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Amaducci S, Colonna N, Cosentino L, Cristallo S, Finocchiaro P, Krtička M, Massimi C, Mastromarco M, Mazzone A, Maugeri EA, Mengoni A, Roederer IU, Straniero O, Valenta S, Vescovi D, Aberle O, Alcayne V, Andrzejewski J, Audouin L, Babiano-Suarez V, Bacak M, Barbagallo M, Bennett S, Berthoumieux E, Billowes J, Bosnar D, Brown A, Busso M, Caamaño M, Caballero-Ontanaya L, Calviño F, Calviani M, Cano-Ott D, Casanovas A, Cerutti F, Chiaveri E, Cortés G, Cortés-Giraldo MA, Damone LA, Davies PJ, Diakaki M, Dietz M, Domingo-Pardo C, Dressler R, Ducasse Q, Dupont E, Durán I, Eleme Z, Fernández-Domínguez B, Ferrari A, Furman V, Göbel K, Garg R, Gawlik-Ramięga A, Gilardoni S, Gonçalves IF, González-Romero E, Guerrero C, Gunsing F, Harada H, Heinitz S, Heyse J, Jenkins DG, Junghans A, Käppeler F, Kadi Y, Kimura A, Knapová I, Kokkoris M, Kopatch Y, Kurtulgil D, Ladarescu I, Lederer-Woods C, Leeb H, Lerendegui-Marco J, Lonsdale SJ, Macina D, Manna A, Martínez T, Masi A, Mastinu P, Mendoza E, Michalopoulou V, Milazzo PM, Mingrone F, Moreno-Soto J, Musumarra A, Negret A, Nolte R, Ogállar F, Oprea A, Patronis N, Pavlik A, Perkowski J, Petrone C, Piersanti L, Pirovano E, Porras I, Praena J, Quesada JM, Ramos-Doval D, Rauscher T, Reifarth R, Rochman D, Rubbia C, Sabaté-Gilarte M, Saxena A, Schillebeeckx P, Schumann D, Sekhar A, Smith AG, Sosnin NV, Sprung P, Stamatopoulos A, Tagliente G, Tain JL, Tarifeño-Saldivia A, Tassan-Got L, Thomas T, Torres-Sánchez P, Tsinganis A, Ulrich J, Urlass S, Vannini G, Variale V, Vaz P, Ventura A, Vlachoudis V, Vlastou R, Wallner A, Woods PJ, Wright T, Žugec P. Measurement of the ^{140}Ce(n,γ) Cross Section at n_TOF and Its Astrophysical Implications for the Chemical Evolution of the Universe. Phys Rev Lett 2024; 132:122701. [PMID: 38579210 DOI: 10.1103/physrevlett.132.122701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/09/2023] [Accepted: 01/31/2024] [Indexed: 04/07/2024]
Abstract
^{140}Ce(n,γ) is a key reaction for slow neutron-capture (s-process) nucleosynthesis due to being a bottleneck in the reaction flow. For this reason, it was measured with high accuracy (uncertainty ≈5%) at the n_TOF facility, with an unprecedented combination of a high purity sample and low neutron-sensitivity detectors. The measured Maxwellian averaged cross section is up to 40% higher than previously accepted values. Stellar model calculations indicate a reduction around 20% of the s-process contribution to the Galactic cerium abundance and smaller sizeable differences for most of the heavier elements. No variations are found in the nucleosynthesis from massive stars.
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Affiliation(s)
- S Amaducci
- INFN Laboratori Nazionali del Sud, Catania, Italy
| | - N Colonna
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Italy
| | - L Cosentino
- INFN Laboratori Nazionali del Sud, Catania, Italy
| | - S Cristallo
- Istituto Nazionale di Astrofisica - Osservatorio Astronomico d'Abruzzo, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Perugia, Italy
| | | | - M Krtička
- Charles University, Prague, Czech Republic
| | - C Massimi
- Istituto Nazionale di Fisica Nucleare, Sezione di Bologna, Italy
- Dipartimento di Fisica e Astronomia, Università di Bologna, Italy
| | - M Mastromarco
- European Organization for Nuclear Research (CERN), Switzerland
| | - A Mazzone
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Italy
- Consiglio Nazionale delle Ricerche, Bari, Italy
| | - E A Maugeri
- Paul Scherrer Institut (PSI), Villigen, Switzerland
| | - A Mengoni
- Istituto Nazionale di Fisica Nucleare, Sezione di Bologna, Italy
- Agenzia nazionale per le nuove tecnologie, l'energia e lo sviluppo economico sostenibile (ENEA), Italy
| | - I U Roederer
- Department of Physics, North Carolina State University, Raleigh, Norh Carolina 27695, USA
- Department of Astronomy, University of Michigan, Ann Arbor, Michigan 48109, USA
- Joint Institute for Nuclear Astrophysics-Center for the Evolution of the Elements (JINA-CEE), USA
| | - O Straniero
- Istituto Nazionale di Astrofisica - Osservatorio Astronomico d'Abruzzo, Italy
- INFN Sezione Napoli, Napoli, Italy
| | - S Valenta
- Charles University, Prague, Czech Republic
| | - D Vescovi
- Istituto Nazionale di Astrofisica - Osservatorio Astronomico d'Abruzzo, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Perugia, Italy
| | - O Aberle
- European Organization for Nuclear Research (CERN), Switzerland
| | - V Alcayne
- Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT), Spain
| | | | - L Audouin
- Institut de Physique Nucléaire, CNRS-IN2P3, Univ. Paris-Sud, Université Paris-Saclay, F-91406 Orsay Cedex, France
| | - V Babiano-Suarez
- Instituto de Física Corpuscular, CSIC - Universidad de Valencia, Spain
| | - M Bacak
- European Organization for Nuclear Research (CERN), Switzerland
- TU Wien, Atominstitut, Stadionallee 2, 1020 Wien, Austria
- CEA Irfu, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Barbagallo
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Italy
- European Organization for Nuclear Research (CERN), Switzerland
| | - S Bennett
- University of Manchester, United Kingdom
| | - E Berthoumieux
- CEA Irfu, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J Billowes
- University of Manchester, United Kingdom
| | - D Bosnar
- Department of Physics, Faculty of Science, University of Zagreb, Zagreb, Croatia
| | - A Brown
- University of York, United Kingdom
| | - M Busso
- Istituto Nazionale di Fisica Nucleare, Sezione di Perugia, Italy
- Dipartimento di Fisica e Geologia, Università di Perugia, Italy
| | - M Caamaño
- IGFAE-Universidade de Santiago de Compostela, Spain
| | | | - F Calviño
- Universitat Politècnica de Catalunya, Spain
| | - M Calviani
- European Organization for Nuclear Research (CERN), Switzerland
| | - D Cano-Ott
- Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT), Spain
| | | | - F Cerutti
- European Organization for Nuclear Research (CERN), Switzerland
| | - E Chiaveri
- European Organization for Nuclear Research (CERN), Switzerland
- University of Manchester, United Kingdom
| | - G Cortés
- Universitat Politècnica de Catalunya, Spain
| | | | - L A Damone
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Italy
- Dipartimento Interateneo di Fisica, Università degli Studi di Bari, Italy
| | - P J Davies
- University of Manchester, United Kingdom
| | - M Diakaki
- European Organization for Nuclear Research (CERN), Switzerland
- National Technical University of Athens, Greece
| | - M Dietz
- School of Physics and Astronomy, University of Edinburgh, United Kingdom
| | - C Domingo-Pardo
- Instituto de Física Corpuscular, CSIC - Universidad de Valencia, Spain
| | - R Dressler
- Paul Scherrer Institut (PSI), Villigen, Switzerland
| | - Q Ducasse
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, 38116 Braunschweig, Germany
| | - E Dupont
- CEA Irfu, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - I Durán
- IGFAE-Universidade de Santiago de Compostela, Spain
| | - Z Eleme
- University of Ioannina, Greece
| | | | - A Ferrari
- European Organization for Nuclear Research (CERN), Switzerland
| | - V Furman
- Affiliated with an institute or an international laboratory covered by a cooperation agreement with CERN
| | - K Göbel
- Goethe University Frankfurt, Germany
| | - R Garg
- School of Physics and Astronomy, University of Edinburgh, United Kingdom
| | | | - S Gilardoni
- European Organization for Nuclear Research (CERN), Switzerland
| | | | - E González-Romero
- Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT), Spain
| | | | - F Gunsing
- CEA Irfu, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - H Harada
- Japan Atomic Energy Agency (JAEA), Tokai-Mura, Japan
| | - S Heinitz
- Paul Scherrer Institut (PSI), Villigen, Switzerland
| | - J Heyse
- European Commission, Joint Research Centre (JRC), Geel, Belgium
| | | | - A Junghans
- Helmholtz-Zentrum Dresden-Rossendorf, Germany
| | - F Käppeler
- Karlsruhe Institute of Technology, Campus North, IKP, 76021 Karlsruhe, Germany
| | - Y Kadi
- European Organization for Nuclear Research (CERN), Switzerland
| | - A Kimura
- Japan Atomic Energy Agency (JAEA), Tokai-Mura, Japan
| | - I Knapová
- Charles University, Prague, Czech Republic
| | - M Kokkoris
- National Technical University of Athens, Greece
| | - Y Kopatch
- Affiliated with an institute or an international laboratory covered by a cooperation agreement with CERN
| | | | - I Ladarescu
- Instituto de Física Corpuscular, CSIC - Universidad de Valencia, Spain
| | - C Lederer-Woods
- School of Physics and Astronomy, University of Edinburgh, United Kingdom
| | - H Leeb
- TU Wien, Atominstitut, Stadionallee 2, 1020 Wien, Austria
| | | | - S J Lonsdale
- School of Physics and Astronomy, University of Edinburgh, United Kingdom
| | - D Macina
- European Organization for Nuclear Research (CERN), Switzerland
| | - A Manna
- Istituto Nazionale di Fisica Nucleare, Sezione di Bologna, Italy
- Dipartimento di Fisica e Astronomia, Università di Bologna, Italy
| | - T Martínez
- Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT), Spain
| | - A Masi
- European Organization for Nuclear Research (CERN), Switzerland
| | - P Mastinu
- INFN Laboratori Nazionali di Legnaro, Italy
| | - E Mendoza
- Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT), Spain
| | - V Michalopoulou
- European Organization for Nuclear Research (CERN), Switzerland
- National Technical University of Athens, Greece
| | - P M Milazzo
- Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, Italy
| | - F Mingrone
- European Organization for Nuclear Research (CERN), Switzerland
| | - J Moreno-Soto
- CEA Irfu, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Musumarra
- Istituto Nazionale di Fisica Nucleare, Sezione di Catania, Italy
- Department of Physics and Astronomy, University of Catania, Italy
| | - A Negret
- Horia Hulubei National Institute of Physics and Nuclear Engineering, Romania
| | - R Nolte
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, 38116 Braunschweig, Germany
| | | | - A Oprea
- Horia Hulubei National Institute of Physics and Nuclear Engineering, Romania
| | | | - A Pavlik
- University of Vienna, Faculty of Physics, Vienna, Austria
| | | | - C Petrone
- Horia Hulubei National Institute of Physics and Nuclear Engineering, Romania
| | - L Piersanti
- Istituto Nazionale di Astrofisica - Osservatorio Astronomico d'Abruzzo, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Perugia, Italy
| | - E Pirovano
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, 38116 Braunschweig, Germany
| | | | | | | | - D Ramos-Doval
- Institut de Physique Nucléaire, CNRS-IN2P3, Univ. Paris-Sud, Université Paris-Saclay, F-91406 Orsay Cedex, France
| | - T Rauscher
- Department of Physics, University of Basel, Switzerland
- Centre for Astrophysics Research, University of Hertfordshire, United Kingdom
| | | | - D Rochman
- Paul Scherrer Institut (PSI), Villigen, Switzerland
| | - C Rubbia
- European Organization for Nuclear Research (CERN), Switzerland
| | - M Sabaté-Gilarte
- European Organization for Nuclear Research (CERN), Switzerland
- Universidad de Sevilla, Spain
| | - A Saxena
- Bhabha Atomic Research Centre (BARC), India
| | - P Schillebeeckx
- European Commission, Joint Research Centre (JRC), Geel, Belgium
| | - D Schumann
- Paul Scherrer Institut (PSI), Villigen, Switzerland
| | - A Sekhar
- University of Manchester, United Kingdom
| | - A G Smith
- University of Manchester, United Kingdom
| | - N V Sosnin
- University of Manchester, United Kingdom
| | - P Sprung
- Paul Scherrer Institut (PSI), Villigen, Switzerland
| | | | - G Tagliente
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Italy
| | - J L Tain
- Instituto de Física Corpuscular, CSIC - Universidad de Valencia, Spain
| | | | - L Tassan-Got
- European Organization for Nuclear Research (CERN), Switzerland
- Institut de Physique Nucléaire, CNRS-IN2P3, Univ. Paris-Sud, Université Paris-Saclay, F-91406 Orsay Cedex, France
- National Technical University of Athens, Greece
| | - Th Thomas
- Goethe University Frankfurt, Germany
| | | | - A Tsinganis
- European Organization for Nuclear Research (CERN), Switzerland
| | - J Ulrich
- Paul Scherrer Institut (PSI), Villigen, Switzerland
| | - S Urlass
- European Organization for Nuclear Research (CERN), Switzerland
- Helmholtz-Zentrum Dresden-Rossendorf, Germany
| | - G Vannini
- Istituto Nazionale di Fisica Nucleare, Sezione di Bologna, Italy
- Dipartimento di Fisica e Astronomia, Università di Bologna, Italy
| | - V Variale
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Italy
| | - P Vaz
- Instituto Superior Técnico, Lisbon, Portugal
| | - A Ventura
- Istituto Nazionale di Fisica Nucleare, Sezione di Bologna, Italy
| | - V Vlachoudis
- European Organization for Nuclear Research (CERN), Switzerland
| | - R Vlastou
- National Technical University of Athens, Greece
| | - A Wallner
- Australian National University, Canberra, Australia
| | - P J Woods
- School of Physics and Astronomy, University of Edinburgh, United Kingdom
| | - T Wright
- University of Manchester, United Kingdom
| | - P Žugec
- Department of Physics, Faculty of Science, University of Zagreb, Zagreb, Croatia
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Garattini L, Finazzi B, Mazzone A. Antibiotic shortages in Europe: Another question of prices? Eur J Intern Med 2024:S0953-6205(24)00125-0. [PMID: 38494376 DOI: 10.1016/j.ejim.2024.03.018] [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: 02/29/2024] [Accepted: 03/13/2024] [Indexed: 03/19/2024]
Affiliation(s)
- L Garattini
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
| | - B Finazzi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - A Mazzone
- Department of Internal Medicine, Legnano and Magenta Hospitals, ASST Ovest Milanese, Legnano, MI, Italy
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Mazzone A, Montano N. Admission in Internal Medicine: The Italian issue. Eur J Intern Med 2024:S0953-6205(24)00091-8. [PMID: 38462417 DOI: 10.1016/j.ejim.2024.02.035] [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: 02/07/2024] [Revised: 02/19/2024] [Accepted: 02/27/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Antonino Mazzone
- ASST OVEST MILANESE, Via Papa Giovanni Paolo II, 20025 Legnano MI, Italy.
| | - Nicola Montano
- Department of Clinical Sciences and Community Health, University of Milan IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, 20121 Milano, Italy
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Mumoli N, Bonaventura A, Marchesi C, Cei M, Morbidoni L, Donatiello I, Mazzone A, Dentali F. A new score to predict Clostridioides difficile infection in medical patients: a sub-analysis of the FADOI-PRACTICE study. Intern Emerg Med 2023; 18:2003-2009. [PMID: 37633862 DOI: 10.1007/s11739-023-03395-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/08/2023] [Indexed: 08/28/2023]
Abstract
Medical divisions are at high risk of Clostridioides difficile infection (CDI) due to patients' frailty and complexity. This sub-analysis of the FADOI-PRACTICE study included patients presenting with diarrhea either at admission or during hospitalization. CDI diagnosis was confirmed when both enzyme immunoassay and A and B toxin detection were found positive. The aim of this sub-analysis was the identification of a new score to predict CDI in hospitalized, medical patients. Five hundred and seventy-two patients with diarrhea were considered. More than half of patients was female, 40% on antibiotics in the previous 4 weeks and 60% on proton pump inhibitors (PPIs). CDI diagnosis occurred in 103 patients (18%). Patients diagnosed with CDI were older, more frequently of female sex, recently hospitalized and bed-ridden, and treated with antibiotics and PPIs. Through a backward stepwise logistic regression model, age > 65 years, female sex, recent hospitalization, recent antibiotic therapy, active cancer, prolonged hospital stay (> 12 days), hypoalbuminemia (albumin < 3 g/dL), and leukocytosis (white blood cells > 9 × 10^9/L) were found to independently predict CDI occurrence. These variables contributed to building a clinical prognostic score with a good sensitivity and a modest specificity for a value > 3 (79% and 58%, respectively; AUC 0.75, 95% CI 0.71-0.79, p < 0.001), that identified low-risk (score ≤ 3; 42.5%) and high-risk (score > 3; 57.5%) patients. Although some classical risk factors were confirmed to increase CDI occurrence, the changing landscape of CDI epidemiology suggests a reappraisal of common risk factors and the development of novel risk scores based on local epidemiology.
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Affiliation(s)
- Nicola Mumoli
- Department of Internal Medicine, Ospedale Fornaroli, ASST Ovest Milanese, Magenta, MI, Italy.
| | - Aldo Bonaventura
- Department of Internal Medicine, Ospedale di Circolo and Fondazione Macchi, ASST Sette Laghi, Varese, Italy
| | - Chiara Marchesi
- Department of Internal Medicine, Legnano Hospital, ASST Ovest Milanese, Legnano, MI, Italy
| | - Marco Cei
- Department of Internal Medicine, Cecina Hospital, Cecina, LI, Italy
| | - Laura Morbidoni
- Department of Internal Medicine, Senigallia Hospital, Senigallia, AN, Italy
| | | | - Antonino Mazzone
- Department of Internal Medicine, Legnano Hospital, ASST Ovest Milanese, Legnano, MI, Italy
| | - Francesco Dentali
- Department of Medicine and Surgery, Insubria University, Varese, Italy
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Mazzone A, Mumoli N. New Coronary Heart Disease Risk Factors: The Dark Side of the Moon. Am J Med 2023; 136:e188-e189. [PMID: 37612027 DOI: 10.1016/j.amjmed.2023.05.008] [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: 04/18/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 08/25/2023]
Affiliation(s)
- Antonino Mazzone
- Department of Internal Medicine, Legnano and Magenta Hospitals, ASST Ovest Milanese, Legnano, MI, Italy.
| | - Nicola Mumoli
- Department of Internal Medicine, Legnano and Magenta Hospitals, ASST Ovest Milanese, Legnano, MI, Italy
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Gatti A, Zizzo G, De Paschale M, Tamburello A, Castelnovo L, Faggioli PM, Clerici P, Brando B, Mazzone A. Assessing SARS-CoV-2-specific T-cell reactivity in late convalescents and vaccinees: Comparison and combination of QuantiFERON and activation-induced marker assays, and relation with antibody status. PLoS One 2023; 18:e0285728. [PMID: 37220145 DOI: 10.1371/journal.pone.0285728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/28/2023] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVES Monitoring of SARS-CoV-2 spread and vaccination strategies have relied on antibody (Ab) status as a correlate of protection. We used QuantiFERON™ (QFN) and Activation-Induced Marker (AIM) assays to measure memory T-cell reactivity in unvaccinated individuals with prior documented symptomatic infection (late convalescents) and fully vaccinated asymptomatic donors (vaccinees). METHODS Twenty-two convalescents and 13 vaccinees were enrolled. Serum anti-SARS-CoV-2 S1 and N Abs were measured using chemiluminescent immunoassays. QFN was performed following instructions and interferon-gamma (IFN-γ) measured by ELISA. AIM was performed on aliquots of antigen-stimulated samples from QFN tubes. SARS-CoV-2-specific memory CD4+CD25+CD134+, CD4+CD69+CD137+ and CD8+CD69+CD137+ T-cell frequencies were measured by flow cytometry. RESULTS In convalescents, substantial agreement was observed between QFN and AIM assays. IFN-γ concentrations and AIM+ (CD69+CD137+) CD4+ T-cell frequencies correlated with each other, with Ab levels and AIM+ CD8+ T-cell frequencies, whereas AIM+ (CD25+CD134+) CD4+ T-cell frequencies correlated with age. AIM+ CD4+ T-cell frequencies increased with time since infection, whereas AIM+ CD8+ T-cell expansion was greater after recent reinfection. QFN-reactivity and anti-S1 titers were lower, whereas anti-N titers were higher, and no statistical difference in AIM-reactivity and Ab positivity emerged compared to vaccinees. CONCLUSIONS Albeit on a limited sample size, we confirm that coordinated, cellular and humoral responses are detectable in convalescents up to 2 years after prior infection. Combining QFN with AIM may enhance detection of naturally acquired memory responses and help stratify virus-exposed individuals in T helper 1-type (TH1)-reactive (QFNpos AIMpos Abshigh), non-TH1-reactive (QFNneg AIMpos Abshigh/low), and pauci-reactive (QFNneg AIMneg Abslow).
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Affiliation(s)
- Arianna Gatti
- Laboratory of Haematology, Transfusion Center, Legnano Hospital, ASST Ovest Milanese, via Papa Giovanni Paolo II, Legnano, Milan, Italy
| | - Gaetano Zizzo
- Department of Internal Medicine, Legnano and Cuggiono Hospitals, ASST Ovest Milanese, via Papa Giovanni Paolo II, Legnano, Milan, Italy
| | - Massimo De Paschale
- Unit of Microbiology, Legnano Hospital, ASST Ovest Milanese, via Papa Giovanni Paolo II, Legnano, Milan, Italy
| | - Antonio Tamburello
- Department of Internal Medicine, Legnano and Cuggiono Hospitals, ASST Ovest Milanese, via Papa Giovanni Paolo II, Legnano, Milan, Italy
| | - Laura Castelnovo
- Department of Internal Medicine, Legnano and Cuggiono Hospitals, ASST Ovest Milanese, via Papa Giovanni Paolo II, Legnano, Milan, Italy
| | - Paola Maria Faggioli
- Department of Internal Medicine, Legnano and Cuggiono Hospitals, ASST Ovest Milanese, via Papa Giovanni Paolo II, Legnano, Milan, Italy
| | - Pierangelo Clerici
- Unit of Microbiology, Legnano Hospital, ASST Ovest Milanese, via Papa Giovanni Paolo II, Legnano, Milan, Italy
| | - Bruno Brando
- Laboratory of Haematology, Transfusion Center, Legnano Hospital, ASST Ovest Milanese, via Papa Giovanni Paolo II, Legnano, Milan, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, Legnano and Cuggiono Hospitals, ASST Ovest Milanese, via Papa Giovanni Paolo II, Legnano, Milan, Italy
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Foglia E, Ferrario L, Garagiola E, Asperti F, Mazzone A, Gatti F, Varalli L, Ponsiglione C, Cannavacciuolo L. The role of INTERCheckWEB digital innovation in supporting polytherapy management. Sci Rep 2023; 13:5544. [PMID: 37016155 PMCID: PMC10072813 DOI: 10.1038/s41598-023-32844-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 04/03/2023] [Indexed: 04/06/2023] Open
Abstract
The study aims at defining the factors affecting the clinicians' decision of changing or confirming the treatment options for frail patients in polytherapy, supporting prescribing patterns, thus also figuring out if the inclination of the clinicians towards digital solutions (INTERCheckWEB) and specific guidelines, could play a role in their decision. A literature review was performed, revealing the main individual, organizational and decisional factors, impacting on the clinicians' propensity to change the current patients' therapy: the clinician perceptions of support in case of clinical guidelines use or INTERCheckWEB use were studied. A qualitative approach was implemented, and thirty-five clinicians completed a questionnaire, aimed at evaluating fifteen different clinical cases, defining if they would change the patient's current therapy depending on the level of information received. Three methodological approaches were implemented. (1) Bivariate correlations to test the relationships between variables. (2) Hierarchical sequential linear regression model to define the predictors of the clinician propensity to change therapy. (3) Fuzzy Qualitative Comparative Analysis-fsQCA, to figure out the combination of variables leading to the outcome. Patient's age and autonomy (p value = 0.000), as well as clinician's perception regarding IT ease of use (p value = 0.043) and seniority (p value = 0.009), number of drugs assumed by the patients (p value = 0.000) and number of concomitant diseases (p value = 0.000) are factors influencing a potential change in the current therapy. The fsQCA-crisp confirms that the clinical conditions of the patients are the driving factors that prompt the clinicians towards a therapy change.
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Affiliation(s)
- Emanuela Foglia
- LIUC Business School, LIUC- University Cattaneo, Healthcare Datascience LAB, Corso Matteotti 22, 21053, Castellanza, Varese, Italy
| | - Lucrezia Ferrario
- LIUC Business School, LIUC- University Cattaneo, Healthcare Datascience LAB, Corso Matteotti 22, 21053, Castellanza, Varese, Italy.
| | - Elisabetta Garagiola
- LIUC Business School, LIUC- University Cattaneo, Healthcare Datascience LAB, Corso Matteotti 22, 21053, Castellanza, Varese, Italy
| | - Federica Asperti
- LIUC Business School, LIUC- University Cattaneo, Healthcare Datascience LAB, Corso Matteotti 22, 21053, Castellanza, Varese, Italy
| | | | | | - Luca Varalli
- ASST Ovest Milanese Hospital, Legnano, Milano, Italy
| | - Cristina Ponsiglione
- Department of Industrial Engineering, University of Naples Federico II, Naples, Italy
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8
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Molica Colella F, Zizzo G, Parrino V, Filosa MT, Cavaliere R, Fazio F, Molica Colella AB, Mazzone A. Effectiveness and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: a 52-week real-life study in an Italian cohort. Adv Rheumatol 2023; 63:15. [PMID: 36973825 DOI: 10.1186/s42358-023-00295-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 11/16/2022] [Accepted: 03/12/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Secukinumab has shown high efficacy in randomized controlled trials in both ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Here, we investigated its real-life effectiveness and tolerability in a cohort of AS and PsA patients. METHODS We retrospectively analyzed medical records of outpatients with AS or PsA treated with secukinumab between December 2017 and December 2019. ASDAS-CRP and DAS28-CRP scores were used to measure axial and peripheral disease activity in AS and PsA, respectively. Data were collected at baseline and after 8, 24, and 52 weeks of treatment. RESULTS Eighty-five adult patients with active disease (29 with AS and 56 with PsA; 23 males and 62 females) were treated. Overall, mean disease duration was 6.7 years and biologic-naïve patients were 85%. Significant reductions in ASDAS-CRP and DAS28-CRP were observed at all time-points. Body weight (in AS) and disease activity status at baseline (particularly in PsA) significantly affected disease activity changes. ASDAS-defined inactive disease and DAS28-defined remission were achieved in comparable proportions between AS and PsA patients, at both 24 weeks (45% and 46%) and 52 weeks (65.5% and 68%, respectively); male sex was found an independent predictor of positive response (OR 5.16, P = 0.027). After 52 weeks, achievement of at least low disease activity and drug retention were observed in 75% of patients. Secukinumab was well-tolerated and only mild injection-site reactions were recorded in 4 patients. CONCLUSION In a real-world setting, secukinumab confirmed great effectiveness and safety in both AS and PsA patients. The influence of gender on treatment response deserves further attention.
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Affiliation(s)
- Francesco Molica Colella
- Unit of Rheumatology, Department of Internal Medicine, Azienda Ospedaliera (A.O.) "Papardo", Messina, Italy.
- Rheumatology Unit, A.O. Papardo, Messina, 98158, Italy.
| | - Gaetano Zizzo
- Section of Rheumatology, Department of Internal Medicine, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Legnano Hospital, Milan, Italy.
- Rheumatology Section, ASST Ovest Milanese, Milan, 20025, Italy.
| | - Vincenzo Parrino
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, Messina University, Messina, Italy
| | - Maria Teresa Filosa
- Unit of Rheumatology, Department of Internal Medicine, Azienda Ospedaliera (A.O.) "Papardo", Messina, Italy
| | - Riccardo Cavaliere
- Department of Adult and Developmental Human Pathology "Gaetano Barresi", Messina University, Messina, Italy
| | - Francesco Fazio
- Department of Veterinary Sciences, "Polo Universitario dell'Annunziata", Messina University, Messina, Italy
| | - Aldo Biagio Molica Colella
- Unit of Rheumatology, Department of Internal Medicine, Azienda Ospedaliera (A.O.) "Papardo", Messina, Italy
| | - Antonino Mazzone
- Section of Rheumatology, Department of Internal Medicine, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Legnano Hospital, Milan, Italy
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9
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Faggioli P, Zaccara E, Castelnovo L, Bompane D, Tamburello A, Lurati A, Laria A, Gangemi D, Giani M, Gnani D, Di Giorgi M, Iura K, Grandelis F, Piazza R, Piana T, Zizzo G, Mazzone A. A new digital health tool for the telemonitoring of patients with scleroderma during iloprost administration: a feasibility and acceptability study. Eur Rev Med Pharmacol Sci 2023; 27:799-804. [PMID: 36734722 DOI: 10.26355/eurrev_202301_31081] [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: 02/04/2023]
Abstract
OBJECTIVE To assess the feasibility of a new device for telemonitoring vital parameters during iloprost infusion. MATERIALS AND METHODS In a pilot study, patients with systemic sclerosis received iloprost infusion while being telemonitored with Umana T1 Heart Monitor, within the hospital, under the supervision of family/community nurses and rheumatologists. Patients were administered a questionnaire to obtain information on satisfaction, practicability, and compliance with the new monitoring device. RESULTS Data recorded by the device for blood pressure, heart rate, and oximetry were concordant with those registered directly by nurses. Most patients found the device useful and thought it could be used at home, even while working. CONCLUSIONS Umana Heart Monitor T1 could be a valuable aid in at-home iloprost therapy in patients with systemic sclerosis.
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Affiliation(s)
- P Faggioli
- Department of Internal Medicine, Rheumatology Unit, ASST Ovest Milanese, Legnano, Italy.
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10
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Gatti A, Fassini P, Mazzone A, Rusconi S, Brando B, Mistraletti G. Kinetics of CD169, HLA-DR, and CD64 expression as predictive biomarkers of SARS-CoV2 outcome. J Anesth Analg Crit Care 2023; 3:6. [PMCID: PMC10041484 DOI: 10.1186/s44158-023-00090-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Introduction Discriminating between virus-induced fever from superimposed bacterial infections is a common challenge in intensive care units. Superimposed bacterial infections can be detected in severe SARS-CoV2-infected patients, suggesting the important role of the bacteria in COVID-19 evolution. However, indicators of patients’ immune status may be of help in the management of critically ill subjects. Monocyte CD169 is a type I interferon-inducible receptor that is up-regulated during viral infections, including COVID-19. Monocyte HLA-DR expression is an immunologic status marker, that decreases during immune exhaustion. This condition is an unfavorable prognostic biomarker in septic patients. Neutrophil CD64 upregulation is an established indicator of sepsis. Methods In this study, we evaluated by flow cytometry the expression of cellular markers monocyte CD169, neutrophil CD64, and monocyte HLA-DR in 36 hospitalized patients with severe COVID-19, as possible indicators of ongoing progression of disease and of patients’ immune status. Blood testings started at ICU admission and were carried on throughout the ICU stay and extended in case of transfer to other units, when applicable. The marker expression in mean fluorescence intensity (MFI) and their kinetics with time were correlated to the clinical outcome. Results Patients with short hospital stay (≤15 days) and good outcome showed higher values of monocyte HLA-DR (median 17,478 MFI) than long hospital stay patients (>15 days, median 9590 MFI, p= 0.04) and than patients who died (median 5437 MFI, p= 0.05). In most cases, the recovery of the SARS-CoV2 infection-related signs was associated with the downregulation of monocyte CD169 within 17 days from disease onset. However in three surviving long hospital stay patients, a persistent upregulation of monocyte CD169 was observed. An increased neutrophil CD64 expression was found in two cases with a superimposed bacterial sepsis. Conclusion Monocyte CD169, neutrophil CD64, and monocyte HLA-DR expression can be used as predictive biomarkers of SARS-CoV2 outcome in acutely infected patients. The combined analysis of these indicators can offer a real-time evaluation of patients’ immune status and of viral disease progression versus superimposed bacterial infections. This approach allows to better define the patients’ clinical status and outcome and may be useful to guide clinicians’ decisions. Our study focused on the discrimination between the activity of viral and bacterial infections and on the detection of the development of anergic states that may correlate with an unfavorable prognosis.
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Affiliation(s)
- Arianna Gatti
- grid.414962.c0000 0004 1760 0715Hematology Laboratory and Transfusion Center, New Hospital of Legnano: Ospedale Nuovo di Legnano, 20025 Legnano, Milano Italy
| | - Paola Fassini
- grid.414962.c0000 0004 1760 0715Department of Intensive Care, New Hospital of Legnano: Ospedale Nuovo di Legnano, 20025 Legnano, Milano Italy
| | - Antonino Mazzone
- grid.414962.c0000 0004 1760 0715Department of Internal Medicine, New Hospital of Legnano: Ospedale Nuovo di Legnano, 20025 Legnano, Milano Italy
| | - Stefano Rusconi
- grid.414962.c0000 0004 1760 0715Department of Infectious Diseases, New Hospital of Legnano: Ospedale Nuovo di Legnano, 20025 Legnano, Milano Italy
| | - Bruno Brando
- grid.414962.c0000 0004 1760 0715Hematology Laboratory and Transfusion Center, New Hospital of Legnano: Ospedale Nuovo di Legnano, 20025 Legnano, Milano Italy
| | - Giovanni Mistraletti
- grid.414962.c0000 0004 1760 0715Department of Intensive Care, New Hospital of Legnano: Ospedale Nuovo di Legnano, 20025 Legnano, Milano Italy
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Zagni E, Frassi M, Mariano GP, Fusaro E, Lomater C, Del Medico P, Iannone F, Foti R, Limonta M, Marchesoni A, Raffeiner B, Viapiana O, Grassi W, Grembiale RD, Guggino G, Mazzone A, Tirri E, Perricone R, Sarzi Puttini PC, De Vita S, Conti F, Zullo A, Simoni L, Fiocchi M, Orsenigo R, Colombo D. A real-world economic analysis of biologic therapies for psoriatic arthritis in Italy: results of the CHRONOS observational longitudinal study. BMC Health Serv Res 2022; 22:1537. [PMID: 36527051 PMCID: PMC9757915 DOI: 10.1186/s12913-022-08954-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Psoriatic arthritis (PsA) is a chronic, immune-mediated, spondyloarthropathy characterised by musculoskeletal signs and symptoms with associated joint pain and tenderness. The average worldwide PsA prevalence is 133/100,000, while in the Italian population is 90-420/100,000. Traditionally, nonsteroidal anti-inflammatory drugs, glucocorticoid, and disease-modifying antirheumatic drugs have been used in the treatment of PsA. However, for those patients who are not adequately controlled with conventional therapies, the new biologics compounds represent a valid option. Biologic therapies have been shown to be more effective but also more expensive than conventional systemic treatments. Based on the CHRONOS study, the economic analyses presented in this paper aim to assess the annualised direct costs and the cost-per-responder of biologics in a real-world context assuming the Italian National Health System perspective. METHODS The economic assessments were carried out on the overall cohort of patients, and on the tumour necrosis factor alpha inhibitors (TNFi) and the secukinumab subgroup, the most prescribed biologic therapies within the CHRONOS study. RESULTS The annual economic impact of PsA in the overall group was €12,622, €11,725 in the secukinumab subgroup, and €12,791 in the TNFi subgroup. Biologics absorbed the main expenditure costs in the treatment of PsA accounting for about the 93% of total costs. At 6 months, secukinumab performed better in all the considered outcomes: cost-per-responder according to EULAR DAS28 and ACR50 response criteria were €12,661- €28,975, respectively, while they were €13,356 - €33,368 in the overall cohort and €13,138 - €35,166 in the TNFi subgroup. At 12 months secukinumab remained the subgroup with the lowest cost-per-responder ratio in EULAR DAS28 and ACR50 response criteria, while TNFi subgroup was the lowest one considered the ACR20. CONCLUSION Despite some potential methodological limitations, our cost-per-response analysis provides physicians and payers additional insights which can complement the traditional risk-benefit profile assessment and drive treatment decisions.
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Affiliation(s)
- Emanuela Zagni
- grid.15585.3cValue &Access, Novartis Farma S.p.A, Largo Umberto Boccioni, 1 21040 Varese, Origgio Italy
| | - Micol Frassi
- grid.412725.7Rheumatology and Clinical Immunology Unit, ASST Spedali Civili, Brescia, Italy
| | | | - Enrico Fusaro
- Rheumatology Dept. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | | | - Rosario Foti
- grid.412844.f0000 0004 1766 6239UOS Reumatologia, A.O.U. Policlinico -Vittorio Emanuele, Catania, Italy
| | - Massimiliano Limonta
- grid.460094.f0000 0004 1757 8431UOSD Reumatologia, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Ombretta Viapiana
- grid.411475.20000 0004 1756 948XU.O.C. Reumatologia, AOUI Verona Borgo Roma, Verona, Italy
| | | | | | | | - Antonino Mazzone
- grid.414962.c0000 0004 1760 0715Medicina Interna MAC area medica, Ospedale Civile di Legnano, Legnano, Italy
| | - Enrico Tirri
- grid.415044.00000 0004 1760 7116Ospedale San Giovanni Bosco, Naples, Italy
| | - Roberto Perricone
- grid.413009.fU.O.C. Reumatologia, Policlinico Tor Vergata, Rome, Italy
| | | | | | - Fabrizio Conti
- grid.417007.5U.O.C. Reumatologia, Azienda Policlinico Umberto I, Rome, Italy
| | | | | | - Martina Fiocchi
- grid.15585.3cValue &Access, Novartis Farma S.p.A, Largo Umberto Boccioni, 1 21040 Varese, Origgio Italy
| | - Roberto Orsenigo
- grid.15585.3cValue &Access, Novartis Farma S.p.A, Largo Umberto Boccioni, 1 21040 Varese, Origgio Italy
| | - Delia Colombo
- grid.15585.3cValue &Access, Novartis Farma S.p.A, Largo Umberto Boccioni, 1 21040 Varese, Origgio Italy
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12
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Colombo D, Frassi M, Pagano Mariano G, Fusaro E, Lomater C, Del Medico P, Iannone F, Foti R, Limonta M, Marchesoni A, Raffeiner B, Viapiana O, Grassi W, Grembiale RD, Guggino G, Mazzone A, Tirri E, Perricone R, Sarzi Puttini PC, De Vita S, Conti F, Ori A, Simoni L, Fiocchi M, Orsenigo R, Zagni E, Frassi M, Caminiti M, Fusaro E, Lomater C, Del Medico P, Iannone F, Foti R, Limonta M, Marchesoni A, Raffeiner B, Viapiana O, Grassi W, Grembiale RD, Guggino G, Mazzone A, Tirri E, Perricone R, Puttini PCS, De Vita S, Conti F. Real-world evidence of biologic treatments in psoriatic arthritis in Italy: results of the CHRONOS (EffeCtiveness of biologic treatments for psoriatic artHRitis in Italy: an ObservatioNal lOngitudinal Study of real-life clinical practice) observational longitudinal study. BMC Rheumatol 2022; 6:57. [PMID: 36089612 PMCID: PMC9464489 DOI: 10.1186/s41927-022-00284-w] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022] Open
Abstract
Background Biologics have demonstrated efficacy in PsA in randomized clinical trials. More evidence is needed on their effectiveness under real clinical practice conditions. The aim of the present work is to provide real-world evidence of the effectiveness of biologics for PsA in the daily clinical practice. Methods CHRONOS was a multicenter, non-interventional, cohort study conducted in 20 Italian hospital rheumatology clinics. Results 399 patients were eligible (56.9% females, mean (SD) age: 52.4 (11.6) years). The mean (SD) duration of PsA and psoriasis was 7.2 (6.9) and 15.3 (12.2) years, respectively. The mean (SD) duration of the biologic treatment under analysis was 18.6 (6.5) months. The most frequently prescribed biologic was secukinumab (40.4%), followed by adalimumab (17.8%) and etanercept (16.5%). The proportion of overall responders according to EULAR DAS28 criteria was 71.8% (95% CI: 66.7–76.8%) out of 308 patients at 6 months and 68.0% (95% CI: 62.7–73.3%) out of 297 patients at 1 year. Overall, ACR20/50/70 responses at 6 months were 41.2% (80/194), 29.4% (57/194), 17.1% (34/199) and at 1-year were 34.9% (66/189), 26.7% (51/191), 18.4% (36/196), respectively. Secondary outcome measures improved rapidly already at 6 months: mean (SD) PASI, available for 87 patients, decreased from 3.2 (5.1) to 0.6 (1.3), the proportion of patients with dactylitis from 23.6% (35/148) to 3.5% (5/142) and those with enthesitis from 33.3% (49/147) to 9.0% (12/133). Conclusions The CHRONOS study provides real-world evidence of the effectiveness of biologics in PsA in the Italian rheumatological practice, confirming the efficacy reported in RCTs across various outcome measures. Supplementary Information The online version contains supplementary material available at 10.1186/s41927-022-00284-w.
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Bonaventura A, Mumoli N, Mazzone A, Colombo A, Evangelista I, Cerutti S, Brivio L, Vecchié A, Bonomi A, Para O, Bellizzi A, Cei M, Fenu P, Tangianu F, Dentali F, Cei F. Correlation of SpO 2/FiO 2 and PaO 2/FiO 2 in patients with symptomatic COVID-19: An observational, retrospective study. Intern Emerg Med 2022; 17:1769-1775. [PMID: 35460432 PMCID: PMC9034256 DOI: 10.1007/s11739-022-02981-3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/24/2022] [Indexed: 11/05/2022]
Abstract
Some patients affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) experience acute hypoxemic respiratory failure progressing toward atypical acute respiratory distress syndrome (ARDS). The aim of the study is to evaluate whether a correlation between ratio of peripheral saturation of oxygen (SpO2) and fraction of inspired oxygen (S/F) and ratio of arterial partial pressure of oxygen and fraction of inspired oxygen (P/F) exists in COVID-19-related ARDS as already known in classical ARDS. In this multicenter, retrospective, observational study, consecutive, adult (≥ 18 years) patients with symptomatic coronavirus disease 2019 (COVID-19) admitted to different COVID-19 divisions in Italy between March and December 2020 were included. Patients with SpO2 > 97% or missing information were excluded. We included 1,028 patients (median age 72 years, prevalence of males [62.2%]). A positive correlation was found between P/F and S/F (r = 0.938, p < 0.0001). A receiver operating characteristic (ROC) curve analysis showed that S/F accurately recognizes the presence of ARDS (P/F ≤ 300 mmHg) in COVID-19 patients, with a cut-off of ≤ 433% showing good sensitivity and specificity. S/F was also tested against P/F values ≤ 200 and ≤ 100 mmHg (suggestive for moderate and severe ARDS, respectively), the latter showing great accuracy for S/F ≤ 178%. S/F was accurate in predicting ARDS for SpO2 ≥ 92%. In conclusion, our findings support the routine use of S/F as a reliable surrogate of P/F in patients with COVID-19-related ARDS.
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Affiliation(s)
- Aldo Bonaventura
- Medicina Generale 1, Medical Center, Department of Internal Medicine, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy.
| | - Nicola Mumoli
- Department of Internal Medicine, Magenta Hospital, ASST Ovest Milanese, Magenta, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, Legnano Hospital, ASST Ovest Milanese, Legnano, Italy
| | - Alessandra Colombo
- Department of Internal Medicine, Magenta Hospital, ASST Ovest Milanese, Magenta, Italy
| | - Isabella Evangelista
- Department of Internal Medicine, Magenta Hospital, ASST Ovest Milanese, Magenta, Italy
| | - Scilla Cerutti
- Department of Internal Medicine, Magenta Hospital, ASST Ovest Milanese, Magenta, Italy
| | - Lorenza Brivio
- Department of Internal Medicine, Legnano Hospital, ASST Ovest Milanese, Legnano, Italy
| | - Alessandra Vecchié
- Medicina Generale 1, Medical Center, Department of Internal Medicine, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy
| | | | - Ombretta Para
- SOD Medicina Interna 1, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | | | - Marco Cei
- Department of Internal Medicine, Cecina Hospital, Cecina, Italy
| | - Patrizia Fenu
- Department of Internal Medicine, Cecina Hospital, Cecina, Italy
| | - Flavio Tangianu
- Medicina Generale 1, Medical Center, Department of Internal Medicine, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy
| | - Francesco Dentali
- Department of Medicine and Surgery, Insubria University, Varese, Italy
| | - Francesco Cei
- Medicina Interna 1, Ospedale San Giuseppe, Empoli, Italy
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Faccia M, Maggiolino A, Natrella G, Zizzadoro C, Mazzone A, Poulopoulou I, Bragaglio A, De Palo P. Ingested versus inhaled limonene in sheep: A pilot study to explore potential different transfer to the mammary gland and effects on milk and Caciotta cheese aroma. J Dairy Sci 2022; 105:8143-8157. [PMID: 36028343 DOI: 10.3168/jds.2022-22016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/07/2022] [Indexed: 11/19/2022]
Abstract
Concentration is a key determinant in the overall positive impact of terpenes on milk and cheese aroma; additionally, route of intake may affect the achievable concentrations of dietary terpenes in milk and cheese. In this study, we explored the possibility that the amount of the monoterpene limonene transferred to sheep milk and its corresponding cheese could differ depending on the route of intake and that the aroma profile of these products could also differ. To this aim, 12 lactating dairy ewes were repeatedly exposed to limonene by the oral or respiratory route during a 48-h test period, according to a 3 × 3 Latin square experimental design. Limonene content was measured in individual and bulk milk samples, in 1-d-old and 15-d-old Caciotta cheese obtained from that milk, in the related whey and curd, and in the air inhaled by the ewes in the respiratory treatment group (to obtain an estimate of the dose actually supplied by this route). Bulk milk and fresh (1-d-old) cheese underwent sensory analysis by ortho-olfactory evaluation. Both intake routes demonstrated transfer of limonene to milk, but the respiratory route transferred limonene with greater efficiency than the oral route. Moreover, according to the protocol used in this study, a short period of respiratory exposure induced a slightly higher limonene content in milk compared with oral exposure. As to the fate of limonene during cheesemaking, an important part of it was lost into the whey, perhaps through volatilization. The differences between milk and cheese tended to dissipate in curd and fresh cheese and disappeared completely after 15 d of ripening. Finally, it was possible to distinguish between the 2 routes of limonene intake using sensory analysis, even though no direct relationship was identified between the different aroma profiles of milks and cheeses from the oral and respiratory groups and their respective limonene contents. Overall, our results expand current knowledge on the biological pathways of terpene transfer from feed to sheep milk and cheese, as well as on the role played by terpenes in the formation of aroma in these products. Our observations may contribute to future development of strategies for external control and better standardization of the presence of odor compounds in milk and cheese from dairy ruminants.
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Affiliation(s)
- M Faccia
- Department of Soil, Plant and Food Sciences, University of Bari A. Moro, 70121 Bari, Italy
| | - A Maggiolino
- Department of Veterinary Medicine, University of Bari A. Moro, 70010 Valenzano, Italy.
| | - G Natrella
- Department of Soil, Plant and Food Sciences, University of Bari A. Moro, 70121 Bari, Italy
| | - C Zizzadoro
- Department of Veterinary Medicine, University of Bari A. Moro, 70010 Valenzano, Italy
| | - A Mazzone
- Order of Chemists of Bari, 70121 Bari, Italy
| | - I Poulopoulou
- Free University of Bozen-Bolzano, 39100 Bolzano, Italy
| | - A Bragaglio
- Department of Veterinary Medicine, University of Bari A. Moro, 70010 Valenzano, Italy
| | - P De Palo
- Department of Veterinary Medicine, University of Bari A. Moro, 70010 Valenzano, Italy
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Laria A, Lurati AM, Marrazza MG, Re K, Mazzocchi D, Faggioli P, Mazzone A. AB1269 SHULMAN’S DISEASE OR EOSINOPHILIC FASCIITIS, A RARE FIBROSING DISORDER: A CASE REPORT TREATED WITH TOCILIZUMAB. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSchulman eosinophilic fasciitis (EF) is a rare fibrosing disorder, typified by erythema, edema, and symmetric induration of the distal bilateral extremities (only proximal to the wrists and ankles) or/and trunk(1).The “groove sign” and/or a pseudocellulite appearance of the involved skin may be present(1), followed by joint contractures (1).Fascial biopsy is the gold standard for making a diagnosis.Systemic corticosteroids are first-line treatment(2).The use of c/bDMARDs is described in literature with clinical improvements(2).Objectivesto evaluate efficacy of Tocilizumab in a patient affected by Shulman’s diseaseMethodsA 54-year-old woman went to our observation for appearance of abrupt-onset simmetric edema followed by induration of the bilateral extremities and trunk. She has been feverish for about 2 weeks associated with diffuse arthromyalgia. On rheumatological examination: non-liftable skin in folds on the bilateral arms and forearms and lower limbs; absence of frank synovitis or lymphoglandular swellings. The blood tests performed showed an increase in acute phase reactants. The ferritin and electrophoretic picture, complement and immunoglobulin dosage were normal. The blood count showed a marked absolute eosinophilia accompanied by modest monocytosis and modest platelet disease. There was a slight increase in LDH and in serum beta2microglobulin. Serology for viral infections and autoimmunity were negative. Screening for celiac disease was negative. Coprocultures, parasitology and the search for the fecal H. pylori antigen are negative. Excluded lymphadenopathy or hepatosplenomegaly to the total body computed tomography. Modest non-buffering pericardial effusion was reported in CT scan. Nailfold capillary changes were absent. Chronic inflammatory bowel diseases were excluded. A skin biopsy of the left forearm confirmed the clinical diagnosis of EF. In particular, it documented thickening of the fascia, site of an inflammatory process that included small lymphocytes, plasma cells, histiocytes and some eosinophils, distributed both diffusely and around blood vessels.The underlying muscle tissue and the supra-fascial skin were free from alterations. Secondary fasciitis was excluded by 18 fluorodeoxyglucose (FDG)-positron emission tomography; this showed a diffusely accumulation of the radiopharmaceutical in the muscles of the forearms and of both lower limbs, compatible with eosinophilic fasciitis and confirmed the pericardial effusion. Immunophenotypic analysis on peripheral blood excluded the presence of a monoclonal cell population. Diagnosis of primary eosinophilic fasciitis was made and therapy was started with methylprednisolone 1 g intravenously for 3 days followed by another 3 boluses of methylprednisolon of 500 mg iv. Given the poor response, it was decided to set up therapy with Methotrexate 15 mg up to a dose of 20 mg intramuscularly per week associated with prednisone 25 mg/day. The rheumatological re-evaluation at 3 months showed a worsening of the fibrosis and diffuse skin edema with an obligatory kyphosis of the spine and limitation in the patient’s movements. Therefore it was decided to start off label infusion therapy with Tocilizumab 8 mg/kg/month.ResultsA complete resolution of the skin picture with disappearance of the pericardial effusion was documented 12 months after the start of the biological drugConclusionThere are currently no guidelines for the treatment of eosinophilic fasciitis. Tocilizumab has been shown to be effective when introduced in the early inflammatory stages of the disease, as in the case described.References[1]Lakhanpal S, Ginsburg WW, Michet CJ, Doyle JA, Moore SB. Eosinophilic fasciitis: clinical spectrum and therapeutic response in 52 cases. Semin Arthritis Rheum. 1988;17(4):221–31.[2]Daniel R. Mazori & Alisa N. Femia & Ruth Ann Vleugels. Eosinophilic Fasciitis: an Updated Review on Diagnosis and Treatment Curr Rheumatol Rep (2017) 19: 74.Disclosure of InterestsNone declared
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Laria A, Lurati AM, Mazzocchi D, Re K, Marrazza MG, Zaccara E, Bompane D, Tamburello A, Castelnovo L, Bini F, Faggioli PM, Mazzone A. AB0645 Nintedanib in treatment of pulmonary fibrosis secondary to Connective Tissue Disease:. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundInterstitial lung disease (ILD) is a common manifestation of systemic sclerosis and other Rheumatic Diseases, and is one of the major causes of mortality. Nintedanib, a tyrosine kinase inhibitor, has been shown to have antifibrotic and anti-inflammatory effects in preclinical models of systemic sclerosis and ILD.ObjectivesTo evaluate efficacy and safety of Nintedanib in pulmonary fibrosis secondary to Connective Tissue Disease.MethodsTen patients with pulmonary fibrosis secondary to Connective Tissue Disease treated with Nintedanib were monitored at baseline, 6 and/or 12 months, with clinical assessment, chest CT scan and/or pulmonary function testing (PFT) with assessment of the diffusing capacity for CO (DLCO). 8/10 patients had a diagnosis of Progressive Systemic Sclerosis, while the remaining ones had Polydermatomyositis and Mixed Connectivitis. All patients were dyspnoic at baseline and presented with dry cough. All patients had pulmonary fibrosis according to high-resolution chest CT scan. All patients had been treated with at least one csDMARD or bDMARD (cyclophosphamide, azathioprine, cyclosporine, rituximab, tocilizumab), prior to receiving nintedanib. At baseline 2/10 patients were treated with Nintedanib monotherapy, 7/10 were in combination therapy with Mycophenolate, 1 patient received a combination therapy with cyclosporine.ResultsCompared to baseline values, 4/7 patients showed stationarity of the respiratory function parameters (DLCO), in 2/7 patients it was observed a significant improvement of the DLCO (with a change of 15%) while in only 1 patient there was a worsening over time. FVC remained stable over time except in 1 patient who got a significant improvement. In 5/9 patients cough improved (unchanged in the rest of patients). Dyspnea (NYHA scale) improved in 6/9 patients, remained stationary in 2/6 patients and became worse in 1 patient. 8/9 patients had a stable chest CT at 6 and / or 12 months, while only 1 patient witnessed a further worsening of the fibrosis. 50% of the patients showed good gastrointestinal tolerance to the full dose of nintedaninb. The other half had the dose reduced in order to improve gastrointestinal symptoms.ConclusionOur data show that patients with ILD associated with Rheumatic Diseases treated with nintedanib had a clinical benefit over dyspnea and cough symptoms and a stabilization of radiological findings 12 months after starting the treatment. Also, respiratory function parameters remained stable over time. Gastrointestinal adverse events, including diarrhea, were common in these patients, but therapeutic dose adjustment led to fast symptoms resolution and good tolerance.References[1]Kristin B Highland, Oliver Distler, Masataka Kuwana, Yannick Allanore, Shervin Assassi, Arata Azuma, Arnaud Bourdin, Christopher P Denton, Jörg H W Distler, Anna Maria Hoffmann-Vold, Dinesh Khanna, Maureen D Mayes, Ganesh Raghu, Madelon C Vonk, Martina Gahlemann, Emmanuelle Clerisme-Beaty, Mannaig Girard, Susanne Stowasser, Donald Zoz, Toby M Maher, SENSCIS trial investigators. Efficacy and safety of nintedanib in patients with systemic sclerosis-associated interstitial lung disease treated with mycophenolate: a subgroup analysis of the SENSCIS trial. Lancet Respir Med. 2021 Jan;9(1):96-106.[2]Oliver Distler, Kristin B Highland, Martina Gahlemann, Arata Azuma, Aryeh Fischer, Maureen D Mayes, Ganesh Raghu, Wiebke Sauter, Mannaig Girard, Margarida Alves, Emmanuelle Clerisme-Beaty, Susanne Stowasser, Kay Tetzlaff, Masataka Kuwana, Toby M Maher, SENSCIS Trial Investigators. Nintedanib for Systemic Sclerosis-Associated Interstitial Lung Disease. N Engl J Med. 2019 Jun 27;380(26):2518-2528.Disclosure of InterestsNone declared
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Catrini E, Ferrario L, Mazzone A, Varalli L, Gatti F, Cannavacciuolo L, Ponsiglione C, Foglia E. Tools supporting polypharmacy management in Italy: Factors determining digital technologies' intention to use in clinical practice. Health Sci Rep 2022; 5:e647. [PMID: 35601037 PMCID: PMC9117970 DOI: 10.1002/hsr2.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Aims INTERCheckWEB is one of the most outstanding digital technologies, that could be implemented at the hospital level, supporting the clinicians in the evaluation of the therapy appropriateness, reducing the potentially inappropriate prescriptions, for the improvement of the clinical decision‐making process. The paper aims at investigating the relationship between clinicians' behaviors towards digital decision support system in therapy appropriateness for elderly patients in polytherapy in medical departments, defining the factors that could influence clinicians to use INTERCheckWEB, for supporting drugs' prescription. Methods A questionnaire was administered to 70 clinicians referring to Internal Medicine wards, of four Italian hospitals. The authors assessed how perceived usefulness, perceived ease of use, image, and output quality, would affect INTERCheckWeb intention to use. Inferential statistics, by means of a regression analysis, were conducted to define the main aspects useful to understand the factors impacting on such digital technology adoption in clinical practice. Results The regression analysis reported that image, perceived ease of use and perceived usefulness, as well as the moderator effect of the voluntary use between the perceived usefulness and the intention to use, are the factors that most influence the use of INTERCheckWEB (adjusted R2 = 0.870). Conclusions Results demonstrated that clinicians would use INTERCheckWEB, when available, to identify all the information on situations that could be dangerous for the patients, thus limiting the drug–drug interactions, optimizing the overall patient's clinical pathway. Furthermore, the implementation of INTERCheckWEB could also contribute to the proper management of COVID‐19 patients, since both hospitalized and symptomatic COVID‐19 patients are frequently older, with comorbidities.
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Affiliation(s)
- Elisabetta Catrini
- Centre for Health Economics, Social and Health Care Managament, LIUC Business School LIUC Università Cattaneo Castellanza Varese Italy
| | - Lucrezia Ferrario
- Centre for Health Economics, Social and Health Care Managament, LIUC Business School LIUC Università Cattaneo Castellanza Varese Italy
| | | | - Luca Varalli
- Pharmaceutical Department ASST Ovest Milanese Legnano Italy
| | - Federico Gatti
- Pharmaceutical Department ASST Ovest Milanese Legnano Italy
| | | | - Cristina Ponsiglione
- Department of Industrial Engineering University of Naples Federico II Naples Italy
| | - Emanuela Foglia
- Centre for Health Economics, Social and Health Care Managament, LIUC Business School LIUC Università Cattaneo Castellanza Varese Italy
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Laria A, Lurati AM, Zizzo G, Zaccara E, Mazzocchi D, Re KA, Marrazza M, Faggioli P, Mazzone A. Interstitial Lung Disease in Rheumatoid Arthritis: A Practical Review. Front Med (Lausanne) 2022; 9:837133. [PMID: 35646974 PMCID: PMC9136053 DOI: 10.3389/fmed.2022.837133] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/07/2022] [Indexed: 11/25/2022] Open
Abstract
Rheumatoid arthritis (RA) is a systemic inflammatory disease, which primarily causes symmetric polyarthritis. An extrarticolar involvement is common, and the commonly involved organ is lungs. Although cardiac disease is responsible for most RA-related deaths, pulmonary disease is also a major contributor, accounting for ~10-20% of all mortality. Pulmonary disease is a common (60-80% of patients with RA) extra-articular complication of RA. Optimal screening, diagnostic, and treatment strategies of pulmonary disease remain uncertain, which have been the focus of an ongoing investigation. Clinicians should regularly assess patients with RA for the signs and symptoms of pulmonary disease and, reciprocally, consider RA and other connective tissue diseases when evaluating a patient with pulmonary disease of an unknown etiology. RA directly affects all anatomic compartments of the thorax, including the lung parenchyma, large and small airways, pleura, and less commonly vessels. In addition, pulmonary infection and drug-induced lung disease associated with immunosuppressive agents used for the treatment of RA may occur.
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Affiliation(s)
- Antonella Laria
- Asst Ovest Milanese–Rheumatology Unit, Magenta Hospital, Milan, Italy
| | | | - Gaetano Zizzo
- Asst Ovest Milanese–Internal Medicine Department, Cuggiono Hospital, Milan, Italy
| | - Eleonora Zaccara
- Asst Ovest Milanese–Internal Medicine Unit, Legnano Hospital, Milan, Italy
| | - Daniela Mazzocchi
- Asst Ovest Milanese–Rheumatology Unit, Magenta Hospital, Milan, Italy
| | - Katia Angela Re
- Asst Ovest Milanese–Rheumatology Unit, Magenta Hospital, Milan, Italy
| | | | - Paola Faggioli
- Asst Ovest Milanese–Internal Medicine Unit, Legnano Hospital, Milan, Italy
| | - Antonino Mazzone
- Asst Ovest Milanese–Internal Medicine Unit, Legnano Hospital, Milan, Italy
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Zizzo G, Tamburello A, Castelnovo L, Laria A, Mumoli N, Faggioli PM, Stefani I, Mazzone A. Immunotherapy of COVID-19: Inside and Beyond IL-6 Signalling. Front Immunol 2022; 13:795315. [PMID: 35340805 PMCID: PMC8948465 DOI: 10.3389/fimmu.2022.795315] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [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: 10/14/2021] [Accepted: 01/25/2022] [Indexed: 01/08/2023] Open
Abstract
Acting on the cytokine cascade is key to preventing disease progression and death in hospitalised patients with COVID-19. Among anti-cytokine therapies, interleukin (IL)-6 inhibitors have been the most used and studied since the beginning of the pandemic. Going through previous observational studies, subsequent randomised controlled trials, and meta-analyses, we focused on the baseline characteristics of the patients recruited, identifying the most favourable features in the light of positive or negative study outcomes; taking into account the biological significance and predictivity of IL-6 and other biomarkers according to specific thresholds, we ultimately attempted to delineate precise windows for therapeutic intervention. By stimulating scavenger macrophages and T-cell responsivity, IL-6 seems protective against viral replication during asymptomatic infection; still protective on early tissue damage by modulating the release of granzymes and lymphokines in mild-moderate disease; importantly pathogenic in severe disease by inducing the proinflammatory activation of immune and endothelial cells (through trans-signalling and trans-presentation); and again protective in critical disease by exerting homeostatic roles for tissue repair (through cis-signalling), while IL-1 still drives hyperinflammation. IL-6 inhibitors, particularly anti-IL-6R monoclonal antibodies (e.g., tocilizumab, sarilumab), are effective in severe disease, characterised by baseline IL-6 concentrations ranging from 35 to 90 ng/mL (reached in the circulation within 6 days of hospital admission), a ratio of partial pressure arterial oxygen (PaO2) and fraction of inspired oxygen (FiO2) between 100 and 200 mmHg, requirement of high-flow oxygen or non-invasive ventilation, C-reactive protein levels between 120 and 160 mg/L, ferritin levels between 800 and 1600 ng/mL, D-dimer levels between 750 and 3000 ng/mL, and lactate dehydrogenase levels between 350 and 500 U/L. Granulocyte-macrophage colony-stimulating factor inhibitors might have similar windows of opportunity but different age preferences compared to IL-6 inhibitors (over or under 70 years old, respectively). Janus kinase inhibitors (e.g., baricitinib) may also be effective in moderate disease, whereas IL-1 inhibitors (e.g., anakinra) may also be effective in critical disease. Correct use of biologics based on therapeutic windows is essential for successful outcomes and could inform future new trials with more appropriate recruiting criteria.
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Affiliation(s)
- Gaetano Zizzo
- Department of Internal Medicine, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Milan, Italy
| | - Antonio Tamburello
- Department of Internal Medicine, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Milan, Italy
| | - Laura Castelnovo
- Department of Internal Medicine, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Milan, Italy
| | - Antonella Laria
- Department of Internal Medicine, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Milan, Italy
| | - Nicola Mumoli
- Department of Internal Medicine, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Milan, Italy
| | - Paola Maria Faggioli
- Department of Internal Medicine, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Milan, Italy
| | - Ilario Stefani
- Department of Internal Medicine, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Milan, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, Milan, Italy
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Sidoli C, Zambon A, Tassistro E, Rossi E, Mossello E, Inzitari M, Cherubini A, Marengoni A, Morandi A, Bellelli G, Tarasconi A, Sella M, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Porcella L, Nardiello I, Chimenti E, Zeni M, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, Pietrogrande L, Mosca M, Corazzin I, Rossi P, Nunziata V, D’Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell’Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Borghi C, Bianchetti A, Crucitti A, DiFrancesco V, Fontana G, Geriatria A, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cassadonte F, Vatrano M, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Seneci F, Fimognari F, Bambar V, Saitta A, Corica F, Braga M, Servi, Ettorre E, Camellini Bellelli CG, Annoni G, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Formilan M, Patrizia G, Santuar L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl’Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Alessandro M, Calogero P, Corvalli G, Di F, Pezzoni D, Platto C, D’Ambrosio V, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Bonetto M, Grasso M, Troisi E, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Faraci B, Bertoletti E, Vannucci M, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D’Amico F, Grippa A, Mazzone A, Cottino M, Vezzadini G, Avanzi S, Brambilla C, Orini S, Sgrilli F, Mello A, Lombardi Muti LE, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D’Amico F, D’Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Cortegiani A, Pistidda L, D’Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study. Aging Clin Exp Res 2022; 34:1827-1835. [PMID: 35396698 DOI: 10.1007/s40520-022-02099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. AIM We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the "Delirium Day project". METHODS We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the "Delirium Day project" (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. RESULTS Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17-1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08-2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62-2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10-1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02-1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68-3.36, p value < 0.0001). CONCLUSION This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.
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Colombo D, Gatti A, Alabardi P, Bompane D, Bonardi G, Mumoli N, Faggioli P, Clerici P, Brando B, Mazzone A. COVID-19-Associated Pneumonia in a B-Cell-Depleted Patient With Non-Hodgkin Lymphoma: Recovery With Hyperimmune Plasma. J Hematol 2022; 11:77-80. [PMID: 35573753 PMCID: PMC9076145 DOI: 10.14740/jh845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/03/2021] [Indexed: 12/03/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) can have a severe course in immunocompromised hosts and patients with hematological malignancies. In some cases, the bad prognosis is associated with the lack of B lymphocytes, with impaired antibody production and inefficient viral clearance. We report a case of a 67-year-old woman with a story of non-Hodgkin lymphoma treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone), who got a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection while being totally depleted of B cells. This condition has determined a severe and prolonged course of COVID-19, with persistently positive nasopharyngeal molecular swabs and lack of anti-SARS-CoV-2 specific antibodies. The clinical recovery was favored by the administration of convalescent hyperimmune plasma.
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Affiliation(s)
- Daniele Colombo
- Internal Medicine Unit, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy
- Corresponding Author: Daniele Colombo, Internal Medicine Unit, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy.
| | - Arianna Gatti
- Hematology Laboratory and Transfusion Center, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy
| | - Patrizia Alabardi
- Internal Medicine Unit, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy
| | - Daniela Bompane
- Internal Medicine Unit, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy
| | - Giorgio Bonardi
- Internal Medicine Unit, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy
| | - Nicola Mumoli
- Internal Medicine Unit, Magenta Hospital, ASST Ovest Milanese, Magenta (MI), Italy
| | - Paola Faggioli
- Internal Medicine Unit, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy
| | - Pierangelo Clerici
- Hematology Laboratory and Transfusion Center, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy
| | - Bruno Brando
- Hematology Laboratory and Transfusion Center, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy
| | - Antonino Mazzone
- Internal Medicine Unit, Legnano Hospital, ASST Ovest Milanese, Legnano (MI), Italy
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Babiano-Suarez V, Balibrea-Correa J, Caballero-Ontanaya L, Domingo-Pardo C, Ladarescu I, Lerendegui-Marco J, Tain JL, Calviño F, Casanovas A, Tarifeño-Saldivia A, Guerrero C, Aberle O, Alcayne V, Amaducci S, Andrzejewski J, Audouin L, Bacak M, Barbagallo M, Bennett S, Berthoumieux E, Billowes J, Bosnar D, Brown A, Busso M, Caamaño M, Calviani M, Cano-Ott D, Cerutti F, Chiaveri E, Colonna N, Cortés G, CortésGiraldo MA, Cosentino L, Cristallo S, Damone LA, Davies PJ, Diakaki M, Dietz M, Dressler R, Ducasse Q, Dupont E, Durán I, Eleme Z, Fernández-Domínguez B, Ferrari A, Finocchiaro P, Furman V, Göbel K, Garg R, Gawlik-Ramięga A, Gilardoni S, Gonçalves IF, González-Romero E, Gunsing F, Harada H, Heinitz S, Heyse J, Jenkins DG, Junghans A, Käppeler F, Kadi Y, Kimura A, Knapová I, Kokkoris M, Kopatch Y, Krtička M, Kurtulgil D, Lederer-Woods C, Leeb H, Lonsdale SJ, Macina D, Manna A, Martínez T, Masi A, Massimi C, Mastinu P, Mastromarco M, Maugeri EA, Mazzone A, Mendoza E, Mengoni A, Michalopoulou V, Milazzo PM, Mingrone F, Moreno-Soto J, Musumarra A, Negret A, Nolte R, Ogállar F, Oprea A, Patronis N, Pavlik A, Perkowski J, Persanti L, Petrone C, Pirovano E, Porras I, Praena J, Quesada JM, Ramos-Doval D, Rauscher T, Reifarth R, Rochman D, Romanets Y, Rubbia C, Sabaté-Gilarte M, Saxena A, Schillebeeckx P, Schumann D, Sekhar A, Smith AG, Sosnin NV, Sprung P, Stamatopoulos A, Tagliente G, Tassan-Got L, Thomas T, Torres-Sánchez P, Tsinganis A, Ulrich J, Urlass S, Valenta S, Vannini G, Variale V, Vaz P, Ventura A, Vescovi D, Vlachoudis V, Vlastou R, Wallner A, Woods PJ, Wright T, Žugec P. First 80Se(n, γ) cross section measurement with high resolution in the full stellar energy range 1 eV - 100 keV and its astrophysical implications for the s-process. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202226011026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Most elements heavier than iron have been generated in the stellar media by means of neutron capture reactions, approximately half are produced by the slow neutron capture or s-process. Radiative neutron capture cross section measurements are of fundamental importance for the study of this mechanism. In this contribution we present a brief summary on the measurement and results for the 80Se(n,γ) cross-section. The experiment was carried out at CERN n_TOF EAR1 via the time of flight (ToF) technique, using four C6D6 scintillation detectors with very fast response. More than a hundred new resonances have been analyzed for the first time with a high accuracy. The MACS obtained at kT = 8 keV is 36% smaller than the recommended value in KADo-NiS. Some of the astrophysical implications of this result are elucidated in this contribution.
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Zucchelli A, Manzoni F, Morandi A, Di Santo S, Rossi E, Valsecchi MG, Inzitari M, Cherubini A, Bo M, Mossello E, Marengoni A, Bellelli G, Tarasconi A, Sella M, Auriemma S, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Margola A, Porcella L, Nardiello I, Chimenti E, Zeni M, Giani A, Famularo S, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Ballestrero A, Minaglia C, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, De F, Pietrogrande L, De B, Mosca M, Corazzin I, Rossi P, Nunziata V, D‘Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell‘Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Bianchetti A, Crucitti A, Di Francesco V, Fontana G, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cannistrà U, Cassadonte F, Vatrano M, Cassandonte F, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Fimognari F, Bambara V, Saitta A, Corica F, Braga M, Ettorre E, Camellini C, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Patrizia G, Santuari L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl‘Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Calogero P, Corvalli G, Pezzoni D, Gentile S, Morandi A, Platto C, D‘Ambrosio V, Faraci B, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Confente S, Bonetto M, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Bertoletti E, Vannucci M, Tesi F, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D‘Amico F, Grippa A, Mazzone A, Riva E, Dell‘Acqua D, Cottino M, Vezzadini G, Avanzi S, Orini S, Sgrilli F, Mello A, Lombardi L, Muti E, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, De F, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D‘Amico F, D‘Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Scapigliati A, Cortegiani A, Vitale F, Pistidda L, D‘Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017. Aging Clin Exp Res 2022; 34:349-357. [PMID: 34417734 PMCID: PMC8847195 DOI: 10.1007/s40520-021-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/31/2021] [Indexed: 01/22/2023]
Abstract
Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric
syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01950-8.
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Mumoli N, Evangelista I, Colombo A, Conte G, Mazzone A. Giant condyloma acuminatum of the perineum. IDCases 2021; 26:e01326. [PMID: 34804801 PMCID: PMC8585615 DOI: 10.1016/j.idcr.2021.e01326] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/01/2021] [Indexed: 11/27/2022] Open
Affiliation(s)
- Nicola Mumoli
- Department of Internal Medicine, ASST Ovest Milanese, Magenta, MI, Italy
| | | | - Alessandra Colombo
- Department of Internal Medicine, ASST Ovest Milanese, Magenta, MI, Italy
| | - Giulia Conte
- Department of Internal Medicine, ASST Ovest Milanese, Magenta, MI, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, ASST Ovest Milanese, Magenta, MI, Italy
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Mumoli N, Mazzone A, Evangelista I, Cei M, Colombo A. Superior vena cava syndrome after pacemaker implantation treated with direct oral anticoagulation. Thromb J 2021; 19:84. [PMID: 34749763 PMCID: PMC8576875 DOI: 10.1186/s12959-021-00321-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/08/2021] [Indexed: 11/12/2022] Open
Abstract
Background Superior Vena Cava (SVC) syndrome, is a quite rare but serious complication after pacemaker lead implantation; most patients are asymptomatic due to the development of adequate venous collateral circulation. Case presentation We report a case of a 75-year-old woman who developed SVC syndrome after transvenous pacemaker implantation with complete resolution of the thrombosis after 3 months of oral anticoagulation. Conclusions Generally other causes as malignancy are considered to be the most common etiology of SVC syndrome, but benign iatrogenic causes, mainly intravascular devices (central vein catheters, cardiac defibrillators and pacemaker wires), are becoming increasingly common. Procedures performed on venous vasculature, causing a possible intimal injury or vein stenosis, provoked by transvenous leads, seem to be the most reasonable explanation for the observed complication.
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Affiliation(s)
- Nicola Mumoli
- Department of Internal Medicine,, Ospedale Fornaroli, via Donatori Sangue, 50, 20013, Magenta, MI, Italy.
| | - Antonino Mazzone
- Department of Internal Medicine,, Ospedale Fornaroli, via Donatori Sangue, 50, 20013, Magenta, MI, Italy
| | - Isabella Evangelista
- Department of Internal Medicine,, Ospedale Fornaroli, via Donatori Sangue, 50, 20013, Magenta, MI, Italy
| | - Marco Cei
- Department of Internal Medicine,, Ospedale Fornaroli, via Donatori Sangue, 50, 20013, Magenta, MI, Italy
| | - Alessandra Colombo
- Department of Internal Medicine,, Ospedale Fornaroli, via Donatori Sangue, 50, 20013, Magenta, MI, Italy
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Diemberger I, Fumagalli S, Mazzone A, Kirchhof P, De Caterina R. The impact of subjective vs objective frailty on the effectiveness and safety outcomes in patients from ETNA-AF-Europe registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Since the risk of atrial fibrillation (AF) increases with ageing, frail patients tend to require long-term anticoagulation. Anticoagulated frail patients may be at increased risk of major bleeding, which becomes more frequent in the elderly. Therefore, oral anticoagulation is often withheld or discontinued in frail, older patients with AF.
Purpose
To compare patient characteristics and annualised stroke and bleeding event rates in subjectively and objectively frail patients in the overall population included in the ETNA-AF-Europe registry. The 1-year follow-up was based on a snapshot dated 31st October 2019.
Methods
ETNA-AF-Europe is a multinational, multicentre, post-authorisation, observational study conducted in patients with AF following an edoxaban treatment regimen. Subjective frailty was categorised using a yes/no option, as perceived by physicians as a personal global judgement, without any external interference. Objective frailty was assessed using an adapted Modified Frailty Index; a shortened, simplified version of the Frailty Index.
Results
ETNA-AF Europe compiled data from 13,092 patients treated with edoxaban once daily, 10.6% and 5.0% were classified as subjectively and objectively frail, respectively (Table 1). Patients classified as objectively frail were younger, had a higher body mass index and higher CHA2DS2-VASc and HAS-BLED scores compared with the subjectively frail patients (Table 1), showing minimal overlap between the two groups. Stroke, major bleeding, all-cause and cardiovascular deaths were higher in patients classified as frail (Figure 1). Annualised event rates were mostly comparable in subjectively and objectively frail patients, except for higher annualised rates of ischaemic stroke, observed in subjectively frail patients, and higher annualised rates of myocardial infarction in objectively frail patients (Figure 1). The adherence to drug recommendations was similar in the subjectively and objectively frail cohorts (78.0% and 79.1%, respectively), but lower than in the general AF population (82.9%) (Table 1).
Conclusions
The presence of frailty (either subjective or objective) predicts cardiovascular events in anticoagulated patients with AF. A comprehensive assessment of frailty could improve the routine care of patients with AF.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Daiichi Sankyo Europe GmbH
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Affiliation(s)
- I Diemberger
- University of Bologna, Cardiology, Bologna, Italy
| | - S Fumagalli
- University of Florence, Geriatric Intensive Care Unit and Geriatric Arrhythmia Unit, Florence, Italy
| | - A Mazzone
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - P Kirchhof
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - R De Caterina
- University of Pisa, Chair of Cardiology, Pisa, Italy
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Vitale J, Mumoli N, Clerici P, De Paschale M, Evangelista I, Cei M, Mazzone A. Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy. JAMA Intern Med 2021; 181:1407-1408. [PMID: 34048531 PMCID: PMC8164145 DOI: 10.1001/jamainternmed.2021.2959] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This cohort study examines the rate of SARS-CoV-2 reinfection among people in Lombardy, Italy, who previously recovered from COVID-19.
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Affiliation(s)
- Josè Vitale
- Magenta Hospital, ASST Ovest Milanese, Magenta, Italy
| | - Nicola Mumoli
- Magenta Hospital, ASST Ovest Milanese, Magenta, Italy
| | | | | | | | - Marco Cei
- Magenta Hospital, ASST Ovest Milanese, Magenta, Italy
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Mumoli N, Conte G, Evangelista I, Cei M, Mazzone A, Colombo A. Post-COVID or long-COVID: Two different conditions or the same? J Infect Public Health 2021; 14:1349-1350. [PMID: 34426096 PMCID: PMC8372476 DOI: 10.1016/j.jiph.2021.08.019] [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: 05/26/2021] [Revised: 08/09/2021] [Accepted: 08/14/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Nicola Mumoli
- Department of Internal Medicine, Ospedale Fornaroli, Magenta, MI, Italy.
| | - Giulia Conte
- Department of Internal Medicine, Ospedale Fornaroli, Magenta, MI, Italy
| | | | - Marco Cei
- Department of Internal Medicine, Ospedale Fornaroli, Magenta, MI, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, Ospedale Fornaroli, Magenta, MI, Italy
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Mumoli N, Bonaventura A, Colombo A, Vecchié A, Cei M, Vitale J, Pavan L, Mazzone A, Dentali F. Lung function and symptoms in post-COVID-19 patients: a single-center experience. Mayo Clin Proc Innov Qual Outcomes 2021; 5:907-915. [PMID: 34396048 PMCID: PMC8352649 DOI: 10.1016/j.mayocpiqo.2021.08.002] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective To address the lack of information about clinical sequelae of coronavirus disease 2019 (COVID-19). Patients and Methods Previously hospitalized COVID-19 patients who were attending the outpatient clinic for post-COVID-19 patients (ASST Ovest Milanese, Magenta, Italy) were included in this retrospective study. They underwent blood draw for complete blood count, C-reactive protein (CRP), ferritin, D-dimer, and arterial blood gas analysis (ABG) and chest high-resolution computed tomography (HRCT) scan. The primary endpoint was the assessment of blood gas exchanges after 3 months. Other endpoints included the assessment of symptoms and chest HRCT scan abnormalities and changes in inflammatory biomarkers after 3 months from hospital admission. Results Eighty-eight patients (men 73.9%) were included. Admission arterial ABG analysis showed hypoxia and hypocapnia and a PaO2/FiO2 of 271.4 (238-304.7) mmHg, that greatly improved after 3 months (426.19 [395.24-461.90] mmHg, P<.001). A 40% of patients was still hypocapnic after 3 months. Inflammatory biomarkers dramatically improved after 3 months from hospitalization. Fever, resting dyspnea, and cough were common at hospital admission and improved after 3 months, when dyspnea on exertion and arthralgias arose. On chest HRCT scan, more than half of individuals still presented interstitial involvement. Positive correlations between the interstitial pattern at 3 months and dyspnea on admission were found. CRP at admission was positively associated with the presence of interstitial involvement at follow-up. The persistence of cough was associated with presence of bronchiectasis and consolidation on follow-up chest HRCT scan. Conclusion While inflammatory biomarker levels normalized after 3 months, signs of lung damage persist for a longer period. These findings support the need for implementing post-COVID-19 outpatient clinics to closely follow-up COVID-19 patients after hospitalization.
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Key Words
- ABG, arterial blood gas
- ARDS, acute respiratory distress syndrome
- COVID-19
- COVID-19, coronavirus disease 2019
- CPAP, continuous positive airway pressure
- CRP, C-reactive protein
- CT, computed tomography
- CVD, cardiovascular disease
- DOE, dyspnea on exertion
- GGO, ground-glass opacity
- HRCT, high-resolution computed tomography
- IQR, interquartile range
- PFT, pulmonary function test
- PaCO2, arterial partial pressure of carbon dioxide
- PaO2, arterial partial pressure of oxygen
- PaO2/FiO2, ratio of arterial partial pressure of oxygen to fractional inspired oxygen
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome coronavirus-2
- SD, standard deviation
- STROBE, Strengthening the Reporting of Observational Studies in Epidemiology
- SpO2, peripheral capillary oxygen saturation
- V/Q, ventilation/perfusion ratio
- chest CT scan
- hypocapnia
- inflammation
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Affiliation(s)
- Nicola Mumoli
- Department of Internal Medicine, ASST Ovest Milanese, Magenta MI, Italy
| | - Aldo Bonaventura
- Department of Internal Medicine, ASST Sette Laghi, Varese, Italy
| | | | | | - Marco Cei
- Department of Internal Medicine, Cecina Hospital, Cecina Livorno), Italy
| | - José Vitale
- Department of Internal Medicine, ASST Ovest Milanese, Magenta MI, Italy
| | - Luca Pavan
- Department of Internal Medicine, ASST Ovest Milanese, Magenta MI, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, ASST Ovest Milanese, Magenta MI, Italy
| | - Francesco Dentali
- Department of Medicine and Surgery, Insubria University, Varese, Italy
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Zizzo G, Caruso S, Ricchiuti E, Turato R, Stefani I, Mazzone A. Amiodarone-induced organizing pneumonia mimicking COVID-19: a case report. Eur J Med Res 2021; 26:62. [PMID: 34176493 PMCID: PMC8236223 DOI: 10.1186/s40001-021-00522-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/22/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Differential diagnosis of interstitial lung diseases (ILDs) during the COVID-19 pandemic is difficult, due to similarities in clinical and radiological presentation between COVID-19 and other ILDs on the one hand, and frequent false-negative swab results on the other. We describe a rare form of interstitial and organizing pneumonia resembling COVID-19, emphasizing some key aspects to focus on to get the right diagnosis and treat the patient properly. CASE PRESENTATION A 76-year-old man presented with short breath and dry cough in the midst of the COVID-19 outbreak. He showed bilateral crackles and interstitial-alveolar opacities on X-ray, corresponding on computed tomography (CT) to extensive consolidations with air bronchograms, surrounded by ground glass opacities (GGO). Although his throat-and-nasopharyngeal swab tested negative, the picture was overall compatible with COVID-19. On the other hand, he showed subacute, rather than hyperacute, clinical onset; few and stable parenchymal consolidations, rather than patchy and rapidly evolving GGO; pleural and pericardial thickening, pleural effusion, and lymph node enlargement, usually absent in COVID-19; and peripheral eosinophilia, rather than lymphopenia, suggestive of hypersensitivity. In the past year, he had been taking amiodarone for a history of ventricular ectopic beats. CT scans, in fact, highlighted hyperattenuation areas suggestive of amiodarone pulmonary accumulation and toxicity. Bronchoalveolar lavage fluid (BALF) investigation confirmed the absence of coronavirus genome in the lower respiratory tract; conversely, high numbers of foamy macrophages, eosinophils, and cytotoxic T lymphocytes with low CD4/CD8 T-cell ratio were detected, confirming the hypothesis of amiodarone-induced cryptogenic organizing pneumonia. Timely discontinuation of amiodarone and initiation of steroid therapy led to resolution of respiratory symptoms, systemic inflammation, and radiographic opacities. CONCLUSIONS A comprehensive analysis of medical and pharmacological history, clinical onset, radiologic details, and peripheral and BALF cellularity, is required for a correct differential diagnosis and management of ILDs in the COVID-19 era.
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Affiliation(s)
- Gaetano Zizzo
- Department of Internal Medicine, Legnano and Cuggiono Hospitals, ASST Ovest Milanese, Milan, Italy.
| | - Stefano Caruso
- Unit of Endoscopy, Cuggiono Hospital, ASST Ovest Milanese, Milan, Italy
| | - Elisabetta Ricchiuti
- Department of Internal Medicine, Legnano and Cuggiono Hospitals, ASST Ovest Milanese, Milan, Italy
| | - Roberto Turato
- Division of Cardiorespiratory Medicine, Cuggiono Hospital, ASST Ovest Milanese, Milan, Italy
| | - Ilario Stefani
- Department of Internal Medicine, Legnano and Cuggiono Hospitals, ASST Ovest Milanese, Milan, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, Legnano and Cuggiono Hospitals, ASST Ovest Milanese, Milan, Italy
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De Giglio R, Di Vieste G, Mondello T, Balduzzi G, Masserini B, Formenti I, Lodigiani S, Pallavicini D, Pintaudi B, Mazzone A. Efficacy and Safety of Bioactive Glass S53P4 as a Treatment for Diabetic Foot Osteomyelitis. J Foot Ankle Surg 2021; 60:292-296. [PMID: 33358382 DOI: 10.1053/j.jfas.2020.06.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 05/03/2020] [Accepted: 06/22/2020] [Indexed: 02/03/2023]
Abstract
Osteomyelitis represents a challenging condition in the diabetic foot with an associated high risk of major amputation. S53P4 Bioactive Glass (BG) has bacterial inhibiting properties on the market and indicated to be used in osteomyelitis. The objective of the study was to test the efficacy and safety of BG in treating diabetic foot osteomyelitis. This was an observational, retrospective, single-centre study involving subjects with diabetes affected by osteomyelitis of the foot who underwent surgical debridement from 01/2016 to 10/2018. Overall, 44 diabetic patients (14 [31.8%] female, aged 68.0 ± 10.2 years, diabetes duration 26.8 ± 11.9 years) were studied: 22 (50%) treated with surgical debridement and a local application of BG; 22 (50%) treated by means of surgical debridement. The primary outcome was the osteomyelitis resolution. Revascularization was performed before surgical procedure in 31 (70.5%) of patients. Systemic antibiotics were used in both groups. The osteomyelitis resolution rate was significantly higher in subjects treated with BG than in subjects treated with traditional procedure (18 [90%] vs 13 [61.9%], respectively p = .03). The odds of BG to reach osteomyelitis resolution was 5.54 times greater than for traditional treatment (odds ratio 5.54, 95% confidence interval 1.10-30.5). The use of BG was associated with an 81% lower probability to need additional antibiotic therapy compared to subjects treated with traditional procedure (odds ratio 0.19, 95% confidence interval 0.04-0.87). The debridement of osteomyelitis followed by application of BG could be an effective and safe option in the treatment of osteomyelitis of the diabetic foot.
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Affiliation(s)
- Roberto De Giglio
- Chief, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy.
| | - Giacoma Di Vieste
- Associate Physician, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Teresa Mondello
- Associate Physician, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Gianmario Balduzzi
- Doctor of Podiatric Medicine, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Benedetta Masserini
- Associate Physician, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Ilaria Formenti
- Associate Physician, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Sara Lodigiani
- Associate Physician, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Dario Pallavicini
- Associate Physician, Department of Radiology, Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Basilio Pintaudi
- Associate Physician, Diabetes Unit, Niguarda Hospital, Milan, Italy
| | - Antonino Mazzone
- Associate Professor and Director of Department of Internal Medicine, ASST OVEST Milanese, Legnano General Hospital, Milan, Italy
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Affiliation(s)
- Giulia Conte
- Department of Internal Medicine, ASST Ovest Milanese, Magenta (MI), Italy
| | - Marco Cei
- Department of Internal Medicine, Cecina Hospital, Cecina (LI), Italy
| | | | - Alessandra Colombo
- Department of Internal Medicine, ASST Ovest Milanese, Magenta (MI), Italy
| | - Josè Vitale
- Department of Intensive Medicine, Ente Ospedaliero Cantonale Mendrisio, TI,
Switzerland
| | - Antonino Mazzone
- Department of Internal Medicine, ASST Ovest Milanese, Magenta (MI), Italy
| | - Nicola Mumoli
- Department of Internal Medicine, ASST Ovest Milanese, Magenta (MI), Italy
- Nicola Mumoli, Department of Internal Medicine,
Ospedale Fornaroli; via al Donatore di Sangue 50, 20013 Magenta (MI), Italy.
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Mumoli N, Evangelista I, Colombo A, Conte G, Mazzone A, Barco S. Transient perivascular inflammation of the carotid artery (TIPIC) syndrome in a patient with COVID-19. Int J Infect Dis 2021; 108:126-128. [PMID: 34000422 PMCID: PMC8119392 DOI: 10.1016/j.ijid.2021.05.017] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
- Nicola Mumoli
- Department of Internal Medicine, ASST Ovest Milanese, Magenta, MI, Italy.
| | | | - Alessandra Colombo
- Department of Internal Medicine, ASST Ovest Milanese, Magenta, MI, Italy
| | - Giulia Conte
- Department of Internal Medicine, ASST Ovest Milanese, Magenta, MI, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, ASST Ovest Milanese, Magenta, MI, Italy
| | - Stefano Barco
- Clinic of Angiology, University Hospital Zurich, Zurich, Switzerland; Center for Thrombosis and Hemostasis, University Medical Center, Mainz, Germany
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Mumoli N, Conte G, Cei M, Vitale J, Capra R, Rotiroti G, Porta C, Monolo D, Colombo A, Mazzone A, Kucher N, Konstantinides SV, Dentali F, Barco S. In-hospital fatality and venous thromboembolism during the first and second COVID-19 waves at a center opting for standard-dose thromboprophylaxis. Thromb Res 2021; 203:82-84. [PMID: 33975205 PMCID: PMC8087571 DOI: 10.1016/j.thromres.2021.04.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 01/27/2023]
Affiliation(s)
- Nicola Mumoli
- Department of Internal Medicine, Magenta Hospital, Magenta, Italy.
| | - Giulia Conte
- Department of Internal Medicine, Magenta Hospital, Magenta, Italy
| | - Marco Cei
- Department of Internal Medicine, Magenta Hospital, Magenta, Italy
| | - Josè Vitale
- Department of Internal Medicine, Magenta Hospital, Magenta, Italy
| | - Riccardo Capra
- Department of Internal Medicine, Magenta Hospital, Magenta, Italy
| | | | - Cesare Porta
- Department of Internal Medicine, Magenta Hospital, Magenta, Italy
| | - Davide Monolo
- Department of Internal Medicine, Magenta Hospital, Magenta, Italy
| | | | - Antonino Mazzone
- Department of Internal Medicine, Magenta Hospital, Magenta, Italy
| | - Nils Kucher
- Clinic of Angiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Francesco Dentali
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Stefano Barco
- Clinic of Angiology, University Hospital Zurich, Zurich, Switzerland; Center for Thrombosis and Hemostasis, University Medical Center, Mainz, Germany
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Lurati A, Laria A, Mazzocchi D, Re KA, Marrazza MG, Faggioli PM, Mazzone A. Improvement of HbA1c in Patients with Type 2 Diabetes Mellitus and Rheumatoid Arthritis Treated with bDMARDs. Open Access Rheumatol 2021; 13:73-78. [PMID: 33953620 PMCID: PMC8092350 DOI: 10.2147/oarrr.s302679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/16/2021] [Indexed: 12/11/2022] Open
Abstract
Objective The aim of our study was to evaluate the possible role of biological treatments for rheumatoid arthritis (RA) in improving the glycemic profile in patients affected not only by RA but also by type 2 diabetes mellitus (2TDM). Methods An observational retrospective study was conducted using data from patients referred to our Rheumatology Unit. Patients with active RA despite standard DMARDs therapy and concomitant 2TDM were selected into one of five exposure groups to first-line bDMARDs (adalimumab, golimumab, etanercept, tocilizumab, sarilumab) and observed for the outcome of CRP, ESR, DAS28CRP and glycated hemoglobin (HbA1c) variations. Results After the start of treatment, there was a significant reduction in the values of acute phase reactants ESR and CRP (p<0.01), DAS28-CRP (p<0.01) and HbA1C (p<0.05), in the absence of any confounding factors such as a reduction in BMI or a change in steroid doses. There was no statistically significant difference between the various treatments. Anti-IL6 drugs appear to be associated with a slightly greater reduction in HbA1c values, bordering on statistical significance (p=0.047). Conclusion Initiation of a bDMARD appears to be associated with an improvement in concomitant 2TDM in patients with active RA, which, in the first hypothesis, is linked with a reduction of the inflammatory milieu.
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Affiliation(s)
| | - Antonella Laria
- Rheumatology Unit, Fornaroli Hospital Magenta Italy, Milan, Italy
| | | | - Katia Angela Re
- Rheumatology Unit, Fornaroli Hospital Magenta Italy, Milan, Italy
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Affiliation(s)
- Paola Maria Faggioli
- Internal Medicine Azienda Socio Sanitaria Territoriale OVEST Milanese, Legnano Hospital, Milan, Italy
| | - Nicola Mumoli
- Internal Medicine Azienda Socio Sanitaria Territoriale OVEST Milanese, Magenta Hospital, Milan, Italy
| | - Antonino Mazzone
- Internal Medicine Azienda Socio Sanitaria Territoriale OVEST Milanese, Legnano Hospital, Milan, Italy
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Evangelista I, Colombo A, Mazzone A, Mumoli N. Renal pyonephrosis with massive pleural empyema. Intensive Care Med 2021; 47:908-909. [PMID: 33876269 DOI: 10.1007/s00134-021-06403-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 04/03/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Isabella Evangelista
- Department of Internal Medicine, Ospedale Fornaroli, via al Donatore di Sangue, 50, 20013, Magenta, MI, Italy
| | - Alessandra Colombo
- Department of Internal Medicine, Ospedale Fornaroli, via al Donatore di Sangue, 50, 20013, Magenta, MI, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, Ospedale Fornaroli, via al Donatore di Sangue, 50, 20013, Magenta, MI, Italy
| | - Nicola Mumoli
- Department of Internal Medicine, Ospedale Fornaroli, via al Donatore di Sangue, 50, 20013, Magenta, MI, Italy.
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Affiliation(s)
- Nicola Mumoli
- Department of Internal Medicine, ASST Ovest Milanese, Ospedali di Magenta e Legnano, Ospedale Fornaroli, via al Donatore di Sangue 50, 20013, Magenta, MI, Italy.
| | - Marco Cei
- Department of Internal Medicine, Cecina Hospital, Cecina, LI, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, ASST Ovest Milanese, Ospedali di Magenta e Legnano, Ospedale Fornaroli, via al Donatore di Sangue 50, 20013, Magenta, MI, Italy
| | - Giulia Conte
- Department of Internal Medicine, ASST Ovest Milanese, Ospedali di Magenta e Legnano, Ospedale Fornaroli, via al Donatore di Sangue 50, 20013, Magenta, MI, Italy
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Laganà N, Cei M, Evangelista I, Cerutti S, Colombo A, Conte L, Mormina E, Rotiroti G, Versace AG, Porta C, Capra R, Vacirca V, Vitale J, Mazzone A, Mumoli N. Suspected myocarditis in patients with COVID-19: A multicenter case series. Medicine (Baltimore) 2021; 100:e24552. [PMID: 33663062 PMCID: PMC7909099 DOI: 10.1097/md.0000000000024552] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/13/2021] [Indexed: 01/05/2023] Open
Abstract
Although myocarditis can be a severe cardiac complication of COVID-19 patients, few data are available in the literature about the incidence and clinical significance in patients affected by SARS-CoV-2. This study aims to describe the prevalence and the clinical features of suspected myocarditis in 3 cohorts of patients hospitalized for COVID-19. We retrospectively evaluated all the consecutive patients admitted for COVID-19 without exclusion criteria. Suspect myocarditis was defined according to current guidelines. Age, sex, in-hospital death, length of stay, comorbidities, serum cardiac markers, interleukin-6, electrocardiogram, echocardiogram, and therapy were recorded. Between March 4 to May 20, 2020, 1169 patients with COVID-19 were admitted in 3 Italian Medicine wards. 12 patients (1%) had suspected acute myocarditis; 5 (41.7%) were men, mean age was 76 (SD 11.34; median 78.5 years); length of stay was 38 days on average (SD 8, median value 37.5); 3 (25%) patients died. 8 (66.7%) had a history of cardiac disease; 7 (58.33%) patients had other comorbidities like diabetes, chronic obstructive pulmonary disease, or renal insufficiency. Myocarditis patients had no difference in sex prevalence, rate of death, comorbidities, elevations in serum cardiac markers as compared with patients without myocardial involvement. Otherwise, there was a significantly higher need for oxygen-support and a higher prevalence of cardiac disease in the myocarditis group. Patients with suspected myocarditis were older, had a higher frequency of previous cardiac disease, and significantly more prolonged hospitalization and a lower value of interleukin-6 than other COVID-19 patients. Further studies, specifically designed on this issue, are warranted.
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Affiliation(s)
- Natascia Laganà
- Department of Internal Medicine, ASST Ovest Milanese, Magenta and Legnano (MI)
- Department of Clinical and Experimental Medicine, Policlinico Universitario “G. Martino”, University of Messina, Messina
| | - Marco Cei
- Department of Internal Medicine, Cecina Hospital, Cecina (LI)
| | | | - Scilla Cerutti
- Department of Internal Medicine, ASST Ovest Milanese, Magenta and Legnano (MI)
| | - Alessandra Colombo
- Department of Internal Medicine, ASST Ovest Milanese, Magenta and Legnano (MI)
| | - Lucia Conte
- Department of Internal Medicine, ASST Ovest Milanese, Magenta and Legnano (MI)
| | - Enricomaria Mormina
- Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Giuseppe Rotiroti
- Department of Internal Medicine, ASST Ovest Milanese, Magenta and Legnano (MI)
| | - Antonio Giovanni Versace
- Department of Clinical and Experimental Medicine, Policlinico Universitario “G. Martino”, University of Messina, Messina
| | - Cesare Porta
- Department of Internal Medicine, ASST Ovest Milanese, Magenta and Legnano (MI)
| | - Riccardo Capra
- Department of Internal Medicine, ASST Ovest Milanese, Magenta and Legnano (MI)
| | - Valerio Vacirca
- Department of Internal Medicine, ASST Ovest Milanese, Magenta and Legnano (MI)
| | - Josè Vitale
- Department of Internal Medicine, ASST Ovest Milanese, Magenta and Legnano (MI)
| | - Antonino Mazzone
- Department of Internal Medicine, ASST Ovest Milanese, Magenta and Legnano (MI)
| | - Nicola Mumoli
- Department of Internal Medicine, ASST Ovest Milanese, Magenta and Legnano (MI)
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40
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Mumoli N, Florian C, Cei M, Evangelista I, Colombo A, Razionale G, Moroni L, Mazzone A. Palliative care in a COVID-19 Internal Medicine ward: A preliminary report. Int J Infect Dis 2021; 105:141-143. [PMID: 33607302 PMCID: PMC7885636 DOI: 10.1016/j.ijid.2021.02.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/22/2022] Open
Abstract
Background in the current pandemic emergency, increased attention has given to treating symptoms that cause suffering in patients with COVID-19. This study aims to describe the role of palliative care in the management of these patients. Methods palliative consultation was requested by the staff as per protocol. In brief, the criteria for referring patients to a palliative care physician or to undergo palliative care were left to the discretion of the physician in charge. We recorded data regarding age, gender, length of stay, type of discharge (dead or alive, and transfer to long-term or hospice facilities). Results Between March 18 to May 8, 2020, 412 patients with COVID-19 were admitted to the Internal Medicine wards of Magenta Hospital, Italy. The palliative care physician was directly involved in 105 cases (25.5%) and performed 236 consultations. Of the 105 patients who received palliative care counselling, 66 (63%) died. The average number of days in care was 2.26 days. The principal reason for counseling was controlling symptoms (54%) and 12% deal with the end of life management. The prevalent symptom, among those which led to the counseling, was restlessness/agitation (41%), followed by emotional issues (26%) such as anxiety, fear, and demoralization. In only 20% of cases, dyspnoea was the reason for symptomatic treatment. Conclusions A large number of hospitalized Covid-19 patients are at high risk of clinical deterioration and death. This leads to the opportunity to integrate a palliative physician into the staff, who treat these patients. There is an urgent need for protocol standardization and formal trials to verify the effectiveness of this approach.
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Affiliation(s)
- Nicola Mumoli
- Department of Internal Medicine, Magenta Hospital, ASST Ovest Milanese, Magenta, MI, Italy.
| | - Clarissa Florian
- Unit of Palliative Care, Abbiategrasso Hospice, Abbiategrasso, MI, Italy
| | - Marco Cei
- Department of Internal Medicine, Cecina Hospital, Cecina, LI, Italy
| | - Isabella Evangelista
- Department of Internal Medicine, Magenta Hospital, ASST Ovest Milanese, Magenta, MI, Italy
| | - Alessandra Colombo
- Department of Internal Medicine, Magenta Hospital, ASST Ovest Milanese, Magenta, MI, Italy
| | - Giancarlo Razionale
- Department of Anesthesiology and Intensive Care, Magenta Hospital, ASST Ovest Milanese, Magenta, MI, Italy
| | - Luca Moroni
- Unit of Palliative Care, Abbiategrasso Hospice, Abbiategrasso, MI, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, Legnano Hospital, ASST Ovest Milanese, Legnano, MI, Italy
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Pieralli F, Vannucchi V, Nozzoli C, Augello G, Dentali F, De Marzi G, Uomo G, Risaliti F, Morbidoni L, Mazzone A, Santini C, Tirotta D, Corradi F, Gerloni R, Gnerre P, Gussoni G, Valerio A, Campanini M, Manfellotto D, Fontanella A. Correction to: Acute cardiovascular events in patients with community acquired pneumonia: results from the observational prospective FADOI-ICECAP study. BMC Infect Dis 2021; 21:195. [PMID: 33607965 PMCID: PMC7893753 DOI: 10.1186/s12879-021-05891-5] [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] [Indexed: 11/12/2022] Open
Affiliation(s)
- Filippo Pieralli
- Intermediate Care Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Vieri Vannucchi
- Internal Medicine, Hospital "Santa Maria Nuova" Florence, Florence, Italy
| | - Carlo Nozzoli
- Intermediate Care Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | | | - Francesco Dentali
- Internal Medicine, Hospital of Luino, ASST-Sette Laghi, and University of Insubria, Varese, Italy
| | - Giulia De Marzi
- Intermediate Care Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Generoso Uomo
- Medical Department, Internal Medicine, Hospital "Cardarelli",Pieralli et al. BMC Infectious Diseases (2021) 21:116 Page 11 of 12, Naples, Italy
| | | | - Laura Morbidoni
- Internal Medicine, Hospital "Civile" of Senigallia, Ancona, Italy
| | - Antonino Mazzone
- Medical Department, Internal Medicine, Hospital "Civile" of Legnano, Milan, Italy
| | - Claudio Santini
- Medical Department, Internal Medicine, Hospital "Vannini", Rome, Italy
| | | | - Francesco Corradi
- Medical Department, Internal Medicine 2, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Riccardo Gerloni
- Internal Medicine, "Ospedali Riuniti di Trieste", Trieste, Italy
| | - Paola Gnerre
- Internal Medicine, "San Paolo" Hospital, Savona, Italy
| | - Gualberto Gussoni
- Research Department, FADOI Foundation, Piazzale Cadorna, 15, 20123, Milan, Italy
| | - Antonella Valerio
- Research Department, FADOI Foundation, Piazzale Cadorna, 15, 20123, Milan, Italy.
| | - Mauro Campanini
- Department of Internal Medicine, Hospital "Maggiore della Carità", Novara, Italy
| | - Dario Manfellotto
- Department of Internal Medicine, Ospedale Fatebenefratelli-AFaR, Isola Tiberina, Rome, Italy
| | - Andrea Fontanella
- Medical Department, Hospital "Buon Consiglio-Fatebenefratelli", Naples, Italy
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Mumoli N, Vitale J, Pagnamenta A, Mastroiacovo D, Cei M, Pomero F, Giorgi-Pierfranceschi M, Giuntini L, Porta C, Capra R, Mazzone A, Dentali F. Bedside Abdominal Ultrasound in Evaluating Nasogastric Tube Placement: A Multicenter, Prospective, Cohort Study. Chest 2021; 159:2366-2372. [PMID: 33545162 DOI: 10.1016/j.chest.2021.01.058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Chest radiography is universally accepted as the method of choice to confirm correct positioning of a nasogastric tube (NGT). Considering also that radiation exposure could increase with multiple insertions in a single patient, bedside abdominal ultrasound (BAU) may be a potentially useful alternative to chest radiography in the management of NGTs. RESEARCH QUESTION What is the accuracy of BAU in confirming the correct positioning of an NGT? STUDY DESIGN AND METHODS After a specific course consisting of 10 h of training, the authors studied, in a prospective multicenter cohort, the validity of BAU to confirm correct NGT placement. All patients were also evaluated by auscultation (whoosh test) and by chest radiography. Every involved operator was blind to each other. Interobserver agreement and accuracy analyses were calculated. RESULTS This study evaluated 606 consecutive inpatients with an indication for NGT insertion. Eighty patients were excluded for protocol violation or incomplete examinations and 526 were analyzed. BAU was positive, negative, and inconclusive in 415 (78.9%), 71 (13.5%), and 40 (7.6%), respectively. The agreement between BAU and chest radiography was excellent. Excluding inconclusive results, BAU had a sensitivity of 99.8% (99.3%-100%), a specificity of 91.0% (88.5%-93.6%), a positive predictive value of 98.3% (97.2%-99.5%), and a negative predictive value of 98.6% (97.6%-99.7%). The accuracy of BAU slightly changed according to the different assignments of the uncertain cases and was improved by the exclusion of patients with an altered level of consciousness. INTERPRETATION These results suggest that BAU has a good positive predictive value and may confirm the correct placement of NGTs when compared with chest radiography. However, considering its suboptimal specificity, caution is necessary before implementing this technique in clinical practice.
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Affiliation(s)
- Nicola Mumoli
- Department of Internal Medicine, Livorno Hospital, Livorno, Italy; Department of Internal Medicine, ASST Ovest Milanese, Magenta, Italy.
| | - Josè Vitale
- Department of Intensive Medicine, Intensive Care Unit and Biostatistics Unit, Regional Hospital Mendrisio, Ente Ospedaliero Cantonale, Switzerland
| | - Alberto Pagnamenta
- Department of Intensive Medicine, Intensive Care Unit and Biostatistics Unit, Regional Hospital Mendrisio, Ente Ospedaliero Cantonale, Switzerland
| | | | - Marco Cei
- Department of Internal Medicine, Cecina Hospital, Cecina, Italy
| | - Fulvio Pomero
- Department of Internal Medicine, Michele e Pietro Ferrero Hospital, Verduno, Italy
| | | | - Lucia Giuntini
- Department of Internal Medicine, Livorno Hospital, Livorno, Italy
| | - Cesare Porta
- Department of Internal Medicine, ASST Ovest Milanese, Magenta, Italy
| | - Riccardo Capra
- Department of Internal Medicine, ASST Ovest Milanese, Magenta, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, ASST Ovest Milanese, Magenta, Italy
| | - Francesco Dentali
- Department of Clinical and Experimental Medicine, Insubria University, Varese, Italy
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Castelnovo L, Tamburello A, Lurati A, Zaccara E, Marrazza MG, Olivetti M, Mumoli N, Mastroiacovo D, Colombo D, Ricchiuti E, Vigano’ P, Paola F, Mazzone A. Anti-IL6 treatment of serious COVID-19 disease: A monocentric retrospective experience. Medicine (Baltimore) 2021; 100:e23582. [PMID: 33429732 PMCID: PMC7793456 DOI: 10.1097/md.0000000000023582] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/06/2020] [Indexed: 01/05/2023] Open
Abstract
COVID-19 is causing a high influx of patients suffering from serious respiratory complications leading the necessity to find effective therapies. These patients seem to present with cytokine perturbation and high levels of IL6. Tocilizumab and sarilumab could be effective in this condition.We retrospectively collected data about 112 consecutive hospitalized in a single center.Fifty (IL6 group) treated with tocilizumab (8 mg/kg intravenously [IV], 2 infusions 12 hours apart) or sarilumab 400 mg IV once and 62 treated with the standard of care but not anti-cytokine drugs (CONTROL group).To determine whether anti-IL6 drugs are effective in improving prognosis and reducing hospitalization times and mortality in COVID-19 pneumonia.To date 84% (42/50) of IL6 group patients have already been discharged and only 2/50 are still recovered and intubated in intensive care. Six/fifty patients (12%) died: 5/6 due to severe respiratory failure within a framework of severe acute respiratory distress syndrome (ARDS), 1 suffered an acute myocardial infarction, and 1 died of massive pulmonary thromboembolism. There were no adverse treatment events or infectious complications. Compared to the CONTROL group they showed a lower mortality rate (12% versus 43%), for the same number of complications and days of hospitalization.Anti-IL6 drugs seem to be effective in the treatment of medium to severe forms of COVID-19 pneumonia reducing the risk of mortality due to multi-organ failure, acting at the systemic level and reducing inflammation levels and therefore microvascular complications. However, it is essential to identify the best time for treatment, which, if delayed, is rendered useless as well as counterproductive. Further studies and ongoing clinical trials will help us to better define patients eligible as candidates for more aggressive intervention.
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Affiliation(s)
- Laura Castelnovo
- Department of Internal Medicine, ASST Ovest Milanese Ospedale di Legnano
| | - Antonio Tamburello
- Department of Internal Medicine, ASST Ovest Milanese Ospedale di Legnano
| | | | - Eleonora Zaccara
- Department of Internal Medicine, ASST Ovest Milanese Ospedale di Legnano
| | | | - Micol Olivetti
- Department of Internal Medicine, ASST Ovest Milanese Ospedale di Magenta
| | - Nicola Mumoli
- Department of Internal Medicine, ASST Ovest Milanese Ospedale di Magenta
| | | | - Daniele Colombo
- Department of Internal Medicine, ASST Ovest Milanese Ospedale di Legnano
| | | | - Paolo Vigano’
- Department of Infectious Diseases, ASST Ovest Milanese Ospedale di Legnano, Italy
| | - Faggioli Paola
- Department of Internal Medicine, ASST Ovest Milanese Ospedale di Legnano
| | - Antonino Mazzone
- Department of Internal Medicine, ASST Ovest Milanese Ospedale di Legnano
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Mazzone A, Castelnovo L, Tamburello A, Faggioli P, Mumoli N. The internist during the COVID-19 pandemic. Ital J Med 2020. [DOI: 10.4081/itjm.2020.1368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Not available
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Mumoli N, Cerutti S, Mazzone A. Man with fever, cough, and weakness. J Am Coll Emerg Physicians Open 2020; 1:1755-1756. [PMID: 33392594 PMCID: PMC7771808 DOI: 10.1002/emp2.12302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 01/22/2023] Open
Affiliation(s)
- Nicola Mumoli
- Department of Internal MedicineMagenta HospitalMagenta (MI)LombardyItaly
| | - Scilla Cerutti
- Department of Internal MedicineMagenta HospitalMagenta (MI)LombardyItaly
| | - Antonino Mazzone
- Department of Internal MedicineMagenta HospitalMagenta (MI)LombardyItaly
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Mazzone A, Castelnovo L, Tamburello A, Gatti A, Brando B, Faggioli P, Mumoli N. Monocytes could be a bridge from inflammation to thrombosis on COVID-19 injury: A case report. Thromb Update 2020; 1:100007. [PMID: 38620636 PMCID: PMC7448736 DOI: 10.1016/j.tru.2020.100007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/17/2020] [Accepted: 08/22/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
| | | | | | - Arianna Gatti
- Transfusion Center Legnano Hospital - ASST Ovest Milanese, Italy
| | - Bruno Brando
- Transfusion Center Legnano Hospital - ASST Ovest Milanese, Italy
| | - Paola Faggioli
- Department of Internal Medicine - ASST Ovest Milanese, Italy
| | - Nicola Mumoli
- Department of Internal Medicine - ASST Ovest Milanese, Italy
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Bakhai A, Fumagalli S, Mazzone A, Diemberger I, Kirchhof P, De Caterina R. Still using “aspirin or nothing” for AF patients with frailty? ETNA-AF-Europe shows frailty corresponds to higher mortality but not neurological bleeding with edoxaban anticoagulation in routine care. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Clinicians are encouraged to anticoagulate frail and older patients. Both groups were underrepresented in pivotal AF stroke prevention trials. Large, more geographically generalizable data are needed for safety and treatment efficacy in these groups. Aim: ETNA-AF-Europe registry assessed key clinical outcomes and risk scores in frail and older patients compared to their counterparts.
Methods
ETNA-AF-Europe is a large, prospective, post-authorisation, observational study of patients with AF being prescribed edoxaban. The registry captured frailty as a single, mandatory field as perceived by physicians. Baseline characteristics evaluation and 1-year outcomes of patients were extracted by presence of frailty and age (≥ vs. <80 years) using descriptive analyses.
Results
Of, 13,090 enrolled patients, 10.6% were considered frail with coding complete for 12,212 patients. Whilst 27.9% of patients were aged ≥80, of these only 25.3% were frail. Frail patients differed from non-frail and had similar baseline characteristics to those aged ≥80 years. Frail patients were more frequently female, with lower BMI and higher HAS-BLED risk score (Table), and incurred the highest rates of overall and cardiovascular deaths and major bleeding, even more than those aged ≥80 (Figure). Despite this, intracranial haemorrhage (ICH) was surprisingly low and comparable.
Conclusions
In this large, Europe wide group of patients with AF anticoagulated with edoxaban, patients considered frail by physicians are not always older. A clinical frailty perception is associated with a 4-fold higher short-term mortality. Whilst major bleeding is higher in this frail cohort, ICH is comparably low. The HAS-BLED score in frail patients prescribed edoxaban, appears to predict non-neurological bleeding. These data provide confidence for prescribing edoxaban in frail AF patients to prevent stroke.
One-year outcomes
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Daiichi Sankyo Europe GmbH, Munich, Germany
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Affiliation(s)
- A Bakhai
- Barnet General Hospital, London, United Kingdom
| | | | - A Mazzone
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | | | - P Kirchhof
- University Heart & Vascular Center Hamburg, Hamburg, Germany
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Manna A, Aberle O, Alcayne V, Amaducci S, Andrzejewski J, Audouin L, Babiano VS, Bacak M, Barbagallo M, Bennett S, Berthoumieux E, Bosnar D, Brown AS, Busso M, Caamaño M, Caballero L, Calviani M, Calvi F, Cano-Ott D, Casanovas A, Cerutti F, Chiaveri E, Colonna N, Cortés GP, Cortés-Giraldo MA, Coséntino L, Cristallo S, Damone LA, Davies PJ, Diakaki M, Dietz M, Domingo-Pardo C, Dressler R, Ducasse Q, Dupont E, Durán I, Eleme Z, Fernández-Domíngez B, Ferrari A, Ferro-Goncalves I, Finocchiaro P, Furman V, Garg R, Gawlik A, Gilardoni S, Göbel K, González-Romero E, Guerrero C, Gunsing F, Heinitz S, Heyse J, Jenkins DG, Jericha E, Jiri U, Junghans A, Kadi Y, Käppeler F, Kimura A, Knapová I, Kokkoris M, Kopatch Y, Krtiička M, Kurtulgil D, Ladarescu I, Lederer-Woods C, Lerendegui-Marco J, Lonsdale SJ, Macina D, Martínez T, Masi A, Massimi C, Mastinu PF, Mastromarco M, Maugeri E, Mazzone A, Mendoza E, Mengoni A, Michalopoulou V, Milazzo PM, Millán-Callado MA, Mingrone F, Moreno-Soto J, Musumarra A, Negret A, Nolte R, Ogállar F, Oprea A, Patronis N, Pavlik A, Perkowski J, Petrone C, Piersanti L, Pirovano E, Porras I, Praena J, Quesada J, Ramos D, Reifarth R, Rochman D, Rubbia C, Sabaté-Gilarte M, Saxena A, Schillebeeckx P, Schumann D, Sekhar A, Smith A, Sosnin N, Sprung P, Stamatopoulos A, Tagliente G, Tain JL, Tarifeno-Saldivia AE, Tassan-Got L, Thomas B, Torres-Sánchez P, Tsinganis A, Urlass S, Valenta S, Vannini G, Variale V, Vaz P, Ventura A, Vescovi D, Vlachoudis V, Vlastou R, Wallner A, Woods PJ, Wright TJ, Žugec P. Setup for the measurement of the 235U(n, f) cross section relative to n-p scattering up to 1 GeV. EPJ Web Conf 2020. [DOI: 10.1051/epjconf/202023901008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The neutron induced fission of 235U is extensively used as a reference for neutron fluence measurements in various applications, ranging from the investigation of the biological effectiveness of high energy neutrons, to the measurement of high energy neutron cross sections of relevance for accelerator driven nuclear systems. Despite its widespread use, no data exist on neutron induced fission of 235U above 200 MeV. The neutron facility n_TOF offers the possibility to improve the situation. The measurement of 235U(n,f) relative to the differential n-p scattering cross-section, was carried out in September 2018 with the aim of providing accurate and precise cross section data in the energy range from 10 MeV up to 1 GeV. In such measurements, Recoil Proton Telescopes (RPTs) are used to measure the neutron flux while the fission events are detected and counted with dedicated detectors. In this paper the measurement campaign and the experimental set-up are illustrated.
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Terranova N, Aberle O, Alcayne V, Amaducci S, Andrzejewski J, Audouin L, Babiano-Suarez V, Bacak M, Barbagallo M, Bennett S, Berthoumieux E, Bosnar D, Brown AS, Busso M, Caamaño M, Caballero L, Calviani M, Calviño F, Cano-Ott D, Casanovas A, Cerutti F, Chiaveri E, Colonna N, Cortés GP, Cortés-Giraldo MA, Cosentino L, Cristallo S, Damone LA, Davies PJ, Diakaki M, Dietz M, Domingo-Pardo C, Dressler R, Ducasse Q, Dupont E, Durán I, Eleme Z, Fernández-Domíngez B, Ferrari A, Ferro-Gonçalves I, Finocchiaro P, Furman V, Garg R, Gawlik A, Gilardoni S, Göbel K, González-Romero E, Guerrero C, Gunsing F, Heinitz S, Heyse J, Jenkins DG, Jericha E, Jiri U, Junghans A, Kadi Y, Käppeler F, Kimura A, Knapová I, Kokkoris M, Kopatch Y, Krtička M, Kurtulgil D, Ladarescu I, Lederer-Woods C, Lerendegui-Marco J, Lonsdale SJ, Macina D, Manna A, Martínez T, Masi A, Massimi C, Mastinu PF, Mastromarco M, Maugeri E, Mazzone A, Mendoza E, Mengoni A, Michalopoulou V, Milazzo PM, Millán-Callado MA, Mingrone F, Moreno-Soto J, Musumarra A, Negret A, Ogállar F, Oprea A, Patronis N, Pavlik A, Perkowski J, Petrone C, Piersanti L, Pirovano E, Porras I, Praena J, Quesada JM, Doval DR, Reifarth R, Rochman D, Rubbia C, Sabaté-Gilarte M, Saxena A, Schillebeeckx P, Schumann D, Sekhar A, Smith AG, Sosnin N, Sprung P, Stamatopoulos A, Tagliente G, Tain JL, Tarifeño-Saldivia AE, Tassan-Got L, Thomas B, Torres-Sánchez P, Tsinganis A, Urlass S, Valenta S, Vannini G, Variale V, Vaz P, Ventura A, Vescovi D, Vlachoudis V, Vlastou R, Wallner A, Woods PJ, Wright TJ, Žugec P. Monte Carlo simulations and n-p differential scattering data measured with Proton Recoil Telescopes. EPJ Web Conf 2020. [DOI: 10.1051/epjconf/202023901024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The neutron-induced fission cross section of 235U, a standard at thermal energy and between 0.15 MeV and 200 MeV, plays a crucial role in nuclear technology applications. The long-standing need of improving cross section data above 20 MeV and the lack of experimental data above 200 MeV motivated a new experimental campaign at the n_TOF facility at CERN. The measurement has been performed in 2018 at the experimental area 1 (EAR1), located at 185 m from the neutron-producing target (the experiment is presented by A. Manna et al. in a contribution to this conference). The 235U(n,f) cross section from 20 MeV up to about 1 GeV has been measured relative to the 1H(n,n)1H reaction, which is considered the primary reference in this energy region. The neutron flux impinging on the 235U sample (a key quantity for determining the fission events) has been obtained by detecting recoil protons originating from n-p scattering in a C2H4 sample. Two Proton Recoil Telescopes (PRT), consisting of several layers of solid-state detectors and fast plastic scintillators, have been located at proton scattering angles of 25.07° and 20.32°, out of the neutron beam. The PRTs exploit the ΔE-E technique for particle identification, a basic requirement for the rejection of charged particles from neutron-induced reactions in carbon. Extensive Monte Carlo simulations were performed to characterize proton transport through the different slabs of silicon and scintillation detectors, to optimize the experimental set-up and to deduce the efficiency of the whole PRT detector. In this work we compare measured data collected with the PRTs with a full Monte Carlo simulation based on the Geant-4 toolkit.
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Gatti A, Radrizzani D, Viganò P, Mazzone A, Brando B. Decrease of Non-Classical and Intermediate Monocyte Subsets in Severe Acute SARS-CoV-2 Infection. Cytometry A 2020; 97:887-890. [PMID: 32654350 PMCID: PMC7404377 DOI: 10.1002/cyto.a.24188] [Citation(s) in RCA: 64] [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: 05/27/2020] [Revised: 06/26/2020] [Accepted: 07/02/2020] [Indexed: 11/15/2022]
Abstract
In patients with severe SARS‐CoV‐2 infection, the development of cytokine storm induces extensive lung damage, and monocytes play a role in this pathological process. Non‐classical (NC) and intermediate (INT) monocytes are known to be involved during viral and bacterial infections. In this study, 30 patients with different manifestations of acute SARS‐CoV‐2 infection were investigated with a flow cytometric study of NC, INT, and classical (CL) monocytes. Significantly reduced NC and INT monocytes and a downregulated HLA‐DR were found in acute patients with severe SARS‐CoV‐2 symptoms. Conversely in patients with moderate symptoms NC and INT monocytes and CD11b expression were increased. © 2020 International Society for Advancement of Cytometry
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Affiliation(s)
- Arianna Gatti
- Hematology Laboratory and Transfusion Center, Western Milan Area Hospital Consortium, Legnano General Hospital, Milan, Italy
| | - Danilo Radrizzani
- Department of Intensive Care, Western Milan Area Hospital Consortium, Legnano General Hospital, Milan, Italy
| | - Paolo Viganò
- Department of Infectious Diseases, Western Milan Area Hospital Consortium, Legnano General Hospital, Milan, Italy
| | - Antonino Mazzone
- Department of Internal Medicine, Western Milan Area Hospital Consortium, Legnano General Hospital, Milan, Italy
| | - Bruno Brando
- Hematology Laboratory and Transfusion Center, Western Milan Area Hospital Consortium, Legnano General Hospital, Milan, Italy
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