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Fedrizzi L, Carugno M, Consonni D, Lombardi A, Bandera A, Bono P, Ceriotti F, Gori A, Pesatori AC. Air pollution exposure, SARS-CoV-2 infection, and immune response in a cohort of healthcare workers of a large university hospital in Milan, Italy. Environ Res 2023; 236:116755. [PMID: 37517490 DOI: 10.1016/j.envres.2023.116755] [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] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
Several studies have examined the possible relationship between air pollutants and the risk of COVID-19 but most returned controversial findings. We tried to assess the association between (short- and long-term) exposure to particulate and gaseous pollutants, SARS-CoV-2 infections, and immune response in a population of healthcare workers (HCWs) with well-characterized individual data. We collected occupational and clinical characteristics of all HCWs who performed a nasopharyngeal swab (NPS) for detecting SARS-CoV-2 at the Policlinico Hospital in Milan (Lombardy, Italy) between February 24, 2020 (day after first documented case of COVID-19 in our hospital) and December 26, 2020 (day before start of the vaccination campaign). Each subject was assigned daily average levels of particulate matter ≤10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) retrieved from the air quality monitoring station closest to his/her residential address. Air pollution data were treated as time-dependent variables, generating person-days at risk. Multivariate Poisson regression models were fit to evaluate the rate of positive NPS and to assess the association between air pollution and antibody titer among NPS-positive HCWs. Among 3712 included HCWs, 635 (17.1%) had at least one positive NPS. A 10 μg/m3 increase in NO2 average concentration in the four days preceding NPS was associated with a higher risk of testing positive [Incidence Rate Ratio (IRR) = 1.08, 95% confidence interval (CI): 1.01; 1.16)]. When considering a 1 μg/m3 increase in 2019 annual NO2 average, we observed a higher risk of infection (IRR: 1.02, 95%CI: 1.00; 1.03) and an increased antibody titer (+2.4%, 95%CI: 1.1; 3.6%). Findings on PM10 and O3 were less consistent and, differently from NO2, were not confirmed in multipollutant models. Our study increases the body of evidence suggesting an active role of air pollution exposure on SARS-CoV-2 infection and confirms the importance of implementing pollution reduction policies to improve public health.
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Affiliation(s)
- Luca Fedrizzi
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Michele Carugno
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Lombardi
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Patrizia Bono
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Angela Cecilia Pesatori
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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2
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Suffritti C, Gualtierotti R, Arcudi S, Ciavarella A, Novembrino C, Lecchi A, La Marca S, Padovan L, Scalambrino E, Clerici M, Bono P, Ceriotti F, Muscatello A, Siboni SM, Peyvandi F. Characterization of Immunogenicity and Safety of COVID-19 mRNA-1273 in HIV-Positive Italian Patients with Hemophilia: A Prospective Single-Center Cohort Study. J Clin Med 2023; 12:5475. [PMID: 37685542 PMCID: PMC10487950 DOI: 10.3390/jcm12175475] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/03/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
To characterize the immunogenicity of mRNA-1273 (Moderna, Cambridge, MA, USA) vaccine in HIV-positive hemophilic patients during the third COVID-19 wave in Italy and to investigate biomarkers of coagulation and endothelial perturbation before and after complete vaccination schedule, twenty-three consecutive adult HIV-positive patients with hemophilia were included. Blood was collected before and two weeks after vaccination. We measured anti-SARS-CoV-2 spike protein antibodies to assess immunogenicity; circulating biomarkers of coagulation (protein C and D-dimer), endothelial perturbation (von Willebrand factor (VWF)) and anti-Platelet Factor 4 (PF4) antibodies were analyzed. Flow-based analysis of thrombus formation was performed in nine patients using a flow-chamber device. Two weeks after completing the vaccination schedule, all patients had anti-spike antibodies values consistent with an effective immunization. Mean (±standard deviation) basal values of protein C and VWF (106 ± 21% and 171 ± 45%, respectively) were not significantly different from data obtained two weeks after the second dose (103 ± 20%, 162 ± 43%, respectively). D-dimer median values (interquartile range) were not significantly different at baseline (442 (603-142) ng/mL) and after the second dose (477 (654-262) ng/mL). Anti-PF4 antibodies were detected in three patients with no associated clinical manifestations. No significant differences were found in flow-based analysis of thrombus formation. Our data demonstrate that in HIV-positive patients with hemophilia, SARS-CoV-2 vaccination is effective and safe, with no effects on coagulation and endothelial perturbation.
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Affiliation(s)
- Chiara Suffritti
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
| | - Roberta Gualtierotti
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
| | - Sara Arcudi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
| | - Alessandro Ciavarella
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Cristina Novembrino
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
| | - Anna Lecchi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
| | - Silvia La Marca
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
| | - Lidia Padovan
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
| | - Erica Scalambrino
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
| | - Marigrazia Clerici
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
| | - Patrizia Bono
- Clinical Laboratory, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Antonio Muscatello
- Infectious Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Simona Maria Siboni
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
| | - Flora Peyvandi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
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Piralla A, Mojoli F, Pellegrinelli L, Ceriotti F, Valzano A, Grasselli G, Gismondo MR, Micheli V, Castelli A, Farina C, Arosio M, Lorini FL, Fanti D, Busni A, Laratta M, Maggi F, Novazzi F, Cabrini L, Callegaro AP, Keim R, Remuzzi G, Cavallero A, Malandrin SMI, Rona R, Giardina F, Ferrari G, Zavaglio F, D'angelo P, Galli C, Bubba L, Binda S, Oggioni M, Uceda Renteria SC, Bono P, Baj A, Ferrante FD, Guarneri D, Tonelli M, Napolitano G, Nava A, Romeo L, Nicolini E, Valaperta R, Varisano L, Mele C, Liguori L, Raggi M, Mongodi S, Pagani M, Severgnini P, Gasberti D, Bonanomi E, Gritti P, Marrazzo F, Giovannini I, Sacchi N, Sagliocco O, Cereda D, Buoro S, Baldanti F, Pariani E. Impact of SARS-CoV-2 Omicron and Delta variants in patients requiring intensive care unit (ICU) admission for COVID-19, Northern Italy, December 2021 to January 2022. Respir Med Res 2023; 83:100990. [PMID: 36871459 PMCID: PMC9984278 DOI: 10.1016/j.resmer.2023.100990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/27/2022] [Accepted: 12/29/2022] [Indexed: 03/06/2023]
Abstract
This multicenter observational study included 171 COVID-19 adult patients hospitalized in the ICUs of nine hospitals in Lombardy (Northern Italy) from December, 1st 2021, to February, 9th 2022. During the study period, the Delta/Omicron variant ratio of cases decreased with a delay of two weeks in ICU patients compared to that in the community; a higher proportion of COVID-19 unvaccinated patients was infected by Delta than by Omicron whereas a higher rate of COVID-19 boosted patients was Omicron-infected. A higher number of comorbidities and a higher comorbidity score in ICU critically COVID-19 inpatients was positively associated with the Omicron infection as well in vaccinated individuals. Although people infected by Omicron have a lower risk of severe disease than those infected by Delta variant, the outcome, including the risk of ICU admission and the need for mechanical ventilation due to infection by Omicron versus Delta, remains uncertain. The continuous monitoring of the circulating SARS-CoV-2 variants remains a milestone to counteract this pandemic.
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Affiliation(s)
- Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Francesco Mojoli
- Anaesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonia Valzano
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Grasselli
- Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Antonio Castelli
- Division of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Claudio Farina
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Marco Arosio
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | | | - Diana Fanti
- Laboratory of Clinical Microbiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Andrea Busni
- Laboratory of Clinical Microbiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Matteo Laratta
- Department of Anesthesia and Intensive Care Ospedale Niguarda, Università degli studi Milano Bicocca, Milan, Italy
| | - Fabrizio Maggi
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Federica Novazzi
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Luca Cabrini
- Intensive Care and Anesthesia Unit, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | | | | | | | | | | | - Roberto Rona
- Department of Anesthesia and Intensive Care Medicine, San Gerardo Hospital ASST Monza, Monza, Italy
| | - Federica Giardina
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Guglielmo Ferrari
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federica Zavaglio
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Piera D'angelo
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Massimo Oggioni
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Patrizia Bono
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andreina Baj
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Davide Guarneri
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Marco Tonelli
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Gavino Napolitano
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Alice Nava
- Laboratory of Clinical Microbiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenzo Romeo
- Residency in Microbiology and Virology, Università degli Studi di Milano, Milan
| | - Elena Nicolini
- Residency in Microbiology and Virology, Università degli Studi di Milano, Milan
| | | | | | - Caterina Mele
- Laboratory of Immunology and Genetics of Rare Diseases, Istituto di Ricerche Farmacologiche Mario Negri IRCCS
| | - Lucia Liguori
- Laboratory of Immunology and Genetics of Rare Diseases, Istituto di Ricerche Farmacologiche Mario Negri IRCCS
| | - Monica Raggi
- Microbiology Laboratory San Gerardo Hospital, Monza, Italy
| | - Silvia Mongodi
- Anaesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michele Pagani
- Anaesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paolo Severgnini
- Department of Biotechnology and Life, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Dario Gasberti
- Intensive Care and Anesthesia Unit, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Ezio Bonanomi
- Department of Emergency and ICU, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Paolo Gritti
- Department of Emergency and ICU, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Francesco Marrazzo
- Department of Anesthesia and Intensive Care Ospedale Niguarda, Università degli studi Milano Bicocca, Milan, Italy
| | - Ilaria Giovannini
- Department of Anesthesia and Intensive Care Ospedale Niguarda, Università degli studi Milano Bicocca, Milan, Italy
| | | | | | - Danilo Cereda
- Direzione Generale Welfare, Regione Lombardia, Milan, Italy
| | - Sabrina Buoro
- Direzione Generale Welfare, Regione Lombardia, Milan, Italy
| | - Fausto Baldanti
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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La Vecchia A, Ippolito G, Taccani V, Gatti E, Bono P, Bettocchi S, Pinzani R, Tagliabue C, Bosis S, Marchisio P, Agostoni C. Correction: Epidemiology and antimicrobial susceptibility of Staphylococcus aureus in children in a tertiary care pediatric hospital in Milan, Italy, 2017-2021. Ital J Pediatr 2022; 48:134. [PMID: 35906624 PMCID: PMC9338457 DOI: 10.1186/s13052-022-01333-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | | | | | | | - Patrizia Bono
- Laboratory of Microbiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Bettocchi
- Pediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,De Marchi Foundation, Pediatric Area, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Raffaella Pinzani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Claudia Tagliabue
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Samantha Bosis
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, via Francesco Sforza 9, 20122, Milan, Italy. .,Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy.
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5
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Consonni D, Lombardi A, Mangioni D, Bono P, Oggioni M, Uceda Renteria S, Valzano A, Bordini L, Nava CD, Tiwana N, Gentiloni Silverj F, Castaldi S, Rognoni M, Cavalieri D'Oro L, Carugno M, Luisetti G, Riboldi L, Ceriotti F, Bandera A, Gori A, Pesatori AC. Immunogenicity and effectiveness of BNT162b2 COVID-19 vaccine in a cohort of healthcare workers in Milan (Lombardy Region, Northern Italy). Epidemiol Prev 2022; 46:250-258. [PMID: 36259341 DOI: 10.19191/ep22.4.a513.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVES to evaluate immunogenicity and effectiveness of BNT162b2 COVID-19 vaccine in a cohort of healthcare workers (HCWs). DESIGN cohort study. SETTING AND PARTICIPANTS in a hospital in Milan (Lombardy Region, Northern Italy) HCWs without ("negative cohort") and with ("positive cohort") history of SARS-CoV-2 infection or elevated serum antibody before the vaccination campaign (27.12.2020) were included. Data collection and follow-up covered the period 27.12.2020-13.05.2022. MAIN OUTCOMES MEASURES 1. serum anti-spike-1 (anti-S1) antibody levels after vaccination; 2. vaccine effectiveness (VE) against SARS-CoV-2 infections (either symptomatic or not) in the negative cohort. Data on infections were extracted from multiple sources (laboratory, accident reports, questionnaires). Vaccination was treated as a time-dependent variable. Using unvaccinated person-time as reference, hazard ratios (HR) of infections and 95% confidence intervals (95%CI) were calculated with a Cox regression model adjusted for gender, age, and occupation. VE was calculated as (1 - HR)×100. RESULTS 5,596 HCWs were included, 4,771 in the negative and 825 in the positive cohort. In both cohorts, serum anti-S1 antibodies were high one months after the second dose, halved after six months, and returned to high levels after the third dose. In the negative cohort, 1,401 SARS-CoV-2 infections were identified. VE was 70% (95%CI 54-80; 46 infected) in the first four months after the second dose and later declined to 16% (95%CI 0-43; 97 infected). After the third dose, VE increased to 57% (95%CI 35-71; 61 infected) in the first month but rapidly declined over time, particularly after three months (24% in the fourth month and 1% afterwards). The number of infections avoided by vaccination was estimated to be 643 (95%CI 236-1,237). CONCLUSIONS in spite of rapidly declining effectiveness, vaccination helped to avoid several hundred infections in the considered hospital.
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Affiliation(s)
- Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy);
- These authors equally contributed to this paper
| | - Andrea Lombardi
- Department of Pathophysiology and Transplantation, University of Milan, Milan (Italy)
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
- These authors equally contributed to this paper
| | - Davide Mangioni
- Department of Pathophysiology and Transplantation, University of Milan, Milan (Italy)
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | - Patrizia Bono
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | - Massimo Oggioni
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | - Sara Uceda Renteria
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | - Antonia Valzano
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | - Lorenzo Bordini
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | - Carlo Domenico Nava
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | - Navpreet Tiwana
- Medical Direction, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | | | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan (Italy)
- Quality Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | - Magda Rognoni
- Epidemiology Unit, Agency for Health Protection Brianza, Monza (Italy)
| | | | - Michele Carugno
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
- Department of Clinical Sciences and Community Health, University of Milan, Milan (Italy)
| | - Giacomo Luisetti
- School of Statistics, University of Milan-Bicocca, Milan (Italy)
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | - Alessandra Bandera
- Department of Pathophysiology and Transplantation, University of Milan, Milan (Italy)
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
| | - Andrea Gori
- Department of Pathophysiology and Transplantation, University of Milan, Milan (Italy)
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan (Italy)
| | - Angela Cecilia Pesatori
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy)
- Department of Clinical Sciences and Community Health, University of Milan, Milan (Italy)
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6
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Bozzi G, Saltini P, Matera M, Morena V, Castelli V, Peri AM, Taramasso L, Ungaro R, Lombardi A, Muscatello A, Bono P, Grancini A, Maraschini A, Matinato C, Gori A, Bandera A. Pneumocystis jirovecii pneumonia in HIV-negative patients, a frequently overlooked problem. A case series from a large Italian center. Int J Infect Dis 2022; 121:172-176. [PMID: 35568363 DOI: 10.1016/j.ijid.2022.05.024] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/06/2022] [Accepted: 05/08/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Pneumocystis jirovecii pneumonia (PCP) still has substantial morbidity and mortality. For non-HIV patients, the course of infection is severe, and management guidelines are relatively recent. We collected all PCP cases (European Organization for Research and Treatment of Cancer criteria) diagnosed in HIV-negative adult inpatients in 2019-2020 at our center in northern Italy. RESULTS Of 20 cases, nine had microbiologic evidence of probable (real-time polymerase chain reaction, RT-PCR) and 11 proven (immunofluorescence) PCP on respiratory specimens. Half were female; the median age was 71.5 years; 14 of 20 patients had hematologic malignancies, five had autoimmune/hyperinflammatory disorders, and one had a solid tumor. RT-PCR cycle threshold (Ct) was 24-37 for bronchoalveolar lavage (BAL) and 32-39 for sputum; Ct was 24-33 on BAL proven cases. Of 20 cases, four received additional diagnoses on BAL. At PCP diagnosis, all patients were not on anti-pneumocystis prophylaxis. We retrospectively assessed prophylaxis indications: 9/20 patients had a main indication, 5/9 because of prednisone treatment ≥ 20 mg (or equivalents) for ≥4 weeks. All patients underwent antimicrobial treatment according to guidelines; 18/20 with concomitant corticosteroids. A total of 4/20 patients died within 28 days from diagnosis. CONCLUSION Despite appropriate treatment, PCP is still associated to high mortality (20%) among non-HIV patients. Strict adherence to prophylaxis guidelines, awareness of gray areas, and prompt diagnosis can help manage this frequently overlooked infection.
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Affiliation(s)
- Giorgio Bozzi
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy.
| | - Paola Saltini
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Malvina Matera
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Valentina Morena
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy Via Giovanni Battista Grassi, 74, 20157, Milano, Italy
| | - Valeria Castelli
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Anna Maria Peri
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Lucia Taramasso
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Riccardo Ungaro
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Andrea Lombardi
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Antonio Muscatello
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Patrizia Bono
- Medical Laboratory of Clinical Chemistry and Microbiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Anna Grancini
- Medical Laboratory of Clinical Chemistry and Microbiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Anna Maraschini
- Medical Laboratory of Clinical Chemistry and Microbiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Caterina Matinato
- Medical Laboratory of Clinical Chemistry and Microbiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, 35, 20122, Milan, Italy
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7
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La Vecchia A, Ippolito G, Taccani V, Gatti E, Bono P, Bettocchi S, Pinzani R, Tagliabue C, Bosis S, Marchisio P, Agostoni C. Epidemiology and antimicrobial susceptibility of Staphylococcus aureus in children in a tertiary care pediatric hospital in Milan, Italy, 2017-2021. Ital J Pediatr 2022; 48:67. [PMID: 35526042 PMCID: PMC9077633 DOI: 10.1186/s13052-022-01262-1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent worldwide and can cause severe diseases. MRSA is associated with other antibiotic resistance. COVID-19 pandemic increased antimicrobial resistance in adult patients. Only a few data report the antimicrobial susceptibility of S. aureus in the Italian pediatric population, before and during the COVID-19 pandemic. Methods We included all the S. aureus positive samples with an available antibiogram isolated from pediatric patients (< 18 years old) in a tertiary care hospital in Milan, Italy, from January 2017 to December 2021. We collected data on demographics, antimicrobial susceptibility, and clinical history. We compared methicillin-susceptible Staphylococcus aureus (MSSA) and MRSA strains. We calculated the frequency of isolation by year. The incidence of isolates during 2020 was compared with the average year isolation frequency using the univariate Poisson test. We compared the proportion of MRSA isolates during 2020 to the average proportion of other years with the Chi-squared test. Results Our dataset included a total of 255 S. aureus isolated from 226 patients, 120 (53%) males, and 106 (47%) females, with a median age of 3.4 years (IQR 0.8 – 10.5). The mean isolation frequency per year was 51. We observed a significant decrease of isolations during 2020 (p = 0.02), but after adjusting for the total number of hospitalization per year there was no evidence that the incidence changed. Seventy-six (30%) S. aureus were MRSA. Twenty (26%) MRSA vs 23 (13%) MSSA (p = 0.02) were hospital-acquired. MRSA strains showed higher resistance to cotrimoxazole, clindamycin, macrolides, levofloxacin, gentamicin, and tetracyclin than MSSA strains. None of MRSA were resistant to linezolid and vancomycin, one was resistant to daptomycin. The proportion of MRSA did not change during the COVID-19 pandemic. The overall clindamycin resistance was high (17%). Recent antibiotic therapy was related to MRSA infection. Conclusion The proportion of MRSA did not change during the COVID-19 pandemic and remained high. Clindamycin should not be used as an empirical MRSA treatment due to its high resistance.
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Affiliation(s)
| | | | | | | | - Patrizia Bono
- Laboratory of Microbiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Bettocchi
- Pediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,De Marchi Foundation, Pediatric Area, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Raffaella Pinzani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Claudia Tagliabue
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Samantha Bosis
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, via Francesco Sforza 9, 20122, Milan, Italy. .,Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy.
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8
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Lombardi A, Renisi G, Consonni D, Oggioni M, Bono P, Renteria SU, Piatti A, Pesatori AC, Castaldi S, Muscatello A, Riboldi L, Ceriotti F, Gori A, Bandera A. Clinical characteristics of healthcare workers with SARS-CoV-2 infection after vaccination with BNT162b2 vaccine. BMC Infect Dis 2022; 22:97. [PMID: 35090388 PMCID: PMC8795942 DOI: 10.1186/s12879-022-07083-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 01/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background The pandemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), had a significant impact worldwide. Vaccines against COVID-19 appear as a tool able to curb out mortality and reduce the circulation of the virus. Little is known so far about the clinical characteristics of individuals who developed SARS-CoV-2 infection after having received the vaccination, as well as the temporal relationship between vaccine administration and symptoms onset. Methods Retrospective cohort study among the 3219 healthcare workers (HCWs) of the Fondazione IRCCS Ospedale Maggiore Policlinico of Milano who received a full immunization with the BNT162b2 vaccine and who developed SARS-CoV-2 infection (documented through positive RT-PCR on nasopharyngeal swab) in March–April 2021. Results Overall, we have identified 15 HCWs with SARS-CoV-2 infection after vaccination, 7 (46.7%) of them were male and the mean age was 38.4 years (SD 14). In 4 of them, the presence of SARS-CoV-2 anti-nucleocapsid (anti-N) antibodies was assessed before vaccination and resulted positive in 1 case. In all HCWs the presence of SARS-CoV-2 anti-spike (anti-S1) antibodies was assessed, on average 42.2 days after the completion of vaccination, with a mean value of 2055 U/mL (SD 1927.3). SARS-CoV-2 infection was ascertained on average 56.2 days after vaccination. The mean cycle threshold (Ct) of SARS-CoV-2 PCR was 26.4, the lineage was characterized in 9 HCWs. None of the HCWs reported a primary or secondary immunodeficiency. Regarding symptoms, they were reported only by 7 (46.7%) HCWs and appeared on average 55 days after the second dose of vaccination. Of those who reported symptoms, one (14.3%) had fever, 7 (100%) rhinitis/conjunctivitis, 4 (57.1%) taste and smell alterations, none had respiratory symptoms, 4 headache/arthralgia (57.1%) and 1 gastrointestinal symptom (14.3%). All symptoms disappeared in a few days and no other unclassified symptoms were reported. Conclusions Infections occurring after vaccination with the BNT162b2 vaccine are mostly asymptomatic and are not associated with the serum titre of anti-S1 antibodies. We did not find a predominance of specific viral variants, with several lineages represented.
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Castaldi S, Perrone PM, Luconi E, Marano G, Auxilia F, Maraschini A, Bono P, Alagna L, Palomba E, Bandera A, Boracchi P, Biganzoli E. Hospital acquired infections in COVID-19 patients in sub intensive care unit: analysis of two waves of admissions. Acta Biomed 2022; 93:e2022313. [PMID: 36300221 PMCID: PMC9686160 DOI: 10.23750/abm.v93i5.13402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/13/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND AIM The pandemic caused by SARS-COV-2 has increased Semi-Intensive Care Unit (SICU) admission, causing an increase in healthcare-associated infection (HAI). Mostly HAI reveals the same risk factors, but fewer studies have analyzed the possibility of multiple coinfections in these patients. The study aimed was to identify patterns of co-presence of different species describing at the same time the association between such patterns and patient demographics and, finally, comparing the patterns between the two cohorts of COVID-19 patients admitted at Policlinico during the first wave and the second one). METHODS All the patients admitted to SICUs during two COVID-19 waves, from March to June 2020 months and from October to December 2020, were screened following the local infection control surveillance program; whoever manifested fever has undergone on microbiological culture to detect bacterial species. Statistical analysis was performed to observe the existence of microbiological patterns through DBSCAN method. RESULTS 246 patients were investigated and 83 patients were considered in our study because they presented infection symptoms with a mean age of 67 years and 33.7% of female patients. During the first and second waves were found respectively 10 and 8 bacterial clusters with no difference regarding the most frequent species. CONCLUSIONS The results show the importance of an analysis which considers the risk factors for the possibility of co- and superinfection (such as age and gender) to structure a good prognostic tool to predict which patients will encounter severe coinfections during hospitalization.
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Affiliation(s)
- Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Pier Mario Perrone
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Ester Luconi
- Unit of Medical Statistics, Biometry and Epidemiology, Department of Biomedical and Clinical Sciences (DIBIC) “L. Sacco”, LITA Vialba Campus, Università degli Studi di Milano
| | - Giuseppe Marano
- Unit of Medical Statistics, Biometry and Epidemiology, Department of Biomedical and Clinical Sciences (DIBIC) “L. Sacco”, LITA Vialba Campus, Università degli Studi di Milano
| | - Francesco Auxilia
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Anna Maraschini
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Patrizia Bono
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Laura Alagna
- Infectious Diseases Unit, IRCCS Ca’ Granda Ospedale Maggiore Policlinico Foundation, Milan, Italy
| | - Emanuele Palomba
- Infectious Diseases Unit, IRCCS Ca’ Granda Ospedale Maggiore Policlinico Foundation, Milan, Italy, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy, Centre for Multidisciplinary Research in Health Science (MACH), University of Milano, 20122 Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, IRCCS Ca’ Granda Ospedale Maggiore Policlinico Foundation, Milan, Italy, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy, Centre for Multidisciplinary Research in Health Science (MACH), University of Milano, 20122 Milan, Italy
| | - Patrizia Boracchi
- Unit of Medical Statistics, Biometry and Epidemiology, Department of Biomedical and Clinical Sciences (DIBIC) “L. Sacco” & DSRC, LITA Vialba Campus, Università degli Studi di Milano
| | - Elia Biganzoli
- Unit of Medical Statistics, Biometry and Epidemiology, Department of Biomedical and Clinical Sciences (DIBIC) “L. Sacco” & DSRC, LITA Vialba Campus, Università degli Studi di Milano
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10
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Ippolito G, La Vecchia A, Umbrello G, Di Pietro G, Bono P, Scalia Catenacci S, Pinzani R, Tagliabue C, Bosis S, Agostoni C, Marchisio PG. Corrigendum: Disappearance of seasonal respiratory viruses in children under two years old during COVID-19 pandemic: A monocentric retrospective study in Milan, Italy. Front Pediatr 2022; 10:1006948. [PMID: 36081636 PMCID: PMC9446236 DOI: 10.3389/fped.2022.1006948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fped.2021.721005.].
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Affiliation(s)
| | | | | | | | - Patrizia Bono
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Laboratory of Virology, Milan, Italy
| | - Stefano Scalia Catenacci
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Intensive Care Unit, Milan, Italy
| | - Raffaella Pinzani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Claudia Tagliabue
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Samantha Bosis
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, Milan, Italy.,Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Paola Giovanna Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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11
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Borroni E, Consonni D, Cugno M, Lombardi A, Mangioni D, Bono P, Oggioni M, Uceda Renteria S, Bordini L, Nava CD, Letzgus M, Gentiloni Silverj F, Castaldi S, Rognoni M, Cavallieri D'Oro L, Carugno M, Riboldi L, Ceriotti F, Bandera A, Gori A, Pesatori AC. Side effects among healthcare workers from a large Milan university hospital after second dose of BNT162b2 mRNA COVID-19 vaccine. Med Lav 2021; 112:477-485. [PMID: 34939617 PMCID: PMC8759050 DOI: 10.23749/mdl.v112i6.12507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/01/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND In Italy, healthcare workers (HCWs) were among the first to receive COVID-19 vaccination. Aim of the present study is to evaluate frequency and severity of adverse events (AEs) following the second dose of BNT162b2 vaccine among HCWs of a large university hospital in Milan, Italy. METHODS One month after having received the second dose of vaccine, HCWs filled-in a form about type, severity, and duration of post-vaccination local and systemic symptoms. We calculated the overall frequency of AEs and used multivariable Poisson regression models (adjusted for sex, age, BMI, smoking, allergy history, previous SARS-CoV-2 infection, anti-hypertensive therapy, and occupation) to calculate risk ratios (RR) and 95% confidence intervals (CI) of AEs according to selected variables. RESULTS We included 3659 HCWs. Overall, 2801 (76.6%) experienced at least one local event, with pain at injection site being the most frequent (2788, 76.2%). Systemic events were reported by 2080 (56.8%) HCWs, with fatigue (52.3%), muscle pain (42.2%), headache (37.7%), joint pain (31.9%), and fever (26.2%) being the most frequent. Risks of systemic events were associated with female gender (RR=1.14, CI: 1.06-1.23), age (strong decrease with increasing age, p-trend<0.001), allergy history (RR=1.13, CI: 1.05-1.20), and current smoking (RR=0.90, CI: 0.84-0.97). HCWs with previous SARS-CoV-2 infection (even if symptomatic) were not at increased risk. CONCLUSIONS Both local and systemic acute effects after second dose of BNT162b2 vaccine were frequently reported. However, symptoms were mostly light/mild and of short duration. Thus, our findings support the safety of COVID-19 vaccination in adults in relatively good health.
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Affiliation(s)
- Elisa Borroni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Dario Consonni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Massimo Cugno
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Andrea Lombardi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Davide Mangioni
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Patrizia Bono
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Massimo Oggioni
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Sara Uceda Renteria
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Lorenzo Bordini
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Carlo Domenico Nava
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Matteo Letzgus
- Medical Direction, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | | | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | | | | | - Michele Carugno
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Alessandra Bandera
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Andrea Gori
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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12
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Cugno M, Consonni D, Lombardi A, Bono P, Oggioni M, Uceda Renteria S, Pesatori AC, Castaldi S, Riboldi L, Bordini L, Nava CD, Ceriotti F, Torri A, Tafuri F, Ghigliazza G, Peyvandi F, Bandera A, Gori A. Increased Risk of Urticaria/Angioedema after BNT162b2 mRNA COVID-19 Vaccine in Health Care Workers Taking ACE Inhibitors. Vaccines (Basel) 2021; 9:vaccines9091011. [PMID: 34579248 PMCID: PMC8473401 DOI: 10.3390/vaccines9091011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 08/11/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
Urticarial eruptions and angioedema are the most common cutaneous reactions in patients undergoing mRNA COVID-19 vaccinations. The vasoactive peptide bradykinin has long been known to be involved in angioedema and recently also in urticaria. Bradykinin is mainly catabolized by angiotensin-converting enzyme (ACE), which is inhibited by ACE inhibitors, a commonly employed class of antihypertensive drugs. We evaluated the risk of developing urticaria/angioedema after inoculation with the BNT162b2 mRNA COVID-19 vaccine in a population of 3586 health care workers. The influences of ACE inhibitors and selected potential confounding variables (sex, age, previous SARS-CoV-2 infection, and allergy history) were evaluated by fitting univariate and multivariable Poisson regression models. The overall cumulative incidence of urticaria/angioedema was 1.8% (65 out of 3586; 95% CI: 1.4–2.3%). Symptoms were mild, and no subject consulted a physician. Subjects taking ACE inhibitors had an adjusted three-fold increased risk of urticaria/angioedema (RR 2.98, 95% CI: 1.12–7.96). When we restricted the analysis to those aged 50 years or more, the adjusted RR was 3.98 (95% CI: 1.44–11.0). In conclusion, our data indicate that subjects taking ACE inhibitors have an increased risk of urticaria/angioedema after vaccination with the BNT162b2 mRNA COVID-19 vaccine. Symptoms are mild and self-limited; however, they should be considered to adequately advise subjects undergoing vaccination.
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Affiliation(s)
- Massimo Cugno
- Internal Medicine, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.T.); (F.T.); (G.G.); (F.P.)
- Correspondence: ; Tel.: +39-0255035340; Fax: +39-0250320742
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (A.C.P.)
| | - Andrea Lombardi
- Infectious Diseases Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.L.); (A.B.); (A.G.)
| | - Patrizia Bono
- Clinical Laboratory, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.B.); (M.O.); (S.U.R.); (F.C.)
| | - Massimo Oggioni
- Clinical Laboratory, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.B.); (M.O.); (S.U.R.); (F.C.)
| | - Sara Uceda Renteria
- Clinical Laboratory, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.B.); (M.O.); (S.U.R.); (F.C.)
| | - Angela Cecilia Pesatori
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (A.C.P.)
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Silvana Castaldi
- Quality Unit, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (L.R.); (L.B.); (C.D.N.)
| | - Lorenzo Bordini
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (L.R.); (L.B.); (C.D.N.)
| | - Carlo Domenico Nava
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (L.R.); (L.B.); (C.D.N.)
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.B.); (M.O.); (S.U.R.); (F.C.)
| | - Adriana Torri
- Internal Medicine, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.T.); (F.T.); (G.G.); (F.P.)
| | - Francesco Tafuri
- Internal Medicine, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.T.); (F.T.); (G.G.); (F.P.)
| | - Gabriele Ghigliazza
- Internal Medicine, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.T.); (F.T.); (G.G.); (F.P.)
| | - Flora Peyvandi
- Internal Medicine, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.T.); (F.T.); (G.G.); (F.P.)
| | - Alessandra Bandera
- Infectious Diseases Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.L.); (A.B.); (A.G.)
- Centre for Multidisciplinary Research in Health Science (MACH), Università degli Studi di Milano, 20122 Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.L.); (A.B.); (A.G.)
- Centre for Multidisciplinary Research in Health Science (MACH), Università degli Studi di Milano, 20122 Milan, Italy
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13
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Bono P, Minchom A, Shetty S, Ma Y, Cruz R, de Jonge M, Yap C, Pasanen A, Skytta T, Iivanainen S, Verlingue L, Jaakkola P, de Miguel M, Arora S, Graham D, Jalkanen S, Hollmen M, Mandelin J, Karvonen M, Kauko T, Koivunen J. LBA38 Bexmarilimab, a novel macrophage re-programmer shows promising anti-tumour activity in phase I/II trial in several last line solid tumour types. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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14
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Comelli A, Consonni D, Lombardi A, Viero G, Oggioni M, Bono P, Uceda Renteria SC, Ceriotti F, Mangioni D, Muscatello A, Piatti A, Pesatori AC, Castaldi S, Riboldi L, Bandera A, Gori A. Nasopharyngeal Testing among Healthcare Workers (HCWs) of a Large University Hospital in Milan, Italy during Two Epidemic Waves of COVID-19. Int J Environ Res Public Health 2021; 18:8748. [PMID: 34444497 PMCID: PMC8392643 DOI: 10.3390/ijerph18168748] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/17/2021] [Accepted: 08/17/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND since October 2020, a second SARS-CoV-2 epidemic wave has hit Italy. We investigate the frequency of positive nasopharyngeal swabs among HCWs during the two waves and the association with occupation and demographic characteristics. METHODS this is a retrospective, observational study conducted in a large university hospital in Milan, Northern Italy. We defined two epidemic waves: 1st (February 2020-July 2020) and 2nd (August 2020-January 2021). Occupational and demographic characteristics of HCWs who underwent nasopharyngeal swabs for SARS-CoV-2 were collected. RESULTS in the 1st wave, 242 positive subjects (7.2%) were found among 3378 HCWs, whereas in the 2nd wave, the positive subjects were 545 out of 4465 (12.2%). In both epidemic waves positive NPSs were more frequent among HCWs with health-related tasks and lower among students (p < 0.001). However, in the 2nd wave, workers engaged in non-health-related tasks had a peak of 20.7% positivity. Among 160 positive HCWs in the 1st wave who were tested again in the 2nd wave, the rate of reinfection based on SARS-CoV2 RNA cycle quantification value was 0.6%. CONCLUSIONS during the 2nd epidemic wave, we confirmed a significant impact of COVID-19 among HCWs. The rise of infection rate among HCWs seems to reflect the increasing spread of SARS-CoV-2 among the overall population.
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Affiliation(s)
- Agnese Comelli
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.L.); (G.V.); (D.M.); (A.M.); (A.B.); (A.G.)
| | - Dario Consonni
- Epidemiology Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (A.C.P.)
| | - Andrea Lombardi
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.L.); (G.V.); (D.M.); (A.M.); (A.B.); (A.G.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Giulia Viero
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.L.); (G.V.); (D.M.); (A.M.); (A.B.); (A.G.)
| | - Massimo Oggioni
- Clinical Laboratory, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.O.); (P.B.); (S.C.U.R.); (F.C.)
| | - Patrizia Bono
- Clinical Laboratory, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.O.); (P.B.); (S.C.U.R.); (F.C.)
| | - Sara Colonia Uceda Renteria
- Clinical Laboratory, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.O.); (P.B.); (S.C.U.R.); (F.C.)
| | - Ferruccio Ceriotti
- Clinical Laboratory, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.O.); (P.B.); (S.C.U.R.); (F.C.)
| | - Davide Mangioni
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.L.); (G.V.); (D.M.); (A.M.); (A.B.); (A.G.)
| | - Antonio Muscatello
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.L.); (G.V.); (D.M.); (A.M.); (A.B.); (A.G.)
| | - Alessandra Piatti
- Medical Direction, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Angela Cecilia Pesatori
- Epidemiology Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (A.C.P.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, 20122 Milan, Italy;
- Quality Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Luciano Riboldi
- Occupational Health Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Alessandra Bandera
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.L.); (G.V.); (D.M.); (A.M.); (A.B.); (A.G.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, 20122 Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.L.); (G.V.); (D.M.); (A.M.); (A.B.); (A.G.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, 20122 Milan, Italy
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15
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Lombardi A, Consonni D, Oggioni M, Bono P, Uceda Renteria S, Piatti A, Pesatori AC, Castaldi S, Muscatello A, Riboldi L, Ceriotti F, Bandera A, Gori A. SARS-CoV-2 anti-spike antibody titres after vaccination with BNT162b2 in naïve and previously infected individuals. J Infect Public Health 2021; 14:1120-1122. [PMID: 34293641 PMCID: PMC8285930 DOI: 10.1016/j.jiph.2021.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/03/2021] [Accepted: 07/07/2021] [Indexed: 02/08/2023] Open
Abstract
Great expectations are placed in vaccines against COVID-19 to control the pandemic. We reviewed the antibody titres in a cohort of healthcare workers (HCWs) vaccinated with BNT162b2 to assess the influence of a previous infection on them. We stratified the results according to the individual history of nasopharyngeal swab (NPS) and symptoms. Among 3475 HCWs the highest titres were recorded among those infected more than 6 months before vaccination, independently of symptoms, followed by those infected less than 6 months before vaccination, especially in those with symptoms, and by uninfected HCWs. Vaccination with BNT162b2 can boost immunity acquired through infection, particularly in those infected more than 6 months before vaccination.
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Affiliation(s)
- Andrea Lombardi
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Dario Consonni
- Epidemiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Oggioni
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Patrizia Bono
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Sara Uceda Renteria
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Alessandra Piatti
- Medical Direction, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angela C Pesatori
- Epidemiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
| | - Silvana Castaldi
- Department Biomedical Sciences for Health, University of Milan, Milan, Italy; Quality and Internal Audit Privacy Unit, University of Milan, Milan, Italy
| | - Antonio Muscatello
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luciano Riboldi
- Occupational Health Unit, Foundation IRCCS Ca' Granda Ospedale MaggiorePoliclinico, Milan, Italy
| | - Ferruccio Ceriotti
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
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16
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Lombardi A, Mangioni D, Consonni D, Cariani L, Bono P, Cantù AP, Tiso B, Carugno M, Muscatello A, Lunghi G, Pesatori AC, Riboldi L, Ceriotti F, Bandera A, Gori A. Seroprevalence of anti-SARS-CoV-2 IgG among healthcare workers of a large university hospital in Milan, Lombardy, Italy: a cross-sectional study. BMJ Open 2021; 11:e047216. [PMID: 33619203 PMCID: PMC7902322 DOI: 10.1136/bmjopen-2020-047216] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To assess the seroprevalence of anti-SARS-CoV-2 IgG among health careworkers (HCWs) in our university hospital and verify the risk of acquiring the infection according to work area. DESIGN Cross-sectional study. SETTING Monocentric, Italian, third-level university hospital. PARTICIPANTS All the employees of the hospital on a voluntary base, for a total of 4055 participants among 4572 HCWs (88.7%). PRIMARY AND SECONDARY OUTCOME MEASURES Number of anti-SARS-CoV-2 positive serology according to working area. Association of anti-SARS-CoV-2 positive serology to selected variables (age, gender, country of origin, body mass index, smoking, symptoms and contact with confirmed cases). RESULTS From 27 April 2020 to 12 June 2020, 4055 HCWs were tested and 309 (7.6%) had a serological positive test. No relevant difference was found between men and women (8.3% vs 7.3%, p=0.3), whereas a higher prevalence was observed among foreign-born workers (27/186, 14.5%, p<0.001), employees younger than 30 (64/668, 9.6%, p=0.02) or older than 60 years (38/383, 9.9%, p=0.02) and among healthcare assistants (40/320, 12.5%, p=0.06). Working as frontline HCWs was not associated with an increased frequency of positive serology (p=0.42). A positive association was found with presence and number of symptoms (p<0.001). The symptoms most frequently associated with a positive serology were taste and smell alterations (OR 4.62, 95% CI: 2.99 to 7.15) and fever (OR 4.37, 95% CI: 3.11 to 6.13). No symptoms were reported in 84/309 (27.2%) HCWs with positive IgG levels. Declared exposure to a suspected/confirmed case was more frequently associated (p<0.001) with positive serology when the contact was a family member (19/94, 20.2%) than a patient or colleague (78/888, 8.8%). CONCLUSIONS SARS-CoV-2 infection occurred undetected in a large fraction of HCWs and it was not associated with working in COVID-19 frontline areas. Beyond the hospital setting, exposure within the community represents an additional source of infection for HCWs.
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Affiliation(s)
- Andrea Lombardi
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
| | - Davide Mangioni
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Consonni
- Epidemiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lisa Cariani
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Patrizia Bono
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Anna Paola Cantù
- Medical Direction, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Basilio Tiso
- Medical Direction, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Michele Carugno
- Epidemiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
| | - Antonio Muscatello
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanna Lunghi
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Angela Cecilia Pesatori
- Epidemiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
| | - Luciano Riboldi
- Occupational Health Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ferruccio Ceriotti
- Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
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17
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Ippolito G, La Vecchia A, Umbrello G, Di Pietro G, Bono P, Scalia Catenacci S, Pinzani R, Tagliabue C, Bosis S, Agostoni C, Marchisio PG. Disappearance of Seasonal Respiratory Viruses in Children Under Two Years Old During COVID-19 Pandemic: A Monocentric Retrospective Study in Milan, Italy. Front Pediatr 2021; 9:721005. [PMID: 34422733 PMCID: PMC8374241 DOI: 10.3389/fped.2021.721005] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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: 06/05/2021] [Accepted: 07/14/2021] [Indexed: 02/01/2023] Open
Abstract
Background: The containment measures adopted during COVID-19 pandemic have influenced the epidemiology of other respiratory viruses. Aim: We analyzed the modification of the incidence and etiology of lower respiratory tract infections (LRTIs) in young children during COVID-19 pandemic. Methods: Case series of all children under 2 years old hospitalized at a tertiary care Hospital in the Center of Milan, Italy diagnosed with LRTIs in three consecutive winter seasons (from the 1st of November to the last day of February in 2018/2019, 2019/2020 and 2020/2021). We compared the number of hospitalizations and viral detections in the 2020/2021 with the average of 2018/2019 and 2019/2020 (pre-COVID-19) using the Poisson distribution. Results: we enrolled 178 patients (66 from 2018/2019, 96 from 2019/2020, 16 from 2020/2021) 94 males (53%) and 84 females (47%), with a median (IQR) age of 5 (2-13) months. The number of hospitalizations during the 2020/2021 season was 80% lower than the average of the pre-COVID-19 seasons (16 vs. 81, p<0.001). Overall, 171 (96%) patient's nasopharyngeal aspirate (NPA) detected at least one virus (110, 64%, single-detection, 61, 36%, co-detections). In 2020/2021 we observed the disappearance of Respiratory Syncytial virus (0 vs. 54, p < 0.001), Influenza virus (0 vs. 6.5, p = 0.002), Metapneumovirus (0 vs. 8, p < 0.001), Parainfluenza viruses (0 vs. 3.5, p = 0.03) and a significant reduction of Adenovirus (2 vs. 7, p = 0.03), Bocavirus (2 vs. 7.5, p = 0.02) and Enterovirus (1 vs. 5, p = 0.04). No significant difference was found for Rhinoviruses (14 cases vs. 17, p = 0.2), other Coronaviruses (0 vs. 2, p = 0.1), and Cytomegalovirus (1 vs. 1, p = 0.7). Conclusions: We observed a striking reduction in hospitalizations due to LRTIs and a modification of the etiology, with enveloped viruses mainly affected.
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Affiliation(s)
| | | | | | | | - Patrizia Bono
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Laboratory of Virology, Milan, Italy
| | - Stefano Scalia Catenacci
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Intensive Care Unit, Milan, Italy
| | - Raffaella Pinzani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Claudia Tagliabue
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Samantha Bosis
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, Milan, Italy.,Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Paola Giovanna Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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18
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Castaldi S, Luconi E, Marano G, Auxilia F, Maraschini A, Bono P, Ungaro R, Bandera A, Boracchi P, Biganzoli E. Hospital Acquired Infections in COVID-19 patients in sub intensive care unit. Acta Biomed 2020; 91:e2020017. [PMID: 32921713 PMCID: PMC7717023 DOI: 10.23750/abm.v91i3.10376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/01/2020] [Indexed: 01/28/2023]
Abstract
The aim of this study is to assess the association among species of bacteria and to identify the presence of clusters of patients in sub intensive care unit with different profiles of infection, and to study the relationship between such profiles and patient demographics (gender, age), kind of investigations and material used to detect the infection. The findings need to analyse a bigger amount of data in the same setting to make evident that it is constant the infection only with Escherichia coli and Staphylocossus epidemidis and a third case in which more bacteria are inlvolved.
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Affiliation(s)
- Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Hospital, Milan, Italy.
| | - Ester Luconi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano Italia.
| | - Giuseppe Marano
- Department of Clinical Sciences and Community Health and DSRC, University of Milan, Italy.
| | | | - Anna Maraschini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano Italia.
| | - Patrizia Bono
- Fondazione IRCCS Ca' Granda Ospedale Maggiore di Policlinico Milano Italia.
| | - Riccardo Ungaro
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano Italia.
| | - Alessandra Bandera
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti University of Milan Italy .
| | - Patrizia Boracchi
- Department of Clinical Sciences and Community Health and DSRC, University of Milan, Italy.
| | - Elia Biganzoli
- Department of Clinical Sciences and Community Health and DSRC, University of Milan, Italy.
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19
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Bono P, Jaakkola P, Shetty S, Ma Y, de Jonge M, Robbrecht D, Minchom A, Pal A, Yap C, Pasanen A, Skytta T, Thibault A, Cruz R, Jalkanen M, Jalkanen S, Hollmén M, Mandelin J, Karvonen M, Koivunen J. 1024MO A phase I/II MATINS trial: Part 1 pharmacokinetic, safety and efficacy results of Clever-1 blockade in advanced cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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20
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Auxilia F, Maraschini A, Bono P, Ungaro R, Luconi E, Biganzoli E, Castaldi S. COVID-19: new scenario old problems. Acta Biomed 2020; 91:90-91. [PMID: 32701922 PMCID: PMC8023089 DOI: 10.23750/abm.v91i9-s.10119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 11/23/2022]
Abstract
The short paper present the problem of hospital acquired infection in subintensive units og a research and teaching hospital.
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Affiliation(s)
- Francesco Auxilia
- Department of Biomedical Sciences for Health University of Milan, Italy.
| | - Anna Maraschini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano, Italy.
| | - Patrizia Bono
- Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano, Italy.
| | - Riccardo Ungaro
- Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano, Italy.
| | - Ester Luconi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano, Italy.
| | - Elia Biganzoli
- Department of Clinical Sciences and Community Health and DSRC, University of Milan, Italy.
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21
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Gastaldi C, Bozzini G, Besana U, Broggini P, Bono P, Pedaci G, Puliatti S, Bevilacqua L, Ciarlariello S, Aydogan T, Sighinolfi M, Micali S, Rocco B, Buizza C. Stone related preoperative factors affecting postoperative PCNL Stone Free Rate (SFR). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)30023-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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22
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Hollmén M, Virtakoivu R, Jaakkola P, Minchom A, Jalkanen S, Karvonen M, Mandelin J, Koivunen J, Bono P. Biomarkers of immune switch induced by a novel anti-macrophage antibody (anti-Clever-1 mAb; FP-1305) in MATINS trial patients with advanced solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz447.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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Bono P, Hollmen M, Jaakkola P, Shetty S, Thibault A, de Jonge M, Minchom A, Ma Y, Yap C, Robbrecht D, Pasanen A, Jalkanen S, Cruz R, Pal A, Karvonen M, Mandelin J, Koivunen J. Immune activation with a novel immune switch anti-macrophage antibody (anti-Clever-1 mAb; FP-1305) in phase I/II first-in-human MATINS trial in patients with advanced solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Soveri LM, Lamminmäki A, Hänninen UA, Karhunen M, Bono P, Osterlund P. Long-term neuropathy and quality of life in colorectal cancer patients treated with oxaliplatin containing adjuvant chemotherapy. Acta Oncol 2019; 58:398-406. [PMID: 30638100 DOI: 10.1080/0284186x.2018.1556804] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Oxaliplatin, combined with capecitabine (CAPOX) or infused 5-fluorouracil (FOLFOX), is standard of care in the adjuvant treatment of colorectal cancer (CRC). Prospective data on prevalence of oxaliplatin induced acute and long-term neuropathy in a real-life patient population and its effects on quality of life (QOL) and survival is limited, and scarce in CAPOX versus FOLFOX treated, especially in a subarctic climate. METHODS One hundred forty-four adjuvant CRC patients (all 72 CAPOX cases and 72 matched FOLFOX controls) were analyzed regarding oxaliplatin induced sensory neuropathy, which was graded according to NCI-CTCAEv3.0. Ninety-two long-term survivors responded to the QOL (EORTC QLQ-C30) and Chemotherapy-Induced Peripheral Neuropathy (EORTC CIPN20) questionnaires and were interviewed regarding long-term neuropathy. RESULTS Acute neurotoxicity was present in 94% (136/144) during adjuvant therapy and there was a significant association between acute neurotoxicity and long-term neuropathy (p < .001). Long-term neuropathy was present in 69% (grade 1/2/3/4 in 36/24/8/1%) at median 4.2 years. Neuropathy grades 2-4 did not influence global health status, but it was associated with decreased physical functioning (p = .031), decreased role functioning (p = .040), and more diarrhea (p = .021) in QLQ-C30 items. There were no differences in acute neurotoxicity, long-term neuropathy, or in QOL between CAPOX and FOLFOX treated. Neuropathy showed no pattern of variation according to starting and stopping month or treatment during winter. CONCLUSIONS Neuropathy following oxaliplatin containing adjuvant chemotherapy is present in two-thirds, years after cessation, and impairs some QOL scales. There is no difference in severity of acute or long-term neuropathy between CAPOX and FOLFOX treated and QOL is similar. No seasonal variation in neuropathy was noted.
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Affiliation(s)
- L. M. Soveri
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
- Department of Oncology at Clinicum, University of Helsinki, Helsinki, Finland
| | - A. Lamminmäki
- Department of Oncology, Kuopio University Central Hospital, Helsinki, Finland
| | - U. A. Hänninen
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
| | - M. Karhunen
- Medical Bioinformatics Centre, Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland
| | - P. Bono
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
- Department of Oncology at Clinicum, University of Helsinki, Helsinki, Finland
| | - P. Osterlund
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
- Department of Oncology at Clinicum, University of Helsinki, Helsinki, Finland
- Department of Oncology, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Life Sciences, Tampere University, Tampere, Finland
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Penttilä P, Bono P, Peltola K, Donskov F. Hyponatremia associates with poor outcome in metastatic renal cell carcinoma patients treated with everolimus: prognostic impact. Acta Oncol 2018; 57:1580-1585. [PMID: 29863419 DOI: 10.1080/0284186x.2018.1477256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The prognostication of metastatic renal cell carcinoma (mRCC) is based on Memorial Sloan Kettering Cancer Center (MSKCC) and International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk classifications. Research has shown that hyponatremia is associated with worse prognosis in cancer. We analyzed the association of hyponatremia and outcome in everolimus-treated mRCC patients. PATIENTS AND METHODS Baseline and on-treatment (≤12 weeks) sodium in 233 mRCC patients was analyzed using Kaplan-Meier, Cox regression and logistic regression. Baseline sodium was correlated with baseline thrombocyte and neutrophil values. RESULTS 65 (28%) and 41 (18%) patients had sodium < lower limit of normal (LLN) at baseline and on-treatment, respectively. Baseline sodium < LLN was associated with shorter overall survival (OS) (6.1 vs. 10.3 months; p < .001) and progression-free survival (PFS) (2.8 vs. 3.5 months; p = .04). On-treatment sodium < LLN was associated with shorter OS (5.4 vs. 9.9 months; p < .001) and PFS (2.8 vs. 4.0 months; p < .001). In multivariate analyses adjusted for IMDC factors, baseline and on-treatment sodium < LLN were significantly associated with shorter OS (adjusted HR 1.46 (95% CI 1.04-2.05); p = .02; adjusted HR 1.80 (95% CI 1.23-2.61); p = .002; respectively). On-treatment sodium < LLN was significantly associated with progressive disease (OR 0.23 (95% CI 0.10-0.56); p = .001). A landmark analysis demonstrated that on-treatment hyponatremia was significantly associated with shorter OS and PFS (p = .01 and p = .03, respectively). On-treatment normalization of hyponatremia was associated with improved OS (unadjusted HR 0.61 (95% CI 0.35-0.98); p = .04), as compared to patients with sustained hyponatremia throughout follow-up. CONCLUSIONS Hyponatremia associates with poor outcome in mRCC patients treated with everolimus. On-treatment normalization of hyponatremia to normal sodium values associates with favorable outcome.
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Affiliation(s)
- P. Penttilä
- Comprehensive Cancer Center Helsinki University Hospital, Helsinki, Finland
| | - P. Bono
- Comprehensive Cancer Center Helsinki University Hospital, Helsinki, Finland
| | - K. Peltola
- Comprehensive Cancer Center Helsinki University Hospital, Helsinki, Finland
| | - F. Donskov
- Department of Oncology, Aarhus University Hospital, Palle, Denmark
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Bono P, Massard C, Peltola K, Azaro A, Italiano A, Kristeleit R, Lassen U, Arkenau HT, Hakulinen P, Garratt C, Ikonen T, Mustonen M, Rodon J. Phase I/II study of ODM-203, a selective dual FGFR/VEGFR inhibitor, in patients with advanced solid tumours. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy279.408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Rosenberg J, Sharma P, de Braud F, Basso U, Calvo E, Bono P, Morse M, Ascierto P, Lopez-Martin J, Brossart P, Rohrberg K, Reguart N, Lin W, Meadows-Shropshire S, Saci A, Callahan M, Siefker-Radtke A. Nivolumab (N) alone or in combination with ipilimumab (I) in patients (pts) with platinum-pretreated metastatic urothelial carcinoma (mUC), including the nivolumab 1 mg/kg + ipilimumab 3 mg/kg expansion from CheckMate 032. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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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Procopio G, Bamias A, Schmidinger M, Hawkins R, Rodriguez Sanchez A, Vazquez S, Srihari N, Kalofonos H, Bono P, Pisal C, Hirschberg Y, Dezzani L, Ahmad Q, Suarez Rodriguez C, Jonasch E. Real-world effectiveness of pazopanib in patients with intermediate prognostic risk advanced renal cell carcinoma (PRINCIPAL study). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.093] [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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Ascierto P, Bono P, Bhatia S, Melero I, Nyakas M, Svane IM, Larkin J, Gomez-Roca C, Schadendorf D, Dummer R, Marabelle A, Hoeller C, Maurer M, Harbison C, Mitra P, Suryawanshi S, Thudium K, Muñoz Couselo E. Efficacy of BMS-986016, a monoclonal antibody that targets lymphocyte activation gene-3 (LAG-3), in combination with nivolumab in pts with melanoma who progressed during prior anti–PD-1/PD-L1 therapy (mel prior IO) in all-comer and biomarker-enriched populations. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.011] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ott P, Le D, Kim J, Ascierto P, Sharma P, Bono P, Peltola K, Jäger D, Evans T, de Braud F, Chau I, Bendell J, Tschaika M, Harbison C, Zhao H, Calvo E, Janjigian Y. Nivolumab (NIVO) in patients (pts) with advanced (adv) chemotherapy-refractory (CT-Rx) esophagogastric (EG) cancer according to microsatellite instability (MSI) status: checkmate 032. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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31
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Benardon S, Lunghi G, Bono P, Orlandi A, Pacela F, Zoccoli A, Boeri E, Sampaolo M, Cusini M. LGV
Chlamydia trachomatis
serotypes: an update from Milan, Italy. Sex Transm Infect 2017; 93:395. [DOI: 10.1136/sextrans-2016-052985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/19/2017] [Accepted: 02/05/2017] [Indexed: 11/03/2022] Open
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Penttilä P, Donskov F, Rautiola J, Peltola K, Laukka M, Bono P. Everolimus-induced pneumonitis associates with favourable outcome in patients with metastatic renal cell carcinoma. Eur J Cancer 2017; 81:9-16. [DOI: 10.1016/j.ejca.2017.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/26/2017] [Accepted: 05/01/2017] [Indexed: 01/13/2023]
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Piralla A, Lunghi G, Ardissino G, Girello A, Premoli M, Bava E, Arghittu M, Colombo MR, Cognetto A, Bono P, Campanini G, Marone P, Baldanti F. FilmArray™ GI panel performance for the diagnosis of acute gastroenteritis or hemorragic diarrhea. BMC Microbiol 2017; 17:111. [PMID: 28494766 PMCID: PMC5427568 DOI: 10.1186/s12866-017-1018-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 04/28/2017] [Indexed: 12/16/2022] Open
Abstract
Background Acute gastroenteritis is a common cause of morbidity and mortality in humans worldwide. The rapid and specific identification of infectious agents is crucial for correct patient management. However, diagnosis of acute gastroenteritis is usually performed with diagnostic panels that include only a few pathogens. In the present bicentric study, the diagnostic value of FilmArray™ GI panels was assessed in unformed stool samples of patients with acute gastroenteritis and in a series of samples collected from pediatric patients with heamorragic diarrhea. The clinical performance of the FilmArray™ gastrointestinal (GI) panel was assessed in 168 stool samples collected from patients with either acute gastroenteritis or hemorragic diarrhea. Samples showing discordant results between FilmArray and routine methods were further analyzed with an additional assay. Results Overall, the FilmArray™ GI panel detected at least one potential pathogen in 92/168 (54.8%) specimens. In 66/92 (71.8%) samples, only one pathogen was detected, while in 26/92 (28.2%) multiple pathogens were detected. The most frequent pathogens were rotavirus 13.9% (22/168), Campylobacter 10.7% (18/168), Clostridium difficile 9.5% (16/168), and norovirus 8.9% (15/168). Clostridium difficile was identified only in patients with acute gastroenteritis (p < 0.01), while STEC was detected exclusively in patients with hemorragic diarrhea (p < 0.01). In addition, Campylobacter spp., Salmonella spp., EPEC and E. coli producing Shiga-like toxin were more frequently detected in patients with hemorragic diarrhea (p < 0.05). The overall percent agreement calculated in samples was 73.8% and 65.5%, while 34.5% were discordant. After additional confirmatory analyses, the proportion of discordant samples decreased to 7.7%. Rotavirus and astrovirus were the most frequently unconfirmed pathogens. Conclusion In conclusion, the FilmArray™ GI panel has proved to be a valuable new diagnostic tool for improving the diagnostic efficiency of GI pathogens.
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Affiliation(s)
- Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giovanna Lunghi
- Microbiology and Virology Unit, Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluigi Ardissino
- Center of HUS Control, Prevention and Management, Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessia Girello
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marta Premoli
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Erika Bava
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Milena Arghittu
- Microbiology and Virology Unit, Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Rosaria Colombo
- Microbiology and Virology Unit, Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Cognetto
- Microbiology and Virology Unit, Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Patrizia Bono
- Microbiology and Virology Unit, Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Campanini
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Piero Marone
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fausto Baldanti
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. .,Section of Microbiology, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
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Scoccianti S, Greto D, Calusi S, Poggesi L, Arilli C, Casati M, Compagnucci A, Becherini C, Carta G, Desideri I, Baki M, Visani L, Simontacchi G, Bonomo P, Bordi L, Bono P, Pallotta S, Livi L. EP-1127: Dose to hippocampus in brain metastases radiosurgery: need for an hippocampal sparing approach. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31563-3] [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: 10/19/2022]
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Greto D, Loi M, Scoccianti S, Baki M, Desideri I, Bordi L, Bono P, Meattini I, Bonomo P, Terziani F, Carfora V, Livi L. PO-0624: Gammaknife Radiosurgery in patients receiving anticancer immunotherapy: efficacy and safety. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31061-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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36
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Rodón J, Peltola K, Azaro A, Alvarez EC, Garratt C, Leskinen H, Bjorklund H, Ruck A, Massard C, Bono P. Phase 1 study of ODM-203, a selective dual FGFR/VEGFR inhibitor, in patients with advanced solid tumours. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw368.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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37
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Penttila P, Rautiola J, Peltola K, Laukka M, Bono P. Everolimus-induced pneumonitis as predictor of outcome in patients with metastatic renal cell carcinoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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38
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Virman J, Lampinen A, Bono P, Luukkaala T, Sunela K, Kujala P, Saharinen P, Kellokumpu-Lehtinen PL. Novel angiogenesis markers as long-term prognostic factors in renal cell cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.34] [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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39
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Rosenberg J, Bono P, Kim J, Spiliopoulou P, Calvo E, Pillai R, Ott P, de Braud F, Morse M, Le D, Jaeger D, Chan E, Harbison C, Lin C, Tschaika M, Azrilevich A, Sharma P. Nivolumab monotherapy in metastatic urothelial cancer (mUC): Updated efficacy by subgroups and safety results from the CheckMate 032 study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.12] [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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Aghemo A, Degasperi E, De Nicola S, Bono P, Orlandi A, D'Ambrosio R, Soffredini R, Perbellini R, Lunghi G, Colombo M. Quantification of Core Antigen Monitors Efficacy of Direct-acting Antiviral Agents in Patients With Chronic Hepatitis C Virus Infection. Clin Gastroenterol Hepatol 2016; 14:1331-6. [PMID: 27046484 DOI: 10.1016/j.cgh.2016.03.035] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 03/01/2016] [Accepted: 03/12/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Widespread use of direct-acting antiviral (DAA) agents to treat patients with hepatitis C virus (HCV) infection has reduced the need for monitoring of HCV RNA levels, because viral kinetics do not predict sustained virologic response (SVR) to these drugs. However, the performance of cheaper tests such as the assay to quantify HCV core antigen (HCV Ag) has not been determined. We investigated the accuracy of the HCV Ag test in predicting which patients receiving DAAs will achieve SVRs at week 12 (SVR12). METHODS We performed a prospective study of 58 patients infected with HCV genotypes 1-5 (45% with HCV genotype 1, 72% with cirrhosis) receiving DAA therapy from the Liver Center at the Università degli Studi of Milan in Italy from January to March 2015. We collected blood samples and measured levels of HCV Ag and HCV RNA at baseline, after 2 and 4 weeks of treatment, the end of treatment, and 12 weeks after treatment ended. We compared the ability of these assays to predict which patients would have SVR12. RESULTS The median baseline level of HCV RNA was 5.79 log10 IU/mL (range, 3.51-7.31 log10 IU/mL) and of HCV Ag was 3226.87 fmol/L (range, 17.30-54,927.00 fmol/L). HCV Ag became undetectable in 71% of patients at week 2, 84% at week 4, and 93% at the end of treatment. HCV RNA became undetectable in 10% of patients at week 2, 43% at week 4, and 100% at the end of treatment (P < .0001). Concordance between the tests in identifying patients who would achieve SVR12 was 40% at week 2, 55% at week 4, and 95% at the end of treatment. Fifty-three of 58 patients (91%) achieved an SVR12; the test for HCV Ag identified 97% of these patients. The tests for HCV Ag and HCV RNA predicted which patients would have SVR12 with positive predictive values of 90% vs 83%, respectively, at week 2 and 89% vs 92%, respectively, at week 4. CONCLUSIONS Tests that measure HCV Ag monitor efficacy of DAA therapy for HCV infection as well as assays that measure HCV RNA and can be recommended for clinical practice. However, measurement of HCV RNA after treatment can rule out relapse in HCV Ag-positive patients.
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Affiliation(s)
- Alessio Aghemo
- A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
| | - Elisabetta Degasperi
- A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Stella De Nicola
- A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Patrizia Bono
- Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Orlandi
- Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberta D'Ambrosio
- A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Roberta Soffredini
- A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Riccardo Perbellini
- A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Giovanna Lunghi
- Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Colombo
- A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
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Abstract
Viene preso in esame il gruppo di 20 neoplasie intrarachidee in età infantile osservate presso la Clinica Neurochirurgica dell'Università di Firenze e si sottolinea la frequenza di alterazioni morfologiche riscontrate all'esame radiografico nei casi di compressioni spinali. In un'epoca in cui gli esami neuroradiologici più complessi (TC ed RM) hanno in gran parte risolto il quesito diagnostico delle compressioni spinali, gli autori sottolineato l'importanza di una accurata valutazione dell'esame radiografico diretto della colonna che potrà meglio indirizzare gli esami neuroradiologici più fini per giungere ad una diagnosi precoce delle compressioni spinali.
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Affiliation(s)
| | | | | | | | - G.A. Pellicano
- Dipartimento di Fisiopatologia Clinica dell'Università, Sezione di Radiodiagnostica. Firenze
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Narra R, Bono P, Zoccoli A, Orlandi A, Piconi S, Grasselli G, Crotti S, Girello A, Piralla A, Baldanti F, Lunghi G. Acute respiratory distress syndrome in adenovirus type 4 pneumonia: A case report. J Clin Virol 2016; 81:78-81. [PMID: 27354307 DOI: 10.1016/j.jcv.2016.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/06/2016] [Accepted: 06/10/2016] [Indexed: 10/21/2022]
Abstract
Human adenoviruses (HAdVs) cause a wide spectrum of clinical syndromes, depending on species and types, from mild respiratory infections to deadly pneumonia: in particular, severe infections occur in immunocompromised patients. In this report, we describe the case of a 36 years-old woman admitted to our intensive care unit (ICU) with severe respiratory distress syndrome caused by adenovirus pneumonia, that required invasive respiratory support (mechanical ventilation and extracorporeal membrane oxygenation). Molecular assays detected the virus in respiratory and plasma specimen and sequencing procedure identified HAdV type 4. Patient improved after cidofovir administration. Leukopenia and subsequent bacterial infection occurred, but the patient recovered completely and was discharged from the hospital after 54days.
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Affiliation(s)
- R Narra
- Virology Unit, Fondazione IRCCS Ospedale Maggiore Ca' Granda, Milan, Italy;, Italy
| | - P Bono
- Virology Unit, Fondazione IRCCS Ospedale Maggiore Ca' Granda, Milan, Italy;, Italy
| | - A Zoccoli
- Virology Unit, Fondazione IRCCS Ospedale Maggiore Ca' Granda, Milan, Italy;, Italy
| | - A Orlandi
- Virology Unit, Fondazione IRCCS Ospedale Maggiore Ca' Granda, Milan, Italy;, Italy
| | - S Piconi
- First Infectious Disease Department, A.O. Luigi Sacco, Milan, Italy
| | - G Grasselli
- Intensive Care Unit, Fondazione IRCCS Ospedale Maggiore Ca' Granda, Italy
| | - S Crotti
- Intensive Care Unit, Fondazione IRCCS Ospedale Maggiore Ca' Granda, Italy
| | - A Girello
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Piralla
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - F Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Section of Microbiology, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - G Lunghi
- Virology Unit, Fondazione IRCCS Ospedale Maggiore Ca' Granda, Milan, Italy;, Italy.
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Rajan A, Berns A, Ringborg U, Celis J, Ponder B, Caldas C, Livingston D, Bristow RG, Hecht TT, Tursz T, van Luenen H, Bono P, Helander T, Seamon K, Smyth JF, Louvard D, Eggermont A, van Harten WH. Excellent translational research in oncology: A journey towards novel and more effective anti-cancer therapies. Mol Oncol 2016; 10:645-51. [PMID: 26797050 PMCID: PMC5423159 DOI: 10.1016/j.molonc.2015.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 12/06/2015] [Accepted: 12/07/2015] [Indexed: 12/02/2022] Open
Abstract
Comprehensive Cancer Centres (CCCs) serve as critical drivers for improving cancer survival. In Europe, we have developed an Excellence Designation System (EDS) consisting of criteria to assess "excellence" of CCCs in translational research (bench to bedside and back), with the expectation that many European CCCs will aspire to this status.
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Affiliation(s)
- A Rajan
- The Netherlands Cancer Institute, The Netherlands
| | - A Berns
- The Netherlands Cancer Institute, The Netherlands
| | | | - J Celis
- Danish Cancer Society, Denmark
| | | | | | | | | | - T T Hecht
- Translational Research Program, National Cancer Institute, USA
| | - T Tursz
- Institut Gustave Roussy, France
| | - H van Luenen
- The Netherlands Cancer Institute, The Netherlands
| | - P Bono
- Helsinki University Central Hospital Cancer Center, Finland
| | - T Helander
- Helsinki University Central Hospital Cancer Center, Finland
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Bono P, Orlandi A, Zoccoli A, Salvatore A, Annaloro C, Tagliaferri E, Lunghi G. Quantiferon CMV assay in allogenic stem cell transplant patients. J Clin Virol 2016; 79:10-11. [PMID: 27043969 DOI: 10.1016/j.jcv.2016.03.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 02/23/2016] [Accepted: 03/27/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Patrizia Bono
- UOS Virologia Fondazione Ca' Granda Policlinico, Milano, Italy.
| | - Anna Orlandi
- UOS Virologia Fondazione Ca' Granda Policlinico, Milano, Italy.
| | | | | | - Claudio Annaloro
- Centro Trapianto Midollo Fondazione Ca' Granda Policlinico, Milano, Italy.
| | - Elena Tagliaferri
- Centro Trapianto Midollo Fondazione Ca' Granda Policlinico, Milano, Italy.
| | - Giovanna Lunghi
- UOS Virologia Fondazione Ca' Granda Policlinico, Milano, Italy.
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Sharma P, Escudier B, McDermott D, George S, Hammers H, Srinivas S, Tykodi S, Sosman J, Procopio G, Plimack E, Castellano D, Gurney H, Donskov F, Bono P, Wagstaff J, Gauler T, Ueda T, Xu L, Waxman I, Motzer R. 3LBA CheckMate 025: a randomized, open-label, phase III study of nivolumab (NIVO) versus everolimus (EVE) in advanced renal cell carcinoma (RCC). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31926-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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46
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Greto D, Scoccianti S, Compagnucci A, Arilli C, Casati M, Francolini G, Cecchini S, Loi M, Bordi L, Bono P, Detti B, Livi L. EP-1357: GammaKnife Radiosurgery in the management of single and multiple brain metastases. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41349-0] [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: 10/23/2022]
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47
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Scoccianti S, Greto D, Francolini G, Desideri I, Cecchini S, Loi M, Casati M, Arilli C, Compagnucci A, Simontacchi G, Bonomo P, Bordi L, Bono P, Livi L. PO-0807: Radiosurgery and brain metastases: high-resolution MRI can significantly change intracranial disease staging. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40799-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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48
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Soveri L, Hermunen K, de Gramont A, Poussa T, Quinaux E, Bono P, André T, Österlund P. Association of adverse events and survival in colorectal cancer patients treated with adjuvant 5-fluorouracil and leucovorin: Is efficacy an impact of toxicity? Eur J Cancer 2014; 50:2966-74. [DOI: 10.1016/j.ejca.2014.08.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/22/2014] [Accepted: 08/06/2014] [Indexed: 12/27/2022]
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Scoccianti S, Greto D, Bordi L, Bono P, Pecchioli G, Casati M, Vanzi E, Compagnucci A, Gadda D, Livi L. O7.02 * RADIOSURGERY AND BRAIN METASTASES: ADEQUATE SEQUENCE OF BRAIN MRI CAN SIGNIFICANTLY CHANGE THE INTRACRANIAL DISEASE STAGING. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.53] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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