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Slouha E, Ibrahim F, Esposito S, Mursuli O, Rezazadah A, Clunes LA, Kollias TF. Botulinum Toxin for the Management of Parkinson's Disease: A Systematic Review. Cureus 2024; 16:e53309. [PMID: 38435899 PMCID: PMC10906698 DOI: 10.7759/cureus.53309] [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] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Parkinson's disease (PD) is a terminal, debilitating neurodegenerative disorder typically affecting individuals over 60. It is associated with various conditions that drastically affect the patient's quality of life (QoL). Although there is no cure for PD, its symptoms can be significantly improved and even resolved through different treatments. Mainstay treatments for PD include levodopa combined with carbidopa, dopamine agonists, and even deep brain stimulation (DBS) of the subthalamic nucleus. New treatment methods have emerged, such as botulinum toxin (BoNT), which further improve symptoms and, thus, the QoL of patients with PD. Botulinum toxin is a potent neurotoxin produced by Clostridium botulinum that typically causes descending paralysis by suppressing acetylcholine secretion. Serotypes used to treat various disorders include serotype A (BoNT-A) and serotype B (BoNT-B). This paper aims to evaluate the outcomes of BoNT injection on different symptoms associated with PD. An extensive review using PubMed, ScienceDirect, and ProQuest articles concerning 'botulinum toxin and Parkinson's disease' was done per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, resulting in 23,803 articles. After applying strict inclusion and exclusion criteria, the total number of articles was finally 41. The results showed that movement disorders were a common occurrence in PD, consisting of tremors, dystonia, and freezing of gait (FOG), with tremors being the most common symptom. Tremors and dystonia were significantly improved following BoNT-A, correlating with significant improvements in various scales subjectively and objectively evaluating the symptoms and QoL. In contrast, FOG was not significantly improved by either BoNT-A or BoNT-B. Pain is associated with movement disorders such as PD and was the primary indication for the administration of BoNT; studies found pain and QoL were significantly improved following BoNT injection. Quality of life can also be affected by sialorrhea and overactive bladder, which often occur as the disease progresses. Injections of BoNT-A and BoNT-B were shown to significantly improve saliva production, flow rate, drooling frequency, voiding frequency, and urinary urge incontinence. Across all studies analyzed, it is evident that BoNT may have a significant effect on improving the QoL of patients suffering from PD. While research continues to find a cure or stop the progression of PD, it remains critical to continue focusing on improving patients' QoL. Future research should evaluate whether BoNT can be used to successfully treat other symptoms of PD, such as epiphora or constipation.
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Affiliation(s)
- Ethan Slouha
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Fadi Ibrahim
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Sarah Esposito
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Odelin Mursuli
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Atbeen Rezazadah
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Lucy A Clunes
- Pharmacology, St George's University School of Medicine, St George's, GRD
| | - Theofanis F Kollias
- Microbiology, Immunology, and Pharmacology, St. George's University School of Medicine, St. George's, GRD
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2
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Slouha E, Ibrahim F, Rezazadah A, Esposito S, Clunes LA, Kollias TF. Anti-diabetics and the Prevention of Dementia: A Systematic Review. Cureus 2023; 15:e49515. [PMID: 38152822 PMCID: PMC10752751 DOI: 10.7759/cureus.49515] [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] [Accepted: 11/26/2023] [Indexed: 12/29/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a worldwide epidemic that is only increasing as the years progress, and as of 2019, affecting over 37 million. T2DM is a chronic condition caused by reduced insulin secretion and increased insulin resistance. Due to insulin not operating at optimal conditions, blood glucose rises and remains high, thus disturbing metabolic hemostasis. Many complications can arise from T2DM, such as coronary vascular disease, kidney damage, eye damage, and, quite significantly, dementia. It is theorized that dementia from T2DM stems from the fact that the brain is susceptible to hyperglycemic conditions, which are promoted by the increase in insulin resistance of target cells in the central nervous system. This directly affects cognitive processes and memory, which correlates to decreased temporal and front lobes volume. The risk of diabetic complications can be minimized with therapeutic interventions such as oral-antidiabetic (OAD) agents and insulin. Several OADs are on the market, but the first-line agent is metformin, a biguanide that decreases glucose production and increases insulin sensitivity. This paper aims to determine if currently prescribed OADs can help slow cognitive decline and reduce the risk and incidence of dementia as a complication of T2DM. Studies found that, for the most part, all OADs except sulfonylureas (SU) significantly slowed the decline of cognitive function and reduced the risk and incidence of dementia. SU's were shown to increase the risk of dementia in most studies. Of all the OADs, thiazolidinediones may be the most beneficial drug class for reducing the risk of dementia in T2DM patients. Future research should focus on whether early intervention with specific classes of OADs can not only improve glycemic control, leading to decreased hyperglycemia but also prevent the build-up of damaged brain tissue and help to reduce the risk and incidence of dementia in patients with T2DM.
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Affiliation(s)
- Ethan Slouha
- Anatomical Sciences, St. George's University School of Medicine, True Blue, GRD
| | - Fadi Ibrahim
- Pharmacology, St. George's University School of Medicine, True Blue, GRD
| | - Atbeen Rezazadah
- Pharmacology, St. George's University School of Medicine, True Blue, GRD
| | - Sarah Esposito
- Pharmacology, St. George's University School of Medicine, True Blue, GRD
| | - Lucy A Clunes
- Pharmacology, St. George's University, St George's, GRD
| | - Theofanis F Kollias
- Microbiology, Immunology and Pharmacology, St. George's University School of Medicine, True Blue, GRD
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3
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Taranto F, Esposito S, Fania F, Sica R, Marzario S, Logozzo G, Gioia T, De Vita P. Breeding effects on durum wheat traits detected using GWAS and haplotype block analysis. Front Plant Sci 2023; 14:1206517. [PMID: 37794940 PMCID: PMC10546023 DOI: 10.3389/fpls.2023.1206517] [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] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/08/2023] [Indexed: 10/06/2023]
Abstract
Introduction The recent boosting of genomic data in durum wheat (Triticum turgidum subsp. durum) offers the opportunity to better understand the effects of breeding on the genetic structures that regulate the expression of traits of agronomic interest. Furthermore, the identification of DNA markers useful for marker-assisted selection could also improve the reliability of technical protocols used for variety protection and registration. Methods Within this motivation context, 123 durum wheat accessions, classified into three groups: landraces (LR), ancient (OC) and modern cultivars (MC), were evaluated in two locations, for 34 agronomic traits, including UPOV descriptors, to assess the impact of changes that occurred during modern breeding. Results The association mapping analysis, performed with 4,241 SNP markers and six multi-locus-GWAS models, revealed 28 reliable Quantitative Trait Nucleotides (QTNs) related to plant morphology and kernel-related traits. Some important genes controlling flowering time and plant height were in linkage disequilibrium (LD) decay with QTNs identified in this study. A strong association for yellow berry was found on chromosome 6A (Q.Yb-6A) in a region containing the nadh-ubiquinone oxidoreductase subunit, a gene involved in starch metabolism. The Q.Kcp-2A harbored the PPO locus, with the associated marker (Ku_c13700_1196) in LD decay with Ppo-A1 and Ppo-A2. Interestingly, the Q.FGSGls-2B.1, identified by RAC875_c34512_685 for flag leaf glaucosity, mapped less than 1 Mb from the Epistatic inhibitors of glaucousness (Iw1), thus representing a good candidate for supporting the morphological DUS traits also with molecular markers. LD haplotype block approach revealed a higher diversity, richness and length of haploblocks in MC than OC and LR (580 in LR, 585 in OC and 612 in MC), suggesting a possible effect exerted by breeding programs on genomic regions associated with the agronomic traits. Discussion Our findings pave new ways to support the phenotypic characterization necessary for variety registration by using a panel of cost-effectiveness SNP markers associated also to the UPOV descriptors. Moreover, the panel of associated SNPs might represent a reservoir of favourable alleles to use in durum wheat breeding and genetics.
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Affiliation(s)
- F. Taranto
- Italian National Council of Research (CNR), Institute of Biosciences and Bioresources (IBBR), Bari, Italy
| | - S. Esposito
- Council for Agricultural Research and Economics (CREA), Research Centre for Cereal and Industrial Crops (CREA-CI), Foggia, Italy
| | - F. Fania
- Council for Agricultural Research and Economics (CREA), Research Centre for Cereal and Industrial Crops (CREA-CI), Foggia, Italy
- Department of Agriculture, Food, Natural Resources, and Engineering (DAFNE) - University of Foggia, Foggia, Italy
| | - R. Sica
- School of Agricultural, Forestry, Food and Environmental Sciences, University of Basilicata, Potenza, Italy
| | - S. Marzario
- School of Agricultural, Forestry, Food and Environmental Sciences, University of Basilicata, Potenza, Italy
| | - G. Logozzo
- School of Agricultural, Forestry, Food and Environmental Sciences, University of Basilicata, Potenza, Italy
| | - T. Gioia
- School of Agricultural, Forestry, Food and Environmental Sciences, University of Basilicata, Potenza, Italy
| | - P. De Vita
- Council for Agricultural Research and Economics (CREA), Research Centre for Cereal and Industrial Crops (CREA-CI), Foggia, Italy
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4
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Fainardi V, Skenderaj K, Ciuni A, Esposito S, Sverzellati N, Pisi G. Effect of elexacaftor-tezacaftor-ivacaftor modulator on lung structure in cystic fibrosis. Pulmonology 2023; 29:441-443. [PMID: 36564238 DOI: 10.1016/j.pulmoe.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 11/25/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- V Fainardi
- Department of Medicine and Surgery, Cystic Fibrosis Unit, Paediatric Clinic Pietro Barilla Children's Hospital, University of Parma, Parma, Italy.
| | - K Skenderaj
- Department of Medicine and Surgery, Cystic Fibrosis Unit, Paediatric Clinic Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | - A Ciuni
- Section of Radiology, Unit of Surgical Sciences, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - S Esposito
- Department of Medicine and Surgery, Cystic Fibrosis Unit, Paediatric Clinic Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | - N Sverzellati
- Section of Radiology, Unit of Surgical Sciences, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Pisi
- Department of Medicine and Surgery, Cystic Fibrosis Unit, Paediatric Clinic Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
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Bonaccio M, Di Castelnuovo A, Costanzo S, Ruggiero E, Esposito S, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Not all plant-based diets are associated with benefits on mortality: the Moli-sani Study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Vegetarians diets are characterized by the absence of some animal foods (e.g. red and processed meats), and a high consumption of plant-based foods. However, plant-based foods can include foods with varying nutritional value and health effects. We examined the association of three different pro-vegetarian (PVG) food patterns defined as general (gPVG), healthful (hPVG) and unhealthful (uPVG), with the risk of all-cause and cardiovascular disease (CVD) mortality in Italians.
Methods
Longitudinal analysis on 22,912 men and women (mean age 55±12 y) from the Moli-sani Study (2005-2010) followed up for 11.2 y (median). Food intake was assessed by a 188-item FFQ. A provegetarian food pattern (FP) was constructed by assigning positive scores to plant foods and reverse scores to animal foods. A healthful and an unhealthful pro-vegetarian FP, which distinguished between healthy (e.g. fruits, vegetables, legumes) and less-healthy plant foods (e.g. fruit juices, potatoes, sugary beverages), were also built up.
Results
In multivariable-adjusted analyses controlled for known risk factors, higher adherence to a gPVG was associated with lower all-cause (HR = 0.83; 95%CI 0.73-0.94) but not CVD mortality (HR = 0.90; 0.72-1.12). Increasing adherence to a hPVG was associated with reduced all-cause mortality risk (HR = 0.82; 0.72-0.95) as well as lower risk of CVD mortality (HR = 0.75; 0.59-0.95). Finally, the uPVG was directly associated with both all-cause (HR = 1.17; 1.03-1.33) and CVD mortality risks (HR = 1.23; 0.99-1.53).
Conclusions
A general pro-vegetarian food pattern was associated with longer survival in Italians. Preferring healthful vegetarian foods provided protection against CVD mortality too. Consistently, a large dietary share of unhealthful vegetarian foods, mostly highly processed, was associated with increased risk mortality. Thus the quality of the plant food consumed is paramount to achieve diet-related benefits on mortality.
Key messages
• A pro-vegetarian food pattern was associated with longer survival but preferring healthful vegetarian foods provided protection against CVD mortality too.
• The quality of the plant food consumed is paramount to achieve diet-related benefits on mortality.
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Affiliation(s)
- M Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | | | - S Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - E Ruggiero
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - S Esposito
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - M Persichillo
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - C Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - MB Donati
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - G de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - L Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
- Department of Medicine and Surgery, University of Insubria , Varese, Italy
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Bonaccio M, Di Castelnuovo A, Costanzo S, Ruggiero E, Esposito S, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Ultra-processed food consumption and survival in older Italians from the Moli-sani Study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Ultra-processed food (UPF) is a major public health concern being reportedly associated with increased risk of non-communicable diseases and lower survival. However, most of the epidemiological evidence has been almost exclusively provided by research conducted in populations of youths or middle-aged adults. We tested the hypothesis that a large dietary share of UPF could be a risk factor also for vulnerable groups, as older adults (≥65 years).
Methods
Longitudinal analysis on 5,215 men and women (mean age 72±5 y) from the Moli-sani Study (2005-2010, Italy) followed up for 10.9 y (median). Food intake was assessed by a 188-item FFQ. UPF was defined using the NOVA classification according to degree of processing, and categorized as quartiles of the ratio (%) between UPF (g/d) and total food consumed (g/d; weight ratio). The overall nutritional quality of the diet was measured by the Food Standard Agency nutrient profiling system dietary index (FSAm-NPS DI).
Results
UPF contributed to 8% (min-max 0.0-58.4%) of the total food eaten daily and represented 14.4% (0.0-70.0%) of daily energy intake. In multivariable-adjusted analyses controlled for known risk factors, higher intake of UPF (Q4, ≥10.2% of total food), as opposed to the lowest (Q1, UPF<4.3%), was associated with increased all-cause mortality (Hazard ratio [HR]=1.19; 95%CI 1.03-1.39); these results remained unchanged after adjustment for the FSAm-NPS DI (HR = 1.21; 95%CI, 1.04-1.41). A linear dose-response relationship of 1% increment in UPF intake with all-cause mortality was also observed (p = 0.017; p for non-linearity=0.85).
Conclusions
A large dietary share of UPF was associated with lower survival in older Italians consuming relatively low amounts of these foods. Expanding on previous studies on different age groups, these findings provide further justification to advise people to limit consumption of UPF even at older age.
Key messages
• A large dietary share of ultra-processed food was associated with lower survival in older Italians consuming relatively low amounts of these foods.
• These findings provide further justification to advise people to limit consumption of ultra-processed food even at older age.
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Affiliation(s)
- M Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | | | - S Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - E Ruggiero
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - S Esposito
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - M Persichillo
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - C Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - MB Donati
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - G de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
| | - L Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED , Pozzilli, Italy
- Department of Medicine and Surgery, University of Insubria , Varese, Italy
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Pecchini F, Esposito S, Casoni Pattacini G, Gozzo D, Trapani V, Piccoli M. V-015 ROBOTIC TARUP: TECHNICAL DETAILS AND INNOVATIVE METHOD OF FIXATION. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
With the recent evolution of minimally invasive hernia repairing techniques, robotic platform has exponentially gained consensus in the field of abdominal wall surgery, leading to the placement of retromuscolar synthetic meshes avoiding the need of extensive tissue dissection as the open approach.
Our aim was to describe the introduction of Robotic Transabdominal Retromuscular Umbilical Prosthetic Hernia Repair (TARUP) at a referral centre for advanced mini-invasive surgery, by reporting the preliminary experience and the technical aspects of the procedure.
Material & Methods
We present a case of a 3 cm umbilical defect associated to supraumbilical diastasis in a young man undergoing TARUP with the Da Vinci Xi system. The robotic boom was placed on the patient's right side, with three trocars on the anterior axillary line. The outline for the mesh was marked by centering the hernia defect with transcutaneous needles to delineate the extent of dissection corresponding to mesh area. Intra-abdominal pressure was of 8–12 mmHg. A retromuscolar plane was created starting from the incision of the ipsilateral posterior rectus sheat. The hernia content was reduced. The junction between the anterior and posterior rectus fascia was incised to cross-over the linea alba and continue the dissection controlaterally. A 15×15 cm polypropylene mesh was positioned in the retrorectus space and fixed with cyanoacrylic glue tack.
Results
Intervention lenght was of 100 minutes. No intra- or post-operative complications occurred.
At present, no early recurrences were observed.
Conclusions
Robotic TARUP represents a safe and reproducible alternative in selected cases where retromuscolar mesh is preferred.
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Affiliation(s)
- F Pecchini
- General Surgery of Emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - S Esposito
- General Surgery of Emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - G Casoni Pattacini
- General Surgery of Emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - D Gozzo
- General Surgery of Emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - V Trapani
- General Surgery of Emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - M Piccoli
- General Surgery of Emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
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8
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Pecchini F, Trapani V, Francescato A, Esposito S, Casoni Pattacini G, Gozzo D, Piccoli M. V-016 PARAHIATAL HERNIA: A RARE CASE OF DIAPHRAGMATIC HERNIA ROBOTICALLY REPAIRED. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
Parahiatal hernia is a rare type of diaphragmatic hernia, consisting in a adjacent but separated defect, lateral to the oesophageal hiatus and crus. It's not so familiar for surgeons, preoperative diagnosis is unlikely to be confirmed, and it is mostly found incidentally during intervention, leading to a complex and difficult repair.
We present a case of parahiatal hernia robotically treated with the aim of emphasizing how robotic system can successfully help surgeons in performing even unexpected confusing and challenging anatomic dissections and procedures.
Material and Methods
A 65-year-old woman underwent robotic parahiatal hernia repair at our Institution. Four robotic trocars were positioned along the transverse umbilical line with the additional Air-seal port at the periumbilical left side for assistant's use.
Dissection and isolation of both parahiatal defect and crural musculature were performed; the defect was closed with not absorbable barbed suture, conventional iatoplasty was also performed and a biosynthetic mesh was placed and fixed as a reinforcement.
Results
The duration of the intervention was of 100 minutes. No. intr- or post-operative complications occurred. Blood loss were inferior than 100 millilitres. The patient started oral intake at the second post-operative day and after discharged.
At six months no recurrences were detected.
Conclusions
Parahiatal hernia are rare entities of which surgeons should be aware. Robotic treatment is safe and feasible and it represents a good tool for a successful management.
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Affiliation(s)
- F Pecchini
- General Surgery of emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - V Trapani
- General Surgery of emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - A Francescato
- General Surgery of emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - S Esposito
- General Surgery of emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - G Casoni Pattacini
- General Surgery of emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - D Gozzo
- General Surgery of emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - M Piccoli
- General Surgery of emergency and New Technologies, Baggiovara General Hospital , Modena , Italy
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9
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Esposito S, Pecchini F, Casoni Pattacini G, Trapani V, Gozzo D, Piccoli M. V-023 R-TAPP AS A TRAINING MODEL IN ROBOTIC SURGERY. Br J Surg 2022. [PMCID: PMC9619739 DOI: 10.1093/bjs/znac308.275] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim The main aim of the project will be evaluating the effectiveness of an experimental structured didactic program in robotic surgery in filling the training gap caused by the pandemic. We intend to evaluate how establishing a training pathway could improve young surgeons’ robotic skills and implement their participation in robotic procedures during the COVID-19 pandemic. We will also evaluate the learning curve of robotic transabdominal preperitoneal inguinal hernia repair (TAPP) for young surgeons with limited experience as first operators at the dual console. Matherials and Methods We designed an experimental stepwise training program in robotic surgery that starts from a first step of theoretical and laboratory lessons, followed by a second phase of bedside assistance training, and finally the completion of low complexity procedures by the trainees proctored at the dual console by senior surgeons. Robotic TAPP was selected as training model. The performance of each trainee will be registered in an evaluation data sheet and Learning scores will be recorded by the tutor with the evaluation of 6 corner steps of the procedure. Results Preliminary results showed improved technical skills and increased team spirit and wellbeing. Conclusions TAPP is a good training model because involves technical steps useful for more complex procedures. The robotic dual console represent an extraordinary training tool and a structured training program positively impacts technical skills and could help filling the training gap caused by the pandemic.
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Affiliation(s)
- S Esposito
- General and Emergency Surgery and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - F Pecchini
- General and Emergency Surgery and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - G Casoni Pattacini
- General and Emergency Surgery and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - V Trapani
- General and Emergency Surgery and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - D Gozzo
- General and Emergency Surgery and New Technologies, Baggiovara General Hospital , Modena , Italy
| | - M Piccoli
- General and Emergency Surgery and New Technologies, Baggiovara General Hospital , Modena , Italy
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10
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Neuenschwander J, Tenenbaum T, Esposito S, Kaplan S, Motov S, Bachur R, Rothman R, Ryan L, Klein A. 47 A Host Protein Test Based on TRAIL, IP-10 and CRP for Differentiating Between Bacterial and Viral Infection Has Potential to Improve Patient Selection for Blood Culture Utilization. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Turnbull C, Macleod A, Esposito S, Gorantla R, Seth S, Ramamoorthy R, Mehendale F. 616 Addressing Challenges to Enable Better Use of Routinely Collected Clinical Photographs: Evaluating the Largest Cleft Dataset for Machine Learning Analysis. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Aim
Orofacial clefts are the most common congenital anomaly to affect the craniofacial region. Surgical repair is usually performed in infancy; however, there are concerning inequalities in access to and quality of surgical care. Scoring aesthetic results after surgery is crucial when determining the success of a repair. A reliable and accurate scoring system utilising large numbers of unstandardised 2-dimentional (2D) photographs of ethnically diverse patients, which is inexpensive, widely accepted and easily applicable, does not exist. Artificial Intelligence (AI) has been applied in various surgical specialities with beneficial results; however, its advantages have not yet been harnessed in cleft care.
We aimed to evaluate the potential use of routinely collected 2D photographs of patients with an orofacial cleft and determine if non-standardised data could be used for machine learning (ML) analysis in cleft research.
Method
A database comprising over 5 million photographs, collected over 20 years, and developed by the international non-governmental organisation Smile Train, was described, and analysed using RStudio and Microsoft Excel.
Results
Description and analysis of the dataset demonstrated that it is the largest and most ethnically inclusive and diverse dataset that currently exists. Preliminary AI analysis confirmed that ML could be used to analyse the data.
Conclusion
The quality of routinely collected data presents challenges for use in research. Addressing such challenges helps ensure that findings are more representative of global burden of disease and will deliver outcomes that are more relevant to a diverse global population. Evidence based minimum standards to optimise future data collection have been identified.
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Affiliation(s)
- C Turnbull
- The University of Edinburgh , Edinburgh , United Kingdom
| | - A Macleod
- The University of Edinburgh , Edinburgh , United Kingdom
| | - S Esposito
- The University of Edinburgh , Edinburgh , United Kingdom
| | - R Gorantla
- The University of Edinburgh , Edinburgh , United Kingdom
| | - S Seth
- The University of Edinburgh , Edinburgh , United Kingdom
| | - R Ramamoorthy
- The University of Edinburgh , Edinburgh , United Kingdom
| | - F Mehendale
- The University of Edinburgh , Edinburgh , United Kingdom
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12
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Minetto S, Zanirato M, Pisaturo V, Makieva S, Esposito S, Cermisoni G, Rabellotti E, Viganò P, Candiani M, Papaleo E, Alteri A. O-222 Surveillance of scientific research integrity in medically assisted reproduction: a systematic review of the retracted literature. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
How many retracted papers are there in the medically assisted reproduction (MAR) literature and, more importantly, what are their particulars?
Summary answer
Article retraction within MAR literature is increasing and the most common reasons for retraction are errors in data and duplicate publications.
What is known already
Article retraction accounts for one of the most serious consequences of research misconduct. Articles may be subject to retraction whenever the findings are found to be unreliable, redundant, plagiarised or the authors are found to have performed unethical research or hidden
Trial registration number
N/A
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Affiliation(s)
- S Minetto
- IRCCS San Raffaele Scientific Institute, Obstetrics and Gynaecology Unit , Milan, Italy
| | - M Zanirato
- IRCCS San Raffaele Scientific Institute, Obstetrics and Gynaecology Unit , Milan, Italy
| | - V Pisaturo
- International Evangelical Hospital , Reproductive medicine , Genoa, Italy
| | - S Makieva
- University Hospital Zurich, Department of Reproductive Endocrinology , Zurich, Switzerland
| | - S Esposito
- IRCCS San Raffaele Scientific Institute, Obstetrics and Gynaecology Unit , Milan, Italy
| | - G.C Cermisoni
- IRCCS San Raffaele Scientific Institute, Obstetrics and Gynaecology Unit , Milan, Italy
| | - E Rabellotti
- IRCCS San Raffaele Scientific Institute, Obstetrics and Gynaecology Unit , Milan, Italy
| | - P Viganò
- IRCCS San Raffaele Scientific Institute, Obstetrics and Gynaecology Unit , Milan, Italy
| | - M Candiani
- IRCCS San Raffaele Scientific Institute, Obstetrics and Gynaecology Unit , Milan, Italy
| | - E Papaleo
- IRCCS San Raffaele Scientific Institute, Obstetrics and Gynaecology Unit , Milan, Italy
| | - A Alteri
- IRCCS San Raffaele Scientific Institute, Obstetrics and Gynaecology Unit , Milan, Italy
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13
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Esposito S, De Santis L, Rabellotti E, Privitera L, Biancardi R, Sarais V, Viganò P, Candiani M, Papaleo E, Alteri A. P-774 Risks management in a donor program: application of Failure Mode and Effect Analysis from gamete matching to gamete thawing. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Is failure mode and effects analysis (FMEA) a useful and effective method of risk assessment in a gamete donor program?
Summary answer
The analysis of the potential failures, their causes and effects significantly improved the safety strategies previously adopted in our gamete donor program.
What is known already
At present, in Italy, the donation of fresh gametes is possible, but almost unmanageable due to the lack of donors and the refund to donors forbidden by law. As a result, many IVF Italian Centers established agreements with foreign gametes cryo-banks in order to meet the huge demand for donation treatments. The exchange of personal sensitive data and gametes between the sending and receiving centers represents a crucial aspect in a donor cycle. Each stage of this process, from gamete request to gamete thawing, is not error-free. FMEA represents a strategy to identify and mitigate potential failures before they occur.
Study design, size, duration
Fifty-eight oocyte and 4 sperm donation cycles were performed at our IVF facility from September 2019 to January 2021. Gametes came from a single Spanish cryo-bank. FMEA represents a proactive risk evaluation tool useful to identify real or potential failures and to develop actions to minimize risks. FMEA was conducted, in January 2021, by a team consisting of 2 gynaecologists, 3 embryologists and 2 quality managers and repeated 8 months later.
Participants/materials, setting, methods
Processes were analyzed to identify and score the potential failure modes using the risk priority number (RPN) scoring system. The calculation has been obtained by multiplying 3 factors: severity, occurrence and detectability scored from 1-5. After calculating the criticality of each failure mode, an action plan was prepared and then effectiveness of new process was monitored. Finally, FMEA was repeated and the improved RPN after the corrective actions was calculated.
Main results and the role of chance
In our gamete donation program, we mapped four phases: gamete request, donor-recipient matching, gamete delivery and gamete thawing. All the steps presented multiple failures and 11 different potential failure modes had been identified. Failure modes as the incorrect transcription of the recipient data, the acceptance of a donor proposal not well-matched with recipients and the receipt of gametes unsuitable for the couple correlate to high-risk scores with 30 RPN. These events may have severe consequences such as an incorrect matching between donor and recipient, and the subsequent birth of a child from a mismatched donor. Although gamete request, donor-recipient matching and receiving gametes phases are mainly characterized by document checking, the introduction of witnessing by another physician or embryologist, reduced the risk by 50%. Therefore, the introduction of double checking by a second operator represents an essential control measure to avoid errors.
Limitations, reasons for caution
This study is influenced by the general limitations of the FMEA approach, such as different personal experiences and skills of the participants since failures may be unrecognized, underestimated or overstated.
Wider implications of the findings
Performing a risk assessment in a donor program represents a valid strategy to mitigate risks of incorrect matching and loss of traceability. Since errors in data record and acceptance of donor proposal may cause important down streaming consequences, the double witnessing is strongly encouraged.
Trial registration number
NA
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Affiliation(s)
- S Esposito
- IRCCS San Raffaele Scientific Istitute, Obstetrics and Gynecology , Milan, Italy
| | - L De Santis
- IRCCS San Raffaele Scientific Istitute, Obstetrics and Gynecology , Milan, Italy
| | - E Rabellotti
- IRCCS San Raffaele Scientific Istitute, Obstetrics and Gynecology , Milan, Italy
| | - L Privitera
- IRCCS San Raffaele Scientific Istitute, Obstetrics and Gynecology , Milan, Italy
| | - R Biancardi
- IRCCS San Raffaele Scientific Istitute, Obstetrics and Gynecology , Milan, Italy
| | - V Sarais
- IRCCS San Raffaele Scientific Istitute, Obstetrics and Gynecology , Milan, Italy
| | - P Viganò
- IRCCS San Raffaele Scientific Istitute, Obstetrics and Gynecology , Milan, Italy
| | - M Candiani
- IRCCS San Raffaele Scientific Istitute, Obstetrics and Gynecology , Milan, Italy
| | - E Papaleo
- IRCCS San Raffaele Scientific Istitute, Obstetrics and Gynecology , Milan, Italy
| | - A Alteri
- IRCCS San Raffaele Scientific Istitute, Obstetrics and Gynecology , Milan, Italy
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14
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Fainardi V, Muscarà M, Skenderaj K, Longo F, Tornesello M, Grandinetti R, Spaggiari C, Neglia C, Esposito S, Pisi G. P134 Prevalence of multi-drug, antimicrobial-resistant bacteria in children with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00466-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Migliori GB, Wu SJ, Matteelli A, Zenner D, Goletti D, Ahmedov S, Al-Abri S, Allen DM, Balcells ME, Garcia-Basteiro AL, Cambau E, Chaisson RE, Chee CBE, Dalcolmo MP, Denholm JT, Erkens C, Esposito S, Farnia P, Friedland JS, Graham S, Hamada Y, Harries AD, Kay AW, Kritski A, Manga S, Marais BJ, Menzies D, Ng D, Petrone L, Rendon A, Silva DR, Schaaf HS, Skrahina A, Sotgiu G, Thwaites G, Tiberi S, Tukvadze N, Zellweger JP, D Ambrosio L, Centis R, Ong CWM. Clinical standards for the diagnosis, treatment and prevention of TB infection. Int J Tuberc Lung Dis 2022; 26:190-205. [PMID: 35197159 PMCID: PMC8886963 DOI: 10.5588/ijtld.21.0753] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND: Tuberculosis (TB) preventive therapy (TPT) decreases the risk of developing TB disease and its associated morbidity and mortality. The aim of these clinical standards is to guide the assessment, management of TB infection (TBI) and implementation of TPT.METHODS: A panel of global experts in the field of TB care was identified; 41 participated in a Delphi process. A 5-point Likert scale was used to score the initial standards. After rounds of revision, the document was approved with 100% agreement.RESULTS: Eight clinical standards were defined: Standard 1, all individuals belonging to at-risk groups for TB should undergo testing for TBI; Standard 2, all individual candidates for TPT (including caregivers of children) should undergo a counselling/health education session; Standard 3, testing for TBI: timing and test of choice should be optimised; Standard 4, TB disease should be excluded prior to initiation of TPT; Standard 5, all candidates for TPT should undergo a set of baseline examinations; Standard 6, all individuals initiating TPT should receive one of the recommended regimens; Standard 7, all individuals who have started TPT should be monitored; Standard 8, a TBI screening and testing register should be kept to inform the cascade of care.CONCLUSION: This is the first consensus-based set of Clinical Standards for TBI. This document guides clinicians, programme managers and public health officers in planning and implementing adequate measures to assess and manage TBI.
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Affiliation(s)
- G B Migliori
- Respiratory Diseases Clinical Epidemiology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - S J Wu
- Division of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, Singapore City
| | - A Matteelli
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy, WHO Collaborating Centre for TB/HIV Collaborative Activities and for TB Elimination Strategy, University of Brescia, Brescia, Italy
| | - D Zenner
- Centre for Global Public Health, Institute for Population Health Sciences, Queen Mary University, London, UK
| | - D Goletti
- Translational Research Unit, National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS, Rome, Italy
| | - S Ahmedov
- USAID, Bureau for Global Health, TB Division, Washington, DC, USA
| | - S Al-Abri
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - D M Allen
- Division of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, Singapore City, Infectious Disease Translational Research Programme, Department of Medicine, National University of Singapore, Yong Loo Lin School of Medicine, Singapore City
| | - M E Balcells
- Department of Infectious Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - A L Garcia-Basteiro
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique, ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - E Cambau
- IAME UMR1137, INSERM, University of Paris, F-75018 Paris; AP-HP-Bichat Hospital, Associate laboratory of National Reference Center for Mycobacteria and Antimycobacterial Resistance, Paris, France
| | - R E Chaisson
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - C B E Chee
- Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore, Singapore
| | - M P Dalcolmo
- Helio Fraga Reference Center, Oswaldo Cruz Foundation Ministry of Health, Rio de Janeiro, Brazil
| | - J T Denholm
- Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC, Australia, Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia
| | - C Erkens
- KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - S Esposito
- Paediatric Clinic, Pietro Barilla Children´s Hospital, University of Parma, Parma, Italy
| | - P Farnia
- Mycobacteriology Research Center (MRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - J S Friedland
- Institute for Infection and Immunity, St George´s, University of London, London, UK
| | - S Graham
- Department of Paediatrics, Center for International Child Health, University of Melbourne, Melbourne, VIC, Australia, Murdoch Children´s Research Institute, Royal Children´s Hospital, Melbourne, Australia
| | - Y Hamada
- Institute for Global Health, University College London, London, UK
| | - A D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - A W Kay
- The Global Tuberculosis Program, Texas Children´s Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - A Kritski
- Academic Tuberculosis Program Center, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - S Manga
- Operational Center, Medecins Sans Frontieres (MSF), Paris, France
| | - B J Marais
- Department of Infectious Diseases and Microbiology, The Children´s Hospital at Westmead, Westmead, NSW, Australia, The University of Sydney Institute for Infectious Diseases, Sydney, NSW, Australia
| | - D Menzies
- Montréal Chest Institute, Montréal, QC, Canada, Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montréal, QC, Canada, McGill International Tuberculosis Centre, Montréal, QC, Canada
| | - D Ng
- Infectious Diseases, National Centre for Infectious Diseases, Singapore
| | - L Petrone
- Translational Research Unit, National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS, Rome, Italy
| | - A Rendon
- Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias CIPTIR, University Hospital of Monterrey UANL (Universidad Autonoma de Nuevo Leon), Monterrey, Mexico
| | - D R Silva
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - H S Schaaf
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - A Skrahina
- Republican Research and Practical Center for Pulmonology and Tuberculosis, Minsk, Belarus
| | - G Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - S Tiberi
- Department of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK, Blizard Institute, Queen Mary University of London, London, UK
| | - N Tukvadze
- National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia
| | - J-P Zellweger
- TB Competence Center, Swiss Lung Association, Berne, Switzerland
| | - L D Ambrosio
- Public Health Consulting Group, Lugano, Switzerland
| | - R Centis
- Respiratory Diseases Clinical Epidemiology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - C W M Ong
- Division of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, Singapore City, Infectious Disease Translational Research Programme, Department of Medicine, National University of Singapore, Yong Loo Lin School of Medicine, Singapore City, National University of Singapore Institute for Health Innovation & Technology (iHealthtech), Singapore, Singapore
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16
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Giannattasio A, Rosa M, Esposito S, Di Mita O, Angrisani F, Acierno S, D'Anna C, Barbato F, Tipo V, Ametrano O. Concomitant SARS-CoV-2 infection and crusted scabies in a 4-month infant. J Eur Acad Dermatol Venereol 2021; 36:e188-e190. [PMID: 34862990 DOI: 10.1111/jdv.17850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
- A Giannattasio
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - M Rosa
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - S Esposito
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - O Di Mita
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - F Angrisani
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - S Acierno
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - C D'Anna
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - F Barbato
- Pediatric Dermatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - V Tipo
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - O Ametrano
- Pediatric Dermatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
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17
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Ruggiero E, Di Castelnuovo A, Costanzo S, Esposito S, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, Bonaccio M. Moderate partially skimmed milk consumption is associated with reduced mortality risk. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Data on milk and other dairy products intake with health outcomes are inconsistent. We investigated the association of milk and total dairy consumption with the risk of all-cause and cause-specific mortality in a Mediterranean population.
Methods
We performed a longitudinal analysis on 22,889 men and women (mean age 55.4±11.7 y; 52.3% women), from the Moli-sani Study cohort (enrollment 2005-2010) followed-up for a median of 11 years. Dietary data were collected through a 188-item food frequency questionnaire. Total dairy consumption (g/d) was calculated as the sum of milk (whole and partially-skimmed, g/d), yogurt (whole and partially skimmed, g/d) and cheese (fresh and hard, g/d). Hazard ratio (HRs) with 95% confidence interval (CI) were calculated by multivariable Cox regression, modelled by spline curves.
Results
In multivariable-adjusted analysis controlled for sociodemographic, clinical and dietary factors, cheese, yogurt or whole milk intake were not associated with either all-cause or cause-specific mortality (p for overall association >0.38), as well as was total diary intake (p > 0.18). On the contrary, non-linear J-shaped curves were observed for the association of partially skimmed milk intake with all-cause and cancer mortality (p value for total and non-linear association=0.0072 and 0.035, and 0.097 and 0.049, respectively; magnitude of the relative reduction =16% and 18% at nadir of 128 and 114 g/d, respectively). A linear association between partially skimmed milk intake and CVD mortality was observed (p for association =0.047; p for non-linearity= 0.41), with HR = 0.82 (95%CI: 0.68-0.98) at 125 g/d and a window of statistically significant protection ranging from 100 to 250 g/d.
Conclusions
In a large Mediterranean population of adults, consumption of 1 standard cup of partially skimmed milk was associated with lower all-cause, cancer and CVD mortality. Other dairy sources were not associated with mortality.
Key messages
In a large Mediterranean population, total dairy intake did not predict mortality. Daily consumption of 1 standard cup of partially skimmed milk lowers the risk of all-cause, cardiovascular and cancer mortality.
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Affiliation(s)
- E Ruggiero
- IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | | | - S Costanzo
- IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - S Esposito
- IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - M Persichillo
- IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - C Cerletti
- IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - MB Donati
- IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - G de Gaetano
- IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - L Iacoviello
- IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine, University of Insubria, Varese, Italy
| | - M Bonaccio
- IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
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18
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Bonaccio M, Di Castelnuovo A, Ruggiero E, Costanzo S, Esposito S, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Ultra-processed food consumption modifies the association of Nutri-Score with all-cause mortality. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.448] [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: 11/14/2022] Open
Abstract
Abstract
Background
The Nutri-Score front-of-pack label rates foods according to their nutritional quality while the NOVA classification is focused on degree of processing; both systems separately predicted mortality in epidemiological contexts. We evaluated whether ultra-processed food (UPF) modifies the association of the Nutri-Score with mortality.
Methods
Longitudinal analysis on 22,549 Italian men and women (mean age 54±12 y) from the Moli-sani Study (2005-2010) followed for 11.2 y. Food intake was assessed by a food frequency questionnaire. The Food Standards Agency nutrient profiling system (FSAm-NPS) score, used to derive the Nutri-Score, was calculated for each food based on its amount of energy, saturated fat, sugar, sodium, fibre, protein, fruits, vegetables, legumes and nuts per 100 g of product. The FSAm-NPS dietary index was calculated for each participant as an energy weighted mean of the FSAm-NPS score of all foods consumed, and increased values indicate lower nutritional quality. UPF intake was the proportion (%) of UPF in the total weight of food consumed (g/d) and categorized as low/high (below/above the population median, respectively).
Results
In a multivariable analysis, 1-SD increase in the FSAm-NPS index led to increased risk of all-cause (HR = 1.07; 95%CI 1.02-1.13) and CVD mortality (HR = 1.08; 1.00-1.18). UPF intake was an effect modifier since the association of FSAm-NPS index with mortality was confined to individuals with high UPF intake (HR = 1.14; 1.05-1.25) but not in those with low UPF (HR = 1.00; 0.93-1.07; p for interaction=0.034). Similar findings were reported for CVD mortality (HR = 1.14;0.99-1.31 and HR = 1.01;0.90-1.13 for high and low UPF consumers, respectively; p for interaction=0.18).
Conclusions
Higher mortality risk associated with a NutriScore revealing nutrient-poor food intake is limited to individuals also reporting high UPF intake. Food labelling systems should account for food processing in addition to nutritional content.
Key messages
Ultra-processed food modifies the association between the 5-color Nutri-Score front-of-pack label with all-cause mortality in an Italian general population. Food labelling systems, that are conceived to help consumers make healthier food choices, should also account for food processing in addition to nutritional content.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - L Iacoviello
- IRCCS NEUROMED, Pozzilli, Italy
- Medicine and Surgery, University of Insubria, Varese-Como, Italy
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19
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Migliori GB, Esposito S. TB disease in children from the prehistoric era. Int J Tuberc Lung Dis 2021; 25:685-686. [PMID: 34802486 DOI: 10.5588/ijtld.21.0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- G B Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri Istituto di Ricovero e Cura a Carattere Scientifico, Tradate
| | - S Esposito
- Paediatric Clinic, Pietro Barilla Children´s Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
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20
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Cermisoni GC, Pagliardini L, Alteri A, Santis LD, Esposito S, Minetto S, Papaleo E, Vigano’ P, Candiani M. P–031 The effect of ejaculatory abstinence period on embryological and clinical outcomes in ICSI cycles: A retrospective analysis of 3,353 cycles. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Does ejaculatory abstinence period in male affect embryological and pregnancy outcomes following fresh embryo transfers in ICSI cycles?
Summary answer
Shorter ejaculatory abstinence period is associated with lower triploid zygotes rate per ICSI cycle but it does not affect clinical outcomes after fresh embryo transfers.
What is known already
Lower sperm quality may negatively impact on fertilisation rate and embryo morphokinetic parameters after ICSI and the effect of the ejaculatory abstinence period before semen collection on seminal parameters and sperm quality has been widely reported. However, the impact of ejaculatory abstinence on clinical outcomes is still controversial. WHO (World Health Organization) guideline recommended that abstinence period should be 2–7 days. Even so, there are no larger prospective trials determining the optimal timing for ejaculatory abstinence period for infertile couples.
Study design, size, duration
This is a single center retrospective observational study of 3,353 fresh cycles from January 2017 to December 2020. Semen analysis was done according to the WHO criteria. Exclusion criteria for this study were frozen gametes and cycles with no retrieved oocytes. Primary outcomes were fertilization rate and triploid zygotes rate. Secondary outcomes were blastulation rate, ongoing pregnancy rate and live birth rate per fresh embryo transfer.
Participants/materials, setting, methods
The correlation between ejaculatory abstinence and continuous outcomes was evaluated by Spearman’s correlation analysis in order to detect potential non-linear associations. Generalized linear model and logistic regression were used, respectively for continuous and binary outcomes, in order to adjust for confounders such as female age, male age, number of retrieved oocytes, percentage of mature oocytes, infertility causes, seminal volume, sperm concentration and total progressive sperm motility. A p value <0.05 was considered significant.
Main results and the role of chance
The male mean age was 40.3±5.5 and mean duration of abstinence was 2.9±1.7 days. The mean age of female patients was 38.2±4.0. Higher ejaculatory abstinence period was associated with a higher sperm concentration (Spearman p = 3.1x10–6) but not with a higher total sperm progressive motility. Even so, no significant correlation with EA were observed when considering fertilization rate, blastulation rate, ongoing pregnancy and live birth rate per transfer in analyzed cycles. Triploid zygote rate was positively associated with a higher ejaculatory abstinence period. For the ejaculatory abstinence period of 1 day (n = 64), 2 days (n = 1523), 3 days (n = 1032), 4 days (n = 408), 5 days (n = 174), 6 days (n = 47) and ≥7 days (n = 105) the mean triploid rate was 2.4%, 2.4%, 2.5%, 4.1%, 3.6%, 5.4% and 4.3%, respectively (Spearman p = 9x10–3). Triploid zygote rate was independent of semen volume, concentration and total progressive motility.
Limitations, reasons for caution
This is a large observational study with a retrospective data collection. Despite our methodological approach, the presence of biases related to retrospective design can not be excluded and it may be a reason for caution.
Wider implications of the findings: Our results demonstrate that ejaculatory abstinence period do not affect blastulation, ongoing pregnancy and live birth rates. The current findings discourage an abstinence time longer than 3 days due to its association with a higher abnormal fertilization rate.
Trial registration number
Not applicable
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Affiliation(s)
- G C Cermisoni
- I.R.C.C.S. San Raffaele Scientific Institute - Milan- Italy, Reproductive Sciences Laboratory- Obstetrics and Gynaecology Unit, Milan, Italy
| | - L Pagliardini
- I.R.C.C.S. San Raffaele Scientific Institute - Milan- Italy, Reproductive Sciences Laboratory- Obstetrics and Gynaecology Unit, Milan, Italy
| | - A Alteri
- I.R.C.C.S. San Raffaele Scientific Institute - Milan- Italy, Obstetrics and Gynaecology Unit, Milan, Italy
| | - L D Santis
- I.R.C.C.S. San Raffaele Scientific Institute - Milan- Italy, Obstetrics and Gynaecology Unit, Milan, Italy
| | - S Esposito
- I.R.C.C.S. San Raffaele Scientific Institute - Milan- Italy, Obstetrics and Gynaecology Unit, Milan, Italy
| | - S Minetto
- I.R.C.C.S. San Raffaele Scientific Institute - Milan- Italy, Obstetrics and Gynaecology Unit, Milan, Italy
| | - E Papaleo
- I.R.C.C.S. San Raffaele Scientific Institute - Milan- Italy, Obstetrics and Gynaecology Unit, Milan, Italy
| | - P Vigano’
- I.R.C.C.S. San Raffaele Scientific Institute - Milan- Italy, Reproductive Sciences Laboratory- Obstetrics and Gynaecology Unit, Milan, Italy
| | - M Candiani
- I.R.C.C.S. San Raffaele Scientific Institute - Milan- Italy, Obstetrics and Gynaecology Unit, Milan, Italy
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Raymond O, Bellefeuille G, Farah R, Shaik J, Esposito S, Hordinsky M. 596 Application of an artificial intelligence (AI) photographic device to track platelet-rich plasma treatment outcomes in females with alopecia. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Koirala S, Borisov S, Danila E, Mariandyshev A, Shrestha B, Lukhele N, Dalcolmo M, Shakya SR, Miliauskas S, Kuksa L, Manga S, Aleksa A, Denholm JT, Khadka HB, Skrahina A, Diktanas S, Ferrarese M, Bruchfeld J, Koleva A, Piubello A, Koirala GS, Udwadia ZF, Palmero DJ, Munoz-Torrico M, Gc R, Gualano G, Grecu VI, Motta I, Papavasileiou A, Li Y, Hoefsloot W, Kunst H, Mazza-Stalder J, Payen MC, Akkerman OW, Bernal E, Manfrin V, Matteelli A, Mustafa Hamdan H, Nieto Marcos M, Cadiñanos Loidi J, Cebrian Gallardo JJ, Duarte R, Escobar Salinas N, Gomez Rosso R, Laniado-Laborín R, Martínez Robles E, Quirós Fernandez S, Rendon A, Solovic I, Tadolini M, Viggiani P, Belilovski E, Boeree MJ, Cai Q, Davidavičienė E, Forsman LD, De Los Rios J, Drakšienė J, Duga A, Elamin SE, Filippov A, Garcia A, Gaudiesiute I, Gavazova B, Gayoso R, Gruslys V, Jonsson J, Khimova E, Madonsela G, Magis-Escurra C, Marchese V, Matei M, Moschos C, Nakčerienė B, Nicod L, Palmieri F, Pontarelli A, Šmite A, Souleymane MB, Vescovo M, Zablockis R, Zhurkin D, Alffenaar JW, Caminero JA, Codecasa LR, García-García JM, Esposito S, Saderi L, Spanevello A, Visca D, Tiberi S, Pontali E, Centis R, D'Ambrosio L, van den Boom M, Sotgiu G, Migliori GB. Outcome of treatment of MDR-TB or drug-resistant patients treated with bedaquiline and delamanid: Results from a large global cohort. Pulmonology 2021; 27:403-412. [PMID: 33753021 DOI: 10.1016/j.pulmoe.2021.02.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 01/08/2023] Open
Abstract
The World Health Organization (WHO) recommends countries introduce new anti-TB drugs in the treatment of multidrug-resistant tuberculosis. The aim of the study is to prospectively evaluate the effectiveness of bedaquiline (and/or delamanid)- containing regimens in a large cohort of consecutive TB patients treated globally. This observational, prospective study is based on data collected and provided by Global Tuberculosis Network (GTN) centres and analysed twice a year. All consecutive patients (including children/adolescents) treated with bedaquiline and/or delamanid were enrolled, and managed according to WHO and national guidelines. Overall, 52 centres from 29 countries/regions in all continents reported 883 patients as of January 31st 2021, 24/29 countries/regions providing data on 100% of their consecutive patients (10-80% in the remaining 5 countries). The drug-resistance pattern of the patients was severe (>30% with extensively drug-resistant -TB; median number of resistant drugs 5 (3-7) in the overall cohort and 6 (4-8) among patients with a final outcome). For the patients with a final outcome (477/883, 54.0%) the median (IQR) number of months of anti-TB treatment was 18 (13-23) (in days 553 (385-678)). The proportion of patients achieving sputum smear and culture conversion ranged from 93.4% and 92.8% respectively (whole cohort) to 89.3% and 88.8% respectively (patients with a final outcome), a median (IQR) time to sputum smear and culture conversion of 58 (30-90) days for the whole cohort and 60 (30-100) for patients with a final outcome and, respectively, of 55 (30-90) and 60 (30-90) days for culture conversion. Of 383 patients treated with bedaquiline but not delamanid, 284 (74.2%) achieved treatment success, while 25 (6.5%) died, 11 (2.9%) failed and 63 (16.5%) were lost to follow-up.
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Affiliation(s)
- S Koirala
- Damien Foundation Nepal, Kathmandu, Nepal
| | - S Borisov
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation
| | - E Danila
- Clinic of Chest Diseases, Immunology and Allergology, Vilnius University Medical Faculty, Centre of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - A Mariandyshev
- Northern State Medical University, Northern (Arctic) Federal University, Arkhangelsk, Russian Federation
| | - B Shrestha
- Kalimati Chest Hospital/GENETUP/Nepal Anti Tuberculosis Association, Kathmandu, Nepal
| | - N Lukhele
- TB/HIV, Hepatitis, & PMTCT Department, World Health Organization, Eswatini WHO Country Office, Mbabane, Eswatini
| | - M Dalcolmo
- Reference Center Hélio Fraga, Fundação Oswaldo Cruz (Fiocruz)/Ministry of Health, Rio de Janeiro, Brazil
| | - S R Shakya
- Lumbini Provincial Hospital, Butwal, Nepal
| | - S Miliauskas
- Department of Pulmonology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - L Kuksa
- MDR-TB Department, Riga East University Hospital for TB and Lung Disease Centre, Riga, Latvia
| | - S Manga
- Department of Infectious Diseases, University National San Antonio Abad Cusco, Cusco, Peru
| | - A Aleksa
- Department of Phthisiology and Pulmonology, Grodno State Medical University, Grodno, Belarus
| | - J T Denholm
- Victorian Tuberculosis Program, Melbourne Health, Department of Infectious Diseases, University of Melbourne, Melbourne, Australia
| | - H B Khadka
- Nepalgjunj TB Referral Center, TB Nepal, Nepalgunj, Nepal
| | - A Skrahina
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - S Diktanas
- Tuberculosis Department, 3rd Tuberculosis Unit, Republican Klaipėda Hospital, Klaipėda, Lithuania
| | - M Ferrarese
- TB Reference Centre, Villa Marelli Institute, Niguarda Hospital, Milan, Italy
| | - J Bruchfeld
- Division of Infectious Diseases, Department of Medicine, Solna, Karolinska Institute, Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - A Koleva
- Pulmonology and Physiotherapy Department, Gabrovo Lung Diseases Hospital, Gabrovo, Bulgaria
| | | | - G S Koirala
- Nepal Anti Tuberculosis Association, Morang Branch, TB Clinic, Biratnagar, Province 1, Nepal
| | - Z F Udwadia
- Department of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India
| | - D J Palmero
- Pulmonology Division, Municipal Hospital F. J. Muñiz, Buenos Aires, Argentina
| | - M Munoz-Torrico
- Clínica de Tuberculosis, Instituto Nacional De Enfermedades Respiratorias Ismael Cosio Villegas, Ciudad De Mexico, Mexico
| | - R Gc
- Damien Foundation, Midpoint District Community Memorial Hospital, Danda, Nawalparasi, Nepal
| | - G Gualano
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', IRCCS, Rome, Italy
| | - V I Grecu
- National Programme for Prevention, Surveillance and Control of Tuberculosis, Dolj Province, Romania
| | - I Motta
- Department of Medical Science, Unit of Infectious Diseases, University of Torino, Italy
| | - A Papavasileiou
- Department of Tuberculosis, Sotiria Athens Hospital of Chest Diseases, Athens, Greece
| | - Y Li
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - W Hoefsloot
- Radboud University Medical Center, Center Dekkerswald, Nijmegen, The Netherlands
| | - H Kunst
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - J Mazza-Stalder
- Division of Pulmonary Medicine, University Hospital of Lausanne CHUV, Lausanne, Switzerland
| | - M-C Payen
- Division of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - O W Akkerman
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, TB Center Beatrixoord, Haren, The Netherlands
| | - E Bernal
- Unidad de Enfermedades Infecciosas, Hospital General Universitario Reina Sofia, Murcia, Spain
| | - V Manfrin
- Infectious and Tropical Diseases Operating Unit, S. Bortolo Hospital, Vicenza, Italy
| | - A Matteelli
- Clinic of Infectious and Tropical Diseases, WHO Collaborating Centre for TB Elimination and TB/HIV Co-infection, University of Brescia, Brescia, Italy
| | | | - M Nieto Marcos
- Internal Medicine Department, Hospital Doctor Moliner, Valencia, Spain
| | - J Cadiñanos Loidi
- Internal Medicine Department, Hospital General de Villalba, Collado Villalba, Spain
| | | | - R Duarte
- National Reference Centre for MDR-TB, Hospital Centre Vila Nova de Gaia, Department of Pneumology, Public Health Science and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - N Escobar Salinas
- Division of Disease Prevention and Control, Department of Communicable Diseases, National Tuberculosis Control and Elimination Programme, Ministry of Health, Santiago, Chile
| | - R Gomez Rosso
- National Institute of Respiratory and Environmental Diseases ¨Prof. Dr. Juan Max Boettner¨ Asunción, Paraguay
| | - R Laniado-Laborín
- Universidad Autónoma de Baja California, Baja California, Mexico; Clínica de Tuberculosis del Hospital General de Tijuana, Tijuana, Baja California, Mexico
| | - E Martínez Robles
- Internal Medicine Department, Hospital de Cantoblanco- Hospital General Universitario La Paz, Madrid, Spain
| | - S Quirós Fernandez
- Pneumology Department, Tuberculosis Unit, Hospital de Cantoblanco- Hospital General Universitario La Paz, Madrid, Spain
| | - A Rendon
- Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias CIPTIR, University Hospital of Monterrey UANL (Universidad Autonoma de Nuevo Leon), Monterrey, Mexico
| | - I Solovic
- National Institute for TB, Lung Diseases and Thoracic Surgery, Vysne Hagy, Catholic University Ruzomberok, Slovakia
| | - M Tadolini
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy; Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - P Viggiani
- Reference Center for MDR-TB and HIV-TB, Eugenio Morelli Hospital, Sondalo, Italy
| | - E Belilovski
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation
| | - M J Boeree
- Radboud University Medical Center, Center Dekkerswald, Nijmegen, The Netherlands
| | - Q Cai
- Zhejiang Integrated Traditional and Western Medicine Hospital, Hangzhou, China
| | - E Davidavičienė
- National TB Registry, Public Health Department, Ministry of Health, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - L D Forsman
- Division of Infectious Diseases, Department of Medicine, Solna, Karolinska Institute, Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - J De Los Rios
- Centro de Excelencia de TBMDR, Hospital Nacional Maria Auxiliadora, Lima, Peru
| | - J Drakšienė
- Tuberculosis Department, 3rd Tuberculosis Unit, Republican Klaipėda Hospital, Klaipėda, Lithuania
| | - A Duga
- Baylor College of Medicine, Children's Foundation, Mbabane, Eswatini; National Pharmacovigilance Center, Eswatini Ministry of Health, Matsapha, Eswatini
| | - S E Elamin
- MDR-TB Department, Abu Anga Teaching Hospital, Khartoum, Sudan
| | - A Filippov
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation
| | - A Garcia
- Pulmonology Division, Municipal Hospital F. J. Muñiz, Buenos Aires, Argentina
| | - I Gaudiesiute
- Department of Pulmonology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - B Gavazova
- Improve the Sustainability of the National TB Programme, Sofia, Bulgaria
| | - R Gayoso
- Reference Center Hélio Fraga, Fundação Oswaldo Cruz (Fiocruz)/Ministry of Health, Rio de Janeiro, Brazil
| | - V Gruslys
- Clinic of Chest Diseases, Immunology and Allergology, Vilnius University Medical Faculty, Centre of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - J Jonsson
- Department of Public Health Analysis and Data Management, Public Health Agency of Sweden, Solna, Sweden
| | - E Khimova
- Northern State Medical University, Northern (Arctic) Federal University, Arkhangelsk, Russian Federation
| | - G Madonsela
- Eswatini National Aids Programme, Mbabane, Eswatini
| | - C Magis-Escurra
- Radboud University Medical Center, Center Dekkerswald, Nijmegen, The Netherlands
| | - V Marchese
- Clinic of Infectious and Tropical Diseases, WHO Collaborating Centre for TB Elimination and TB/HIV Co-infection, University of Brescia, Brescia, Italy
| | - M Matei
- Hospital of Pneumophtisiology Leamna, Dolj Province, Romania; University of Medicine and Pharmacy, Craiova, Romania
| | - C Moschos
- Department of Tuberculosis, Sotiria Athens Hospital of Chest Diseases, Athens, Greece
| | - B Nakčerienė
- National TB Registry, Public Health Department, Ministry of Health, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - L Nicod
- Division of Pulmonary Medicine, University Hospital of Lausanne CHUV, Lausanne, Switzerland
| | - F Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', IRCCS, Rome, Italy
| | - A Pontarelli
- Respiratory Infectious Diseases Unit, Cotugno Hospital, A.O.R.N. dei Colli, Naples, Italy
| | - A Šmite
- MDR-TB Department, Riga East University Hospital for TB and Lung Disease Centre, Riga, Latvia
| | | | - M Vescovo
- Pulmonology Division, Municipal Hospital F. J. Muñiz, Buenos Aires, Argentina
| | - R Zablockis
- Clinic of Chest Diseases, Immunology and Allergology, Vilnius University Medical Faculty, Centre of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - D Zhurkin
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - J-W Alffenaar
- University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, Australia; Westmead Hospital, Sydney, Australia; Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - J A Caminero
- Pneumology Department, Hospital General de Gran Canaria "Dr. Negrin", Las Palmas de Gran Canaria, Spain; Vital Strategies, New York, USA
| | - L R Codecasa
- TB Reference Centre, Villa Marelli Institute, Niguarda Hospital, Milan, Italy
| | | | - S Esposito
- Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | - L Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of z, University of Sassari, Sassari, Italy
| | - A Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy; Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Varese-Como, Italy
| | - D Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy; Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Tradate, Varese-Como, Italy
| | - S Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; Department of Infection, Royal London and Newham Hospitals, Barts Health NHS Trust, London, United Kingdom
| | - E Pontali
- Department of Infectious Diseases, Galliera Hospital, Genova, Italy
| | - R Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - L D'Ambrosio
- Public Health Consulting Group, Lugano, Switzerland
| | - M van den Boom
- World Health Organization Regional office for Europe, Copenhagen, Denmark
| | - G Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of z, University of Sassari, Sassari, Italy
| | - G B Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy.
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Conti V, Corbi G, Manzo V, Sellitto C, Iannello F, Esposito S, De Bellis E, Iannaccone T, Filippelli A. The role of pharmacogenetics for antithrombotic therapy management: new achievements and barriers yet to overcome. Curr Med Chem 2020; 28:6675-6703. [PMID: 33390104 DOI: 10.2174/0929867328666201231124715] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/30/2020] [Accepted: 11/14/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Pharmacogenetics investigates the response to pharmacological treatments based on individual genetic background. Actually, numerous pharmacogenetic tests help to predict the response to drugs used in different medical areas, contributing to the so-called personalized medicine. OBJECTIVE This review aims to update the available data on the genotype-guided treatment with both the anticoagulant and antiplatelet agents. Moreover, it shed light on the pitfalls still contrasting the implementation of cardiovascular pharmacogenetics. METHODS A review of the literature on the studies investigating the effects of the genotype-guided anticoagulant and antiplatelet treatment was performed. RESULTS Considering the large use of antithrombotic drugs, pharmacogenetics has particular importance in this field. Several polymorphisms influence the response to both anticoagulant and antiplatelet agents, and tests, based on their identification, are now available. CONCLUSIONS Recent randomized clinical trials demonstrated that pharmacogenetics might successfully contribute to optimizing the antiplatelet therapy also in patients particularly complicated to treat. However, despite accumulating evidence on the utility and feasibility of some pharmacogenetics tests, several barriers still contrast their implementation into clinical practice.
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Affiliation(s)
- V Conti
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - G Corbi
- Department of Medicine and Health Sciences, University of Molise, Campobasso. Italy
| | - V Manzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - C Sellitto
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - F Iannello
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - S Esposito
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - E De Bellis
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - T Iannaccone
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - A Filippelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
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Esposito S, Sparaco M, Maniscalco GT, Signoriello E, Lanzillo R, Russo C, Carmisciano L, Cepparulo S, Lavorgna L, Gallo A, Trojsi F, Brescia Morra V, Lus G, Tedeschi G, Saccà F, Signori A, Bonavita S. Lifestyle and Mediterranean diet adherence in a cohort of Southern Italian patients with Multiple Sclerosis. Mult Scler Relat Disord 2020; 47:102636. [PMID: 33333418 DOI: 10.1016/j.msard.2020.102636] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 09/06/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Several studies supported the beneficial effects of the Mediterranean diet (MeDi) on chronic diseases. In Multiple Sclerosis (MS), the MeDi might interfere with systemic inflammatory state, gut microbiota, and comorbidities. The Med Diet Score (MDS) estimates the adherence to the MeDi and the cardiovascular (CV) risk. Aims of our study were i) to photograph lifestyle and diet habits of a southern Italy cohort of people with MS (pwMS), and ii) to investigate the impact of the MeDi on MS clinical outcomes. SUBJECTS/METHODS We conducted a multi-center, cross-sectional study, enrolling 435 consecutive consenting pwMS, attending the outpatient clinics for routine follow-up visits. Participants underwent a clinical examination and a 29-item self-administered questionnaire on life and dietary habits. Disease phenotype, Expanded Disability Status Scale (EDSS), MS Severity Score (MSSS), waist circumference (WC), Body Mass Index (BMI), therapies, and comorbidities, were updated. MDS was assessed and correlated with current and retrospective clinical data. RESULTS 75.8% of respondents were interested in nutrition, 72.8% were non-smokers, 52.9% performed physical activity, and 45.6% used food supplements. MDS was higher in pwMS with normal WC (p = 0.031), and inversely correlated with MSSS (p = 0.013) and EDSS (p = 0.012) at survey time. MDS did not correlate with the total number of relapses (before and after diagnosis) (p = 0.372). Metabolic comorbidities were associated with an increased 10-year CV risk (r = 0.85, p = 0.002). CONCLUSION Our findings suggest a putative beneficial effect of the MeDi on WC, MS course and disability. Given the role of chronic systemic inflammation in maintenance of autoimmunity and secondary neurodegeneration, both involved in long-term disability, we may suppose a beneficial effect of the MeDi on MS long-term disability outcomes, probably mediated by a modulation of the gut microbiota and the low-grade chronic systemic inflammation.
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Affiliation(s)
- S Esposito
- First Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - M Sparaco
- Multiple Sclerosis Center, Second Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - G T Maniscalco
- Neurological Clinic and Multiple Sclerosis Center, "AORN A. Cardarelli", Naples, Italy
| | - E Signoriello
- Multiple Sclerosis Center, Second Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - R Lanzillo
- Multiple Sclerosis Center, Department of Neuroscience, Reproductive Sciences and Odontostomatology, "Federico II University", Naples, Italy
| | - C Russo
- Multiple Sclerosis Center, Department of Neuroscience, Reproductive Sciences and Odontostomatology, "Federico II University", Naples, Italy
| | - L Carmisciano
- Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genova, Genova, Italy
| | - S Cepparulo
- Multiple Sclerosis Center, Second Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - L Lavorgna
- First Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - A Gallo
- First Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - F Trojsi
- First Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - V Brescia Morra
- Multiple Sclerosis Center, Department of Neuroscience, Reproductive Sciences and Odontostomatology, "Federico II University", Naples, Italy
| | - G Lus
- Multiple Sclerosis Center, Second Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Tedeschi
- First Division of Neurology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - F Saccà
- Multiple Sclerosis Center, Department of Neuroscience, Reproductive Sciences and Odontostomatology, "Federico II University", Naples, Italy
| | - A Signori
- Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genova, Genova, Italy
| | - S Bonavita
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
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Esposito S, Zona S, Vergine G, Fantini M, Marchetti F, Stella M, Valletta E, Biasucci G, Lanari M, Dodi I, Bigi M, Magista AM, Vaienti F, Cella A, Affanni P, Re MC, Sambri V, Principi N. How to manage children if a second wave of COVID-19 occurs. Int J Tuberc Lung Dis 2020; 24:1116-1118. [PMID: 33126950 DOI: 10.5588/ijtld.20.0543] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- S Esposito
- Paediatric Clinic, Pietro Barilla Children´s Hospital, University of Parma, Parma, Italy
| | - S Zona
- Azienda Unità Sanitaria Locale (AUSL) di Modena, Modena, Italy
| | - G Vergine
- Department of Paediatrics, Infermi Hospital Rimini, ASL Romagna, Rimini, Italy
| | - M Fantini
- Unit of Microbiology, Greater Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - F Marchetti
- Department of Paediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - M Stella
- Paediatric Clinic, ASL Romagna, Cesena, Italy
| | - E Valletta
- Department of Paediatrics, AUSL Romagna, Forlì, Italy
| | - G Biasucci
- Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - M Lanari
- Emergency Paediatrics, Policlinico Sant´Orsola, University of Bologna, Bologna, Italy
| | - I Dodi
- General and Emergency Paediatrics, Pietro Barilla Children´s Hospital, Parma, Italy
| | - M Bigi
- Paediatric Community Unit, ASL Romagna, Rimini, Italy
| | - A M Magista
- Paediatric Community Unit, ASL Romagna, Ravenna, Italy
| | - F Vaienti
- Department of Paediatrics, AUSL Romagna, Forlì, Italy
| | - A Cella
- Paediatric Emergency Unit, Guglielmo da Saliceto City Hospital, Piacenza, Italy
| | - P Affanni
- Laboratory of Hygiene and Public Health, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - M C Re
- Microbiology Unit, Policlinico Sant´Orsola, University of Bologna, Bologna, Italy
| | - V Sambri
- Unit of Microbiology, Greater Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - N Principi
- Università degli Studi di Milano, Milan, Italy, ,
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Esposito S, Stone GG, Papaparaskevas J. In vitro activity of aztreonam/avibactam against a global collection of Klebsiella pneumoniae collected from defined culture sources in 2016 and 2017. J Glob Antimicrob Resist 2020; 24:14-22. [PMID: 32841721 DOI: 10.1016/j.jgar.2020.08.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/12/2020] [Accepted: 08/03/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES This study reports on the activity of aztreonam/avibactam (ATM-AVI) against a collection of Klebsiella pneumoniae collected in 2016 and 2017. METHODS Non-duplicate K. pneumoniae isolates were collected from four regions (Africa/Middle East, n = 785; Asia-Pacific, n = 1433; Europe, n = 4236; Latin America, n = 1499) and five culture sources (blood, n = 902; intra-abdominal, n = 992; urinary tract, n = 2148; skin and skin structure, n = 1409; lower respiratory tract, n = 2502). MICs were determined at a central laboratory using Clinical and Laboratory Standards Institute (CLSI) broth microdilution methodology. Susceptibility was determined using European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints. RESULTS For all culture sources, against all K. pneumoniae, the highest rates of susceptibility were seen for amikacin (>84%), ceftazidime/avibactam (>94%), colistin (>92%) and meropenem (>83%), and >99.9% of isolates were inhibited at an ATM-AVI MIC of ≤4 mg/L. Among meropenem-resistant (MEM-R, n = 583) and meropenem-resistant metallo-β-lactamase-negative (MEM-R-MBLN; n = 469) isolates, susceptibility was highest to ceftazidime/avibactam (79.9% and 99.4%, respectively) and colistin (67.2% and 62.7%, respectively). All MEM-R-MBLN isolates from blood, intra-abdominal, urinary tract and skin and skin structure sources, and all but one isolate from respiratory sources, were inhibited at an ATM-AVI MIC of ≤2 mg/L. Against the meropenem-resistant metallo-β-lactamase positive (MEM-R-MBLP; n = 114) isolates, susceptibility to colistin was between 75.0% (urinary tract isolates) and 93.3% (lower respiratory tract isolates). All MEM-R-MBLP isolates were inhibited at an ATM-AVI MIC of ≤0.5 mg/L. CONCLUSIONS ATM-AVI is active against K. pneumoniae isolates from a range of culture sources across Africa/Middle East, Asia-Pacific, Europe and Latin America. ATM-AVI also has activity against MEM-R-MBLN and MEM-R-MBLP isolates.
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Affiliation(s)
- S Esposito
- Department of Infectious Diseases, University of Salerno, Salerno, Italy
| | - G G Stone
- Pfizer Inc., 558 Eastern Point Rd, Groton, CT 06340, USA
| | - J Papaparaskevas
- Microbiology Department, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece.
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Talarico V, Marseglia GL, Lanari M, Esposito S, Masi S, De Filippo M, Gallelli L, Licari A, Lubrano R, Zampogna S. Pediatric urticaria in the Emergency Department: epidemiological characteristics and predictive factors for its persistence in children. Eur Ann Allergy Clin Immunol 2020; 53:80-85. [PMID: 32372590 DOI: 10.23822/eurannaci.1764-1489.148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Introduction. Acute urticaria (AU) in children is a common clinical manifestation responsible for admission to the emergency department (ED). We aimed to analyze the epidemiological characteristics of AU in children and to identify predictors of both severity and progression. Material and methods. We evaluated 314 children admitted to the ED with a diagnosis of AU. We analyzed information concerning its onset, duration, severity, possible triggering factors, and the persistence of symptoms after 1, 3, and 6 months. Results. The most common etiological factors were infections (43.9%); in up to 32.4% of cases, AU was considered as idiopathic. AU was significantly most common in males and pre-school children. At the 6-month follow-up, 9.5% of children presented a persistence of urticaria, mainly those with contact (44.4%) or idiopathic (30.4%) forms. Conclusions. The AU etiology identified by history in the ED may be a significant predictor of persistence after a first attack of AU.
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Affiliation(s)
- V Talarico
- Department of Pediatrics, Pugliese-Ciaccio Hospital of Catanzaro, Catanzaro, Italy
| | - G L Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - M Lanari
- Department of Pediatric Emergency, S. Orsola Hospital, Bologna, Italy
| | - S Esposito
- Department of Medicine and Surgery, Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | - S Masi
- Department of Pediatrics, Meyer Hospital and University of Firenze, Florence, Italy
| | - M De Filippo
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - L Gallelli
- Department of Pharmacology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - A Licari
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - R Lubrano
- Department of Pediatrics, La Sapienza University of Rome, Hospital of Latina, Latina, Italy
| | - S Zampogna
- Department of Pediatrics, Pugliese-Ciaccio Hospital of Catanzaro, Catanzaro, Italy
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Turco R, Bonelli B, Armandi M, Spiridigliozzi L, Dell’Agli G, Deorsola F, Esposito S, Di Serio M. Active and stable ceria-zirconia supported molybdenum oxide catalysts for cyclooctene epoxidation: Effect of the preparation procedure. Catal Today 2020. [DOI: 10.1016/j.cattod.2019.10.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Esposito S, Aversano R, Bradeen JM, Di Matteo A, Villano C, Carputo D. Deep-sequencing of Solanum commersonii small RNA libraries reveals riboregulators involved in cold stress response. Plant Biol (Stuttg) 2020; 22 Suppl 1:133-142. [PMID: 30597710 DOI: 10.1111/plb.12955] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/22/2018] [Indexed: 06/09/2023]
Abstract
Among wild species used in potato breeding, Solanum commersonii displays the highest tolerance to low temperatures under both acclimated (ACC) and non-acclimated (NACC) conditions. It is also the first wild potato relative with a known whole genome sequence. Recent studies have shown that abiotic stresses induce changes in the expression of many small non-coding RNA (sncRNA). We determined the small non-coding RNA (sncRNAome) of two clones of S. commersonii contrasting in their cold response phenotypes via smRNAseq. Differential analysis provided evidence that expression of several miRNAs changed in response to cold stress conditions. Conserved miR408a and miR408b changed their expression under NACC conditions, whereas miR156 and miR169 were differentially expressed only under ACC conditions. We also report changes in tasiRNA and secondary siRNA expression under both stress conditions. Our results reveal possible roles of sncRNA in the regulatory networks associated with tolerance to low temperatures and provide useful information for a more strategic use of genomic resources in potato breeding.
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Affiliation(s)
- S Esposito
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy
| | - R Aversano
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy
| | - J M Bradeen
- Department of Plant Pathology and The Stakman-Borlaug Center for Sustainable Plant Health, University of Minnesota, St. Paul, MN, USA
| | - A Di Matteo
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy
| | - C Villano
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy
| | - D Carputo
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy
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Marfella R, Cacciatore F, Balestrieri ML, Esposito S, Mansueto G, Paolisso P, Golino P, Amarelli C, Maiello C, Ursomando F, Salerno G, Palmieri V, Benincasa G, Paolisso G, Napoli C. P4543Steatosis in explanted heart of type 2 diabetic patients with end-stage heart failure: progression of intra-myocytes fat accumulation in non-diabetic heart implanted in diabetic patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
How metabolic impairment leads to cardiac dysfunction in diabetics is unknown. A recent theory, derived mainly from rodent models, involves lipid over-storage to cardiomyocytes. Previous human study demonstrated cardiac steatosis on explanted hearts of diabetics with heart failure. However, this study did not provide any evidence about the effects of diabetes milieu on implanted non-diabetic heart.
Purpose
We evaluated intramyocyte lipid infiltration in explanted heart of type 2 diabetics with end-stage heart failure. Moreover, we studied the effects of diabetic milieu on myocyte lipid infiltration and cardiac function of non-diabetic implanted hearts in type 2 diabetics one year after heart transplantation (HTx).
Methods
We conducted a prospective study with a follow-up of 12 months on 88 patients over 18 years of age underwent first HTX. Patients with pre-HTx diabetes duration for at least 6 months were included in the study. Patients with endomyocardial biopsy (EMB) considered positive for rejection, according to International Society for Heart Lung Transplantation (ISHLT), and with post-HTx diabetes were excluded from the study. All patients underwent immunosuppression induction according ISHLT indications. All patients were followed applying internationally accepted patient evaluations (echocardiography and metabolic control) and EMB schedules. EBM from patients without rejection evidences were evaluated for intramyocyte lipid infiltration with oil red-O staining (Or-O).
Results
The patients were divided in diabetics (44%, age 51.6±7.2 y, diabetes duration 11±3 y) and no-diabetics (56%, 52.1±10.9 y). The patients were matched on the basis of eligibility for a HTx. Seven patients (3 diabetics and 4 no-diabetics) died in hospital. 5 (11%) patients developed post- HTx diabetes. No differences were seen in rejection (12% vs. 10%), infection (9% vs. 10%), renal dysfunction (9% vs. 8%) or mortality (7% vs. 8%). Therefore, the study population included 23 no-diabetics and 22 diabetics. After 1 year, we evidenced an impairment of both sx and dx ventricular function as showed by a significantly reduction of ejection fraction and TAPSE in diabetic patients (Figure-A). Although diastolic function not show significant differences among groups, the E/e' ratio showed lower reduction in diabetics. Or-O evidenced that 91% of diabetic and only 2 of no-diabetic explanted hearts (9%) showed intramyocyte lipid infiltration (Figure-B). Moreover, Or-O of EMB, for monitoring heart transplant during 1 year, evidenced a progressive intramyocyte lipid infiltration in 18 diabetics (81%), whereas none of no-diabetics showed intramyocyte lipid infiltration.
Conclusions
Our data show that almost all of the explanted diabetic hearts had intramyocyte lipid infiltration. More interesting, we observed that healthy heart transplanted in recipients with pretransplant diabetes were affected early by metabolic disorders leading to intramyocyte lipid infiltration.
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Affiliation(s)
- R Marfella
- University della Campania Luigi Vanvitelli, Clinical Department of Internal Medicine and Specialistics, Naples, Italy
| | - F Cacciatore
- Federico II University of Naples, Department of Translational Medical Sciences, Naples, Italy
| | - M L Balestrieri
- University della Campania Luigi Vanvitelli, Department of Precision Medicine, Naples, Italy
| | - S Esposito
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - G Mansueto
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - P Paolisso
- University della Campania Luigi Vanvitelli, Clinical Department of Internal Medicine and Specialistics, Naples, Italy
| | - P Golino
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - C Amarelli
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - C Maiello
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - F Ursomando
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - G Salerno
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - V Palmieri
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - G Benincasa
- University della Campania Luigi Vanvitelli, Clinical Department of Internal Medicine and Specialistics, Naples, Italy
| | - G Paolisso
- University della Campania Luigi Vanvitelli, Clinical Department of Internal Medicine and Specialistics, Naples, Italy
| | - C Napoli
- University della Campania Luigi Vanvitelli, Clinical Department of Internal Medicine and Specialistics, Naples, Italy
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Marcone R, Caputo A, Esposito S, Senese VP. Prejudices towards people with intellectual disabilities: reliability and validity of the Italian Modern and Classical Prejudices Scale. J Intellect Disabil Res 2019; 63:911-916. [PMID: 30628119 DOI: 10.1111/jir.12590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 12/11/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Prejudices and negative attitudes towards intellectual disabilities (IDs) may hinder social inclusion of ID individuals, limiting their well-being. This study investigated the psychometric characteristics of the Italian Modern and Classical Prejudices Scale (MCPS-IT) towards people with ID and the effects of gender, age and socio-economic status (SES) on prejudices. METHOD The MCPS-IT was administered to 474 adults (69% women, age range 18-70 years, M = 33.13) in conjunction with a questionnaire evaluating socio-demographic information (SES), the contact and the education about ID people and the social dominance orientation. RESULTS Results confirmed that Italian MCPS has a two-factor structure that measures in a reliable and valid way prejudice towards people with ID. Multivariate analyses of variance confirmed a weak gender difference in both scales and age differences in modern scale. No SES differences were found. CONCLUSION The Italian MCPS represents a valid scale that can be used to monitor the social context of people with ID.
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Affiliation(s)
- R Marcone
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Caserta, Italy
| | - A Caputo
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Caserta, Italy
| | - S Esposito
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Caserta, Italy
| | - V P Senese
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Caserta, Italy
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Lavorgna L, Esposito S, Lanzillo R, Sparaco M, Ippolito D, Cocco E, Fenu G, Borriello G, De Mercanti S, Frau J, Capuano R, Trojsi F, Rosa L, Clerico M, Laroni A, Morra VB, Tedeschi G, Bonavita S. Factors interfering with parenthood decision-making in an Italian sample of people with multiple sclerosis: an exploratory online survey. J Neurol 2019; 266:707-716. [PMID: 30649617 DOI: 10.1007/s00415-019-09193-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 12/21/2018] [Accepted: 01/08/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Little is known about the influence of multiple sclerosis (MS) diagnosis on parenthood attitude in people with MS (pwMS). OBJECTIVE To investigate the impact of diagnosis, clinical features and external disease-related influences on parenthood decision-making in Italian pwMS. METHODS A web-based survey was posted on SMsocialnetwork.com to investigate clinical status, parenthood desire, influences on family planning, pregnancy outcomes, abortions and adoptions of pwMS. RESULTS 33/395 respondents never wanted to become parent because of MS ("anti-parenthood after diagnosis"). 362 declared to be in favor of parenthood. 51% pwMS having a child by the survey time had already received the MS diagnosis at first childbirth. The frequency of a second child in pwMS after diagnosis was 38% compared to 67% in people without yet MS diagnosis. 16% of pwMS were discouraged to become parent after diagnosis, mainly by medical personnel. In 71% of respondents, diagnosis did not delay the decision to become parent and only 39% were counseled by treating physician to plan pregnancy. Patients' distribution according to the clinical phenotype (exclusively relapsing vs exclusively progressive) showed a higher proportion of progressive patients in the "anti-parenthood after diagnosis" subgroup. CONCLUSION MS diagnosis impacted dramatically on the life project of 7% of pwMS that decided not to have children because of the disease and in pro-parenthood pwMS impacted especially on having the second child. Only a minority was counseled to plan pregnancy. A worse disease course driving to a progressive phenotype at survey time might have negatively impacted on parenthood desire.
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Affiliation(s)
- L Lavorgna
- First Division of Neurology, University of Campania Luigi Vanvitelli, Piazza Miraglia, 2, 80138, Naples, Italy.
| | - S Esposito
- First Division of Neurology, University of Campania Luigi Vanvitelli, Piazza Miraglia, 2, 80138, Naples, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - R Lanzillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II, Naples, Italy
| | - M Sparaco
- First Division of Neurology, University of Campania Luigi Vanvitelli, Piazza Miraglia, 2, 80138, Naples, Italy
| | - D Ippolito
- First Division of Neurology, University of Campania Luigi Vanvitelli, Piazza Miraglia, 2, 80138, Naples, Italy
| | - E Cocco
- Department of Medical Sciences and Public Health, Multiple Sclerosis Centre, Binaghi Hospital, University of Cagliari, Cagliari, Italy
| | - G Fenu
- Department of Medical Sciences and Public Health, Multiple Sclerosis Centre, Binaghi Hospital, University of Cagliari, Cagliari, Italy
| | - G Borriello
- Department of Neurology and Psychiatry, S. Andrea MS Center, Sapienza University, Rome, Italy
| | - S De Mercanti
- Clinical and Biological Sciences Department, University of Torino, Turin, Italy
| | - J Frau
- Department of Medical Sciences and Public Health, Multiple Sclerosis Centre, Binaghi Hospital, University of Cagliari, Cagliari, Italy
| | - R Capuano
- First Division of Neurology, University of Campania Luigi Vanvitelli, Piazza Miraglia, 2, 80138, Naples, Italy
| | - F Trojsi
- First Division of Neurology, University of Campania Luigi Vanvitelli, Piazza Miraglia, 2, 80138, Naples, Italy
| | - L Rosa
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II, Naples, Italy
| | - M Clerico
- Clinical and Biological Sciences Department, University of Torino, Turin, Italy
| | - A Laroni
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - V Brescia Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II, Naples, Italy
| | - G Tedeschi
- First Division of Neurology, University of Campania Luigi Vanvitelli, Piazza Miraglia, 2, 80138, Naples, Italy
- Neurological Institute for Diagnosis and Care "Hermitage Capodimonte", MRI Center SUN-FISM, Naples, Italy
| | - S Bonavita
- First Division of Neurology, University of Campania Luigi Vanvitelli, Piazza Miraglia, 2, 80138, Naples, Italy
- Neurological Institute for Diagnosis and Care "Hermitage Capodimonte", MRI Center SUN-FISM, Naples, Italy
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Giuliani G, Esposito S, Formisano G, Misitano P, Krizzuk D, Bianchi P. Robotic total mesorectal excision for low and ultralow rectal cancer: Short-term postoperative outcomes and long-term survival. Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Lavorgna L, De Stefano M, Sparaco M, Moccia M, Abbadessa G, Montella P, Buonanno D, Esposito S, Clerico M, Cenci C, Trojsi F, Lanzillo R, Rosa L, Morra VB, Ippolito D, Maniscalco G, Bisecco A, Tedeschi G, Bonavita S. Fake news, influencers and health-related professional participation on the Web: A pilot study on a social-network of people with Multiple Sclerosis. Mult Scler Relat Disord 2018; 25:175-178. [PMID: 30096683 DOI: 10.1016/j.msard.2018.07.046] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/04/2018] [Accepted: 07/29/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Over the last few decades, patients have increasingly been searching for health information on the Internet. This aspect of information seeking is important, especially for people affected by chronic pathologies and require lifelong treatment and management. These people are usually very well informed about the disease but are nonetheless vulnerable to hopes of being cured or saved, often amplified by misinformation, myths, legends, and therapies that are not always scientifically proven. Many studies suggest that some individuals prefer to rely on the Internet as their main source of information, often hindering the patient-doctor relationship. A professional approach is imperative to maintain confidentiality, honesty, and trust in the medical profession. OBJECTIVE we aimed to examine, in a medically supervised Italian web community (SMsocialnetwotk.com) dedicated to people with Multiple Sclerosis (pwMS), the posts shared by users and to verify the reliability of contents of posts shared by users pinpointed as Influencers through an online questionnaire. METHODS we grouped the posts published on SMsocialnetwork from April to June 2015 into those with medical content (scientifically correct or fake news), and those related to social interactions. Later, we gave a questionnaire to the community asking to identify the three users/Influencers providing the most reliable advice for everyday life with MS and the three users/Influencers providing the most useful information about MS treatments. RESULTS 308 posts reported scientific and relevant medical information, whereas 72 posts included pieces of fake news. 1420 posts were of general interest. Four out of the 6 Influencers had written only posts with correct medical information (3 were pwMS, 1 was a Neurologist) and never any fake news. The remaining 2 appointed Influencers (2 pwMS) had written only posts about general interests. CONCLUSION the identification of fake news and their authors has shown that the latter are never appointed as Influencers. SMsocialnetwork.com acted as a "web safe environment" where the Influencers contributed by sharing only correct medical information and never fake news. We speculate that the presence of neurologists and psychologists supervising the information flow might have contributed to reduce the risk of fake news spreading and to avoid their acquisition of authoritative meaning.
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Affiliation(s)
- L Lavorgna
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy.
| | - M De Stefano
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy
| | - M Sparaco
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy
| | - M Moccia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy
| | - G Abbadessa
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy
| | - P Montella
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy
| | - D Buonanno
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy
| | - S Esposito
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy
| | - M Clerico
- Department of Biological and Clinical Sciences, University of Torino, Italy
| | - C Cenci
- Center for Digital Health Humanities, Rome, Italy
| | - F Trojsi
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy
| | - R Lanzillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy
| | - L Rosa
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy
| | - V Brescia Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy
| | - D Ippolito
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy
| | - G Maniscalco
- Multiple Sclerosis Center, Cardarelli Hospital, Naples, Italy
| | - A Bisecco
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy
| | - G Tedeschi
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy
| | - S Bonavita
- Ist Clinic of Neurology, University of Campania "Luigi Vanvitelli", Italy
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Orsi A, Azzari C, Bozzola E, Chiamenti G, Chirico G, Esposito S, Francia F, Lopalco P, Prato R, Russo R, Villani A, Franco E. Hexavalent vaccines: characteristics of available products and practical considerations from a panel of Italian experts. J Prev Med Hyg 2018; 59:E107-E119. [PMID: 30083617 PMCID: PMC6069402] [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] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 05/30/2018] [Indexed: 06/08/2023]
Abstract
Combination vaccines represent a valuable technological innovation in the field of infectious disease prevention and public health, because of their great health and economic value from the individual, societal, and healthcare system perspectives. In order to increase parents' and healthcare professionals' confidence in the vaccination programs and maintain their benefits to society, more information about the benefits of innovative vaccination tools such as combination vaccines is needed. Purpose of this work is an examination of available hexavalent vaccines, that protect against Diphtheria, Tetanus, Pertussis, Poliomyelitis, Hepatitis B and Haemophilus influenzae type b infections. From the epidemiological updates of vaccine preventable diseases to the vaccine development cycle, from the immunogenicity of antigenic components to the safety and co-administration with other vaccines, several aspects of available hexavalent vaccines are discussed and deepened. Also a number of practical considerations on schedules, age of employment, strategies for vaccination recovery, vaccination in at-risk births are issued, based on the recommendations of Italian Ministry of Health, Italian Society of Pharmacology (SIF), Italian Society for Pediatrics (SIP), Italian Federation of Family Paediatricians (FIMP) and Italian Society of Hygiene, Preventive Medicine and Public Health (SItI).
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Affiliation(s)
- A. Orsi
- Department of Health Sciences, University of Genoa, “Ospedale Policlinico San Martino IRCCS” Teaching Hospital, Genoa, Italy
| | - C. Azzari
- Pediatric Immunology Unit “Anna Meyer” Hospital, University of Florence, Italy
| | - E. Bozzola
- Bambino Gesù Children Hospital, Pediatric and Infectious Diseases Unit, Rome, Italy
| | - G. Chiamenti
- Italian Federation of Family Paediatricians (FIMP), Verona, Italy
| | - G. Chirico
- Neonatal Intensive Care Unit, ASST Spedali Civili, Children Hospital of Brescia, Italy
| | - S. Esposito
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Italy
| | - F. Francia
- Italian Society of Hygiene, Preventive Medicine and Public Health (SitI) and Department of Public Health, Local Health Authority of Bologna, Italy
| | - P. Lopalco
- Hygiene and Epidemiology section, Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - R. Prato
- Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - R. Russo
- Maternity and Pediatrics Services, Local Health Authority of Benevento, Italy
| | - A. Villani
- Bambino Gesù Children Hospital, Pediatric and Infectious Diseases Unit, Rome, Italy
- Italian Society for Pediatrics (SIP)
| | - E. Franco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Solaro C, Cella M, Signori A, Martinelli V, Radaelli M, Centonze D, Sica F, Grasso MG, Clemenzi A, Bonavita S, Esposito S, Patti F, D'Amico E, Cruccu G, Truini A. Identifying neuropathic pain in patients with multiple sclerosis: a cross-sectional multicenter study using highly specific criteria. J Neurol 2018; 265:828-835. [PMID: 29404736 DOI: 10.1007/s00415-018-8758-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pain is a common and heterogeneous complication of multiple sclerosis (MS). In this multicenter, cross sectional study, we aimed at investigating the prevalence of pain in MS using highly specific criteria for distinguishing the different types of pain. MATERIALS AND METHODS After a structured interview, in patients with pain, clinical examination and DN4 questionnaire were used for distinguishing neuropathic and nociceptive pain. In subjects with neuropathic pain, the Neuropathic Pain Symptom Inventory was used for differentiating neuropathic pain symptoms. RESULTS We enrolled 1249 participants (832 F, 417 M, mean age 33.9 years, mean disease duration 8 years, mean EDSS 3.2); based on clinical evaluation and DN4 score 429 patients (34.34%) were classified with pain (470 pain syndromes): 286 nociceptive pain syndromes and 184 neuropathic pain syndromes. Multivariate analysis showed that pain was associated with age, gender and disease severity and that neuropathic pain was distinctly associated with EDSS. CONCLUSIONS Our study, providing definite information on the prevalence, characteristics and variables associated with neuropathic pain due to MS, shows that a more severe disease course is associated with a higher risk of neuropathic pain. Our findings might, therefore, provide a basis for improving the clinical management of this common MS complication.
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Affiliation(s)
- Claudio Solaro
- Department of Rehabilitation, Mons Luigi Novarese Novarese, Moncrivello, Italy.
| | - M Cella
- Department of Neurology, ASL3 Genovese, Genoa, Italy
| | - Alessio Signori
- Section of Biostatistics, Department of Health Sciences, University of Genova, Genoa, Italy
| | | | - Marta Radaelli
- Department of Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - D Centonze
- Neurology Clinic, Department of Systems Medicine, Tor Vergata University, Rome, Italy.,Istituto Neurologico Mediterraneo Neuromed, IRCCS, Pozzilli (IS), Italy
| | - F Sica
- Neurology Clinic, Department of Systems Medicine, Tor Vergata University, Rome, Italy.,Istituto Neurologico Mediterraneo Neuromed, IRCCS, Pozzilli (IS), Italy
| | - M G Grasso
- Santa Lucia Foundation, IRCCS, Rome, Italy
| | - A Clemenzi
- Santa Lucia Foundation, IRCCS, Rome, Italy
| | - S Bonavita
- Clinic of Neurology, Second University of Naples, Naples, Italy
| | - S Esposito
- Clinic of Neurology, Second University of Naples, Naples, Italy
| | - F Patti
- Department of Neurosciences, University of Catania, Catania, Italy
| | - E D'Amico
- Department of Neurosciences, University of Catania, Catania, Italy
| | - G Cruccu
- Department of Neurology and Psychiatry, University of Rome-La Sapienza, Rome, Italy
| | - A Truini
- Department of Neurology and Psychiatry, University of Rome-La Sapienza, Rome, Italy
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Frati F, Incorvaia C, Cavaliere C, Di Cara G, Marcucci F, Esposito S, Masieri S. The skin prick test. J BIOL REG HOMEOS AG 2018; 32:19-24. [PMID: 29552869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The skin prick test (SPT) is the most common test for the diagnosis of allergy. SPT is performed by pricking the skin, usually in the volar surface of the forearm, with a lancet through a drop of an allergen extract and is usually the first choice test in the diagnostic workup for allergic diseases because of its reliability, safety, convenience and low cost. SPT is minimally invasive and has the advantage of testing multiple allergens in 15 to 20 min. In children, SPT is far less disturbing than venipuncture and is used to obtain a sample of serum to measure specific IgE through in vitro tests. There is a good correlation (about 85-95%) between SPT and in vitro tests. Globally, SPT is an excellent diagnostic tool, with a positive predictive value ranging from 95-100%. SPTs can identify sensitivity to inhalants, foods, some drugs, occupational allergens, hymenoptera venom and latex. However, the relevance of such sensitivity to allergens should always be carefully interpreted in the light of the clinical history, because sensitization and clinical allergy may not coincide. In regards to safety, though the reports of systemic reactions, and particularly anaphylaxis, are very rare, in vitro IgE tests should be preferred if previous severe reactions emerge from the patients clinical history.
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Affiliation(s)
- F Frati
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - C Incorvaia
- Cardiac/Pulmonary Rehabilitation, ASST Pini/CTO, Milan, Italy
| | - C Cavaliere
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - G Di Cara
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - F Marcucci
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - S Esposito
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - S Masieri
- Department of Sense Organs, Sapienza University, Rome, Italy
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Petz W, Ribero D, Bertani E, Borin S, Formisano G, Esposito S, Spinoglio G, Bianchi P. Suprapubic approach for robotic complete mesocolic excision in right colectomy: Oncologic safety and short-term outcomes of an original technique. Eur J Surg Oncol 2017; 43:2060-2066. [DOI: 10.1016/j.ejso.2017.07.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 05/30/2017] [Accepted: 07/27/2017] [Indexed: 02/06/2023] Open
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Esposito S, Principi N. Impact of nasopharyngeal microbiota on the development of respiratory tract diseases. Eur J Clin Microbiol Infect Dis 2017; 37:1-7. [PMID: 28795339 DOI: 10.1007/s10096-017-3076-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/24/2017] [Indexed: 12/31/2022]
Abstract
Knowledge of whether and how respiratory microbiota composition can prime the immune system and provide colonisation resistance, limiting consecutive pathobiont overgrowth and infections, is essential to improving the prevention and therapy of respiratory disorders. Modulation of dysbiotic ecosystems or reconstitution of missing microbes might be a possible measure to reduce respiratory diseases. The aim of this review is to analyse the role of nasopharyngeal microbiota in the development of respiratory tract disease in paediatric-age subjects. PubMed was used to search for all studies published over the last 15 years using the following key words: "microbiota" or "microbioma" and "nasopharyngeal" or "respiratory" or "nasal" and "children" or "paediatric" or "infant". Analysis of the literature showed that respiratory microbiota can regulate health and disease development in the respiratory tract. Like the gut microbiota, the respiratory microbiota is established at birth, and early respiratory microbiota composition determines bacterial succession patterns and respiratory health in children. Protective and dangerous bacteria have been identified, and this can be considered the base for developing new approaches to diseases that respond poorly to traditional interventions. Reconstitution of missing microbes can be achieved by the administration of pre- and probiotics. Modulation of respiratory microbiota by favouring colonisation of the upper respiratory tract by beneficial commensals can interfere with the proliferation and activity of resident pathobionts and is a possible new measure to reduce the risk of disease. However, further studies are needed because a deeper understanding of these and related issues can be transferred to clinical practice.
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Affiliation(s)
- S Esposito
- Pediatric Clinic, Università degli Studi di Perugia, Piazza Menghini 1, 06129, Perugia, Italy.
| | - N Principi
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
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Rodari G, Guez S, Manzoni F, Chalouhi KK, Profka E, Bergamaschi S, Salera S, Tadini G, Ulivieri FM, Spada A, Giavoli C, Esposito S. Birmingham epidermolysis severity score and vitamin D status are associated with low BMD in children with epidermolysis bullosa. Osteoporos Int 2017; 28:1385-1392. [PMID: 28012019 DOI: 10.1007/s00198-016-3883-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 12/12/2016] [Indexed: 10/20/2022]
Abstract
UNLABELLED Bone status impairment represents a complication of generalized forms of epidermolysis bullosa (EB); however, the prevalence and the main determinants of this event in localized forms remain poorly defined. Birmingham epidermolysis bullosa severity (BEBS) score and 25-hydroxyvitamin D levels are strongly associated with low bone mass, suggesting that vitamin D may play a potential beneficial role in bone health. Further longitudinal studies are needed in order to confirm this hypothesis. INTRODUCTION Bone status impairment represents a complication of generalized forms of EB; thus, we aimed to estimate the prevalence of low bone mass, to examine mineralization differences in various EB subtypes and to identify the most important determinants of bone impairment in children with either generalized or localized EB. METHODS An observational study of 20 children (11 males; mean age ± standard deviation, 11.7 ± 3.9 years) with EB was performed. Clinical history, physical examination, laboratory studies, X-ray of the left hand and wrist for bone age, and dual energy X-ray absorptiometry scans of the lumbar spine were obtained. Areal bone mineral density (aBMD Z-scores) and bone mineral apparent density were related to the BEBS score. RESULTS Areal BMD Z-score (mean -1.82 ± 2.33, range, -7.6-1.7) was reduced (<-2 SD) in 8 patients (40%), whereas aBMD Z-score adjusted for bone age was low in 7 patients (35%). BEBS score and 25-hydroxyvitamin D serum levels were the most important elements associated with aBMD (P = 0.0001 and P = 0.016, respectively). A significant correlation between the aBMD Z-score and area of skin damage, insulin-like growth factor-1, C-reactive protein, and sodium serum levels was also found. CONCLUSIONS Low aBMD can be considered a systemic complication of EB, primarily associated with BEBS score and 25-hydroxyvitamin D levels. Therefore, longitudinal evaluation of bone status is ongoing in these patients to define whether vitamin D supplementation would prevent, or at least reduce, bone status impairment.
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Affiliation(s)
- G Rodari
- Endocrinology and Metabolic Diseases Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S Guez
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F Manzoni
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - K K Chalouhi
- Department of Radiology, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, Italy
| | - E Profka
- Endocrinology and Metabolic Diseases Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S Bergamaschi
- Endocrinology and Metabolic Diseases Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S Salera
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Tadini
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F M Ulivieri
- Bone Metabolic Unit, Division of Nuclear Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Spada
- Endocrinology and Metabolic Diseases Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - C Giavoli
- Endocrinology and Metabolic Diseases Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - S Esposito
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Russo A, Concia E, Cristini F, De Rosa FG, Esposito S, Menichetti F, Petrosillo N, Tumbarello M, Venditti M, Viale P, Viscoli C, Bassetti M. Current and future trends in antibiotic therapy of acute bacterial skin and skin-structure infections. Clin Microbiol Infect 2017; 22 Suppl 2:S27-36. [PMID: 27125562 DOI: 10.1016/s1198-743x(16)30095-7] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [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: 03/26/2016] [Revised: 04/15/2016] [Accepted: 04/17/2016] [Indexed: 12/26/2022]
Abstract
In 2013 the US Food and Drug Administration (FDA) issued recommendations and guidance on developing drugs for treatment of skin infection using a new definition of acute bacterial skin and skin-structure infection (ABSSSI). The new classification includes cellulitis, erysipelas, major skin abscesses and wound infection with a considerable extension of skin involvement, clearly referring to a severe subset of skin infections. The main goal of the FDA was to better identify specific infections where the advantages of a new antibiotic could be precisely estimated through quantifiable parameters, such as improvement of the lesion size and of systemic signs of infection. Before the spread and diffusion of methicillin-resistant Staphylococcus aureus (MRSA) in skin infections, antibiotic therapy was relatively straightforward. Using an empiric approach, a β-lactam was the preferred therapy and cultures from patients were rarely obtained. With the emergence of MRSA in the community setting, initial ABSSSI management has been changed and readdressed. Dalbavancin, oritavancin and tedizolid are new drugs, approved or in development for ABSSSI treatment, that also proved to be efficient against MRSA. Dalbavancin and oritavancin have a long half-life and can be dosed less frequently. This in turn makes it possible to treat patients with ABSSSI in an outpatient setting, avoiding hospitalization or potentially allowing earlier discharge, without compromising efficacy. In conclusion, characteristics of long-acting antibiotics could represent an opportunity for the management of ABSSSI and could profoundly modify the management of these infections by reducing or in some cases eliminating both costs and risks of hospitalization.
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Affiliation(s)
- A Russo
- Department of Public Health and Infectious Diseases, 'Sapienza' University of Rome, Rome, Italy
| | - E Concia
- Division of Infectious Diseases, Department of Pathology, Azienda Ospedaliera Universitaria Integrata di Verona, Policlinico 'G.B. Rossi', Verona, Italy
| | - F Cristini
- Infectious Diseases Unit - Department of Medical and Surgical Sciences, University of Bologna, Teaching Hospital S. Orsola-Malpighi, Bologna, Italy
| | - F G De Rosa
- Department of Medical Sciences, University of Turin; Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy
| | - S Esposito
- Department of Infectious Diseases, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Università di Salerno, Salerno, Italy
| | - F Menichetti
- Infectious Disease Unit, Nuovo Santa Chiara Hospital, Pisa, Italy
| | - N Petrosillo
- National Institute for Infectious Diseases Lazzaro Spallanzani-INMI IRCCS, Rome, Italy
| | - M Tumbarello
- Institute of Infectious Diseases, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, 'Sapienza' University of Rome, Rome, Italy
| | - P Viale
- Infectious Diseases Unit - Department of Medical and Surgical Sciences, University of Bologna, Teaching Hospital S. Orsola-Malpighi, Bologna, Italy
| | - C Viscoli
- Infectious Diseases Division, University of Genoa and IRCCS San Martino-IST, Genoa, Italy
| | - M Bassetti
- Infectious Diseases Division, Santa Maria Misericordia Hospital, Udine, Italy.
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Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, Esposito S, Ganmaa D, Goodall EC, Grant C, Janssens W, Laaksi I, Manaseki-Holland S, Murdoch D, Neale RE, Rees JR, Simpson S, Stelmach I, Kumar GT, Urashima M, Camargo CA. S102 Vitamin d supplementation to prevent acute respiratory infections: systematic review and meta-analysis of individual participant data. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.108] [Citation(s) in RCA: 5] [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: 11/03/2022]
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Chiappini E, Lo Vecchio A, Garazzino S, Marseglia GL, Bernardi F, Castagnola E, Tomà P, Cirillo D, Russo C, Gabiano C, Ciofi D, Losurdo G, Bocchino M, Tortoli E, Tadolini M, Villani A, Guarino A, Esposito S. Recommendations for the diagnosis of pediatric tuberculosis. Eur J Clin Microbiol Infect Dis 2016; 35:1-18. [PMID: 26476550 DOI: 10.1007/s10096-015-2507-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 10/07/2015] [Indexed: 01/10/2023]
Abstract
Tuberculosis (TB) is still the world's second most frequent cause of death due to infectious diseases after HIV infection, and this has aroused greater interest in identifying and managing exposed subjects, whether they are simply infected or have developed one of the clinical variants of the disease. Unfortunately, not even the latest laboratory techniques are always successful in identifying affected children because they are more likely to have negative cultures and tuberculin skin test results, equivocal chest X-ray findings, and atypical clinical manifestations than adults. Furthermore, they are at greater risk of progressing from infection to active disease, particularly if they are very young. Consequently, pediatricians have to use different diagnostic strategies that specifically address the needs of children. This document describes the recommendations of a group of scientific societies concerning the signs and symptoms suggesting pediatric TB, and the diagnostic approach towards children with suspected disease.
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De Cosmi V, Mehta NM, Boccazzi A, Milani GP, Esposito S, Bedogni G, Agostoni C. Nutritional status, metabolic state and nutrient intake in children with bronchiolitis. Int J Food Sci Nutr 2016; 68:378-383. [PMID: 27790933 DOI: 10.1080/09637486.2016.1245714] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Nutrition has a coadjuvant role in the management of children with acute diseases. We aimed to examine nutritional status, macronutrient requirements and actual macronutrient delivery in bronchiolitis. The nutritional status was classified according to WHO criteria and resting energy expenditure (MREE) was measured using an indirect calorimeter. Bland-Altman analysis was used to examine the agreement between MREE and estimated energy expenditure (EEE) with standard equations. Based on the ratio MREE/EEE in relation to Schofield equation on admission, we defined the subjects' metabolic status. A total of 35 patients were enrolled and 46% were malnourished on admission, and 25.8% were hypermetabolic, 37.1% hypometabolic and 37.1% normometabolic. We performed a 24-h recall in 10 children and 80% were overfed (AEI: MREE >120%). Mean bias (limits of agreement) with MREE was 8.9 (-73.9 to 91.8%) for Schofield; 61.0 (-41 to 163%) for Harris-Benedict; and 9.9 (-74.4 to 94.2%) for FAO-WHO equation. Metabolism of infants with bronchiolitis is not accurately estimated by equations.
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Affiliation(s)
- V De Cosmi
- a Pediatric Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Laboratorio di Statistica Medica, Biometria ed Epidemiologia 'G.A. Maccacaro' Department of Clinical Sciences and Community Health , University of Milan , Milan , Italy
| | - N M Mehta
- b Division of Critical Care Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine , Boston Children's Hospital, Boston, Massachusetts; Center for Nutrition, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School , Boston , MA , USA
| | - A Boccazzi
- c Pediatric Intermediate Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , University of Milan , Milan , Italy
| | - G P Milani
- d Pediatric Emergency Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico , Milan , Italy
| | - S Esposito
- e Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , University of Milan , Milan , Italy
| | - G Bedogni
- c Pediatric Intermediate Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , University of Milan , Milan , Italy
| | - C Agostoni
- c Pediatric Intermediate Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , University of Milan , Milan , Italy
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Esposito S, Noviello S. Quale Ruolo per i Glicopeptidi in Terapia Intensiva? J Chemother 2016. [DOI: 10.1080/1120009x.2003.11782354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Esposito S. La Monosomministrazione è Sufficiente per Ciascun Tipo di Antibiotico-Profilassi in Chirurgia? J Chemother 2016. [DOI: 10.1080/1120009x.1999.11782279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lo Vecchio A, Lancella L, Tagliabue C, De Giacomo C, Garazzino S, Mainetti M, Cursi L, Borali E, De Vita MV, Boccuzzi E, Castellazzi L, Esposito S, Guarino A. Clostridium difficile infection in children: epidemiology and risk of recurrence in a low-prevalence country. Eur J Clin Microbiol Infect Dis 2016; 36:177-185. [PMID: 27696233 DOI: 10.1007/s10096-016-2793-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 09/16/2016] [Indexed: 02/07/2023]
Abstract
Clostridium difficile infection (CDI) is increasingly found in children worldwide, but limited data are available from children living in southern Europe. A 6-year retrospective study was performed to investigate the epidemiology, clinical features, treatment, and risk of recurrence in Italy. Data of children with community- and hospital-acquired CDI (CA-CDI and HA-CDI, respectively) seen at seven pediatric referral centers in Italy were recorded retrospectively. Annual infection rates/10,000 hospital admissions were calculated. Logistic regression was used to investigate risk factors for recurrence. A total of 177 CDI episodes was reported in 148 children (83 males, median age 55.3 months), with a cumulative infection rate of 2.25/10,000 admissions, with no significant variability over time. The majority of children (60.8 %) had CA-CDI. Children with HA-CDI (39.2 %) had a longer duration of symptoms and hospitalization (p = 0.003) and a more common previous use of antibiotics (p = 0.0001). Metronidazole was used in 70.7 % of cases (87/123) and vancomycin in 29.3 % (36/123), with similar success rates. Recurrence occurred in 16 children (10.8 %), and 3 (2 %) of them presented a further treatment failure. The use of metronidazole was associated with a 5-fold increase in the risk of recurrence [odds ratio (OR) 5.18, 95 % confidence interval (CI) 1.1-23.8, p = 0.03]. Short bowel syndrome was the only underlying condition associated with treatment failure (OR 5.29, 95 % CI 1.17-23.8, p = 0.03). The incidence of pediatric CDI in Italy is low and substantially stable. In this setting, there is a limited risk of recurrence, which mainly concerns children treated with oral metronidazole and those with short bowel syndrome.
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Affiliation(s)
- A Lo Vecchio
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - L Lancella
- Ospedale Pediatrico Bambino Gesù, Piazza Sant'Onofrio 4, Rome, Italy
| | - C Tagliabue
- Università degli Studi di Milano Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Gaetano Pini 3, Milan, Italy
| | - C De Giacomo
- Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore 3, Milan, Italy
| | - S Garazzino
- Regina Margherita Children's Hospital, University of Turin, Piazza Polonia 94, Turin, Italy
| | - M Mainetti
- Hospital of Ravenna, Via Vincenzo Randi 5, Ravenna, Italy
| | - L Cursi
- Ospedale Pediatrico Bambino Gesù, Piazza Sant'Onofrio 4, Rome, Italy
| | - E Borali
- Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore 3, Milan, Italy
| | - M V De Vita
- Regina Margherita Children's Hospital, University of Turin, Piazza Polonia 94, Turin, Italy
| | - E Boccuzzi
- Ospedale Pediatrico Bambino Gesù, Piazza Sant'Onofrio 4, Rome, Italy
| | - L Castellazzi
- Università degli Studi di Milano Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Gaetano Pini 3, Milan, Italy
| | - S Esposito
- Università degli Studi di Milano Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Gaetano Pini 3, Milan, Italy
| | - A Guarino
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
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48
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Principi N, Marchisio P, Rosazza C, Sciarrabba CS, Esposito S. Acute otitis media with spontaneous tympanic membrane perforation. Eur J Clin Microbiol Infect Dis 2016; 36:11-18. [PMID: 27677281 DOI: 10.1007/s10096-016-2783-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 09/05/2016] [Indexed: 10/20/2022]
Abstract
The principal aim of this review is to present the current knowledge regarding acute otitis media (AOM) with spontaneous tympanic membrane perforation (STMP) and to address the question of whether AOM with STMP is a disease with specific characteristics or a severe case of AOM. PubMed was used to search for all studies published over the past 15 years using the key words "acute otitis media" and "othorrea" or "spontaneous tympanic membrane perforation". More than 250 articles were found, but only those published in English and providing data on aspects related to perforation of infectious origin were considered. Early Streptococcus pneumoniae infection due to invasive pneumococcal strains, in addition to coinfections and biofilm production due mainly to non-typeable Haemophilus influenzae, seem to be precursors of STMP. However, it is unclear why some children have several STMP episodes during the first years of life that resolve without complications in adulthood, whereas other children develop chronic suppurative otitis media. Although specific aetiological agents appear to be associated with an increased risk of AOM with STMP, further studies are needed to determine whether AOM with STMP is a distinct disease with specific aetiological, clinical and prognostic characteristics or a more severe case of AOM than the cases that occur without STMP. Finally, it is important to identify preventive methods that are useful not only in otitis-prone children with uncomplicated AOM, but also in children with recurrent AOM and those who experience several episodes with STMP.
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Affiliation(s)
- N Principi
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Commenda 9, 20122, Milan, Italy
| | - P Marchisio
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Commenda 9, 20122, Milan, Italy
| | - C Rosazza
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Commenda 9, 20122, Milan, Italy
| | - C S Sciarrabba
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Commenda 9, 20122, Milan, Italy
| | - S Esposito
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Commenda 9, 20122, Milan, Italy.
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49
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Sharifi-Rad J, Soufi L, Ayatollahi SAM, Iriti M, Sharifi-Rad M, Varoni EM, Shahri F, Esposito S, Kuhestani K, Sharifi-Rad M. Anti-bacterial effect of essential oil from Xanthium strumarium against shiga toxin-producing Escherichia coli. Cell Mol Biol (Noisy-le-grand) 2016; 62:69-74. [PMID: 27650979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/24/2016] [Indexed: 06/06/2023]
Abstract
Shiga toxin-producing Escherichia coli (STEC) serotype O157:H7 is one of the most important human pathogenic microorganisms, which can cause life-threatening infections. Xanthium strumarium L. is a plant with anti-bacterial activity against gram-negative and gram-positive bacteria. This study aims to demonstrate in vitro efficacy of the essential oil (EO) extracted from Xanthium strumarium L. against E. coli O157:H7. Using the agar test diffusion, the effect of Xanthium strumarium L. EO (5, 10, 15, 30, 60, and 120 mg/mL) was verified at each of the four different growth phases of E. coli O157:H7. Cell counts of viable cells and colony forming unit (CFU) were determined at regular time points using Breed's method and colony counting method, respectively. No viable cell was detectable after the 1 hour-exposure to X. strumarium EO at 30, 60, and 120 mg/mL concentrations. No bacterial colony was formed after 1 h until the end of the incubation period at 24 h. At lower concentrations, the number of bacteria cells decreased and colonies could be observed only after incubation. At the exponential phase, the EO at 15 mg/mL was only bacteriostatic, while from 30 mg/mL started to be bactericidal. X. strumarium EO antibacterial activity against Shiga toxin-producing E. coli O157:H7 is dependent on EO concentration and physiological state of the microorganisms tested. The best inhibitory activity was achieved during the late exponential and the stationary phases.
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Affiliation(s)
- J Sharifi-Rad
- Zabol University of Medical Sciences Zabol Medicinal Plants Research Center Zabol Iran
| | - L Soufi
- Guilan University of Medical Sciences Rasht Iran
| | - S A M Ayatollahi
- Shahid Beheshti University of Medical Sciences Phytochemistry Research Center Tehran Iran
| | - M Iriti
- Milan State University Department of Agricultural and Environmental Sciences Milan Italy
| | - M Sharifi-Rad
- University of Zabol Department of Range and Watershed Management, Faculty of Natural Resources Zabol Iran
| | - E M Varoni
- Milan State University Department of Biomedical, Surgical and Dental Sciences Milan Italy
| | - F Shahri
- Zahedan University of Medical Sciences Department of Optometry, School of Rehabilitation Zahedan Iran
| | - S Esposito
- Università degli Studi di Milano, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Pediatric High Intensive Care Unit, Department of Pathophysiology and Transplantation Milan Italy
| | - K Kuhestani
- Zabol University of Medical Sciences Zabol Iran
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50
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Bonavita S, Sacco R, Esposito S, d'Ambrosio A, Della Corte M, Corbo D, Docimo R, Gallo A, Lavorgna L, Cirillo M, Bisecco A, Esposito F, Tedeschi G. Default mode network changes in multiple sclerosis: a link between depression and cognitive impairment? Eur J Neurol 2016; 24:27-36. [DOI: 10.1111/ene.13112] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 06/27/2016] [Indexed: 12/01/2022]
Affiliation(s)
- S. Bonavita
- Department of Medical, Surgical, Neurological; Metabolic and Aging Sciences; Second University of Naples; Naples Italy
- MRI Center ‘SUN FISM’; Neurological Institute for Diagnosis and Care ‘Hermitage Capodimonte’; Naples Italy
| | - R. Sacco
- Department of Medical, Surgical, Neurological; Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - S. Esposito
- Department of Medical, Surgical, Neurological; Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - A. d'Ambrosio
- Department of Medical, Surgical, Neurological; Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - M. Della Corte
- MRI Center ‘SUN FISM’; Neurological Institute for Diagnosis and Care ‘Hermitage Capodimonte’; Naples Italy
| | - D. Corbo
- MRI Center ‘SUN FISM’; Neurological Institute for Diagnosis and Care ‘Hermitage Capodimonte’; Naples Italy
| | - R. Docimo
- Department of Medical, Surgical, Neurological; Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - A. Gallo
- Department of Medical, Surgical, Neurological; Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - L. Lavorgna
- Department of Medical, Surgical, Neurological; Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - M. Cirillo
- Neuroradiology Service; Department of Radiology; Second University of Naples; Naples Italy
| | - A. Bisecco
- Department of Medical, Surgical, Neurological; Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - F. Esposito
- Department of Medicine Surgery and Dentistry; University of Salerno; Salerno Italy
| | - G. Tedeschi
- Department of Medical, Surgical, Neurological; Metabolic and Aging Sciences; Second University of Naples; Naples Italy
- MRI Center ‘SUN FISM’; Neurological Institute for Diagnosis and Care ‘Hermitage Capodimonte’; Naples Italy
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