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Surace T, Buoli M, Affaticati LM, Esposito G, Capuzzi E, Colzani L, La Tegola D, Biagi E, Colmegna F, Caldiroli A, Clerici M. Which clinical factors delay proper treatment in panic disorder? A cross-sectional multicentric study. Early Interv Psychiatry 2024. [PMID: 38357849 DOI: 10.1111/eip.13506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/30/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024]
Abstract
AIM The aim of the present study was to identify clinical and socio-demographic factors associated with duration of untreated illness (DUI) in patients affected by panic disorder (PD). METHODS Data were collected from patients' medical records (N = 157) of two mental health services respectively located in Milan and in Monza (Italy). Correlation analyses and analysis of variance (ANOVAs) were run to analyse the relation between DUI and quantitative/qualitative variables respectively. Statistically significant variables in uni- variate analyses were then inserted in a linear multivariable regression model (backward procedure). RESULTS Mean DUI was 27.33 (±50.56) months. Patients with an earlier age at onset (r = -0.270; p < .01), a longer duration of illness (r = 0.483; p < .01) and who received a lifetime psychotherapy (F = 6.86; p = .01) had a longer DUI. The final global model showed that a longer DUI was associated with pre-onset poly-substance misuse (p = .05) and a longer duration of illness (p < .01). CONCLUSION The results of our study showed that a longer DUI was predicted by clinical factors such as the presence of a pre-onset poly-substance use disorder and that delayed proper treatment can lead to a chronicization of PD, as indicated by a longer duration of illness. Further studies are needed to in-depth investigate the role of DUI in influencing the course and outcome of anxiety disorders, including PD.
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Affiliation(s)
- T Surace
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - M Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - L M Affaticati
- Department of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
| | - G Esposito
- Department of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
| | - E Capuzzi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - L Colzani
- Department of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
| | - D La Tegola
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - E Biagi
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - F Colmegna
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - A Caldiroli
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - M Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- Department of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
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2
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Brancato V, Esposito G, Coppola L, Cavaliere C, Mirabelli P, Scapicchio C, Borgheresi R, Neri E, Salvatore M, Aiello M. Standardizing digital biobanks: integrating imaging, genomic, and clinical data for precision medicine. J Transl Med 2024; 22:136. [PMID: 38317237 PMCID: PMC10845786 DOI: 10.1186/s12967-024-04891-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/14/2024] [Indexed: 02/07/2024] Open
Abstract
Advancements in data acquisition and computational methods are generating a large amount of heterogeneous biomedical data from diagnostic domains such as clinical imaging, pathology, and next-generation sequencing (NGS), which help characterize individual differences in patients. However, this information needs to be available and suitable to promote and support scientific research and technological development, supporting the effective adoption of the precision medicine approach in clinical practice. Digital biobanks can catalyze this process, facilitating the sharing of curated and standardized imaging data, clinical, pathological and molecular data, crucial to enable the development of a comprehensive and personalized data-driven diagnostic approach in disease management and fostering the development of computational predictive models. This work aims to frame this perspective, first by evaluating the state of standardization of individual diagnostic domains and then by identifying challenges and proposing a possible solution towards an integrative approach that can guarantee the suitability of information that can be shared through a digital biobank. Our analysis of the state of the art shows the presence and use of reference standards in biobanks and, generally, digital repositories for each specific domain. Despite this, standardization to guarantee the integration and reproducibility of the numerical descriptors generated by each domain, e.g. radiomic, pathomic and -omic features, is still an open challenge. Based on specific use cases and scenarios, an integration model, based on the JSON format, is proposed that can help address this problem. Ultimately, this work shows how, with specific standardization and promotion efforts, the digital biobank model can become an enabling technology for the comprehensive study of diseases and the effective development of data-driven technologies at the service of precision medicine.
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Affiliation(s)
| | - Giuseppina Esposito
- Bio Check Up S.R.L, 80121, Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131, Naples, Italy
| | | | | | - Peppino Mirabelli
- UOS Laboratori di Ricerca e Biobanca, AORN Santobono-Pausilipon, Via Teresa Ravaschieri, 8, 80122, Naples, Italy
| | - Camilla Scapicchio
- Academic Radiology, Department of Translational Research, University of Pisa, via Roma, 67, 56126, Pisa, Italy
| | - Rita Borgheresi
- Academic Radiology, Department of Translational Research, University of Pisa, via Roma, 67, 56126, Pisa, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, via Roma, 67, 56126, Pisa, Italy
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Papadopoulos NG, Akdis CA, Akdis M, Damialis A, Esposito G, Fergadiotou I, Goroncy C, Guitton P, Gotua M, Erotokritou K, Jartti T, Murray C, Nenes A, Nikoletseas S, Finotto S, Pandis SN, Ramiconi V, Simpson A, Soudunsaari A, Stårbröst A, Staiano M, Varriale A, Xepapadaki P, Zuberbier T, Annesi-Maesano I. Addressing adverse synergies between chemical and biological pollutants at schools-The 'SynAir-G' hypothesis. Allergy 2024; 79:294-301. [PMID: 37654007 DOI: 10.1111/all.15857] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/17/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023]
Abstract
While the number and types of indoor air pollutants is rising, much is suspected but little is known about the impact of their potentially synergistic interactions, upon human health. Gases, particulate matter, organic compounds but also allergens and viruses, fall within the 'pollutant' definition. Distinct populations, such as children and allergy and asthma sufferers are highly susceptible, while a low socioeconomic background is a further susceptibility factor; however, no specific guidance is available. We spend most of our time indoors; for children, the school environment is of paramount importance and potentially amenable to intervention. The interactions between some pollutant classes have been studied. However, a lot is missing with respect to understanding interactions between specific pollutants of different classes in terms of concentrations, timing and sequence, to improve targeting and upgrade standards. SynAir-G is a European Commission-funded project aiming to reveal and quantify synergistic interactions between different pollutants affecting health, from mechanisms to real life, focusing on the school setting. It will develop a comprehensive and responsive multipollutant monitoring system, advance environmentally friendly interventions, and disseminate the generated knowledge to relevant stakeholders in accessible and actionable formats. The aim of this article it to put forward the SynAir-G hypothesis, and describe its background and objectives.
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Affiliation(s)
- Nikolaos G Papadopoulos
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland, Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Mubeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland, Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Athanasios Damialis
- Department of Ecology, School of Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | | | | | - Maia Gotua
- Center for Allergy and Immunology Research (CAIR), Tbilisi, Georgia
| | | | - Tuomas Jartti
- PEDEGO Research Unit, University of Oulu, Oulu, Finland
- Department of Pediatrics, Oulu University Hospital, Oulu, Finland
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Clare Murray
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
| | - Athanasios Nenes
- Laboratory of Atmospheric Processes and their Impacts, School of Architecture, Civil and Environmental Engineering, Swiss Institute of Technology, Lausanne, Switzerland
| | - Sotirios Nikoletseas
- Computer Engineering and Informatics Department, University of Patras, Patras, Greece
| | - Susetta Finotto
- Molecular Pneumology Department, University Hospital of Erlangen, Erlangen, Germany
| | - Spyros N Pandis
- Institute of Chemical Engineering Sciences (ICEHT), Foundation for Research and Technology Hellas (FORTH), Patras, Greece
| | - Valeria Ramiconi
- The European Federation of Allergy and Airways Diseases Patients' Association (EFA), Brussels, Belgium
| | - Angela Simpson
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
| | | | | | - Maria Staiano
- Institute of Food Science, CNR Italy, Avellino, Italy
| | - Antonio Varriale
- Institute of Food Science, CNR Italy, Avellino, Italy
- URT-ISA, CNR at Department of Biology, University of Naples Federico II, Naples, Italy
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Torsten Zuberbier
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- Global Allergy & Asthma European Network of Excellence-GA2LEN, Berlin, Germany
| | - Isabella Annesi-Maesano
- Department of Allergic and Respiratory Disease, Institut Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Montpellier University Hospital, Montpellier, France
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Esposito G, Allarà C, Randon M, Aiello M, Salvatore M, Aceto G, Pescapè A. A Biobanking System for Diagnostic Images: Architecture Development, COVID-19-Related Use Cases, and Performance Evaluation. JMIR Form Res 2023; 7:e42505. [PMID: 38064636 PMCID: PMC10760513 DOI: 10.2196/42505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/22/2023] [Accepted: 09/27/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Systems capable of automating and enhancing the management of research and clinical data represent a significant contribution of information and communication technologies to health care. A recent advancement is the development of imaging biobanks, which are now enabling the collection and storage of diagnostic images, clinical reports, and demographic data to allow researchers identify associations between lifestyle and genetic factors and imaging-derived phenotypes. OBJECTIVE The aim of this study was to design and evaluate the system performance of a network for an operating biobank of diagnostic images, the Bio Check Up Srl (BCU) Imaging Biobank, based on the Extensible Neuroimaging Archive Toolkit open-source platform. METHODS Three usage cases were designed focusing on evaluation of the memory and computing consumption during imaging collections upload and during interactions between two kinds of users (researchers and radiologists) who inspect chest computed tomography scans of a COVID-19 cohort. The experiments considered three network setups: (1) a local area network, (2) virtual private network, and (3) wide area network. The experimental setup recorded the activity of a human user interacting with the biobank system, which was continuously replayed multiple times. Several metrics were extracted from network traffic traces and server logs captured during the activity replay. RESULTS Regarding the diagnostic data transfer, two types of containers were considered: the Web and the Database containers. The Web appeared to be the more memory-hungry container with a higher computational load (average 2.7 GB of RAM) compared to that of the database. With respect to user access, both users demonstrated the same network performance level, although higher resource consumption was registered for two different actions: DOWNLOAD & LOGOUT (100%) for the researcher and OPEN VIEWER (20%-50%) for the radiologist. CONCLUSIONS This analysis shows that the current setup of BCU Imaging Biobank is well provisioned for satisfying the planned number of concurrent users. More importantly, this study further highlights and quantifies the resource demands of specific user actions, providing a guideline for planning, setting up, and using an image biobanking system.
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Affiliation(s)
- Giuseppina Esposito
- Bio Check Up Srl, Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Ciro Allarà
- Bio Check Up Srl, Naples, Italy
- Faculty of Engineering, Free University of Bozen-Bolzano, Bolzano, Italy
| | | | | | | | - Giuseppe Aceto
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Naples, Italy
| | - Antonio Pescapè
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Naples, Italy
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Lorusso L, Minaldi E, Esposito G, Piaggi P, Bottici V, Brogioni S, Giani C, Valerio L, Molinaro E, Elisei R, Agate L. Radio-iodine refractory thyroid cancer patients: a tailored follow-up based on clinicopathological features. J Endocrinol Invest 2023; 46:2165-2173. [PMID: 37084131 PMCID: PMC10514097 DOI: 10.1007/s40618-023-02076-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/21/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE To report the experience of a single center for the selection of radioiodine-refractory (RAIR) thyroid cancer patients (RAIR-TC) who needed tyrosine kinase inhibitor (TKIs) treatment. PATIENTS AND METHODS We evaluated all features of 279 RAIR-TC patients both at the time of diagnosis and at the RAIR diagnosis. RESULTS Ninety-nine patients received indication to TKIs (Group A), while 180 remained under active surveillance (Group B). Group A had greater tumor size, more aggressive histotype, more frequent macroscopic extrathyroidal extension, distant metastases, advanced AJCC stage, and higher ATA risk of recurrence. After RAIR diagnosis, 93.9% of Group A had progression of disease (PD) after which TKIs' therapy was started. The remaining 6.1% of patients had a so severe disease at the time of RAIR diagnosis that TKIs' therapy was immediately started. Among Group B, 42.7% had up to 5 PD, but the majority underwent local treatments. The mean time from RAIR diagnosis to the first PD was shorter in Group A, and the evidence of PD within 25 months from RAIR diagnosis was associated with the decision to start TKIs. CONCLUSIONS According to our results, a more tailored follow-up should be applied to RAIR-TC patients. A too strict monitoring and too many imaging evaluations might be avoided in those with less-aggressive features and low rate of progression. Conversely, RAIR-TC with an advanced stage at diagnosis and a first PD occurring within 25 months from RAIR diagnosis would require a more stringent follow-up to avoid a late start of TKIs.
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Affiliation(s)
- L. Lorusso
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - E. Minaldi
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - G. Esposito
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - P. Piaggi
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - V. Bottici
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - S. Brogioni
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - C. Giani
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - L. Valerio
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - E. Molinaro
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - R. Elisei
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - L. Agate
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
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Pellegrino C, Agamennone M, Iacobelli BD, Turchi B, Capitanucci ML, Beati F, Forlini V, Sollini ML, Marras CE, Esposito G, Palma P, Bella GD, D'Urzo R, Caldaro T, Castelli E, Conforti A, Bagolan P, Mosiello G. Long-term urological outcome of cloaca patients with multidisciplinary management. Pediatr Surg Int 2023; 39:247. [PMID: 37584865 DOI: 10.1007/s00383-023-05539-2] [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] [Accepted: 08/09/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE Urological management of Cloacal Malformation (CM) focuses on preserving renal function and continence. Study aim was to analyze urinary and intestinal outcomes in CM patients, considering the length of common channel (CC) and presence of occult spinal dysraphism (OSD). METHODS Retrospective review of CM treated at our institution by a multidisciplinary team from 1999 to 2020. Patients with follow-up < 2.5 years were excluded. Length of CC, renal function, urinary and bowel outcomes, presence of associated anomalies (especially OSD) were evaluated. RESULTS Twenty patients were included, median age at follow-up: 8 years (4-15). A long CC > 3 cm was described in 11 (55%). Chronic kidney disease was found in 3 patients. Urinary continence was achieved in 8/20 patients, dryness (with intermittent catheterization) in 9/20. Fecal continence was obtained in 3/20, cleanliness in 14 (under bowel regimen). OSD was present in 10 patients (higher prevalence in long-CC, 73%). Among OSD, 1 patient reached fecal continence, 7 were clean; 2 achieved urinary continence, while 6 were dry. CONCLUSIONS Length of CC and OSD may affect urinary and fecal continence. An early counseling can improve outcome at long-term follow-up. Multidisciplinary management with patient centralization in high grade institutions is recommended to achieve better results.
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Affiliation(s)
- C Pellegrino
- Division of Neuro-Urology, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
| | - M Agamennone
- Division of Neuro-Urology, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
- Pediatric Surgery, University of Genoa, DINOGMI, Largo Paolo Daneo 3, 16132, Genoa, GE, Italy
| | - B D Iacobelli
- Neonatal Surgery Unit, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy.
| | - B Turchi
- Division of Neuro-Urology, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
- Urology Unit, Azienda Ospedaliera Sant'Andrea, 'Sapienza' University of Rome, Via di Grottarossa, 1035/1039, 00189, Rome, RM, Italy
| | - M L Capitanucci
- Division of Neuro-Urology, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
| | - F Beati
- Neonatal Surgery Unit, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
| | - V Forlini
- Division of Neuro-Urology, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
- Pediatric Surgery, University of Genoa, DINOGMI, Largo Paolo Daneo 3, 16132, Genoa, GE, Italy
| | - M L Sollini
- Division of Neuro-Urology, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
- Division of Physical Rehabilitation, University of Tor Vergata, Via Cracovia 50, 00133, Rome, RM, Italy
| | - C E Marras
- Neurosurgery Unit, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
| | - G Esposito
- Neurosurgery Unit, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
| | - P Palma
- Neurosurgery Unit, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
| | - G Della Bella
- Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital IRCCS, 00165, Rome, Italy
| | - R D'Urzo
- Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital IRCCS, 00165, Rome, Italy
| | - T Caldaro
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza di Sant'Onofrio, 4, 00165, Rome, RM, Italy
| | - E Castelli
- Neurorehabilitation Unit, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy
| | - A Conforti
- Neonatal Surgery Unit, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
| | - P Bagolan
- Neonatal Surgery Unit, Area of Fetal, Neonatal and Cardiological Sciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - G Mosiello
- Division of Neuro-Urology, Bambino Gesu' Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, RM, Italy
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Santangelo M, Althuwaynee O, Alvioli M, Ardizzone F, Bianchi C, Bornaetxea T, Brunetti MT, Bucci F, Cardinali M, Donnini M, Esposito G, Gariano SL, Grita S, Marchesini I, Melillo M, Peruccacci S, Salvati P, Yazdani M, Fiorucci F. Inventory of landslides triggered by an extreme rainfall event in Marche-Umbria, Italy, on 15 September 2022. Sci Data 2023; 10:427. [PMID: 37400466 DOI: 10.1038/s41597-023-02336-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/27/2023] [Indexed: 07/05/2023] Open
Abstract
Systematic and timely documentation of triggered (i.e. event) landslides is fundamental to build extensive datasets worldwide that may help define and/or validate trends in response to climate change. More in general, preparation of landslide inventories is a crucial activity since it provides the basic data for any subsequent analysis. In this work we present an event landslide inventory map (E-LIM) that was prepared through a systematic reconnaissance field survey in about 1 month after an extreme rainfall event hit an area of about 5000 km2 in the Marche-Umbria regions (central Italy). The inventory reports evidence of 1687 triggered landslides in an area of ~550 km2. All slope failures were classified according to type of movement and involved material, and documented with field pictures, wherever possible. The database of the inventory described in this paper as well as the collection of selected field pictures associated with each feature is publicly available at figshare.
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Affiliation(s)
- M Santangelo
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - O Althuwaynee
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - M Alvioli
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - F Ardizzone
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - C Bianchi
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - T Bornaetxea
- Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU) (visiting at CNR-IRPI), Leioa, Spain
| | - M T Brunetti
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - F Bucci
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy.
| | - M Cardinali
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - M Donnini
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - G Esposito
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - S L Gariano
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - S Grita
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
- Università degli Studi di Roma "La Sapienza", Rome, Italy
| | - I Marchesini
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - M Melillo
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - S Peruccacci
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - P Salvati
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - M Yazdani
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
| | - F Fiorucci
- Italian National Research Council - Research Institute for Geo-Hydrological Protection (CNR-IRPI), Perugia, Italy
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8
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Bermpeis K, Esposito G, Bertolone D, Gallinoro E, Verstreken S, Bogaerts E, Munhoz D, Heggermont W, Dierckx R, Bartunek J, Vanderheyden M. Safety of Ventricular Endomyocardial Biopsy in Heart Transplant Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.587] [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: 04/05/2023] Open
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9
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Esposito G, Montalto C, Crimi G, Grippo R, Morici N, Bruschi G, Testa L, De Marco F, Soriano F, Nava S, Stefanini G, Bedogni F, Oreglia JA. Time course of ischemic and bleeding burden in consecutive patients undergoing transcatheter aortic valve replacement (FOCUS-ONE registry). Int J Cardiol 2023; 381:2-7. [PMID: 36898584 DOI: 10.1016/j.ijcard.2023.03.009] [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: 12/18/2022] [Revised: 02/25/2023] [Accepted: 03/05/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND AND AIMS Ischemic or bleeding events might occur after transcatheter aortic valve replacement (TAVR), with the potential to hamper clinical outcomes. This study aimed to characterize the average daily ischemic risks (ADIRs) and the average daily bleeding risks (ADBRs) over 1-year in all consecutive patients undergoing TAVR. METHODS ADBR included all bleeding events according to VARC-2 definition, and ADIR included cardiovascular deaths, myocardial infarction and ischemic stroke. ADIRs and ADBRs were assessed within different timeframes post TAVR: acute (0-30 days), late (31-180 days), and very late (>181 days). Generalized estimating equations were used to test the least squares mean differences for the pairwise comparison of ADIRs and ADBRs. Our analysis was performed in the overall cohort and according to antithrombotic strategy (LT-OAC vs No LT-OAC). RESULTS Ischemic burden was higher than bleeding burden, independently from the indication to LT-OAC, and in all timeframes examined. In the overall population, ADIRs were three-fold ADBRs (0.0467 [95% CI, 0.0431-0.0506] vs 0.0179 [95% CI, 0.0174-0.0185]; p < 0.001*). While ADIR was significantly higher in the acute phase, ADBR was relatively stable in all timeframes analysed. Of note, in LT-OAC population, OAC + SAPT group showed lower ischemic risk and higher bleeding events compared with OAC alone (ADIR: 0.0447 [95% CI: 0.0417-0.0477] vs 0.0642 [95% CI: 0.0557-0.0728]; p < 0.001*, ADBR 0.0395 [95% CI: 0.0381-0.0409] vs 0.0147 [95% CI: 0.0138-0.0156]; p < 0.001*). CONCLUSIONS In patients undergoing TAVR Average daily risk fluctuates over time. However, ADIRs overcome ADBRs in all timeframes, especially in the acute phase and regardless of antithrombotic strategy adopted.
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Affiliation(s)
- G Esposito
- Interventional Cardiology Unit, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy; Department of Advanced Biomedical Sciences, University of Naples, Federico II, Naples, Italy.
| | - C Montalto
- Interventional Cardiology Unit, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
| | - G Crimi
- Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV), IRCCS, Ospedale Policlinico San Martino, Genoa, Italy.
| | - R Grippo
- Interventional Cardiology Unit, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
| | - N Morici
- IRCCS S. Maria Nascente - Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - G Bruschi
- Interventional Cardiology Unit, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
| | - L Testa
- Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - F De Marco
- Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - F Soriano
- Interventional Cardiology Unit, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
| | - S Nava
- Interventional Cardiology Unit, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
| | - G Stefanini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Italy- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - F Bedogni
- IRCCS S. Maria Nascente - Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - J A Oreglia
- Interventional Cardiology Unit, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
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10
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Dilaghi E, Lahner E, Annibale B, Esposito G. Systematic review and meta-analysis: Artificial intelligence for the diagnosis of gastric precancerous lesions and Helicobacter pylori infection. Dig Liver Dis 2022; 54:1630-1638. [PMID: 35382973 DOI: 10.1016/j.dld.2022.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 01/29/2022] [Revised: 03/12/2022] [Accepted: 03/16/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND The endoscopic diagnosis of Helicobacter-pylori(H.pylori) infection and gastric precancerous lesions(GPL), namely atrophic-gastritis and intestinal-metaplasia, still remains challenging. Artificial intelligence(AI) may represent a powerful resource for the endoscopic recognition of these conditions. AIMS To explore the diagnostic performance(DP) of AI in the diagnosis of GPL and H.pylori infection. METHODS A systematic-review was performed by two independent authors up to September 2021. Inclusion criteria were studies focusing on the DP of AI-system in the diagnosis of GPL and H.pylori infection. The pooled accuracy of studies included was reported. RESULTS Overall, 128 studies were found (PubMed-Embase-Cochrane Library) and four and nine studies were finally included regarding GPL and H.pylori infection, respectively. The pooled-accuracy(random effects model) was 90.3%(95%CI 84.3-94.9) and 79.6%(95%CI 66.7-90.0) with a significant heterogeneity[I2=90.4%(95%CI 78.5-95.7);I2=97.9%(97.2-98.6)] for GPL and H.pylori infection, respectively. The Begg's-test showed a significant publication-bias(p = 0.0371) only among studies regarding H.pylori infection. The pooled-accuracy(random-effects-model) was similar considering only studies using CNN-model for the diagnosis of H.pylori infection: 74.1%[(95%CI 51.6-91.3);I2=98.9%(95%CI 98.5-99.3)], Begg's-test(p = 0.1416) did not show publication-bias. CONCLUSION AI-system seems to be a good resource for an easier diagnosis of GPL and H.pylori infection, showing a pooled-diagnostic-accuracy of 90% and 80%, respectively. However, considering the high heterogeneity, these promising data need an external validation by randomized control trials and prospective real-time studies.
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Affiliation(s)
- E Dilaghi
- Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, Roma 1035 - 00189, Italy
| | - E Lahner
- Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, Roma 1035 - 00189, Italy
| | - B Annibale
- Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, Roma 1035 - 00189, Italy
| | - G Esposito
- Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, Roma 1035 - 00189, Italy.
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11
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Montecchio D, Mattei MR, Esposito G, Andreottola G, Ferrentino R. Mathematical modelling of an intermittent anoxic/aerobic MBBR: Estimation of nitrification rates and energy savings. J Environ Manage 2022; 321:116026. [PMID: 35998531 DOI: 10.1016/j.jenvman.2022.116026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/22/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
This study aimed at modelling the performance of a novel MBBR configuration, named A/O-MBBR, comprised of a pre-anoxic reactor, with an HRT of 4.5 h, coupled with an intermittent anoxic/aerobic MBBR (HRT = 6.8 h). The lab-scale system was fed with municipal wastewater with an average influent Total Ammonia Nitrogen (TAN) and total COD (TCOD) concentrations of 46 mg of TAN-N L-1 and 310 mg TCOD L-1. During the whole experimental period, TAN removal efficiency was always higher than 96%; denitrification was also very effective, achieving nitrate and nitrite concentrations in the effluent both lower than 5 mg NOx-N L-1 on average. Moreover, TCOD average removal efficiency was equal to 85%. Modelling was performed to investigate the nitrification efficacy enhancement; to this aim, a biofilm model was developed, adopting the equations for mixed-culture biofilms and the Activated Model Sludge n°1 (ASM1) for the biological processes rates. The model allowed to determine the maximum uptake rate for autotrophic growth (μA was 2.5 d-1) and the semisaturation constant (KOA was 0.2 mg O2 L-1), suggesting that the nitrification process was 3-fold faster than average and very effective at low oxygen concentrations. The model estimated that about 85% of TAN was removed by the biofilm and only the remaining part by suspended biomass in the bulk liquid. Finally, it was assessed that the A/O-MBBR configuration allowed for a 45-60% savings of the energy requirement compared to a Benchmark WWTP layout.
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Affiliation(s)
- D Montecchio
- Istituto di Ricerca Sulle Acque-CNR, Area Della Ricerca RM1, 00015 Monterotondo, Roma, Italy.
| | - M R Mattei
- Department of Mathematics and Applications "Renato Caccioppoli", University of Naples Federico II, Via Cintia, Monte S. Angelo, 80126 Napoli, Italy.
| | - G Esposito
- Department of Civil, Architectural and Environmental Engineering, University of Naples Federico II, Via Claudio 21, 80125, Naples, Italy.
| | - G Andreottola
- Department of Civil, Environmental and Mechanical Engineering, University of Trento, Via Mesiano 77, 38123, Trento, Italy.
| | - R Ferrentino
- Department of Civil, Environmental and Mechanical Engineering, University of Trento, Via Mesiano 77, 38123, Trento, Italy.
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12
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Gallinoro E, Paolisso P, Vanderheyden M, Esposito G, Bertolone DT, Mileva N, Bermpeis K, Belmonte M, De Colle C, Candreva A, Penicka M, Collet C, Sonck J, De Bruyne B, Barbato E. Assessment of absolute coronary flow and microvascular resistance reserve in patients with severe aortic stenosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
The development of left ventricular hypertrophy in patients with severe aortic stenosis (AS) is accompanied by adaptive coronary flow regulation, both in epicardial and microvascular compartment, which ultimately lead to a chronic ischemic insult even in the absence of obstructive coronary artery disease. Intracoronary continuous thermodilution of saline through a dedicated infusion catheter is a novel tool that allows to measure absolute coronary flow and microvascular resistance at rest and during hyperemia and to calculate both coronary flow reserve (CFR) and Microvascular Resistance Reserve (MRR)
Purpose
We aimed to assess absolute coronary flow, microvascular resistance, CFR and MRR in patients with AS, by continuous intracoronary thermodilution, comparing these hemodynamic findings with a propensity-score matched contemporary cohort of patients without AS.
Methods
Absolute coronary blood flow and microvascular resistance were measured by continuous thermodilution in 29 patients with AS and compared to 15 controls matched for age, gender, diabetes mellitus and functional severity of epicardial coronary lesions. Myocardial work, total myocardial mass and LAD-specific mass were quantified by echocardiography and cardiac-CT.
Results
Patients with AS presented a significantly positive LV remodeling with lower global longitudinal strain and higher global work index compared to controls (p<0.02). Total LV myocardial mass and LAD-specific myocardial mass were significantly higher in patients with AS. Compared to matched controls, absolute resting flow in the LAD was significantly higher in the AS cohort (86 [66–107] ml/min vs 68 [52–75] ml/min, p=0.036), resulting, in lower CFR (2.30±0.69 vs 2.89±0.77, p=0.005) and MRR (2.73±0.74 vs 3.53±0.95, p=0.005) in the AS cohort compared to controls (Figure 1). No differences were found in hyperemic flow and resting and hyperemic resistances. Interestingly, hyperemic myocardial perfusion (calculated as the ratio between the absolute coronary flow in the LAD and the mass subtended by the vessel, expressed in mL/min/g), but not resting, was significantly lower in the AS group (1.9 [1.5–2.5] ml/min/g vs 2.3 [2–3.1] ml/min/g p=0.036).
Conclusions
In patients with severe aortic stenosis and non-obstructive coronary artery disease, with the progression of LVH, the compensatory mechanism of increased resting flow maintains an adequate perfusion at rest, but not during hyperemia (Figure 2). As consequence, both CFR and MRR are significantly impaired.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Gallinoro
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - P Paolisso
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | | | - G Esposito
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - D T Bertolone
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - N Mileva
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - K Bermpeis
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - M Belmonte
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - C De Colle
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - A Candreva
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - M Penicka
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - C Collet
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - J Sonck
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - B De Bruyne
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - E Barbato
- Cardiovascular Research Center Aalst , Aalst , Belgium
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13
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Canciello G, Tozza S, Lombardi R, Nolano M, Todde G, Severi D, Borrelli F, Acampa W, Esposito G, Manganelli F, Losi MA. Global longitudinal strain and quantitative sensory testing in pre-symptomatic patients with mutation for transthyretin amyloidosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Hereditary transthyretin (ATTRv) amyloidosis is a rare, autosomal dominant, and devastating disease. If untreated, the disease is fatal within 4–15 years from onset.
Thus, diagnosis in the early stages of ATTRv amyloidosis is crucial to start treatment and to prevent or delay disease progression. However, the diagnosis of symptomatic ATTRv amyloidosis in TTR gene mutation carriers may be challenging.
Purpose
We aimed identifying early indexes of cardiac and/or neurological involvement in pre-symptomatic subjects (carriers) harboring a TTR gene mutation.
Methods
Eight TTR-mutation carriers (mean age 51±9 years, 5 males) constituted the study populations. Mutations identified were: Val30Met in 4, and Phe64Leu in the remaining 4 patients. Patients underwent tactile and thermal quantitative sensory testing (QST), 99mTc-labeled bisphosphonate (HMDP) scintigraphy with the evaluation of Perugini score, and comprehensive echocardiogram with evaluation of global longitudinal strain (GLS).
Results
Table 1 reports results in overall patients. PADO indicates predicted age of disease onset. MWT indicates maximal wall thickness at echocardiography.
There was a strong and inverse correlation between the °C degree at HPT and GLS (r=−0.790; p=0.02, demonstrating that a worse HPT corresponded a better GLS (Figure 1).
Conclusion
GLS and QST findings support an early involvement of heart and small nerve fibers even many years before the PADO. Interestingly, cardiac impairment seems to not parallel that of small nerve fibers. An inhomogeneous accumulation of fibrils, as well possible different pathophysiological mechanisms in heart and nerve fibers, might result in a variable organ impairment at least in the earliest stage of disease.
Our observation needs to be tested in a wider population with such a rare disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- G Canciello
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - S Tozza
- Federico II, Neuroscience and Reproductive and Odontostomatological Sciences, University Federico II , Naples , Italy
| | - R Lombardi
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - M Nolano
- Federico II, Neuroscience and Reproductive and Odontostomatological Sciences, University Federico II , Naples , Italy
| | - G Todde
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - D Severi
- Federico II, Neuroscience and Reproductive and Odontostomatological Sciences, University Federico II , Naples , Italy
| | - F Borrelli
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - W Acampa
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - G Esposito
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - F Manganelli
- Federico II, Neuroscience and Reproductive and Odontostomatological Sciences, University Federico II , Naples , Italy
| | - M A Losi
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
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14
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Borrelli F, Lombardi R, Canciello G, Frisso G, Todde G, Paoletta D, Esposito G, Losi MA. Mechano-energetic efficiency in patients with hypertrophic cardiomyopathy with and without sarcomeric mutations. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Hypertrophic Cardiomyopathy (HCM) is mainly caused by sarcomeric mutations. In about 40% of cases the causal mutation is unknown. Myocardial mechano-energetic efficiency per unit of left ventricular (LV) mass (MEEi) is an echocardiographic parameter of LV pump performance. Sarcomeric mutations may affect energy efficiency.
Purpose
We investigated the effects of the presence of sarcomeric mutations on MEEi in patients with HCM.
Methods
We included 49 genetically screened HCM patients (50±10 years, 27% women) with LV ejection fraction >50%, LV maximal wall thickness >14 mm and no moderate to severe mitral regurgitation. MEEi was calculated as the ratio between stroke volume and heart rate, normalized by LV mass. Echo-LV mass was calculated as LV epicardial minus LV endocardial volumes in 4 and 2 chamber views multiplied by 1.05, a method validated with nuclear magnetic resonance.
Results
27 HCM patients carried a sarcomeric mutation (HCM-Sarc; 55%). As shown in the table, patients with and without sarcomeric mutations (HCM-Sarc vs HCM-NoSarc) had similar LV ejection fraction, heart rate, LV mass and LV outflow tract gradient. HCM-Sarc showed early age at diagnosis, higher frequency of HCM family history and significantly reduced MEEi as compared with HCM-NoSarc. Presence of sarcomeric mutation could be predicted by younger age, lower MEEi and by family history of HCM (overall p<0.05).
Conclusions
In a population of HCM patients, the presence of a sarcomeric mutation is the only determinant of reduced the LV pump performance as estimated by MEEi. MEEi may be used as an imaging biomarker in sarcomeric mutation carriers.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Borrelli
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - R Lombardi
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - G Canciello
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - G Frisso
- Federico II University Hospital, Department of Translational Medicine , Naples , Italy
| | - G Todde
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - D Paoletta
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - G Esposito
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - M A Losi
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
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15
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Gallinoro E, Fernandez-Peregrina E, Bertolone DT, Paolisso P, Bermpeis K, Esposito G, Belmonte M, Candreva A, Mileva N, Munhoz D, Sonck J, Barbato E, Collet C, De Bruyne B. Repeatability of bolus and continuous thermodilution for assessing coronary microvasculatory function. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The bolus thermodilution-derived index of microcirculatory resistance (IMR) has emerged over years as the standard of reference to invasively define coronary microvascular dysfunction (CMD). However, the technique still presents some limitations, mainly related to the fact that manual injection of saline bolus accounts for some variance in the measurements. Continuous intracoronary thermodilution has been recently introduced as a tool to directly quantify absolute coronary flow and microvascular resistance both at rest and during hyperemia and has shown to be safe and operator independent. Microvascular resistance reserve (MRR), derived from continuous thermodilution, has been validated as novel index specific for microcirculation and independent from myocardial mass.
Purpose
To compare head-to-head the intra-observer repeatability of bolus and continuous thermodilution for assessing microvascular function.
Methods
Patients undergoing coronary angiography in the absence of obstructive coronary artery disease were prospectively enrolled. Bolus and continuous intracoronary thermodilution measurements were performed in duplicates in the left anterior descending artery (LAD). Patients were randomly assigned in a 1:1 ratio to undergo first bolus thermodilution or first continuous thermodilution assessment.
Results
A total of 102 patients were enrolled. Average FFR was 0.86±0.06. Coronary Flow Reserve (CFR) calculated with continuous thermodilution (CFRthermo) was significantly lower than bolus thermodilution-derived CFR (CFRbolus) (2.63±0.65 and 3.29±1.17, respectively, p<0.001). CFRthermo showed a lower variability and a higher agreement than CFRbolus (variability 12.74±10.41% vs 31.26±24.85%, respectively, p<0.001; ICC= 0.78 (0.70–0.85) and 0.48 (0.32–0.62), respectively, p<0.001, Figure 1). Both MRR and IMR showed a good agreement (ICC 0.81 (0.74–0.87) and 0.80 (0.71–0.86)) but the variability of the MRR was significantly lower (12.44±10.06% vs 24.24±19.27, respectively, p<0.001, Figure 1). Reproducibility data of all indices derived from duplicated measurements of bolus and continuous thermodilution are reported in Table 2.
Conclusion
Continuous intracoronary thermodilution has a higher repeatability than bolus thermodilution in the assessment of CMD.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Gallinoro
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | | | - D T Bertolone
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - P Paolisso
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - K Bermpeis
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - G Esposito
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - M Belmonte
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - A Candreva
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - N Mileva
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - D Munhoz
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - J Sonck
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - E Barbato
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - C Collet
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - B De Bruyne
- Cardiovascular Research Center Aalst , Aalst , Belgium
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16
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Todde G, Monda E, Canciello G, Lioncino M, Lombardi R, Rubino M, Borrelli F, Caiazza M, Paoletta D, De Simone G, Pacileo G, Esposito G, Limongelli G, Losi MA. HCM-AF South Italy score for prediction of new-onset atrial fibrillation in patients with hypertrophic cardiomyopathy: data from a derivation and validation italian cohorts. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Only one score for prediction of new-onset atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM) has been developed in North America (HCM-AF North America score).
Purpose
To develop a new score (HCM-AF South Italy score) in an Italian derivation cohort and to test the new score with that from North America, in an Italian validation cohort.
Methods
A cohort of 228 patients with HCM and without history of AF, followed at referral center 1 for HCM, was used for model development. A cohort of 226 patients without history of AF, followed at referral center 2, was used for external validation. During follow-up (IQR 3–13 years, median 8 years), 59 (26%) patients developed new-onset AF. Data in the development cohort generated the HCM-AF South Italy score, a point score to predict AF probability: left atrial dimension >49 mm (+5 points), age at clinical evaluation <55 years (+2 points), the use of angiotensin-converting enzyme (ACE) or inhibitor or angiotensin receptor blocker (ARB) at initial evaluation (+2 points), low left ventricular (LV) ejection fraction (<50%) (+2 points), LV outflow tract obstruction (LVOTO) >25 mmHg (+2 points), NYHA class >1 (+1 point).
Results
Patients from the validation cohort were older, had lower prevalence of HCM family history, lower systolic and diastolic blood pressure, taken fewer drugs like beta-blockers, ACE or ARB, calcium-channel blockers, and antiarrhythmic drugs and had lower LVOTO than patients from the derivation cohort, (overall p<0.05). During follow-up (IQR 1–10 years, median 5 years), 25 (11%) patients developed AF. ROC curve analysis demonstrated that HCM-AF South Italy score was superior to HCM-AF North America score (Figure). A HCM- AF South Italy score >4 identified patients at risk of AF with a sensitivity of 48%, specificity of 76%, PPV of 20% and NPV of 92%.
Conclusion
Although derived and tested in little and quite different populations, the performance of the HCM-AF South Italy score was superior to that of the score developed in North America.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- G Todde
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - E Monda
- University Luigi Vanvitelli, Inherited and Rare Cardiovascular Diseases Unit, Department of Translational Medical Sciences , Naples , Italy
| | - G Canciello
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - M Lioncino
- University Luigi Vanvitelli, Inherited and Rare Cardiovascular Diseases Unit, Department of Translational Medical Sciences , Naples , Italy
| | - R Lombardi
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - M Rubino
- University Luigi Vanvitelli, Inherited and Rare Cardiovascular Diseases Unit, Department of Translational Medical Sciences , Naples , Italy
| | - F Borrelli
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - M Caiazza
- University Luigi Vanvitelli, Inherited and Rare Cardiovascular Diseases Unit, Department of Translational Medical Sciences , Naples , Italy
| | - D Paoletta
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - G De Simone
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - G Pacileo
- University Luigi Vanvitelli, Inherited and Rare Cardiovascular Diseases Unit, Department of Translational Medical Sciences , Naples , Italy
| | - G Esposito
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
| | - G Limongelli
- University Luigi Vanvitelli, Inherited and Rare Cardiovascular Diseases Unit, Department of Translational Medical Sciences , Naples , Italy
| | - M A Losi
- Federico II University of Naples, Advanced Biomedical Sciences , Naples , Italy
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17
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Oliva A, Castiello D, Franzone A, Condorelli G, Colombo A, Esposito G, Stefanini G, Piccolo R. P2Y12 inhibitors monotherapy in patients undergoing complex vs. non-complex percutaneous coronary intervention: a meta-analysis of randomized trials. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Monotherapy with P2Y12 inhibitors (P2Y12i) is emerging as alternative strategy to dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). However, early withdrawal of aspirin as part of P2Y12i monotherapy regimens may pose concerns in high-risk patients, such as those undergoing complex PCI.
Purpose
To evaluate the efficacy and safety of P2Y12i monotherapy after a short course of DAPT (1- to 3-month) compared with standard DAPT (≥12-month) according to PCI complexity.
Methods
We performed a meta-analysis of randomized trials using random effects models to combine hazard ratios (HRs) with 95% confidence intervals (CIs). No restrictions were applied to the type of P2Y12 receptor inhibitor (clopidogrel, prasugrel, or ticagrelor) or to the definition of complex PCI. Within-trial interactions were pooled to estimate heterogeneity between complex and noncomplex PCI strata. The study protocol was registered in the PROSPERO (CRD42021291027).
Results
We screened 7,502 unique citations, of which 2,948 were screened at title and abstract level and 576 were judged potentially eligible for full-text assessment. We included in the analysis five trials (1–5) enrolling 31,627 patients, of whom 8,328 (26.3%) underwent complex PCI; characteristics of trials and patient populations are summarized in Table 1. Risk estimates for efficacy and safety outcomes associated with P2Y12i monotherapy and standard DAPT across studies included in the analysis, stratified by complex and noncomplex PCI, are reported in Figure 1. P2Y12i monotherapy compared with standard DAPT was associated with a similar risk of all-cause death, stent thrombosis, and stroke, with no evidence for interaction between complex and noncomplex PCI. We found heterogeneity in the treatment effect of P2Y12i monotherapy vs. standard DAPT with respect to myocardial infarction (P-interaction=0.027). Compared with standard DAPT, P2Y12i monotherapy decreased the risk of myocardial infarction in complex PCI (HR 0.77, 95% CI 0.60–0.99, P=0.042), but not in noncomplex PCI patients (HR 1.09, 95% CI 0.90–1.30, P=0.382). The risk of major bleeding was significantly reduced by P2Y12i monotherapy with a consistent treatment effect (P-interaction=0.699) in both complex and noncomplex PCI strata.
Conclusions
Patients undergoing complex PCI may derive more benefit and less harm from P2Y12i monotherapy after early aspirin withdrawal compared with standard DAPT, resulting in decreased risks of myocardial infarction and bleeding.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Oliva
- Humanitas Research Hospital , Milan , Italy
| | - D Castiello
- Federico II University of Naples, Department of Advanced Biomedical Sciences , Naples , Italy
| | - A Franzone
- Federico II University of Naples, Department of Advanced Biomedical Sciences , Naples , Italy
| | | | - A Colombo
- Humanitas Research Hospital , Milan , Italy
| | - G Esposito
- Federico II University of Naples, Department of Advanced Biomedical Sciences , Naples , Italy
| | | | - R Piccolo
- Federico II University of Naples, Department of Advanced Biomedical Sciences , Naples , Italy
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18
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Bertolone D, Gallinoro E, Candreva A, Fernandez Peregrina E, Bailleul E, Meeus P, Sonck J, Bermpeis K, Esposito G, Paolisso P, Heggermont W, Adjedj J, Barbato E, Collet C, De Bruyne B. Saline-induced coronary hyperemia with continuous intracoronary thermodilution is mediated by intravascular hemolysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
To test whether local hemolysis is a potential mechanism of saline-induced coronary hyperemia.
Background
Absolute coronary flow can be measured by intracoronary continuous thermodilution of saline through the lateral side holes of a dedicated infusion cathete. A saline infusion rate at 15–20 mL/min induces an immediate, steady-state, maximal microvascular vasodilation. The mechanism of this hyperemic response remains unclear.
Methods
Twelve patients undergoing left and right catheterization were included. The left coronary artery and the coronary sinus were selectively cannulated. Absolute resting and hyperemic coronary flow were measured by continuous intracoronary thermodilution. Arterial and venous samples were collected from the coronary artery and the coronary sinus in five phases: baseline (BL); resting flow measurement (Rest, saline infusion at 10 mL/min); hyperemia (Hyperemia,saline infusion at 20 mL/min); post-hyperemia (Post-Hyperemia, two minutes after the cessation of saline infusion); and control phase (Control, during infusion of saline through the guide catheter at 30 mL/min).
Results
Hemolysis was visually detected only in the centrifugated venous blood samples collected during the Hyperemia phase. As compared to Rest, during Hyperemia both LDH (131.50±21.89 U/dL [Rest] and 258.33±57.40 U/dL [Hyperemia], p<0.001) and plasma free hemoglobin (PFHb, 4.92±3.82 mg/dL [Rest] and 108.42±46.58 mg/dL [Hyperemia], p<0.001) significantly increased in the coronary sinus. The percentage of hemolysis was significantly higher during the Hyperemia phase (0.04±0.02% [Rest] vs 0.89±0.34% [Hyperemia], p<0.001).
Conclusions
Saline-induced hyperemia through a dedicated intracoronary infusion catheter is associated with hemolysis. Vasodilatory compounds released locally, like ATP, are likely ultimately responsible for localized microvascular vasodilation.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Bertolone
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - E Gallinoro
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - A Candreva
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | | | - E Bailleul
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - P Meeus
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - J Sonck
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - K Bermpeis
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - G Esposito
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - P Paolisso
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - W Heggermont
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - J Adjedj
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - E Barbato
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - C Collet
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - B De Bruyne
- Cardiovascular Research Center Aalst , Aalst , Belgium
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19
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Ilardi F, Manzo R, Franzone A, Angellotti D, Avvedimento M, Iapicca C, Manzi L, Verde N, Simonetti F, Castiello D, Leone A, Mariani A, Piccolo R, Cirillo P, Esposito G. Prognostic role of global work efficiency in patients undergoing transcatheter aortic valve implantation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Non-invasive myocardial work (MW) quantification has emerged in the last years as an alternative echocardiographic tool for myocardial function assessment. Its role in patients with severe aortic stenosis (AS) after aortic valve implantation (TAVI) has not been adequately investigated.
Purpose
We aimed to evaluate MW indices as early echocardiographic markers of LV reverse remodeling within a month after TAVI and their prognostic value.
Methods and results
We conducted a single-centre prospective study, enrolling 88 consecutive patients (mean age 79.9±6.4 years, 35% males) with AS undergoing TAVI between April 2018 and 2021, selected from the EffecTAVI registry. Exclusion criteria were prior valve surgery, atrial fibrillation, left bundle branch block (LBBB) at baseline and and suboptimal quality of imaging. Echocardiographic assessment was performed before TAVI and at 30-day follow-up, including quantification of 2D global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE). LV peak systolic pressure was estimated non-invasively from the sum of systolic blood pressure and trans-aortic mean gradient. One month after the procedure, there was a significant improvement of LV GLS (−18.4±4.2 vs −19.5±4.2%, before and after TAVI respectively, p=0.006), a significant reduction of GWI (2406±567 vs 1908±479 mmHg%, p<0.001), GCW (2783±616 vs 2202±463 mmHg%, p<0.001), and GWW (238±203 vs 173±127 mmHg%, p=0.002). Conversely, MWE did not change early after intervention (90.4±6.2 vs 91.4±5.1%, p=0.113). After TAVI, 32 patients (36.4%) developed LV dyssynchrony due to LBBB or pacemaker implantation. When the population was divided according to the presence or absence of LV dyssynchrony at 30-day follow-up, a significant reduction in GWW was found only in the those without dyssynchrony (241±229 vs 142±103 mmHg% before and after TAVI, p<0.001). Consistently, in this subgroup, MWE significantly improved after TAVI (90±7 vs 93±5%, p=0.001), while a trend of MWE reduction was observed in patients who developed dyssynchrony after TAVI (91±5 vs 89±5%, p=0.110). In the overall population, a 30-day value of MWE≤92% was associated with an increased rate of cardiovascular events (composite of all-cause death and rehospitalization for heart failure) at 1-year follow-up (29.5% vs 4.8%, long rank p=0.003). In multivariable Cox-regression analysis, adjusted for confounders, GWE after TAVI (HR: 0.892, CI: 0.817–0.974; p=0.011) was independently associated with events at 1-year follow-up.
Conclusions
In patients with severe AS undergoing TAVI a significant reduction of GWW and improvement of MWE can be detected only in those who do not develop LV dyssynchrony. In this setting, MWE≤92% early after TAVI is associated with poor outcome. Thus, MWE could represent an alternative tool for myocardial function assessment and prognostic evaluation in patients receiving TAVI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Ilardi
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - R Manzo
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - A Franzone
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - D Angellotti
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - M Avvedimento
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - C Iapicca
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - L Manzi
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - N Verde
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - F Simonetti
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - D Castiello
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - A Leone
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - A Mariani
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - R Piccolo
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - P Cirillo
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
| | - G Esposito
- Federico II University Hospital, Advanced Biomedical Sciences , Naples , Italy
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20
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Paolisso P, Gallinoro E, Belmonte M, Bertolone DT, Bermpeis K, Esposito G, Seki R, Fabbricatore D, Bartunek J, Vanderheyden M, Wyffels E, Sonck J, Collet C, De Bruyne B, Barbato E. Microvascular dysfunction in patients with diabetes mellitus: assessment of absolute coronary flow and microvascular resistance reserve. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Coronary microvascular dysfunction (CMD) is an early feature of diabetic cardiomyopathy, which usually precedes the onset of systolic and diastolic dysfunction (DDF). Continuous intracoronary thermodilution allows an accurate and reproducible assessment of absolute coronary blood flow and microvascular resistance thus allowing the evaluation of coronary flow reserve (CFR) and Microvascular Resistance Reserve (MRR), a novel index specific for microvascular function, which is independent from the myocardial mass. In the present study we compared absolute coronary flow and resistance, CFR and MRR assessed by continuous intracoronary thermodilution in diabetic versus non-diabetic patients. Left atrial reservoir strain (LASr), an early marker of DDF was compared between the two groups.
Methods
In this observational retrospective study, 108 patients with suspected angina and non-obstructive coronary artery disease (NOCAD) consecutively undergoing elective coronary angiography (CAG) from September 2018 to June 2021 were enrolled. The invasive functional assessment of microvascular function was performed in the left anterior descending artery (LAD) with intracoronary continuous thermodilution. Patients were classified according to the presence of DM. Absolute resting and hyperemic coronary flow (in mL/min) and resistance (in WU) were compared between the two cohorts. FFR was measured to assess coronary epicardial lesions, while CFR and MRR were calculated to assess microvascular function. LAS, assessed by speckle tracking echocardiography, was used to detect early myocardial structural changes potentially associated with microvascular dysfunction.
Results
The median FFR value was 0.83 [0.79–0.87] without any significant difference between the two groups. Absolute resting and hyperemic flow in the left anterior descending coronary were similar between diabetic and non-diabetic patients. Similarly, resting and hyperemic resistances did not change significantly between the two groups. In the DM cohort the CFR and MRR were significantly lower compared to the control group (CFR=2.4±0.6 and 2.9±0.8; MRR=2.8±0.9 and 3.5±1 for diabetic and non-diabetic patients respectively, [p<0.05 for both], Figure 1 and 2). Likewise, diabetic patients had a significantly lower reservoir, contractile and conductive LAS (all p<0.05).
Conclusions
Compared with non-diabetic patients, CFR and MRR were lower in patients with DM and non-obstructive epicardial coronary arteries, while both resting and hyperemic coronary flow and resistance were similar. LASr was lower in diabetic patients, confirming the presence of a subclinical DDF associated to the microcirculatory impairment. Continuous intracoronary thermodilution-derived indexes provide a reliable and operator-independent assessment of coronary macro- and microvasculature and might potentially facilitate widespread clinical adoption of invasive physiologic assessment of suspected microvascular disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P Paolisso
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - E Gallinoro
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - M Belmonte
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - D T Bertolone
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - K Bermpeis
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - G Esposito
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - R Seki
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | | | - J Bartunek
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | | | - E Wyffels
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - J Sonck
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - C Collet
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - B De Bruyne
- Cardiovascular Research Center Aalst , Aalst , Belgium
| | - E Barbato
- Cardiovascular Research Center Aalst , Aalst , Belgium
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21
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Porrazzo A, Cipressa F, De Gregorio A, De Pittà C, Sales G, Ciapponi L, Morciano P, Esposito G, Tabocchini MA, Cenci G. Author Correction: Low dose rate γ-irradiation protects fruit fly chromosomes from double strand breaks and telomere fusions by reducing the esi-RNA biogenesis factor Loquacious. Commun Biol 2022; 5:1033. [PMID: 36175493 PMCID: PMC9522893 DOI: 10.1038/s42003-022-03984-8] [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] [Indexed: 11/16/2022] Open
Affiliation(s)
- A Porrazzo
- Dipartimento di Biologia e Biotecnologie "C. Darwin", Sapienza Università di Roma, Rome, Italy.,Fondazione Cenci Bolognetti/ Istituto Pasteur Italia, Rome, Italy
| | - F Cipressa
- Fondazione Cenci Bolognetti/ Istituto Pasteur Italia, Rome, Italy.,Centro Studi e Ricerche "Enrico Fermi", Rome, Italy.,Department of Ecological and Biological Sciences, Università degli Studi della Tuscia, Viterbo, Italy
| | - A De Gregorio
- Dipartimento di Biologia e Biotecnologie "C. Darwin", Sapienza Università di Roma, Rome, Italy
| | - C De Pittà
- Dipartimento di Biologia, Università di Padova, Padua, Italy
| | - G Sales
- Dipartimento di Biologia, Università di Padova, Padua, Italy
| | - L Ciapponi
- Dipartimento di Biologia e Biotecnologie "C. Darwin", Sapienza Università di Roma, Rome, Italy
| | - P Morciano
- INFN-Laboratori Nazionali del Gran Sasso, 67100, Assergi, Italy
| | - G Esposito
- Istituto Superiore di Sanita' ISS, Rome, Italy.,INFN-Roma 1, Rome, Italy
| | | | - G Cenci
- Dipartimento di Biologia e Biotecnologie "C. Darwin", Sapienza Università di Roma, Rome, Italy. .,Fondazione Cenci Bolognetti/ Istituto Pasteur Italia, Rome, Italy.
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22
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Porrazzo A, Cipressa F, De Gregorio A, De Pittà C, Sales G, Ciapponi L, Morciano P, Esposito G, Tabocchini MA, Cenci G. Low dose rate γ-irradiation protects fruit fly chromosomes from double strand breaks and telomere fusions by reducing the esi-RNA biogenesis factor Loquacious. Commun Biol 2022; 5:905. [PMID: 36057690 PMCID: PMC9440893 DOI: 10.1038/s42003-022-03885-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022] Open
Abstract
It is still continuously debated whether the low-dose/dose-rate (LDR) of ionizing radiation represents a hazard for humans. Model organisms, such as fruit flies, are considered valuable systems to reveal insights into this issue. We found that, in wild-type Drosophila melanogaster larval neuroblasts, the frequency of Chromosome Breaks (CBs), induced by acute γ-irradiation, is considerably reduced when flies are previously exposed to a protracted dose of 0.4 Gy delivered at a dose rate of 2.5 mGy/h. This indicates that this exposure, which is associated with an increased expression of DNA damage response proteins, induces a radioadaptive response (RAR) that protects Drosophila from extensive DNA damage. Interestingly, the same exposure reduces the frequency of telomere fusions (TFs) from Drosophila telomere capping mutants suggesting that the LDR can generally promote a protective response on chromatin sites that are recognized as DNA breaks. Deep RNA sequencing revealed that RAR is associated with a reduced expression of Loquacious D (Loqs-RD) gene that encodes a well-conserved dsRNA binding protein required for esiRNAs biogenesis. Remarkably, loss of Loqs mimics the LDR-mediated chromosome protection as it decreases the IR-induced CBs and TFs frequency. Thus, our molecular characterization of RAR identifies Loqs as a key factor in the cellular response to LDR and in the epigenetic routes involved in radioresistance. Chronic low y-radiation exposure to Drosophila cells decreases chromosome breaks induced by high-dose irradiation and telomere dysfunction by reducing the esiRNA biogenesis factor Loquacious D.
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Affiliation(s)
- A Porrazzo
- Dipartimento di Biologia e Biotecnologie "C. Darwin", Sapienza Università di Roma, Rome, Italy.,Fondazione Cenci Bolognetti/ Istituto Pasteur Italia, Rome, Italy
| | - F Cipressa
- Fondazione Cenci Bolognetti/ Istituto Pasteur Italia, Rome, Italy.,Centro Studi e Ricerche "Enrico Fermi", Rome, Italy
| | - A De Gregorio
- Dipartimento di Biologia e Biotecnologie "C. Darwin", Sapienza Università di Roma, Rome, Italy
| | - C De Pittà
- Dipartimento di Biologia, Università di Padova, Padua, Italy
| | - G Sales
- Dipartimento di Biologia, Università di Padova, Padua, Italy
| | - L Ciapponi
- Dipartimento di Biologia e Biotecnologie "C. Darwin", Sapienza Università di Roma, Rome, Italy
| | - P Morciano
- INFN-Laboratori Nazionali del Gran Sasso, 67100, Assergi, Italy
| | - G Esposito
- Istituto Superiore di Sanita' ISS, Rome, Italy.,INFN-Roma 1, Rome, Italy
| | | | - G Cenci
- Dipartimento di Biologia e Biotecnologie "C. Darwin", Sapienza Università di Roma, Rome, Italy. .,Fondazione Cenci Bolognetti/ Istituto Pasteur Italia, Rome, Italy.
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23
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Bin Eid W, Lim M, Halstead E, Esposito G, Dimitriou D. A cross-cultural comparison of sleep patterns between typically developing children and children with ASD living in Saudi Arabia and the United Kingdom. Res Dev Disabil 2022; 128:104290. [PMID: 35810543 DOI: 10.1016/j.ridd.2022.104290] [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] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/10/2022] [Accepted: 06/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sleep is crucial for child development, especially for children with ASD. While it is known that children with ASD experience more severe sleep problems and that these problems tend to persist compared to their typically developing counterparts, these findings tend to come from only Western countries. A cross-cultural study is important to understand if the prevailing understanding of sleep in children with ASD can be extended to different cultural backgrounds. AIM A cross-cultural study is conducted, involving typically developing children and children with ASD aged 5-12 across two countries: Saudi Arabia and the United Kingdom. METHODS AND PROCEDURES Using a combination of questionnaires measuring ASD severity (CARS-2), sleep quality (CSHQ), sociodemographic and lifestyle variables and sleep diaries, 244 children were sampled using a mixture of snowball and convenience sampling methods. OUTCOMES AND RESULTS Children with ASD experience more sleep problems compared to typically developing children in Saudi Arabia, and these problems similarly persist across time. Specifically, it was found that children with ASD in Saudi Arabia experience greater sleep onset latency and a greater number of night awakenings. Additionally, across the ASD groups, it was found that children from Saudi Arabia generally experienced poorer sleep than children in the United Kingdom in terms of shorter sleep duration, although children in the United Kingdom tended to report more instances of sleep anxiety and parasomnias. CONCLUSIONS AND IMPLICATIONS Several reasons such as parental education about sleep hygiene, cultural influences and social hours were put forward as potential explanations for cross-cultural differences. Findings served to emphasise the importance of culturally-appropriate interventions and public education regarding child sleep.
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Affiliation(s)
- W Bin Eid
- Sleep Education and Research Laboratory, UCL Institute of Education, 25 Woburn Square, WC1H 0AA London, UK
| | - M Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore
| | - E Halstead
- Sleep Education and Research Laboratory, UCL Institute of Education, 25 Woburn Square, WC1H 0AA London, UK
| | - G Esposito
- Affiliative Behaviour and Physiology Lab, Department of Psychology and Cognitive Science, University of Trento, Corso Bettini, 31, I-38068 Rovereto, Italy.
| | - D Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, 25 Woburn Square, WC1H 0AA London, UK.
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24
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Oliva A, Papirio S, Esposito G, Lens PNL. Ultrasounds application for nut and coffee wastes valorisation via biomolecules solubilisation and methane production. Waste Manag 2022; 150:373-382. [PMID: 35917628 DOI: 10.1016/j.wasman.2022.07.010] [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] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/05/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
Lignocellulosic materials (LMs) are abundant feedstocks with excellent potential for biofuels and biocommodities production. In particular, nut and coffee wastes are rich in biomolecules, e.g. sugars and polyphenols, the valorisation of which still has to be fully disclosed. This study investigated the effectiveness of ultrasounds coupled with hydrothermal (i.e. ambient temperature vs 80 °C) and methanol (MeOH)-based pretreatments for polyphenols and sugar solubilisation from hazelnut skin (HS), almond shell (AS), and spent coffee grounds (SCG). The liquid fraction obtained from the pretreated HS was the most promising in terms of biomolecules solubilisation. The highest polyphenols, i.e. 123.9 (±2.3) mg/g TS, and sugar, i.e. 146.0 (±3.4) mg/g TS, solubilisation was obtained using the MeOH-based medium. However, the MeOH-based media were not suitable for direct anaerobic digestion (AD) due to the MeOH inhibition during AD. The water-based liquors obtained from pretreated AS and SCG exhibited a higher methane potential, i.e. 434.2 (±25.1) and 685.5 (±39.5) mL CH4/g glucosein, respectively, than the HS liquors despite having a lower sugar concentration. The solid residues recovered after ultrasounds pretreatment were used as substrates for AD as well. Regardless the pretreatment condition, the methane potential of the ultrasounds pretreated HS, AS, and SCG was not improved, achieving maximally 255.4 (±7.4), 42.8 (±3.3), and 366.2 (±4.2) mL CH4/g VS, respectively. Hence, the solid and liquid fractions obtained from HS, AS, and SCG showed great potential either as substrates for AD or, in perspective, for biomolecules recovery in a biorefinery context.
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Affiliation(s)
- A Oliva
- Department of Microbiology and Ryan Institute, National University of Ireland Galway, University Road, H91 TK33 Galway, Ireland.
| | - S Papirio
- Department of Civil, Architectural and Environmental Engineering, University of Naples Federico II, Via Claudio 21, 80125 Naples, Italy
| | - G Esposito
- Department of Civil, Architectural and Environmental Engineering, University of Naples Federico II, Via Claudio 21, 80125 Naples, Italy
| | - P N L Lens
- Department of Microbiology and Ryan Institute, National University of Ireland Galway, University Road, H91 TK33 Galway, Ireland
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Oliva A, Tan LC, Papirio S, Esposito G, Lens PNL. Fed-batch anaerobic digestion of raw and pretreated hazelnut skin over long-term operation. Bioresour Technol 2022; 357:127372. [PMID: 35623606 DOI: 10.1016/j.biortech.2022.127372] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 06/15/2023]
Abstract
This study provided important insights on the anaerobic digestion (AD) of hazelnut skin (HS) by operating a fed-batch AD reactor over 240 days and focusing on several factors impacting the process in the long term. An efficient reactor configuration was proposed to increase the substrate load while reducing the solid retention time during the fed-batch AD of HS. Raw HS produced maximally 19.29 mL CH4/g VSadd/d. Polyphenols accumulated in the reactor and the use of NaOH to adjust the pH likely inhibited AD. Maceration and methanol-organosolv pretreatments were, thus, used to remove polyphenols from HS (i.e. 82 and 97%, respectively) and improve HS biodegradation. Additionally, organosolv pretreatment removed 9% of the lignin. The organosolv-pretreated HS showed an increment in methane potential of 21%, while macerated HS produced less methane than the raw substrate, probably due to the loss of non-structural sugars during maceration.
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Affiliation(s)
- A Oliva
- Department of Microbiology and Ryan Institute, National University of Ireland Galway, University Road, H91 TK33, Galway, Ireland.
| | - L C Tan
- Department of Microbiology and Ryan Institute, National University of Ireland Galway, University Road, H91 TK33, Galway, Ireland
| | - S Papirio
- Department of Civil, Architectural and Environmental Engineering, University of Naples Federico II, Via Claudio 21, 80125, Naples, Italy
| | - G Esposito
- Department of Civil, Architectural and Environmental Engineering, University of Naples Federico II, Via Claudio 21, 80125, Naples, Italy
| | - P N L Lens
- Department of Microbiology and Ryan Institute, National University of Ireland Galway, University Road, H91 TK33, Galway, Ireland
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Galati G, Esposito G, Somigliana E, Muzii L, Franchi M, Corrao G, Parazzini F. P-717 Trends in the incidence of major birth defects after Assisted Reproductive Technologies (ART) in Lombardy Region, Northern Italy. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Does the association between Assisted Reproductive Technologies (ART) and birth defects change over time?
Summary answer
The increased incidence of birth defects in ART pregnancies is not steady over time. A decline of this risk emerged in most recent years.
What is known already
The incidence of birth defects is increased in pregnancies after ART. The latest meta-analysis showed that infants born following IVF-ICSI have a 40% increased risk (Zhao et al., 2020). Even if infertile women are exposed to higher risk per se, some ART related factors may also contribute. To note, ART procedures are continuously evolving, and it cannot be excluded that the magnitude of the association of ART and birth defects may have changed in recent years. We failed to identify in the literature studies reporting on the trends of birth defects in IVF-ICSI pregnancies over time.
Study design, size, duration
This is a population-based study using the automated system of healthcare utilization databases from Lombardy, a region located in Northern Italy accounting for about 10 million inhabitants. We identified deliveries occurring between January 2014 and December 2020 from women beneficiaries of the public health system using the standard discharge form and the certificate of delivery assistance. We excluded cases with incomplete information and pregnancies obtained by intrauterine insemination or ovarian hyperstimulation alone.
Participants/materials, setting, methods
The rate of newborns affected by major defects was calculated among natural and IVF-ICSI pregnancies. A logistic regression model was used to adjust for maternal sociodemographic features (i.e., age, nationality, marital status, education, and employment). Data are presented as adjusted odd ratio (aOR) and corresponding 95% Confidence Interval (CI) of major defects among IVF-ICSI pregnancies compared to natural conceptions. Analyses were repeated for every calendar year.
Main results and the role of chance
A total of 508,421 live births were included, of whom 14,067 (2.8%) were achieved with IVF-ICSI. The proportion of non-spontaneous conceptions per year progressively increased over the years, being 2.1%, 2.3%, 2.6%, 2.8%, 3.2%, 3.4% and 3.2% in 2014, 2015, 2016, 2017, 2018, 2019, and 2020, respectively (p < 0.0001). Overall, 13,080 birth defects were recorded, of whom 412 occurred among ART newborns (3.1%). The risk of birth defects is increased in women undergoing ART (aOR 1.13; 95%CI:1.02-1.25), but a decreasing trend over time was highlighted. Indeed, the aOR dropped from 1.40 (95%CI: 1.04-1.91) in 2014 to 0.7 (95%CI: 0.73-1.28) in 2020 (p < 0.001). During the study period, a statistically significant reduction in multiple pregnancies (p-value for trend <0.0001) and in the ratio of ICSI to conventional IVF (p-value for trend <0.0001) was also observed, potentially explaining the positive trend observed for birth defects.
Limitations, reasons for caution
The diagnosis of malformation is based on information detected at the time of delivery, and not during the subsequent infant’s hospitalization, or later in lifetime. Further, we have no information on pregnancies terminated early. Finally, data was collected from registries and this modality may expose the findings to some inaccuracies.
Wider implications of the findings
The increased risk of birth defects in IVF-ICSI pregnancies is not steady over time. A decline of this risk emerged in our region. Policy changes in ART may explain this beneficial effect. Evidence obtained more than one decade ago may not be valid in the modern era of IVF.
Trial registration number
not applicable
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Affiliation(s)
- G Galati
- “Sapienza” University of Rome, Department of Obstetrics and Gynecology , Roma, Italy
| | - G Esposito
- University of Milan, Department of Clinical Sciences and Community Health , Milan, Italy
| | - E Somigliana
- University of Milan- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health , Milan, Italy
| | - L Muzii
- “Sapienza” University of Rome, Department of Obstetrics and Gynecology , Roma, Italy
| | - M Franchi
- Laboratory of Healthcare Research & Pharmacoepidemiology- University of Milano-Bicocca, Department of Statistics and Quantitative Methods , Milan, Italy
| | - G Corrao
- Laboratory of Healthcare Research & Pharmacoepidemiology- University of Milano-Bicocca, Department of Statistics and Quantitative Methods , Milan, Italy
| | - F Parazzini
- University of Milan- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health , Milan, Italy
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Esposito G. Using fNIRS to study Mother-Child Brain-to-Brain Synchrony in Typical and Atypical Contexts. Eur Psychiatry 2022. [PMCID: PMC9567528 DOI: 10.1192/j.eurpsy.2022.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
A potential avenue of investigating the caregiver-infant relationship lies in caregiver-infant synchrony, which refers to the coordinated interplay of behavioural and physiological signals reflecting the bi-directional attunement of one individual to the other’s psychophysiological, cognitive, emotional and behavioural state. Here, we aim to study how early naturalistic caregiver-infant interactions give raise to caregiver-infant attachment, which influences physiological and psychological processes by modulating brain sensitivity. Furthermore, we aim to study how caregiver-infant bond shapes neural pathways involved in socio-emotional regulation in typical and atypical contexts. We present new evidence from fNIRS hyperscanning studies, where we measured simultaneous caregiver (mothers, N=30 and fathers N=38) and child brain activity (N=70). From the mother-child hyperscanning study (Azhari et al., 2019; 2020; 2021), we have found that higher levels of parenting stress are correlated to lower mother-child brain-to-brain synchrony, especially in the areas of the medial left prefrontal cortex. Additionally, maternal anxious attachment (Azhari et al., 2020a) also correlated in lower mother-child synchrony in the frontal and medial left prefrontal regions. These areas contain structures implicated in the inference of mental states and social cognition, highlighting the role of psychological factors such as parenting stress and attachment style in the influence of caregiver-infant bond formation during naturalistic interactions. From the combined mother- and father-child free play sessions (Azhari et al., 2020b), behavioural data revealed that parenting stress and caregivers’ recall of their past bonding experiences their own parents interact with each other to influence the eventual quality of dyadic interaction with their child.
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Vriesendorp PA, Wilschut JM, Diletti R, Daemen J, Kardys I, Zijlstra F, Van Mieghem NM, Bennett J, Esposito G, Sabate M, den Dekker WK. Immediate versus staged revascularisation of non-culprit arteries in patients with acute coronary syndrome: a systematic review and meta-analysis. Neth Heart J 2022; 30:449-456. [PMID: 35536483 PMCID: PMC9474746 DOI: 10.1007/s12471-022-01687-7] [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] [Accepted: 02/21/2022] [Indexed: 12/02/2022] Open
Abstract
Although there is robust evidence that revascularisation of non-culprit vessels should be pursued in patients presenting with an acute coronary syndrome (ACS) and multivessel coronary artery disease (MVD), the optimal timing of complete revascularisation remains disputed. In this systematic review and meta-analysis our results suggest that outcomes are comparable for immediate and staged complete revascularisation in patients with ACS and MVD. However, evidence from randomised controlled trials remains scarce and cautious interpretation of these results is recommended. More non-biased evidence is necessary to aid future decision making on the optimal timing of complete revascularisation.
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Affiliation(s)
- P A Vriesendorp
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
- The Heart Centre, The Alfred Hospital, Melbourne, Australia
| | - J M Wilschut
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - R Diletti
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - J Daemen
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - I Kardys
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - F Zijlstra
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - N M Van Mieghem
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - J Bennett
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium
| | - G Esposito
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - M Sabate
- Cardiovascular Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - W K den Dekker
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands.
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29
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Raffrenato E, Badenhorst MJ, Harvatine KJ, Shipandeni MNT, du Plessis L, Esposito G, van Zyl WH. The diurnal patterns of ruminal enzymatic activity and in vitro digestibility of starch, neutral detergent fiber, and protein. J Dairy Sci 2022; 105:4961-4970. [PMID: 35450711 DOI: 10.3168/jds.2021-21350] [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: 12/19/2021] [Accepted: 02/18/2022] [Indexed: 11/19/2022]
Abstract
The objective of this study was to determine whether diurnal patterns in starch, neutral detergent fiber (NDF) and protein digestibilities and amylolytic, fibrolytic, and proteolytic activities exist in dairy cows. Rumen fluid was collected from 4 ruminally cannulated Holstein dairy cows before the morning feeding and subsequently every 4 h for a 24-h period. Two of the cows were restricted from feed for 8 h overnight, and the other 2 continued to receive their feed ad libitum, to isolate and quantify the effects of changes in feeding behavior at night. After 2 runs the cows were crossed over between night feeding treatments. Rumen fluid was analyzed for enzymatic activity and in vitro starch, NDF, and nitrogen digestibility. Circadian rhythm analyses of enzymatic activity and in vitro digestibility were conducted by fitting the linear form of a cosine function with a 24-h period. Patterns were observed in activity for amylase, lichenase, endoglucanase, and xylanase, with the highest activities observed at the time points subsequent to milking and feed delivery. Protease activity was unaffected by either feeding treatment or possible feeding behavior. When fitted to a cosine function, all the parameters tested followed a daily pattern that was sensitive to the overnight availability of feed, although the parameters responded differently to the feeding treatment. The patterns displayed by in vitro digestibility results of starch, NDF, and nitrogen, across the various fluid collection time points, were highly variable. The time at peak (acrophase) observed in the enzymatic analysis did not correspond to those observed in the in vitro analysis. These results suggest that different interpretations should be given to enzymatic activities and in vitro digestibility values, and the time of rumen fluid collection relative to feeding time should be considered and reported when rumen fluid is used for research or commercial purposes. Maximum digestibility appears in fact to be reached around 4 to 5 h after the main ration delivery for NDF and starch and around ration delivery for protein.
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Affiliation(s)
- E Raffrenato
- Department of Animal Sciences, Faculty of AgriSciences, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa; R&D RUM&N Sas, Reggio Emilia, Italy 42123.
| | - M J Badenhorst
- Department of Animal Sciences, Faculty of AgriSciences, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
| | - K J Harvatine
- Department of Animal Science, Pennsylvania State University, University Park 16802
| | - M N T Shipandeni
- Department of Animal Sciences, Faculty of Agriculture and Natural Resources, University of Namibia, Private Bag 13301, Windhoek, Namibia
| | - L du Plessis
- Department of Microbiology, Faculty of AgriSciences, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
| | - G Esposito
- Department of Animal Sciences, Faculty of AgriSciences, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
| | - W H van Zyl
- Department of Microbiology, Faculty of AgriSciences, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
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30
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Iorio GG, Carbone L, Donadono V, Rovetto MY, Sarno L, Saccone G, Mazzarelli LL, Sirico A, Esposito G, Buonfantino C, DI Girolamo R, Arduino B, D'Alessandro P, Maruotti GM. Bleeding epulis gravidarum: what to evaluate? Minerva Obstet Gynecol 2022; 74:171-177. [PMID: 35421917 DOI: 10.23736/s2724-606x.21.04960-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Hormonal changes during pregnancy may induce modifications in oral mucosa. Epulis gravidarum (EG) is an oral disease arising during pregnancy, usually regressing after delivery. A case of EG managed at our department is described and those previously reported in literature are reviewed in order to define EG clinical features for stratifying the risk of complications and the need of surgery during pregnancy as well as which factors should be considered more relevant in EG management. EVIDENCE ACQUISITION Electronic databases (Medline, Embase, Web of Sciences, Scopus and Cochrane Library) were searched from inception of each databases until May 2021 to identify clinical studies on management of EG diagnosed during pregnancy. The aim of this review was to identify factors influencing the need and timing of surgical management. EVIDENCE SYNTHESIS A woman with a triplet pregnancy suffering from EG, complicated by profuse bleeding, required Caesarean section (CS) given the triplet pregnancy and the impending preterm labor. The surgical removal of EG was not performed because it spontaneously regressed without consequences 40 days after delivery. Review analysis indicated that EG clinical management is dependent on types of symptoms and their severity. Multilinear regression analysis showed that operative management strategy was associated with bone loss on X-ray (t=4.23, P=0.003), while EG surgical treatment during pregnancy was associated with pain (t=-2.91, P=0.03). No significant differences were found in management strategy, according to pain (P=0.12), interference with mastication (P=0.98) and speech (P=0.36). A poor oral hygiene was described in 71% of patients as hypothetical trigger. CONCLUSIONS EG management strategy depends on bleeding, pain and bone loss on X-ray. A multidisciplinary approach is useful to perform a rapid and appropriate diagnosis and to better evaluate pros and cons of surgery during pregnancy and following management.
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Affiliation(s)
- Giuseppe G Iorio
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, School of Medicine, Federico II University, Naples, Italy -
| | - Luigi Carbone
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, School of Medicine, Federico II University, Naples, Italy
| | - Vera Donadono
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, School of Medicine, Federico II University, Naples, Italy
| | - Marika Y Rovetto
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, School of Medicine, Federico II University, Naples, Italy
| | - Laura Sarno
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, School of Medicine, Federico II University, Naples, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, School of Medicine, Federico II University, Naples, Italy
| | - Laura L Mazzarelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, School of Medicine, Federico II University, Naples, Italy
| | - Angelo Sirico
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, School of Medicine, Federico II University, Naples, Italy
| | - Giuseppina Esposito
- Department of Public Health, School of Medicine, Federico II University, Naples, Italy
| | - Cira Buonfantino
- Department of Public Health, School of Medicine, Federico II University, Naples, Italy
| | - Raffaella DI Girolamo
- Center for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Bruno Arduino
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, School of Medicine, Federico II University, Naples, Italy
| | - Pietro D'Alessandro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, School of Medicine, Federico II University, Naples, Italy
| | - Giuseppe M Maruotti
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, School of Medicine, Federico II University, Naples, Italy
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31
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Gargiulo G, Serino F, Esposito G. Cardiovascular mortality in patients with acute and chronic coronary syndrome: insights from the clinical evidence on ticagrelor. Eur Rev Med Pharmacol Sci 2022; 26:2524-2542. [PMID: 35442468 DOI: 10.26355/eurrev_202204_28490] [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] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The purpose of this review is to discuss cardiovascular mortality as clinical outcome in the setting of both acute and chronic coronary syndromes (ACS and CCS) with a focus on the clinical evidence supporting the mortality benefit of ticagrelor across multiple subpopulations. MATERIALS AND METHODS Papers considered for this review were retrieved from a PubMed search, using different combinations of keywords (e.g., mortality AND coronary syndrome AND dual antiplatelet therapy AND ticagrelor), without limitations in terms of publication date and language. RESULTS Prevention of ischemic events and death is of outmost relevance in patients with ACS and CCS, given the high rate of recurrence of such events and fatalities. Owing to the evolving nature of patients with CCS, characterized by a broad spectrum of clinical presentations and previous medical history, as well as the advances in the therapeutic and invasive management of ACS, greater attention to the rate of hard clinical outcomes, improvement in the long-term prognosis, and reduction in the residual risk of recurrent events are increasingly reported among cardiologists. Dual antiplatelet therapy (DAPT) is the cornerstone of antithrombotic therapy aimed at lowering the rate of ischemic events and death in patients treated both conservatively and invasively after ACS, as well as improving prognosis in patients with CCS. Significant differences are emerging among oral P2Y12 inhibitors with regards to mortality benefit. CONCLUSIONS Ticagrelor is an effective and well-tolerated option to attain a meaningful and clinically relevant reduction in cardiovascular mortality in both acute and chronic settings across a broad range of high-risk patient subpopulations with an acceptable payoff in terms of bleeding risk.
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Affiliation(s)
- G Gargiulo
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
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32
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Huiliñir C, Acosta L, Yanez D, Montalvo S, Esposito G, Retamal G, Levicán G, Guerrero L. Corrigendum to "Elemental sulfur-based autotrophic denitrification in stoichiometric S0/N ratio: Calibration and validation of a kinetic model" [Bioresour. Technol. 307 (2020) 123229]. Bioresour Technol 2022; 347:126445. [PMID: 34863607 DOI: 10.1016/j.biortech.2021.126445] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- C Huiliñir
- Laboratorio de Biotecnología Ambiental, Departamento de Ingeniería Química, Universidad de Santiago de Chile, Av. Lib. Bdo. O Higgins 3363, Santiago, Chile.
| | - L Acosta
- Laboratorio de Biotecnología Ambiental, Departamento de Ingeniería Química, Universidad de Santiago de Chile, Av. Lib. Bdo. O Higgins 3363, Santiago, Chile
| | - D Yanez
- Laboratorio de Biotecnología Ambiental, Departamento de Ingeniería Química, Universidad de Santiago de Chile, Av. Lib. Bdo. O Higgins 3363, Santiago, Chile
| | - S Montalvo
- Laboratorio de Biotecnología Ambiental, Departamento de Ingeniería Química, Universidad de Santiago de Chile, Av. Lib. Bdo. O Higgins 3363, Santiago, Chile
| | - G Esposito
- Department of Civil, Architectural and Environmental Engineering, University of Naples Federico II, Via Claudio 21, 80125 Naples, Italy
| | - G Retamal
- Laboratorio de Microbiología Básica y Aplicada, Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Av. Lib. Bdo. O Higgins 3363, Santiago, Chile
| | - G Levicán
- Laboratorio de Microbiología Básica y Aplicada, Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Av. Lib. Bdo. O Higgins 3363, Santiago, Chile
| | - L Guerrero
- Departamento de Ingeniería Química y Ambiental, Universidad Técnica Federico Santa María, Av. España 1680, Valparaíso, Chile
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Paolisso P, Gallinoro E, Mileva N, Moya A, Fabbricatore D, Esposito G, De Colle C, Spapen J, Heggermont W, Collet C, Van Camp G, Vanderheyden M, Barbato E, Bartunek J, Penicka M. Performance of non-invasive myocardial work to predict the first hospitalization for de novo heart failure with preserved ejection fraction (HFpEF). Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Dr. Paolisso, Dr. Esposito, Dr. Fabbricatore are supported by a research grant from the CardioPaTh PhD Program of University of Naples Federico II
Background
Non-invasive myocardial work (MW) is a validated index of left ventricular (LV) systolic performance, incorporating afterload and myocardial metabolism. The role of MW in predicting the first hospitalization for de novo heart failure with preserved ejection fraction (HFpEF) is still unknown.
Purpose
To investigate the diagnostic performance of MW to predict the first de novo HFpEF hospitalization in ambulatory individuals with preserved LVEF.
Methods
Twenty-nine patients with trans-thoracic echocardiography performed at least 6 months before the first HFpEF hospitalization were compared with 29 matched controls. MW was derived as the area of pressure-strain loop using speckle-tracking and brachial artery blood pressure. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were collected. First HFpEF hospitalization and its combination with cardiovascular death (MACE) and all-cause of death (MAE) were assessed.
Results
At baseline, future HFpEF patients showed lower GWI, GCW, GWE and higher GWW than controls (all p < 0.05). At admission versus baseline, GWE significantly decreased, and GWW increased in the HFpEF group (p < 0.05), whereas no significant difference was observed in the controls over time. GWW, with a cut-off of 170 mmHg%, showed the largest AUC to predict first HFpEF hospitalization (AUC = 0.80, 95% CI 0.69–0.91, p < 0.001), MACE (AUC = 0.80, 95% CI 0.66–0.90, p < 0.001) and MAE (AUC = 0.79, 95% CI 0.62–0.88, p = 0.001). GWW > 170 mmHg% was associated with a 4-fold increase of MACE (HR = 4.5, 95% CI 1.59–13.12, p = 0.005) and a 3-fold higher risk of MAE (HR = 2.9, 95% CI 1.24–6.6, p = 0.014).
Conclusions
In ambulatory patients with preserved LVEF and risk factors, GWW showed high accuracy to predict the first HFpEF hospitalization and its combination with mortality. The GWW routine assessment may be clinically helpful in patients with dyspnea. Abstract Figure 1: Serial changes of LARs, LV GLS Abstract Figure 2:Kaplan–Meier survival curves fo
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Affiliation(s)
- P Paolisso
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - E Gallinoro
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - N Mileva
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - A Moya
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | | | - G Esposito
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - C De Colle
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - J Spapen
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - W Heggermont
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - C Collet
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - G Van Camp
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | | | - E Barbato
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - J Bartunek
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - M Penicka
- Cardiovascular Research Center Aalst, Aalst, Belgium
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Aiello M, Baldi D, Esposito G, Valentino M, Randon M, Salvatore M, Cavaliere C. Evaluation of AI-Based Segmentation Tools for COVID-19 Lung Lesions on Conventional and Ultra-low Dose CT Scans. Dose Response 2022; 20:15593258221082896. [PMID: 35422680 PMCID: PMC9002358 DOI: 10.1177/15593258221082896] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/04/2022] [Indexed: 11/16/2022] Open
Abstract
A reliable diagnosis and accurate monitoring are pivotal steps for treatment and prevention of COVID-19. Chest computed tomography (CT) has been considered a crucial diagnostic imaging technique for the injury assessment of the viral pneumonia. Furthermore, the automatization of the segmentation methods for lung alterations helps to speed up the diagnosis and lighten radiologists' workload. Considering the assiduous pathology monitoring, ultra-low dose (ULD) chest CT protocols have been implemented to drastically reduce the radiation burden. Unfortunately, the available AI technologies have not been trained on ULD-CT data and validated and their applicability deserves careful evaluation. Therefore, this work aims to compare the results of available AI tools (BCUnet, CORADS AI, NVIDIA CLARA Train SDK and CT Pneumonia Analysis) on a dataset of 73 CT examinations acquired both with conventional dose (CD) and ULD protocols. COVID-19 volume percentage, resulting from each tool, was statistically compared. This study demonstrated high comparability of the results on CD-CT and ULD-CT data among the four AI tools, with high correlation between the results obtained on both protocols (R > .68, P < .001, for all AI tools).
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Affiliation(s)
| | | | | | - Marika Valentino
- Istituto di Scienze Applicate e
Sistemi Intelligenti “Eduardo Caianiello” (ISASI-CNR), Pozzuoli, Italy
- Università Degli Studi di Napoli
Federico II, Dip. di Ingegneria Elettrica e Delle Tecnologie
Dell'Informazione, Italy
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Aiello M, Esposito G, Pagliari G, Borrelli P, Brancato V, Salvatore M. How does DICOM support big data management? Investigating its use in medical imaging community. Insights Imaging 2021; 12:164. [PMID: 34748101 PMCID: PMC8574146 DOI: 10.1186/s13244-021-01081-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/25/2021] [Indexed: 12/15/2022] Open
Abstract
The diagnostic imaging field is experiencing considerable growth, followed by increasing production of massive amounts of data. The lack of standardization and privacy concerns are considered the main barriers to big data capitalization. This work aims to verify whether the advanced features of the DICOM standard, beyond imaging data storage, are effectively used in research practice. This issue will be analyzed by investigating the publicly shared medical imaging databases and assessing how much the most common medical imaging software tools support DICOM in all its potential. Therefore, 100 public databases and ten medical imaging software tools were selected and examined using a systematic approach. In particular, the DICOM fields related to privacy, segmentation and reporting have been assessed in the selected database; software tools have been evaluated for reading and writing the same DICOM fields. From our analysis, less than a third of the databases examined use the DICOM format to record meaningful information to manage the images. Regarding software, the vast majority does not allow the management, reading and writing of some or all the DICOM fields. Surprisingly, if we observe chest computed tomography data sharing to address the COVID-19 emergency, there are only two datasets out of 12 released in DICOM format. Our work shows how the DICOM can potentially fully support big data management; however, further efforts are still needed from the scientific and technological community to promote the use of the existing standard, encouraging data sharing and interoperability for a concrete development of big data analytics.
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Affiliation(s)
- Marco Aiello
- IRCCS SDN, Via Emanuele Gianturco 113, 80143, Naples, Italy.
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Tofani M, Esposito G, Berardi A, Galeoto G, Iorio S, Marceca M. Community-Based Rehabilitation Indicators: Validation and Preliminary Evidence for Disability in Italy. Int J Environ Res Public Health 2021; 18:ijerph182111256. [PMID: 34769774 PMCID: PMC8583160 DOI: 10.3390/ijerph182111256] [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] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
Community-based rehabilitation (CBR) is a multi-sectorial community strategy for guaranteeing that people with disabilities enjoy the same rights and opportunities as all other community members. CBR is organized in a five-component matrix—namely, health, education, social, livelihood, and empowerment. To measure the effectiveness of CBR, the World Health Organization (WHO) has developed standardized indicators. The objective of the present study is to translate and validate the CBR indicators (CBR-Is), providing preliminary evidence of their use for disability in Italy. After obtaining permission from the WHO, the CBR-Is followed a process of translation and cross-cultural adaptation according to international guidelines. An examination of internal consistency and reliability was than performed. The intra-rater reliability was estimated using the Intraclass Correlation Coefficient with a 95% confidence interval. In order to measures the differences between people with and without disabilities, an independent sample t-test was used for quantitative indicators. The Italian version of the CBR-Is (IT-CBR-Is) was administered to 234 people. The internal consistency showed a good value, with a Cronbach’s alpha coefficient of 0.862, and the intra-rater reliability analysis showed solid values for each domain (range: 0.723–0.882). Statistically significant differences between people with and without disabilities were found for each domain of the CBR matrix—namely, health, social, education, livelihood, and empowerment. The IT-CBR-Is are consistent and reliable measures when used to investigate disability in a community-based inclusive development perspective. National stakeholders can now have specific indicators to implement services and actions for people with disabilities.
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Affiliation(s)
- Marco Tofani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy;
- Department of Intensive Neurorehabiiltation and Robotics, Bambino Gesù Pediatric Hospital IRCCS, 00165 Rome, Italy
- Correspondence:
| | | | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.B.); (G.G.)
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.B.); (G.G.)
| | - Silvia Iorio
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Rome, Italy;
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy;
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Avvedimento M, Leone A, Spinelli A, Franzone A, Esposito G, Piccolo R. Prehospital ECG in patients with acute myocardial infarction during the COVID-19 pandemic. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
A delayed presentation of patients with ST-segment elevation myocardial infarction (STEMI) has been reported globally after the outbreak of coronavirus disease-19 (COVID-19). However, it remains unknown whether differences already exist at the time of pre-hospital electrocardiograms (ECGs).
Purpose
We therefore compared pre-hospital ECGs of STEMI patients hospitalized in Italy after the first reported case of COVID-19 on February 21, 2020 with data from the same period in 2019 to identifying potential changes between the two periods.
Methods
We analyzed prehospital ECGs of patients with a final diagnosis of STEMI from February 21, 2020, to April 16, 2020. Data were divided in two periods, before and after the first confirmed case of COVID-19 in Italy. Pathological Q-waves and the Anderson-Wilkins acuteness score, which estimates the acuteness of ischemia, were independently assessed by two reviewers.
Results
167 (5.15%) of out 3,239 ECGs qualified for STEMI and were included in the analysis. ECGs recorded during the COVID-19 pandemic showed more frequently pathological Q-wave complexes compared with the control period (54.5% vs. 22.1%, risk difference 32.3%, 95% confidence intervals [CI], 21.2 to 43.5 percentage points) and presented a higher number of pathological Q-waves (1.4±1.6 vs. 0.5±1.2; p<0.001). The Anderson-Wilkins acuteness score was significantly lower during the COVID-19 period (2.4±0.9 vs. 2.8±0.7; p<0.001), suggesting a lower probability of acute ischemia.
Conclusions
Pre-hospital ECGs of patients with a final diagnosis of STEMI presented more frequently the signs of late ischemia during the COVID-19 pandemic.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- M Avvedimento
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A Leone
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A Spinelli
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A Franzone
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - G Esposito
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - R Piccolo
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
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D'Apice S, Paolillo R, Boccella N, Coretti L, Lama A, Avvedimento M, Esposito G, Mattace Raso G, Lembo F, Perrino C. Partial loss of Akap1 promotes cardiac dysfunction, gut barrier dysfunction and alterations of gut microbiota composition during aging. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Mitochondrial A-kinase anchoring proteins (mitoAKAP) encoded by the Akap1 gene are crucially involved in multiple cellular processes, including cardiomyocyte survival and function. Whether mitoAKAP levels play a role in aging and gut microbiota composition is currently unknown.
Purpose
The aim of this study was to highlight the complex interplay between cardiac dysfunction, gut barrier integrity, gut microbiota composition and aging in young (6-month-old, 6m) and old (24-month-old, 24m) wild type (wt) and Akap1 heterozygous mice (Akap1+/−).
Methods
Cardiac function was analyzed by echocardiography in 6m and 24m wt and Akap1+/− mice. Gut microbial DNA was extracted and gut microbiota composition was analyzed by Illumina Mi-Seq analysis. Bioinformatics analysis was carried out to identify major intestinal populations. Alpha diversity within each sample was determined, and then analyzed according to genotype and age; then, inter-sample diversity was determined. For each dataset, we used UniFrac to calculate the differences between microbial communities based on phylogenetic distance between taxa sets in a phylogenetic tree. Bioinformatics analyses were performed using the analysis of similarities (ANOSIM). To evaluate the role of mitoAKAPs in intestinal permeability, we analyzed intestinal junction proteins expression levels in colon samples of all groups. Variance analysis was performed to determine significance among the groups.
Results
Partial loss of Akap1 accelerated the progression of cardiac dysfunction in 24m mice, as demonstrated by a significantly lower % fractional shortening (%FS) compared to 24m wt mice (%FS, wt 6m: 60±3; Akap1−/+ 6m: 58±5; wt 24m: 49±6*; Akap1−/+ 24m: 39±12*§; *p<0.05 vs. wt 6m; §p<0.05 vs. wt 24m). In 24m Akap1+/− mice, aging was associated to enhanced colon permeability, as shown by reduced levels of Ocludins and Tight Junction Proteins 1 mRNA expression. A principal coordinate analysis of fecal samples based on their unweighted UniFrac distances revealed that samples from Akap1+/− 24m mice cluster apart from wt 24m samples, suggesting that Akap1+/− 24m mice exhibit a different assortment of microbial communities. This observation was supported by ANOSIM R statistic that revealed significant differences in gut microbiota composition between wt and Akap1+/− 24m mice (ANOSIM R=0.475, P=0.023), We analyzed the differences in abundance of all 2,042 Operational Taxonomic Units (OTUs) between age-matched wt and Akap1+/−. We identified 10 OTUs differently represented in wt and Akap1+/− 6m mice, while a bigger set of bacterial OTUs (19) were different between wt and Akap1+/− 24m mice. Consistent with previous results in patients with heart failure, we identified Clostridiales, Blautia producta and R. Torques among differently regulated species.
Conclusion
Partial Akap1 deletion plays an important role in the progression toward HF and modulates colon permeability and gut microbiota composition during aging.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Programma STAR Grant by Federico II University and Compagnia San Paolo
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Affiliation(s)
- S D'Apice
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - R Paolillo
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - N Boccella
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - L Coretti
- Federico II University of Naples, Department of Pharmacy, Naples, Italy
| | - A Lama
- Federico II University of Naples, Department of Pharmacy, Naples, Italy
| | - M Avvedimento
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - G Esposito
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - G Mattace Raso
- Federico II University of Naples, Department of Pharmacy, Naples, Italy
| | - F Lembo
- Federico II University of Naples, Department of Pharmacy, Naples, Italy
| | - C Perrino
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
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Gallinoro E, Paolisso P, Bermpeis K, Peregrina EF, Candreva A, Esposito G, Fabbricatore D, Sonck J, Di Gioia G, Vanderheyden M, Bartunek J, Collet C, De Bruyne B, Barbato E. Angiography vs physiology-based deferral of revascularization in patients with reduced left ventricular ejection fraction: a 10-year clinical follow-up. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Deferring percutaneous coronary intervention (PCI) in patients with non-ischemic coronary stenoses based on fractional flow reserve (FFR) and preserved left ventricular ejection fraction (LVEF) is associated with favorable long-term clinical outcomes. In patients with reduced LVEF, the role of reversible/residual ischemia in deferring revascularization is still debated.
Purpose
To investigate whether FFR provides additive clinical benefit compared to coronary angiography in deferring revascularization in patients with intermediate coronary stenoses and reduced LVEF.
Methods
Among 4577 coronary angiographies performed between 2002 and 2010, consecutive patients with reduced LVEF (≤50%) and at least one intermediate coronary stenosis [diameter stenosis (DS)% 40–70%] in whom revascularization was deferred based either on FFR (FFR-guided) or angiography (Angiography-guided) were screened. The primary endpoint of the study was cumulative incidence of death at 10 years.
Results
A total of 843 patients were included (209 in the FFR-guided and 634 in the Angio-guided group). Median clinical follow-up was 7.1 years (IQR 3.2–11.2 years). After 1:1 propensity score matching, baseline characteristics between the two groups were similar. All-cause death at 10 years was significantly lower in the FFR-guided compared with the Angiography-guided group (94 [45%] vs 115 [55%], HR 0.72 [95% CI 0.55–0.95], p<0.05). Similarly, the incidence of major adverse cardiovascular and cerebrovascular events (MACCE, composite of all-cause death, myocardial infarction, any revascularization and stroke) was lower in the FFR guided group (125 [60%] vs 140 [67%], HR 0.77 [95% CI 0.61–0.98], p<0.05).
Conclusions
In patients with reduced LVEF and associated coronary artery disease, deferring revascularization of intermediate stenoses based on FFR is associated with lower incidence of death and MACCE at 10 years.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Gallinoro
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - P Paolisso
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - K Bermpeis
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - E F Peregrina
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - A Candreva
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - G Esposito
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | | | - J Sonck
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - G Di Gioia
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | | | - J Bartunek
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - C Collet
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - B De Bruyne
- Cardiovascular Research Center Aalst, Aalst, Belgium
| | - E Barbato
- Cardiovascular Research Center Aalst, Aalst, Belgium
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Scudiero F, Canonico ME, Sanna GD, Saba PG, Esposito G, Parodi G. Dual antiplatelet therapy with 3rd generation P2Y12 inhibitors in STEMI patients: impact of Body Mass Index on high on-treatment platelet reactivity. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
High on-treatment platelet reactivity (HTPR) has been associated with high risk of ischemic events in STEMI patients. Body mass index (BMI) and specifically overweight and obesity are risk factors for increased platelet reactivity in different series of patients, however data regarding their relationship with pharmacodynamic response to oral 3rd generation P2Y12 inhibitors is still lacking.
Purpose
This study aims to assess the association between BMI and HTPR in STEMI patients treated with oral 3rd generation P2Y12 inhibitors.
Methods
Overall, 429 STEMI were enrolled in this study. Patients were divided into two groups according to BMI (BMI <25; BMI ≥25). A propensity score matching (1:1) was performed to balance potential confounders in baseline study characteristics. Platelet reactivity was assessed by VerifyNow at baseline and after 3rd generation P2Y12 inhibitor (ticagrelor or prasugrel) loading dose (LD). Blood samples were obtained at baseline (T0), 1 hour (T1), 2 hours (T2), 4–6 hours (T3) and 8–12 hours (T4) after the LD. HTPR was defined with a platelet reactivity unit values ≥208 units.
Results
The mean age of the enrolled population was 62±12 and male rate was 75%. Patients with a BMI ≥25 were younger (61±12 Vs 64±11, p=0.006), with a higher prevalence of male gender (78% vs 68%, p=0.035), and hypertension (56% vs 46%, p=0.072), and they were less frequently treated with pre-PCI mophine use (30% Vs 42%; p=0.018). After propensity score matching (Table), patients with BMI ≥25 had similar values of baseline platelet reactivity [T0: 308 (285–342) vs 300 (281–330), p=0.396), while they had higher level of platelet reactivity at 1 and 2 hours after the LD [T1: 285 (200–308) vs 265 (196–320), p=0.047); T2: 241 (87–305) vs 200 (56–256), p=0.004)] and higher rate of HRPT [T1: (66% vs 47%, p=0.004); T2: (40% vs 24%, p=0.006)]. Furthermore, multivariable analysis demonstrated that BMI ≥25 was an independent predictor of HTPR at 2h (OR 2.01, 95% CI 1.18–3.42; p=0.009). Conversely, starting from 4 hour after the LD, platelet reactivity values [T3: 68 (7–173) vs 15 (6–71), p=0.76); T4: 38 (4–104) vs 44 (4–82), p=0.958)] and HRPT rates (T3: 13% vs 10%, p=0.595; T4: 1% vs 1%, p=0.320) were comparable among the study groups.
Conclusions
A BMI ≥25 is associated with decelerated pharmacodynamic response to oral 3rd generation P2Y12 inhibitors LD and resulted a strong predictor of HRPT in STEMI patients treated by dual antiplatelet therapy with ticagrelor or prasugrel.
Funding Acknowledgement
Type of funding sources: None. Table, panel ATable, panel B
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Affiliation(s)
- F Scudiero
- Bolognini Hospital, Cardiology unit, Seriate, Italy
| | - M E Canonico
- Federico II University Hospital, Department of Advanced Biomedical Sciences, Naples, Italy
| | - G D Sanna
- University of Sassari, Clinical and Interventional Cardiology, Sassari, Italy
| | - P G Saba
- University of Sassari, Clinical and Interventional Cardiology, Sassari, Italy
| | - G Esposito
- Federico II University Hospital, Department of Advanced Biomedical Sciences, Naples, Italy
| | - G Parodi
- University of Sassari, Clinical and Interventional Cardiology, Sassari, Italy
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Canonico ME, Scudiero F, Sanna GD, Siciliano R, Guarino S, Saba PS, Esposito G, Parodi G. Impact of smoking habit on baseline and on-treatment platelet reactivity in STEMI patients treated with 3rd generation P2Y12. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Smoking habit is a well known risk factor for cardiovascular disease. High on-treatment platelet reactivity has been associated with high risk of ischemic events in STEMI patients. The relationship between platelet reactivity and smoking habit was investigated only in few studies, and the impact of smoke on platelet reactivity in STEMI patients treated with 3rd generation P2Y12 inhibitor is still lacking.
Purpose
This study aim to assess the impact of smoking habits on baseline and on-treatment platelet reactivity in STEMI patients treated with 3rd generation P2Y12 inhibitor.
Methods
Overall, 429 STEMI patients were enrolled in this study. Patients were divided into two groups according to smoking habit. Platelet reactivity was assessed by VerifyNow at baseline and after 3rd generation P2Y12 inhibitor (ticagrelor or prasugrel) loading dose (LD). Blood samples were obtained at baseline (T0), and after 1 hour (T1), 2 hours (T2), 4–6 hours (T3) and 8–12 hours (T4) after LD.
Results
The mean age of the enrolled population was 62±12 and male rate was 75%. Patients with smoking habit were younger (75.8% vs 38.9%, p<0.001 for age <65 years), with higher prevalence of family history of CAD, while with a lower rate hypertension (43.4% vs 65.9%, p<0.001) and previous myocardial infarction (5.3% vs 11.4%, p=0.022) (Table). Smoker patients had lower platelet reactivity either at baseline [T0: 249 (205–285) vs 284 (230–324), p<0.001] or at 2 hours after the LD [T2: 107 (18–279) vs 136 (51–260), p=0.003] (Table). Similarly, Smoker patients experienced a lower rate of in-hospital composite adverse event of death, reinfarction, stroke or acute kidney injury (1.6% vs 12.4%; p≤0.001) (Table). Multivariate analysis demonstrated that left ventricular ejection fraction at admission (OR= 0.916, 95% CI 0.865–0.969; p=0.002), and platelet reactivity at baseline (OR= 1.013, 95% CI 1.002–1.024; p=0.024) were independent predictors of in-hospital composite adverse event.
Conclusions
Smoker status is associated with lower platelet reactivity either at baseline or after LD and with a better short-term prognosis in STEMI patients treated by dual antiplatelet therapy with ticagrelor or prasugrel.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | | | - G D Sanna
- University of Sassari, Sassari, Italy
| | | | - S Guarino
- University of Sassari, Sassari, Italy
| | - P S Saba
- University of Sassari, Sassari, Italy
| | - G Esposito
- Federico II University Hospital, Naples, Italy
| | - G Parodi
- University of Sassari, Sassari, Italy
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Oliva A, Avvedimento M, Franzone A, Windecker S, Valgimigli M, Esposito G, Juni P, Piccolo R. Mortality after bleeding versus myocardial infarction in coronary artery disease: a systematic review and meta-analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Bleeding is the principal safety concern of antithrombotic therapy and occurs frequently among patients with coronary artery disease (CAD).
Aims
We aim to evaluate the prognostic impact of bleeding on mortality compared with that of myocardial infarction (MI) in patients with CAD.
Methods
We searched Medline and Embase for studies that included patients with CAD and that reported both, the association between the occurrence of bleeding and mortality, and between the occurrence of MI and mortality within the same population. Adjusted hazard ratios (HRs) for mortality associated with bleeding and MI were extracted and ratio of hazard ratios (rHRs) were pooled by using inverse variance weighted random effects meta-analyses. Early events included periprocedural or within 30-day events after revascularization or acute coronary syndrome (ACS). Late events included spontaneous or beyond 30-day events after revascularization or ACS.
Results
141,059 patients were included across 16 studies and 128,660 (91%) underwent percutaneous coronary intervention. Major bleeding increased the risk of mortality to the same extent of MI (ratioHR bleedingvsMI 1.10, 95% CI, 0.71–1.71, P=0.668). Early bleeding was associated with a higher risk of mortality than early MI (ratioHR bleedingvsMI 1.46, 95% CI, 1.13–1.89, P=0.004), although this finding was not present when only randomized trials were included. Late bleeding was prognostically comparable to late MI (ratioHR bleedingvsMI 1.14, 95% CI, 0.87–1.49, P=0.358).
Conclusions
Compared with MI, major and late bleeding is associated with a similar increase in mortality, whereas early bleeding might have a stronger association with mortality.
Impact on daily practice. Major and late bleeding should be considered prognostically equivalent to MI, given the similar association with mortality. Early bleeding has even a stronger association with mortality than early MI, emphasizing the importance of bleeding avoidance strategies among patients undergoing PCI.
Funding Acknowledgement
Type of funding sources: None. Visual AbstractBleeding vs MI risk of mortality
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Affiliation(s)
- A Oliva
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - M Avvedimento
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A Franzone
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - S Windecker
- Bern University Hospital, Inselspital, Department of Cardiology, Bern, Switzerland
| | - M Valgimigli
- Bern University Hospital, Inselspital, Department of Cardiology, Bern, Switzerland
| | - G Esposito
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - P Juni
- University of Toronto, Applied Health Research Centre of the Li Ka Shing Knowledge Institute, Department of Medicine, St M, Toronto, Canada
| | - R Piccolo
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
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Franzese M, Di Serafino L, Stabile E, Giugliano G, Leone A, Ilardi F, Strisciuglio T, Esposito G. Quantitative flow ratio for the functional assessment of extracranial internal carotid artery stenosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
In asymptomatic patients at high surgical risk presenting with significant extracranial internal carotid artery stenoses, a selective invasive angiography is performed before carotid artery stenting (CAS). Sometimes, the angiographic findings of the stenosis could be discordant from those observed at the non-invasive imaging evaluation and the use of a pressure-wire to evaluate the hemodynamic potential of the stenosis, might be dangerous for the higher risk of cerebrovascular events.
Purpose
The Quantitative Flow Ratio (QFR), by estimating the contrast flow velocity and based on a 3-dimensional quantitative angiography, might be of value as an online angiography-based functional assessment of internal carotid stenoses, in order to guide the physicians in the decision-making process to proceed or not to revascularization.
Methods
We prospectively enrolled 14 asymptomatic patients with an indication for invasive treatment of internal carotid artery stenosis. The echo-colour-Doppler was performed in 28 vessels and the Peak Systolic Velocity (PSV, cm/sec) was used to identify functionally significant stenoses (PSV >120cm/sec). At the angiography, internal carotid artery stenosis degree was obtained according to NASCET criteria (%DSNASCET) and the lesion considered angiographically significant if >60%. After the exclusion of 4 vessels, QFR, Area Stenosis (AS, %) and Minimal Lumen Area (MLA, mm2) were obtained in the remaining 24 vessels (Figure 1, Panel A and B).
Results
At the linear regression analysis, QFR values significantly correlated with PSV (r2=0.71, p<0.001) as well as with %DSNASCET (r2=0.81, p<0.001). In addition, using the PSV as reference, QFR showed good accuracy to predict the presence of a functionally significant stenosis (AUC=1.00, p<0.001) with a cut-off value of 0.90. Similarly, the MLA significantly correlated with both the PSV and %DSNASCET (respectively, r2=0.61 and r2=0.60, p<0.001) as well as the AS (respectively, r2=0.68 and r2=0.87, p<0.001) (Figure 2).
Conclusion
This study suggests the possibility to adopt QFR for the functional assessment of extracranial internal carotid artery stenoses and should be considered as hypothesis generating to design a larger validation trial.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Franzese
- Federico II University of Naples, Naples, Italy
| | | | - E Stabile
- Federico II University of Naples, Naples, Italy
| | - G Giugliano
- Federico II University of Naples, Naples, Italy
| | - A Leone
- Federico II University of Naples, Naples, Italy
| | - F Ilardi
- Federico II University of Naples, Naples, Italy
| | | | - G Esposito
- Federico II University of Naples, Naples, Italy
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Stichele GV, Dürr A, Yoon G, Schüle R, Blackstone C, Esposito G, Buffel C, Oliveira I, Freitag C, van Rooijen S, Hoffmann S, Thielemans L, Cowling B. OTHER NMDs. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.379] [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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Piccirillo M, Bonanno L, Garassino M, Dazzi C, Cavanna L, Esposito G, Burgio M, Rosetti F, Rizzato S, Arenare L, Gargiulo P, Di Liello R, De Marinis F, Crinò L, Morgillo F, Ciardiello F, Normanno N, Gallo C, Gridelli C, Morabito A. 1207O Bevacizumab + erlotinib vs erlotinib alone as first-line treatment of pts with EGFR mutated advanced non squamous NSCLC: Final analysis of the multicenter, randomized, phase III BEVERLY trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Donadono V, Saccone G, Sarno L, Esposito G, Mazzarelli LL, Sirico A, Guida M, Martinelli P, Zullo F, Maruotti GM. Association between lymphadenopathy after toxoplasmosis seroconversion in pregnancy and risk of congenital infection. Eur J Clin Microbiol Infect Dis 2021; 41:45-51. [PMID: 34458947 DOI: 10.1007/s10096-021-04337-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 08/16/2021] [Indexed: 12/19/2022]
Abstract
The aim of the study was to describe the pregnancy outcome of a large cohort of women with toxoplasmosis seroconversion in pregnancy and to investigate the relation between maternal lymphadenopathy and risk of congenital toxoplasmosis (CT). This was a retrospective study involving women with confirmed toxoplasmosis seroconversion in pregnancy between 2001 and 2017. Women were clinically evaluated for lymphadenopathy and classified as follows: lymphadenopathy absent (L-) or lymphadenopathy present (L+). The mothers were treated and followed-up according to local protocol, and neonates were monitored at least for 1 year in order to diagnose CT. A total of 218 women (one twin pregnancy) were included in the analysis. Pregnancy outcome was as follows: 149 (68%) of children not infected, 62 (28.3%) infected, 4 (1.8%) first trimester termination of pregnancy, 2 (0.9%) first trimester miscarriages, and 3 (1.4%) stillbirths (of which one already counted in the infected cohort). 13.8% of women were L+ , and they were nearly three times more likely to have a child with CT compared to L- women (aOR, 2.90; 95%CI, 1.28-6.58). Moreover, the result was still statistically significant when the analysis was restricted to 81 children whose mothers were clinically examined and received treatment within 5 weeks from estimated time of infection. In conclusion, there is a positive association between L+ status in pregnant women, and risk of CT also confirmed when restricting the analysis to women with early diagnosis of seroconversion and treatment. This data could be very useful in counselling pregnant women with toxoplasmosis seroconversion and lead to direct a more specific therapeutic and diagnostic protocol.
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MESH Headings
- Adult
- Antibodies, Protozoan/blood
- Female
- Humans
- Infant
- Infant, Newborn
- Infant, Newborn, Diseases/diagnosis
- Infant, Newborn, Diseases/parasitology
- Infectious Disease Transmission, Vertical
- Lymphadenopathy/blood
- Lymphadenopathy/diagnosis
- Lymphadenopathy/parasitology
- Male
- Pregnancy
- Pregnancy Complications, Infectious/blood
- Pregnancy Complications, Infectious/diagnosis
- Pregnancy Complications, Infectious/parasitology
- Pregnancy Outcome
- Prenatal Exposure Delayed Effects/diagnosis
- Prenatal Exposure Delayed Effects/parasitology
- Retrospective Studies
- Seroconversion
- Toxoplasmosis/blood
- Toxoplasmosis/diagnosis
- Toxoplasmosis/parasitology
- Toxoplasmosis/transmission
- Toxoplasmosis, Congenital/diagnosis
- Toxoplasmosis, Congenital/parasitology
- Young Adult
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Affiliation(s)
- Vera Donadono
- Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy.
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Laura Sarno
- Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Giuseppina Esposito
- Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Laura L Mazzarelli
- Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Angelo Sirico
- Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Maurizio Guida
- Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Pasquale Martinelli
- Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Fulvio Zullo
- Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Giuseppe M Maruotti
- Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
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Abstract
Artisanal cheeses and other fermented milk products have long been part of the diet of African rural communities. Cheese is a source of nutrients that are essential to the development and growth of children in rural areas, where intake of amino acids, vitamin A, vitamin B12, calcium, phosphate, and polyunsaturated fatty acids may be limited. Wara, Karish, Ayib, Takammart, Wagashi, Domiati, and Ras are prominent cheeses of African origin. Artisanal cheese making should be expanded to improve people’s nutritional status at low cost, stimulate the local economy, and empower small-scale farmers. This review firstly gives an overview of artisanal cheese production and consumption, and evaluates opportunities and challenges, while focusing on an African perspective. Secondly, it provides an insight into strategies that could improve cheese making at small-scale level. Possible areas of research and knowledge gaps are highlighted, particularly ways of improving cheese quality and safety.
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48
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Gragnano E, Saccone G, Tagliaferri S, Esposito G, Paino JA, Campanile M, Maruotti GM, Guida M. Computerized cardiotocography in singleton gestations with diabetes mellitus: a retrospective study. Minerva Obstet Gynecol 2021; 74:161-164. [PMID: 34096692 DOI: 10.23736/s2724-606x.21.04786-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the use of computerized cardiotocography (C-CTG) in women with diabetes mellitus. METHODS This was a retrospective cohort study of women with diabetes mellitus referred to University of Naples Federico II from January 2018 to January 2020 for antenatal monitoring. Only women who underwent antenatal monitoring with C-CTG were included in the study. For the purpose of this study only the C-CTG recorded at the time of outpatient admission were analysed. Women were divided into four groups: 1. Women with diabetes mellitus type 1; 2. Women with diabetes mellitus type 2; 3. Women with gestational diabetes mellitus (GDM); 4. Control group without diabetes mellitus. The primary outcome of the study was the C-CTG short term variability (STV). RESULTS A total of 298 patients were included in the study, 89 with type 1 diabetes (group 1), 27 with type 2 diabetes (group 2), 77 with GDM (group 3) and 105 controls (group 4). Fetal heart rate was statistically higher in pregnant women with pre-pregnancy diabetes both Type 1 and 2 compared to gestational diabetes and physiological pregnancies. The parameters of STV, APRS and DPRS were statistically lower in the pregnant group with pre-pregnancy type 1 diabetes than in type 2 and compared to group 3 and 4. CONCLUSIONS Fetal heart rate was statistically higher in pregnant women with pre-pregnancy diabetes, both Type 1 and 2, compared to gestational diabetes and controls. STV, APRS and DPRS were statistically lower in the pregnant group with pre-pregnancy type 1 diabetes than in type 2 and compared to group 3 and 4.
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Affiliation(s)
- Elisabetta Gragnano
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy -
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Salvatore Tagliaferri
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giuseppina Esposito
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Jessica A Paino
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Marta Campanile
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giuseppe M Maruotti
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Maurizio Guida
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
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Bonanno L, Dal Maso A, Pavan A, Zulato E, Esposito G, Fassan M, Nardo G, Pasello G, Guarneri V, Calabrese F, Rea F, Indraccolo S, Conte P. 51P Liver kinase B1 (LKB1) and phosphorylated AMP kinase (AMPK) expression in small cell lung cancer (SCLC): Association with prognosis and tumour immune microenvironment (TIME) features. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01893-1] [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: 10/21/2022]
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Gargiulo P, Di Liello R, Arenare L, Gridelli C, Morabito A, Ciardiello F, Gebbia V, Maione P, Spagnuolo A, Palumbo G, Esposito G, Della Corte C, Morgillo F, Mancuso G, Gravina A, Schettino C, Di Maio M, Gallo C, Perrone F, Piccirillo M. 167P Chemotherapy-induced neutropenia and treatment efficacy in advanced non-small cell lung cancer (aNSCLC): A pooled analysis of 6 randomized trials. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)02009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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