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De Mase A, Spina E, Servillo G, Barbato S, Leone G, Giordano F, Muto M, Guarnieri G, Alfieri G, Longo K, Di Iorio W, Muto M, Candelaresi P, Andreone V. Effects of immediate thrombolytic treatment in imaging area on functional outcome in patients with acute ischemic stroke. Neurol Sci 2024; 45:1557-1563. [PMID: 37926747 DOI: 10.1007/s10072-023-07166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Door-to-needle time (DNT) is an established predictor of outcome in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT). Several strategies have been proposed to streamline in-hospital pathways, among which treatment at CT/MR bed. AIM To explore the impact of treatment at CT/MR bed, here defined as imaging area (IA), on functional outcome in stroke patients treated with IVT alone. METHODS All AIS patients treated with IVT alone at our center in 2020, 2021, and 2022 were included. Patients with any previous disability were excluded. The cohort was divided into two groups, depending on the treatment site. One group received IVT at IA, the other at emergency room or stroke unit (non-IA). Regression analysis assessed the association between treatment site and 3-month outcome. RESULTS A total of 327 patients who received IVT alone were included in the analysis. One hundred thirty-three (40.7%) were in the IA group and 194 (59.3%) in the non-IA group. The groups showed similar baseline characteristics. In the IA group, DNT was 45 min shorter. Despite similar rates of functional independence (mRS 0-2), the IA group showed higher rates of excellent outcome (mRS 0-1) compared to the non-IA group (60.1% vs 42.8%, p<0.01). Immediate treatment at IA was independently associated to excellent outcome (OR 1.78 [1.03-3.08]). CONCLUSIONS Thrombolytic treatment at IA lowers DNT and is an independent predictor of excellent outcome after AIS. Our study emphasizes the importance of immediate thrombolytic treatment at IA, soon after radiological eligibility is confirmed. Immediate treatment at IA should be a standard-of-care for AIS.
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Affiliation(s)
- Antonio De Mase
- Neurology and Stroke Unit, A.O.R.N. Cardarelli, Via Cardarelli 9, 80131, Napoli, Italy
| | - Emanuele Spina
- Neurology and Stroke Unit, A.O.R.N. Cardarelli, Via Cardarelli 9, 80131, Napoli, Italy
| | - Giovanna Servillo
- Neurology and Stroke Unit, A.O.R.N. Cardarelli, Via Cardarelli 9, 80131, Napoli, Italy
| | - Stefano Barbato
- Neurology and Stroke Unit, A.O.R.N. Cardarelli, Via Cardarelli 9, 80131, Napoli, Italy
| | - Giuseppe Leone
- Diagnostic and Interventional Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy
| | - Flavio Giordano
- Diagnostic and Interventional Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy
| | - Massimo Muto
- Diagnostic and Interventional Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy
| | - Gianluigi Guarnieri
- Diagnostic and Interventional Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy
| | - Gennaro Alfieri
- Neurology and Stroke Unit, A.O.R.N. Cardarelli, Via Cardarelli 9, 80131, Napoli, Italy
| | - Katia Longo
- Neurology and Stroke Unit, A.O.R.N. Cardarelli, Via Cardarelli 9, 80131, Napoli, Italy
| | - Walter Di Iorio
- Neurology and Stroke Unit, A.O.R.N. Cardarelli, Via Cardarelli 9, 80131, Napoli, Italy
| | - Mario Muto
- Diagnostic and Interventional Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy
| | - Paolo Candelaresi
- Neurology and Stroke Unit, A.O.R.N. Cardarelli, Via Cardarelli 9, 80131, Napoli, Italy.
| | - Vincenzo Andreone
- Neurology and Stroke Unit, A.O.R.N. Cardarelli, Via Cardarelli 9, 80131, Napoli, Italy
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Gragnano E, Opancina V, Muto G, Giordano F, Guarnieri G, Hirsch J, Della Gata L, Piovan E, Muto M. Treatment of Spinal Aneurysmal Bone Cyst with Percutaneous Injection of Hydroxyapatite Osteoconductive Cement. Cardiovasc Intervent Radiol 2023; 46:1726-1731. [PMID: 37978064 DOI: 10.1007/s00270-023-03606-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE The aim of this study was to evaluate treatment efficacy of percutaneous injection of hydroxyapatite-osteoconductive-cement in patients with spinal aneurysmal bone cysts. MATERIALS AND METHODS The study was designed as a retrospective observational clinical study. We included patients who were diagnosed with of spinal aneurysmal bone cyst, at our institution between 2013 and 2020, and treated with percutaneous injection of osteoconductive cement: "Cerament"® (BONESUPPORT AB, Lund, Sweden). Typical clinical and radiological features of the ABCs treatment and follow-up were investigated. RESULTS Our study included nine patients, two children and seven adults. Three different types of approaches were applied: (single pedicle approach in 3 patients; double pedicle approach in 2 patients; while in the remaining cases, a multiple access approach was used. VAS score decreased from 8.5 ± 0.5 before treatment to 4.1 ± 0.9 at 6-months-follow up. All of the patients reacted well to treatment, with none neurological complications, complete loss of pain and achieved osteosclerosis as radiological marker of treatment success. CONCLUSION Treatment of symptomatic spinal ABC's with hydroxyapatite cement is effective to achieve complete pain reduction and sclerosis.
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Affiliation(s)
- Eduardo Gragnano
- Faculty of Medicine, The University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Valentina Opancina
- Diagnostic and Interventional Neuroradiology Unit, A.O.R.N. Cardarelli, Naples, Italy.
- Department of Radiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
| | - Gianluca Muto
- Service de Radiologie, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland
| | - Flavio Giordano
- Diagnostic and Interventional Neuroradiology Unit, A.O.R.N. Cardarelli, Naples, Italy
| | - Gianluigi Guarnieri
- Diagnostic and Interventional Neuroradiology Unit, A.O.R.N. Cardarelli, Naples, Italy
| | - Joshua Hirsch
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Luigi Della Gata
- Diagnostic and Interventional Neuroradiology Unit, A.O.R.N. Cardarelli, Naples, Italy
| | - Enrico Piovan
- U.O.C. of Neuroradiology, Department of Health Services, Carlo Poma Hospital, ASST-Mantova, Mantua, Italy
| | - Mario Muto
- Diagnostic and Interventional Neuroradiology Unit, A.O.R.N. Cardarelli, Naples, Italy
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Di Donna A, Muto G, Giordano F, Muto M, Guarnieri G, Servillo G, De Mase A, Spina E, Leone G. Diagnosis and management of tandem occlusion in acute ischemic stroke. Eur J Radiol Open 2023; 11:100513. [PMID: 37609048 PMCID: PMC10440394 DOI: 10.1016/j.ejro.2023.100513] [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: 06/05/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
Approximately 20-30% of patients with acute ischemic stroke, caused by large intracranial vessel occlusion, have a tandem lesion, defined as simultaneous presence of high-grade stenosis or occlusion of the cervical internal carotid artery and thromboembolic occlusion of the intracranial terminal internal carotid artery or its branches, usually the middle cerebral artery. Patients with tandem lesions have usually worse outcomes than patients with single intracranial occlusions, and intravenous thrombolysis is less effective in these patients. Although endovascular thrombectomy is currently a cornerstone therapy in the management of acute ischemic stroke due to large vessel occlusion, the optimal management of extracranial carotid lesions in tandem occlusion remains controversial. Acute placement of a stent in the cervical carotid artery lesion is the most used therapeutic strategy compared with stented balloon angioplasty and thrombectomy alone without carotid artery revascularization; however, treatment strategies in these patients are often more complex than with single occlusion, so treatment decisions can change based on clinical and technical considerations. The aim of this review is to analyze the results of different studies and trials, investigating the periprocedural neurointerventional management of patients with tandem lesions and the safety, efficacy of the different technical strategies available as well as their impact on the clinical outcome in these patients, to strengthen current recommendations and thus optimize patient care.
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Affiliation(s)
- Antonio Di Donna
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Via Cardarelli 1, Naples 80131, Italy
| | - Gianluca Muto
- Division of Diagnostic and Interventional Neuroradiology, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Flavio Giordano
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Via Cardarelli 1, Naples 80131, Italy
| | - Massimo Muto
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Via Cardarelli 1, Naples 80131, Italy
| | - Gianluigi Guarnieri
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Via Cardarelli 1, Naples 80131, Italy
| | - Giovanna Servillo
- Unit of Neurorology and Stroke Unit, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Via Cardarelli 1, Naples 80131, Italy
| | - Antonio De Mase
- Unit of Neurorology and Stroke Unit, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Via Cardarelli 1, Naples 80131, Italy
| | - Emanuele Spina
- Unit of Neurorology and Stroke Unit, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Via Cardarelli 1, Naples 80131, Italy
| | - Giuseppe Leone
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Via Cardarelli 1, Naples 80131, Italy
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Giraudo C, Guarnieri G, Molena B, Caminati M, Stramare R, Vianello A. The lung-protective effect of prior mRNA vaccination on breakthrough COVID-19 patients receiving high flow nasal oxygen for hypoxemic acute respiratory failure. Pulmonology 2023; 29:421-423. [PMID: 35963831 PMCID: PMC9304153 DOI: 10.1016/j.pulmoe.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- C Giraudo
- Department of Medicine DIMED, University of Padova, Padova, Italy
| | - G Guarnieri
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - B Molena
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - M Caminati
- Department of Medicine, University of Verona
| | - R Stramare
- Department of Medicine DIMED, University of Padova, Padova, Italy
| | - A Vianello
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
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Mase AD, Candelaresi P, Spina E, Giordano F, Barbato S, Servillo G, Prestipino E, Fasolino A, Guarnieri G, Leone G, Muto M, Muto M, Andreone V. Intra-Arterial Thrombolysis to Improve Final Thrombolysis in Cerebral Infarction Score after Thrombectomy: A Case-Series Analysis. Neurointervention 2023:neuroint.2023.00052. [PMID: 37068868 DOI: 10.5469/neuroint.2023.00052] [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: 01/28/2023] [Accepted: 03/19/2023] [Indexed: 04/19/2023] Open
Abstract
Endovascular thrombectomy is the standard treatment in selected patients with acute ischemic stroke and large vessel occlusion, but continuous improvement in angiographic and clinical outcome is still needed. Intra-arterial thrombolysis has been tested as a possible rescue tool in unsuccessful thrombectomy, or as an adjuvant therapy after the endovascular procedure, to pursue complete recanalization. Here we present a case series analysis of intra-arterial alteplase administration (5 mg bolus, repeated up to 15 mg if Thrombolysis in Cerebral Infarction (TICI) scale ≥2c is not achieved) in 15 consecutive anterior circulation stroke patients after unsuccessful thrombectomy, defined as TICI score ≤2b after at least 3 passes or if unsuitable for further endovascular attempts, with the aim of improving recanalization. An improvement of final TICI score was achieved in 10 of 15 patients (66.7%). TICI score ≥2c was achieved after 5 mg intra-arterial tissue plasminogen activator (iaTPA) in 4 patients, and after 10 mg iaTPA in 5 cases. Six of 15 patients received 15 mg iaTPA: 1 of 6 showed angiographical improvement. A major effect of intra-arterial alteplase was observed for distally migrated emboli. None of the patients experienced any symptomatic hemorrhagic transformation or other major bleeding. Our report shows, in a very small cohort, a high rate of final TICI score improvement, encouraging the development of randomized controlled trials of rescue intra-arterial thrombolysis in patients with suboptimal angiographic results after mechanical thrombectomy.
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Affiliation(s)
- Antonio De Mase
- Neurology and Stroke Unit, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Paolo Candelaresi
- Neurology and Stroke Unit, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Emanuele Spina
- Neurology and Stroke Unit, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Flavio Giordano
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
| | - Stefano Barbato
- Neurology and Stroke Unit, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Giovanna Servillo
- Neurology and Stroke Unit, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Elio Prestipino
- Neurology and Stroke Unit, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Alessandra Fasolino
- Neurology and Stroke Unit, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Gianluigi Guarnieri
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
| | - Giuseppe Leone
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
| | - Massimo Muto
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
| | - Mario Muto
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
| | - Vincenzo Andreone
- Neurology and Stroke Unit, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
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Gortan Cappellari G, Semolic A, Zanetti M, Vinci P, Cremasco G, Ius M, Bruckbauer M, Guarnieri G, Busetto L, Donini L, Barazzoni R. ESPEN-EASO Algorythm For Diagnosis Of Sarcopenic Obesity (SO) In Older Adults. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.183] [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: 03/28/2023]
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Guarnieri G, Chiurato L, Baiardini I, Caminati M, Senna G, Scarpa B, Vianello A. A hierarchical cluster analysis of the psycological impact of the COVID-19 pandemic on Italian severe asthma patients. J Asthma 2023:1-7. [PMID: 36951668 DOI: 10.1080/02770903.2023.2188565] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
INTRODUCTION In the context of COVID-19 pandemic a consistent medical concern raised among severe asthma patients though the studies excluded an increased risk of severe disease as well as an increased susceptibility.The aim of the study was to apply the Psychological General Well-Being Index (PGWBI) questionnaire to severe asthmatics during the COVID-19 pandemic and to evaluate data with a hierarchical cluster analysis. METHODS 114 severe asthmatics were asked to respond anonymously to the PGWBI questionnaire. The patients underwent lung functional test, fractional exhaled nitric oxide (FeNO) measurement, Asthma Control Test (ACT) and Asthma Control Questionnaire (ACQ6). A hierarchical cluster analysis was performed using an agglomerative approach and complete linkage to evaluate the results. RESULTS The study population predominantly included female (60%), middle-aged patients, with normal lung function parameters, mild signs of airway and satisfactory asthma control. The PGWBI score (82.46 ± 16.53) of the study population showed a good state of psychological well-being and was similar to that of a representative sample of healthy adult Italian subjects. Thus Hierarchical cluster analysis identified 3 groups of patients: Cluster 1 (32%), Cluster 2 (64%), and Cluster 3 (4%). Whilst the Cluster 2 patients' PGWBI score fell within the normal range, the Cluster 1 patients had a significantly lower total score (68.57 ± 7.2; p < 0.05), suggesting moderate distress. The Cluster 3 patients presented a total score markedly low.Conclusion Although the majority of the severe asthma patients studied demonstrated good mental well-being during the COVID-19 pandemic, some did indeed show moderate to severe psychological distress.
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Affiliation(s)
- G Guarnieri
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health University of Padova, Respiratory Pathophysiology Division, Padova, Italy
| | - L Chiurato
- Department of Statistical Sciences and Department of Mathematics Tullio Levi-Civita, University of Padova, Padova, Italy
| | - I Baiardini
- Allergy & Respiratory Diseases Department, Azienda Ospedaliera Universitaria IRCCS San Martino, Genoa, Italy
| | - M Caminati
- Department of Medicine, University of Verona and Verona University Hospital, Verona, Italy
| | - G Senna
- Department of Medicine, University of Verona and Verona University Hospital, Verona, Italy
- Allergy Unit and Asthma Center, Verona University Hospital, Verona, Italy
| | - B Scarpa
- Department of Statistical Sciences and Department of Mathematics Tullio Levi-Civita, University of Padova, Padova, Italy
| | - A Vianello
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health University of Padova, Respiratory Pathophysiology Division, Padova, Italy
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Leone G, Muto M, Giordano F, Guarnieri G, Donna AD, Russo C, Romano DG, Candelaresi P, Servillo G, Spina E, Mase AD, Andreone V, Muto M. Initial Experience Using the New pHLO 0.072-inch Large-Bore Catheter for Direct Aspiration Thrombectomy in Acute Ischemic Stroke. Neurointervention 2023; 18:30-37. [PMID: 36792060 PMCID: PMC9986350 DOI: 10.5469/neuroint.2022.00479] [Citation(s) in RCA: 1] [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: 12/24/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
PURPOSE A direct aspiration, first pass technique (ADAPT) has been introduced as a rapid and safe thrombectomy strategy in patients with intracranial large vessel occlusion (LVO). The aim of the study is to determine the technical feasibility, safety, and functional outcome of ADAPT using the newly released large bore pHLO 0.072-inch aspiration catheter (AC; Phenox). MATERIALS AND METHODS We performed a retrospective analysis of data collected prospectively (October 2019-November 2021) from 2 comprehensive stroke centers. Accessibility of the thrombus, vascular recanalization, time to recanalization, and procedure-related complications were evaluated. National Institutes of Health stroke scale scores at presentation and discharge and the modified Rankin scale (mRS) score at 90 days post-procedure were recorded. RESULTS Twenty-five patients (14 female, 11 male) with occlusions of the anterior circulation were treated. In 84% of cases, ADAPT led to successful recanalization with a median procedure time of 28 minutes. In the remaining cases, successful recanalization required (to a total of 96%; modified thrombolysis in cerebral infarction score 2b/3) the use of stent retrievers. No AC-related complications were reported. Other complications included distal migration of the thrombus, requiring a stent-retriever, and symptomatic PH2 hemorrhage in 16% and 4%, respectively. After 3 months, 52% of the patients had mRS scores of 0-2 with an overall mortality rate of 20%. CONCLUSION Results from our retrospective case series revealed that thrombectomy of LVOs with pHLO AC is safe and effective in cases of large-vessel ischemic stroke. Rates of complete or near-complete recanalization after the first pass with this method might be used as a new benchmark in future trials.
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Affiliation(s)
- Giuseppe Leone
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
| | - Massimo Muto
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
| | - Flavio Giordano
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
| | - Gianluigi Guarnieri
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
| | - Antonio Di Donna
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
| | - Camilla Russo
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
| | - Daniele Giuseppe Romano
- Unit of Neuroradiology, AOU San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy
| | - Paolo Candelaresi
- Unit of Neurology and Stroke, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Giovanna Servillo
- Unit of Neurology and Stroke, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Emanuele Spina
- Unit of Neurology and Stroke, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Antonio De Mase
- Unit of Neurology and Stroke, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Vincenzo Andreone
- Unit of Neurology and Stroke, Department of Emergency and Acceptance, A.O.R.N. Antonio Cardarelli Hospital, Naples, Italy
| | - Mario Muto
- Unit of Interventional Neuroradiology, Department of Advanced Diagnostic and Therapeutic Technologies, A.O.R.N. Antonio Cardarelli Hospital, Napoli, Italy
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Guarnieri G, Molena B, Chieco Bianchi F, Vianello A. Biologics and anti-Sars Cov2 vaccination in severe asthma riding the big wave: Unity is strength! Pulmonology 2022:S2531-0437(22)00128-3. [PMID: 35798641 PMCID: PMC9181274 DOI: 10.1016/j.pulmoe.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- G Guarnieri
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health University of Padova, Respiratory Pathophysiology Unit, Padova, Italy.
| | - B Molena
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health University of Padova, Respiratory Pathophysiology Unit, Padova, Italy
| | - F Chieco Bianchi
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health University of Padova, Respiratory Pathophysiology Unit, Padova, Italy
| | - A Vianello
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health University of Padova, Respiratory Pathophysiology Unit, Padova, Italy
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Cellai I, Filippi S, Comeglio P, Cipriani S, Maseroli E, Di Stasi V, Todisco T, Marchiani S, Tamburrino L, Villanelli F, Vezzani S, Corno C, Fambrini M, Guarnieri G, Sarchielli E, Morelli A, Rastrelli G, Maggi M, Vignozzi L. Testosterone positively regulates vagina NO-induced relaxation: an experimental study in rats. J Endocrinol Invest 2022; 45:1161-1172. [PMID: 35072927 PMCID: PMC9098587 DOI: 10.1007/s40618-022-01743-4] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/01/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Female sexual response involves a complex interplay between neurophysiological mechanisms and the nitric oxide (NO)-mediated relaxation of clitoris and vagina. The aim of this study was to evaluate sex steroids regulation of the relaxant pathway in vagina, using a validated animal model. METHODS Subgroups of OVX Sprague-Dawley rats were treated with 17β-estradiol, testosterone, or testosterone and letrozole, and compared with a group of intact animals. Masson's trichrome staining was performed for morphological evaluation of the distal vaginal wall, in vitro contractility studies investigated the effect of OVX and in vivo treatments on vaginal smooth muscle activity. RNA from vaginal tissue was analyzed by semi-quantitative RT-PCR. RESULTS Immunohistochemical analysis showed that OVX induced epithelial and smooth muscle structural atrophy, testosterone and testo + letrozole increased the muscle bundles content and organization without affecting the epithelium while 17β-estradiol mediated the opposite effects. In vitro contractility studies were performed on noradrenaline pre-contracted vaginal strips from each experimental group. Acetylcholine (0.001-10 µM) stimulation induced a concentration-dependent relaxation, significantly reduced by NO-synthase inhibitor L-NAME and by guanylate cyclase inhibitor ODQ. OVX resulted in a decreased responsiveness to acetylcholine, restored by testosterone, with or without letrozole, but not by 17β-estradiol. OVX sensitivity to the NO-donor SNP was higher than in the control. Vardenafil, a PDE5 inhibitor, enhanced SNP effect in OVX + testosterone as well as in control, as supported by RNA expression analysis. CONCLUSIONS Our study demonstrates that testosterone improves the NO-mediated smooth muscle vaginal cells relaxation confirming its role in maintaining the integrity of muscular relaxant machinery.
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Affiliation(s)
- I Cellai
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - S Filippi
- Interdepartmental Laboratory of Functional and Cellular Pharmacology of Reproduction, Department of Neurosciences, Drug Research and Child Health (NEUROFARBA), University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - P Comeglio
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - S Cipriani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - E Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - V Di Stasi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - T Todisco
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - S Marchiani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - L Tamburrino
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - F Villanelli
- Endocrinology Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - S Vezzani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - C Corno
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - M Fambrini
- Division of Obstetrics and Gynecology, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - G Guarnieri
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - E Sarchielli
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - A Morelli
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - M Maggi
- Endocrinology Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
- I.N.B.B. (Istituto Nazionale Biostrutture e Biosistemi), Viale delle Medaglie d'Oro 305, 00136, Rome, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy.
- I.N.B.B. (Istituto Nazionale Biostrutture e Biosistemi), Viale delle Medaglie d'Oro 305, 00136, Rome, Italy.
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11
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Guarnieri G, Achille A, Lococo S, Vianello A. Pregnancy in Alpha 1 Antitrypsin (AAT) Deficiency and the role of intravenous AAT therapy. Pulmonology 2022; 28:317-319. [DOI: 10.1016/j.pulmoe.2022.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/17/2022] Open
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12
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Vianello A, Guarnieri G, Lionello F. Unvaccinated COVID-19 patients in the ICU: views from both sides of the barrier. Pulmonology 2022; 28:161-163. [PMID: 35140047 PMCID: PMC8776404 DOI: 10.1016/j.pulmoe.2022.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- A Vianello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, 35122, Italy.
| | - G Guarnieri
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, 35122, Italy
| | - F Lionello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, 35122, Italy
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13
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Comeglio P, Sarchielli E, Filippi S, Cellai I, Guarnieri G, Morelli A, Rastrelli G, Maseroli E, Cipriani S, Mello T, Galli A, Bruno BJ, Kim K, Vangara K, Papangkorn K, Chidambaram N, Patel MV, Maggi M, Vignozzi L. Treatment potential of LPCN 1144 on liver health and metabolic regulation in a non-genomic, high fat diet induced NASH rabbit model. J Endocrinol Invest 2021; 44:2175-2193. [PMID: 33586025 PMCID: PMC8421272 DOI: 10.1007/s40618-021-01522-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/27/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE Low free testosterone (T) level in men is independently associated with presence and severity of Non-Alcoholic Steatohepatitis (NASH). The histological and molecular effects of oral testosterone prodrug LPCN 1144 treatment on hepatic fibrosis and NASH features are unknown. A metabolic syndrome-induced NASH model in rabbits consuming high fat diet (HFD) has been previously used to assess treatment effects of injectable T on hepatic fibrosis and NASH features. Here we present results on LPCN 1144 in this HFD-induced, NASH preclinical model. METHODS Male rabbits were randomly assigned to five groups: regular diet (RD), HFD, HFD + 1144 vehicle (HFD + Veh), HFD + 1144 (1144), and HFD + 1144 + α-tocopherol (1144 + ALPHA). Rabbits were sacrificed after 12 weeks for liver histological, biochemical and genetic analyses. Histological scores were obtained through Giemsa (inflammation), Masson's trichrome (steatosis and ballooning), and Picrosirius Red (fibrosis) staining. RESULTS Compared to RD, HFD and HFD + Veh significantly worsened NASH features and hepatic fibrosis. Considering HFD and HFD + Veh arms, histological and biomarker features were not significantly different. Both 1144 and 1144 + ALPHA arms improved mean histological scores of NASH as compared to HFD arm. Importantly, percentage of fibrosis was improved in both 1144 (p < 0.05) and 1144 + ALPHA (p = 0.05) treatment arms vs. HFD. Both treatment arms also reduced HFD-induced inflammation and fibrosis mRNA markers. Furthermore, 1144 treatments significantly improved HFD-induced metabolic dysfunctions. CONCLUSIONS Histological and biomarker analyses demonstrate that LPCN 1144 improved HFD-induced hepatic fibrosis and NASH biochemical, biomolecular and histochemical features. These preclinical findings support a therapeutic potential of LPCN 1144 in the treatment of NASH and of hepatic fibrosis.
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Affiliation(s)
- P Comeglio
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - E Sarchielli
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - S Filippi
- Interdepartmental Laboratory of Functional and Cellular Pharmacology of Reproduction, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - I Cellai
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - G Guarnieri
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - A Morelli
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - E Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - S Cipriani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - T Mello
- Gastroenterology Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - A Galli
- Gastroenterology Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - B J Bruno
- Lipocine Inc., Salt Lake City, Utah, 84088, USA
| | - K Kim
- Lipocine Inc., Salt Lake City, Utah, 84088, USA
| | - K Vangara
- Lipocine Inc., Salt Lake City, Utah, 84088, USA
| | | | | | - M V Patel
- Lipocine Inc., Salt Lake City, Utah, 84088, USA
| | - M Maggi
- Endocrinology Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
- I.N.B.B. (Istituto Nazionale Biostrutture E Biosistemi), Rome, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy.
- I.N.B.B. (Istituto Nazionale Biostrutture E Biosistemi), Rome, Italy.
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14
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Mason P, Liviero F, Crivellaro M, Maculan P, Maestrelli P, Guarnieri G. Cutaneous sensitization to aziridine preceding the onset of occupational asthma. Occup Med (Lond) 2021; 70:135-138. [PMID: 32002545 DOI: 10.1093/occmed/kqz154] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We describe a 47-year-old non-atopic woman, working as a spray painter in a tannery for 23 years, with a 16-year history of cutaneous symptoms and a subsequent 2-year history of asthmatic symptoms after exposure to aerosol and vapour of polyfunctional aziridine (PFA) at work. To confirm the occupational origin of the dermatitis and asthma we performed a skin prick test with PFA and a specific inhalation challenge (SIC) with PFA. Prick test with PFA elicited an immediate positive skin reaction. She developed an immediate asthmatic reaction upon SIC with PFA. The onset of occupational dermatitis before asthma is consistent with the hypothesis that the sensitization to PFA was triggered in the skin. The observation that the reactions elicited in skin and airways upon exposure to PFA exhibited the same time course, suggests a similar mechanism at both sites. Thus, the avoidance of both skin and airway exposure to PFA should be recommended in workplace hygiene practice.
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Affiliation(s)
- P Mason
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - F Liviero
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - M Crivellaro
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - P Maculan
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - P Maestrelli
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - G Guarnieri
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy
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15
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Francica G, Binder FC, Guarnieri G, Mitchison MT, Goold J, Plastina F. Quantum Coherence and Ergotropy. Phys Rev Lett 2020; 125:180603. [PMID: 33196219 DOI: 10.1103/physrevlett.125.180603] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/13/2020] [Accepted: 09/22/2020] [Indexed: 06/11/2023]
Abstract
Constraints on work extraction are fundamental to our operational understanding of the thermodynamics of both classical and quantum systems. In the quantum setting, finite-time control operations typically generate coherence in the instantaneous energy eigenbasis of the dynamical system. Thermodynamic cycles can, in principle, be designed to extract work from this nonequilibrium resource. Here, we isolate and study the quantum coherent component to the work yield in such protocols. Specifically, we identify a coherent contribution to the ergotropy (the maximum amount of unitarily extractable work via cyclical variation of Hamiltonian parameters). We show this by dividing the optimal transformation into an incoherent operation and a coherence extraction cycle. We obtain bounds for both the coherent and incoherent parts of the extractable work and discuss their saturation in specific settings. Our results are illustrated with several examples, including finite-dimensional systems and bosonic Gaussian states that describe recent experiments on quantum heat engines with a quantized load.
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Affiliation(s)
- G Francica
- CNR-SPIN, I-84084 Fisciano (Salerno), Italy
| | - F C Binder
- Institute for Quantum Optics and Quantum Information-IQOQI Vienna, Austrian Academy of Sciences, Boltzmanngasse 3, 1090 Vienna, Austria
| | - G Guarnieri
- School of Physics, Trinity College Dublin, Dublin 2, Ireland
| | - M T Mitchison
- School of Physics, Trinity College Dublin, Dublin 2, Ireland
| | - J Goold
- School of Physics, Trinity College Dublin, Dublin 2, Ireland
| | - F Plastina
- Dipartimento di Fisica, Università della Calabria, 87036 Arcavacata di Rende (CS), Italy
- INFN-Gruppo Collegato di Cosenza
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16
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Guarnieri G, Ranieri F, Lipartiti T, Spangaro F, Giuntini D, Faccini L, Toigo G, Legnani F, Raimondi A, Campanacci L. Protein-calorie malnutrition in hemodialysis patients. Int J Artif Organs 2020. [DOI: 10.1177/039139888000300307] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- G. Guarnieri
- Institute of Medical Pathology University of Trieste, Trieste, Italy
| | - F. Ranieri
- Institute of Medical Pathology University of Trieste, Trieste, Italy
| | - T. Lipartiti
- Institute of Medical Pathology University of Trieste, Trieste, Italy
| | - F. Spangaro
- Institute of Medical Pathology University of Trieste, Trieste, Italy
| | - D. Giuntini
- Institute of Medical Pathology University of Trieste, Trieste, Italy
| | - L. Faccini
- Institute of Medical Pathology University of Trieste, Trieste, Italy
| | - G. Toigo
- Institute of Medical Pathology University of Trieste, Trieste, Italy
| | - F. Legnani
- Institute of Medical Pathology University of Trieste, Trieste, Italy
| | - A. Raimondi
- Institute of Medical Pathology University of Trieste, Trieste, Italy
| | - L Campanacci
- Institute of Medical Pathology University of Trieste, Trieste, Italy
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17
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Ambrosanio G, Arthimulam G, Leone G, Guarnieri G, Muto M, Muto M. Bailouts During Neurointervention; Novel Techniques in Tackling Coil Migration and Premature Intravascular Detachment of Microcatheter Tip. World Neurosurg 2020; 142:167-170. [PMID: 32615295 DOI: 10.1016/j.wneu.2020.06.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Intracranial vascular malformations are increasingly being treated via the endovascular route. Though generally safe, a multitude of intraprocedural complications that potentially lead to disastrous clinical outcomes may arise. It is crucial for the operators to be well versed with the various techniques that are available to overcome any procedure-specific complications. METHODS We present 2 cases in which we encountered premature intravascular detachment of the microcatheter tip and coil migration while treating a dural arteriovenous fistula and aneurysm, respectively. We used a stentriever to remove the detached microcatheter tip and suction using the reperfusion catheter to remove the migrated coil, both techniques that have not been reported in the literature thus far. RESULTS Detached microcatheter tip and migrated coil were successfully retrieved using a stentriever and aspiration catheter. CONCLUSIONS These novel techniques could potentially reduce mortality and morbidity associated with neurointervention.
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Affiliation(s)
| | - Ganesan Arthimulam
- Department of Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy; Neurointerventional Unit, Department of Diagnostic Imaging, Kuala Lumpur General Hospital, Malaysia.
| | - Giuseppe Leone
- Department of Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy
| | | | - Massimo Muto
- Department of Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy
| | - Mario Muto
- Department of Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy
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18
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Della Gatta L, Guarnieri G, Ambrosanio G, Capobianco E, Muto M. Clinical and imaging selection for CT guided - fluoroscopy 0203 disk treatment. J BIOL REG HOMEOS AG 2020; 34:15-19. SPECIAL ISSUE: OZONE THERAPY. [PMID: 33176413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Low Back Pain (LBP) is the most common spine disease and it is the most common cause of absence from work in developed countries. At lumbar level, the natural history of herniated disc is characterized by a disappearance of clinical symptoms in up to 60% with conservative treatment through simple rest for about 6 weeks and reduction of the disk heniation revealed by CT or MR scans within eight to nine months after the onset of back pain. Surgery is considered the treatment of choice for extruded, migrated and free fragment herniated disk associated to clinical symptomatology of cono-cauda syndrome, progressive foot droop and hyperalgic radiculopathy. patients with a small or contained herniated disk, without any benefit from conservative medical treatment, can be candidates for one of minimally invasive percutaneous techniques, whose outcome, though, depends on the characteristics of hernia itself and on the chosen technique. The aim of this paper is to discuss about O2-O3 treatment for symptomatic not extruded herniated disk at lumbar level, highlighting about indication inclusion exclusion criteria and our results.
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Affiliation(s)
- L Della Gatta
- Neuroradiology Service Cardarelli Hospital, Naples, Italy
| | - G Guarnieri
- Neuroradiology Service Cardarelli Hospital, Naples, Italy
| | - G Ambrosanio
- Neuroradiology Service Cardarelli Hospital, Naples, Italy
| | - E Capobianco
- Neuroradiology Service Cardarelli Hospital, Naples, Italy
| | - M Muto
- Neuroradiology Service Cardarelli Hospital, Naples, Italy
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19
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Sarchielli E, Comeglio P, Filippi S, Cellai I, Guarnieri G, Rapizzi E, Rastrelli G, Vignozzi L, Morelli A, Maggi M. P-01-2 Is Testosterone Administration Able to Improve Physical Performance in Order to Do Physical Activity in an Experimental Model of Functional Hypogonadism? J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.154] [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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20
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Cipriani S, Maseroli E, Cellai I, Filippi S, Comeglio P, Frison M, Amoriello R, Ballerini C, Sarchielli E, Guarnieri G, Morelli A, Maggi M, Vignozzi L. HP-1-1 Anti Inflammatory Effects of Androgenic Signaling in Human Vagina: A Potential Therapeutical Application for the Genitourinary Syndrome of Menopause. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.111] [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: 10/24/2022]
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21
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Felline S, Del Coco L, Kaleb S, Guarnieri G, Fraschetti S, Terlizzi A, Fanizzi FP, Falace A. The response of the algae Fucus virsoides (Fucales, Ochrophyta) to Roundup® solution exposure: A metabolomics approach. Environ Pollut 2019; 254:112977. [PMID: 31377326 DOI: 10.1016/j.envpol.2019.112977] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/28/2019] [Accepted: 07/27/2019] [Indexed: 06/10/2023]
Abstract
Glyphosate, as a broad-spectrum herbicide, is frequently detected in water and several studies have investigated its effects on several freshwater aquatic organisms. Yet, only few investigations have been performed on marine macroalgae. Here, we studied both the metabolomics responses and the effect on primary production in the endemic brown algae Fucus virsoides exposed to different concentration (0, 0.5, 1.5 and 2.5 mg L-1) of a commercial glyphosate-based herbicide, namely Roundup®. Our results show that Roundup® significantly reduced quantum yield of photosynthesis (Fv/Fm) and caused alteration in the metabolomic profiles of exposed thalli compared to controls. Together with the decrease in the aromatic amino acids (phenylalanine and tyrosine), an increase in shikimate content was detected. The branched-amino acids differently varied according to levels of herbicide exposure, as well as observed for the content of choline, formate, glucose, malonate and fumarate. Our results suggest that marine primary producers could be largely affected by the agricultural land use, this asking for further studies addressing the ecosystem-level effects of glyphosate-based herbicides in coastal waters.
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Affiliation(s)
- S Felline
- CoNISMa, Piazzale Flaminio 9, 00196, Roma, Italy
| | - L Del Coco
- Department of Biology, Environmental Sciences and Technologies, University of Salento, 73100, Lecce, Italy
| | - S Kaleb
- Department of Life Sciences, University of Trieste, 34127, Trieste, Italy
| | - G Guarnieri
- CoNISMa, Piazzale Flaminio 9, 00196, Roma, Italy; Department of Biology, Environmental Sciences and Technologies, University of Salento, 73100, Lecce, Italy
| | - S Fraschetti
- Department of Biology, University of Naples Federico II, 80926, Napoli, Italy; Stazione Zoologica Anton Dohrn, 80121, Napoli, Italy
| | - A Terlizzi
- Department of Life Sciences, University of Trieste, 34127, Trieste, Italy; Stazione Zoologica Anton Dohrn, 80121, Napoli, Italy
| | - F P Fanizzi
- Department of Biology, Environmental Sciences and Technologies, University of Salento, 73100, Lecce, Italy.
| | - A Falace
- Department of Life Sciences, University of Trieste, 34127, Trieste, Italy
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22
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Guarnieri G, Bonadonna P, Olivieri E, Schiappoli M. Occupational Asthma Induced by Exposure to Quinoa. J Investig Allergol Clin Immunol 2019; 29:451-452. [PMID: 31283525 DOI: 10.18176/jiaci.0432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G Guarnieri
- Occupational Medicine, Department of Cardiologic, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - P Bonadonna
- Allergy Unit and Asthma Center, Hospital and University of Verona, Verona, Italy
| | - E Olivieri
- Allergy Unit and Asthma Center, Hospital and University of Verona, Verona, Italy
| | - M Schiappoli
- Allergy Unit and Asthma Center, Hospital and University of Verona, Verona, Italy
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23
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Cannizzaro R, Magris R, Fornasarig M, Pivetta E, Maiero S, Mongiat M, De Re V, Canzonieri V, De Paoli A, Turriziani V, Guarnieri G, Buonadonna A, Belluco C, Serraino D, Spessotto P. Evaluation of neoangiogenesis in locally advanced gastric cancer before and after neoadjuvant radiochemotherapy by probe confocal laser endomicroscopy (PCLE). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.292] [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: 11/14/2022] Open
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24
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Guarnieri G, Magris R, Maiero S, Fornasarig M, Belluco C, Canzonieri V, Cannizzaro R. Is FNA always necessary in submucosal lesion miming GIST? Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.322] [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: 11/15/2022] Open
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25
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Guarnieri G, Ng NHY, Modi K, Eisert J, Paternostro M, Goold J. Quantum work statistics and resource theories: Bridging the gap through Rényi divergences. Phys Rev E 2019; 99:050101. [PMID: 31212510 DOI: 10.1103/physreve.99.050101] [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] [Received: 06/13/2018] [Indexed: 06/09/2023]
Abstract
The work performed on or extracted from a nonautonomous quantum system described by means of a two-point projective-measurement approach is a stochastic variable. We show that the cumulant generating function of work can be recast in the form of quantum Rényi-α divergences, and by exploiting the convexity of this cumulant generating function, derive a single-parameter family of bounds for the first moment of work. Higher order moments of work can also be obtained from this result. In this way, we establish a link between quantum work statistics in stochastic approaches and resource theories for quantum thermodynamics, a theory in which Rényi-α divergences take a central role. To explore this connection further, we consider an extended framework involving a control switch and an auxiliary battery, which is instrumental to reconstructing the work statistics of the system. We compare and discuss our bounds on the work distribution to findings on deterministic work studied in resource-theoretic settings.
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Affiliation(s)
- G Guarnieri
- School of Physics, Trinity College Dublin, Dublin 2, Ireland
| | - N H Y Ng
- Dahlem Center for Complex Quantum Systems, Freie Universität Berlin, 14195 Berlin, Germany
| | - K Modi
- School of Physics and Astronomy, Monash University, Victoria 3800, Australia
| | - J Eisert
- Dahlem Center for Complex Quantum Systems, Freie Universität Berlin, 14195 Berlin, Germany
| | - M Paternostro
- Centre for Theoretical Atomic, Molecular and Optical Physics, Queen's University Belfast, Belfast BT7 1NN, United Kingdom
| | - J Goold
- School of Physics, Trinity College Dublin, Dublin 2, Ireland
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Filippi S, Maggi M, Sarchielli E, Comeglio P, Cellai I, Corno C, Guarnieri G, Vignozzi L, Morelli A. PO-01-049 Testosterone counteracts metabolic syndrome-related changes in skeletal muscle fiber metabolism and improves exercise performance in the rabbit. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.201] [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: 11/27/2022]
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Cappellari M, Mangiafico S, Saia V, Pracucci G, Nappini S, Nencini P, Konda D, Sallustio F, Vallone S, Zini A, Bracco S, Tassi R, Bergui M, Cerrato P, Pitrone A, Grillo F, Saletti A, De Vito A, Gasparotti R, Magoni M, Puglielli E, Casalena A, Causin F, Baracchini C, Castellan L, Malfatto L, Menozzi R, Scoditti U, Comelli C, Duc E, Comai A, Franchini E, Cosottini M, Mancuso M, Peschillo S, De Michele M, Giorgianni A, Delodovici ML, Lafe E, Denaro MF, Burdi N, Internò S, Cavasin N, Critelli A, Chiumarulo L, Petruzzellis M, Doddi M, Carolei A, Auteri W, Petrone A, Padolecchia R, Tassinari T, Pavia M, Invernizzi P, Turcato G, Forlivesi S, Ciceri EFM, Bonetti B, Inzitari D, Toni D, Limbucci N, Consoli A, Renieri L, Fainardi E, Gandini R, Pampana E, Diomedi M, Koch G, Verganti L, Sacchetti F, Zelent G, Bigliardi G, Picchetto L, Vandelli L, Romano DG, Cioni S, Gennari P, Cerase A, Martini G, Stura G, Daniele D, Naldi A, Papa R, Vinci SL, Bernava G, Velo M, Caragliano A, Tessitore A, Buonomo O, Musolino R, La Spina P, Casella C, Carolina Fazio M, Cotroneo M, Onofrio M, Azzini C, Casetta I, Mardighian D, Frigerio M, Costa A, Di Egidio V, Lattanzi R, Assetta M, Cester G, Mavilio N, Serrati C, Piazza P, Epifani E, Andreone A, Castellini P, Latte L, Grisendi I, Vaudano G, Comelli S, Cavallo R, Chianale G, Simonetti L, Taglialatela F, Isceri S, Procaccianti G, Zaniboni A, Borghi A, Bonatti G, Ferro F, Bonatti M, Dall’Ora E, Currò Dossi R, Turri E, Turri M, Puglioli M, Lazzarotti G, Lauretti D, Giannini N, Maccarone M, Orlandi G, Chiti A, Guidetti G, Biraschi F, Falcou A, Anzini A, Mancini A, Fausti S, Di Mascio MT, Durastanti L, Sbardella E, Mellina V, Baruzzi F, Pellegrino C, Terrana A, Carimati F, Ruggiero M, Sanna A, Passarin MG, Colosimo C, Pedicelli A, D’Argento F, Alexandre A, Frisullo G, Zappoli F, Martignoni A, Cavallini A, Persico A, Valvassori L, Piano M, Agostoni E, Motto C, Gatti A, Longoni M, Guccione A, Tortorella R, Zampieri P, Zimatore DS, Grazioli A, Ricciardi GK, Augelli R, Bovi P, Tomelleri G, Micheletti N, Semeraro V, Lucarelli N, Ganimede M, Tinelli A, Pia Prontera M, Pesare A, Cagliari E, Quatrale R, Federico F, Passalacqua G, Filauri P, Orlandi B, De Santis F, Gabriele A, Tiseo C, Armentano A, Di Benedetto O, Silvagni U, Perrotta P, Crispino E, Stancati F, Rizzuto S, Pugliese P, Pisani E, Siniscalchi A, Gaudiano C, Pirritano D, Del Giudice F, Calia S, Ganci G, Sugo A, Scomazzoni F, Simionato F, Roveri L, De Nicola M, Giannoni M, Bruni S, Gambelli E, Provinciali L, Carriero A, Coppo L, Baldan J, Paolo Nuzzi N, Marcheselli S, Corato M, Cotroneo E, Ricciardi F, Gigli R, Pozzessere C, Pezzella FR, Corsi F, Squassina G, Cobelli M, Morassi M, Magni E, Pepe F, Bigni B, Costa P, Crabbio M, Griffini S, Palmerini F, Piras MP, Natrella M, Fanelli G, Cristoferi M, Bottacchi E, Corso G, Tosi P, Amistà P, Russo M, Tettoni S, Gallesio I, Mascolo MC, Meloni GB, Fabio C, Maiore M, Pintus F, Pischedda A, Manca A, Mongili C, Zanda B, Sanna A, Baule A, Pappalardo MP, Craparo G, Gallo C, Monaco S, Mannino M, Terruso V, Muto M, Guarnieri G, Andreone V, Dui G, Ticca A, Salmaggi A, Iannucci G, Pinna V, Di Clemente L, Perini F, De Boni A, De Luca C, De Giorgi F, Corraine S, Enne P, Ganau C, Piras V. IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke. Stroke 2019; 50:909-916. [DOI: 10.1161/strokeaha.118.023316] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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
Background and Purpose—
As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set).
Methods—
We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline ≤24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve.
Results—
National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779).
Conclusions—
The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.
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Affiliation(s)
- Manuel Cappellari
- Stroke Unit (M. Cappellari, S.F., B.B.), Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Salvatore Mangiafico
- Interventional Neuroradiology Unit (S.M., S.N.), Ospedale Careggi-University Hospital, Firenze, Italy
| | - Valentina Saia
- Neurology and Stroke Unit (T.T., V.S.), Santa Corona Hospital, Pietra Ligure, Italy
| | - Giovanni Pracucci
- Stroke Unit (D.I., P.N., G.P.), Ospedale Careggi-University Hospital, Firenze, Italy
- University of Florence, Firenze, Italy (G.P., P.N., D.I.)
| | - Sergio Nappini
- Interventional Neuroradiology Unit (S.M., S.N.), Ospedale Careggi-University Hospital, Firenze, Italy
| | - Patrizia Nencini
- Stroke Unit (D.I., P.N., G.P.), Ospedale Careggi-University Hospital, Firenze, Italy
- University of Florence, Firenze, Italy (G.P., P.N., D.I.)
| | - Daniel Konda
- Interventional Neuroradiology Unit (D.K.), Policlinico Tor Vergata, Roma, Italy
| | | | - Stefano Vallone
- Neuroradiology Unit, Ospedale Civile S. Agostino-Estense University Hospital, Modena, Italy (S.V.)
| | - Andrea Zini
- Stroke Unit, IRCCS Istituto delle Scienze Neurologiche, Maggiore Hospital, Bologna, Italy (A.Z.)
| | - Sandra Bracco
- Interventional Neuroradiology Unit (S.B.), Ospedale S. Maria delle Scotte-University Hospital, Siena, Italy
| | - Rossana Tassi
- Stroke Unit (R.T.), Ospedale S. Maria delle Scotte-University Hospital, Siena, Italy
| | - Mauro Bergui
- Interventional Neuroradiology Unit (M.B.), Città della Salute e della Scienza-Molinette, Torino, Italy
| | - Paolo Cerrato
- Stroke Unit (P.C.), Città della Salute e della Scienza-Molinette, Torino, Italy
| | - Antonio Pitrone
- Interventional Neuroradiology Unit (A. Pitrone), Policlinico G. Martino, Messina, Italy
| | | | - Andrea Saletti
- Interventional Neuroradiology Unit (A.S.), Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | - Alessandro De Vito
- Stroke Unit (A.D.V.), Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | | | - Mauro Magoni
- Stroke Unit (M. Magoni), Spedali Civili, Brescia, Italy
| | - Edoardo Puglielli
- Vascular and Interventional Radiology Unit (E.P.), Ospedale Civile Mazzini, Teramo, Italy
| | | | - Francesco Causin
- Neuroradiology Unit (F.C.), Azienda Ospedaliero-Univeristaria, Padova, Italy
| | | | - Lucio Castellan
- Interventional Neuroradiology Unit (L. Castellan), IRCCS San Martino-IST, Genova, Italy
| | - Laura Malfatto
- Stroke Unit (L.M.), IRCCS San Martino-IST, Genova, Italy
| | - Roberto Menozzi
- Interventional Neuroradiology Unit (R.M.), Ospedale Universitario, Parma, Italy
| | | | - Chiara Comelli
- Interventional Neuroradiology Unit (C.C.), Ospedale San Giovanni Bosco, Torino, Italy
| | - Enrica Duc
- Neurology Unit (E.D.), Ospedale San Giovanni Bosco, Torino, Italy
| | - Alessio Comai
- Radiology Unit (A. Comai), Ospedale Centrale, Bolzano, Italy
| | | | - Mirco Cosottini
- Neuroradiology Unit (M. Cosottini), Ospedale Cisanello, Pisa, Italy
| | | | - Simone Peschillo
- Interventional Neuroradiology Unit (S.P.), Sapienza University Hospital, Roma, Italy
| | | | - Andrea Giorgianni
- Neuroradiology Unit (A.G.), Ospedale Universitario Circolo, ASST Sette Laghi, Varese, Italy
| | | | - Elvis Lafe
- Diagnostic and Interventional Neuroradiology Unit (E.L.), San Matteo Hospital and C. Mondino Foundation, Pavia, Italy
| | | | - Nicola Burdi
- Interventional Radiology Unit (N.B.), Ospedale SS. Annunziata, Taranto, Italy
| | | | - Nicola Cavasin
- Neuroradiology Unit (N.C.), Ospedale dell’Angelo, USSL3 Serenissima, Mestre, Italy
| | - Adriana Critelli
- Neurology Unit (A. Critelli), Ospedale dell’Angelo, USSL3 Serenissima, Mestre, Italy
| | | | - Marco Petruzzellis
- Interventional Neuroradiology Unit (M. Petruzzellis), Policlinico, Bari, Italy
| | - Marco Doddi
- Interventional Neuroradiology Unit (M.D.), Presidio Ospedaliero SS. Filippo e Nicola, Avezzano, Italy
| | - Antonio Carolei
- Stroke Unit (A. Carolei), Presidio Ospedaliero SS. Filippo e Nicola, Avezzano, Italy
| | - William Auteri
- Interventional Neuroradiology Unit (W.A.), Azienda Ospedaliera Annunziata, Cosenza, Italy
| | - Alfredo Petrone
- Neurology Unit (A. Petrone), Azienda Ospedaliera Annunziata, Cosenza, Italy
| | | | - Tiziana Tassinari
- Neurology and Stroke Unit (T.T., V.S.), Santa Corona Hospital, Pietra Ligure, Italy
| | - Marco Pavia
- Interventional Neuroradiology Unit (M. Pavia), Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy
| | - Paolo Invernizzi
- Stroke Unit (P.I.), Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy
| | - Gianni Turcato
- Emergency Department, Girolamo Fracastoro Hospital, San Bonifacio (Verona), Italy (G.T.)
| | - Stefano Forlivesi
- Stroke Unit (M. Cappellari, S.F., B.B.), Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Bruno Bonetti
- Stroke Unit (M. Cappellari, S.F., B.B.), Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Domenico Inzitari
- Stroke Unit (D.I., P.N., G.P.), Ospedale Careggi-University Hospital, Firenze, Italy
- University of Florence, Firenze, Italy (G.P., P.N., D.I.)
| | - Danilo Toni
- Stroke Unit (M.D.M., D.T.), Sapienza University Hospital, Roma, Italy
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Caminati M, Vianello A, Chieco Bianchi F, Festi G, Guarnieri G, Marchi MR, Micheletto C, Olivieri M, Tognella S, Guerriero M, Senna G. Relevance of TH2 Markers in the Assessment and Therapeutic Management of Severe Allergic Asthma: A Real-Life Perspective. J Investig Allergol Clin Immunol 2019; 30:35-41. [PMID: 30676321 DOI: 10.18176/jiaci.0379] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Although blood eosinophils are currently recognized as the main clinical marker of TH2-type inflammation, their relevance in identifying asthma severity remains a matter of debate. METHODS Our retrospective real-life study on severe asthmatics included in the NEONet Italian database aimed to investigate the relevance of blood eosinophil count and fractional exhaled nitric oxide (FeNO) in the clinical assessment of severe asthma and their role as potential predictors of responsiveness to anti-IgE therapy. The cut-off values chosen were 300 eosinophils/mm3 and FeNO of 30 ppm. RESULTS We evaluated 132 adult patients. No significant differences were observed between the groups (high and low baseline eosinophil counts) in terms of demographic data, total IgE, lung function, patient-reported outcomes, or nasal comorbidities. The Asthma Control Test score and Asthma Quality of Life Questionnaire scores were poorer in patients with FeNO ≥30 ppb than in patients with FeNO <30 ppb. In the high FeNO subgroup, more frequent hospital admissions and a higher number of working days lost in the previous year were registered. A combined score including both eosinophils and FeNO did not improve the accuracy of the individual parameters. In the high-eosinophil subgroup, the proportion of responders to omalizumab was greater and increased at each follow-up time point. CONCLUSIONS Our findings show that blood eosinophil count is not an unequivocal marker of asthma severity, whereas a higher FeNO level is associated with more frequent hospital admissions and more working days lost. Blood eosinophils seem to act as a predictor of response to omalizumab.
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Affiliation(s)
- M Caminati
- Asthma Center and Allergy Unit, Verona University Hospital, Verona, Italy
| | - A Vianello
- Respiratory Pathophysiology Division, University-City Hospital of Padua, Padua, Italy
| | - F Chieco Bianchi
- Respiratory Pathophysiology Division, University-City Hospital of Padua, Padua, Italy
| | - G Festi
- Pulmonary Unit, Verona University Hospital, Verona, Italy
| | - G Guarnieri
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - M R Marchi
- Respiratory Pathophysiology Division, University-City Hospital of Padua, Padua, Italy
| | - C Micheletto
- Respiratory Unit, Mater Salutis Hospital, Legnago, Italy
| | - M Olivieri
- Unit of Occupational Medicine, Verona University Hospital, Verona, Italy
| | - S Tognella
- Respiratory Unit, Orlandi General Hospital, Bussolengo, Italy
| | - M Guerriero
- Department of Computer Science, University of Verona, Verona, Italy
| | - G Senna
- Asthma Center and Allergy Unit, Verona University Hospital, Verona, Italy
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Guarnieri G, Muto M, Politi LS. Spine and Cord Imaging Anatomy. Clin Neuroradiol 2019. [DOI: 10.1007/978-3-319-68536-6_37] [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: 11/28/2022]
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Guarnieri G, Muto M, Politi LS. Spine and Cord Imaging Anatomy. Clin Neuroradiol 2019. [DOI: 10.1007/978-3-319-61423-6_37-1] [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: 10/26/2022]
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Muto M, Giurazza F, Guarnieri G, Marcia S. Percutaneous Image-Guided Spine Treatment. Clin Neuroradiol 2019. [DOI: 10.1007/978-3-319-61423-6_39-2] [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: 11/30/2022]
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Muto M, Giurazza F, Guarnieri G, Marcia S. Percutaneous Image-Guided Spine Treatment. Clin Neuroradiol 2019. [DOI: 10.1007/978-3-319-68536-6_39] [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: 11/29/2022]
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Sarchielli E, Morelli A, Guarnieri G, Iorizzi M, Sgambati E. Corrigendum to "Neuroprotective effects of quercetin 4'-O-β-d-diglucoside on human striatal precursor cells in nutrient deprivation condition." [Acta Histochemica, 2018 Feb;120(2):122-128]. Acta Histochem 2018; 120:858. [PMID: 30446258 DOI: 10.1016/j.acthis.2018.11.002] [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: 10/27/2022]
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Abstract
We consider the process of hemodialysis performed by means of a hollow fiber dialyzer with a special focus on the dynamics of the light solutes (including metabolic waste products) through the porous fibers membrane. The model we illustrate here completes the one formulated in a previous paper in which solutes concentrations in the dialyzate were neglected. Exploiting the large difference between the characteristic time of the processes in the machine and the relaxation time to equilibrium in the body, we confine our study to the case of constant input data in order to emphasize the role of the solute transport mechanisms. Numerical solutions show that diffusion is dominant at the early stage of filtration.
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Affiliation(s)
- A. Fasano
- Dipartimento di Matematica e Informatica “U. Dini”, Università degli Studi di Firenze, Firenze, Italy
- FIAB SpA, Firenze, Italy
- IASI-CNR, Roma, Italy
| | - G. Guarnieri
- Dipartimento di Matematica e Informatica “U. Dini”, Università degli Studi di Firenze, Firenze, Italy
| | - A. Farina
- Dipartimento di Matematica e Informatica “U. Dini”, Università degli Studi di Firenze, Firenze, Italy
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Giurazza F, Corvino F, Cavaglià E, Cangiano G, Amodio F, De Magistris G, Frauenfelder G, Guarnieri G, Muto M, Niola R. Arterial embolizations with microvascular plug in extracranial and intracranial districts: technical results. Radiol Med 2017; 123:236-243. [PMID: 29116602 DOI: 10.1007/s11547-017-0831-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE A new detachable microvascular plug (MVP, Reverse Medical®, Irvine, CA, USA) has been recently developed; three models are available according to the size (MVP3-MVP5-MVP7). MVP3 and MVP5 are released through a 0.027″ microcatheter, MVP7 through a 4 Fr catheter. This series aims to describe an initial single-center experience examining intraprocedural safety and technical success of MVP. MATERIALS AND METHODS Ten patients (mean age 55.1 years) have been treated for arterial embolization using MVP; eight extracranial and two intracranial arterial embolizations have been performed. The embolizations were because of: four bleedings, three aneurysms, two pseudoaneurysms, and one presurgical nephrectomy. RESULTS MVP3 was used in five cases, MVP5 in four cases, and MVP 7 once. In all cases, the MVP was successfully released in < 1 min. In six patients, the MVP was the sole embolizing agent employed, while in four subjects, it was positioned complementary after coils. The technical and clinical success was obtained in 100%; hemorrhages were interrupted and aneurysms and pseudoaneurysms did not show recanalization at follow-up. CONCLUSIONS MVP seems to be a safe embolizing device that interventional radiologists should consider when facing arterial embolization of both body and neuroarterial districts; the main advantage is related to MVP3 and MVP5 models that can be adopted for distal embolization thanks to the precise release through 0.027″ microcatheter.
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Affiliation(s)
- Francesco Giurazza
- Interventional Radiology Department, AORN Cardarelli di Napoli, Via A. Cardarelli 9, 80131, Naples, Italy.
| | - Fabio Corvino
- Interventional Radiology Department, AORN Cardarelli di Napoli, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Errico Cavaglià
- Interventional Radiology Department, AORN Cardarelli di Napoli, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Gianluca Cangiano
- Interventional Radiology Department, AORN Cardarelli di Napoli, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Francesco Amodio
- Interventional Radiology Department, AORN Cardarelli di Napoli, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Giuseppe De Magistris
- Interventional Radiology Department, AORN Cardarelli di Napoli, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Giulia Frauenfelder
- Radiology Department, Università Campus Bio-Medico di Roma, Via Alvaro Del Portillo 200, 00198, Rome, Italy
| | - Gianluigi Guarnieri
- Neuroradiology Department, AORN Cardarelli di Napoli, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Mario Muto
- Neuroradiology Department, AORN Cardarelli di Napoli, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Raffaella Niola
- Interventional Radiology Department, AORN Cardarelli di Napoli, Via A. Cardarelli 9, 80131, Naples, Italy
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Muto M, Giurazza F, Frauenfelder G, Marcia S, Masala S, Guarnieri G. Interventions and Therapy in Rheumatology. Radiol Clin North Am 2017; 55:1103-1110. [DOI: 10.1016/j.rcl.2017.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Giurazza F, Guarnieri G, Murphy KJ, Muto M. Intradiscal O 2O 3: Rationale, Injection Technique, Short- and Long-term Outcomes for the Treatment of Low Back Pain Due to Disc Herniation. Can Assoc Radiol J 2017; 68:171-177. [PMID: 28438284 DOI: 10.1016/j.carj.2016.12.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [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: 12/13/2016] [Accepted: 12/29/2016] [Indexed: 12/15/2022] Open
Abstract
The management of low back pain should always start with a conservative approach; however, when it fails, intervention is required and at that moment the most appropriate choice remains unclear. Before invasive surgery, minimally invasive techniques can be adopted. In European trials and in a trans-Canadian clinical trial 03 ozone has been used successfully. In total over 50,000 patients have been treated safely. Ozone is a gas normally present in the atmosphere with potent oxidizing power; it has been used for percutaneous intradiscal injection combined with oxygen (O2O3) at very low concentrations for 15 years in Europe. The main indication is back pain with or without radicular pain but without motor deficits, which is refractory to 4-6 weeks of conservative therapies. Its mechanism of action on the disc is mechanical (volume reduction by subtle dehydration of the nucleus pulposis) and antinflammatory. The intradiscal ozone injection is performed with a thin needle (18-22 gauge) image guided by computed tomography or angiofluoroscopy and is usually complimented by periganglionic injection of corticosteroids and anesthetics. This combination gives immediate pain relief and allows time for the ozone to act. It is a cost-effective procedure that presents a very low complication rate (0.1%). The radicular pain is resolved before the back pain does, as is seen with microdiscectomy. Peer-reviewed publications of large randomized trials, case series, and meta analysis from large samples of patients have demonstrated the procedure to be safe and effective in the short and the long terms, with benefits recognized up to 10 years after treatment. We aim to review the principles of action of O2O3 and report the injection techniques, complications, and short- and long-term outcomes.
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Affiliation(s)
| | | | - Kieran J Murphy
- Department of Medical Imaging, Toronto Western Hospital, Toronto, Ontario, Canada.
| | - Mario Muto
- Neuroradiology Department, Cardarelli Hospital, Naples, Italy
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Muto M, Giurazza F, Guarnieri G, Miele V, Marcia S, Masala S, Guglielmi G. Percutaneous Treatment of Vertebral Fractures. Semin Musculoskelet Radiol 2017; 21:349-356. [PMID: 28571095 DOI: 10.1055/s-0037-1602407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The thoracolumbar junction and lumbosacral segment are the portions of the spinal column most prone to acute traumatic fractures. Multiple classifications and injury severity score systems have been published to standardize the management of patients, establishing stable/unstable and surgical/nonsurgical fractures. In the past, patients could be treated only by surgical stabilization or conservative methods. The latter implied bed rest, long immobilization periods, prolonged drugs therapies, and, at worst, the evolution of kyphosis. Percutaneous mini-invasive treatments have been developed to improve the quality of life of patients affected by stable fractures, by rapidly recovering mobility and preventing deformity of the spinal column. These approaches, based on assisted techniques, imply the placement of different types of expandable bone implant systems. We discuss the treatment of vertebral fractures, focusing on percutaneous procedures and analyzing indications, contraindications, and outcomes of patients affected by vertebral nonosteoporotic/nonneoplastic but traumatic fractures.
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Affiliation(s)
- Mario Muto
- Department of Neuroradiology, Ospedale A. Cardarelli, Naples, Italy
| | | | | | - Vittorio Miele
- Department of Radiology, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Stefano Marcia
- Department of Radiology, Ospedale Santissima Trinità, Cagliari, Italy
| | - Salvatore Masala
- Department of Musculoskeletal Radiology, Università degli Studi Tor Vergata, Rome, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy.,Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Foggia, Italy
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Abstract
Arachnoid cysts are extra-cerebral, intra-arachnoidal cerebrospinal fluid collections - the most frequent congenital developmental intracranial cystic lesions. They are often diagnosed incidentally during imaging exams acquired for different reasons, and are usually asymptomatic. Rare complications are post-traumatic rupture with consequent subdural haematomas. Spontaneous bleeding should be acknowledged as a rare but possible complication of this benign lesion. We report on the case of a patient presenting with a giant arachnoid cyst extending to the left frontal, temporal and parietal lobes associated with acute subdural haematoma without history of trauma.
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Mason P, Scarpa MC, Guarnieri G, Giordano G, Baraldi E, Maestrelli P. Exhaled nitric oxide dynamics in asthmatic reactions induced by diisocyanates. Clin Exp Allergy 2016; 46:1531-1539. [PMID: 27533788 DOI: 10.1111/cea.12798] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 07/01/2016] [Accepted: 07/05/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Isocyanate-induced asthmatic reactions are associated with delayed increase in fractional exhaled nitric oxide measured at expiratory flow of 50 mL/s (FeNO50), a biomarker of airway inflammation. The time course of FeNO increase is compatible with the activation of NO synthase, but the origin of NO production in the lung is undetermined. OBJECTIVE The aim of this study was to define the dynamics of airway and alveolar NO during specific inhalation challenge (SIC) with isocyanates and the role of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO synthase. METHODS Spirometry, exhaled NO parameters (FeNO50, bronchial wall NO concentration, NO airway diffusing capacity, NO flux to luminal space, alveolar NO) and ADMA levels in exhaled breath condensate were measured before and at intervals up to 24 h after exposure to isocyanates. The results were compared between 17 SIC-positive and eight SIC-negative subjects. RESULTS A significant FeNO50 increase in SIC-positive subjects was detected 24 h after exposure and was associated with the augmented NO flux from airway wall to the lumen, whereas airway NO diffusion and alveolar NO were not affected. The changes in NO dynamics were specific for the subjects who developed an asthmatic reaction, but were independent from the pattern and magnitude of bronchoconstriction. There was no evidence that exhaled NO is modulated by the changes in ADMA concentration. CONCLUSIONS AND CLINICAL RELEVANCE Because isocyanate-induced increase in FeNO50 was almost exclusively determined by the increase in NO flux, the use of FeNO50 appears adequate to monitor the exhaled NO dynamics during SIC. FeNO50 measurement may provide additional information to spirometry, because bronchoconstriction and airway inflammatory responses are dissociated.
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Affiliation(s)
- P Mason
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - M C Scarpa
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - G Guarnieri
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - G Giordano
- Women's and Children's Health Department, University of Padova, Padova, Italy
| | - E Baraldi
- Women's and Children's Health Department, University of Padova, Padova, Italy
| | - P Maestrelli
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
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Barazzoni R, Cappellari GG, Semolic A, Ius M, Pivetti G, Zanetti M, Vinci P, Guarnieri G. MON-P212: Predictive Value for Metabolic Syndrome of Anthropometric and Calculated Surrogate Markers of Visceral Fat in an Overweight Population Cohort. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30846-9] [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: 11/28/2022]
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Caminati M, Senna G, Stefanizzi G, Bellamoli R, Longhi S, Chieco-Bianchi F, Guarnieri G, Tognella S, Olivieri M, Micheletto C, Festi G, Bertocco E, Mazza M, Rossi A, Vianello A. Drop-out rate among patients treated with omalizumab for severe asthma: Literature review and real-life experience. BMC Pulm Med 2016; 16:128. [PMID: 27562427 PMCID: PMC5000547 DOI: 10.1186/s12890-016-0290-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 08/18/2016] [Indexed: 11/29/2022] Open
Abstract
Background In patients with asthma, particularly severe asthma, poor adherence to inhaled drugs negatively affects the achievement of disease control. A better adherence rate is expected in the case of injected drugs, such as omalizumab, as they are administered only in a hospital setting. However, adherence to omalizumab has never been systematically investigated. The aim of this study was to review the omalizumab drop-out rate in randomized controlled trials (RCTs) and real-life studies. A comparative analysis was performed between published data and the Italian North East Omalizumab Network (NEONet) database. Results In RCTs the drop-out rate ranged from 7.1 to 19.4 %. Although the reasons for withdrawal were only occasionally reported, patient decision and adverse events were the most frequently reported causes. In real-life studies the drop-out rate ranged from 0 to 45.5 %. In most cases lack of efficacy was responsible for treatment discontinuation. According to NEONet data, 32 % of treated patients dropped out, with an increasing number of drop outs observed over time. Patient decision and lack of efficacy accounted for most treatment withdrawals. Conclusions Treatment adherence is particularly crucial in patients with severe asthma considering the clinical impact of the disease and the cost of non-adherence. The risk of treatment discontinuation has to be carefully considered both in the experimental and real-life settings. Increased knowledge regarding the main reasons for patient withdrawal is important to improve adherence in clinical practice.
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Affiliation(s)
- M Caminati
- Asthma Center and Allergy Unit, Verona General and University Hospital, Verona, Italy.
| | - G Senna
- Asthma Center and Allergy Unit, Verona General and University Hospital, Verona, Italy
| | - G Stefanizzi
- Asthma Center and Allergy Unit, Verona General and University Hospital, Verona, Italy
| | - R Bellamoli
- Asthma Center and Allergy Unit, Verona General and University Hospital, Verona, Italy
| | - S Longhi
- Asthma Center and Allergy Unit, Verona General and University Hospital, Verona, Italy
| | - F Chieco-Bianchi
- Respiratory Pathophysiology Division, University-City Hospital of Padua, Padua, Italy
| | - G Guarnieri
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - S Tognella
- Respiratory Unit, Orlandi General Hospital, Bussolengo, Verona, Italy
| | - M Olivieri
- Unit of Occupational Medicine, Verona General and University Hospital, Verona, Italy
| | - C Micheletto
- Respiratory Unit, Mater Salutis Hospital, Legnago, Verona, Italy
| | - G Festi
- Pulmonary Unit, Verona University and General Hospital, Verona, Italy
| | - E Bertocco
- Respiratory pathology Unit, Arzignano General Hospital, Vicenza, Italy
| | - M Mazza
- Pulmonary Unit, Pordenone General Hospital, Pordenone, Italy
| | - A Rossi
- Pulmonary Unit, Verona University and General Hospital, Verona, Italy
| | - A Vianello
- Respiratory Pathophysiology Division, University-City Hospital of Padua, Padua, Italy
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Muto M, Giurazza F, Silva RP, Guarnieri G. Rational approach, technique and selection criteria treating lumbar disk herniations by oxygen-ozone therapy. Interv Neuroradiol 2016; 22:736-740. [PMID: 27485047 DOI: 10.1177/1591019916659266] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 06/22/2016] [Indexed: 11/17/2022] Open
Abstract
Radicular lumbar back pain is an important public health problem not yet benefiting from a unequivocal treatment approach. Medical and physical therapies represent the first solution; however, when these fail, the second therapeutic step is still controversial and mini-invasive treatments may play an important role. In these cases oxygen-ozone therapy has been proved to be a very safe and effective option that is widely used with different modalities. This paper, by reviewing oxygen-ozone therapy literature data, aims to describe the rationale of oxygen-ozone therapy for the treatment of lumbar disk herniations, propose an effective procedural technique and clarify patient selection criteria; furthermore, complications and follow-up management are also considered.
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Affiliation(s)
- Mario Muto
- Cardarelli Hospital, Neuroradiology Department, Naples, Italy
| | - Francesco Giurazza
- Cardarelli Hospital, Neuroradiology Department, Naples, Italy .,Università Campus Bio-Medico di Roma, Radiology Department, Rome, Italy
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Barazzoni R, Gortan Cappellari G, Semolic A, Ius M, Dore F, Giacca M, Zanetti M, Vinci P, Guarnieri G. Intravenous lipid infusion and total plasma fatty acids positively modulate plasma acylated ghrelin in vivo. Clin Nutr 2016; 36:775-781. [PMID: 27312085 DOI: 10.1016/j.clnu.2016.05.017] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/20/2016] [Accepted: 05/26/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS Ghrelin is a gastric orexigenic hormone whose activating acylation plays a relevant role in the regulation of energy balance. Nutritional modulators of ghrelin acylation and plasma acylated ghrelin (AG) concentration remain however largely undefined. We aimed at investigating whether circulating free fatty acids (FFA) contribute to regulate plasma AG and its ratio (AG/TG) to total hormone (TG). METHODS Plasma FFA, TG, AG and AG/TG were measured in a primary outpatient care setting in a community-based population cohort of 850 individuals (age 54 ± 10 years, M/F: 408/442) from the North-East Italy MoMa study. 150-min intravenous lipid infusions in rodents (10% lipids, 600 μl/h) were used to investigate the potential causal role of FFA in the regulation of plasma ghrelin profile. RESULTS Plasma FFA were associated positively with AG and AG/TG while negatively with TG (P < 0.01). Associations between FFA, AG and AG/TG remained statistically significant (P < 0.02) in multiple regression analysis including HOMA insulin resistance and metabolic confounders, and both AG and AG/TG but not TG increased through plasma FFA quartiles (P < 0.01). Consistent with these findings, intravenous lipid infusion with plasma FFA elevation caused elevations of AG and AG/TG (P < 0.05) with no TG modifications. CONCLUSIONS The current findings demonstrate a novel role for circulating FFA availability to up-regulate plasma AG, which could involve FFA-induced stimulation of ghrelin acylation.
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Affiliation(s)
- R Barazzoni
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy.
| | - G Gortan Cappellari
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | - A Semolic
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | - M Ius
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | - F Dore
- Dept of Nuclear Medicine, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Trieste, Italy
| | - M Giacca
- Molecular Medicine Laboratory, International Centre for Genetics, Engineering and Biotechnology, Trieste, Italy
| | - M Zanetti
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | - P Vinci
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | - G Guarnieri
- Dept. of Medical, Surgical and Health Sciences, University of Trieste, Italy
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Fraschetti S, Guarnieri G, Gambi C, Bevilacqua S, Terlizzi A, Danovaro R. Impact of offshore gas platforms on the structural and functional biodiversity of nematodes. Mar Environ Res 2016; 115:56-64. [PMID: 26878347 DOI: 10.1016/j.marenvres.2016.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/29/2016] [Accepted: 02/03/2016] [Indexed: 06/05/2023]
Abstract
The Mediterranean Sea hosts hundreds of offshore gas platforms, whose activity represents a potential threat to marine ecosystems. Evidence from several studies indicates that nematodes can be highly sensitive to changes in the environmental quality. Here, we investigated the response of nematode assemblages to the presence of offshore gas platforms (located in the central Mediterranean Sea) in terms of spatial heterogeneity, structural and functional diversity. Since the effect of the investigated offshore platforms on macrofaunal assemblages were previously assessed by Terlizzi et al. (2008), the study provided also the opportunity to compare the response of different benthic compartments to the same impact related to fossil fuel extraction on marine environments. The platforms had a significant impact on nematode assemblages up to 1000 m distance from the structure. The effects were evident in term of: a) more homogeneous spatial distribution of nematode assemblages, b) increased trophic diversity of deposit feeders and c) changes in life strategies with an increase of opportunistic species in sediments closer to the platforms. Such effects seemed to be related to the dimension of the platform structures, rather than to chemical pollution or changes in food availability. These findings suggest that the platforms exert a physical alteration of the surrounding environment that is reflected by altered structural and functional traits of nematode biodiversity. The use of nematodes for monitoring the effects of the platforms only partially matched with the results obtained using macrofauna, providing further insights on potential outcomes on the functional response of marine assemblages to fossil fuel extraction.
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Affiliation(s)
- S Fraschetti
- Department of Biological and Environmental Sciences and Technology, University of Salento, CoNISMa, I-73100 Lecce, Italy.
| | - G Guarnieri
- Department of Biological and Environmental Sciences and Technology, University of Salento, CoNISMa, I-73100 Lecce, Italy
| | - C Gambi
- Department of Life and Environmental Science, Polytechnic University of Marche, Via Brecce Bianche, 60131 Ancona, Italy
| | - S Bevilacqua
- Department of Biological and Environmental Sciences and Technology, University of Salento, CoNISMa, I-73100 Lecce, Italy
| | - A Terlizzi
- Department of Biological and Environmental Sciences and Technology, University of Salento, CoNISMa, I-73100 Lecce, Italy
| | - R Danovaro
- Department of Life and Environmental Science, Polytechnic University of Marche, Via Brecce Bianche, 60131 Ancona, Italy; Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy
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Abstract
Spinal trauma is very frequent injury with different severity and prognosis varying from asymptomatic condition to temporary neurological dysfunction, focal deficit or fatal event. The major causes of spinal trauma are high- and low-energy fall, traffic accident, sport and blunt impact. The radiologist has a role of great responsibility to establish the presence or absence of lesions, to define the characteristics, to assess the prognostic influence and therefore treatment. Imaging has an important role in the management of spinal trauma. The aim of this paper was to describe: incidence and type of vertebral fracture; imaging indication and guidelines for cervical trauma; imaging indication and guidelines for thoracolumbar trauma; multidetector CT indication for trauma spine; MRI indication and protocol for trauma spine.
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Affiliation(s)
| | - Roberto Izzo
- Neuroradiology Unit, Cardarelli Hospital, Naples, Italy
| | - Mario Muto
- Neuroradiology Unit, Cardarelli Hospital, Naples, Italy
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Abstract
Vertebral cementoplasty is a well-known mini-invasive treatment to obtain pain relief in patients affected by vertebral porotic fractures, primary or secondary spine lesions and spine trauma through intrametameric cement injection. Two major categories of treatment are included within the term vertebral cementoplasty: the first is vertebroplasty in which a simple cement injection in the vertebral body is performed; the second is assisted technique in which a device is positioned inside the metamer before the cement injection to restore vertebral height and allow a better cement distribution, reducing the kyphotic deformity of the spine, trying to obtain an almost normal spine biomechanics. We will describe the most advanced techniques and indications of vertebral cementoplasty, having recently expanded the field of applications to not only patients with porotic fractures but also spine tumours and trauma.
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Affiliation(s)
- Mario Muto
- 1 Neuroradiology Department, Cardarelli Hospital, Naples, Italy
| | | | - Francesco Giurazza
- 2 Radiology Department-Università Campus Bio-Medico di Roma, Rome, Italy
| | - Luigi Manfrè
- 3 Minimal Invasive Spine Department-AOEC "Cannizzaro", Catania, Italy
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Barazzoni R, Gortan Cappellari G, Semolic A, Ius M, Mamolo L, Dore F, Giacca M, Zanetti M, Vinci P, Guarnieri G. Plasma total and unacylated ghrelin predict 5-year changes in insulin resistance. Clin Nutr 2015; 35:1168-73. [PMID: 26508327 DOI: 10.1016/j.clnu.2015.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 06/15/2015] [Revised: 09/23/2015] [Accepted: 10/05/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS Ghrelin is a gastric hormone circulating in acylated (AG) and unacylated (UG) forms, and higher plasma total ghrelin (TG) and UG may be cross-sectionally associated with lower insulin resistance in metabolic syndrome patients. The potential value of ghrelin forms in predicting insulin resistance and its time-related changes in community-based population cohorts remains unknown. METHODS We measured TG, AG and calculated UG (TG-AG) in 716 individuals from the North-East-Italy MoMa study (age: 55 ± 9 years, BMI: 29 ± 5 kg/m(2), M/F:349/367) to test the hypothesis that circulating TG and UG, but not AG are negatively associated with insulin resistance (HOMA). We further hypothesized that baseline TG and UG negatively predict 5-year HOMA changes in a 350-individual subgroup. RESULTS Baseline TG and UG were associated negatively with HOMA after adjusting for gender and body mass index (BMI). Baseline gender- and BMI-adjusted TG and UG were also negatively associated with HOMA at 5-year follow-up (n = 350), and changes in TG and UG were negatively associated with changes in HOMA (P < 0.05) after adjustment for anthropometric and metabolic confounders. No statistically significant correlations were observed between AG and baseline or 5-year HOMA. CONCLUSIONS In a North-East Italy community-based population cohort, plasma TG and UG but not AG are negatively associated with HOMA. TG and UG and their changes also independently predict 5-year HOMA changes. TG and UG are therefore novel potential modulators of insulin resistance and may contribute to predict its time-related changes in humans.
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Affiliation(s)
- R Barazzoni
- Internal Medicine, Dept of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy.
| | - G Gortan Cappellari
- Internal Medicine, Dept of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - A Semolic
- Internal Medicine, Dept of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - M Ius
- Internal Medicine, Dept of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - L Mamolo
- Internal Medicine, Dept of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - F Dore
- Dept of Nuclear Medicine, Azienda Ospedaliero - Universitaria Ospedali Riuniti, Trieste, Italy
| | - M Giacca
- Molecular Medicine Laboratory, International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
| | - M Zanetti
- Internal Medicine, Dept of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - P Vinci
- Internal Medicine, Dept of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - G Guarnieri
- Internal Medicine, Dept of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
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Abstract
Vertebroplasty (VP) is a percutaneous mini-invasive technique developed in the late 1980s as antalgic and stabilizing treatment in patients affected by symptomatic vertebral fracture due to porotic disease, traumatic injury and primary or secondary vertebral spine tumors. The technique consists of a simple metameric injection of an inert cement (poly-methyl-methacrylate, PMMA), through a needle by trans-peduncular, parapeduncular or trans-somatic approach obtaining a vertebral augmentation and stabilization effect associated with pain relief. The technique is simple and fast, and should be performed under fluoroscopy or CT guidance in order to obtain a good result with low complication rate. The aim of this paper is to illustrate the utility of VP, the indications-contraindications criteria, how to technically perform the technique using imaging guidance, and the results and complications of this treatment in patients affected by symptomatic vertebral compression fracture.
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Affiliation(s)
| | | | - Mario Muto
- Neuroradiology Service, Cardarelli Hospital, Naples, Italy
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