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Dettori M, Riccardi N, Canetti D, Antonello RM, Piana AF, Palmieri A, Castiglia P, Azara AA, Masia MD, Porcu A, Ginesu GC, Cossu ML, Conti M, Pirina P, Fois A, Maida I, Madeddu G, Babudieri S, Saderi L, Sotgiu G. Infections in lung transplanted patients: A review. Pulmonology 2024; 30:287-304. [PMID: 35710714 DOI: 10.1016/j.pulmoe.2022.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 03/29/2022] [Accepted: 04/25/2022] [Indexed: 02/07/2023] Open
Abstract
Lung transplantation can improve the survival of patients with severe chronic pulmonary disorders. However, the short- and long-term risk of infections can increase morbidity and mortality rates. A non-systematic review was performed to provide the most updated information on pathogen, host, and environment-related factors associated with the occurrence of bacterial, fungal, and viral infections as well as the most appropriate therapeutic options. Bacterial infections account for about 50% of all infectious diseases in lung transplanted patients, while viruses represent the second cause of infection accounting for one third of all infections. Almost 10% of patients develop invasive fungal infections during the first year after lung transplant. Pre-transplantation comorbidities, disruption of physical barriers during the surgery, and exposure to nosocomial pathogens during the hospital stay are directly associated with the occurrence of life-threatening infections. Empiric antimicrobial treatment after the assessment of individual risk factors, local epidemiology of drug-resistant pathogens and possible drug-drug interactions can improve the clinical outcomes.
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Affiliation(s)
- M Dettori
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - N Riccardi
- StopTB Italia Onlus, Milan, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - D Canetti
- StopTB Italia Onlus, Milan, Italy; Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - R M Antonello
- Clinical Department of Medical, Surgical and Health Sciences, Trieste University, Trieste, Italy
| | - A F Piana
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A Palmieri
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - P Castiglia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A A Azara
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - M D Masia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G C Ginesu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - M L Cossu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - M Conti
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - P Pirina
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A Fois
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - I Maida
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G Madeddu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - S Babudieri
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - L Saderi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G Sotgiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; StopTB Italia Onlus, Milan, Italy.
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Cristoni S, Vitarelli F, Spiti S, Brambilla M, Larini M, Calabrone L, Brogna C, Malvandi AM, Conti M, Puccio G, Donato K, Beccari T, Bertelli M, Leoni V. Unraveling the complexity of anti-doping analysis: reassessing meldonium detection and doping verdicts in a case study. Eur Rev Med Pharmacol Sci 2023; 27:114-118. [PMID: 38112958 DOI: 10.26355/eurrev_202312_34695] [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: 12/21/2023]
Abstract
BACKGROUND The precision and accuracy of mass spectrometry (MS) made it a fundamental tool in anti-doping analysis. High-resolution (HR) mass spectrometers significantly improved compound identification. This study systematically analyzes data from an athlete (Subject 1) who tested positive for meldonium and compares it with data from a healthy volunteer (Subject 2) to examine the correctness of the doping verdict. CASE PRESENTATION The documentation related to Subject 1 was thoroughly processed and analyzed. A study involving a volunteer (Subject 2) replicated Subject 1 regimen and urine sample collection for data alignment with anti-doping results, with Subject 2 reporting not using meldonium. The anti-doping agency's analysis of Subject 1 showed the presence of meldonium at a concentration close to the established cut-off level. However, a closer examination revealed that one specific ion, crucial for meldonium identification, was absent from the mass spectra. Analyzing Subject 2 data, using the same methodology, the absence of the specific ion was confirmed, even though the volunteer did not consume meldonium. The European directive and the method that was validated and cited by the anti-doping agency identified meldonium on at least four specific ions, whereas the anti-doping analysis used only three ions. This discrepancy compromises the specificity of meldonium identification. CONCLUSIONS To enhance the analytical methodology, two strategic interventions are suggested: adjusting the meldonium cut-off value and expanding the analysis to include meldonium metabolites. By addressing these avenues, the precision of meldonium detection and doping verdicts can be improved. In conclusion, this study challenges the anti-doping agency's verdict and prompts a reevaluation of meldonium detection methodologies in anti-doping measures.
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Affiliation(s)
- S Cristoni
- I.S.B. - Ion Source & Biotechnology SRL, Milan, Italy.
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Schmidt FP, Mannheim JG, Linder PM, Will P, Kiefer LS, Conti M, la Fougère C, Rausch I. Impact of the maximum ring difference on image quality and noise characteristics of a total-body PET/CT scanner. Z Med Phys 2023:S0939-3889(23)00113-7. [PMID: 37867050 DOI: 10.1016/j.zemedi.2023.09.001] [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: 02/14/2023] [Revised: 07/14/2023] [Accepted: 09/25/2023] [Indexed: 10/24/2023]
Abstract
The sensitivity of a PET system highly depends on the axial acceptance angle or maximum ring difference (MRD), which can be particularly high for total-body scanners due to their larger axial field of views (aFOVs). This study aims to evaluate the impact on image quality (IQ) and noise performance when MRD85 (18°), the current standard for clinical use, is increased to MRD322 (52°) for the Biograph Vision Quadra (Siemens Healthineers). METHODS Studies with a cylindrical phantom covering the 106 cm aFOV and an IEC phantom filled with 18F, 68Ga and 89Zr were performed for acquisition times from 60 to 1800 s and activity concentrations from 0.4 to 3 kBq/ml to assess uniformity, contrast recovery coefficients (CRCs) and to characterize noise by coefficient of variation (CV). Spatial resolution was compared for both MRDs by sampling a quadrant of the FOV with a point source. Further IQ, CV, liver SUVmean and SUVmax were compared for a cohort of 5 patients scanned with [18F]FDG (3 MBq/kg, 1 h p.i.) from 30 to 300 s. RESULTS CV was improved by a factor of up to 1.49 and is highest for short acquisition times, peaks at the center field of view and mitigates parabolic in axial direction with no difference to MRD85 beyond the central 80 cm. No substantial differences between the two evaluated MRDs in regards to uniformity, SUVmean or CRC for the different isotopes were observed. A degradation of the average spatial resolution of 0.9 ± 0.2 mm in the central 40 cm FOV was determined with MRD322. Depending on the acquisition time MRD322 resulted in a decrease of SUVmax between 23.8% (30 s) and 9.0% (300 s). CONCLUSION Patient and phantom studies revealed that scan time could be lowered by approximately a factor of two with MRD322 while maintaining similar noise performance. The moderate degradation in spatial resolution for MRD322 is worth to exploit the full potential of the Quadra by either shorten scan times or leverage noise performance in particular for low count scenarios such as ultra-late imaging or dynamic studies with high temporal resolution.
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Affiliation(s)
- F P Schmidt
- Department of Nuclear Medicine and Clinical Molecular Imaging, University hospital Tuebingen, Tuebingen, Germany; Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard-Karls University Tuebingen, Tuebingen, Germany.
| | - J G Mannheim
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard-Karls University Tuebingen, Tuebingen, Germany; Cluster of Excellence iFIT (EXC 2180) "Image Guided and Functionally Instructed Tumor Therapies", University of Tuebingen, Tuebingen, Germany
| | - P M Linder
- Department of Nuclear Medicine and Clinical Molecular Imaging, University hospital Tuebingen, Tuebingen, Germany
| | - P Will
- Department of Nuclear Medicine and Clinical Molecular Imaging, University hospital Tuebingen, Tuebingen, Germany
| | - L S Kiefer
- Department of Nuclear Medicine and Clinical Molecular Imaging, University hospital Tuebingen, Tuebingen, Germany
| | - M Conti
- Siemens Medical Solutions USA Inc., Molecular Imaging, Knoxville, TN, USA
| | - C la Fougère
- Department of Nuclear Medicine and Clinical Molecular Imaging, University hospital Tuebingen, Tuebingen, Germany; Cluster of Excellence iFIT (EXC 2180) "Image Guided and Functionally Instructed Tumor Therapies", University of Tuebingen, Tuebingen, Germany
| | - I Rausch
- QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
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Calugi S, Dalle Grave A, Conti M, Dametti L, Chimini M, Dalle Grave R. Reply to Meule, A. Comment on "Calugi et al. The Role of Weight Suppression in Intensive Enhanced Cognitive Behavioral Therapy for Adolescents with Anorexia Nervosa: A Longitudinal Study. Int. J. Environ. Res. Public Health 2023, 20, 3221". Int J Environ Res Public Health 2023; 20:6691. [PMID: 37681831 PMCID: PMC10487535 DOI: 10.3390/ijerph20176691] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023]
Abstract
We read the comments by Meule on our article with great interest, and we thank the author for his thoughtful suggestions [...].
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Affiliation(s)
- Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Monte Baldo 89, 37016 Verona, Italy; (A.D.G.); (M.C.); (L.D.); (M.C.); (R.D.G.)
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5
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Calugi S, Dalle Grave A, Conti M, Dametti L, Chimini M, Dalle Grave R. The Role of Weight Suppression in Intensive Enhanced Cognitive Behavioral Therapy for Adolescents with Anorexia Nervosa: A Longitudinal Study. Int J Environ Res Public Health 2023; 20:3221. [PMID: 36833916 PMCID: PMC9967636 DOI: 10.3390/ijerph20043221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
The study aimed to establish the role of weight suppression in a cohort of adolescents with anorexia nervosa treated with intensive enhanced cognitive behavioral therapy (CBT-E). One hundred and twenty-eight adolescent patients with anorexia nervosa (128 females and 2 males), aged between 14 and 19 years, were recruited from consecutive referrals to a community-based eating disorder clinic offering intensive CBT-E. Weight, height, Eating Disorder Examination Questionnaire, and Brief Symptom Inventory scores were recorded at admission, end-of-treatment, and at a 20-week follow-up. In addition, the developmental weight suppression (DWS, difference between one's highest premorbid and current z-BMI, i.e., BMI z-scores) was calculated. The mean baseline z-BMI was -4.01 (SD = 2.27), and the mean DWS was 4.2 (SD = 2.3). One hundred and seven patients (83.4%) completed the treatment and showed both considerable weight gain and reduced scores for eating-disorder and general psychopathology. Among completers, 72.9% completed the 20-week follow-up and maintained the improvement reached at the end-of-treatment. DWS was negatively correlated with end-of-treatment and follow-up z-BMI. This indicates that weight suppression is a predictor of the BMI outcome of intensive CBT-E and confirms that this treatment is promising for adolescents with anorexia nervosa.
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Affiliation(s)
- Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Monte Baldo 89, 37016 Garda, VR, Italy
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6
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Rodia R, Meloni PE, Mascia C, Balestrieri C, Ruggiero V, Serra G, Conti M, Loi M, Pes F, Onali S, Perra A, Littera R, Velluzzi F, Mariotti S, Chessa L, Boi F. Direct-acting antivirals used in HCV-related liver disease do not affect thyroid function and autoimmunity. J Endocrinol Invest 2023; 46:359-366. [PMID: 36048357 PMCID: PMC9859881 DOI: 10.1007/s40618-022-01909-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/19/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE It is well known that interferon-α (IFN-α), used for long time as the main therapy for HCV-related disease, induces thyroid alterations, but the impact of the new direct-acting antivirals (DAAs) on thyroid is not established. Aim of this prospective study was to evaluate if DAAs therapy may induce thyroid alterations. METHODS A total of 113 HCV patients, subdivided at the time of the enrollment in naïve group (n = 64) and in IFN-α group (n = 49) previously treated with pegylated interferon-α and ribavirin, were evaluated for thyroid function and autoimmunity before and after 20-32 weeks of DAAs. RESULTS Before starting DAAs, a total of 8/113 (7.1%) patients showed Hashimoto's thyroiditis (HT) all belonging to IFN-α group (8/49, 16.3%), while no HT cases were found in the naïve group. Overall, 7/113 (6.2%) patients were hypothyroid: 3/64 (4.7%) belonging to naïve group and 4/49 (8.2%) to IFN-α group. Furthermore, a total of 8/113 patients (7.1%) showed subclinical hyperthyroidism: 2/64 (3.1%) were from naïve group and 6/49 (12.2%) from IFN-α group. Interestingly, after DAAs therapy, no new cases of HT, hypothyroidism and hyperthyroidism was found in all series, while 6/11 (54.5%) patients with non-autoimmune subclinical thyroid dysfunction became euthyroid. Finally, the only association between viral genotypes and thyroid alterations was genotype 1 and hypothyroidism. CONCLUSIONS This study supports evidence that DAAs have a limited or missing influence on thyroid in patients with HCV-related diseases. Moreover, it provides preliminary evidence that subclinical non-autoimmune thyroid dysfunction may improve after HCV infection resolution obtained by DAAs.
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Affiliation(s)
- R Rodia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - P E Meloni
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - C Mascia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - C Balestrieri
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - V Ruggiero
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - G Serra
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - M Conti
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - M Loi
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - F Pes
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - S Onali
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - A Perra
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - R Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - F Velluzzi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - S Mariotti
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - L Chessa
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - F Boi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy.
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Bramato V, Rocchi C, Conti M, Liguori C, Pagano A, Castelli A, Manfredi N, Mari L, Ermini R, Spanetta M, Lauretti B, Izzi F, Placidi F. Cardiovascular autonomic function in chronic insomnia assessed by cardiovascular reflexes. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Camera M, Brambilla M, Canzano P, Becchetti A, Conti M, Teruzzi G, Porro B, Muratori E, Tedesco C, Montorsi P, Bartorelli A, Tremoli E, Trabattoni D. Patent foramen ovale (PFO) and migraine: role of platelet Tissue Factor expression and oxidative stress. The LEARNER study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1835] [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
Migraine is a chronic neurovascular disorder with a multifactorial aetiology. A strong relationship links migraine with aura (MHA) and patent foramen ovale (PFO), with migraine regression after PFO closure. Increased platelet aggregation and oxidative stress were documented in migraineurs. Current guidelines suggest the use of aspirin or P2Y12-antagonists. To date, however, no clear mechanisms connecting MHA to PFO has been demonstrated.
Purpose
To perform a comprehensive analysis of platelet activation, inflammation and oxidative stress status in 78 aspirin-treated MHA-patients before (T0) and 6-months after (T1) PFO closure (LEARNER Study-NCT03521193-clinicaltrials.gov). Primary endpoint was migraine regression rate in relation to these parameters.
Methods
P-selectinpos-, activated-glycoproteinIIbIIIa (aGPIIbIIIa)pos-, Tissue Factor (TF)pos-, reactive oxygen species (ROS)pos-platelets, platelet-leukocyte aggregates (PLA) and microvesicles (MVs) were evaluated by flow cytometry; thrombin generation (TG) by Calibrated Automated Thrombogram (CAT) assay; oxidative stress status by mass spectrometry. Twelve aspirin-treated-healthy subjects (HS) were enrolled for comparison. To test the effect of PFO patients' plasma on platelet activation, blood from HS was plasma-depleted and replaced with a pool of plasma from PFO patients.
Results
Migraine resolution occurred in 69.7%, significant reduction in 27%, while no effect was observed in 2 patients (3.2%). Only ROSpos-platelets, and TFpos-platelets and -MVs were significantly higher at T0, sustaining a TG capacity that was associated with an altered blood GSSG/GSH (Oxidized/Reduced Glutathione) ratio. This phenotype reverted to HS levels at T1 (Fig. 1). MHA-PFO plasma, added to HS blood, mirrored the in vivo platelet activation and N-acetylcysteine blunted it. In vitro GSSG treatment of HS platelets reproduced the in vivo condition. Aspirin had little effect on the platelet prothrombotic phenotype which was effectively inhibited by a P2Y12-antagonist (Fig.2).
Conclusions
MHA-PFO patients show a platelet-associated prothrombotic phenotype, characterized by a marked thrombin generation capacity sustained by an elevated number of platelets and MVs expressing a functionally active Tissue Factor and sustained by altered oxidative stress status. This phenotype, not fully controlled by aspirin but by P2Y12-antagonism, reverted after PFO closure together with a complete migraine remission.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Italian Ministry of Health
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Affiliation(s)
- M Camera
- University of Milan, eDepartment of Pharmaceutical Sciences , Milan , Italy
| | | | - P Canzano
- Centro cardiologico Monzino , Milan , Italy
| | | | - M Conti
- Centro cardiologico Monzino , Milan , Italy
| | - G Teruzzi
- Centro cardiologico Monzino , Milan , Italy
| | - B Porro
- Centro cardiologico Monzino , Milan , Italy
| | - E Muratori
- Centro cardiologico Monzino , Milan , Italy
| | - C Tedesco
- Centro cardiologico Monzino , Milan , Italy
| | - P Montorsi
- Centro cardiologico Monzino , Milan , Italy
| | | | - E Tremoli
- Centro cardiologico Monzino , Milan , Italy
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9
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Camera M, Brambilla M, Canzano P, Becchetti A, Conti M, Agostoni PG, Pengo M, Tortorici E, Mancini ME, Andreini D, Bonomi A, Parati GF. Long COVID-19 syndrome: association of cardiopulmonary impairment with a persistent platelet activation. Eur Heart J 2022. [PMCID: PMC9619691 DOI: 10.1093/eurheartj/ehac544.3038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background A considerable proportion of patients do not fully recover from COVID-19 infection and report symptoms that persist beyond the initial phase of infection: this condition is defined long-COVID-19 syndrome (LCS). LCS can involve lungs as well as several extrapulmonary organs, including the cardiovascular system. The risk and 1-year burden of cardiovascular diseases (CVD) is increased in COVID-19 survivors, even in subjects at low risk of CVD. Recently, we documented that acute COVID-19 infection induces altered platelet activation state characterized by a prothrombotic phenotype and by the formation of platelet-leukocyte aggregates (PLA), that may be involved in the pulmonary microthrombi found in autoptic specimens. No data are yet available on the contribution of platelet activation to residual pulmonary impairment and procoagulant potential in LCS patients. Purpose To study platelet activation status, microvesicle (MV) profile, platelet thrombin generation capacity (pTGC) in LCS patients enrolled at 6 months after resolution of the acute phase (6mo-FU), compared to acute COVID-19 infection patients. Methods 6mo-FU COVID-19 patients (n=24) with established LCS were enrolled at Centro Cardiologico Monzino. Residual pulmonary impairment was assessed by Cardiopulmonary Exercise Testing (CPET) and 64-rows-CT scan evaluation. Platelet activation (P-selectin, Tissue Factor [TF] and PLA) and MV profile were assessed by flow cytometry; pTGC by calibrated automated thrombogram. 46 patients enrolled during acute COVID-19 infection and 46 healthy subjects (HS) were used for comparison. Results Dispnea in LCS patients was confirmed by CPET showing compromised alveolus-capillary membrane diffusion and residual pulmonary impairment. TF+-platelet and -MV levels were 3-fold (1.5% [1.2–2.9] vs 2.4% [1.6–5.7]) and 2-fold (217/μl [137–275] vs 435/μl [275–633]) lower at 6mo-FU compared to acute phase, being comparable to HS. pTGC behaved similarly. At 6mo-FU, the MV profile, in terms of total number and cell origin, returned to physiological levels. Conversely, although lower than that measured in acute phase, a 2.5-fold higher platelet P-selectin expression (6.9% [3–13.5] vs 11.7% [5.2–18.9]) and PLA formation (35.5% [27.4–46.8] vs 67.7% [45.7–85.3]) was observed at 6mo-FU compared to HS. Interestingly, a significant correlation between PLA formation and residual pulmonary impairment was observed (r=−0.423; p=0.02). Conclusion These data strengthen the hypothesis that the presence of PLA in the bloodstream, and thus also in the pulmonary microcirculation, may contribute to support pulmonary dysfunction still observed in LCS patients. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Italian Ministry of Health (Ricerca Corrente 2020 MPP COVID4)
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Affiliation(s)
- M Camera
- University of Milan, eDepartment of Pharmaceutical Sciences , Milan , Italy
| | | | - P Canzano
- Centro cardiologico Monzino , Milan , Italy
| | | | - M Conti
- Centro cardiologico Monzino , Milan , Italy
| | | | - M Pengo
- Italian Auxological Institute San Luca Hospital , Milan , Italy
| | - E Tortorici
- Italian Auxological Institute San Luca Hospital , Milan , Italy
| | | | - D Andreini
- Centro cardiologico Monzino , Milan , Italy
| | - A Bonomi
- Centro cardiologico Monzino , Milan , Italy
| | - G F Parati
- Italian Auxological Institute San Luca Hospital , Milan , Italy
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Altorki N, Wang X, Kozono D, Watt C, Landreneau R, Wigle D, Port J, Jones D, Conti M, Ashrafi A, Keenan R, Bauer T, Kohman L, Stinchcombe T, Vokes E. PL03.06 Lobar or Sub-lobar Resection for Peripheral Clinical Stage IA = 2 cm Non-small Cell Lung Cancer (NSCLC): Results From an International Randomized Phase III Trial (CALGB 140503 [Alliance]). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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11
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Dalle Grave R, Dalle Grave A, Bani E, Oliosi A, Conti M, Dametti L, Calugi S. The impact of the COVID-19 pandemic on intensive cognitive behavioral therapy outcomes in patients with anorexia nervosa-A cohort study. Int J Eat Disord 2022; 56:216-224. [PMID: 35751430 PMCID: PMC9349485 DOI: 10.1002/eat.23765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study aimed to assess the impact of the COVID-19 pandemic on the efficacy of an intensive treatment based on enhanced cognitive behavioral therapy (CBT-E) in patients with anorexia nervosa. METHODS This cohort study analyzed 57 patients with anorexia nervosa who experienced the COVID-19 pandemic during intensive CBT-E, comparing their outcomes (body mass index [BMI], eating-disorder and general psychopathology, and clinical impairment) with those of patients with anorexia nervosa matched by gender, age, and BMI given the same treatment before the COVID-19 outbreak as controls. Patients were assessed at baseline, at the end of treatment and after 20 weeks of follow-up. RESULTS More than 75% of patients during the pandemic versus 85% of controls completed the treatment, a difference that was not significant. BMI, eating disorder and general psychopathology and clinical impairment scores improved significantly from baseline to 20-week follow-up in both groups. However, the improvement was more marked in controls than in those treated during the COVID-19 pandemic. CONCLUSION Patients with anorexia nervosa given intensive CBT-E during the COVID-19 pandemic had significantly improved psychopathology, albeit to a lesser extent than patients given the same treatment before the COVID-19 pandemic. PUBLIC SIGNIFICANCE STATEMENT In this study, the outcome of 57 patients with anorexia treated with intensive enhanced cognitive behavior therapy during the COVID-19 pandemic was compared with a matched group treated before the pandemic hit. The rate of remission from anorexia nervosa was similar between the two groups. However, patients exposed to the COVID-19 pandemic showed lesser improvement than those not exposed.
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Affiliation(s)
| | - Anna Dalle Grave
- Department of Eating and Weight DisordersVilla Garda HospitalGardaItaly
| | - Elena Bani
- Department of Eating and Weight DisordersVilla Garda HospitalGardaItaly
| | - Alessandra Oliosi
- Department of Eating and Weight DisordersVilla Garda HospitalGardaItaly
| | - Maddalena Conti
- Department of Eating and Weight DisordersVilla Garda HospitalGardaItaly
| | - Laura Dametti
- Department of Eating and Weight DisordersVilla Garda HospitalGardaItaly
| | - Simona Calugi
- Department of Eating and Weight DisordersVilla Garda HospitalGardaItaly
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12
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Conti M, Serra P, Befacchia G, Santarelli F, Benvenuto M, Fabiani D, Napoletano C. P5 ACCESSORY PATHWAYS HIGH–DENSITY MAPPING IN WOLFF–PARKINSON–WHITE SYNDROME. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Wolff–Parkinson–White syndrome is a common condition characterized by atrioventricular accessory pathways (AP), which can be asymptomatic or can be responsible for atrioventricular reentrant tachycardia or rapid conduction of atrial fibrillation to the ventricles: for this reason, patients are referred for catheter ablation procedures. Although success rates of ablation are >95%, late recurrences can occur in 2–21% of cases mainly depending on the anatomical position. Current approaches remain suboptimal, and when failures occur, they may be due to technical difficulties such as poor contact or catheter stability, inability to access the target site as well as mapping errors resulting in inaccurate location of the AP itself. High–density mapping represents an alternative approach to mapping arrhythmias since the collection of a high density of points allows pathway conduction to be mapped more efficiently. The use of a new software called open–window mapping proved to be reliable in the localization of AP and therefore in the determination of the effective ablation site. A 41–year–old male patient was referred to our Centre following the ECG finding of manifest ventricular preexcitation and short–lasting paroxysmal palpitations. In the Electrophysiology Lab, the diagnostic catheters were inserted with the “fluoroless” technique using the EnSite Precision™ mapping system (Abbott): the ECG and the endocavitary electrograms were indicative of a right Parahissian accessory pathway. The mapping was performed with a multipolar catheter (Advisor™ HD Grid). Once the location of the pathway had been estimated, the roving acquisition interval (RAI) was set according to the expected position of atrial and ventricular electrogram. The RAI window was centered at this point and was opened in both directions (open window mapping) to fully include signals leading up to and traveling away from the AP. It accurately showed the location of the pathway just few millimeters from the Hissian potential. The baseline electrophysiological study revealed an effective antegrade refractory period (PREAP) of 320 msec. In isoproterenol, antegrade PREAP was reduced to 300 msec and inducibility of arrhythmias was not observed. Therefore, in consideration of the poor conductive properties and the non–inducibility of arrhythmias, as well as the anatomical site near the conduction system, it was decided not to proceed with the ablation due to the significant risk of atrio–ventricular block.
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Affiliation(s)
- M Conti
- OSPEDALE “G. MAZZINI”, TERAMO
| | - P Serra
- OSPEDALE “G. MAZZINI”, TERAMO
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13
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Zanelli S, Fiorio E, Zampiva I, Zacchi F, Borghesani G, Giontella E, Parolin V, Biondani P, Zuliani S, Dieci MV, Mioranza E, Zorzi M, Conti M, Gibellini D, Verlato G, Milella M. Risk and severity of SARS-CoV-2 infection in breast cancer patients undergoing a structured infection screening program at the University and Hospital Trust of Verona. Ann Oncol 2022; 33:661-663. [PMID: 35276335 PMCID: PMC8904004 DOI: 10.1016/j.annonc.2022.02.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- S Zanelli
- Section of Oncology, Department of Medicine, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - E Fiorio
- Section of Oncology, Department of Medicine, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - I Zampiva
- Section of Oncology, Department of Medicine, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy; Centro Ricerche Cliniche di Verona (CRC), Verona, Italy
| | - F Zacchi
- Section of Oncology, Department of Medicine, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - G Borghesani
- Section of Oncology, Department of Medicine, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - E Giontella
- Section of Oncology, Department of Medicine, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - V Parolin
- Section of Oncology, Department of Medicine, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - P Biondani
- Section of Oncology, Department of Medicine, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - S Zuliani
- Section of Oncology, Department of Medicine, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - M V Dieci
- Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy; Department of Oncology, Surgery and Gastroenterology, University of Padova, Padua, Italy
| | - E Mioranza
- Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy
| | - M Zorzi
- Veneto Tumor Registry, Azienda Zero, Padua, Italy
| | - M Conti
- Section of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - D Gibellini
- Department of Diagnostic and Public Health, Microbiology Section, University of Verona, Verona, Italy
| | - G Verlato
- Section of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - M Milella
- Section of Oncology, Department of Medicine, University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, Italy.
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14
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Sotgiu MA, Piga G, Mazzarello V, Zarbo IR, Carta A, Saderi L, Sotgiu S, Conti M, Saba L, Crivelli P. Corpus callosum volumetrics and clinical progression in early multiple sclerosis. Eur Rev Med Pharmacol Sci 2022; 26:225-231. [PMID: 35048999 DOI: 10.26355/eurrev_202201_27772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Corpus callosum (CC) is commonly affected in multiple sclerosis (MS), with known association between CC atrophy and MS clinical activity. In this study, we assessed the association of callosal atrophy, lesions volume and residual CC volume with the clinical disability of early MS patients. SUBJECTS AND METHODS Thirteen MS subjects (9 female, mean age 36.9 years), studied with magnetic resonance imaging (MRI) were selected. MRI scans were performed at baseline (T0), at 6 (T1), 12 (T2), and 24 months (T3) from baseline. CC was segmented into three sections (genu, body, and splenium); callosal boundaries were outlined and all CC lesions were manually traced. Normal CC and CC lesion volumes were measured using a semiautomatic software. RESULTS From January 2014 to December 2016, all selected patients had confluent lesions on MRI at T3 with a significant increase in the size of confluent lesions compared to baseline (p=0.0007). At T1, a significant increase in the size of confluent (p=0.02) and single lesions located in the callosal body (p=0.04) was detected in patients with EDSS ≥1.5. Also, CC residual volume (CCR) rather than the whole CC volume (CCV) significantly correlated (p=0.03) with the clinical progression of MS in the whole cohort. CONCLUSIONS In early MS patients with higher EDSS at baseline, a significant increase in confluent CC lesions size is evident, particularly in the callosal body. Also, median CCR is significantly associated with MS progression in the whole MS group, regardless of initial EDSS. Given their significant association with disability, we encourage measuring CC body lesions and residual CC size for therapeutic decisions and prognostic planning in early MS.
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Affiliation(s)
- M A Sotgiu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
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15
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Dalle Grave R, Dametti L, Conti M, Bersan C, Dalle Grave A, Calugi S. Day-hospital enhanced cognitive behavior therapy for adults with eating disorders: Immediate and follow-up effects. Int J Eat Disord 2022; 55:125-130. [PMID: 34687248 DOI: 10.1002/eat.23632] [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: 09/03/2021] [Revised: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To assess outcomes in adult patients with eating disorders administered enhanced cognitive behavioral therapy (CBT-E) in a day-hospital setting. METHOD Forty-three consecutive patients with eating disorders (86% females; mean age 28.8 [SD = 11.8]) were admitted to a 13-week day-hospital CBT-E program. Twenty-five (58.1%) patients were underweight (i.e., body mass index [BMI] <18.5 kg/m2 ; BMI 15.4 [SD = 2.2]) and 18 not (mean BMI 23.1 [SD = 6.3]) at baseline. All patients responded poorly to prior outpatient treatment. Body mass index and Eating Disorder Examination Questionnaire (EDE-Q), Brief Symptom Inventory (BSI), and Clinical Impairment Assessment (CIA) scores were recorded at baseline, end of treatment, and 20-week follow-up. RESULTS In 37 patients (86.0%) who completed the treatment, there were substantial improvements in eating-disorder features, general psychopathology, clinical impairment, and body weight (only in underweight patients), which were well maintained at follow-up. DISCUSSION Day-hospital CBT-E is a promising treatment for adults with eating disorders.
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Affiliation(s)
| | - Laura Dametti
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Italy
| | - Maddalena Conti
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Italy
| | - Chiara Bersan
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Italy
| | - Anna Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Italy
| | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Italy
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16
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Bäumer C, Bäcker CM, Conti M, Fragoso Costa P, Herrmann K, Kazek SL, Jentzen W, Panin V, Siegel S, Teimoorisichani M, Wulff J, Timmermann B. Can a ToF-PET photon attenuation reconstruction test stopping-power estimations in proton therapy? A phantom study. Phys Med Biol 2021; 66. [PMID: 34534971 DOI: 10.1088/1361-6560/ac27b5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/13/2021] [Indexed: 01/19/2023]
Abstract
Objective. The aim of the phantom study was to validate and to improve the computed tomography (CT) images used for the dose computation in proton therapy. It was tested, if the joint reconstruction of activity and attenuation images of time-of-flight PET (ToF-PET) scans could improve the estimation of the proton stopping-power.Approach. The attenuation images, i.e. CT images with 511 keV gamma-rays (γCTs), were jointly reconstructed with activity maps from ToF-PET scans. Theβ+activity was produced with FDG and in a separate experiment with proton-induced radioactivation. The phantoms contained slabs of tissue substitutes. The use of theγCTs for the prediction of the beam stopping in proton therapy was based on a linear relationship between theγ-ray attenuation, the electron density, and the stopping-power of fast protons.Main results. The FDG based experiment showed sufficient linearity to detect a bias of bony tissue in the heuristic look-up table, which maps between x-ray CT images and proton stopping-power.γCTs can be used for dose computation, if the electron density of one type of tissue is provided as a scaling factor. A possible limitation is imposed by the spatial resolution, which is inferior by a factor of 2.5 compared to the one of the x-ray CT.γCTs can also be derived from off-line, ToF-PET scans subsequent to the application of a proton field with a hypofractionated dose level.Significance. γCTs are a viable tool to support the estimation of proton stopping with radiotracer-based ToF-PET data from diagnosis or staging. This could be of higher potential relevance in MRI-guided proton therapy.γCTs could form an alternative approach to make use of in-beam or off-line PET scans of proton-inducedβ+activity with possible clinical limitations due to the low number of coincidence counts.
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Affiliation(s)
- C Bäumer
- West German Proton Therapy Centre Essen, Am Mühlenbach 1, Essen, Germany.,University Hospital Essen, Hufelandstr. 55, Essen, Germany.,West German Cancer Center (WTZ), Hufelandstr. 55, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,TU Dortmund University, Department of Physics, Otto-Hahn-Str. 4a, Dortmund, Germany
| | - C M Bäcker
- West German Proton Therapy Centre Essen, Am Mühlenbach 1, Essen, Germany.,University Hospital Essen, Hufelandstr. 55, Essen, Germany.,West German Cancer Center (WTZ), Hufelandstr. 55, Essen, Germany.,TU Dortmund University, Department of Physics, Otto-Hahn-Str. 4a, Dortmund, Germany
| | - M Conti
- Siemens Medical Solutions USA Inc., Knoxville, Tennessee, United States of America
| | - P Fragoso Costa
- University Hospital Essen, Hufelandstr. 55, Essen, Germany.,University Hospital Essen, Clinic for Nuclear Medicine, Hufelandstr. 55, Essen, Germany
| | - K Herrmann
- University Hospital Essen, Hufelandstr. 55, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,University Hospital Essen, Clinic for Nuclear Medicine, Hufelandstr. 55, Essen, Germany
| | - S L Kazek
- University Hospital Essen, Hufelandstr. 55, Essen, Germany.,University Hospital Essen, Clinic for Nuclear Medicine, Hufelandstr. 55, Essen, Germany
| | - W Jentzen
- University Hospital Essen, Hufelandstr. 55, Essen, Germany.,University Hospital Essen, Clinic for Nuclear Medicine, Hufelandstr. 55, Essen, Germany
| | - V Panin
- Siemens Medical Solutions USA Inc., Knoxville, Tennessee, United States of America
| | - S Siegel
- Siemens Medical Solutions USA Inc., Knoxville, Tennessee, United States of America
| | - M Teimoorisichani
- Siemens Medical Solutions USA Inc., Knoxville, Tennessee, United States of America
| | - J Wulff
- West German Proton Therapy Centre Essen, Am Mühlenbach 1, Essen, Germany.,University Hospital Essen, Hufelandstr. 55, Essen, Germany.,West German Cancer Center (WTZ), Hufelandstr. 55, Essen, Germany
| | - B Timmermann
- West German Proton Therapy Centre Essen, Am Mühlenbach 1, Essen, Germany.,University Hospital Essen, Hufelandstr. 55, Essen, Germany.,West German Cancer Center (WTZ), Hufelandstr. 55, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,University Hospital Essen, Department of Particle Therapy, Hufelandstr. 55, Essen, Germany
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17
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Conti M, Tonlorenzi D, Brunelli M, Traina G. Learning effect and repeatability of stabilometric measurements: "standard" vs. usual foot placement. Arch Ital Biol 2021; 159:95-103. [PMID: 34184241 DOI: 10.12871/00039829202124] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The existence of a learning effect by which subjects progressively reduce body sway over the course of repetitive stabilometric measurements is currently debated. Also, the position and orientation of the feet on the platform can have a substantial influence on the outcome measurements. The aim of the present work was to assess the effect of feet positions on mean total velocity (V) of the center of pressure and the area (AR) covered by its displacements during quiet standing. A group of 35 healthy young subjects was examined during two successive sessions consisting of five recordings with their feet placed either in the recommended (standard, SP) or their usual most comfortable (UP) position. Results show a slight decreasing trend that failed to be statistically significant checked with Friedman's ANOVA (SP AR, χ2(4)=6.10, p=0.19 and V, χ2(4)=8.66, p=0.07 and UP AR, χ2(4)=2.32, p=0.68 and V, χ2(4)=1.19, p=0.88). Nonetheless, values of AR and V showed a notable decrement especially evident in the SP exam reaching, respectively, 24% and 11% from baseline, whereas variability measured by the coefficient of variation was the same in the two exams. Given the results, a learning effect should not be ruled out with confidence. Also, usual foot placement would be preferable to avoid this effect. Further research is needed to take into consideration the great variability of stabilometric measurements and the fact that different subjects could adapt more readily to the test conditions than others.
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Affiliation(s)
| | | | | | - G Traina
- Dipartimento di Scienze Farmaceutiche, Università degli Studi di Perugia, Perugia, Italy -
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18
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Bufi E, Piacentini M, Belli P, Conti M, Ciriello G, Franceschini G, Giuliani M, Terribile D, Valente I, Manfredi R. Is subareolar intraoperative biopsy still necessary to predict nipple involvement? Eur Rev Med Pharmacol Sci 2021; 25:661-668. [PMID: 33577020 DOI: 10.26355/eurrev_202101_24627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To predict the occult tumor involvement of nipple-areola complex (NAC) using preoperative MR imaging and to investigate whether the intraoperative histopathological examination of the subareolar tissue is still necessary. PATIENTS AND METHODS Out of 712 patients submitted to nipple-sparing mastectomy (NSM) between 2014 and 2019, we selected 188 patients who underwent preoperative breast MRI. Breast MRI and intraoperative histopathological examination of the subareolar tissue were performed to predict NAC involvement at permanent pathology. All parameters were correlated with final pathological NAC assessment by univariate and multivariate analysis. RESULTS Forty-three patients (22.9%) had tumor involvement of the NAC. At univariate analysis, non-mass enhancement type (p = 0.009), multifocality/multicentricity (p = 0.002), median tumor size (p < 0.001), median tumor-NAC distance measured by MRI (p < 0.001), tumor-NAC distance ≤ 10 mm (p < 0.001) and tumor-NAC distance ≤ 20 mm (p < 0.001), and lymphovascular invasion (p = 0.001) were significantly correlated with NAC involvement. At multivariate analysis, only tumor-NAC distance ≤ 10 mm retained statistical significance. The sensitivity and specificity of MRI tumor-NAC distance ≤ 10 mm were 79.1% and 97.2% and those of intraoperative pathologic assessment were 74,4% and 100%, respectively. CONCLUSIONS Tumor-NAC distance is the only reliable MRI characteristic that can predict NAC involvement in breast cancer patients. Although several cut-offs showed promising performances, intraoperative pathologic assessment is still mandatory.
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Affiliation(s)
- E Bufi
- UOC Radiologia Diagnostica ed Interventistica Generale, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy.
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Dalle Grave R, Conti M, Calugi S. Effectiveness of intensive cognitive behavioral therapy in adolescents and adults with anorexia nervosa. Int J Eat Disord 2020; 53:1428-1438. [PMID: 32691431 DOI: 10.1002/eat.23337] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 05/19/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This study aimed to compare the effectiveness of an intensive treatment based on enhanced cognitive behavioral therapy (CBT-E) in adolescent and adult patients with anorexia nervosa. METHODS A total of 150 consecutive patients (74 adolescents and 81 adults) were admitted to a 20-week intensive CBT-E program (13 weeks of inpatient followed by 7 weeks of day-hospital treatment). All patients had responded poorly to previous outpatient treatments and were assessed at admission, end of treatment (EOT), and 20- and 60-week follow-ups. RESULTS About 70% of eligible patients began the program, and more than 85% completed it. Body mass index (BMI) in adults and BMI-for-age percentile in adolescents improved significantly from baseline to EOT, remained stable until 20-week follow-up, and slightly decreased from 20-week follow-up to 60-week follow-up, while remaining in the lower normal range. Eating disorder psychopathology, general psychopathology, and clinical impairment scores decreased significantly at EOT and showed only a slight increase from EOT to follow-ups. No difference was found between adolescent and adult patients in treatment acceptance, dropout, or any outcome measure. DISCUSSION These findings indicate that intensive CBT-E seems to be an effective treatment for severely ill adolescent and adult patients with anorexia nervosa.
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Affiliation(s)
- Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda (VR), Veneto, Italy
| | - Maddalena Conti
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda (VR), Veneto, Italy
| | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda (VR), Veneto, Italy
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Castagna A, Garofalo R, Conti M, Khair Y, Gumina S, De Giorgi S. Arthroscopic transosseous versus suture anchor repair: clinical outcomes in patients with bilateral rotator cuff tears. J BIOL REG HOMEOS AG 2020; 34:51-57. Congress of the Italian Orthopaedic Research Society. [PMID: 33261256] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The aim of our study was to define if Arthroscopic Transosseous Rotator Cuff Techniques should have comparable results to those of the suture-anchors technique in a single row configuration. We reported the preliminary results of a consecutive population of 22 patients who underwent a rotator cuff treatment on the left and right sides for average medium-sized thickness tears with minimal fatty infiltration with the two different techniques: transosseous rotator cuff repair technique on one side and single row with suture-anchors on the other side, in different times. Subjective evaluation with DASH questionnaires, Constant Scores and Numerical Rating Scale (NRS) for pain evaluation, have been submitted pre and postoperatively after both operations. A statistical analysis was performed to assess the superiority of one technique and to compare pre and postoperative ROM data and clinical outcomes. A transosseous rotator cuff repair was performed in 7 patients on the dominant arm, while the other 15 patients had dominant arm cuff tear lesions repaired by using suture-anchors technique. At last follow-up a significant improvement, in shoulder pain and function, was referred at both sides. Also, DASH, Constant Scores and NRS for pain evaluation improved with both techniques, but no statistical difference was found between them. Arthroscopic transosseous rotator cuff repair technique shows comparable results to those of the suture-anchors technique in a single row configuration.
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Affiliation(s)
- A Castagna
- Shoulder and Elbow Unit, IRCCS Humanitas Institute, Rozzano, Milano, Italy
| | - R Garofalo
- Shoulder Service, Miulli Hospital, Acquaviva delle Fonti, Bari, Italy
| | - M Conti
- Shoulder and Elbow Unit, IRCCS Humanitas Institute, Rozzano, Milano, Italy
| | - Y Khair
- Jordan Royal Medical Service, Amman, Jordan
| | - S Gumina
- University of Rome La Sapienza, Rome, Italy
| | - S De Giorgi
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs University of Bari, Italy
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Abstract
Increasing occlusal vertical dimension (OVD) by means of oral splints is a practice widely used in the treatment of temporomandibular disorders (TMD), specifically myofascial pain, although the results are still uncertain. Oral splints with a vertical height that significantly exceeds the clinical rest position are considered by some researchers to be a better therapeutic solution in alleviating TMD symptoms than are “low” splints.
In our observational study, 21 patients suffering from myofascial pain were examined for the effects of wearing a “high” oral splint while sleeping for 3 months. To ensure proper splint making, a mandibular stretching procedure was used to induce a relaxation of the patients’ masticatory muscles and allow the correct alignment of the jaws. Results showed a marked increase of the interocclusal distance or “free space” (hence of OVD; from 0.64±0.53 mm to 1.42±0.76 mm, p<0.0001) measured by a kinesiograph, followed by a substantial reduction of the intensity of pain in oral and extraoral regions after using the splint. These results support the view that increasing OVD beyond the clinical rest position is not detrimental to patients’ health. More importantly, high oral splints has been shown to be a promising therapeutic aid for the treatment of TMD and correlated pain syndromes. This clinical trial was registered on clinicaltrials.gov (Identifier: NCT02908568).
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Affiliation(s)
| | | | | | | | - G Traina
- Dipartimento di Scienze Farmaceutiche, Università degli Studi di Perugia, Perugia, Italy -
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Brunelli M, Conti M, Tonlorenzi D, Traina G. Changes of sensory and pain thresholds in healthy subjects after mandibular extension at maximum mouth opening: implications for temporomandibular disorders therapy. Arch Ital Biol 2020; 158:17-23. [DOI: 10.12871/00039829202012] [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: 11/03/2022]
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Busnelli M, Manzini S, Conti M, Chiesa G. Impact Of Dietary Choline On Atherosclerosis Development In Conventionally Raised Apoe-Ko Mice Expressing Different Levels Of Apoa-I. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Formato G, Hart E, Hamilton M, Manghat N, Bucciarelli-Ducci C, Caputo M, Schievano S, Auricchio F, Conti M, Biglino G. 283Morphometric analysis of internal carotid arteries in hypertensives implementing a semi-automatic measurement platform for magnetic resonance imaging data. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez114.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - E Hart
- Bristol Heart Institute, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - M Hamilton
- University Hospitals Bristol, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - N Manghat
- University Hospitals Bristol, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - C Bucciarelli-Ducci
- Bristol Heart Institute, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - M Caputo
- Bristol Heart Institute, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - S Schievano
- Great Ormond Street Hospital for Children, London, United Kingdom of Great Britain & Northern Ireland
| | | | - M Conti
- University of Pavia, Pavia, Italy
| | - G Biglino
- Bristol Heart Institute, Bristol, United Kingdom of Great Britain & Northern Ireland
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Boyd C, Luskin K, Eastwood D, Conti M, Mohammed A. The Obesity Paradox and Predictors of Thirty Day Mortality in a Single Center Heart Failure Population. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Guelfi R, Conti M, Zanfrini S, Brunelli M, Traina G. Postural Disorders Produced by School Furniture on a Population of a Junior High School. Arch Ital Biol 2019; 157:15-23. [PMID: 31111953 DOI: 10.12871/00039829201912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In recent years people suffering of backache has significantly increased. This led us to focus our attention on the adequacy of school furniture for the correct development of the adult posture. The standing posture of 67 students of middle school has been analyzed at the beginning and at the end of two consecutive scholastic years using a stabilometric platform. Starting from the second year, about half of the students were provided with the furniture designed following European standard (UNI EN 1729:2006), while the other half maintained the traditional one. The main purpose of this research has been to verify by means of posturometric analysis the effects on postural parameters of the use of traditional furniture in comparison to the furniture following the UNI EN 1729:2006. We observed that prolonged sitting at school changes some posturometric variables of schoolchildren. Since no differences has been found between the two groups, the validity of the European standards is questioned. The present study allowed us to single out four anthropometric parameters that should be considered in order to devise a new model of adjustable furniture. By adjusting every year the furniture of each student, it would be possible to avoid (at least at school) the adoption of wrong postural positions that could be responsible for backache and other common musculoskeletal disorders.
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Affiliation(s)
- R Guelfi
- Dipartimento di Scienze Farmaceutiche, Università degli Studi di Perugia, via San Costanzo, 06126 Perugia, Italy - E-mail:
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Cesari E, Castagna A, Garofalo R, Gigante A, Conti M, Markopoulos N, Maffulli N. Tendon cell ciliary length as a biomarker of in situ cytoskeletal tensional homeostasis. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.03.2013.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- E. Cesari
- Shoulder and Elbow Surgery Unit: Istituto Clinico Humanitas Rozzano, Milan, Italy
| | - A. Castagna
- Shoulder and Elbow Surgery Unit: Istituto Clinico Humanitas Rozzano, Milan, Italy
| | - R. Garofalo
- Department of Orthopedic and Traumatology, F. Miulli Hospital. Acquaviva delle Fonti, Bari, Italy
| | - A. Gigante
- Orthopaedics Clinic, School of Medicine, Marche Polytechnic University, Ancona, Italy
- Department of Molecular Pathology and Innovative Therapies, School of Medicine, Marche Polytechnic University, Ancona, Italy
| | - M. Conti
- Shoulder and Elbow Surgery Unit: Istituto Clinico Humanitas Rozzano, Milan, Italy
| | - N. Markopoulos
- Shoulder and Elbow Surgery Unit: Istituto Clinico Humanitas Rozzano, Milan, Italy
| | - N. Maffulli
- Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, UK
- Department of Physical and Rehabilitation Medicine, University of Salerno, Italy
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Maggio A, Tamponi M, Gabriele D, Conti M, Meloni G, Gabriele P, Stasi M. 299. Prostate cancer dose-fraction sensitivity deduced from radiotherapy outcome of 17949 patients. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Poggiu A, Tamponi M, Sanna F, Bona R, Pinna F, Crivelli P, Gabriele D, Montella R, Sanna E, Conti M, Marini P. 310. A radiomics analysis process using free software platforms: Our experience in Sassari. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Rito ML, Formato G, Auricchio F, Frigiola A, Giamberti A, Conti M. RF02 ANOMALOUS AORTIC CORONARY ARTERY ORIGIN. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550078.51578.1a] [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: 11/05/2022]
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Marongiu F, Biondi G, Sorano GG, Mameli G, Conti M, Mamusa AM, Balestrieri A. Bleeding Time and Oral Anticoagulant Therapy. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1651646] [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: 10/28/2022]
Affiliation(s)
- F Marongiu
- Institute of Internal Medicine, University of Cagliari, Cagliari, Italy
| | - G Biondi
- Institute of Internal Medicine, University of Cagliari, Cagliari, Italy
| | - G G Sorano
- Institute of Internal Medicine, University of Cagliari, Cagliari, Italy
| | - G Mameli
- Institute of Internal Medicine, University of Cagliari, Cagliari, Italy
| | - M Conti
- Institute of Internal Medicine, University of Cagliari, Cagliari, Italy
| | - A M Mamusa
- Institute of Internal Medicine, University of Cagliari, Cagliari, Italy
| | - A Balestrieri
- Institute of Internal Medicine, University of Cagliari, Cagliari, Italy
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Affiliation(s)
- G Biondi
- Institute of Internal Medicine, University of Cagliari, Italy
| | - G G Sorano
- Institute of Internal Medicine, University of Cagliari, Italy
| | - M Conti
- Institute of Internal Medicine, University of Cagliari, Italy
| | - G Mameli
- Institute of Internal Medicine, University of Cagliari, Italy
| | - R Cirillo
- Institute of Internal Medicine, University of Cagliari, Italy
| | - F Marongiu
- Institute of Internal Medicine, University of Cagliari, Italy
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Affiliation(s)
- F Marongiu
- Institute of Internal Medicine, University of Cagliari, Italy
| | - G Biondi
- Institute of Internal Medicine, University of Cagliari, Italy
| | - M Conti
- Institute of Internal Medicine, University of Cagliari, Italy
| | - M L Murtas
- Institute of Endocrinology, University of Cagliari, Italy
| | - G Mameli
- Institute of Internal Medicine, University of Cagliari, Italy
| | - G G Sorano
- Institute of Internal Medicine, University of Cagliari, Italy
| | - E Martinox
- Institute of Endocrinology, University of Cagliari, Italy
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Marongiu F, Conti M, Murtas ML, Mameli G, Sorano GG, Martino E. What Causes the Increase in Platelet Mean Volume in Thyroid Pathological Conditions? Thromb Haemost 2018. [DOI: 10.1055/s-0038-1645220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- F Marongiu
- Clinica Medica I, University of Cagliari, Italy
| | - M Conti
- Clinica Medica I, University of Cagliari, Italy
| | - M L Murtas
- Cattedra di Endocrinologia, University of Cagliari, Italy
| | - G Mameli
- Clinica Medica I, University of Cagliari, Italy
| | - G G Sorano
- Clinica Medica I, University of Cagliari, Italy
| | - E Martino
- Cattedra di Endocrinologia, University of Cagliari, Italy
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Bertuccelli M, Falcone A, Campoccia S, Conti M, Brunetti I, Caramella D, Giulianotti PC, Mosca F, Bartolozzi C, Conte PF. Intrahepatic Chemotherapy with Floxuridine, Leucovorin and Dexamethasone in Continuous Infusion and Mitomycin-c Bolus in Unresectable Hepatic Metastases from Colorectal Cancer: A Phase II Study. Tumori 2018; 85:473-7. [PMID: 10774568 DOI: 10.1177/030089169908500609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Intrahepatic continuous infusion FUDR induces a 50% response rate in patients with hepatic metastases from colorectal cancer. Lower rates have been observed in pretreated patients. The combination of floxuridine plus leucovorin has obtained over 70% responses, with high hepatic toxicity. The use of dexamethasone can decrease hepatic toxicity. A randomized study reported an increase in response rate and a decrease in hepatic toxicity in a group of patients treated with floxuridine plus dexamethasone compared to a group receiving only floxuridine. Moreover, the combination of mitomycin C, carmustine and floxuridine is also effective in pretreated patients. Methods On such premises, since July 1993 we have treated 39 patients affected by unresectable hepatic metastases from colon carcinoma (26 patients) and rectal carcinoma (13 patients) with the combination continuous infusion of floxuridine (0.20 mg/kg per day) + leucovorin (7.5 mg/m2/day) + dexamethasone (20 mg on days 1 to 14) and bolus mitomycin C (10 mg/m2 on day 1) via the hepatic artery. Cycles were administered every four weeks. There were as 28 males and 11 females, with a median age of 64 years (range, 39-75) and a median PS = 0. Twenty-two patients were pretreated with systemic chemotherapy including 5-fluorouracil plus leucovorin. Total number of cycles was 189, with a median of 6 cycles per patient (range, 1-12). Results Of 39 patients 37 were assessable for response (2 patients were not assessable because they stopped chemotherapy for occlusion of the catheter after the first cycle). There were 3 complete responses (1 in a naive patient and 2 in pretreated patients), 16 partial responses (11 in pretreated patients and 5 in chemonaive patients), 4 minor responses, 4 stable disease and 10 progressive disease. The overall response rate was 51.3% (95 CI, 51.3-86.7%). Median time to progression was 6 months (range, 1-34+). Overall survival was 18 months (range, 1-34+). Of 39 patients, 36 were assessable for toxicity (WHO) (3 patients died after the first cycle for progression of disease): diarrhea and nausea-vomiting grade 3-4 occurred respectively in 15 (41%) and 3 patients (8%); hepatic toxicity was mild. Conclusions The treatment we used showed an elevated activity in liver metastases from colorectal cancer even in patients pretreated and resistant to systemic chemotherapy, although toxicity grade 3-4 diarrhea occurred in approximately 40% of the patients.
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Affiliation(s)
- M Bertuccelli
- Sezione di Oncologia Medica, Ospedale di Livorno, Italy
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Calugi S, El Ghoch M, Conti M, Dalle Grave R. Preoccupation with shape or weight, fear of weight gain, feeling fat and treatment outcomes in patients with anorexia nervosa: A longitudinal study. Behav Res Ther 2018; 105:63-68. [PMID: 29689516 DOI: 10.1016/j.brat.2018.04.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 04/05/2018] [Accepted: 04/09/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The study aimed to evaluate the trajectories of change over time in body-image concern components in patients with anorexia nervosa treated by means of intensive enhanced cognitive behavioural therapy. Moreover, it aimed to study the role of body-image concern components in changes in eating and general psychopathology as well as work and social functioning. METHOD Sixty-six adult patients with anorexia nervosa were recruited. Body mass index (BMI); Eating Disorder Examination 'Dietary Restraint' and 'Eating Concern' subscales; Brief Symptom Inventory (BSI); and Work and Social Adjustment Scale (WSAS) scores were recorded at admission, end of treatment, and at 6- and 12-month follow-ups. The trajectories of change of three components of body image concern, namely 'preoccupation with shape or weight', 'fear of weight gain' and 'feeling fat', were assessed. RESULTS The treatment was associated with a significant improvement in outcome variables and body-image concern components. Baseline 'preoccupation with shape or weight' predicted improvement in Eating Concern, BSI and WSAS scores, while the change in 'fear of weight gain' was associated with improvement in dietary restraint. Baseline and end-of-therapy scores for all three measured body-image concern components predicted achievement of BMI ≥18.5 kg/m2 at 6- and 12-month follow-ups. DISCUSSION These findings highlight the importance of assessing and addressing body-image concern in the management of patients with anorexia nervosa.
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Affiliation(s)
- Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, VR, Italy.
| | - Marwan El Ghoch
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, VR, Italy
| | - Maddalena Conti
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, VR, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, VR, Italy
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Calugi S, Franchini C, Pivari S, Conti M, El Ghoch M, Dalle Grave R. Anorexia nervosa and childhood sexual abuse: Treatment outcomes of intensive enhanced cognitive behavioural therapy. Psychiatry Res 2018; 262:477-481. [PMID: 28927864 DOI: 10.1016/j.psychres.2017.09.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 08/25/2017] [Accepted: 09/11/2017] [Indexed: 09/30/2022]
Abstract
Sexual abuse has been widely studied as a risk factor in anorexia nervosa, but data on its influence on treatment outcomes are scarce. Hence, we compared short- and long-term outcomes of inpatient enhanced cognitive-behavioural therapy (CBT-E) in patients with anorexia nervosa who had and had not suffered sexual abuse. Eighty-one patients were recruited, and body mass index (BMI), Eating Disorder Examination, Brief Symptom Inventory, and Work and Social Adjustment Scale scores were recorded before and after treatment, and at 6- and 12-month follow-ups. Twenty patients (24.7%) reported experiencing childhood sexual abuse before anorexia nervosa onset, while 61 (75.3%) reported none. Both groups displayed similar characteristics before treatment, and similarly large increases in BMI, eating-disorder, general psychopathology, and work and social functioning from baseline to 12-month follow-up. Based on these findings, childhood sexual abuse does not appear to compromise outcomes in patients with anorexia nervosa treated via intensive CBT-E.
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Affiliation(s)
- Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, VR, Italy.
| | - Cecilia Franchini
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, VR, Italy
| | - Silvia Pivari
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, VR, Italy
| | - Maddalena Conti
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, VR, Italy
| | - Marwan El Ghoch
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, VR, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, VR, Italy
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Conti M, Garofalo R, Castagna A, Massazza G, Ceccarelli E. Dynamic brace is a good option to treat first anterior shoulder dislocation in season. Musculoskelet Surg 2017; 101:169-173. [PMID: 28770511 DOI: 10.1007/s12306-017-0497-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 07/19/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE We evaluate the ability of in-season competitive athletes to return to competition after an anterior shoulder instability treated conservatively with a new dynamic brace combined with a specific rehabilitation program. METHODS Twenty soccer players affected by traumatic anterior shoulder dislocation have been enrolled in the "Footballer In Season Fast Rehab" project during 2 consecutive football seasons. We excluded patients affected by rotator cuff tears and the bony defect over 25%. All the players have been treated the day after the first dislocation with a new dynamic brace used until the end of the second month after the first glenohumeral dislocation combined with a specific rehab protocol. Athletes were evaluated for the time necessary to completely resume sport activities, to complete the season, and for the recurrence of dislocation. RESULTS All the athletes enrolled in this study were able to come back on the ground in approximately 40 days after the dislocation except 2 of them. Only two athletes claimed a slight discomfort at the return to play. One athlete had a traumatic relapse of the instability, 50 days after the dislocation. Another athlete claimed to have had a subluxation during a training session 45 days after the dislocation. 90% of the athletes were able to end the season without any shoulder discomfort. CONCLUSIONS The dynamic brace combined to the rehabilitation protocol represents the solution that allows a quick start of resumption of training while maintaining a stable pain-free shoulder. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- M Conti
- MedSport Human Performance Lab, Como, Italy
| | - R Garofalo
- Ospedale Generale Regionale "F. Miulli" Acquaviva delle Fonti, Bari, Italy
| | - A Castagna
- Istituto Clinico Humanitas, Rozzano, Milan, Italy
| | - G Massazza
- Physical Medicine and Rehabilitation, University of Turin, Turin, Italy
| | - E Ceccarelli
- Ospedale Casilino, Via Casilina, 1040, Rome, Italy.
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Schaefferkoetter J, Townsend D, Conti M, Shi X, Soo R, Tam J, Sinha A, Tham I. P3.13-004 Prospective Study of Sequential Ultra-Low then Standard Dose 18F-FDG PET/CT Scans for Lung Lesion Detectability. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Alaimo G, Auricchio F, Conti M, Zingales M. Multi-objective optimization of nitinol stent design. Med Eng Phys 2017; 47:13-24. [DOI: 10.1016/j.medengphy.2017.06.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/06/2017] [Accepted: 06/14/2017] [Indexed: 11/27/2022]
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Pontone G, Guglielmo M, Guaricci A, Andreini D, Guglielmo M, Mushtaq S, Conti M, Marconi S, Pepi M, Tondo C, Fassini G. P5129Left atrial appendage closure guided by 3D printed patient-specific models. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Concolino D, Amico L, Cappellini M, Cassinerio E, Conti M, Donati M, Falvo F, Fiumara A, Maccarone M, Manna R, Matucci A, Musumeci M, Nicoletti A, Nisticò R, Papadia F, Parini R, Peluso D, Pensabene L, Pisani A, Pistone G, Rigoldi M, Romani I, Tenuta M, Torti G, Veroux M, Zachara E. Home infusion program with enzyme replacement therapy for Fabry disease: The experience of a large Italian collaborative group. Mol Genet Metab Rep 2017; 12:85-91. [PMID: 28702361 PMCID: PMC5484973 DOI: 10.1016/j.ymgmr.2017.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 11/20/2022] Open
Abstract
Fabry disease (FD) [OMIM 301500] is an X-linked lysosomal storage disorder caused by a deficiency of the lysosomal enzyme alpha-galactosidase A, resulting in progressive multisystem accumulation of globotriaosylceramide (Gb3). Although the introduction of Enzyme Replacement Therapy (ERT) resulted in a variety of clinical benefits, life-long intravenous (IV) treatment with ERT with an every other week schedule, may interfere with daily life activities and impact on QoL. We report here a multicentric, observational, longitudinal data analysis on a large cohort of 85 Italian FD patients (45 males, 40 females) from 11 out of 20 Italian regions, who received a cumulative number of 4269 home infusions of agalsidase alfa. For the whole cohort, the average duration of home therapy was 1 year and 11 months (range 3 months–4 years and 6 months), and during this period, compliance to treatment (number of infusions performed vs scheduled) reached 100%. The EQ-5 VAS scale was administered to patients to evaluate the self-reported QoL, 58% of patients showing an increase of EQ-5 VAS score at follow up compared to baseline (home treatment start) or remaining stable. A mild increase of average disease severity, measured through Mainz Severity Score Index (MSSI), was found during hospital treatment (p < 0,007), while it remained stable between the first home therapy infusion and last follow up. Interestingly, 4 out of 7 (57%) patients, showing an improvement in FD-related clinical status after starting home therapy, had previously a sub-optimal compliance to treatment during the period of hospital treatment management. Only 4 adverse non serious reactions (0,093%) were reported totally in 2 patients during home treatment. We conclude that home infusions in eligible patients with FD are safe, contribute to improve treatment compliance and therapeutic clinical outcomes, and may have a positive impact on self-perceived QoL.
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Affiliation(s)
- D. Concolino
- Department of Medical and Surgical Science, Pediatric Unit, University “Magna Graecia”, Catanzaro, Italy
- Corresponding author at: Department Medical and Surgical Science, Pediatric Unit, University “Magna Graecia” of Catanzaro, “Pugliese-Ciaccio” Hospital, Viale Pio X, 88100 Catanzaro, Italy.Department Medical and Surgical SciencePediatric UnitUniversity “Magna Graecia” of Catanzaro“Pugliese-Ciaccio” HospitalViale Pio XCatanzaro88100Italy
| | - L. Amico
- Nephrology Unit, Ospedali Riuniti Villa Sofia, Cervello, Palermo, Italy
| | - M.D. Cappellini
- Rare Diseases Centre, Department of Medicine and Medical Specialities, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - E. Cassinerio
- Rare Diseases Centre, Department of Medicine and Medical Specialities, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - M. Conti
- Nephrology Unit, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - M.A. Donati
- Metabolic and Neuromuscular Unit, AOU Meyer Hospital, Florence, Italy
| | - F. Falvo
- Department of Medical and Surgical Science, Pediatric Unit, University “Magna Graecia”, Catanzaro, Italy
| | - A. Fiumara
- Regional Referral Center for Inborn Errors Metabolism, Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, Catania, Italy
| | - M. Maccarone
- Nephrology and Dialysis Unit, Ospedale di Lanciano, Chieti, Italy
| | - R. Manna
- Periodic Fevers Research and Rare Diseases Centre, Internal Medicine Department, Policlinico Gemelli, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - A. Matucci
- SOD Immunoallergologia, AOU Careggi, Firenze, Italy
| | - M.B. Musumeci
- Sapienza University, Department of Molecular and Clinical Medicine, Cardiology, Sant'Andrea Hospital, Rome, Italy
| | - A. Nicoletti
- Department of Medical and Surgical Science, Pediatric Unit, University “Magna Graecia”, Catanzaro, Italy
| | - R. Nisticò
- Neuroimaging Research Unit, Institute of Bioimaging and Molecular Physiology, National Research Council, Germaneto, Catanzaro, Italy
| | - F. Papadia
- U.O.C. Malattie Metaboliche Genetica Medica, PO Giovanni XXIII, A.O.U. Policlinico Consorziale, Bari, Italy
| | - R. Parini
- UOS Malattie Metaboliche Rare, Clinica Pediatrica, Ospedale San Gerardo, Via Pergolesi 33, Monza, Italy
| | - D. Peluso
- Neurology Unit, Azienda Ospedaliera S. Carlo, Potenza, Italy
| | - L. Pensabene
- Department of Medical and Surgical Science, Pediatric Unit, University “Magna Graecia”, Catanzaro, Italy
| | - A. Pisani
- Renal Unit, Department of Public Health, “Federico II” University, Naples, Italy
| | - G. Pistone
- UOC Dermatologia e MTS Dipartimento DIBIMIS AOUP “Paolo Giaccone” Palermo, Italy
| | - M. Rigoldi
- Dept. of Internal Medicine, San Gerardo Hospital, Monza, Italy
| | - I. Romani
- NEUROFARBA Department, University of Florence, V.le Pieraccini 6, 50139 Florence, Italy
| | - M. Tenuta
- Neurology Unit, Azienda Ospedaliera Universitaria S. G. di Dio e Ruggi D'Aragona, Salerno, Italy
| | - G. Torti
- Clinica Nefrologica, Ospedale San Gerardo, Monza, Italy
| | - M. Veroux
- Vascular Surgery and Organ Transplant Unit, Department of Medical, Surgery Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
| | - E. Zachara
- U.O.C. Cardiologia 2, Ospedale San Camillo-Forlanini, Rome, Italy
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Ciconte G, Mangual J, Li W, Mcspadden L, Conti M, Saviano M, Cuko A, Vitale R, Lipartiti F, Vicedomini G, Pappone C. 759A substrate targeted ablation strategy improves outcomes in patients with persistent atrial fibrillation. Europace 2017. [DOI: 10.1093/ehjci/eux147.008] [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: 11/12/2022] Open
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Calovic Z, Ciconte G, Mangual J, Badie N, Mcspadden L, Saviano M, Cuko A, Conti M, Lipartiti F, Giordano F, Vicedomini G, Pappone C. P1010Enhanced electrical synchrony of multipoint pacing with automatic AVD programming. Europace 2017. [DOI: 10.1093/ehjci/eux151.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Crabolu M, Pani D, Raffo L, Conti M, Crivelli P, Cereatti A. In vivo estimation of the shoulder joint center of rotation using magneto-inertial sensors: MRI-based accuracy and repeatability assessment. Biomed Eng Online 2017; 16:34. [PMID: 28320423 PMCID: PMC5359843 DOI: 10.1186/s12938-017-0324-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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: 12/15/2016] [Accepted: 03/11/2017] [Indexed: 11/13/2022] Open
Abstract
Background The human gleno-humeral joint is normally represented as a spherical hinge and its center of rotation is used to construct humerus anatomical axes and as reduction point for the computation of the internal joint moments. The position of the gleno-humeral joint center (GHJC) can be estimated by recording ad hoc shoulder joint movement following a functional approach. In the last years, extensive research has been conducted to improve GHJC estimate as obtained from positioning systems such as stereo-photogrammetry or electromagnetic tracking. Conversely, despite the growing interest for wearable technologies in the field of human movement analysis, no studies investigated the problem of GHJC estimation using miniaturized magneto-inertial measurement units (MIMUs). The aim of this study was to evaluate both accuracy and precision of the GHJC estimation as obtained using a MIMU-based methodology and a functional approach. Methods Five different functional methods were implemented and comparatively assessed under different experimental conditions (two types of shoulder motions: cross and star type motion; two joint velocities: ωmax = 90°/s, 180°/s; two ranges of motion: Ɵ = 45°, 90°). Validation was conducted on five healthy subjects and true GHJC locations were obtained using magnetic resonance imaging. Results The best performing methods (NAP and SAC) showed an accuracy in the estimate of the GHJC between 20.6 and 21.9 mm and repeatability values between 9.4 and 10.4 mm. Methods performance did not show significant differences for the type of arm motion analyzed or a reduction of the arm angular velocity (180°/s and 90°/s). In addition, a reduction of the joint range of motion (90° and 45°) did not seem to influence significantly the GHJC position estimate except in a few subject-method combinations. Conclusions MIMU-based functional methods can be used to estimate the GHJC position in vivo with errors of the same order of magnitude than those obtained using traditionally stereo-photogrammetric techniques. The methodology proposed seemed to be robust under different experimental conditions. The present paper was awarded as “SIAMOC Best Methodological Paper 2016”.
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Affiliation(s)
- M Crabolu
- Department of Electrical and Electronic Engineering, University of Cagliari, Piazza d'Armi, 09123, Cagliari, Italy.
| | - D Pani
- Department of Electrical and Electronic Engineering, University of Cagliari, Piazza d'Armi, 09123, Cagliari, Italy
| | - L Raffo
- Department of Electrical and Electronic Engineering, University of Cagliari, Piazza d'Armi, 09123, Cagliari, Italy
| | - M Conti
- Department POLCOMING, University of Sassari, Sassari, Italy
| | - P Crivelli
- Department POLCOMING, University of Sassari, Sassari, Italy
| | - A Cereatti
- Department POLCOMING, University of Sassari, Sassari, Italy.,Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Sassari, Italy.,Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
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de Beaufort H, Nauta F, Conti M, Cellitti E, Trentin C, Faggiano E, van Bogerijen G, Figueroa C, Moll F, van Herwaarden J, Auricchio F, Trimarchi S. Extensibility and Distensibility of the Thoracic Aorta in Patients with Aneurysm. Eur J Vasc Endovasc Surg 2017; 53:199-205. [DOI: 10.1016/j.ejvs.2016.11.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 11/15/2016] [Indexed: 12/31/2022]
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Calza L, Colangeli V, Magistrelli E, Bussini L, Conti M, Ramazzotti E, Mancini R, Viale P. Plasma trough concentrations of darunavir/ritonavir and raltegravir in older patients with HIV-1 infection. HIV Med 2017; 18:474-481. [PMID: 28116848 DOI: 10.1111/hiv.12478] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of the study was to assess plasma concentrations of darunavir/ritonavir and raltegravir in older patients compared with younger patients with HIV-1 infection. METHODS In this observational, open-label study, adult HIV-infected out-patients aged ≤ 40 years (younger patients) or ≥ 60 years (older patients) and treated with tenofovir/emtricitabine plus darunavir/ritonavir (800/100 mg daily) or raltegravir (400 mg twice daily) were asked to participate. The trough concentrations (Ctrough ) of darunavir/ritonavir and raltegravir were assessed at steady state using a validated high-performance liquid chromatography (HPLC)-tandem mass spectrometry method. RESULTS A total of 88 HIV-positive patients were enrolled in the study. Forty-six patients were treated with darunavir/ritonavir, and 42 with raltegravir. The geometric mean plasma Ctrough (coefficient of variation) of raltegravir was comparable between the 19 older and 23 younger subjects: 106 ng/mL (151%) and 94 ng/mL (129%), respectively [geometric mean ratio (GMR) 0.85; 95% confidence interval (CI) 0.71-1.57; P = 0.087]. In contrast, the geometric mean plasma Ctrough of darunavir was significantly higher among the 21 older patients [2209 ng/mL (139%)] than among the 25 younger patients [1876 ng/mL (162%); GMR 1.56; 95% CI: 1.22-1.88; P = 0.004]. Similarly, the geometric mean Ctrough of ritonavir was significantly higher among older than among younger individuals. CONCLUSIONS The mean plasma Ctrough of darunavir and ritonavir was significantly higher in older patients than in younger patients with HIV-1 infection, while the mean plasma level of raltegravir was comparable in the two groups. However, both regimens showed good tolerability in both younger and older subjects.
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Affiliation(s)
- L Calza
- Department of Medical and Surgical Sciences, Clinics of Infectious Diseases, Bologna, Italy
| | - V Colangeli
- Department of Medical and Surgical Sciences, Clinics of Infectious Diseases, Bologna, Italy
| | - E Magistrelli
- Department of Medical and Surgical Sciences, Clinics of Infectious Diseases, Bologna, Italy
| | - L Bussini
- Department of Medical and Surgical Sciences, Clinics of Infectious Diseases, Bologna, Italy
| | - M Conti
- Central Laboratory, S. Orsola-Malpighi Hospital, "Alma Mater Studiorum", University of Bologna, Bologna, Italy
| | - E Ramazzotti
- Central Laboratory, S. Orsola-Malpighi Hospital, "Alma Mater Studiorum", University of Bologna, Bologna, Italy
| | - R Mancini
- Central Laboratory, S. Orsola-Malpighi Hospital, "Alma Mater Studiorum", University of Bologna, Bologna, Italy
| | - P Viale
- Department of Medical and Surgical Sciences, Clinics of Infectious Diseases, Bologna, Italy
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Amorese V, Corda M, Donadu M, Usai D, Pisanu F, Milia F, Marras F, Sanna A, Delogu D, Mazzarello V, Manzoni G, Conti M, Meloni GB, Zanetti S, Doria C. Total hip prosthesis complication, periprosthetic infection with external fistulizing due to Enterobacter cloacae complex multiple drugs resistance: A clinical case report. Int J Surg Case Rep 2017; 36:90-93. [PMID: 28558347 PMCID: PMC5447565 DOI: 10.1016/j.ijscr.2017.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 05/11/2017] [Accepted: 05/14/2017] [Indexed: 12/02/2022] Open
Abstract
The incidence of periprosthetic hip infections his just below 2%, and the Enterobacteriaceae are fairly rare, being the cause of infection in 3–6% of cases. A 76 year old woman with multiple comorbidities underwent surgical implantation of endoprosthesis of the left hip. Multidisciplinary diagnosis of a rare periprosthetic infection.
Introduction The Enterobacter cloacae is a microorganism found in the intestinal flora of the majority of animals, including humans. Primary infections caused by E. cloacae are rare in immunocompetent patients, but are very common in hospital settings in newborns and immunocompromised patients, and can be aggravated by the insurgence of antibiotic resistance. The incidence of periprosthetic hip infections is just below 2%. Case presentation A 76 year old woman with multiple comorbidities underwent surgical implantation of intermediary total hip prosthesis of the left hip, in a different health facility, in February 2014, after the basicervical fracture of the upper femur extremity due to trauma. After an episode of dislocation of the prosthetic implant, in September 2014, she underwent a surgical operation to implant the acetabular component. A month later not in our facility, following a re-hospitalization for the dislocation of the arthroprosthesis, an infection from E. cloacae complex was discovered. After 2 years of chronic infection she came to our attention; the clinical picture featured coxalgia and secreting fistula in the surgical wound. Following a specific antibiotic therapy, carried out intravenously over the course of a month, we decided to intervene removing the left hip arthroprosthesis and placing an antibiotic spacer following the direction deduced from the antibiogram study of August 2016. Conclusion The patient was hospitalized in our facility and 2 months later she underwent another operation to remove the antibiotic spacer and to place a new total hip arthroprosthesis. Multiple swabs showed the complete healing from the infection, which was confirmed a couple of months later.
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Affiliation(s)
- V Amorese
- Department of Orthopaedic, University of Sassari, Sardinia, Italy
| | - M Corda
- Department of Orthopaedic, University of Sassari, Sardinia, Italy
| | - M Donadu
- Department of Biomedical Sciences, University of Sassari, Sassari, Sardinia, Italy.
| | - D Usai
- Department of Biomedical Sciences, University of Sassari, Sassari, Sardinia, Italy
| | - F Pisanu
- Department of Orthopaedic, University of Sassari, Sardinia, Italy
| | - F Milia
- Department of Orthopaedic, University of Sassari, Sardinia, Italy
| | - F Marras
- Department of Orthopaedic, University of Sassari, Sardinia, Italy
| | - A Sanna
- Department of Orthopaedic, University of Sassari, Sardinia, Italy
| | - D Delogu
- Department of Biomedical Sciences, University of Sassari, Sassari, Sardinia, Italy
| | - V Mazzarello
- Department of Biomedical Sciences, University of Sassari, Sassari, Sardinia, Italy
| | - G Manzoni
- Department of Radiology, University of Sassari, Sassari, Sardinia, Italy
| | - M Conti
- Department of Radiology, University of Sassari, Sassari, Sardinia, Italy
| | - G B Meloni
- Department of Radiology, University of Sassari, Sassari, Sardinia, Italy
| | - S Zanetti
- Department of Biomedical Sciences, University of Sassari, Sassari, Sardinia, Italy
| | - C Doria
- Department of Orthopaedic, University of Sassari, Sardinia, Italy
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Aina A, Barbero M, Cagnie B, Castelli E, Cook C, Ferrari S, Foglia A, Bizzarri P, Giraudo D, Littlewood C, Pillastrini P, Piscitelli D, Romano M, Tettamanti A, Vanti C, Vercelli S, Voogt L, Maria A, Emanuele S, Paolo P, Francesco S, Antonio C, Ilaria C, Giuseppe O, Raffaele B, Serena F, Alessandro A, Bonfanti M, Pasquetti M, Arianna B, Paolo P, Carla V, Brioschi D, Vitali M, Pedretti A, Fraschini G, Tettamanti A, Castellini G, Gianola S, Bonovas S, Banfi G, Moja L, Castellini G, Gianola S, Frigerio P, Agostini M, Bolotta R, Corbetta D, Gasparini M, Gozzer P, Guariento E, Li L, Pecoraro V, Sirtori V, Turolla A, Andreano A, Moja L, Castellini G, Gianola S, Bonovas S, Moja L, Chiarotto A, Terwee CB, Boers M, Ostelo RW, Chiarotto A, Maxwell LJ, Terwee CB, Wells GA, Tugwell P, Ostelo RW, Chiarotto A, Clijsen R, Fernandez-de-las-Penas C, Barbero M, Matteo C, Sara R, Stefano V, Cislaghi M, Penone G, Marinelli G, Rezzan G, Melegati G, Gatti R, Claudio C, Francesca T, Moriondo A, Stefano V, Doronzio S, Paci M, Ferrari S, Vanti C, Monticone M, Ferrari S, Vanti C, Monticone M, Fabiola G, Anna Z, Serena B, Giorgia C, Francesco S, Ghirlanda F, Schneebeli A, Cescon C, Barbero M, Gioia G, Faccendini S, Aina A, Tettamanti A, Granzotto G, Coppola L, Gava I, Frassinelli M, Gattinoni F, Guidotti L, Postiglione M, Lombardi B, Paci M, Leoni D, Storer D, Gatti R, Egloff M, Barbero M, Tiziano M, Andrea T, Maremmani D, Cencini S, Plebani G, Moresi F, Barbero M, Isnardi M, Gallace A, Cescon C, Gatti R, Moretti N, Maselli, Testa M, Negrini S, Donzelli S, Saveri F, Negrini A, Parzini S, Romano M, Zaina F, Nesi L, Ferrarello F, Bianchi VAM, Paci M, Paci M, Nannetti L, Lombardi B, Mini G, Marchettini M, Ferrarello F, Paci M, Piccolo F, Agosta F, Sarasso E, Adamo P, Temporiti F, Falini A, Gatti R, Filippi M, Piscitelli D, Meroni R, Pellicciari L, Mondelli MA, Favaron T, Cerri CG, Tallarita EA, Elisa R, Stefano V, Sara R, Matteo C, Stefano V, Sarasso E, Agosta F, Tomić A, Basaia S, Dragašević N, Svetel M, Copetti M, Kostic VS, Filippi M, Saveri F, Romano M, Mastrantonio M, Negrini A, Zaina F, Stefano N, Schneebeli A, Castellini G, Redaelli V, Soldini E, Barbero M, Segat M, Casonato O, Margelli M, Pillon S, Spunton V, Fenini R, Garofalo R, Conti M, Valagussa G, Balatti V, Trentin L, Melli S, Norsi M, Grossi E, Vanossi M, Saveri F, Romano M, Vanti C, Taioli S, Gardenghi I, Bertozzi L, Rosso A, Romeo A, Pillastrini P, Vanti C, Ferrari S, Ruggeri M, Monticone M, Vanti C, Filippo B, Conti C, Faresin F, Ruggeri M, Piccarreta R, Ferrari S, Luca V, Stefano V, Claudia V, Joseph CM, Carmen D, Fabrizio P, Youssef S, Montesano M, Picardi M, De Giampaulis P, Corbo M, Pisani L, Anna Z, Fabiola G, Carolina R, Francesco S. 5th National Congress of the Italian Society of Physiotherapy. Arch Physiother 2016. [DOI: 10.1186/s40945-016-0022-4] [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: 11/10/2022] Open
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Bruno L, Piro F, Conti M, Tumietto F, Forchielli M, Stancari A, Guarguaglini A, Piazza G, Patrono D, Puggioli C, Bersani G. SUN-P103: Evaluation of Three Different Antibiotic Lock-Therapies in Combination with Urokinase for the Treatment of Central Venous Catheter-Related Bloodstream Infections. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30446-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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