1
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Orlandi E, Fontana G, Licitra L, Tinelli C, Camarda AM, Grau C, Frank SJ. Comprehensive insights on the underlying potential and advantage of proton therapy over intensity-modulated photon radiation therapy as highlighted in a wide real world data analysis. Radiother Oncol 2024; 193:110122. [PMID: 38309585 DOI: 10.1016/j.radonc.2024.110122] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/30/2024] [Indexed: 02/05/2024]
Affiliation(s)
- Ester Orlandi
- Radiation Oncology Unit, Clinical Department, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy; Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy.
| | - Giulia Fontana
- Radiation Oncology Unit, Clinical Department, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy
| | - Lisa Licitra
- Scientific Directorate, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy; Department of Head & Neck Medical Oncology 3, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; Department of Oncology & Haemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Carmine Tinelli
- CNAO National Center for Oncological Hadrontherapy, Scientific Direction Office, Pavia, Italy
| | - Anna Maria Camarda
- Radiation Oncology Unit, Clinical Department, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy
| | - Cai Grau
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Steven Jay Frank
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77030, USA
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2
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Cassinotti A, Mezzina N, De Silvestri A, Di Paolo D, Lenti MV, Bezzio C, Stradella D, Mauri M, Zadro V, Ricci C, Casini V, Radice E, Massari A, Maconi G, Saibeni S, Caprioli F, Tari R, Fichera M, Cortelezzi CC, Parravicini M, Tinelli C, Testoni PA, Pace F, Segato S, Invernizzi P, Occhipinti P, Manes G, Di Sabatino A, Pastorelli L, Vecchi M, Ardizzone S. Continuous clinical remission with biologics in ulcerative colitis: the 'AURORA' comparison study. Eur J Gastroenterol Hepatol 2022; 34:1238-1246. [PMID: 36165081 DOI: 10.1097/meg.0000000000002443] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Comparative trials among biological drugs for the treatment of ulcerative colitis (UC) provided conflicting results. After patent expire of infliximab originator, adalimumab, infliximab biosimilar, golimumab and vedolizumab have been approved in Italy.We compared the efficacy of these four biologics in UC according to the concept of continuous clinical remission (CCR). METHODS In a retrospective, multicentre study, all UC patients treated with adalimumab, infliximab biosimilar, golimumab or vedolizumab between 2014 and 2019 were included. All drugs were compared to each other according to the 1-year CCR rate, defined as Mayo partial score ≤2, with bleeding subscore = 0, without any relapse or optimization with dose escalation, topical treatments or steroid use after first clinical remission. RESULTS Four-hundred sixteen patients (adalimumab = 90, infliximab biosimilar = 105, golimumab = 79, vedolizumab = 142) were included. CCR was achieved in similar percentages among the groups (33%, 37%, 28%, 37%, respectively). All drugs were equivalent in biologic-naive patients, while vedolizumab was better than a second anti-TNFα in prior anti-TNFα agent failures. No differences were found according to type of adverse events or severe adverse events. CONCLUSIONS Based on a strict definition of clinical remission, all biologics appear equally effective at 1 year. Changing to vedolizumab is more effective than switching to another anti-TNFα in TNFα failures.
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Affiliation(s)
- Andrea Cassinotti
- Gastroenterology Unit, Department of Biochemical and Clinical Sciences "L. Sacco", University of Milan, ASST Fatebenefratelli Sacco, Milan
- Gastroenterology and Digestive Endoscopy Unit, ASST Sette Laghi, Varese
| | - Nicolò Mezzina
- Gastroenterology Unit, Department of Biochemical and Clinical Sciences "L. Sacco", University of Milan, ASST Fatebenefratelli Sacco, Milan
- Postgraduate School in Gastroenterology, University of Milan, Milan
| | | | - Dhanai Di Paolo
- Postgraduate School in Gastroenterology, University of Milan, Milan
- Gastroenterology Unit, Policlinico San Donato, San Donato Milanese
| | - Marco Vincenzo Lenti
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia
| | | | | | - Martina Mauri
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza
| | - Valentina Zadro
- Gastroenterology Unit, Department of Biochemical and Clinical Sciences "L. Sacco", University of Milan, ASST Fatebenefratelli Sacco, Milan
- Postgraduate School in Gastroenterology, University of Milan, Milan
| | - Chiara Ricci
- Gastroenterology Unit, ASST Spedali Civili Brescia, Brescia
| | | | | | - Alessandro Massari
- Gastroenterology Unit, Department of Biochemical and Clinical Sciences "L. Sacco", University of Milan, ASST Fatebenefratelli Sacco, Milan
| | - Giovanni Maconi
- Gastroenterology Unit, Department of Biochemical and Clinical Sciences "L. Sacco", University of Milan, ASST Fatebenefratelli Sacco, Milan
| | | | - Flavio Caprioli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano
| | - Roberto Tari
- Gastroenterology Unit, Ospedale Maggiore della Carità, Novara
| | - Maria Fichera
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza
| | | | - Marco Parravicini
- Gastroenterology and Digestive Endoscopy Unit, ASST Sette Laghi, Varese
| | - Carmine Tinelli
- Clinical Epidemiology and Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia
| | | | - Fabio Pace
- Gastroenterology Unit, ASST Bergamo Est, Seriate
| | - Sergio Segato
- Gastroenterology and Digestive Endoscopy Unit, ASST Sette Laghi, Varese
| | - Pietro Invernizzi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza
| | | | | | - Antonio Di Sabatino
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia
| | - Luca Pastorelli
- Gastroenterology Unit, Policlinico San Donato, San Donato Milanese
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Maurizio Vecchi
- Postgraduate School in Gastroenterology, University of Milan, Milan
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico
| | - Sandro Ardizzone
- Gastroenterology Unit, Department of Biochemical and Clinical Sciences "L. Sacco", University of Milan, ASST Fatebenefratelli Sacco, Milan
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3
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Borgonovo F, Stangalini CA, Tinelli C, Mariani C, Mileto D, Cossu MV, Abbati L, Bilardo L, Gagliardi G, Cutrera M, Pellicciotta M, Armiento L, Dedivitiis G, Capetti AF, Rizzardini G. Decay rate of antiS1/S2 IgG serum levels after 6 months of BNT162b2 vaccination in a cohort of COVID-19-naive and COVID-19-experienced subjects. Hum Vaccin Immunother 2022; 18:2060018. [PMID: 35511791 PMCID: PMC9897653 DOI: 10.1080/21645515.2022.2060018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/15/2022] [Accepted: 03/28/2022] [Indexed: 02/06/2023] Open
Abstract
Vaccination toward SARS-CoV-2 reduced mortality and 'boosters' are being implemented. We offer scientific contribution about IgG production in the COVID-19 experienced population. From January 2021 to March 2021, 183 residents and staff from the Elderly Nursing Home "San Giuseppe Moscati" who had received two doses of the BNT162b2 vaccine were enrolled. The antibody response was assessed by the DiaSorin LIAISON-CLIA S1/S2® IgG solution. Cutoff levels for response (>39 BAU/mL) and neutralizing activity (>208 BAU/mL) were derived from DiaSorin official data. Serology was assessed before and after the first vaccination, and 2 weeks and 6 months after the second vaccination. Anti-S IgG in COVID-19 experienced, baseline IgG producers spiked after the first vaccination to median 5044 BAU/mL and decayed at 6 months to 2467.4 BAU/mL. Anti-S IgG in COVID-19 experienced, baseline IgG non-producers spiked after the second vaccination to median 1701.7 BAU/mL and decayed at 6 months to 904.8 BAU/mL. Anti-S IgG in COVID-19 naïve subjects spiked after the second vaccination to median 546 BAU/mL and decayed at 6 months to 319.8 BAU/mL. The differences between sequential timepoint levels in each group were statistically significant (p < .0001). Serology analysis revealed different kinetics between COVID-19 experienced subjects depending on baseline response, possibly predicting different IgG persistence in blood.
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Affiliation(s)
- Fabio Borgonovo
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | | | - Carmine Tinelli
- Biometrics and Clinical Statistics Service, Scientific Direction, Fondazione IRCCS Policlinico, Pavia, Italy
| | - Chiara Mariani
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Davide Mileto
- Clinical Microbiology Unit, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Maria Vittoria Cossu
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Laura Abbati
- ’San Giuseppe Moscati’ Foundation, Milano, Italy
| | - Lara Bilardo
- ’San Giuseppe Moscati’ Foundation, Milano, Italy
| | - Gloria Gagliardi
- Clinical Microbiology Unit, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Miriam Cutrera
- Clinical Microbiology Unit, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Martina Pellicciotta
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Luciana Armiento
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Gianfranco Dedivitiis
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Amedeo F. Capetti
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
| | - Giuliano Rizzardini
- 1st Division of Infectious Diseases, ‘Luigi Sacco’ University Hospital, Milano, Italy
- School of Medicine, University of the Witwatersrand, Johannesburg, South Africa
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4
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Di Natali G, Carlisi E, Marin L, Tinelli C, Lisi C. [Remote functional evaluation after reconstruction of the anterior cruciate ligament in amateur sportsmen with sedentary work]. G Ital Med Lav Ergon 2022; 44:366-375. [PMID: 36622826] [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] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 01/10/2023]
Abstract
SUMMARY The anterior cruciate ligament (ACL) is the most commonly injured knee ligament. Currently there are two commonly used surgical procedures: middle third patellar tendon grafts (bone-patellar tendon-bone: BTB) and semitendinosus autografts or semitendinosus combined with gracilis tendon autografts (ST/G). Purpose. The aim of this study is to compare the rehabilitation results over time of amateur sportsmen who have undergone anterior cruciate ligament (ACL) reconstruction surgery by means of one of the two most commonly used procedures: middle third patellar tendon grafts (bone-patellar tendon-bone: BTB) and semitendinosus and gracilis tendon autografts (ST/G). Method. 30 subjects divided into two groups, (15 BTB and 15 ST / G), were evaluated during rehabilitation and at three follow-up periods (16 weeks, 24 weeks, 2 years). Evaluation involved clinical examination, isokinetic tests, and functional rating scales: Lysholm and IKDC. Results. The clinical evaluation resulted in the following mean values: the value of the Lysholm score was 78 in both group at 16 weeks, 91 in group A and 94 in group B at 24 weeks, 98 in group A and 99 in group B at 2 years; the value of the IKDC score was 14 in group A and 15 in group B at 16 weeks, 12 in group A and 14 in group B at 24 weeks, 14 in group A and 15 in group B at 2 years. No major complications occurred during rehabilatation Conclusions. Subjects in both groups showed good neoligament stability up to the 24-week follow up. At the 2-year follow-up the subjects of group B showed poor neoligament stability that prevented the return to the previous level of sporting activity; all the subjects with high intensity sports activity needed a greater muscle strengthening. No statistically significant differences between the two groups are seen.
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Affiliation(s)
- Giuseppe Di Natali
- Rehabilitation Unit, Department of Medicine, Foundation IRCCS Hospital San Matteo Pavia
| | - Ettore Carlisi
- Rehabilitation Unit, Department of Medicine, Foundation IRCCS Hospital San Matteo Pavia
| | - Luca Marin
- Department of Research, Asomi College of Sciences, Marsa, Malta
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Foundation IRCCS Hospital San Matteo Pavia
| | - Claudio Lisi
- Rehabilitation Unit, Department of Medicine, Foundation IRCCS Hospital San Matteo Pavia
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5
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Rossi GCM, Tinelli C, Milano G, Lanteri S, Ricciarelli G, Giannì L, Pasinetti GM, Scudeller L. Randomised, Single Blind, Controlled, Three-Month Clinical Trial on the Evaluation and Treatment of the Ocular Surface Damage Following Phacoemulsification. Vision (Basel) 2022; 6:vision6030042. [PMID: 35893759 PMCID: PMC9326562 DOI: 10.3390/vision6030042] [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: 04/30/2022] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: To determine efficacy of two lacrimal substitutes on signs and symptoms of ocular surface disease after phacoemulsification; to determine impact of surgery on patients’ vision related quality of life. Monocentric, randomised, physician blinded, three parallel groups clinical trial. Design and Methods: Patients in the operative list for phacoemulsification have been screened for eligibility; they underwent (at time 0, 15, 45 and 90 days): slit lamp examination; tear film break-up time (BUT); corneal staining; tear volume; 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ); Ocular Surface Disease Index (OSDI). Treatments to be compared were: 1. standard of care-SOC (lomefloxacine and tobramicine/dexamethasone fixed combination 4 times a day for 2 weeks), 2. SOC + carboxymethylcellulose sodium 0.5% and glycerin 0.9%, 3. SOC + Sodium Hyaluronate 0.15%. Study treatment started at T15. Groups were compared with parametric or nonparametric tests, and with Pearson’s χ2 test. Correlation between continuous variables was assessed by means of Pearson’s or Spearman’s coefficient. Results: Fifty-three patients were enrolled. At 45 and at 90 days from surgery, the group receiving lacrimal substitutes presented better BUT and Schirmer I test (p = 0.009, <0.001, <0.001 and 0.001, respectively); dry eye presence showed significant difference by group at time 90 (p = 0.019). General vision, near activity and vision-specific dependency subscales improved after surgery (p = <0.001, 0.004 and 0.048, respectively). At 45 and 90 days from surgery, the OSDI score significantly changed (p < 0.001).Conclusions: Cataract surgery causes the onset or the worsening of dry eye. Use of artificial tears can significantly reduce symptoms and signs of dry eye in patients after phacoemulsification.
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Affiliation(s)
- Gemma Caterina Maria Rossi
- Department of Surgical Sciences, University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.M.); (S.L.); (G.R.); (L.G.)
- ASST Bergamo Est, Ospedale Locatelli, 24020 Piario, Italy
- Correspondence:
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (C.T.); (L.S.)
| | - Giovanni Milano
- Department of Surgical Sciences, University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.M.); (S.L.); (G.R.); (L.G.)
- Medicine and Surgery Faculty, University of Pavia, 27100 Pavia, Italy
| | - Sara Lanteri
- Department of Surgical Sciences, University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.M.); (S.L.); (G.R.); (L.G.)
| | - Gabriella Ricciarelli
- Department of Surgical Sciences, University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.M.); (S.L.); (G.R.); (L.G.)
| | - Laura Giannì
- Department of Surgical Sciences, University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.M.); (S.L.); (G.R.); (L.G.)
| | | | - Luigia Scudeller
- Clinical Epidemiology and Biometric Unit, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (C.T.); (L.S.)
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6
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Maffioli P, D'Angelo A, Tinelli C, Falcone C, Galasso G, Derosa G. Detection of sieric BAG3 in patients affected by cardiovascular diseases: State of art and perspectives. J Cell Biochem 2021; 123:54-58. [PMID: 34908187 DOI: 10.1002/jcb.30192] [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: 07/05/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 11/07/2022]
Abstract
BAG3 is highly expressed in the heart and its functions are essential in maintaining cardiac muscle cells homeostasis. In the past, BAG3 was detected in serum from advanced heart failure patients and its higher levels were correlated to an increased death risk. Moreover, it has also been reported that BAG3 levels in serum are increased in patients with hypertension, a known cardiovascular risk marker. Evidence from different laboratories suggested the possibility to use BAG3-based strategies to improve the clinical outcome of cardiovascular disease patients. This review aims to highlight the biological roles of intracellular or secreted BAG3 in myocardiocytes and propose additional new data on the levels of sieric BAG3 in patients with acute myocardial infarction (AMI), never assessed before. We evaluated BAG3 serum levels in relation to cardiovascular risk parameters in 64 AMI patients aged ≥18 years of either sex. We observed significant (p < .01) correlations of BAG3 positivity with dyslipidemic status and diabetic disease. We did not observe any significant correlations of BAG3 levels with smoking habit, hypertension or familiarity for AMI, although BAG3-positive seemed to be more numerous than BAG3-negative patients among hypertensives and among patients with familiarity for AMI. Furthermore, a significant (p < .001) correlation of BAG3 positivity with diuretics assumption was also noted. In conclusion, 32.8% of the patients were BAG3-positive and were characterized by some particular features as comorbidity presence or concomitant therapies. The significance of these observations needs to be verified by more extensive studies and could help in the validation of the use of BAG3 as a biomarker in heart attack risk stratification.
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Affiliation(s)
- Pamela Maffioli
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Angela D'Angelo
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.,Laboratory of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Colomba Falcone
- Cardiology Unit, Istituto di Cura Città di Pavia, University of Pavia, Pavia, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Baronissi, Italy
| | - Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.,Laboratory of Molecular Medicine, University of Pavia, Pavia, Italy
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7
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Pagella F, Maiorano E, Ugolini S, Lizzio R, Sovardi F, Mirabella R, Nanfitò L, Tinelli C, De Silvestri A, Olivieri C, Spinozzi G, Matti E. Epidemiological, clinical and endoscopic features of epistaxis severity and quality of life in Hereditary haemorrhagic telangiectasia: a cross-sectional study. Rhinology 2021; 59:577-584. [PMID: 34726201 DOI: 10.4193/rhin21.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Epistaxis is the main complaint in patients with Hereditary haemorrhagic telangiectasia (HHT). Even though the role of epistaxis in affecting the quality of life (QoL) is well-known, little is known about epidemiological and clinical factors contributing to epistaxis severity and QoL. METHODOLOGY This is a cross-sectional study, including adult patients with HHT with epistaxis. All patients underwent an otolaryngological evaluation with nasal endoscopy. Epistaxis severity was graded using the FID score, and QoL was evaluated with the Short-Form Health Survey (SF-36). Descriptive statistics were produced for demographic characteristics; the Shapiro-Wilk test was used to test the normal distribution of quantitative variables. Correlation between the quantitative variables was evaluated with Pearson's correlation coefficient. Both univariate and multivariate linear regression models were fitted to find associations between demographic or clinical factors and the FID score or SF-36. RESULTS A total of 234 patients with HHT were included in the study. The univariate analysis highlighted the association between high blood pressure, septal perforation, nocturnal epistaxis, surgery, blood transfusion, hormonal therapy and both FID score and QoL. Sex, allergic rhinitis and nasal polyposis were neither related to epistaxis severity nor perceived health. CONCLUSIONS Epistaxis severity and QoL in patients with HHT are influenced by several clinical factors both dependent and independent from HHT. Some of the results are consistent with those already published, but for the first time, we extended the analysis to different clinical parameters, such as endoscopic findings, never assessed before.
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Affiliation(s)
- F Pagella
- Department of Otorhinolaryngology, University of Pavia, Pavia, Italy.,Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - E Maiorano
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Ugolini
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - R Lizzio
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - F Sovardi
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - R Mirabella
- Department of Otorhinolaryngology, University of Pavia, Pavia, Italy.,Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - L Nanfitò
- Department of Otorhinolaryngology, University of Pavia, Pavia, Italy.,Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Tinelli
- Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A De Silvestri
- Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Olivieri
- Molecular Medicine Department, General Biology and Medical Genetics Unit, University of Pavia, Italy
| | - G Spinozzi
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - E Matti
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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8
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Varchetta S, Mele D, D'Ambrosio R, Perbellini R, Lombardi A, Rojas A, Paolucci S, Baldanti F, Oliviero B, Mantovani S, Tinelli C, De Silvestri A, Romero Gomez M, Lampertico P, Mondelli MU. A new algorithm shows superior ability to discriminate liver fibrosis stages in chronic hepatitis C. J Viral Hepat 2021; 28:1443-1451. [PMID: 34228858 DOI: 10.1111/jvh.13570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/11/2021] [Accepted: 06/30/2021] [Indexed: 12/09/2022]
Abstract
Previous evidence suggests that sialic acid-binding Ig-like lectin 7 (Siglec-7) protein is significantly increased in patients with chronic hepatitis C virus (HCV) infection and directly correlates with clinical parameters of liver inflammation and fibrosis. The aim of this study was to determine the diagnostic value of Siglec-7 as a non-invasive tool to assess liver fibrosis in patients with chronic hepatitis C in a cross-sectional study. Serum levels of Siglec-7 were retrospectively tested in 1007 consecutive patients with chronic HCV infection recruited at three different European sites and data examined by the 'imperfect gold-standard' statistical analysis. Liver stiffness obtained by transient elastography (TE) was considered the standard reference. Liver fibrosis was staged according to published cut-offs of liver stiffness measurement by TE. Accuracy of detection of liver fibrosis stage was not increased by Siglec-7 alone. However, we developed a new index (SiGAP) including Siglec-7, γ-glutamyl transferase, age and platelet count which showed increased sensitivity and specificity in predicting fibrosis compared with APRI or FIB4 indices. The AUROC of SiGAP for the diagnosis of significant (≥F2) and advanced liver fibrosis (≥F3) showed significantly higher values than those of APRI and FIB-4. Siglec-7 may be useful as a complementary tool to assess liver fibrosis stage in patients with chronic hepatitis C when included in a specifically designed algorithm, which showed high level of accuracy in the detection of F2 and F3 fibrosis stage.
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Affiliation(s)
- Stefania Varchetta
- Division of Clinical Immunology and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Dalila Mele
- Division of Clinical Immunology and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberta D'Ambrosio
- Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Riccardo Perbellini
- Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Andrea Lombardi
- Division of Clinical Immunology and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Angela Rojas
- SeLiver Group, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Stefania Paolucci
- Molecular Virology Unit, Division of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Division of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Barbara Oliviero
- Division of Clinical Immunology and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefania Mantovani
- Division of Clinical Immunology and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carmine Tinelli
- Biostatistics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Manuel Romero Gomez
- SeLiver Group, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.,UGC de Enfermedades Digestivas, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Pietro Lampertico
- Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Pathophysiology and Transplantation, CRC "A.M. and A. Migliavacca" Centre for Liver Disease, University of Milan, Milan, Italy
| | - Mario U Mondelli
- Division of Clinical Immunology and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
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9
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Plaitano C, Periti F, Guagliano R, Bertone C, Barillà D, Arpa C, Tinelli C, Gallo FG, Bianchi A, Magli A. Optical coherence tomography angiography in healthy children: A comparison of macular structure. Eur J Ophthalmol 2021; 32:2005-2010. [PMID: 34493114 DOI: 10.1177/11206721211043749] [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] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of the present study was to investigate the perfusion density (PD) of macular superficial (SCP) and deep capillary plexus (DCP), the size of foveal avascular zone (FAZ) and central macular thickness (CMT) in healthy children using optical coherence tomography angiography (OCT-A). PATIENTS AND METHODS About 206 eyes of 111 children were analyzed. The correlation of gestational age (GA), birth weight (BW), age, sex, refractive errors, and visual acuity (VA) with OCT-A parameters were investigated. RESULTS The mean PD of the fovea and the mean FAZ area of SCP were 17.1% (DS: 4.26) and 234.47 (DS: 106.39) µm2. The mean PD of the fovea and the mean FAZ area of DCP were 13.5% (DS: 5.23) and 298.32 (DS: 112.37) µm2. Superficial and deep FAZ areas were not correlated with sex, age, BW, refractive errors, or VA. FAZ area of SCP was correlated with foveal PD (r = -0.76) and with CMT (r = -0.68). FAZ area of DCP was correlated with foveal's PD (r = -0.61). There was no correlation between CMT and refractive errors. CONCLUSION OCT-A may provide a non-invasive and reliable approach to evaluate macular perfusion in children. As the FAZ area, PD, and CMT change during the growth period, we performed established a reference range for different ages.
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Affiliation(s)
- Carmen Plaitano
- Department of Pediatric Ophthalmology, University Hospital of Salerno, University of Salerno, Salerno, Italy
| | | | | | - Chiara Bertone
- Eye Clinic, University Hospital, IRCCS S. Matteo, Pavia, Italy
| | | | - Cristina Arpa
- Eye Clinic, University Hospital, IRCCS S. Matteo, Pavia, Italy
| | - Carmine Tinelli
- Biometric Service, University Hospital, IRCCS S. Matteo, Pavia, Italy
| | - Flavio Gioele Gallo
- Department of Pediatric Ophthalmology, University Hospital of Salerno, University of Salerno, Salerno, Italy
| | | | - Adriano Magli
- Department of Pediatric Ophthalmology, University Hospital of Salerno, University of Salerno, Salerno, Italy
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10
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Pagella F, Pusateri A, Maiorano E, Spinozzi G, Ugolini S, Lizzio R, Mirabella R, Tinelli C, Olivieri C, Matti E. Endoscopic surgical treatment of epistaxis in hereditary haemorrhagic telangiectasia: our experience. ACTA ACUST UNITED AC 2021; 41:59-68. [PMID: 33746224 PMCID: PMC7982753 DOI: 10.14639/0392-100x-n0915] [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: 06/10/2020] [Accepted: 10/16/2020] [Indexed: 11/23/2022]
Abstract
Objectives Hereditary haemorrhagic telangiectasia (HHT) is a rare autosomal dominant disease characterised by epistaxis. Surgical procedures for epistaxis vary from diathermocoagulation to nasal closure. The aim of this paper is to report our experience in endoscopic surgical management of epistaxis in HHT patients. Methods This is a descriptive, longitudinal study carried out at the Otorhinolaryngology Department of IRCCS Policlinico San Matteo in Pavia, a reference centre for the treatment and diagnosis of HHT. We retrospectively evaluated HHT patients who underwent surgery for epistaxis from 1996 to 2015, including only those treated with endoscopic surgery. Results Among the 591 patients hospitalised and screened for HHT, 323 (54.7%) underwent endoscopic surgery for epistaxis, for a total of 679 procedures. General anaesthesia was used in 77.2% of procedures; argon plasma coagulation was the instrument of choice in the majority of patients, followed by lasers and quantum molecular resonance technology. Conclusions We report one of the largest cohorts undergoing endoscopic treatment of epistaxis in HHT patients. This mini-invasive surgical treatment allowed us to control epistaxis without major complications and nasal packaging and can be repeated over time. For these reasons, we recommend it as first choice in case of epistaxis in HHT patients.
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Affiliation(s)
- Fabio Pagella
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,University of Pavia, Italy
| | - Alessandro Pusateri
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Eugenia Maiorano
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,University of Pavia, Italy
| | - Giuseppe Spinozzi
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sara Ugolini
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,University of Pavia, Italy
| | - Roberta Lizzio
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rosolino Mirabella
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,University of Pavia, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | - Carla Olivieri
- University of Pavia, Italy.,General Biology and Medical Genetics, Department of Molecular Medicine, Pavia, Italy
| | - Elina Matti
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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11
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Guagliano R, Barillà D, Bertone C, Montescani S, Verticchio Vercellin AC, Arpa C, Tinelli C, De Angelis G, Quaranta L. Evaluation of macular and optic nerve head parameters in amblyopic eyes: An optical coherence tomography study. Eur J Ophthalmol 2021; 32:1991-1996. [PMID: 34348510 DOI: 10.1177/11206721211036811] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate morphological differences in retinal nerve fibers layers (RNFL), optic nerve head (ONH), ganglion cell complex (GCC), and macular thickness between amblyopic and normal eyes from spectral domain optical coherence tomography (SD-OCT). METHODS Of 234 eyes of 117 children, four groups emerged: group A (162 eyes of 81 non-amblyopic subjects); group B (32 fellow eyes of 32 subjects with monolateral amblyopia); group C (32 amblyopic eyes of 32 subjects affected by monolateral amblyopia); group D (8 amblyopic eyes of 4 subjects with bilateral amblyopia). Patients underwent SD-OCT for ONH parameters, RNFL, GCC and macular thickness, retina map, and ONH scan quality index (SQI). Two-sided p values <0.05 were taken as statistically significant. (Analysis: STATA v.13). RESULTS Parameters with a significant difference between groups (p < 0.005) with their Standard Deviation (SD) are presented: rim area, 2.08 (0.49) mm2 in group A and 1.76 (0.68) mm2 in group C; disk area, 2.43 (0.45) mm2 in group A and 2.02 (0.71) mm2 in group C; central macular thickness, 250.99 (19.74) µm in group A and 267.16 (23.52) µm in group C; nerve fiber ONH SQI, 62.82 (13.15) in group A, 51.26 (15.55) in group C, 48.29 (14.37) in group D; retina map SQI, 63.34 (10.34) in group A and 57.34 (9.84) in group C. For other parameters no significant difference was observed (p > 0.005). CONCLUSIONS Amblyopia may influence optic nerve morphology, central macular thickness, and OCT scan quality. RNFL and GCC are not affected by monolateral amblyopia.
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Affiliation(s)
- Rosanna Guagliano
- Eye Clinic, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Donatella Barillà
- Eye Clinic, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Chiara Bertone
- Eye Clinic, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Silvia Montescani
- Eye Clinic, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | | | - Cristina Arpa
- Eye Clinic, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Carmine Tinelli
- Unit of Biometry and Medical Statistics, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giovanni De Angelis
- Eye Clinic, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.,Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Luciano Quaranta
- Eye Clinic, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.,Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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12
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Moroni M, Pirovano M, Brugnatelli S, Zucca M, Morreale M, Rizzo V, Ferrari A, Tinelli C, De Silvestri A, Meregalli M, Giordano M, Artale S, Cergnul M, Bollina R, Rizzo M, Pedrazzoli P. Lycopene minimizes skin toxicity and oxidative stress in patients treated with panitumumab-containing therapy for metastatic colorectal cancer. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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13
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Lucotti P, Lovati E, Lenti MV, Valvo B, Sprio E, Aronico N, Giuffrida P, Dell'Aera D, Pasini A, Ubezio C, Delliponti M, Tinelli C, Corazza GR, Di Sabatino A. Abnormal post-prandial glucagon-like peptide release in patients with Crohn's disease. Clin Res Hepatol Gastroenterol 2021; 45:101533. [PMID: 33036955 DOI: 10.1016/j.clinre.2020.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/31/2020] [Accepted: 08/26/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Glucagon-like peptide GLP-1 and -2 have been shown to regulate immune responses in immune-mediated disorders, including Crohn's disease (CD). Our aim was to investigate post-prandial GLP release and its potential link to chronic inflammation, insulin secretion/sensitivity and body composition changes in CD patients. METHODS Fifteen patients with CD, 15 healthy controls (HC) and 15 patients with metabolic syndrome (MS) were recruited. All patients underwent assessment of body composition by means of bio-impedance followed by a meal tolerance test (MTT). Only one CD patient did not tolerate the MTT and was excluded. RESULTS Basal GLP-1 levels were up-regulated in CD, however, as compared to HC, stimulated GLP-1 secretion was significantly reduced in CD (-31 %, p < 0.05) as in MS (-52 %, p < 0.003). Similarly, basal GLP-2 levels were comparable to that of HC, while response to MTT in CD was virtually absent (p < 0.05). Similar fasting insulin sensitivity, estimated 1st and 2nd phase insulin secretion and insulinogenic index were found in CD and in HC. Post-prandial GLP secretion was positively correlated to insulin secretion indices, both in CD and MS. In CD, high-sensitive C reactive protein levels (hsCRP) and extra-cellular to intra-cellular water ratio (ECW/ICW), an index of cellular inflammation, were inversely correlated with stimulated GLP-1 (p < 0.05 and p < 0.01, respectively) levels. CONCLUSION CD is characterized by abnormal fasting and post-prandial GLP levels. Circulating GLP influences subclinical inflammation and glucose metabolism in CD patients, but not their body composition parameters.
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Affiliation(s)
- Pietro Lucotti
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Elisabetta Lovati
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Marco Vincenzo Lenti
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Beatrice Valvo
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Elisa Sprio
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Nicola Aronico
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Paolo Giuffrida
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Dominica Dell'Aera
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Alessandra Pasini
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Cristina Ubezio
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Mariangela Delliponti
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, San Matteo Hospital Foundation, Pavia, Italy
| | - Gino Roberto Corazza
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
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14
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Ferraioli G, Maiocchi L, Savietto G, Tinelli C, Nichetti M, Rondanelli M, Calliada F, Preda L, Filice C. Performance of the Attenuation Imaging Technology in the Detection of Liver Steatosis. J Ultrasound Med 2021; 40:1325-1332. [PMID: 32960457 PMCID: PMC8246860 DOI: 10.1002/jum.15512] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 05/12/2023]
Abstract
OBJECTIVES The main aim was to assess the performance and cutoff value for the detection of liver steatosis (grade S > 0) with the Attenuation Imaging-Penetration (ATI-Pen) algorithm available on the Aplio i-series ultrasound systems (Canon Medical Systems, Otawara, Japan). The magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) was used as the reference standard. Secondary aims were to compare the results to those obtained with the previous ATI algorithm (Attenuation Imaging-General [ATI-Gen]) and with the controlled attenuation parameter (CAP) and to generate a regression equation between ATI-Pen and ATI-Gen values. METHODS Consecutive adult patients potentially at risk of liver steatosis were prospectively enrolled. Each patient underwent ultrasound quantification of liver steatosis with ATI-Pen and ATI-Gen and a CAP assessment with the FibroScan system (Echosens, Paris, France). The MRI-PDFF evaluation was performed within a week. The correlations between ATI-Pen, ATI-Gen, the CAP, and the MRI-PDFF were analyzed with the Pearson rank correlation coefficient. The diagnostic performance of ATI-Pen, ATI-Gen, and the CAP was assessed with receiver operating characteristic curves and an area under the receiver operating characteristic curve (AUROC) analysis. RESULTS Seventy-two individuals (31 male and 41 female) were enrolled. Correlation coefficients of ATI-Pen, ATI-Gen, and the CAP with the MRI-PDFF were 0.78, 0.83, and 0.58, respectively. The AUROCs of ATI-Pen, ATI-Gen, and the CAP for detecting steatosis (S > 0) were 0.90 (95% confidence interval, 0.81-0.96), 0.92 (0.82-0.98), and 0.85 (0.74-0.92), and the cutoffs were greater than 0.69 dB/cm/MHz, greater than 0.62 dB/cm/MHz, and greater than 273 dB/m. The regression equation between ATI-Pen and ATI-Gen was ATI-Pen = 0.88 ATI-Gen + 0.13. CONCLUSIONS Attenuation Imaging is a reliable tool for detecting liver steatosis, showing an excellent correlation with the MRI-PDFF and high performance with AUROCs of 0.90 or higher.
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Affiliation(s)
- Giovanna Ferraioli
- Department of Clinical, Surgical, Diagnostic, and Pediatric SciencesUniversity of PaviaPaviaItaly
| | - Laura Maiocchi
- Department of Clinical Sciences and Infectious DiseasesFondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San MatteoPaviaItaly
| | - Giovanni Savietto
- Department of RadiologyFondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San MatteoPaviaItaly
| | - Carmine Tinelli
- Department of Clinical Epidemiology and Biometric UnitFondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San MatteoPaviaItaly
| | - Mara Nichetti
- Department of Applied Health SciencesAzienda di Servizi Alla Persona di PaviaPaviaItaly
| | - Mariangela Rondanelli
- Department of Public HealthUniversity of PaviaPaviaItaly
- Istituto di Ricovero e Cura a Carattere Scientifico Mondino FoundationPaviaItaly
| | - Fabrizio Calliada
- Department of Clinical, Surgical, Diagnostic, and Pediatric SciencesUniversity of PaviaPaviaItaly
| | - Lorenzo Preda
- Department of Clinical, Surgical, Diagnostic, and Pediatric SciencesUniversity of PaviaPaviaItaly
- Department of RadiologyFondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San MatteoPaviaItaly
| | - Carlo Filice
- Department of Clinical, Surgical, Diagnostic, and Pediatric SciencesUniversity of PaviaPaviaItaly
- Department of Clinical Sciences and Infectious DiseasesFondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San MatteoPaviaItaly
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15
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Manciulli T, Enríquez-Laurente R, Tamarozzi F, Lissandrin R, Elizalde M, Sedano C, Bardales K, Vola A, De Silvestri A, Tinelli C, Brunetti E, Santivanez S, Mariconti M. Field Performance of a Rapid Diagnostic Test for the Serodiagnosis of Abdominal Cystic Echinococcosis in the Peruvian Highlands. Am J Trop Med Hyg 2021; 105:181-187. [PMID: 34029208 PMCID: PMC8274789 DOI: 10.4269/ajtmh.21-0045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/11/2021] [Indexed: 11/07/2022] Open
Abstract
We evaluated the performance of a commercial rapid diagnostic test (RDT) in a field setting for the diagnosis of abdominal cystic echinococcosis (CE) using sera collected during an ultrasound population screening in a highly endemic region of the Peruvian Andes. Abdominal CE was investigated by ultrasonography. Sera collected from individuals with abdominal CE (cases) and age- and gender-matched volunteers with no abdominal CE (controls) were tested independently in two laboratories (Peru and Italy) using the VIRapid® HYDATIDOSIS RDT and RIDASCREEN® Echinococcus IgG enzyme-linked immunosorbent assay. Performance indexes of single and serially combined tests were calculated and applied to hypothetical screening and clinical scenarios. Test concordance was also evaluated. Prevalence of abdominal CE was 6.00% (33 of 546) by ultrasound. Serum was obtained from 33 cases and 81 controls. The VIRapid test showed similar sensitivity (76% versus 74%) and lower specificity (79% versus 96%) than results obtained in a hospital setting. RDTs showed better performance when excluding subjects reporting surgery for CE and if weak bands were considered negative. Concordance between tests was moderate to very good. In hypothetical screening scenarios, ultrasound alone or confirmed by RDTs provided more reliable prevalence figures than serology alone, which overestimated it by 5 to 20 times. In a simulation of case diagnosis with pre-test probability of CE of 50%, positive and negative post-test probabilities of the VIRapid test were 78% and 22%, respectively. The application of the VIRapid test alone would not be reliable for the assessment of population prevalence of CE, but could help clinical decision making in resource-limited settings.
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Affiliation(s)
- Tommaso Manciulli
- PhD School of Experimental Medicine, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | | | - Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Raffaella Lissandrin
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Maira Elizalde
- Instituto Peruano de Parasitologia Clinica y Experimental, Lima, Peru
| | - Cesar Sedano
- Instituto Peruano de Parasitologia Clinica y Experimental, Lima, Peru
| | - Karina Bardales
- Instituto Peruano de Parasitologia Clinica y Experimental, Lima, Peru
| | - Ambra Vola
- Unit of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Annalisa De Silvestri
- Unit of Epidemiology and Biostatistics, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Carmine Tinelli
- Unit of Epidemiology and Biostatistics, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Enrico Brunetti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Unit of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Saul Santivanez
- Instituto Peruano de Parasitologia Clinica y Experimental, Lima, Peru
| | - Mara Mariconti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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16
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Lenti MV, Aronico N, Giuffrida P, Costa S, Costetti M, Musacchio C, Pastorelli L, Mengoli C, Borrelli de Andreis F, Cococcia S, Tinelli C, Klersy C, Vecchi M, Pilotto A, Di Sabatino A. Multidimensional Prognostic Index Predicts Clinical Outcome and Mortality in Hospitalised Older Patients with Diverticular Disease. Gerontology 2021; 68:44-52. [PMID: 33849017 DOI: 10.1159/000515161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 02/11/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The Multidimensional Prognostic Index (MPI) is a validated tool for assessing mortality risk in hospitalised patients. We aimed to evaluate whether the MPI predicted mortality and the risk of developing diverticular disease (DD) complications in older patients. METHODS This is a multicentre study conducted in January 2016-March 2018. All patients with DD aged 65 years and older were included. Patients were stratified into three groups according to MPI groups (1, low risk; 2, moderate risk; 3, high risk). Risk of developing DD complications and mortality rate were assessed. Bivariate models were fitted. RESULTS One hundred hospitalised patients with DD (mean age 77.9 ± 10.6 years, 53 female patients) were included. Patients with higher MPI groups were more likely to develop DD complications. In particular, 12 (46.2%), 21 (52.5%), and 28 (82.4%) patients with complicated DD were distributed to the MPI 1, MPI 2, and MPI 3 groups (p = 0.0063), respectively. Two patients died in the MPI 1, 4 in the MPI 2, and 29 in the MPI 3 group, with mortality rates of 4.0 per 100 person-year (95% confidence interval [CI] 1.0-15.9), 5.6 (95% CI 2.1-15.0), and 89.2 (95% CI 62-130), respectively (log-rank test p < 0.001). In bivariate analysis, after adjustment for age >80 years, Charlson Comorbidity Index >4, DD complications, and the presence of thromboembolism, higher MPI group was independently associated with higher mortality. Those in the MPI 3 group experienced a greater risk of 1-year hospital readmission (p < 0.001). CONCLUSION MPI predicted mortality in patients with DD and also correlated with the risk of developing DD complications. Studies focussing on possible pathophysiological mechanisms between DD complications and MPI are needed.
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Affiliation(s)
- Marco Vincenzo Lenti
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Nicola Aronico
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Paolo Giuffrida
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Stefania Costa
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Martina Costetti
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Clarissa Musacchio
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Genova, Italy
| | - Luca Pastorelli
- Department of Gastroenterology and Digestive Endoscopy Unit, IRCCS San Donato Hospital Foundation, University of Milan, San Donato Milanese, Milan, Italy
| | - Caterina Mengoli
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | | | - Sara Cococcia
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Carmine Tinelli
- Service of Biometry and Statistics, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Catherine Klersy
- Service of Biometry and Statistics, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Maurizio Vecchi
- Gastroenterology and Endoscopy Unit, IRCCS Ca' Granda Hospital Foundation, University of Milan, Milan, Italy
| | - Alberto Pilotto
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Genova, Italy.,Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
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17
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Brazzelli V, Maffioli P, Bolcato V, Ciolfi C, D'Angelo A, Tinelli C, Derosa G. Psoriasis and Diabetes, a Dangerous Association: Evaluation of Insulin Resistance, Lipid Abnormalities, and Cardiovascular Risk Biomarkers. Front Med (Lausanne) 2021; 8:605691. [PMID: 33834030 PMCID: PMC8021695 DOI: 10.3389/fmed.2021.605691] [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: 09/12/2020] [Accepted: 01/15/2021] [Indexed: 01/05/2023] Open
Abstract
Aims: Psoriasis is an immune-mediated dermatosis with cardio-metabolic comorbidities. The aim of this study was to assess insulin-resistance, lipid abnormalities, and cardiovascular risk biomarkers in psoriatic patients with or without type 2 diabetes mellitus (T2DM). Methods and materials: We enrolled 425 patients: 86 psoriatics, 69 psoriatics with T2DM, 120 T2DM patients, and 150 healthy subjects. We measured the Psoriasis Area and Severity Index (PASI), body mass index (BMI), insulin-resistance parameters [glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), fasting plasma insulin (FPI), and with homeostasis model assessment index (HOMA index)], lipidic panel, plasminogen activator inhibitor-1 (PAI-1), homocysteine, soluble adhesion molecules, matrix metalloproteinase, and adipocytokines. Results: FPG, HbA1c, and HOMA-IR were higher in diabetics with psoriasis (p < 0.0001) than in psoriatics. FPI levels were higher in diabetics with psoriasis than in diabetics and psoriatics (p < 0.0001), and higher in psoriatics than controls (p < 0.0001). Psoriatics and diabetics with psoriasis showed higher triglyceride and LDL-C levels (p < 0.0001) than diabetics. Homocysteine was higher in psoriatics and diabetics with psoriasis (p < 0.0001) than in diabetics. PAI-1 was higher in diabetics with psoriasis than diabetics (p < 0.01). sICAM-1 and sVCAM-1 were higher in diabetics with psoriasis than diabetics (p < 0.001 and p < 0.01) and psoriatics (p < 0.001 and p < 0.0001). Visfatin and resistin were lower in psoriatics (p < 0.0001) and in diabetics with psoriasis (p < 0.001 and p < 0.0001, respectively) than diabetics. Conclusions: A limitation of this study is that there is a significant difference in mean age between controls and other study groups: the lack of matching between case and control groups may interfere with the external validity of the study findings. Despite this, the study highlights a pathogenetic link between psoriasis, considered a pre-diabetic condition, and diabetes. Insulin-resistance seems to be the keystone of psoriasis comorbidities. Psoriasis reinforces diabetes, causing a greater cardiometabolic risk.
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Affiliation(s)
- Valeria Brazzelli
- Institute of Dermatology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Pamela Maffioli
- Department of Internal Medicine and Therapeutics, Centre of Diabetes and Metabolic Diseases, University of Pavia and Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy.,Centre for Prevention, Surveillance, Diagnosis and Treatment of Rare Diseases, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Vittorio Bolcato
- Department of Public Health, Experimental and Forensic Medicine, Forensic Science Section, University of Pavia, Pavia, Italy
| | - Christian Ciolfi
- Institute of Dermatology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Angela D'Angelo
- Department of Internal Medicine and Therapeutics, Centre of Diabetes and Metabolic Diseases, University of Pavia and Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy.,Laboratory of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, Centre of Diabetes and Metabolic Diseases, University of Pavia and Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy.,Centre for Prevention, Surveillance, Diagnosis and Treatment of Rare Diseases, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy.,Laboratory of Molecular Medicine, University of Pavia, Pavia, Italy
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18
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Abstract
BACKGROUND AND OBJECTIVES Busulfan (Bu) is an old drug, but is still well recommended as an alkylating agent during conditioning therapy, before hematopoietic stem cell transplantation. Although its dose administration is standardized and based on patient weight, therapeutic drug monitoring is required in order to maintain its exposure [as area under the concentration-time curve (AUC) from 0 to infinity AUC0-∞] within a narrow therapeutic range and, if necessary, to adjust the dose with as short a lead time as possible. The aim of the study is to evaluate the agreement (as calculated AUC) between a gold standard analytical method and a new one that is faster and easier. METHODS We analyzed 221 plasma samples from 37 children (0.25-16 years; 4-62.5 kg) and 11 adults (21-59 years; 45-80 kg), corresponding to 52 AUC values (ng h/mL). The drug exposure was calculated, simultaneously, by two validated analytical methods. The reference method was a high-performance liquid chromatography (HPLC) assay combined with an ultraviolet detector (UV). The test method had a triple quadrupole mass spectrometer (MS) as detector; the clean-up procedures of the samples were different and faster. RESULTS The agreement between the two methods (reference and test) was evaluated in terms of Bu exposure differences based on Lin's concordance correlation coefficient (CCC) and represented by the Bland-Altman plot. The CCC between the AUC of the two methods was excellent (0.868; 95% CI: 0.802-0.935). The precision of the measures (expressed by Pearson's italic "r") was 0.872, and the accuracy (accounted by the bias correction factor) was 0.996. CONCLUSIONS We can conclude that the HPLC-MS/MS assay represents a very good alternative to the reference.
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Affiliation(s)
- Simona De Gregori
- Clinical and Experimental Pharmacokinetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi, 19, 27100, Pavia, Italy.
| | - Carmine Tinelli
- Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federica Manzoni
- Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonella Bartoli
- Clinical and Experimental Pharmacokinetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi, 19, 27100, Pavia, Italy
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19
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Garofoli F, Mazzucchelli I, Angelini M, Klersy C, Tinelli C, Carletti GV, Calcaterra V, Gardella B, Tzialla C. The dynamical interplay of perinatal leptin with birthweight and 3-month weight, in full-term, preterm, IUGR mother-infant dyads. J Matern Fetal Neonatal Med 2020; 35:3729-3735. [PMID: 33161792 DOI: 10.1080/14767058.2020.1839750] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate the dynamical interplay between perinatal leptin concentrations and neonatal weight evolution until 3 months of age. METHODS In a prospective observational study, maternal, cord blood and neonatal plasma leptin concentrations were correlated to birthweight and 3-month weight in 26 full-term, 20 preterm, and 17 intrauterine growth restriction (IUGR) mother-neonate couples. RESULTS The median of maternal, cord blood, neonatal leptin concentrations were significantly different among the three groups (p = 0.010; <0.001; =0.041 correspondingly). In the respect of the full-term group, higher concentrations were reported in preterm and IUGR mothers and lower concentrations in cord blood and neonatal plasma. The post-hoc comparisons showed that maternal concentrations were significantly higher in the IUGR group (p = 0.005 vs full-term), cord blood concentrations resulted always significantly lower (preterm, IUGR vs full-term p < 0.001) and neonatal concentrations were significantly lower in the preterm group (p = 0.018 vs full-term). Neonatal birthweight and 3-month weight were always significantly different among groups (p < 0.001), even if preterm and IUGR still had lower weight than full-term, the percent increasing of weight between birth and 3-month demonstrated that preterm and IUGR infants have grown significantly faster, (preterm, IUGR vs full-term p < 0.001). The univariable analysis showed a maternal leptin association with offspring' birthweight (R = -38%, p = 0.006) and with 3-month weight (R = -43%, p = 0.002). Accounting for confounders, these associations lost significance. Cord blood leptin concentrations positively correlated with birthweight and with 3-month weight (both, p < 0.001). The latter correlation, when adjusting for birthweight became negative (R = -43% p < 0.001). CONCLUSION Our results showed that maternal leptin levels lost their influence on neonatal weight when considering confounders. At 3-month, once birthweight adjusted, the percent increasing of weight was statistically larger in preterm and IUGR than the full-term group and the correlation between cord blood leptin and weight turned negative, from positive at birth. These data may be a clue for further investigation on the relationship between perinatal leptin concentrations and catch-up growth.
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Affiliation(s)
- Francesca Garofoli
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia
| | - Iolanda Mazzucchelli
- Department of Internal Medicine and Therapeutics, Unit of Rheumatology, Università di Pavia, Pavia, Italia
| | - Micol Angelini
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia
| | - Catherine Klersy
- Biometry and Clinical Epidemiology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia
| | - Carmine Tinelli
- Biometry and Clinical Epidemiology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia
| | | | - Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, Pavia, Italia.,Pediatric Endocrinology Unit, Department of Maternal and Children's Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia
| | - Barbara Gardella
- Department of Obstetrics and Gynaecology, Università di Pavia, Fondazione IRCCS Policlinico, Pavia, Italia
| | - Chryssoula Tzialla
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia
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20
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Pagella F, Maiorano E, Matti E, Tinelli C, De Silvestri A, Ugolini S, Lizzio R, Olivieri C, Pusateri A, Spinozzi G. FID Score: an effective tool in Hereditary Haemorrhagic Telangiectasia - related epistaxis. Rhinology 2020; 58:516-521. [PMID: 32584331 DOI: 10.4193/rhin20.078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hereditary haemorrhagic telangiectasia (HHT) is a rare disease characterized by a multisystemic vascular dysplasia and epistaxis, that is the most common cause of disability and social impairment. Patient management strictly depends on the severity of this symptom; therefore, it is of paramount importance for the clinicians to effectively grade epistaxis severity. The aim of this report was to validate the Frequency, Intensity and Duration score (FID) for grading epistaxis severity in patients with HHT; we studied repeatability and external validity comparing FID score with Epistaxis Severity Score (ESS). METHODS This is a descriptive, observational study that included 264 adult HHT patients with epistaxis. Diagnosis of HHT was established with Curacao criteria or positivity at genetic testing. Nosebleed severity was evaluated according to the FID score and the ESS. The first 30 patients were included in the validation of the FID score, which was graded on days 0, 1, 3 and 7. In the remaining 234 patients, a comparison between the ESS and FID score was performed. RESULTS The statistical analysis performed in order to validate the FID score showed very good agreement between scores calculated on different days; analysis comparing the FID score with the ESS revealed a high correlation between the two grading systems. CONCLUSIONS The FID score is a quick, easy and precise tool for evaluating HHT-related epistaxis and could be a possible alternative to the ESS. The FID score meets the need for an intuitive and smart grading system that is easy to manage in clinicians’ hands.
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Affiliation(s)
- F Pagella
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Otorhinolaryngology, Università degli Studi di Pavia, Pavia, Italy
| | - E Maiorano
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Otorhinolaryngology, Università degli Studi di Pavia, Pavia, Italy
| | - E Matti
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Tinelli
- Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A De Silvestri
- Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Ugolini
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Otorhinolaryngology, Università degli Studi di Pavia, Pavia, Italy
| | - R Lizzio
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Olivieri
- Molecular Medicine Department, General Biology and Medical Genetics Unit, University of Pavia, Italy
| | - A Pusateri
- Otorhinolaryngology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - G Spinozzi
- Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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21
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Carichino L, Harris A, Lapin S, Guidoboni G, Cassani S, De Silvestri A, Tinelli C, Milano G, Siesky B, Verticchio Vercellin AC. Waveform parameters of retrobulbar vessels in glaucoma patients with different demographics and disease severity. Eur J Ophthalmol 2020; 30:1019-1027. [DOI: 10.1177/1120672119848259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: To identify novel velocity waveform parameters of the ophthalmic artery and central retinal artery by computer-aided image processing of Doppler ultrasonography measurements, and to evaluate correlations between the waveform parameters and different demographics and disease severity of open-angle glaucoma patients. Methods: Thirty-six images of 36 open-angle glaucoma patients were considered. A semiautomated image processing code was used to detect the digitalized ophthalmic artery and central retinal artery velocity waveforms and to extract the waveform parameters. Concordance correlation coefficient, two-sample t-test, and Pearson’s correlation coefficient were used to test for similarities, differences, and associations among variables. Results: Female glaucoma patients showed a statistically higher ophthalmic artery normalized distance between ascending and descending limb (p = 0.004), hypertensive glaucoma patients a statistically higher ophthalmic artery peak systolic velocity time (p = 0.025), glaucoma patients with hyperlipidemia a statistically higher ophthalmic artery resistivity index (p = 0.023) and a statistically higher ophthalmic artery peak systolic velocity acceleration (p = 0.025), glaucoma patients with cardiovascular diseases a statistically lower central retinal artery normalized distance between ascending and descending limb of the wave (p = 0.033) and a statistically higher central retinal artery period (p = 0.028), and patients with different body mass index a statistically different central retinal artery normalized distance between ascending and descending limb of the wave (p = 0.016). Groups with different disease severity, classified following the Brusini glaucoma staging system 2, showed statistically different central retinal artery normalized distance between ascending and descending limb of the wave (p < 0.001) and central retinal artery period (p = 0.016). No statistical differences were found in regard to race, diabetes status, glaucoma family history, and smoking. Discussion: Ophthalmic artery and central retinal artery computer-aided analysis of velocity waveforms could identify novel waveform parameters capable of differentiating among different demographics and disease severity of open-angle glaucoma patients.
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Affiliation(s)
- Lucia Carichino
- Department of Mathematical Sciences, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Alon Harris
- Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sergey Lapin
- Department of Mathematics and Statistics, Washington State University, Pullman, WA, USA
| | - Giovanna Guidoboni
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, USA
| | - Simone Cassani
- Department of Mathematical Sciences, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometric Unit, Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Matteo, Pavia, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Matteo, Pavia, Italy
| | - Giovanni Milano
- University Eye Clinic, Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Matteo, Pavia, Italy
| | - Brent Siesky
- Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
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22
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Bruttini C, Verticchio Vercellin A, Klersy C, De Silvestri A, Tinelli C, Riva I, Oddone F, Katsanos A, Quaranta L. The Mont Blanc Study: The effect of altitude on intra ocular pressure and central corneal thickness. PLoS One 2020; 15:e0237343. [PMID: 32764811 PMCID: PMC7413504 DOI: 10.1371/journal.pone.0237343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/23/2020] [Indexed: 11/18/2022] Open
Abstract
The aim of the Mont Blanc Study was to investigate the relationship between intraocular pressure (IOP), central corneal thickness (CCT), and altitude in healthy subjects. Thirty-three eyes of 33 healthy volunteers (mean age: 24.8 years, 17 females) had their IOP measured with Perkins and I-Care tonometers and their CCT using ultrasound pachymetry at three locations in Italy with different altitudes: Pavia, (PV), 77 meters above sea level (a.s.l); Courmayeur (CM), 1300 meters a.s.l; Pointe Helbronner (PH), 3466 meters a.s.l.). The measurements were performed at 9 am, 11 am, 1 pm and 3 pm (±30’) in indoor settings (mean temperature of 19°C) in PV and PH. At 9 am, CCT and IOP were measured outdoor (mean temperature of -1.4°C) at PH. The mean values of the IOP curve decreased from PV to PH with the Perkins (p = 0.02) and I-Care tonometers (p = 0.001). Instead, CCT increased upon ascension from PV to PH (p = 0.01), and from CM to PH (p = 0.002). When exposed to sub-zero temperature, the IOP increased (p<0.001), while the CCT did not change (p = 0.30). The results suggest that IOP significantly decreased and CCT significantly increased upon ascension from the sea level to higher altitudes.
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Affiliation(s)
- Carlo Bruttini
- University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alice Verticchio Vercellin
- University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,IRCCS-Fondazione G.B. Bietti, Rome, Italy.,Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States of America
| | - Catherine Klersy
- Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Ivano Riva
- IRCCS-Fondazione G.B. Bietti, Rome, Italy
| | | | - Andreas Katsanos
- Department of Ophthalmology, University of Ioannina, Ioannina, Greece
| | - Luciano Quaranta
- University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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23
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Pasi F, Corbella F, Baio A, Capelli E, De Silvestri A, Tinelli C, Nano R. Radiation-induced circulating miRNA expression in blood of head and neck cancer patients. Radiat Environ Biophys 2020; 59:237-244. [PMID: 32040721 DOI: 10.1007/s00411-020-00832-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/25/2020] [Indexed: 06/10/2023]
Abstract
In recent years, scientists have found evidence confirming the aberrant expression of miRNAs in cancer patients compared to healthy individuals. The growing interest in the identification of non-invasive and specific diagnostic and prognostic molecular markers has identified microRNAs as potential candidates in cancer diagnosis, prognosis and treatment response. In the present study, we have analyzed the expression profile of circulating miR-21, -191 and -421 in peripheral blood of head and neck cancer patients (HNC) to investigate a possible modulation of mRNA levels by radiation and to identify the role of mRNA as biomarkers of cancer prognosis. Results showed a modulation of the microRNA expression at different time points after radiotherapy, suggesting that treatment may influence the release of circulating miRNAs depending also on the time interval elapsed since radiotherapy. The expression levels of miR-21, -191 and -421 were higher in blood of patients treated with radiotherapy alone after 6 months from the end of therapy and high levels of them seemed to correlate with the remission of the disease. The trends shown in this study confirmed that miRNAs could be useful prognosis markers and could provide preliminary data for further evaluation in predicting patients' response to radiotherapy by developing miRNA-based treatments to improve the sensitivity of cancer cells to radiotherapy.
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Affiliation(s)
- Francesca Pasi
- Radiotherapy Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, Pavia, Italy.
- Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Via Ferrata 9, Pavia, Italy.
| | - Franco Corbella
- Radiotherapy Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, Pavia, Italy
| | - Ambrogia Baio
- Radiotherapy Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, Pavia, Italy
| | - Enrica Capelli
- Department of Earth and Environmental Sciences, Laboratory of Immunology and Genetic Analysis, University of Pavia, Via Taramelli 21, Pavia, Italy
| | | | - Carmine Tinelli
- Biometry and Medical Statistics, Policlinico San Matteo di Pavia, Pavia, Italy
| | - Rosanna Nano
- Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Via Ferrata 9, Pavia, Italy
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24
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De Silvestri A, Capittini C, Mallucci G, Bergamaschi R, Rebuffi C, Pasi A, Martinetti M, Tinelli C. The Involvement of HLA Class II Alleles in Multiple Sclerosis: A Systematic Review with Meta-analysis. Dis Markers 2019; 2019:1409069. [PMID: 31781296 PMCID: PMC6875418 DOI: 10.1155/2019/1409069] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 10/01/2019] [Accepted: 10/08/2019] [Indexed: 12/20/2022]
Abstract
Multiple Sclerosis (MS) displays a heterogeneous clinical onset and progression, which are mostly unpredictable, but demyelination of the central nervous system (CNS) leads to substantial deficits of sensory, motor, autonomic, and neurocognitive functions. Considering all genetic studies on MS, including the advanced genome-wide association studies, the risk linked to HLA alleles remains the highest among other susceptibility genetic variants. However, given the genetic variability of HLA alleles in different ethnic groups, we conducted a systematic review of reviews and meta-analyses aiming at summarizing all the results on the association between MS and HLA class II genes. We systematically searched meta-analyses and systematic reviews dealing with MS and HLA in all ethnicities. From 154 records, we included 5 articles collecting HLA data from 15,232 MS patients and 24,194 ethnically matched controls. DRB1∗15 (OR ranging from 1.39 in Chinese Han to 2.59 in Caucasians) and DQB1∗06:02 (OR ranging from 1.91 in Caucasians to 2.49 in Colombian) alleles confer an increased risk for MS transethnically (Caucasians, Chinese, South Americans, Carribeans, Middle Easterners, Japanese, and North Africans). DRB1∗01, DRB1∗09, DRB1∗11, DRB1∗12, and DRB1∗16 alleles were protective, in agreement with the type of amino-acidic (aa) residues (ranging from position 9 to 90) included in pockets 1, 4, 6, 7, and 9, which are most involved in peptide presentation. Changes in aa residues affect the capability of HLA molecules in binding myelin peptides. DQB1∗06:02 risk allele seems to be the most interesting target as humanized mice expressing only DQB1∗06:02 develop MS-like disease mediated by autoimmune reactions against myelin oligodendrocytic basic protein that stabilizes the myelin. Our summary of results from a high number of patients and controls suggests that allelic variants from both DQB1 and DRB1 genes are equally involved in MS susceptibility/protection transethnically.
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Affiliation(s)
- A. De Silvestri
- Clinical Epidemiology and Biometric Unit, IRCCS Policlinico S. Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy
| | - C. Capittini
- Clinical Epidemiology and Biometric Unit, IRCCS Policlinico S. Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy
- Department of Biology and Biotechnology “Lazzaro Spallanzani”, University of Pavia, Italy
| | - G. Mallucci
- Inter-Department Multiple Sclerosis Research Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - R. Bergamaschi
- Inter-Department Multiple Sclerosis Research Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - C. Rebuffi
- Scientific Documentation Service, IRCCS Policlinico S. Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy
| | - A. Pasi
- Department of Transfusion Medicine and Immuno-Hematology (Laboratory of Immunogenetics), IRCCS Policlinico S. Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy
| | - M. Martinetti
- Department of Biology and Biotechnology “Lazzaro Spallanzani”, University of Pavia, Italy
| | - C. Tinelli
- Clinical Epidemiology and Biometric Unit, IRCCS Policlinico S. Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy
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25
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Periti F, Toma C, Plaitano C, Guagliano R, Bertone C, Barillà D, Arpa C, Vandelli G, Bianchi A, Vulpetti A, Tinelli C, Bianchi PE. Microvascular parameters evaluated with optical coherence tomography-angiography in children: comparison between preterm and full-term patients. Acta Ophthalmol 2019; 97:e1032-e1034. [PMID: 31074193 DOI: 10.1111/aos.14131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Francesca Periti
- IRCCS Polyclinic San Matteo Foundation University Eye Clinic Pavia Italy
| | - Caterina Toma
- Eye Clinic University Hospital Maggiore della Carita’ Novara Italy
| | - Carmen Plaitano
- IRCCS Polyclinic San Matteo Foundation University Eye Clinic Pavia Italy
| | - Rosanna Guagliano
- IRCCS Polyclinic San Matteo Foundation University Eye Clinic Pavia Italy
| | - Chiara Bertone
- IRCCS Polyclinic San Matteo Foundation University Eye Clinic Pavia Italy
| | - Donatella Barillà
- IRCCS Polyclinic San Matteo Foundation University Eye Clinic Pavia Italy
| | - Cristina Arpa
- IRCCS Polyclinic San Matteo Foundation University Eye Clinic Pavia Italy
| | - Giulio Vandelli
- IRCCS Polyclinic San Matteo Foundation University Eye Clinic Pavia Italy
| | - Alessandro Bianchi
- IRCCS Polyclinic San Matteo Foundation University Eye Clinic Pavia Italy
| | - Andrea Vulpetti
- IRCCS Polyclinic San Matteo Foundation University Eye Clinic Pavia Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometrics Unit IRCCS Polyclinic San Matteo Foundation Pavia Italy
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Morbini P, Alberizzi P, Ferrario G, Capello G, De Silvestri A, Pedrazzoli P, Tinelli C, Benazzo M. The evolving landscape of human papillomavirus-related oropharyngeal squamous cell carcinoma at a single institution in Northern Italy. ACTA ACUST UNITED AC 2019; 39:9-17. [PMID: 30936574 PMCID: PMC6444161 DOI: 10.14639/0392-100x-1905] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/27/2017] [Indexed: 12/17/2022]
Abstract
The increasing incidence of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) observed in several developed countries has not yet been documented in Italy. To investigate changes in the epidemiology of HPV-related OPSCC we reviewed the HPV status of cases evaluated at our centre in northern Italy before and after 2010. The results were correlated with patient age, sex, oropharyngeal subsite (classified as palatine tonsil, tongue base, palatine arch/palate/uvula, posterior oropharyngeal wall, and oropharynx not otherwise specified), AJCC tumour stage, risk factor exposure (smoke, alcohol), disease history (recurrence, metastasis, second tumours), outcome and survival. Positivity for p16 and HR HPV DNA was required to classify HPV-related OPSCC. HPV-related tonsillar OPSCC increased significantly after 2010, while a non-significant reduction of HPV-related extra-tonsillar OPSCC was observed. Non-keratinising morphology was strongly associated with HPV positivity. HPV16 was the most common genotype; the frequency of other high-risk genotype infections decreased after 2010. At multivariate analysis, HPV status showed a significant association with better outcome. We documented an increase of HPV-related OPSCC in our Italian population, synchronous with the increase observed in several Western countries, which in recent years reached a prevalence similar to that reported in central European countries. Our results indicate that HPV infection in head and neck oncology is relevant in Italy and needs to be considered for accurate patient stratification.
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Affiliation(s)
- P Morbini
- Department of Molecular Medicine, Pathology Unit, University of Pavia, Italy.,Pathology Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - P Alberizzi
- Pathology Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - G Ferrario
- Pathology Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - G Capello
- Pathology Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - A De Silvestri
- Clinical Epidemiology and Biometrics Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - P Pedrazzoli
- Department of Oncology, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - C Tinelli
- Clinical Epidemiology and Biometrics Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - M Benazzo
- Department of Otolaryngology, University of Pavia and Foundation IRCCS Policlinico S. Matteo, Italy
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Pisoni C, Spairani S, Manzoni F, Ariaudo G, Naboni C, Moncecchi M, Balottin U, Tinelli C, Gardella B, Tzialla C, Stronati M, Bollani L, Orcesi S. Depressive symptoms and maternal psychological distress during early infancy: A pilot study in preterm as compared with term mother-infant dyads. J Affect Disord 2019; 257:470-476. [PMID: 31310909 DOI: 10.1016/j.jad.2019.07.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Preterm birth does not only affect infants but also represents an unexpected and traumatic event for parents. There are few reports on parenting stress during early infancy comparing preterm and term mothers, with the results being somewhat inconsistent. METHODS As part of a longitudinal study, preterm mother-infant and term mother-infant dyads were enrolled. Dyads were assessed twice: during hospitalisation in the neonatal intensive care unit (NICU) and at 3 months of infant age (corrected age for preterm). Each mother completed a self-report set of psychological questionnaire in both time points. All the children underwent a neurological examination at 40 weeks post conceptional age and at 3 months (corrected age for preterm). RESULTS 20 preterm and 20 term dyads were included. NICU mothers reported elevated postnatal depressive symptoms and high stress level, even if the preterm infants were with low perinatal risk and normal neurological examination. Comparing preterm infant with low perinatal risk and normal neurological examination with term-born children at 3 months, we found higher parental stress in term mothers than in preterm mothers. LIMITATIONS This study was limited by a relatively small sample size; findings are preliminary and warrant further investigation in larger-scale study. CONCLUSIONS Findings confirm that becoming a mother of a preterm infant is an event associated with emotional distress. These symptoms may resolve with time, and sometimes are independent of the infant's clinical severity. Assessing parental sources of stress and subsequent follow-up is essential to promote parental support, both for preterm and term mothers.
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Affiliation(s)
- C Pisoni
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - S Spairani
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - F Manzoni
- Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Ariaudo
- Child Neurology and Psychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - C Naboni
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - M Moncecchi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - U Balottin
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy; Child Neurology and Psychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - C Tinelli
- Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - B Gardella
- Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - C Tzialla
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - M Stronati
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - L Bollani
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Orcesi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy; Child Neurology and Psychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
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Garofoli F, Mazzucchelli I, Decembrino L, Bartoli A, Angelini M, Broglia M, Tinelli C, Banderali G, Stronati M. Levels and effectiveness of oral retinol supplementation in VLBW preterm infants. Int J Immunopathol Pharmacol 2019; 32:2058738418820484. [PMID: 30897987 PMCID: PMC6311539 DOI: 10.1177/2058738418820484] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Retinol palmitate oral administration is convenient, but it is difficult to
assess/monitor its nutritional status in preterm infants and literature is
controversial about the administration route and the effectiveness of vitamin A
supplementation. We primarily evaluated retinol plasma levels to assess the
vitamin A nutritional status in preterm infants (<1500 g; 32 weeks) after
28 days of oral supplementation (3000 IU/kg/day, retinol palmitate drops), in
addition to vitamin A standard amount as suggested by European Society of
Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines. We
then observed the rate of typical preterm pathologies in the supplemented group
(31 newborns) and in 10 matching preterm infants, hospitalized in neonatal
intensive care unit (NICU) in the same period, who received neither vitamin A
supplementation nor parents allowed plasma sampling. Oral integration resulted
in constant retinol plasma concentration around the desired level of 200 ng/mL,
but without statistical increase during the study period. Due to the complexity
of vitamin A metabolism and the immaturity of preterm infant’s organs, retinol
supplementation may had first saturated other needy tissues; therefore,
plasmatic measures may not be consistent with improved global vitamin A body
distribution. Therefore, achieving a constant retinol concentration is a
valuable result and supportive for oral administration: decreasing levels, even
after parenteral/enteral supplementation, were reported in the literature. In
spite of favourable trend and no adverse events, we did not report statistical
difference in co-morbidities. This investigation confirms the necessity to
perform further trials in preterm newborns, to find an index reflecting the
complex nutritional retinol status after oral administration of vitamin A,
highlighting its effectiveness/tolerability in correlated preterm infant’s
pathologies.
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Affiliation(s)
- Francesca Garofoli
- 1 Neonatal Immunology Laboratory, UOC Neonatology and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Iolanda Mazzucchelli
- 1 Neonatal Immunology Laboratory, UOC Neonatology and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,2 Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Lidia Decembrino
- 3 Department of the Mother and Child Health, UOC Neonatology and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonella Bartoli
- 4 Clinical and Experimental Pharmacokinetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Micol Angelini
- 1 Neonatal Immunology Laboratory, UOC Neonatology and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Monica Broglia
- 4 Clinical and Experimental Pharmacokinetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carmine Tinelli
- 5 Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Mauro Stronati
- 1 Neonatal Immunology Laboratory, UOC Neonatology and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,2 Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
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Garofoli F, Ciardelli L, Angelini M, Gentile R, Mazzucchelli I, Tinelli C, Bollani L, Tzialla C. The role of immature platelet fraction (IPF%) in full-term and preterm infants: Italian data of a promising clinical biomarker in neonates. Int J Lab Hematol 2019; 42:e10-e13. [PMID: 31298786 DOI: 10.1111/ijlh.13071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Francesca Garofoli
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Laura Ciardelli
- Chemical and Clinics Laboratory, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Micol Angelini
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Raffaele Gentile
- Chemical and Clinics Laboratory, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Iolanda Mazzucchelli
- Department of Internal Medicine and Therapeutics, Università of Pavia, Pavia, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lina Bollani
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Chryssoula Tzialla
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
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30
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Wolfler A, Piastra M, Amigoni A, Santuz P, Gitto E, Rossetti E, Tinelli C, Montani C, Savron F, Pizzi S, D'amato L, Mondardini MC, Conti G, De Silvestri A. A shared protocol for porcine surfactant use in pediatric acute respiratory distress syndrome: a feasibility study. BMC Pediatr 2019; 19:203. [PMID: 31215483 PMCID: PMC6580470 DOI: 10.1186/s12887-019-1579-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/06/2019] [Indexed: 12/20/2022] Open
Abstract
Background Pediatric ARDS still represents a difficult challenge in Pediatric Intensive Care Units (PICU). Among different treatments proposed, exogenous surfactant showed conflicting results. Aim of this multicenter retrospective observational study was to evaluate whether poractant alfa use in pediatric ARDS might improve gas exchange in children less than 2 years old, according to a shared protocol. Methods The study was carried out in fourteen Italian PICUs after dissemination of a standardized protocol for surfactant administration within the Italian PICU network. The protocol provides the administration of surfactant (50 mg/kg) divided in two doses: the first dose is used as a bronchoalveolar lavage while the second as supplementation. Blood gas exchange variations before and after surfactant use were recorded. Results Sixty-nine children, age 0–24 months, affected by Acute Respiratory Distress Syndrome treated with exogenous porcine surfactant were enrolled. Data collection consisted of patient demographics, respiratory variables and arterial blood gas analysis. The most frequent reasons for PICU admission were acute respiratory failure, mainly bronchiolitis and pneumonia, and septic shock. Fifty-four children (78.3%) had severe ARDS (define by oxygen arterial pressure and inspired oxygen fraction ratio (P/F) < 100), 15 (21.7%) had moderate ARDS (100 < P/F < 200). PO2, P/F, Oxygenation Index (OI) and pH showed a significant improvement after surfactant use with respect to baseline (p < 0.001 at each included time-point for each parameter). No significant difference in blood gas variations were observed among four different subgroups of diseases (bronchiolitis, pneumonia, septic shock and others). Overall, 11 children died (15.9%) and among these, 10 (90.9%) had complex chronic conditions. Two children (18.2%) died while being treated with Extracorporeal Membrane Oxygenation (ECMO). Mortality for severe pARDS was 20.4%. Conclusion The use of porcine Surfactant improves oxygenation, P/F ratio, OI and pH in a population of children with moderate or severe pARDS caused by multiple diseases. A shared protocol seems to be a good option to obtain the same criteria of enrollment among different PICUs and define a unique way of use and administration of the drug for future studies.
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Affiliation(s)
- Andrea Wolfler
- Division of Anesthesia and Intensive Care Unit, Department of Pediatrics, Children's Hospital Vittore Buzzi, Via Castelvetro 32, 20152, Milan, Italy.
| | - Marco Piastra
- Pediatric ICU, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angela Amigoni
- Pediatric ICU, Department of Woman's and Child's Health, University Hospital, Padova, Italy
| | - Pierantonio Santuz
- Department of Neonatal and Pediatric Intensive Care, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Eloisa Gitto
- Pediatric ICU, Pediatric Department, University Hospital G Martino, Messina, Italy
| | - Emanuele Rossetti
- Pediatric ICU, Department of Anesthesia and Intensive Care, Children's Hospital Bambino Gesù, Rome, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit - Foundation IRCCS San Matteo, Pavia, Italy
| | - Cinzia Montani
- Pediatric ICU, Department of Anesthesia and Intensive Care, Foundation IRCCS Ca Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Savron
- Pediatric ICU, Department of Anesthesia and Intensive Care, Institute for Maternal and Child health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Simone Pizzi
- Pediatric ICU, Department of Anesthesia and Intensive Care, Children's Hospital Salesi, Ancona, Italy
| | - Luigia D'amato
- Pediatric ICU, Department of Anesthesia and Intensive Care, Children's Hospital Santobono-Pausillipon, Naples, Italy
| | - Maria Cristina Mondardini
- Pediatric ICU, Department of Pediatric Anesthesia and Intensive Care, University Hospital St. Orsola Malpighi Polyclinic, Bologna, Italy
| | - Giorgio Conti
- Pediatric ICU, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometric Unit - Foundation IRCCS San Matteo, Pavia, Italy
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31
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Barr RG, De Silvestri A, Scotti V, Manzoni F, Rebuffi C, Capittini C, Tinelli C. Diagnostic Performance and Accuracy of the 3 Interpreting Methods of Breast Strain Elastography: A Systematic Review and Meta-analysis. J Ultrasound Med 2019; 38:1397-1404. [PMID: 30411806 DOI: 10.1002/jum.14849] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 06/08/2023]
Abstract
There are 3 methods of interpreting breast strain elastography: the elastographic-to-B-mode length ratio (E/B), a 5-point color scale (5P), and the strain ratio (SR). This meta-analysis assessed which method is superior to the others. A systematic search of the medical literature was performed in July 2017. Studies were eligible for inclusion if they fulfilled the following criteria: (1) had biopsy-proven or long-term stability as the reference standard; (2) used either the E/B, 5P, or SR to interpret results; and (3) had at least 50 cases. A total of 220 records were retrieved; 60 full-text articles were examined, and 46 were included in the meta-analysis. Publication years ranged from 2007 and 2017. The quality of studies was generally high. The mean age of women was 48 years; 12,398 lesions (4242 malignant) were analyzed. For the 5P method, the sensitivity was 77%; specificity, 87%; positive likelihood ratio (LR), 5.3; and negative LR, 0.24. For the SR method, sensitivity was 87%; specificity, 81%; positive LR, 4.8; and negative LR, 0.16. For the E/B method, sensitivity was 96%; specificity, 88%; positive LR, 7.1; and negative LR, 0.03. Of the 3 methods, the E/B had the highest sensitivity, and the E/B and 5P had the highest specificity. With a negative LR of 0.03, the E/B method can downgrade lesions with a pretest probability of 50% to a 2% probability of malignancy.
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Affiliation(s)
- Richard G Barr
- Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio USA
- Southwoods Imaging, Youngstown, Ohio USA
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Clinical Epidemiology and Biometeric Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Center for Scientific Documentation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometeric Unit, Pavia, Italy
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Clinical Epidemiology and Biometeric Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Center for Scientific Documentation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Valeria Scotti
- Center for Scientific Documentation, Pavia, Italy
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Clinical Epidemiology and Biometeric Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Center for Scientific Documentation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Federica Manzoni
- Clinical Epidemiology and Biometeric Unit, Pavia, Italy
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Clinical Epidemiology and Biometeric Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Center for Scientific Documentation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Chiara Rebuffi
- Center for Scientific Documentation, Pavia, Italy
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Clinical Epidemiology and Biometeric Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Center for Scientific Documentation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Cristina Capittini
- Clinical Epidemiology and Biometeric Unit, Pavia, Italy
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Clinical Epidemiology and Biometeric Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Center for Scientific Documentation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometeric Unit, Pavia, Italy
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Clinical Epidemiology and Biometeric Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Center for Scientific Documentation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
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Natali F, Cancellieri A, Tinelli C, De Silvestri A, Livi V, Ferrari M, Romagnoli M, Paioli D, Trisolini R. A Trained Pulmonologist Can Reliably Assess Endosonography-Derived Lymph Node Samples during Rapid On-Site Evaluation. Respiration 2019; 97:540-547. [PMID: 30982053 DOI: 10.1159/000496549] [Citation(s) in RCA: 5] [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: 11/23/2018] [Accepted: 12/31/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The widespread use of rapid on-site evaluation is hampered by constraints related to time and resources, inadequate reimbursement, and evidence from randomized trials that show a lack of increase in diagnostic yield and specimen adequacy associated with its usage. OBJECTIVE We aimed to verify whether a pulmonologist can assess endosonography-derived lymph node samples after a comprehensive and reproducible training provided by a specialist pathologist. METHODS Prospective, observational trial structured in three phases. In the first (training) phase, a pathologist critically evaluated the smears from 150 archival endosonography cases with a pulmonologist. In the second (test) phase, the pulmonologist was asked to assess 50 archival endosonography-derived samples. In the last (real-life) phase, the pulmonologist classified the samples from 200 patients during the endosonography. The overall agreement between pulmonologist and pathologist (gold standard), assessed through κ-statistics, was the primary outcome. The agreement for the identification of specific cytological categories was the secondary outcome. RESULTS The overallagreement between pulmonologist and pathologist was 84% (κ0.765, 95% CI 0.732-0.826) in the test phase and 89.7% (κ 0.844, 95% CI 0.799-0.881) in the real-life phase. The agreement for specific cytological categories was 92.7% (95% CI 0.824-0.980) for inadequate samples, 90.3% (95% CI 84.5-94.5%) for reactive lymphadenopathies, 90.5% (95% CI 0.845-0.946) for malignancy, and 73% (95% CI 0.515-0.897) for granulomatous samples. CONCLUSIONS A trained pulmonologist can reliably assess adequacy and malignancy for endosonography-derived samples, which could be useful in institutions where a cytopathologist/cytotechnician is not available regularly.
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Affiliation(s)
- Filippo Natali
- Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi and Ospedale Maggiore, Bologna, Italy
| | | | - Carmine Tinelli
- Clinical Epidemiology and Biometry Unit, IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Vanina Livi
- Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi and Ospedale Maggiore, Bologna, Italy
| | - Marco Ferrari
- Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi and Ospedale Maggiore, Bologna, Italy
| | - Micaela Romagnoli
- Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi and Ospedale Maggiore, Bologna, Italy
| | - Daniela Paioli
- Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi and Ospedale Maggiore, Bologna, Italy
| | - Rocco Trisolini
- Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi and Ospedale Maggiore, Bologna, Italy,
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Savasta S, Bassanese F, Hruby C, Foiadelli T, Siri B, Gori V, Votto M, Tinelli C, Marseglia GL. Absence of lingual frenulum in children with Ehlers-Danlos Syndrome: a retrospective study of forty cases and literature review of a twenty years long debate. Minerva Pediatr (Torino) 2019; 73:230-235. [PMID: 30961343 DOI: 10.23736/s2724-5276.19.05530-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Ehlers-Danlos syndrome (EDS) is part of connective tissue disorders and is characterized by skin hyperextensibility, joint hypermobility, easy bruising and other severe manifestations such as epilepsy, pneumothorax, arterial rupture and bowel perforation. In 2017 a new classification was published, indicating major and minor criteria for each form of EDS. Further reports in the past years tried to determine whether or not the absence of lingual frenulum should be included in minor criteria for the diagnosis of EDS, but a consensus has still not been reached. The aim of this study was to assess the clinical relevance of lingual frenulum absence, evaluating its prevalence in a cohort of EDS pediatric patients and comparing it to a group of controls. METHODS Patients with Ehlers-Danlos syndrome were observed at our Department of Pediatrics of Policlinico S. Matteo in Pavia, Italy. Each patient underwent clinical examination of the oral cavity, and controls were chosen among patients referred to our Department. RESULTS Thirty-three over 40 patients showed absence of lingual frenulum and 3 of them showed frenulum hypoplasia. Absence or hypoplasia of lingual frenulum showed a prevalence of 90% in our population, whereas only 3/170 controls (1.8%), had lingual frenulum absence. Overall, absence of the lingual frenulum showed a sensibility of 90% and a specificity of 98.2% in our population. CONCLUSIONS In agreement with other authors, we believe that the absence of lingual frenulum should be included in the minor diagnostic criteria for Ehlers-Danlos Syndrome.
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Affiliation(s)
- Salvatore Savasta
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy -
| | - Francesco Bassanese
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Chiara Hruby
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Thomas Foiadelli
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Barbara Siri
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Viviana Gori
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Martina Votto
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Carmine Tinelli
- Department of Pediatrics, Regina Margherita Pediatric Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Gian L Marseglia
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
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Savasta S, Bassanese F, Hruby C, Foiadelli T, Siri B, Gori V, Votto M, Tinelli C, Marseglia GL. Absence of lingual frenulum in children with Ehlers-Danlos Syndrome: a retrospective study of forty cases and literature review of a twenty years long debate. Minerva Pediatr (Torino) 2019. [PMID: 30961343 DOI: 10.23736/s0026-4946.19.05530-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Ehlers-Danlos syndrome (EDS) is part of connective tissue disorders and is characterized by skin hyperextensibility, joint hypermobility, easy bruising and other severe manifestations such as epilepsy, pneumothorax, arterial rupture and bowel perforation. In 2017 a new classification was published, indicating major and minor criteria for each form of EDS. Further reports in the past years tried to determine whether or not the absence of lingual frenulum should be included in minor criteria for the diagnosis of EDS, but a consensus has still not been reached. The aim of this study was to assess the clinical relevance of lingual frenulum absence, evaluating its prevalence in a cohort of EDS pediatric patients and comparing it to a group of controls. METHODS Patients with Ehlers-Danlos syndrome were observed at our Department of Pediatrics of Policlinico S. Matteo in Pavia, Italy. Each patient underwent clinical examination of the oral cavity, and controls were chosen among patients referred to our Department. RESULTS Thirty-three over 40 patients showed absence of lingual frenulum and 3 of them showed frenulum hypoplasia. Absence or hypoplasia of lingual frenulum showed a prevalence of 90% in our population, whereas only 3/170 controls (1.8%), had lingual frenulum absence. Overall, absence of the lingual frenulum showed a sensibility of 90% and a specificity of 98.2% in our population. CONCLUSIONS In agreement with other authors, we believe that the absence of lingual frenulum should be included in the minor diagnostic criteria for Ehlers-Danlos Syndrome.
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Affiliation(s)
- Salvatore Savasta
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy -
| | - Francesco Bassanese
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Chiara Hruby
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Thomas Foiadelli
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Barbara Siri
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Viviana Gori
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Martina Votto
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Carmine Tinelli
- Department of Pediatrics, Regina Margherita Pediatric Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Gian L Marseglia
- Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
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Mannarino S, Bulzomì P, Codazzi AC, Rispoli GA, Tinelli C, De Silvestri A, Manzoni F, Chiapedi S. Inferior vena cava, abdominal aorta, and IVC-to-aorta ratio in healthy Caucasian children: Ultrasound Z-scores according to BSA and age. J Cardiol 2019; 74:388-393. [PMID: 30952562 DOI: 10.1016/j.jjcc.2019.02.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/11/2019] [Accepted: 02/28/2019] [Indexed: 01/30/2023]
Abstract
The pediatric ultrasound measurement of the inferior vena cava (IVC) and aorta (AO) with the study of the collapsibility index (CI) and of IVC-to-AO ratio (IVC/AO) can provide clinicians in the acute care setting with information on abnormal volume status but one of the major limitations is a lack of reference normal values by body surface area (BSA) and age. The aim of this study was to provide reference ranges for the sonographic measurement of IVC, AO, and IVC/AO ratio in healthy Caucasian Italian children. METHODS We enrolled prospectively 516 healthy Caucasian Italian children aged between 1 month and 16 years. Echocardiographic IVC and AO diameters were collected and presented separately for children aged ≤1 year and for children aged over 1 year. For children >1 year we categorized subjects into 3 years classes. CI and IVC/AO for the systolic aortic diameter were then calculated. For children over 1 year, age reference ranges were age-related or BSA-related; for children of ≤1 year, reference ranges were determined with their 90% confidence intervals regardless of age and of BSA. RESULTS Tables and charts with reference ranges for all the echocardiographic measurements are presented for children aged >1 year according to age and BSA. The equations to obtain percentile and Z-score for each echocardiographic measurement are provided. The reference ranges for children aged ≤1 year are shown considering the small 90% confidence intervals for upper and lower limits. CI was 30% (SD 17%) in children >1 year and 36% (SD 16%) in children <1 year. IVC/AOs showed age-dependent values from 0.83 (SD 0.20) age <1 year to 1.22 (SD 0.31) in older subjects. CONCLUSIONS We report reliable reference ranges for echocardiographic measurement of IVC, AO, CI, and IVC/AO for a Caucasian Italian healthy pediatric population.
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Affiliation(s)
- Savina Mannarino
- Pediatric Cardiology, Department of Pediatric, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Patrizia Bulzomì
- Pediatric Division, ASST Santi Paolo e Carlo, Presidio Ospedaliero San Carlo Borromeo, Milano, Italy
| | - Alessia Claudia Codazzi
- Pediatric Cardiology, Department of Pediatric, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Gaetana Anna Rispoli
- Pediatric Radiology - Radiodiagnostic Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometry Unit, San Matteo Hospital Foundation, Pavia, Italy
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometry Unit, San Matteo Hospital Foundation, Pavia, Italy.
| | - Federica Manzoni
- Clinical Epidemiology and Biometry Unit, San Matteo Hospital Foundation, Pavia, Italy
| | - Silvia Chiapedi
- Pediatric Cardiology, Department of Pediatric, ASST Ovest Milanese, Legnano Hospital, Legnano, Italy
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Bertino G, Lepenne Y, Tinelli C, Giordano L, Cacciola S, Di Santo D, Occhini A, Benazzo M, Bussi M. Radial vs ulnar forearm flap: a preliminary study of donor site morbidity. ACTA ACUST UNITED AC 2019; 39:322-328. [PMID: 30933177 PMCID: PMC6843587 DOI: 10.14639/0392-100x-2102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/02/2018] [Indexed: 12/03/2022]
Abstract
The objective of this study was to compare donor site morbidity after reconstructive surgery with Ulnar Forearm Free Flap (UFFF) and Radial Forearm Free Flap (RFFF) with subjective methods. The UFFF and the RFFF were applied for reconstruction of soft tissue defects of the head and neck region in 30 patients (20 M and 10 F; age range 28-75 years) affected by head and neck squamous cell carcinoma. The Disability of Arm, Shoulder and Hand (DASH) questionnaire was used to assess morbidity of the donor site. Analysis of the patients’ DASH scores showed an overall median DASH total score of 9.17. No significant differences were observed for median values of the RFFF and UFFF groups (7.14 vs 10 respectively) or for the values in males and females (5 vs 13.3 respectively). The UFFF can be considered a valid alternative to the RFFF for reconstruction of soft tissue defects of the head and neck area; it is safe, easy to harvest and is not associated with major morbidities of the donor site as demonstrated by the DASH questionnaire.
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Affiliation(s)
- G Bertino
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Y Lepenne
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - C Tinelli
- Biometric Unit, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | - L Giordano
- Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Milan, Italy
| | - S Cacciola
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - D Di Santo
- Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Milan, Italy
| | - A Occhini
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - M Benazzo
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - M Bussi
- Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Milan, Italy
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Canzi P, Avato I, Manfrin M, Simoncelli AM, Magnetto M, Rebecchi E, Tinelli C, Neri M, Beltrame MA, Benazzo M. Anatomic variations of the round window niche: radiological study and related endoscopic anatomy. Surg Radiol Anat 2019; 41:853-857. [PMID: 30900005 DOI: 10.1007/s00276-019-02225-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 03/15/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE In the last decades, literature has shown an increasing interest in round windows (RW) anatomy due to its pivotal role in deafness surgery. The high variability of this anatomical region, with particular regard to the round windows niche (RWN), has been studied by several authors through different methods of investigation. The aim of the present research was to radiologically examine the morphological variability of the RWN and to link the imaging findings to the endoscopic view. METHODS High-resolution CT scans of 300 temporal bones without neuro-otological pathologies were retrospectively reviewed by 2 neuroradiologist and 1 ENT surgeon who independently evaluated the RWN morphological variations. To link the radiological to the endoscopic data, 45 cadaveric human temporal bones were submitted to a radiological evaluation and to an otoendoscopy conducted through a posterior tympanotomy approach. RESULTS Three variants of the RWN were detected on coronal CT scan reconstructions: 155 "cylindrical-type", 97 "j-type" and 48 "truncated cone-type". For each radiological type the endoscopic findings showed a specific endoscopic position of the RW chamber, which results in different degrees of RW membrane visibility when analysed through a posterior tympanotomy approach. CONCLUSIONS To the best of our knowledge, this is the first description of the above-mentioned RWN radiological variations supported by endoscopic data. This study suggests an additional anatomical evaluation that could be useful to predict the RW membrane visibility through a posterior tympanotomy approach. Further studies are required to support the clinical implications of our observations.
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Affiliation(s)
- Pietro Canzi
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
| | - Irene Avato
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.,Experimental Medicine, University of Pavia, Pavia, Italy
| | - Marco Manfrin
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Anna Maria Simoncelli
- Department of Diagnostic Radiology and Interventional Radiology and Neuroradiology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Marianna Magnetto
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Elisabetta Rebecchi
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Carmine Tinelli
- Biometric Service, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Marinella Neri
- Department of Radiology, Santa Maria del Carmine Hospital, Rovereto, Italy
| | - Millo Achille Beltrame
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Marco Benazzo
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
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Ferraioli G, De Silvestri A, Lissandrin R, Maiocchi L, Tinelli C, Filice C, Barr RG. Evaluation of Inter-System Variability in Liver Stiffness Measurements. Ultraschall Med 2019; 40:64-75. [PMID: 29566420 DOI: 10.1055/s-0043-124184] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM The primary aim of this study was to determine the inter-system variability of liver stiffness measurements (LSMs) in patients with varying degrees of liver stiffness. The secondary aim was to determine the inter-observer variability of measurements. MATERIALS AND METHODS 21 individuals affected by chronic hepatitis C and 5 healthy individuals were prospectively enrolled. The assessment of LSMs was performed using six ultrasound (US) systems, four of which with point shear wave elastography (p-SWE) and two with 2 D shear wave elastography (2D-SWE) systems. The Fibroscan (Echosens, France) was used as the reference standard. Four observers performed the measurements in pairs (A-B, C-D). The agreement between different observers or methods was calculated using Lin's concordance correlation coefficient. The Bland-Altman limits of agreement (LOA) were calculated as well. RESULTS There was agreement above 0.80 for all pairs of systems. The mean difference between the values of the systems with 2D-SWE technique was 1.54 kPa, whereas the maximum mean difference between the values of three out of four systems with the pSWE technique was 0.79 kPa. The intra-patient concordance for all systems was 0.89 (95 % CI: 0.83 - 0.94). Inter-observer agreement was 0.96 (95 % CI: 0.94 - 0.98) for the pair of observers A-B and 0.93 (95 % CI: 0.89 - 0.96) for the pair of observers C-D. CONCLUSION The results of this study show that the agreement between LSMs performed with different US systems is good to excellent and the overall inter-observer agreement in "ideal conditions" is above 0.90 in expert hands.
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Affiliation(s)
- Giovanna Ferraioli
- Clinical Sciences and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, Medical School University of Pavia, Italy
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Raffaella Lissandrin
- Clinical Sciences and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, Medical School University of Pavia, Italy
| | - Laura Maiocchi
- Clinical Sciences and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, Medical School University of Pavia, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlo Filice
- Clinical Sciences and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, Medical School University of Pavia, Italy
| | - Richard G Barr
- Radiology, Northeastern Ohio Medical University, Rootstown, United States
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Campanelli R, Codazzi A, Poletto V, Abbà C, Catarsi P, Fois G, Avanzini M, Brazzelli V, Tzialla C, De Silvestri A, Tinelli C, Licari A, Berra-Romani R, Zuccolo E, Moccia F, Mannarino S, Rosti V, Massa M. Kinetic and Angiogenic Activity of Circulating Endothelial Colony Forming Cells in Patients with Infantile Haemangioma Receiving Propranolol. Thromb Haemost 2019; 119:274-284. [DOI: 10.1055/s-0038-1676855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AbstractEndothelial progenitor cells (EPCs) have been suggested to contribute to the neovascularization of infantile haemangioma (IH). There is strong evidence of the efficacy of propranolol in the treatment of IH, possibly by inhibiting both vasculogenesis and angiogenesis in the tumour. We evaluate the frequency of circulating endothelial colony forming cells (ECFCs), as the best EPC surrogate, in patients with IH at diagnosis and while receiving propranolol by an ex vivo 12-month longitudinal study. Biological aspects of the ECFCs, such as their in vitro angiogenic potential, membrane CXCR4 expression and Ca2+ signalling, were investigated. Circulating ECFCs were isolated by in vitro culture and expanded for 2 to 3 passages in 23 patients with IH (median age: 5.5 months, range: 5.5 weeks–11 months) before and 3, 6, 9 and 12 months after receiving propranolol. Twenty-four healthy subjects comparable for age were also assessed (CTRLs). Untreated patients with IH had a circulating ECFC frequency lower (p = 0.001) than CTRLs; nevertheless, in in vitro starving conditions, ECFCs showed enhanced capacity to form tube-like structures than those of CTRLs. Patients with IH following the therapy with propranolol had a significantly increased (p = 0.022) circulating ECFC frequency, that showed a diminished tube-like formation capacity in vitro, and an altered constitutive store-operated Ca2+ entry. ECFCs play a role in IH pathogenesis; the response to propranolol therapy is associated with their increased frequency in the peripheral blood and a reduction of their vasculogenic activity.
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Affiliation(s)
- Rita Campanelli
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Alessia Codazzi
- Cardiology Clinic of Pediatrics, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Valentina Poletto
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Carlotta Abbà
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Paolo Catarsi
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Gabriela Fois
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Maria Avanzini
- Immunology and Transplantation Laboratory/Cell Factory/Pediatric Haematology/Oncology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Valeria Brazzelli
- Department of Clinical-Surgical, Diagnostic and Pediatric Science, Institute of Dermatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Chryssoula Tzialla
- Neonatal Intensive Care Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | | | - Carmine Tinelli
- Epidemiology Service, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Amelia Licari
- Department of Pediatrics, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Roberto Berra-Romani
- Department of Biomedicine, School of Medicine, Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - Estella Zuccolo
- Laboratory of General Physiology, Department of Biology and Biotechnology “Lazzaro Spallanzani,” University of Pavia, Pavia, Italy
| | - Francesco Moccia
- Laboratory of General Physiology, Department of Biology and Biotechnology “Lazzaro Spallanzani,” University of Pavia, Pavia, Italy
| | - Savina Mannarino
- Cardiology Clinic of Pediatrics, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Vittorio Rosti
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Margherita Massa
- Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
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40
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Carlisi E, Cecini M, Di Natali G, Manzoni F, Tinelli C, Lisi C. Focused extracorporeal shock wave therapy for greater trochanteric pain syndrome with gluteal tendinopathy: a randomized controlled trial. Clin Rehabil 2018; 33:670-680. [PMID: 30585498 DOI: 10.1177/0269215518819255] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES: To investigate if focused extracorporeal shock wave therapy (f-ESWT) is an effective treatment in a population affected by greater trochanteric pain syndrome (GTPS). DESIGN: Randomized controlled trial, with blind outcome assessors. SETTING: Outpatients, University Hospital. SUBJECTS: A total of 50 patients affected by GTPS with gluteal tendinopathy. INTERVENTIONS: The study group was assigned to receive f-ESWT, the control group received ultrasound therapy (UST). MAIN MEASURES: We assessed hip pain and lower limb function by means of a numeric rating scale (p-NRS) and the Lower Extremity Functional Scale (LEFS scale), respectively. The first follow-up evaluation (2M-FUP) was performed two months after the first treatment session, the second (6M-FUP) was carried out six months later. RESULTS: The mean age of the population was 61.24 (9.26) years. A marked prevalence of the female sex was recorded (44 subjects, 86%). The statistical analysis showed a significant pain reduction over time for the study group and the control group, the f-ESWT proving to be significantly more effective than UST ( P < 0.05) at the 2M-FUP (2.08 vs 3.36) and at the 6M-FUP (0.79 vs 2.03). A marked improvement of the LEFS total score was observed in both groups as well, but we found no statistical differences in the comparisons between groups. CONCLUSION: Our findings support the hypothesis that f-ESWT is effective in reducing pain, both in the short-term and in the mid-term perspective. We also observed a functional improvement in the affected lower limb, but, in this case, f-ESWT showed not to be superior to UST.
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Affiliation(s)
- Ettore Carlisi
- 1 Rehabilitation Unit, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Miriam Cecini
- 1 Rehabilitation Unit, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy.,4 Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | - Giuseppe Di Natali
- 1 Rehabilitation Unit, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Federica Manzoni
- 2 Clinical Epidemiology and Biometric Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.,3 Biostatistics and Clinical Epidemiology Unit, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Carmine Tinelli
- 2 Clinical Epidemiology and Biometric Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Claudio Lisi
- 1 Rehabilitation Unit, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
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41
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Guagliano R, Spallone L, Lombardo S, Trabucco P, Bertone C, Barillà D, Tinelli C, Bianchi PE. Vitamin A- and E-based liposomal tear replacement in pediatric patients. Minerva Pediatr 2018; 69:556-557. [PMID: 29181963 DOI: 10.23736/s0026-4946.17.05092-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Rosanna Guagliano
- San Matteo Institute for Research and Care Foundation, Pavia, Italy -
| | - Laura Spallone
- San Matteo Institute for Research and Care Foundation, Pavia, Italy.,University of Pavia, Pavia, Italy
| | - Sara Lombardo
- San Matteo Institute for Research and Care Foundation, Pavia, Italy.,University of Pavia, Pavia, Italy
| | - Paolo Trabucco
- San Matteo Institute for Research and Care Foundation, Pavia, Italy.,University of Pavia, Pavia, Italy
| | - Chiara Bertone
- San Matteo Institute for Research and Care Foundation, Pavia, Italy
| | | | - Carmine Tinelli
- Unit of Biometrics and Clinical Epidemiology, San Matteo Institute for Research and Care Foundation, Pavia, Italy
| | - Paolo E Bianchi
- San Matteo Institute for Research and Care Foundation, Pavia, Italy.,University of Pavia, Pavia, Italy
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42
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Capittini C, De Silvestri A, Terzaghi M, Scotti V, Rebuffi C, Pasi A, Manni R, Martinetti M, Tinelli C. Correlation between HLA-DQB1*06:02 and narcolepsy with and without cataplexy: approving a safe and sensitive genetic test in four major ethnic groups. A systematic meta-analysis. Sleep Med 2018; 52:150-157. [DOI: 10.1016/j.sleep.2018.08.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 07/24/2018] [Accepted: 08/21/2018] [Indexed: 01/06/2023]
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43
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Ferraioli G, De Silvestri A, Reiberger T, Taylor-Robinson SD, de Knegt RJ, Maiocchi L, Mare R, Bucsics T, Atzori S, Tinelli C, Sporea I. Adherence to quality criteria improves concordance between transient elastography and ElastPQ for liver stiffness assessment-A multicenter retrospective study. Dig Liver Dis 2018; 50:1056-1061. [PMID: 29705030 DOI: 10.1016/j.dld.2018.03.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/25/2018] [Accepted: 03/26/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Assessment of liver stiffness provides important diagnostic and prognostic information in patients with chronic liver disease. AIMS To investigate whether the use of quality criteria (i) improves the concordance between transient elastography (TE) and a novel point shear wave elastography technique (ElastPQ®) and (ii) impacts on the performance of ElastPQ® for liver fibrosis staging using TE as the reference standard. METHODS In this multicenter retrospective study, data of patients undergoing liver stiffness measurements (LSM) in five European centers were collected. TE was performed with FibroScan® (Echosens, France) and ElastPQ® with EPIQ® or Affiniti® systems (Philips, The Netherlands). The agreement between TE and ElastPQ® LSMs was assessed with Lin's concordance correlation coefficient (CCC). Diagnostic performance of ElastPQ® was assessed by the area under receiver operating characteristic (AUROC) curves. RESULTS Overall, 664 patients were included: mean age: 54.8(13.5) years, main etiologies: viral hepatitis (83.1%) and NAFLD (7.5%). CCC increased significantly when LSMs with ElastPQ® were obtained with IQR/M ≤ 30% (p < 0.001). The diagnostic performance of ElastPQ® for fibrosis staging also increased if LSM values were obtained with IQR/M ≤ 30%. CONCLUSION Quality criteria should be followed when using ElastPQ® for LSM, since the concordance with TE fibrosis staging was better at an ElastPQ® IQR/M ≤ 30.
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Affiliation(s)
- Giovanna Ferraioli
- Clinical Sciences and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, Medical University of Pavia, Pavia, Italy.
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Thomas Reiberger
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria
| | | | - Robert J de Knegt
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Laura Maiocchi
- Clinical Sciences and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, Medical University of Pavia, Pavia, Italy
| | - Ruxandra Mare
- Department of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy, Timişoara, Romania
| | - Theresa Bucsics
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria
| | - Sebastiana Atzori
- St Mary's Hospital Campus, Imperial College London, London, United Kingdom
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Ioan Sporea
- Department of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy, Timişoara, Romania
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Goddi A, Bortolotto C, Raciti MV, Fiorina I, Aiani L, Magistretti G, Sacchi A, Tinelli C, Calliada F. High-Frame Rate Vector Flow Imaging of the Carotid Bifurcation in Healthy Adults: Comparison With Color Doppler Imaging. J Ultrasound Med 2018; 37:2263-2275. [PMID: 29574932 DOI: 10.1002/jum.14579] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 11/07/2017] [Accepted: 12/09/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To evaluate the carotid bifurcation in healthy adults using a commercial system equipped with high-frame rate vector flow imaging (VFI) based on the plane wave and to compare VFI with color Doppler imaging. METHODS Carotid bifurcation diameters and flow characteristics of 60 vessels in 60 healthy volunteers were evaluated quantitatively and qualitatively to assess complex flow patterns and their extension and duration. RESULTS Complex flow in the internal carotid artery (ICA) was associated with a statistically significant difference in the ΔICA sinus-to-common carotid artery (CCA) diameter ratio (the relative change in diameter between the CCA and ICA sinus.) Vector flow imaging and color Doppler imaging were in accordance when detecting complex flow in 96.7% of cases; in 3.3% of cases, only VFI identified small recirculation areas of short duration. Vector flow imaging highlighted a larger extension of the complex flow (mean ± SD, 47.7 ± 28.5 mm2 ; median, 45.5 mm2 ) compared with color Doppler imaging (mean, 29.2 ± 19.9 mm2 ; median, 29.5 mm2 ) and better depicted different complex flow patterns; a strong correlation (r = 0.84) was found between the ΔICA sinus-to-CCA diameter ratio and the complex flow extension. Vector flow imaging showed a longer duration of the flow disturbances (mean, 380 ± 218 milliseconds; median, 352.5 milliseconds) compared with color Doppler imaging (mean, 325 ± 206 milliseconds; median, 333 milliseconds), and there was a strong correlation (r = 0.92). CONCLUSIONS Vector flow imaging is as effective as color Doppler imaging in the detection of flow disturbances, but it is more powerful in the assessment of complex flow patterns.
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Affiliation(s)
- Alfredo Goddi
- Centro Medico SME-Diagnostica per Immagini, Varese, Italy
| | - Chandra Bortolotto
- Radiology Unit, University of Pavia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Maria Vittoria Raciti
- Radiology Unit, University of Pavia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Ilaria Fiorina
- Radiology Unit, University of Pavia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Luca Aiani
- Centro Medico SME-Diagnostica per Immagini, Varese, Italy
| | | | - Andrea Sacchi
- Centro Medico SME-Diagnostica per Immagini, Varese, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Fabrizio Calliada
- Radiology Unit, University of Pavia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
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45
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Campo I, Luisetti M, Griese M, Trapnell BC, Bonella F, Grutters JC, Nakata K, Van Moorsel CHM, Costabel U, Cottin V, Ichiwata T, Inoue Y, Braschi A, Bonizzoni G, Iotti GA, Tinelli C, Rodi G. A Global Survey on Whole Lung Lavage in Pulmonary Alveolar Proteinosis. Chest 2018; 150:251-3. [PMID: 27396783 DOI: 10.1016/j.chest.2016.04.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 04/14/2016] [Indexed: 10/21/2022] Open
Affiliation(s)
- Ilaria Campo
- Pneumology Unit, IRCCS San Matteo Hospital Foundation and University of Pavia, Pavia, Italy.
| | - Maurizio Luisetti
- Pneumology Unit, IRCCS San Matteo Hospital Foundation and University of Pavia, Pavia, Italy
| | - Matthias Griese
- Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, University of Munich, Munich, Germany
| | - Bruce C Trapnell
- Translational Pulmonary Science Center, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Francesco Bonella
- Interstitial and Rare Lung Disease Unit, Ruhrlandklinik University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Jan C Grutters
- Centre of Interstitial Lung Diseases, St. Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands
| | - Koh Nakata
- Niigata University Medical and Dental School, Niigata, Japan
| | - Coline H M Van Moorsel
- Centre of Interstitial Lung Diseases, St. Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands
| | - Ulrich Costabel
- Interstitial and Rare Lung Disease Unit, Ruhrlandklinik University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Vincent Cottin
- National Reference Centre for Rare Pulmonary Disease, Hopital Louis Pradel, Lyon, France
| | - Toshio Ichiwata
- Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Yoshikazu Inoue
- Department of Diffuse Lung Diseases and Respiratory Failure, Clinical Research Centre, National Hospital Organization Kinki-Chuo Chest Medical Centre, Osaka, Japan
| | - Antonio Braschi
- Department of Anesthesiology and Intensive Care, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Giacomo Bonizzoni
- Pneumology Unit, IRCCS San Matteo Hospital Foundation and University of Pavia, Pavia, Italy
| | - Giorgio A Iotti
- Department of Anesthesiology and Intensive Care, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Giuseppe Rodi
- Department of Anesthesiology and Intensive Care, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
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Pisoni C, Spairani S, Fauci F, Ariaudo G, Tzialla C, Tinelli C, Politi P, Balottin U, Stronati M, Orcesi S. Effect of maternal psychopathology on neurodevelopmental outcome and quality of the dyadic relationship in preterm infants: an explorative study. J Matern Fetal Neonatal Med 2018; 33:103-112. [PMID: 30021468 DOI: 10.1080/14767058.2018.1487935] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: The literature shows that parents of preterm infants are at risk of psychological distress and that this may impact on the quality of the parent-child relationship and on the child's development.Aim: This longitudinal study was conducted to examine in preterm infants relationships between maternal psychological variables, parental protective factors, perinatal infant variables, and neurodevelopmental outcome. Furthermore, we explored the impact of these variables on the quality of the mother-infant relationship (dyadic synchrony).Subjects and methods: A total of 29 preterm infants (GA < 34 weeks) and their mothers were evaluated twice: at t0, during the infant's hospitalization in the neonatal intensive care unit (NICU), and at 12 months of infant corrected age (t2).Results: With the exception of decreases in anxiety and perceived social support and an increase in the rate of severe depression at follow-up, there were no significant changes between t0 and t1 assessments. The infant's perinatal risk status was the variable that impacted most on maternal psychopathology. Furthermore, our data revealed that baseline maternal stress related to the appearance of the child and to the mother's perception of her parenting role represent a risk factor in relation to developmental outcome at 12 months of corrected age. Finally, no correlations emerged between dyadic synchrony and infant perinatal data, maternal psychological variables (at t0 and at t1), or child developmental outcome at t1.Conclusions: Our results underline the need to identify negative maternal affective states early in the mother-child relationship and to provide mothers with adequate support in the NICU, to enhance their parental role.
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Affiliation(s)
- C Pisoni
- Neonatal Intensive Care Unit, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - S Spairani
- Child Neurology and Psychiatry Unit, C. Mondino National Neurological Institute, Pavia, Italy
| | - F Fauci
- Child Neurology and Psychiatry Unit, C. Mondino National Neurological Institute, Pavia, Italy
| | - G Ariaudo
- Child Neurology and Psychiatry Unit, C. Mondino National Neurological Institute, Pavia, Italy
| | - C Tzialla
- Neonatal Intensive Care Unit, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - C Tinelli
- Epidemiology and Biometric Unit, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - P Politi
- Consultation-Liaison Psychological Medicine Program, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - U Balottin
- Child Neurology and Psychiatry Unit, C. Mondino National Neurological Institute, Pavia, Italy.,Department of Brain and Behavioural Sciences, Child Neurology and Psychiatry Unit, University of Pavia, Pavia, Italy
| | - M Stronati
- Neonatal Intensive Care Unit, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - S Orcesi
- Child Neurology and Psychiatry Unit, C. Mondino National Neurological Institute, Pavia, Italy
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47
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Porru D, Bobbi V, Di Franco C, Viglio A, Novario M, Tinelli C, Gardella B, Nappi R, Spinillo A, Paulli M, Rovereto B. Clinical and histological findings in bladder pain syndrome/interstitial cystitis: The implication of time of symptoms. Journal of Clinical Urology 2018. [DOI: 10.1177/2051415817747474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To find out whether a correlation exists between denudation of urothelium and time of symptom onset in patients with bladder pain syndrome/interstitial cystitis (BPS/IC), and to search for a correlation between the impact of symptoms. Patients and methods: Fifty-seven consecutive patients underwent cystoscopy under anaesthesia to classify those cases suspected of being affected with BPS/IC. The time elapsed between onset of symptoms and diagnosis at the time of bladder biopsy was also defined as BPS/IC duration. Bladder biopsies were taken including detrusor muscle, three deep cold biopsies of posterior, anterior and lateral bladder wall. Results: Statistical analysis showed significant correlation between BPS/IC duration and the presence of Hunner’s lesions ( P<0.023). Hunner’s lesion with cystoscopy and histological evidence of urothelial denudation with bladder biopsy appear to be related to BPS/IC duration. Thus an early diagnosis allows an appropriate therapeutic approach to be started to prevent a more severe evolution of this multifaceted painful syndrome. Conclusions: Our study shows a correlation between the time of symptom onset and evidence of urothelial denudation and with detrusor mast cell count in the whole group of patients. BPS/IC duration did not seem to correlate with the severity of symptoms, but rather with the presence of associated diseases. Level of evidence: Not applicable for this multicentre audit.
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Affiliation(s)
- Daniele Porru
- Urology Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Valentina Bobbi
- Urology Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | | | - Alessandra Viglio
- Molecular Medicine Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Mattia Novario
- Molecular Medicine Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Barbara Gardella
- Obstetric and Gynecological Clinic, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Rossella Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Arsenio Spinillo
- Obstetric and Gynecological Clinic, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Marco Paulli
- Molecular Medicine Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Bruno Rovereto
- Urology Department, Fondazione IRCCS Policlinico San Matteo, Italy
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48
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Quaretti P, Leati G, Moramarco LP, Cionfoli N, Corti R, Tinelli C, Fiorina I, Galli F. Percutaneous Transanastomotic Stent Graft Deployment to Salvage Dysfunctional Native Forearm Radiocephalic Fistulae: Feasibility and Primary Patency at 12 Months. J Vasc Interv Radiol 2018; 29:986-992. [DOI: 10.1016/j.jvir.2018.02.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/18/2018] [Accepted: 02/25/2018] [Indexed: 10/16/2022] Open
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49
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Spairani S, Pisoni C, Ariaudo G, Moncecchi M, Balottin U, Manzoni P, Tinelli C, Gardella B, Politi P, Tzialla C, Stronati M, Orcesi S. The Mother-Child Relationship during the First Months of Life: Preliminary Considerations in Preterm as Compared with Term Mother-Infant Dyads. Am J Perinatol 2018; 35:578-582. [PMID: 29695001 DOI: 10.1055/s-0038-1639362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 10/17/2022]
Abstract
INTRODUCTION From the prognostic perspective, the quality of the mother-child relationship during the first months of life has been variously associated with different factors such as the child's psychomotor/cognitive development and emotional-behavioral disorders. METHODS The main aim of this study was to describe, at term age and 3 months of corrected age, the features and the prevalent patterns of the mother-child relationship in a group of 20 mother-preterm infant dyads and to compare them with those of a group of 20 mother-term infant dyads. RESULTS A relatively high rate of inadequate dyadic synchrony was found in our sample of preterms at 40 weeks of gestational age (half of the sample analyzed). The quality of the dyadic relationship and the prevalent patterns of the mother-child relationship were found to differ between the two groups we studied; moreover, the subjects at risk of relational problems remained substantially the same during the first 3 months of life. DISCUSSION These data underline that in preterm children, the first weeks of life, coinciding with their hospitalization, represent a crucial time for establishing a valid dyadic relationship and for considering and planning any preventive interventions; after all, the earlier the risk of relational problems becomes a real possibility, the more likely it is to negatively impact on a child's overall development.
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Affiliation(s)
- S Spairani
- Child Neurology and Psychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - C Pisoni
- Neonatal Intensive Care Unit, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - G Ariaudo
- Child Neurology and Psychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - M Moncecchi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - U Balottin
- Child Neurology and Psychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Paolo Manzoni
- Neonatology and NICU, S. Anna Hospital, Torino, Italy
| | - C Tinelli
- Clinical Epidemiology and Biometric Unit, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - B Gardella
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - P Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Chryssoula Tzialla
- Neonatal Intensive Care Unit, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Mauro Stronati
- Neonatal Intensive Care Unit, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - S Orcesi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
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50
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Guarene M, Badulli C, Cremaschi AL, Sbarsi I, Cacciatore R, Tinelli C, Pasi A, Bergamaschi P, Perotti CG. Luminex ® xMAP ® technology is an effective strategy for high-definition human leukocyte antigen typing of cord blood units prior to listing. Int J Artif Organs 2018; 41:284-288. [PMID: 29546777 DOI: 10.1177/0391398818762356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Allele-level donor-recipient match at HLA-A, HLA-B, HLA-C and HLA-DRB1 loci impacts the outcome after cord blood transplantation for hematologic malignancies and modifies the strategy of donor selection. High definition of both class I and II HLA loci at time of listing is a way to improve the attractiveness of cord blood bank inventories, reducing the time for donor search and procurement and simplifying donor choice, in particular, for patients of non-European heritage. METHODS In 2014, Luminex® xMAP® technology was introduced in our laboratory practice and was applied to cord blood units typing. In this study, we evaluated the impact of this strategy in comparison with the platform in use until 2013, relying on LiPA reverse polymerase chain reaction-sequence-specific oligonucleotide (revPCR-SSO) plus polymerase chain reaction-sequence-specific primer (PCR-SSP). RESULTS In 2014, the time for testing was shorter (141 vs 181 days on average), the number of test repetitions was lower (in particular for HLA-A locus, p = 0.026), and the cost reduced (240.7 vs 395.6 euros per unit on average) compared to 2013, demonstrating that Luminex xMAP technology is superior to the previous approach. CONCLUSION Luminex xMAP platform has useful application in cord blood banking programs, to achieve high-definition HLA typing of cord blood units at the time of banking in a quick, accurate, and cost-effective manner.
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Affiliation(s)
- Marco Guarene
- 1 Service of Immunohematology and Transfusion Medicine, Immunogenetics Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carla Badulli
- 1 Service of Immunohematology and Transfusion Medicine, Immunogenetics Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,2 Service of Clinical Chemistry and Laboratory Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Anna L Cremaschi
- 1 Service of Immunohematology and Transfusion Medicine, Immunogenetics Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,3 Service of Immunohematology and Transfusion Medicine, ASST Melegnano e della Martesana, Vizzolo Predabissi, Italy
| | - Ilaria Sbarsi
- 1 Service of Immunohematology and Transfusion Medicine, Immunogenetics Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rosalia Cacciatore
- 1 Service of Immunohematology and Transfusion Medicine, Immunogenetics Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carmine Tinelli
- 4 Service of Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Annamaria Pasi
- 1 Service of Immunohematology and Transfusion Medicine, Immunogenetics Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paola Bergamaschi
- 1 Service of Immunohematology and Transfusion Medicine, Immunogenetics Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,5 Department of Biology and Biotechnology "L.Spallanzani," University of Pavia, Pavia, Italy
| | - Cesare G Perotti
- 1 Service of Immunohematology and Transfusion Medicine, Immunogenetics Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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