shown that the factors used for correcting the calculated peak areas to their expected values decrease with an increasing relative peak-area uncertainty. The accuracy of taking the systematic influence inducing the correction factors into account is given by the dispersion of the correction factors corresponding to specific peaks. It was shown that the highest accuracy is obtained in the peak analyses with the GammaVision and Gamma-W software.
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Affiliation(s)
- M Bruggeman
- Studiecentrum voor Kernenergie, Kernenergie, Boeretang 200, B-2400 Mol, Belgium
| | - S M Collins
- National Physical Laboratory, Teddington, Middlesex TW11 0LW, UK
| | - L Done
- Horia Hulubei National Institute for Research and Development in Physics and Nuclear Engineering (IFIN_HH), 30 Reactorului Street, POB MG-6, RO-077125 Bucharest-Magurele, Romania
| | - M Đurašević
- Institute of Nuclear Sciences "Vinča", Laboratory for Nuclear and Plasma Physics, University of Belgrade, Belgrade, Serbia
| | - M A Duch
- Universitat Politècnica de Catalunya (UPC), Institut de Tècniques Energetiques, Diagonal 647, 08028 Barcelona, Spain
| | - A Gudelis
- Center for Physical Sciences and Technology, Savanoriu Ave. 231, Vilnus, Lithuania
| | - M Hyža
- National Radiation Protection Institute, Bartoškova 1450/28, 140 00 Praha 4, Czech Republic
| | - A Jevremović
- Institute of Nuclear Sciences "Vinča", Laboratory for Nuclear and Plasma Physics, University of Belgrade, Belgrade, Serbia
| | - A Kandić
- Institute of Nuclear Sciences "Vinča", Laboratory for Nuclear and Plasma Physics, University of Belgrade, Belgrade, Serbia
| | - M Korun
- "Jožef Stefan" Institute, Jamova cesta 39, 1000 Ljubljana, Slovenia.
| | - S Ilie
- Horia Hulubei National Institute for Research and Development in Physics and Nuclear Engineering (IFIN_HH), 30 Reactorului Street, POB MG-6, RO-077125 Bucharest-Magurele, Romania
| | - J M Lee
- Korea Research Institute of Standards and Science, Daejeon 305-340, Republic of Korea
| | - K B Lee
- Korea Research Institute of Standards and Science, Daejeon 305-340, Republic of Korea
| | - A Luca
- Horia Hulubei National Institute for Research and Development in Physics and Nuclear Engineering (IFIN_HH), 30 Reactorului Street, POB MG-6, RO-077125 Bucharest-Magurele, Romania
| | - R M Margineanu
- Horia Hulubei National Institute for Research and Development in Physics and Nuclear Engineering (IFIN_HH), 30 Reactorului Street, POB MG-6, RO-077125 Bucharest-Magurele, Romania
| | - A Pantelica
- Horia Hulubei National Institute for Research and Development in Physics and Nuclear Engineering (IFIN_HH), 30 Reactorului Street, POB MG-6, RO-077125 Bucharest-Magurele, Romania
| | - I Serrano
- Universitat Politècnica de Catalunya (UPC), Institut de Tècniques Energetiques, Diagonal 647, 08028 Barcelona, Spain
| | - B Šešlak
- Institute of Nuclear Sciences "Vinča", Laboratory for Nuclear and Plasma Physics, University of Belgrade, Belgrade, Serbia
| | - L C Tugulan
- Horia Hulubei National Institute for Research and Development in Physics and Nuclear Engineering (IFIN_HH), 30 Reactorului Street, POB MG-6, RO-077125 Bucharest-Magurele, Romania
| | - L Verheyen
- Studiecentrum voor Kernenergie, Kernenergie, Boeretang 200, B-2400 Mol, Belgium
| | - B Vodenik
- "Jožef Stefan" Institute, Jamova cesta 39, 1000 Ljubljana, Slovenia
| | - I Vukanac
- Institute of Nuclear Sciences "Vinča", Laboratory for Nuclear and Plasma Physics, University of Belgrade, Belgrade, Serbia
| | - Z Zeng
- Tsinghua University, Department of Engineering Physics, Beijing, PR China
| | - B Zorko
- "Jožef Stefan" Institute, Jamova cesta 39, 1000 Ljubljana, Slovenia
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Pithon A, Luca A, Buttu A, Vesin JM, Roten L, Sticherling C, Pascale P, Bisch L, Le Bloa M, Tran N, Pruvot E. P342Severe bi-atrial remodeling in persistent atrial fibrillation not terminated by catheter ablation. Europace 2017. [DOI: 10.1093/ehjci/eux141.068] [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: 11/12/2022] Open
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Luca A, Buttu A, Vesin JM, Pithon A, Le Bloa M, Bish L, Pascale P, Roten L, Sticherling C, Pruvot E. P335High level of atrial ECG organization in persistent atrial fibrillation remaining in sinus rhythm after a single ablation procedure. Europace 2017. [DOI: 10.1093/ehjci/eux141.061] [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: 11/13/2022] Open
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50
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Raffa GM, Luca A, Badhwar V, Pilato M. International Participation in The Society of Thoracic Surgeons Database Improves Outcomes: Initial Italian Experience. Ann Thorac Surg 2017; 101:2028-9. [PMID: 27106455 DOI: 10.1016/j.athoracsur.2015.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 09/08/2015] [Accepted: 09/14/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Giuseppe M Raffa
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation and Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127, Palermo, Italy.
| | - Angelo Luca
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation and Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127, Palermo, Italy
| | - Vinay Badhwar
- Division of Cardiac Surgery, Presbyterian University Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michele Pilato
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation and Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, Palermo, Italy
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