1
|
Marongiu F, Ruberto MF, Marongiu S, Mameli A, Barcellona D. Do we need more guidance on thrombophilia testing? Challenges and special considerations. Expert Rev Hematol 2024; 17:27-37. [PMID: 38228491 DOI: 10.1080/17474086.2024.2306821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 01/15/2024] [Indexed: 01/18/2024]
Abstract
INTRODUCTION Thrombophilia testing (TT) is a laboratory procedure designed to detect the risk factors involved in the pathogenesis of vascular occlusions. The role of TT is also controversial because it has a limited impact on the choice and duration of antithrombotic treatments. AREAS COVERED We reviewed, by examining MEDLINE up to October 2023. Accepted and not accepted thrombophilia markers are discussed along with the appropriateness or not of prescribing TT in several conditions such as: provoked and unprovoked venous thromboembolism (VTE), women who are planning a pregnancy whose relatives had VTE or have a hereditary thrombophilia, before assumption of estro-progestins, after multiple pregnant loss, arterial thrombosis, retinal vein occlusion, and splanchnic vein thrombosis. EXPERT OPINION TT is not essential in the management of VTE, but it may be useful for limiting adverse events in case of thrombophilia. We expose our criticism of items afforded by other guidelines by presenting our opinion based on both the scientific evidence and clinical practice. We also deal with common mistakes in prescribing and interpretations of TT hoping to purpose an educational approach on this topic. Finally, we emphasize the creation of the expert in hemostasis and thrombosis who should be present in every hospital.
Collapse
Affiliation(s)
- Francesco Marongiu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Haemostasis and Thrombosis Unit, Azienda Ospedaliera Universitaria of Cagliari, Cagliari, Italy
| | - Maria Filomena Ruberto
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Silvia Marongiu
- Internal Medicine department, SS Trinità Hospital, ASL, Cagliari, Italy
| | - Antonella Mameli
- Haemostasis and Thrombosis Unit, Azienda Ospedaliera Universitaria of Cagliari, Cagliari, Italy
| | - Doris Barcellona
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Haemostasis and Thrombosis Unit, Azienda Ospedaliera Universitaria of Cagliari, Cagliari, Italy
| |
Collapse
|
2
|
Mameli A, Sestu A, Marongiu F, Barcellona D. Living on Oral Anticoagulants: Duke Anticoagulation Satisfaction Scale Results. J Clin Med 2023; 12:7574. [PMID: 38137642 PMCID: PMC10743469 DOI: 10.3390/jcm12247574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/03/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Direct oral anticoagulants (DOACs) are widely used in patients with atrial fibrillation and venous thromboembolism. The lack of the need for laboratory monitoring and a better safety than vitamin K antagonists (VKAs) has probably changed the quality of life of patients on these oral anticoagulants. This was a real-life prospective observational cohort study. The aim was to evaluate if a long-term treatment with DOACs could offer a better quality of life than VKAs. Moreover, age, gender, education level, time in therapeutic range for VKAs, taking medication once or twice a day for DOACs, the total daily number of medications and thrombotic and bleeding complications were considered as variables probably associated with the quality of life of these patients. METHODS Between January and December 2021, the Duke Anticoagulation Satisfaction Scale (DASS) 25-items was administered as an interview to patients on either VKAs or DOACs therapy. During the follow-up period, all of the patients were closely monitored to evaluate possible bleeding and thrombotic events. RESULTS The analysis included 300 outpatients treated with VKAs and 254 treated with DOACs. In general, the quality of life was better in patients taking DOACs (DASS total score: DOACs = 44.7, 42.9-46.5 vs. VKAs = 51, 49.2-52.8, p < 0.0001) as the daily-life limitations, hassles and burdens and the psychological impact were less important than in patients on VKAs therapy. CONCLUSIONS VKAs negatively influence the daily-life of the patients in terms of both less satisfaction and time-consuming tasks. DOACs confer a better quality of life even if some concerns emerge from not knowing how their therapy is working.
Collapse
Affiliation(s)
- Antonella Mameli
- Department of Internal Medicine, Azienda Ospedaliero-Universitaria di Cagliari, 09123 Cagliari, Italy; (A.M.); (A.S.)
| | - Alessandro Sestu
- Department of Internal Medicine, Azienda Ospedaliero-Universitaria di Cagliari, 09123 Cagliari, Italy; (A.M.); (A.S.)
| | - Francesco Marongiu
- Department of Medical Science and Public Health, University of Cagliari, 09123 Cagliari, Italy;
| | - Doris Barcellona
- Department of Medical Science and Public Health, University of Cagliari, 09123 Cagliari, Italy;
| |
Collapse
|
3
|
Barcellona D, Schirru P, Mameli A, Cornacchini S, Fenu L, Marongiu F. Over-anticoagulation by vitamin K antagonists and gender differences. Int J Cardiol 2022; 362:147-151. [DOI: 10.1016/j.ijcard.2022.05.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/10/2022] [Accepted: 05/02/2022] [Indexed: 11/25/2022]
|
4
|
Mione MA, Vandalon V, Mameli A, Kessels WMM, Roozeboom F. Atmospheric-Pressure Plasma-Enhanced Spatial ALD of SiO 2 Studied by Gas-Phase Infrared and Optical Emission Spectroscopy. J Phys Chem C Nanomater Interfaces 2021; 125:24945-24957. [PMID: 34824660 PMCID: PMC8607820 DOI: 10.1021/acs.jpcc.1c07980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/26/2021] [Indexed: 06/13/2023]
Abstract
An atmospheric-pressure plasma-enhanced spatial atomic layer deposition (PE-s-ALD) process for SiO2 using bisdiethylaminosilane (BDEAS, SiH2[NEt2]2) and O2 plasma is reported along with an investigation of its underlying growth mechanism. Within the temperature range of 100-250 °C, the process demonstrates self-limiting growth with a growth per cycle (GPC) between 0.12 and 0.14 nm and SiO2 films exhibiting material properties on par with those reported for low-pressure PEALD. Gas-phase infrared spectroscopy on the reactant exhaust gases and optical emission spectroscopy (OES) on the plasma region are used to identify the species that are involved in the ALD process. Based on the identified species, we propose a reaction mechanism where BDEAS molecules adsorb on -OH surface sites through the exchange of one of the amine ligands upon desorption of diethylamine (DEA). The remaining amine ligand is removed through combustion reactions activated by the O2 plasma species leading to the release of H2O, CO2, and CO in addition to products such as N2O, NO2, and CH-containing species. These volatile species can undergo further gas-phase reactions in the plasma as indicated by the observation of OH*, CN*, and NH* excited fragments in OES. Furthermore, the infrared analysis of the precursor exhaust gas indicated the release of CO2 during precursor adsorption. Moreover, this analysis has allowed the quantification of the precursor depletion yielding values between 10 and 50% depending on the processing parameters. Besides providing insights into the chemistry of atmospheric-pressure PE-s-ALD of SiO2, our results demonstrate that infrared spectroscopy performed on exhaust gases is a valuable approach to quantify relevant process parameters, which can ultimately help evaluate and improve process performance.
Collapse
Affiliation(s)
- M A Mione
- Department of Applied Physics, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| | - V Vandalon
- Department of Applied Physics, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| | - A Mameli
- TNO-Holst Centre, High Tech Campus 31, 5656 AE Eindhoven, The Netherlands
| | - W M M Kessels
- Department of Applied Physics, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| | - F Roozeboom
- Department of Applied Physics, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
- TNO-Holst Centre, High Tech Campus 31, 5656 AE Eindhoven, The Netherlands
| |
Collapse
|
5
|
Spinas E, Deias M, Mameli A, Giannetti L. Pulp canal obliteration after extrusive and lateral luxation in young permanent teeth: A scoping review. Eur J Paediatr Dent 2021; 22:55-60. [PMID: 33719484 DOI: 10.23804/ejpd.2021.22.01.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM In the literature, no single therapeutic approach is preferred for treating dental pulp responses such as pulp canal obliteration (PCO). Some authors still recommend preventive endodontic treatment, whereas others choose not to intervene, to avoid causing possible iatrogenic complications. This review was conducted to explore, in the current scientific literature, the degree of knowledge concerning the onset and development of PCO and pulp necrosis (PN) following dental trauma (i.e. extrusive luxation and lateral luxation) in children and young adults (6-20 years). The authors also evaluated whether and to what extent the stage of dental root development at the time of traumatic dental injury (TDI) influences these pulp responses, and whether PN can arise in teeth already affected by PCO. MATERIALS AND METHODS The literature search was carried out during the period October 2019 to January 2020, using the following databases: PubMed/MEDLINE, SCOPUS and Web of Science. Articles in English reporting on young patients with PCO or PN in permanent teeth affected by trauma were included. Theresearch, whose questions were summarised according to the PICO method, considered the following aspects: patient age, type of TDI, stage of root development, initial treatment, presence of calcification or necrosis, time to onset of the two outcomes (PCO and PN), and duration of follow-up. The articles found were evaluated by two reviewers; in the event of disagreement regarding the inclusion of an article, a third reviewer was called upon to decide. RESULTS The initial screening of the databases, using the selected search keywords, yielded a total of 343 articles. After exclusion of duplicates and articles not meeting the inclusion criteria, 11 articles remained. Of these, only four completely met the inclusion criteria. Closer analysis of these four publications revealed that they would not easily yield standardised sets of clinical data that might be homogenised in order to produce clear meta-analytical data. Hence the need to limit the data collected to the following seven items: number and type of injuries, type of initial intervention, duration of follow-up, main pulp responses, number and type of pulp responses. CONCLUSIONS PCO is a physiological pulp response associated with a traumatic event, usually a luxation injury. It is diagnosed on the basis of combined radiographic and clinical-anamnesticdata. Signs of PCO start to appear at around one year after the traumatic event, and its development reaches completion by about five years post-trauma. PN, on the other hand, is clearly apparent within the first year. Endodontic treatment, be it carried out as a preventive measure or following detection of PCO, is inappropriate and can cause serious iatrogenic damage. Treatment is indicated only in cases of definite PN.
Collapse
Affiliation(s)
- E Spinas
- Department of Surgical Sciences, Sports Dental Research Center, University of Cagliari, Cagliari, Italy
| | - M Deias
- Department of Surgical Sciences, Sports Dental Research Center, University of Cagliari, Cagliari, Italy
| | - A Mameli
- Department of Surgical Sciences, Sports Dental Research Center, University of Cagliari, Cagliari, Italy
| | - L Giannetti
- Department of Surgical Sciences, Pedodontics Division, University of Modena-Reggio, Modena, Italy
| |
Collapse
|
6
|
Orrù G, Mameli A, Demontis C, Rossi P, Ratto D, Occhinegro A, Piras V, Kuqi L, Berretta M, Taibi R, Scano A, Coni P. Oral human papilloma virus infection: an overview of clinical-laboratory diagnosis and treatment. Eur Rev Med Pharmacol Sci 2020; 23:8148-8157. [PMID: 31599444 DOI: 10.26355/eurrev_201909_19035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this review is to describe the "hot points" of current clinical governance for oral HPV comprising the use of new diagnostic molecular procedures, namely, Pyrosequencing and Next Generation Sequencing. MATERIALS AND METHODS The data on oral HPV was collected through two levels of research. First for all, we used the canonical medical search engines, PubMed, and Medline, followed by the study of current commercial tools for HPV diagnosis, particularly within commercial companies involved in the molecular procedures for HPV detecting and genotyping. RESULTS Different medical procedures are now described and used throughout the world in HPV diagnosis and treatment. However, the laboratory methods are often validated and used for genital infections, and, in these cases, data are missing in the literature as regards the clinical approach for oral lesions. CONCLUSIONS Dental care units are often the front line for a clinical evaluation of a possible HPV lesion in the oral cavity, which means that correct clinical governance could avoid a viral neoplastic progression of this disease with great advantages for the patient. In this case, the problem is due to the difficulty in lesion recognition but also and more especially the absence of correct laboratory diagnosis and subsequent treatment in the clinical course.
Collapse
Affiliation(s)
- G Orrù
- Department of Surgical Sciences, Molecular Biology Service (MBS), University of Cagliari, Cagliari, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Cherchi R, Grimaldi G, Pinna-Susnik M, Riva L, Sarais S, Santoru M, Perra R, Allieri R, Porcu GS, Nemolato S, Mameli A, Loi F, Ferrari PA. Retrospective outcomes analysis of 99 consecutive uniportal awake lung biopsies: a real standard of care? J Thorac Dis 2020; 12:4717-4730. [PMID: 33145045 PMCID: PMC7578489 DOI: 10.21037/jtd-20-1551] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Surgical lung biopsy for interstitial lung disease (ILD) is traditionally performed through video-assisted thoracic surgery (VATS) and general anesthesia (GA). The mortality and morbidity rates associated with this procedure are not negligible, especially in patients with significant risk factors and respiratory impairment. Based on these considerations, our center evaluated a safe non-intubated VATS approach for lung biopsy performed in ILD subjects. Methods Ninety-nine patients affected by undetermined ILD were enrolled in a retrospective cohort study. In all instances, lung biopsies were performed using a non-intubated VATS technique, in spontaneously breathing patients, with or without intercostal nerve blockage. The primary end-point was the diagnostic yield, while surgical and global operating room times, post-operative length of stay (pLOS), numeric pain rating scale (NPRS) after surgery and early mortality were considered as secondary outcomes. Results All the procedures were carried out without conversion to GA. The pathological diagnosis was achieved in 97 patients with a diagnostic yield of 98%. The mean operating room length-of-stay and operating time were 73.7 and 42.5 min, respectively. Mean pLOS was 1.3 days with a low readmissions rate (3%). No mortality in the first 30 days due to acute exacerbation of ILD occurred. Both analgesia methods resulted in optimal feasibility with a mean NPRS score of 1.13. Conclusions In undetermined ILD patients, surgical lung biopsy with a non-intubated VATS approach and spontaneous ventilation anesthesia appears to be both a practical and safe technique with an excellent diagnostic yield and high level of patient satisfaction.
Collapse
Affiliation(s)
- Roberto Cherchi
- Division of Thoracic Surgery, "A. Businco" Oncology Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Giulia Grimaldi
- Division of Thoracic Surgery, "A. Businco" Oncology Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Matteo Pinna-Susnik
- Division of Thoracic Surgery, "A. Businco" Oncology Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Laura Riva
- Division of Thoracic Surgery, "A. Businco" Oncology Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Sabrina Sarais
- Division of Thoracic Surgery, "A. Businco" Oncology Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Massimiliano Santoru
- Division of Thoracic Surgery, "A. Businco" Oncology Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Roberto Perra
- Pulmonology Unit and Respiratory Physiopathology Laboratory, "R. Binaghi" and "SS. Trinità" Hospitals, ATS Sardegna, Cagliari, Italy
| | - Roberto Allieri
- Radiology Service, "R. Binaghi" Hospital, ATS Sardegna, Cagliari, Italy
| | - Giuseppe S Porcu
- Histopathology Department, "A. Businco" Oncology Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Sonia Nemolato
- Histopathology Department, "A. Businco" Oncology Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Antonella Mameli
- Internal Medicine and Haemocoagulopathies Division, AOU of Monserrato, Monserrato, Italy
| | - Federica Loi
- Sardinian Epidemiological Observatory, IZS of Sardinia, Cagliari, Italy
| | - Paolo A Ferrari
- Division of Thoracic Surgery, "A. Businco" Oncology Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| |
Collapse
|
8
|
Kharroubi A, Petit-Colau MD, Jouhannet C, Mameli A, Karsenti A, Gigou F, Tremblay B. Endarterectomy with "systematized" resection anastomosis of carotid bulb, about 240 cases. J Med Vasc 2020; 45:260-267. [PMID: 32862983 DOI: 10.1016/j.jdmv.2020.07.005] [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] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 07/18/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Carotid endarterectomy has traditionally been the strategy for the surgical management of carotid stenosis. Alongside the usual techniques, this study presents another technique: endarterectomy with systematized resection-anastomosis. MATERIAL AND METHODS A retrospective study from January 2006 to December 2018, included all patients managed for carotid stenosis at Meaux hospital with the "endarterectomy with systematized resection-anastomosis" technique. The perioperative death and stroke rate were evaluated according to the judgment criterion "homolateral ischemic stroke and any stroke or perioperative death". Statistical analysis of the data was performed using SPSS software. RESULTS For 415 carotids operated, we identified 240 managed with this technique. The average age was 71.7±9.6 years, 70% men and 30% women. The main cardiovascular risk factor was hypertension (76.7%), 24.2% of patients had an ischemic heart disease history, 43.7% homolateral ischemic stroke and 29% transient ischemic attack. Bilateral lesions were diagnosed in 6.2% of patients and 7.5% had contralateral occlusion. Carotid stenosis was symptomatic in 52.9% of patients. The average stenosis rate observed was 82.9±8.1% on computed tomography angiogram and 83.7±7.7% on magnetic resonance angiogram. The shunt was used in 45.4% of procedures. The average length of stay was 5.9±2.3 days. All patients had satisfactory results in terms of patency and anatomical appearance on the 1st check. In the post-operative period during the first month, complications occurred in 12.5% of patients (1.6% acute coronary syndrome, 0.8% neurological event, 0.8% death, 0.4% infection, 12.1% hematoma, 1.6% recovery for bleeding). The overall perioperative death and stroke rate was 2.6%. Myocardial infarction and sepsis were the causes of death for the 2 patients in the peri operative period. The mean duration of follow-up was 21.2 months, without any restenosis or occurrence of neurological complications. One patient died beyond the 1st month of follow-up without established cause, and the overall mortality rate was 1.3%. CONCLUSION Thromboendarterectomy with "systematized" anastomosis resection represents an angioplasty method for carotid stenosis surgical management under visual control.
Collapse
Affiliation(s)
- A Kharroubi
- Department of vascular and thoracic surgery, GHEF (Grand Hôpital de l'Est Francilien), Meaux site, 6-8 St fiacre street, BP 218, 77104 Meaux Cedex, France; Ibn Zohr University, Faculty of Medicine and Pharmacy, department of Vascular surgery, quartier Tilila, 80000 Agadir, Morocco.
| | - M D Petit-Colau
- Department of vascular and thoracic surgery, GHEF (Grand Hôpital de l'Est Francilien), Meaux site, 6-8 St fiacre street, BP 218, 77104 Meaux Cedex, France
| | - C Jouhannet
- Department of vascular and thoracic surgery, GHEF (Grand Hôpital de l'Est Francilien), Meaux site, 6-8 St fiacre street, BP 218, 77104 Meaux Cedex, France
| | - A Mameli
- Department of vascular and thoracic surgery, GHEF (Grand Hôpital de l'Est Francilien), Meaux site, 6-8 St fiacre street, BP 218, 77104 Meaux Cedex, France
| | - A Karsenti
- Department of vascular and thoracic surgery, GHEF (Grand Hôpital de l'Est Francilien), Meaux site, 6-8 St fiacre street, BP 218, 77104 Meaux Cedex, France
| | - F Gigou
- Department of vascular and thoracic surgery, GHEF (Grand Hôpital de l'Est Francilien), Meaux site, 6-8 St fiacre street, BP 218, 77104 Meaux Cedex, France
| | - B Tremblay
- Department of vascular and thoracic surgery, GHEF (Grand Hôpital de l'Est Francilien), Meaux site, 6-8 St fiacre street, BP 218, 77104 Meaux Cedex, France
| |
Collapse
|
9
|
Mameli A, Schirru P, Porru M, Marongiu F, Barcellona D. Underuse of anticoagulant therapy in hospitalized older patients: comment on the article of Wojszel et al. J Thromb Thrombolysis 2020; 49:136-137. [DOI: 10.1007/s11239-019-01960-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
10
|
Abstract
AIM The aim of this study is to produce a clinical therapy protocol for a group of 20 athletes between the ages of 8 and 14, who all suffered traumas affecting hard dental and periodontal tissues. MATERIALS AND METHODS This study involves a group of 20 athletes (10 male and 10 female) who had suffered dental traumas of varying severity. In order to collect the data, two classification systems were used: one for hard tissue traumas and another for periodontal lesions. The athletes were subdivided into lesion groups, treated depending on the type of lesions and then followed-up over a period of 5 years. A statistical analysis was carried out to study the association between type of lesions, types of sports and the number of teeth involved. RESULTS We found that recovery time ranged from 3 to 5 days for uncomplicated fractures and up to 14 days for luxations. Only four complications were registered during the follow-up period and these were most likely due to the severity of the trauma. Out of the 20 athletes, 16 had begun and maintained the habit of using mouth protection devices when practicing their sport. The statistical analysis focused on the possible association between the risk levels of a sport and the typical lesions and complications that usually occur. Due to their high frequency, the two types of lesions taken into account in our study were complicated fractures (FP) and luxated/fractured teeth (LF). The average number of teeth involved varied according to the sport's risk level (medium or high) with averages of 1.6 teeth involved for medium-risk sports and 2.0 teeth for high-risk sports. CONCLUSIONS What emerged in particular was the regular progress in the recovery time needed for the injuries sustained, with few complications or delays in rehabilitation; we also noted that the numerous athletes who habitually used mouthguards while competing during the recovery period did not suffer any recurrences of injuries or further complications. Regarding the results of our statistical analysis, no association was found between the sport's risk, the types of lesions and the occurrence of complications. In addition, analysis of the average number of teeth involved showed that there is no statistical evidence to reject the hypothesis that the ratios remain the same in the two groups.
Collapse
Affiliation(s)
- E Spinas
- Department of Surgical Sciences, Sports Dental Research Center, University of Cagliari, Cagliari, Italy
| | - L Giannetti
- Department of Surgical Sciences, Pedodontics Division, University of Modena-Reggio, Modena, Italy
| | - A Mameli
- Department of Surgical Sciences, Sports Dental Research Center, University of Cagliari, Cagliari, Italy
| | - D Re
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| |
Collapse
|
11
|
Marongiu F, Mameli A, Grandone E, Barcellona D. Pulmonary Thrombosis: A Clinical Pathological Entity Distinct from Pulmonary Embolism? Semin Thromb Hemost 2019; 45:778-783. [PMID: 31537029 DOI: 10.1055/s-0039-1696942] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Since Virchow's autopsy studies in the mid-1800s, it has generally been believed that pulmonary embolism (PE) originated from the embolization of fibrin fragments from a deep venous thrombosis (DVT). However, a DVT is often not found in patients with PE (up to 50% of cases). Could fibrin form in the pulmonary vessels without coming from the periphery? In this review, the authors will try to support the hypothesis that a pulmonary thrombosis (PT) may develop. They will do so through different clinical models related to some pathological conditions such as pneumonia, chronic obstructive pulmonary disease (COPD), and asthma, all of which show a close relationship between local inflammation and activation of blood coagulation, two defensive systems that may lead to fibrin deposition in the lungs, thus recognizing the possibility that PT may be a newly recognized entity. An increased risk for PE has been demonstrated in these conditions. Sickle cell disease and assisted reproductive technologies are other very different conditions in which an increased risk for PE has been found. Gaucher's disease is a rare hereditary condition in which the hemostatic system could have a role in the pathogenesis of pulmonary hypertension, which complicates the course of the disease. In particular, the increased risk for PT, common to all these conditions, deserves attention when a patient presents with sudden dyspnea, an unexpected COPD exacerbation, or severe sudden asthmatic dyspnea. As a consequence, prediction scores for venous thromboembolism could be revised.
Collapse
Affiliation(s)
- Francesco Marongiu
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonella Mameli
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Elvira Grandone
- Atherosclerosis and Thrombosis Unit, IRCCS Ospedale Casa Sollievo della Sofferenza, Foggia, Italy.,Department of Obstetrics and Gynecology, First Moscow State Medical University, Moscow, Russia
| | - Doris Barcellona
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| |
Collapse
|
12
|
Spinas E, Generali L, Mameli A, Demontis C, Martinelli D, Giannetti L. Delayed tooth replantation and inflammatory root resorption in childhood and adolescence. J BIOL REG HOMEOS AG 2019; 33:623-627. [PMID: 30945526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Avulsion of one or more permanent teeth represents an emergency in dentistry. The main treatment is the replantation of the tooth/teeth as soon as possible to decrease possible complications. However, this is not always possible, and, in many cases, the patient undergoes a delayed replantation and subsequently prosthetic and implant treatments.
Collapse
Affiliation(s)
- E Spinas
- Department of Surgical Sciences, Sports Dental Research Center, University of Cagliari, Cagliari, Italy
| | - L Generali
- Department of Surgical Sciences, Pedodontics Division, University of Modena-Reggio, Modena, Italy
| | - A Mameli
- Department of Surgical Sciences, Sports Dental Research Center, University of Cagliari, Cagliari, Italy
| | - C Demontis
- Department of Surgical Sciences, Sports Dental Research Center, University of Cagliari, Cagliari, Italy
| | - D Martinelli
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" of Chieti and Pescara, Chieti, Italy
| | - L Giannetti
- Department of Surgical Sciences, Pedodontics Division, University of Modena-Reggio, Modena, Italy
| |
Collapse
|
13
|
Infusino E, Didonna V, Mameli A, Bettiol M. 134. DynaLog file-based Procedure for a daily monitoring of IMRT dose delivery. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.145] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
14
|
Marino C, Carbonini C, Veronese I, Agostinelli S, Aimonetto S, Bagalà P, Barbiero S, Benecchi G, Borzi G, Bresciani S, Broggi S, Cagni E, Casale M, Cilla S, Clemente S, Consorti R, Corletto D, Delana A, Esposito M, Falco M, Fedele D, Fusella M, Garibaldi C, Gasperi C, Giglioli F, Giancaterino S, Iervolino C, Infusino E, Mameli A, Manco L, Masi L, Menghi E, Moretti E, Nardiello B, Paladini L, Panizza D, Pastore G, Radice A, Redaelli I, Rosica F, Russo S, Saiani F, Savini A, Siragusa C, Strigari L, Talamonti C, Vaccara E, Villaggi E, Zucchetti C, Stasi M, Mancosu P. 40. Design of a national survey to assess the technology applied to SBRT. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.050] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
15
|
Ruberto MF, Marongiu F, Mandas A, Mameli A, Porru M, Cianchetti E, Barcellona D. The venous thromboembolic risk and the clot wave analysis: a useful relationship? Clin Chem Lab Med 2018; 56:448-453. [PMID: 29031015 DOI: 10.1515/cclm-2017-0678] [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] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 09/12/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hospitalized patients with acute medical conditions have higher venous thromboembolism (VTE) risk. A patient with a final Padua Prediction Score (PPS) of ≥4 is considered to be at high risk for VTE. The aim of this study was to investigate on a possible relationship between PPS, the dynamics of the clot formation, i.e. the clot waveform analysis (CWA) of aPTT, fibrinogen and D-Dimer in a large group of medical patients. METHODS CWA in terms of velocity (first derivative), acceleration (second derivative), density (Delta) of aPTT, fibrinogen, D-Dimer and PPS for VTE were determined in 801 medical patients divided in three groups (without antithrombotic prophylaxis and high PPS, without antithrombotic prophylaxis and low PPS, with antithrombotic prophylaxis and high PPS) and a group of healthy subjects. RESULTS CWA, fibrinogen and D-Dimer values were higher in the medical patients with high PPS with or without antithrombotic prophylaxis when compared with patients without antithrombotic prophylaxis with low PPS and healthy subjects. The second derivative, fibrinogen and D-Dimer were significantly associated with a high PPS score (≥4): odds ratio (OR) = 1.53, 95% confidence interval (CI) = 1.03-2.28; OR = 1.91, 95% CI = 1.3-2.79; OR = 3.16, 95% CI = 2.29-4.36, respectively. Interactions between first derivative and D-Dimer (OR = 2.14, 95% CI = 1.23-3.72) and first derivative and fibrinogen (OR = 1.75, 95% CI = 1.02-2.98) were found. CONCLUSIONS CWA could give useful information to recognize a hypercoagulable state in patients admitted to a medical ward with high and low PPS. First and second derivative aPTT, D-Dimer and fibrinogen levels could be added to PPS to better assess the global thromboembolic risk of these patients.
Collapse
Affiliation(s)
- Maria Filomena Ruberto
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Marongiu
- Internal Medicine and Haemostasis and Thrombosis Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy, Phone: +39070 6754188
| | - Antonella Mandas
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonella Mameli
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Mariagrazia Porru
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Elisabetta Cianchetti
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Doris Barcellona
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| |
Collapse
|
16
|
Mameli A, Verheijen MA, Mackus AJM, Kessels WMM, Roozeboom F. Isotropic Atomic Layer Etching of ZnO Using Acetylacetone and O 2 Plasma. ACS Appl Mater Interfaces 2018; 10:38588-38595. [PMID: 30286289 PMCID: PMC6225338 DOI: 10.1021/acsami.8b12767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Atomic layer etching (ALE) provides Ångström-level control over material removal and holds potential for addressing the challenges in nanomanufacturing faced by conventional etching techniques. Recent research has led to the development of two main classes of ALE: ion-driven plasma processes yielding anisotropic (or directional) etch profiles and thermally driven processes for isotropic material removal. In this work, we extend the possibilities to obtain isotropic etching by introducing a plasma-based ALE process for ZnO which is radical-driven and utilizes acetylacetone (Hacac) and O2 plasma as reactants. In situ spectroscopic ellipsometry measurements indicate self-limiting half-reactions with etch rates ranging from 0.5 to 1.3 Å/cycle at temperatures between 100 and 250 °C. The ALE process was demonstrated on planar and three-dimensional substrates consisting of a regular array of semiconductor nanowires (NWs) conformally covered using atomic layer deposition of ZnO. Transmission electron microscopy studies conducted on the ZnO-covered NWs before and after ALE proved the isotropic nature and the damage-free characteristics of the process. In situ infrared spectroscopy measurements were used to elucidate the self-limiting nature of the ALE half-reactions and the reaction mechanism. During the Hacac etching reaction that is assumed to produce Zn(acac)2, carbonaceous species adsorbed on the ZnO surface are suggested as the cause of the self-limiting behavior. The subsequent O2 plasma step resets the surface for the next ALE cycle. High etch selectivities (∼80:1) over SiO2 and HfO2 were demonstrated. Preliminary results indicate that the etching process can be extended to other oxides such as Al2O3.
Collapse
Affiliation(s)
- A. Mameli
- Department
of Applied Physics, Eindhoven University
of Technology, P.O. Box 513, Eindhoven 5600 MB, The Netherlands
| | - M. A. Verheijen
- Department
of Applied Physics, Eindhoven University
of Technology, P.O. Box 513, Eindhoven 5600 MB, The Netherlands
| | - A. J. M. Mackus
- Department
of Applied Physics, Eindhoven University
of Technology, P.O. Box 513, Eindhoven 5600 MB, The Netherlands
| | - W. M. M. Kessels
- Department
of Applied Physics, Eindhoven University
of Technology, P.O. Box 513, Eindhoven 5600 MB, The Netherlands
| | - F. Roozeboom
- Department
of Applied Physics, Eindhoven University
of Technology, P.O. Box 513, Eindhoven 5600 MB, The Netherlands
- TNO-Holst
Centre, High Tech Campus
21, Eindhoven 5656 AE, The Netherlands
- E-mail:
| |
Collapse
|
17
|
Petruzzella M, Zobenica Ž, Cotrufo M, Zardetto V, Mameli A, Pagliano F, Koelling S, van Otten FWM, Roozeboom F, Kessels WMM, van der Heijden RW, Fiore A. Anti-stiction coating for mechanically tunable photonic crystal devices. Opt Express 2018; 26:3882-3891. [PMID: 29475245 DOI: 10.1364/oe.26.003882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 01/18/2018] [Indexed: 06/08/2023]
Abstract
A method to avoid the stiction failure in nano-electro-opto-mechanical systems has been demonstrated by coating the system with an anti-stiction layer of Al2O3 grown by atomic layer deposition techniques. The device based on a double-membrane photonic crystal cavity can be reversibly operated from the pull-in back to its release status. This enables to electrically switch the wavelength of a mode over ~50 nm with a potential modulation frequency above 2 MHz. These results pave the way to reliable nano-mechanical sensors and optical switches.
Collapse
|
18
|
Mameli A, Barcellona D, Marongiu F. Fatal Cytopenia Induced by Low-Dose Methotrexate in Elderly With Rheumatoid Arthritis. Identification of Risk Factors. Am J Ther 2017; 24:e106-e107. [DOI: 10.1097/mjt.0000000000000486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
19
|
Porru M, Mameli A, Cianchetti ME, Musu M, Schirru P, Ruberto MF, Barcellona D, Marongiu F. Dabigatran overdose: a case report of acute hepatitis. Extracorporeal treatment. Int J Hematol 2016; 105:532-535. [PMID: 27910004 DOI: 10.1007/s12185-016-2158-0] [Citation(s) in RCA: 6] [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: 07/01/2016] [Revised: 11/22/2016] [Accepted: 11/24/2016] [Indexed: 12/01/2022]
Abstract
Dabigatran is an oral, direct thrombin inhibitor approved by international regulatory agencies for stroke prevention in patients with paroxysmal or persistent non-rheumatic atrial fibrillation (AF). The benefits of dabigatran are widely described, but its use in the geriatric population is not without risk. Chronic kidney disease is a common comorbidity with AF, and thus frequent checks of renal function in elderly patients are recommended. We report a case of dabigatran intoxication in an elderly man affected by heart failure and worsening renal function, who developed acute hepatitis and coma, which was successfully treated with continuous veno-venous hemodiafiltration. Although extracorporeal therapy has been suggested as a strategy for clearing dabigatran during acute bleeding, this approach may be useful in other dabigatran-related, life-threatening conditions, such as that described in this report.
Collapse
Affiliation(s)
- Mariagrazia Porru
- Internal Medicine and Haemocoagulopathies Unit, Azienda Ospedaliero Universitaria (A.O.U.), Presidio "Duilio Casula", University of Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - Antonella Mameli
- Internal Medicine and Haemocoagulopathies Unit, Azienda Ospedaliero Universitaria (A.O.U.), Presidio "Duilio Casula", University of Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy.
| | - Maria E Cianchetti
- Internal Medicine and Haemocoagulopathies Unit, Azienda Ospedaliero Universitaria (A.O.U.), Presidio "Duilio Casula", University of Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - Mario Musu
- Intensive Care Unit, Azienda Ospedaliero Universitaria (A.O.U.), Presidio "Duilio Casula", University of Cagliari, Monserrato, Cagliari, Italy
| | - Paola Schirru
- Internal Medicine and Haemocoagulopathies Unit, Azienda Ospedaliero Universitaria (A.O.U.), Presidio "Duilio Casula", University of Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - Maria F Ruberto
- Internal Medicine and Haemocoagulopathies Unit, Azienda Ospedaliero Universitaria (A.O.U.), Presidio "Duilio Casula", University of Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - Doris Barcellona
- Internal Medicine and Haemocoagulopathies Unit, Azienda Ospedaliero Universitaria (A.O.U.), Presidio "Duilio Casula", University of Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - Francesco Marongiu
- Internal Medicine and Haemocoagulopathies Unit, Azienda Ospedaliero Universitaria (A.O.U.), Presidio "Duilio Casula", University of Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| |
Collapse
|
20
|
Mameli A, Palmas MA, Antonelli A, Contu P, Prandoni P, Marongiu F. A retrospective cohort study of patients with pulmonary embolism: the impact of comorbidities on patient's outcome. Eur Respir J 2016; 48:555-7. [DOI: 10.1183/13993003.02193-2015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 04/16/2016] [Indexed: 11/05/2022]
|
21
|
Gaudino D, Bellesi L, Stimato G, Di Venanzio C, Mameli A, Infusino E, Ippolito E, Silipigni S, Rinaldi C, Ramella S, Trodella L, D'Angelillo R. Comparison of field-in-field tangential treatment versus the conventional treatment. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.091] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
22
|
Gaudino D, Stimato G, Di Venanzio C, Mameli A, Infusino E, Bellesi L, Ippolito E, Silipigni S, Rinaldi C, Ramella S, Trodella L, D'Angelillo R. Radiotherapy in breast cancer with voluntary deep-inspiration breath-hold using BrainLab Exactrac. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.068] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
23
|
Infusino E, Bellesi L, Carnevale A, Di Venanzio C, Gaudino G, Mameli A, Matteucci P, Molfese E, Stimato G, Trodella L. Dosimetric comparison of 3D conformal vs volumetric ARC radiation therapy vs hybrid 3D/B-VMAT for mediastinal tumor. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.116] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
24
|
Stimato G, Gaudino D, Di Venanzio C, Mameli A, Infusino E, Bellesi L, Ippolito E, Silipigni S, Rinaldi C, D'Angelillo R, Ramella S, Trodella L. A new 3D radiotherapy technique reduces skin toxicity for large breast and/or high BMI patients. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.220] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
25
|
Robledo R, Mameli A, Scudiero C, Vona G, Corrias L, Bachis V, Culigioni C, Calò C. Non-random distribution of 17 Y-chromosome STR loci in different areas of Sardinia. Forensic Sci Int Genet 2015; 16:26-28. [DOI: 10.1016/j.fsigen.2014.11.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/27/2014] [Accepted: 11/25/2014] [Indexed: 11/29/2022]
|
26
|
Mameli A, Marongiu F. Thromboembolic disease in patients with rheumatoid arthritis undergoing joint arthroplasty: Update on prophylaxes. World J Orthop 2014; 5:645-652. [PMID: 25405093 PMCID: PMC4133472 DOI: 10.5312/wjo.v5.i5.645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Revised: 03/26/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
The risk of venous thromboembolism (VTE) in rheumatoid arthritis (RA) and the higher incidence of RA patients undergoing major orthopedic surgery is well recognized. The objective of the present study is to describe the incidence of VTE and discuss the correct prophylaxis in RA patients undergoing knee or hip replacement. A systematic review of studies on thromboprophylaxis in RA patients undergoing major orthopedic surgery was performed. Detailed information was extracted to calculate the rate of VTE in RA orthopedic patients and analyze the thromboprophylaxis performed and bleeding complications. Eight articles were eligible for full review. No difference in the overall rate of VTE was observed between RA patients and controls. No significant differences were found in RA patients in terms of bleeding complications. The data on the optimal prophylaxis to be used in RA patients were insufficient to recommend any of the several options available. In the absence of dedicated guidelines for the care of RA patients undergoing orthopedic surgery, management must be individualized to obtain favorable patient outcome, weighing up all the factors that might put the patient at risk for higher bleeding and thrombotic events.
Collapse
|
27
|
Tijani Y, Mameli A, Chtata H, Taberkant M, Lekehal B, Sefiani Y, Elmesnaoui A, Ammar F, Bensaid Y, Feito B, Bellenot F, Fallouh A, Cheysson E. [Exceptional association of bilateral popliteal aneurysm with an abdominal aortic aneurysm in Marfan syndrome]. ACTA ACUST UNITED AC 2014; 39:278-81. [PMID: 24951295 DOI: 10.1016/j.jmv.2014.05.003] [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: 08/14/2013] [Accepted: 04/14/2014] [Indexed: 10/25/2022]
Abstract
Marfan syndrome is an autosomal dominant disorder with rheumatoid, ophthalmological, neurological, cutaneous and cardiovascular manifestations. Aneurysmal lesions affecting both the abdominal aorta and the peripheral arteries are not often described in the literature. We report a case associating a bilateral popliteal aneurysm and an aneurysm of the infra-renal abdominal aorta.
Collapse
Affiliation(s)
- Y Tijani
- Service de chirurgie vasculaire, CHU de Rabat, rue lmfadal Cherkaoui, 6527 Rabat, Maroc.
| | - A Mameli
- Service de chirurgie vasculaire et thoracique, centre hospitalier René-Dubos, 95300 Pontoise, France
| | - H Chtata
- Service de chirurgie vasculaire, CHU de Rabat, rue lmfadal Cherkaoui, 6527 Rabat, Maroc
| | - M Taberkant
- Service de chirurgie vasculaire, CHU de Rabat, rue lmfadal Cherkaoui, 6527 Rabat, Maroc
| | - B Lekehal
- Service de chirurgie vasculaire, CHU de Rabat, rue lmfadal Cherkaoui, 6527 Rabat, Maroc
| | - Y Sefiani
- Service de chirurgie vasculaire, CHU de Rabat, rue lmfadal Cherkaoui, 6527 Rabat, Maroc
| | - A Elmesnaoui
- Service de chirurgie vasculaire, CHU de Rabat, rue lmfadal Cherkaoui, 6527 Rabat, Maroc
| | - F Ammar
- Service de chirurgie vasculaire, CHU de Rabat, rue lmfadal Cherkaoui, 6527 Rabat, Maroc
| | - Y Bensaid
- Service de chirurgie vasculaire, CHU de Rabat, rue lmfadal Cherkaoui, 6527 Rabat, Maroc
| | - B Feito
- Service de chirurgie vasculaire et thoracique, centre hospitalier René-Dubos, 95300 Pontoise, France
| | - F Bellenot
- Service de chirurgie vasculaire et thoracique, centre hospitalier René-Dubos, 95300 Pontoise, France
| | - A Fallouh
- Service de chirurgie vasculaire et thoracique, centre hospitalier René-Dubos, 95300 Pontoise, France
| | - E Cheysson
- Service de chirurgie vasculaire et thoracique, centre hospitalier René-Dubos, 95300 Pontoise, France
| |
Collapse
|
28
|
Pham Dang A, Fourcade L, Bertin F, Mameli A, Arhip S, Gardet E. [MacLeod syndrome and pneumothorax: don't be fooled]. Rev Mal Respir 2012. [PMID: 23200584 DOI: 10.1016/j.rmr.2012.06.014] [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: 11/15/2022]
Abstract
INTRODUCTION MacLeod syndrome, also known as Swyer-James syndrome, is a rare syndrome characterized by unilateral lung hyperlucency. It is a form of constrictive bronchiolitis which is caused by repeated acute bronchiolitis and/or pulmonary infections during infancy. CASE REPORT The patient was a 26-year-old man who had had a first left pneumothorax at the age of 21. He smokes tobacco. When he was 1-year-old he had experienced repeated episodes of acute bronchiolitis. At age 26, he suffered from a second left pneumothorax which was wrongly diagnosed as a recurrent drain-resistant pneumothorax. Misdiagnosed, he underwent a chemical pleurodesis during thoracoscopy. As a hyperlucency remained in the left upper part of the lung on chest X-ray, further investigations were undertaken and a diagnosis of MacLeod syndrome was made. CONCLUSIONS MacLeod syndrome is rare. It can be associated with pneumothorax which can be a source of misdiagnosis and error in the management of these patients. Therefore, the diagnostic criteria and therapeutic indications are reiterated. The probable mechanism of association between pneumothorax and Macleod syndrome is also discussed.
Collapse
Affiliation(s)
- A Pham Dang
- Service de chirurgie infantile, hôpital Mère-Enfant, 8 avenue Dominique-Larrey, Limoges cedex, France.
| | | | | | | | | | | |
Collapse
|
29
|
Robledo R, Corrias L, Bachis V, Puddu N, Mameli A, Vona G, Calò CM. Analysis of a Genetic Isolate: The Case of Carloforte (Italy). Hum Biol 2012; 84:735-54. [DOI: 10.3378/027.084.0602] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2013] [Indexed: 01/19/2023]
|
30
|
Abstract
Psoriasis and psoriatic arthritis are linked diseases characterised by (distinct ?) immune-mediated pathogenetic mechanisms and by a genetic background interacting with environmental factors. Some candidate susceptibility genes have been studied extensively; they include HLA genes, genes within the HLA region and genes outside the HLA region; among them corneodesmosin and other genes of PSORS1 region, MICA and TNF-a polymorphisms. The main findings in the literature are discussed.
Collapse
Affiliation(s)
- A Mathieu
- Rheumatology Unit, University of Cagliari, Monserrato, Cagliari, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Mameli A, Barcellona D, Vannini ML, Marongiu F. A routine silica-based activated partial thromboplastin time (Hemosil aPTT-SP™) mostly excludes the presence of lupus anticoagulant. Int J Lab Hematol 2011; 33:e12-3. [DOI: 10.1111/j.1751-553x.2011.01314.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
32
|
Mameli A, Barcellona D, Vannini ML, Marongiu F. High frequency of inadequate test requests for antiphospholipid antibodies in daily clinical practice. Clin Chem Lab Med 2011; 49:695-8. [PMID: 21303298 DOI: 10.1515/cclm.2011.111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We have empirically noted that many physicians routinely request anti-phospholipid antibodies (aPL) without a correct clinical indication. The aim of this study was to evaluate retrospectively whether aPL testing at our Thrombosis Centre was justified. METHODS Medical records from 520 subjects for aPL screening tests for various clinical conditions were reviewed. The aPL screening tests were: lupus anticoagulant (LA), anti-cardiolipin antibodies (aCL) and anti-β(2) glycoptotein I (aβ(2) GPI). Requests for aPL screening were divided into justified, potentially justified or not adequately justified. RESULTS aPL testing requests were considered justified in 358 (69%) patients, potentially justified in 66 (12.6%) and not adequately justified in 96 (18.4%). LA was positive in 65 (18%) of justified requests and in only one (1%) of the 96 potentially justified requests. None of the 66 not adequately justified for aPL testing was positive for LA. aβ(2) GPI was positive in 63 (17.6%) of the 358 justified, in four (6%) of the 66 potentially justified and in five (5.2%) of the 96 not adequately justified requests; aCL IgG were positive in 59 (16.4%) of the 358 justified and in five (7.5%) and six (6.2%) of the potentially justified and not adequately justified requests, respectively. The presence of the triple aPL positivity was found exclusively in the justified requests. CONCLUSIONS This study suggests that requests for aPL tests should be addressed more adequately. This work could be an example of how to focus attention on requests for laboratory tests especially on the basis of valid clinical criteria before the analyte is measured.
Collapse
Affiliation(s)
- Antonella Mameli
- Dipartimento di Scienze Mediche Internistiche M. Aresu and Azienda Mista Ospedaliero-Universitaria, University of Cagliari, Cagliari, Italy
| | | | | | | |
Collapse
|
33
|
|
34
|
Mameli A, Barcellona D, Marongiu F. Rheumatoid arthritis and thrombosis. Clin Exp Rheumatol 2009; 27:846-855. [PMID: 19917173] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To review prevalence, risk factors and mechanisms of thrombosis in rheumatoid arthritis (RA). METHODS Available medical literature on PubMed was reviewed and relevant information summarized. RESULTS Patients affected by RA present an increased risk of thromboembolism, an important cause of morbidity and mortality. Research is focused on the role of disease-associated risk factors and predisposing conditions such as endothelial dysfunction, hypercoagulability, pro-thrombotic conditions, inflammatory markers, immobility and complications following major knee or hip replacement. CONCLUSION Thrombosis is a possible manifestation in RA patients. A number of factors are suspected to play a role in the increased thromboembolic risk. The mechanisms responsible for thrombosis in these patients remain unclear, however, the identification of the thrombophilic risk factors is clinically useful to determine in which patients occurrence is more likely.
Collapse
Affiliation(s)
- A Mameli
- Azienda Ospedaliero-Universitaria of Cagliari, Italy.
| | | | | |
Collapse
|
35
|
Gatibelza ME, Laroye B, Lombard J, Mameli A, Thomas E. Management of a Ruptured Infected Abdominal Aortic Aneurysm and a Spondylodiscitis Due to Gemella haemolysans. Ann Vasc Surg 2009; 23:536.e13-7. [PMID: 19110401 DOI: 10.1016/j.avsg.2008.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2007] [Revised: 10/21/2008] [Accepted: 10/27/2008] [Indexed: 02/06/2023]
Affiliation(s)
- M E Gatibelza
- Department of Vascular and Thoracic Surgery, Centre Hospitalier de Niort, Niort Cedex, France.
| | | | | | | | | |
Collapse
|
36
|
Cauli A, Porru G, Vacca A, Mameli A, Ibba V, Mura V, Piga M, Mathieu A. [IFN-alpha-induced psoriatic arthritis and HCV-related liver cirrhosis. Therapeutic options and patient's opinion]. Reumatismo 2009; 60:57-60. [PMID: 18432326 DOI: 10.4081/reumatismo.2008.57] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hepatitis C virus (HCV) infection in the setting of Psoriatic Arthritis is an additional variable to be considered in the therapeutic approach to the disease because of the complications of an immunosuppressive treatment in the course of a chronic infection and the possible hepatotoxicity of many drugs conventionally used to treat psoriatic arthritis. The case reported explores the therapeutic options in a patient with IFN-alpha-induced psoriatic arthritis, characterised by severe arthritis and psoriasis but also the concomitant presence of HCV chronic hepatitis, in light of the patient's concerns.
Collapse
Affiliation(s)
- A Cauli
- Cattedra di Reumatologia II, Dipartimento di Scienze Mediche, Università degli Studi di Cagliari, Policlinico Universitario, 09042 Cagliari, Italia.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Mameli A, Cauli A, Taccari E, Scarpa R, Punzi L, Lapadula G, Peluso R, Ramonda R, Spadaro A, Iannone F, Fanni V, Vacca A, Passiu G, Fiorillo MT, Carcassi C, Sorrentino R, Mathieu A. Association of MICA alleles with psoriatic arthritis and its clinical forms. A multicenter Italian study. Clin Exp Rheumatol 2008; 26:649-652. [PMID: 18799098] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Analysis of the association between psoriatic arthritis (PsA) clinical forms and MICA gene transmembrane polymorphisms. METHODS Patients were classified as having peripheral asymmetric oligoarthritis (AO), peripheral symmetric poly-arthritis (PA) and spondylitis (SP), or disease combinations (PA/SP, OA/SP). Two hundred and twenty-six patients with PsA were typed for MICA exon 5 microsatellite (TM) by heteroduplex analysis and compared with 225 normal controls. RESULTS MICA-TM microsatellite typing revealed that, among the different clinical forms of PsA, only the combined PA/SP subset shows a significant positive association with MICA-A9 and a lower frequency of MICA-A4, A5 genotype in PsA patients with a decrease, only in the PA/SP cohort, of all MICA-A5 combinations except MICA-A5, -A9. CONCLUSION These results suggest a role for genes within the HLA region in the pathogenesis of PsA, and reinforce the idea that the different forms of PsA may have heterogeneous genetic basis.
Collapse
Affiliation(s)
- A Mameli
- 2nd Chair of Rheumatology and Rheumatology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Vacca A, Garau P, Cauli A, Mameli A, Mathieu A. Primary antiphospholipid syndrome with mesenteric venous thrombosis presenting with intestinal infarction: a case description. Lupus 2007; 16:455-6. [PMID: 17664239 DOI: 10.1177/0961203307078699] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
39
|
Cauli A, Vacca A, Mameli A, Passiu G, Fiorillo MT, Sorrentino R, Mathieu A. A sardinian patient with ankylosing spondylitis and HLA–B*2709 co-occurring with HLA–B*1403. ACTA ACUST UNITED AC 2007; 56:2807-9. [PMID: 17665402 DOI: 10.1002/art.22819] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
40
|
Vacca A, Siotto P, Cauli A, Montisci R, Garau P, Ibba V, Mameli A, Passiu G, Iliceto S, Mathieu A. Absence of epicardial coronary stenosis in patients with systemic sclerosis with severe impairment of coronary flow reserve. Ann Rheum Dis 2006; 65:274-5. [PMID: 16410537 PMCID: PMC1798021 DOI: 10.1136/ard.2005.040154] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
41
|
Sanna G, Bertolaccini ML, Mameli A, Hughes GRV, Khamashta MA, Mathieu A. Antiphospholipid antibodies in patients with scleroderma: prevalence and clinical significance. Ann Rheum Dis 2006; 64:1795-6. [PMID: 16284349 PMCID: PMC1755293 DOI: 10.1136/ard.2005.038430] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
42
|
Pizzamiglio M, Mameli A, My D, Garofano L. Forensic identification of a murderer by LCN DNA collected from the inside of the victim's car. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/s0531-5131(03)01855-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
43
|
Gerra G, Garofano L, Bosari S, Pellegrini C, Zaimovic A, Moi G, Bussandri M, Moi A, Brambilla F, Mameli A, Pizzamiglio M, Donnini C. Analysis of monoamine oxidase A (MAO-A) promoter polymorphism in male heroin-dependent subjects: behavioural and personality correlates. J Neural Transm (Vienna) 2004; 111:611-21. [PMID: 15088154 DOI: 10.1007/s00702-004-0129-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2003] [Accepted: 02/11/2004] [Indexed: 10/26/2022]
Abstract
The promoter of the monoamine oxidase A (MAO-A) gene was analysed to test whether length variation of the repeat polymorphism contributes to variation in individual vulnerability to aggressive-criminal behaviour, and liability to heroin dependence. The repeat number of the MAO-A polymorphism was assessed in 199 male subjects of Italian descent, a sample comprising 95 healthy subjects and 104 heroin-dependent subjects including 52 addicted individuals with violent behaviour and antisocial personality disorder. The frequency of the low-activity 3-repeat allele was significantly higher in violent offenders among heroin addicts, compared to addicted individuals without antisocial behaviour (34.6 vs. 15.4%; p<0.03) and controls (18.9%; p<0.05). No significant difference was evidenced in the frequencies of the MAO-A alleles between heroin-dependent subjects in general and control subjects. High activity 4-repeat allele frequency was significantly higher in addicted individuals without antisocial behavior compared to antisocial-aggressive heroin-dependent subjects (76.9 vs. 55.8%; p<0.02). Buss Durkee Hostility Inventory (BDHI) mean total scores were significantly higher in heroin addicts than in controls (p<0.001), and in antisocial-violent heroin addicts in comparison with addicted individuals without antisocial behaviour (p<0.005). Among heroin addicts BDHI irritability, suspiciousness and resentment subscales scores were found significantly higher in low activity 3-repeat allele subjects than in high activity alleles subjects (p<0.001; p<0.05; p<0.05, respectively). No association was found between MAO-A polymorphism and suicide history. Our findings suggest that the low-activity 3-repeat allele of the MAO-A promoter polymorphism confers increased susceptibility to antisocial-violent behavior and aggressiveness, rather than drug dependence per se, in heroin-dependent males.
Collapse
Affiliation(s)
- G Gerra
- Centro Studi Farmaco-tossicodipendenze, Ser T, AUSL, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
The genetic structure of the population of Alia (Sicily, Italy) was analyzed using 15 short tandem repeats: TPOX, D2S1338, D3S1358, FIBRA, D5S818, CSF1PO, D7S820, D8S1179, TH01, VWA, D13S317, D16S539, D18S51, D19S433, and D21S11. Two of these markers, D2S1338 and D19S433, have never before been used in research on population genetics and only recently have they been put to use in forensic medicine. Results of the analysis underline the genetic isolation of the Alia population and show it to be a recent bottleneck as a consequence of a cholera epidemic in 1837. While comparing the Alia population with other populations from Sicily, a genetic heterogeneity within Sicily was uncovered, thus confirming previous results obtained from the analysis of classical markers. This heterogeneity underlines the existence of genetic boundaries within the island. Comparisons with other Italian, Mediterranean, and European populations highlight the differentiation of the Sicilian population, reflecting the presence of a genetic boundary that separates Sicily from northern and central Italy and from the western Mediterranean basin.
Collapse
Affiliation(s)
- C M Calò
- Department of Experimental Biology, Section of Anthropological Sciences, University of Cagliari, Cagliari, Italy
| | | | | | | | | |
Collapse
|
45
|
Cauli A, Dessole G, Fiorillo MT, Vacca A, Mameli A, Bitti P, Passiu G, Sorrentino R, Mathieu A. Increased level of HLA-B27 expression in ankylosing spondylitis patients compared with healthy HLA-B27-positive subjects: a possible further susceptibility factor for the development of disease. Rheumatology (Oxford) 2002; 41:1375-9. [PMID: 12468816 DOI: 10.1093/rheumatology/41.12.1375] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [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: 11/12/2022] Open
Abstract
OBJECTIVE In B27 transgenic rats, susceptibility to the development of a spondyloarthropathy-like disease has been shown to correlate with the level of B27 transgene expression on lymphoid cells. The aim of this work was to study HLA-B27 molecule expression in peripheral blood mononuclear cells (PBMCs) from patients with ankylosing spondylitis (AS) and from normal controls (NC). METHODS Twenty B27(+) AS patients and 16 B27(+) NC were studied. HLA-B27 whole molecules and free heavy chains (HCs) and total HLA class I molecules were evaluated at the surface of PBMCs by immunofluorescence and flow cytometry. B27 subtypes were defined with the PCR-SSP (polymerase chain reaction-sequence-specific primer) technique. Cellular activation was evaluated by the expression of CD69, CD25 molecules and interferon gamma (IFN-gamma) production. RESULTS B27 expression was 55,536.3+/-18,961.0 MESF (molecules of equivalent soluble fluorochromes) units in AS and 25,936.0+/-12,117.5 MESF in NC (P=0.00009), total HLA class I expression was 448,840.2+/-136,293.8 MESF in AS and 533,494.4+/-232,931.1 MESF in NC (not significant), HC expression was 10,593.4+/-6,396.1 MESF in AS and 14,843.0+/-7,544.2 MESF in NC (not significant). The higher B27 expression in the SA group was not due to higher cell activation as it was not correlated with CD69 and CD25 expression in PBMCs or with the level of IFN-gamma. HLA-B27 expression did not correlate with indexes of disease status [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Metrology Index (BASMI)]. CONCLUSIONS We found greater expression of HLA-B27 molecules in patients with AS than in healthy subjects. This phenomenon was not accompanied by general up-regulation of HLA class I molecules or by greater expression of classical T-cell activation markers. On this basis we propose that the higher expression of the HLA-B27 molecules is a further predisposing factor for the development of AS.
Collapse
Affiliation(s)
- A Cauli
- Cattedra di Reumatologia II, University of Cagliari, Sardinia, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Mathieu A, Sanna G, Mameli A, Pinna C, Vacca A, Cauli A, Passiu G, Piga M. Sustained normalization of cerebral blood-flow after iloprost therapy in a patient with neuropsychiatric systemic lupus erythematosus. Lupus 2002; 11:52-6. [PMID: 11898921 DOI: 10.1191/0961203302lu137cr] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [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: 11/05/2022]
Abstract
We report the case of a 30-year-old caucasian woman affected by SLE who developed neurological symptoms (prosopagnosia and visual-spatial agnosia) after nine years of disease. Brain MRI showed no abnormalities while a brain SPECT scan showed diffuse uptake defects and hypoperfusion areas in the right and left frontal-parietal regions. At that time the patient was on hydroxychloroquine (400 mg/day) and oral prednisolone (0.5 mg/kg/day) as maintenance therapy. One year later the patient showed worsening of Raynaud's phenomenon with digital dystrophic lesions and was therefore treated with an intravenous infusion of Iloprost (1.5 ng/kg/min per 6h/day for 10 days consecutively), while baseline treatment remained unchanged. One month later the patient showed a dramatic improvement in her cognitive function and subsequent SPECT scans showed the gradual disappearance of perfusion abnormalities. This first report of Iloprost treatment in CNS lupus suggests the potential therapeutic usefulness of this drug in patients with SLE and functional CNS involvement.
Collapse
Affiliation(s)
- A Mathieu
- Center for Systemic Rheumatic Diseases, Cagliari, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Cauli A, Dessole G, Nurchis PP, Vacca A, Mameli A, Garau P, Pala R, Passiu G, Mathieu A. [The role of HLA-B27 molecules in the pathogenesis of ankylosing spondylitis]. Reumatismo 2002; 54:266-71. [PMID: 12404037 DOI: 10.4081/reumatismo.2002.266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [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: 11/23/2022] Open
Abstract
Ankylosing Spondylitis (AS) is characterised by the strongest association with an HLA antigen ever described for any disease. It represents therefore the ideal model for the understanding of the link between immune-mediated diseases and the HLA system. The role of HLA-B27 in the pathogenesis of AS will be discussed focusing on the recently described higher expression of these molecules in patients with AS compared with healthy controls.
Collapse
Affiliation(s)
- A Cauli
- Cattedra di Reumatologia II, Dipartimento di Scienze Mediche, Università degli Studi di Cagliari.
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Vacca A, Garau P, Meloni L, Montisci R, Mameli A, Passiu G, Mathieu A. Right atrial thrombosis in systemic lupus erythematosus. Clin Exp Rheumatol 2001; 19:761. [PMID: 11791659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
|