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Reggiani C, Pellacani G, Reggiani Bonetti L, Zanelli G, Azzoni P, Chester J, Kaleci S, Ferrari B, Bellini P, Longo C, Bertoni L, Magnoni C. An intraoperative study with ex vivo fluorescence confocal microscopy: diagnostic accuracy of the three visualization modalities. J Eur Acad Dermatol Venereol 2020; 35:e92-e94. [PMID: 32692878 DOI: 10.1111/jdv.16831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- C Reggiani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - G Pellacani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - L Reggiani Bonetti
- Department of Pathology, Ospedale Policlinico e Nuovo Ospedale Civile S.Agostino Estense Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - G Zanelli
- Department of Pathology, Ospedale Policlinico e Nuovo Ospedale Civile S.Agostino Estense Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - P Azzoni
- Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - J Chester
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - S Kaleci
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - B Ferrari
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - P Bellini
- Dentistry and Oral and Maxillofacial Surgery Unit, Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - C Longo
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Modena, Italy
| | - L Bertoni
- Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - C Magnoni
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
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Spertilli Raffaelli C, Rossetti B, Paglicci L, Colafigli M, Punzi G, Borghi V, Pecorari M, Santoro MM, Penco G, Antinori A, Zazzi M, De Luca A, Zanelli G. Impact of transmitted HIV-1 drug resistance on the efficacy of first-line antiretroviral therapy with two nucleos(t)ide reverse transcriptase inhibitors plus an integrase inhibitor or a protease inhibitor. J Antimicrob Chemother 2019; 73:2480-2484. [PMID: 29945251 DOI: 10.1093/jac/dky211] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 05/09/2018] [Indexed: 11/14/2022] Open
Abstract
Objectives To examine the impact of transmitted drug resistance (TDR) on response to first-line regimens with integrase strand transfer inhibitors (INSTIs) or boosted protease inhibitors (bPIs). Methods From an Italian observational database (ARCA) we selected HIV-1-infected drug-naive patients starting two NRTIs and either an INSTI or a bPI, with an available pre-ART resistance genotype. The endpoint was virological failure (VF; plasma HIV-1 RNA >200 copies/mL after week 24). WHO surveillance drug resistance mutations and the Stanford algorithm were used to classify patients into three resistance categories: no TDR (A), TDR but fully-active ART prescribed (B), TDR and at least low-level resistance to one or more prescribed drug (C). Results We included 1365 patients with a median follow-up of 96 weeks (IQR 54-110): 1205 (88.3%) starting bPI and 160 (11.7%) INSTI. Prevalence of TDR was 6.1%, 12.5%, 2.6% and 0% for NRTI, NNRTI, bPI and INSTI, respectively. Cumulative Kaplan-Meier estimates for VF at 48 weeks were 11% (95% CI 10.1%-11.9%) for the bPI group and 7.7% (95% CI 5.4%-10%) for the INSTI group. In the INSTI group, cumulative estimates for VF at 48 weeks were 6% (95% CI 4%-8%) in resistance category A, 5% (95% CI 1%-10%) in B and 50% (95% CI 30%-70%) in C (P < 0.001). Resistance category C [versus A, adjusted hazard ratio (aHR) 12.6, 95% CI 3.2-49.8, P < 0.001] and nadir CD4 (+100 cells/mm3, aHR 0.6, 95% CI 0.4-0.9, P = 0.03) predicted VF. In the bPI group, VF rates were not influenced by baseline resistance. Conclusions Our data support the need for NRTI resistance genotyping in patients starting an INSTI-based first-line ART.
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Affiliation(s)
- C Spertilli Raffaelli
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.,University Division of Infectious Diseases, Hospital Department of Specialized and Internal Medicine, Siena University Hospital, Siena, Italy
| | - B Rossetti
- University Division of Infectious Diseases, Hospital Department of Specialized and Internal Medicine, Siena University Hospital, Siena, Italy.,Clinic of Infectious Diseases, Catholic University of Sacred Heart, Rome, Italy
| | - L Paglicci
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.,University Division of Infectious Diseases, Hospital Department of Specialized and Internal Medicine, Siena University Hospital, Siena, Italy
| | - M Colafigli
- Clinic of Infectious Diseases, Catholic University of Sacred Heart, Rome, Italy
| | - G Punzi
- Virology, Bari Hospital, Bari, Italy
| | - V Borghi
- Infectious Diseases Unit, Modena Hospital, Modena, Italy
| | - M Pecorari
- Microbiology and Virology Unit, University Hospital, Modena, Italy
| | - M M Santoro
- Department of Experimental Medicine and Surgery, University of Rome 'Tor Vergata', Rome, Italy
| | - G Penco
- Infectious Diseases Department, Ente Ospedaliero Ospedali Galliera, Genoa, Italy
| | - A Antinori
- Infectious Diseases Department, INMI 'Lazzaro Spallanzani', Rome, Italy
| | - M Zazzi
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - A De Luca
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.,University Division of Infectious Diseases, Hospital Department of Specialized and Internal Medicine, Siena University Hospital, Siena, Italy
| | - G Zanelli
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.,University Division of Infectious Diseases, Hospital Department of Specialized and Internal Medicine, Siena University Hospital, Siena, Italy
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3
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Rodijk FMW, Zanelli G, Geerligs M, van Erp PEJ, Peppelman M. The influence of different shavers on the skin quantified by non-invasive reflectance confocal microscopy. Skin Res Technol 2016; 22:311-7. [PMID: 27381679 DOI: 10.1111/srt.12263] [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] [Accepted: 07/29/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND The impact of personal care devices on skin is mainly assessed using subjective tools. However, new objective, accurate non-invasive in vivo imaging techniques have been developed. The aim of this study was to evaluate the ability of reflectance confocal microscopy (RCM) in quantifying morphological impact of shavers on skin. Furthermore, tape stripping (TS) as method to study morphological impact of shavers was evaluated. METHODS In 12 healthy male subjects, for two consecutive days, a split-face test was performed in the neck; on one side a shaver was applied, while the other side was exposed to TS. The stratum corneum (SC) thickness was quantified using RCM and sensory observations were evaluated using questionnaires. RESULTS Shavers with a different impact on skin, can be discriminated by RCM; shaver B removed more SC after application than the skin friendlier shaver A. Furthermore, the changes in SC thickness induced by TS corresponded well to that of the shavers. CONCLUSION RCM is able to quantify the impact of different shavers on skin. Besides, TS appeared to be a suitable model mimicking the mechanical impact of shavers on skin. RCM in combination with the TS model appeared to be a suitable minimally invasive model to obtain morphological and cell biological data on skin-material interactions caused by different personal care devices.
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Affiliation(s)
- F M W Rodijk
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands
| | - G Zanelli
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands
| | - M Geerligs
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands
| | - P E J van Erp
- Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M Peppelman
- Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands
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4
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Vergori A, Masi G, Donati D, Ginanneschi F, Annunziata P, Cerase A, Mencarelli M, Rossetti B, De Luca A, Zanelli G. Listeria meningoencephalitis and anti-GQ1b antibody syndrome. Infection 2016; 44:543-6. [PMID: 26825308 DOI: 10.1007/s15010-015-0862-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 11/23/2015] [Indexed: 01/20/2023]
Abstract
We report the first case of Listeria monocytogenes meningoencephalitis associated with anti-GQ1b antibody syndrome in an immunocompetent adult. A prompt diagnosis, made thanks to the multidisciplinary contribution, allowed a combined therapeutic approach leading to final favourable outcome, despite several intercurrent complications.
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Affiliation(s)
- A Vergori
- University Division of Infectious Diseases, Department of Medical Biotechnologies, University of Siena, 53100, Siena, Italy
| | - G Masi
- Department of Medicine, Surgery and Neurosciences, Clinical Neuroimmunology Unit, University of Siena, Siena, Italy
| | - D Donati
- Department of Medicine, Surgery and Neurosciences, Clinical Neuroimmunology Unit, University of Siena, Siena, Italy
| | - F Ginanneschi
- Department of Medicine, Surgery and Neurosciences, Clinical Neuroimmunology Unit, University of Siena, Siena, Italy
| | - P Annunziata
- Department of Medicine, Surgery and Neurosciences, Clinical Neuroimmunology Unit, University of Siena, Siena, Italy
| | - A Cerase
- Unit of Neuroimaging and Neurointervention, University Hospital of Siena, Siena, Italy
| | - M Mencarelli
- University Division of Infectious Diseases, Department of Medical Biotechnologies, University of Siena, 53100, Siena, Italy
| | - B Rossetti
- University Division of Infectious Diseases, Department of Medical Biotechnologies, University of Siena, 53100, Siena, Italy
| | - A De Luca
- University Division of Infectious Diseases, Department of Medical Biotechnologies, University of Siena, 53100, Siena, Italy
| | - G Zanelli
- University Division of Infectious Diseases, Department of Medical Biotechnologies, University of Siena, 53100, Siena, Italy.
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5
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Tordini G, Giaccherini R, Pacenti L, Miracco C, Zazzi M, Zanelli G. Cutaneous leishmaniasis: usefulnessof PCR on paraffin-embedded skin biopsies as part of routine investigation. Annals of Tropical Medicine & Parasitology 2013; 101:745-9. [DOI: 10.1179/136485907x229059] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Zanelli G, Bianco C, Cusi MG. Testicular involvement during Toscana virus infection: an unusual manifestation? Infection 2012; 41:735-6. [PMID: 23160838 DOI: 10.1007/s15010-012-0368-9] [Citation(s) in RCA: 10] [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: 10/12/2012] [Accepted: 11/06/2012] [Indexed: 10/27/2022]
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7
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Tordini G, Giaccherini R, Sammarro G, Braito A, Zanelli G. Human leishmaniasis in Tuscany: a changing pattern of visceral disease? Ann Trop Med Parasitol 2010; 104:171-4. [PMID: 20406584 DOI: 10.1179/136485910x12647085215499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- G Tordini
- Department of Molecular Biology, Siena University, Policlinico Santa Maria alle Scotte, Siena, Italy.
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8
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Di Rosa G, Armando M, Zanelli G, Frascarelli F, Petrarca M, Castelli E. FP12-MO-01 3-D dynamic postural task-related evaluation in cerebral palsy. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)70323-5] [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: 10/20/2022]
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9
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Esposito S, Leone S, Noviello S, Ianniello F, Russo M, Foti G, Carpentieri MS, Cellesi C, Zanelli G, Cellini A, Girmenia C, De Lalla F, Maiello A, Maio P, Acone N, Marranconi F, Sabbatani S, Pantaleoni M, Ghinelli F, Soranzo ML, Viganò P, Re T, Viale P, Scudeller L. Outpatient parenteral antibiotic therapy in the elderly: an Italian observational multicenter study. J Chemother 2009; 21:193-8. [PMID: 19423473 DOI: 10.1179/joc.2009.21.2.193] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Bacterial infections are the most frequent cause of hospitalization in elderly patients. In the early eighties, the advantages of Outpatient parenteral Antibiotic therapy (OPAT) were identified in the United States, and suitable therapeutic programs were established. In order to understand the different ways of managing OPAT, a National OPAT Registry was set up in 2003 in Italy. This study analyzes data concerning bacterial infections in 176 elderly patients including demographics, therapeutic management, clinical response, and side-effects. Bone and joint infections (48.9%) and skin and soft tissue infections (27.8%) were the most common infections treated with OPAT. Teicoplanin (28.9%) and ceftriaxone (22.1%) were the top two antibiotics chosen. OPAT was mainly performed at a hospital infusion center (52.8%). The clinical success rate was high and side-effects were low (12.6% of cases). Management of bacterial infections in the elderly with an outpatient program is effective and safe.
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Affiliation(s)
- S Esposito
- Dipartimento di Malattie Infettive, Seconda Università degli Studi, Napoli, Italy.
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10
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Petrarca M, Zanelli G, Patanè F, Frascarelli F, Cappa P, Castelli E. Reach-to-grasp interjoint coordination for moving object in children with hemiplegia. J Rehabil Med 2009; 41:995-100. [DOI: 10.2340/16501977-0436] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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11
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Esposito S, Leone S, Noviello S, Ianniello F, Fiore M, Russo M, Foti G, Carpentieri MS, Cellesi C, Zanelli G, Cellini A, Girmenia C, De Lalla F, Maiello A, Maio P, Marranconi F, Sabbatani S, Pantaleoni M, Ghinelli F, Soranzo ML, Vigano P, Re T, Viale P, Scudeller L, Scaglione F, Vullo V. Outpatient parenteral antibiotic therapy for bone and joint infections: an italian multicenter study. J Chemother 2007; 19:417-22. [PMID: 17855186 DOI: 10.1179/joc.2007.19.4.417] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In the early eighties, the advantages of outpatient parenteral antibiotic therapy (OPAT) (reduced costs, no hospitalization trauma in children, no immobilization syndrome in elderly, reduction in nosocomial infections by multiresistant organisms) were identified in the United States, and suitable therapeutic programs were established. Currently, more than 250,000 patients per year are treated according to an OPAT program. In order to understand the different ways of managing OPAT and its results, a National OPAT Registry was set up in 2003 in Italy. Analysis of data concerning osteomyelitis, septic arthritis, prosthetic joint infection and spondylodiskitis, allowed information to be acquired about 239 cases of bone and joint infections, with particular concern to demographics, therapeutic management, clinical response, and possible side effects. Combination therapy was the first-line choice in 66.9% of cases and frequently intravenous antibiotics were combined with oral ones. Teicoplanin (38%) and ceftriaxone (14.7%), whose pharmacokinetic/pharmacodynamic properties permit once-a-day administration, were the two top antibiotics chosen; fluoroquinolones (ciprofloxacin and levofloxacin) were the most frequently utilized oral drugs. Clinical success, as well as patients' and doctors' satisfaction with the OPAT regimen was high. Side-effects were mild and occurred in 11% of cases. These data confirm that the management of bone and joint infections in an outpatient setting is suitable, effective and safe.
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Affiliation(s)
- S Esposito
- Dipartimento di Malattie Infettive, Seconda Universita degli Studi, Napoli, Italy.
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12
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Tordini G, Giaccherini R, Corbisiero R, Zanelli G. Relapsing fever in a traveller from Senegal: determination of Borrelia species using molecular methods. Trans R Soc Trop Med Hyg 2006; 100:992-4. [PMID: 16455121 DOI: 10.1016/j.trstmh.2005.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2005] [Revised: 10/26/2005] [Accepted: 11/03/2005] [Indexed: 11/21/2022] Open
Abstract
We describe a case of a febrile patient returning from Senegal in which haemoscopic and molecular investigation confirmed tick-borne relapsing fever (TBRF), suggesting Borrelia crocidurae as the causative agent. This case emphasises the need to include TBRF in the differential diagnosis of fever following a journey from endemic countries, including malarial areas.
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Affiliation(s)
- G Tordini
- Department of Molecular Biology, Clinic and Laboratory of Infectious Diseases, Siena University, Policlinico Santa Maria alle Scotte, Viale Bracci 16, 53100 Siena, Italy.
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13
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Santori D, Fabbiani M, Zanelli G, Sansoni A, Pippi F, Braito A, Pippi L, Rossi M, Rottoli P. [Retrospective study of tuberculosis in the Province of Siena]. Infez Med 2005; 13:175-81. [PMID: 16397420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
We report here the results of a retrospective study carried out on 200 tuberculosis cases admitted to the Hospital of Siena during the period 1994-2003. For each case, epidemiological, clinical and microbiological data were collected in order to analyze the trend of tuberculosis over the years and to compare our experience with similar studies. Indigenous patients were significantly older than immigrants (60.1 vs 34.2 yrs) more frequently affected by underlying chronic diseases. Overcrowding and HIV infection were predisposing conditions in 30 subjects (15% of cases) recently arrived from high endemicity countries. Pulmonary tuberculosis (TB) was diagnosed in 71% of cases, irrespective of origin. The death rate was 5%. Microbiological investigation was positive in 74.4% of examined subjects; 9.8% of isolates were resistant to one or more antituberculous drugs. The number of cases admitted to the Hospital seems to have slowly decreased in the last few years; factors that may influence this trend are discussed. Our results confirm a distinct epidemiological pattern of the disease between indigenous patients and immigrants, which is typical of low-endemicity countries. The delay in the diagnosis and management of the disease observed in this case-series report underlines the need to improve information on TB and skill in treatment, and to maintain specialized centres.
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Affiliation(s)
- D Santori
- Clinica Malattie Infettive, Università di Siena, Italy
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14
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Zanelli G, Pollini S, Sansoni A, Cresti S, Pilli E, Rossolini GM, Cellesi C. Molecular typing of Staphylococcus aureus isolates from an intensive care unit. New Microbiol 2004; 27:293-9. [PMID: 15460533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Seventeen S. aureus clinical isolates, collected from an Intensive Care Unit (ICU) during a seven-month period were analyzed to investigate their antimicrobial susceptibility and clonal diversity. Eleven isolates (65%) were found to be resistant to methicillin (MRSA). Pulsed-field gel electrophoresis (PFGE) profiles of genomic DNAs, and analysis of the polymorphisms of the variable regions of the protein A (spa) and coagulase (coa) genes revealed a lower clonal heterogeneity among MRSA than among methicillin-susceptible isolates (MSSA). Two of the MRSA clones were repeatedly isolated in different patients, within a variable period of time, suggesting the presence in the ward of a resident, endemic and multi-drug resistant MRSA population. Our results also emphasize the lower discriminatory power of spa and coa typing compared with PFGE typing.
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MESH Headings
- Bacterial Proteins/genetics
- Bacterial Typing Techniques
- Chromosomes, Bacterial/genetics
- Coagulase/genetics
- DNA, Bacterial/analysis
- DNA, Bacterial/isolation & purification
- Drug Resistance, Multiple, Bacterial
- Electrophoresis, Gel, Pulsed-Field
- Genes, Bacterial
- Hospitals, University
- Inpatients
- Intensive Care Units
- Italy
- Methicillin Resistance
- Polymorphism, Genetic
- Polymorphism, Restriction Fragment Length
- Staphylococcal Infections/epidemiology
- Staphylococcal Infections/microbiology
- Staphylococcal Protein A/genetics
- Staphylococcus aureus/classification
- Staphylococcus aureus/genetics
- Staphylococcus aureus/isolation & purification
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15
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Zanelli G, Sansoni A, Zanchi A, Cresti S, Pollini S, Rossolini GM, Cellesi C. Staphylococcus aureus nasal carriage in the community: a survey from central Italy. Epidemiol Infect 2002; 129:417-20. [PMID: 12403117 PMCID: PMC2869900 DOI: 10.1017/s0950268802007434] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Recently, concern has increased regarding the spread of methicillin-resistant Staphylococcus aureus (MRSA) in the community. We studied 812 subjects from central Italy to establish the rates of nasal carriage of S. aureus, and antibiotic susceptibility patterns, in the community. The prevalence of S. aureus nasal carriage was 30.5%. Only one subject, with predisposing risk factors for acquisition, was identified as carrier of MRSA (prevalence of 0.12%). The presence of MRSA in the community of our area still appears to be a rare event. Among methicillin-susceptible S. aureus (MSSA) isolates, a surprisingly high rate (18%) of resistance to rifampin was observed.
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Affiliation(s)
- G Zanelli
- Clinica delle Malattie Infettive, Dipartimento di Biologia Molecolare, Università di Siena, Italia
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16
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Abstract
A healthy 27-year-old woman presented, four months after childbirth, ingravescent pain and claudication of the left lower limb. Magnetic Resonance Imaging of the lumbosacral and iliac regions showed widespread muscular-skeletal lesions. The patient underwent surgery; Cryptococcus neoformans was isolated from surgical samples. Liposomal amphotericin B, fluconazole and itraconazole were administered. Laboratory findings showed lymphocytopenia, with reduction of CD4+ lymphocytes (23 cells per cubic millimeter) in the absence of HIV infection and any other defined immunodeficiency. This is a rare case of muscular-skeletal cryptococcal infection isolated in a subject affected with idiopathic CD4+ lymphocytopenia.
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Affiliation(s)
- G Zanelli
- Istituto di Clinica delle Malattie Infettive, Università di Siena, Siena, Italy.
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17
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Cappelli R, Masotti L, Zanelli G, Battistini S, Forconi S. Deep vein thrombosis during varicella in a child with factor V Leiden mutation and familial deficiency of protein S. Thromb Haemost 2001; 85:370. [PMID: 11246564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Affiliation(s)
- G Zanelli
- Department of Dermatology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA
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Barzan L, Barra S, Franchin G, Talamini R, Zanelli G, Caruso G, Maione A, Pin M, Politi D, Gobitti C. Squamous cell carcinoma of the posterior pharyngeal wall: characteristics compared with the lateral wall. J Laryngol Otol 1995; 109:120-5. [PMID: 7706916 DOI: 10.1017/s0022215100129445] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Squamous cell carcinoma of the posterior oro- and hypopharyngeal wall (SCCPPW) is a relatively rare tumour. A retrospective investigation of 63 patients with SCCPPW and 449 patients with carcinoma of the lateral oro- and hypopharyngeal wall, treated between 1964 and 1992, has been carried out. Most SCCPPW were asymptomatic, macroscopically superficial and at early stages. They were usually detected by chance during an examination for a different type of malignancy. Fifty-seven percent of SCCPPW patients had multiple tumours; however this occurrence did not alter the survival rate. The crude five-year survival rate for SCCPPW was 22 percent and was not significantly different from that of patients with lateral wall tumours. Moreover, both local control and recurrences also were not statistically different.
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Affiliation(s)
- L Barzan
- Division of Otolaryngology, Ospedale Civile, Pordenone, Italy
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20
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Abstract
Non-steroidal anti-inflammatory drug induced small intestinal inflammation may have an adverse effect on the joints of patients with rheumatoid arthritis. We therefore assessed small intestinal and joint inflammation in patients with rheumatoid arthritis before and after three to nine months' treatment with sulphasalazine (n = 40) and other second line drugs (n = 20), while keeping the dosage of non-steroidal anti-inflammatory drug at the same level. Sulphasalazine significantly decreased the mean (SD) faecal excretion of 111indium labelled leucocytes from 2.39 (2.22)% to 1.33 (1.13)% (normal less than 1%, p less than 0.01) and improved the joint inflammation as assessed by a variety of parameters. There was no significant correlation between the effects of sulphasalazine treatment on the intestine and the joints. Treatment with other second line drugs had no significant effect on the faecal excretion of 111indium (1.58 (1.04)% and 1.86 (1.51)%, respectively) but improved joint inflammation significantly. The lack of correlation between the intestinal and joint inflammation and their response to treatment suggests that the two are not causally related.
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Affiliation(s)
- I Bjarnason
- Section of Gastroenterology, MRC Clinical Research Centre, Harrow, Middlesex, United Kingdom
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21
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Brigden G, Zanelli G, Lahiri A, Raftery E. Blood pool ventriculography with a new technetium-labelled complex (99mTc-DEPIC): a clinical evaluation. Eur J Nucl Med 1990; 16:795-9. [PMID: 2209648 DOI: 10.1007/bf00833013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A new, single bolus method of in vivo blood pool imaging using a technetium Tc99m phosphine isocyanide complex (DEPIC) which binds to pre-albumin was evaluated in volunteers (n = 4) and patients (n = 20). DEPIC was assessed for its safety and possible drug interactions. Its duration of action and quality of ventriculography were compared with imaging using standard in vivo red cell labelling (PYP) during two 3-h scanning periods 1 week apart. DEPIC had a mean plasma half-life of 3.3 h. The count rate over the left ventricle was initially 42% higher with DEPIC than with PYP. However, removal of DEPIC by the liver resulted in equivalent count rates by 1 h, and by 3 h PYP count rates were 22% higher than DEPIC. Immediately post injection mean (SD) difference in the left ventricular ejection fraction between the two methods was 2.4% (7.7%). Satisfactory DEPIC scans were obtained up to 2 h post injection, but by 3 h there was a mean difference of 13% (11.3%). DEPIC was found to be a safe alternative to red all labelling for blood pool angiography, suitable for routine work. The single bolus methodology and high initial count rates offer improved efficiency and a capability for truly emergency scanning.
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Affiliation(s)
- G Brigden
- Department of Cardiology, Northwick Park Hospital and Clinical Research Centre, Harrow, Middlesex, UK
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22
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Bjarnason I, Price AB, Zanelli G, Smethurst P, Burke M, Gumpel JM, Levi AJ. Clinicopathological features of nonsteroidal antiinflammatory drug-induced small intestinal strictures. Gastroenterology 1988; 94:1070-4. [PMID: 3345876 DOI: 10.1016/0016-5085(88)90568-9] [Citation(s) in RCA: 125] [Impact Index Per Article: 3.5] [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: 01/05/2023]
Abstract
The clinicopathological features in 4 patients are described where nonsteroidal antiinflammatory drugs appear to have caused small intestinal strictures. Two patients had rheumatoid arthritis and 2 patients had osteoarthritis; all had received nonsteroidal antiinflammatory drugs for 1.5-30 yr. Three patients had an initial illness characterized by diarrhea, profound weight loss, and hypoalbuminemia. Intestinal radiology at this stage ranged from subtle changes to those of Crohn's disease. Three patients underwent surgery. At operation the bland external appearance contrasted with the striking mucosal appearances of multiple concentric, circumferential, diaphragmatic strictures that caused luminal stenosis to a pinhole. These septa were due to submucosal fibrosis and the histopathological picture appears to represent a new nosological entity.
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Affiliation(s)
- I Bjarnason
- Section of Gastroenterology, Medical Research Centre, Harrow, Middlesex, United Kingdom
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23
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Bjarnason I, Zanelli G, Prouse P, Smethurst P, Smith T, Levi S, Gumpel MJ, Levi AJ. Blood and protein loss via small-intestinal inflammation induced by non-steroidal anti-inflammatory drugs. Lancet 1987; 2:711-4. [PMID: 2888943 DOI: 10.1016/s0140-6736(87)91075-0] [Citation(s) in RCA: 159] [Impact Index Per Article: 4.3] [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: 01/03/2023]
Abstract
Nearly three-quarters of patients on long-term treatment with non-steroidal anti-inflammatory drugs (NSAIDs) have small-intestinal inflammation, the consequences of which are largely unknown. Two potentially important complications, blood and protein loss from the small intestine, have been studied. 49 patients on NSAIDs underwent study with an indium-111 labelled leucocyte technique which localises and measures intestinal inflammation. 32 patients underwent simultaneous study with technetium-99m labelled red blood cells (RBC), which showed identical sites of localisation to 111In-leucocytes in 19. Intestinal blood loss was measured in 8 patients by use of chromium-51 labelled RBC, and a significant correlation between blood loss and intestinal inflammation was found. Intestinal protein loss was assessed in 9 patients with 51Cr-labelled proteins; patients with NSAID-induced small-intestinal inflammation were found to have a protein-losing enteropathy. These studies show that small intestinal inflammation caused by NSAIDs is associated with blood and protein loss, both of which may contribute to the general ill-health of rheumatic patients.
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Affiliation(s)
- I Bjarnason
- Section of Gastroenterology, MRC Clinical Research Centre, Harrow, Middlesex
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Bjarnason I, Zanelli G, Smith T, Prouse P, Williams P, Smethurst P, Delacey G, Gumpel MJ, Levi AJ. Nonsteroidal antiinflammatory drug-induced intestinal inflammation in humans. Gastroenterology 1987; 93:480-9. [PMID: 3609658 DOI: 10.1016/0016-5085(87)90909-7] [Citation(s) in RCA: 277] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This study examines the effects of nonsteroidal antiinflammatory drugs on the small intestine in humans. Using an 111In-leukocyte technique in patients with rheumatoid arthritis (n = 90) and osteoarthritis (n = 7), it appears that nonsteroidal antiinflammatory drugs cause small intestinal inflammation in two-thirds of patients on long-term treatment and on discontinuation, the inflammation may persist for up to 16 mo. The prevalence and magnitude of the intestinal inflammation was unrelated to the type and dose of nonsteroidal drugs and previous or concomitant second-line drug treatment. There was a significant inverse correlation (r = -0.29, p less than 0.05) between fecal 111In excretion and hemoglobin levels in patients treated with nonsteroidal antiinflammatory drugs. The kinetics of fecal indium 111 excretion in patients treated with nonsteroidal antiinflammatory drugs was almost identical to that of patients with small bowel Crohn's disease. Eighteen patients on nonsteroidal antiinflammatory drugs underwent a radiologic examination of the small bowel and 3 were found to have asymptomatic ileal disease with ulceration and strictures. Nineteen patients on nonsteroidal antiinflammatory drugs, 20 healthy controls, and 13 patients with Crohn's ileitis underwent a dual radioisotopic ileal function test with tauro 23 (75Se) selena-25-homocholic acid and cobalt 58-labeled cyanocobalamine. On day 4, more than half of the patients with rheumatoid arthritis had evidence of bile acid malabsorption, but the ileal dysfunction was much milder than seen in patients with Crohn's ileitis.
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25
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26
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Bjarnason I, Zanelli G, Smith T, Smethurst P, Price AB, Gumpel MJ, Levi AJ. The pathogenesis and consequence of non steroidal anti-inflammatory drug induced small intestinal inflammation in man. Scand J Rheumatol Suppl 1987; 64:55-62. [PMID: 3324305 DOI: 10.3109/03009748709096722] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Non steroidal anti-inflammatory drugs (NSAID's) have recently been shown to cause small intestinal inflammation in the majority of patients receiving these on a regular basis for more than one year. The development of inflammation is preceded by an NSAID effect to increase small intestinal permeability. Increased intestinal permeability is shown to be related to drug potency to inhibit cyclooxygenase and the effect is systemically mediated rather than a local irritant one. More recently, increased intestinal permeability due to NSAID's has been reduced by concomitant prostaglandin administration, showing that prostaglandins are essential for maintaining intestinal integrity in man. It is proposed that altered intestinal permeability allows the mucosa to be exposed to bacterial degradation products or other toxins and together with reduced chemotaxic response and altered neutrophil function due to NSAID's, this series of events leads to bacterial invasion of the mucosa which is evident by the techniques of 111Indium leucocyte scans and faecal collections. The consequence of such inflammation is that it may explain intestinal perforations and strictures which are occasionally seen in subjects on NSAID's. Most patients with NSAID-induced small intestinal inflammation may be bleeding from the intestine, loosing protein and some have ileal dysfunction. The small intestine may be a greater source of morbidity than the stomach, in patients receiving NSAID's.
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Affiliation(s)
- I Bjarnason
- Section of Gastroenterology, MRC Clinical Research Centre, Harrow, Middlesex, England
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27
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Amerio A, Giudici Cipriani A, Cananzi C, Zanelli G, Zinicola N. [Surgical treatment of the ascitic patient using LeVeen peritoneojugular shunt. Personal case reports]. MINERVA CHIR 1986; 41:125-33. [PMID: 3515230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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28
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Abstract
The suggestion that the intestinal mucosa may be abnormally permeable and thus a site of antigen absorption in rheumatoid arthritis was tested by a 51Cr EDTA intestinal permeability test. Twelve patients with rheumatoid arthritis untreated by non-steroidal anti-inflammatory drugs (NSAIDs) had normal test results, while 12 NSAID-treated patients had increased intestinal permeability. Ten volunteers ingested aspirin, ibuprofen and indomethacin 8 and 1 hours before the study. The increased intestinal permeability was proportional to drug potency to inhibit cyclo-oxygenase. Intestinal permeability also increased following an indomethacin suppository, which suggests that the effect is systemically mediated. 111Indium leucocyte scintigrams and faecal collection showed no evidence of intestinal inflammation in 9 patients untreated by NSAIDs. Twenty-nine of 53 NSAID-treated patients showed abnormal localisation of 111indium in the right iliac fossa at 20 hours, and 32 of 49 patients had increased faecal excretion of 111indium. A 99mTc-porphyrin scan suggested that the main site of NSAID-induced intestinal inflammation was the small bowel. NSAIDs are thus shown to disrupt intestinal integrity and long term treatment leads to inflammation of the small intestine.
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29
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Zanelli G, Banchini E, Villani LG. [Obliterating arteriopathy of the lower extremities in young adults: reflexions and considerations on some epidemiological, clinical, angiographic and therapeutic aspects]. Acta Biomed Ateneo Parmense 1983; 54:163-167. [PMID: 6225284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The authors report their experience about juvenile arteriopathy and analysing their cases (42). They discuss about the character of a real nosologic entity of this pathology. The clinical symptoms, the arteriographic pictures and particularly the pathologic lesions verified in this study aren't different from these that are found in the chronic atherosclerotic arteriopathies.
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30
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Zinicola N, Zanelli G, Patrone P, Cerruti R, Bonelli U, Baglietto F. [Recent vascular injuries of the extremities. Personal experience in several cases]. MINERVA CHIR 1982; 37:1885-92. [PMID: 7177443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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31
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Zanelli G, Patrone P, Cerruti R, Bonelli U, Baglietto F, Zinicola N. [Renal artery aneurysm. Review of the literature and personal experience]. Minerva Urol 1982; 34:307-312. [PMID: 6762498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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32
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Zinicola N, Zanelli G, Cerruti R. [Traumatic arterial spasm. Reflections on several personal cases]. MINERVA CHIR 1978; 33:1719-26. [PMID: 740258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Four personal cases and the treatment adopted are described. The incidence of this event is discussed. Attention is drawn to what is felt to be the most suitable treatment of traumatic ischaemia with a possibility of underlying spasm at in the light of the existing knowledge.
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33
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Patrone P, Zanelli G, Cerruti R. [Angiographic images of liver cirrhosis]. Minerva Dietol Gastroenterol 1978; 24:299-304. [PMID: 757271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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34
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Zinicola N, Zanelli G, Ferrero S, Patrone P, Picetti C. [Indications and possibilities of the preoperative arteriography: use in the peripheral arterial surgery]. Angiologia 1975; 27:262-71. [PMID: 1190556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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35
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Zanelli G, Ferrero S, Patrone P. [Agenesia of the gallbladder and the cystic duct. Apropos of 2 personal cases]. MINERVA CHIR 1975; 30:539-41. [PMID: 1178127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
After a survey of the literature on gall bladder and cystic duct agenesia, two personally observed cases are described. Stress is laid on the aetiopathogenesis, physiopathology and clinical aspects of the malformation.
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36
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Zanelli G, Patrone P, Ferrero S. [Morbidity and mortality in major amputations of the limbs for obliterating arteriopathy. Observations on 202 cases]. MINERVA CHIR 1974; 29:1083-8. [PMID: 4437778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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37
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Zanelli G, Ferrero S. [Proteolytic enzymes in the management of some morbid forms of angiological interest]. Minerva Cardioangiol 1974; 22:379-82. [PMID: 4465746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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38
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Zanelli G, Ferrero S, Zinicola N. [Plethysmographic modifications during the dumping syndrome before and after antiserotonin treatment]. MINERVA CHIR 1973; 28:1122-6. [PMID: 4125592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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39
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Zinicola N, Zanelli G, Ferrero S. [Accidental complete severance of the femoral vein during saphectomy]. Minerva Cardioangiol 1972; 20:632-5. [PMID: 4566129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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40
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Zanelli G, Ferrero S, Patrone P. [Taurine in the therapy of obliterating arteriopathy of the lower extremities. I. Clinical results in various evolutive phases]. Minerva Cardioangiol 1971; 19:605-15. [PMID: 5128422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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41
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Zanelli G, Quaglia A, Zino P. [Taurine in the therapy of obliterating arteriopathy of the lower extremities. II. Hemoximetric changes in various evolutive stages]. Minerva Cardioangiol 1971; 19:616-9. [PMID: 5128423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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