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Masotti L, Landini G, Panigada G, Grifoni E, Tarquini R, Cei F, Cimolato BMA, Vannucchi V, Di Pietro M, Piani F, Fortini A, Faraone A, Nenci G, Cipollini F, Blanc P, Lotti P, Di Natale M, Risaliti F, Aquilini D, Seravalle C, Bribani A, Farsi A, Micheletti I, Cioni E, Pelagalli G, Mattaliano C, Pinto G, Madonia EM, Sivieri I, Mannini M, Valoriani A, Brancati S, Rosselli M, Pavone E, Burla MC, Sergi A. PREDICTORS OF POOR OUTCOME IN TOCILIZUMAB TREATED PATIENTS WITH SARS-CoV-2 RELATED SEVERE RESPIRATORY FAILURE: A MULTICENTRE REAL WORLD STUDY. Int Immunopharmacol 2022; 107:108709. [PMID: 35334359 PMCID: PMC8938681 DOI: 10.1016/j.intimp.2022.108709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/05/2022] [Accepted: 03/13/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Luca Masotti
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy.
| | | | - Grazia Panigada
- Internal Medicine, SS Damiano and Cosma Hospital, Pescia, Italy
| | - Elisa Grifoni
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | | | - Francesco Cei
- Internal Medicine I, San Giuseppe Hospital, Empoli, Italy
| | | | - Vieri Vannucchi
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
| | - Massimo Di Pietro
- Infectious Diseases, Santa Maria Annunziata Hospital, Florence, Italy
| | - Fiorella Piani
- Internal Medicine, Santa Maria Annunziata Hospital, Florence, Italy
| | - Alberto Fortini
- Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy
| | - Antonio Faraone
- Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy
| | - Gabriele Nenci
- Internal Medicine II, San Jacopo Hospital, Pistoia, Italy
| | | | | | - Pamela Lotti
- Internal Medicine, Santo Stefano Hospital, Prato, Italy
| | | | | | | | | | - Andrea Bribani
- Internal Medicine, Serristori Hospital, Figline Valdarno, Italy
| | - Alessandro Farsi
- Allergology and Clinical Immunology, Ex Misericordia and Dolce Hospital, Prato, Italy
| | | | - Elisa Cioni
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | | | | | - Gabriele Pinto
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | | | - Irene Sivieri
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | | | | | | | | | - Eleonora Pavone
- SOC Governance Farmaceutica and Appropriatezza Prescrittiva, Azienda USL Toscana Centro, Italy
| | - Maria Chiara Burla
- SOC Governance Farmaceutica and Appropriatezza Prescrittiva, Azienda USL Toscana Centro, Italy
| | - Alessandro Sergi
- SOC Monitoraggio and Programmazione performance clinico-assistenziale, Azienda USL Toscana Centro, Italy
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Tarquini R, Pala L, Brancati S, Vannini G, De Cosmo S, Mazzoccoli G, Rotella CM. Clinical Approach to Diabetic Cardiomyopathy: A Review of Human Studies. Curr Med Chem 2019; 25:1510-1524. [PMID: 28685679 DOI: 10.2174/0929867324666170705111356] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 03/15/2017] [Accepted: 03/21/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetic Cardiomyopathy (DC) has been defined as a distinct entity characterized by the presence of diastolic or systolic cardiac dysfunction in a diabetic patient in the absence of other causes for Cardiomyopathy, such as coronary artery disease (CAD), hypertension (HTN), or valvular heart disease. Diabetes affects every organ in the body and cardiovascular disease accounts for two-thirds of the mortality in the diabetic population. Diabetes-related heart disease occurs in the form of coronary artery disease (CAD), cardiac autonomic neuropathy or DC. The prevalence of cardiac failure is high in the diabetic population and DC is a common, but underestimated cause of heart failure in diabetes. The strong association between diabetes and heart failure has fueled intense human and animal research aimed at identifying the mechanisms underlying diabetic myocardial disease. Despite significant progress made, the precise pathogenesis of diabetic Cardiomyopathy is yet to be clearly defined. Hyperglycemia, dyslipidemia and inflammation are thought to play key roles in the generation of reactive oxygen or nitrogen species which are in turn involved. METHODS We have reviewed the up-to-date scientific literature addressing these issues. RESULTS The myocardial interstitium undergoes alterations resulting in abnormal contractile function noted in DC. In the early stages of the disease, diastolic dysfunction is the only abnormality, but systolic dysfunction supervenes in the later stages with impaired left ventricular ejection fraction. Transmitral Doppler echocardiography is usually used to assess diastolic dysfunction, but tissue Doppler Imaging and Cardiac Magnetic Resonance Imaging are being increasingly used for early detection of DC. Diabetic patients with microvascular complications show the strongest association between diabetes and Cardiomyopathy, an association that parallels the duration and severity of hyperglycemia. CONCLUSION The management of DC involves improvement in lifestyle, control of glucose and lipid abnormalities, together with treatment of hypertension and CAD, if present.
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Affiliation(s)
- Roberto Tarquini
- Division of Intersystemic Internal Medicine, Department of Internal Medicine, USL Toscana Centro, S.Giuseppe Hospital, Empoli, Firenze, Italy
| | - Laura Pala
- Department of Biomedical Experimental and Clinical Sciences, SOD Diabetology, University of Florence and Careggi University Hospital, Florence, Italy
| | - Simona Brancati
- Division of Intersystemic Internal Medicine, Department of Internal Medicine, USL Toscana Centro, S.Giuseppe Hospital, Empoli, Firenze, Italy
| | - Giulia Vannini
- Division of Intersystemic Internal Medicine, Department of Internal Medicine, USL Toscana Centro, S.Giuseppe Hospital, Empoli, Firenze, Italy
| | - Salvatore De Cosmo
- Division of Internal Medicine and Chronobiology Unit, Department of Medical Sciences, IRCCS Scientific Institute and Regional General Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy
| | - Gianluigi Mazzoccoli
- Division of Internal Medicine and Chronobiology Unit, Department of Medical Sciences, IRCCS Scientific Institute and Regional General Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy
| | - Carlo Maria Rotella
- Department of Biomedical Experimental and Clinical Sciences, SOD Diabetology, University of Florence and Careggi University Hospital, Florence, Italy
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Amedei A, Pimpinelli N, Grassi A, Bella CD, Niccolai E, Brancati S, Benagiano M, D'Elios S, Bosi A, D'Elios MM. Skin CD30(+) T cells and circulating levels of soluble CD30 are increased in patients with graft versus host disease. Auto Immun Highlights 2015; 5:21-6. [PMID: 26000151 PMCID: PMC4389013 DOI: 10.1007/s13317-013-0054-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 07/30/2013] [Indexed: 11/17/2022]
Abstract
Objective To determine serum soluble CD30 (sCD30) levels in patients with graft versus host disease (GVHD). Methods Serum soluble CD30 levels and IgE levels were assayed by a sensitive ELISA in 57 patients with bone marrow transplantation, and in 44 healthy controls. We analyzed the type of effector T cells in patients with GVHD. Results Serum levels of sCD30 and serum IgE levels were significantly higher (p values <0.05) in patients with acute and chronic GVHD than in healthy controls. We found that CD30+ T-cells are present in the skin of patients with GVHD. Conclusion These results suggest that serum sCD30 levels may be helpful for the management of patients with bone marrow transplantation.
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Affiliation(s)
- Amedeo Amedei
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134 Florence, Italy
| | - Nicola Pimpinelli
- Dipartimento di Chirurgia e Medicina Traslazionale, Università di Firenze, Florence, Italy
| | - Alessia Grassi
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134 Florence, Italy
| | - Chiara Della Bella
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134 Florence, Italy
| | - Elena Niccolai
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134 Florence, Italy
| | - Simona Brancati
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134 Florence, Italy
| | - Marisa Benagiano
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134 Florence, Italy
| | - Sofia D'Elios
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134 Florence, Italy
| | - Alberto Bosi
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134 Florence, Italy
| | - Mario M D'Elios
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Largo Brambilla 3, 50134 Florence, Italy
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Raimondi M, Landriscina M, Pellicori S, Brancaglione A, Comelli A, Sforzini I, Rizzardi R, Brancati S, Poma S. [Territorial emergency: physician or nurse?]. Minerva Anestesiol 2004; 70:405-9. [PMID: 15181423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
This study was conceived to assess a pattern of Italian prehospital critical care team, especially referring to the advanced life support (ALS) rescue team. Function and management of ALS rescue team and its relationship with other members of the emergency medical system (intra hospital physician, basic life support team, general practitioner) are analysed; stress is laidon the knowledge, the background and the complexity of the emergency procedures. The benefit of 2 major prehospital options of the ALS team, composed by 1 physician and 1 nurse staffing or by 2 trained nurse staffing, is discussed; the importance of educational programs for ambulance teams, a comparison of cost-effectiveness and the number of emergency teams availability is underlined. The authors, finally emphasize the advantages of a territorial coverage with an integrated system of ambulances staffed with specially trained rescuers or technicians, ambulances with rescuers and nurses, and ALS teams staffed with emergency physician and 1 nurse (integrated or not with ambulances with 2 trained nurses), being perfectly capable to face up any background in pre-hospital emergency medicine setting.
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Affiliation(s)
- M Raimondi
- Centrale Operativa S S U Em. 118 Pavia e Provincia, I R C C S Policlinico S Matteo, Pavia, Italy
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