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Coperchini F, Greco A, Rotondi M. Changing the structure of PFOA and PFOS: a chemical industry strategy or a solution to avoid thyroid-disrupting effects? J Endocrinol Invest 2024:10.1007/s40618-024-02339-w. [PMID: 38522066 DOI: 10.1007/s40618-024-02339-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/12/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND The family of perfluoroalkyl and polyfluoroalkyl substances (PFAS) raised concern for their proven bioaccumulation and persistence in the environment and animals as well as for their hazardous health effects. As a result, new congeners of PFAS have rapidly replaced the so-called "old long-chain PFAS" (mainly PFOA and PFOS), currently out-of-law and banned by most countries. These compounds derive from the original structure of "old long-chain PFAS", by cutting or making little conformational changes to their structure, thus obtaining new molecules with similar industrial applications. The new congeners were designed to obtain "safer" compounds. Indeed, old-long-chain PFAS were reported to exert thyroid disruptive effects in vitro, and in vivo in animals and humans. However, shreds of evidence accumulated so far indicate that the "restyling" of the old PFAS leads to the production of compounds, not only functionally similar to the previous ones but also potentially not free of adverse health effects and bioaccumulation. Studies aimed at characterizing the effects of new-PFAS congeners on thyroid function indicate that some of these new-PFAS congeners showed similar effects. PURPOSE The present review is aimed at providing an overview of recent data regarding the effects of novel PFAS alternatives on thyroid function. RESULTS AND CONCLUSIONS An extensive review of current legislation and of the shreds of evidence obtained from in vitro and in vivo studies evaluating the effects of the exposure to novel PFOA and PFOS alternatives, as well as of PFAS mixture on thyroid function will be provided.
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Affiliation(s)
- F Coperchini
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, Italy
| | - A Greco
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, Italy
| | - M Rotondi
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, Italy.
- Laboratory for Endocrine Disruptors, Unit of Endocrinology and Metabolism, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, Italy.
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Messineo D, Massaro F, Izzo P, Milani A, Polimeni R, Iannella G, Marinozzi S, Consorti F, Cocuzza S, Maniaci A, Mucchino A, Nannarelli M, Greco A, Magliulo G, Salducci M, Pace A. Radiomic Application for Head and Neck Squamocellular Tumor: Systematic Review. Clin Ter 2024; 175:153-160. [PMID: 38571474 DOI: 10.7417/ct.2024.5048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Abstract Radiomics represents the convergence of artificial intelligence and radiological data analysis, primarily applied in the diagnosis and treatment of cancer. In the head and neck region, squamous cell carcinoma is the most prevalent type of tumor. Recent radiomics research has revealed that specific bio-imaging characteristics correlate with various molecular features of Head and Neck Squamous Cell Carcinoma (HNSCC), particularly Human Papillomavirus (HPV). These tumors typically present a unique phenotype, often affecting younger patients, and show a favorable response to radiation therapy. This study provides a systematic review of the literature, summarizing the application of radiomics in the head and neck region. It offers a comprehensive analysis of radiomics-based studies on HNSCC, evaluating its potential for tumor evaluation, risk stratification, and outcome prediction in head and neck cancer treatment.
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Affiliation(s)
- D Messineo
- Radiological, Oncological and Anatomo-Pathological Sciences Department, Sapienza University of Rome, Rome, Italy
| | - F Massaro
- Radiological, Oncological and Anatomo-Pathological Sciences Department, Sapienza University of Rome, Rome, Italy
| | - P Izzo
- Pietro Valdoni" Surgery Department I, Sapienza University of Rome, Rome, Italy
| | - A Milani
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - R Polimeni
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - G Iannella
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - S Marinozzi
- Department of Molecular Medicine, Unit of History of Medicine and Bioethics, Sapienza University of Rome, Rome, Italy
| | - F Consorti
- Scienze Chirurgiche Department, Sapienza University of Rome, Rome, Italy
| | - S Cocuzza
- Otorinolaringoiatria Department, University of Catania, Catania, Italy
| | - A Maniaci
- Otorinolaringoiatria Department, University of Catania, Catania, Italy
| | - A Mucchino
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - M Nannarelli
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - A Greco
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - G Magliulo
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - M Salducci
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
| | - A Pace
- Organi di senso Department, Sapienza University of Rome, Rome, Italy
- Department of Molecular Medicine, Unit of History of Medicine and Bioethics, Sapienza University of Rome, Rome, Italy
- Scienze Chirurgiche Department, Sapienza University of Rome, Rome, Italy
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Grossini E, De Zanet D, Apostolo D, Mallela VR, La Rocca G, Greco A, Coratza G, Minisini R, Pirisi M. rs1801253 Gly/Gly carriage in the ADRB1 gene leads to unbalanced cardiac sympathetic modulation as assessed by spectral analysis of heart rate variability. Clin Auton Res 2024; 34:205-208. [PMID: 38032435 DOI: 10.1007/s10286-023-01001-4] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/04/2023] [Indexed: 12/01/2023]
Affiliation(s)
- E Grossini
- Laboratory of Physiology, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy.
| | - D De Zanet
- Laboratory of Physiology, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - D Apostolo
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - V R Mallela
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - G La Rocca
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - A Greco
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - G Coratza
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - R Minisini
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
| | - M Pirisi
- Internal Medicine Unit, Department of Translational Medicine, Università del Piemonte Orientale, "Maggiore Della Carità" Hospital, Novara, Italy
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4
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Greco A, Baek S, Middelmann T, Mehring C, Braun C, Marquetand J, Siegel M. Discrimination of finger movements by magnetomyography with optically pumped magnetometers. Sci Rep 2023; 13:22157. [PMID: 38092937 PMCID: PMC10719385 DOI: 10.1038/s41598-023-49347-z] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
Optically pumped magnetometers (OPM) are quantum sensors that offer new possibilities to measure biomagnetic signals. Compared to the current standard surface electromyography (EMG), in magnetomyography (MMG), OPM sensors offer the advantage of contactless measurements of muscle activity. However, little is known about the relative performance of OPM-MMG and EMG, e.g. in their ability to detect and classify finger movements. To address this in a proof-of-principle study, we recorded simultaneous OPM-MMG and EMG of finger flexor muscles for the discrimination of individual finger movements on a single human participant. Using a deep learning model for movement classification, we found that both sensor modalities were able to discriminate finger movements with above 89% accuracy. Furthermore, model predictions for the two sensor modalities showed high agreement in movement detection (85% agreement; Cohen's kappa: 0.45). Our findings show that OPM sensors can be employed for contactless discrimination of finger movements and incentivize future applications of OPM in magnetomyography.
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Affiliation(s)
- Antonino Greco
- Department of Neural Dynamics and Magnetoencephalography, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
- Centre for Integrative Neuroscience, University of Tübingen, Tübingen, Germany.
- MEG-Center, University of Tübingen, Tübingen, Germany.
| | - Sangyeob Baek
- Department of Neural Dynamics and Magnetoencephalography, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Centre for Integrative Neuroscience, University of Tübingen, Tübingen, Germany
- MEG-Center, University of Tübingen, Tübingen, Germany
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Italy
| | - Thomas Middelmann
- Department of Biosignals, Physikalisch-Technische Bundesanstalt (PTB), Berlin, Germany
| | - Carsten Mehring
- Bernstein Center Freiburg, University of Freiburg, Freiburg Im Breisgau, Germany
- Faculty of Biology, University of Freiburg, 79104, Freiburg Im Breisgau, Germany
| | - Christoph Braun
- Department of Neural Dynamics and Magnetoencephalography, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Centre for Integrative Neuroscience, University of Tübingen, Tübingen, Germany
- MEG-Center, University of Tübingen, Tübingen, Germany
| | - Justus Marquetand
- Department of Neural Dynamics and Magnetoencephalography, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Centre for Integrative Neuroscience, University of Tübingen, Tübingen, Germany
- MEG-Center, University of Tübingen, Tübingen, Germany
- Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Markus Siegel
- Department of Neural Dynamics and Magnetoencephalography, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Centre for Integrative Neuroscience, University of Tübingen, Tübingen, Germany
- MEG-Center, University of Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), University of Tübingen, Tübingen, Germany
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Meliante PG, Colizza A, Di Stadio A, D'Erme G, Gilardi A, Cambria F, Greco A, Ralli M, De Vincentiis M. Montgomery Salivary Bypass Tube vs Self-Expandable Metal Stents for the treatment of esophageal strictures after total laryngectomy: a crossover study. Clin Ter 2023; 174:478-482. [PMID: 38048108 DOI: 10.7417/ct.2023.5012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Objectives Dysphagia affects 16% of patients undergoing total laryngectomy; of these, a third is due to pharyngoesophageal stenosis. Currently, the treatment is cyclic dilation of the stricture and Montgomery Salivary Bypass Tube (MSBT) application. The aim of this study is to assess whether using Self-Expandable Metal Stent (SEMS) may give better results after a non-durable response to repeated dilatation and application of MSBT. Materials and Methods We verified whether using SEMS after at least 3 cyclic dilations and application of MSBT results in a longer dysphagia-free time in laryngectomized patients with pharyngolesopha-geal stenosis. Secondary outcomes were the duration of the procedures, radiation exposure and complications. Results We enrolled 6 patients with a median age of 65 years (QR 62.5 - 75.75), of which 50% had undergone radiotherapy. Friedman's test for the duration of the dysphagia-free period did not show a statistically significant difference between the two groups (Friedman chi-squared = 2.6667, df = 1, p-value = 0.1025). The time required to implant the MSBT was significantly less than that required to implant the SEMS (Friedman chi-squared = 6, df = 1, p-value = 0.01431). Radiation exposure was absent for MSBT, while SEMS implant required an exposure to X-rays during the procedure and after 48 hours for placement verification. Two patients experienced short-term complications after SEMS implantation and one after two weeks from MSBT implantation; none of them had any health consequences. Conclusion In patients who are already undergoing cyclic dilations and application of MSBT, switching to SEMS is not beneficial. Furthermore, MSBT has a significantly shorter implant procedure, does not expose the patient to X-rays, and, in the absence of complications, has a longer duration before removal.
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Affiliation(s)
- P G Meliante
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - A Colizza
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - A Di Stadio
- Department G.F Ingrassia, Unit of Otolaryngology, University of Catania, Catania, Italy
| | - G D'Erme
- Integrated Head and Neck Care Department, Policlinico Umberto I, Rome, Italy
| | - A Gilardi
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - F Cambria
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - A Greco
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - M Ralli
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - M De Vincentiis
- Department of Sense Organs, Sapienza University of Rome, Italy
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Ermini L, Taurone S, Greco A, Artico M. Cancer progression: a single cell perspective. Eur Rev Med Pharmacol Sci 2023; 27:5721-5747. [PMID: 37401310 DOI: 10.26355/eurrev_202306_32812] [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: 07/05/2023]
Abstract
Tumor tissues are constituted by a dynamic diversity of malignant and non-malignant cells, which shape a puzzling biological ecosystem affecting cancer biology and response to treatments. Over the course of the tumoral disease, cancer cells acquire genotypic and phenotypic changes, allowing them to improve cellular fitness and overcome environmental and treatment constraints. This progression is depicted by an evolutionary process in which single cells expand as a result of an interaction between single-cell changes and the local microenvironment. Recent technological developments have made it possible to depict the development of cancer at the single-cell level, offering a novel method for understanding the biology of this complex disease. Here, we review those complex interactions from the perspective of single cells and introduce the concept of omics for single-cell studies. This review emphasizes the evolutionary dynamics that control cancer progression and the capacity of single cells to escape the local environment and colonize distant sites. We are assisting a rapid progression of studies carried out at the single-cell level, and we survey relevant single-cell technologies looking at multi-omics studies. These forefront approaches will address the combined contribution of both genetic and non-genetic factors to cancer progression and will pave the path for precision medicine in cancer.
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Affiliation(s)
- L Ermini
- Department of Cancer Research, NORLUX Neuro-Oncology Laboratory, Luxembourg Institute of Health L-1526, Luxembourg, Luxembourg.
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Vezzelli A, Verzè S, Morbioli L, Solazzo L, Greco A, Benetti C, Cenacchi V, Breda M. Development and validation of a bioanalytical method for the quantification of CHF6550 and its metabolite (CHF6671) in rat plasma and lung homogenate using LC–MS/MS. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1222:123678. [PMID: 37028170 DOI: 10.1016/j.jchromb.2023.123678] [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] [Received: 12/23/2022] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 04/08/2023]
Abstract
A selective and sensitive liquid chromatography-tandem mass spectrometry method was developed and validated for accurate determination of CHF6550 and its main metabolite in rat plasma and lung homogenate samples. All biological samples were prepared by simple protein precipitation method using deuterated internal standards. The analytes were separated on a HSS T3 analytical column with 3.2 min run time at flow rate of 0.5 mL/min. The detection was performed on a triple-quadrupole tandem mass spectrometer equipped with positive-ion electrospray ionization by selected-reaction monitoring of the transitions at m/z 735.3 → 98.0 for CHF6550 and m/z 638.3 → 319.2 and 638.3 → 376.2 for CHF6671. The calibration curves for plasma samples were linear between 50 and 50000 pg/mL for both analytes. The calibration curves for lung homogenate samples were linear within 0.1-100 ng/mL for CHF6550 and 0.3-300 ng/mL for CHF6671. The method was successfully applied to a 4-week toxicity study.
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Affiliation(s)
- A Vezzelli
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy.
| | - S Verzè
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy
| | - L Morbioli
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy
| | - L Solazzo
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy
| | - A Greco
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy
| | - C Benetti
- Chiesi Farmaceutici S.p.A, Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - V Cenacchi
- Chiesi Farmaceutici S.p.A, Nuovo Centro Ricerche, Largo Belloli 11/a, 43122 Parma, Italy
| | - M Breda
- Aptuit (Verona) Srl, an Evotec company, Via A. Fleming, 4, Verona, Italy
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Mazzoni M, Todoerti K, Agnelli L, Minna E, Pagliardini S, Di Marco T, Borrello MG, Neri A, Greco A. Transcriptomic landscape of TIMP3 oncosuppressor activity in thyroid carcinoma. Cancer Cell Int 2022; 22:400. [PMID: 36503426 PMCID: PMC9743531 DOI: 10.1186/s12935-022-02811-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Papillary thyroid cancer (PTC) is the most frequent thyroid tumor. The tissue inhibitor of metalloproteinase-3 (TIMP3) gene encodes a matrix metalloproteinases inhibitor that exerts a tumor suppressor role in several tumor types. TIMP3 is frequently downregulated in PTC by promoter methylation. We have previously functionally demonstrated that TIMP3 exerts an oncosuppressor role in PTC: TIMP3 restoration in the PTC-derived NIM1 cell line affects in vitro migration, invasion and adhesive capability, while reduces tumor growth, angiogenesis and macrophage recruitment in vivo. To get a deeper insight on the mediators of TIMP3 oncosuppressor activity in thyroid tumors, here we focused on the TIMP3 related transcriptome. METHODS TCGA database was used for investigating the genes differentially expressed in PTC samples with low and high TIMP3 expression. Genome wide expression analysis of clones NIM1-T23 (expressing a high level of TIMP3 protein) and NIM1-EV (control empty vector) was performed. Gene sets and functional enrichment analysis with clusterProfiler were applied to identify the modulated biological processes and pathways. CIBERSORT was used to evaluate the distribution of different immunological cell types in TCGA-PTC tumor samples with different TIMP3 expression levels. Real time PCR was performed for the validation of selected genes. RESULTS Thyroid tumors with TIMP3-high expression showed a down-modulation of inflammation-related gene sets, along with a reduced protumoral hematopoietic cells fraction; an enrichment of cell adhesion functions was also identified. Similar results were obtained in the TIMP3-overexpessing NIM1 cells in vitro model, where a down-regulation of immune-related function gene sets, some of which also identified in tumor samples, was observed. Interestingly, through enrichment analysis, were also recognized terms related to cell adhesion, extracellular matrix organization, blood vessel maintenance and vascular process functions that have been found modulated in our previous in vitro and in vivo functional studies. CONCLUSIONS Our results highlight the correlation of TIMP3 expression levels with the regulation of inflammatory functions and the immune infiltration composition associated with different PTC prognosis, thus providing a broader view on the oncosuppressor role of TIMP3 in PTC.
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Affiliation(s)
- M. Mazzoni
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - K. Todoerti
- grid.417893.00000 0001 0807 2568Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - L. Agnelli
- grid.417893.00000 0001 0807 2568Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - E. Minna
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - S. Pagliardini
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - T. Di Marco
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M. G. Borrello
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - A. Neri
- Scientific Directorate, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - A. Greco
- grid.417893.00000 0001 0807 2568Molecular Mechanisms Unit, Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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Rastelli C, Greco A, De Pisapia N, Finocchiaro C. Balancing novelty and appropriateness leads to creative associations in children. PNAS Nexus 2022; 1:pgac273. [PMID: 36712330 PMCID: PMC9802071 DOI: 10.1093/pnasnexus/pgac273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 12/01/2022] [Indexed: 12/05/2022]
Abstract
Creative problem solving is a fundamental skill of human cognition and is conceived as a search process whereby a novel and appropriate solution is generated. However, it is unclear whether children are able to balance novelty and appropriateness to generate creative solutions and what are the underlying computational mechanisms. Here, we asked children, ranging from 10 to 11 years old, to perform a word association task according to three instructions, which triggered a more appropriate (ordinary), novel (random), or balanced (creative) response. Results revealed that children exhibited greater cognitive flexibility in the creative condition compared to the control conditions, as revealed by the structure and resiliency of the semantic networks. Moreover, responses' word embeddings extracted from pretrained deep neural networks showed that semantic distance and category switching index increased in the creative condition with respect to the ordinary condition and decreased compared to the random condition. Critically, we showed how children efficiently solved the exploration/exploitation trade-off to generate creative associations by fitting a computational reinforcement learning (RL) model that simulates semantic search strategies. Our findings provide compelling evidence that children balance novelty and appropriateness to generate creative associations by optimally regulating the level of exploration in the semantic search. This corroborates previous findings on the adult population and highlights the crucial contribution of both components to the overall creative process. In conclusion, these results shed light on the connections between theoretical concepts such as bottom-up/top-down modes of thinking in creativity research and the exploration/exploitation trade-off in human RL research.
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Affiliation(s)
| | - Antonino Greco
- MEG Center, University of Tübingen, 72076 Tübingen, Germany,Department of Neural Dynamics and Magnetoencephalography, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany,Werner Reichardt Center for Integrative Neuroscience, University of Tübingen, 72076 Tübingen, Germany
| | - Nicola De Pisapia
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
| | - Chiara Finocchiaro
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
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10
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Coperchini F, Greco A, Denegri M, Ripepi FA, Grillini B, Bertini J, Calì B, Villani L, Magri F, Croce L, Gaetano C, Cappelli C, Trimboli P, Chiovato L, Rotondi M. Vitamin D and interferon-γ co-operate to increase the ACE-2 receptor expression in primary cultures of human thyroid cells. J Endocrinol Invest 2022; 45:2157-2163. [PMID: 35829990 PMCID: PMC9277975 DOI: 10.1007/s40618-022-01857-9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/29/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND A more severe course of COVID-19 was associated with low levels of Vitamin D (VitD). Moreover in vitro data showed that VitD up-regulates the mRNA of the Angiotensin Converting Enzyme 2 (ACE-2), the SARS-COV-2 receptor in different type of cells. ACE-2 is expressed in several type of tissues including thyroid cells, on which its mRNA was shown to be up-regulated by interferon-gamma (IFN-γ). The aim of the present study was to investigate if treatment with VitD alone or in combination with IFN-γ would increase ACE-2 both at mRNA and protein levels in primary cultures of human thyrocytes. MATERIALS AND METHODS Primary thyroid cell cultures were treated with VitD and IFN-γ alone or in combination for 24 h. ACE-2 mRNA levels were measured by Real-time Polymerase Chain Reaction (RT-PCR). The presence of ACE-2 on thyroid cell membrane was assessed by immunocytochemistry basally and after the previous mentioned treatments. RESULTS ACE-2 mRNA levels increased after treatment with VitD and IFN-γ alone. The combination treatment (VitD + IFN-γ) showed an additive increase of ACE-2-mRNA. Immunocytochemistry experiments showed ACE-2 protein on thyroid cells membrane. ACE-2 expression increased after treatment with VitD and IFN-γ alone and further increased by the combination treatment with VitD + IFN-γ. CONCLUSIONS VitD would defend the body by SARS-COV2 both by regulating the host immune defense and by up-regulating of the expression of the ACE-2 receptor. The existence of a co-operation between VitD and IFN-γ demonstrated in other systems is supported also for ACE-2 up-regulation. These observations lead to an increased interest for the potential therapeutic benefits of VitD supplementation in COVID-19.
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Affiliation(s)
- F Coperchini
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
| | - A Greco
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
| | - M Denegri
- Unit of Molecular Cardiology 27100, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - F A Ripepi
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - B Grillini
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - J Bertini
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - B Calì
- Unit of Pathology, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
| | - L Villani
- Department of General and Minimally Invasive Surgery, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
| | - F Magri
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - L Croce
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - C Gaetano
- Laboratory of Epigenetics, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100, Pavia, Italy
| | - C Cappelli
- Department of Clinical and Experimental Sciences, SSD Medicina Ad Indirizzo Endocrino-Metabolico, University of Brescia, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - P Trimboli
- Clinic for Endocrinology and Diabetology, Lugano Regional Hospital, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana (USI), Lugano, Switzerland
| | - L Chiovato
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
| | - M Rotondi
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy.
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy.
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11
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Frustaci AM, Del Poeta G, Visentin A, Sportoletti P, Fresa A, Vitale C, Murru R, Chiarenza A, Sanna A, Mauro FR, Reda G, Gentile M, Varettoni M, Baratè C, Borella C, Greco A, Deodato M, Zamprogna G, Laureana R, Cipiciani A, Galitzia A, Curto Pelle A, Morelli F, Malvisi L, Coscia M, Laurenti L, Trentin L, Montillo M, Cairoli R, Tedeschi A. Coexisting conditions and concomitant medications do not affect venetoclax management and survival in chronic lymphocytic leukemia. Ther Adv Hematol 2022; 13:20406207221127550. [PMID: 36246422 PMCID: PMC9554118 DOI: 10.1177/20406207221127550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/08/2022] [Indexed: 11/21/2022] Open
Abstract
Background The question of which parameters may be informative on venetoclax outcome in chronic lymphocytic leukemia (CLL) is still unclear. Furthermore, the choice to treat with venetoclax can be challenging in patients with baseline characteristics or comorbidities that may potentially favor some specific adverse events. Objectives This study was aimed to evaluate whether age, fitness status, patients'/disease characteristics, or concomitant medications may predict outcomes in CLL patients receiving venetoclax. Design Retrospective observational study. Methods Impact of age, presence of Cumulative Illness Rating Scale (CIRS) >6 or severe organ impairment (CIRS3+), Eastern Cooperative Oncology Group-Performance Status (ECOG-PS), renal function, and concomitant medications were retrospectively analyzed on treatment management (definitive discontinuation due to toxicity, discontinuation due to toxicity, Tox-DTD; permanent dose reduction, PDR) and survival [progression free survival (PFS), event free survival (EFS), overall survival (OS)] in unselected patients receiving venetoclax monotherapy in common practice. Results A total of 221 relapsed/refractory patients were included. Tox-DTD and PDR were reported in 5.9% and 21.7%, respectively, and were not influenced by any fitness parameter, age, number or type of concomitant medication, baseline neutropenia, or impaired renal function. None of these factors were associated with tumor lysis syndrome (TLS) development. Age and coexisting conditions had no influence on PFS and EFS. At univariate analysis, OS was significantly shorter only in patients with ECOG-PS >1 (p < 0.0001) and elderly (⩾65 years) with CIRS >6 (p = 0.014) or CIRS3+ (p = 0.031). ECOG-PS >1 retained an independent role only for EFS and OS. While Tox-DTD affected all survival outcomes, no differences in PFS were reported among patients permanently reducing dose or interrupting venetoclax for > 7 days. Conclusion Clinical outcome with venetoclax is not influenced by comorbidities, patients' clinical characteristics, or concomitant medications. Differently from other targeted therapies, this demonstrates that, except ECOG-PS, none of the parameters generally considered for treatment choice, including baseline neutropenia or impaired renal function, should rule the decision process with this agent. Anyway, if clinically needed, a correct drug management does not compromise treatment efficacy and may avoid toxicity-driven discontinuations. Plain Language Summary Chapter 1: Why was this study done? Chapter 2: Which are the main findings of the study? Chapter 3: How these findings may impact on clinical practice? Coexisting conditions and concomitant medications do not affect venetoclax management and survival in chronic lymphocytic leukemia • The question of which parameters may be informative on venetoclax outcome in chronic lymphocytic leukemia is still unclear. Furthermore, the choice to treat with venetoclax can be challenging in patients with baseline characteristics or comorbidities that may potentially favor some specific adverse events (e.g. compromised renal function or baseline neutropenia).• In our large series of patients treated outside of clinical trials, we demonstrated that neither age, fitness, comorbidities nor concomitant medications impact on venetoclax management and survival. Importantly, patients presenting with baseline neutropenia or impaired renal function did not have a higher rate of dose reductions or toxicity-driven discontinuations, thus further underlining that venetoclax may be safely administered even in those categories with no preclusions.• Differently from other targeted agents, our data demonstrate that none of the baseline factors commonly considered in treatment decision process retains a role with venetoclax. Finally, permanent dose reductions and temporary interruptions did not adversely impact PFS suggesting that, if clinically needed, a correct drug management should be adopted with no risk of compromising venetoclax efficacy.
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Affiliation(s)
| | | | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Paolo Sportoletti
- Centro di Ricerca Emato-Oncologica (CREO), Department of Medicine and Surgery, Institute of Hematology, University of Perugia, Perugia, Italy
| | - Alberto Fresa
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Candida Vitale
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, Università di Torino, Torino, Italy
| | - Roberta Murru
- Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A.Businco, ARNAS ‘G. Brotzu’, Cagliari, Italy
| | - Annalisa Chiarenza
- Hematology Division, A.O.U. Policlinico ‘G. Rodolico-S.Marco’, Catania, Italy
| | | | - Francesca Romana Mauro
- Hematology, Department of Translational and Precision Medicine, ‘Sapienza’ University, Roma, Italy
| | - Gianluigi Reda
- U.O.C. Ematologia, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milano, Italy
| | | | - Marzia Varettoni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Claudia Baratè
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Chiara Borella
- Department of Hematology, Ospedale San Gerardo, Monza, Italy
| | - Antonino Greco
- Department of Hematology, Azienda Ospedaliera Giovanni Panìco, Tricase, Italy
| | - Marina Deodato
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Giulia Zamprogna
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Roberta Laureana
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Roma, Italy
| | - Alessandra Cipiciani
- Centro di Ricerca Emato-Oncologica (CREO), Department of Medicine and Surgery, Institute of Hematology, University of Perugia, Perugia, Italy
| | - Andrea Galitzia
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Angelo Curto Pelle
- Hematology Division, A.O.U. Policlinico ‘G. Rodolico-S.Marco’, University of Catania, Catania, Italy
| | | | | | - Marta Coscia
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, Università di Torino, Torino, Italy
| | - Luca Laurenti
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Marco Montillo
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Roberto Cairoli
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Alessandra Tedeschi
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
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Spagnolo M, Laudani C, Occhipinti G, Agnello F, Legnazzi M, Scalia L, Mauro MS, Rochira C, Finocchiaro S, Greco A, Capodanno D. Impact of the ISCHEMIA randomized clinical trial on the management of patients with chronic coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1366] [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
In the ISCHEMIA trial, patients with chronic coronary syndromes (CCS) and moderate or severe ischemia had no significant difference in combined ischemic events with an initial invasive compared with a conservative strategy [1]. Coronary computed tomography angiography (CCTA) was part of the pre-randomization workup of ISCHEMIA and is gaining popularity over ischemia testing or initial invasive coronary angiography (ICA) as the initial diagnostic strategy for CCS [2].
Purpose
To analyse whether the results of the ISCHEMIA trial had a sizeable impact on the diagnostic algorithm for CCS by analysing trends in referral to ICA and/or revascularization.
Methods
ICAs performed in CCS patients between November 2019 and February 2022 at a high-volume centre were analysed. Two groups were defined based on procedure date: i) pre-ISCHEMIA, including ICAs performed before March 2020 (date of trial publication); ii) post-ISCHEMIA, including ICAs performed ≥3 months (i.e., blanking period) after trial publication. The primary outcome was the incidence of referral to ICA by CCTA. Secondary objectives included referral to ICA or revascularization by ischemia testing, referral to revascularization by CCTA, and referral by CCTA to ICA that did not require further intervention.
Results
A total of 2,365 patients qualified for the analysis, of which 487 (20.6%) and 1878 (79.4%) in the pre-ISCHEMIA and post-ISCHEMIA groups, respectively. There were no notable differences in baseline characteristics between groups. The primary outcome occurred more frequently in the post-ISCHEMIA group (73.5% vs 32.5%, p<0.01). Referral to ICA by ischemia testing was lower in the post-ISCHEMIA group (31.6%, vs 52.5% p<0.01), while referral for revascularization by CCTA was more frequent (8.3% vs 12.0% p<0.01). There were no significant differences in referral to revascularization by ischemia testing (3.4% vs 3.0%, p=0.73) and referral by CCTA to ICA that did not require further intervention (60.3% vs 60.8%, p=0.90).
Conclusions
At two years from publication, the ISCHEMIA trial seems to have impacted significantly on the decision-making algorithm for patients with CCS. The frequency of referral to ICA and revascularization by CCTA considerably increased, paralleled by decreased referral to ICA by ischemia testing.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Spagnolo
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - C Laudani
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - G Occhipinti
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - F Agnello
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - M Legnazzi
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - L Scalia
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - M S Mauro
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - C Rochira
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - S Finocchiaro
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - A Greco
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
| | - D Capodanno
- Azienda Ospedaliero Universitaria Policlinico, University of Catania , Catania , Italy
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13
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Hepting M, Bejas M, Nag A, Yamase H, Coppola N, Betto D, Falter C, Garcia-Fernandez M, Agrestini S, Zhou KJ, Minola M, Sacco C, Maritato L, Orgiani P, Wei HI, Shen KM, Schlom DG, Galdi A, Greco A, Keimer B. Gapped Collective Charge Excitations and Interlayer Hopping in Cuprate Superconductors. Phys Rev Lett 2022; 129:047001. [PMID: 35938998 DOI: 10.1103/physrevlett.129.047001] [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] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/29/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
We use resonant inelastic x-ray scattering to probe the propagation of plasmons in the electron-doped cuprate superconductor Sr_{0.9}La_{0.1}CuO_{2}. We detect a plasmon gap of ∼120 meV at the two-dimensional Brillouin zone center, indicating that low-energy plasmons in Sr_{0.9}La_{0.1}CuO_{2} are not strictly acoustic. The plasmon dispersion, including the gap, is accurately captured by layered t-J-V model calculations. A similar analysis performed on recent resonant inelastic x-ray scattering data from other cuprates suggests that the plasmon gap is generic and its size is related to the magnitude of the interlayer hopping t_{z}. Our work signifies the three dimensionality of the charge dynamics in layered cuprates and provides a new method to determine t_{z}.
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Affiliation(s)
- M Hepting
- Max-Planck-Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
| | - M Bejas
- Facultad de Ciencias Exactas, Ingeniería y Agrimensura and Instituto de Física de Rosario (UNR-CONICET), Avenida Pellegrini 250, 2000 Rosario, Argentina
| | - A Nag
- Diamond Light Source, Harwell Campus, Didcot OX11 0DE, United Kingdom
| | - H Yamase
- International Center of Materials Nanoarchitectonics, National Institute for Materials Science, Tsukuba 305-0047, Japan
- Department of Condensed Matter Physics, Graduate School of Science, Hokkaido University, Sapporo 060-0810, Japan
| | - N Coppola
- Dipartimento di Ingegneria Industriale, Università di Salerno, I-84084 Fisciano (Salerno), Italy
| | - D Betto
- Max-Planck-Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
| | - C Falter
- Institut für Festkörpertheorie, Westfälische Wilhelms-Universität, Wilhelm-Klemm-Straße 10, 48149 Münster, Germany
| | | | - S Agrestini
- Diamond Light Source, Harwell Campus, Didcot OX11 0DE, United Kingdom
| | - Ke-Jin Zhou
- Diamond Light Source, Harwell Campus, Didcot OX11 0DE, United Kingdom
| | - M Minola
- Max-Planck-Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
| | - C Sacco
- Dipartimento di Ingegneria Industriale, Università di Salerno, I-84084 Fisciano (Salerno), Italy
| | - L Maritato
- Dipartimento di Ingegneria Industriale, Università di Salerno, I-84084 Fisciano (Salerno), Italy
- CNR-SPIN Salerno, Università di Salerno, I-84084 Fisciano (Salerno), Italy
| | - P Orgiani
- CNR-SPIN Salerno, Università di Salerno, I-84084 Fisciano (Salerno), Italy
- CNR-IOM, TASC Laboratory in Area Science Park, 34139 Trieste, Italy
| | - H I Wei
- LASSP, Department of Physics, Cornell University, Ithaca, New York 14853, USA
| | - K M Shen
- LASSP, Department of Physics, Cornell University, Ithaca, New York 14853, USA
| | - D G Schlom
- Department of Materials Science and Engineering, Cornell University, Ithaca, New York 14853, USA
- Kavli Institute at Cornell for Nanoscale Science, Ithaca, New York 14853, USA
- Leibniz-Institut für Kristallzüchtung, Max-Born-Straße 2, 12489 Berlin, Germany
| | - A Galdi
- Dipartimento di Ingegneria Industriale, Università di Salerno, I-84084 Fisciano (Salerno), Italy
- Cornell Laboratory for Accelerator Based Sciences and Education, Cornell University, Ithaca, New York 14853, USA
| | - A Greco
- Facultad de Ciencias Exactas, Ingeniería y Agrimensura and Instituto de Física de Rosario (UNR-CONICET), Avenida Pellegrini 250, 2000 Rosario, Argentina
| | - B Keimer
- Max-Planck-Institute for Solid State Research, Heisenbergstraße 1, 70569 Stuttgart, Germany
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14
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Manzo R, Listorti I, Colasante A, Scarselli F, Greco P, Arrivi C, Watson L, Greco A, Varricchio M, Pirastu G, Musella M, Barberi M, Uva D, Pristera' A, Greco E. P-267 A continuous culture medium with a lower concentration of lactate has a pronounced effect on the percentage of usable blastocysts on day 5. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Does Continuous Single Culture Medium NX, an embryo culture medium containing 1mM lactate, support increased blastocyst development over high lactate Vitrolife G1/G2 Series sequential culture?
Summary answer
There is a statistically significant increase in day 5 usable blastocysts in low lactate culture medium compared to the one with high lactate medium.
What is known already
Studies have shown that day 5 is the most desirable day to obtain blastocysts that are of an expansion, grade and quality to be utilized for transfer and/or vitrification procedures as those result in the highest success of clinical pregnancy,as compared to day 6/ 7 blastocysts, that do not meet criteria. Moreover, recent studies have indicated that there is an increase in chromosomal correctness of embryos cultured in a 1mM lactate environment as opposed to the higher 6-10mM lactate concentrations that have historically been believed necessary for successful blastocyst culture and resulting pregnancy.
Study design, size, duration
A prospective split sibling oocytes study was performed on 50 ICSI and IMSI cycles from October 2020 through April 2021. Oocytes were divided into the low lactate medium and high lactate gradient medium immediately following ICSI/IMSI and thereafter cultured in those medium until the final day of blastocyst culture. All patient ages were included in the sample population.
Participants/materials, setting, methods
This study was carried out in a private clinic. All patient stimulation protocol information and diagnosis’ were recorded; however, there was no restriction on participation. The endpoint was to analyse the resulting usable blastocyst rates on day 5 and day 6 in both arms of the study, using a denominator of normal 2PN fertilization. If a blastocyst was transferred or cryopreserved on day 5 or day 6, it was determined to be usable.
Main results and the role of chance
The resulting data was stratified not only by day 5 and day 6 usable blastocyst rates but also by patient age. It illustrates a statistically significant improvement in day 5 usable blastocysts for patients <35 in CSCM-NXC vs G1/G2 at 56% and 42%, respectively, a 14% increase (p < .05). The overall day 5 usable blastocyst rate was also statistically significant in CSCM-NXC (47%) as compared to G1/G2 (36%), (p < .05) with all ages considered. Additionally, on day 5, there was a higher percentage of usable blastocysts demonstrated in low lactate vs high in patients aged 35-37 (65% vs 42%, respectively) and 41-42 (41% vs 15%). Statistical significance was reversed in patients <35 on day 6, with G1/G2 having 24% usable blasts and CSCM-NXC 10% (p < .05). Interestingly, though not significant, G1/G2 had an increase in usable blastocyst percentage on day 5 in patients >42 (20% vs 11%), but overall, CSCM-NXC saw an increase in that same age group by 16%.
Limitations, reasons for caution
Though statistical significance was found in this study, a greater number will help to bolster the statistical power of the observations. Additionally, more studies are needed in order to ascertain if low lactate has an effect on the development prior to ICSI and resulting culture.
Wider implications of the findings
The mechanism of action that leads to the successful embryo development in low lactate embryo culture medium is vastly unknown, so further studies are required in order to understand the complexities and the impact of the observations provided.
Trial registration number
not applicable.
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Affiliation(s)
- R Manzo
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - I Listorti
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - A Colasante
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - F Scarselli
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - P Greco
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - C Arrivi
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - L Watson
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - A Greco
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | | | - G Pirastu
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - M Musella
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - M Barberi
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - D Uva
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - A Pristera'
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
| | - E Greco
- Clinica Villa Mafalda, Private IVF Center , Rome, Italy
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15
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Pirastu G, Listorti I, Manzo R, Barberi M, Musella M, Zazzaro V, Colasante A, Varricchio M, Scarselli F, Mencacci C, Arrivi C, Litwicka K, Greco P, Greco A, Greco E. P-260 Study of kinetic parameters using KIDscoreTMDay5 version 3.0 in euploid, mosaic and aneuploid blastocysts. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Do kinetic parameters change among euploid, mosaic and aneuploid blastocysts? Is the KIDscoreTMDay5 version 3.0 (KS-5.3) correlated to preimplantation genetic testing for aneuploidies (PGT-A) results?
Summary answer
The KS-5.3 differs in embryo ploidy classes. The analysis of the kinetic variables showed that the aneuploid embryos were significantly slower than euploid and mosaic.
What is known already
Chromosomal abnormalities affect more than 50% of embryos in women with >35 years of age and PGT-A is the best way to predict embryo’s ploidy status decreasing implantation failure and miscarriage. However, this procedure is not always possible due to social or moral issues. So, the use of the non-invasive time lapse monitoring could be helpful to determine the morphokinetic characteristics in the different ploidy classes. KS-5.3 (vitrolife,Sweden) is a scoring model based on morphokinetic data, developed to predict the pregnancy rate of day-5 blastocysts. Recent publications showed differences in kinetic parameters between euploid and aneuploid embryos.
Study design, size, duration
This retrospective study analyzed 728 blastocysts with PGT-A results obtained at Villa Mafalda Clinic from May 2020 to June 2021. Embryos were cultured in EmbryoScope+ time-lapse system (Vitrolife) at 37 °C, 6%CO2, and 5% O2. The PGT-A was performed using next-generation sequence (NGS) technology on the trophectoderm biopsy sample on day 5/6/7. Automatic annotations for division times and quality gradings were performed by senior embryologists and all kinetic values were reported in hours post microinjection.
Participants/materials, setting, methods
728 blastocysts were classified in: (E) euploid (n = 172), (M) mosaicism (n = 171) and (A) aneuploid (n = 385). In this study, they were considered KS-5.3 and the following kinetic variables: the time to reach 2 cells (t2), 3 cells (t3), 4 cells (t4), 5 cells (t5), and the blastocyst formation (TB). Continuous variables were reported as the median and interquartile range (IQR). For the statistical analysis, nonparametric tests were performed and p < 0.05 was considered statistically significant.
Main results and the role of chance
KS5.3 was significantly different between groups [E = 6.6(4.6-7.9) vs M = 5.3(2.9-7.2) vs A = 4.0(2.5-6.6), p < 0.0001]. It was significantly higher in euploid than in mosaic and aneuploid (EvsM p = 0.0007, EvsA p <0.0001, MvsA p = 0.0077). A significant delay in t2,t3,t4 and tb was showed in aneuploid embryos compared to euploid and mosaic, whereas there was no significant difference between euploid and mosaic: [t2: E = 25.80 (24.56-28.09), M = 25.99 (24.49-28.91), A = 27.02 (25.30-29.47), EvsA p <0.0001, AvsM p = 0.03, EvsM p = 0.32]; [t3: E = 37.08 (34.74-39.34), M = 36.69 (34.55-40.02), E = 38.45 (35.93-41.14), EvsA p = 0.0003, MvsA p = 0.002, EvsM p >0.99]; [t4: E = 38.28 (35.63-41.19), M = 38.49 (35.47-42.13), A 39.72 (37.25-43.31), EvsA p = 0.0001, MvsA p = 0.02, EvsM p = 0.65]; [tb: E = 107.70 (102.20-114.30), M = 110.10 (103.60-116.80), A = 113.7 (106.80-122.70), EvsA p <0.0001, MvsA p <0.0001, EvsM p = 0.42]. As for t5, there were no differences among the groups. Longer cell cycles in aneuploid embryos could be associated with activated DNA repair mechanism or during chromosome segregation. Instead, regarding the mosaics, there was a significant difference with euploid embryos only in KS5.3. The age was similar between euploid and mosaic [E = 36.29 (33.42-39.00) vs M = 36.71 (34.00-39.33) p = 0.99], whereas that was significantly higher in aneuploid embryos [A = 39.11(36.01-42.27), EvsA/EvsM p <0.0001].
Limitations, reasons for caution
All these findings have to be validated in a larger sample size. Furthermore, for the retrospective nature of this study, there were some confounding factors, such as protocol of stimulation, female age, and malefactor. This research did not consider the importance of every single kinetic parameter.
Wider implications of the findings
A further study is needed to verify if there is a correlation between morphology and ploidy status. This could clarify the difference in KS-5.3 between euploid and mosaic. In order to decrease age bias, we should enlarge the sample size to analyze a subgroup of patients with higher maternal age.
Trial registration number
not applicable
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Affiliation(s)
- G Pirastu
- Villa Mafalda, fertility clinic , Roma, Italy
| | - I Listorti
- Villa Mafalda, fertility clinic , Roma, Italy
| | - R Manzo
- Villa Mafalda, fertility clinic , Roma, Italy
| | - M Barberi
- Villa Mafalda, fertility clinic , Roma, Italy
| | - M Musella
- Villa Mafalda, fertility clinic , Roma, Italy
| | - V Zazzaro
- Villa Mafalda, fertility clinic , Roma, Italy
| | - A Colasante
- Villa Mafalda, fertility clinic , Roma, Italy
| | | | - F Scarselli
- Villa Mafalda, fertility clinic , Roma, Italy
| | - C Mencacci
- Villa Mafalda, fertility clinic , Roma, Italy
| | - C Arrivi
- Villa Mafalda, fertility clinic , Roma, Italy
| | - K Litwicka
- Villa Mafalda, fertility clinic , Roma, Italy
| | - P Greco
- Villa Mafalda, fertility clinic , Roma, Italy
| | - A Greco
- Villa Mafalda, fertility clinic , Roma, Italy
| | - E Greco
- Villa Mafalda, fertility clinic , Roma, Italy
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Donno V, Greco E, Greco A, Miniasi M, Pristerà A, Pirastu G, Varricchio M, Litwicka K, Arrivi C, Mencacci C, Greco P. P-165 Which are the determining factors influencing the success rate of egg donation programs with imported vitrified oocytes? Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Which are the determining factors influencing the success rate of egg donation programs with imported vitrified oocytes?
Summary answer
Number of oocytes available after warming, male BMI and semen characteristics are critical parameters influencing reproductive results of oocyte donation programs with imported vitrified oocytes
What is known already
The use of vitrified oocytes from foreign banks and the performance of ICSI using fresh sperm from the recipient's partner is a widely used method of heterologous fertilisation. Recent evidence has questioned the overall effectiveness of this approach: vitrification and warming may reduce the number of oocytes available for insemination, resulting in a lower rate of live births per cycle. Recent studies have attempted to define the right clinical strategy to improve the effectiveness of oocyte vitrification cycles, stressing the importance of the number of imported oocytes (8-9 oocytes) and transfer to the blastocyst stage.
Study design, size, duration
Observational longitudinal cohort study of 431 cycles of oocyte donation conducted between January 2015 and February 2019. A total of 398 couples (mean female age: 43.2 ± 3.5, 28-50 years; mean male age: 44.7 ± 6.1, 28-73 years) underwent an IVF cycle with imported donated vitrified oocytes (mean donor age: 25.2 ± 3.5, 19-34 years). All consecutive oocyte donation cycles conducted at the centre for Reproductive Medicine of the European Hospital in Rome were included.
Participants/materials, setting, methods
In order to assess which factors are associated with the various outcomes, uni-and multi-variable analyses were conducted. In the multivariable analyses, variables that showed a p value<0.1 in the univariable analyses were included in the final model. The results were presented as Odds Ratio (OR). The corresponding 95% Confidence Interval (95% CI) was also exposed. A p value <0.05 was considered statistically significant. All analyses were performed with STATA v16.1 statistical software.
Main results and the role of chance
A univariate analysis was carried out showing that among the demographic characteristics studied, the only one that proved significantly able to influence the outcome of the pregnancy test was male BMI. In 49% of unsuccessful cycles, the male BMI was above 25 (p = 0.03). The correlation is confirmed when comparing cycle outcomes in couples with normal/underweight vs overweight/obese men (p = 0.03). The relationship between female or donor BMI and treatment outcome, however, was not statistically significant. The day on which embryo transfer is performed affects the outcome of the cycle: transferring on day 2 compared to day 5 reduces the probability of clinical pregnancy (ET in day 2= positive clinical pregnancy in 4/16 (25%); ET in day 3= 158/307 (51.4%); ET in day 5=40/67 (59.7%). The relationship between male BMI classes and sperm parameters was studied: the distribution of concentration is different in the 3 BMI groups (p = 0.011); in particular, obese men have a significantly lower concentration than normal-weight men (p = 0.006 after Bonferroni correction). There were no statistically significant differences in volume (P = 0.722), morphology (p = 0.100) and motility (p = 0.179), although there was a downward trend in motility, with a reduction in obese subjects compared to normal weight.
Limitations, reasons for caution
This is an observational study and our findings are in contrast with previous studies which do not show any correlation between male partner BMI categories and reproductive outcomes in egg donation programs.
Wider implications of the findings
Our study shows that the number of oocytes available after warming, male BMI, semen characteristics and blastocyst transfer are critical parameters able to influence the reproductive outcomes of egg donation programs with imported vitrified oocytes.
Trial registration number
Not applicable
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Affiliation(s)
- V Donno
- University of Modena and Reggio Emilia, Department of Medical and Surgical Sciences of the Mother- Children and Adults , Modena, Italy
| | - E Greco
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - A Greco
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - M.G Miniasi
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - A Pristerà
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - G Pirastu
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - M.T Varricchio
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - K Litwicka
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - C Arrivi
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - C Mencacci
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
| | - P Greco
- Villa Mafalda, Reproductive Medicine , 00199 Rome, Italy
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Colizza A, Ralli M, Turchetta R, Minni A, Greco A, de Vincentiis M. Otolaryngology adverse events following COVID-19 vaccines. Eur Rev Med Pharmacol Sci 2022; 26:4113-4116. [PMID: 35731083 DOI: 10.26355/eurrev_202206_28981] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Since the outbreak of COVID-19 pandemic, the international scientific community aimed at developing a vaccine to protect against the infection and prevent serious forms of the disease. To date, various adverse events of COVID-19 vaccines have been reported, mostly mild to moderate. MATERIALS AND METHODS In this short communication, we reviewed available literature and described the most frequent otolaryngology adverse events reported after COVID-19 vaccination. RESULTS The most frequent adverse events following COVID-19 vaccine described in the literature are represented by audiovestibular symptoms, such as tinnitus, sudden sensorineural hearing loss, vertigo, and dizziness. Other side effects include facial nerve palsy, epistaxis, and oral manifestations (lichen planus, bleeding, ulcers, and vesicles). CONCLUSIONS COVID-19 vaccine is of utmost importance in limiting the spread of SARS-CoV-2. Otolaryngology-related side effects have been described, but none was severe or life threatening. The mechanisms underlying these effects are still mostly unknown.
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Affiliation(s)
- A Colizza
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
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D'Angelo A, Petrella C, Greco A, Ralli M, Vitali M, Giovagnoli R, De Persis S, Fiore M, Ceccanti M, Messina MP. Acute alcohol intoxication: a clinical overview. Clin Ter 2022; 173:280-291. [PMID: 35612344 DOI: 10.7417/ct.2022.2432] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract Alcohol is a legal and yet detrimental psychoactive substance, capable of establishing addiction and impacting the physical, mental, social, and economic health of people. Alcohol intake causes a large variety of tissue damages severely impacting the nervous system, digestive and cardiovascular systems and causing oral cavity, oropharyngeal, hypopharyngeal, esophageal, colon-rectal, laryngeal, liver and intrahepatic bile duct, and breast cancers. Alcohol can also play a role in the pathogenesis of diabetes mellitus, cardiomyopathy and hemorrhagic strokes. When drunk during pregnancy it is proved to be responsible for serious damage to fetuses causing a wide range of pathological conditions from miscarriage to Fetal Alcoholic Spectrum Disorder (FASD). Acute ethanol intoxication happens when the amount of alcohol consumed is greater than the disposal capacity of the liver, causing an accumulation of its metabolites displayed by initial dysphoria and disinhibition. Nausea, vomiting, memory loss could happen. Although, it can lead to more serious conditions like impaired speaking, impaired coordination, unstable gait, nystagmus, stupor, or coma. Respiratory depression and death could also happen in such cases. Unfortunately, diagnosis of acute alcohol intoxication is difficult because most of the drinkers deny or minimize their assumption. It is dramatically important to assess when the last intake happened to avoid withdrawal syndrome. Alcohol acute intoxication can be considered a serious harm to health and a relevant issue for healthcare provid-ers working in emergency rooms. Differential diagnosis is crucial to avoid serious outcomes. There is no consensus about therapies for acute intoxication, but supportive and symptomatic treatments were proved effective. The repercussions of alcohol misuse over drinkers' social, familiar, economical and working life enhance the importance of a multidisciplinary approach in such cases.
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Affiliation(s)
- A D'Angelo
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Italy
| | - C Petrella
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome, Italy
| | - A Greco
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - M Ralli
- Department of Sense Organs, Sapienza University of Rome, Italy
| | | | - R Giovagnoli
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Italy
| | | | - M Fiore
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome, Italy
| | - M Ceccanti
- SITAC, Società Italiana per il Trattamento dell'Alcolismo e le sue Complicanze, Rome, Italy
| | - M P Messina
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Italy
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19
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Mameli M, Franchi J, Calusi G, Deken M, Johnson Z, van der Veen L, Lahn M, Vezzelli A, Cardin R, Greco A, Breda M. Validation of an LC–MS/MS method for the quantification IOA-289 in human plasma and its application in a first-in-human clinical trial. J Pharm Biomed Anal 2022; 217:114829. [DOI: 10.1016/j.jpba.2022.114829] [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] [Received: 03/10/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/25/2022]
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Sidoli C, Zambon A, Tassistro E, Rossi E, Mossello E, Inzitari M, Cherubini A, Marengoni A, Morandi A, Bellelli G, Tarasconi A, Sella M, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Porcella L, Nardiello I, Chimenti E, Zeni M, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, Pietrogrande L, Mosca M, Corazzin I, Rossi P, Nunziata V, D’Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell’Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Borghi C, Bianchetti A, Crucitti A, DiFrancesco V, Fontana G, Geriatria A, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cassadonte F, Vatrano M, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Seneci F, Fimognari F, Bambar V, Saitta A, Corica F, Braga M, Servi, Ettorre E, Camellini Bellelli CG, Annoni G, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Formilan M, Patrizia G, Santuar L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl’Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Alessandro M, Calogero P, Corvalli G, Di F, Pezzoni D, Platto C, D’Ambrosio V, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Bonetto M, Grasso M, Troisi E, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Faraci B, Bertoletti E, Vannucci M, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D’Amico F, Grippa A, Mazzone A, Cottino M, Vezzadini G, Avanzi S, Brambilla C, Orini S, Sgrilli F, Mello A, Lombardi Muti LE, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D’Amico F, D’Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Cortegiani A, Pistidda L, D’Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study. Aging Clin Exp Res 2022; 34:1827-1835. [PMID: 35396698 DOI: 10.1007/s40520-022-02099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. AIM We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the "Delirium Day project". METHODS We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the "Delirium Day project" (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. RESULTS Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17-1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08-2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62-2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10-1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02-1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68-3.36, p value < 0.0001). CONCLUSION This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.
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Rizzo MI, Fallico N, Beneduce N, Ruoppolo G, Ciofalo A, Vagnoni S, Palmieri A, De Virgilio A, Greco A, Zama M. Objective and subjective evaluation of Velopharyngeal Dysfunction (VPD) following surgical repair of the cleft palate using the furlow palatoplasty - A new tool. J Plast Reconstr Aesthet Surg 2022; 75:3448-3456. [PMID: 35768288 DOI: 10.1016/j.bjps.2022.02.024] [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: 06/14/2021] [Accepted: 02/12/2022] [Indexed: 11/30/2022]
Abstract
Velopharyngeal dysfunction (VPD) diagnosis and speech surgery outcomes are currently based solely on subjective evaluation criteria consisting of perceptual speech assessment and functional imaging. This study describes an objective and comparable method in VPD assessment and investigates the concurrence between the objective and subjective evaluations. The present study included 20 paediatric patients presenting with VPD after primary repair (intravelar veloplasty) of cleft palate. Our protocol was based on computerized analysis of voice parameters by means of an objective tool, spectrography integrated with Multi-Dimensional Voice Program (MDVP). The protocol also included perceptual evaluation by speech therapist and phoniatrician (consensus listening), and parents. This is a single surgeon, single centre experience and all patients underwent a secondary Furlow's palatoplasty. Assessments were performed pre- and postoperatively and upon completion of speech therapy. Results were compared using the two-tailed t student test for paired data. Statistical significance was set for p-values <0.05. Data analysis confirmed an improvement in velopharyngeal closure after surgery and speech therapy consistently with the results of perceptual evaluations. The results of the study confirmed the availability and reliability of an objective method for VPD evaluation based on the analysis of voice parameters with investigations that are simple and easily available in a hospital setting.
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Affiliation(s)
- M I Rizzo
- Ospedale Pediatrico Bambino Gesù, Department of Plastic and Maxillo-facial surgery, Piazza di Sant'Onofrio 4, 00165 Roma, Italy
| | - N Fallico
- Spires Cleft Centre, Salisbury Oxford, UK
| | - N Beneduce
- Sapienza University, Department of Maxillofacial surgery, Viale del policlinico 155, 00161 Roma, Italy.
| | - G Ruoppolo
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - A Ciofalo
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - S Vagnoni
- Ospedale Pediatrico Bambino Gesù, Department of Plastic and Maxillo-facial surgery, Piazza di Sant'Onofrio 4, 00165 Roma, Italy
| | - A Palmieri
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - A De Virgilio
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - A Greco
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - M Zama
- Ospedale Pediatrico Bambino Gesù, Department of Plastic and Maxillo-facial surgery, Piazza di Sant'Onofrio 4, 00165 Roma, Italy
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22
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De Giorgio F, Ricci E, Arena E, Greco A, Ralli M. COVID-19 pandemic and days of absence from work in workers with flu-like symptoms in the City of Rome, Italy. Clin Ter 2022; 173:64-66. [PMID: 35147649 DOI: 10.7417/ct.2022.2394] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
ABSTRACT COVID-19 has dramatically affected working forces. We aim to report our occupational medicine service's experience in managing suspected COVID-19 cases during the pandemic through a retrospec-tive observational study. We compared the number of days employees were absent from work due to flu-like symptoms from March 2020 to February 2021 to the same period the previous year (2019-2020). Two hundred thirty-four patients (+47.2% compared to the previous year) who tested negative for SARS-CoV-2 reported flu-like symp-toms; the number of days of absence from work was 2812 (+190.2% compared to the previous year). On average, employees with flu-like symptoms lost 12.07 working days compared to 6.12 in the previous year (p<0.0001). In conclusion, in our sample COVID-19 has increased the number of working day loss. However, our approach proved to be important, especially during the first months of the pandemic, to limit SARS-CoV-2 spread in workplaces.
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Affiliation(s)
- F De Giorgio
- Department of Health Care Surveillance and Bioethics, section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.,ondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - E Ricci
- Department of Health Care Surveillance and Bioethics, section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - E Arena
- Department of Health Care Surveillance and Bioethics, section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Greco
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - M Ralli
- Department of Sense Organs, Sapienza University of Rome, Italy
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Zucchelli A, Manzoni F, Morandi A, Di Santo S, Rossi E, Valsecchi MG, Inzitari M, Cherubini A, Bo M, Mossello E, Marengoni A, Bellelli G, Tarasconi A, Sella M, Auriemma S, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Margola A, Porcella L, Nardiello I, Chimenti E, Zeni M, Giani A, Famularo S, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Ballestrero A, Minaglia C, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, De F, Pietrogrande L, De B, Mosca M, Corazzin I, Rossi P, Nunziata V, D‘Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell‘Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Bianchetti A, Crucitti A, Di Francesco V, Fontana G, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cannistrà U, Cassadonte F, Vatrano M, Cassandonte F, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Fimognari F, Bambara V, Saitta A, Corica F, Braga M, Ettorre E, Camellini C, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Patrizia G, Santuari L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl‘Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Calogero P, Corvalli G, Pezzoni D, Gentile S, Morandi A, Platto C, D‘Ambrosio V, Faraci B, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Confente S, Bonetto M, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Bertoletti E, Vannucci M, Tesi F, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D‘Amico F, Grippa A, Mazzone A, Riva E, Dell‘Acqua D, Cottino M, Vezzadini G, Avanzi S, Orini S, Sgrilli F, Mello A, Lombardi L, Muti E, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, De F, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D‘Amico F, D‘Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Scapigliati A, Cortegiani A, Vitale F, Pistidda L, D‘Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017. Aging Clin Exp Res 2022; 34:349-357. [PMID: 34417734 PMCID: PMC8847195 DOI: 10.1007/s40520-021-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/31/2021] [Indexed: 01/22/2023]
Abstract
Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric
syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01950-8.
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Bianco MR, Ralli M, Minni A, Greco A, de Vincentiis M, Allegra E. Evaluation of olfactory dysfunction persistence after COVID-19: a prospective study. Eur Rev Med Pharmacol Sci 2022; 26:1042-1048. [PMID: 35179771 DOI: 10.26355/eurrev_202202_28014] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Alterations of the olfactory function in patients affected by COVID-19 often have an early onset and a variable duration ranging from a few weeks to months. The aim of this study was to evaluate olfactory dysfunction persistence after recovery from COVID-19, and potential related clinical-demographic conditions. PATIENTS AND METHODS A total of 76 patients recovered from COVID-19 from at least 20 days with olfactory dysfunction during the infection were included in the study. For the subjective evaluation of olfactory function, a visual analogic scale (VAS) was used. The objective evaluation was performed with the use of the Sniffin' Sticks test. RESULTS Objective assessment of olfactory function revealed that 48 (63.16%) patients were found to be normosmic (TDI ≥ 30.5), 26 (34.21%) were hyposmic (TDI from 30.5 to 16.5) and two (2.63%) were anosmic (TDI ≤ 16.5) at the time of the evaluation. These results did not show a significant difference between subjective and objective tests (p = 0.45). Most patients recovered their sense of smell within the first two months after recovery while a portion (22.2%) still experienced olfactory alterations 4-6 months after SARS-CoV-2 infection. Patients who had not recovered their sense of smell had a significantly longer period of SARS-CoV-2 positivity compared to patients that fully recovered (36.07 ± 7.78 days vs. 29 ± 7.89 days; p = 0.04). CONCLUSIONS Our results suggest that the duration of the infection negatively correlates with the recovery of olfactory function.
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Affiliation(s)
- M R Bianco
- Otolaryngology Unit, Department of Health Science, University of Catanzaro, Catanzaro, Italy.
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Tedeschi A, Frustaci AM, Mauro FR, Chiarenza A, Coscia M, Ciolli S, Reda G, Laurenti L, Varettoni M, Murru R, Baratè C, Sportoletti P, Greco A, Borella C, Rossi V, Deodato M, Biagi A, Zamprogna G, Pelle AC, Lapietra G, Vitale C, Morelli F, Cassin R, Fresa A, Cavalloni C, Postorino M, Ielo C, Cairoli R, Di Raimondo F, Montillo M, Del Poeta G. Do age, fitness, and concomitant medications influence management and outcomes of patients with CLL treated with ibrutinib? Blood Adv 2021; 5:5490-5500. [PMID: 34525181 PMCID: PMC8714729 DOI: 10.1182/bloodadvances.2021004824] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/27/2021] [Indexed: 11/22/2022] Open
Abstract
Functional reserve of organs and systems is known to be relevant in predicting immunochemotherapy tolerance. Age and comorbidities, assessed by the cumulative illness rating scale (CIRS), have been used to address chemotherapy intensity. In the ibrutinib era, it is still unclear whether age, CIRS, and Eastern Cooperative Oncology Group performance status (ECOG-PS) retain their predictive role on treatment vulnerability. In this series of 712 patients with chronic lymphocytic leukemia (CLL) treated with ibrutinib outside clinical trials, baseline ECOG-PS and neutropenia resulted as the most accurate predictors of treatment feasibility and outcomes. Age did not independently influence survival and ibrutinib tolerance, indicating that not age per se, but age-related conditions, may affect drug management. We confirmed the role of CIRS > 6 as a predictor of a poorer progression- and event-free survival (PFS, EFS). The presence of a severe comorbidity was significantly associated with permanent dose reductions (PDRs), not translating into worse outcomes. As expected, del(17p) and/or TP53mut and previous therapies affected PFS, EFS, and overall survival. No study so far has analyzed the influence of concomitant medications and CYP3A inhibitors with ibrutinib. In our series, these factors had no impact, although CYP3A4 inhibitors use correlated with Cox regression analysis, with an increased risk of PDR. Despite the limitation of its retrospective nature, this large study confirmed the role of ECOG-PS as the most accurate predictor of ibrutinib feasibility and outcomes, and importantly, neutropenia emerged as a relevant tool influencing patients' vulnerability. Although CIRS > 6 retained a significant impact on PFS and EFS, its value should be confirmed by prospective studies.
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Affiliation(s)
- Alessandra Tedeschi
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Anna Maria Frustaci
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Francesca Romana Mauro
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto I, Rome, Italy
| | - Annalisa Chiarenza
- Division of Hematology, AOU “Policlinico-Vittorio Emanuele,” University of Catania, Catania, Italy
| | - Marta Coscia
- Division of Hematology, AOU Città della Salute e della Scienza di Torino, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Stefania Ciolli
- Department of Hematology, Università degli Studi di Firenze, Firenze, Italy
| | - Gianluigi Reda
- Department of Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Luca Laurenti
- Hematology Institute, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Roma, Italy
| | - Marzia Varettoni
- Division of Hematology Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberta Murru
- Hematology and Stem Cell Transplantation Unit, Ospedale A. Businco, ARNAS “G. Brotzu,” Cagliari, Italy
| | - Claudia Baratè
- Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy
| | - Paolo Sportoletti
- Division of Hematology and Clinical Immunology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Antonino Greco
- Department of Hematology, Azienda Ospedaliera Giovanni Panìco, Tricase, Italy
| | - Chiara Borella
- Department of Hematology, Ospedale San Gerardo, Monza, Italy
| | - Valentina Rossi
- Hematology & Transfusion Medicine L. Sacco University Hospital and School of Medicine, Milano, Italy; and
| | - Marina Deodato
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Annalisa Biagi
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Giulia Zamprogna
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Angelo Curto Pelle
- Division of Hematology, AOU “Policlinico-Vittorio Emanuele,” University of Catania, Catania, Italy
| | - Gianfranco Lapietra
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto I, Rome, Italy
| | - Candida Vitale
- Division of Hematology, AOU Città della Salute e della Scienza di Torino, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Francesca Morelli
- Department of Hematology, Università degli Studi di Firenze, Firenze, Italy
| | - Ramona Cassin
- Department of Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Alberto Fresa
- Hematology Institute, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Roma, Italy
| | - Chiara Cavalloni
- Division of Hematology Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Massimiliano Postorino
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Claudia Ielo
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto I, Rome, Italy
| | - Roberto Cairoli
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Francesco Di Raimondo
- Division of Hematology, AOU “Policlinico-Vittorio Emanuele,” University of Catania, Catania, Italy
| | - Marco Montillo
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Giovanni Del Poeta
- Hematology, Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
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Ralli M, Colizza A, Cambria F, Gilardi A, Meliante P, Cavalcanti L, Minni A, Greco A, de Vincentiis M. Effects of COVID-19 pandemic on head and neck oncology activity: the experience of our University Hospital. Eur Rev Med Pharmacol Sci 2021; 25:7268-7271. [PMID: 34919225 DOI: 10.26355/eurrev_202112_27419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has severely affected otolaryngology and head and neck activities, also involving diagnosis and treatment of patients with oncology diseases with consequent delays and tumor upstaging. The aim of this study was to describe the experience of our otolaryngology unit during the pandemic on patients with cancer of the head and neck, comparing data on anatomical site of origin and preferred treatment with pre-pandemic data. PATIENTS AND METHODS This study retrospectively analyzed the clinical records of patients treated for oncology disorders of the head and neck in the Otolaryngology Unit of the Policlinico Umberto I, Sapienza University of Rome, between March 10, 2020, and March 9, 2021. Data were compared with the same period of the previous year (March 10, 2019 - March 9, 2020). RESULTS During the pandemic, we treated 92 patients with malignant tumor of the head and neck, compared to 101 patients treated during the same period of 2019 (-8.91%). The most common anatomical sites of origin of the neoplasms were larynx, oral cavity, and oropharynx. Surgical approach was preferred in 57 patients (61.95%); non-surgical treatments were performed in 35 cases (38.05%). Compared to the same period of the previous year, we found a 12.90% decrease in the number of oncology patients undergoing surgery, while patients treated exclusively with non-surgical approaches increased by 18.42%. CONCLUSIONS Despite the impact of COVID-19 on the activity of our otolaryngology unit and on the whole healthcare system, diagnostic and therapeutic procedures for patients affected by malignancy of head and neck region were only minimally impacted.
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Affiliation(s)
- M Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
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Ghiasi S, Dell'Acqua C, Benvenuti SM, Scilingo EP, Gentili C, Valenza G, Greco A. Classifying subclinical depression using EEG spectral and connectivity measures. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:2050-2053. [PMID: 34891691 DOI: 10.1109/embc46164.2021.9630044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Detecting depression on its early stages helps preventing the onset of severe depressive episodes. In this study, we propose an automatic classification pipeline to detect subclinical depression (i.e., dysphoria) through the electroencephalography (EEG) signal. To this aim, we recorded the EEG signals in resting condition from 26 female participants with dysphoria and 38 female controls. The EEG signals were processed to extract several spectral and functional connectivity features to feed a nonlinear Support Vector Machine (SVM) classifier embedded with a Recursive Feature Elimination (RFE) algorithm. Our recognition pipeline obtained a maximum classification accuracy of 83.91% in recognizing dysphoria patients with a combination of connectivity and spectral measures. Moreover, an accuracy of 76.11% was achieved with only the 4 most informative functional connections, suggesting a central role of cortical connectivity in the theta band for early depression recognition. The present study can facilitate the diagnosis of subclinical conditions of depression and may provide reliable indicators of depression for the clinical community.
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Calderone D, Mauro MS, Greco A, Capodanno D, Tamburino C. Characterization of actionable bleeding and thrombotic risk trade-offs in patients undergoing percutaneous coronary intervention. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2106] [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
Patients undergoing percutaneous coronary intervention (PCI) are at risk of developing bleeding and/or thrombotic complications. Bleeding and thrombotic risk characteristics may overlap in some patients, which makes decision-making for dual antiplatelet therapy duration a clinical challenge. The actual proportion of PCI patients who have an increased bleeding risk and/or an increased thrombotic risk is unclear.
Purpose
Aim of this study is to identify sizeable and actionable proportions of patients at high bleeding risk (HBR) and/or at high thrombotic risk (HTR) in a contemporary cohort of PCI patients.
Methods
We retrospectively included all patients undergoing PCI at our Institution from November 2019 to April 2020 and identified those at HBR or HTR based on criteria from the Academic Research Consortium for High Bleeding Risk (ARC-HBR) or criteria from Giustino and colleagues, respectively. Since belonging to the HBR and HTR groups was non-mutually exclusive, patients were further stratified into 4 mutually exclusive subgroups: 1) HBR/HTR; 2) HBR, non-HTR; 3) non-HBR, HTR; and 4) non-HBR, non-HTR. In addition, the new ARC-HBR trade-off model (integrating patients' characteristics to define the individual risks of bleeding and thrombotic events) was applied to rank patients based on their computed risk scores for bleeding and thrombosis. Patients were categorized based on the ratio between the ARC-HBR thrombotic and the bleeding risk scores (i.e., high [1.5], intermediate [0.75–1.5], low [<0.75]).
Results
A total of 312 patients were included, of which 93 (30%) presented with HBR and 116 (37%) with HTR. Among patients with HBR, 41% presented with HTR. Among patients with HTR, 33% presented with HBR. Overall, 12.2% of patients had HBR/HTR, 17.6% had HBR, non-HTR, 25.0% had non-HBR, HTR, and 45.2% had non-HBR, non-HTR. Based on the ARC-HBR trade off score, 16.3% of patients had a higher risk of thrombosis than the risk of bleeding, 45.9% had similar risks, and 37.8% had a higher risk of bleeding than the risk of thrombosis. Among patients who had HBR/HTR, the trade-off model identified 8% as having a higher risk of thrombosis than the risk of bleeding and 18.4% as having a higher risk of bleeding than the risk of thrombosis.
Conclusions
Characterizing the risk of bleeding and thrombotic complications is an important prerequisite for tailoring strategies to individual patients, hence minimizing the risks and improving the outcome of PCI. More than half of patients undergoing PCI presented with HBR, HTR, or both. About 40% of patients presented with characteristics of high risk, which make them actionable (e.g., by using shorter durations of dual antiplatelet therapy in patients at HBR and non-HTR or using longer durations in patients at non-HBR and HTR). The ARC-HBR trade off model score is an additional useful tool that may be used to identify an additional quarter of actionable patients in the HBR/HTR category.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Calderone
- Azienda Ospedaliero Universitaria “G.Rodolico - S. Marco”, Cardiology Unit, Catania, Italy
| | - M S Mauro
- Azienda Ospedaliero Universitaria “G.Rodolico - S. Marco”, Cardiology Unit, Catania, Italy
| | - A Greco
- Azienda Ospedaliero Universitaria “G.Rodolico - S. Marco”, Cardiology Unit, Catania, Italy
| | - D Capodanno
- Azienda Ospedaliero Universitaria “G.Rodolico - S. Marco”, Cardiology Unit, Catania, Italy
| | - C Tamburino
- Azienda Ospedaliero Universitaria “G.Rodolico - S. Marco”, Cardiology Unit, Catania, Italy
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Dusi V, Barcellini A, Greco A, Vitolo V, Vai A, Mirandola A, Zambrino D, Roccio M, Coccia M, Turco A, Sanzo A, Vicentini A, Ghio S, Orlandi E, Rordorf R. Hadrontherapy for intra- or para-cardiac tumors: evaluation of cardiac radiation dose distribution and acute cardiac effects. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2864] [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
There is growing interest in the possibility of using X-rays and hadrons (protons and carbon ions) for antiarrhythmic purposes both at the ventricular and the atrial level, but knowledge about the effects on cardiac tissue outside the target is still limited. Hadron therapy has the dosimetric advantage over photons of a greater ability to concentrate high doses on the target while minimizing the off-target dose. Oncological studies have shown a linear relationship between the mean total heart dose (Dm-heart) of X-rays and the long-term risk of heart damage, particularly when the Dm-heart is>5 Gray (Gy).
Objectives
We designed a prospective study aimed at investigating the effect of heavy particles on cardiac structure and function and on cardiac rhythm in patients undergoing hadrontherapy for intra or para-cardiac tumors.
Methods
Patients candidates to hadrontherapy with a mean predicted cardiac dose grather than zero underwent close cardiological monitoring including blood pressure detection, 12-lead ECG, 12-lead Holter ECG (including time-domain indices of heart rate variability in all cases and Brugada leads in selected cases), cardiac US and cardiac (troponin and natriuretic peptides) and inflammatory biomarkers. These assessments were obtained at baseline, during (ECG and biomarkers only) and at the end of the hadrontherapy cycle, and then every 3–6 months as appropriate. Physicists and radiotherapists collaborated to implement a robust optimization of the treatment plan aimed at minimizing cardiac dose. We present the results of the monitoring up to the end of the hadrontherapy.
Results
17 consecutive patients (56±18 years, range 20–77 years, 59% male) have been enrolled to date, including 3 cases (18%) of intra-cardiac tumors (2 primary and 1 metastatic), who have undergone to 16±6 sessions of radiotherapy each, in 71% of cases with respiratory gating during delivery. Most patients (76%) were treated with carbon ions, the remaining with protons (mean total dose on the neoplastic target 51.8±10.7 Gy, from 2 to 4.2 Gy per fraction). Sixty-one percent of patients had ≥1 cardiovascular risk factor, 6% had a known heart disease (valvular cardiomyopathy despite aortic valve replacement with biological prosthesis and post-surgical pericarditis). The mean dose on the whole heart was 3.58±2.05 Gy, the maximum dose was 33.78±23.99 Gy, with a very variable dose distribution on cardiac substructures depending on the tumor site (table). At the end of the scheduled radiotherapy sessions (24±9 days), no significant changes were observed in cardiac function, cardiac rhythm, ventricular repolarization, biomarkers and autonomic indices.
Conclusions
Hadrontherapy with protons and carbon ions aimed at the treatment of para-cardiac or intra-cardiac tumors allowed to maintain a low heart Dm and showed no signs of acute cardiac toxicity. The collection of potential cardiac effects in the medium and long term is ongoing.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- V Dusi
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - A Barcellini
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - A Greco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - V Vitolo
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - A Vai
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - A Mirandola
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - D Zambrino
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - M Roccio
- Policlinic Foundation San Matteo IRCCS, Department of Gynecology, Pavia, Italy
| | - M Coccia
- University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Turco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Sanzo
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - A Vicentini
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - E Orlandi
- National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - R Rordorf
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
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Dusi V, Masiello L, Vicentini A, Savastano S, Petracci B, Sanzo A, Baldi E, Greco A, Turco A, Raineri C, Scelsi L, Ghio S, Serio A, Arbustini E, Rordorf R. Long-term outcome of patients with cardiolaminopathy undergoing defibrillator implantation: single-center experience. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0628] [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
Mutations in the LMNA gene are associated with a high arrhythmic risk. The history of the disease in patients undergoing ICD implantation is poorly characterized.
Purpose
To evaluate the phenotype of patients with cardiolaminopathy at the time of first ICD implantation, the incidence, characteristics and timing of ventricular arrhythmias (VAs) during follow up and the predictive value of the European score (that assigns a point each to non-sustained VT (NSVT), left ventricular ejection fraction (LVEF)<45% at first contact, male sex and non-missense mutations) and of the Wahbi score (that also includes conduction disturbances) for both VAs and heart failure (HF) related outcomes.
Methods
Patients were identified retrospectively. Clinical and device data were collected at baseline and during follow-up.
Results
We identified 26 patients (54% male, 42±8 years, 31% with familial history of sudden cardiac death, 31% with non-missense mutation) undergoing ICD implantation, 96% in primary prevention, 47% with single chamber ICD, 38% with dual chamber ICD. At the time of implantation, 30% had skeletal muscle involvement, 15% history of syncope, 4% of cardiac arrest, 62% previous NSVT. Also, 38% had a history of supraventricular arrhythmias and 61% had AV conduction disturbances. LVEF was 41±11%, 35% were in NYHA class ≥2, the mean European and Wahbi scores were 2.1±0.8 and 18.2±8.9, respectively. During 8.3±5 years, 15% were transplanted, 8% died due to HF, 4% underwent LVAD implantation, despite 31% having received an upgrade to CRT-D. Appropriate device interventions occurred in 46% of patients with a median time to first event of 29 months (IQR 13–93), for a total of 137 ATP, 51% of which effective (median 3ATP/patient, IQR 1–8) and of 26 shocks, 96% of which effective (median 2 shocks/patient, IQR 1–3); 12% had an arrhythmic storm. The first treated arrhythmia was a polymorphic VT/VF in 17%, a monomorphic VT in the others (medium cycle length 293±37 msec). Survival free from appropriate ICD interventions at 1 and at 5 years was 75% and 19% respectively in case of a European score ≥3 vs 94% and 82% in case of a score <3 (Logrank test p<0.01), 72% and 46% in case of Wahbi score ≥30 vs 100% and 86% with score <30 (p<0.01), with no differences in terms of death/transplant (figure). At last follow-up, 92% of patients a were taking beta-blocker, 42% amiodarone, 8% sotalol, 4% flecainide, 8% mexiletine. Also, 4% had undergone invasive VT ablation, 8% bilateral cardiac sympathetic denervation.
Conclusions
Patients with cardiolaminopathy are at a high risk of both arrhythmic and heart failure progression over the first decade after implantation of the first ICD. A European score ≥3 identifies patients with 5-year shock/ATP free survival of less than 20% but does not predict death/transplantation. The first arrhythmic event in these patients is more frequently a rapid monomorphic VT with modest ATP efficacy.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- V Dusi
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - L.C Masiello
- University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Vicentini
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - S Savastano
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - B Petracci
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - A Sanzo
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - E Baldi
- University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Greco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Turco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - C Raineri
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - L Scelsi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Serio
- Policlinic Foundation San Matteo IRCCS, Center for Cardiovascular Genetic Diseases, Pavia, Italy
| | - E Arbustini
- Policlinic Foundation San Matteo IRCCS, Center for Cardiovascular Genetic Diseases, Pavia, Italy
| | - R Rordorf
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
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Sepe R, Greco A, De Luca A, Caputo F, Berto F. Influence of thermo-mechanical material properties on the structural response of a welded butt-joint by FEM simulation and experimental tests. Forces in Mechanics 2021. [DOI: 10.1016/j.finmec.2021.100018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ruoppolo G, Mariani L, Quaglieri S, Longo L, Pescerelli P, Cilfone A, Cocchi C, Marcotullio D, Greco A, De Vincentiis M. Unilateral vocal fold paralysis post-thyroidectomy: does early intervention allow for better voice recovery? Eur Rev Med Pharmacol Sci 2021; 25:1177-1184. [PMID: 33629287 DOI: 10.26355/eurrev_202102_24820] [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] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Thyroidectomy is the primary cause of unilateral vocal fold paralysis (UVFP). A delay in rehabilitation may cause dysfunctional phenomena and worsen dysphonia. The main aim is to investigate the impact of early Speech Therapy (ST) on voice recovery in UVFP post-thyroidectomy and propose an appropriate treatment schedule. PATIENTS AND METHODS 93 patients with UVFP were analysed. 72 presented transient paralysis and 21 permanent ones. Individuals with permanent paralysis were retrospectively divided in two groups. Group A was composed of 11 patients (8 F, 3 M; mean age: 50.5 ± 8.6) who received ST within 8 weeks; Group B comprised 10 patients (7 F, 3 M; mean age: 57 ± 11.5) treated after more than 8 weeks. Videolaryngostroboscopy (VLS) was assessed and both objective and subjective voice parameters were collected. The non-parametric Wilcoxon test was applied to the sample. RESULTS The resolution of supraglottic compensations was observed in 91% of cases in Group A, whereas in only 40% of cases in Group B. A functional glottal closure occurred in 73% of patients in group A, while it was completely absent in group B. Group A showed a statistically significant difference between the values of Jitter, NHR, TMF and VHI collected pre-ST compared to that collected after 1 year. Conversely, a statistically significant difference was found only for VHI values in group B. CONCLUSIONS Early ST brings benefits to patients with permanent UVFP, both on voice recovery and on quality of life. A ST protocol should be applied both before and after thyroidectomy. The ST treatment should start early after surgery.
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Affiliation(s)
- G Ruoppolo
- Department of Sensorial Organs, Sapienza University of Rome, Rome, Italy.
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Barbato C, Di Certo MG, Gabanella F, Petrella C, Fiore M, Passananti C, Colizza A, Cavalcanti L, Ralli M, Greco A, De Vincentiis M, Minni A. Staying tuned for post-COVID-19 syndrome: looking for new research to sniff out. Eur Rev Med Pharmacol Sci 2021; 25:5318-5321. [PMID: 34486708 DOI: 10.26355/eurrev_202108_26553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Post-COVID-19 syndrome was defined as a persistent and protracted illness, which follows acute COVID-19 infection. This condition continues for more than 12 weeks and cannot be attributed to other clinical situations. Researchers and clinicians are allied in unraveling the molecular pathogenetic mechanisms and the clinical development of this unexpected SARS-CoV-2 infectious evolution. Anosmia, dysgeusia, fatigue, dyspnea, and 'brain fog' are common symptoms observed in the Post-COVID-19 syndrome, depicting a multiorgan involvement associated with injuries involving mainly cardiovascular, pulmonary, musculoskeletal, and neuropsychiatric systems. This commentary analyzes the state of the art of Post-COVID-19 interdisciplinary studies, confirming that we are facing a truly intricate biomedicine story.
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Affiliation(s)
- C Barbato
- Institute of Biochemistry and Cell Biology (IBBC), Consiglio Nazionale delle Ricerche (CNR), Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
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Iovine E, Zazzaro V, Pirastu G, Scarselli F, Ruberti A, Paccagnini D, Colasante A, Greco P, Pristerà A, Varricchio MT, Caragia A, Greco A, Minasi MG, Greco E. P–566 Advanced paternal age can influence aneuploidy rate in egg donation cycles with poor sperm quality. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Could advanced paternal age influences the embryos aneuploidy rate in eggs donation cycles with poor sperm quality?
Summary answer
In case of severe male factors increased paternal age can affect embryos aneuploidy rate in egg donation cycles.
What is known already
While the impact of advanced maternal age on reproductive is well understood, the effect of paternal age on reproductive function is controversial. Many studies have shown that Advanced Paternal Age (APA) could impact on male fertility potential affecting testicular function and sperm quality. Moreover, APA also has been associated with increased epigenetics changes and DNA mutations. Increased paternal age could be associated with different types of disorders such as autism, schizopherenia and bipolar disorders. Egg donation cycles, controlling female variables, represent the ideal model for the study of the impact of paternal age on reproductive outcomes.
Study design, size, duration
We retrospectively analyzed 43 egg donation cycles (October 2014-January 2020) with ≥ 50% survival rate of vitrified/warmed oocyte. Only cycles with poor sperm quality were considered. Cycles were divided in two GROUPS: group–1 included male paternal age ≤ 45 while group–2 included male paternal age >45. Data, shown as avarage±SD, were analyzed with Chi square or Student-t test.
Participants/materials, setting, methods
Group–1 included 20 cycles and 219 oocytes, male age was 40,89 ±6.12; Group–2 included 17 cycles and 173 oocytes, male age was 51±6.06. Respectively, in Group 1 and in Group 2, donor age were 22.4±2.65 and 24.8±3.88 (NS). All oocytes were injected with abnormal sperm samples according to WHO 2010. Embryos were cultured in time-lapse system until blastocyst stage. Trophectoderm biopsy and PGT-A analysis were performed according to standardized laboratory protocols.
Main results and the role of chance
Oocytes survival rates in Group1 and 2 were 86% (188/219) and 90.7% (157/173) (NS), respectively. Fertilization rates in Group1 and –2 were 71.42 (135/189) and 73.45% (119/162) (NS), respectively. The total number of obtained embryos (transferred + frozen) were 81 and 801 in Group–1 and –2, respectively. The rates of obtained embryos per reiceved occytes were 37% (81/219) and 46.24% (80/173) in Group–1 and –2 (p < 0.7), respectively. The PGT-A analysis showed 38.7% (31/80) and 31.17% (24/77) of euploid (NS) and 25% (20/80)and 42.85% (33/77) of aneuploid embryos (P < 0.05) in Group–1 and –2, respectively. Mosaic embryos were 33.5% (26/80) and 27.27%(21/77), in Group–1 and –2, respectively. (NS). These results indicate that in presence of severe male factor, advanced paternal age could increase embryos aneuploidy rate raising incidence of chromosomal abnormalities.
Limitations, reasons for caution
Each donor was stimulated with different protocols according to her history and hormones levels. Nothing is known about which type of sperm parameters (semen amount, morphology or motility) have a major impact when focusing on the embryos genetic outcome.
Wider implications of the findings: To better known the effect of APA, it could be necessary identify embryos chromosomal abnormalities and the correlation with specific sperm parameters. Further studies should be done to confirm the APA effect in patients with severe male factors and define a cut-off male age where PGT-A should be recommended.
Trial registration number
Not applicable
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Affiliation(s)
- E Iovine
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - V Zazzaro
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - G Pirastu
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - F Scarselli
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - A Ruberti
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - D Paccagnini
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - A Colasante
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - P Greco
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - A Pristerà
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | | | - A Caragia
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - A Greco
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - M G Minasi
- Villa Mafalda, medicina della riproduzione, roma, Italy
| | - E Greco
- Villa Mafalda, medicina della riproduzione, roma, Italy
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Scarselli F, Cursio E, Colasante A, Zazzaro V, Andrea P, Gatti S, Paccagnini D, Uva D, Cerquetti C, Greco P, Greco A, Mencacci C, Litwicka K, Minasi MG, Greco E. P–091 Magnetic Activated Cell Sorting (MACS) improves euploid blastocysts rate in pre-implantation genetic testing cycles with high levels of sperm DNA fragmentation and advanced paternal age. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Can MACS increase euploid blastocyst rate in Pre-implantation Genetic Testing (PGT) cycles for AMA-APA (Advanced Maternal-Paternal Age) in patients with high sperm DNA fragmentation (SDF)?
Summary answer
A slight increase in euploid blastocyst rate was found using MACS in infertile patients with high SDF undergoing PGT cycles compared to the control group.
What is known already
Many authors have shown a close correlation between the presence of apoptotic markers on spermatozoa and the failure of assisted reproduction treatments. In normal physiological conditions, apoptotic spermatozoa with phosphatidylserine (PS) residues externalized on the plasma membrane, are eliminated along female genital tract, preventing oocyte fertilization. MACS eliminates apoptotic sperm whit PS residues using superparamagnetic microbeads conjugated with annexin V. This technique reduces the proportion of sperm with high rates of SDF and can be used to maximize ART procedures results. MACS application improves sperm quality, fertilization, cleavage and pregnancy rates reducing miscarriage rate.
Study design, size, duration
From June to November 2020, 10 couples in which MACS was applied to select non-apoptotic spermatozoa, were randomly enrolled in our study (MACS group) and 8 couples without MACS were considered as controls (No-MACS Group). All couples in both groups underwent a PGT cycle and had high sperm DNA Fragmentation (> 20%). A higher rate of euploid and diploid-euploid mosaic blastocysts were obtained in the MACS group compared to the control group.
Participants/materials, setting, methods
Patients with severe oligoastenoteratozoospermia were excluded. MACS protocol was performed as follows: semen sample was analyzed (WHO 2010) and washed with buffered medium; pellet was removed and a swim-up was performed. Retrieved spermatozoa were washed with a binding buffer (Miltenyi Biotec), centrifuged (400 g x 4 minutes) and supernatant discarded. Pellet was covered with Annexin-V and re-suspended. After 15 minutes incubation at room temperature, the sample was eluted through the column and collected for ICSI.
Main results and the role of chance
In MACS group, female and male mean age ± SD were 41.6 ± 2.1 and 43.5 ± 7.3, respectively. Female and male mean age ± SD were 41.7 ± 2.8 and 44.6 ± 8.1 in the No-MACS group, respectively. In MACS and No-MACS groups, injected oocytes were 44 and 35, fertilized oocytes were 32 (72.3%) and 27 (77.1%) (NS), blastocyst formation rates were 71.8% (23/32) and 48.1% (13/27) (NS), respectively. In No-MACS group, only 1 euploid and 1 diploid-euploid mosaic blastocysts were obtained (1/13 = 8%) (NS). In MACS group, 4 euploid blastocysts were formed (4/23 = 17.4%) whereas mosaic diploid-euploid blastocysts were 3/23 (13.0%) (NS). Aneuploid blastocysts were 16/23 (69.6%) in MACS group and 11/13 (84.6%) in No-MACS group (NS).
Limitations, reasons for caution
AMA and APA of couples enrolled should be considered as a limit of the study. A larger number of patients and biopsied blastocysts are needed to analyze clinical results and perform a robust statistical analysis establishing if MACS is useful to improve transferable blastocyst rate in patients with high SDF.
Wider implications of the findings: MACS is useful to select non apoptotic sperms; although fertilization, cleavage and blastocyst rates are not improved, aneuploid blastocysts rate slightly decreases using MACS. It I possible that, selecting spermatozoa free from PS residues, MACS allows to choose spermatozoa with a better DNA packaging, thus affecting the embryo ploidy.
Trial registration number
non applicable
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Affiliation(s)
- F Scarselli
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - E Cursio
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - A Colasante
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - V Zazzaro
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - P Andrea
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - S Gatti
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - D Paccagnini
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - D Uva
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - C Cerquetti
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - P Greco
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - A Greco
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - C Mencacci
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - K Litwicka
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - M G Minasi
- Villa Mafalda, Reproductive Medicine, Rome, Italy
| | - E Greco
- Villa Mafalda, Reproductive Medicine, Rome, Italy
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Greco A, Garoffolo G, Chiesa E, Riva F, Dorati R, Modena T, Conti B, Pesce M, Genta I. Nanotechnology, a booster for the multitarget drug verteporfin. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Scuderi L, Anselmi G, Greco A, Abdolrahimzadeh B, Costa MC, Scuderi G. Early identification of keratoconus using pachymetric indexes obtained with spectral domain optical coherence tomography. Clin Ter 2021; 172:347-357. [PMID: 34247218 DOI: 10.7417/ct.2021.2339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose To evaluate the diagnostic ability of pachymetric indexes obtained with Spectral Domain Optical Coherence Tomography (SD-OCT) for early detection of keratoconus (Kc). Methods 64 patients with Kc in at least one eye (95 eyes, 46 men and 18 women, average age 27.84 ±13.50), 59 healthy control subjects (100 eyes, 28 men and 31 women, average age 27.15 ±16.14). All patients underwent detailed clinical examination, topography and anterior segment OCT. 37 subjects (37 eyes, 27 men and 10 women, average age 24.23 ± 14.24) having one eye with manifest Kc and the fellow eye without clinical signs of Kc were identified. We studied two groups of pachymetric indexes: C1-C2, M1-M2, pCLMI, Pmin-P2 (Group 1 indexes) and PPD, PSD, PSSD and PASD (Group 2 indexes). A ROC (Receiver Operating Characteristic) curve was developed to compare the diagnostic accuracy, relative sensitivity and specificity for each index. Results In manifest keratoconus, C1-C2, M1-M2, and pCLMI are significantly higher compared to the control group (P<0.0001); for suspect keratoconus, all Group 1 indexes are significantly higher compared to healthy subjects (P<0.0001) excluding M1-M2 obtained using a constant area circle (P = 0.02). Furthermore, for manifest and suspect keratoconus, PPD, PSD, PSSD and PASD are significantly higher compared to the control group (P <0.0001). Conclusion The studied pachymetric indexes in patients with Kc have high diagnostic accuracy and are statistically significant when compared with healthy subjects (p<0.0001) and can provide a useful tool for keratoconus screening.
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Affiliation(s)
- L Scuderi
- Ophthalmology Unit, Department of Sense Organs, Policlinico Umberto I, Rome, Italy
| | - G Anselmi
- Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Faculty of Medicine and Psychology "Sapienza" University of Rome, Rome, Italy
| | - A Greco
- Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Faculty of Medicine and Psychology "Sapienza" University of Rome, Rome, Italy
| | | | | | - G Scuderi
- Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Faculty of Medicine and Psychology "Sapienza" University of Rome, Rome, Italy
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Ralli M, Angeletti D, D'Aguanno V, Campo F, Fiore M, Greco A, de Vincentiis M. Evaluation of Surgical and Functional Outcomes of Supracri- coid Laryngectomy and Rehabilitation Protocols. Clin Ter 2021; 172:363-368. [PMID: 34247220 DOI: 10.7417/ct.2021.2341] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract Laryngeal squamous cell carcinoma (LSCC) is the most common malignant neoplasms of the head and neck. Several treatment options exist for LSCC according to cancer location and stage at diagnosis; proposed treatments include surgery alone or in combination with chemotherapy and radiotherapy. In selected LSCC cases in the T2-T4 staging, supracricoid laryngectomy (SCL) is an organ-sparing surgical approach aimed at preserving the main laryngeal functions that has been proposed as an alternative to total laryngectomy. Rehabilitation for swallowing and respiratory functions plays a central role after SCL; functional outcomes after SCL may significantly vary among different centers but they are generally satisfactory when oncological radicality has been obtained and the rehabilitation protocol starts promptly. In this clinical review, we analyzed functional outcomes for swallowing and voice rehabilitation in patients after SCL, as well as the optimal SCL surgical technique, post-operative complications and comparison with total laryngectomy or radio-chemotherapy protocols.
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Affiliation(s)
- M Ralli
- Department of Sense Organs, University of Rome "Sapienza", Policlinico Umberto I, Rome, Italy
| | - D Angeletti
- Department of Sense Organs, University of Rome "Sapienza", Policlinico Umberto I, Rome, Italy
| | - V D'Aguanno
- Department of Sense Organs, University of Rome "Sapienza", Policlinico Umberto I, Rome, Italy
| | - F Campo
- Department of Sense Organs, University of Rome "Sapienza", Policlinico Umberto I, Rome, Italy
| | - M Fiore
- Institute of Cell Biology and Neuro-biology, IBCN-CNR, Rome, Italy
| | - A Greco
- Department of Sense Organs, University of Rome "Sapienza", Policlinico Umberto I, Rome, Italy
| | - M de Vincentiis
- Department of Oral and Maxillofacial Sciences, University of Rome "Sapienza", Policlinico Umberto I, Rome, Italy
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Greco A, Gallitto G, D’Alessandro M, Rastelli C. Increased Entropic Brain Dynamics during DeepDream-Induced Altered Perceptual Phenomenology. Entropy (Basel) 2021; 23:839. [PMID: 34208923 PMCID: PMC8306862 DOI: 10.3390/e23070839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/20/2021] [Accepted: 06/23/2021] [Indexed: 01/02/2023]
Abstract
In recent years, the use of psychedelic drugs to study brain dynamics has flourished due to the unique opportunity they offer to investigate the neural mechanisms of conscious perception. Unfortunately, there are many difficulties to conduct experiments on pharmacologically-induced hallucinations, especially regarding ethical and legal issues. In addition, it is difficult to isolate the neural effects of psychedelic states from other physiological effects elicited by the drug ingestion. Here, we used the DeepDream algorithm to create visual stimuli that mimic the perception of hallucinatory states. Participants were first exposed to a regular video, followed by its modified version, while recording electroencephalography (EEG). Results showed that the frontal region's activity was characterized by a higher entropy and lower complexity during the modified video, with respect to the regular one, at different time scales. Moreover, we found an increased undirected connectivity and a greater level of entropy in functional connectivity networks elicited by the modified video. These findings suggest that DeepDream and psychedelic drugs induced similar altered brain patterns and demonstrate the potential of adopting this method to study altered perceptual phenomenology in neuroimaging research.
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Affiliation(s)
- Antonino Greco
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy;
- Centre for Integrative Neuroscience, University of Tübingen, 72076 Tübingen, Germany
- MEG Center, University of Tübingen, 72076 Tübingen, Germany
| | - Giuseppe Gallitto
- Department of Neurology, University Hospital Essen, 45147 Essen, Germany;
| | - Marco D’Alessandro
- Institute of Cognitive Sciences and Technologies, National Research Council, 00185 Rome, Italy;
| | - Clara Rastelli
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy;
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Taurone S, Ralli M, Nebbioso M, Greco A, Artico M, Attanasio G, Gharbiya M, Plateroti AM, Zamai L, Micera A. The role of inflammation in diabetic retinopathy: a review. Eur Rev Med Pharmacol Sci 2021; 24:10319-10329. [PMID: 33155187 DOI: 10.26355/eurrev_202010_23379] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Diabetic retinopathy and diabetes represent serious health conditions, being considered among the main causes of blindness. In recent years, anti-VEGF therapies have been of great help in the treatment of retinal pathology and, until now, they represent the primary choice therapy for diabetic retinopathy. Nevertheless, many patients do not experience significant benefits of vision after an anti-VEGF monotherapy. For this reason, several researchers recently focused their attention on the mechanisms that play a central role in the development and progression of diabetic retinopathy. RESULTS Available scientific evidence confirms that diabetic retinopathy requires other molecules capable of modifying the mechanisms that, together with angiogenesis, contribute to the development of the condition, such as vascular and neuroinflammation. CONCLUSIONS This review summarizes the current knowledge of the pathological changes that occur in diabetic retinopathy and that might contribute to identify possible new strategies for the treatment of this condition.
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Affiliation(s)
- S Taurone
- IRCCS - Fondazione Bietti, Rome, Italy.
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Greco A, Tonialini L, Scalzulli PR, De Santis G, Prete E, La Rosa E, Cascavilla N, Tarantini G, Pavone V. PIXANTRONE (PIX) IN RELAPSED/REFRACTORY DIFFUSE LARGE B‐CELL LYMPHOMA (R/R DLBCL). REAL LIFE EXPERIENCE IN 27 PATIENTS. Hematol Oncol 2021. [DOI: 10.1002/hon.41_2881] [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: 11/11/2022]
Affiliation(s)
- A Greco
- Pia Fondazione Card. G. Panico Hospital, Unit of Hematology Tricase Italy
| | - L Tonialini
- Pia Fondazione Card. G. Panico Hospital, Unit of Hematology Tricase Italy
| | - P. R Scalzulli
- Casa Sollievo della Sofferenza Hospital, Unit of Hematology San Giovanni Rotondo Italy
| | - G De Santis
- Monsignor Raffaele Dimiccoli Hospital, Unit of Hematology Barletta Italy
| | - E Prete
- Pia Fondazione Card. G. Panico Hospital, Unit of Hematology Tricase Italy
| | - E La Rosa
- Pia Fondazione Card. G. Panico Hospital, Unit of Hematology Tricase Italy
| | - N Cascavilla
- Casa Sollievo della Sofferenza Hospital, Unit of Hematology San Giovanni Rotondo Italy
| | - G Tarantini
- Monsignor Raffaele Dimiccoli Hospital, Unit of Hematology Barletta Italy
| | - V Pavone
- Pia Fondazione Card. G. Panico Hospital, Unit of Hematology Tricase Italy
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Tua L, Turco A, Acquaro M, Scelsi L, Greco A, Ghio S, Savastano S, Sanzo A, Vicentini A, Petracci B, Vullo E, Vicini Scajola L, Pelenghi S, Oltrona Visconti L, Rordorf R. Long-term follow-up of heart transplant patients treated with permanent pacemaker: a monocentric study. Europace 2021. [DOI: 10.1093/europace/euab116.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background and purpose
Permanent pacemaker implantation (PPMi) is needed in about 5% of patients following heart transplant (HTx) primarily due to sinus node dysfunction (SND), which commonly occurs in an early phase, or to atrio-ventricular block (ABV), which is common later on. Currently, data on rate of ventricular pacing (VP) is lacking and little is known on long-term outcomes after PPMi.
Methods
This was a retrospective, monocentric study. Among 1123 patients treated with HTx, all with biatrial technique, from november 1985 to march 2019 at our institution, 61 (5.4%) patients needed PPMi. PM parameters, clinical and echocardiographic data were collected at 1 month and at 1-3-5-10 years follow-up. The primary aim was to analyse the percentage of right ventricular pacing in the overall population and in subgroups stratified by the timing of PPMi and by pacing indication. Secondary endpoints were to analyze long-term outcomes according to the percentage of ventricular pacing and to the type of implanted PM (single vs. dual chamber).
Results
Among patients treated with PPMi (68.9% single-chamber), 62.2% were implanted for SND and 36% for AVB. Early PPMi (< 3 months after HTx), occurred in 34.4% of patients, mainly due to SND, while late PPMi (> 3 months after HTx) occurred in 65,6% with an equal distribution between SND and AVB. Median follow-up time from HTx was 140 months and 82 months from PPMi. Overall mean rate of VP was 21%. Rate of VP was higher in patients implanted early rather than late after HTx, both at 1 month (91% vs 2%, P = 0,002) and at 1 year after the procedure (43 vs 1, P = 0,037). Patients with AVB had a greater rate of VP compared to those implanted for SND, irrespective of timing of implantation and these findings were still present at 3 and 5 years follow-up (62 vs 1%, P = 0,011 at 3 years and 80 vs 6%, P = 0,002 at 5 years). VP declined progressively after PPM implantation. No differences were observed in terms of 10-years mortality between early vs late PPMi, dual vs single-chamber and mean VP > 21% vs ≤ 21%.
Conclusions
Patients treated with PPMi after HTx show on average low percentage of VP over long-term follow-up. AV block indication and early implantation are associated with a higher percentage of VP. The rate of VP, the timing of PPMi and the use of single vs dual chamber PM do not affect overall prognosis or left ventricular systolic function. Our data may justify implantation of a single-chamber PPM, which bears less complications and procedural time, in the majority of HTx patients needing PPMi.
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Affiliation(s)
- L Tua
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - A Turco
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - M Acquaro
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - L Scelsi
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - A Greco
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - S Savastano
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - A Sanzo
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - A Vicentini
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - B Petracci
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - E Vullo
- San Gerardo Hospital, Cardiology Department, Monza, Italy
| | - L Vicini Scajola
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - S Pelenghi
- Policlinic Foundation San Matteo IRCCS, Cardiothoracic Surgery, Pavia, Italy
| | - L Oltrona Visconti
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - R Rordorf
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
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Montanari Vergallo G, Ralli M, Angeletti D, di Luca A, Mazzariol B, Greco A, di Luca NM, De Vincentiis M. Can a causal relationship be established between acoustic neuroma and occupational exposure to non-ionizing radiations from mobile devices? Comparison between scientific literature data and medico-legal methodology. Clin Ter 2021; 172:197-205. [PMID: 33956036 DOI: 10.7417/ct.2021.2313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Over the process of establishing the causal relation-ship, medical and legal methodologies may be at variance over the definitional standards and terminologies applied, which can hinder the activities of expert witnesses. OBJECTIVES The article's authors have set out to assess whether, and under what conditions, a causal relationship can be established between acoustic neuroma and exposure to non-ionizing radiation from mobile communication devices. METHODS The study design is a Systematic Review. The authors have drawn upon a 2020 Turin Court of Appeals ruling which found such a causal relationship in a somewhat peculiar case: rare tumor and exposure to non-ionizing radiation of unusually long and regular dura-tion. The case presents several peculiarities, herein analyzed in light of a) scientific evidence relative to the etiopathogenesis of the neuroma; b) available medico-legal literature defining causality evaluation criteria, and lastly c) court filings in regard to the probability standards applied to prove causal relationship. RESULTS A direct tie cannot be proven, not even in cases of sub-stantially intense and lengthy exposure, if the medico-legal standards applied are not consistent enough to prove that nexus is more likely than not. DISCUSSION Several elements suggest a causal relationship is unlikely: a) a dearth of evidence on humans; b) rats exposed to such radiation have developed cardiac tumors, not in their ears; c) exposure has caused no tumors in mice; d) the length of exposure is incompat-ible with tumor size and type. That fourth point only concerns the case herein explored, whereas the first three have a general scope of validity. The main limitation of the present study design is the heterogeneity among the included studies. Retrospective and prospective studies have been included, which may be a source of bias.
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Affiliation(s)
| | - M Ralli
- Dipartimento di Organi di Senso, Università "La Sapienza", Roma, Italy
| | - D Angeletti
- Dipartimento di Organi di Senso, Università "La Sapienza", Roma, Italy
| | - A di Luca
- Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italy
| | - B Mazzariol
- Dipartimento SAIMLAL, Università "La Sapienza", Roma, Italy
| | - A Greco
- Dipartimento di Organi di Senso, Università "La Sapienza", Roma, Italy
| | - N M di Luca
- Dipartimento SAIMLAL, Università "La Sapienza", Roma, Italy
| | - M De Vincentiis
- Dipartimento di Organi di Senso, Università "La Sapienza", Roma, Italy
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Altissimi G, Colizza A, Cianfrone G, de Vincentiis M, Greco A, Taurone S, Musacchio A, Ciofalo A, Turchetta R, Angeletti D, Ralli M. Drugs inducing hearing loss, tinnitus, dizziness and vertigo: an updated guide. Eur Rev Med Pharmacol Sci 2021; 24:7946-7952. [PMID: 32767320 DOI: 10.26355/eurrev_202008_22477] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The awareness of audio-vestibular side effects of drugs, such as hearing loss, tinnitus, dizziness and vertigo, has widely increased in the recent years. The present guide represents an update of the previous documents published by the authors in 2005 and 2011 on drug-induced ototoxicity and vestibulotoxicity. MATERIALS AND METHODS The authors performed a comprehensive analysis of audio-vestibular side effects of commercially available drugs based on the British National Formulary, a pharmaceutical reference book that contains a wide range of useful information and advice on prescription and pharmacology. RESULTS Commercially available drugs and their active principles have been classified based on their audio-vestibular side effects, as reported by the pharmaceutical companies and/or health agencies. Drugs have been categorized based on the field of application, the therapeutic indication and the pharmacological properties. CONCLUSIONS General practitioners, otolaryngology, neurology and audiology specialists should be aware of possible audio-vestibular side effects of drugs, such as hearing loss, tinnitus, dizziness and vertigo. The present guide represents a practical tool to rapidly identify potential audio-vestibular side effects of drugs as reported by the pharmaceutical companies and/or health agencies.
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Affiliation(s)
- G Altissimi
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
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Fusconi M, Candelori F, Weiss L, Riccio A, Priori R, Businaro R, Mastromanno L, Musy I, de Vincentiis M, Greco A. Qualitative mucin disorders in patients with primary Sjögren's syndrome: a literature review. Med Oral Patol Oral Cir Bucal 2021; 26:e71-e77. [PMID: 33247578 PMCID: PMC7806352 DOI: 10.4317/medoral.23996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/09/2020] [Indexed: 11/05/2022] Open
Abstract
Background It is a common opinion that Primary Sjögren Syndrome (pSS) damages the exocrine glands and determines the reduction of secreted saliva, some studies show that there are qualitative anomalies of the mucins produced in saliva, including MUC7, MUC5B, MUC1. The purpose of this study is to trace all the information useful to establish whether there is a qualitative or quantitative defect of the mucins in the pSS.
Material and Methods We reviewed the literature by looking for publications relevant to the topic in electronic databases. Sixteen articles met the search criteria. The studies were divided into two categories, those that studied the rheological characteristics of the saliva and those that studied the structural and / or metabolism modifications of the muciparous cells in the salivary glands.
Results in Patients with pSS, xerostomia and the reduction of salivary spinnbarkeit are only partially related to the reduction of the unstimulated salivary flow. In pSS, pathological alterations of mucins’ chemical-physical properties prevail as a cause of the clinical characteristics. Moreover, in pSS there are structural and metabolism changes in salivary glands’ muciparous cells.
Conclusions There is much evidence that supports the presence of qualitative alterations in the saliva’s rheological properties in Patients with pSS, and these are the main cause, more than the reduction of the unstimulated salivary flow, of the disease clinical characteristics - dry mouth and complications in the oral cavity. Therefore we propose to add to the classification criteria of pSS also a qualitative test of salivary glycoproteins. Key words:Primary Sjögren's syndrome, mucin, MUC7, MUC5B, MUC1, sulphate oligosaccharides.
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D'Angelo A, Ferraguti G, Petrella C, Greco A, Ralli M, Vitali M, Framarino Dei Malatesta M, Fiore M, Ceccanti M, Messina MP. Challenges for Midwives' Healthcare Practice in the Next Decade: COVID-19 - Global Climate Changes - Aging and Pregnancy - Gestational Alcohol Abuse. Clin Ter 2020; 171:e30-e36. [PMID: 33346323 DOI: 10.7417/ct.2021.2277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Midwives are multifaceted healthcare professionals whose competence spectrum includes a large variety of knowledge and skills going from antenatal care to education and research. The aim of this review is to suggest the future challenges midwives are going to face in the upcoming decade of this Century. COVID-19 and other infections will reasonably impact healthcare workers all over the world. Midwives are frontline healthcare professionals who are constantly at risk of contagion as their job implies close contact with women, physical support and hand touch. Also, menstruation waste plays a large role in the pollution of waters, severely impacting hygiene in the developing countries and fueling climate change. Appropriate disposal of used menstrual material is still insufficient in many countries of the world especially because of lack of sanitary education on girls. As educators, midwives will be more involved into preventing inappropriate disposal of menstrual hygiene devices by educating girls around the world about the green alternatives to the commercial ones. Despite the evidences about the fertility decrement that occurs with aging, women keep postponing reproduction and increasing their chance being childless or suffering complications related to the advanced maternal age. Teen pregnancies are as well an important issue for midwives who will be called to face more age-related issues and use a tailored case to case approach, enhancing their family planning skills. Another crucial role of midwifery regards the information about the risk of drinking alcohol during gestation. Alcohol assumption during pregnancy is responsible for serious damage to the fetus causing a wide range of pathological conditions related to Fetal Alcoholic Spectrum Disorder, leading cause of mental retardation in children of western countries. On the whole, midwives have demonstrated their willingness to expand their practice through continuing professional development, and through specialist and advanced roles especially in preventive and educational positions.
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Affiliation(s)
- A D'Angelo
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome
| | - G Ferraguti
- Department of Experimental Medicine, Sapienza University of Rome
| | - C Petrella
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome
| | - A Greco
- Department of Sense Organs, Medical faculty, Sapienza University of Rome
| | - M Ralli
- Department of Sense Organs, Medical faculty, Sapienza University of Rome
| | | | | | - M Fiore
- Institute of Biochemistry and Cell Biology, IBBC-CNR, Rome
| | - M Ceccanti
- Centro Riferimento Alcologico Regione Lazio, ASL Roma 1, Rome, Italy
| | - M P Messina
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome
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D'Agostino D, Greco A, Masselli C, Minichiello F. The employment of an earth-to-air heat exchanger as pre-treating unit of an air conditioning system for energy saving: A comparison among different worldwide climatic zones. Energy Build 2020; 229:110517. [PMID: 33041474 PMCID: PMC7532812 DOI: 10.1016/j.enbuild.2020.110517] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/14/2020] [Accepted: 09/26/2020] [Indexed: 06/11/2023]
Abstract
A great fraction (20-40%) of primary energy is required for building air conditioning, so the use of renewable energy sources is increasing. The geothermal energy for Heating, Ventilating and Air Conditioning (HVAC) systems can be used considering an Earth-to-Air Heat eXchanger (EAHX). This work analyses the performance of an EAHX through a mathematical model (2D), as a function of diameter and length of the air ducts. The problem is solved with finite element method. A case study office building is analyzed. The air conditioning plant is characterized by fan-coil units and primary air; the EAHX is positioned upstream the Air Handling Unit (AHU) to pre-cool/pre-heat the air. The building is virtually placed initially in six Italian cities (different climatic zones according to Italian regulation DPR 412/93) and subsequently in eight worldwide cities according to Köppen climate classification. The following parameters are calculated: air temperature variation and thermal efficiency of the EAHX; the decreasing of cooling and heating capacity of the coils into the AHU. The best results refer to a duct length of 100 m for Ottawa (warm-summer humid continental climate, 65% capacity reduction), the worst ones for Rio de Janeiro (tropical wet and dry climate, maximum 24% reduction).
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Affiliation(s)
- D D'Agostino
- Department of Industrial Engineering, University of Naples Federico II, P.le Tecchio 80, 80125 Napoli, Italy
| | - A Greco
- Department of Industrial Engineering, University of Naples Federico II, P.le Tecchio 80, 80125 Napoli, Italy
| | - C Masselli
- Department of Industrial Engineering, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, SA, Italy
| | - F Minichiello
- Department of Industrial Engineering, University of Naples Federico II, P.le Tecchio 80, 80125 Napoli, Italy
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Rastelli C, Greco A, Finocchiaro C. Revealing the Role of Divergent Thinking and Fluid Intelligence in Children's Semantic Memory Organization. J Intell 2020; 8:E43. [PMID: 33327564 PMCID: PMC7768431 DOI: 10.3390/jintelligence8040043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/24/2020] [Accepted: 12/07/2020] [Indexed: 01/21/2023] Open
Abstract
The current theories suggest the fundamental role of semantic memory in creativity, mediating bottom-up (divergent thinking) and top-down (fluid intelligence) cognitive processes. However, the relationship between creativity, intelligence, and the organization of the semantic memory remains poorly-characterized in children. We investigated the ways in which individual differences in children's semantic memory structures are influenced by their divergent thinking and fluid intelligence abilities. The participants (mean age 10) were grouped by their levels (high/low) of divergent thinking and fluid intelligence. We applied a recently-developed Network Science approach in order to examine group-based semantic memory graphs. Networks were constructed from a semantic fluency task. The results revealed that divergent thinking abilities are related to a more flexible structure of the semantic network, while fluid intelligence corresponds to a more structured semantic network, in line with the previous findings from the adult sample. Our findings confirm the crucial role of semantic memory organization in creative performance, and demonstrate that this phenomenon can be traced back to childhood. Finally, we also corroborate the network science methodology as a valid approach to the study of creative cognition in the developmental population.
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Meomartino L, Greco A, Mennonna G, Auletta L, Pasolini MP, Fatone G, Costanza D, Lamagna B, Valle GD, Lamagna F. Joint laxity in canine hip dysplasia assessed using the hip flexed not distracted ventrodorsal view. J Small Anim Pract 2020; 62:187-193. [PMID: 33260263 DOI: 10.1111/jsap.13270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/31/2020] [Accepted: 10/26/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The ventrodorsal hip extended standard view is conventionally used for radiographic screening of canine hip dysplasia. However, because the ventrodorsal hip extended standard view minimises hip joint laxity, several alternative views have been proposed. Our aim was to evaluate a new ventrodorsal hip flexed and not distracted view to assess joint laxity, by comparing it with the ventrodorsal hip extended standard and ventrodorsal hip flexed and distracted views. MATERIALS AND METHODS Between April 2013 and March 2017, all dogs referred to the University of Naples "Federico II" for the diagnosis of canine hip dysplasia were studied using the ventrodorsal hip extended standard, ventrodorsal hip flexed and not distracted and ventrodorsal hip flexed and distracted views. The Norberg angle and the laxity index were measured for each view. RESULTS Overall, 102 dogs, 67 males and 35 females, mean age 15 months, were included. The mean (±standard deviation) Norberg angles were 99.77° (±10.42°), 89.29° (±14.32°) and 91.80° (±13.50°) for the ventrodorsal hip extended standard, ventrodorsal hip flexed and not distracted and ventrodorsal hip flexed and distracted views, respectively. The mean (± standard deviation) laxity indices were 0.19 (± 0.14), 0.39 (± 0.25) and 0.36 (± 0.21), respectively. The ventrodorsal hip flexed and distracted and ventrodorsal hip flexed and not distracted views had lower Norberg angle and higher laxity index values compared with the ventrodorsal hip extended standard view. The ventrodorsal hip flexed and distracted and ventrodorsal hip extended standard views are in strong agreement for the measurement of both Norberg angle and laxity index, as confirmed by Bland-Altman analysis and the intraclass correlation coefficient. CLINICAL SIGNIFICANCE The ventrodorsal hip flexed and distracted and ventrodorsal hip flexed and not distracted views obtained with the hip in a neutral position reveal joint laxity better than the ventrodorsal hip extended standard view. Unlike the ventrodorsal hip flexed and distracted view, the ventrodorsal hip flexed and not distracted view does not require human operators or special devices for positioning the dog. The wide age range of the dogs enrolled might have influenced the laxity index measurements, since capsular fibrosis in older dogs reduces laxity.
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Affiliation(s)
- L Meomartino
- Interdepartmental Centre of Veterinary Radiology, University of Naples Federico II, Via Federico Delpino 1, Naples, 80137, Italy
| | - A Greco
- Interdepartmental Centre of Veterinary Radiology, University of Naples Federico II, Via Federico Delpino 1, Naples, 80137, Italy.,Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Naples, 80131, Italy
| | - G Mennonna
- Interdepartmental Centre of Veterinary Radiology, University of Naples Federico II, Via Federico Delpino 1, Naples, 80137, Italy
| | - L Auletta
- Institute of Biostructure and Bioimaging - IBB, National Research Council - CNR, Via T. De Amicis 95, Naples, 80145, Italy
| | - M P Pasolini
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Via Federico Delpino 1, Naples, 80137, Italy
| | - G Fatone
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Via Federico Delpino 1, Naples, 80137, Italy
| | - D Costanza
- Interdepartmental Centre of Veterinary Radiology, University of Naples Federico II, Via Federico Delpino 1, Naples, 80137, Italy
| | - B Lamagna
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Via Federico Delpino 1, Naples, 80137, Italy
| | - G D Valle
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Via Federico Delpino 1, Naples, 80137, Italy
| | - F Lamagna
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Via Federico Delpino 1, Naples, 80137, Italy
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Badagliacca R, D'Alto M, Ghio S, Greco A, Papa S, Romeo E, Casu G, Corda M, Paciocco P, D'Agostino C, Galgano G, Stolfo D, Correale M, Naeije R, Vizza C. Determinants of pulmonary vascular resistance reduction with upfront oral therapy in idiopathic pulmonary arterial hypertension: relevance in risk assessment. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2283] [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
In pulmonary arterial hypertension (PAH) upfront oral therapy represents the standard of care for naive patients at low and intermediate risk. However little is known about associated changes in risk assessment and prediction of low risk status achievement.
Purpose
To evaluate determinants of PVR reduction in patients treated with upfront oral therapy and to create a score to predict PVR reduction after upfront oral treatment and compared its additive value on top of the European and REVEAL scoring system in predicting treatment response.
Methods
One-hundred-eighty-one consecutive naive PAH patients treated with upfront therapy at 11 italian centers were retrospectively evaluated. Evaluation included clinical, hemodynamic and simple echocardiographic parameters, together with European and REVEAL 2.0 risk scores.
Results
At the time of diagnosis, the majority of the patients was idiopathic PAH (80.6%), female (66.3%), at intermediate risk, 71.8% and 55.2%, respectively, according to the European (average method) and the REVEAL 2.0 risk scores. Ambrisentan-Tadalafil was the most frequent combination used (62%). The median PVR reduction obtained after 180 days (IQR 79–394) was −40.4% (IQR −25.8; −45.3).
Age ≥60 years, male-sex, baseline mPAP 48 mmHg associated with low CI (<2.5 l/min/m2), and RV/LV ratio >1 associated with low TAPSE (<18 mm) emerged as independent predictors of poor PVR reduction, defined as the lower tertile of PVR changes (−25.8%). A treatment response score was created deriving weighted integers from the beta coefficient.
At second evaluation 78 (43.1%) patients achieved or remained at European-derived low risk status, while 63 (34.8%) considering the REVEAL 2.0 score.
Multivariate analysis for the prediction of treatment failure, defined as the absence of low-risk status at follow-up, demonstrated the incremental prognostic power of the models incorporating the treatment response score (≥3) on top of the European and REVEAL 2.0 scores, improving risk discrimination by 63.2% (IDI index 0.056) and 36.8% (IDI index 0.080), respectively.
Conclusions
A significant proportion of PAH patients treated with upfront oral combination are not able to achieve a low-risk status. The treatment response score helps clinicians in predicting treatment failure at the time of diagnosis.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - M D'Alto
- AORN Ospedali dei Colli - Monaldi Hospital, Naples, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - A Greco
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - S Papa
- Sapienza University of Rome, Rome, Italy
| | - E Romeo
- AORN Ospedali dei Colli - Monaldi Hospital, Naples, Italy
| | - G Casu
- San Francesco Hospital, Nuoro, Italy
| | - M Corda
- AO Brotzu Hospital, Cagliari, Italy
| | - P Paciocco
- University of Milan-Bicocca, Milan, Italy
| | | | - G Galgano
- Regional General Hospital F. Miulli, Acquaviva Delle Fonti, Italy
| | - D Stolfo
- University Hospital Riuniti, Trieste, Italy
| | - M Correale
- AORN Ospedali dei Colli - Monaldi Hospital, Naples, Italy
| | - R Naeije
- Free University of Brussels (VUB), Brussels, Belgium
| | - C.D Vizza
- Sapienza University of Rome, Rome, Italy
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