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Affiliation(s)
- Davide Giordano
- Otolaryngology Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cecilia Botti
- Department of Biomedical, Metabolic and Neural Sciences, Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea Castellucci
- Otolaryngology Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Roberto Piro
- Pneumology Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Angelo Ghidini
- Otolaryngology Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Tata A, Zacometti C, Massaro A, Bragolusi M, Ceroni S, Falappa S, Prataviera D, Merenda M, Piro R, Catania S. Empowering veterinary clinical diagnosis in industrial poultry production by ambient mass spectrometry and chemiometrics: a new approach for precise poultry farming. Poult Sci 2024; 103:103709. [PMID: 38598914 PMCID: PMC11017065 DOI: 10.1016/j.psj.2024.103709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024] Open
Abstract
Untargeted metabolomic profiling, by ambient mass spectrometry and chemometric tools, has made a dramatic impact on human disease detection. In a similar vein, this study attempted the translation of this clinical human disease experience to farmed poultry for precise veterinary diagnosis. As a proof of principle, in this diagnostic/prognostic study, direct analysis in real-time high resolution mass spectrometry (DART-HRMS) was used in an untargeted manner to analyze fresh tissues (abdominal fat, leg skin, liver, and leg muscle) of pigmented and non-pigmented broilers to investigate the causes of lack of pigmentation in an industrial poultry farm. Afterwards, statistical analysis was applied to the DART-HRMS data to retrieve the molecular features that codified for 2 broiler groups, that is, properly pigmented and non-pigmented broilers. Higher abundance of oxidized lipids, high abundance of oxidized bile derivatives, and lower levels of tocopherol isomers (Vitamin E) and retinol (Vitamin A) were captured in nonpigmented than in pigmented broilers. In addition, conventional rapid analyses were used: 1) color parameters of the tissues of pigmented and non-pigmented broilers were measured to rationalize the color differences in abdominal fat, leg skin and leg muscle, and 2) macronutrients were determined in broiler leg muscle, to capture a detailed picture of the pathology and exclude other possible causes. In this study, the DART-HRMS system performed well in retrieving valuable chemical information from broilers that explained the differences between the 2 groups of broilers in absorption of xanthophylls and the subsequent lack of proper broiler pigmentation in affected broilers. The results suggest this technology could be useful in providing near real-time feedback to aid in veterinary decision-making in poultry farming.
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Affiliation(s)
- Alessandra Tata
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy.
| | - Carmela Zacometti
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Andrea Massaro
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Marco Bragolusi
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Simona Ceroni
- Fileni Alimentare SPA, Località Cerrete Collicelli N° 8, Cingoli, Macerata 62011, Italy
| | - Sonia Falappa
- Fileni Alimentare SPA, Località Cerrete Collicelli N° 8, Cingoli, Macerata 62011, Italy
| | - Davide Prataviera
- Avian Medicine Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Buttapietra, Verona 37060, Italy
| | - Marianna Merenda
- Avian Medicine Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Buttapietra, Verona 37060, Italy
| | - Roberto Piro
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Salvatore Catania
- Avian Medicine Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Buttapietra, Verona 37060, Italy
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Zacometti C, Sammarco G, Massaro A, Lefevre S, Frégière-Salomon A, Lafeuille JL, Candalino IF, Piro R, Tata A, Suman M. Authenticity assessment of ground black pepper by combining headspace gas-chromatography ion mobility spectrometry and machine learning. Food Res Int 2024; 179:114023. [PMID: 38342542 DOI: 10.1016/j.foodres.2024.114023] [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: 10/19/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 02/13/2024]
Abstract
Currently, the authentication of ground black pepper is a major concern, creating a need for a rapid, highly sensitive and specific detection tool to prevent the introduction of adulterated batches into the food chain. To this aim, head space gas-chromatography ion mobility spectrometry (HS-GC-IMS), combined with machine learning, is tested in this initial, proof-of-concept study. A broad variety of authentic samples originating from eight countries and three continents were collected and spiked with a range of adulterants, both endogenous sub-products and an assortment of exogenous materials. The method is characterized by no sample preparation and requires 20 min for chromatographic separation and ion mobility data acquisition. After an explorative analysis of the data, those were submitted to two different machine learning algorithms (partial least squared discriminant analysis-PLS-DA and support vector machine-SVM). While the PLS-DA model did not provide fully satisfactory performances, the combination of HS-GC-IMS and SVM successfully classified the samples as authentic, exogenously-adulterated or endogenously-adulterated with an overall accuracy of 90 % and 96 % on withheld test set 1 and withheld test set 2, respectively (at a 95 % confidence level). Some limitations, expected to be mitigated by further research, were encountered in the correct classification of endogenously adulterated ground black pepper. Correct categorization of the ground black pepper samples was not adversely affected by the operator or the time span of data collection (the method development and model challenge were carried out by two operators over 6 months of the study, using ground black pepper harvested between 2015 and 2019). Therefore, HS-GC-IMS, coupled to an intelligent tool, is proposed to: (i) aid in industrial decision-making before utilization of a new batch of ground black pepper in the production chain; (ii) reduce the use of time-consuming conventional analyses and; (iii) increase the number of ground black pepper samples analyzed within an industrial quality control frame.
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Affiliation(s)
- Carmela Zacometti
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratory of Experimental Chemistry, Vicenza, Italy
| | - Giuseppe Sammarco
- Advanced Laboratory Research, Barilla G. e R. Fratelli S.p.A., Via Mantova, 166, 43122 Parma, Italy
| | - Andrea Massaro
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratory of Experimental Chemistry, Vicenza, Italy
| | - Stephane Lefevre
- Food Integrity Laboratory, Global Quality and Food Safety Center of Excellence, McCormick & Co., Inc., 999 avenue des Marchés, 84200 Carpentras, France
| | - Aline Frégière-Salomon
- Food Integrity Laboratory, Global Quality and Food Safety Center of Excellence, McCormick & Co., Inc., 999 avenue des Marchés, 84200 Carpentras, France
| | - Jean-Louis Lafeuille
- Global Quality and Food Safety Center of Excellence, McCormick & Co., Inc., 999 avenue des Marchés, 84200 Carpentras, France
| | - Ingrid Fiordaliso Candalino
- Global Quality and Food Safety Center of Excellence, McCormick & Co., Inc., Viale Iotti Nilde, 50038 San Piero (FI), Italy
| | - Roberto Piro
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratory of Experimental Chemistry, Vicenza, Italy
| | - Alessandra Tata
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratory of Experimental Chemistry, Vicenza, Italy
| | - Michele Suman
- Advanced Laboratory Research, Barilla G. e R. Fratelli S.p.A., Via Mantova, 166, 43122 Parma, Italy; Catholic University Sacred Heart, Department for Sustainable Food Process, Piacenza, Italy.
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Ciammella P, Cozzi S, Borghetti P, Galaverni M, Nardone V, Ruggieri MP, Sepulcri M, Scotti V, Bruni A, Zanelli F, Piro R, Tagliavini E, Botti A, Iori F, Alì E, Bennati C, Tiseo M. Redetermination of PD-L1 expression after chemio-radiation in locally advanced PDL1 negative NSCLC patients: retrospective multicentric analysis. Front Oncol 2024; 14:1325249. [PMID: 38357196 PMCID: PMC10866304 DOI: 10.3389/fonc.2024.1325249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/02/2024] [Indexed: 02/16/2024] Open
Abstract
Background Chemoradiation therapy (CRT) is the treatment of choice for locally advanced non-small cell lung cancer (LA-NSCLC). Several clinical trials that combine programmed cell death 1 (PD1) axis inhibitors with radiotherapy are in development for patients with LA-NSCLC. However, the effect of CRT on tumor cells programmed cell death ligand-1 (PD-L1) expression is unknown. Methods In this multicentric retrospective study, we analyzed paired NSCLC specimens that had been obtained pre- and post-CRT. PD-L1 expression on tumor cells was studied by immunohistochemistry. The purpose of this study was to evaluate the feasibility, risk of complications, and clinical relevance of performing re-biopsy after CRT in patients with PD-L1 negative LA-NSCLC. Results Overall, 31 patients from 6 centers with PD-L1 negative LA-NSCLC were analyzed. The percentage of tumor cells with PD-L1 expression significantly increased between pre- and post-CRT specimens in 14 patients (45%). Nine patients had unchanged PD-L1 expression after CRT, in five patients the rebiopsy material was insufficient for PD-L1 analysis and in two patients no tumor cells at rebiopsy were found. The post-rebiopsy complication rate was very low (6%). All patients with positive PD-L1 re-biopsy received Durvalumab maintenance after CRT, except one patient who had a long hospitalization for tuberculosis reactivation. Median PFS of patients with unchanged or increased PD-L1 expression was 10 and 16.9 months, respectively. Conclusion CRT administration can induce PD-L1 expression in a considerable fraction of PD-L1 negative patients at baseline, allowing them receiving the maintenance Durvalumab in Europe. Hence, after a definitive CRT, PD-L1 redetermination should be considered in patients with LA-NSCLC PD-L1 negative, to have a better selection of maintenance Durvalumab candidates.
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Affiliation(s)
- Patrizia Ciammella
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Salvatore Cozzi
- Radiation Oncology Department, Centre Lèon Bèrard, Lyon, France
| | - Paolo Borghetti
- Dipartimento di Radioterapia Oncologica, Università e ASST Spedali Civili di Brescia, Brescia, Italy
| | - Marco Galaverni
- Radiation Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Valerio Nardone
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli, Napoli, Italy
| | - Maria Paola Ruggieri
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Matteo Sepulcri
- Radiation Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Vieri Scotti
- Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Alessio Bruni
- Radiation Therapy Unit, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Francesca Zanelli
- Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Roberto Piro
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elena Tagliavini
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Botti
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Federico Iori
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Emanuele Alì
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Bennati
- Department of Hematology-Onco, S Maria delle Croci Hospital, Ravenna, Italy
| | - Marcello Tiseo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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Zhao DF, Xue L, Zhou XS, Jin WY, Zhou YJ, Tong SM, Wang PF, Li YX, Piro R, Qiao HM, Yu GX, Su CY, Li BH. Importance of timing and training to implement awake prone positioning in patients with COVID-19: a single-center prospective observational study. J Thorac Dis 2023; 15:6858-6867. [PMID: 38249881 PMCID: PMC10797349 DOI: 10.21037/jtd-23-1441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/10/2023] [Indexed: 01/23/2024]
Abstract
Background Awake prone positioning (APP) is broadly implemented in patients with severe acute respiratory syndrome coronavirus 2 related disease [coronavirus disease 2019 (COVID-19)] admitted to hospital with severe respiratory distress syndrome. This prospective observational study aimed to explore the factors influencing the implementation of APP in patients with acute respiratory failure due to COVID-19. Methods Patients with COVID-19, all hospitalized with positive X-ray findings and oxygen supplementation requirement, in the Respiratory Step-Down Unit of the Peking University Third Hospital between January 6th, 2023, and January 20th, 2023, were included in this study. Data regarding basic information, activities of daily living (ADLs) scores, oxygen therapy, vital signs, and duration of APP were collected to investigate the factors influencing prone positioning. Results Among the 134 patients included, 55.2% showed an improvement in oxygen saturation 1 hour after APP. Logistic regression revealed that the pre-APP heart rate (HR) [odds ratio (OR) =1.032; P=0.046] and peripheral oxygen saturation (SpO2) (OR =0.720; P<0.001) were the associated factors of the improvement in SpO2 after treatment. Multiple linear regression revealed that the ADL scores and pre-APP respiratory rate (RR) were the associated factors of the duration of prone positioning (P<0.01). The APP technical steering group effectively improved duration of APP. Conclusions Patients with low SpO2 and increased HR before treatment showed greater improvement in oxygen saturation. Patients with lower tolerance to ADL but lower RRs were those to demonstrate a longer duration of prone positioning. This is pointing towards establishing the most favorable time window for APP during the course of COVID-19: after the ADLs have already decreased, but before significant tachypnea has appeared.
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Affiliation(s)
- Dong-Fang Zhao
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Lei Xue
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Xiao-Shu Zhou
- Department of Nursing, Peking University Third Hospital, Beijing, China
| | - Wei-Yi Jin
- Department of Nursing, Peking University Third Hospital, Beijing, China
| | - Yu-Jie Zhou
- Department of General Surgery, Peking University Third Hospital, Beijing, China
| | - Su-Mei Tong
- Department of Cardiology, Peking University Third Hospital, Beijing, China
| | - Pan-Feng Wang
- Department of Tumor Radiotherapy, Peking University Third Hospital, Beijing, China
| | - Yu-Xuan Li
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Roberto Piro
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Hong-Mei Qiao
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Gui-Xiang Yu
- Department of Cardiology, Peking University Third Hospital, Beijing, China
| | - Chun-Yan Su
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Bao-Hua Li
- Department of Nursing, Peking University Third Hospital, Beijing, China
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Zacometti C, Massaro A, di Gioia T, Lefevre S, Frégière-Salomon A, Lafeuille JL, Fiordaliso Candalino I, Suman M, Piro R, Tata A. Thermal desorption direct analysis in real-time high-resolution mass spectrometry and machine learning allow the rapid authentication of ground black pepper and dried oregano: A proof-of-concept study. J Mass Spectrom 2023; 58:e4953. [PMID: 37401136 DOI: 10.1002/jms.4953] [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] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/12/2023] [Accepted: 06/01/2023] [Indexed: 07/05/2023]
Abstract
Thermal desorption direct analysis in real-time high-resolution mass spectrometry (TD-DART-HRMS) approaches have gained popularity for fast screening of a variety of samples. With rapid volatilization of the sample at increasing temperatures outside the mass spectrometer, this technique can provide a direct readout of the sample content with no sample preparation. In this study, TD-DART-HRMS's utility for establishing spice authenticity was examined. To this aim, we directly analyzed authentic (typical) and adulterated (atypical) samples of ground black pepper and dried oregano in positive and negative ion modes. We analyzed a set of authentic ground black pepper samples (n = 14) originating from Brazil, Sri Lanka, Madagascar, Ecuador, Vietnam, Costa Rica, Indonesia, Cambodia, and adulterated samples (n = 25) consisting of mixtures of ground black pepper with this spice's nonfunctional by-products (pinheads or spent) or with different exogenous materials (olive kernel, green lentils, black mustard seeds, red beans, gypsum plaster, garlic, papaya seeds, chili, green aniseed, or coriander seeds). TD-DART-HRMS facilitated the capture of informative fingerprinting of authentic dried oregano (n = 12) originating from Albania, Turkey, and Italy and those spiked (n = 12) with increasing percentages of olive leaves, sumac, strawberry tree leaves, myrtle, and rock rose. A predictive LASSO classifier was built, after merging by low-level data fusion, the positive and negative datasets for ground black pepper. Fusing multimodal data allowed retrieval of more comprehensive information from both datasets. The resultant classifier achieved on the withheld test set accuracy, sensitivity, and specificity of 100%, 75%, and 90%, respectively. On the contrary, the sole TD-(+)DART-HRMS spectra of the oregano samples allowed construction of a LASSO classifier that predicted the adulteration of the oregano with excellent statistical indicators. This classifier achieved, on the withheld test set, 100% each for accuracy, sensitivity, and specificity.
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Affiliation(s)
- Carmela Zacometti
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
| | - Andrea Massaro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
| | - Tommaso di Gioia
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
| | - Stephane Lefevre
- Food Integrity Laboratory, Global Quality and Food Safety Center of Excellence, McCormick & Co., Inc., Carpentras, France
| | - Aline Frégière-Salomon
- Food Integrity Laboratory, Global Quality and Food Safety Center of Excellence, McCormick & Co., Inc., Carpentras, France
| | - Jean-Louis Lafeuille
- Global Quality and Food Safety Center of Excellence, McCormick & Co., Inc., Carpentras, France
| | | | - Michele Suman
- Advanced Laboratory Research, Barilla G. e R. Fratelli S.p.A., Parma, Italy
- Department for Sustainable Food Process, Catholic University Sacred Heart, Piacenza, Italy
| | - Roberto Piro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
| | - Alessandra Tata
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
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Zacometti C, Tata A, Stella R, Leone S, Pallante I, Merenda M, Catania S, Pozzato N, Piro R. DART-HRMS allows the detection of toxic alkaloids in animal autopsy specimens and guides the selection of confirmatory methods in accidental plant poisoning. Anal Chim Acta 2023; 1264:341309. [PMID: 37230724 DOI: 10.1016/j.aca.2023.341309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/26/2023] [Accepted: 04/30/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND In cases of suspected animal poisonings or intoxications, there is the need for high-throughput, rapid and accurate analytical tools capable of giving rapid answers and, thus, speeding up the early stages of investigations. Conventional analyses are very precise, but do not meet the need for rapid answers capable of orienting the decisions and the choice of appropriate countermeasures. In this context, the use of ambient mass spectrometry (AMS) screening methods in toxicology laboratories could satisfy the requests of forensic toxicology veterinarians in a timely manner. RESULTS As a proof of principle, direct analysis in real time high resolution mass spectrometry (DART-HRMS) was applied to a veterinary forensic case in which 12 of a group of 27 sheep and goats died with an acute neurological onset. Because of evidence in the rumen contents, the veterinarians hypothesized an accidental intoxication after ingestion of vegetable materials. The DART-HRMS results showed abundant signals of the alkaloids calycanthine, folicanthidine and calycanthidine, both in the rumen content and at the liver level. The DART-HRMS phytochemical fingerprinting of detached Chimonanthus praecox seeds was also compared with those acquired from the autopsy specimens. Liver, rumen content and seed extracts were then subjected to LC-HRMS/MS analysis to gather additional insights and confirm the putative assignment of calycanthine anticipated by DART-HRMS. HPLC-HRMS/MS confirmed the presence of calycanthine in both rumen contents and liver specimens and allowed its quantification, ranging from 21.3 to 46.9 mg kg-1 in the latter. This is the first report detailing the quantification of calycanthine in liver after a deadly intoxication event. SIGNIFICANCE AND NOVELTY Our study illustrates the potential of DART-HRMS to offer a rapid and complementary alternative to guide the selection of confirmatory chromatography-MSn strategies in the analysis of autopsy specimens from animals with suspected alkaloid intoxication. This method offers the consequent saving of time and resources over those needed for other methods.
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Affiliation(s)
- Carmela Zacometti
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Viale Fiume, 78, 36100, Vicenza, VI, Italy
| | - Alessandra Tata
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Viale Fiume, 78, 36100, Vicenza, VI, Italy.
| | - Roberto Stella
- Laboratorio Farmaci Veterinari e Ricerca, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università, 10, 35020, Legnaro, PD, Italy
| | - Stefania Leone
- Laboratorio di Diagnostica Clinica e Sierologia di Piano, Istituto Zooprofilattico Sperimentale delle Venezie, via Bovolino, 1/C, 37060, Buttapietra, VR, Italy; Laboratorio di Medicina Forense Veterinaria, Istituto Zooprofilattico Sperimentale delle Venezie, Viale Fiume, 78, 36100, Vicenza, VI, Italy
| | - Ivana Pallante
- Laboratorio di Medicina Forense Veterinaria, Istituto Zooprofilattico Sperimentale delle Venezie, Viale Fiume, 78, 36100, Vicenza, VI, Italy
| | - Marianna Merenda
- Laboratorio di Diagnostica Clinica e Sierologia di Piano, Istituto Zooprofilattico Sperimentale delle Venezie, via Bovolino, 1/C, 37060, Buttapietra, VR, Italy
| | - Salvatore Catania
- Laboratorio di Diagnostica Clinica e Sierologia di Piano, Istituto Zooprofilattico Sperimentale delle Venezie, via Bovolino, 1/C, 37060, Buttapietra, VR, Italy
| | - Nicola Pozzato
- Laboratorio di Medicina Forense Veterinaria, Istituto Zooprofilattico Sperimentale delle Venezie, Viale Fiume, 78, 36100, Vicenza, VI, Italy
| | - Roberto Piro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Viale Fiume, 78, 36100, Vicenza, VI, Italy
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Zacometti C, Tata A, Massaro A, Riuzzi G, Bragolusi M, Cozzi G, Piro R, Khazzar S, Gerardi G, Gottardo F, Segato S. Seasonal Variation in Raw Milk VOC Profile within Intensive Feeding Systems. Foods 2023; 12:foods12091871. [PMID: 37174409 PMCID: PMC10178752 DOI: 10.3390/foods12091871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
The study aimed to assess the seasonal variation in raw milk volatile organic compounds (VOCs) from three indoor feeding systems based on maize silage (n = 31), silages/hay (n = 19) or hay (n = 16). After headspace solid-phase microextraction (HS-SPME), VOC profiles were determined by gas chromatography (GC). Chemical and VOC (log10 transformations of the peak areas) data were submitted to a two-way ANOVA to assess the feeding system (FS) and season (S) effects; an interactive principal component analysis (iPCA) was also performed. The interaction FS × S was never significant. The FS showed the highest (p < 0.05) protein and casein content for hay-milk samples, while it did not affect any VOCs. Winter milk had higher (p < 0.05) proportions of protein, casein, fat and some carboxylic acids, while summer milk was higher (p < 0.05) in urea and 2-pentanol and methyl aldehydes. The iPCA confirmed a seasonal spatial separation. Carboxylic acids might generate from incomplete esterification in the mammary gland and/or milk lipolytic activity, while aldehydes seemed to be correlated with endogenous lipid or amino acid oxidation and/or feed transfer. The outcomes suggested that VOCs could be an operative support to trace raw milk for further mild processing.
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Affiliation(s)
- Carmela Zacometti
- Experimental Chemistry Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, 36100 Vicenza, Italy
| | - Alessandra Tata
- Experimental Chemistry Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, 36100 Vicenza, Italy
| | - Andrea Massaro
- Experimental Chemistry Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, 36100 Vicenza, Italy
| | - Giorgia Riuzzi
- Department of Animal Medicine, Production and Health, University of Padova, 35020 Legnaro, Italy
| | - Marco Bragolusi
- Experimental Chemistry Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, 36100 Vicenza, Italy
| | - Giulio Cozzi
- Department of Animal Medicine, Production and Health, University of Padova, 35020 Legnaro, Italy
| | - Roberto Piro
- Experimental Chemistry Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, 36100 Vicenza, Italy
| | - Sara Khazzar
- Department of Animal Medicine, Production and Health, University of Padova, 35020 Legnaro, Italy
| | - Gabriele Gerardi
- Department of Animal Medicine, Production and Health, University of Padova, 35020 Legnaro, Italy
| | - Flaviana Gottardo
- Department of Animal Medicine, Production and Health, University of Padova, 35020 Legnaro, Italy
| | - Severino Segato
- Department of Animal Medicine, Production and Health, University of Padova, 35020 Legnaro, Italy
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Piro R, Fontana M, Casalini E, Rossi L, Simeone MS, Ghinassi F, Ruggiero P, Pollorsi C, Taddei S, Beghe' B, Facciolongo NC. Safety and Diagnostic Accuracy of the Transnasal Approach for Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA). Diagnostics (Basel) 2023; 13:diagnostics13081405. [PMID: 37189506 DOI: 10.3390/diagnostics13081405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/24/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe and accurate diagnostic procedure used for investigating mediastinal pathologies. It is usually performed using an oral approach. The nasal route has been proposed but not extensively investigated. With the aim to report the use of linear EBUS through the nasal route and compare its accuracy and safety with the oral one, we conducted a retrospective analysis of the subjects who underwent an EBUS-TBNA procedure at our center. From January 2020 to December 2021, 464 subjects underwent an EBUS-TBNA, and in 417 patients, EBUS was performed through the nose or mouth. Nasal insertion of the EBUS bronchoscope was performed in 58.5% of the patients. No difference between the two insertion routes was observed in terms of location or number of stations sampled per subject. Procedure complications were mild and similar between the two groups (10.2% for the nasal group vs. 9.8% for the oral group). Minor epistaxis occurred in five subjects in the nasal group. Comparing the two groups, the rates of adequate specimens were similar (95.1% vs. 94.8%), as were the proportions of diagnostic specimens (84% vs. 82%). In conclusion, the nasal route for EBUS-TBNA is a valid alternative to the oral one.
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Affiliation(s)
- Roberto Piro
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Matteo Fontana
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Eleonora Casalini
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Laura Rossi
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- Respiratory Diseases Unit, Azienda Ospedaliero-Universitaria of Modena, 41121 Modena, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplantation, Oncology and Regenerative Medicine, Faculty of Medicine and Surgery, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Maria Serena Simeone
- Respiratory Diseases Unit, Azienda Ospedaliero-Universitaria of Modena, 41121 Modena, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplantation, Oncology and Regenerative Medicine, Faculty of Medicine and Surgery, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Federica Ghinassi
- Respiratory Diseases Unit, Azienda Ospedaliero-Universitaria of Modena, 41121 Modena, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplantation, Oncology and Regenerative Medicine, Faculty of Medicine and Surgery, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Patrizia Ruggiero
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Chiara Pollorsi
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Sofia Taddei
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Bianca Beghe'
- Respiratory Diseases Unit, Azienda Ospedaliero-Universitaria of Modena, 41121 Modena, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplantation, Oncology and Regenerative Medicine, Faculty of Medicine and Surgery, University of Modena and Reggio Emilia, 41121 Modena, Italy
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10
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Pavone P, Russello G, Salati G, Corsini R, Salsi P, Vizzini L, Lombardini C, Spaggiari L, Besutti G, Menozzi V, Spadoni A, Facciolongo N, Piro R, Carretto E, Massari M. Active screening of COVID-19-associated pulmonary aspergillosis with serum beta-glucan and endotracheal aspirates galactomannan and fungal culture. Mycoses 2023; 66:219-225. [PMID: 36380646 DOI: 10.1111/myc.13545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Since February 2021 active screening of COVID-19-associated pulmonary aspergillosis (CAPA) has been implemented in our institution. OBJECTIVES To evaluate CAPA incidence in our centre and evaluate performance of our screening protocol. METHODS We screened once per week, collecting endotracheal aspirates for fungal culture and galactomannan (GM) and serum for 1,3-ß-D-glucan (BG). In case of positivity (GM more than 4.5, platelia assay, and/or BG >7 pg/ml, wako and/or positive fungal culture), second-level investigations were performed to pursue CAPA diagnosis according to ECMM/ISHAM criteria: bronchoalveolar lavage (BAL) fungal culture and GM, chest computed tomography (CT), serum GM. RESULTS A total of 102 patients were screened (median age 64 years, range 39-79; 28 (27.4%) females). Twenty-two patients were diagnosed with CAPA (21%). 12 patients were positive for serum BG, 17 patients were positive for endotracheal aspirates GM and 27 patients were positive for endotracheal aspirates fungal culture. Thirty-two BALs were performed, and 26 patients underwent CT chest. Following the second level investigations 61% of the patients with positive screening tests were diagnosed with CAPA. Serum BG above 20 pg/ml or positive serum GM were always associated with typical CT chest signs of aspergillosis. Compared with 1 single positive test, having 2 positive screening test was significantly more associated with CAPA diagnosis (p = .0004). CONCLUSIONS Active CAPA screening with serum 1,3-ß-D-glucan and endotracheal aspirates galactomannan and fungal cultures and consequent second level investigations led to high number of CAPA diagnosis. Combining more positive fungal biomarkers was more predictive of CAPA diagnosis.
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Affiliation(s)
- Paolo Pavone
- Infectious Disease, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Giuseppe Russello
- Microbiology, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Salati
- Intensive Care, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Romina Corsini
- Infectious Disease, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Pierpaolo Salsi
- Intensive Care, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Loredana Vizzini
- Microbiology, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Cristina Lombardini
- Intensive Care, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Lucia Spaggiari
- Radiology, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Giulia Besutti
- Radiology, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Valentina Menozzi
- Infectious Disease, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Anna Spadoni
- Infectious Disease, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Nicola Facciolongo
- Pulmonology, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Roberto Piro
- Pulmonology, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Edoardo Carretto
- Microbiology, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Marco Massari
- Infectious Disease, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
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11
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Tata A, Marzoli F, Cordovana M, Tiengo A, Zacometti C, Massaro A, Barco L, Belluco S, Piro R. A multi-center validation study on the discrimination of Legionella pneumophila sg.1, Legionella pneumophila sg. 2-15 and Legionella non- pneumophila isolates from water by FT-IR spectroscopy. Front Microbiol 2023; 14:1150942. [PMID: 37125166 PMCID: PMC10133462 DOI: 10.3389/fmicb.2023.1150942] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
This study developed and validated a method, based on the coupling of Fourier-transform infrared spectroscopy (FT-IR) and machine learning, for the automated serotyping of Legionella pneumophila serogroup 1, Legionella pneumophila serogroups 2-15 as well as their successful discrimination from Legionella non-pneumophila. As Legionella presents significant intra- and inter-species heterogeneities, careful data validation strategies were applied to minimize late-stage performance variations of the method across a large microbial population. A total of 244 isolates were analyzed. In details, the method was validated with a multi-centric approach with isolates from Italian thermal and drinking water (n = 82) as well as with samples from German, Italian, French, and British collections (n = 162). Specifically, robustness of the method was verified over the time-span of 1 year with multiple operators and two different FT-IR instruments located in Italy and Germany. Moreover, different production procedures for the solid culture medium (in-house or commercial) and different culture conditions (with and without 2.5% CO2) were tested. The method achieved an overall accuracy of 100, 98.5, and 93.9% on the Italian test set of Legionella, an independent batch of Legionella from multiple European culture collections, and an extra set of rare Legionella non-pneumophila, respectively.
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Affiliation(s)
- Alessandra Tata
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
- *Correspondence: Alessandra Tata,
| | - Filippo Marzoli
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | | | - Alessia Tiengo
- OIE Italian Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Padova, Italy
| | - Carmela Zacometti
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
| | - Andrea Massaro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
| | - Lisa Barco
- OIE Italian Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Padova, Italy
| | - Simone Belluco
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Roberto Piro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
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12
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Massaro A, Tata A, Pallante I, Bertazzo V, Bottazzari M, Paganini L, Dall'Ava B, Stefani A, De Buck J, Piro R, Pozzato N. Metabolic signature of Mycobacterium avium subsp. paratuberculosis infected and infectious dairy cattle by integrating nuclear magnetic resonance analysis and blood indices. Front Vet Sci 2023; 10:1146626. [PMID: 37138915 PMCID: PMC10150450 DOI: 10.3389/fvets.2023.1146626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/09/2023] [Indexed: 05/05/2023] Open
Abstract
The early diagnosis of Mycobacterium avium subsp. paratuberculosis (MAP) is one of the current challenges of farmers and veterinarians. This work aimed to investigate the changes in metabolic levels associated with natural MAP infection in infected and infectious dairy cattle. The study included sera from 23 infectious/seropositive, 10 infected but non-infectious/seronegative, and 26 negative Holstein Fresian cattle. The samples were selected from a collection of samples gathered during a prospective study. The samples were analyzed by quantitative nuclear magnetic resonance (NMR) spectroscopy and routine blood chemistry. The blood indices and the 1H NMR data were concatenated by low-level data fusion, resulting in a unique global fingerprint. Afterwards, the merged dataset was statistically analyzed by the least absolute shrinkage and selection operator (LASSO), which is a shrinkage and selection method for supervised learning. Finally, pathways analysis was performed to get more insights on the possible dysregulated metabolic pathways. The LASSO model achieved, in a 10 time repeated 5-fold cross-validation, an overall accuracy of 91.5% with high values of sensitivity and specificity in classifying correctly the negative, infected, and infectious animals. The pathway analysis revealed MAP-infected cattle have increased tyrosine metabolism and enhanced phenylalanine, tyrosine and tryptophan biosynthesis. The enhanced synthesis and degradation of ketone bodies was observed both in infected and infectious cattle. In conclusion, fusing data from multiple sources has proved to be useful in exploring the altered metabolic pathways in MAP infection and potentially diagnosing negative animals within paratuberculosis-infected herds.
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Affiliation(s)
- Andrea Massaro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
| | - Alessandra Tata
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
- *Correspondence: Alessandra Tata
| | - Ivana Pallante
- Laboratorio di Medicina Forense Veterinaria, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
| | - Valentina Bertazzo
- Medicina di Laboratorio, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Massimo Bottazzari
- Laboratorio di Diagnostica Clinica e Sierologia di Piano, Istituto Zooprofilattico Sperimentale delle Venezie, Verona, Italy
| | - Laura Paganini
- Laboratorio di Diagnostica Clinica e Sierologia di Piano, Istituto Zooprofilattico Sperimentale delle Venezie, Verona, Italy
| | - Brunella Dall'Ava
- Laboratorio di Diagnostica Clinica e Sierologia di Piano, Istituto Zooprofilattico Sperimentale delle Venezie, Verona, Italy
| | - Annalisa Stefani
- Medicina di Laboratorio, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Jeroen De Buck
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Roberto Piro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
| | - Nicola Pozzato
- Laboratorio di Medicina Forense Veterinaria, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
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13
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Tata A, Pallante I, Zacometti C, Moressa A, Bragolusi M, Negro A, Massaro A, Binato G, Gallocchio F, Angeletti R, Pozzato N, Piro R. Rapid, novel screening of toxicants in poison baits, and autopsy specimens by ambient mass spectrometry. Front Chem 2022; 10:982377. [PMID: 36092679 PMCID: PMC9452653 DOI: 10.3389/fchem.2022.982377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/20/2022] [Indexed: 11/15/2022] Open
Abstract
Animal poisoning and dissemination of baits in the environment have public health and ethological implications, which can be followed by criminal sanctions for those responsible. The reference methods for the analysis of suspect baits and autopsy specimens are founded on chromatographic-based techniques. They are extremely robust and sensitive, but also very expensive and laborious. For this reason, we developed an ambient mass spectrometry (AMS) method able to screen for 40 toxicants including carbamates, organophosphate and chlorinated pesticides, coumarins, metaldehyde, and strychnine. Spiked samples were firstly purified and extracted by dispersive solid phase extraction (QuEChERS) and then analyzed by direct analysis in real time high-resolution mass spectrometry (DART-HRMS). To verify the performance of this new approach, 115 authentic baits (n = 59) and necropsy specimens (gastrointestinal content and liver, n = 56) were assessed by the official reference methods and combined QuEChERS-DART-HRMS. The agreement between the results allowed evaluation of the performances of the new screening method for a variety of analytes and calculation of the resultant statistical indicators (the new method had overall accuracy 89.57%, sensitivity of 88.24%, and a specificity of 91.49%). Taking into account only the baits, 96.61% of overall accuracy was achieved with 57/59 samples correctly identified (statistical sensitivity 97.50%, statistical specificity 94.74%). Successful identification of the bitter compound, denatonium benzoate, in all the samples that contained rodenticides (28/28) was also achieved. We believe initial screening of suspect poison baits could guide the choice of reference confirmatory methods, reduce the load in official laboratories, and help the early stages of investigations into cases of animal poisoning.
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Affiliation(s)
- Alessandra Tata
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
- *Correspondence: Alessandra Tata,
| | - Ivana Pallante
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Medicina Forense Veterinaria, Vicenza, Italy
| | - Carmela Zacometti
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Alessandra Moressa
- Istituto Zooprofilattico Sperimentale delle Venezie, Chimica, Legnaro, Italy
| | - Marco Bragolusi
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Alessandro Negro
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Andrea Massaro
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Giovanni Binato
- Istituto Zooprofilattico Sperimentale delle Venezie, Chimica, Legnaro, Italy
| | - Federica Gallocchio
- Istituto Zooprofilattico Sperimentale delle Venezie, Chimica, Legnaro, Italy
| | - Roberto Angeletti
- Istituto Zooprofilattico Sperimentale delle Venezie, Chimica, Legnaro, Italy
| | - Nicola Pozzato
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Medicina Forense Veterinaria, Vicenza, Italy
| | - Roberto Piro
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
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14
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Tata A, Massaro A, Marzoli F, Miano B, Bragolusi M, Piro R, Belluco S. Authentication of Edible Insects’ Powders by the Combination of DART-HRMS Signatures: The First Application of Ambient Mass Spectrometry to Screening of Novel Food. Foods 2022; 11:foods11152264. [PMID: 35954032 PMCID: PMC9368114 DOI: 10.3390/foods11152264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/27/2022] Open
Abstract
This feasibility study reports the use of direct analysis in real-time high-resolution mass spectrometry (DART-HRMS) in profiling the powders from edible insects, as well as the potential for the identification of different insect species by classification modeling. The basis of this study is the revolution that has occurred in the field of analytical chemistry, with the improved capability of ambient mass spectrometry to authenticate food matrices. In this study, we applied DART-HRMS, coupled with mid-level data fusion and a learning method, to discriminate between Acheta domesticus (house cricket), Tenebrio molitor (yellow mealworm), Locusta migratoria (migratory locust), and Bombyx mori (silk moth). A distinct metabolic fingerprint was observed for each edible insect species, while the Bombyx mori fingerprint was characterized by highly abundant linolenic acid and quinic acid; palmitic and oleic acids are the statistically predominant fatty acids in black soldier fly (Hermetia illucens). Our chemometrics also revealed that the amino acid proline is a discriminant molecule in Tenebrio molitor, whereas palmitic and linoleic acids are the most informative molecular features of the house cricket (Acheta domesticus). Good separation between the four different insect species was achieved, and cross-validation gave 100% correct identification for all training samples. The performance of the random forest classifier was examined on a test set and produced excellent results, in terms of overall accuracy, sensitivity, and specificity. These results demonstrate the reliability of the DART-HRMS as a screening method in a future quality control scenario to detect complete substitution of insect powders.
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Affiliation(s)
- Alessandra Tata
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, 36100 Vicenza, Italy; (A.M.); (B.M.); (M.B.); (R.P.)
- Correspondence:
| | - Andrea Massaro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, 36100 Vicenza, Italy; (A.M.); (B.M.); (M.B.); (R.P.)
| | - Filippo Marzoli
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy; (F.M.); (S.B.)
| | - Brunella Miano
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, 36100 Vicenza, Italy; (A.M.); (B.M.); (M.B.); (R.P.)
| | - Marco Bragolusi
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, 36100 Vicenza, Italy; (A.M.); (B.M.); (M.B.); (R.P.)
| | - Roberto Piro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, 36100 Vicenza, Italy; (A.M.); (B.M.); (M.B.); (R.P.)
| | - Simone Belluco
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy; (F.M.); (S.B.)
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15
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Facciolongo N, Bonacini M, Galeone C, Ruggiero P, Menzella F, Ghidoni G, Piro R, Scelfo C, Catellani C, Zerbini A, Croci S. Bronchial thermoplasty in severe asthma: a real-world study on efficacy and gene profiling. Allergy Asthma Clin Immunol 2022; 18:39. [PMID: 35534846 PMCID: PMC9087992 DOI: 10.1186/s13223-022-00680-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/27/2022] [Indexed: 12/02/2022]
Abstract
Background Bronchial thermoplasty (BT) is an effective treatment in severe asthma. How to select patients who more likely benefit from BT is an unmet clinical need. Moreover, mechanisms of BT efficacy are still largely unknown. We sought to determine BT efficacy and to identify potential mechanisms of response. Methods This retrospective cohort study evaluated clinical outcomes in 27 patients with severe asthma: 13 with T2-high and 14 with T2-low endotype. Expression levels of 20 genes were compared by real-time PCR in bronchial biopsies performed at the third BT session versus baseline. Clinical response was measured based on Asthma Control Questionnaire (ACQ) score < 1.5, asthma exacerbations < 2, oral corticosteroids reduction of at least 50% at 12 months post-BT. Patients were classified as responders when they had at least 2 of 3 outcome measures. Results 81% of patients were defined as responders. BT induced a reduction in alpha smooth muscle actin (ACTA2) and an increase in CD68, fibroblast activation protein-alpha (FAP), alpha-1 and alpha-2 type I collagen (COL1A1, COL1A2) gene expression in the majority of patients. A higher reduction in ubiquitin carboxy-terminal-hydrolase L1 (PGP9.5) mRNA correlated with a better response based on Asthma Quality of Life Questionnaire (AQLQ). Lower changes in CD68 and FAP mRNAs correlated with a better response based on ACQ. Lower levels of occludin (OCLN), CD68, connective tissue growth factor (CTGF), higher levels of secretory leukocyte protease inhibitor (SLPI) and lower changes in CD68 and CTGF mRNAs were observed in patients who had less than 2 exacerbations post-BT. Lower levels of COL1A2 at baseline were observed in patients who had ACQ < 1.5 at 12 months post-BT. Conclusions BT is effective irrespective of the asthma endotypes and seems associated with airway remodelling. Quantification of OCLN, CD68, CTGF, SLPI, COL1A2 mRNAs could be useful to identify patients with better results. Trial registration: The study protocol was approved by the Local Ethics Committee (Azienda USL-IRCCS of Reggio Emilia—Comitato Etico Area Vasta Nord of Emilia Romagna; protocol number: 2019/0014076) and all the patients provided written informed consent before participating in the study. Supplementary Information The online version contains supplementary material available at 10.1186/s13223-022-00680-4.
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Affiliation(s)
- Nicola Facciolongo
- Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Martina Bonacini
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Carla Galeone
- Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Patrizia Ruggiero
- Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Menzella
- Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy. .,Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda Unità Sanitaria Locale-IRCCS, 42123, Reggio Emilia, Italy.
| | - Giulia Ghidoni
- Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Roberto Piro
- Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Scelfo
- Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Catellani
- Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandro Zerbini
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Croci
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
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16
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Tata A, Massaro A, Riuzzi G, Lanza I, Bragolusi M, Negro A, Novelli E, Piro R, Gottardo F, Segato S. Ambient mass spectrometry for rapid authentication of milk from Alpine or lowland forage. Sci Rep 2022; 12:7360. [PMID: 35513691 PMCID: PMC9072378 DOI: 10.1038/s41598-022-11178-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/15/2022] [Indexed: 01/22/2023] Open
Abstract
Metabolomics approaches, such as direct analysis in real time-high resolution mass spectrometry (DART-HRMS), allow characterising many polar and non-polar compounds useful as authentication biomarkers of dairy chains. By using both a partial least squares discriminant analysis (PLS-DA) and a linear discriminant analysis (LDA), this study aimed to assess the capability of DART-HRMS, coupled with a low-level data fusion, discriminate among milk samples from lowland (silages vs. hay) and Alpine (grazing; APS) systems and identify the most informative biomarkers associated with the main dietary forage. As confirmed also by the LDA performed against the test set, DART-HRMS analysis provided an accurate discrimination of Alpine samples; meanwhile, there was a limited capacity to correctly recognise silage- vs. hay-milks. Supervised multivariate statistics followed by metabolomics hierarchical cluster analysis allowed extrapolating the most significant metabolites. Lowland milk was characterised by a pool of energetic compounds, ketoacid derivates, amines and organic acids. Seven informative DART-HRMS molecular features, mainly monoacylglycerols, could strongly explain the metabolomic variation of Alpine grazing milk and contributed to its classification. The misclassification between the two lowland groups confirmed that the intensive dairy systems would be characterised by a small variation in milk composition.
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Affiliation(s)
- Alessandra Tata
- Experimental Chemistry Laboratory, Istituto Zooprofilattico Sperimentale Delle Venezie, Vicenza, Italy
| | - Andrea Massaro
- Experimental Chemistry Laboratory, Istituto Zooprofilattico Sperimentale Delle Venezie, Vicenza, Italy
| | - Giorgia Riuzzi
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro (PD), Italy
| | - Ilaria Lanza
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro (PD), Italy
| | - Marco Bragolusi
- Experimental Chemistry Laboratory, Istituto Zooprofilattico Sperimentale Delle Venezie, Vicenza, Italy
| | - Alessandro Negro
- Experimental Chemistry Laboratory, Istituto Zooprofilattico Sperimentale Delle Venezie, Vicenza, Italy
| | - Enrico Novelli
- Department of Comparative Biomedicine and Food Science, University of Padova, Legnaro (PD), Italy
| | - Roberto Piro
- Experimental Chemistry Laboratory, Istituto Zooprofilattico Sperimentale Delle Venezie, Vicenza, Italy
| | - Flaviana Gottardo
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro (PD), Italy
| | - Severino Segato
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro (PD), Italy.
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Cozzi S, Timon G, Tagliavini E, Piro R, Borghi E, Tiseo M, Iotti C, ciammella P. PO-1271 Redetermination Of Pd-L1 Expression After Chemo-Radiation In Locally Advanced Pd-L1 Negative NSCLC (RECAL TRIAL. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03235-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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18
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Tata A, Massaro A, Damiani T, Piro R, Dall'Asta C, Suman M. Detection of soft-refined oils in extra virgin olive oil using data fusion approaches for LC-MS, GC-IMS and FGC-Enose techniques: The winning synergy of GC-IMS and FGC-Enose. Food Control 2022. [DOI: 10.1016/j.foodcont.2021.108645] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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19
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Stella R, Mastrorilli E, Pretto T, Tata A, Piro R, Arcangeli G, Biancotto G. New strategies for the differentiation of fresh and frozen/thawed fish: Non-targeted metabolomics by LC-HRMS (part B). Food Control 2022. [DOI: 10.1016/j.foodcont.2021.108461] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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20
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Piro R, Casalini E, Fontana M, Galeone C, Ruggiero P, Taddei S, Ghidoni G, Patricelli G, Facciolongo N. Efficacy and safety of EBUS-TBNA under conscious sedation with meperidine and midazolam. Thorac Cancer 2022; 13:533-538. [PMID: 34994092 PMCID: PMC8841700 DOI: 10.1111/1759-7714.14286] [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: 10/21/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 01/23/2023] Open
Abstract
Background According to the guidelines, endobronchial ultrasound guided transbronchial needle aspiration (EBUS‐TBNA) is the technique of choice for the diagnosis of mediastinal involvement in lung cancer; it is also useful for other mediastinal malignancies and benign pathology. Nevertheless, there is still discussion about whether to perform it under general anesthesia or under conscious sedation. Methods We retrospectively analyzed the data of all patients who underwent EBUS‐TBNA under conscious sedation with up to 1 mg/kg of meperidine and up to 0.15 mg/kg of midazolam in the Interventional Pulmonology Unit of the Azienda USL‐IRCCS Santa Maria Nuova of Reggio Emilia during 2 consecutive years. Demographic data, indication for the procedure, duration, number of lymph node sampled, number of passes per station, diagnostic yield, drugs dosage, questionnaire score, and complications were collected. Results A total of 302 patients underwent EBUS‐TBNA, and 68% of the patients were males and the mean age was 65 ± 13 years old. The average duration of procedures was 24.4 minutes and the mean dosage of drugs was 4.32 ± 1.52 mg for midazolam and 50.86 ± 13.71 mg for meperidine. The mean number of lymph nodes sampled per patient was 1.75 ± 0.82, and each patient received an average of 4.71 ± 1.78 passes. A total of 90.7% of patients completed the procedures, 85% had adequate samples, and 94.4% of patients declared with Likert's questionnaire that they strongly agree to repeat the test if necessary. Conclusion EBUS‐TBNA performed under conscious sedation with meperidine and midazolam is feasible and well‐tolerated and has a similar diagnostic yield of that reported in literature.
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Affiliation(s)
- Roberto Piro
- Pulmonology Unit, Department of Medical Specialties, Azienda Unità Sanitaria Locale - IRCCS Tecnologie, Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Eleonora Casalini
- Pulmonology Unit, Department of Medical Specialties, Azienda Unità Sanitaria Locale - IRCCS Tecnologie, Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Matteo Fontana
- Pulmonology Unit, Department of Medical Specialties, Azienda Unità Sanitaria Locale - IRCCS Tecnologie, Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Carla Galeone
- Pulmonology Unit, Department of Medical Specialties, Azienda Unità Sanitaria Locale - IRCCS Tecnologie, Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Patrizia Ruggiero
- Pulmonology Unit, Department of Medical Specialties, Azienda Unità Sanitaria Locale - IRCCS Tecnologie, Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Sofia Taddei
- Pulmonology Unit, Department of Medical Specialties, Azienda Unità Sanitaria Locale - IRCCS Tecnologie, Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Giulia Ghidoni
- Pulmonology Unit, Department of Medical Specialties, Azienda Unità Sanitaria Locale - IRCCS Tecnologie, Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Giulia Patricelli
- Pulmonology Unit, Azienda Sanitaria Locale Brindisi, Brindisi, Italy
| | - Nicola Facciolongo
- Pulmonology Unit, Department of Medical Specialties, Azienda Unità Sanitaria Locale - IRCCS Tecnologie, Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
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21
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Massaro A, Stella R, Negro A, Bragolusi M, Miano B, Arcangeli G, Biancotto G, Piro R, Tata A. New strategies for the differentiation of fresh and frozen/thawed fish: A rapid and accurate non-targeted method by ambient mass spectrometry and data fusion (part A). Food Control 2021. [DOI: 10.1016/j.foodcont.2021.108364] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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22
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Piro R, Fontana M, Casalini E, Taddei S, Bertolini M, Iori M, Facciolongo N. Cone beam CT augmented fluoroscopy allows safe and efficient diagnosis of a difficult lung nodule. BMC Pulm Med 2021; 21:327. [PMID: 34670551 PMCID: PMC8527755 DOI: 10.1186/s12890-021-01697-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/11/2021] [Indexed: 11/24/2022] Open
Abstract
Background Detection of small peripheral lung nodules is constantly increasing with the development of low dose computed tomography lung cancer screening programs. A tissue diagnosis is often required to confirm malignity, with endobronchial biopsies being associated with a lower pneumothorax rate than percutaneous approaches. Endoscopic diagnosis of peripheral small size lung nodules is however often challenging using traditional bronchoscopy and endobronchial ultrasound alone. New virtual bronchoscopic navigation techniques such as electromagnetic navigational bronchoscopy (ENB) have developed to improve peripheral navigation, with diagnostic yield however remaining in the 30–50% range for small lesions. Recent studies have shown the benefits of combining Cone beam computed tomography (CBCT) with ENB to improve diagnostic yield to up to 83%. The use of ENB however remains limited by disposable cost, bronchus sign dependency and inaccuracies due to CT to body divergence. Case presentation This case report highlights the feasibility and usefulness of CBCT-guided bronchoscopy for the sampling of lung nodules difficult to reach through traditional bronchoscopy because of nodule size and peripheral position. Procedure was scheduled in a mobile robotic hybrid operating room with patient under general anaesthesia. CBCT acquisition was performed to localize the target lesion and plan the best path to reach it into bronchial tree. A dedicated software was used to segment the lesion and the bronchial path which 3D outlines were automatically fused in real time on the fluoroscopic images to augment live guidance. Navigation to the lesion was guided with bronchoscopy and augmented fluoroscopy alone. Before the sampling, CBCT imaging was repeated to confirm the proper position of the instrument into the lesion. Four transbronchial needle aspirations (TBNA) were performed and the tissue analysis showed a primary lung adenocarcinoma. Conclusions CBCT and augmented fluoroscopy technique is a safe and effective and has potential to improve early stage peripheral lesions endobronchial diagnostic yield without ENB. Additional studies are warranted to confirm its safety, efficacy and technical benefits, both for diagnosis of oncological and non-oncological disease and for endobronchial treatment of inoperable patients.
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Affiliation(s)
- Roberto Piro
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42123, Reggio Emilia, Italy.
| | - Matteo Fontana
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42123, Reggio Emilia, Italy
| | - Eleonora Casalini
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42123, Reggio Emilia, Italy
| | - Sofia Taddei
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42123, Reggio Emilia, Italy
| | - Marco Bertolini
- Medical Physics Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mauro Iori
- Medical Physics Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Nicola Facciolongo
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42123, Reggio Emilia, Italy
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23
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Patrucco F, Failla G, Ferrari G, Galasso T, Candoli P, Mondoni M, Piro R, Facciolongo NC, Renda T, Salio M, Scala R, Solidoro P, Mattei A, Donato P, Vaschetto R, Balbo PE. Bronchoscopy during COVID-19 pandemic, ventilatory strategies and procedure measures. Panminerva Med 2021; 63:529-538. [PMID: 34606187 DOI: 10.23736/s0031-0808.21.04533-x] [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] [Indexed: 11/08/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has changed bronchoscopy practices worldwide. Bronchoscopy is a high-risk aerosol-generating procedure with a potential for direct SARS-CoV-2 exposure and hospital-acquired infection. Current guidelines about personal protective equipment and environment considerations represent key competencies to minimize droplets dispersion and reduce the risk of transmission. Different measures should be put in field based on setting, patient's clinical characteristics, urgency and indications of bronchoscopy. The use of this technique in SARS-CoV-2 patients is reported primarily for removal of airway plugs and for obtaining microbiological culture samples. In mechanically ventilated patients with SARS-CoV-2, bronchoscopy is commonly used to manage complications such as hemoptysis, atelectasis or lung collapse when prone positioning, physiotherapy or recruitment maneuvers have failed. Further indications are represented by assistance during percutaneous tracheostomy. Continuous positive airway pressure, non-invasive ventilation support and high flow nasal cannula oxygen are frequently used in patient affected by Coronavirus Disease-2019 (COVID-19): management of patients' airways and ventilation strategies differs from bronchoscopy indications, patient's clinical status and in course or required ventilatory support. Sedation is usually administered by the pulmonologist (performing the bronchoscopy) or by the anesthetist depending on the complexity of the procedure and the level of sedation required. Finally, elective bronchoscopy for diagnostic indications during COVID-19 pandemic should be carried on respecting rigid standards which allow to minimize potential viral transmission, independently from patient's COVID-19 status. This narrative review aims to evaluate the indications, procedural measures and ventilatory strategies of bronchoscopy performed in different settings during COVID-19 pandemic.
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Affiliation(s)
- Filippo Patrucco
- Respiratory Diseases Unit, Medical Department, AOU Maggiore della Carità, Novara, Italy - .,Translational Medicine Department, University of Eastern Piedmont, Novara, Italy -
| | - Giuseppe Failla
- Interventional Pneumology Unit, Onco-Haematologic and Pneumo-Haematolgoic Department, AORN A. Cardarelli, Napoli, Italy.,Diagnostic and Therapeutic Bronchoscopy Unit, ARNAS Civico e Benfratelli, Palermo, Italy
| | - Giovanni Ferrari
- Pulmonology and Semi-Intensive Respiratory Units, Medical Department, AO Mauriziano, Torino, Italy
| | - Thomas Galasso
- Interventional Pneumology Unit, Thoraco-Cardio-Vascular Department, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Piero Candoli
- Interventional Pneumology Unit, Thoraco-Cardio-Vascular Department, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Michele Mondoni
- Pulmonology Unit, Cardio-Respiratory Department, Ospedale San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Roberto Piro
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Nicola C Facciolongo
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Teresa Renda
- Pneumology and Thoraco-Pulmonary Physiopathology Unit, Cardio-Thoraco-Vascular Department, Careggi Hospital, Firenze, Italy
| | - Mario Salio
- Respiratory Diseases Unit, Internistic Department, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Raffaele Scala
- Pneumology Unit, Cardio-Thoraco-Neuro-Vascular Department, San Donato Hospital, Azienda USL Toscana Sud Est, Arezzo, Italy
| | - Paolo Solidoro
- Pneumology Unit, Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza, Torino, Italy.,Medical Sciences Department, University of Turin, Italy
| | - Alessio Mattei
- Pneumology Unit, Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza, Torino, Italy
| | - Paolo Donato
- Intensive Care Unit 1, Emergency Department, AOU Maggiore della Carità, Novara, Italy
| | - Rosanna Vaschetto
- Translational Medicine Department, University of Eastern Piedmont, Novara, Italy.,Intensive Care Unit 1, Emergency Department, AOU Maggiore della Carità, Novara, Italy
| | - Piero E Balbo
- Respiratory Diseases Unit, Medical Department, AOU Maggiore della Carità, Novara, Italy
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24
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Tata A, Marzoli F, Massaro A, Passabì E, Bragolusi M, Negro A, Cristaudo I, Piro R, Belluco S. Assessing direct analysis in real-time mass spectrometry for the identification and serotyping of Legionella pneumophila. J Appl Microbiol 2021; 132:1479-1488. [PMID: 34543502 DOI: 10.1111/jam.15301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/01/2021] [Accepted: 09/05/2021] [Indexed: 12/11/2022]
Abstract
AIMS The efficacy of ambient mass spectrometry to identify and serotype Legionella pneumophila was assessed. To this aim, isolated waterborne colonies were submitted to a rapid extraction method and analysed by direct analysis in real-time mass spectrometry (DART-HRMS). METHODS AND RESULTS The DART-HRMS profiles, coupled with partial least squares discriminant analysis (PLS-DA), were first evaluated for their ability to differentiate Legionella spp. from other bacteria. The resultant classification model achieved an accuracy of 98.1% on validation. Capitalising on these encouraging results, DART-HRMS profiling was explored as an alternative approach for the identification of L. pneumophila sg. 1, L. pneumophila sg. 2-15 and L. non-pneumophila; therefore, a different PLS-DA classifier was built. When tested on a validation set, this second classifier reached an overall accuracy of 95.93%. It identified the harmful L. pneumophila sg. 1 with an impressive specificity (100%) and slightly lower sensitivity (91.7%), and similar performances were reached in the classification of L. pneumophila sg. 2-15 and L. non-pneumophila. CONCLUSIONS The results of this study show the DART-HMRS method has good accuracy, and it is an effective method for Legionella serogroup profiling. SIGNIFICANCE AND IMPACT OF THE STUDY These preliminary findings could open a new avenue for the rapid identification and quick epidemiologic tracing of L. pneumophila, with a consequent improvement to risk assessment.
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Affiliation(s)
- Alessandra Tata
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Filippo Marzoli
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Andrea Massaro
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Eleonora Passabì
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Marco Bragolusi
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Alessandro Negro
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Ilaria Cristaudo
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Roberto Piro
- Istituto Zooprofilattico Sperimentale delle Venezie, Laboratorio di Chimica Sperimentale, Vicenza, Italy
| | - Simone Belluco
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
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Piro R, Taddei S, Fontana M, Scelfo C, Casalini E, Facciolongo N. Lung "holes" after cryobiopsy: a case report. BMC Pulm Med 2021; 21:274. [PMID: 34425803 PMCID: PMC8381528 DOI: 10.1186/s12890-021-01640-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transbronchial lung cryobiopsy is a safe technique increasingly used in the study of lung diseases. Until now, only a case of pneumatocele was described but this interesting condition is probably underestimated because CT scan is routinely not performed after transbronchial lung cryobiopsies. CASE PRESENTATION We report a case of a woman presenting two pneumatoceles after lung cryobiopsies performed for the study of an interstitial lung disease. The finding was obtained with a CT scan performed because of the appearance of hemoptysis, four days after the biopsies. CONCLUSIONS Small cavitations could develop after cryobiopsies in the absence of an active infection. Studies that prospectively perform CT scan of the chest in patients who have undergone these samplings could be useful to know the incidence of iatrogenic lesions.
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Affiliation(s)
- Roberto Piro
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42123, Reggio Emilia, Italy.
| | - Sofia Taddei
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42123, Reggio Emilia, Italy
| | - Matteo Fontana
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42123, Reggio Emilia, Italy
| | - Chiara Scelfo
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42123, Reggio Emilia, Italy
| | - Eleonora Casalini
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42123, Reggio Emilia, Italy
| | - Nicola Facciolongo
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42123, Reggio Emilia, Italy
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26
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Massaro A, Negro A, Bragolusi M, Miano B, Tata A, Suman M, Piro R. Oregano authentication by mid-level data fusion of chemical fingerprint signatures acquired by ambient mass spectrometry. Food Control 2021. [DOI: 10.1016/j.foodcont.2021.108058] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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27
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Marzoli F, Bortolami A, Pezzuto A, Mazzetto E, Piro R, Terregino C, Bonfante F, Belluco S. A systematic review of human coronaviruses survival on environmental surfaces. Sci Total Environ 2021; 778:146191. [PMID: 33714096 PMCID: PMC7927581 DOI: 10.1016/j.scitotenv.2021.146191] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/08/2021] [Accepted: 02/24/2021] [Indexed: 05/02/2023]
Abstract
The current pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has led people to implement preventive measures, including surface disinfection and use of alcohol-based hand gel, in order to avoid viral transmission via fomites. However, the role of surface transmission is still debated. The present systematic review aims to summarize all the evidence on surface survival of coronaviruses infecting humans. The analysis of 18 studies showed the longest coronavirus survival time is 28 days at room temperature (RT) on different surfaces: polymer banknotes, vinyl, steel, glass, and paper banknotes. Concerning SARS-CoV-2 human infection from contaminated surfaces, dangerous viral load on surfaces for up to 21 days was determined on polymer banknotes, steel, glass and paper banknotes. For viruses other than SARS-CoV-2, the longest period of survival was 14 days, recorded on glass. Environmental conditions can affect virus survival, and indeed, low temperatures and low humidity support prolonged survival of viruses on contaminated surfaces independently of surface type. Furthermore, it has been shown that exposure to sunlight significantly reduces the risk of surface transmission. Although studies are increasingly investigating the topic of coronavirus survival, it is difficult to compare them, given the methodology differences. For this reason, it is advisable to define a reference working protocol for virus survival trials, but, as an immediate measure, there is also a need for further investigations of coronavirus survival on surfaces.
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Affiliation(s)
- Filippo Marzoli
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy.
| | - Alessio Bortolami
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Alessandra Pezzuto
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Eva Mazzetto
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Roberto Piro
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Calogero Terregino
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Francesco Bonfante
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Simone Belluco
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
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Piro R, Casalini E, Livrieri F, Fontana M, Ghidoni G, Taddei S, Facciolongo N. Interventional pulmonology during COVID-19 pandemic: current evidence and future perspectives. J Thorac Dis 2021; 13:2495-2509. [PMID: 34012596 PMCID: PMC8107537 DOI: 10.21037/jtd-20-2192] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Indexed: 01/08/2023]
Abstract
COVID-19, caused by SARS-CoV-2 infection, has become increasingly prevalent worldwide, reaching a pandemic stage in March 2020. The organization of health care services had to change because of this new disease, with the need to reallocate staff and materials, besides changing management protocols. A very important challenge is not to expose patients and health care workers to the risk of infection and not to waste personal protective equipment (PPE). In the field of interventional pulmonology, various aspects related to COVID-19 must be taken into great consideration. Although bronchoscopy is not a first-line test for patients with suspected SARS-CoV-2 infection, it has a role in selected cases and it can be useful for differential diagnosis. However, bronchoscopy is an aerosol-generating procedure, that’s why its unjustified use could contribute to propagate the virus. For this reason, the utility of each procedure must be carefully evaluated, the patient has to be properly investigated before the procedure, which has to be performed with specific precautions, including adequate PPE. In this review, we summarize the knowledge and the principal statements about endoscopic activity in COVID-19 period, in both diagnosis of COVID-19 and management of patients. How to safely perform both bronchoscopic and pleural-related procedures (thoracoscopy, pleural biopsy and drainage of pleural effusions) is described with the aim to help the staff to decide when and how performing a procedure. We also highlight how interventional pulmonology could help in matter of complications related to COVID-19.
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Affiliation(s)
- Roberto Piro
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy
| | - Eleonora Casalini
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy
| | - Francesco Livrieri
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy
| | - Matteo Fontana
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy
| | - Giulia Ghidoni
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy
| | - Sofia Taddei
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy
| | - Nicola Facciolongo
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy
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29
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Menzella F, Barbieri C, Fontana M, Scelfo C, Castagnetti C, Ghidoni G, Ruggiero P, Livrieri F, Piro R, Ghidorsi L, Montanari G, Gibellini G, Casalini E, Falco F, Catellani C, Facciolongo N. Effectiveness of noninvasive ventilation in COVID-19 related-acute respiratory distress syndrome. Clin Respir J 2021; 15:779-787. [PMID: 33728822 PMCID: PMC8251172 DOI: 10.1111/crj.13361] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [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: 05/24/2020] [Revised: 10/25/2020] [Accepted: 03/11/2021] [Indexed: 01/08/2023]
Abstract
Introduction During this long COVID‐19 pandemic outbreak, continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) are being widely used to treat patients with moderate to severe acute respiratory failure (ARF). As for now, data on the efficacy of NIV in COVID‐19 acute respiratory distress syndrome (ARDS) are lacking, and for this reason it is extremely important to accurately determine the outcomes of this strategy. This study aimed to evaluate clinical data and outcomes of NIV in patients with COVID‐19 ARDS. Matherials and methods Seventy‐nine consecutive patients with sudden worsening of respiratory failure were evaluated. All patients (71% male) had a confirmed SARS‐CoV‐2 infection and signs, symptoms and radiological findings compatible with COVID‐19 pneumonia and all of them underwent a trial of NIV. Primary outcomes were NIV success and failure defined by intubation and mortality rate. Secondary outcome was the duration of NIV. Results NIV was successful in 38 (48.1%) patients (Table 1). EOT was necessary in 21 patients (26.6%). Death occurred in 20 patients (25.3%). In the group of patients having failed a trial with NIV and then being intubated, compared to those who continued NIV, there was no higher mortality rate. By evaluating the ICU survival outcome of the subgroup of patients intubated after NIV, 57% of the patients were discharged and 43% died. Conclusion Previous studies conducted on patients undergoing invasive mechanical ventilation showed higher mortality rate than the present study. Our data showed that NIV can avoid intubation in almost half of the patients. Therefore, this data could reassure clinicians who would consider using NIV in COVID‐19 ARDS‐related treatment.
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Affiliation(s)
- Francesco Menzella
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Chiara Barbieri
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Matteo Fontana
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Chiara Scelfo
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Claudia Castagnetti
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Giulia Ghidoni
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Patrizia Ruggiero
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Francesco Livrieri
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Roberto Piro
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Luca Ghidorsi
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Gloria Montanari
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Giorgia Gibellini
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Eleonora Casalini
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Francesco Falco
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Chiara Catellani
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Nicola Facciolongo
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia, Italy
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30
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Piro R, Fontana M, Livrieri F, Menzella F, Casalini E, Taddei S, De Giorgi F, Facciolongo N. Pleural mesothelioma: When echo-endoscopy (EUS-B-FNA) leads to diagnosis in a minimally invasive way. Thorac Cancer 2021; 12:981-984. [PMID: 33533181 PMCID: PMC7952787 DOI: 10.1111/1759-7714.13868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 01/19/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is an asbestos‐related and locally invasive tumor with poor prognosis. The acquisition of histological material is mandatory in order to establish a diagnosis. In this situation, the sampling of tissue is generally performed via a thoracoscopic pleural biopsy, either medically or surgically. The use of endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) or transesophageal fine needle aspiration with an EBUS scope (EUS‐B‐FNA) of pleural lesions have only rarely been reported due to the theoretical limitations of tissue acquisition in such cases. We herein report a rare case of MPM successfully diagnosed via EUS‐B‐FNA in a 49‐year‐old woman with an unusual presentation characterized by solid thickening in the right mediastinal pleura.
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Affiliation(s)
- Roberto Piro
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Matteo Fontana
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Livrieri
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Menzella
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Eleonora Casalini
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Sofia Taddei
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Federica De Giorgi
- Pathology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Unit of Pathological Anatomy, University Hospital of Parma, Parma, Italy
| | - Nicola Facciolongo
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
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31
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Tata A, Pallante I, Massaro A, Miano B, Bottazzari M, Fiorini P, Dal Prà M, Paganini L, Stefani A, De Buck J, Piro R, Pozzato N. Serum Metabolomic Profiles of Paratuberculosis Infected and Infectious Dairy Cattle by Ambient Mass Spectrometry. Front Vet Sci 2021; 7:625067. [PMID: 33553289 PMCID: PMC7854907 DOI: 10.3389/fvets.2020.625067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/02/2020] [Accepted: 12/21/2020] [Indexed: 01/06/2023] Open
Abstract
Mycobacterium avium subsp. paratuberculosis (MAP) is the causative agent of paratuberculosis [Johne's disease (JD)], a chronic disease that causes substantial economic losses in the dairy cattle industry. The long incubation period means clinical signs are visible in animals only after years, and some cases remain undetected because of the subclinical manifestation of the disease. Considering the complexity of JD pathogenesis, animals can be classified as infected, infectious, or affected. The major limitation of currently available diagnostic tests is their failure in detecting infected non-infectious animals. The present study aimed to identify metabolic markers associated with infected and infectious stages of JD. Direct analysis in real time coupled with high resolution mass spectrometry (DART-HRMS) was, hence, applied in a prospective study where cohorts of heifers and cows were followed up annually for 2–4 years. The animals' infectious status was assigned based on a positive result of both serum ELISA and fecal PCR, or culture. The same animals were retrospectively assigned to the status of infected at the previous sampling for which all JD tests were negative. Stored sera from 10 infected animals and 17 infectious animals were compared with sera from 20 negative animals from the same herds. Two extraction protocols and two (-/+) ionization modes were tested. The three most informative datasets out of the four were merged by a mid-level data fusion approach and submitted to partial least squares discriminant analysis (PLS-DA). Compared to the MAP negative subjects, metabolomic analysis revealed the m/z signals of isobutyrate, dimethylethanolamine, palmitic acid, and rhamnitol were more intense in infected animals. Both infected and infectious animals showed higher relative intensities of tryptamine and creatine/creatinine as well as lower relative abundances of urea, glutamic acid and/or pyroglutamic acid. These metabolic differences could indicate altered fat metabolism and reduced energy intake in both infected and infectious cattle. In conclusion, DART-HRMS coupled to a mid-level data fusion approach allowed the molecular features that identified preclinical stages of JD to be teased out.
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Affiliation(s)
- Alessandra Tata
- Istituto Zooprofilattico delle Venezie (IZSVe), Legnaro, Italy
| | - Ivana Pallante
- Istituto Zooprofilattico delle Venezie (IZSVe), Legnaro, Italy
| | - Andrea Massaro
- Istituto Zooprofilattico delle Venezie (IZSVe), Legnaro, Italy
| | - Brunella Miano
- Istituto Zooprofilattico delle Venezie (IZSVe), Legnaro, Italy
| | | | - Paola Fiorini
- Istituto Zooprofilattico delle Venezie (IZSVe), Legnaro, Italy
| | - Mauro Dal Prà
- Istituto Zooprofilattico delle Venezie (IZSVe), Legnaro, Italy
| | - Laura Paganini
- Istituto Zooprofilattico delle Venezie (IZSVe), Legnaro, Italy
| | | | - Jeroen De Buck
- Department of Production Animal Health, University of Calgary, Calgary, AB, Canada
| | - Roberto Piro
- Istituto Zooprofilattico delle Venezie (IZSVe), Legnaro, Italy
| | - Nicola Pozzato
- Istituto Zooprofilattico delle Venezie (IZSVe), Legnaro, Italy
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32
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Riuzzi G, Tata A, Massaro A, Bisutti V, Lanza I, Contiero B, Bragolusi M, Miano B, Negro A, Gottardo F, Piro R, Segato S. Authentication of forage-based milk by mid-level data fusion of (+/−) DART-HRMS signatures. Int Dairy J 2021. [DOI: 10.1016/j.idairyj.2020.104859] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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33
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Belluco S, Mancin M, Marzoli F, Bortolami A, Mazzetto E, Pezzuto A, Favretti M, Terregino C, Bonfante F, Piro R. Prevalence of SARS-CoV-2 RNA on inanimate surfaces: a systematic review and meta-analysis. Eur J Epidemiol 2021; 36:685-707. [PMID: 34313896 PMCID: PMC8313411 DOI: 10.1007/s10654-021-00784-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/29/2021] [Indexed: 02/07/2023]
Abstract
Coronavirus disease (COVID-19) is a respiratory disease affecting many people and able to be transmitted through direct and perhaps indirect contact. Direct contact transmission, mediated by aerosols or droplets, is widely demonstrated, whereas indirect transmission is only supported by collateral evidence such as virus persistence on inanimate surfaces and data from other similar viruses. The present systematic review aims to estimate SARS-CoV-2 prevalence on inanimate surfaces, identifying risk levels according to surface characteristics. Data were obtained from studies in published papers collected from two databases (PubMed and Embase) with the last search on 1 September 2020. Included studies had to be papers in English, had to deal with coronavirus and had to consider inanimate surfaces in real settings. Studies were coded according to our assessment of the risk that the investigated surfaces could be contaminated by SARS-CoV-2. A meta-analysis and a metaregression were carried out to quantify virus RNA prevalence and to identify important factors driving differences among studies. Thirty-nine out of forty retrieved paper reported studies carried out in healthcare settings on the prevalence of virus RNA, five studies carry out also analyses through cell culture and six tested the viability of isolated viruses. Overall prevalences of SARS-CoV-2 RNA on high-, medium- and low-risk surfaces were 0.22 (CI95 [0.152-0.296]), 0.04 (CI95 [0.007-0.090]), and 0.00 (CI95 [0.00-0.019]), respectively. The duration surfaces were exposed to virus sources (patients) was the main factor explaining differences in prevalence.
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Affiliation(s)
- Simone Belluco
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy.
| | - Marzia Mancin
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Filippo Marzoli
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Alessio Bortolami
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Eva Mazzetto
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Alessandra Pezzuto
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Michela Favretti
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Calogero Terregino
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Francesco Bonfante
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
| | - Roberto Piro
- Department of Food Safety, Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, Italy
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34
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Livrieri F, Ghidoni G, Piro R, Menzella F, Cavazza A, Lazzaretti C, Massari M, Montanari G, Fontana M, Facciolongo NC. May 2020: Is It Always COVID-19 No Matter What? Int Med Case Rep J 2020; 13:563-567. [PMID: 33173352 PMCID: PMC7646501 DOI: 10.2147/imcrj.s277474] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 09/08/2020] [Indexed: 12/24/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing a massive outbreak throughout the world. In this period, diseases other than coronavirus disease (COVID-19) have not disappeared; however, it is hard for doctors to diagnose diseases that can mimic the clinical, radiological, and laboratory features of COVID-19, especially rare lung diseases such as acute eosinophilic pneumonia (AEP). We report the clinical case of a young patient who presented to the Emergency Department with respiratory failure and clinical symptoms, radiological aspects, and blood tests compatible with COVID-19; two swabs and a serology test for SARS-CoV-2 were performed, both resulted negative, but the respiratory failure worsened. Peripheral eosinophilia guided us to consider the possibility of a rare disease such as AEP, even if radiology findings were not pathognomonic. Therefore, we decided to perform a flexible bronchoscopy with bronchoalveolar lavage (BAL) at the lingula, which showed the presence of eosinophilia greater than 40%. As a consequence, we treated the patient with high-dose corticosteroids that completely resolved the respiratory symptoms. This case report highlights the difficulty of making alternative diagnoses during the COVID-19 pandemic, especially for rare lung diseases such as AEP, which may have initial characteristics similar to COVID-19.
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Affiliation(s)
- Francesco Livrieri
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia 42123, Italy
| | - Giulia Ghidoni
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia 42123, Italy
| | - Roberto Piro
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia 42123, Italy
| | - Francesco Menzella
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia 42123, Italy
| | - Alberto Cavazza
- Pathology Unit, Azienda USL/IRCCS di Reggio Emilia, Reggio Emilia 42100, Italy
| | - Claudia Lazzaretti
- Infectious Diseases, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Marco Massari
- Infectious Diseases, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Gloria Montanari
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia 42123, Italy
| | - Matteo Fontana
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia 42123, Italy
| | - Nicola Cosimo Facciolongo
- Department of Medical Specialties, Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia 42123, Italy
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35
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Scelfo C, Fontana M, Casalini E, Menzella F, Piro R, Zerbini A, Spaggiari L, Ghidorsi L, Ghidoni G, Facciolongo NC. A Dangerous Consequence of the Recent Pandemic: Early Lung Fibrosis Following COVID-19 Pneumonia - Case Reports. Ther Clin Risk Manag 2020; 16:1039-1046. [PMID: 33154646 PMCID: PMC7605965 DOI: 10.2147/tcrm.s275779] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 08/07/2020] [Accepted: 09/28/2020] [Indexed: 01/08/2023] Open
Abstract
The outbreak of the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) started in China in December 2019. COVID-19 patients at presentation show a wide spectrum of clinical and pathological involvement. We report two cases of respiratory insufficiency due to COVID-19 pneumonia that occurred in adults without a history of respiratory diseases. Although these patients improved and were discharged from the acute ward, during the hospitalization they both progressed with a subsequent clinical and radiological worsening, pointing out one of the main concerns for these patients at discharge: the possibility of developing persistent lung abnormalities also in healthy people not having other risk factors. In conclusion, these cases represent two examples of early lung fibrosis in patients with COVID-19 pneumonia with different severity disease evolution and highlight the need for long-term follow-up strategies. The etiology of this fibrosis is under discussion: we suppose that it could be due to either a possible outcome of natural history of lung damage produced by ARDS, or to the lung injury related to high oxygen level or to the lung damage directly induced by viral infection or finally to the autoimmune response. At this moment, it is not possible to predict how many people will have consequences due to COVID-19 pneumonia, and therefore we believe that careful follow-up should be mandatory.
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Affiliation(s)
- Chiara Scelfo
- Department of Medical Specialties, Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Matteo Fontana
- Department of Medical Specialties, Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Eleonora Casalini
- Department of Medical Specialties, Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Menzella
- Department of Medical Specialties, Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Roberto Piro
- Department of Medical Specialties, Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandro Zerbini
- Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Lucia Spaggiari
- Department of Radiology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Ghidorsi
- Department of Medical Specialties, Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giulia Ghidoni
- Department of Medical Specialties, Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Nicola C Facciolongo
- Department of Medical Specialties, Pneumology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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36
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Piro R, Tonelli R, Cavazza A, Taddei S, Clini E, Facciolongo N. Echoendoscopic appearance of mediastinal metastasis from papillary renal carcinoma. Thorac Cancer 2020; 11:3631-3633. [PMID: 33078535 PMCID: PMC7705613 DOI: 10.1111/1759-7714.13704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022] Open
Abstract
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is being increasingly used in the diagnostic workup of mediastinal diseases. Here, we report a patient with cystic lesions located in the mediastinum, the sampling of which facilitated the diagnosis of renal neoplasm. This paper confirms the usefulness and safety of EBUS/TBNA on cystic lesions and describes a rare presentation of intrathoracic metastases from carcinoma of the kidney.
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Affiliation(s)
- Roberto Piro
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Roberto Tonelli
- Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Reggio Emilia, Italy.,Respiratory Disease Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Reggio Emilia, Italy
| | - Alberto Cavazza
- Pathology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Sofia Taddei
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Enrico Clini
- Respiratory Disease Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Reggio Emilia, Italy
| | - Nicola Facciolongo
- Pulmonology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Menzella F, Fontana M, Salvarani C, Massari M, Ruggiero P, Scelfo C, Barbieri C, Castagnetti C, Catellani C, Gibellini G, Falco F, Ghidoni G, Livrieri F, Montanari G, Casalini E, Piro R, Mancuso P, Ghidorsi L, Facciolongo N. Efficacy of tocilizumab in patients with COVID-19 ARDS undergoing noninvasive ventilation. Crit Care 2020; 24:589. [PMID: 32993751 PMCID: PMC7523258 DOI: 10.1186/s13054-020-03306-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 09/22/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is extremely variable, ranging from asymptomatic patients to those who develop severe acute respiratory distress syndrome (ARDS). As for now, there are still no really effective therapies for coronavirus disease 2019 (COVID-19). Some evidences suggest that tocilizumab (TCZ) may avoid the progression of severe COVID-19. The aim of this retrospective case-control study was to analyze the efficacy and safety of TCZ in patients with COVID-19 ARDS undergoing noninvasive mechanical ventilation (NIV). METHODS Seventy-nine consecutive patients with severe COVID-19 pneumonia and worsening acute respiratory failure (ARF) were admitted to the Pulmonology Unit of Azienda USL of Reggio Emilia-IRCCS. All patients were inflamed (elevated CRP and IL-6 levels) and received NIV at admission according to the presence of a pO2/FiO2 ratio ≤ 200 mmHg. The possibility of being treated with TCZ depended on the drug availability. The primary outcome was the in-hospital mortality rate. A secondary composite outcome of worsening was represented by the patients who died in the pulmonology unit or were intubated. RESULTS Out of 79 patients, 41 were treated with TCZ. Twenty-eight patients received intravenous (IV) TCZ and 13 patients received subcutaneous (SC) TCZ. In-hospital overall mortality rate was 38% (30/79 patients). The probabilities of dying and being intubated during the follow-up using Kaplan-Meier method were significantly lower in total patients treated with TCZ compared to those of patients not treated with TCZ (log-rank p value = 0.006 and 0.036, respectively). However, using Cox multivariate analyses adjusted for age and Charlson comorbidity index only the association with the reduced risk of being intubated or dying maintained the significance (HR 0.44, 95%CI 0.22-0.89, p = 0.022). Two patients treated with TCZ developed cavitating lung lesions during the follow-up. CONCLUSIONS This study shows that TCZ treatment may be effective in COVID-19 patients with severe respiratory impairment receiving NIV. More data on safety are required. Randomized controlled trials are needed to confirm these results.
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Affiliation(s)
- Francesco Menzella
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy.
| | - Matteo Fontana
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Carlo Salvarani
- Division of Rheumatology, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Massari
- Infectious Disease Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Patrizia Ruggiero
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Chiara Scelfo
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Chiara Barbieri
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Claudia Castagnetti
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Chiara Catellani
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Giorgia Gibellini
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Francesco Falco
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Giulia Ghidoni
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Francesco Livrieri
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Gloria Montanari
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Eleonora Casalini
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Roberto Piro
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Ghidorsi
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Nicola Facciolongo
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
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Pozzato N, Piva E, Pallante I, Bombana D, Stella R, Zanardello C, Tata A, Piro R. Rapid detection of asperphenamate in a hay batch associated with constipation and deaths in dairy cattle. The application of DART-HRMS to veterinary forensic toxicology. Toxicon 2020; 187:122-128. [PMID: 32891666 DOI: 10.1016/j.toxicon.2020.08.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/18/2020] [Accepted: 08/30/2020] [Indexed: 12/19/2022]
Abstract
Direct analysis in real time (DART) coupled to high-resolution mass spectrometry (HRMS) was applied for the first time to veterinary forensic toxicology to investigate the presence of toxic compounds in hay after an episode of acute intoxication in a dairy cattle farm. In addition to gross field necropsy and histological examination, microbial cultures, and heavy metals analysis, the molecular fingerprinting of the suspected hay batch was investigated by DART-HRMS. DART-HRMS revealed a distinct signal of m/z 507.2289 in the hay batch thought to be associated with the digestive complications. A search on chemical structure databases matched the ion with asperphenamate, a toxin produced by Penicillium spp. and Aspergillus spp. Liquid Chromatography-HMRS analysis and electrospray-HRMS-MS/MS of the hay extracts further characterized the structure and confirmed the identification of the compound as asperphenamate. Asperphenamate is fungal metabolite which can have cytotoxic and antitumor activity in humans, and it is classified as acute toxicant and harmful if swallowed.
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Affiliation(s)
- Nicola Pozzato
- Laboratorio di Diagnostica Clinica e Sierologia di Piano, SCT1 Verona e Vicenza, Istituto Zooprofilattico Sperimentale delle Venezie, Via San Giacomo, 5, Verona, 37135, Italy.
| | - Elena Piva
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Viale Fiume, 78, Vicenza, 36100, Italy.
| | - Ivana Pallante
- Laboratorio di Diagnostica Clinica e Sierologia di Piano, SCT1 Verona e Vicenza, Istituto Zooprofilattico Sperimentale delle Venezie, Via San Giacomo, 5, Verona, 37135, Italy.
| | - Dino Bombana
- Veterinary Practitioner, Villafranca di Verona, 37069, Italy.
| | - Roberto Stella
- Laboratorio residui e farmaci, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università, 10, Legnaro, 35020, Italy.
| | - Claudia Zanardello
- Laboratorio di Diagnostica Specialistica e istopatologia, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università, 10, Legnaro, 35020, Italy.
| | - Alessandra Tata
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Viale Fiume, 78, Vicenza, 36100, Italy.
| | - Roberto Piro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Viale Fiume, 78, Vicenza, 36100, Italy.
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Marchioni A, Andrisani D, Tonelli R, Piro R, Andreani A, Cappiello GF, Meschiari E, Dominici M, Bavieri M, Barbieri F, Taddei S, Casalini E, Falco F, Gozzi F, Bruzzi G, Fantini R, Tabbì L, Castaniere I, Facciolongo N, Clini E. Integrated intErventional bronchoscopy in the treatment of locally adVanced non-small lung cancER with central Malignant airway Obstructions: a multicentric REtrospective study (EVERMORE). Lung Cancer 2020; 148:40-47. [PMID: 32795722 DOI: 10.1016/j.lungcan.2020.07.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/15/2020] [Accepted: 07/27/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Despite new therapeutic perspectives, the presence of central airways occlusion (CAO) in patients with locally advanced non-small cell lung cancer (NSCLC) is associated with poor survival. There is no clear evidence on the clinical impact of interventional bronchoscopy as a part of an integrated treatment to cure these patients. MATERIALS AND METHODS This retrospective cohort study was conducted in two teaching hospitals over a 10 years period (January 2010-January 2020) comparing patients with NSCLC at stage IIIB and CAO at disease onset treated with chemotherapy/radiotherapy (standard therapy-ST) with those receiving interventional bronchoscopy plus ST (integrated treatment-IT). Primary outcome was 1-year survival. The onset of respiratory events, symptoms-free interval, hospitalization, need for palliation, and overall mortality served as secondary outcomes. RESULTS A total of 100 patients were included, 60 in the IT and 40 in the ST group. Unadjusted Kaplan-Meier estimates showed greater effect of IT compared to ST on 1-year survival (HR = 2.1 95%CI[1.1-4.8], p = 0.003). IT showed a significantly higher survival gain over ST in those patients showing KRAS mutation (7.6 VS 0.8 months,<0.0001), a lumen occlusion >65% (6.6 VS 2.9 months,<0.001), and lacking the involvement of left bronchus (7 VS 2.3 months,<0.0001). Compared to ST, IT also showed a favorable difference in terms of new hospitalizations (p = 0.03), symptom-free interval (p = 0.02), and onset of atelectasis (p = 0.01). CONCLUSIONS In patients with NSCLC stage IIIB and CAO, additional interventional bronchoscopy might impact on 1-year survival. Genetic and anatomic phenotyping might allow identifying those patients who may gain life expectancy from the endoscopic intervention.
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Affiliation(s)
- Alessandro Marchioni
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
| | - Dario Andrisani
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy; Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Modena, Italy.
| | - Roberto Tonelli
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy; Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Modena, Italy.
| | - Roberto Piro
- Respiratory Diseases Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Alessandro Andreani
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
| | - Gaia Francesca Cappiello
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
| | - Emmanuela Meschiari
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
| | - Massimo Dominici
- University Hospital of Modena, Oncology Unit, University of Modena Reggio Emilia, Modena, Italy.
| | - Mario Bavieri
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
| | - Fausto Barbieri
- University Hospital of Modena, Oncology Unit, University of Modena Reggio Emilia, Modena, Italy.
| | - Sofia Taddei
- Respiratory Diseases Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Eleonora Casalini
- Respiratory Diseases Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Francesco Falco
- Respiratory Diseases Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Filippo Gozzi
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
| | - Giulia Bruzzi
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
| | - Riccardo Fantini
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
| | - Luca Tabbì
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
| | - Ivana Castaniere
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy; Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Modena, Italy.
| | - Nicola Facciolongo
- Respiratory Diseases Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Enrico Clini
- University Hospital of Modena, Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy.
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Contoli M, Rogliani P, Di Marco F, Braido F, Corsico AG, Amici CA, Piro R, Sarzani R, Lessi P, Scognamillo C, Scichilone N, Santus P. Satisfaction with chronic obstructive pulmonary disease treatment: results from a multicenter, observational study. Ther Adv Respir Dis 2020; 13:1753466619888128. [PMID: 31760881 PMCID: PMC6878607 DOI: 10.1177/1753466619888128] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Indexed: 12/28/2022] Open
Abstract
Background: Understanding the level of patients’ satisfaction with treatment and its determinants have the potential to impact therapeutic management and clinical outcome in chronic conditions such as chronic obstructive pulmonary disease (COPD). Methods: A national, multicenter, longitudinal, observational study of COPD from 20 Italian pulmonary centers to explore patients’ satisfaction to treatment [assessed by the Treatment Satisfaction Questionnaire, 9 items (TSQM-9)] and association with clinical parameters [including dyspnea score, COPD Assessment Test (CAT) score, exacerbation rate], adherence to treatment [Morisky Medication-Taking Adherence Scale (MMAS-4)], illness perception [evaluated by Brief Illness Perception Questionnaire (B-IPQ)] in a 1-year follow up. Results: A total of 401 COPD patients were enrolled [69.4% group B Global Initiative for COPD (GOLD), considering 366 patients with available GOLD 2017 classification at enrollment]. At enrollment, satisfaction with treatment was moderate, being TSQM-9 mean scores for effectiveness 64.2 [95% confidence interval (CI) 62.5–65.9], for convenience 75.8 (95% CI 74.2–77.3), and for global satisfaction 65.7 (95% CI 64.0–67.4). Global satisfaction was negatively associated with disease perception (β = −0.4709, p < 0.0001), and grade of dyspnea (β = −4.2564, p = 0.009). Satisfaction with treatment was lower in patients with poor compared with optimal adherence to treatment (β = −4.5608, p = 0.002). Changes in inhalation regimens during follow up did not modify the satisfaction with treatment. Conclusions: The results of this real-life study showed that the patients’ satisfaction with treatments is only moderate in COPD. A high grade of patients’ satisfaction is associated mainly with a low perception of the disease, high adherence to treatment and lower level of dyspnea. Trial Registration: Clinicaltrials.gov identifier: NCT02689492 The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Marco Contoli
- Department of Medical Sciences, University of Ferrara, Emilia-Romagna, Italy
| | - Paola Rogliani
- Department of Experimental Medicine, University of Rome 'Tor Vergata,' Rome, Italy
| | - Fabiano Di Marco
- Department of Health Science, Università di Milano, Bergamo, Italy
| | - Fulvio Braido
- Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Angelo G Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | | | - Roberto Piro
- Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy
| | - Riccardo Sarzani
- Internal Medicine and Geriatrics, Università Politecnica delle Marche and IRCCS-INRCA, Ancona, Italy
| | | | | | | | - Pierachille Santus
- Department of Biomedical and Clinical Sciences (DIBIC), Università di Milano, Division of Respiratory Diseases, 'L. Sacco' Hospital, Via G.B. Grassi 74, Milan 20157, Italy
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Brera C, Debegnach F, Minardi V, Pannunzi E, Santis BD, Miraglia M, Bergamini C, Biancardi A, Bodda M, Bonassisa L, Burdaspal P, Cantamessa L, Chessa G, Commissati I, Corrao A, Dömsödi J, Esposito G, Focardi C, Garbini D, Gatti M, Gibellino C, Kroeger K, Lombardi FM, Mambelli P, Mastrantoni J, Michelet JY, Møller T, Pascale M, Petrini C, Pietri A, Piombino M, Piro R, Pittet A, Rizzi N, Stroka J, Thim AM, Ubaldi A, Villani A, Zanon F. Immunoaffinity Column Cleanup with Liquid Chromatography for Determination of Aflatoxin B1 in Corn Samples: Interlaboratory Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/90.3.765] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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
An interlaboratory study was conducted to evaluate the effectiveness of an immunoaffinity column cleanup liquid chromatography (LC) method for the determination of aflatoxin B1 levels in corn samples, enforced by European Union legislation. A test portion was extracted with methanolwater (80 + 20); the extract was filtered, diluted with phosphate-buffered saline solution, filtered on a microfiber glass filter, and applied to an immunoaffinity column. The column was washed with deionized water to remove interfering compounds, and the purified aflatoxin B1 was eluted with methanol. Aflatoxin B1 was separated and determined by reversed-phase LC with fluorescence detection after either pre- or postcolumn derivatization. Precolumn derivatization was achieved by generating the trifluoroacetic acid derivative, used by 8 laboratories. The postcolumn derivatization was achieved either with pyridinium hydrobromide perbromide, used by 16 laboratories, or with an electrochemical cell by the addition of bromide to the mobile phase, used by 5 laboratories. The derivatization techniques used were not significantly different when compared by the Student's t-test; the method was statistically evaluated for all the laboratories. Five corn sample materials, both spiked and naturally contaminated, were sent to 29 laboratories (22 Italian and 7 European). Test portions were spiked with aflatoxin B1 at levels of 2.00 and 5.00 ng/g. The mean values for recovery were 82% for the low level and 84% for the high contamination level. Based on results for spiked samples (blind pairs at 2 levels) as well as naturally contaminated samples (blind pairs at 3 levels), the values for relative standard deviation for repeatability (RSDr) ranged from 9.9 to 28.7%. The values for relative standard deviation for reproducibility (RSDR) ranged from 18.6 to 36.8%. The method demonstrated acceptable within- and between-laboratory precision for this matrix, as evidenced by the HorRat values.
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Affiliation(s)
- Carlo Brera
- Italian National Institute for Health (ISS), National Center for Food Quality and Risk Assessment, GMO and Mycotoxins Unit, Viale Regina Elena, 299-00161 Rome, Italy
| | - Francesca Debegnach
- Italian National Institute for Health (ISS), National Center for Food Quality and Risk Assessment, GMO and Mycotoxins Unit, Viale Regina Elena, 299-00161 Rome, Italy
| | - Valentina Minardi
- Italian National Institute for Health (ISS), National Center for Food Quality and Risk Assessment, GMO and Mycotoxins Unit, Viale Regina Elena, 299-00161 Rome, Italy
| | - Elena Pannunzi
- Italian National Institute for Health (ISS), National Center for Food Quality and Risk Assessment, GMO and Mycotoxins Unit, Viale Regina Elena, 299-00161 Rome, Italy
| | - Barbara De Santis
- Italian National Institute for Health (ISS), National Center for Food Quality and Risk Assessment, GMO and Mycotoxins Unit, Viale Regina Elena, 299-00161 Rome, Italy
| | - Marina Miraglia
- Italian National Institute for Health (ISS), National Center for Food Quality and Risk Assessment, GMO and Mycotoxins Unit, Viale Regina Elena, 299-00161 Rome, Italy
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Piro R, Tonelli R, Taddei S, Marchioni A, Musci G, Clini E, Facciolongo N. Atypical diagnosis for typical lung carcinoid. BMC Pulm Med 2019; 19:168. [PMID: 31477066 PMCID: PMC6719370 DOI: 10.1186/s12890-019-0929-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 08/27/2019] [Indexed: 11/30/2022] Open
Abstract
Background The diagnosis of lung typical carcinoid tumors results challenging when limited size and unfavorable sampling location is associated. It has been reported that bronchoscopy with endobronchial ultrasound (EBUS) significantly increases the diagnostic yield of peripheral nodules smaller than 2 cm. Case presentation A 70-year-old Caucasian male complained of persistent fever and cough despite several antibiotic courses and steroid treatment. Chest radiology revealed the presence of a small single nodular opacity in the left upper lobe, whose standardized maximum uptake value (SUV) at fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) was significantly high (4.5). The patient underwent bronchial endoscopy but any appreciable sign of endobronchial or intramural involvement was detected. Only radial ultrasound-guided bronchoscopy (R-EBUS) allowed transbronchial sampling whose pathological analysis revealed a typical carcinoid tumor. The patients underwent surgical lobectomy and clinic-radiological follow was started. Conclusions With this case we aim at stressing the importance of ultrasound in the diagnostic process of lung small peripheral carcinoid, especially if they present without mucosal or sub mucosal involvement.
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Affiliation(s)
- Roberto Piro
- Respiratory Diseases Unit, Azienda Unità Sanitaria Locale - IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Roberto Tonelli
- Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy
| | - Sofia Taddei
- Respiratory Diseases Unit, Azienda Unità Sanitaria Locale - IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy.
| | - Alessandro Marchioni
- Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy
| | - Giovanni Musci
- Pathology Unit Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Enrico Clini
- Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy
| | - Nicola Facciolongo
- Respiratory Diseases Unit, Azienda Unità Sanitaria Locale - IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
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Lococo F, Di Stefano T, Rapicetta C, Piro R, Gelli MC, Muratore F, Ricchetti T, Taddei S, Zizzo M, Cesario A, Facciolongo N, Paci M. Thoracic Hyper-IgG4-Related Disease Mimicking Malignant Pleural Mesothelioma. Lung 2019; 197:387-390. [PMID: 30941506 DOI: 10.1007/s00408-019-00224-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 03/26/2019] [Indexed: 01/13/2023]
Abstract
We report a rare case of a IgG4-related disease presenting with recurrent pleural effusion, pleural thickness and multiple mediastinal lymphadenopathies and no involvement of other extrathoracic organs. A 65-year-old man with a previous asbestos exposure presented with cough and pain discomfort. A large right pleural effusion was detected and evacuated (siero-haematic liquid). With the suspicious of a pleural mesothelioma, a CT-scan before and a 18F-FDG PET/CT-scan later were performed revealing multiple pleural thickenings and multiple mediastinal lymphadenopathies with radiotracer uptake. EBUS-TBNA EBUS-TBNA did not result in a formal pathological diagnosis; thus, multiple pleural biopsy were performed via right thoracoscopy. At pathology the pleura was markedly thickened by a chronic fibroinflammatory process with scattered lymphoid follicles and a large number of mature plasma cells. Immunohistochemistry shows a mixed B (CD20+) and T (CD3+) population of lymphocytes, without light chain restriction and an increased number of IgG4-positive plasma cells. A presumptive diagnosis of IgG4-related disease was formulated. Total body CT-scan excluded other organ involvement. Blood test showed elevated serum IgG4 concentrations (253 mg/dL) and mild elevation of acute-phase reactants (C-reactive protein 10.7 mg/L). Autoimmune profile was negative. A diagnosis of definite IgG4-related disease was made, and treatment with prednisone 50 mg/day was started.
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Affiliation(s)
- Filippo Lococo
- Unit of Thoracic Surgery, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Teresa Di Stefano
- Unit of Thoracic Surgery, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cristian Rapicetta
- Unit of Thoracic Surgery, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Roberto Piro
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Carolina Gelli
- Unit of Pathology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Muratore
- Unit of Reumatology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Tommaso Ricchetti
- Unit of Thoracic Surgery, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Sofia Taddei
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Unit of Surgical Oncology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alfredo Cesario
- Direzione Scientifica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - Nicola Facciolongo
- Pulmonology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimiliano Paci
- Unit of Thoracic Surgery, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Miano B, Righetti L, Piro R, Dall’Asta C, Folloni S, Galaverna G, Suman M. Direct analysis real-time–high-resolution mass spectrometry for Triticum species authentication. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2018; 35:2291-2297. [DOI: 10.1080/19440049.2018.1520398] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Brunella Miano
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università, Legnaro, Italy
| | - Laura Righetti
- Department of Food and Drug, University of Parma, Parma, Italy
| | - Roberto Piro
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università, Legnaro, Italy
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Facciolongo N, Di Stefano A, Pietrini V, Galeone C, Bellanova F, Menzella F, Scichilone N, Piro R, Bajocchi GL, Balbi B, Agostini L, Salsi PP, Formisano D, Lusuardi M. Nerve ablation after bronchial thermoplasty and sustained improvement in severe asthma. BMC Pulm Med 2018; 18:29. [PMID: 29422039 PMCID: PMC5806286 DOI: 10.1186/s12890-017-0554-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/07/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Bronchial thermoplasty (BT) is a non-pharmacological intervention for severe asthma whose mechanism of action is not completely explained by a reduction of airway smooth muscle (ASM). In this study we analyzed the effect of BT on nerve fibers and inflammatory components in the bronchial mucosa at 1 year. METHODS Endobronchial biopsies were obtained from 12 subjects (mean age 47 ± 11.3 years, 50% male) with severe asthma. Biopsies were performed at baseline (T0) and after 1 (T1), 2 (T2) and 12 (T12) months post-BT, and studied with immunocytochemistry and microscopy methods. Clinical data including Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Questionnaire (ACQ) scores, exacerbations, hospitalizations, oral corticosteroids use were also collected at the same time points. RESULTS A statistically significant reduction at T1, T2 and T12 of nerve fibers was observed in the submucosa and in ASM compared to T0. Among inflammatory cells, only CD68 showed significant changes at all time points. Improvement of all clinical outcomes was documented and persisted at the end of follow up. CONCLUSIONS A reduction of nerve fibers in epithelium and in ASM occurs earlier and persists at one year after BT. We propose that nerve ablation may contribute to mediate the beneficial effects of BT in severe asthma. TRIAL REGISTRATION Registered on April 2, 2013 at ClinicalTrials.gov Identifier: NCT01839591 .
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Affiliation(s)
- N Facciolongo
- Department of Medical Specialties, Pulmonology Unit, Arcispedale Santa Maria Nuova - IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy.
| | - A Di Stefano
- Pulmunology Unit and Laboratory of Citoimmunopatology, Istituti Clinici Scientifici Maugeri SpA, SB, IRCCS, Veruno (NO), Italy
| | - V Pietrini
- Department of Neurosciences, Laboratory of Neuropathology, University of Parma, Parma, Italy
| | - C Galeone
- Department of Medical Specialties, Pulmonology Unit, Arcispedale Santa Maria Nuova - IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - F Bellanova
- Department of Neurosciences, Laboratory of Neuropathology, University of Parma, Parma, Italy
| | - F Menzella
- Department of Medical Specialties, Pulmonology Unit, Arcispedale Santa Maria Nuova - IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - N Scichilone
- Departement of Biomedicine and Medical Specialties, Pulmonology Unit, University of Palermo, Palermo, Italy
| | - R Piro
- Department of Medical Specialties, Pulmonology Unit, Arcispedale Santa Maria Nuova - IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - G L Bajocchi
- Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - B Balbi
- Pulmunology Unit and Laboratory of Citoimmunopatology, Istituti Clinici Scientifici Maugeri SpA, SB, IRCCS, Veruno (NO), Italy
| | - L Agostini
- Department of Medical Specialties, Pulmonology Unit, Arcispedale Santa Maria Nuova - IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - P P Salsi
- Anesthesiology and Critical Care Unit, Arcispedale Santa Maria Nuova -IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - D Formisano
- Research and Statistics, Arcispedale Santa Maria Nuova -IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy
| | - M Lusuardi
- Pulmonary Rehabilitation, S. Sebastiano Hospital, Correggio (RE), Azienda USL di Reggio Emilia, Reggio Emilia, Italy
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Costantini M, Apolone G, Tanzi S, Falco F, Rondini E, Guberti M, Fanello S, Cavuto S, Savoldi L, Piro R, Mecugni D, Di Leo S. Is early integration of palliative care feasible and acceptable for advanced respiratory and gastrointestinal cancer patients? A phase 2 mixed-methods study. Palliat Med 2018; 32:46-58. [PMID: 28952881 DOI: 10.1177/0269216317731571] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 12/25/2022]
Abstract
BACKGROUND There is evidence that early integration of palliative care improves quality of life, lowers spending and helps clarify preferences and goals for advanced cancer patients. Little is known about the feasibility and acceptability of early integration. AIM Assessing feasibility of early integration of palliative care, and exploring concerns perceived and problems encountered by patients, relatives and oncologists. DESIGN A phase 2 mixed-methods study ( ClinicalTrials.Gov :NCT02078700). METHODS Oncologists of two outpatient clinics offered a specialised palliative care intervention integrated with standard oncological care to all consecutive newly diagnosed metastatic respiratory/gastrointestinal cancer patients. We interviewed samples of patients, relatives and oncologists to explore strengths and weaknesses of the intervention. RESULTS The intervention was proposed to 44/54 eligible patients (81.5%), 40 (90.1%) accepted, 38 (95.0%) attended the first palliative care visit. The intervention was completed for 32 patients (80.0%). It did not start for three (7.5%) and was interrupted for three patients who refused (7.5%). The Palliative Care Unit performed 274 visits in 38 patients (median per patient 4.5), and 24 family meetings with relatives of 16 patients. All patients and most relatives referred to the usefulness of the intervention, specifically for symptoms management, information and support to strategies for coping. Oncologists highlighted their difficulties in informing patients on palliative intervention, sharing information and coordinating patient's care with the palliative care team. CONCLUSION Early integration of palliative care in oncological setting seems feasible and well accepted by patients, relatives and, to a lesser extent, oncologists. Some difficulties emerged concerning patient information and inter-professional communication.
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Affiliation(s)
| | | | - Silvia Tanzi
- 3 Palliative Care Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Francesco Falco
- 4 Pulmonology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Ermanno Rondini
- 5 Oncology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Monica Guberti
- 6 Department of Health Professions, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Silvia Fanello
- 5 Oncology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Silvio Cavuto
- 7 Department Infrastructure Research and Statistics, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Luisa Savoldi
- 7 Department Infrastructure Research and Statistics, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Roberto Piro
- 4 Pulmonology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Daniela Mecugni
- 8 Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Silvia Di Leo
- 9 Psycho-Oncology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
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Tenconi S, Galeone C, Fugazzaro S, Rapicetta C, Piro R, Formisano D. F-079PERIOPERATIVE AND LONG-TERM EFFECTS OF COMPREHENSIVE PULMONARY REHABILITATION ON EXERCISE CAPACITY, POSTOPERATIVE OUTCOME AND QUALITY OF LIFE IN PATIENTS UNDERGOING LUNG RESECTION: A RANDOMIZED CONTROLLED TRIAL GRANTED BY THE MINISTRY OF HEALTH. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fugazzaro S, Costi S, Mainini C, Kopliku B, Rapicetta C, Piro R, Bardelli R, Rebelo PFS, Galeone C, Sgarbi G, Lococo F, Paci M, Ricchetti T, Cavuto S, Merlo DF, Tenconi S. PUREAIR protocol: randomized controlled trial of intensive pulmonary rehabilitation versus standard care in patients undergoing surgical resection for lung cancer. BMC Cancer 2017; 17:508. [PMID: 28760151 PMCID: PMC5537935 DOI: 10.1186/s12885-017-3479-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 07/10/2017] [Indexed: 02/08/2023] Open
Abstract
Background Non-small cell lung cancer is the most common type of lung cancer. Surgery is proven to be the most effective treatment in early stages, despite its potential impact on quality of life. Pulmonary rehabilitation, either before or after surgery, is associated with reduced morbidity related symptoms and improved exercise capacity, lung function and quality of life. Methods We describe the study protocol for the open-label randomized controlled trial we are conducting on patients affected by primary lung cancer (stages I-II) eligible for surgical treatment. The control group receives standard care consisting in one educational session before surgery and early inpatient postoperative physiotherapy. The treatment group receives, in addition to standard care, intensive rehabilitation involving 14 preoperative sessions (6 outpatient and 8 home-based) and 39 postoperative sessions (15 outpatient and 24 home-based) with aerobic, resistance and respiratory training, as well as scar massage and group bodyweight exercise training. Assessments are performed at baseline, the day before surgery and one month and six months after surgery. The main outcome is the long-term exercise capacity measured with the Six-Minute Walk Test; short-term exercise capacity, lung function, postoperative morbidity, length of hospital stay, quality of life (Short Form 12), mood disturbances (Hospital Anxiety and Depression Scale) and pain (Numeric Rating Scale) are also recorded and analysed. Patient compliance and treatment-related side effects are also collected. Statistical analyses will be performed according to the intention-to-treat approach. T-test for independent samples will be used for continuous variables after assessment of normality of distribution. Chi-square test will be used for categorical variables. Expecting a 10% dropout rate, assuming α of 5% and power of 80%, we planned to enrol 140 patients to demonstrate a statistically significant difference of 25 m at Six-Minute Walk Test. Discussion Pulmonary Resection and Intensive Rehabilitation study (PuReAIR) will contribute significantly in investigating the effects of perioperative rehabilitation on exercise capacity, symptoms, lung function and long-term outcomes in surgically treated lung cancer patients. This study protocol will facilitate interpretation of future results and wide application of evidence-based practice. Trial registration ClinicalTrials.gov Registry n. NCT02405273 [31.03.2015].
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Affiliation(s)
- Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy. .,Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Via del Pozzo n°71, 41124, Modena, Italy. .,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, L.go P. Daneo n°3, 16132, Genoa, Italy.
| | - Carlotta Mainini
- Physical Medicine and Rehabilitation Unit - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Besa Kopliku
- Physical Medicine and Rehabilitation Unit - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Cristian Rapicetta
- Unit of Thoracic Surgery - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Roberto Piro
- Pulmonology Unit - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Roberta Bardelli
- Physical Medicine and Rehabilitation Unit - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Patricia Filipa Sobral Rebelo
- Physical Medicine and Rehabilitation Unit - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Carla Galeone
- Unit of Thoracic Surgery - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Giorgio Sgarbi
- Unit of Thoracic Surgery - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Filippo Lococo
- Unit of Thoracic Surgery - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Massimiliano Paci
- Unit of Thoracic Surgery - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Tommaso Ricchetti
- Unit of Thoracic Surgery - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Silvio Cavuto
- Research and Statistics Infrastructure Unit, Arcispedale Santa Maria Nuova-IRCCS, Viale Umberto I n°50, 42123, Reggio Emilia, Italy
| | - Domenico Franco Merlo
- Research and Statistics Infrastructure Unit, Arcispedale Santa Maria Nuova-IRCCS, Viale Umberto I n°50, 42123, Reggio Emilia, Italy
| | - Sara Tenconi
- Unit of Thoracic Surgery - Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
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Aliberti S, Ramirez J, Giuliani F, Wiemken T, Sotgiu G, Tedeschi S, Carugati M, Valenti V, Marchioni M, Camera M, Piro R, Del Forno M, Milani G, Faverio P, Richeldi L, Deotto M, Villani M, Voza A, Tobaldini E, Bernardi M, Bellone A, Bassetti M, Blasi F. Individualizing duration of antibiotic therapy in community-acquired pneumonia. Pulm Pharmacol Ther 2017; 45:191-201. [PMID: 28666965 DOI: 10.1016/j.pupt.2017.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/24/2017] [Accepted: 06/26/2017] [Indexed: 11/19/2022]
Abstract
International experts suggest tailoring antibiotic duration in community-acquired pneumonia (CAP) according to patients' characteristics. We aimed to assess the effectiveness of an individualized approach to antibiotic duration based on time in which CAP patients reach clinical stability during hospitalization. In a multicenter, non-inferiority, randomized, controlled trial hospitalized adult patients with CAP reaching clinical stability within 5 days after hospitalization were randomized to a standard vs. individualized antibiotic duration. In the Individualized group, antibiotics were discontinued 48 h after the patient reached clinical stability, with at least five days of total antibiotic treatment. Early failure within 30 days was the primary composite outcome. 135 patients were randomized to the Standard group and 125 to the Individualized group. The trial was interrupted by the safety committee because of an apparent inferiority of the Individualized group over the Standard treatment: 14 (11.2%) patients in the Individualized group experienced early failure vs. 10 (7.4%) patients in the Standard group, p = 0.200, at the intention-to-treat analysis. 30-day mortality rate was four-time higher in the Individualized group than the Standard group. Shortening antibiotic duration according to patients' characteristics still remains an open question.
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Affiliation(s)
- Stefano Aliberti
- Department of Pathophysiology and Transplantation, University of Milan, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Julio Ramirez
- University of Louisville, School of Medicine, Department of Medicine, Division of Infectious Diseases, Louisville, KY, United States
| | - Fabio Giuliani
- Department of Pathophysiology and Transplantation, University of Milan, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Timothy Wiemken
- University of Louisville, School of Medicine, Department of Medicine, Division of Infectious Diseases, Louisville, KY, United States
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassari - Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy
| | - Sara Tedeschi
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant'Orsola Malpighi Hospital, Alma Mater Studiorum University of Bologna, Italy
| | - Manuela Carugati
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Valenti
- Department of Health Bioscience, University of Milan - Respiratory Unit, Policlinico di San Donato, IRCCS - San Donato Milanese, Milan, Italy
| | | | - Marco Camera
- Clinica Malattie Infettive, DIPMI, DISSAL, IRCCS AOU San Martino-IST, Università di Genova, Genova, Italy
| | - Roberto Piro
- Pulmonology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Manuela Del Forno
- Respiratory and Critical Care, Sant'Orsola Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), Bologna, Italy
| | - Giuseppe Milani
- UO Pneumologia, ASST Lariana Ospedale S.Anna, S. Fermo della Battaglia, Como, Italy
| | - Paola Faverio
- School of Medicine and Surgery, University of Milan Bicocca, San Gerardo Hospital, Monza, Italy
| | - Luca Richeldi
- National Institute for Health Research Respiratory Biomedical Research Unit, Mailpoint 813, LE75 E Level, South Academic Block, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Martina Deotto
- Division of Internal Medicine, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy
| | - Massimiliano Villani
- Dipartimento Cardio-Respiratorio, Unità Operativa di Pneumologia, San Carlo Borromeo Hospital, Via Pio II, 3, 20153 Milan, Italy
| | - Antonio Voza
- U.O. di Pronto Soccorso e Medicina d'Urgenza, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Eleonora Tobaldini
- Fondazione IRCSS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Mauro Bernardi
- Semeiotica Medica, Policlinico Sant'Orsola Malpighi, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Andrea Bellone
- Department of Emergency Medicine, San Anna Hospital, San Fermo della Battaglia, Como, Italy
| | - Matteo Bassetti
- Santa Maria Misericordia University Hospital, Infectious Diseases Division, Udine, Italy
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, University of Milan, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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50
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Lococo F, Galeone C, Lasagni L, Carbonelli C, Tagliavini E, Piro R, Zucchi L, Sgarbi G. Endobronchial Hamartoma Subtotally Occluding the Right Main Bronchus and Mimicking Bronchial Carcinoid Tumor. Medicine (Baltimore) 2016; 95:e3369. [PMID: 27082600 PMCID: PMC4839844 DOI: 10.1097/md.0000000000003369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Hamartomas are very rarely identified as an endobronchial lesion. Herein, we describe a peculiar case of a 55-year-old woman with persistent cough and increasing dyspnea and radiological detection of a solid lesion subtotally occluding the main right bronchus. Despite the radiological and radiometabolic (18-fluoro-2-deoxy-d-glucose positron emission tomography/computer tomography scan) features were highly suspected for bronchial carcinoid, the definitive diagnosis after endoscopic removal was indicative of an endobronchial hamartoma. When considering differential diagnosis of an endobronchial lesion, the physicians should take firmly in mind such rare entity and, accordingly, bronchoscopy and bronchoscopic biopsy should be done as first step in management of all cases presenting with endobronchial lesions.
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Affiliation(s)
- Filippo Lococo
- From the Unit of Thoracic Surgery (FL, CG, GS); Pulmonology Unit (LL, CC, RP, LZ); and Unit of Pathology (ET), Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
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