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Mancini I, Agosti P, Boscarino M, Ferrari B, Artoni A, Palla R, Spreafico M, Crovetti G, Volpato E, Rossini S, Novelli C, Gattillo S, Barcella L, Salmoiraghi M, Falanga A, Peyvandi F. Lombardy diagnostic and therapeutic network of thrombotic microangiopathy. Orphanet J Rare Dis 2022; 17:246. [PMID: 35739601 PMCID: PMC9229100 DOI: 10.1186/s13023-022-02400-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 06/12/2022] [Indexed: 11/14/2022] Open
Abstract
Background Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy (TMA) requiring urgent treatment. Standardization of its diagnosis and optimal management is challenging. This study aimed to evaluate the role of centralized, rapid testing of ADAMTS13 in patients experiencing acute TMAs requiring plasma-exchange (PEX) and to estimate the incidence of TTP in a large Italian Region. Methods We perfomed a cohort study in the frame of the project “Set-up of a Lombardy network for the study and treatment of patients undergoing apheresis”, including 11 transfusion centers in the Region. Consecutive patients referred from 2014 to 2016 with acute TMAs requiring PEX were enrolled. Centralized ADAMTS13 activity testing was performed at the Milan Hemophilia and Thrombosis Center within 24 h. Results Forty-three TMA patients (44 events) were enrolled, of whom 35 (81%) had severe ADAMTS13 deficiency. Patients with severe ADAMTS13 deficiency were younger, mainly women, with a higher prevalence of autoimmune disorders and a lower prevalence of cancer. Clinical and laboratory characteristics of patients with and without severe ADAMTS13 deficiency largely overlapped, with a lower platelet count being the only baseline marker that significantly differed between the two patient groups (ADAMTS13 activity < 10% vs ≥ 10%: median difference of -27 × 109/l, 95% CI − 37 to − 3). PEX treatment was initiated in all patients, but soon discontinued in cases without severe ADAMTS13 deficiency. In this group, the mortality rate was higher and no episode exacerbations or relapses within 6 months occured. The estimated average annual incidence of acute acquired TTP events was 1.17 [0.78–1.55] per million people. Conclusions Severe ADAMTS13 deficiency distinguished two groups of patients with largely overlapping clinical features but different treatment and disease course. This study provides a feasible model implemented in a large Italian region for the practical clinical approach to TMAs and underlines the importance of urgent ADAMTS13 activity testing for an accurate differential diagnosis and therapeutic approach. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02400-y.
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Affiliation(s)
- I Mancini
- Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, and Fondazione Luigi Villa, Via Pace 9, 20122, Milan, Italy
| | - P Agosti
- Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, and Fondazione Luigi Villa, Via Pace 9, 20122, Milan, Italy
| | - M Boscarino
- Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, and Fondazione Luigi Villa, Via Pace 9, 20122, Milan, Italy
| | - B Ferrari
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - A Artoni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - R Palla
- Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, and Fondazione Luigi Villa, Via Pace 9, 20122, Milan, Italy
| | - M Spreafico
- Transfusion Medicine and Haematology Department, "A. Manzoni" Hospital, ASST-Lecco, Lecco, Italy
| | - G Crovetti
- SIMT, ASST Valle Olona, Busto Arsizio, Italy
| | - E Volpato
- Division of Immunohaematology and Transfusion Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - S Rossini
- Division of Immunohaematology and Transfusion Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - C Novelli
- Transfusion Center and Haematology Laboratory, Legnano Hospital, ASST Ovest Milanese, Legnano, Italy
| | - S Gattillo
- Immuno-Hematology and Transfusion Medicine Unit, San Raffaele Hospital, Milan, Italy
| | - L Barcella
- Immunohematology Division, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - M Salmoiraghi
- Unità Organizzativa Programmazione Della DG Welfare, Unità Organizzativa Programmazione Della DG Welfare Regione Lombardia, Regione Lombardia, Milan, Italy
| | - A Falanga
- Immunohematology Division, Hospital Papa Giovanni XXIII, Bergamo, Italy.,Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
| | - F Peyvandi
- Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, and Fondazione Luigi Villa, Via Pace 9, 20122, Milan, Italy. .,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy.
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Volpato E, Cavalera C, Castelnuovo G, Molinari E, Pagnini F. The "common" experience of voice-hearing and its relationship with shame and guilt: a systematic review. BMC Psychiatry 2022; 22:281. [PMID: 35443637 PMCID: PMC9022353 DOI: 10.1186/s12888-022-03902-6] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite Auditory Verbal Hallucinations (AVHs) having been long associated with mental illness, they represent a common experience also in the non-clinical population, yet do not exhibit distress or need for care. Shame and guilt are emotions related to one's perception of oneself and one's responsibility. As such, they direct our attention to aspects of AVHs that are under-researched and elusive, particularly about the status of voices as others, their social implications and the constitution and conceptualisation of the self. OBJECTIVES This paper aims to provide a systematic review of studies that investigated the relationship between auditory hallucinations, shame, and guilt in people without relevant signs of psychiatric issues. METHODS We searched studies reporting information about voices characteristics, the relationship between voices and hearers, hearer's reactions, and beliefs, paying peculiar attention to shame and guilt issues. Included papers were evaluated for risk of bias. RESULTS Eleven studies that explored the relationship between AVHs, shame and guilt, were extracted. Phenomenological, pragmatic, as well as neuropsychological features of hearing voices in non-clinical populations, allowed us to note a dynamic relationship and the constellation of subjective experiences that can occur. The role of guilt was characterized by few studies and mixed results, while shame was mainly common. CONCLUSIONS Due to the high heterogeneity detected and the scarce sources available, further studies should focus on both the aetiology and the bidirectional relationship between hearing voices, shame, and guilt in non-clinical people. This can be helpful in therapies for non-clinical populations who are distressed by their voices (e.g., psychotherapy), and for whom shame, and guilt may contribute to negative consequences such as isolation, anxiety or future depression. Moreover, it might favour the development and implication of different treatments considering emotion regulation, distress tolerance and interpersonal sensitivity on the clinical populations.
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Affiliation(s)
- E. Volpato
- grid.8142.f0000 0001 0941 3192Present Address: Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123 Milan, Italy ,grid.418563.d0000 0001 1090 9021IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - C. Cavalera
- grid.8142.f0000 0001 0941 3192Present Address: Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123 Milan, Italy
| | - G. Castelnuovo
- grid.8142.f0000 0001 0941 3192Present Address: Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123 Milan, Italy ,grid.418224.90000 0004 1757 9530Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory , Verbania , Italy
| | - E. Molinari
- grid.8142.f0000 0001 0941 3192Present Address: Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123 Milan, Italy ,grid.418224.90000 0004 1757 9530Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - F. Pagnini
- grid.8142.f0000 0001 0941 3192Present Address: Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123 Milan, Italy ,grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
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Volpato E, Bosio C, Previtali E, Leone S, Armuzzi A, Pagnini F, Graffigna G. The evolution of IBD perceived engagement and care needs across the life-cycle: a scoping review. BMC Gastroenterol 2021; 21:293. [PMID: 34261434 PMCID: PMC8278693 DOI: 10.1186/s12876-021-01850-1] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 06/21/2021] [Indexed: 12/22/2022] Open
Abstract
Background The chronic and progressive evolution of Inflammatory Bowel Diseases (IBD), with its prototypical fluctuating trend, creates a condition of psycho-social discomfort, impacting the quality of life in terms of personal, working, and interpersonal. Aims In this article, we want to identify the nature and extent of the research evidence on the life experiences, the perceived engagement, the psychological, social care and welfare needs of people affected by IBD across the lifecycle. Methods Following the approach set out by Arksey and O’Malley and the PRISMA extension for scoping reviews, we conducted a scoping review in March 2019 and closed the review with an update in October 2019. It was performed using electronic databases covering Health and Life Sciences, Social Sciences and Medical Sciences, such as PubMed, Medline, Embase, Scopus, Cochrane, Web of Science, PsycInfo. Results We identified 95 peer-reviewed articles published from 2009 to 2019, that allowed to detection the main needs in children (psychological, need to be accepted, physical activity, feeding, parent style, support, social needs), adolescents (to understand, physical and psychological needs, protection, relational, gratitude, respect, and engagement) and adults (information, medical, psychological, social, work-related, practical, future-related, engagement). Although the literature confirms that the majority of the IBD units have planned provision for the different types of transitions, the quality and appropriateness of these services have not been assessed or audited for all the kinds of challenges across the life cycle. Conclusions The literature shows the relevance of organizing a flexible, personalized health care process across all the critical phases of the life cycle, providing adequate benchmarks for comparison in a multidisciplinary perspective and ensuring continuity between hospital and territory. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-021-01850-1.
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Affiliation(s)
- E Volpato
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123, Milan, Italy. .,IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
| | - C Bosio
- EngageMinds Hub Consumer, Food and Health Research Center, Università Cattolica del Sacro Cuore, Milan, Cremona, Italy
| | - E Previtali
- AMICI Onlus, Associazione nazionale per le Malattie Infiammatorie Croniche dell'Intestino, Milan, Italy
| | - S Leone
- AMICI Onlus, Associazione nazionale per le Malattie Infiammatorie Croniche dell'Intestino, Milan, Italy
| | - A Armuzzi
- Università Cattolica del Sacro Cuore di Roma, Rome, Italy.,IRCCS Policlinico Gemelli, Rome, Italy
| | - F Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123, Milan, Italy.,Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, USA
| | - G Graffigna
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123, Milan, Italy.,EngageMinds Hub Consumer, Food and Health Research Center, Università Cattolica del Sacro Cuore, Milan, Cremona, Italy
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Capogrosso P, Ventimiglia E, Volpato E, Boeri L, Cazzaniga W, Montorsi F, Salonia A. PO-01-076 Patterns of national health system reimbursed prescription for erectile dysfunction: An ecological population-based study. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Serum immunoreactive calcitonin (iCT) assay was performed in 92 patients suffering from different kinds of cancer of the lung and in 42 healthy control subjects. Gel filtration of serum of patients suffering from microcytoma was carried out on Sephadex G75 to study the forms of circulating iCT. The obtained results (pg/ml M ± SE) were: 1) normal subjects, 73 ± 3; 2) epidermoidal cancer, 105 ± 19; 3) adenocarcinoma, 116 ± 47; 4) anaplastic carcinoma with large cells, 156 ± 74; 5) microcytoma, 354 ± 74; 6) chronic obstructive bronchitis, 38 ± 6. Gel filtration of serum of patients with microcytoma demonstrated the same behavior as in normal subjects. We can conclude that iCT increases significantly in microcytoma with extensive disease (84 % of cases): in this condition, the iCT assay can be useful as a marker in follow-up of disease.
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Vitacca M, Montini A, Lunetta C, Banfi P, Bertella E, De Mattia E, Lizio A, Volpato E, Lax A, Morini R, Paneroni M. Impact of an early respiratory care programme with non-invasive ventilation adaptation in patients with amyotrophic lateral sclerosis. Eur J Neurol 2018; 25:556-e33. [PMID: 29266547 DOI: 10.1111/ene.13547] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/04/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Forced vital capacity (FVC) <80% is one of the key indications for starting non-invasive ventilation (NIV) in amyotrophic lateral sclerosis (ALS). It was hypothesized that a very early start of NIV could lengthen the free interval before death compared to later-start NIV; as a secondary outcome, the survival rate of patients on NIV without tracheotomy was also evaluated. METHODS This retrospective study was conducted on 194 ALS patients, divided into a later group (LG) with FVC <80% at NIV prescription (n = 129) and a very early group (VEG) with FVC ≥80% at NIV prescription (n = 65). Clinical and respiratory functional data and time free to death between groups over a 3-year follow-up were compared. RESULT At 36 months from diagnosis, mortality was 35% for the VEG versus 52.7% for the LG (P = 0.022). Kaplan-Meier survival curves adjusted for tracheotomy showed a lower probability of death (P = 0.001) for the VEG as a whole (P = 0.001) and for the non-bulbar (NB) subgroup (P = 0.007). Very early NIV was protective of survival for all patients [hazard ratio (HR) 0.45; 95% confidence interval (CI) 0.28-0.74; P = 0.001] and for the NB subgroup (HR 0.43; 95% CI 0.23-0.79; P = 0.007), whilst a tracheotomy was protective for all patients (HR 0.27; 95% CI 0.15-0.50; P = 0.000) and both NB (HR 0.26; 95% CI 0.12-0.56; P = 0.001) and bulbar subgroups (HR 0.29; 95% CI 0.11-0.77; P = 0.013). Survival in VEG patients on NIV without tracheotomy was three times that for the LG (43.1% vs. 14.7%). CONCLUSION Very early NIV prescription prolongs the free time from diagnosis to death in NB ALS patients whilst tracheotomy reduces the mortality risk in all patients.
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Affiliation(s)
- M Vitacca
- Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - A Montini
- Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - C Lunetta
- NEMO Clinical Centre, Fondazione Serena Onlus, Milano, Italy
| | - P Banfi
- Don Gnocchi Foundation IRCCS - Onlus, Milano, Italy
| | - E Bertella
- Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - E De Mattia
- NEMO Clinical Centre, Fondazione Serena Onlus, Milano, Italy
| | - A Lizio
- NEMO Clinical Centre, Fondazione Serena Onlus, Milano, Italy
| | - E Volpato
- Don Gnocchi Foundation IRCCS - Onlus, Milano, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - A Lax
- Don Gnocchi Foundation IRCCS - Onlus, Milano, Italy
| | - R Morini
- Neurorehabilitation Division, ICS Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - M Paneroni
- Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Lumezzane, Brescia, Italy
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Pagnini F, Marconi A, Tagliaferri A, Manzoni GM, Gatto R, Fabiani V, Gragnano G, Rossi G, Volpato E, Banfi P, Palmieri A, Graziano F, Castelnuovo G, Corbo M, Molinari E, Riva N, Sansone V, Lunetta C. Meditation training for people with amyotrophic lateral sclerosis: a randomized clinical trial. Eur J Neurol 2017; 24:578-586. [DOI: 10.1111/ene.13246] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/04/2017] [Indexed: 02/02/2023]
Affiliation(s)
- F. Pagnini
- Department of Psychology; Università Cattolica del Sacro Cuore; Milan Italy
- Azienda Ospedaliera Niguarda Ca’ Granda; Milan Italy
| | - A. Marconi
- NEuroMuscular Omnicentre (NEMO) − Fondazione Serena Onlus; Milan Italy
| | | | | | - R. Gatto
- Azienda Ospedaliera Niguarda Ca’ Granda; Milan Italy
| | - V. Fabiani
- Azienda Ospedaliera Niguarda Ca’ Granda; Milan Italy
| | - G. Gragnano
- NEuroMuscular Omnicentre (NEMO) − Fondazione Serena Onlus; Milan Italy
| | - G. Rossi
- NEuroMuscular Omnicentre (NEMO) − Fondazione Serena Onlus; Milan Italy
| | - E. Volpato
- Department of Psychology; Università Cattolica del Sacro Cuore; Milan Italy
- IRCCS Fondazione Don Carlo Gnocchi ONLUS; Milan Italy
| | - P. Banfi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS; Milan Italy
| | - A. Palmieri
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology; University of Padova; Padua Italy
| | - F. Graziano
- Department of Brain and Behavioural Sciences; Università degli Studi di Pavia; Pavia Italy
| | - G. Castelnuovo
- Department of Psychology; Università Cattolica del Sacro Cuore; Milan Italy
- Psychology Research Laboratory; Istituto Auxologico Italiano IRCCS; Piancavallo Italy
| | - M. Corbo
- Department of Neurorehabilitation Sciences; Casa Cura Policlinico; Milan Italy
| | - E. Molinari
- Department of Psychology; Università Cattolica del Sacro Cuore; Milan Italy
- Psychology Research Laboratory; Istituto Auxologico Italiano IRCCS; Piancavallo Italy
| | - N. Riva
- Department of Neurology; INSPE and Division of Neuroscience; San Raffaele Scientific Institute, Milan Italy
| | - V. Sansone
- NEuroMuscular Omnicentre (NEMO) − Fondazione Serena Onlus; Milan Italy
| | - C. Lunetta
- NEuroMuscular Omnicentre (NEMO) − Fondazione Serena Onlus; Milan Italy
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Gomiero A, Volpato E, Nasci C, Perra G, Viarengo A, Dagnino A, Spagnolo A, Fabi G. Use of multiple cell and tissue-level biomarkers in mussels collected along two gas fields in the northern Adriatic Sea as a tool for long term environmental monitoring. Mar Pollut Bull 2015; 93:228-244. [PMID: 25724089 DOI: 10.1016/j.marpolbul.2014.12.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 09/22/2014] [Revised: 12/13/2014] [Accepted: 12/15/2014] [Indexed: 06/04/2023]
Abstract
As a consequence of the growing global demand of energy supplies, intense oil and gas exploration and exploitation programs have been carried out worldwide especially within the marine environments. The release of oil-derived compounds in the sea from anthropogenic sources both as effluents or accidental spill is perceived as a major environmental concern. An approach based on a combination of biomarkers and the distribution of some classes of environmentally relevant pollutants was used to investigate the occurrence of a stress syndrome in mussels (Mytilus galloprovincialis) collected at three gas platforms placed in two distinct oceanographic districts within the Adriatic Sea. Biological responses were integrated by a ranking algorithm which demonstrated both a range of biological effects reflecting exposure gradients and a temporal related trend in the investigated responses. The overall results demonstrate a moderate to absent pollution from studied gas platforms with low but remarkable biological disturbance in sentinel organisms.
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Affiliation(s)
- A Gomiero
- National Research Council - ISMAR, Largo Fiera della Pesca 1, 60125 Ancona, Italy; Department of Sciences and Technological Innovation (DiSIT), University of Piemonte Orientale, Viale T. Michel 11, 15123 Alessandria, Italy.
| | - E Volpato
- Thetis SpA, Castello 2737/f, 30122 Venice, Italy
| | - C Nasci
- Thetis SpA, Castello 2737/f, 30122 Venice, Italy
| | - G Perra
- Department of Physical Sciences, Earth and Environment, University of Siena, Via P.A. Mattioli 4, 53100 Siena, Italy
| | - A Viarengo
- Department of Sciences and Technological Innovation (DiSIT), University of Piemonte Orientale, Viale T. Michel 11, 15123 Alessandria, Italy
| | - A Dagnino
- Department of Sciences and Technological Innovation (DiSIT), University of Piemonte Orientale, Viale T. Michel 11, 15123 Alessandria, Italy
| | - A Spagnolo
- National Research Council - ISMAR, Largo Fiera della Pesca 1, 60125 Ancona, Italy
| | - G Fabi
- National Research Council - ISMAR, Largo Fiera della Pesca 1, 60125 Ancona, Italy
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