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Malandrone F, Catrambone V, Carletto S, Rossini PG, Coletti Moja M, Oliva F, Pagani M, Valenza G, Ostacoli L. Restoring bottom-up communication in brain-heart interplay after trauma-focused psychotherapy in breast cancer patients with post-traumatic stress disorder. J Affect Disord 2024; 351:143-150. [PMID: 38281599 DOI: 10.1016/j.jad.2024.01.172] [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: 01/04/2023] [Revised: 05/18/2023] [Accepted: 01/17/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND The psychological impact of breast cancer (BC) is substantial, with a significant number of patients (up to 32 %) experiencing post-traumatic stress disorder (PTSD). Exploring the emotional aspects of PTSD through the functional brain-heart interplay (BHI) offers valuable insights into the condition. BHI examines the functional interactions between cortical and sympathovagal dynamics. This study aims to investigate changes in functional directional BHI after trauma-focused (TF) psychotherapy, specifically Eye Movement Desensitization and Reprocessing (EMDR), in comparison to treatment as usual (TAU) among BC patients with PTSD. To our knowledge, this study represents the first examination of such changes. METHODS We enrolled thirty BC patients who met the criteria for a PTSD diagnosis, with fourteen receiving EMDR and fifteen receiving TAU over a two- to three-month period. We analyzed changes in the emotional response during a script-driven imagery setting. Quantification of the functional interplay between EEG and sympathovagal dynamics was achieved using the synthetic data generation model (SDG) on electroencephalographic (EEG) and heartbeat series. Our focus was on the difference in the BHI index extracted at baseline and post-treatment. RESULTS We found statistically significant higher coupling in the heart-to-brain direction in patients treated with EMDR compared to controls. This suggests that the flow of information from the autonomic nervous system to the central nervous system is restored following EMDR-induced recovery from PTSD. Furthermore, we observed a significant correlation between improvements in PTSD symptoms and an increase in functional BHI after EMDR treatment. CONCLUSIONS TF psychotherapy, particularly EMDR, appears to facilitate the restoration of the bottom-up flow of interoceptive information, which is dysfunctional in patients with PTSD. The application of BHI analysis to the study of PTSD not only aids in identifying biomarkers of the disorder but also enhances our understanding of the changes brought about by TF treatments.
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Affiliation(s)
- F Malandrone
- Department of Clinical and Biological Sciences, University of Turin, Italy
| | - V Catrambone
- NeuroCardiovascular Intelligence Lab, Department of Information Engineering & Research Centre "E. Piaggio", School of Engineering, University of Pisa, Italy
| | - S Carletto
- Department of Clinical and Biological Sciences, University of Turin, Italy.
| | - P G Rossini
- Department of Clinical and Biological Sciences, University of Turin, Italy
| | - M Coletti Moja
- Neurology Department, Ospedale degli Infermi, Ponderano, Italy
| | - F Oliva
- Department of Clinical and Biological Sciences, University of Turin, Italy
| | - M Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - G Valenza
- NeuroCardiovascular Intelligence Lab, Department of Information Engineering & Research Centre "E. Piaggio", School of Engineering, University of Pisa, Italy
| | - L Ostacoli
- Department of Clinical and Biological Sciences, University of Turin, Italy
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2
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Alvino FG, Gini S, Minetti A, Pagani M, Sastre-Yagüe D, Barsotti N, De Guzman E, Schleifer C, Stuefer A, Kushan L, Montani C, Galbusera A, Papaleo F, Lombardo MV, Pasqualetti M, Bearden CE, Gozzi A. Synaptic-dependent developmental dysconnectivity in 22q11.2 deletion syndrome. bioRxiv 2024:2024.03.29.587339. [PMID: 38585897 PMCID: PMC10996624 DOI: 10.1101/2024.03.29.587339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Chromosome 22q11.2 deletion is among the strongest known genetic risk factors for neuropsychiatric disorders, including autism and schizophrenia. Brain imaging studies have reported disrupted large-scale functional connectivity in people with 22q11 deletion syndrome (22q11DS). However, the significance and biological determinants of these functional alterations remain unclear. Here, we use a cross-species design to investigate the developmental trajectory and neural underpinnings of brain dysconnectivity in 22q11DS. We find that LgDel mice, an established mouse model of 22q11DS, exhibit age-specific patterns of functional MRI (fMRI) dysconnectivity, with widespread fMRI hyper-connectivity in juvenile mice reverting to focal hippocampal hypoconnectivity over puberty. These fMRI connectivity alterations are mirrored by co-occurring developmental alterations in dendritic spine density, and are both transiently normalized by developmental GSK3β inhibition, suggesting a synaptic origin for this phenomenon. Notably, analogous hyper- to hypoconnectivity reconfiguration occurs also in human 22q11DS, where it affects hippocampal and cortical regions spatially enriched for synaptic genes that interact with GSK3β, and autism-relevant transcripts. Functional dysconnectivity in somatomotor components of this network is predictive of age-dependent social alterations in 22q11.2 deletion carriers. Taken together, these findings suggest that synaptic-related mechanisms underlie developmentally mediated functional dysconnectivity in 22q11DS.
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Affiliation(s)
- F G Alvino
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
| | - S Gini
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
- Center for Mind and Brain Sciences, University of Trento, Rovereto, Italy
| | - A Minetti
- Department of Biology, Unit of Cell and Developmental Biology, University of Pisa, Pisa, Italy
| | - M Pagani
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
- IMT School for Advanced Studies, Lucca, Italy
| | - D Sastre-Yagüe
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
- Center for Mind and Brain Sciences, University of Trento, Rovereto, Italy
| | - N Barsotti
- Centro per l'Integrazione della Strumentazione Scientifica dell'Universita di Pisa (CISUP), Pisa, Italy
| | - E De Guzman
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
| | - C Schleifer
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California
| | - A Stuefer
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
- Center for Mind and Brain Sciences, University of Trento, Rovereto, Italy
| | - L Kushan
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California
| | - C Montani
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
| | - A Galbusera
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
| | - F Papaleo
- Genetics of Cognition Laboratory, Neuroscience area, Istituto Italiano di Tecnologia, Genova, Italy
| | - M V Lombardo
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - M Pasqualetti
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
- Centro per l'Integrazione della Strumentazione Scientifica dell'Universita di Pisa (CISUP), Pisa, Italy
| | - C E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California
| | - A Gozzi
- Functional Neuroimaging Laboratory, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems @UniTn, Rovereto, Italy
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3
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Bavbek S, Kepil Özdemir S, Bonadonna P, Atanaskovic-Markovic M, Barbaud A, Brockow K, Laguna Martinez J, Nakonechna A, Pagani M, Arcolacı A, Lombardo C, Torres MJ. Hypersensitivity reactions to proton pump inhibitors. An EAACI position paper. Allergy 2024; 79:552-564. [PMID: 38013608 DOI: 10.1111/all.15961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023]
Abstract
Proton pump inhibitors (PPIs) are invaluable therapeutic options in a variety of dyspeptic diseases. In addition to their well-known risk profile, PPI consumption is related to food and environmental allergies, dysbiosis, osteoporosis, as well as immediate and delayed hypersensitivity reactions (HSRs). The latter, although a rare event, around 1%-3%, due to the extraordinarily high rate of prescription and consumption of PPIs are related to a substantial risk. In this Position Paper, we provide clinicians with practical evidence-based recommendations for the diagnosis and management of HSRs to PPIs. Furthermore, the unmet needs proposed in the document aim to stimulate more in-depth investigations in the topic.
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Affiliation(s)
- Sevim Bavbek
- Division of Immunology and Allergy, Department of Chest Diseases, School of Medicine, Ankara University, Ankara, Turkey
| | - Seçil Kepil Özdemir
- Department of Chest Diseases, Allergy and Immunology Unit, İzmir Faculty of Medicine, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, University of Health Sciences, İzmir, Turkey
| | | | - Marina Atanaskovic-Markovic
- Department of Allergology and Pulmonology, Faculty of Medicine, University of Belgrade, University Children's Hospital, Belgrade, Serbia
| | - Annick Barbaud
- Département de dermatologie et allergologie, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Sorbonne Université, Hôpital Tenon, Paris, France
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Jose Laguna Martinez
- Allergy Unit, Allergo-Anaesthesia Unit, Faculty of Medicine, Hospital Central de la Cruz Roja, Alfonso X El Sabio University, Madrid, Spain
| | - Alla Nakonechna
- Allergy and Clinical Immunology Department, University of Liverpool, Royal Preston Hospital, Lancashire Teaching Hospitals, NHS Foundation Trust, Liverpool, UK
| | - Mauro Pagani
- Medicine Department, Medicine Ward Mantova Hospital, ASST di Mantova, Mantova, Italy
| | | | - Carla Lombardo
- Division of Dermatology and Allergy, APSS - Trento Hospital, Trento, Italy
| | - Maria J Torres
- Allergy Unit, Regional University Hospital of Malaga, IBIMA-UMA-ARADyAL, Malaga, Spain
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4
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Mozzini C, Pagani M. The Heart Failure Knights. Curr Probl Cardiol 2023; 48:101834. [PMID: 37244515 DOI: 10.1016/j.cpcardiol.2023.101834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
The 2021 European Society of Cardiology guidelines for the diagnosis and treatment of acute and chronic heart failure (HF) have abandoned the sequential approach for optimal drug therapy and proposed four drug classes, the so-called 4 "pillars" (angiotensin-converting enzyme inhibitors; angiotensin receptor-neprilysin inhibitors; beta-blockers; mineralocorticoid receptor antagonists and sodium-glucose co-transporter 2 inhibitors) to be initiated and titrated in all patients with reduced ejection fraction HF (HFrEF). In addition, new molecules have been considered, derived from recently reported advances from trials in HFrEF. In this review, Authors examine in particular these new molecules, as further "knights" for HF. In particular, vericiguat, a novel oral soluble guanylate cyclase stimulator, has proved effective in patients with HFrEF who had recently been hospitalized or had received intravenous diuretic therapy. The selective cardiac myosin activator omecamtiv mecarbil and the cardiac myosin inhibitors aficamten and mavacamten are under investigation. Cardiac myosin stimulator, omecamtiv mecarbil, has shown efficacy in HFrEF, lowering HF related events or cardiovascular death, while the 2 inhibitors, mavacamten and aficamten have been shown to reduce hypercontractility and left ventricular outflow obstruction improving functional capacity in randomized trials targeting hypertrophic cardiomyopathy. These agents are the prototypes of active pipelines promising to deliver an array of molecules against HF in the near future.
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Affiliation(s)
- Chiara Mozzini
- Department of Medicine, ASST Mantova, C. Poma Hospital, Mantova, Italy.
| | - Mauro Pagani
- Department of Medicine, ASST Mantova, C. Poma Hospital, Mantova, Italy
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5
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Zerbi V, Pagani M, Markicevic M, Matteoli M, Pozzi D, Fagiolini M, Bozzi Y, Galbusera A, Scattoni ML, Provenzano G, Banerjee A, Helmchen F, Basson MA, Ellegood J, Lerch JP, Rudin M, Gozzi A, Wenderoth N. Correction: Brain mapping across 16 autism mouse models reveals a spectrum of functional connectivity subtypes. Mol Psychiatry 2022; 27:3920-3921. [PMID: 35322201 PMCID: PMC9708546 DOI: 10.1038/s41380-022-01510-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- V Zerbi
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
| | - M Pagani
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy
| | - M Markicevic
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
| | - M Matteoli
- Laboratory of Pharmacology and Brain Pathology, Neurocenter, Humanitas Clinical and Research Center - IRCCS, Rozzano, Mi, Italy
- CNR Institute of Neuroscience, Milano, Italy
| | - D Pozzi
- Laboratory of Pharmacology and Brain Pathology, Neurocenter, Humanitas Clinical and Research Center - IRCCS, Rozzano, Mi, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - M Fagiolini
- F.M. Kirby Neurobiology Department, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Y Bozzi
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Italy
| | - A Galbusera
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy
| | - M L Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - G Provenzano
- Department of Cellular, Computational and Integrative Biology. (CIBIO), University of Trento, Trento, Italy
| | - A Banerjee
- Brain Research Institute, University of Zurich, Zurich, Switzerland
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - F Helmchen
- Brain Research Institute, University of Zurich, Zurich, Switzerland
| | - M A Basson
- Centre for Craniofacial and Regenerative Biology, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College, London, London, UK
| | - J Ellegood
- Mouse Imaging Ctr., Hosp. For Sick Children, Toronto, ON, Canada
| | - J P Lerch
- Mouse Imaging Ctr., Hosp. For Sick Children, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - M Rudin
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - A Gozzi
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy.
| | - N Wenderoth
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
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6
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Barbaud A, Garvey LH, Arcolaci A, Brockow K, Mori F, Mayorga C, Bonadonna P, Atanaskovic-Markovic M, Moral L, Zanoni G, Pagani M, Soria A, Jošt M, Caubet JC, Carmo A, Mona AA, Alvarez-Perea A, Bavbek S, Benedetta B, Bilo MB, Blanca-López N, Bogas HG, Buonomo A, Calogiuri G, Carli G, Cernadas J, Cortellini G, Celik G, Demir S, Doña I, Dursun AB, Eberlein B, Faria E, Fernandes B, Garcez T, Garcia-Nunez I, Gawlik R, Gelincik A, Gomes E, Gooi JHC, Grosber M, Gülen T, Hacard F, Hoarau C, Janson C, Johnston SL, Joerg L, Kepil Özdemir S, Klimek L, Košnik M, Kowalski ML, Kuyucu S, Kvedariene V, Laguna JJ, Lombardo C, Marinho S, Merk H, Meucci E, Morisset M, Munoz-Cano R, Murzilli F, Nakonechna A, Popescu FD, Porebski G, Radice A, Regateiro FS, Röckmann H, Romano A, Sargur R, Sastre J, Scherer Hofmeier K, Sedláčková L, Sobotkova M, Terreehorst I, Treudler R, Walusiak-Skorupa J, Wedi B, Wöhrl S, Zidarn M, Zuberbier T, Agache I, Torres MJ. Allergies and COVID-19 vaccines: An ENDA/EAACI Position paper. Allergy 2022; 77:2292-2312. [PMID: 35112371 DOI: 10.1111/all.15241] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [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: 09/13/2021] [Revised: 12/17/2021] [Accepted: 01/03/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Anaphylaxis, which is rare, has been reported after COVID-19 vaccination, but its management is not standardized. METHOD Members of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology interested in drug allergy participated in an online questionnaire on pre-vaccination screening and management of allergic reactions to COVID-19 vaccines, and literature was analysed. RESULTS No death due to anaphylaxis to COVID-19 vaccines has been confirmed in scientific literature. Potential allergens, polyethylene glycol (PEG), polysorbate and tromethamine are excipients. The authors propose allergy evaluation of persons with the following histories: 1-anaphylaxis to injectable drug or vaccine containing PEG or derivatives; 2-anaphylaxis to oral/topical PEG containing products; 3-recurrent anaphylaxis of unknown cause; 4-suspected or confirmed allergy to any mRNA vaccine; and 5-confirmed allergy to PEG or derivatives. We recommend a prick-to-prick skin test with the left-over solution in the suspected vaccine vial to avoid waste. Prick test panel should include PEG 4000 or 3500, PEG 2000 and polysorbate 80. The value of in vitro test is arguable. CONCLUSIONS These recommendations will lead to a better knowledge of the management and mechanisms involved in anaphylaxis to COVID-19 vaccines and enable more people with history of allergy to be vaccinated.
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Affiliation(s)
- Annick Barbaud
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Tenon, Département de dermatologie et allergologie, Paris, France
| | - Lene Heise Garvey
- Allergy Clinic, Copenhagen University Hospital at Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Alessandra Arcolaci
- Immunology Unit, University Hospital of Verona, Policlinico G.B. Rossi, Verona, Italy
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital
| | - Cristobalina Mayorga
- Allergy Clinical Unit, Hospital Regional Universitario de Málaga-Instituto de Investigación Biomédica de Málaga-IBIMA, ARADyAL, Málaga, Spain
| | | | | | - Luis Moral
- Moral Luis. Pediatric Allergy and Respiratory Unit, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Giovanna Zanoni
- Giovanna Zanoni, Immunology Unit, Policlinico G.B. Rossi, Azienda Ospedaliera Universitaria Integrata Verona, Italy
| | - Mauro Pagani
- Medicine Department, Medicine Ward Mantova Hospital, ASST di Mantova, Italy
| | - Angèle Soria
- Sorbonne Université, INSERM 1135 Cimi-Paris, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Departement de dermatologie et d'allergologie, Paris, France
| | - Maja Jošt
- University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - Jean-Christoph Caubet
- Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland
| | - Abreu Carmo
- Allergy and Clinical Immunology Unit, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real and Allergy and Clinical Immunology Unit, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Al-Ahmad Mona
- Microbiology Department, Faculty of Medicine, Kuwait University, Kuwait
| | | | - Sevim Bavbek
- School of Medicine, Department of Pulmonary Diseases, Division of Allergy, FAAAI, Ankara University, Ankara, Turkey
| | - Biagioni Benedetta
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Disease, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - M Beatrice Bilo
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
- Allergy Unit - Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Italy
| | | | - Herrera Gádor Bogas
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, and Allergy Unit, Hospital Regional Universitario de Málaga-HRUM, Málaga, Spain
| | - Alessandro Buonomo
- Allergy Unit - Fondazione Policlinico Gemelli IRCCS - Largo Gemelli, Rome, Italy
| | | | - Giulia Carli
- SOS Allergologia e Immunologia, Azienda USL Toscana Centro, Ospedale S. Stefano, Prato, Italy
| | - Josefina Cernadas
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de S. João, Porto and Allergy Unit, Hospital Lusíadas, Porto, Portugal
| | - Gabriele Cortellini
- Allergy Unit, Departments of Internal Medicine, Azienda Sanitaria della Romagna, Rimini, Hospital, Rimini, Italy
| | - Gülfem Celik
- Department of Chest Diseases, Division of Immunology and allergy, Ankara University School of Medicine cebeci Hospital, Ankara, Turkey
| | - Semra Demir
- Istanbul University, Istanbul Faculty of Medicine, Internal Medicine, Immunology and Allergic Diseases, Istanbul, Turkey
| | - Inmaculada Doña
- Allergy Research Group, Allergy Unit, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga-IBIMA, Plaza del Hospital Civil s/n, Málaga, Spain
| | | | - Bernadette Eberlein
- Faculty of Medicine, Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany
| | - Emilia Faria
- Allergy and Clinical Immunology Unit, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal
| | - Bryan Fernandes
- Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Tomaz Garcez
- Immunology Department, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Radoslaw Gawlik
- Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, Katowice, Poland
| | - Asli Gelincik
- Istanbul University, Istanbul Faculty of Medicine, Internal Medicine, Immunology and Allergic Diseases, Istanbul, Turkey
| | - Eva Gomes
- Allergy Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Jimmy H C Gooi
- Department of Clinical Immunology, King's College Hospital, London, UK
| | - Martine Grosber
- Department of Dermatology, Universitair Ziekenhuis, Vrije Universiteit Brussel, Brussel, Belgium
| | - Theo Gülen
- Department of Respiratory Medicine and Allergy, Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Florence Hacard
- Allergology and Clinical Immunology Department, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Cyrille Hoarau
- Service transversal d'allergologie et immunologie clinique, CHR de Tours, Tours, France
| | | | | | - Lukas Joerg
- Division of Allergology and Clinical Immunology, Department of Pneumology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Seçil Kepil Özdemir
- Department of Chest Diseases, Division of Allergy and Immunology, Chest Diseases and Surgery Training and Research Hospital, Izmir, Turkey
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | | | - Marek L Kowalski
- Department of Immunology and Allergy, Medical University of Lodz, Poland
| | - Semanur Kuyucu
- Faculty of Medicine, Dpt of Pediatric Allergy and Immunology, Mersin University, Mersin, Turkey
| | - Violeta Kvedariene
- Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Institute of Clinical Medicine, Clinic of Chest diseases, Immunology and Allergology, Faculty of Medicine, Vilnius, Lithuania
| | - Jose Julio Laguna
- Allergy Unit, Allergo-Anaesthesia Unit, Faculty of Medicine, Hospital Central de la Cruz Roja, Alfonso X El Sabio University, Madrid, Spain
| | | | - Susana Marinho
- Allergy Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust and University of Manchester, Manchester, UK
| | | | - Elisa Meucci
- SOS Allergologia ed Immunologia clinica, Azienda USL Toscana Centro, Ospedale San Giovanni di Dio, Firenze, Italy
| | | | | | | | - Alla Nakonechna
- Allergy and Clinical Immunology Department, University of Liverpool, Royal Preston Hospital, Lancashire Teaching Hospitals, NHS Foundation Trust, UK
| | - Florin-Dan Popescu
- Department of Allergology, Carol Davila University of Medicine and Pharmacy, Nicolae Malaxa Clinical Hospital, Bucharest, Romania
| | - Grzegorz Porebski
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Radice
- SOS Allergologia ed Immunologia clinica, Azienda USL Toscana Centro, Ospedale San Giovanni di Dio, Firenze, Italy
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal
- Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- ICBR - Coimbra Institute for Clinical and Biomedical Research, CIBB, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Heike Röckmann
- Department of Dermatology, University Medical Centre Utrecht-Heidelberglaan 100, Utrecht, The Netherlands
| | | | - Ravishankar Sargur
- Clinical Immunology and Allergy Unit, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Joaquin Sastre
- Allergy Department, Fundación Jiménez Diaz, Universidad Autonoma de Madrid, CIBERES, Instituto de Salud Carlos III, Spain
| | | | | | - Marta Sobotkova
- Department of Immunology, Motol University Hospital and 2nd Faculty of Medicine Charles University, Prague, Czech Republic
| | | | - Regina Treudler
- Department of Dermatology, Venerology and Allergology, Universitätsmedizin Leipzig, Leipzig, Germany
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Walusiak-Skorupa Jolanta, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Bettina Wedi
- Department of Dermatology & Allergy, OE6600, Comprehensive Allergy Center, Hannover Medical School, Hannover, Germany
| | - Stefan Wöhrl
- Floridsdorf Allergy Center (FAZ), Vienna, Austria
| | - Mihael Zidarn
- University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, and Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Torsten Zuberbier
- Charité - Universitätsmedizin Berlin, Klinik für Dermatologie, Berlin, Germany
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Maria J Torres
- Allergy Unit, Regional University Hospital of Malaga, IBIMA-UMA-ARADyAL, Malaga, Spain
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7
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Savioli G, Ceresa I, Novelli V, Pagani M, Belliato M, Grulli F, Fumoso F, Lapia F, Brattoli M, Bressan M. P277 SECRET BEYOND THE DOOR. TRIAGE ANALYSIS AND RECOGNITION AT THE DOOR OF ELDERLY PATIENTS WITH PULMONARY EMBOLISM WHO ARRIVE IN THE EMERGENCY ROOM. THE REAL–LIFE EXPERIENCE OF 5 YEARS IN THE EMERGENCY ROOM. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.268] [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]
Abstract
Abstract
Background
The range of symptoms of pulmonary embolism is wide and its recognition difficult.
Purpose
to analyze the efficiency of triage in the EP.
Methods
Single–center retrospective observational study, on all geriatric patients (>75 years) who entered our ED, where they were diagnosed with acute PE. Enrollment began in 2015 and ended in 2019. We analyzed means of presentation, priority codes for medical examination, exit code, hospitalization needs. We collected data from medical history, physical examination, laboratory tests, imaging, outcomes.
Results
We enrolled 247 patients, all in need of hospitalization. 44% came for dyspnea, 17% for chest pain, 16% for signs of DVT, 8% for syncope. 5% had only atypical symptoms (dizziness, general malaise, low–grade fever, neurological symptoms …). 45% had concomitant deep vein thrombosis. 50% showed alteration of the ECG tracing, 49% alteration of the shock index. Only 4% showed hypotension, 13% tachycardia and 8% desaturation. 39% arrived with their own vehicle. 32% was allocated to the area with low intensity of care, 68% to the area with medium–high intensity of care. As regards the priority code for the visit, 0% received a non–urgency code (white code or code 5), 27.9% a minor urgency code (green code or code 4) and 3.6% a high priority to the visit with assignment to low intensity of care (low intensity yellow or code 3). 63.15% received an emergency code (urgency or code 2) and 5.3% an emergency code (red code or code 1). The severity code at discharge, given on clinical criteria, was a low severity code (white or green) in 18% of cases, while 76% was considered high severity (urgency, yellow code) and in 6% for very high gravity (red code). 34% showed massive PE, 32% showed organ damage. 41% were considered to be at high risk of short–term mortality according to European guidelines, 8% required intensive care and in–hospital mortality was 7.7%. Under triage is 32%.
Conclusions
The population that arrives in ED due to pulmonary embolism presents extremely varied symptomatological pictures, and an overall high degree of clinical risk and care and therapeutic complexity in spite of the symptoms complained of and vital parameters. Under–riage remains a real problem for ED for this category of patients.
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Affiliation(s)
- G Savioli
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - I Ceresa
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - V Novelli
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - M Pagani
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - M Belliato
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - F Grulli
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - F Fumoso
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - F Lapia
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - M Brattoli
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
| | - M Bressan
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTENSIVE CARE UNIT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, ITALY, PAVIA; INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; DEPARTMENT OF DRUG SCIENCE, UNIVERSITY OF PAVIA, PAVIA
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8
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Franchini M, Glingani C, Donno GD, Lucchini G, Beccaria M, Amato M, Castelli GP, Bianciardi L, Pagani M, Ghirardini M, Puma G, Presciuttini B, Costantino MT, Frigato M, Crosato V, Tiecco G, Mulè A, Papalia DA, Inglese F, Spreafico F, Garuti M, Pecoriello A, Cervi G, Greco G, Galavotti V, Santini T, Berselli A, Montalto C, Bertoletti R, Bellometti SA, Capuzzo E, Benazzi D, Grisolia G, Pajola F, Stradoni R, Zani M, Verzola A, Codeluppi V, Vesentini S, Bellocchio E, Candini M, Ambrosi G, Carandina F, Scarduelli C, Reggiani A, Casari S. Convalescent Plasma for Hospitalized COVID-19 Patients: A Single-Center Experience. Life (Basel) 2022; 12:life12030420. [PMID: 35330170 PMCID: PMC8950373 DOI: 10.3390/life12030420] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/07/2022] [Accepted: 03/11/2022] [Indexed: 12/20/2022] Open
Abstract
In Winter 2020, Italy, and in particular the Lombardy region, was the first country in the Western hemisphere to be hit by the COVID-19 pandemic. Plasma from individuals recovered from COVID-19 (COVID-19 convalescent plasma, CCP) was the first therapeutic tool adopted to counteract the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In this retrospective cohort study, we report the experience of the city hospital of Mantua, Lombardy region, on the compassionate use of CCP in patients hospitalized for severe COVID-19. Between April 2020 and April 2021, 405 consecutive COVID-19 patients received 657 CCP units with a median anti-SARS-CoV-2 neutralizing antibody (nAb) titer of 160 (interquartile range (IQR), 80−320). Their median age was 68 years (IQR, 56−78 years), and 62% were males. At enrollment, 55% of patients had an increased body mass index (BMI), and 25.6% had at least three comorbidities. The 28-day crude mortality rate was 12.6% (51/405). Young age (<68 years), mild disease (admission to low-intensity departments) and early treatment (<7 days from symptoms onset) with high nAb titer (≥320) CCP were found as independently associated with a favorable response to CCP treatment. No safety concerns were recorded, with a rate of CCP-related adverse reactions (all of mild intensity) of 1.3%. In our real-life experience, the first in the western world, early administration of high-titer CCP was a safe and effective treatment for hospitalized COVID-19 patients.
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Affiliation(s)
- Massimo Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (C.G.); (E.C.); (M.Z.)
- Correspondence: ; Tel.: +39-0376-201234; Fax: +39-0376-220144
| | - Claudia Glingani
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (C.G.); (E.C.); (M.Z.)
| | - Giuseppe De Donno
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Giuseppe Lucchini
- Biostatistic Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy;
| | - Massimiliano Beccaria
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Massimo Amato
- Emergency Department, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.A.); (D.B.)
| | - Gian Paolo Castelli
- Department of Anesthesiology and Intensive Care, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.P.C.); (A.B.); (C.M.)
| | - Leonardo Bianciardi
- Anesthesiology and Intensive Care Unit, SS Trinità and San Marcellino Muravera (Cagliari) Hospital, ASL 8 Cagliari, 09043 Cagliari, Italy;
| | - Mauro Pagani
- Internal Medicine Unit, Department of Medicine, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.P.); (B.P.)
| | - Marco Ghirardini
- Department of Medicine, Hospital of Asola, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.G.); (T.S.)
| | - Giuseppe Puma
- Unit of Infectious Diseases, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.P.); (S.C.)
| | - Barbara Presciuttini
- Internal Medicine Unit, Department of Medicine, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.P.); (B.P.)
| | - Maria Teresa Costantino
- Allergology and Clinical Immunology Unit, Department of Medicine, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.T.C.); (M.F.)
| | - Marilena Frigato
- Allergology and Clinical Immunology Unit, Department of Medicine, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.T.C.); (M.F.)
| | - Verena Crosato
- Infectious and Tropical Diseases Clinic, University of Brescia and Azienda Socio Sanitaria Territoriale Spedali Civili, 25123 Brescia, Italy; (V.C.); (G.T.); (A.M.); (D.A.P.)
| | - Giorgio Tiecco
- Infectious and Tropical Diseases Clinic, University of Brescia and Azienda Socio Sanitaria Territoriale Spedali Civili, 25123 Brescia, Italy; (V.C.); (G.T.); (A.M.); (D.A.P.)
| | - Alice Mulè
- Infectious and Tropical Diseases Clinic, University of Brescia and Azienda Socio Sanitaria Territoriale Spedali Civili, 25123 Brescia, Italy; (V.C.); (G.T.); (A.M.); (D.A.P.)
| | - Dorothea Angela Papalia
- Infectious and Tropical Diseases Clinic, University of Brescia and Azienda Socio Sanitaria Territoriale Spedali Civili, 25123 Brescia, Italy; (V.C.); (G.T.); (A.M.); (D.A.P.)
| | - Francesco Inglese
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Fabio Spreafico
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Martina Garuti
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Antonietta Pecoriello
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Giulia Cervi
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Graziana Greco
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Vanni Galavotti
- Intensive Care Respiratory Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.D.D.); (M.B.); (F.I.); (F.S.); (M.G.); (A.P.); (G.C.); (G.G.); (V.G.)
| | - Tiziana Santini
- Department of Medicine, Hospital of Asola, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.G.); (T.S.)
| | - Angela Berselli
- Department of Anesthesiology and Intensive Care, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.P.C.); (A.B.); (C.M.)
| | - Carlo Montalto
- Department of Anesthesiology and Intensive Care, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.P.C.); (A.B.); (C.M.)
| | - Riccardo Bertoletti
- Medical Direction, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (R.B.); (S.A.B.); (F.P.)
| | - Simona Aurelia Bellometti
- Medical Direction, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (R.B.); (S.A.B.); (F.P.)
| | - Enrico Capuzzo
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (C.G.); (E.C.); (M.Z.)
| | - Dario Benazzi
- Emergency Department, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (M.A.); (D.B.)
| | - Gianpaolo Grisolia
- Department of Obstetrics and Gynecology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy;
| | - Fabio Pajola
- Medical Direction, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (R.B.); (S.A.B.); (F.P.)
| | - Raffaello Stradoni
- General Direction, Azienda Socio Sanitaria Territoriale of Valcamonica, 25043 Breno, Italy;
| | - Matteo Zani
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (C.G.); (E.C.); (M.Z.)
| | - Adriano Verzola
- Management Planning and Control Service, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy;
| | - Vito Codeluppi
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Silvia Vesentini
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Elisa Bellocchio
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Marco Candini
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Giorgina Ambrosi
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Francesca Carandina
- Department of Anesthesiology and Intensive Care, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (V.C.); (S.V.); (E.B.); (M.C.); (G.A.); (F.C.)
| | - Cleante Scarduelli
- Intensive Cardiopulmonary Rehabilitation Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy;
| | - Albino Reggiani
- Cardiology Unit, Destra Secchia Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy;
| | - Salvatore Casari
- Unit of Infectious Diseases, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale of Mantova, 46100 Mantova, Italy; (G.P.); (S.C.)
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Pagani M, Bavbek S, Alvarez‐Cuesta E, Berna Dursun A, Bonadonna P, Castells M, Cernadas J, Chiriac A, Sahar H, Madrigal‐Burgaleta R, Sanchez Sanchez S. Hypersensitivity reactions to chemotherapy: an EAACI Position Paper. Allergy 2022; 77:388-403. [PMID: 34587281 DOI: 10.1111/all.15113] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 03/30/2021] [Accepted: 08/27/2021] [Indexed: 12/19/2022]
Abstract
Chemotherapeutic drugs have been widely used in the treatment of cancer disease for about 70 years. The development of new treatments has not hindered their use, and oncologists still prescribe them routinely, alone or in combination with other antineoplastic agents. However, all chemotherapeutic agents can induce hypersensitivity reactions (HSRs), with different incidences depending on the culprit drug. These reactions are the third leading cause of fatal drug-induced anaphylaxis in the United States. In Europe, deaths related to chemotherapy have also been reported. In particular, most reactions are caused by platinum compounds, taxanes, epipodophyllotoxins and asparaginase. Despite their prevalence and relevance, the ideal pathways for diagnosis, treatment and prevention of these reactions are still unclear, and practice remains considerably heterogeneous with vast differences from center to center. Thus, the European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology organized a task force to provide data and recommendations regarding the allergological work-up in this field of drug hypersensitivity reactions. This position paper aims to provide consensus on the investigation of HSRs to chemotherapeutic drugs and give practical recommendations for clinicians that treat these patients, such as oncologists, allergologists and internists. Key sections cover risk factors, pathogenesis, symptoms, the role of skin tests, in vitro tests, indications and contraindications of drug provocation tests and desensitization of neoplastic patients with allergic reactions to chemotherapeutic drugs. Statements, recommendations and unmet needs were discussed and proposed at the end of each section.
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Affiliation(s)
- Mauro Pagani
- Department of Medicine Medicine Ward C. Poma Mantova HospitalASST Mantova Mantova Italy
| | - Sevim Bavbek
- Division of Immunology and Allergy Department of Chest Diseases Ankara University School of Medicine Ankara Turkey
| | | | - Adile Berna Dursun
- Department of Immunology and Allergic Diseases Recep Tayyip Erdoğan University Rize Turkey
| | | | - Mariana Castells
- Division of Rheumatology, Immunology and Allergy Department of Medicine Brigham and Women's HospitalHarvard Medical School Boston Massachusetts USA
| | - Josefina Cernadas
- Department of Allergy and Clinical Immunology Medical University, H. S. Joao Porto Portugal
| | - Anca Chiriac
- Division of Allergy Department of Pulmonology Hôpital Arnaud de VilleneuveUniversity Hospital of Montpellier Montpellier France
| | - Hamadi Sahar
- The Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts USA
| | - Ricardo Madrigal‐Burgaleta
- Allergy & Severe Asthma Service St Bartholomew's Hospital'sBarts Health NHS Trust London UK
- Drug Desensitisation Centre Catalan Institute of Oncology (ICO) Bellvitge University Hospital Barcelona Spain
| | - Soledad Sanchez Sanchez
- Division of Allergy & Clinical Immunology Department of Medicine University Hospital Complex of A Coruna A Coruna Spain
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10
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Bavbek S, Pagani M, Alvarez‐Cuesta E, Castells M, Dursun AB, Hamadi S, Madrigal‐Burgaleta R, Sanchez‐Sanchez S, Vultaggio A. Hypersensitivity reactions to biologicals: An EAACI position paper. Allergy 2022; 77:39-54. [PMID: 34157134 DOI: 10.1111/all.14984] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 03/29/2021] [Revised: 05/31/2021] [Accepted: 06/15/2021] [Indexed: 12/15/2022]
Abstract
Biologicals are crucial targeted therapeutic agents in oncological, immunological, and inflammatory diseases, and their use in clinical practice is broadening. In recent years, the spread of Personalized Precision Medicine has facilitated a proliferation of new treatment options, especially biologicals. Consequently, biologicals are now among the drugs that most frequently cause hypersensitivity reactions (HSRs). Patients can develop HSRs to these agents during the first-lifetime exposure or after repeated exposure, and these HSRs can be potentially life-threatening or limit therapeutic options. Despite the relatively high prevalence, the underlying mechanisms of these HSRs remain obscure, and the optimal management pathways are still a matter of discussion. In this Position Paper, the authors will provide evidence-based recommendations for diagnosing and managing HSRs to biologicals. Additionally, the document defines unmet needs as an opportunity to shape future research.
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Affiliation(s)
- Sevim Bavbek
- Division of Immunology and Allergy Department of Chest Diseases School of Medicine Ankara University Ankara Turkey
| | - Mauro Pagani
- Medical Department Medicine Ward ASST di Mantova Mantova Italy
| | | | - Mariana Castells
- Division of Allergy and Immunology Department of Medicine Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
| | - Adile Berna Dursun
- Department of Immunology and Allergic Diseases Recep Tayyip Erdoğan University Rize Turkey
| | - Sahar Hamadi
- Division of Allergy and Immunology Department of Medicine Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
| | - Ricardo Madrigal‐Burgaleta
- Allergy & Severe Asthma Service St Bartholomew's Hospital Barts Health NHS Trust London UK
- Drug Desensitisation Centre Catalan Institute of Oncology Barcelona Spain
| | | | - Alessandra Vultaggio
- Department of Biomedicine Azienda Ospedaliera Universitaria Careggi Florence Italy
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11
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Zerbi V, Pagani M, Markicevic M, Matteoli M, Pozzi D, Fagiolini M, Bozzi Y, Galbusera A, Scattoni ML, Provenzano G, Banerjee A, Helmchen F, Basson MA, Ellegood J, Lerch JP, Rudin M, Gozzi A, Wenderoth N. Brain mapping across 16 autism mouse models reveals a spectrum of functional connectivity subtypes. Mol Psychiatry 2021; 26:7610-7620. [PMID: 34381171 PMCID: PMC8873017 DOI: 10.1038/s41380-021-01245-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 06/30/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023]
Abstract
Autism Spectrum Disorder (ASD) is characterized by substantial, yet highly heterogeneous abnormalities in functional brain connectivity. However, the origin and significance of this phenomenon remain unclear. To unravel ASD connectopathy and relate it to underlying etiological heterogeneity, we carried out a bi-center cross-etiological investigation of fMRI-based connectivity in the mouse, in which specific ASD-relevant mutations can be isolated and modeled minimizing environmental contributions. By performing brain-wide connectivity mapping across 16 mouse mutants, we show that different ASD-associated etiologies cause a broad spectrum of connectional abnormalities in which diverse, often diverging, connectivity signatures are recognizable. Despite this heterogeneity, the identified connectivity alterations could be classified into four subtypes characterized by discrete signatures of network dysfunction. Our findings show that etiological variability is a key determinant of connectivity heterogeneity in ASD, hence reconciling conflicting findings in clinical populations. The identification of etiologically-relevant connectivity subtypes could improve diagnostic label accuracy in the non-syndromic ASD population and paves the way for personalized treatment approaches.
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Affiliation(s)
- V Zerbi
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
| | - M Pagani
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy
| | - M Markicevic
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
| | - M Matteoli
- Laboratory of Pharmacology and Brain Pathology, Neurocenter, Humanitas Clinical and Research Center - IRCCS, Rozzano, Mi, Italy
- CNR Institute of Neuroscience, Milano, Italy
| | - D Pozzi
- Laboratory of Pharmacology and Brain Pathology, Neurocenter, Humanitas Clinical and Research Center - IRCCS, Rozzano, Mi, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - M Fagiolini
- F.M. Kirby Neurobiology Department, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Y Bozzi
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Italy
| | - A Galbusera
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy
| | - M L Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - G Provenzano
- Department of Cellular, Computational and Integrative Biology. (CIBIO), University of Trento, Trento, Italy
| | - A Banerjee
- Brain Research Institute, University of Zurich, Zurich, Switzerland
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - F Helmchen
- Brain Research Institute, University of Zurich, Zurich, Switzerland
| | - M A Basson
- Centre for Craniofacial and Regenerative Biology, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College, London, London, UK
| | - J Ellegood
- Mouse Imaging Ctr., Hosp. For Sick Children, Toronto, ON, Canada
| | - J P Lerch
- Mouse Imaging Ctr., Hosp. For Sick Children, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - M Rudin
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - A Gozzi
- Functional Neuroimaging Lab, Istituto Italiano di Tecnologia, Center for Neuroscience and Cognitive Systems, Rovereto, Italy.
| | - N Wenderoth
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
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Abstract
Atherothrombosis is the leading cause of death worldwide, but the precise mechanisms are not yet fully understood. Traditional cardiovascular risk factors have been known for many years, but are not enough to predict individual risk despite consolidated and emerging risk scoring systems. Clonal Haematopoiesis of Indeterminate Potential (CHIP) refers to the clonal expansion of a population of haematopoietic cells in response to the acquisition of a somatic mutation, without any clinical or biological sign of haematological malignancy. The prevalence of this condition increases with age, reaching 10 to20% of the general population aged >70 years. Recent studies have shown a link between CHIP and cardiovascular diseases. CHIP carriers have higher risk of cardiovascular diseases with also a more severe prognosis. Inflammation and immunity play a critical role in enhancing the cardiovascular consequences of CHIP. In this review we discuss the association between CHIP and cardiovascular diseases focusing on inflammation and other pathways shared with atherosclerosis progression. It is hopeful that in the future patients recognized as CHIP carriers may be classified as high-risk cardiovascular patients and new treatment targets will be required for them.
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Affiliation(s)
- Chiara Mozzini
- Department of Medicine, Section of Internal Medicine, Carlo Poma Hospital, Mantova Italy.
| | - Mauro Pagani
- Department of Medicine, Section of Internal Medicine, Carlo Poma Hospital, Mantova Italy
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13
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Abstract
Neutrophil extracellular traps (NETs) are net-like chromatin fibers that are released from dying neutrophils during infections. NETs are a sort of scaffold, ideal to retain microbes. The main function of NETs is the trapping and killing pathogens, as such as bacteria, fungi, viruses (including SARS-CoV-2) and protozoa. The death of neutrophils via NETs formation is called "NETosis." Nevertheless, recent studies suggest that NETosis is involved in several diseases, other than infections. Very recently, it has been shown that NETs formation contributes to venous thromboembolism but also to atherosclerosis progression, creating a link between venous and arterial thrombosis. The presence of NETs in the luminal portion of human atherosclerotic vessels and coronary specimens obtained from patients after acute myocardial infarction has been detected. This review provides evidence of the most important updates about the role of NETs in myocardial infarction, in heart failure and in the process of atherosclerosis itself. The prognostic significance of NETs-related markers in cardiovascular diseases will be discussed, in order to assess targeted therapeutic strategies.
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Affiliation(s)
- Chiara Mozzini
- Department of Medicine, Section of Internal Medicine, Carlo Poma Hospital, Mantova Italy.
| | - Mauro Pagani
- Department of Medicine, Section of Internal Medicine, Carlo Poma Hospital, Mantova Italy
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14
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Pezzo M, Orioli M, Pagani M, Caiola S, Liumbruno GM, Franchini M. Superwarfarin poisoning: a challenging diagnosis. Diagnosis (Berl) 2021; 0:dx-2021-0064. [PMID: 34214292 DOI: 10.1515/dx-2021-0064] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 06/01/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Mario Pezzo
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
| | - Marica Orioli
- Laboratory of Forensic Toxicology, Department of Biomedical, Surgical and Dental Science, University of Milan, Milan, Italy
| | - Mauro Pagani
- Department of Medicine, Carlo Poma Hospital, Mantova, Italy
| | - Simone Caiola
- Department of Medicine, Carlo Poma Hospital, Mantova, Italy
| | | | - Massimo Franchini
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
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15
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Mozzini C, Setti A, Cicco S, Pagani M. The Most Severe Paradigm of Early Cardiovascular Disease: Hutchinson-Gilford Progeria. Focus on the Role of Oxidative Stress. Curr Probl Cardiol 2021; 47:100900. [PMID: 34167843 DOI: 10.1016/j.cpcardiol.2021.100900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 12/14/2022]
Abstract
Oxidative stress (OS) is one of the most frequently recognized causes of ageing. Telomere erosion, defects in the DNA damage response and alterations in the nuclear architecture are also associated with premature ageing. The most severe premature ageing syndrome, Hutchinson-Gilford progeria syndrome (HGPS) is associated with alterations in nuclear shape resulting in the deregulation of lamin A/C. In this review we describe emerging data reporting the role of OS and antioxidant defence in progeroid syndromes focusing on HGPS. We explore precise antioxidant defence mechanisms and related drugs that may create a potential path out of the woods in this disease. Pathways regulated by Nuclear factor E2 related factor (Nrf2), by Nuclear Factor kappa B (NF-kB), and related to the Unfolded Protein Response (UPR) and Endoplasmic Reticulum (ER) stress are under investigation in HGPS patients for which the goal is a significant lifespan extension in particular by postponing atherosclerosis-related complications.
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Affiliation(s)
- Chiara Mozzini
- Department of Medicine, Section of Internal Medicine, Carlo Poma Hospital, Mantova Italy.
| | - Angela Setti
- Department of Medicine, Section of Internal Medicine, University of Verona, Verona, Italy.
| | - Sebastiano Cicco
- Unit of Internal Medicine "Guido Baccelli", Department of Biomedical Sciences and Human Oncology University of Bari, Aldo Moro Medical School, Bari, Italy.
| | - Mauro Pagani
- Department of Medicine, Section of Internal Medicine, Carlo Poma Hospital, Mantova Italy.
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16
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Lucini D, Malacarne M, Pagani M, Morizzo C, Kozakova M, Nannipieri M, Palombo C. A four-week prehabilitation program in candidates for bariatric surgery improves hemodynamic load, metabolism and cardiac autonomic regulation. Acta Diabetol 2021; 58:517-520. [PMID: 33515099 DOI: 10.1007/s00592-020-01645-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/23/2020] [Indexed: 12/01/2022]
Affiliation(s)
- D Lucini
- Exercise Medicine Unit, BIOMETRA Department, Humanitas Clinical and Research Center, University of Milan, Via Alessandro Manzoni, 56, Milan, Italy.
- Exercise Medicine Unit, Humanitas Clinical and Research Center, Rozzano, Italy.
| | - M Malacarne
- Exercise Medicine Unit, BIOMETRA Department, Humanitas Clinical and Research Center, University of Milan, Via Alessandro Manzoni, 56, Milan, Italy
- Exercise Medicine Unit, Humanitas Clinical and Research Center, Rozzano, Italy
| | - M Pagani
- Exercise Medicine Unit, BIOMETRA Department, Humanitas Clinical and Research Center, University of Milan, Via Alessandro Manzoni, 56, Milan, Italy
| | - C Morizzo
- Department of Surgical, Medical, Molecular Pathology and Critical Area Medicine, University of Pisa, Pisa, Italy
| | - M Kozakova
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Nannipieri
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - C Palombo
- Department of Surgical, Medical, Molecular Pathology and Critical Area Medicine, University of Pisa, Pisa, Italy
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17
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Franchini M, Glingani C, Morandi M, Corghi G, Cerzosimo S, Beduzzi G, Storti A, Di Stasi V, Rastrelli G, Vignozzi L, Mengoli C, Garuti M, Beccaria M, Inglese F, Caruso B, Petilino RA, Amato M, Nicchio M, Pagani M, Bellani A, Castelli G, Casari S, De Donno G. Safety and Efficacy of Convalescent Plasma in Elderly COVID-19 Patients: The RESCUE Trial. Mayo Clin Proc Innov Qual Outcomes 2021; 5:403-412. [PMID: 33585799 PMCID: PMC7869678 DOI: 10.1016/j.mayocpiqo.2021.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective To assess the safety and efficacy of convalescent plasma (CP) transfusion in elderly people with moderate to severe coronavirus disease 2019 (COVID-19) living in a long-term care facility (LTCF). Patients and Methods Twenty-two consecutive elderly patients with COVID-19 infection living in an LTCF in Lombardy, Italy, who were given CP during May 15 to July 31, 2020, were enrolled in a prospective cohort study. Their clinical, instrumental, and laboratory parameters were assessed following the CP treatment. The overall mortality rate in this group was compared with that recorded in other LTCFs in Lombardy during the 3-month period from March to May 2020. Results Of the 22 patients enrolled, 68.2% (n=15) received 1 CP unit, 27.3% (n=6) received 2 units, and 4.5% (n=1) received 3 units. Of the CP units transfused, 76.7% (23/30) had a neutralizing antibody titer of 1:160 or greater. No adverse reactions were recorded during or after CP administration. Improvements in clinical, functional, radiologic, and laboratory parameters during the 14 days after CP transfusion were observed in all 19 patients who survived. Viral clearance was achieved in all patients by the end of follow-up (median, 66 days; interquartile range, 48-80 days). The overall mortality rate was 13.6% (3/22), which compared favorably with that in the control group (38.3% [281/733]; P=.02) and corresponded to a 65% reduction in mortality risk. Conclusion Early administration of CP with an adequate anti-severe acute respiratory syndrome coronavirus 2 antibody titer to elderly symptomatic patients with COVID-19 infection in an LTCF was safe and effective in eliminating the virus, restoring patients' immunity, and blocking the progression of COVID-19 infection, thereby improving patients' survival. Trial Registration ClinicalTrials.gov: NCT04569188.
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Key Words
- COVID-19, coronavirus disease 2019
- CP, convalescent plasma
- CRP, C-reactive protein
- Fio2, fraction of inspired oxygen
- IL-6, interleukin 6
- IQR, interquartile range
- ISS, Italian National Institute of Health
- LTCF, long-term care facility
- NNT, number needed to treat
- NS, not significant
- PCR, polymerase chain reaction
- RESCUE, Real-time Evaluation of Safety and Efficacy of Convalescent Plasma Units Transfused to Elderly Patients With COVID-19
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
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Affiliation(s)
- Massimo Franchini
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
| | - Claudia Glingani
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
| | - Mario Morandi
- Green Park Residence, Mantova Salus Group, Mantova, Italy
| | | | - Sara Cerzosimo
- Green Park Residence, Mantova Salus Group, Mantova, Italy
| | - Gloria Beduzzi
- Green Park Residence, Mantova Salus Group, Mantova, Italy
| | - Andrea Storti
- Green Park Residence, Mantova Salus Group, Mantova, Italy
| | - Vincenza Di Stasi
- "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence-Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi Hospital, Florence, Italy
| | - Giulia Rastrelli
- "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence-Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi Hospital, Florence, Italy
| | - Linda Vignozzi
- "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence-Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi Hospital, Florence, Italy
| | - Carlo Mengoli
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
| | | | | | | | | | | | - Massimo Amato
- Emergency Department, Carlo Poma Hospital, Mantova, Italy
| | | | - Mauro Pagani
- Department of Medicine, Ospedale Destra Secchia, Carlo Poma Hospital, Mantova, Italy
| | - Angela Bellani
- Department of Frailty, Carlo Poma Hospital, Mantova, Italy
| | - Gianpaolo Castelli
- Department of Anesthesiology and Intensive Care, Carlo Poma Hospital, Mantova, Italy
| | - Salvatore Casari
- Unit of Infectious Diseases, Carlo Poma Hospital, Mantova, Italy
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18
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Atenza A, Tamain M, Pereira B, Tiple A, Egret A, Garrouste C, Pagani M, Heng A. Utilisation du rituximab par voie sous-cutanée dans le traitement des syndromes néphrotiques idiopathiques à lésions glomérulaires minimes et de la hyalinose segmentaire et focale primitive chez l’adulte : étude pilote. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.150] [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: 11/24/2022]
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19
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Franchini M, Glingani C, De Donno G, Casari S, Caruso B, Terenziani I, Perotti C, Del Fante C, Sartori F, Pagani M. The first case of acquired hemophilia A associated with SARS-CoV-2 infection. Am J Hematol 2020; 95:E197-E198. [PMID: 32401344 PMCID: PMC7273016 DOI: 10.1002/ajh.25865] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/08/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Massimo Franchini
- Department of Hematology and Transfusion MedicineCarlo Poma Hospital, ASST Mantova Mantova Italy
| | - Claudia Glingani
- Department of Hematology and Transfusion MedicineCarlo Poma Hospital, ASST Mantova Mantova Italy
| | | | - Salvatore Casari
- Unit of Infectious DiseasesCarlo Poma Hospital, ASST Mantova Mantova Italy
| | | | | | - Cesare Perotti
- Immunohaematology and Transfusion Service, Apheresis and Cell Therapy UnitFondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Claudia Del Fante
- Immunohaematology and Transfusion Service, Apheresis and Cell Therapy UnitFondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Filippo Sartori
- Department of MedicineOspedale Destra Secchia, ASST Mantova Mantova Italy
| | - Mauro Pagani
- Department of MedicineOspedale Destra Secchia, ASST Mantova Mantova Italy
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20
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Gerosa M, Facciotti F, Larghi P, Bosotti R, Vasco C, Gagliani N, Cordiglieri C, Rottoli E, Penatti AE, Argolini LM, Karnani B, Kobayashi Y, Bombaci M, Van Hamburg JP, Gualtierotti R, Gatti S, Torretta S, Pignataro L, Tas SW, Caporali R, Abrignani S, Pagani M, Grassi F, Meroni PL, Flavell R, Geginat J. THU0221 EVIDENCE FOR A PATHOGENIC ROLE OF EXTRA-FOLLICULAR, IL-10 PRODUCING CCR6+B-HELPER T-CELLS IN SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1532] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:IL-10 plays a key role in systemic lupus erythematosus (SLE) pathogenesis, promoting B-cell response. IL10 is mainly secreted by regulatory T-cells, but follicular helper T-cells (TFH), also produce it. We previously identified a subset of CCR6+IL-7R+T-cells in human tonsils providing IL-10-dependent B-cell help. These CCR6+T-cells were able to produce IL-10, inducing IgG production.Objectives:to investigate a possible role of CD4+CCR6+IL7R+T-cells in SLE pathogenesis.Methods:37 patients fulfilling the ACR criteria for SLE have been included. Disease activity was assessed by 2k-SLEDAI. PBMC were analyzed by flow cytometry, using specific lineage markers. CCR6+IL7R+T-cells purified from total PBMC of SLE patients or healthy donors (HD) were co-cultured with autologous CD20+B-cells. IL-10, Il-17, total IgG and anti-dsDNA antibodies titers in patients serum and culture supernatants were assessed by ELISA. Embedded sections of lymph nodes from 8 SLE patients were analyzed by immunofluorescence (IF).Results:IL10 levels were significantly higher in SLE patients (Fig 1A). CD4+CCR6+IL7R+T-cells were significantly increased in SLE, in particular in those with higher disease activity and higher IL10 levels. CD4+CCR6+IL7R+T-cells levels associated with anti-dsDNA positivity. CCR6+IL7R+T-cells of SLE patients induced production of IgG and anti-dsDNA IgG (in anti-dsDNA + patients) from autologous B-cells, providing spontaneous help for autoantibody productionex vivo(Fig 1B-C). The IF study of lymph nodes of SLE patients showed that IL-10-producing CCR6+T-cells were highly abundant and co-localized with B-cells at follicle margins.Fig 1Conclusion:our study revealed a novel population of extra-follicular B-helper T-cells, which produce IL-10 and could play a prominent pathogenic role in SLE. Further studies will clarify if this potentially pathogenic cell population might represent a possible future therapeutic target.References:[1]Facciotti F. J Allergy Clin Immunol. 2016; Geginat J. Semin Immunol. 2019; Tsokos GC. Nat Rev Rheumatol. 2019Tab 1:SLE patients characteristics(n=37)DemographicsFemale/Male, n37/5Age, years, median (IQR)44 (38-49)Disease duration, years, median (IQR)19 (11-26)Lab testsANA86%*anti-dsDNA (%)46% medium/high titre41%Disease activity and clinical manifestations SLEDAI-2K, median (min-max)3.5 (0-24) Moderate/high activity19%Ongoing therapyPrednisone dose mg/day, median (IQR)7,5 mg (2,5 – 20)hydroxychloroquine78%Immunosuppressants87%Fig 2Disclosure of Interests: :Maria Gerosa: None declared, Federica Facciotti: None declared, Paola Larghi: None declared, Roberto Bosotti: None declared, Chiara Vasco: None declared, Nicola Gagliani: None declared, Chiara Cordiglieri: None declared, Elsa Rottoli: None declared, Alessandra Emiliana Penatti: None declared, Lorenza Maria Argolini: None declared, Bhavna Karnani: None declared, Yasushi Kobayashi: None declared, Mauro Bombaci: None declared, Jan Piet Van Hamburg: None declared, Roberta Gualtierotti: None declared, Stefano Gatti: None declared, Sara Torretta: None declared, Lorenzo Pignataro: None declared, Sander W. Tas: None declared, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB, Sergio Abrignani: None declared, Massimiliano Pagani: None declared, Fabio Grassi: None declared, Pier Luigi Meroni: None declared, Richard Flavell: None declared, Jens Geginat: None declared
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21
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Geginat J, Vasco M, Gerosa M, Tas SW, Pagani M, Grassi F, Flavell RA, Meroni P, Abrignani S. IL-10 producing regulatory and helper T-cells in systemic lupus erythematosus. Semin Immunol 2019; 44:101330. [PMID: 31735515 DOI: 10.1016/j.smim.2019.101330] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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] [Indexed: 12/13/2022]
Abstract
Systemic lupus erythematosus (SLE) is a highly heterogeneous autoimmune disease characterised by the production of pathogenic autoantibodies against nuclear self-antigens. The anti-inflammatory and tolerogenic cytokine Interleukin-10 appears to play a paradoxical pathogenic role in SLE and is therefore currently therapeutically targeted in clinical trials. It is generally assumed that the pathogenic effect of IL-10 in SLE is due to its growth and differentiation factor activity on autoreactive B-cells, but effects on other cells might also play a role. To date, a unique cellular source of pathogenic IL-10 in SLE has not been identified. In this review, we focus on the contribution of different CD4+T-cell subsets to IL-10 and autoantibody production in SLE. In particular, we discuss that IL-10 produced by different subsets of adaptive regulatory T-cells, follicular helper T-cells and extra-follicular B-helper T-cells is likely to have different effects on autoreactive B-cell responses. A better understanding of the role of IL-10 in B-cell responses and lupus would allow to identify the most promising therapies for individual SLE patients in the future.
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Affiliation(s)
- J Geginat
- INGM-National Institute of Molecular Genetics "Romeo ed Enrica Invernizzi", Milan, Italy.
| | - M Vasco
- INGM-National Institute of Molecular Genetics "Romeo ed Enrica Invernizzi", Milan, Italy
| | - M Gerosa
- DISCCO, Department of Clinical Science and Community Health, University of Milan, Italy; ASST Istituto G. Pini, Milan, Italy
| | - S W Tas
- Amsterdam UMC, University of Amsterdam, Department of Rheumatology & Clinical Immunology and Department of Experimental Immunology, Amsterdam Infection & Immunity Institute and Amsterdam Rheumatology & immunology Center (ARC), Academic Medical Center, Amsterdam, the Netherlands
| | - M Pagani
- INGM-National Institute of Molecular Genetics "Romeo ed Enrica Invernizzi", Milan, Italy; Amsterdam UMC, University of Amsterdam, Department of Rheumatology & Clinical Immunology and Department of Experimental Immunology, Amsterdam Infection & Immunity Institute and Amsterdam Rheumatology & immunology Center (ARC), Academic Medical Center, Amsterdam, the Netherlands; Department of Medical Biotechnology and Translational Medicine, University of Milan, Italy
| | - F Grassi
- INGM-National Institute of Molecular Genetics "Romeo ed Enrica Invernizzi", Milan, Italy; Institute for Research in Biomedicine, Bellinzona, Switzerland
| | - R A Flavell
- Department of Immunobiology, and Howard Hughes Medical Institute, School of Medicine, Yale University, New Haven, USA
| | - Pl Meroni
- Istituto Auxologico Italiano, Milano, Italy
| | - S Abrignani
- INGM-National Institute of Molecular Genetics "Romeo ed Enrica Invernizzi", Milan, Italy; DISCCO, Department of Clinical Science and Community Health, University of Milan, Italy
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22
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Bocchialini G, Braggio C, Ventura L, Pagani M, Carbognani P, Rusca M, Ampollini L. EP1.17-14 Less Is More: An Unusual Case of Benign Emptying of the Post - Pneumonectomy Space. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2424] [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: 10/25/2022]
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23
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Baldi E, Buratti S, Contri E, Canevari S, Molinari S, Pagani M, Lusona B, Mojoli F, Bertona R, Osti R, Palo A, Oltrona Visconti L, De Ferrari GM, Savastano S. P2828Survival after an out-of-hospital cardiac arrest decrease over time in all Utstein categories. The importance of a long follow-up. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1138] [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
Survival beyond 1-month after an out-of-hospital cardiac arrest (OHCA) is still considered a challenge for OHCA registries and it is often unexplored. However, a longer follow-up could help to better comprehend the long-term issues of OHCA survivors.
Purpose
Our aim was to evaluate the long-term outcome after OHCA via an Utstein-based cardiac arrest registry with a long follow-up (up to 5 years).
Methods
We enrolled all the people with an OHCA of any aetiology in our Province (about 55ehz748.1138 inhabitants in northern Italy) in whom CPR was attempted. The primary endpoint was the survival at 1 month, and the secondary endpoints were the survival at 6 months and then every year until 5 years after OHCA.
Results
In the first 45 months (October 2014–June 2018) 1774 resuscitation attempts for confirmed OHCAs were enrolled. Baseline characteristics: male 59.7%; mean age of 73.4±16 years; mean EMS response time was 11:31±5:09 mins; home location 78.8%; bystander-witnessed events were 56.1%; EMS witnessed event 15.6%; bystander CPR 39.5%; AED use before EMS arrival 2.5%; medical etiology 93%; first shockable rhythm 18.2% (90.7% VF, 2.5% VT without pulse, 6.8% AED shockable). When considering survival from the event (Figure 1 – left panel), survival was significantly higher for shockable Utstein categories (p<0.001). Considering only those patients discharged alive (Figure 1 – right panel) long term survival was significantly higher (p<0.01) once again for shockable rhythms. Interestingly, in this category survival continued to decrease over time ranging about from 90% in the first year to about 80% at four years.
Figure 1
Conclusions
Our results demonstrated that survival after OHCA can change over the time in all the Utstein categories, so we believe that a longer follow-up should be encouraged by next Utstein style revision.
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Affiliation(s)
- E Baldi
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - S Buratti
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - E Contri
- Foundation IRCCS Policlinic San Matteo, AAT 118, Pavia, Italy
| | - S Canevari
- Azienda Regionale Emergenza Urgenza (AREU), SOREU Pianura, Milano, Italy
| | - S Molinari
- Foundation IRCCS Policlinic San Matteo, AAT 118, Pavia, Italy
| | - M Pagani
- Foundation IRCCS Policlinic San Matteo, Intensive Care Unit, Pavia, Italy
| | - B Lusona
- Foundation IRCCS Policlinic San Matteo, Intensive Care Unit, Pavia, Italy
| | - F Mojoli
- Foundation IRCCS Policlinic San Matteo, Intensive Care Unit, Pavia, Italy
| | - R Bertona
- Azienda Ospedaliera della Provincia di Pavia, Division of Cardiology, Vigevano, Italy
| | - R Osti
- Azienda Ospedaliera della Provincia di Pavia, Division of Cardiology, Voghera, Italy
| | - A Palo
- Foundation IRCCS Policlinic San Matteo, AAT 118, Pavia, Italy
| | - L Oltrona Visconti
- Foundation IRCCS Policlinic San Matteo, Division of Cardiology, Pavia, Italy
| | - G M De Ferrari
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - S Savastano
- Foundation IRCCS Policlinic San Matteo, Division of Cardiology, Pavia, Italy
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Asteria CR, Lucchini G, Guarda L, Ricci P, Pagani M, Boccia L. The detection of interval colorectal cancers following screening by fecal immunochemical test may predict worse outcomes and prompt ethical concerns: a 6-year population-based cohort study in a full district. Eur J Cancer Prev 2019; 28:17-26. [PMID: 29111981 DOI: 10.1097/cej.0000000000000416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The rates of colorectal cancer (CRC) interval surveyed in screen-detected patients using a fecal immunochemical test (FIT) are not negligible. The aim of this study was to assess the effect of interval cancer on outcomes compared with a population with cancer diagnosed after a positive test result. All patients between 50 and 71 years of age, who were residents of the Mantua district, affected by CRC and operated on from 2005 to 2010 were reviewed. Other than patient-related, disease-related, and treatment-related factors and tumor location, this population was differentiated as either participating or not to screening and then into populations developing interval cancer after a negative FIT result. Mortality was investigated by univariate analysis and by overall survival rates. The mean age of the 975 patients enrolled was 62 years (61.7% males). Most patients (n=575, 59%) were not screen detected, and 400 (41%) were screen detected. Fifty-six (5.7%) patients in the latter group, representing 14% of the participants, developed interval cancer after a negative FIT result. Their cancer was mostly localized in the right colon (41.1%) instead of the left colon and rectum (P=0.02). They also showed higher stages (P=0.001), a moderate degree of differentiation (P=0.001), and overall higher mortality rates than patients with cancer diagnosed after a positive test result (P=0.001). The effect of interval CRC after screening with FIT resulted in worse outcomes compared with the FIT-positive group. With such findings, patients who had negative results for FIT should be informed of the risk of developing cancer within the rounds of screening to independently gain educational skills in the area of health prevention.
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Affiliation(s)
| | | | - Linda Guarda
- Department of Epidemiology, Public Health Observatory, ATS Val Padana, Mantua, Italy
| | - Paolo Ricci
- Department of Epidemiology, Public Health Observatory, ATS Val Padana, Mantua, Italy
| | - Mauro Pagani
- Department of Medicine, Medicine Unit Pieve Coriano, Carlo Poma ASST
| | - Luigi Boccia
- Department of Surgery and Orthopaedics, General Surgery Unit
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Pagani M, Bavbek S, Dursun AB, Bonadonna P, Caralli M, Cernadas J, Cortellini G, Costantino MT, Gelincik A, Lucchini G, Castells M. Role of Skin Tests in the Diagnosis of Immediate Hypersensitivity Reactions to Taxanes: Results of a Multicenter Study. The Journal of Allergy and Clinical Immunology: In Practice 2019; 7:990-997. [DOI: 10.1016/j.jaip.2018.09.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 08/30/2018] [Accepted: 09/18/2018] [Indexed: 11/30/2022]
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26
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Canosa A, Pagani M, Brunetti M, Barberis M, Iazzolino B, Ilardi A, Cammarosano S, Manera U, Moglia C, Calvo A, Cistaro A, Chiò A. Correlation between Apolipoprotein E genotype and brain metabolism in amyotrophic lateral sclerosis. Eur J Neurol 2018; 26:306-312. [PMID: 30240096 DOI: 10.1111/ene.13812] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 09/10/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE The aim of the study was to evaluate the metabolic correlates of Apolipoprotein E (APOE) genotype in amyotrophic lateral sclerosis (ALS) and to investigate the role of ε2 as a risk factor for cognitive impairment. METHODS A total of 159 ALS cases underwent APOE and ALS-related genes analysis, neuropsychological assessment and cerebral 18 F-2-fluoro-2-deoxy-D-glucose positron emission tomography. The APOE genotype was regressed against whole brain metabolism as assessed by 18 F-2-fluoro-2-deoxy-D-glucose positron emission tomography, with age, sex, education, type of onset and C9orf72 status as covariates. RESULTS Brain metabolism was significantly positively correlated with APOE genotype from ε2/ε2 to ε3/ε4 in the left prefrontal [Brodmann area (BA) 10], orbitofrontal (BAs 11, 45, 47) and anterior cingulate (BA 32) cortices. There was a tendency to a relative hypometabolism going towards the ε2/ε2 extreme. CONCLUSIONS We found a highly significant, relatively lower metabolism in association with the ε2 allele in extra-motor areas typically affected in frontotemporal dementia (left prefrontal, orbitofrontal and anterior cingulate cortices), strengthening the finding of a role of ε2 as a risk factor for cognitive impairment in ALS. Our data suggested a link between cholesterol homeostasis and neurodegeneration.
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Affiliation(s)
- A Canosa
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - M Pagani
- Institute of Cognitive Sciences and Technologies (CNR), Rome, Italy.,Department of Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden
| | - M Brunetti
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - M Barberis
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - B Iazzolino
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - A Ilardi
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - S Cammarosano
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - U Manera
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin
| | - C Moglia
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin.,Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin
| | - A Calvo
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin.,Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin.,Neuroscience Institute of Turin (NIT), Turin
| | - A Cistaro
- PET Centre AFFIDEA IRMET, Turin, Italy
| | - A Chiò
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin.,Institute of Cognitive Sciences and Technologies (CNR), Rome, Italy.,Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin.,Neuroscience Institute of Turin (NIT), Turin
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Baldi E, Palo A, Danza AI, Canevari F, Mosca C, Molinari S, Pagani M, Lusona B, Mojoli F, Bertona R, Osti R, De Ferrari GM, Oltrona Visconti L, Savastano S. P264Long-term survival after an out-of-hospital cardiac arrest: beyond 1 month follow-up. Our three years experience. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p264] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E Baldi
- IRCCS Polyclinic San Matteo Foundation, University of Pavia, School of Cardiovascular Disease, Pavia, Italy
| | - A Palo
- IRCCS Polyclinic San Matteo Foundation, AAT 118, Pavia, Italy
| | - A I Danza
- IRCCS Polyclinic San Matteo Foundation, University of Pavia, School of Cardiovascular Disease, Pavia, Italy
| | - F Canevari
- IRCCS Polyclinic San Matteo Foundation, AAT 118, Pavia, Italy
| | - C Mosca
- University of Pavia, Pavia, Italy
| | - S Molinari
- IRCCS Polyclinic San Matteo Foundation, AAT 118, Pavia, Italy
| | - M Pagani
- IRCCS Polyclinic San Matteo Foundation, Intensive Care Unit, Pavia, Italy
| | - B Lusona
- IRCCS Polyclinic San Matteo Foundation, Intensive Care Unit, Pavia, Italy
| | - F Mojoli
- IRCCS Polyclinic San Matteo Foundation, Intensive Care Unit, Pavia, Italy
| | - R Bertona
- Azienda Ospedaliera della Provincia di Pavia, Division of Cardiology, Vigevano, Italy
| | - R Osti
- Azienda Ospedaliera della Provincia di Pavia, Division of Cardiology, Voghera, Italy
| | - G M De Ferrari
- IRCCS Polyclinic San Matteo Foundation, Cardiac Intensive Care Unit, Pavia, Italy
| | - L Oltrona Visconti
- IRCCS Polyclinic San Matteo Foundation, Division of Cardiology, Pavia, Italy
| | - S Savastano
- IRCCS Polyclinic San Matteo Foundation, Division of Cardiology, Pavia, Italy
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Bonadonna P, Zanotti R, Pagani M, Bonifacio M, Scaffidi L, Olivieri E, Franchini M, Reccardini F, Costantino MT, Roncallo C, Mauro M, Boni E, Rizzini FL, Bilò MB, Marcarelli AR, Passalacqua G. Anaphylactic Reactions After Discontinuation of Hymenoptera Venom Immunotherapy: A Clonal Mast Cell Disorder Should Be Suspected. The Journal of Allergy and Clinical Immunology: In Practice 2018; 6:1368-1372. [DOI: 10.1016/j.jaip.2017.11.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 11/09/2017] [Accepted: 11/16/2017] [Indexed: 11/15/2022]
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Aitini E, Rabbi C, Mambrini A, Cavazzini G, Pari F, Zamagni D, Cantore M, Pagani M, Sorio M, Lusenti A, Adami F, Smerieri F. Epirubicin, Cisplatin and Continuous Infusion 5-Fluorouracil (ECF) in Locally Advanced or Metastatic Gastric Cancer: A Single Institution Experience. Tumori 2018; 87:20-4. [PMID: 11669552 DOI: 10.1177/030089160108700105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background The role of chemotherapy in locally advanced or metastatic gastric cancer has been controversial, but chemotherapy has recently been shown to relieve tumor-related symptoms, improve quality of life and prolong survival when compared with best supportive care. Furthermore, palliative chemotherapy is also cost-effective. “Second-generation” combination chemotherapy regimens were developed in the 1980s with high activity in advanced or metastatic gastric cancer (EAP, FAMTX, PELF, ECF). In randomized studies, EAP demonstrated no difference in activity but a significantly higher overall toxicity and toxic death rate than FAMTX, and the ECF (epirubicin, cisplatin, 5-fluorouracil) regimen gave a survival and response advantage, tolerable toxicity, better quality of life and was more cost-effective than FAMTX. Methods Sixty patients with locally advanced or metastatic gastric cancer were treated with the ECF regimen (21 weeks of 5-fluorouracil given by continuous infusion through a central line at 200 mg/m2 for 24-hr combined with cisplatin at 60 mg/m2 iv and epirubicin at 50 mg/m2 iv beginning on day 1 and repeated every 3 weeks for 8 courses). There were 42 males and 18 females, with a median age of 64 years (range, 40-74). The median performance status was 1. The histologic type was adenocarcinoma in 44 patients and undifferentiated carcinoma in 16 (27%). Three patients had locally advanced disease (5%) and 57 had metastatic disease (95%). Seven patients (12%) had received prior chemotherapy for advanced disease. Results All patients were assessable for toxicity and 55 for response (5 had insufficient treatment). Toxicity was mild or moderate, and there was no toxic death. Incidence of WHO toxicity ≥ 2 was nausea and vomiting in 3%, mucositis in 3%, leukopenia in 7%, anemia in 3%, and thrombocytopenia in 2%. Port-a-Cath toxicity was thrombosis in 4, dislocation in 2 and infection in 3 patients. Seven complete responses and 13 partial responses (overall response rate, 36%) were achieved, with a response rate of 39% in untreated and 17% in pretreated patients. Nine patients (16%) had stable disease and 26 (47%) progressive disease. Most patients felt symptomatically improved on ECF. Conclusions Our study confirms that the ECF regimen has a favorable pattern of toxicity and is feasible on an outpatient basis. However, it did not confirm the high response rate reported in other phase II trials.
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Affiliation(s)
- E Aitini
- Medical Oncology and Hematology Department, Carlo Poma Hospital, Mantua, Italy.
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30
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Pagani M, Antico A, Bellarosa S, Cavazzini G, Aitini E. Primary Pulmonary High Grade Non-Hodgkin's Lymphoma in an Elderly Patient. A Case Report. Tumori 2018; 93:622-4. [DOI: 10.1177/030089160709300620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
An 82-year-old non-smoker female was admitted with cough, fever and poor general health. Radiological examination revealed a right parahilar mass and a transbronchial biopsy confirmed the presence of a tumor. Immunohistochemical analysis established the diagnosis of high-grade primary pulmonary lymphoma. The rare nature of this disease, its non-specific clinical presentation and particular prognosis, also in elderly patients, are discussed in this article.
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Affiliation(s)
- Mauro Pagani
- Medical Oncology Department, Carlo Poma Hospital, Mantua, Italy
| | - Andrea Antico
- Medical Oncology Department, Carlo Poma Hospital, Mantua, Italy
| | | | | | - Enrico Aitini
- Medical Oncology Department, Carlo Poma Hospital, Mantua, Italy
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31
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Savastano S, Baldi E, Raimondi M, Guerci M, Canevari F, Danza A, Mosca C, Molinari S, Pagani M, Lusona B, Mojoli F, Bertona R, Osti R, Oltrona Visconti L. P2750The challenge of long-term survival after an out-of-hospital cardiac arrest: one month is not enough. Our two years experience. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2750] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S. Savastano
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - E. Baldi
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - M. Raimondi
- Policlinic Foundation San Matteo IRCCS, AAT 118, Pavia, Italy
| | - M. Guerci
- Policlinic Foundation San Matteo IRCCS, AAT 118, Pavia, Italy
| | - F. Canevari
- Policlinic Foundation San Matteo IRCCS, AAT 118, Pavia, Italy
| | - A.I. Danza
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - C. Mosca
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - S. Molinari
- Policlinic Foundation San Matteo IRCCS, AAT 118, Pavia, Italy
| | - M. Pagani
- Policlinic Foundation San Matteo IRCCS, Intensive care unit, Pavia, Italy
| | - B. Lusona
- Policlinic Foundation San Matteo IRCCS, Intensive care unit, Pavia, Italy
| | - F. Mojoli
- Policlinic Foundation San Matteo IRCCS, Intensive care unit, Pavia, Italy
| | - R. Bertona
- Ospedale Civile, Cardiology, Vigevano, Italy
| | - R. Osti
- Ospedale Civile, Cardiology, Voghera, Italy
| | - L. Oltrona Visconti
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
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33
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Bonadonna P, Passalacqua G, Reccardini F, Rizzini FL, Mauro M, Franchini M, Pagani M, Roncallo C, Costantino MT, Zanotti R. Severe Anaphylactic Reactions after Stopping Hymenoptera Venom Immunotherapy. a Clonal Mast Cell Disorder Should be Suspected. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Asteria CR, Pucciarelli S, Gerard L, Mantovani N, Pagani M, Boccia L, Ricci P, Troiano L, Lucchini G, Pulica C. The impact of colorectal screening program on the detection of right-sided colorectal cancer. A 5-year cohort study in the Mantua District. Int J Colorectal Dis 2015; 30:1627-37. [PMID: 26255258 DOI: 10.1007/s00384-015-2352-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND High rates of advanced colorectal cancer (CRC) are still diagnosed in the right side of the colon. This study aimed to investigate whether screening programs increase CRC detection and whether tumor location is associated with survival outcome. METHODS Patients affected by CRC, aged from 50 to 69 years and operated on from 2005 to 2009 were reviewed. Other than patient-, disease-, and treatment-related factors, detection mode and tumor location were recorded. Overall (OS) and disease-free survival (DFS) were investigated, using univariate and multivariate analyses. RESULTS Mean age of 386 patients included was 62.0 years, 59 % were males. CRC was detected by screening in 17 % of cases, and diagnosis was made from symptoms in 67 % and emergency surgery for 16 %. Screen-detected CRCs were located in the left colon (59 %), then in rectum (25 %) and in proximal colon (16 %) (p = 0.02). Most of CRC patients urgently operated on had cancer located in proximal colon (45 %), then in the left colon (36 %) and in rectum (18 %) (p = 0.001). Right-sided CRC demonstrated higher pTNM stage (p = 0.001), adequate harvest count nodes (p = 0.0001), metastatic nodes (p = 0.02), and poor differentiation grading (p = 0.0001). With multivariate analysis, poor differentiation grade was independently associated with both worse OS (HR 3.6, p = 0.05) and worse DFS (HR 8.1, p = 0.0001), while distant recurrence was associated with worse OS (HR 20.1, p = 0.0001). CONCLUSION Low rates of right-sided CRC are diagnosed following screening program. Proximal CRC demonstrates aggressive behavior without impact on outcome. These findings prompt concern about population awareness for CRC screening.
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Affiliation(s)
- Corrado R Asteria
- Department of Surgery and Orthopaedics, General Surgery Units of Asola, Mantua and Pieve C., Carlo Poma Hospital, 80° Fanteria Place, 1-46041, Asola, Mantua, Italy.
| | - Salvatore Pucciarelli
- Department of Surgery Oncology and Gastroenterology, Surgical Clinic I, School of Medicine, University of Padua, Padua, Italy
| | - Leonardo Gerard
- Department of Surgery and Orthopaedics, General Surgery Units of Asola, Mantua and Pieve C., Carlo Poma Hospital, 80° Fanteria Place, 1-46041, Asola, Mantua, Italy
| | - Nicola Mantovani
- Department of Surgery and Orthopaedics, Digestive Endoscopy Unit, Carlo Poma Hospital, Mantua, Italy
| | - Mauro Pagani
- Department of Medicine, Medicine Unit, Pieve Coriano, Carlo Poma Hospital Mantua, Mantua, Italy
| | - Luigi Boccia
- Department of Surgery and Orthopaedics, General Surgery Units of Asola, Mantua and Pieve C., Carlo Poma Hospital, 80° Fanteria Place, 1-46041, Asola, Mantua, Italy
| | - Paolo Ricci
- Epidemiological Observatory Local Health-care Authority (LHCA), Mantua, Italy
| | - Luigi Troiano
- Department of Surgery and Orthopaedics, Digestive Endoscopy Unit, Carlo Poma Hospital, Mantua, Italy
| | - Giuseppe Lucchini
- Department of Healthcare Medical Management, Biostatistic Service, Carlo Poma Hospital, Mantua, Italy
| | - Coriolano Pulica
- Department of Surgery and Orthopaedics, General Surgery Units of Asola, Mantua and Pieve C., Carlo Poma Hospital, 80° Fanteria Place, 1-46041, Asola, Mantua, Italy
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35
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De Agostini G, Bonetti L, Moleri C, Belotti L, Colombo S, Pagani M, Cabiddu M, Borgonovo K, Ruggeri L, Rossi F, Coinu A, Cavalleri M, Astori A, Ghilardi M, Aceti A, Peccati M, Petrelli F, Losi M, Barni S. Find yourself with a smile. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv347.26] [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: 11/12/2022] Open
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Bonadonna P, Pagani M, Aberer W, Bilò MB, Brockow K, Oude Elberink H, Garvey L, Mosbech H, Romano A, Zanotti R, Torres MJ. Drug hypersensitivity in clonal mast cell disorders: ENDA/EAACI position paper. Allergy 2015; 70:755-63. [PMID: 25824492 DOI: 10.1111/all.12617] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2015] [Indexed: 01/08/2023]
Abstract
Mastocytosis is a clonal disorder characterized by the proliferation and accumulation of mast cells (MC) in different tissues, with a preferential localization in skin and bone marrow (BM). The excess of MC in mastocytosis as well as the increased releasability of MC may lead to a higher frequency and severity of immediate hypersensitivity reactions. Mastocytosis in adults is associated with a history of anaphylaxis in 22-49%. Fatal anaphylaxis has been described particularly following hymenoptera stings, but also occasionally after the intake of drugs such as nonsteroidal anti-inflammatory drugs, opioids and drugs in the perioperative setting. However, data on the frequency of drug hypersensitivity in mastocytosis and vice versa are scarce and evidence for an association appears to be limited. Nevertheless, clonal MC disorders should be ruled out in cases of severe anaphylaxis: basal serum tryptase determination, physical examination for cutaneous mastocytosis lesions, and clinical characteristics of anaphylactic reaction might be useful for differential diagnosis. In this position paper, the ENDA group performed a literature search on immediate drug hypersensitivity reactions in clonal MC disorders using MEDLINE, EMBASE, and Cochrane Library, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation.
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Affiliation(s)
- P. Bonadonna
- Allergy Unit; Azienda Ospedaliera Universitaria Intergrata of Verona; Verona Italy
| | - M. Pagani
- Medicine Ward; Pieve di Coriano Hospital Azienda Ospedaliera Carlo Poma Mantova; Mantova Italy
| | - W. Aberer
- Department of Dermatology and Venerology; Medizinische Universitat Graz; Graz Austria
| | - M. B. Bilò
- Allergy Unit; Department of Internal Medicine; Ospedali Riuniti di Ancona; Ancona Italy
| | - K. Brockow
- Department of Dermatology and Allergy Biederstein; Technische Universität München; Munich Germany
| | - H. Oude Elberink
- Department of Allergology; GRIAC Research Institute; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - L. Garvey
- Allergy Clinic; Copenhagen University Hospital; Gentofte Denmark
| | - H. Mosbech
- Allergy Clinic; Copenhagen University Hospital; Gentofte Denmark
| | - A. Romano
- Allergy Unit Complesso Integrato Columbus; Rome and IRCCS Oasi Maria S.S.; Troina Italy
| | - R. Zanotti
- Department of Medicine; Hematology Section; Azienda Ospedaliera Universitaria Intergrata of Verona; Verona Italy
| | - M. J. Torres
- Allergy Unit; Regional University Hospital-IBIMA; UMA; Málaga Spain
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Di Lorenzo G, Monaco L, Daverio A, Santarnecchi E, Verrdo A, Niolu C, Fernandez I, Pagani M, Siracusano A. Emdr Therapy Changes the Resting-state Eeg. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30537-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Salvioli B, Pellegatta G, Malacarne M, Pace F, Malesci A, Pagani M, Lucini D. Autonomic nervous system dysregulation in irritable bowel syndrome. Neurogastroenterol Motil 2015; 27:423-30. [PMID: 25581440 DOI: 10.1111/nmo.12512] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 12/17/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Autonomic nervous system (ANS) regulation may be altered in functional diseases, including irritable bowel syndrome (IBS), but published data are not clear to date. The aim of the study was to analyze ANS function in IBS subjects classified by Rome III criteria and healthy controls using standardized technique. METHODS ANS activity was evaluated by autoregressive spectral analysis of RR interval and systolic arterial pressure variabilities, to obtain indices of sympatho-vagal modulation of the heart and of spontaneous cardiac baroreflex (α index). A symptom list was used to score 18 somatic complaints (score 0-180) (4SQ). Fatigue and stress were assessed through the use of a global scoring index (0-10). KEY RESULTS We enrolled 41 IBS subjects (29 F, age 40 ± 2 years) and 42 healthy matched controls. Heart rate was higher in IBS than control subjects (69 ± 2 vs 61 ± 1; p < 0.001). The total variance of RR interval variability, and α index, were significantly lower in IBS compared to controls (1983.12 ± 384.64 ms(2) vs 4184.55 ± 649.59 ms(2) ; 18.1 ± 2 ms/mmHg vs 29 ± 3 ms/mmHg; p < 0.01). The α index results showed an inverse correlation with stress scores and somatic symptoms. CONCLUSIONS & INFERENCES IBS subjects display a significant reduction in α index, an established marker of cardiac baroreflex. ANS dysfunction appears to be involved in the pathophysiology of IBS and its assessment may open new perspectives for clinical management of patients suffering from IBS.
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Affiliation(s)
- B Salvioli
- University of Bologna, Bologna, Italy; Department of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, Italy
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Pagani M, Sonni I, Capriotti G. Functional imaging in neurodegenerative disorders: past, present and future. Q J Nucl Med Mol Imaging 2014; 58:329-331. [PMID: 25519924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- M Pagani
- Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy
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Quartuccio N, Van Weehaeghe D, Cistaro A, Jonsson C, Van Laere K, Pagani M. Positron emission tomography neuroimaging in amyotrophic lateral sclerosis: what is new? Q J Nucl Med Mol Imaging 2014; 58:344-54. [PMID: 25375229 DOI: pmid/25375229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease involving upper and lower motor neurons, extra-motor neurons, microglia and astrocytes. The neurodegenerative process results in progressive muscle paralysis and even in cognitive impairment. Within the complex diagnostic work-up, positron emission tomography (PET) represents a valuable imaging tool in the assessment of patients with ALS. PET, by means of different radiotracers (i.e. 18F-fluorodeoxyglucose, 6-[18F]fluoro-L-dopa, [11C]flumazenil) can assess the status of the wide range of brain regions and neural circuits, which can be affected by ALS. Furthermore, experimental radiocompounds have been developed for the evaluation of white matter, which plays a role in the progression of the disease. Here we present a comprehensive review including in different sections the most relevant PET studies: studies investigating ALS and ALS-mimicking conditions (especially primary lateral sclerosis and other neurodegenerative diseases), articles selecting specific subsets of patients (with bulbar or spinal onset), studies investigating patients with familial type of ALS, studies evaluating the role of the white matter in ALS and papers evaluating the diagnostic sensitivity of PET in ALS patients.
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Affiliation(s)
- N Quartuccio
- Nuclear Medicine Unit, Department of Biomedical Sciences and of Morphologic and Functional Images University of Messina, Italy -
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Tassorelli C, Jensen RH, De Icco R, Allena M, Katzarava Z, Lainez JM, Leston JA, Fadic R, Spadafora S, Pagani M, Giuseppe N. EHMTI-0327. Information and communication technology for improving the management of medication overuse headache: results of the comoestas multicentric, multinational study. J Headache Pain 2014. [PMCID: PMC4182052 DOI: 10.1186/1129-2377-15-s1-d63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Pagani M, De Carli F, Morbelli S, Öberg J, Chincarini A, Frisoni GB, Galluzzi S, Perneczky R, Drzezga A, van Berckel BNM, Ossenkoppele R, Didic M, Guedj E, Brugnolo A, Picco A, Arnaldi D, Ferrara M, Buschiazzo A, Sambuceti G, Nobili F. Volume of interest-based [18F]fluorodeoxyglucose PET discriminates MCI converting to Alzheimer's disease from healthy controls. A European Alzheimer's Disease Consortium (EADC) study. Neuroimage Clin 2014; 7:34-42. [PMID: 25610765 PMCID: PMC4299956 DOI: 10.1016/j.nicl.2014.11.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 10/14/2014] [Accepted: 11/11/2014] [Indexed: 01/18/2023]
Abstract
An emerging issue in neuroimaging is to assess the diagnostic reliability of PET and its application in clinical practice. We aimed at assessing the accuracy of brain FDG-PET in discriminating patients with MCI due to Alzheimer's disease and healthy controls. Sixty-two patients with amnestic MCI and 109 healthy subjects recruited in five centers of the European AD Consortium were enrolled. Group analysis was performed by SPM8 to confirm metabolic differences. Discriminant analyses were then carried out using the mean FDG uptake values normalized to the cerebellum computed in 45 anatomical volumes of interest (VOIs) in each hemisphere (90 VOIs) as defined in the Automated Anatomical Labeling (AAL) Atlas and on 12 meta-VOIs, bilaterally, obtained merging VOIs with similar anatomo-functional characteristics. Further, asymmetry indexes were calculated for both datasets. Accuracy of discrimination by a Support Vector Machine (SVM) and the AAL VOIs was tested against a validated method (PALZ). At the voxel level SMP8 showed a relative hypometabolism in the bilateral precuneus, and posterior cingulate, temporo-parietal and frontal cortices. Discriminant analysis classified subjects with an accuracy ranging between .91 and .83 as a function of data organization. The best values were obtained from a subset of 6 meta-VOIs plus 6 asymmetry values reaching an area under the ROC curve of .947, significantly larger than the one obtained by the PALZ score. High accuracy in discriminating MCI converters from healthy controls was reached by a non-linear classifier based on SVM applied on predefined anatomo-functional regions and inter-hemispheric asymmetries. Data pre-processing was automated and simplified by an in-house created Matlab-based script encouraging its routine clinical use. Further validation toward nonconverter MCI patients with adequately long follow-up is needed. 18F-FDG-PET/CT analysis of metabolic differences between MCI converting to AD and HC Large and very well controlled cohorts from EADC-Consortium were investigated. Data were analyzed by a friendly-to-use Matlab-based script and Support Vector Machine. Excellent discrimination between MCI and HC (sensitivity 92%; specificity 91%) Highest accuracy reported so far in MCI and promising implementation in clinical routine
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Affiliation(s)
- M Pagani
- Institute of Cognitive Sciences and Technologies, Rome, Italy ; Department of Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden
| | - F De Carli
- Institute of Bioimaging and Molecular Physiology, Consiglio Nazionale delle Ricerche (CNR), Genoa, Italy
| | - S Morbelli
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - J Öberg
- Department of Hospital Physics, Karolinska Hospital, Stockholm, Sweden
| | - A Chincarini
- National Institute for Nuclear Physics (INFN), Genoa, Italy
| | - G B Frisoni
- LENITEM Laboratory of Epidemiology and Neuroimaging, IRCCS S. Giovanni di Dio-FBF, Brescia, Italy ; University Hospitals and University of Geneva, Geneva, Switzerland
| | - S Galluzzi
- LENITEM Laboratory of Epidemiology and Neuroimaging, IRCCS S. Giovanni di Dio-FBF, Brescia, Italy
| | - R Perneczky
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College London of Science, Technology and Medicine, London, UK ; West London Cognitive Disorders Treatment and Research Unit, London, UK ; Department of Psychiatry and Psychotherapy, Technische Universität, Munich, Germany
| | - A Drzezga
- Department of Nuclear Medicine, Technische Universität, Munich, Germany
| | - B N M van Berckel
- Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands
| | - R Ossenkoppele
- Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands
| | - M Didic
- APHM, CHU Timone, Service de Neurologie et Neuropsychologie, Aix-Marseille University, INSERM U 1106, Marseille, France
| | - E Guedj
- APHM, CHU Timone, Service de Médecine Nucléaire, CERIMED, INT CNRS UMR7289 , Aix-Marseille University, Marseille 13005, France
| | - A Brugnolo
- Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU, San Martino-IST, Genoa, Italy
| | - A Picco
- Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU, San Martino-IST, Genoa, Italy
| | - D Arnaldi
- Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU, San Martino-IST, Genoa, Italy
| | - M Ferrara
- Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU, San Martino-IST, Genoa, Italy
| | - A Buschiazzo
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - G Sambuceti
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - F Nobili
- Clinical Neurology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, IRCCS AOU, San Martino-IST, Genoa, Italy
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Pagani M, Marpaung D, Eggleton BJ. Ultra-wideband microwave photonic phase shifter with configurable amplitude response. Opt Lett 2014; 39:5854-5857. [PMID: 25361102 DOI: 10.1364/ol.39.005854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We introduce a new principle that enables separate control of the amplitude and phase of an optical carrier, simply by controlling the power of two stimulated Brillouin scattering (SBS) pumps. This technique is used to implement a microwave photonic phase shifter with record performance, which solves the bandwidth limitation of previous gain-transparent SBS-based phase shifters, while achieving unprecedented minimum power fluctuations, as a function of phase shift. We demonstrate 360° continuously tunable phase shift, with less than 0.25 dB output power fluctuations, over a frequency band from 1.5 to 31 GHz, limited only by the measurement equipment.
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Pagani M, Giovannetti AM, Covelli V, Sattin D, Leonardi M. Caregiving for Patients in Vegetative and Minimally Conscious States: Perceived Burden as a Mediator in Caregivers’ Expression of Needs and Symptoms of Depression and Anxiety. J Clin Psychol Med Settings 2014; 21:214-22. [DOI: 10.1007/s10880-014-9399-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sattin D, Covelli V, Pagani M, Giovannetti AM, Raggi A, Meucci P, Cerniauskaite M, Quintas R, Schiavolin S, Leonardi M. Do diagnostic differences between vegetative state and minimally conscious state patients correspond to differences in functioning and disability profiles? Results from an observational multi-center study on patients with DOC. Eur J Phys Rehabil Med 2014; 50:309-321. [PMID: 24518146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Patients in vegetative (VS) and minimally conscious state (MCS) have different degrees of consciousness recovery but both display severe levels of disability. AIM To describe and compare VS and MCS patients' functioning and disability according to ICF model (International Classification of Functioning, Disability and Health). DESIGN Observational cross-sectional multi-center study involving sixty-nine Italian centers. SETTING Patients recruited in post-acute, long-term care facilities and at home in Italy. POPULATION Adult patients in VS and MCS. METHODS ICF Functioning profiles were completed and, for each ICF chapter and domain, extension and severity indexes were developed. Indexes have been compared between VS and MCS patients with Mann Whitney U test. Descriptive statistics have been applied to describe the most relevant categories that had a percentage of missing below 25% and that were reported as a problem by at least 50% of patients. RESULTS A total of 564 patients were enrolled: 396 in VS (mean age 56.8), 168 in MCS (mean age 54.2). Fifty-eight ICF categories were selected: of them, 24 were from Activity and Participation (A&P). Few differences between patients in VS and MCS were reported in Body Functions (BF), mostly referred to mental, sensory and digestive functions; among A&P, differences were found only in learning chapter. For VS patients less environmental barriers were reported than MCS patients. CONCLUSION Patients in VS and MCS have similar functioning and disability profiles and similar needs thus levels of care and assistance should not be different across the two conditions. CLINICAL REHABILITATION IMPACT An ICF-based methodology of data collection enables to describe VS and MCS patients' functioning and disability: this is helpful when rehabilitation programs based on the features of single patients with DOC need to be planned.
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Affiliation(s)
- D Sattin
- Neurology Public Health and Disability Unit Scientific Directorate Neurological Institute C. Besta IRCCS Foundation Milan, Italy -
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Tassorelli C, Jensen R, Allena M, De Icco R, Sances G, Katsarava Z, Lainez M, Leston J, Fadic R, Spadafora S, Pagani M, Nappi G. A consensus protocol for the management of medication-overuse headache: Evaluation in a multicentric, multinational study. Cephalalgia 2014; 34:645-655. [PMID: 24558185 DOI: 10.1177/0333102414521508] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The management of medication-overuse headache (MOH) is often difficult and no specific guidelines are available as regards the most practical and effective approaches. In this study we defined and tested a consensus protocol for the management of MOH on a large population of patients distributed in different countries. SUBJECTS AND METHODS The protocol was based on evidence from the literature and on consolidated expertise of the members of the consensus group. The study was conducted according to a multicentric interventional design with the enrolment of 376 MOH subjects in four centres from Europe and two centres in Latin America. The majority of patients were treated according to an outpatient detoxification programme. The post-detoxification follow-up lasted six months. RESULTS At the final evaluation, two-thirds of the subjects were no longer overusers and in 46.5% of subjects headache had reverted back to an episodic pattern of headache. When comparing the subjects who underwent out-patient detoxification vs those treated with in-patient detoxification, both regimens proved effective, although the drop-out rate was higher in the out-patient approach. CONCLUSIONS The present findings support the effectiveness and usability of the proposed consensus protocol in different countries with different health care modalities.
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Affiliation(s)
- C Tassorelli
- Headache Science Center, C. Mondino National Neurological Institute, Pavia Dept. of Brain and Behaviour, University of Pavia, Italy
| | - R Jensen
- Danish Headache Centre, Department of Neurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Denmark
| | - M Allena
- Headache Science Center, C. Mondino National Neurological Institute, Pavia
| | - R De Icco
- Headache Science Center, C. Mondino National Neurological Institute, Pavia Dept. of Brain and Behaviour, University of Pavia, Italy
| | - G Sances
- Headache Science Center, C. Mondino National Neurological Institute, Pavia
| | - Z Katsarava
- Department of Neurology, University of Essen, Germany
| | - M Lainez
- Foundation of the Valencian Community, University Clinical Hospital, Spain
| | - Ja Leston
- Foundation for Combating Neurological Diseases of Childhood, Argentina
| | - R Fadic
- Department of Neurology, Pontificia Catolica University of Chile, Chile
| | | | - M Pagani
- Bioengeneering and Medical Informatics Consortium (CBIM), Italy
| | - G Nappi
- Headache Science Center, C. Mondino National Neurological Institute, Pavia
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Pagani M, Bonadonna P. Skin test protocol for the prevention of hypersensitivity reactions to oxaliplatin. Anticancer Res 2014; 34:537-540. [PMID: 24403513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND/AIM Several hypersensitivity reactions (HSRs) to oxaliplatin have been reported. Presently, there is no reliable way to predict the development of this adverse reaction. The aim of the present study was to evaluate the reliability of skin tests in the detection of patients at risk of developing HSRs to oxaliplatin. PATIENTS AND METHODS Patients under treatment with oxaliplatin underwent the prick test at a concentration of 1 mg/ml and, if negative, intradermal injection at a concentration of 0.1 mg/ml, one hour before each course of oxaliplatin, starting from the second administration. RESULTS A group of 101 patients were submitted to skin tests: two were positive, whereas five developed HSR despite negative tests (false-negative rate: 5.05%). These patients underwent desensitization, which permitted to conclude the planned schedule in five cases. CONCLUSION A negative skin test to oxaliplatin has a good reliability in predicting HSRs. We suggest performing tests only in patients that have received at least five courses of oxaliplatin.
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Affiliation(s)
- Mauro Pagani
- General Medicine Division Pieve di Coriano Hospital Via Bugatte1, 46020 Pieve di Coriano Mantova Italy.
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Di Lorenzo G, Monaco L, Daverio A, Giannoudas I, Verardo A, La Porta P, Niolu C, Fernandez I, Pagani M, Siracusano A. EPA-1793 – Enhancement of right hemisphere eeg functional connectivity after emdr therapy. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78912-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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He BJ, Nolte G, Nagata K, Takano D, Yamazaki T, Fujimaki Y, Maeda T, Satoh Y, Heckers S, George MS, Lopes da Silva F, de Munck JC, Van Houdt PJ, Verdaasdonk RM, Ossenblok P, Mullinger K, Bowtell R, Bagshaw AP, Keeser D, Karch S, Segmiller F, Hantschk I, Berman A, Padberg F, Pogarell O, Scharnowski F, Karch S, Hümmer S, Keeser D, Paolini M, Kirsch V, Koller G, Rauchmann B, Kupka M, Blautzik J, Pogarell O, Razavi N, Jann K, Koenig T, Kottlow M, Hauf M, Strik W, Dierks T, Gotman J, Vulliemoz S, Lu Y, Zhang H, Yang L, Worrell G, He B, Gruber O, Piguet C, Hubl D, Homan P, Kindler J, Dierks T, Kim K, Steinhoff U, Wakai R, Koenig T, Kottlow M, Melie-García L, Mucci A, Volpe U, Prinster A, Salvatore M, Galderisi S, Linden DEJ, Brandeis D, Schroeder CE, Kayser C, Panzeri S, Kleinschmidt A, Ritter P, Walther S, Haueisen J, Lau S, Flemming L, Sonntag H, Maess B, Knösche TR, Lanfer B, Dannhauer M, Wolters CH, Stenroos M, Haueisen J, Wolters C, Aydin U, Lanfer B, Lew S, Lucka F, Ruthotto L, Vorwerk J, Wagner S, Ramon C, Guan C, Ang KK, Chua SG, Kuah WK, Phua KS, Chew E, Zhou H, Chuang KH, Ang BT, Wang C, Zhang H, Yang H, Chin ZY, Yu H, Pan Y, Collins L, Mainsah B, Colwell K, Morton K, Ryan D, Sellers E, Caves K, Throckmorton S, Kübler A, Holz EM, Zickler C, Sellers E, Ryan D, Brown K, Colwell K, Mainsah B, Caves K, Throckmorton S, Collins L, Wennberg R, Ahlfors SP, Grova C, Chowdhury R, Hedrich T, Heers M, Zelmann R, Hall JA, Lina JM, Kobayashi E, Oostendorp T, van Dam P, Oosterhof P, Linnenbank A, Coronel R, van Dessel P, de Bakker J, Rossion B, Jacques C, Witthoft N, Weiner KS, Foster BL, Miller KJ, Hermes D, Parvizi J, Grill-Spector K, Recanzone GH, Murray MM, Haynes JD, Richiardi J, Greicius M, De Lucia M, Müller KR, Formisano E, Smieskova R, Schmidt A, Bendfeldt K, Walter A, Riecher-Rössler A, Borgwardt S, Fusar-Poli P, Eliez S, Schmidt A, Sekihara K, Nagarajan SS, Schoffelen JM, Guggisberg AG, Nolte G, Balazs S, Kermanshahi K, Kiesenhofer W, Binder H, Rattay F, Antal A, Chaieb L, Paulus W, Bodis-Wollner I, Maurer K, Fein G, Camchong J, Johnstone J, Cardenas-Nicolson V, Fiederer LDJ, Lucka F, Yang S, Vorwerk J, Dümpelmann M, Cosandier-Rimélé D, Schulze-Bonhage A, Aertsen A, Speck O, Wolters CH, Ball T, Fuchs M, Wagner M, Kastner J, Tech R, Dinh C, Haueisen J, Baumgarten D, Hämäläinen MS, Lau S, Vogrin SJ, D'Souza W, Haueisen J, Cook MJ, Custo A, Van De Ville D, Vulliemoz S, Grouiller F, Michel CM, Malmivuo J, Aydin U, Vorwerk J, Küpper P, Heers M, Kugel H, Wellmer J, Kellinghaus C, Scherg M, Rampp S, Wolters C, Storti SF, Boscolo Galazzo I, Del Felice A, Pizzini FB, Arcaro C, Formaggio E, Mai R, Manganotti P, Koessler L, Vignal J, Cecchin T, Colnat-Coulbois S, Vespignani H, Ramantani G, Maillard L, Rektor I, Kuba R, Brázdil M, Chrastina J, Rektorova I, van Mierlo P, Carrette E, Strobbe G, Montes-Restrepo V, Vonck K, Vandenberghe S, Ahmed B, Brodely C, Carlson C, Kuzniecky R, Devinsky O, French J, Thesen T, Bénis D, David O, Lachaux JP, Seigneuret E, Krack P, Fraix V, Chabardès S, Bastin J, Jann K, Gee D, Kilroy E, Cannon T, Wang DJ, Hale JR, Mayhew SD, Przezdzik I, Arvanitis TN, Bagshaw AP, Plomp G, Quairiaux C, Astolfi L, Michel CM, Mayhew SD, Mullinger KJ, Bagshaw AP, Bowtell R, Francis ST, Schouten AC, Campfens SF, van der Kooij H, Koles Z, Lind J, Flor-Henry P, Wirth M, Haase CM, Villeneuve S, Vogel J, Jagust WJ, Kambeitz-Ilankovic L, Simon-Vermot L, Gesierich B, Duering M, Ewers M, Rektorova I, Krajcovicova L, Marecek R, Mikl M, Bracht T, Horn H, Strik W, Federspiel A, Schnell S, Höfle O, Stegmayer K, Wiest R, Dierks T, Müller TJ, Walther S, Surmeli T, Ertem A, Eralp E, Kos IH, Skrandies W, Flüggen S, Klein A, Britz J, Díaz Hernàndez L, Ro T, Michel CM, Lenartowicz A, Lau E, Rodriguez C, Cohen MS, Loo SK, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Giannoudas I, La Porta P, Verardo AR, Niolu C, Fernandez I, Siracusano A, Flor-Henry P, Lind J, Koles Z, Bollmann S, Ghisleni C, O'Gorman R, Poil SS, Klaver P, Michels L, Martin E, Ball J, Eich-Höchli D, Brandeis D, Salisbury DF, Murphy TK, Butera CD, Mathalon DH, Fryer SL, Kiehl KA, Calhoun VC, Pearlson GD, Roach BJ, Ford JM, McGlashan TH, Woods SW, Volpe U, Merlotti E, Vignapiano A, Montefusco V, Plescia GM, Gallo O, Romano P, Mucci A, Galderisi S, Mingoia G, Langbein K, Dietzek M, Wagner G, Smesny, Scherpiet S, Maitra R, Gaser C, Sauer H, Nenadic I, Gonzalez Andino S, Grave de Peralta Menendez R, Grave de Peralta Menendez R, Sanchez Vives M, Rebollo B, Gonzalez Andino S, Frølich L, Andersen TS, Mørup M, Belfiore P, Gargiulo P, Ramon C, Vanhatalo S, Cho JH, Vorwerk J, Wolters CH, Knösche TR, Watanabe T, Kawabata Y, Ukegawa D, Kawabata S, Adachi Y, Sekihara K, Sekihara K, Nagarajan SS, Wagner S, Aydin U, Vorwerk J, Herrmann C, Burger M, Wolters C, Lucka F, Aydin U, Vorwerk J, Burger M, Wolters C, Bauer M, Trahms L, Sander T, Faber PL, Lehmann D, Gianotti LRR, Pascual-Marqui RD, Milz P, Kochi K, Kaneko S, Yamashita S, Yana K, Kalogianni K, Vardy AN, Schouten AC, van der Helm FCT, Sorrentino A, Luria G, Aramini R, Hunold A, Funke M, Eichardt R, Haueisen J, Gómez-Aguilar F, Vázquez-Olvera S, Cordova-Fraga T, Castro-López J, Hernández-Gonzalez MA, Solorio-Meza S, Sosa-Aquino M, Bernal-Alvarado JJ, Vargas-Luna M, Vorwerk J, Magyari L, Ludewig J, Oostenveld R, Wolters CH, Vorwerk J, Engwer C, Ludewig J, Wolters C, Sato K, Nishibe T, Furuya M, Yamashiro K, Yana K, Ono T, Puthanmadam Subramaniyam N, Hyttinen J, Lau S, Güllmar D, Flemming L, Haueisen J, Sonntag H, Vorwerk J, Wolters CH, Grasedyck L, Haueisen J, Maeß B, Freitag S, Graichen U, Fiedler P, Strohmeier D, Haueisen J, Stenroos M, Hauk O, Grigutsch M, Felber M, Maess B, Herrmann B, Strobbe G, van Mierlo P, Vandenberghe S, Strobbe G, Cárdenas-Peña D, Montes-Restrepo V, van Mierlo P, Castellanos-Dominguez G, Vandenberghe S, Lanfer B, Paul-Jordanov I, Scherg M, Wolters CH, Ito Y, Sato D, Kamada K, Kobayashi T, Dalal SS, Rampp S, Willomitzer F, Arold O, Fouladi-Movahed S, Häusler G, Stefan H, Ettl S, Zhang S, Zhang Y, Li H, Kong X, Montes-Restrepo V, Strobbe G, van Mierlo P, Vandenberghe S, Wong DDE, Bidet-Caulet A, Knight RT, Crone NE, Dalal SS, Birot G, Spinelli L, Vulliémoz S, Seeck M, Michel CM, Emory H, Wells C, Mizrahi N, Vogrin SJ, Lau S, Cook MJ, Karahanoglu FI, Grouiller F, Caballero-Gaudes C, Seeck M, Vulliemoz S, Van De Ville D, Spinelli L, Megevand P, Genetti M, Schaller K, Michel C, Vulliemoz S, Seeck M, Genetti M, Tyrand R, Grouiller F, Vulliemoz S, Spinelli L, Seeck M, Schaller K, Michel CM, Grouiller F, Heinzer S, Delattre B, Lazeyras F, Spinelli L, Pittau F, Seeck M, Ratib O, Vargas M, Garibotto V, Vulliemoz S, Vogrin SJ, Bailey CA, Kean M, Warren AE, Davidson A, Seal M, Harvey AS, Archer JS, Papadopoulou M, Leite M, van Mierlo P, Vonck K, Boon P, Friston K, Marinazzo D, Ramon C, Holmes M, Koessler L, Rikir E, Gavaret M, Bartolomei F, Vignal JP, Vespignani H, Maillard L, Centeno M, Perani S, Pier K, Lemieux L, Clayden J, Clark C, Pressler R, Cross H, Carmichael DW, Spring A, Bessemer R, Pittman D, Aghakhani Y, Federico P, Pittau F, Grouiller F, Vulliémoz S, Gotman J, Badier JM, Bénar CG, Bartolomei F, Cruto C, Chauvel P, Gavaret M, Brodbeck V, van Leeuwen T, Tagliazzuchi E, Melloni L, Laufs H, Griskova-Bulanova I, Dapsys K, Klein C, Hänggi J, Jäncke L, Ehinger BV, Fischer P, Gert AL, Kaufhold L, Weber F, Marchante Fernandez M, Pipa G, König P, Sekihara K, Hiyama E, Koga R, Iannilli E, Michel CM, Bartmuss AL, Gupta N, Hummel T, Boecker R, Holz N, Buchmann AF, Blomeyer D, Plichta MM, Wolf I, Baumeister S, Meyer-Lindenberg A, Banaschewski T, Brandeis D, Laucht M, Natahara S, Ueno M, Kobayashi T, Kottlow M, Bänninger A, Koenig T, Schwab S, Koenig T, Federspiel A, Dierks T, Jann K, Natsukawa H, Kobayashi T, Tüshaus L, Koenig T, Kottlow M, Achermann P, Wilson RS, Mayhew SD, Assecondi S, Arvanitis TN, Bagshaw AP, Darque A, Rihs TA, Grouiller F, Lazeyras F, Ha-Vinh Leuchter R, Caballero C, Michel CM, Hüppi PS, Hauser TU, Hunt LT, Iannaccone R, Stämpfli P, Brandeis D, Dolan RJ, Walitza S, Brem S, Graichen U, Eichardt R, Fiedler P, Strohmeier D, Freitag S, Zanow F, Haueisen J, Lordier L, Grouiller F, Van de Ville D, Sancho Rossignol A, Cordero I, Lazeyras F, Ansermet F, Hüppi P, Schläpfer A, Rubia K, Brandeis D, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Giannoudas I, Verardo AR, La Porta P, Niolu C, Fernandez I, Siracusano A, Tamura K, Karube C, Mizuba T, Matsufuji M, Takashima S, Iramina K, Assecondi S, Ostwald D, Bagshaw AP, Marecek R, Brazdil M, Lamos M, Slavícek T, Marecek R, Jan J, Meier NM, Perrig W, Koenig T, Minami T, Noritake Y, Nakauchi S, Azuma K, Minami T, Nakauchi S, Rodriguez C, Lenartowicz A, Cohen MS, Rodriguez C, Lenartowicz A, Cohen MS, Iramina K, Kinoshita H, Tamura K, Karube C, Kaneko M, Ide J, Noguchi Y, Cohen MS, Douglas PK, Rodriguez CM, Xia HJ, Zimmerman EM, Konopka CJ, Epstein PS, Konopka LM, Giezendanner S, Fisler M, Soravia L, Andreotti J, Wiest R, Dierks T, Federspiel A, Razavi N, Federspiel A, Dierks T, Hauf M, Jann K, Kamada K, Sato D, Ito Y, Okano K, Mizutani N, Kobayashi T, Thelen A, Murray M, Pastena L, Formaggio E, Storti SF, Faralli F, Melucci M, Gagliardi R, Ricciardi L, Ruffino G, Coito A, Macku P, Tyrand R, Astolfi L, He B, Wiest R, Seeck M, Michel C, Plomp G, Vulliemoz S, Fischmeister FPS, Glaser J, Schöpf V, Bauer H, Beisteiner R, Deligianni F, Centeno M, Carmichael DW, Clayden J, Mingoia G, Langbein K, Dietzek M, Wagner G, Smesny S, Scherpiet S, Maitra R, Gaser C, Sauer H, Nenadic I, Dürschmid S, Zaehle T, Pannek H, Chang HF, Voges J, Rieger J, Knight RT, Heinze HJ, Hinrichs H, Tsatsishvili V, Cong F, Puoliväli T, Alluri V, Toiviainen P, Nandi AK, Brattico E, Ristaniemi T, Grieder M, Crinelli RM, Jann K, Federspiel A, Wirth M, Koenig T, Stein M, Wahlund LO, Dierks T, Atsumori H, Yamaguchi R, Okano Y, Sato H, Funane T, Sakamoto K, Kiguchi M, Tränkner A, Schindler S, Schmidt F, Strauß M, Trampel R, Hegerl U, Turner R, Geyer S, Schönknecht P, Kebets V, van Assche M, Goldstein R, van der Meulen M, Vuilleumier P, Richiardi J, Van De Ville D, Assal F, Wozniak-Kwasniewska A, Szekely D, Harquel S, Bougerol T, David O, Bracht T, Jones DK, Horn H, Müller TJ, Walther S, Sos P, Klirova M, Novak T, Brunovsky M, Horacek J, Bares M, Hoschl C C, Fellhauer I, Zöllner FG, Schröder J, Kong L, Essig M, Schad LR, Arrubla J, Neuner I, Hahn D, Boers F, Shah NJ, Neuner I, Arrubla J, Hahn D, Boers F, Jon Shah N, Suriya Prakash M, Sharma R, Kawaguchi H, Kobayashi T, Fiedler P, Griebel S, Biller S, Fonseca C, Vaz F, Zentner L, Zanow F, Haueisen J, Rochas V, Rihs T, Thut G, Rosenberg N, Landis T, Michel C, Moliadze V, Schmanke T, Lyzhko E, Bassüner S, Freitag C, Siniatchkin M, Thézé R, Guggisberg AG, Nahum L, Schnider A, Meier L, Friedrich H, Jann K, Landis B, Wiest R, Federspiel A, Strik W, Dierks T, Witte M, Kober SE, Neuper C, Wood G, König R, Matysiak A, Kordecki W, Sieluzycki C, Zacharias N, Heil P, Wyss C, Boers F, Arrubla J, Dammers J, Kawohl W, Neuner I, Shah NJ, Braboszcz C, Cahn RB, Levy J, Fernandez M, Delorme A, Rosas-Martinez L, Milne E, Zheng Y, Urakami Y, Kawamura K, Washizawa Y, Hiyoshi K, Cichocki A, Giroud N, Dellwo V, Meyer M, Rufener KS, Liem F, Dellwo V, Meyer M, Jones-Rounds JD, Raizada R, Staljanssens W, Strobbe G, van Mierlo P, Van Holen R, Vandenberghe S, Pefkou M, Becker R, Michel C, Hervais-Adelman A, He W, Brock J, Johnson B, Ohla K, Hitz K, Heekeren K, Obermann C, Huber T, Juckel G, Kawohl W, Gabriel D, Comte A, Henriques J, Magnin E, Grigoryeva L, Ortega JP, Haffen E, Moulin T, Pazart L, Aubry R, Kukleta M, Baris Turak B, Louvel J, Crespo-Garcia M, Cantero JL, Atienza M, Connell S, Kilborn K, Damborská A, Brázdil M, Rektor I, Kukleta M, Koberda JL, Bienkiewicz A, Koberda I, Koberda P, Moses A, Tomescu M, Rihs T, Britz J, Custo A, Grouiller F, Schneider M, Debbané M, Eliez S, Michel C, Wang GY, Kydd R, Wouldes TA, Jensen M, Russell BR, Dissanayaka N, Au T, Angwin A, O'Sullivan J, Byrne G, Silburn P, Marsh R, Mellic G, Copland D, Bänninger A, Kottlow M, Díaz Hernàndez L, Koenig T, Díaz Hernàndez L, Bänninger A, Koenig T, Hauser TU, Iannaccone R, Mathys C, Ball J, Drechsler R, Brandeis D, Walitza S, Brem S, Boeijinga PH, Pang EW, Valica T, Macdonald MJ, Oh A, Lerch JP, Anagnostou E, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Verardo AR, Giannoudas I, La Porta P, Niolu C, Fernandez I, Siracusano A, Shimada T, Matsuda Y, Monkawa A, Monkawa T, Hashimoto R, Watanabe K, Kawasaki Y, Matsuda Y, Shimada T, Monkawa T, Monkawa A, Watanabe K, Kawasaki Y, Stegmayer K, Horn H, Federspiel A, Razavi N, Bracht T, Laimböck K, Strik W, Dierks T, Wiest R, Müller TJ, Walther S, Koorenhof LJ, Swithenby SJ, Martins-Mourao A, Rihs TA, Tomescu M, Song KW, Custo A, Knebel JF, Murray M, Eliez S, Michel CM, Volpe U, Merlotti E, Vignapiano A, Montefusco V, Plescia GM, Gallo O, Romano P, Mucci A, Galderisi S, Laimboeck K, Jann K, Walther S, Federspiel A, Wiest R, Strik W, Horn H. Abstracts of Presentations at the International Conference on Basic and Clinical Multimodal Imaging (BaCI), a Joint Conference of the International Society for Neuroimaging in Psychiatry (ISNIP), the International Society for Functional Source Imaging (ISFSI), the International Society for Bioelectromagnetism (ISBEM), the International Society for Brain Electromagnetic Topography (ISBET), and the EEG and Clinical Neuroscience Society (ECNS), in Geneva, Switzerland, September 5-8, 2013. Clin EEG Neurosci 2013; 44:1550059413507209. [PMID: 24368763 DOI: 10.1177/1550059413507209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- B J He
- National Institutes of Health, Bethesda, MD, USA
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Geginat J, Paroni M, Facciotti F, Gruarin P, Kastirr I, Caprioli F, Pagani M, Abrignani. S. The CD4-centered universe of human T cell subsets. Semin Immunol 2013; 25:252-62. [DOI: 10.1016/j.smim.2013.10.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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