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Rizzello V, Tinti MD, Gori M, Marini M, Palmieri V, De Gennaro L, Manca P, Matassini MV, Di Nora C, Bianco M, Carigi S, Gentile P, Leonardi G, Orso F, Gorini M, Gonzini L, Lucci D, Maggioni AP, De Maria R, Tavazzi L. [The IN-HF Registry: the history and the scientific production for the Italian cardiology community]. G Ital Cardiol (Rome) 2024; 25:301-308. [PMID: 38639120 DOI: 10.1714/4252.42293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
The Italian Network on Congestive Heart Failure (IN-CHF) project, later known as IN-HF Online, was launched in 1995 to provide the Italian cardiology community with a digital tool, standardized across the country, for managing outpatients with heart failure (HF), that enabled the creation of a database for clinical, educational and scientific purposes. During its almost three decades of activity, this observational research program has achieved highly positive scientific results. Indeed, IN-HF fostered professional relationships among individuals working in different centers, established a cultural network for the care of HF patients, periodically updated on the scientific advances, and allowed the assessment of several clinical, epidemiological, and prognostic features. These findings have been published in numerous national and international journals, as summarized in the present overview.
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Affiliation(s)
- Vittoria Rizzello
- Area Scompenso, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze - U.O.C. Cardiologia, A.O. San Giovanni Addolorata, Roma
| | - Maria Denitza Tinti
- Area Scompenso, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze - U.O.C. Cardiologia, A.O. San Camillo Forlanini, Roma
| | - Mauro Gori
- Area Scompenso, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze - U.O.C. Cardiologia 1, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo
| | - Marco Marini
- Area Scompenso, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze - S.O.D. Cardiologia-UTIC, A.O.U. delle Marche, Ancona
| | - Vittorio Palmieri
- Area Scompenso, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze - U.O.C. Cardiochirurgia, A.O. S. Anna e S. Sebastiano, Caserta
| | - Luisa De Gennaro
- Area Scompenso, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze - U.O.C. Cardiologia, Ospedale San Paolo, Bari
| | - Paolo Manca
- Area Scompenso, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze - Cardiologia, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, ISMETT IRCCS, Palermo
| | - Maria Vittoria Matassini
- Area Scompenso, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze - S.O.D. Cardiologia-UTIC, A.O.U. delle Marche, Ancona
| | - Concetta Di Nora
- Area Scompenso, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze - S.O.C. Cardiochirurgia, Azienda Sanitaria Universitaria Friuli Centrale, Udine
| | - Matteo Bianco
- Area Scompenso, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze - S.C.D.O. Cardiologia, A.O.U. San Luigi Gonzaga, Orbassano (TO)
| | - Samuela Carigi
- U.O. Cardiologia, Ospedale Infermi Rimini, AUSL della Romagna
| | - Piero Gentile
- Cardiologia 2-Insufficienza Cardiaca e Trapianti, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Giuseppe Leonardi
- U.O.S.D. Scompenso Cardiaco, A.O.U. Policlinico Catania P.O.G. Rodolico, Catania
| | - Francesco Orso
- Dipartimento di Cardiologia e Geriatria, A.O.U. Careggi, Firenze
| | - Marco Gorini
- Centro Studi ANMCO, Fondazione per il Tuo cuore, Firenze
| | - Lucio Gonzini
- Centro Studi ANMCO, Fondazione per il Tuo cuore, Firenze
| | - Donata Lucci
- Centro Studi ANMCO, Fondazione per il Tuo cuore, Firenze
| | | | - Renata De Maria
- Area Scompenso, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Firenze - Istituto Fisiologia Clinica CNR, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Luigi Tavazzi
- Maria Cecilia Hospital GVM Care & Research, Cotignola (RA)
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Friggeri G, Moretti I, Amato F, Marrani AG, Sciandra F, Colombarolli SG, Vitali A, Viscuso S, Augello A, Cui L, Perini G, De Spirito M, Papi M, Palmieri V. Multifunctional scaffolds for biomedical applications: Crafting versatile solutions with polycaprolactone enriched by graphene oxide. APL Bioeng 2024; 8:016115. [PMID: 38435469 PMCID: PMC10908559 DOI: 10.1063/5.0184933] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
The pressing need for multifunctional materials in medical settings encompasses a wide array of scenarios, necessitating specific tissue functionalities. A critical challenge is the occurrence of biofouling, particularly by contamination in surgical environments, a common cause of scaffolds impairment. Beyond the imperative to avoid infections, it is also essential to integrate scaffolds with living cells to allow for tissue regeneration, mediated by cell attachment. Here, we focus on the development of a versatile material for medical applications, driven by the diverse time-definite events after scaffold implantation. We investigate the potential of incorporating graphene oxide (GO) into polycaprolactone (PCL) and create a composite for 3D printing a scaffold with time-controlled antibacterial and anti-adhesive growth properties. Indeed, the as-produced PCL-GO scaffold displays a local hydrophobic effect, which is translated into a limitation of biological entities-attachment, including a diminished adhesion of bacteriophages and a reduction of E. coli and S. aureus adhesion of ∼81% and ∼69%, respectively. Moreover, the ability to 3D print PCL-GO scaffolds with different heights enables control over cell distribution and attachment, a feature that can be also exploited for cellular confinement, i.e., for microfluidics or wound healing applications. With time, the surface wettability increases, and the scaffold can be populated by cells. Finally, the presence of GO allows for the use of infrared light for the sterilization of scaffolds and the disruption of any bacteria cell that might adhere to the more hydrophilic surface. Overall, our results showcase the potential of PCL-GO as a versatile material for medical applications.
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Affiliation(s)
| | - I. Moretti
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Roma, Italy
| | - F. Amato
- Dipartimento di Chimica, Università di Roma “La Sapienza,” p.le A. Moro 5, I-00185 Roma, Italy
| | - A. G. Marrani
- Dipartimento di Chimica, Università di Roma “La Sapienza,” p.le A. Moro 5, I-00185 Roma, Italy
| | - F. Sciandra
- Istituto di Scienze e Tecnologie Chimiche “Giulio Natta”-SCITEC (CNR), C/O Istituto di Biochimica e Biochimica Clinica, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168-Roma, Italy
| | - S. G. Colombarolli
- Istituto di Scienze e Tecnologie Chimiche “Giulio Natta”-SCITEC (CNR), C/O Istituto di Biochimica e Biochimica Clinica, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168-Roma, Italy
| | - A. Vitali
- Istituto di Scienze e Tecnologie Chimiche “Giulio Natta”-SCITEC (CNR), C/O Istituto di Biochimica e Biochimica Clinica, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168-Roma, Italy
| | - S. Viscuso
- Istituto di Scienze e Tecnologie Chimiche “Giulio Natta”-SCITEC (CNR), C/O Istituto di Biochimica e Biochimica Clinica, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168-Roma, Italy
| | | | - L. Cui
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Roma, Italy
| | | | - M. De Spirito
- Authors to whom correspondence should be addressed: and
| | - M. Papi
- Authors to whom correspondence should be addressed: and
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Innocenti F, Palmieri V. Editorial: Cardiovascular involvement during sepsis: therapeutic and prognostic consequences. Front Cardiovasc Med 2023; 10:1314834. [PMID: 38028501 PMCID: PMC10647882 DOI: 10.3389/fcvm.2023.1314834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- F. Innocenti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy
| | - V. Palmieri
- Cardiosurgery Unit, Cardiovascular Department, “Sant’Anna e San Sebastiano” National Hospital, Caserta, Italy
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Palmieri V, Montisci A, Vietri MT, Colombo PC, Sala S, Maiello C, Coscioni E, Donatelli F, Napoli C. Artificial intelligence, big data and heart transplantation: Actualities. Int J Med Inform 2023; 176:105110. [PMID: 37285695 DOI: 10.1016/j.ijmedinf.2023.105110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND As diagnostic and prognostic models developed by traditional statistics perform poorly in real-world, artificial intelligence (AI) and Big Data (BD) may improve the supply chain of heart transplantation (HTx), allocation opportunities, correct treatments, and finally optimize HTx outcome. We explored available studies, and discussed opportunities and limits of medical application of AI to the field of HTx. METHOD A systematic overview of studies published up to December 31st, 2022, in English on peer-revied journals, have been identified through PUBMED-MEDLINE-WEB of Science, referring to HTx, AI, BD. Studies were grouped in 4 domains based on main studies' objectives and results: etiology, diagnosis, prognosis, treatment. A systematic attempt was made to evaluate studies by the Prediction model Risk Of Bias ASsessment Tool (PROBAST) and the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD). RESULTS Among the 27 publications selected, none used AI applied to BD. Of the selected studies, 4 fell in the domain of etiology, 6 in the domain of diagnosis, 3 in the domain of treatment, and 17 in that of prognosis, as AI was most frequently used for algorithmic prediction and discrimination of survival, but in retrospective cohorts and registries. AI-based algorithms appeared superior to probabilistic functions to predict patterns, but external validation was rarely employed. Indeed, based on PROBAST, selected studies showed, to some extent, significant risk of bias (especially in the domain of predictors and analysis). In addition, as example of applicability in the real-world, a free-use prediction algorithm developed through AI failed to predict 1-year mortality post-HTx in cases from our center. CONCLUSIONS While AI-based prognostic and diagnostic functions performed better than those developed by traditional statistics, risk of bias, lack of external validation, and relatively poor applicability, may affect AI-based tools. More unbiased research with high quality BD meant for AI, transparency and external validations, are needed to have medical AI as a systematic aid to clinical decision making in HTx.
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Affiliation(s)
- Vittorio Palmieri
- Azienda Ospedaliera dei Colli Monaldi-Cotugno-CTO, Department of Cardiac Surgery and Transplantation, Naples, Italy.
| | - Andrea Montisci
- Division of Cardiothoracic Intensive Care, Cardiothoracic Department, ASST Spedali Civili, Brescia, Italy
| | - Maria Teresa Vietri
- Department of Precision Medicine, "Luigi Vanvitelli" University of Campania School of Medicine, Naples, Italy
| | - Paolo C Colombo
- Milstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Silvia Sala
- Chair of Anesthesia and Intensive Care, University of Brescia, Brescia, Italy
| | - Ciro Maiello
- Azienda Ospedaliera dei Colli Monaldi-Cotugno-CTO, Department of Cardiac Surgery and Transplantation, Naples, Italy
| | - Enrico Coscioni
- Department of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Francesco Donatelli
- Department of Cardiac Surgery, Istituto Clinico Sant'Ambrogio, Milan, Italy; Chair of Cardiac Surgery, University of Milan, Milan, Italy
| | - Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), "Luigi Vanvitelli" University of Campania School of Medicine, Naples, Italy
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Palmieri V, Vietri MT, Montalto A, Montisci A, Donatelli F, Coscioni E, Napoli C. Cardiotoxicity, Cardioprotection, and Prognosis in Survivors of Anticancer Treatment Undergoing Cardiac Surgery: Unmet Needs. Cancers (Basel) 2023; 15:cancers15082224. [PMID: 37190153 DOI: 10.3390/cancers15082224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Anticancer treatments are improving the prognosis of patients fighting cancer. However, anticancer treatments may also increase the cardiovascular (CV) risk by increasing metabolic disorders. Atherosclerosis and atherothrombosis related to anticancer treatments may lead to ischemic heart disease (IHD), while direct cardiac toxicity may induce non-ischemic heart disease. Moreover, valvular heart disease (VHD), aortic syndromes (AoS), and advanced heart failure (HF) associated with CV risk factors and preclinical CV disease as well as with chronic inflammation and endothelial dysfunction may also occur in survivors of anti-carcer treatments. METHODS Public electronic libraries have been searched systematically looking at cardiotoxicity, cardioprotection, CV risk and disease, and prognosis after cardiac surgery in survivors of anticancer treatments. RESULTS CV risk factors and disease may not be infrequent among survivors of anticancer treatments. As cardiotoxicity of established anticancer treatments has been investigated and is frequently irreversible, cardiotoxicity associated with novel treatments appears to be more frequently reversible, but also potentially synergic. Small reports suggest that drugs preventing HF in the general population may be effective also among survivors of anticancer treatments, so that CV risk factors and disease, and chronic inflammation, may lead to indication to cardiac surgery in survivors of anticancer treatments. There is a lack of substantial data on whether current risk scores are efficient to predict prognosis after cardiac surgery in survivors of anticancer treatments, and to guide tailored decision-making. IHD is the most common condition requiring cardiac surgery among survivors of anticancer treatments. Primary VHD is mostly related to a history of radiation therapy. No specific reports exist on AoS in survivors of anticancer treatments. CONCLUSIONS It is unclear whether interventions to dominate cancer- and anticancer treatment-related metabolic syndromes, chronic inflammation, and endothelial dysfunction, leading to IHD, nonIHD, VHD, HF, and AoS, are as effective in survivors of anticancer treatments as in the general population. When CV diseases require cardiac surgery, survivors of anticancer treatments may be a population at specifically elevated risk, rather than affected by a specific risk factor.
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Affiliation(s)
- Vittorio Palmieri
- Unit of Cardiac Surgery, Cardiovascular Department, Azienda Ospedaliera di Rilevanza Nazionale "San Sebastiano e Sant'Anna", 81100 Caserta, Italy
| | - Maria Teresa Vietri
- Department of Precision Medicine, School of Medicine, "Luigi Vanvitelli" University of Campania, 80100 Naples, Italy
| | - Andrea Montalto
- Unit of Cardiac Surgery, Cardiovascular Department, Azienda Ospedaliera di Rilevanza Nazionale "San Sebastiano e Sant'Anna", 81100 Caserta, Italy
| | - Andrea Montisci
- Division of Cardiothoracic Intensive Care, Cardiothoracic Department, ASST Spedali Civili, 25123 Brescia, Italy
| | - Francesco Donatelli
- Department of Cardiac Surgery, Istituto Clinico Sant'Ambrogio, 20161 Milan, Italy
- Cardiac Surgery, University of Milan, 20122 Milan, Italy
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi D'Aragona, 84131 Salerno, Italy
| | - Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), "Luigi Vanvitelli" University of Campania School of Medicine, 80100 Naples, Italy
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Montisci A, Palmieri V, Vietri MT, Sala S, Maiello C, Donatelli F, Napoli C. Big Data in cardiac surgery: real world and perspectives. J Cardiothorac Surg 2022; 17:277. [PMID: 36309702 PMCID: PMC9617748 DOI: 10.1186/s13019-022-02025-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
Big Data, and the derived analysis techniques, such as artificial intelligence and machine learning, have been considered a revolution in the modern practice of medicine. Big Data comes from multiple sources, encompassing electronic health records, clinical studies, imaging data, registries, administrative databases, patient-reported outcomes and OMICS profiles. The main objective of such analyses is to unveil hidden associations and patterns. In cardiac surgery, the main targets for the use of Big Data are the construction of predictive models to recognize patterns or associations better representing the individual risk or prognosis compared to classical surgical risk scores. The results of these studies contributed to kindle the interest for personalized medicine and contributed to recognize the limitations of randomized controlled trials in representing the real world. However, the main sources of evidence for guidelines and recommendations remain RCTs and meta-analysis. The extent of the revolution of Big Data and new analytical models in cardiac surgery is yet to be determined.
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Palmieri V, Amarelli C, Mattucci I, Bigazzi MC, Cacciatore F, Maiello C, Golino P. Predicting major events in ambulatory patients with advanced heart failure awaiting heart transplantation: a pilot study. J Cardiovasc Med (Hagerstown) 2022; 23:387-393. [PMID: 35645029 DOI: 10.2459/jcm.0000000000001304] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS In heart failure (HF), prognostic risk scores focus on all-cause mortality prediction. However, in advanced HF (AdHF) ambulatory patients awaiting heart transplantation (HTx), hospitalizations for acutely decompensated/worsening HF are relevant to clinical decision-making, but unpredicted by common risk functions. METHODS Among consecutive ambulatory patients added to the waitlist for HTx, event discriminators within 2 years from recruitment were assessed prospectively by area under the curve from receiver-operating characteristic curves, and by Cox proportional hazards models. Primary composite end points included the first between all-cause mortality and acutely decompensated/worsening HF requiring hospitalization and specific treatments. RESULTS In 89 patients, 36 primary composite events were recorded in a 2-year follow-up (40% of the study sample), and associated with nonischemic etiology and nonsinus rhythm, with lower systolic blood pressure (BP), lower plasma sodium and hemoglobin concentrations, and with higher N-terminal pro-brain natriuretic peptide (NT-proBNP), larger left ventricular (LV) dimensions and lower LV ejection fraction, greater proportion of significant mitral regurgitation, lower tricuspid annulus peak systolic excursion (TAPSE), lower percentage of predicted distance at 6-minute walking test (%p6MWT) and lower global symptoms burden by the Kansas City Cardiomyopathy Questionnaire, lower peak oxygen uptake by cardiopulmonary exercise, and higher wedge pressure by right heart catheterization, as compared with those with no events (P < 0.05). Only Metabolic Exercise Cardiac Kidney Index (MECKI) at recruitment was higher with patients reporting events, which predicted composite end points in addition to and independently of NT-proBNP, and lower systolic BP (all P < 0.05). In an alternative risk model, severe mitral regurgitation and lower TAPSE replaced MECKI and BP but not NT-proBNP (all P < 0.01). CONCLUSION Higher NT-pro-BNP, lower systolic BP and higher MECKI may contribute to predicting all-cause death and acutely decompensated/worsening HF among ambulatory patients awaiting HTx, with lower TAPSE and severe mitral regurgitation representing further alternative independent prognosticators.
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Affiliation(s)
- Vittorio Palmieri
- Heart Transplantation Unit, Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO
| | - Cristiano Amarelli
- Heart Transplantation Unit, Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO
| | - Irene Mattucci
- Heart Transplantation Unit, Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO
| | - Maurizio Cappelli Bigazzi
- Cardiology Unit, Department of Cardiology and Medicine, Ospedali dei Colli Monaldi-Cotugno-CTO & University of Campania 'Luigi Vanvitelli'
| | - Francesco Cacciatore
- Heart Transplantation Unit, Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO.,Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Ciro Maiello
- Heart Transplantation Unit, Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO
| | - Paolo Golino
- Cardiology Unit, Department of Cardiology and Medicine, Ospedali dei Colli Monaldi-Cotugno-CTO & University of Campania 'Luigi Vanvitelli'
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Iacoviello M, Cipriani M, Valente S, Marini M, Ammirati E, Benvenuto M, Cassaniti LR, De Maria R, Gori M, Municinò A, Navazio A, Amodeo V, Aspromonte N, Barili F, Casolo G, Clemenza F, Di Eusanio M, Di Lenarda A, Di Tano G, Domenicucci S, Faggian G, Francese GM, Frongillo D, Gilardi R, Iacovoni A, Imazio M, Livi U, Maiello C, Milano A, Mondino M, Moreo AM, Mortara A, Murrone A, Palmieri V, Pelenghi S, Pini D, Pistono M, Porcu M, Potena L, Rinaldi M, Romanò M, Roncon L, Rossini R, Russo CF, Scotto di Uccio F, Urbinati S, Zecchin M, Caldarola P, Oliveti A, Frigerio M, Musumeci F, Gulizia MM, Oliva F, Gabrielli D, Colivicchi F. [ANMCO Position paper: Care pathway for advanced heart failure patients candidate for heart transplantation/ventricular assist device]. G Ital Cardiol (Rome) 2022; 23:340-378. [PMID: 35578958 DOI: 10.1714/3796.37817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Heart failure is a complex clinical syndrome with a severe prognosis, despite therapeutic progress. The management of the advanced stages of the syndrome is particularly complex in patients who are referred to palliative care as well as in those who are candidates for cardiac replacement therapy. For the latter group, a prompt recognition of the transition to the advanced stage as well as an early referral to the centers for cardiac replacement therapy are essential elements to ensure that patients follow the most appropriate diagnostic-therapeutic pathway. The aim of this document is to focus on the main diagnostic and therapeutic aspects related to the advanced stages of heart failure and, in particular, on the management of patients who are candidates for cardiac replacement therapy.
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Affiliation(s)
| | | | | | - Marco Marini
- S.O.D. Cardiologia-Emodinamica-UTIC, A.O.U. Ospedali Riuniti, Ancona
| | - Enrico Ammirati
- Cardiologia 2-Insufficienza Cardiaca e Trapianti, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Manuela Benvenuto
- U.O.C. Cardiologia-UTIC-Emodinamica, Presidio Ospedaliero "G. Mazzini", Teramo
| | - Leonarda Rosaria Cassaniti
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania
| | - Renata De Maria
- Istituto di Fisiologia Clinica CNR, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Mauro Gori
- U.O.C. Cardiologia 1, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo
| | - Annamaria Municinò
- Dipartimento di Cardiologia, Ospedale Andrea Gallino, ASL3 Genovese, Genova
| | - Alessandro Navazio
- S.O.C. Cardiologia Ospedaliera, Presidio Ospedaliero Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia
| | - Vincenzo Amodeo
- U.O.C. Cardiologia-UTIC, Ospedale Santa Maria degli Ungheresi, Polistena (RC)
| | - Nadia Aspromonte
- U.O.S. Scompenso Cardiaco, Dipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma
| | - Fabio Barili
- S.C. Cardiochirurgia, Ospedale Santa Croce e Carle, Cuneo
| | - Giancarlo Casolo
- U.O.C. Cardiologia, Ospedale Versilia, Azienda USL Toscana Nord-Ovest, Lido di Camaiore (LU)
| | - Francesco Clemenza
- Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT) - IRCCS, Palermo
| | | | - Andrea Di Lenarda
- S.C. Cardiovascolare e Medicina dello Sport, Dipartimento Cardiotoracovascolare, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste
| | - Giuseppe Di Tano
- U.O. di Cardiologia-UTIC, Ospedale Civile Oglio Po, Casalmaggiore (CR)
| | | | - Giuseppe Faggian
- Divisione di Cardiochirurgia, Azienda Ospedaliera Universitaria Integrata Verona, Verona
| | - Giuseppina Maura Francese
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania
| | - Doriana Frongillo
- U.O.C. Cardiologia, Ospedale San Sebastiano Martire, ASL Roma 6, Frascati (RM)
| | - Rossella Gilardi
- S.C. Cardiochirurgia, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Attilio Iacovoni
- U.O.C. Cardiologia 1, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo
| | - Massimo Imazio
- Cardiologia, Dipartimento Cardiotoracico, Ospedale Santa Maria della Misericordia, Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), Udine
| | - Ugolino Livi
- Cardiochirurgia, Dipartimento Cardiotoracico, Ospedale Santa Maria della Misericordia, Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), Udine
| | - Ciro Maiello
- Dipartimento di Cardiochirurgia e dei Trapianti, A.O.R.N. Ospedale dei Colli - P.O. Monaldi, Napoli
| | - Aldo Milano
- Cardiochirurgia, A.O.U. Consorziale Policlinico di Bari, Bari
| | - Michele Mondino
- Anestesia e Rianimazione 3, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Antonella Maurizia Moreo
- Cardiologia 4-Diagnostica e Riabilitativa, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Andrea Mortara
- Dipartimento di Cardiologia Clinica, Policlinico di Monza, Monza
| | - Adriano Murrone
- S.C. Cardiologia-UTIC, Ospedali di Città di Castello e di Gubbio-Gualdo Tadino, AUSL Umbria 1, Perugia
| | - Vittorio Palmieri
- Dipartimento di Cardiochirurgia e dei Trapianti, A.O.R.N. Ospedale dei Colli - P.O. Monaldi, Napoli
| | - Stefano Pelenghi
- U.O.C. Cardiochirurgia, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Daniela Pini
- U.O. Cardiologia Clinica, Istituto Clinico Humanitas, Rozzano (MI)
| | - Massimo Pistono
- Cardiologia, I.C.S. Maugeri - IRCCS Sede di Veruno, Gattico-Veruno (NO)
| | | | - Luciano Potena
- IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | - Mauro Rinaldi
- S.C. Cardiochirurgia, A.O.U. Città della Salute e della Scienza di Torino, Torino
| | - Massimo Romanò
- Comitato Ordinatore, Master Universitario di II Livello in Cure Palliative, Università degli Studi, Milano
| | - Loris Roncon
- U.O.C. Cardiologia, Ospedale Santa Maria della Misericordia, Rovigo
| | | | - Claudio Francesco Russo
- S.C. Cardiochirurgia, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | | | | | - Massimo Zecchin
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Università di Trieste
| | | | | | - Maria Frigerio
- Cardiologia 2-Insufficienza Cardiaca e Trapianti, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Francesco Musumeci
- U.O. Cardiochirurgia e Centro Trapianti di Cuore, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera Ospedale S. Camillo Forlanini, Roma
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania - Fondazione per il Tuo cuore - Heart Care Foundation, Firenze
| | - Fabrizio Oliva
- Cardiologia 1-Emodinamica, Unità di Cure Intensive Cardiologiche, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
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9
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Innocenti F, Palmieri V, Stefanone VT, D'Argenzio F, Cigana M, Montuori M, Capretti E, De Paris A, Calcagno S, Tassinari I, Pini R. Comparison of Troponin I levels versus myocardial dysfunction on prognosis in sepsis. Intern Emerg Med 2022; 17:223-231. [PMID: 33730362 DOI: 10.1007/s11739-021-02701-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
In the context of sepsis, we tested the relationship between echocardiographic findings and Troponin, and their impact on prognosis. In this prospective study, we enrolled 325 septic patients (41% with shock), not mechanically ventilated, between October, 2012 and June, 2019 among those admitted to our High-Dependency Unit. By echocardiography within 24 h from the admission, sepsis-induced myocardial dysfunction (SIMD) was defined as left ventricular (LV) systolic dysfunction (speckle-tracking-based global longitudinal peak systolic strain, GLS, > - 14%) and/or right ventricular (RV) systolic dysfunction (Tricuspid Annular Plane Systolic Excursion, TAPSE < 16 mm). Troponin I levels were measured upon admission (T0) and after 24 h (T1); it was considered normal if > 0.1 ng/mL. Mortality was assessed at day-7 and day-28 end-points. One-hundred and forty-two patients had normal Troponin level at T0 and T1 (G1), 69 had abnormal levels at T0 or T1 (G2) and 114 showed abnormal Troponin levels at both T0 and T1 (G3). Compared to G1, patients in G3 had worse LV and RV systolic function (GLS - 11.6 ± 3.4% vs - 14.0 ± 3.5%, p < 0.001; TAPSE 18 ± 0.5 vs 19 ± 0.5 mm, p = 0.047) and greater day-28 (34% vs 20%, p = 0.015) mortality. In a Cox survival analysis including age, Troponin and SOFA score, mortality was predicted by the presence of SIMD (RR 3.24, 95% CI 1.72-6.11, p < 0.001) with no contribution of abnormal Troponin level. While abnormal Troponin levels were associated with SIMD diagnosed by echocardiography, only the presence of SIMD predicted the short- and medium-term mortality rate, without an independent contribution of increased Troponin levels.
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Affiliation(s)
- Francesca Innocenti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy.
| | - Vittorio Palmieri
- Transplant Cardiosurgery Unit, Department of Cardiac Surgery and Transplant, Ospedale Dei Colli Monaldi-Cotugno-CTO, Naples, Italy
| | - Valerio Teodoro Stefanone
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Federico D'Argenzio
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Marco Cigana
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Michele Montuori
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Elisa Capretti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Anna De Paris
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Stefano Calcagno
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Irene Tassinari
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Riccardo Pini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
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10
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Montisci A, Vietri MT, Palmieri V, Sala S, Donatelli F, Napoli C. Cardiac Toxicity Associated with Cancer Immunotherapy and Biological Drugs. Cancers (Basel) 2021; 13:4797. [PMID: 34638281 PMCID: PMC8508330 DOI: 10.3390/cancers13194797] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 12/19/2022] Open
Abstract
Cancer immunotherapy significantly contributed to an improvement in the prognosis of cancer patients. Immunotherapy, including human epidermal growth factor receptor 2 (HER2)-targeted therapies, immune checkpoint inhibitors (ICI), and chimeric antigen receptor-modified T (CAR-T), share the characteristic to exploit the capabilities of the immune system to kill cancerous cells. Trastuzumab is a monoclonal antibody against HER2 that prevents HER2-mediated signaling; it is administered mainly in HER2-positive cancers, such as breast, colorectal, biliary tract, and non-small-cell lung cancers. Immune checkpoint inhibitors (ICI) inhibit the binding of CTLA-4 or PD-1 to PDL-1, allowing T cells to kill cancerous cells. ICI can be used in melanomas, non-small-cell lung cancer, urothelial, and head and neck cancer. There are two main types of T-cell transfer therapy: tumor-infiltrating lymphocytes (or TIL) therapy and chimeric antigen receptor-modified T (CAR-T) cell therapy, mainly applied for B-cell lymphoma and leukemia and mantle-cell lymphoma. HER2-targeted therapies, mainly trastuzumab, are associated with left ventricular dysfunction, usually reversible and rarely life-threatening. PD/PDL-1 inhibitors can cause myocarditis, rare but potentially fulminant and associated with a high fatality rate. CAR-T therapy is associated with several cardiac toxic effects, mainly in the context of a systemic adverse effect, the cytokines release syndrome.
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Affiliation(s)
- Andrea Montisci
- Division of Cardiothoracic Intensive Care, ASST Spedali Civili, 25123 Brescia, Italy;
| | - Maria Teresa Vietri
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy;
| | - Vittorio Palmieri
- Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO, 80131 Naples, Italy;
| | - Silvia Sala
- Department of Anesthesia and Intensive Care, University of Brescia, 25121 Brescia, Italy;
| | - Francesco Donatelli
- Cardiac Surgery, University of Milan, 20122 Milan, Italy
- Department of Cardiac Surgery, Istituto Clinico Sant’Ambrogio, 20149 Milan, Italy
| | - Claudio Napoli
- Clinical Department of Internal Medicine and Specialistics, University Department of Advanced Clinical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy;
- IRCCS SDN, 80143 Naples, Italy
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11
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Montisci A, Palmieri V, Liu JE, Vietri MT, Cirri S, Donatelli F, Napoli C. Severe Cardiac Toxicity Induced by Cancer Therapies Requiring Intensive Care Unit Admission. Front Cardiovasc Med 2021; 8:713694. [PMID: 34540917 PMCID: PMC8446380 DOI: 10.3389/fcvm.2021.713694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/27/2021] [Indexed: 12/28/2022] Open
Abstract
A steadying increase of cancer survivors has been observed as a consequence of more effective therapies. However, chemotherapy regimens are often associated with significant toxicity, and cardiac damage emerges as a prominent clinical issue. Many mechanisms sustain chemotherapy-induced cardiac toxicity: direct myocyte damage, arrhythmia induction, coronary vasospasm, and accelerated atherosclerosis. Anthracyclines are the most studied cardiotoxic drugs and represent a clinical model for cardiac damage induced by chemotherapy. In patients suffering from advanced heart failure (HF) because of chemotherapy-related cardiomyopathy, when refractory to optimal medical therapy, mechanical circulatory support or heart transplantation represents an effective treatment. Here, the main mechanisms of cardiac toxicity induced by cancer therapies are analyzed, with a focus on patients requiring intensive care unit (ICU) admission during the course of the disease because of acute cardiac toxicity, takotsubo syndrome, and acute-on-chronic HF in patients suffering from chemotherapy-induced cardiomyopathy. In a subset of patients, cardiac toxicity can be acute and life-threatening, leading to overt cardiogenic shock. The management of critically ill cancer patients poses a unique challenge and requires a multidisciplinary approach. Moreover, no etiologic therapy is available, and only supportive measures can be implemented.
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Affiliation(s)
- Andrea Montisci
- Division of Cardiothoracic Intensive Care, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili, Brescia, Italy
| | - Vittorio Palmieri
- Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO, Naples, Italy
| | - Jennifer E Liu
- Department of Medicine/Cardiology Service, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Maria T Vietri
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Silvia Cirri
- Department of Anesthesia and Intensive Care, Istituto Clinico Sant'Ambrogio, Milan, Italy
| | | | - Claudio Napoli
- Clinical Department of Internal Medicine and Specialistics, University Department of Advanced Clinical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico - Synlab Diagnostica Nucleare (IRCCS SDN), Naples, Italy
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12
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Innocenti F, Palmieri V, Tassinari I, Capretti E, De Paris A, Gianno A, Marchesini A, Montuori M, Pini R. Change in Myocardial Contractility in Response to Treatment with Norepinephrine in Septic Shock. Am J Respir Crit Care Med 2021; 204:365-368. [PMID: 33945774 DOI: 10.1164/rccm.202102-0442le] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | | | - Elisa Capretti
- Azienda Ospedaliero-Universitaria Careggi Firenze, Italy
| | - Anna De Paris
- Azienda Ospedaliero-Universitaria Careggi Firenze, Italy
| | - Adriana Gianno
- Azienda Ospedaliero-Universitaria Careggi Firenze, Italy
| | | | | | - Riccardo Pini
- Azienda Ospedaliero-Universitaria Careggi Firenze, Italy
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13
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Napoli C, Bontempo P, Palmieri V, Coscioni E, Maiello C, Donatelli F, Benincasa G. Epigenetic Therapies for Heart Failure: Current Insights and Future Potential. Vasc Health Risk Manag 2021; 17:247-254. [PMID: 34079271 PMCID: PMC8164213 DOI: 10.2147/vhrm.s287082] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 04/29/2021] [Indexed: 12/20/2022] Open
Abstract
Despite the current reductionist approach providing an optimal indication for diagnosis and treatment of patients with heart failure with reduced ejection fraction (HFrEF), there are no standard pharmacological therapies for heart failure with preserved ejection fraction (HFpEF). Although in its infancy in cardiovascular diseases, the epigenetic-based therapy ("epidrugs") is capturing the interest of physician community. In fact, an increasing number of controlled clinical trials is evaluating the putative beneficial effects of: 1) direct epigenetic-oriented drugs, eg, apabetalone, and 2) repurposed drugs with a possible indirect epigenetic interference, eg, metformin, statins, sodium glucose transporter inhibitors 2 (SGLT2i), and omega 3 polyunsaturated fatty acids (PUFAs) in both HFrEF and HFpEF, separately. Apabetalone is the first and unique direct epidrug tested in cardiovascular patients to date, and the BETonMACE trial has reported a reduction in first HF hospitalization (any EF value) and cardiovascular death in patients with type 2 diabetes and recent acute coronary syndrome, suggesting a possible role in secondary prevention. Patients with HFpEF seem to benefit from supplementation to the standard therapy with statins, metformin, and SGLT2i owing to their ability in reducing mortality. In contrast, the vasodilator hydralazine, with or without isosorbide dinitrate, did not provide beneficial effects. In HFrEF, metformin and SGLT2i could reduce the risk of incident HF and mortality in affected patients whereas clinical trials based on statins provided mixed results. Furthermore, PUFAs diet supplementation was significantly associated with reduced cardiovascular risk in both HFpEF and HFrEF. Future large trials will reveal whether direct and indirect epitherapy will remain a work in progress or become a useful way to customize the therapy in the real-world management of HFpEF and HFrEF. Our goal is to discuss the recent advancement in the epitherapy as a possible way to improve personalized therapy of HF.
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Affiliation(s)
- Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Paola Bontempo
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Vittorio Palmieri
- Department of Cardiac Surgery and Transplantation, Heart Transplantation Unit in Adults of the 'Ospedali dei Colli Monaldi-Cotugno-CTO', Naples, Italy
| | - Enrico Coscioni
- Department of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Ciro Maiello
- Department of Cardiovascular Surgery and Transplants, Monaldi Hospital, Azienda dei Colli, Naples, Italy
| | - Francesco Donatelli
- Chair of Cardiac Surgery, Department of Cardiothoracic Center, Istituto Clinico Sant'Ambrogio, University of Milan, Milan, Italy
| | - Giuditta Benincasa
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", Naples, 80138, Italy
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Innocenti F, Palmieri V, Stefanone VT, D'Argenzio F, Cigana M, Montuori M, Capretti E, De Paris A, Calcagno S, Tassinari I, Pini R. Prognostic stratification in septic patients with overt and cryptic shock by speckle tracking echocardiography. Intern Emerg Med 2021; 16:757-764. [PMID: 33131014 DOI: 10.1007/s11739-020-02545-3] [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: 06/30/2020] [Accepted: 10/17/2020] [Indexed: 01/25/2023]
Abstract
We evaluated the prevalence and prognostic value of left (LV) and right (RV) ventricular systolic dysfunction in the presence of overt and cryptic shock. In this prospective study, between October 2012 and June 2019, we enrolled 354 patients with sepsis, 41% with shock, among those admitted to the Emergency Department High-Dependency Unit. Patients were grouped based on the presence of shock, or by the presence of lactate levels ≥ (LAC +) or < 2 mmol/L (LAC-) evaluated within the first 24 h. By echocardiography performed within 24 h from the admission, LV systolic dysfunction was defined as global longitudinal strain (GLS) > -14%; RV systolic dysfunction as Tricuspid Annular Plane Systolic Excursion (TAPSE) < 16 mm. All-cause mortality was assessed at day-7 and day-28 follow-up. Mean values of LV GLS (-12.3 ± 3.4 vs -12.9 ± 3.8%) and TAPSE (1.8 ± 0.7 vs 1.8 ± 0.5 cm, all p = NS) were similar in patients with and in those without shock. LV GLS was significantly worse in LAC + than LAC- patients (- 11.2 ± 3.1 vs - 12.9 ± 3.7%, p = 0.001). In patients without shock, as well as in those LAC-, LV dysfunction was associated with increased day-28 mortality rate (78% vs 57% in non-survivors and survivors without shock and 74% vs 53% in non-survivors and survivors LAC-, all p < 0.01). LV (RR 2.26, 95% CI 1.37-3.74) and RV systolic dysfunction (RR 1.85, 95% CI 1.22-2.81) were associated with increased 28-day mortality rate in addition and independent to LAC + (RR 1.81, 95% CI 1.15-2.84). In conclusion, LV and RV ventricular dysfunction were independently associated with an increased mortality rate, altogether with the presence of cryptic shock.
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Affiliation(s)
- Francesca Innocenti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy.
| | - Vittorio Palmieri
- Transplant Cardiosurgery Unit, Department of Cardiac Surgery and Transplant, Ospedale Dei Colli Monaldi-Cotugno-CTO, Naples, Italy
| | - Valerio Teodoro Stefanone
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Federico D'Argenzio
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Marco Cigana
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Michele Montuori
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Elisa Capretti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Anna De Paris
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Stefano Calcagno
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Irene Tassinari
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
| | - Riccardo Pini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Firenze, Italy
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15
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Maiello C, Cacciatore F, Amarelli C, Palmieri V, Golino P. Repetitive levosimendan in outpatients affected by advanced heart failure: the need for a uniform approach. J Cardiovasc Med (Hagerstown) 2021; 22:149. [PMID: 32858638 DOI: 10.2459/jcm.0000000000001090] [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: 11/05/2022]
Affiliation(s)
- Ciro Maiello
- Department of Cardiac Surgery and Transplantation, Heart Transplantation Unit in Adults of the 'Ospedali dei Colli Monaldi-Cotugno-CTO'
| | - Francesco Cacciatore
- Department of Translational Medical Sciences and Internal Medicine and Geriatrics, 'Federico II' University of Naples
| | - Cristiano Amarelli
- Department of Cardiac Surgery and Transplantation, Heart Transplantation Unit in Adults of the 'Ospedali dei Colli Monaldi-Cotugno-CTO'
| | - Vittorio Palmieri
- Department of Cardiac Surgery and Transplantation, Heart Transplantation Unit in Adults of the 'Ospedali dei Colli Monaldi-Cotugno-CTO'
| | - Paolo Golino
- Department of Cardiology, Cardiology Unit of the 'L. Vanvitelli' University of Campania at the 'Ospedali dei Colli Monaldi-Cotugno-CTO', Naples, Italy
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16
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Abete R, Iacovoni A, Vecchi AL, Palmieri V, De Ponti R, Mortara A, Senni M. 275 Role of right ventricle in acute heart failure with preserved ejection fraction: a comparison between hypertensive pulmonary edema and decompensated heart failure. Eur Heart J Suppl 2020. [DOI: 10.1093/eurheartj/suaa202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
Limited data are available on the pathophysiological role of the right ventricle (RV) in patients with acute heart failure with preserved ejection fraction (AHF-PEF) and its impact on the main clinical manifestation such as pulmonary oedema or peripheral congestion. Mainly through right-to-left stroke volume mismatch and ventricular-arterial decoupling, right chambers size and function may play a key role leading to fluid overload or maldistributed phenotypes.
Methods and results
In this monocenter, prospective, observational study 80 consecutive patients with AHF-PEF were enrolled. A complete echocardiographic examination was performed within 6 hours from emergency department admission; multiparametric RV function was carefully evaluated in the very acute phase. Focusing on hypertensive pulmonary oedema (H-AHF) and decompensated AHF without pulmonary oedema (D-AHF) phenotypes, the study aims to analyze the echocardiographic peculiarities of these clinical entities in the early phase of admission and its modification at discharge (D-AHF n = 58, H-AHF n = 22). Baseline clinical characteristics were comparable in both groups, except for coronary artery disease more prevalent in H-AHF and atrial fibrillation more prevalent in D-AHF. D-AHF patients showed dilated and dysfunctional right chambers compared to H-AHF. Regarding systolic function, normal values of fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE) were registered in H-AHF at admission and at discharge. D-AHF showed greater systolic pulmonary artery pressure (sPAP) and lower TAPSE/sPAP ratio. Left ventricular dimensions and function were comparable in both groups. Conversely, E/e’ ratio was significantly higher in H-AHF at admission. Data are summarized in the tables and figures below.
Conclusion
D-AHF and H-AHF represent different phenotypes of AHF-PEF. Right heart structure and function and ventricular-arterial coupling could play a crucial role in their pathophysiology. Non dilated RV with preserved systolic function seems to be crucial to develop pulmonary oedema without signs of peripheral congestion. Further investigations are needed to corroborate the hypothesis of interventricular stroke volume mismatch in the complex AHF-PEF clinical scenario.
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Affiliation(s)
- Raffaele Abete
- Department of Cardiologypoliclinico di Monza, Monza
- Cardiovascular Department & Cardiology Unitpapa Giovanni XXIII Hospital, Bergamo
- Department of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Attilio Iacovoni
- Cardiovascular Department & Cardiology Unitpapa Giovanni XXIII Hospital, Bergamo
| | | | - Vittorio Palmieri
- Department of Cardiac Surgery and Transplantationaorn dei Colli Monaldi-Cotugno-CTO, Naples
| | | | | | - Michele Senni
- Cardiovascular Department & Cardiology Unitpapa Giovanni XXIII Hospital, Bergamo
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Pasqualucci D, Iacovoni A, Palmieri V, De Maria R, Iacoviello M, Battistoni I, Macera F, Olivotto I, Arbustini E, Mortara A. Epidemiology of cardiomyopathies: essential context knowledge for a tailored clinical work-up. Eur J Prev Cardiol 2020; 29:1190-1199. [PMID: 33623987 DOI: 10.1093/eurjpc/zwaa035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/10/2020] [Accepted: 08/01/2020] [Indexed: 12/19/2022]
Abstract
Cardiomyopathies (CMPs) are primary disorders of myocardial structure and function in the absence of coronary artery disease, hypertension, valvular disease, and congenital heart disease. Knowledge of the incidence and prevalence of CMPs may help clinicians to compare their observations in clinical practice with expected cases per person-year and to avoid under-reporting in clinical context. Currently, available estimates of prevalence and incidence of CMPs are based on clinical data, collected with a wide variability in population-source, and before the genetic testing evolved as a standard diagnostic tool. This review focuses on the epidemiology of CMPs in subjects aged between 18 and 55 years. A structured up-to-date diagnostic flow-chart for CMPs diagnosis and assessment is proposed to avoid misdiagnosis of CMPs in the young population and in subjects with unexplained cardiac disorders.
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Affiliation(s)
- Daniele Pasqualucci
- Department of Cardiology, Azienda Ospedaliera Brotzu, Piazzale Ricchi 1, 09134, Cagliari, Italy
| | - Attilio Iacovoni
- Cardiovascular Department, ASST Papa Giovanni XXIII Hospital, Piazza OMS, 1, 24127, Bergamo, Italy
| | - Vittorio Palmieri
- Heart Transplantation Unit, Department of cardiac surgery and transplantation, Ospedali dei Colli ,Via L. Bianchi s.n.c. 80131 Naples, Italy
| | - Renata De Maria
- CNR Institute of Clinical Physiology, CardioThoracic and Vascular Department, ASST Great Metropolitan Hospital Niguarda, Piazza Ospedale Maggiore 3 20162, Milan, Italy
| | - Massimo Iacoviello
- Cardiology Unit of Riuniti Policlinic University Hospital, Department of Medical and Surgical Sciences, University of Foggia, ViaLuigi Pinto 1, 71122, Foggia, Italy
| | - Ilaria Battistoni
- CCU-Cardiology Department, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", via Conca 71 60020, Ancona, Italy
| | - Francesca Macera
- Heart Failure and Transplant Unit, De Gasperis CardioCenter, ASST Great Metropolitan Hospital Niguarda, P.zza Ospedale Maggiore 3, 20162 Milan, Italy
| | - Iacopo Olivotto
- Cardiomiopathy Unit, Careggi University Hospital, Viale Pieraccini 1, 50134, Florence, Italy
| | - Eloisa Arbustini
- Centre for Inherited Cardiovascular Diseases, IRCCS Fondazione Policlinico San Matteo, Viale Camillo Golgi, 19, 27100 Pavia, Italy
| | - Andrea Mortara
- Department of Clinical Cardiology, Policlinico di Monza, Via Carlo Amati, 111, 20900 Monza, Italy
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18
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Innocenti F, Palmieri V, Stefanone VT, Donnini C, D'Argenzio F, Cigana M, Tassinari I, Pini R. Epidemiology of right ventricular systolic dysfunction in patients with sepsis and septic shock in the emergency department. Intern Emerg Med 2020; 15:1281-1289. [PMID: 32279167 DOI: 10.1007/s11739-020-02325-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/24/2020] [Indexed: 12/21/2022]
Abstract
We evaluated whether in sepsis, right ventricular (RV) systolic dysfunction (RVSD) predicts short-term all-cause mortality, independently to left ventricular (LV) global longitudinal peak systolic strain (GLS). This is a prospective observational study. We enrolled 252 septic patients (40% with shock) between October 2012 and July 2018 among those admitted to High-Dependency Unit. By echocardiography within 24 h from the admission (T1), RVSD was defined as Tricuspid Annular Plane Systolic Excursion (TAPSE) < 16 mm, while left ventricular systolic dysfunction (LVSD) was defined by bi-dimensional speckle-tracking-based global longitudinal peak systolic strain (GLS) > -14%. We assessed all-cause mortality at day-7 and at day-28 from admission. Mortality rate was 14% by day-7 and 26% by day-28 follow-up. RVSD was found in 85 patients (34%), was isolated in 29% (25/85) and coexisted with LVSD in 71% (60/85) patients. LVSD was present in 63% of patients (159/252), and was isolated in 99 patients. Day-7 mortality rate was twofold higher in the presence of RVSD (20% vs 11%), without reaching the statistical significance (p = 0.097). By day-28, mortality rate was as high as 44% with and 23% without RVSD (p = 0.001). In a Cox survival analysis, RVSD predicted higher mortality rate by day-28 follow-up (RR 2.43, 95% CI 1.47-4.00, p = 0.001), independent to shock and in addition to LVSD. In sepsis, RVSD predicted all-cause mortality by day-28 follow-up, independent to LVSD.
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Affiliation(s)
- Francesca Innocenti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy.
| | - Vittorio Palmieri
- Transplant Cardiosurgery Unit, Department of Cardiosurgery and Transplant, University Hospital Monaldi-Cotugno-CTO, Naples, Italy
| | - Valerio Teodoro Stefanone
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Chiara Donnini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Federico D'Argenzio
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Marco Cigana
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Irene Tassinari
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Riccardo Pini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
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Palmieri V, Papi M. Can graphene take part in the fight against COVID-19? Nano Today 2020; 33:100883. [PMID: 32382315 DOI: 10.1016/j.nntod.2020.100883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/25/2020] [Accepted: 04/29/2020] [Indexed: 05/28/2023]
Abstract
The pneumonia outbreak of coronavirus disease 2019 (COVID-19) represents a global issue. The bidimensional material graphene has captured much attention due to promising antimicrobial applications and has also demonstrated antiviral efficacy. In response to this global outbreak, we summarized the current state of knowledge of graphene and virus interaction as well as possible successful applications to fight COVID-19. Antibody-conjugated graphene sheets can rapidly detect targeted virus proteins and can be useful for large population screening, but also for the development of environmental sensors and filters, given the low cost of graphene materials. Functionalized graphene has demonstrated a good viral capture capacity that, combined with heat or light-mediated inactivation, could be used as a disinfectant. Graphene sensors arrays can be implemented on standard utility textiles and drug efficacy screening. Thanks to its high versatility, we foresee that graphene may have a leading role in the fight against COVID-19.
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Affiliation(s)
- V Palmieri
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Roma, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italy
- Institute for Complex Systems (ISC), National Research Council (CNR), Rome, Italy
| | - M Papi
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Roma, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italy
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20
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Palmieri V, Papi M. Can graphene take part in the fight against COVID-19? Nano Today 2020; 33:100883. [PMID: 32382315 PMCID: PMC7203038 DOI: 10.1016/j.nantod.2020.100883] [Citation(s) in RCA: 141] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/25/2020] [Accepted: 04/29/2020] [Indexed: 04/14/2023]
Abstract
The pneumonia outbreak of coronavirus disease 2019 (COVID-19) represents a global issue. The bidimensional material graphene has captured much attention due to promising antimicrobial applications and has also demonstrated antiviral efficacy. In response to this global outbreak, we summarized the current state of knowledge of graphene and virus interaction as well as possible successful applications to fight COVID-19. Antibody-conjugated graphene sheets can rapidly detect targeted virus proteins and can be useful for large population screening, but also for the development of environmental sensors and filters, given the low cost of graphene materials. Functionalized graphene has demonstrated a good viral capture capacity that, combined with heat or light-mediated inactivation, could be used as a disinfectant. Graphene sensors arrays can be implemented on standard utility textiles and drug efficacy screening. Thanks to its high versatility, we foresee that graphene may have a leading role in the fight against COVID-19.
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Affiliation(s)
- V. Palmieri
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Roma, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italy
- Institute for Complex Systems (ISC), National Research Council (CNR), Rome, Italy
| | - M. Papi
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Roma, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italy
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Cacciatore F, Palmieri V, Amarelli C, Maiello C, Napoli C. Further evidence on HLA‐DR matching in determining heart transplantation outcomes. Transpl Int 2020; 33:1551-1552. [DOI: 10.1111/tri.13698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Francesco Cacciatore
- Cardiac Transplantation Unit Department of Cardiac Surgery and Transplantation Ospedali dei Colli Naples Italy
- Department of Translational Medical Sciences Federico II University of Naples Naples Italy
| | - Vittorio Palmieri
- Cardiac Transplantation Unit Department of Cardiac Surgery and Transplantation Ospedali dei Colli Naples Italy
| | - Cristiano Amarelli
- Cardiac Transplantation Unit Department of Cardiac Surgery and Transplantation Ospedali dei Colli Naples Italy
| | - Ciro Maiello
- Cardiac Transplantation Unit Department of Cardiac Surgery and Transplantation Ospedali dei Colli Naples Italy
| | - Claudio Napoli
- Clinical Department of Internal Medicine Specialistic Units and Regional Referring Centre for Clinical Immunology of Organ Transplantation (LIT) University Department of Advanced Medical and Surgical Sciences (DAMSS) University of Campania "Luigi Vanvitelli" Naples Italy
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22
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Mortara A, Vaira L, Palmieri V, Iacoviello M, Battistoni I, Iacovoni A, Macera F, Pasqualucci D, Bochicchio M, De Maria R. Would You Prescribe Mobile Health Apps for Heart Failure Self-care? An Integrated Review of Commercially Available Mobile Technology for Heart Failure Patients. Card Fail Rev 2020; 6:e13. [PMID: 32537246 PMCID: PMC7277786 DOI: 10.15420/cfr.2019.11] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 11/05/2019] [Indexed: 02/06/2023] Open
Abstract
Treatment of chronic diseases, such as heart failure, requires complex protocols based on early diagnosis; self-monitoring of symptoms, vital signs and physical activity; regular medication intake; and education of patients and caregivers about relevant aspects of the disease. Smartphones and mobile health applications could be very helpful in improving the efficacy of such protocols, but several barriers make it difficult to fully exploit their technological potential and produce clear clinical evidence of their effectiveness. App suppliers do not help users distinguish between useless/dangerous apps and valid solutions. The latter are few and often characterised by rapid obsolescence, lack of interactivity and lack of authoritative information. Systematic reviews can help physicians and researchers find and assess the ‘best candidate solutions’ in a repeatable manner and pave the way for well-grounded and fruitful discussion on their clinical effectiveness. To this purpose, the authors assess 10 apps for heart failure self-care using the Intercontinental Marketing Statistics score and other criteria, discuss the clinical effectiveness of existing solutions and identify barriers to their use in practice and drivers for change.
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Affiliation(s)
| | - Lucia Vaira
- Department of Engineering for Innovation, University of Salento Lecce, Italy
| | - Vittorio Palmieri
- Department of Cardiac Surgery and Transplantation, AORN dei Colli Monaldi-Cotugno-CTO Naples, Italy
| | - Massimo Iacoviello
- Cardiology Unit, Cardiothoracic Department, University Hospital Policlinico Bari, Italy
| | - Ilaria Battistoni
- SOD Cardiology-Haemodynamics-UTIC, Department of Cardiovascular Sciences, University Hospital Azienda, United Hospitals of Ancona Ancona, Italy
| | - Attilio Iacovoni
- Cardiovascular Department, ASST Pope John XXIII Hospital Bergamo, Italy
| | - Francesca Macera
- Cardiology, Heart Failure and Transplantation, ASST Great Metropolitan Hospital Niguarda Milan, Italy
| | | | - Mario Bochicchio
- Department of Engineering for Innovation, University of Salento Lecce, Italy
| | - Renata De Maria
- National Research Council, Institute of Clinical Physiology, ASST Great Metropolitan Hospital Niguarda Milan, Italy
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Alghamdi A, Palmieri V, Alotaibi N, Martel M, Barkun AN, Zogopoulos G, Chaudhury P, Chen Y. A268 PREOPERATIVE EUS-GUIDED FNA IS ASSOCIATED WITH BETTER OVERALL SURVIVAL IN RESECTABLE PANCREATIC CANCER WHEN COMPARED TO UPFRONT SURGERY WITHOUT PREOPERATIVE TISSUE ACQUISITION: A SYSTEMIC REVIEW AND META-ANALYSIS. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the standard of care in advanced pancreatic cancer. In resectable disease, preoperative EUS-FNA can help to identify benign etiology and other cancers while preventing unnecessary surgery. However, concerns regarding tumor seeding and pancreatitis have led some experts to advocate for upfront surgery without tissue sampling.
Aims
To conduct a systematic review and meta-analysis of the risks and benefits of performing pre-operative EUS-FNA in patients with suspected, resectable pancreatic cancer.
Methods
A literature search was performed up to April 2019 using MEDLINE, EMBASE, and ISI Web of Knowledge databases with terms specified for pancreatic neoplasm and FNA. All fully published adult studies that compared preoperative EUS-FNA to EUS without FNA in resectable pancreatic cancer for short- and long-term outcomes were included. Results were reported as Odds ratios (OR) or weighted mean differences (WMD) with 95% confidence intervals (CI) using a random effects model. Heterogeneity, publication bias and quality of studies were evaluated. Sensitivity analyses were performed. The primary outcome is overall survival. Secondary outcomes include cancer free survival, tumor recurrence and seeding, and post FNA adverse events.
Results
An initial search yielded 2814 citations. Six retrospective studies were included with 1155 patients in the EUS-FNA group vs 2067 patients in the comparator group. Overall survival was reported in three studies (n=2701: 796 EUS-FNA, 1905 non-FNA). Patients with preoperative EUS-FNA had better overall survival compared to the non-FNA group (WMD, 4.40 months [0.02 to 8.78]). In adenocarcinoma patients (2 studies, n=2050), there was no significant difference in overall survival (WMD, 2.94 months [-3.87 to 9.74]). Cancer-free survival did not differ significantly between the two groups (WMD, 2.08 months [-2.22 to 6.38]). Moreover, EUS with FNA was not associated with increased rates of tumor recurrence (OR, 0.55 [0.30–1.02]) or peritoneal carcinomatosis (OR, 0.81 [0.56–1.18]). Post-FNA pancreatitis was rare (1.7%), with all patients treated conservatively. Sensitivity analyses yielded similar findings across the different outcomes tested.
Conclusions
In this meta-analysis, preoperative EUS-FNA in resectable pancreatic cancer was associated with significantly greater overall survival when compared to the non-FNA group with no significant difference in rate of tumour recurrence and/or peritoneal seeding. These findings are limited by the retrospective nature of the included studies; randomized controlled trials are needed to confirm these results.
Funding Agencies
None
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Affiliation(s)
- A Alghamdi
- McGill University Health Centre, Montreal, QC, Canada
| | - V Palmieri
- McGill University Health Centre, Montreal, QC, Canada
| | - N Alotaibi
- McGill University Health Centre, Montreal, QC, Canada
| | - M Martel
- McGill University Health Centre, Montreal, QC, Canada
| | - A N Barkun
- McGill University Health Centre, Montreal, QC, Canada
| | - G Zogopoulos
- McGill University Health Centre, Montreal, QC, Canada
| | - P Chaudhury
- McGill University Health Centre, Montreal, QC, Canada
| | - Y Chen
- McGill University Health Centre, Montreal, QC, Canada
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Palmieri V, Ramana-Kumar A, Martel M, Forbes N, Mohamed R, Chatterjee A, Kenshil S, Desilets E, Donnellan F, Gan I, Lam E, Telford JJ, Sandha GS, Teshima CW, May G, Mosko J, Paquin S, Sahai A, Barkun AN, Chen Y. A279 EUS-GUIDED BILIARY DRAINAGE IN MALIGNANT DISTAL BILIARY OBSTRUCTION: AN INTERNATIONAL SURVEY TO IDENTIFY BARRIERS OF TECHNOLOGY IMPLEMENTATION. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.278] [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
Endoscopic ultrasound-guided biliary drainage (EUS-BD) is a promising alternative to endoscopic retrograde cholangiopancreatography (ERCP) in malignant distal biliary obstruction (MDBO). Recent small randomized controlled trials comparing EUS-BD with ERCP suggest that EUS-BD achieves a similar technical success rate and safety profile while potentially being associated with lower rates of stent dysfunction However, its application in clinical practice has been impeded by various undefined barriers.
Aims
To evaluate the current practice of EUS-BD and the determinants for its clinical implementation in MDBO.
Methods
An online survey was generated using Google Forms. Five endoscopy societies have distributed the survey as of October 10th, 2019. Survey questions measured participant characteristics, EUS-BD in different clinical scenarios, and potential barriers to implementation. Descriptive statistics were calculated using frequencies, chi-square statistics were used for inferential analysis, and a standard step-wise multivariable analysis was performed to identify independent variables for and against the use of EUS-BD.
Results
To date, 102 physicians have participated in the survey (response rate 7.97%). The majority of participants are from North America (39.2%), Asia (31.4%), and Europe (19.6%). Most participants are gastroenterologists with formal therapeutic endoscopy training (66.7%), though only 28.4% have received EUS-BD training. In unresectable cancer, 85.1% of respondents favoured EUS-BD over percutaneous biliary drainage following ERCP failure (p<0.0001), while in borderline resectable disease, 72.3% preferred EUS-BD. On multivariable analysis, male gender, formal training in EUS-BD, and unresectable cancer were independent variables for the use of EUS-BD. Conversely, independent discouraging factors for EUS-BD included fear of adverse events, limited high-quality data, lack of local expertise, and inadequate access to EUS technology.
Conclusions
In this international survey, it appears that EUS-BD is gaining traction, especially in the setting of unresectable disease following ERCP failure. However, barriers to implementation include the lack of high-quality data, fear for adverse events, limited experts in the field, and inadequate access to EUS technology. This suggest the need for high-quality clinical trials, increased endoscopist training in this field, and further technology development in EUS-BD in order to increase its uptake in clinical practice.
Funding Agencies
None
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Affiliation(s)
- V Palmieri
- Gastroenterology and Hepatology, McGill University, Montreal, QC, Canada
| | - A Ramana-Kumar
- Gastroenterology and Hepatology, McGill University, Montreal, QC, Canada
| | - M Martel
- Gastroenterology and Hepatology, McGill University, Montreal, QC, Canada
| | - N Forbes
- Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada
| | - R Mohamed
- Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada
| | - A Chatterjee
- Gastroenterology and Hepatology, University of Ottawa, Ottawa, ON, Canada
| | - S Kenshil
- Gastroenterology and Hepatology, University of Ottawa, Ottawa, ON, Canada
| | - E Desilets
- Gastroenterology, Université de Sherbrooke, St-Basile-le-Grand, QC, Canada
| | - F Donnellan
- Gastroenterology and Hepatology, University of British Columbia, Vancouver, BC, Canada
| | - I Gan
- Gastroenterology and Hepatology, University of British Columbia, Vancouver, BC, Canada
| | - E Lam
- Gastroenterology and Hepatology, University of British Columbia, Vancouver, BC, Canada
| | - J J Telford
- Gastroenterology and Hepatology, University of British Columbia, Vancouver, BC, Canada
| | - G S Sandha
- Medicine, University of Alberta, Edmonton, AB, Canada
| | - C W Teshima
- Gastroenterology, University of Toronto, Toronto, ON, Canada
| | - G May
- Medicine, University of Toronto, Toronto, ON, Canada
| | - J Mosko
- Medicine, University of Toronto, Toronto, ON, Canada
| | - S Paquin
- Gastroenterology, Université de Montréal, Montreal, QC, Canada
| | - A Sahai
- Gastroenterology, Université de Montréal, Montreal, QC, Canada
| | - A N Barkun
- Gastroenterology and Hepatology, McGill University, Montreal, QC, Canada
| | - Y Chen
- Gastroenterology and Hepatology, McGill University, Montreal, QC, Canada
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Cacciatore F, Amarelli C, Maiello C, Mattucci I, Salerno G, Di Maio M, Palmieri V, Curcio F, Pirozzi F, Mercurio V, Benincasa G, Golino P, Bonaduce D, Napoli C, Abete P. Sacubitril/valsartan in patients listed for heart transplantation: effect on physical frailty. ESC Heart Fail 2020; 7:757-762. [PMID: 32074411 PMCID: PMC7160499 DOI: 10.1002/ehf2.12610] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/29/2019] [Accepted: 12/09/2019] [Indexed: 12/11/2022] Open
Abstract
AIMS The aim of this study was to investigate prospectively the effect of sacubitril/valsartan in advanced heart failure (HF) patients in waiting list for heart transplantation (HT) and the effect on physical frailty (PF). METHODS AND RESULTS We treated 37 consecutive patients with advanced HF with sacubitril/valsartan. Patients were followed up until HT, device implant, or last follow-up visit after 2 years of follow-up. At baseline, mean New York Heart Association (NYHA) class was 3.1 ± 0.4, with 64.9% in NYHA III and 35.1% NYHA IIIB. Left ventricular ejection fraction was 23.5 ± 5.8%, VO2 max was 10.3 ± 2.3 mL/kg/min, cardiac index was 2.3 ± 0.5 L/min/m2 , and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) was 4943.0 ± 5326.8 pg/mL. After a mean follow-up of 17.1 ± 4.4 months, no deaths were observed, but NYHA class improved significantly with 56.8% in NYHA II, 40.5% in NYHA III, and 2.7% in NYHA IIIB (P < 0.001). VO2 max and 6 min walk test (6MWT) increased, whereas pulmonary systolic blood pressure, E/E', VE/VCO2 slope, and NT-pro-BNP decreased. At right heart catheterization performed after 1 year of follow-up, cardiac index and pulmonary vascular resistance remained stable, while a decrease in systolic pulmonary artery pressure and pulmonary capillary wedge pressure is observed. Furosemide dosage decrease from 102.7 ± 69.4 to 78.7 ± 66.3 mg (P = 0.040). PF decreased from 3.35 ± 1.0 at baseline to 1.57 ± 1.3 at the end of follow-up (P < 0.001), with a reduction in all PF domains. CONCLUSIONS Our study showed a rapid improvement in PF in HT waiting list patients treated with sacubitril/valsartan. The improvement in all PF domains was paralleled by VO2 and 6MWT increase and together with an NT-pro-BNP reduction constant over the follow-up.
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Affiliation(s)
- Francesco Cacciatore
- Department of Translational Medical Sciences, University of Naples 'Federico II', 80131, Naples, Italy.,Department of Cardiovascular Surgery and Transplant, Monaldi Hospital, Azienda dei Colli, 80131, Naples, Italy
| | - Cristiano Amarelli
- Department of Cardiovascular Surgery and Transplant, Monaldi Hospital, Azienda dei Colli, 80131, Naples, Italy
| | - Ciro Maiello
- Department of Cardiovascular Surgery and Transplant, Monaldi Hospital, Azienda dei Colli, 80131, Naples, Italy
| | - Irene Mattucci
- Department of Cardiovascular Surgery and Transplant, Monaldi Hospital, Azienda dei Colli, 80131, Naples, Italy
| | - Gemma Salerno
- Department of Cardiovascular Surgery and Transplant, Monaldi Hospital, Azienda dei Colli, 80131, Naples, Italy
| | - Marco Di Maio
- Department of Cardiology, Università degli Studi della Campania 'Luigi Vanvitelli', Monaldi Hospital, 80131, Naples, Italy
| | - Vittorio Palmieri
- Department of Cardiovascular Surgery and Transplant, Monaldi Hospital, Azienda dei Colli, 80131, Naples, Italy
| | - Francesco Curcio
- Department of Translational Medical Sciences, University of Naples 'Federico II', 80131, Naples, Italy
| | - Flora Pirozzi
- Department of Translational Medical Sciences, University of Naples 'Federico II', 80131, Naples, Italy
| | - Valentina Mercurio
- Department of Translational Medical Sciences, University of Naples 'Federico II', 80131, Naples, Italy
| | - Giuditta Benincasa
- University Department of Advanced Medical and Surgical Sciences, Clinical Department of Internal and Specialty Medicine (DAI), Università degli Studi della Campania 'Luigi Vanvitelli', 80138, Naples, Italy
| | - Paolo Golino
- Department of Cardiology, Università degli Studi della Campania 'Luigi Vanvitelli', Monaldi Hospital, 80131, Naples, Italy
| | - Domenico Bonaduce
- Department of Translational Medical Sciences, University of Naples 'Federico II', 80131, Naples, Italy
| | - Claudio Napoli
- University Department of Advanced Medical and Surgical Sciences, Clinical Department of Internal and Specialty Medicine (DAI), Università degli Studi della Campania 'Luigi Vanvitelli', 80138, Naples, Italy
| | - Pasquale Abete
- Department of Translational Medical Sciences, University of Naples 'Federico II', 80131, Naples, Italy
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Mortara A, Gabrielli D, Pugliese FR, Corcione A, Perticone F, Fontanella A, Mercuro G, Cricelli C, Iacoviello M, D'Ambrosio G, Guarracino F, Modesti PA, Vescovo G, De Maria R, Iacovoni A, Macera F, Palmieri V, Pasqualucci D, Battistoni I, Alunni G, Aspromonte N, Caldarola P, Campanini M, Caporale R, Casolo G, Cipriani M, Di Tano G, Domenicucci S, Murrone A, Nardi F, Navazio A, Oliva F, Parretti D, Urbinati S, Valente S, Valeriano V, Zuin G, Metra M, Sinagra G, Gulizia MM, Di Lenarda A. [ANMCO/FADOI/SIAARTI/SIC/SIMG/SIMI/SIMEU consensus document: The clinical care pathway of acute heart failure patients from symptom onset to discharge from the emergency department]. G Ital Cardiol (Rome) 2019; 20:289-334. [PMID: 31066371 DOI: 10.1714/3151.31321] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Acute heart failure (AHF) represents a relevant burden for emergency departments worldwide. AHF patients have markedly worse long-term outcomes than patients with other acute cardiac diseases (e.g. acute coronary syndromes); mortality or readmissions rates at 3 months approximate 33%, whereas 1-year mortality from index discharge ranges from 25% to 50%.The multiplicity of healthcare professionals acting across the care pathway of AHF patients represents a critical factor, which generates the need for integrating the different expertise and competence of general practitioners, emergency physicians, cardiologists, internists, and intensive care physicians to focus on care goals able to improve clinical outcomes.This consensus document results from the cooperation of the scientific societies representing the different healthcare professionals involved in the care of AHF patients and describes shared strategies and pathways aimed at ensuring both high quality care and better outcomes. The document describes the patient journey from symptom onset to the clinical suspicion of AHF and home management or referral to emergency care and transportation to the hospital, through the clinical diagnostic pathway in the emergency department, acute treatment, risk stratification and discharge from the emergency department to ordinary wards or home. The document analyzes the potential role of a cardiology fast-track and Observation Units and the transition to outpatient care by general practitioners and specialist heart failure clinics.The increasing care burden and complex problems generated by AHF are unlikely to be solved without an integrated multidisciplinary approach. Efficient networking among emergency departments, intensive care units, ordinary wards and primary care settings is crucial to achieve better outcomes. Thanks to the joint effort of qualified scientific societies, this document aims to achieve this goal through an integrated, shared and applicable pathway that will contribute to a homogeneous care management of AHF patients across the country.
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Affiliation(s)
- Andrea Mortara
- Dipartimento di Cardiologia Clinica, Policlinico di Monza, Monza (MB)
| | - Domenico Gabrielli
- ASUR Marche - Area Vasta 4 Fermo, Ospedale Civile Augusto Murri, Fermo, Ancona - Presidente ANMCO
| | - Francesco Rocco Pugliese
- Dipartimento di Medicina d'Urgenza, Ospedale Sandro Pertini, ASL Roma 2, Roma - Presidente SIMEU
| | - Antonio Corcione
- Dipartimento di Anestesia, A.O.R.N. dei Colli, Napoli - Presidente SIAARTI
| | - Francesco Perticone
- Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi "Magna Graecia", Catanzaro - Past-President SIMI
| | - Andrea Fontanella
- Dipartimento di Medicina Interna, Ospedale Buon Consiglio Fatebenefratelli, Napoli - Presidente FADOI
| | - Giuseppe Mercuro
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi, Cagliari - Past-President SIC
| | - Claudio Cricelli
- Società Italiana di Medicina Generale e delle Cure Primarie, Firenze - Presidente SIMG
| | - Massimo Iacoviello
- Unità di Cardiologia, Dipartimento Cardiotoracico, Ospedale Policlinico Universitario, Bari
| | - Gaetano D'Ambrosio
- Società Italiana di Medicina Generale e delle Cure Primarie - SIMG, Firenze
| | - Fabio Guarracino
- U.O.C. Anestesia e Rianimazione Cardiotoracovascolare, Dipartimento di Anestesia e Rianimazione, AOUP, Pisa
| | | | - Giorgio Vescovo
- Dipartimento di Medicina Interna, Ospedale S. Antonio, Padova
| | - Renata De Maria
- Istituto di Fisiologia Clinica del CNR, Dipartimento Cardiotoracovascolare, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Attilio Iacovoni
- Dipartimento Cardiovascolare, ASST Ospedale Papa Giovanni XXIII, Bergamo
| | - Francesca Macera
- Cardiologia 2, Insufficienza Cardiaca e Trapianti, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Vittorio Palmieri
- Dipartimento di Cardiochirurgia e dei Trapianti, A.O.R.N. dei Colli Monaldi-Cotugno-CTO, Napoli
| | | | - Ilaria Battistoni
- S.O.D. Cardiologia-Emodinamica-UTIC, Dipartimento di Scienze Cardiovascolari, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona
| | | | - Nadia Aspromonte
- Polo Scienze Cardiovascolari e Toraciche, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli", Roma
| | | | - Mauro Campanini
- Dipartimento Medico, A.O.U. Maggiore, Novara - Presidente Fondazione FADOI
| | - Roberto Caporale
- U.O.C. Cardiologia Interventistica, Ospedale Annunziata, Cosenza
| | - Giancarlo Casolo
- S.C. Cardiologia, Nuovo Ospedale Versilia, Lido di Camaiore (LU)
| | - Manlio Cipriani
- Cardiologia 2, Insufficienza Cardiaca e Trapianti, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | | | | | - Adriano Murrone
- Cardiologia-UTIC, Ospedale di Città di Castello, Azienda USL Umbria 1
| | - Federico Nardi
- S.C. Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL)
| | - Alessandro Navazio
- U.O.C. Cardiologia, IRCCS Arcispedale S. Maria Nuova, AUSL di Reggio Emilia, Reggio Emilia
| | - Fabrizio Oliva
- Cardiologia 2, Insufficienza Cardiaca e Trapianti, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Damiano Parretti
- Società Italiana di Medicina Generale e delle Cure Primarie, Firenze - SIMG, Responsabile Area Cardiovascolare
| | | | - Serafina Valente
- U.O.C. Cardiologia Ospedaliera, Azienda Ospedaliero-Universitaria Senese, Siena
| | - Valentina Valeriano
- Dipartimento di Medicina d'Urgenza, Ospedale Sandro Pertini, ASL Roma 2, Roma
| | | | - Marco Metra
- Divisione di Cardiologia, Università degli Studi e Spedali Civili, Brescia
| | - Gianfranco Sinagra
- Dipartimento Cardiotoracovascolare, Azienda Sanitaria Universitaria Integrata, Università degli Studi, Trieste
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania - Presidente Fondazione per il Tuo cuore - Heart Care Foundation Onlus, Firenze
| | - Andrea Di Lenarda
- S.C. Cardiovascolare e Medicina dello Sport, Azienda Sanitaria Universitaria Integrata, Trieste
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Vecchi AL, Iacovoni A, Palmieri V, De Ponti R, Senni M. [Role of the right ventricle in heart failure with preserved ejection fraction]. G Ital Cardiol (Rome) 2019; 20:574-583. [PMID: 31593161 DOI: 10.1714/3228.32056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Heart failure with preserved ejection fraction represents an emerging pandemic and one of the most relevant causes of admission in the elderly population. The hemodynamic and prognostic role of the right ventricular function in this population has been recently investigated and a position statement on behalf of the Heart Failure Association of the European Society of Cardiology has been published to guide physicians to perform a multiparametric evaluation of right ventricular morphology and function. In this brief review we summarize the role of the right ventricle and pulmonary pressure in heart failure with preserved ejection fraction, focusing on hemodynamic and clinical characteristics that identify high-risk patients with poor prognosis.
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Affiliation(s)
- Andrea Lorenzo Vecchi
- Dipartimento Cardiovascolare, Ospedale di Circolo e Fondazione Macchi, Università dell'Insubria, Varese
| | - Attilio Iacovoni
- Dipartimento Cardiovascolare, Ospedale Papa Giovanni XXIII, Bergamo
| | - Vittorio Palmieri
- U.O.S.D. Chirurgia dei Trapianti, Dipartimento di Cardiochirurgia e dei Trapianti, Ospedali dei Colli Monaldi-Cotugno-C.T.O., Napoli
| | - Roberto De Ponti
- Dipartimento Cardiovascolare, Ospedale di Circolo e Fondazione Macchi, Università dell'Insubria, Varese
| | - Michele Senni
- Dipartimento Cardiovascolare, Ospedale Papa Giovanni XXIII, Bergamo
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De Maria R, Macera F, Gorini M, Battistoni I, Iacoviello M, Iacovoni A, Palmieri V, Pasqualucci D, Leonardi G, Pagnoni N, Montagna L, Floresta M, Midi P, Pulignano G, Mortara A. P320Heart failure with mid-range (HFmrEF) or recovered (HFrecEF) ejection fraction: differential determinants of transition. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Heart failure with mid-range ejection fraction (HFmrEF) has been identified as a multi-faceted phenotype that may encompass both patients with mild disease or those who from previous HFrEF recover EF (HFrecEF)
Purpose
To describe clinical characteristics and factors associated with phenotype transition at follow-up.
Methods
From 2009 to 2016, 1194 patients with baseline EF<50% and a second echocardiographic determination during clinically stability at a median of 6 months were enrolled in the IN-CHF Registry. Based on EF at enrollment, 335 (28%) had HFmrEF and 859 (72%) had HFrEF. We compared baseline clinical characteristics and predictors associated with follow-up reclassification to HFmrEF or full EF recovery
Results
When compared to HFrEF patients, those with HFmrEF had less often an ischemic etiology, advanced symptoms and a HF admission in the previous year. No other differences were found in clinical characteristics and drug therapy (Table).
At a median follow-up of 6 months, 30% of HFrEF patients improved EF by 14 (9) units: 21% showed partial EF recovery (transition to HFmrEF) and 9% had full EF recovery. Conversely among HFmrEF patients 22% improved EF, by 9 (5) units, to full recovery, and 18% deteriorated by 1.5 (5.5) units sloping to HFrEF.
By multivariable logistic regression analysis, variables associated with EF recovery at 6-month follow-up differed between baseline phenotypes. Within HFrEF, ischemic etiology (OR 0.46, 95% CI 0.33–0.64) and NYHA class III-IV symptoms (OR 0.57, 95% CI 0.38–0.68) were associated with a lower likelihood of EF recovery, while a history of HF<6 month correlated with a higher likelihood of EF recovery (OR 2.44, 95% CI 1.76–3.39). Within HFmrEF, while ischemic etiology (OR 0.66, 95% CI 0.19–0.68) was also associated with a lower likelihood of EF recovery, a history of atrial fibrillation at enrollment correlated with higher likelihood of EF recovery (OR 2.66, 95% CI 1.37–5.17) by 6 month-follow-up.
At a median follow-up of 36+28 months mortality was 4.6% vs 6.9% in HFrecEF vs non-recovered patients (log rank p=0.08).
Baseline characteristics HFrEF vs HFmrEF
Conclusions
HFmrEF patients showed a less severe clinical picture than HFrEF patients, but had EF recovery less often. EF improvement is negatively associated with ischemic etiology in both phenotypes, and positively associated with atrial fibrillation in HFmrEF and a short history of HF in HFrEF.
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Affiliation(s)
- R De Maria
- CNR Institute of Clinical Physiology, Milan, Italy
| | - F Macera
- Niguarda Ca' Granda Hospital, De Gasperis CardioCenter, Milan, Italy
| | - M Gorini
- ANMCO Study Center, Florence, Italy
| | - I Battistoni
- University Hospital Riuniti of Ancona, Ancona, Italy
| | | | - A Iacovoni
- Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - V Palmieri
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | | | - G Leonardi
- Polyclinic Hospital “Rodolico”, Catania, Italy
| | - N Pagnoni
- Hospital San Giovanni Addolorata, Rome, Italy
| | - L Montagna
- University Hospital San Luigi Gonzaga, Orbassano, Italy
| | - M Floresta
- Ospedale Cervello-Villa Sofia, Palermo, Italy
| | - P Midi
- Albano-Genzano Hospital, ASL Rome 6, Albano Laziale, Italy
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Marfella R, Cacciatore F, Balestrieri ML, Esposito S, Mansueto G, Paolisso P, Golino P, Amarelli C, Maiello C, Ursomando F, Salerno G, Palmieri V, Benincasa G, Paolisso G, Napoli C. P4543Steatosis in explanted heart of type 2 diabetic patients with end-stage heart failure: progression of intra-myocytes fat accumulation in non-diabetic heart implanted in diabetic patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
How metabolic impairment leads to cardiac dysfunction in diabetics is unknown. A recent theory, derived mainly from rodent models, involves lipid over-storage to cardiomyocytes. Previous human study demonstrated cardiac steatosis on explanted hearts of diabetics with heart failure. However, this study did not provide any evidence about the effects of diabetes milieu on implanted non-diabetic heart.
Purpose
We evaluated intramyocyte lipid infiltration in explanted heart of type 2 diabetics with end-stage heart failure. Moreover, we studied the effects of diabetic milieu on myocyte lipid infiltration and cardiac function of non-diabetic implanted hearts in type 2 diabetics one year after heart transplantation (HTx).
Methods
We conducted a prospective study with a follow-up of 12 months on 88 patients over 18 years of age underwent first HTX. Patients with pre-HTx diabetes duration for at least 6 months were included in the study. Patients with endomyocardial biopsy (EMB) considered positive for rejection, according to International Society for Heart Lung Transplantation (ISHLT), and with post-HTx diabetes were excluded from the study. All patients underwent immunosuppression induction according ISHLT indications. All patients were followed applying internationally accepted patient evaluations (echocardiography and metabolic control) and EMB schedules. EBM from patients without rejection evidences were evaluated for intramyocyte lipid infiltration with oil red-O staining (Or-O).
Results
The patients were divided in diabetics (44%, age 51.6±7.2 y, diabetes duration 11±3 y) and no-diabetics (56%, 52.1±10.9 y). The patients were matched on the basis of eligibility for a HTx. Seven patients (3 diabetics and 4 no-diabetics) died in hospital. 5 (11%) patients developed post- HTx diabetes. No differences were seen in rejection (12% vs. 10%), infection (9% vs. 10%), renal dysfunction (9% vs. 8%) or mortality (7% vs. 8%). Therefore, the study population included 23 no-diabetics and 22 diabetics. After 1 year, we evidenced an impairment of both sx and dx ventricular function as showed by a significantly reduction of ejection fraction and TAPSE in diabetic patients (Figure-A). Although diastolic function not show significant differences among groups, the E/e' ratio showed lower reduction in diabetics. Or-O evidenced that 91% of diabetic and only 2 of no-diabetic explanted hearts (9%) showed intramyocyte lipid infiltration (Figure-B). Moreover, Or-O of EMB, for monitoring heart transplant during 1 year, evidenced a progressive intramyocyte lipid infiltration in 18 diabetics (81%), whereas none of no-diabetics showed intramyocyte lipid infiltration.
Conclusions
Our data show that almost all of the explanted diabetic hearts had intramyocyte lipid infiltration. More interesting, we observed that healthy heart transplanted in recipients with pretransplant diabetes were affected early by metabolic disorders leading to intramyocyte lipid infiltration.
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Affiliation(s)
- R Marfella
- University della Campania Luigi Vanvitelli, Clinical Department of Internal Medicine and Specialistics, Naples, Italy
| | - F Cacciatore
- Federico II University of Naples, Department of Translational Medical Sciences, Naples, Italy
| | - M L Balestrieri
- University della Campania Luigi Vanvitelli, Department of Precision Medicine, Naples, Italy
| | - S Esposito
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - G Mansueto
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - P Paolisso
- University della Campania Luigi Vanvitelli, Clinical Department of Internal Medicine and Specialistics, Naples, Italy
| | - P Golino
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - C Amarelli
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - C Maiello
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - F Ursomando
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - G Salerno
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - V Palmieri
- AO dei Colli-Monaldi Hospital, Department of Cardiovascular Surgery and Transplant, Naples, Italy
| | - G Benincasa
- University della Campania Luigi Vanvitelli, Clinical Department of Internal Medicine and Specialistics, Naples, Italy
| | - G Paolisso
- University della Campania Luigi Vanvitelli, Clinical Department of Internal Medicine and Specialistics, Naples, Italy
| | - C Napoli
- University della Campania Luigi Vanvitelli, Clinical Department of Internal Medicine and Specialistics, Naples, Italy
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30
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Brunelli R, De Spirito M, Giancotti A, Palmieri V, Parasassi T, Di Mascio D, Flammini G, D'Ambrosio V, Monti M, Boccaccio A, Pappalettere C, Ficarella E, Papi M, Lamberti L. The biomechanics of the umbilical cord Wharton Jelly: Roles in hemodynamic proficiency and resistance to compression. J Mech Behav Biomed Mater 2019; 100:103377. [PMID: 31398692 DOI: 10.1016/j.jmbbm.2019.103377] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/21/2019] [Accepted: 07/30/2019] [Indexed: 11/15/2022]
Abstract
The umbilical cord is a complex structure containing three vessels, one straight vein and two coiled arteries, encased by the Wharton Jelly (WJ) a spongy structure made of collagen and hydrated macromolecules. Fetal blood reaches the placenta through the arteries and flows back to the fetus through the vein. The role of the WJ in maintaining cord circulation proficiency and the ultimate reason for arterial coiling still lack of reasonable mechanistic interpretations. We performed biaxial tension tests and evidenced significant differences in the mechanical properties of the core and peripheral WJ. The core region, located between the arteries and the vein, resulted rather stiffer close to the fetus. Finite element modelling and optimization based inverse method were used to create 2D and 3D models of the cord and to simulate stress distribution in different hemodynamic conditions, compressive loads and arterial coiling. We recorded a facilitated stress transmission from the arteries to the vein through the soft core of periplacental WJ. This condition generates a pressure gradient that boosts the venous backflow circulation towards the fetus. Peripheral WJ allows arteries to act as pressure buffering chambers during the cardiac diastole and helps to dissipate compressive forces away from vessels. Altered WJ biomechanics may represent the structural basis of cord vulnerability in many high-risk clinical conditions.
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Affiliation(s)
- R Brunelli
- Dipartimento Materno Infantile e Scienze Urologiche, Università Sapienza, Roma, Italy
| | - M De Spirito
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italy; Istituto di Fisica, Università Cattolica del Sacro Cuore, Roma, Italy
| | - A Giancotti
- Dipartimento Materno Infantile e Scienze Urologiche, Università Sapienza, Roma, Italy
| | - V Palmieri
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italy; Istituto di Fisica, Università Cattolica del Sacro Cuore, Roma, Italy
| | - T Parasassi
- Istituto di Farmacologia Traslazionale, CNR, Roma, Italy
| | - D Di Mascio
- Dipartimento Materno Infantile e Scienze Urologiche, Università Sapienza, Roma, Italy
| | - G Flammini
- Dipartimento Materno Infantile e Scienze Urologiche, Università Sapienza, Roma, Italy
| | - V D'Ambrosio
- Dipartimento Materno Infantile e Scienze Urologiche, Università Sapienza, Roma, Italy
| | - M Monti
- Dipartimento Materno Infantile e Scienze Urologiche, Università Sapienza, Roma, Italy
| | - A Boccaccio
- Dipartimento di Meccanica, Matematica e Management, Politecnico di Bari, Bari, Italy
| | - C Pappalettere
- Dipartimento di Meccanica, Matematica e Management, Politecnico di Bari, Bari, Italy
| | - E Ficarella
- Dipartimento di Meccanica, Matematica e Management, Politecnico di Bari, Bari, Italy
| | - M Papi
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Roma, Italy; Istituto di Fisica, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - L Lamberti
- Dipartimento di Meccanica, Matematica e Management, Politecnico di Bari, Bari, Italy
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Molina E, D'Ambrosio M, Settimo E, Di Palo D, Bonfrate L, Garruti G, Palmieri V, Portincasa P. Alarming Effect Of Sedentary Lifestyles And Liver Steatosis On Intima-Media Thickness, Despite Adherence To Mediterranean Diet: Features From The ‘Foie Gras’ Project In Apulia, Italy. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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32
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Skliarova H, Cisternino S, Cicoria G, Marengo M, Carturan S, Martini P, Boschi A, Alvarez C, Palmieri V, Esposito J. TECHN-OSP: Molybdenum target preparation techniques for cyclotron-based technetium-99m production. Nucl Med Biol 2019. [DOI: 10.1016/s0969-8051(19)30213-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Skliarova H, Cisternino S, Cazzola E, Gorgoni G, Cicoria G, Marengo M, Palmieri V. Use of magnetron sputtering technique for medical cyclotron solid target preparation. Nucl Med Biol 2019. [DOI: 10.1016/s0969-8051(19)30276-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Palmieri V, Perini G, De Spirito M, Papi M. Graphene oxide touches blood: in vivo interactions of bio-coronated 2D materials. Nanoscale Horiz 2019; 4:273-290. [PMID: 32254085 DOI: 10.1039/c8nh00318a] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Graphene oxide is the hot topic in biomedical and pharmaceutical research of the current decade. However, its complex interactions with human blood components complicate the transition from the promising in vitro results to clinical settings. Even though graphene oxide is made with the same atoms as our organs, tissues and cells, its bi-dimensional nature causes unique interactions with blood proteins and biological membranes and can lead to severe effects like thrombogenicity and immune cell activation. In this review, we will describe the journey of graphene oxide after injection into the bloodstream, from the initial interactions with plasma proteins to the formation of the "biomolecular corona", and biodistribution. We will consider the link between the chemical properties of graphene oxide (and its functionalized/reduced derivatives), protein binding and in vivo response. We will also summarize data on biodistribution and toxicity in view of the current knowledge of the influence of the biomolecular corona on these processes. Our aim is to shed light on the unsolved problems regarding the graphene oxide corona to build the groundwork for the future development of drug delivery technology.
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Affiliation(s)
- V Palmieri
- Fondazione Policlinico A. Gemelli IRCSS-Università Cattolica Sacro Cuore, Largo Francesco Vito 1, 00168, Roma, Italy.
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35
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Azzolini O, Barrera MT, Beeman JW, Bellini F, Beretta M, Biassoni M, Bossio E, Brofferio C, Bucci C, Canonica L, Capelli S, Cardani L, Carniti P, Casali N, Cassina L, Clemenza M, Cremonesi O, Cruciani A, D’Addabbo A, Dafinei I, Domizio SD, Ferroni F, Gironi L, Giuliani A, Gorla P, Gotti C, Keppel G, Martinez M, Morganti S, Nagorny S, Nastasi M, Nisi S, Nones C, Orlandi D, Pagnanini L, Pallavicini M, Palmieri V, Pattavina L, Pavan M, Pessina G, Pettinacci V, Pirro S, Pozzi S, Previtali E, Puiu A, Rusconi C, Schäffner K, Tomei C, Vignati M, Zolotarova A. Search of the neutrino-less double beta decay of 82 Se into the excited states of 82 Kr with CUPID-0. Eur Phys J C Part Fields 2018; 78:888. [PMID: 30881205 PMCID: PMC6394250 DOI: 10.1140/epjc/s10052-018-6340-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/13/2018] [Indexed: 06/09/2023]
Abstract
The CUPID-0 experiment searches for double beta decay using cryogenic calorimeters with double (heat and light) read-out. The detector, consisting of 24 ZnSe crystals 95 % enriched in 82 Se and two natural ZnSe crystals, started data-taking in 2017 at Laboratori Nazionali del Gran Sasso. We present the search for the neutrino-less double beta decay of 82 Se into the 0 1 + , 2 1 + and 2 2 + excited states of 82 Kr with an exposure of 5.74 kg · yr (2.24 × 10 25 emitters · yr). We found no evidence of the decays and set the most stringent limits on the widths of these processes: Γ ( 82 Se → 82 Kr 0 1 + )8.55 × 10 - 24 yr - 1 , Γ ( 82 Se → 82 Kr 2 1 + ) < 6.25 × 10 - 24 yr - 1 , Γ ( 82 Se → 82 Kr 2 2 + )8.25 × 10 - 24 yr - 1 (90 % credible interval).
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Affiliation(s)
- O. Azzolini
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padova Italy
| | - M. T. Barrera
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padova Italy
| | - J. W. Beeman
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720 USA
| | - F. Bellini
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - M. Beretta
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - M. Biassoni
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - E. Bossio
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - C. Brofferio
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - C. Bucci
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - L. Canonica
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Present Address: Max-Planck-Institut für Physik, 80805 Munich, Germany
| | - S. Capelli
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - L. Cardani
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - P. Carniti
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - N. Casali
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - L. Cassina
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - M. Clemenza
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - O. Cremonesi
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | | | - A. D’Addabbo
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Gran Sasso Science Institute, 67100 L’Aquila, Italy
| | - I. Dafinei
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - S. Di Domizio
- Dipartimento di Fisica, Università di Genova, 16146 Genoa, Italy
- INFN, Sezione di Genova, 16146 Genoa, Italy
| | - F. Ferroni
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - L. Gironi
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - A. Giuliani
- CSNSM, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay, France
- DiSAT, Università dell’Insubria, 22100 Como, Italy
| | - P. Gorla
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - C. Gotti
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - G. Keppel
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padova Italy
| | - M. Martinez
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
- Present Address: Fundacion ARAID and U. Zaragoza, C/ Pedro Cerbuna 12, 50009 Zaragoza, Spain
| | | | - S. Nagorny
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Gran Sasso Science Institute, 67100 L’Aquila, Italy
- Present Address: Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Nastasi
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - S. Nisi
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - C. Nones
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - D. Orlandi
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - L. Pagnanini
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - M. Pallavicini
- Dipartimento di Fisica, Università di Genova, 16146 Genoa, Italy
- INFN, Sezione di Genova, 16146 Genoa, Italy
| | - V. Palmieri
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padova Italy
| | - L. Pattavina
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Gran Sasso Science Institute, 67100 L’Aquila, Italy
- Present Address: Physik Department, Technische Universität München, D85748 Garching, Germany
| | - M. Pavan
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - G. Pessina
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - V. Pettinacci
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - S. Pirro
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - S. Pozzi
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - E. Previtali
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - A. Puiu
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - C. Rusconi
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Department of Physics and Astronomy, University of South Carolina, Columbia, SC 29208 USA
| | - K. Schäffner
- Gran Sasso Science Institute, 67100 L’Aquila, Italy
| | - C. Tomei
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - M. Vignati
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - A. Zolotarova
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
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36
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Azzolini O, Barrera MT, Beeman JW, Bellini F, Beretta M, Biassoni M, Bossio E, Brofferio C, Bucci C, Canonica L, Capelli S, Cardani L, Carniti P, Casali N, Cassina L, Clemenza M, Cremonesi O, Cruciani A, D’Addabbo A, Dafinei I, Domizio SD, Ferroni F, Gironi L, Giuliani A, Gorla P, Gotti C, Keppel G, Martinez M, Morganti S, Nagorny S, Nastasi M, Nisi S, Nones C, Orlandi D, Pagnanini L, Pallavicini M, Palmieri V, Pattavina L, Pavan M, Pessina G, Pettinacci V, Pirro S, Pozzi S, Previtali E, Puiu A, Rusconi C, Schäffner K, Tomei C, Vignati M, Zolotarova A. Analysis of cryogenic calorimeters with light and heat read-out for double beta decay searches. Eur Phys J C Part Fields 2018; 78:734. [PMID: 30839752 PMCID: PMC6190965 DOI: 10.1140/epjc/s10052-018-6202-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/28/2018] [Indexed: 06/09/2023]
Abstract
The suppression of spurious events in the region of interest for neutrinoless double beta decay will play a major role in next generation experiments. The background of detectors based on the technology of cryogenic calorimeters is expected to be dominated by α particles, that could be disentangled from double beta decay signals by exploiting the difference in the emission of the scintillation light. CUPID-0, an array of enriched Zn 82 Se scintillating calorimeters, is the first large mass demonstrator of this technology. The detector started data-taking in 2017 at the Laboratori Nazionali del Gran Sasso with the aim of proving that dual read-out of light and heat allows for an efficient suppression of the α background. In this paper we describe the software tools we developed for the analysis of scintillating calorimeters and we demonstrate that this technology allows to reach an unprecedented background for cryogenic calorimeters.
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Affiliation(s)
- O. Azzolini
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padua Italy
| | - M. T. Barrera
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padua Italy
| | - J. W. Beeman
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720 USA
| | - F. Bellini
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - M. Beretta
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - M. Biassoni
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - E. Bossio
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - C. Brofferio
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - C. Bucci
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - L. Canonica
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Present Address: Max-Planck-Institut für Physik, 80805 Munich, Germany
| | - S. Capelli
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - L. Cardani
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - P. Carniti
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - N. Casali
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - L. Cassina
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - M. Clemenza
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - O. Cremonesi
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | | | - A. D’Addabbo
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- GSSI, Gran Sasso Science Institute, 67100 L’Aquila, Italy
| | - I. Dafinei
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - S. Di Domizio
- Dipartimento di Fisica, Università di Genova, 16146 Genoa, Italy
- INFN, Sezione di Genova, 16146 Genoa, Italy
| | - F. Ferroni
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - L. Gironi
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - A. Giuliani
- CSNSM, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay, France
- DiSAT, Università dell’Insubria, 22100 Como, Italy
| | - P. Gorla
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - C. Gotti
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - G. Keppel
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padua Italy
| | - M. Martinez
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
- Present Address: Universidad de Zaragoza, 50009 Zaragoza, Spain
| | | | - S. Nagorny
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- GSSI, Gran Sasso Science Institute, 67100 L’Aquila, Italy
- Present Address: Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Nastasi
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - S. Nisi
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - C. Nones
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - D. Orlandi
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - L. Pagnanini
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - M. Pallavicini
- Dipartimento di Fisica, Università di Genova, 16146 Genoa, Italy
- INFN, Sezione di Genova, 16146 Genoa, Italy
| | - V. Palmieri
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padua Italy
| | - L. Pattavina
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- GSSI, Gran Sasso Science Institute, 67100 L’Aquila, Italy
| | - M. Pavan
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - G. Pessina
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - V. Pettinacci
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - S. Pirro
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - S. Pozzi
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - E. Previtali
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - A. Puiu
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - C. Rusconi
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Department of Physics and Astronomy, University of South Carolina, Columbia, SC 29208 USA
| | - K. Schäffner
- GSSI, Gran Sasso Science Institute, 67100 L’Aquila, Italy
| | - C. Tomei
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - M. Vignati
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - A. Zolotarova
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
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37
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La Rosa G, Narducci ML, Pelargonio G, Bianco M, Almohani A, Bencardino G, Perna F, Inzani F, Novelli V, Marano R, Spera F, Pinnacchio G, Palmieri V, Zeppilli P, Crea F. P1016Ventricular arrhythmias in athletes and non-athletes: diagnostic role of electroanatomic mapping and CARTO-guided endomyocardial biopsy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p1016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- G La Rosa
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - M L Narducci
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - G Pelargonio
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - M Bianco
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - A Almohani
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - G Bencardino
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - F Perna
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - F Inzani
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - V Novelli
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - R Marano
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - F Spera
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - G Pinnacchio
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - V Palmieri
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - P Zeppilli
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
| | - F Crea
- Catholic University of the Sacred Heart, Department of Cardiovascular Medicine, Rome, Italy
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38
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Palmieri V, Palermo A. Patients’ self-evaluation of symptoms, signs and compliance to therapy for heart failure surveillance: A pilot study on identification of worsening heart failure. Monaldi Arch Chest Dis 2018; 88:919. [DOI: 10.4081/monaldi.2018.919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/12/2018] [Accepted: 06/22/2018] [Indexed: 11/23/2022] Open
Abstract
In patients with chronic heart failure (HF), it is unclear whether self-evaluation of HF-related symptoms and signs may contribute to the surveillance of clinical stability over time or the early identification of worsening HF. Therefore, HF-related symptoms and signs, and compliance to therapy were investigated by a self-administrated questionnaire in patients hospitalized due to worsening HF (cases) as well in those with stable HF (controls). The temporal interval of interest for the questionnaire focused on 2 to 7 days before the hospitalization of the control visit. A method called “classic” extrapolated a surveillance score by 4 questions revealing HF-related symptoms or signs (higher score indicative of more symptoms or sings reported). Alternatively, 3 additional questions enriched the “classic” questionnaire, including one on whether the health status was perceived as stable, improved or worsening. The score from “perceived health status” inquiry was used as “conditional factor” to computed the surveillance score as: conditional factor + [conditional factor X (the sum of the points yielded by the responses to each question on symptoms, sings and compliance to therapy)]. Among 51 patients hospitalized due to worsening HF and 104 with chronic HF (retrospective study), the area under the curve (receiver operating characteristic) discriminating worsening HF was 0.90 by the classic, and 0.96 by the conditional method (both p<0.001), yielding error rates of 2 in 10 by the classic and 1 in 10 by the conditional method. In a pilot longitudinal study in 37 ambulatory HF patients from a different population source, predicting worsening HF by alternative questionnaires within 12 weeks from the visit yielded consistent results. In conclusion, patients’ self-monitoring symptoms, signs and compliance by a standardized questionnaire and a conditional method for generating relative a score, may be a promising method for HF stability surveillance.
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39
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Azzolini O, Barrera MT, Beeman JW, Bellini F, Beretta M, Biassoni M, Brofferio C, Bucci C, Canonica L, Capelli S, Cardani L, Carniti P, Casali N, Cassina L, Clemenza M, Cremonesi O, Cruciani A, D'Addabbo A, Dafinei I, Di Domizio S, Ferroni F, Gironi L, Giuliani A, Gorla P, Gotti C, Keppel G, Marini L, Martinez M, Morganti S, Nagorny S, Nastasi M, Nisi S, Nones C, Orlandi D, Pagnanini L, Pallavicini M, Palmieri V, Pattavina L, Pavan M, Pessina G, Pettinacci V, Pirro S, Pozzi S, Previtali E, Puiu A, Reindl F, Rusconi C, Schäffner K, Tomei C, Vignati M, Zolotarova AS. First Result on the Neutrinoless Double-β Decay of ^{82}Se with CUPID-0. Phys Rev Lett 2018; 120:232502. [PMID: 29932707 DOI: 10.1103/physrevlett.120.232502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/16/2018] [Indexed: 06/08/2023]
Abstract
We report the result of the search for neutrinoless double beta decay of ^{82}Se obtained with CUPID-0, the first large array of scintillating Zn^{82}Se cryogenic calorimeters implementing particle identification. We observe no signal in a 1.83 kg yr ^{82}Se exposure, and we set the most stringent lower limit on the 0νββ ^{82}Se half-life T_{1/2}^{0ν}>2.4×10^{24} yr (90% credible interval), which corresponds to an effective Majorana neutrino mass m_{ββ}<(376-770) meV depending on the nuclear matrix element calculations. The heat-light readout provides a powerful tool for the rejection of α particles and allows us to suppress the background in the region of interest down to (3.6_{-1.4}^{+1.9})×10^{-3} counts/(keV kg yr), an unprecedented level for this technique.
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Affiliation(s)
- O Azzolini
- INFN Laboratori Nazionali di Legnaro, I-35020 Legnaro (Pd), Italy
| | - M T Barrera
- INFN Laboratori Nazionali di Legnaro, I-35020 Legnaro (Pd), Italy
| | - J W Beeman
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - F Bellini
- Dipartimento di Fisica, Sapienza Università di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - M Beretta
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - M Biassoni
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - C Brofferio
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - C Bucci
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
| | - L Canonica
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - S Capelli
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - L Cardani
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - P Carniti
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - N Casali
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - L Cassina
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - M Clemenza
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - O Cremonesi
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - A Cruciani
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - A D'Addabbo
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
| | - I Dafinei
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - S Di Domizio
- Dipartimento di Fisica, Università di Genova, I-16146 Genova, Italy
- INFN Sezione di Genova, I-16146 Genova, Italy
| | - F Ferroni
- Dipartimento di Fisica, Sapienza Università di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - L Gironi
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - A Giuliani
- CNRS/CSNSM, Centre de Sciences Nucléaires et de Sciences de la Matière, 91405 Orsay, France
- DISAT, Università dell'Insubria, 22100 Como, Italy
| | - P Gorla
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
| | - C Gotti
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - G Keppel
- INFN Laboratori Nazionali di Legnaro, I-35020 Legnaro (Pd), Italy
| | - L Marini
- Dipartimento di Fisica, Università di Genova, I-16146 Genova, Italy
- INFN Sezione di Genova, I-16146 Genova, Italy
| | - M Martinez
- Dipartimento di Fisica, Sapienza Università di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - S Morganti
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - S Nagorny
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
- Gran Sasso Science Institute, 67100 L'Aquila, Italy
| | - M Nastasi
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - S Nisi
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
| | - C Nones
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - D Orlandi
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
| | - L Pagnanini
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
- Gran Sasso Science Institute, 67100 L'Aquila, Italy
| | - M Pallavicini
- Dipartimento di Fisica, Università di Genova, I-16146 Genova, Italy
- INFN Sezione di Genova, I-16146 Genova, Italy
| | - V Palmieri
- INFN Laboratori Nazionali di Legnaro, I-35020 Legnaro (Pd), Italy
| | - L Pattavina
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
- Gran Sasso Science Institute, 67100 L'Aquila, Italy
| | - M Pavan
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - G Pessina
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - V Pettinacci
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - S Pirro
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
| | - S Pozzi
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - E Previtali
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - A Puiu
- Dipartimento di Fisica, Università di Milano Bicocca, I-20126 Milano, Italy
- INFN Sezione di Milano Bicocca, I-20126 Milano, Italy
| | - F Reindl
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - C Rusconi
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - K Schäffner
- INFN Laboratori Nazionali del Gran Sasso, I-67100 Assergi (AQ), Italy
- Gran Sasso Science Institute, 67100 L'Aquila, Italy
| | - C Tomei
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - M Vignati
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Roma, Italy
| | - A S Zolotarova
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
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Bugli F, Cacaci M, Palmieri V, Di Santo R, Torelli R, Ciasca G, Di Vito M, Vitali A, Conti C, Sanguinetti M, De Spirito M, Papi M. Curcumin-loaded graphene oxide flakes as an effective antibacterial system against methicillin-resistant Staphylococcus aureus. Interface Focus 2018; 8:20170059. [PMID: 29696091 PMCID: PMC5915661 DOI: 10.1098/rsfs.2017.0059] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2018] [Indexed: 12/16/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for serious hospital infections worldwide and represents a global public health problem. Curcumin, the major constituent of turmeric, is effective against MRSA but only at cytotoxic concentrations or in combination with antibiotics. The major issue in curcumin-based therapies is the poor solubility of this hydrophobic compound and the cytotoxicity at high doses. In this paper, we describe the efficacy of a composite nanoparticle made of curcumin (CU) and graphene oxide (GO), hereafter GOCU, in MRSA infection treatment. GO is a nanomaterial with a large surface area and high drug-loading capacity. GO has also antibacterial properties due mainly to a mechanical cutting of the bacterial membranes. For this physical mechanism of action, microorganisms are unlikely to develop resistance against this nanomaterial. In this work, we report the capacity of GO to support and stabilize curcumin molecules in a water environment and we demonstrate the efficacy of GOCU against MRSA at a concentration below 2 µg ml-1. Further, GOCU displays low toxicity on fibroblasts cells and avoids haemolysis of red blood cells. Our results indicate that GOCU is a promising nanomaterial against antibiotic-resistant MRSA.
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Affiliation(s)
- F. Bugli
- Microbiology Institute, Fondazione Policlinico Universitario A. Gemelli, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
| | - M. Cacaci
- Microbiology Institute, Fondazione Policlinico Universitario A. Gemelli, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
| | - V. Palmieri
- Physics Institute, Fondazione Policlinico Universitario A. Gemelli, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
- Institute for Complex Systems, National Research Council (ISC-CNR), Via dei Taurini 19, 00185 Rome, Italy
| | - R. Di Santo
- Physics Institute, Fondazione Policlinico Universitario A. Gemelli, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
| | - R. Torelli
- Microbiology Institute, Fondazione Policlinico Universitario A. Gemelli, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
| | - G. Ciasca
- Physics Institute, Fondazione Policlinico Universitario A. Gemelli, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
| | - M. Di Vito
- Microbiology Institute, Fondazione Policlinico Universitario A. Gemelli, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
- Dipartimento Scienze Agrarie Università di Bologna Alma Mater Studorium, Bologna, Italy
| | - A. Vitali
- CNR-ICRM, c/o Institute of Biochemistry and Clinical Biochemistry, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
| | - C. Conti
- CNR-ICRM, c/o Institute of Biochemistry and Clinical Biochemistry, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
| | - M. Sanguinetti
- Microbiology Institute, Fondazione Policlinico Universitario A. Gemelli, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
| | - M. De Spirito
- Physics Institute, Fondazione Policlinico Universitario A. Gemelli, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
| | - M. Papi
- Physics Institute, Fondazione Policlinico Universitario A. Gemelli, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
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Azzolini O, Barrera MT, Beeman JW, Bellini F, Beretta M, Biassoni M, Brofferio C, Bucci C, Canonica L, Capelli S, Cardani L, Carniti P, Casali N, Cassina L, Clemenza M, Cremonesi O, Cruciani A, D’Addabbo A, Dafinei I, Domizio SD, Ferroni F, Gironi L, Giuliani A, Gorla P, Gotti C, Keppel G, Martinez M, Morganti S, Nagorny S, Nastasi M, Nisi S, Nones C, Orlandi D, Pagnanini L, Pallavicini M, Palmieri V, Pattavina L, Pavan M, Pessina G, Pettinacci V, Pirro S, Pozzi S, Previtali E, Puiu A, Reindl F, Rusconi C, Schäffner K, Tomei C, Vignati M, Zolotarova A. CUPID-0: the first array of enriched scintillating bolometers for 0 ν β β decay investigations. Eur Phys J C Part Fields 2018; 78:428. [PMID: 30996670 PMCID: PMC6435222 DOI: 10.1140/epjc/s10052-018-5896-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/14/2018] [Indexed: 06/09/2023]
Abstract
The CUPID-0 detector hosted at the Laboratori Nazionali del Gran Sasso, Italy, is the first large array of enriched scintillating cryogenic detectors for the investigation of82 Se neutrinoless double-beta decay ( 0 ν β β ). CUPID-0 aims at measuring a background index in the region of interest (RoI) for 0 ν β β at the level of 10- 3 counts/(keV kg years), the lowest value ever measured using cryogenic detectors. CUPID-0 operates an array of Zn82 Se scintillating bolometers coupled with bolometric light detectors, with a state of the art technology for background suppression and thorough protocols and procedures for the detector preparation and construction. In this paper, the different phases of the detector design and construction will be presented, from the material selection (for the absorber production) to the new and innovative detector structure. The successful construction of the detector lead to promising preliminary detector performance which is discussed here.
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Affiliation(s)
- O. Azzolini
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padua Italy
| | - M. T. Barrera
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padua Italy
| | - J. W. Beeman
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720 USA
| | - F. Bellini
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - M. Beretta
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - M. Biassoni
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - C. Brofferio
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - C. Bucci
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - L. Canonica
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Massachusetts Institute of Technology, Cambridge, MA 02139 USA
- Present Address: Max-Planck-Institut fur Physik, 80805 Munich, Germany
| | - S. Capelli
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - L. Cardani
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - P. Carniti
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - N. Casali
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - L. Cassina
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - M. Clemenza
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - O. Cremonesi
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - A. Cruciani
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - A. D’Addabbo
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - I. Dafinei
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - S. Di Domizio
- Dipartimento di Fisica, Università di Genova, 16146 Genoa, Italy
- INFN, Sezione di Genova, 16146 Genoa, Italy
| | - F. Ferroni
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - L. Gironi
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - A. Giuliani
- CSNSM, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay, France
- DiSAT, Università dell’Insubria, 22100 Como, Italy
| | - P. Gorla
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - C. Gotti
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - G. Keppel
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padua Italy
| | - M. Martinez
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | | | - S. Nagorny
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Gran Sasso Science Institute, 67100 L’Aquila, Italy
| | - M. Nastasi
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - S. Nisi
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - C. Nones
- CEA-Saclay, DSM/IRFU, 91191 Gif-sur-Yvette Cedex, France
| | - D. Orlandi
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - L. Pagnanini
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Gran Sasso Science Institute, 67100 L’Aquila, Italy
| | - M. Pallavicini
- Dipartimento di Fisica, Università di Genova, 16146 Genoa, Italy
- INFN, Sezione di Genova, 16146 Genoa, Italy
| | - V. Palmieri
- INFN, Laboratori Nazionali di Legnaro, 35020 Legnaro, Padua Italy
| | - L. Pattavina
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Gran Sasso Science Institute, 67100 L’Aquila, Italy
| | - M. Pavan
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - G. Pessina
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - V. Pettinacci
- Dipartimento di Fisica, Sapienza Università di Roma, 00185 Rome, Italy
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - S. Pirro
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
| | - S. Pozzi
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - E. Previtali
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - A. Puiu
- Dipartimento di Fisica, Università di Milano-Bicocca, 20126 Milan, Italy
- INFN, Sezione di Milano Bicocca, 20126 Milan, Italy
| | - F. Reindl
- INFN, Sezione di Roma, 00185 Rome, Italy
- Institut fur Hochenergiephysik der AW, 1050 Wien, Austria
- Atominstitut, Technical University Vienna, 1020 Wien, Austria
| | - C. Rusconi
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Department of Physics and Astronomy, University of South Carolina, Columbia, SC 29208 USA
| | - K. Schäffner
- INFN, Laboratori Nazionali del Gran Sasso, Assergi, 67010 L’Aquila, Italy
- Gran Sasso Science Institute, 67100 L’Aquila, Italy
| | - C. Tomei
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - M. Vignati
- INFN, Sezione di Roma, 00185 Rome, Italy
| | - A. Zolotarova
- CEA-Saclay, DSM/IRFU, 91191 Gif-sur-Yvette Cedex, France
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Palmieri V, Innocenti F, Guzzo A, Donnini C, Stefanone VT, Pini R. Left ventricular global longitudinal systolic function predicts mortality in sepsis independent to the shock index. ACTA ACUST UNITED AC 2018. [DOI: 10.21037/jeccm.2018.04.01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Alduino C, Alessandria F, Alfonso K, Andreotti E, Arnaboldi C, Avignone FT, Azzolini O, Balata M, Bandac I, Banks TI, Bari G, Barucci M, Beeman JW, Bellini F, Benato G, Bersani A, Biare D, Biassoni M, Bragazzi F, Branca A, Brofferio C, Bryant A, Buccheri A, Bucci C, Bulfon C, Camacho A, Caminata A, Canonica L, Cao XG, Capelli S, Capodiferro M, Cappelli L, Cardani L, Cariello M, Carniti P, Carrettoni M, Casali N, Cassina L, Cereseto R, Ceruti G, Chiarini A, Chiesa D, Chott N, Clemenza M, Conventi D, Copello S, Cosmelli C, Cremonesi O, Crescentini C, Creswick RJ, Cushman JS, D'Addabbo A, D'Aguanno D, Dafinei I, Datskov V, Davis CJ, Del Corso F, Dell'Oro S, Deninno MM, Di Domizio S, Di Vacri ML, Di Paolo L, Drobizhev A, Ejzak L, Faccini R, Fang DQ, Faverzani M, Ferri E, Ferroni F, Fiorini E, Franceschi MA, Freedman SJ, Fujikawa BK, Gaigher R, Giachero A, Gironi L, Giuliani A, Gladstone L, Goett J, Gorla P, Gotti C, Guandalini C, Guerzoni M, Gutierrez TD, Haller EE, Han K, Hansen EV, Heeger KM, Hennings-Yeomans R, Hickerson KP, Huang HZ, Iannone M, Ioannucci L, Kadel R, Keppel G, Kogler L, Kolomensky YG, Leder A, Ligi C, Lim KE, Liu X, Ma YG, Maiano C, Maino M, Marini L, Martinez M, Martinez Amaya C, Maruyama RH, Mei Y, Moggi N, Morganti S, Mosteiro PJ, Nagorny SS, Napolitano T, Nastasi M, Nisi S, Nones C, Norman EB, Novati V, Nucciotti A, Nutini I, O'Donnell T, Olcese M, Olivieri E, Orio F, Orlandi D, Ouellet JL, Pagliarone CE, Pallavicini M, Palmieri V, Pattavina L, Pavan M, Pedretti M, Pedrotta R, Pelosi A, Pessina G, Pettinacci V, Piperno G, Pira C, Pirro S, Pozzi S, Previtali E, Reindl F, Rimondi F, Risegari L, Rosenfeld C, Rossi C, Rusconi C, Sakai M, Sala E, Salvioni C, Sangiorgio S, Santone D, Schaeffer D, Schmidt B, Schmidt J, Scielzo ND, Singh V, Sisti M, Smith AR, Stivanello F, Taffarello L, Tatananni L, Tenconi M, Terranova F, Tessaro M, Tomei C, Ventura G, Vignati M, Wagaarachchi SL, Wallig J, Wang BS, Wang HW, Welliver B, Wilson J, Wilson K, Winslow LA, Wise T, Zanotti L, Zarra C, Zhang GQ, Zhu BX, Zimmermann S, Zucchelli S. First Results from CUORE: A Search for Lepton Number Violation via 0νββ Decay of ^{130}Te. Phys Rev Lett 2018; 120:132501. [PMID: 29694201 DOI: 10.1103/physrevlett.120.132501] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Indexed: 06/08/2023]
Abstract
The CUORE experiment, a ton-scale cryogenic bolometer array, recently began operation at the Laboratori Nazionali del Gran Sasso in Italy. The array represents a significant advancement in this technology, and in this work we apply it for the first time to a high-sensitivity search for a lepton-number-violating process: ^{130}Te neutrinoless double-beta decay. Examining a total TeO_{2} exposure of 86.3 kg yr, characterized by an effective energy resolution of (7.7±0.5) keV FWHM and a background in the region of interest of (0.014±0.002) counts/(keV kg yr), we find no evidence for neutrinoless double-beta decay. Including systematic uncertainties, we place a lower limit on the decay half-life of T_{1/2}^{0ν}(^{130}Te)>1.3×10^{25} yr (90% C.L.); the median statistical sensitivity of this search is 7.0×10^{24} yr. Combining this result with those of two earlier experiments, Cuoricino and CUORE-0, we find T_{1/2}^{0ν}(^{130}Te)>1.5×10^{25} yr (90% C.L.), which is the most stringent limit to date on this decay. Interpreting this result as a limit on the effective Majorana neutrino mass, we find m_{ββ}<(110-520) meV, where the range reflects the nuclear matrix element estimates employed.
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Affiliation(s)
- C Alduino
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | | | - K Alfonso
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - E Andreotti
- Dipartimento di Fisica e Matematica, Università dell'Insubria, Como I-22100, Italy
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - C Arnaboldi
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - F T Avignone
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - O Azzolini
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - M Balata
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - I Bandac
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - T I Banks
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - G Bari
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - M Barucci
- Dipartimento di Fisica, Università di Firenze, Firenze I-50125, Italy
- INFN - Sezione di Firenze, Firenze I-50125, Italy
| | - J W Beeman
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - F Bellini
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - G Benato
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - A Bersani
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - D Biare
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - M Biassoni
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - F Bragazzi
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - A Branca
- INFN - Sezione di Padova, Padova I-35131, Italy
| | - C Brofferio
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A Bryant
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Buccheri
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - C Bucci
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - C Bulfon
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - A Camacho
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - A Caminata
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - L Canonica
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - X G Cao
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - S Capelli
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | | | - L Cappelli
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - L Cardani
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - M Cariello
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - P Carniti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M Carrettoni
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - N Casali
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - L Cassina
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - R Cereseto
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - G Ceruti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - A Chiarini
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - D Chiesa
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - N Chott
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - M Clemenza
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - D Conventi
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - S Copello
- INFN - Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - C Cosmelli
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - O Cremonesi
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | | | - R J Creswick
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - J S Cushman
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - A D'Addabbo
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - D D'Aguanno
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Ingegneria Civile e Meccanica, Università degli Studi di Cassino e del Lazio Meridionale, Cassino I-03043, Italy
| | - I Dafinei
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - V Datskov
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - C J Davis
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - F Del Corso
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - S Dell'Oro
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
- INFN - Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - M M Deninno
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - S Di Domizio
- INFN - Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - M L Di Vacri
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Scienze Fisiche e Chimiche, Università dell'Aquila, L'Aquila I-67100, Italy
| | - L Di Paolo
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Drobizhev
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - L Ejzak
- Department of Physics, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - R Faccini
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - D Q Fang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - M Faverzani
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - E Ferri
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - F Ferroni
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - E Fiorini
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M A Franceschi
- INFN - Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - S J Freedman
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B K Fujikawa
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - R Gaigher
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - A Giachero
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - L Gironi
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A Giuliani
- CSNSM, Univ. Paris-Sud, CNRS/IN2P3, Universit Paris-Saclay, 91405 Orsay, France
| | - L Gladstone
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J Goett
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - P Gorla
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - C Gotti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Guandalini
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - M Guerzoni
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - T D Gutierrez
- Physics Department, California Polytechnic State University, San Luis Obispo, California 93407, USA
| | - E E Haller
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
| | - K Han
- INPAC and School of Physics and Astronomy, Shanghai Jiao Tong University; Shanghai Laboratory for Particle Physics and Cosmology, Shanghai 200240, China
| | - E V Hansen
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - K M Heeger
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R Hennings-Yeomans
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - K P Hickerson
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - H Z Huang
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - M Iannone
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - L Ioannucci
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - R Kadel
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - G Keppel
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - L Kogler
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - Yu G Kolomensky
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Leder
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - C Ligi
- INFN - Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - K E Lim
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - X Liu
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - Y G Ma
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - C Maiano
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M Maino
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - L Marini
- INFN - Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - M Martinez
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
- Laboratorio de Fisica Nuclear y Astroparticulas, Universidad de Zaragoza, Zaragoza 50009, Spain
| | - C Martinez Amaya
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - R H Maruyama
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Mei
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - N Moggi
- INFN - Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum - Università di Bologna, Bologna I-40127, Italy
| | - S Morganti
- INFN - Sezione di Roma, Roma I-00185, Italy
| | | | - S S Nagorny
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- INFN - Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - T Napolitano
- INFN - Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - M Nastasi
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - S Nisi
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - C Nones
- Service de Physique des Particules, CEA / Saclay, 91191 Gif-sur-Yvette, France
| | - E B Norman
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - V Novati
- CSNSM, Univ. Paris-Sud, CNRS/IN2P3, Universit Paris-Saclay, 91405 Orsay, France
| | - A Nucciotti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - I Nutini
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- INFN - Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - T O'Donnell
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - M Olcese
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - E Olivieri
- Dipartimento di Fisica, Università di Firenze, Firenze I-50125, Italy
- INFN - Sezione di Firenze, Firenze I-50125, Italy
| | - F Orio
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - D Orlandi
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - J L Ouellet
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - C E Pagliarone
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Ingegneria Civile e Meccanica, Università degli Studi di Cassino e del Lazio Meridionale, Cassino I-03043, Italy
| | - M Pallavicini
- INFN - Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - V Palmieri
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - L Pattavina
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Pavan
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M Pedretti
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Pedrotta
- INFN - Sezione di Padova, Padova I-35131, Italy
| | - A Pelosi
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - G Pessina
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | | | - G Piperno
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - C Pira
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - S Pirro
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - S Pozzi
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - E Previtali
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - F Reindl
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - F Rimondi
- INFN - Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum - Università di Bologna, Bologna I-40127, Italy
| | - L Risegari
- Dipartimento di Fisica, Università di Firenze, Firenze I-50125, Italy
- INFN - Sezione di Firenze, Firenze I-50125, Italy
| | - C Rosenfeld
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - C Rossi
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - C Rusconi
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Sakai
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - E Sala
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Salvioni
- Dipartimento di Fisica e Matematica, Università dell'Insubria, Como I-22100, Italy
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - S Sangiorgio
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D Santone
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Scienze Fisiche e Chimiche, Università dell'Aquila, L'Aquila I-67100, Italy
| | - D Schaeffer
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - B Schmidt
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Schmidt
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - N D Scielzo
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - V Singh
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - M Sisti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A R Smith
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - F Stivanello
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | | | - L Tatananni
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Tenconi
- CSNSM, Univ. Paris-Sud, CNRS/IN2P3, Universit Paris-Saclay, 91405 Orsay, France
| | - F Terranova
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M Tessaro
- INFN - Sezione di Padova, Padova I-35131, Italy
| | - C Tomei
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - G Ventura
- Dipartimento di Fisica, Università di Firenze, Firenze I-50125, Italy
- INFN - Sezione di Firenze, Firenze I-50125, Italy
| | - M Vignati
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - S L Wagaarachchi
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Wallig
- Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B S Wang
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - H W Wang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - B Welliver
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Wilson
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - K Wilson
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - L A Winslow
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - T Wise
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
- Department of Physics, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - L Zanotti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Zarra
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - G Q Zhang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - B X Zhu
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - S Zimmermann
- Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S Zucchelli
- INFN - Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum - Università di Bologna, Bologna I-40127, Italy
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Innocenti F, Palmieri V, Guzzo A, Stefanone VT, Donnini C, Pini R. SOFA score and left ventricular systolic function as predictors of short-term outcome in patients with sepsis. Intern Emerg Med 2018; 13:51-58. [PMID: 27909859 DOI: 10.1007/s11739-016-1579-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 07/25/2016] [Accepted: 11/19/2016] [Indexed: 01/25/2023]
Abstract
In a group of septic patients, we assess the short-term prognostic value of LV systolic performance, evaluated through conventional left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (LV GLS). One hundred forty-seven patients with sepsis were recruited; LVEF by planimetry and peak GLS by 2D speckle tracking could be assessed within 24 h. The study population was stratified according to SOFA tertiles assessed at the time of the echocardiogram (G1: SOFA score <5; G2: SOFA score 5-7; G3: SOFA score >7). Day-7 follow-up data were used as reference. Patients in G2 and G3 show a significant hemodynamic derangement, paralleling the more pronounced organ damage by definition; nevertheless, LVEF and GLS are comparable among the three groups (both p > 0.1). All-cause mortality at day-7 follow-up is slightly lower in G1 (9%) versus G2 and G3 (14 and 26%, respectively, p = NS). Analyses through ROC curves focusing on day-7 mortality show that the SOFA score fairly correlates with events (AUC 0.635, p = 0.037), while low LVEF (AUC 0.35, p = 0.022) and less negative GLS (AUC 0.73, p = 0.001) do so. In multivariate analyses, mortality by day-7 follow-up is more likely per higher GLS (i.e., indicative of worst systolic dysfunction, HR 1.22/%, p = 0.005) and per increasing SOFA score (HR 1.22/unit, p = 0.010), whereas LVEF, adjusted for age and SOFA score, does not enter the prognostic model. In the very short term in patients with severe sepsis, LV systolic function assessment by means of GLS predicts the short-term prognosis, independent of SOFA.
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Affiliation(s)
- Francesca Innocenti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy.
| | - Vittorio Palmieri
- Cardiology Unit, Department of Heart and Vessels, SG Moscati National Hospital, Avellino, Italy
| | - Aurelia Guzzo
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Valerio Teodoro Stefanone
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Chiara Donnini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Riccardo Pini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
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Amato F, Duse G, Consoletti L, Lo Presti C, Firetto V, Ciliberto G, Parigi LA, Palmieri V, Mazza M. Efficacy and safety of 5% lidocaine-medicated plasters in localized pain with neuropathic and/or inflammatory characteristics: an observational, real-world study. Eur Rev Med Pharmacol Sci 2017; 21:4228-4235. [PMID: 29028074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Based on clinical study results, 5% lidocaine-medicated plaster (5% LMP) is currently recommended for the treatment of localized peripheral neuropathic pain, such as post-herpetic neuralgia (PHN). However, its effective action, as well as the high safety, have indeed led to its use in clinical practice for pain conditions with similar pathophysiological mechanisms. In this study, the efficacy and safety of 5% LMP were investigated in patients with localized pain with neuropathic and/or inflammatory characteristics, such as PHN, post-traumatic/surgical or musculoskeletal pain. PATIENTS AND METHODS 503 patients with localized pain treated with 5% LMP were evaluated at baseline (T0), after 30 days (T30) and after 60 days (T60). The primary endpoint was number and proportion of 30% responders at T60, whereas secondary endpoints included number and proportion of 30% responders at T30, mean pain intensity, mean extension of the painful area, dynamic mechanical allodynia and quality of sleep. Evaluations were assessed in all patients and subgroups based on different clinical entities. Concomitant treatments and adverse reactions were also recorded. RESULTS 72% and 90% of all patients responded to 5% LMP treatment at T30 and T60, respectively. Comparable results were also obtained in subgroups such as PHN patients (72% and 68% at T30 and T60, respectively), and musculoskeletal pain (73% and 83% at T30 and T60, respectively). The mean pain intensity, as well as the extension of the painful area, significantly decreased during the study, in all patients and each subgroup. In addition, secondary endpoints significantly improved at each time-point compared with baseline, in all groups. CONCLUSIONS The effectiveness and safety of 5% LMP were shown in localized pain conditions such as neuropathic and, importantly, in musculoskeletal pain, a condition never investigated with this product. This field-practice study suggests that topical pain-reducing strategies such as 5% LMP could be effective in neuropathic and/or inflammatory, localized pain conditions.
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Affiliation(s)
- F Amato
- Pain Therapy Regional Hub, Cosenza Hospital, Cosenza, Italy.
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Palmieri V, Bozzi M, Signorino G, Papi M, De Spirito M, Brancaccio A, Maulucci G, Sciandra F. α-Dystroglycan hypoglycosylation affects cell migration by influencing β-dystroglycan membrane clustering and filopodia length: A multiscale confocal microscopy analysis. Biochim Biophys Acta Mol Basis Dis 2017; 1863:2182-2191. [DOI: 10.1016/j.bbadis.2017.05.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/05/2017] [Accepted: 05/28/2017] [Indexed: 12/26/2022]
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47
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Papi M, Caputo D, Palmieri V, Coppola R, Palchetti S, Bugli F, Martini C, Digiacomo L, Pozzi D, Caracciolo G. Clinically approved PEGylated nanoparticles are covered by a protein corona that boosts the uptake by cancer cells. Nanoscale 2017; 9:10327-10334. [PMID: 28702661 DOI: 10.1039/c7nr03042h] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Today, liposomes are an advanced technology of drug carriers with a dozen drugs in clinical practice and many more in clinical trials. A bottleneck associated with the clinical translation of liposomes has long been 'opsonization', i.e. the adsorption of plasma proteins at the liposome surface resulting in their rapid clearance from circulation. For decades, the most popular way to avoid opsonization has been grafting polyethylene glycol (PEG) onto the liposome surface. Recent studies have clarified that grafting PEG onto the liposome surface reduces, but does not completely prevent protein binding. In this work, we employed dynamic light scattering, zeta-potential analysis, one-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis (1D-SDS-PAGE), semi-quantitative densitometry and cell imaging to explore the bio-nano-interactions between human plasma (HP) and Onivyde, a PEGylated liposomal drug that has recently been approved by the Food and Drug Administration (FDA) for the treatment of metastatic pancreatic ductal adenocarcinoma (PDAC). To properly evaluate the role of PEGylation, an unPEGylated variant of Onivyde was used as a reference. Collectively, our findings suggest that: (i) although PEGylated, Onivyde is not "stealth" in HP; (ii) surface chemistry is more important than PEGylation in controlling the bio-nano-interactions between Onivyde and plasma components. Of note is that the PC was found to boost the cellular uptake of Onivyde in the pancreas ductal adenocarcinoma cell line (PANC-1) thus suggesting its prominent role in its indication for PDAC treatment. Relevant implications for drug delivery and drug design are discussed.
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Affiliation(s)
- M Papi
- Istituto di Fisica, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
| | - D Caputo
- University Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - V Palmieri
- Istituto di Fisica, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
| | - R Coppola
- University Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - S Palchetti
- Department of Molecular Medicine, "Sapienza" University of Rome, Viale Regina Elena 291, 00161 Rome, Italy. and Istituti Fisioterapici Ospitalieri, Istituto Regina Elena, Via Elio Chianesi 53, 00144 Rome, Italy
| | - F Bugli
- Istituto di Microbiologia, Universitá Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
| | - C Martini
- Istituto di Microbiologia, Universitá Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
| | - L Digiacomo
- Department of Molecular Medicine, "Sapienza" University of Rome, Viale Regina Elena 291, 00161 Rome, Italy. and Department of Bioscience and Biotechnology, University of Camerino, Via Gentile III da Varano, 62032 Camerino, MC, Italy
| | - D Pozzi
- Department of Molecular Medicine, "Sapienza" University of Rome, Viale Regina Elena 291, 00161 Rome, Italy. and Istituti Fisioterapici Ospitalieri, Istituto Regina Elena, Via Elio Chianesi 53, 00144 Rome, Italy
| | - G Caracciolo
- Department of Molecular Medicine, "Sapienza" University of Rome, Viale Regina Elena 291, 00161 Rome, Italy.
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D’Addabbo A, Alduino C, Alfonso K, Artusa DR, Avignone FT, Azzolini O, Banks TI, Bari G, Beeman J, Bellini F, Bersani A, Biassoni M, Branca A, Brofferio C, Bucci C, Camacho A, Caminata A, Canonica L, Cao XG, Capelli S, Cappelli L, Carbone L, Cardani L, Carniti P, Casali N, Cassina L, Chiesa D, Chott N, Clemenza M, Copello S, Cosmelli C, Cremonesi O, Creswick RJ, Cushman JS, Dafinei I, Davis CJ, Dell’Oro S, Deninno MM, Di Domizio S, Di Vacri ML, Drobizhev A, Fang DQ, Faverzani M, Fernandes G, Ferri E, Ferroni F, Fiorini E, Franceschi MA, Freedman SJ, Fujikawa BK, Giachero A, Gironi L, Giuliani A, Gladstone L, Gorla P, Gotti C, Gutierrez TD, Haller EE, Han K, Hansen E, Heeger KM, Hennings-Yeomans R, Hickerson KP, Huang HZ, Kadel R, Keppel G, Kolomensky YG, Leder A, Ligi C, Lim KE, Liu X, Ma YG, Maino M, Marini L, Martinez M, Maruyama RH, Mei Y, Moggi N, Morganti S, Mosteiro PJ, Napolitano T, Nones C, Norman EB, Nucciotti A, O’Donnell T, Orio F, Ouellet JL, Pagliarone CE, Pallavicini M, Palmieri V, Pattavina L, Pavan M, Pessina G, Pettinacci V, Piperno G, Pira C, Pirro S, Pozzi S, Previtali E, Rosenfeld C, Rusconi C, Sangiorgio S, Santone D, Scielzo N, Singh V, Sisti M, Smith AR, Taffarello L, Tenconi M, Terranova F, Tomei C, Trentalange S, Vignati M, Wagaarachchi SL, Wang BS, Wang HW, Wilson J, Winslow LA, Wise T, Woodcraft A, Zanotti L, Zhang GQ, Zhu BX, Zimmermann S, Zucchelli S. The CUORE and CUORE-0 experiments at LNGS. EPJ Web Conf 2017. [DOI: 10.1051/epjconf/201716407047] [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
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Palmieri V, Gravino E, Russo C, Salvati A, Lombardi C, Sauro R, Rosato G. Coronary atherosclerosis burden by coronary computed tomography in type II diabetes with preclinical non-obstructive carotid atherosclerosis and without inducible myocardial ischemia. Diabetes Res Clin Pract 2017; 123:112-119. [PMID: 28002752 DOI: 10.1016/j.diabres.2016.11.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 08/13/2016] [Accepted: 11/29/2016] [Indexed: 10/20/2022]
Abstract
AIMS To quantify cardiovascular risk in persons with type-2 diabetes (DM) and established carotid atherosclerosis, without inducible myocardial ischemia by stress imaging. METHODS We selected clinically healthy DM and subjects without DM (nonDM, controls) with non-obstructive carotid atherosclerosis and without significant coronary artery disease (CAD) by stress echocardiography. Coronary flow velocity reserve (CFR) was assessed during stress echocardiography. In those with negative stress imaging, coronary artery calcium (CAC) assessment by computed tomography (CT) was proposed. Outcome at 180-day follow-up was performed by visits or telephone interview. RESULTS Total CAC was greater in DM (n=19) than in nonDM (n=19, CAC: 225±158 vs 78±65Agatston units, 156±161 vs 53±51 in the left anterior descendent artery, both p<0.05). Coronary stenosis burden was greater in DM than in nonDM, albeit <75% in all cases; CFR was lower in DM than nonDM (p<0.05). Mean age was slightly higher (69±6 vs 64±12, p>0.2), and male gender tended to be less frequent (63 vs 79%) with DM than with nonDM; all subjects showed dyslipidemia, and almost all had arterial hypertension. Based on CAC, a 10-year cardiovascular risk was 10-20% in 78% of the DM and in 28% of the non-DM, and was >20% in 11% of the DM but in none of the nonDM. A single non-fatal myocardial infarction was recorded within 180days from test, among DM. CONCLUSIONS Based on CAC, in the presence of non-obstructive carotid atherosclerosis, asymptomatic DM may show significantly higher CAD burden than nonDM even in the absence of inducible myocardial ischemia.
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Affiliation(s)
- Vittorio Palmieri
- Unit of Cardiology, Department of Heart and Vessels, "S. G. Moscati" National Hospital, Avellino, Italy.
| | - Enzo Gravino
- Department of Radiology, "S. G. Moscati" National Hospital, Avellino, Italy
| | - Cesare Russo
- Department of Medicine, Columbia University, New York, NY, USA
| | - Armenio Salvati
- Department of Radiology, "S. G. Moscati" National Hospital, Avellino, Italy
| | - Carmelo Lombardi
- Department of Radiology, "S. G. Moscati" National Hospital, Avellino, Italy
| | - Rosario Sauro
- Unit of Cardiology, Department of Heart and Vessels, "S. G. Moscati" National Hospital, Avellino, Italy
| | - Giuseppe Rosato
- Unit of Cardiology, Department of Heart and Vessels, "S. G. Moscati" National Hospital, Avellino, Italy
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Bugli F, Palmieri V, Torelli R, Papi M, De Spirito M, Cacaci M, Galgano S, Masucci L, Paroni Sterbini F, Vella A, Graffeo R, Posteraro B, Sanguinetti M. In vitro effect of clarithromycin and alginate lyase against helicobacter pylori biofilm. Biotechnol Prog 2016; 32:1584-1591. [PMID: 27535356 DOI: 10.1002/btpr.2339] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/05/2016] [Indexed: 12/31/2022]
Abstract
It is now established that the gastric pathogen Helicobacter pylori has the ability to form biofilms in vitro as well as on the human gastric mucosa. The aim of this study is to evaluate the antimicrobial effects of Clarithromycin on H. pylori biofilm and to enhance the effects of this antibiotic by combining it with Alginate Lyase, an enzyme degrading the polysaccharides present in the extracellular polymeric matrix forming the biofilm. We evaluated the Clarithromycin minimum inhibition concentration (MIC) on in vitro preformed biofilm of a H. pylori. Then the synergic effect of Clarithromycin and Alginate Lyase treatment has been quantified by using the Fractional Inhibitory Concentration index, measured by checkerboard microdilution assay. To clarify the mechanisms behind the effectiveness of this antibiofilm therapeutic combination, we used Atomic Force Microscopy to analyze modifications of bacterial morphology, percentage of bacillary or coccoid shaped bacteria cells and to quantify biofilm properties. © 2016 American Institute of Chemical Engineers Biotechnol. Prog., 32:1584-1591, 2016.
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Affiliation(s)
- F Bugli
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - V Palmieri
- Istituto di Fisica, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - R Torelli
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - M Papi
- Istituto di Fisica, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - M De Spirito
- Istituto di Fisica, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - M Cacaci
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - S Galgano
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - L Masucci
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - F Paroni Sterbini
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - A Vella
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - R Graffeo
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - B Posteraro
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - M Sanguinetti
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
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