1
|
Lieti G, L'imperio V, Cavalli A, Ravasi C, Longhi S, Fogazzi GB, La Milia V. A case of acute kidney injury due to ethylene glycol intoxication. G Ital Nefrol 2023; 40:40-02-2023-05. [PMID: 37179477] [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] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
In this article we describe a case of acute kidney injury caused by ethylene glycol intoxication which partially reversed after temporary hemodialysis treatment. The diagnosis was obtained after the patient's clinical history and the finding of ethylene glycol in the blood, numerous intratubular crystals at renal biopsy, and the presence of large amounts of atypical - spindle-like and needle-like - calcium oxalate crystals in the urinary sediment.
Collapse
Affiliation(s)
- Giulia Lieti
- Università degli studi di Milano-Bicocca, Scuola di Specializzazione in Nefrologia
| | | | | | - Chiara Ravasi
- U.O. Nefrologia e dialisi, Ospedale A. Manzoni, Lecco
| | - Selena Longhi
- U.O. Nefrologia e dialisi, Ospedale A. Manzoni, Lecco
| | - Giovanni Battista Fogazzi
- Laboratorio clinico e di ricerca sul sedimento urinario, SC di Nefrologia, Dialisi e Trapianto di Rene, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano
| | | |
Collapse
|
2
|
Radetti G, Puel A, Franceschi R, Longhi S, Gallo N, Betterle C. A non-classical presentation of APECED in a family with heterozygous R203X AIRE gene mutation. J Endocrinol Invest 2023; 46:629-632. [PMID: 36251243 DOI: 10.1007/s40618-022-01937-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/08/2022] [Indexed: 10/24/2022]
Abstract
PURPOSE Biallelic loss-of-function mutations of AIRE cause the autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) syndrome. However, single nucleotide mutations may cause a milder phenotype. In this paper, we describe an unusual and mild phenotype in a mother and her two children (son and daughter) who carry a rare heterozygous mutation of AIRE. METHODS AND RESULTS The son presented with alopecia and subclinical hypothyroidism due to Hashimoto's Thyroiditis (HT); the daughter had alopecia, vaginal mycosis, stomach pains and subclinical hypothyroidism due to HT; and the mother had alopecia, vaginal mycosis and stomach pains. Organ- and non-organ-specific autoantibodies were evaluated as well as antibodies against interleukin-17A, -17F, -22 (IL-Abs) and interferon -α and -ω (IFN-Abs). The organ- and non-organ-specific autoantibodies screening was negative in the son, while the daughter was positive for liver-kidney microsomal antibodies (LKMAbs) and the mother was positive for glutamic acid decarboxylase antibodies (GADAbs). Daughter and mother were also positive for IFN-Abs. Analysis of the AIRE gene identified a rare heterozygous R203X mutation in all three family members. CONCLUSIONS We describe for a first time a family with heterozygous R203X AIRE mutation causing an APECED-like condition, as confirmed by presence of IFN-Abs. The unusual mild phenotype should be reassuring for the patients and assist in their clinical management.
Collapse
Affiliation(s)
- G Radetti
- Department of Pediatrics, Regional Hospital, Lorenz Böhler 5, 39100, Bolzano, Italy.
| | - A Puel
- Laboratory of Human Genetics of Infectious Diseases, INSERM UMR 1163, University of Paris, Imagine Institute, Paris, France
| | - R Franceschi
- Division of Paediatrics, S. Chiara General Hospital, Trento, Italy
| | - S Longhi
- Department of Pediatrics, Regional Hospital, Lorenz Böhler 5, 39100, Bolzano, Italy
| | - N Gallo
- Unit of Laboratory Medicine, Department of Medicine, University of Padua, Padua, Italy
| | - C Betterle
- Endocrine Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| |
Collapse
|
3
|
Radetti G, Puel A, Franceschi R, Longhi S, Gallo N, Betterle C. Correction to: A non-classical presentation of APECED in a family with heterozygous R203X AIRE gene mutation. J Endocrinol Invest 2023; 46:437. [PMID: 36462145 DOI: 10.1007/s40618-022-01965-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Affiliation(s)
- G Radetti
- Department of Pediatrics, Regional Hospital, Lorenz Böhler 5, 39100, Bolzano, Italy.
| | - A Puel
- Laboratory of Human Genetics of Infectious Diseases, INSERM UMR 1163, University of Paris, Imagine Institute, Paris, France
| | - R Franceschi
- Division of Paediatrics, S. Chiara General Hospital, Trento, Italy
| | - S Longhi
- Department of Pediatrics, Regional Hospital, Lorenz Böhler 5, 39100, Bolzano, Italy
| | - N Gallo
- Unit of Laboratory Medicine, Department of Medicine, University of Padua, Padua, Italy
| | - C Betterle
- Endocrine Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| |
Collapse
|
4
|
Guaraldi P, Rocchi C, Cani I, Gagliardi C, Longhi S, Baschieri F, Rinaldi R, Frezza E, D'Angelo R, Barletta G, Calandra-Buonaura G, Galiè N, Massa R, Cortelli P. Cardiovascular reflex tests detect autonomic dysfunction in symptomatic and pre-symptomatic subjects with hereditary transthyretin amyloidosis. Clin Auton Res 2023; 33:15-22. [PMID: 36625973 DOI: 10.1007/s10286-022-00921-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Autonomic dysfunction is a distinctive but undervalued feature of hereditary transthyretin amyloidosis (ATTRv). It may predate the onset of polyneuropathy and cardiomyopathy, thereby providing crucial prognostic and therapeutic information. The objective of this study was to assess autonomic function by means of the standardized cardiovascular autonomic reflex tests (CRTs) in a cohort of subjects with genetically proven ATTRv from non-endemic areas who were in the symptomatic and pre-symptomatic stages. METHODS All subjects enrolled in this cross-sectional study had genetically proven ATTRv. They underwent the head-up tilt test, Valsalva manoeuvre, deep breathing test, cold face test and handgrip test while under continuous blood pressure and heart rate monitoring. Based on the results of the nerve conduction study, the subjects were divided into two groups: those with polyneuropathy (ATTRv-wPN) and those without polyneuropathy (ATTRv-woPN). Age- and sex-matched healthy controls (HC) were used for comparison. RESULTS Thirty-seven ATTRv subjects (19 with ATTRv-wPN, 18 with ATTRv-woPN) and 41 HC performed the CRTs. Of these 37 subjects with ATTRv, four (11%) presented neurogenic orthostatic hypotension the during head-up tilt test. Based on the results of the CRTs, autonomic dysfunction characterized by either sympathetic or parasympathetic impairment was detected in 37% and 63% of ATTRv-wPN subjects, respectively. Subjects with ATTRv-woPN presented a significant impairment of autonomic responses to the Valsalva manoeuvre compared to the HC (overshoot p = 0.004; Valsalva ratio p = 0.001). CONCLUSION Autonomic dysfunctions are frequent in subjects with ATTRv when investigated by means of standardized CRTs, and are also relevant in the pre-symptomatic stage. Cardiovagal functions are the primary functions affected, among others. This may be crucial in defining the proper diagnostic workout for early diagnosis and improving the likelihood of providing the patient with prompt administration of disease-modifying treatments.
Collapse
Affiliation(s)
- P Guaraldi
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.
| | - C Rocchi
- Neurology Unit, Department of Systems Medicine, Policlinico Tor Vergata, Rome, Italy
| | - I Cani
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - C Gagliardi
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
- UO Cardiologia, IRCCS Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - S Longhi
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
- UO Cardiologia, IRCCS Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - F Baschieri
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - R Rinaldi
- UOC Clinica Neurologica Rete Metropolitana NEUROMET IRCCS Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - E Frezza
- Neuromuscular Diseases Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - R D'Angelo
- UOC Clinica Neurologica Rete Metropolitana NEUROMET IRCCS Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - G Barletta
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - G Calandra-Buonaura
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - N Galiè
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
- UO Cardiologia, IRCCS Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - R Massa
- Neuromuscular Diseases Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - P Cortelli
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| |
Collapse
|
5
|
Porcari A, Pagura L, Canepa M, Biagini E, Cappelli F, Tini G, Dore F, Longhi S, Sciagra' R, Fontana M, Gillmore J, Rapezzi C, Merlo M, Sinagra G. Prognostic implications of biventricular uptake of bone tracers at planar scintigraphy in transthyretin cardiac amyloidosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1770] [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
The prognostic role of bone tracer uptake in transthyretin cardiac amyloidosis (ATTR-CA) is controversial. A further characterization of cardiac retention measured by Perugini scale with differentiation between biventricular (BiV) and isolated left ventricle (LV) uptake has never been attempted previously.
Purpose
The study investigated the potential prognostic significance of BiV uptake in ATTR-CA.
Methods
In this multicentre, observational study, we analysed data of ATTR-CA patients who underwent bone tracer scintigraphy with acquisition of both planar and single photon emission computed tomography (SPECT) imaging. Cardiac uptake was defined according to the Perugini visual scale. Planar BiV uptake was defined according to right ventricle (RV) uptake: 0= absent, 1= < bone, 2= equal to bone, and 3= > bone and confirmed by SPECT imaging. The primary outcome was a composite of cardiac death or hospitalization for heart failure. The secondary outcome was all-cause mortality.
Results
All 124 ATTR-CA patients enrolled had LV and RV free wall uptake on SPECT images. Of them, 93 (75%) had BiV uptake visible on planar scintigraphy. BiV uptake was found in 14%, 70%, and 92% of Perugini grade 1, 2 and 3 respectively. Compared to those with isolated LV uptake, patients with BiV uptake were older (81 vs 77 years, p=0.006) and more frequently in NYHA≥3 (32% vs 10%, p=0.018). During a median follow-up of 21 months, BiV uptake was associated with a greater occurrence of the primary outcome compared to isolated LV uptake (40% vs 19%, p=0.021), whereas the Perugini scale was not (p=0.2) (Figure 1). At multivariable analysis, NYHA class ≥3 (hazard ratio [HR] 8.1, p=0.007), eGFR <60 ml/min (HR 2.1, p=0.025) and higher degree of RV uptake (HR 1.69, p=0.007) emerged as independent prognostic parameters. In an external cohort of 463 ATTR-CA patients with a median follow-up of 30 months, planar BiV uptake was independently associated with all-cause mortality, with an incremental risk in higher grades of RV uptake (p<0.001) (Figure 1).
Conclusions
The presence of BiV uptake at planar scintigraphy identified ATTR-CA patients with worse cardiovascular and global outcomes (Figure 2), potentially serving as a novel prognostic marker.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- A Porcari
- Giuliano Isontina University Health Authority, Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department , Trieste , Italy
| | - L Pagura
- Giuliano Isontina University Health Authority, Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department , Trieste , Italy
| | - M Canepa
- Ospedale Policlinico San Martino IRCCS, Cardiovascular Unit, Department of Internal Medicine , Genoa , Italy
| | - E Biagini
- University Hospital of Bologna S. Orsola-Malpighi Polyclinic, Department of Experimental, Diagnostic and Specialty Medicine, Cardiology Unit , Bologna , Italy
| | - F Cappelli
- Careggi University Hospital, Cardiomyopathy Unit , Florence , Italy
| | - G Tini
- Ospedale Policlinico San Martino IRCCS, Cardiovascular Unit, Department of Internal Medicine , Genoa , Italy
| | - F Dore
- Giuliano Isontina University Health Authority, Department of Nuclear Medicine , Trieste , Italy
| | - S Longhi
- University Hospital of Bologna S. Orsola-Malpighi Polyclinic, Department of Experimental, Diagnostic and Specialty Medicine, Cardiology Unit , Bologna , Italy
| | - R Sciagra'
- Careggi University Hospital, Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio” , Florence , Italy
| | - M Fontana
- Royal Free London NHS Foundation Trust, National Amyloidosis Centre, Division of Medicine , London , United Kingdom
| | - J Gillmore
- Royal Free London NHS Foundation Trust, National Amyloidosis Centre, Division of Medicine , London , United Kingdom
| | - C Rapezzi
- University Hospital of Ferrara, Cardiothoracic Department , Ferrara , Italy
| | - M Merlo
- Giuliano Isontina University Health Authority, Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department , Trieste , Italy
| | - G Sinagra
- Giuliano Isontina University Health Authority, Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department , Trieste , Italy
| |
Collapse
|
6
|
Milia VL, Tonolo S, Luzzaro F, Bonato C, Limardo M, Longhi S, Ravasi C, Viganò S, Cavalli A. Sustained humoral response six months after the anti-SARS-CoV-2 mRNA-BNT162b2 vaccine in hemodialysis patients: should booster vaccine doses be given in all patients at the same time? Clin Kidney J 2022; 15:1012-1014. [PMID: 35498885 PMCID: PMC9050530 DOI: 10.1093/ckj/sfac047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Silvia Tonolo
- Microbiology Unit, A. Manzoni Hospital, Lecco, Italy
| | | | - Claudio Bonato
- Department of Clinical Services, A. Manzoni Hospital, Lecco, Italy
| | - Monica Limardo
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Selena Longhi
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Chiara Ravasi
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Sara Viganò
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Andrea Cavalli
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| |
Collapse
|
7
|
Lopes LR, Losi MA, Sheikh N, Laroche C, Charron P, Gimeno J, Kaski JP, Maggioni AP, Tavazzi L, Arbustini E, Brito D, Celutkiene J, Hagege A, Linhart A, Mogensen J, Garcia-Pinilla JM, Ripoll-Vera T, Seggewiss H, Villacorta E, Caforio A, Elliott PM, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Erlinge D, Emberson J, Glikson M, Gray A, Kayikcioglu M, Maggioni A, Nagy KV, Nedoshivin A, Petronio AS, Hesselink JR, Wallentin L, Zeymer U, Caforio A, Blanes JRG, Charron P, Elliott P, Kaski JP, Maggioni AP, Tavazzi L, Tendera M, Komissarova S, Chakova N, Niyazova S, Linhart A, Kuchynka P, Palecek T, Podzimkova J, Fikrle M, Nemecek E, Bundgaard H, Tfelt-Hansen J, Theilade J, Thune JJ, Axelsson A, Mogensen J, Henriksen F, Hey T, Nielsen SK, Videbaek L, Andreasen S, Arnsted H, Saad A, Ali M, Lommi J, Helio T, Nieminen MS, Dubourg O, Mansencal N, Arslan M, Tsieu VS, Damy T, Guellich A, Guendouz S, Tissot CM, Lamine A, Rappeneau S, Hagege A, Desnos M, Bachet A, Hamzaoui M, Charron P, Isnard R, Legrand L, Maupain C, Gandjbakhch E, Kerneis M, Pruny JF, Bauer A, Pfeiffer B, Felix SB, Dorr M, Kaczmarek S, Lehnert K, Pedersen AL, Beug D, Bruder M, Böhm M, Kindermann I, Linicus Y, Werner C, Neurath B, Schild-Ungerbuehler M, Seggewiss H, Pfeiffer B, Neugebauer A, McKeown P, Muir A, McOsker J, Jardine T, Divine G, Elliott P, Lorenzini M, Watkinson O, Wicks E, Iqbal H, Mohiddin S, O'Mahony C, Sekri N, Carr-White G, Bueser T, Rajani R, Clack L, Damm J, Jones S, Sanchez-Vidal R, Smith M, Walters T, Wilson K, Rosmini S, Anastasakis A, Ritsatos K, Vlagkouli V, Forster T, Sepp R, Borbas J, Nagy V, Tringer A, Kakonyi K, Szabo LA, Maleki M, Bezanjani FN, Amin A, Naderi N, Parsaee M, Taghavi S, Ghadrdoost B, Jafari S, Khoshavi M, Rapezzi C, Biagini E, Corsini A, Gagliardi C, Graziosi M, Longhi S, Milandri A, Ragni L, Palmieri S, Olivotto I, Arretini A, Castelli G, Cecchi F, Fornaro A, Tomberli B, Spirito P, Devoto E, Bella PD, Maccabelli G, Sala S, Guarracini F, Peretto G, Russo MG, Calabro R, Pacileo G, Limongelli G, Masarone D, Pazzanese V, Rea A, Rubino M, Tramonte S, Valente F, Caiazza M, Cirillo A, Del Giorno G, Esposito A, Gravino R, Marrazzo T, Trimarco B, Losi MA, Di Nardo C, Giamundo A, Musella F, Pacelli F, Scatteia A, Canciello G, Caforio A, Iliceto S, Calore C, Leoni L, Marra MP, Rigato I, Tarantini G, Schiavo A, Testolina M, Arbustini E, Di Toro A, Giuliani LP, Serio A, Fedele F, Frustaci A, Alfarano M, Chimenti C, Drago F, Baban A, Calò L, Lanzillo C, Martino A, Uguccioni M, Zachara E, Halasz G, Re F, Sinagra G, Carriere C, Merlo M, Ramani F, Kavoliuniene A, Krivickiene A, Tamuleviciute-Prasciene E, Viezelis M, Celutkiene J, Balkeviciene L, Laukyte M, Paleviciute E, Pinto Y, Wilde A, Asselbergs FW, Sammani A, Van Der Heijden J, Van Laake L, De Jonge N, Hassink R, Kirkels JH, Ajuluchukwu J, Olusegun-Joseph A, Ekure E, Mizia-Stec K, Tendera M, Czekaj A, Sikora-Puz A, Skoczynska A, Wybraniec M, Rubis P, Dziewiecka E, Wisniowska-Smialek S, Bilinska Z, Chmielewski P, Foss-Nieradko B, Michalak E, Stepien-Wojno M, Mazek B, Lopes LR, Almeida AR, Cruz I, Gomes AC, Pereira AR, Brito D, Madeira H, Francisco AR, Menezes M, Moldovan O, Guimaraes TO, Silva D, Ginghina C, Jurcut R, Mursa A, Popescu BA, Apetrei E, Militaru S, Coman IM, Frigy A, Fogarasi Z, Kocsis I, Szabo IA, Fehervari L, Nikitin I, Resnik E, Komissarova M, Lazarev V, Shebzukhova M, Ustyuzhanin D, Blagova O, Alieva I, Kulikova V, Lutokhina Y, Pavlenko E, Varionchik N, Ristic AD, Seferovic PM, Veljic I, Zivkovic I, Milinkovic I, Pavlovic A, Radovanovic G, Simeunovic D, Zdravkovic M, Aleksic M, Djokic J, Hinic S, Klasnja S, Mircetic K, Monserrat L, Fernandez X, Garcia-Giustiniani D, Larrañaga JM, Ortiz-Genga M, Barriales-Villa R, Martinez-Veira C, Veira E, Cequier A, Salazar-Mendiguchia J, Manito N, Gonzalez J, Fernández-Avilés F, Medrano C, Yotti R, Cuenca S, Espinosa MA, Mendez I, Zatarain E, Alvarez R, Pavia PG, Briceno A, Cobo-Marcos M, Dominguez F, Galvan EDT, Pinilla JMG, Abdeselam-Mohamed N, Lopez-Garrido MA, Hidalgo LM, Ortega-Jimenez MV, Mezcua AR, Guijarro-Contreras A, Gomez-Garcia D, Robles-Mezcua M, Blanes JRG, Castro FJ, Esparza CM, Molina MS, García MS, Cuenca DL, de Mallorca P, Ripoll-Vera T, Alvarez J, Nunez J, Gomez Y, Fernandez PLS, Villacorta E, Avila C, Bravo L, Diaz-Pelaez E, Gallego-Delgado M, Garcia-Cuenllas L, Plata B, Lopez-Haldon JE, Pena Pena ML, Perez EMC, Zorio E, Arnau MA, Sanz J, Marques-Sule E. Association between common cardiovascular risk factors and clinical phenotype in patients with hypertrophic cardiomyopathy from the European Society of Cardiology (ESC) EurObservational Research Programme (EORP) Cardiomyopathy/Myocarditis registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:42-53. [PMID: 35138368 PMCID: PMC9745665 DOI: 10.1093/ehjqcco/qcac006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 12/15/2022]
Abstract
AIMS The interaction between common cardiovascular risk factors (CVRF) and hypertrophic cardiomyopathy (HCM) is poorly studied. We sought to explore the relation between CVRF and the clinical characteristics of patients with HCM enrolled in the EURObservational Research Programme (EORP) Cardiomyopathy registry. METHODS AND RESULTS 1739 patients with HCM were studied. The relation between hypertension (HT), diabetes (DM), body mass index (BMI), and clinical traits was analysed. Analyses were stratified according to the presence or absence of a pathogenic variant in a sarcomere gene. The prevalence of HT, DM, and obesity (Ob) was 37, 10, and 21%, respectively. HT, DM, and Ob were associated with older age (P<0.001), less family history of HCM (HT and DM P<0.001), higher New York Heart Association (NYHA) class (P<0.001), atrial fibrillation (HT and DM P<0.001; Ob p = 0.03) and LV (left ventricular) diastolic dysfunction (HT and Ob P<0.001; DM P = 0.003). Stroke was more frequent in HT (P<0.001) and mutation-positive patients with DM (P = 0.02). HT and Ob were associated with higher provocable LV outflow tract gradients (HT P<0.001, Ob P = 0.036). LV hypertrophy was more severe in Ob (P = 0.018). HT and Ob were independently associated with NYHA class (OR 1.419, P = 0.017 and OR 1.584, P = 0.004, respectively). Other associations, including a higher proportion of females in HT and of systolic dysfunction in HT and Ob, were observed only in mutation-positive patients. CONCLUSION Common CVRF are associated with a more severe HCM phenotype, suggesting a proactive management of CVRF should be promoted. An interaction between genotype and CVRF was observed for some traits.
Collapse
Affiliation(s)
- Luis R Lopes
- Corresponding author. Tel: +447765109343, , Twitter handle: @LuisRLopesDr
| | - Maria-Angela Losi
- Department of Advanced Biomedical Sciences, University Federico II, Corso Umberto I, 40, Naples 80138, Italy
| | - Nabeel Sheikh
- Department of Cardiology and Division of Cardiovascular Sciences, Guy's and St. Thomas’ Hospitals and King's College London, Strand, London WC2R 2LS, UK
| | - Cécile Laroche
- EORP, European Society of Cardiology, Sophia-Antipolis, France
| | | | | | - Juan P Kaski
- Institute of Cardiovascular Science, University College London, Gower St, London WC1E 6BT, UK,Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London WC1N 3JH, UK
| | - Aldo P Maggioni
- EORP, European Society of Cardiology, Sophia-Antipolis, France,Maria Cecilia Hospital, GVM Care&Research, Via Corriera, 1, Cotignola 48033 RA, Italy
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care&Research, Via Corriera, 1, Cotignola 48033 RA, Italy
| | | | - Dulce Brito
- Serviço de Cardiologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1169-050, Portugal,CCUL, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz MB, Lisbon 1649-028, Portugal
| | - Jelena Celutkiene
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Universiteto g. 3, Vilnius 01513, Lithuania,State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | | | - Ales Linhart
- 2nd Department of Internal Cardiovascular Medicine, General University Hospital and First Medical Faculty, Charles University, Opletalova 38, Prague 110 00, Czech Republic
| | - Jens Mogensen
- Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | - José Manuel Garcia-Pinilla
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares. Servicio de Cardiología. Hospital Universitario Virgen de la Victoria. IBIMA. Málaga and Ciber-Cardiovascular. Instituto de Salud Carlos III. Madrid, Spain
| | - Tomas Ripoll-Vera
- Inherited Cardiovascular Disease Unit Son Llatzer University Hospital & IdISBa, Palma de Mallorca, Spain
| | - Hubert Seggewiss
- Universitätsklinikum Würzburg, Deutsches Zentrum für Herzinsuffizienz (DZHI), Comprehensive Heart Failure Center (CHFC), Am Schwarzenberg 15, Haus 15A, 97078 Wurzburg, Germany
| | - Eduardo Villacorta
- Member of National Centers of expertise for familial cardiopathies (CSUR), Cardiology Department, University Hospital of Salamanca. Institute of Biomedical Research of Salamanca (IBSAL), CIBERCV, Salamanca, Spain
| | | | - Perry M Elliott
- Institute of Cardiovascular Science, University College London, Gower St, London WC1E 6BT, UK,St. Bartholomew's Hospital, Barts Heart Centre, Barts Health NHS Trust, Whitechapel Rd, London E1 1BB, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
La Milia V, Tonolo S, Luzzaro F, Bonato C, Casartelli1 D, Limardo M, Longhi S, Ravasi C, Viganò S, Cavalli A. Humoral and T Cell Response to SARS-CoV-2 mRNA BNT162b2 vaccination in a Cohort of Kidney Transplant Recipients and their Cohabitants Living Kidney Donor Partners. Clin Kidney J 2022; 15:820-821. [PMID: 35371437 PMCID: PMC8967661 DOI: 10.1093/ckj/sfac010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
| | - Silvia Tonolo
- Microbiology Unit, A. Manzoni Hospital, Lecco, Italy
| | | | - Claudio Bonato
- Department of Clinical Services, A. Manzoni Hospital, Lecco, Italy
| | | | - Monica Limardo
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Selena Longhi
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Chiara Ravasi
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Sara Viganò
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Andrea Cavalli
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| |
Collapse
|
9
|
Saturi G, Santona L, Sguazzotti MS, Caponetti AG, Massa P, Ponziani A, Gagliardi C, Giovannetti AG, Lovato L, Attina D, Bonfiglioli R, Saia F, Galie N, Biagini E, Longhi S. Different aortic valve calcium scores by computed tomography scan in patients with severe aortic stenosis and concomitant cardiac amyloidosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The coexistence of cardiac amyloidosis (CA) and degenerative aortic stenosis (AS) is increasing but the diagnosis is challenging because these two conditions share a common echocardiographic phenotype (1). Different predictors have been proposed in the last few years, including clinical, ECG-graphic and echocardiographic features (2–3).
Purpose
To identify a new marker of concomitant CA in patients with severe AS analyzing computed tomography scan (CT).
Methods
55 patients with severe AS and suspicion of concomitant CA were retrospectively enrolled. Patients with a bicuspid aortic valve, previous aortic valve replacement, or an incomplete diagnostic workup for CA were excluded. 33 patients underwent CT-scan and were included in the final analysis.
Results
None of the patients presented laboratory suspicion for AL amyloidosis; 12 patients (AS-CA) had positive 99m Tc-DPD bone scintigraphy (two with visual score 1, eight score 2 and two score 3), 21 patients (AS-alone) had negative bone scintigraphy. AS-CA patients had a median age of 85,5 years (versus 81,5) with only one female patient (versus 8 in the AS-alone group). AVA indexed were comparable between AS-CA and AS-alone groups (0,4 versus 0, 3 mm2/m2, p: 0.25). Stroke volume evaluated by pulsed Doppler, maximum and mean gradient were significatively lower in AS-CA group (respectively 30 versus 41 ml/m2, p: 0.017, 62 versus 74 mmHg, 0.038 and 33 versus 46 mmHg, p:0.022) with a higher percentage of low flow-low gradient aortic stenosis in AS-CA group (7 patients, 58% vs 3 patients in AS-alone 14%, p: 0.027), in line with the literature. ECG at first presentation in AS-CA group showed atrial fibrillation in 8 patients (67%), versus 2 patients in the AS-alone group (10%), and lower QRS voltages (peripheral QRS score 40 mV vs 51 mV, p-value:0.017; total QRS score 113 mV versus 155 mV, p-value: 0.005). The echocardiogram showed a more thickened IVS and PW in AS-CA patients (17 versus 15 mm, p: 0.05 and 15 versus 14 mm, p: 0.013), an augmented left ventricular mass (441 versus 356 g, p: 0.036) with a decreases longitudinal systolic function (septal S wave at TDI 4.4 versus 5.2 cm/s, p: 0.026, lateral S wave 4.1 versus 5.6 cm/s, p: 0.024) and a reduction in myocardial contraction fraction (12 versus 14%, p: 0.036).
CT- aortic valve calcium was quantified by an experienced operator. A statistically significant difference between AS-CA and AS-alone groups was observed in calcium score (3345 versus 4785 Hounsfield units, p: 0.037) calcium volume (2411 versus 3626 mm2, p: 0.03) and calcium mass (687 versus 1147 g, p: 0.023)
Conclusions
This study is the first to our knowledge to use relative aortic valve calcium score evaluation from CT imaging to characterize patients with severe AS with or without concomitant CA in addition to the classical clinical, ECG graphic, echocardiographic parameters. CT-aortic valve calcium burner was significatively lower in patients with concomitant CA.
Funding Acknowledgement
Type of funding sources: None. CT scan and bone scintigraphy
Collapse
Affiliation(s)
- G Saturi
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - L Santona
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - M S Sguazzotti
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - A G Caponetti
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - P Massa
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - A Ponziani
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - C Gagliardi
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - A G Giovannetti
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - L Lovato
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - D Attina
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - R Bonfiglioli
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - F Saia
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - N Galie
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - E Biagini
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - S Longhi
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| |
Collapse
|
10
|
Sguazzotti M, Caponetti AG, Saturi G, Ponziani A, Massa P, Dal Passo B, Accietto A, Longhi S, Bonfiglioli R, Mattana F, Guaraldi P, Cortelli P, Galie N, Biagini E, Gagliardi C. Analysis of characteristics and prognostic impact of phenotypes in hereditary ATTR. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1804] [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
Hereditary transthyretin-related amyloidosis (h-ATTR) is a systemic infiltrative disease caused by a single amino acid mutation on the transthyretin (TTR) gene, which destabilizes the protein and can determine its deposition on multiple organs, including heart and peripheral nervous system.
Purpose
We aimed to characterize and compare clinical, instrumental, and prognostic features of patients affected by h-ATTR by dividing the population into the disease's main phenotypes (unaffected carriers, cardiac, neurological or mixed phenotype).
Methods
Two hundred and eighty-five subjects of a single-centre cohort with a recognized pathogenic mutation on TTR gene were retrospectively included in the analysis. Phenotypes of disease were defined at baseline. Neurological phenotype (NP) was defined according to sensorimotor and/or autonomic dysfunction, while cardiac phenotype (CP) was defined in the presence of unexplained maximum wall thickness >12 mm and other typical echocardiographic findings. Unaffected carriers (UC) and mixed phenotypes (MP) presented none or both of the above-mentioned features, respectively.
Results
Two hundred and ten patients showed clinical signs of the disease, 37 (13%) with CP, 65 (23%) with NP and 108 (38%) with MP, while 75 subjects (26%) were UC. Ile68Leu was the most represented mutation (96 subjects, 34%), followed by Val30Met (21%) and Glu89Gln (13%). NP patients (mostly Val30Met) had mPND score >1 in 45% of patients, were younger at diagnosis (mean 47 years, p<0,001 vs CP/MP), and sex was equally distributed. In contrast, CP patients were older at diagnosis (mean 70 years, p<0,001 vs CP/MP), predominantly male (as well as in MP) with a higher incidence of tunnel carpal syndrome and a shorter time interval between onset of symptoms and diagnosis (mean 17 months, p<0,001 vs CP/MP). NYHA class, ECG findings, left ventricular wall thickness and ejection fraction did not significantly differ between CP and MP. After a mean follow-up of 59 months, 98 (34%) patients died. On a Kaplan-Meier survival analysis, mean survival times were 208, 123, 150 and 95 months for UC, CP, NP and MP, respectively, with a statistically significant difference in affected patients between NP and MP (p=0.012).
Conclusions
H-ATTR is a rare systemic disorder whose natural history, including age of onset, clinical characteristics and instrumental findings, is strongly influenced by primary phenotypes, ranging from the excellent prognosis of unaffected carriers to the inauspicious outcome of mixed phenotypes.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- M Sguazzotti
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - A G Caponetti
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - G Saturi
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - A Ponziani
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - P Massa
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - B Dal Passo
- Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - A Accietto
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - S Longhi
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - R Bonfiglioli
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - F Mattana
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | | | | | - N Galie
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - E Biagini
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - C Gagliardi
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| |
Collapse
|
11
|
La Milia V, Tonolo S, Luzzaro F, Bonato C, Cavalli A, Foglieni B, Debiase C, Limardo M, Longhi S, Ravasi C, Viganò S. The humoral immune response to SARS-CoV-2 mounts and is durable in symptomatic haemodialysis patients. Nephrol Dial Transplant 2021; 36:1132-1134. [PMID: 33609131 PMCID: PMC7928722 DOI: 10.1093/ndt/gfab047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/12/2021] [Indexed: 12/18/2022] Open
Affiliation(s)
| | - Silvia Tonolo
- Microbiology Unit, A. Manzoni Hospital, Lecco, Italy
| | | | - Claudio Bonato
- Department of Clinical Services, A. Manzoni Hospital, Lecco, Italy
| | - Andrea Cavalli
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Barbara Foglieni
- Transfusion Medicine and Hematology Unit, A. Manzoni Hospital, Lecco, Italy
| | | | - Monica Limardo
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Selena Longhi
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Chiara Ravasi
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| | - Sara Viganò
- Nephrology and Dialysis Unit, A. Manzoni Hospital, Lecco, Italy
| |
Collapse
|
12
|
Mazucatto I, Totti F, Longhi S, Alves F, Lins L, Bailer M, Navarro G, Ogeda E. Implementation and segment of fasting abbreviation project in a private hospital in the city of São paulo - Brazil. We are ready? Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.567] [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: 11/26/2022]
|
13
|
Caponetti A, Longhi S, Saturi G, Ponziani A, Sguazzotti M, Massa P, Milandri A, Salvi F, Biagini E, Rapezzi C, Galie' N, Gagliardi C. A clinical and instrumental study of heart failure in amyloidotic cardiomyopathy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2143] [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
Heart failure (HF) is one of the main features of amyloidotic cardiomyopathy (AC) and it is supposed to carry important prognostic implications. Despite the intrinsic etiologic heterogeneity of AC, HF has been mainly attributed to diastolic dysfunction, but the role played by the different amyloid subtypes of AC and by the clinical and hemodynamic factors in the pathophysiology of HF remains unclear.
Objectives
We aimed to assess the hemodynamic profile and outcome of patients with or without advanced HF (defined as NYHA class III-IV) at the time of first evaluation in light-chain (AL), hereditary transthyretin-related (h-ATTR) and non-mutant transthyretin-related (wt-ATTR) AC.
Methods
Among the 411 patients diagnosed with AC (156 AL, 131 h-ATTR, 124 wt-ATTR) at our Centre between 1990–2019, we analyzed central hemodynamic data, echocardiographic, clinical, ECG details and survival of the whole cohort. Cox regression analysis was used to stratify prognosis.
Results
112 (27%) patients presented advanced HF at first evaluation and frequently showed severe symmetric left ventricle wall thickening (higher values in h-ATTR), non-dilated left ventricle, preserved ejection fraction and pathological global longitudinal strain and/or myocardial contraction fraction.
At ECG, a significantly lower QRS voltage was present in advanced HF patients. Hemodynamically, elevated filing pressures on both cardiac sides were present in patients in NYHA III-IV class of the three etiologies. Overall survival at 2 years was 35% for AL, 83% for h-ATTR, 65% for wt-TTR. H-ATTR and wt-TTR were favorable predictors of survival, while reduced cardiac index and elevated filling pressures were indepedently associated with higher mortality.
Conclusions
The characterization of hemodynamic profile plays a central role in predicting the natural history of AC, since reduced stroke volume and elevated filling pressures are the best predictors of mortality, reflecting a physiopathological restrictive model of the disease. Conversely, left ventricular ejection fraction is rarely abnormal and it is not a reliable marker of poor prognosis, especially in the early stages of the disease. AL amyloidosis shows the worst outcome probably due to a combination of the underlying illness and light chains cardiotoxicity.
LVEF and cardiac index in HF
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- A.G Caponetti
- Alma Mater Studiorum, University of Bologna, Cardiology, Bologna, Italy
| | - S Longhi
- Alma Mater Studiorum, University of Bologna, Cardiology, Bologna, Italy
| | - G Saturi
- Alma Mater Studiorum, University of Bologna, Cardiology, Bologna, Italy
| | - A Ponziani
- Alma Mater Studiorum, University of Bologna, Cardiology, Bologna, Italy
| | - M Sguazzotti
- Alma Mater Studiorum, University of Bologna, Cardiology, Bologna, Italy
| | - P Massa
- Alma Mater Studiorum, University of Bologna, Cardiology, Bologna, Italy
| | - A Milandri
- Alma Mater Studiorum, University of Bologna, Cardiology, Bologna, Italy
| | - F Salvi
- Bellaria Hospital, Neurology, Bologna, Italy
| | - E Biagini
- Alma Mater Studiorum, University of Bologna, Cardiology, Bologna, Italy
| | - C Rapezzi
- University of Ferrara, Cardiology, Ferrara, Italy
| | - N Galie'
- Alma Mater Studiorum, University of Bologna, Cardiology, Bologna, Italy
| | - C Gagliardi
- Alma Mater Studiorum, University of Bologna, Cardiology, Bologna, Italy
| |
Collapse
|
14
|
La Milia V, Bacchini G, Bigi MC, Casartelli D, Cavalli A, Corti M, Crepaldi M, Limardo M, Longhi S, Manzoni C, Ravasi C, Stucchi V, Viganò S. COVID-19 Outbreak in a Large Hemodialysis Center in Lombardy, Italy. Kidney Int Rep 2020; 5:1095-1099. [PMID: 32642606 PMCID: PMC7246019 DOI: 10.1016/j.ekir.2020.05.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Vincenzo La Milia
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | - Giuseppe Bacchini
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | - Maria Carla Bigi
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | | | - Andrea Cavalli
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | - Mauro Corti
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | - Monica Crepaldi
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | - Monica Limardo
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | - Selena Longhi
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | - Celestina Manzoni
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | - Chiara Ravasi
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | - Valentina Stucchi
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | - Sara Viganò
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| |
Collapse
|
15
|
Abstract
Non-Bloch-band theory describes bulk energy spectra and topological invariants in non-Hermitian crystals with open boundaries, where the bulk eigenstates are squeezed toward the edges (skin effect). However, the interplay of non-Bloch-band theory, skin effect, and coherent Bloch dynamics is so far unexplored. In two-band non-Hermitian lattices, it is shown here that collapse of non-Bloch bands and skin modes deeply changes the Bloch dynamics under an external force. In particular, for resonance forcing non-Bloch-band collapse results in Wannier-Stark ladder coalescence and chiral Zener tunneling between the two dispersive Bloch bands.
Collapse
Affiliation(s)
- S Longhi
- Dipartimento di Fisica, Politecnico di Milano and Istituto di Fotonica e Nanotecnologie del Consiglio Nazionale delle Ricerche, Piazza L. da Vinci 32, I-20133 Milano, Italy and IFISC (UIB-CSIC), Instituto de Fisica Interdisciplinar y Sistemas Complejos-Palma de Mallorca E-07122, Spain
| |
Collapse
|
16
|
Caminati M, Senna G, Vianello A, Ricci G, Bellamoli R, Longhi S, Crivellaro M, Marcer G, Monai M, Passalacqua G. Thunderstorm Asthma: A Critical Appraisal Based on Clinical Practice. J Investig Allergol Clin Immunol 2019; 28:273-275. [PMID: 30073965 DOI: 10.18176/jiaci.0259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M Caminati
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - G Senna
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - A Vianello
- Respiratory Pathophysiology Division, University-City Hospital of Padua, Padua, Italy
| | - G Ricci
- Emergency Department, Clinical Toxicology Unit, Verona University and General Hospital, Verona, Italy
| | - R Bellamoli
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - S Longhi
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - M Crivellaro
- Allergy Service, Department of Medicine and Public Health, University of Padua, Padua, Italy
| | - G Marcer
- Allergy Service, Department of Medicine and Public Health, University of Padua, Padua, Italy
| | - M Monai
- Meteorological Service, Veneto Regional Agency for Environment Protection and Prevention, Padua, Italy
| | - G Passalacqua
- Allergy and Respiratory Diseases, Policlinico San Martino, University of Genoa, Italy
| |
Collapse
|
17
|
Mazucatto I, Totti F, Longhi S, Rodrigues F, Magalhães L, Mendonça L, Nascimento C, Jordão M, Bailer M. SUN-PO027: Protein Target in Critically Ill Patients. Is it Possible to Achieve? Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32662-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
Mazucatto I, Longhi S, Totti F, Lazo G, Alves F, Lins L, Sanches L. SUN-PO236: Evaluation of Muscle Mass Loss Related to the Time of Mechanical Ventilation, Diagnosis and Age. Is there a Relationship? Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32868-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
19
|
Mazucatto I, Longhi S, Totti F, Alves F, Lins L, Nascimento C, Arrais A, Paiva T, Sanches L. SUN-PO237: Nutric Score X NRS Nutritional Risk Screening. Is There Difference in Results in the Same Population? Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32869-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
20
|
Abstract
The discovery of topological phases in non-Hermitian open classical and quantum systems challenges our current understanding of topological order. Non-Hermitian systems exhibit unique features with no counterparts in topological Hermitian models, such as failure of the conventional bulk-boundary correspondence and non-Hermitian skin effect. Advances in the understanding of the topological properties of non-Hermitian lattices with translational invariance have been reported in several recent studies; however little is known about non-Hermitian quasicrystals. Here we disclose topological phases in a quasicrystal with parity-time (PT) symmetry, described by a non-Hermitian extension of the Aubry-André-Harper model. It is shown that the metal-insulating phase transition, observed at the PT symmetry breaking point, is of topological nature and can be expressed in terms of a winding number. A photonic realization of a non-Hermitian quasicrystal is also suggested.
Collapse
Affiliation(s)
- S Longhi
- Dipartimento di Fisica - Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy and Istituto di Fotonica e Nanotecnologie - Consiglio Nazionale delle Ricerche, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| |
Collapse
|
21
|
Aicardi V, Tiscornia C, Pena DF, Del Vecchio L, Cimadoro E, Bacchini G, Longhi S. FP750THE NUTRITIONAL STATUS IN ELDERLY HEMODIALYSIS PATIENTS: A COMPARISON BETWEEN ITALY AND CHILE. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp750] [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: 11/13/2022] Open
Affiliation(s)
- Valeria Aicardi
- Centro de Dialysis Cermedial V Region, Vina del Mar y Valparaiso, Chile
| | | | | | | | | | | | | |
Collapse
|
22
|
Longhi S, Del Vecchio L, Martelli L, Ardissino G. FP106RISK OF aHUS IN FAMILIES MEMBERS WITH COMPLEMENT GENES MUTATIONS. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp106] [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: 11/12/2022] Open
|
23
|
Le Breton N, Longhi S, Rockenbauer A, Guigliarelli B, Marque SRA, Belle V, Martinho M. Probing the dynamic properties of two sites simultaneously in a protein–protein interaction process: a SDSL-EPR study. Phys Chem Chem Phys 2019; 21:22584-22588. [DOI: 10.1039/c9cp04660g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Probing two sites simultaneously in a protein–protein interaction process combining spin labels of different EPR signatures.
Collapse
Affiliation(s)
| | - S. Longhi
- Aix Marseille Univ
- CNRS
- AFMB
- Marseille
- France
| | - A. Rockenbauer
- Research Center of Natural Sciences
- Budapest University of Technology and Economics
- Budapest
- Hungary
| | | | | | - V. Belle
- Aix Marseille Univ., CNRS, BIP
- Marseille
- France
| | - M. Martinho
- Aix Marseille Univ., CNRS, BIP
- Marseille
- France
| |
Collapse
|
24
|
Ardissino G, Tel F, Testa S, Paglialonga F, Longhi S, Martelli L, Consolo S, Picicco D, Dodaro A, Daprai L, Colombo R, Arghittu M, Perrone M, Chidini G, Scalia Catenacci S, Cropanese I, Consonni D. A simple prognostic index for Shigatoxin-related hemolytic uremic syndrome at onset: data from the ItalKid-HUS network. Eur J Pediatr 2018; 177:1667-1674. [PMID: 30094644 DOI: 10.1007/s00431-018-3198-7] [Citation(s) in RCA: 11] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/09/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022]
Abstract
Shigatoxin Escherichia coli-related hemolytic uremic syndrome (eHUS) is a severe thrombotic microangiopathy (TMA) burdened by life-threatening complications and long-term sequelae. Since hemoconcentration is associated with worse outcome, we tried to develop a reliable and easy-to-calculate index for predicting complications and sequelae based on hemoglobin (Hb) at presentation. The first laboratory examinations with signs of TMA in eHUS patients were analyzed in relation to the outcomes with the receiver operating characteristic curves and their areas under the curve (AUC) for Hb and creatinine (sCr). A total of 197 eHUS patients were identified of whom 24% did not have anemia at presentation. Hb level was the best predictor of a poor outcome (AUC 0.67) but the combination of Hb with sCr, in the formula [(Hb in g/dL + (sCr in mg/dL × 2)], showed an even better AUC of 0.75. The described scoring system was also strongly associated and predictive of all complications and health care needs (8% of patients with scoring > 13 died or entered a permanent vegetative state compared with 0% of those with ≤ 13).Conclusion: The presented score is a simple and early predictor of both short- and long-term outcomes and identifies patients who should undergo rapid volume expansion to counteract hemoconcentration, the spreading of microvascular thrombosis, and the consequent increased organ damage. What is Known: • In eHUS, hemoconcentration is associated with worse short- and long-term outcome. • A prognostic index to identify patients at higher risk for complications at presentation is not available. What is New: • We developed a simple and early prognostic index for eHUS outcome with the combination of Hb and sCr at onset, in the following formula [(Hb in g/dL + (sCr in mg/dL × 2)]. • The proposed HUS Severity Score can promptly identify patients with good outcome and those with high risk of worse short- and long-term outcome.
Collapse
Affiliation(s)
- Gianluigi Ardissino
- Center for HUS Prevention Control and Management, Pediatric Nephrology, Dialysis and Transplantation Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Francesca Tel
- Center for HUS Prevention Control and Management, Pediatric Nephrology, Dialysis and Transplantation Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Testa
- Center for HUS Prevention Control and Management, Pediatric Nephrology, Dialysis and Transplantation Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Paglialonga
- Center for HUS Prevention Control and Management, Pediatric Nephrology, Dialysis and Transplantation Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Selena Longhi
- Center for HUS Prevention Control and Management, Pediatric Nephrology, Dialysis and Transplantation Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Martelli
- Center for HUS Prevention Control and Management, Pediatric Nephrology, Dialysis and Transplantation Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Consolo
- Center for HUS Prevention Control and Management, Pediatric Nephrology, Dialysis and Transplantation Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Damiano Picicco
- Center for HUS Prevention Control and Management, Laboratory of Microbiology, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonella Dodaro
- Center for HUS Prevention Control and Management, Laboratory of Microbiology, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Daprai
- Center for HUS Prevention Control and Management, Laboratory of Microbiology, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Rosaria Colombo
- Center for HUS Prevention Control and Management, Laboratory of Microbiology, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Milena Arghittu
- Center for HUS Prevention Control and Management, Laboratory of Microbiology, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Michela Perrone
- Center for HUS Prevention Control and Management, Neonatal Intensive Care Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanna Chidini
- Center for HUS Prevention Control and Management, Maternal-Child Anesthesia and Intensive Care Departement, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Scalia Catenacci
- Center for HUS Prevention Control and Management, Maternal-Child Anesthesia and Intensive Care Departement, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Isabella Cropanese
- Center for HUS Prevention Control and Management, Child and Adolescent Neuropsychiatric Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Dario Consonni
- Center for HUS Prevention Control and Management at the Epidemiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | | |
Collapse
|
25
|
Abstract
Exceptional points (EPs), that is, branch point singularities of non-Hermitian Hamiltonians, are ubiquitous in optics. So far, the signatures of EPs have been mostly studied assuming classical light. In the passive parity-time (PT) optical coupler, a fingerprint of EPs resulting from the coalescence of two resonance modes is a qualitative change of the photon decay law, from damped Rabi-like oscillations to transparency, as the EP is crossed by increasing the loss rate. However, when probed by nonclassical states of light, quantum interference can hide EPs. Here it is shown that, under excitation with polarization-entangled two-photon states, the EP phase transition is smoothed until it disappears as the effective particle statistics are changed from bosonic to fermionic.
Collapse
|
26
|
Longhi S. Probing one-dimensional topological phases in waveguide lattices with broken chiral symmetry. Opt Lett 2018; 43:4639-4642. [PMID: 30272702 DOI: 10.1364/ol.43.004639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 08/24/2018] [Indexed: 06/08/2023]
Abstract
One-dimensional lattices with chiral symmetry are known to possess quantized Zak phase and nontrivial topological phases. Here it is shown that the quantized Zak phase and nontrivial edge states, partially protected by inversion symmetry rather than chiral symmetry, can be observed and probed in the bulk exploiting continuous-time photonic quantum walk in zig-zag waveguide arrays. The averaged beam displacement measurements can detect quantized Zak phase and nontrivial topological phases in the extended Su-Schrieffer-Heeger model with broken chiral symmetry.
Collapse
|
27
|
Sanches L, Alves F, Totti F, Buonso I, Bailer M, Nascimento C, Lins L, Jordão M, Longhi S. Nutritional support: Delivery versus energy requirements. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1508] [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: 11/26/2022]
|
28
|
Longhi S. PT symmetry and antisymmetry by anti-Hermitian wave coupling and nonlinear optical interactions. Opt Lett 2018; 43:4025-4028. [PMID: 30106943 DOI: 10.1364/ol.43.004025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 07/25/2018] [Indexed: 06/08/2023]
Abstract
Light propagation in systems with anti-Hermitian coupling, described by a spinor-like wave equation, provides a general route for the observation of antiparity-time (PT) symmetry in optics. Remarkably, under a different definition of parity operator, a PT symmetry can be found as well in such systems. Such symmetries are ubiquitous in nonlinear optical interactions and are exemplified by considering modulation instability in optical fibers and optical parametric amplification.
Collapse
|
29
|
Abstract
Exceptional points (EPs) with a global collapse of pairs of eigenfunctions are shown to arise in two locally coupled and spatially extended optical structures with balanced gain and loss. The global collapse at the EP deeply changes light propagation, which becomes very sensitive to small changes of initial conditions or system parameters, similar to what happens in models of classical or quantum catastrophes. The implications of global collapse for light behavior are illustrated by considering discrete beam diffraction and Bloch oscillation catastrophe in coupled waveguide lattices.
Collapse
|
30
|
Abstract
Coherent virtual absorption (CVA) is a recently introduced phenomenon for which exponentially growing waves incident on a conservative optical medium are neither reflected nor transmitted, at least transiently. CVA has been associated with complex zeros of the scattering matrix and can be regarded as the time reversal of the decay process of a quasi-mode sustained by the optical medium. Here we consider CVA for discretized light transport in coupled resonator optical waveguides or waveguide arrays and show that a distinct kind of CVA, which is not related to the complex zero excitation of quasi-modes, can be observed. This result suggests that a scattering matrix analysis cannot fully capture CVA phenomena.
Collapse
|
31
|
Veronesi A, Talamini R, Longhi S, Crivellari D, Galligioni E, Tirelli U, Trovò MG, Magri MD, Frustaci S, Figoli F, Zagonel V, Tumolo S, Grigoletto E. Carcinoembryonic Antigen (CEA) in the Follow-Up of Disease-Free Breast Cancer Patients. Tumori 2018; 68:477-80. [PMID: 7168012 DOI: 10.1177/030089168206800605] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Carcinoembryonic antigen (CEA) assays (2536) were performed in 380 disease-free breast cancer patients after radical mastectomy. In the 334 evaluable patients with 3 or more determinations, the overall relapse rate after a median follow-up of 29 months was 11 %. Of 203 patients with normal CEA values, 19 (9.3 %) relapsed. In the 50 patients with the highest CEA value greater than 20 ng/ml, the relapse rate was 26 %; in the 12 patients with gradually increasing CEA elevations it was 50 %. However, CEA was unable to predict recurrence in N- patients. Premastectomy N+ was significantly associated with greater than 20 ng/ml or gradually increasing CEA values, suggesting the lack of an independent prognostic value of CEA in our patient population.
Collapse
|
32
|
Capecci M, Ceravolo MG, D'Orazio F, Ferracuti F, Iarlori S, Lazzaro G, Longhi S, Romeo L, Verdini F. A tool for home-based rehabilitation allowing for clinical evaluation in a visual markerless scenario. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2015:8034-7. [PMID: 26738157 DOI: 10.1109/embc.2015.7320257] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This work deals with the design of an interactive monitoring tool for home-based physical rehabilitation. The software platform includes a video processing stage and the exercise performance evaluation. Image features are extracted by a Kinect v2 sensor and elaborated to return the exercises score. Furthermore the tool provides to physiotherapists a quantitative exercise evaluation of subject's performances. The proposed tool for home rehabilitation has been tested on 5 subjects and 5 different exercises and results are presented. In particular both exercises and relative evaluation indexes were selected by specialists in neurorehabilitation.
Collapse
|
33
|
Lepore G, Bonfanti R, Bozzetto L, Di Blasi V, Girelli A, Grassi G, Iafusco D, Laviola L, Rabbone I, Schiaffini R, Bruttomesso D, Mammì F, Bruzzese M, Schettino M, Nuzzo M, Di Blasi V, Fresa R, Lambiase C, Iafusco D, Zanfardino A, Confetto S, Bozzetto L, Annuzzi G, Alderisio A, Riccardi G, Gentile S, Marino G, Guarino G, Zucchini S, Maltoni G, Suprani T, Graziani V, Nizzoli M, Acquati S, Cavani R, Romano S, Michelini M, Manicardi E, Bonadonna R, Dei Cas A, Dall'aglio E, Papi M, Riboni S, Manicardi V, Manicardi E, Manicardi E, Pugni V, Lasagni A, Street M, Pagliani U, Rossi C, Assaloni R, Brunato B, Tortul C, Zanette G, Li Volsi P, Zanatta M, Tonutti L, Agus S, Pellegrini M, Ceccano P, Pozzilli G, Anguissola B, Buzzetti R, Moretti C C, Leto G, Pozzilli P, Manfrini S, Maurizi A, Leotta S, Altomare M, Abbruzzese S, Carletti S, Suraci C, Filetti S, Manca Bitti M, Arcano S, Cavallo M, De Bernardinis M, Pitocco D, Caputo S, Rizzi A, Manto A, Schiaffini R, Cappa M, Benevento D, Frontoni S, Malandrucco I, Morano S, Filardi T, Lauro D, Marini M, Castaldo E, Sabato D, Tuccinardi F, Forte E, Viterbori P, Arnaldi C, Minuto N, d'Annunzio G, Corsi A, Rota R, Scaranna C, Trevisan R, Valentini U, Girelli A, Bonfadini S, Zarra E, Plebani A, Prandi E, Felappi B, Rocca A, Meneghini E, Galli P, Ruggeri P, Carrai E, Fugazza L, Baggi V, Conti D, Bosi E, Laurenzi A, Caretto A, Molinari C, Orsi E, Grancini V, Resi V, Bonfanti R, Favalli V, Bonura C, Rigamonti A, Bonomo M, Bertuzzi F, Pintaudi B, Disoteo O, Perseghin G, Perra S, Chiovato L, De Cata P, Zerbini F, Lovati E, Laneri M, Guerraggio L, Bossi A, De Mori V, Galetta M, Meloncelli I, Aiello A A, Di Vincenzo S, Nuzzi A, Fraticelli E, Ansaldi E, Battezzati M, Lombardi M, Balbo M, Lera R, Secco A, De Donno V, Cadario F, Savastio S, Ponzani C, Aimaretti G, Rabbone I, Ignaccolo G, Tinti D, Cerutti F, Bari F, Giorgino F, Piccinno E, Zecchino O, Cignarelli M, Lamacchia O, Picca G, De Cosmo S, Rauseo A, Tomaselli L, Tumminia A, Egiziano C, Scarpitta A, Maggio F, Cardella F, Roppolo R, Provenzano V, Fleres M, Scorsone A, Scatena A, Gregori G, Lucchesi S, Gadducci F, Di Cianni S, Pancani S, Del Prato S, Aragona M, Crisci I, Calianno A, Fattor B, Crazzolara D, Reinstadler P, Longhi S, Incelli G, Rauch S, Romanelli T, Orrasch M, Cauvin V, Franceschi R, Lalli C, Pianta A, Marangoni A, Aricò C, Marin N, Nogara N, Simioni N, Filippi A, Gidoni Guarneri G, Contin M.L M, Decata A, Bondesan L, Confortin L, Coracina A, Lombardi S, Costa Padova S, Cipponeri E, Scotton R, Galasso S, Boscari F, Zanon M, Vinci C, Lisato G, Gottardo L, Bonora E, Trombetta M, Negri C, Brangani C, Maffeis C, Sabbion A, Marigliano M. Metabolic control and complications in Italian people with diabetes treated with continuous subcutaneous insulin infusion. Nutr Metab Cardiovasc Dis 2018; 28:335-342. [PMID: 29428572 DOI: 10.1016/j.numecd.2017.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/31/2017] [Accepted: 12/02/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIM The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII). METHODS AND RESULTS Questionnaires investigating the organisation of diabetes care centres, individuals' clinical and metabolic features and pump technology and its management were sent to adult and paediatric diabetes centres that use CSII for treatment in Italy. Information on standard clinical variables, demographic data and acute and chronic diabetic complications was derived from local clinical management systems. The sample consisted of 6623 people with diabetes, which was obtained from 93 centres. Of them, 98.8% had type 1 diabetes mellitus, 57.2% were female, 64% used a conventional insulin pump and 36% used a sensor-augmented insulin pump. The median glycated haemoglobin (HbA1c) level was 60 mmol/mol (7.6%). The HbA1c target (i.e. <58 mmol/mol for age <18 years and <53 mmol/mol for age >18 years) was achieved in 43.4% of paediatric and 23% of adult participants. Factors such as advanced pump functions, higher rate of sensor use, pregnancy in the year before the study and longer duration of diabetes were associated with lower HbA1c levels. The most common chronic complications occurring in diabetes were retinopathy, microalbuminuria and hypertension. In the year before the study, 5% of participants reported ≥1 episode of severe hypoglycaemic (SH) episodes (SH) and 2.6% reported ≥1 episode of ketoacidosis. CONCLUSIONS Advanced personal skills and use of sensor-based pump are associated with better metabolic control outcomes in Italian people with diabetes who were treated with CSII. The reduction in SH episodes confirms the positive effect of CSII on hypoglycaemia. CLINICAL TRIAL REGISTRATION NUMBER NCT 02620917 (ClinicalTrials.gov).
Collapse
|
34
|
Moroni G, Depetri F, Del Vecchio L, Gallelli B, Raffiotta F, Giglio E, Brunini F, D'Amico M, Longhi S, Radice A, Messa P, Sinico RA. Low-dose rituximab is poorly effective in patients with primary membranous nephropathy. Nephrol Dial Transplant 2018; 32:1691-1696. [PMID: 27387472 DOI: 10.1093/ndt/gfw251] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/28/2016] [Indexed: 11/14/2022] Open
Abstract
Background The optimal dosing and the efficacy of rituximab for primary membranous nephropathy (PMN) has not been established. This multicentric prospective study evaluates the efficacy and safety of low-dose rituximab (RTX) therapy in patients with PMN in clinical practice. Methods Thirty-four consecutive patients with PMN and nephrotic syndrome were included and received RTX (375 mg/m2) once (18 patients) or twice (16 patients). RTX was the first-line therapy for 19 (56%) and the second line for 15 (44%) patients. All patients were followed for 12 months after RTX and 24 for at least 18 months (mean 23.9 ± 18.6 months). Results At 12 months, 5 patients (14.7%) achieved complete response, 10 (29.4%) partial and 19 (55.8%) no response. Response occurred ∼6 months after RTX. At 24 months, the clinical situation was unchanged: two non-responders achieved partial response and two responders relapsed. Responders had significantly higher baseline GFR and lower anti-PLA2R antibodies compared with non-responders. Outcome was similar between one or two doses of RTX (non-responders 55.5 versus 56%, respectively) and between patients who had received previous therapy versus those receiving RTX as first-line therapy (non-responders 40 versus 68%, respectively). In the 15 patients already treated, the response to RTX was comparable to that of previous therapies. Conclusion Low-dose RTX obtains remission in <50% of PMN patients. Probably, higher doses and longer treatments are needed to induce and maintain a response. The balance between the costs and benefits should guide the selection of the patient and the optimal dosage.
Collapse
Affiliation(s)
- Gabriella Moroni
- Nephrological Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico Milano, Italy
| | - Federica Depetri
- Nephrological Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico Milano, Italy
| | - Lucia Del Vecchio
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | | | - Francesca Raffiotta
- Nephrological Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico Milano, Italy
| | - Elisa Giglio
- Nephrological Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico Milano, Italy
| | - Francesca Brunini
- Clinical Immunology Unit & Renal Unit, S. Carlo Borromeo Hospital, Milano, Italy
| | | | - Selena Longhi
- Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy
| | - Antonella Radice
- Microbiology and Virology Department, S. Carlo Borromeo Hospital, Milano, Italy
| | - Piergiorgio Messa
- Nephrological Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico Milano, Italy
| | - Renato Alberto Sinico
- Department of Medicine and Surgery, Università degli Studi di Milano, Monza (MB), Italy
| |
Collapse
|
35
|
Longhi S. Equivalence principle and quantum mechanics: quantum simulation with entangled photons. Opt Lett 2018; 43:226-229. [PMID: 29328244 DOI: 10.1364/ol.43.000226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 12/04/2017] [Indexed: 06/07/2023]
Abstract
Einstein's equivalence principle (EP) states the complete physical equivalence of a gravitational field and corresponding inertial field in an accelerated reference frame. However, to what extent the EP remains valid in non-relativistic quantum mechanics is a controversial issue. To avoid violation of the EP, Bargmann's superselection rule forbids a coherent superposition of states with different masses. Here we suggest a quantum simulation of non-relativistic Schrödinger particle dynamics in non-inertial reference frames, which is based on the propagation of polarization-entangled photon pairs in curved and birefringent optical waveguides and Hong-Ou-Mandel quantum interference measurement. The photonic simulator can emulate superposition of mass states, which would lead to violation of the EP.
Collapse
|
36
|
Longhi S. Refractionless propagation of discretized light. Opt Lett 2017; 42:5086-5089. [PMID: 29240143 DOI: 10.1364/ol.42.005086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/07/2017] [Indexed: 06/07/2023]
Abstract
Light refraction, i.e., the bending of the path of a light wave at the interface between two different dielectric media, is ubiquitous in optics. Refraction arises from the different speeds of light and is unavoidable in continuous media, according to Snell's Law. Here we show rather counterintuitively that omnidirectional refractionless propagation can be observed for discretized light crossing a tilted interface separating two homogeneous waveguide lattices.
Collapse
|
37
|
Radetti G, Grugni G, Lupi F, Marazzi N, Longhi S, Fanolla A, Sartorio A. The relationship between hyperthyrotropinemia and metabolic and cardiovascular risk factors in a large group of overweight and obese children and adolescents. J Endocrinol Invest 2017; 40:1311-1319. [PMID: 28585021 DOI: 10.1007/s40618-017-0705-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 05/29/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE Mild TSH elevations are frequently observed in obese patients, in the absence of any detectable thyroid disease. Our objective is to evaluate the relationship between the raised TSH levels and the biochemical and clinical consequences of obesity. METHODS This is a retrospective cross-sectional study of a large population of obese children and adolescents. We evaluated 833 subjects (340 m, 493 f), aged 14.4 ± 2.5 (range 5.2-18.5) years, height SDS 0.27 ± 1.04 (-3.49-4.35), and BMI SDS 2.94 ± 0.59 (1.60-4.68). Body composition, free T4, TSH, anti-TPO antibodies, anti-TG antibodies, inflammation markers (total WBC and the subtypes, ultrasensitive C-reactive protein), and metabolic parameters [AST, ALT, γGT, ALP, glycaemia, insulin, total cholesterol (TC), HDL-cholesterol (HDL-C), and LDL-cholesterol (LDL-C), triglycerides (TG)] were measured, and oral disposition index (ODI) and cardiovascular risk factors (TC/HDL-C and TG/HDL-C) were calculated. After exclusion of the subjects showing anti-thyroid antibodies, the remaining 779 (325 m, 454 f) were then subdivided into two subgroups according to a TSH value below (group A) or above (group B) 4.5 mU/L. RESULTS Clinical characteristics and hematological markers of patients with and without positive anti-thyroid antibodies were similar, with the exception of higher TSH levels in the latter group. Using analysis of covariance, the subjects of group B had significantly higher values of TC (170.3 ± 28.7 vs 163.3 ± 32.9 mg/dL; p < 0.05), systolic (125.8 ± 13.5 vs 124.5 ± 13.1 mm/Hg), and diastolic blood pressure (79.2 ± 8.0 vs 77.9 ± 8.2 mm/Hg) than subjects of group A. No difference was observed in body composition, ODI, and the cardiovascular risk factors between these two groups. CONCLUSION TSH elevation in overweight and obese children and adolescents, being associated with a higher TC and blood pressure, might negatively influence the cardiac status. Longitudinal studies are requested, however, to confirm this hypothesis and, therefore, to conclude whether a substitutive treatment with l-thyroxine is really needed in these patients.
Collapse
Affiliation(s)
- G Radetti
- Marienklinik, via Claudia De Medici 2, 39100, Bolzano, Italy.
| | - G Grugni
- Experimental Laboratory for Auxo-endocrinological Research and Division of Auxology, Istituto Auxologico Italiano, Research Institute, Milan, Verbania, Italy
| | - F Lupi
- Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
| | - N Marazzi
- Experimental Laboratory for Auxo-endocrinological Research and Division of Auxology, Istituto Auxologico Italiano, Research Institute, Milan, Verbania, Italy
| | - S Longhi
- Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
| | - A Fanolla
- Department of Biostatistics, Regional Hospital of Bolzano, Bolzano, Italy
| | - A Sartorio
- Experimental Laboratory for Auxo-endocrinological Research and Division of Auxology, Istituto Auxologico Italiano, Research Institute, Milan, Verbania, Italy
| |
Collapse
|
38
|
Longhi S. Reflectionless and invisible potentials in photonic lattices. Opt Lett 2017; 42:3229-3232. [PMID: 28809915 DOI: 10.1364/ol.42.003229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 07/21/2017] [Indexed: 06/07/2023]
Abstract
An arbitrarily shaped optical potential on a discrete photonic lattice, which transversely drifts at a speed greater than the maximum speed allowed by the light cone of the lattice band, becomes reflectionless. Such an intriguing result, which arises from the discrete translational symmetry of the lattice, is peculiar to discretized light and does not have any counterpart for light scattering in continuous optical media. A drifting non-Hermitian optical potential of the Kramers-Kronig type also is an invisible potential, i.e., a discrete optical beam crosses the drifting potential without being distorted, delayed, nor advanced.
Collapse
|
39
|
Capecci M, Ceravolo MG, Ferracuti F, Iarlori S, Longhi S, Romeo L, Russi SN, Verdini F. Accuracy evaluation of the Kinect v2 sensor during dynamic movements in a rehabilitation scenario. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:5409-5412. [PMID: 28269481 DOI: 10.1109/embc.2016.7591950] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In this paper, the accuracy evaluation of the Kinect v2 sensor is investigated in a rehabilitation scenario. The accuracy analysis is provided in terms of joint positions and angles during dynamic postures used in low-back pain rehabilitation. Although other studies have focused on the validation of the accuracy in terms of joint angles and positions, they present results only considering static postures whereas the rehabilitation exercise monitoring involves to consider dynamic movements with a wide range of motion and issues related to the joints tracking. In this work, joint positions and angles represent clinical features, chosen by medical staff, used to evaluate the subject's movements. The spatial and temporal accuracy is investigated with respect to the gold standard, represented by a stereophotogrammetric system, characterized by 6 infrared cameras. The results provide salient information for evaluating the reliability of Kinect v2 sensor for dynamic postures.
Collapse
|
40
|
Longhi S. Photonic Loschmidt echo in binary waveguide lattices. Opt Lett 2017; 42:2551-2554. [PMID: 28957282 DOI: 10.1364/ol.42.002551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 06/06/2017] [Indexed: 06/07/2023]
Abstract
Time reversal is one of the most intriguing yet elusive wave phenomena of major interest in different areas of classical and quantum physics. Time reversal requires in principle to flip the sign of the Hamiltonian of the system, leading to a revival of the initial state (Loschmidt echo). Here it is shown that Loschmidt echo of photons can be observed in an optical setting without resorting to reversal of the Hamiltonian. We consider photonic propagation in a binary waveguide lattice and show that, by exchanging the two sublattices after some propagation distance, a Loschmidt echo can be observed. Examples of Loschmidt echoes for single photon and NOON states are given in one- and two-dimensional waveguide lattices.
Collapse
|
41
|
Del Vecchio L, Aicardi V, Longhi S, Tiscornia C, Pena F, Vargas K, Npobloete H, Pontoriero G. SP424THE NUTRITIONAL STATUS IN ELDERLY HEMODIALYSIS PATIENTS:A COMPARISON BETWEEN ITALY AND CHILE. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx148.sp424] [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: 11/13/2022] Open
|
42
|
Mateos-Diaz E, Amara S, Roussel A, Longhi S, Cambillau C, Carrière F. Probing Conformational Changes and Interfacial Recognition Site of Lipases With Surfactants and Inhibitors. Methods Enzymol 2017; 583:279-307. [DOI: 10.1016/bs.mie.2016.09.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
43
|
Abstract
Parity-time (PT) symmetry is one of the most important accomplishments in optics over the past decade. Here the concept of PT mode-locking (ML) of a laser is introduced, in which active phase-locking of cavity axial modes is realized by asymmetric mode coupling in a complex time crystal. PT ML shows a transition from single- to double-pulse emission as the PT symmetry breaking point is crossed. The transition can show a turbulent behavior, depending on a dimensionless modulation parameter that plays the same role as the Reynolds number in hydrodynamic flows.
Collapse
|
44
|
Caminati M, Senna G, Stefanizzi G, Bellamoli R, Longhi S, Chieco-Bianchi F, Guarnieri G, Tognella S, Olivieri M, Micheletto C, Festi G, Bertocco E, Mazza M, Rossi A, Vianello A. Drop-out rate among patients treated with omalizumab for severe asthma: Literature review and real-life experience. BMC Pulm Med 2016; 16:128. [PMID: 27562427 PMCID: PMC5000547 DOI: 10.1186/s12890-016-0290-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 08/18/2016] [Indexed: 11/29/2022] Open
Abstract
Background In patients with asthma, particularly severe asthma, poor adherence to inhaled drugs negatively affects the achievement of disease control. A better adherence rate is expected in the case of injected drugs, such as omalizumab, as they are administered only in a hospital setting. However, adherence to omalizumab has never been systematically investigated. The aim of this study was to review the omalizumab drop-out rate in randomized controlled trials (RCTs) and real-life studies. A comparative analysis was performed between published data and the Italian North East Omalizumab Network (NEONet) database. Results In RCTs the drop-out rate ranged from 7.1 to 19.4 %. Although the reasons for withdrawal were only occasionally reported, patient decision and adverse events were the most frequently reported causes. In real-life studies the drop-out rate ranged from 0 to 45.5 %. In most cases lack of efficacy was responsible for treatment discontinuation. According to NEONet data, 32 % of treated patients dropped out, with an increasing number of drop outs observed over time. Patient decision and lack of efficacy accounted for most treatment withdrawals. Conclusions Treatment adherence is particularly crucial in patients with severe asthma considering the clinical impact of the disease and the cost of non-adherence. The risk of treatment discontinuation has to be carefully considered both in the experimental and real-life settings. Increased knowledge regarding the main reasons for patient withdrawal is important to improve adherence in clinical practice.
Collapse
Affiliation(s)
- M Caminati
- Asthma Center and Allergy Unit, Verona General and University Hospital, Verona, Italy.
| | - G Senna
- Asthma Center and Allergy Unit, Verona General and University Hospital, Verona, Italy
| | - G Stefanizzi
- Asthma Center and Allergy Unit, Verona General and University Hospital, Verona, Italy
| | - R Bellamoli
- Asthma Center and Allergy Unit, Verona General and University Hospital, Verona, Italy
| | - S Longhi
- Asthma Center and Allergy Unit, Verona General and University Hospital, Verona, Italy
| | - F Chieco-Bianchi
- Respiratory Pathophysiology Division, University-City Hospital of Padua, Padua, Italy
| | - G Guarnieri
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - S Tognella
- Respiratory Unit, Orlandi General Hospital, Bussolengo, Verona, Italy
| | - M Olivieri
- Unit of Occupational Medicine, Verona General and University Hospital, Verona, Italy
| | - C Micheletto
- Respiratory Unit, Mater Salutis Hospital, Legnago, Verona, Italy
| | - G Festi
- Pulmonary Unit, Verona University and General Hospital, Verona, Italy
| | - E Bertocco
- Respiratory pathology Unit, Arzignano General Hospital, Vicenza, Italy
| | - M Mazza
- Pulmonary Unit, Pordenone General Hospital, Pordenone, Italy
| | - A Rossi
- Pulmonary Unit, Verona University and General Hospital, Verona, Italy
| | - A Vianello
- Respiratory Pathophysiology Division, University-City Hospital of Padua, Padua, Italy
| | | |
Collapse
|
45
|
Abstract
A broad class of planar dielectric media with complex permittivity profiles that are fully invisible, for both left and right incidence sides, is introduced. Such optical media are locally isotropic, non-magnetic, and belong to the recently discovered class of Kramers-Kronig media [Nat. Photonics9, 436 (2015)], i.e., the spatial profiles of the real and imaginary parts of the dielectric permittivity are related each other by a Hilbert transform. The transition from unidirectional to bidirectional invisibility, and the possibility to realize sharp reflection above a cut-off incidence angle, are also discussed.
Collapse
|
46
|
del Vecchio L, Aicardi V, Longhi S, Ravasi C, Cimadoro E, Bordoli M, La Milia V, Pontoriero G. MP676THE ROLE OF AGE ON NUTRITIONAL STATUS AND WATER BALANCE IN HEMODIALYSIS PATIENTS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw199.23] [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: 11/13/2022] Open
|
47
|
Sabatino M, Potena L, Longhi S, Masetti M, Gagliardi C, Milandri A, Manfredini V, Cinelli M, Marinelli G, Pinna A, Rapezzi C, Grigioni F. Outcomes of Heart Transplantation for Transthyretin-Related Amyloid Cardiomyopathy. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
48
|
Del Vecchio L, Longhi S, Locatelli F. Safety concerns about intravenous iron therapy in patients with chronic kidney disease. Clin Kidney J 2016; 9:260-7. [PMID: 26985378 PMCID: PMC4792617 DOI: 10.1093/ckj/sfv142] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 11/20/2015] [Indexed: 01/12/2023] Open
Abstract
Anaemia in chronic kidney disease (CKD) is managed primarily with erythropoiesis-stimulating agents (ESAs) and iron therapy. Following concerns around ESA therapy, intravenous (IV) iron is being administered more and more worldwide. However, it is still unclear whether this approach is safe at very high doses or in the presence of very high ferritin levels. Some observational studies have shown a relationship between either high ferritin level or high iron dose and increased risk of death, cardiovascular events, hospitalization or infection. Others have not been able to confirm these findings. However, they suffer from indication biases. On the other hand, the majority of randomized clinical trials have only a very short follow-up (and thus drug exposure) and are inadequate to assess the mortality risk. None of them have tested the role of different iron doses on hard end points. With the lack of clear evidence coming from well-designed and large-scale studies, several data suggest that excessive iron therapy may be toxic in several aspects, ranging from iron overload to tissue damage from labile iron. A number of experimental and clinical data suggest that either excessive iron therapy or iron overload may be a possible culprit of atherogenesis. The process seems to be mediated by oxidative stress. Iron therapy should also be used cautiously in the presence of active infections, since iron is essential for bacterial growth. Recently, the European Medicines Agency officially raised concerns about rare hypersensitivity reactions following IV iron administration. The balance has been in favour of benefits. In several European countries, this has created a lot of confusion and somewhat slowed the run towards excessive use. Altogether, IV iron remains a mainstay of anaemia treatment in CKD patients. However, in our opinion, its excessive use should be avoided, especially in patients with high ferritin levels and when ESA agents are not contraindicated.
Collapse
Affiliation(s)
- Lucia Del Vecchio
- Department of Nephrology and Dialysis , A. Manzoni Hospital , Lecco , Italy
| | - Selena Longhi
- Department of Nephrology and Dialysis , A. Manzoni Hospital , Lecco , Italy
| | | |
Collapse
|
49
|
Ferrè F, DeBelvis AG, Valerio L, Longhi S, Lazzari A, Fattore G, Ricciardi W, Maresso A. The performance of the Italian Health System under fiscal constraints. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv174.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
50
|
Abstract
BACKGROUND Standard low-flux haemodialysis (HD) is not very efficacious, and patient morbidity and mortality rates are still very high. According to the initial study design, the MPO study reported that high-flux HD (hf-HD) showed a significant 37% relative risk reduction of mortality in patients with serum albumin ≤4 g/dl; online haemodiafiltration (HDF) is considered the most efficient technique of using high-flux membranes, as clearances of small solutes, like urea, are higher than in haemofiltration and clearances of middle solutes, like β2-microglobulin, are higher than in hf-HD. SUMMARY Three randomized trials have recently been published analysing the effect of online HDF on mortality. Two trials were unable to demonstrate a positive effect of HDF on survival, while 1 showed a significantly better survival in patients randomized to HDF in comparison to those randomized to hf-HD. It is intriguing that post hoc analyses of these 3 studies showed that the patients randomized to online HDF who received the highest convection volumes had a lower risk of mortality and cardiovascular events than those randomized to HD. Four very recently published meta-analyses have shown inconsistent results concerning the effect of convective treatments in improving patient general and cardiovascular survival, while they have consistently shown a significant reduction of the intradialytic symptomatic hypotension in patients treated with convective techniques in comparison with those treated with prevalent diffusive ones. Key Messages: The results of the randomized trials on the effect of HDF in improving patient survival are inconclusive. Moreover, trials specifically designed for testing the effect of increased convection of online HDF on patient survival and morbidity in comparison to patients treated with hf-HD are still awaited.
Collapse
|