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Del Borgo C, Garattini S, Bortignon C, Carraro A, Di Trento D, Gasperin A, Grimaldi A, De Maria SG, Corazza S, Tieghi T, Belvisi V, Kertusha B, De Masi M, D'Onofrio O, Bagaglini G, Bonanni G, Zuccalà P, Fabietti P, Tortellini E, Guardiani M, Spagnoli A, Marocco R, Alunni Fegatelli D, Lichtner M. Effectiveness, Tolerability and Prescribing Choice of Antiviral Molecules Molnupiravir, Remdesivir and Nirmatrelvir/r: A Real-World Comparison in the First Ten Months of Use. Viruses 2023; 15:v15041025. [PMID: 37113006 PMCID: PMC10145588 DOI: 10.3390/v15041025] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
In 2022, three antiviral drugs-molnupiravir, remdesivir and nirmatrelvir/ritonavir-were introduced for treatment of mild-to-moderate COVID-19 in high-risk patients. The aim of this study is the evaluation of their effectiveness and tolerability in a real-life setting. A single-center observational study was set up, with the involvement of 1118 patients, with complete follow-up data, treated between the 5th of January and the 3rd of October 2022 at Santa Maria Goretti's hospital in Latina, Central Italy. A univariable and a multivariable analysis were performed on clinical and demographic data and composite outcome, the persistence of symptoms at 30 days and time to negativization, respectively. The three antivirals showed a similar effectiveness in containing the progression of the infection to severe COVID-19 and a good tolerability in the absence of serious adverse effects. Persistence of symptoms after 30 days was more common in females than males and less common in patients treated with molnupiravir and nirmatrelvir/r. The availability of different antiviral molecules is a strong tool and, if correctly prescribed, they can have a significant role in changing the natural history of infection for frail persons, in which vaccination could be not sufficient for the prevention of severe COVID-19.
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Affiliation(s)
- Cosmo Del Borgo
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Silvia Garattini
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Carolina Bortignon
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Anna Carraro
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Daniela Di Trento
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Gasperin
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Alessandra Grimaldi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Sara Giovanna De Maria
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Sara Corazza
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Tiziana Tieghi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Valeria Belvisi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Blerta Kertusha
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Margherita De Masi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Ombretta D'Onofrio
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Gabriele Bagaglini
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Gabriella Bonanni
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Paola Zuccalà
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Paolo Fabietti
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Eeva Tortellini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
| | - Mariasilvia Guardiani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
| | - Alessandra Spagnoli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
| | - Raffaella Marocco
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Danilo Alunni Fegatelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
| | - Miriam Lichtner
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
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Marocco R, Del Borgo C, Tortellini E, Garattini S, Carraro A, Di Trento D, Gasperin A, Grimaldi A, Tieghi T, Belvisi V, Kertusha B, Guardiani M, Zuccalà P, Alunni Fegatelli D, Spagnoli A, Lichtner M. Use of Remdesivir in Patients with SARS-CoV-2 Pneumonia in a Real-Life Setting during the Second and Third COVID-19 Epidemic Waves. Viruses 2023; 15:v15040947. [PMID: 37112927 PMCID: PMC10143300 DOI: 10.3390/v15040947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/08/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
In this retrospective comparative study, we evaluated the effectiveness of remdesivir (RDSV) in patients with SARS-CoV-2 pneumonia. Individuals hospitalized between March 2020 and August 2022 at S.M. Goretti Hospital, Latina, with a positive test for SARS-CoV-2 and, concomitantly, pneumonia, were included. The overall survival was the primary endpoint. The composite secondary endpoint included death or progression in severe ARDS at 40 days. The study population was stratified according to treatment into two groups: the RDSV group (patients treated with RDSV-based regimens) and the no-RDSV group (patients treated with any other, not RDSV-based, regimens). Factors associated with death and progression to severe ARDS or death were assessed by multivariable analysis. A total of 1153 patients (632 belonging to the RDSV group and 521 to the no-RDSV group) were studied. The groups were comparable in terms of sex, PaO2/FiO2 at admission, and duration of symptoms before hospitalization. Further, 54 patients (8.5%) in the RDSV group and 113 (21.7%) in the no-RDSV group (p < 0.001) died. RDSV was associated with a significantly reduced hazard ratio (HR) of death (HR, 0.69 [95% CI, 0.49-0.97]; p = 0.03), compared to the no-RDSV group, as well as a significantly reduced OR of progression in severe ARDS or death (OR, 0.70 [95% CI 0.49-0.98]; p = 0.04). An overall significantly higher survival rate was observed in the RDSV group (p < 0.001, by log-rank test). These findings reinforce the survival benefit of RDSV and support its routine clinical use for the treatment of COVID-19 patients.
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Affiliation(s)
- Raffaella Marocco
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Cosmo Del Borgo
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Eeva Tortellini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Silvia Garattini
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Anna Carraro
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Daniela Di Trento
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Andrea Gasperin
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Alessandra Grimaldi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Tiziana Tieghi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Valeria Belvisi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Blerta Kertusha
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Mariasilvia Guardiani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Paola Zuccalà
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Danilo Alunni Fegatelli
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Alessandra Spagnoli
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Miriam Lichtner
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
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Marocco R, Carraro A, Zingaropoli MA, Nijhawan P, Tortellini E, Guardiani M, Mengoni F, Zuccalà P, Belvisi V, Kertusha B, Parente A, Del Borgo C, Vullo V, Ciardi M, Mastroianni CM, Lichtner M. Role of Tocilizumab in Down Regulating sCD163 Plasmatic Levels in a Cohort of COVID-19 Patients. Front Immunol 2022; 13:871592. [PMID: 35444637 PMCID: PMC9013773 DOI: 10.3389/fimmu.2022.871592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background CD163, a haptoglobin-hemoglobin scavenger receptor mostly expressed by monocytes and macrophages, is involved in the regulation of inflammatory processes. Following proteolytic cleavage after pro-inflammatory stimulation, CD163 is shed from the cell surface and its soluble form in plasma, sCD163, is a biomarker of monocyte/macrophage lineage activation. The assessment of sCD163 plasmatic levels in an early stage of the disease could have clinical utility in predicting the severity of COVID-19 pneumonia. The use of tocilizumab (monoclonal antibody anti-IL-6 receptor) in COVID-19 patients reduces lethality rate at 30 days. The aim of the study was to investigate the effect of tocilizumab on sCD163 plasmatic levels in a cohort of COVID-19 patients. Methods In COVID-19 patients, on hospital admission (T0), after 7 days from hospitalization (T7) and after 45 days from discharge (T45) sCD163 plasmatic levels were evaluated, along with other laboratory parameters. COVID-19 patients were stratified into tocilizumab (TCZ) and non-tocilizumab (non-TCZ) groups. TCZ group was further divided into responder (R) and non-responder (NR) groups. Patients who died or required mechanical ventilation were defined as NR. As control group, healthy donors (HD) were enrolled. Results Seventy COVID-19 patients and 47 HD were enrolled. At T0, sCD163 plasmatic levels were higher in COVID-19 patients compared to HD (p<0.0001) and the longitudinal evaluation showed a reduction in sCD163 plasmatic levels at T7 compared to T0 (p=0.0211). At T0, both TCZ and non-TCZ groups showed higher sCD163 plasmatic levels compared to HD (p<0.0001 and p=0.0147, respectively). At T7, the longitudinal evaluation showed a significant reduction in sCD163 plasmatic levels (p=0.0030) only in the TCZ group, reaching levels comparable to those of HD. Conversely, not statistically significance in non-TCZ group was observed and, at T7, a statistically significance was found comparing non-TCZ group to HD (p=0.0019). At T0, R and NR groups showed not statistically significance in sCD163 plasmatic levels and both groups showed higher levels compared to HD (p=0.0001 and p=0.0340, respectively). The longitudinal evaluation showed significant reductions in both groups (R: p=0.0356; NR: p=0.0273) independently of the outcome. After 45 days of follow-up sCD163 plasmatic levels remain stable. Conclusion sCD163 plasmatic levels are increased in COVID-19 pneumonia and is efficiently down-regulated by tocilizumab treatment regardless of the clinical outcome.
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Affiliation(s)
- Raffaella Marocco
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - Anna Carraro
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Maria Antonella Zingaropoli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- *Correspondence: Maria Antonella Zingaropoli,
| | - Parni Nijhawan
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Eeva Tortellini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Mariasilvia Guardiani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Fabio Mengoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Paola Zuccalà
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - Valeria Belvisi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - Blerta Kertusha
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Alberico Parente
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Cosmo Del Borgo
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - Vincenzo Vullo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Maria Rosa Ciardi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | - Miriam Lichtner
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Martellucci S, Belvisi V, Ralli M, Stadio AD, Musacchio A, Greco A, Gallo A, Vincentiis MD, Attanasio G. Assistance Dogs for Persons with Hearing Impairment: A Review. Int Tinnitus J 2019; 23:26-30. [PMID: 31469524 DOI: 10.5935/0946-5448.20190005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The use of dogs to help people with disabilities has been known for a long time. Assistance dogs carry out a variety of practical tasks for disabled people with appropriate and targeted training, including assisting deaf persons or people with profound hearing loss. The benefits of assistance dogs for persons with hearing impairment (hearing dogs) include a) improved ability to carry out daily tasks through the codified reporting of sounds proper of everyday life and/or of dangerous situations and b) psychosocial aspects such as companionship and sense of protection. The benefits derived from the use of assistance dogs for persons with hearing impairment are less studied compared to those of assistance dogs employed for other disabilities. Moreover, the role of hearing dogs may appear rather controversial considering technological advances in the field of surgical or prosthetic rehabilitation for people with hearing impairment. This article aims to review features and training of hearing dogs, the effects of their employment and legislative aspects for their owners.
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Affiliation(s)
| | - Valeria Belvisi
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - Massimo Ralli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Arianna Di Stadio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Angela Musacchio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Antonio Greco
- Department of Otolaryngology, University of Perugia, Italy
| | - Andrea Gallo
- Department of Otolaryngology, University of Perugia, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | - Giuseppe Attanasio
- Department of ENT Clinic, Umberto I University Hospital of Rome, Rome, Italy
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Belvisi V, Martellucci S, Garbuglia AR, Del Borgo C, Martellucci S, Baiocchini A, Manicone AM, Bagni O, Mastroianni CM, Gallo A. Case report: human papilloma virus type 120-related papillomatosis mimicking laryngeal carcinoma. Infection 2017; 45:709-713. [PMID: 28534319 DOI: 10.1007/s15010-017-1028-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 05/11/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The relationship between human papilloma virus (HPV) and upper respiratory tract pathology was better understood in recent years and represents now an issue of particular interest in carcinogenesis and in immunocompromised host. We describe a case in which a rare genotype HPV-related papillomatosis mimics laryngeal carcinoma in an immunocompromised host. METHODS A 54-year-old woman with a history of HIV-HCV coinfection and anal and laryngeal cancer successfully treated some years before was hospitalized for severe dyspnea, cough and dysphagia. Fiberoptic endoscopic evaluation raised the suspicion of tumor relapse showing the presence of a large glottic-supraglottic ulcerated mass. Several laryngeal biopsies demonstrated koilocytosis and p16 expression, according to a possible HPV infection, and focal figures of mild dysplasia of epithelium. 18 F-FDG PET/CT did not show high glycolytic activity at laryngeal level. An invasive upper respiratory tract papillomatosis in an immunocompromised host was suspected because of the patient's clinical improvement after antiretroviral therapy. CONCLUSION Pharyngeal swab and oral rinse harboured the same HPV120 genotype sequence, a betapapillomavirus of recent description and not yet related to any similar clinical presentations.
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Affiliation(s)
- Valeria Belvisi
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Via Giulio Cesare 41\B, 04100, Latina, Italy.
| | - Salvatore Martellucci
- Department of Surgical Biotechnologies and Sciences, ENT Section, "Sapienza" University of Rome, Latina, Italy
| | | | - Cosmo Del Borgo
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Via Giulio Cesare 41\B, 04100, Latina, Italy
| | - Stanislao Martellucci
- Department of Surgical Biotechnologies and Sciences, ENT Section, "Sapienza" University of Rome, Latina, Italy
| | | | | | - Oreste Bagni
- Department of Nuclear Medicine, "S.M. Goretti" Hospital, Latina, Italy
| | - Claudio Maria Mastroianni
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Via Giulio Cesare 41\B, 04100, Latina, Italy
| | - Andrea Gallo
- Department of Surgical Biotechnologies and Sciences, ENT Section, "Sapienza" University of Rome, Latina, Italy
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Falcone M, Iraci F, Raponi G, Goldoni P, Belvisi V, Delle Rose D, Santino I, Murri R, Fantoni M, Carfagna P, Sanguinetti M, Fontana C, Farcomeni A, Tiseo G, Aceti A, Cauda R, Vullo V, Mastroianni C, Andreoni M, Venditti M. Nursing home residence is associated with spread of Clostridium difficile ribotype 027 in central Italy. J Hosp Infect 2016; 94:201-3. [DOI: 10.1016/j.jhin.2016.06.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 12/19/2022]
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Del Borgo C, Maneschi F, Belvisi V, Morelli F, Vetica A, Marocco R, Tieghi T, Lichtner M, Mastroianni CM. Postpartum fever in the presence of a fibroid: Sphingomonas paucimobilis sepsis associated with pyomyoma. BMC Infect Dis 2013; 13:574. [PMID: 24308831 PMCID: PMC4029743 DOI: 10.1186/1471-2334-13-574] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 12/02/2013] [Indexed: 11/20/2022] Open
Abstract
Background Pyomyoma is a life-threatening complication of uterine leiomyoma. It may occur in post- menopausal women, during pregnancy and in the postpartum period. Fever may be the only manifestation during the early stages of the disease. We detail the first reported case of postpartum pyomyoma-related sepsis due to Sphingomonas paucimobilis, a Gram-negative bacillus that is gaining recognition as an important human pathogen. Case presentation A woman presented with an asymptomatic uterine fibroid and a two-week history of fever during the postpartum period. Suppurative uterine leiomyoma was diagnosed, and blood cultures grew Sphingomonas paucimobilis. The myoma was surgically removed from the uterus without hysterectomy. Intravenous antimicrobial therapy was given for fifteen days, and the patient was discharged from hospital in good condition. Conclusion Pyomyoma should be considered in broad differential diagnosis of postpartum fever. This case highlights a unique disease manifestation of S. paucimobilis, an emerging opportunistic pathogen with increasing significance in the nosocomial setting.
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Affiliation(s)
- Cosmo Del Borgo
- Infectious Disease Unit, Fondazione Eleonora Lorillard Spencer Cenci, Sapienza University, Corso Della Repubblica 79, 04100 Latina, Italy.
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Belvisi V, Del Borgo C, Morelli F, Marocco R, Tieghi T, Fabietti P, Vetica A, Lichtner M, Mastroianni C. Late onset invasive pneumococcal disease in a liver transplanted patient: beyond the Austrian syndrome. Transpl Infect Dis 2013; 15:E111-4. [DOI: 10.1111/tid.12083] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 12/08/2012] [Accepted: 01/16/2013] [Indexed: 01/02/2023]
Affiliation(s)
- V. Belvisi
- Infectious Disease Unit; SM Goretti Hospital; Fondazione Eleonora Lorillard Spencer Cenci; Sapienza University; Latina; Italy
| | - C. Del Borgo
- Infectious Disease Unit; SM Goretti Hospital; Fondazione Eleonora Lorillard Spencer Cenci; Sapienza University; Latina; Italy
| | - F. Morelli
- Infectious Disease Unit; SM Goretti Hospital; Fondazione Eleonora Lorillard Spencer Cenci; Sapienza University; Latina; Italy
| | - R. Marocco
- Infectious Disease Unit; SM Goretti Hospital; Fondazione Eleonora Lorillard Spencer Cenci; Sapienza University; Latina; Italy
| | - T. Tieghi
- Infectious Disease Unit; SM Goretti Hospital; Fondazione Eleonora Lorillard Spencer Cenci; Sapienza University; Latina; Italy
| | - P. Fabietti
- Infectious Disease Unit; SM Goretti Hospital; Fondazione Eleonora Lorillard Spencer Cenci; Sapienza University; Latina; Italy
| | - A. Vetica
- Infectious Disease Unit; SM Goretti Hospital; Fondazione Eleonora Lorillard Spencer Cenci; Sapienza University; Latina; Italy
| | - M. Lichtner
- Infectious Disease Unit; SM Goretti Hospital; Fondazione Eleonora Lorillard Spencer Cenci; Sapienza University; Latina; Italy
| | - C.M. Mastroianni
- Infectious Disease Unit; SM Goretti Hospital; Fondazione Eleonora Lorillard Spencer Cenci; Sapienza University; Latina; Italy
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Mastroianni CM, Citton R, Del Borgo C, Belvisi V. Pandemic influenza H1N1, legionellosis, splenic rupture, and vascular thrombosis: A dangerous cocktail. J Postgrad Med 2012; 58:228-9. [DOI: 10.4103/0022-3859.101652] [Citation(s) in RCA: 3] [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: 11/04/2022] Open
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Gramegna P, Latronico T, Branà MT, Di Bari G, Mengoni F, Belvisi V, Mascellino MT, Lichtner M, Vullo V, Mastroianni CM, Liuzzi GM. In vitro downregulation of matrix metalloproteinase-9 in rat glial cells by CCR5 antagonist maraviroc: therapeutic implication for HIV brain infection. PLoS One 2011; 6:e28499. [PMID: 22174822 PMCID: PMC3234279 DOI: 10.1371/journal.pone.0028499] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 11/09/2011] [Indexed: 11/18/2022] Open
Abstract
Background Matrix metalloproteinases (MMPs) released by glial cells are important mediators of neuroinflammation and neurologic damage in HIV infection. The use of antiretroviral drugs able to combat the detrimental effect of chronic inflammation and target the exaggerated MMP activity might represent an attractive therapeutic challenge. Recent studies suggest that CCR5 antagonist maraviroc (MVC) exerts immunomodulant and anti-inflammatory activity beyond its anti-HIV properties. We investigated the in vitro effect of MVC on the activity of MMPs in astrocyte and microglia cultures. Methodology/Principal Findings Primary cultures of rat astrocytes and microglia were activated by exposure to phorbol myristate acetate (PMA) or lypopolysaccharide (LPS) and treated in vitro with MVC. Culture supernatants were subjected to gelatin zymography and quantitative determination of MMP-9 and MMP-2 was done by computerized scanning densitometry. MMP-9 levels were significantly elevated in culture supernatants from both LPS- and PMA-activated astrocytes and microglia in comparison to controls. The treatment with MVC significantly inhibited in a dose-dependent manner the levels and expression of MMP-9 in PMA-activated astrocytes (p<0,05) and, to a lesser extent, in PMA-activated microglia. By contrast, levels of MMP-2 did not significantly change, although a tendency to decrease was seen in PMA-activated astrocytes after treatment with MVC. The inhibition of levels and expression of MMP-9 in PMA-activated glial cells did not depend on cytotoxic effects of MVC. No inhibition of MMP-9 and MMP-2 were found in both LPS-activated astrocytes and microglia. Conclusions The present in vitro study suggests that CCR5 antagonist compounds, through their ability to inhibit MMP-9 expression and levels, might have a great potential for the treatment of HIV-associated neurologic damage.
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Affiliation(s)
- Pasqua Gramegna
- Department of Biochemistry and Molecular Biology, University of Bari, Bari, Italy
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Rago A, Ridola L, Lichtner M, Mecarocci S, Marocco R, Cenfra N, Belvisi V, Mastroianni CM, Cimino G. Hepatitis B reactivation despite entecavir prophylaxis in a patient with chronic lymphocytic leukaemia receiving bendamustine. J Antimicrob Chemother 2011; 67:510-1. [PMID: 22110085 DOI: 10.1093/jac/dkr486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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12
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Lichtner M, Mastroianni CM, Rossi R, Russo G, Belvisi V, Marocco R, Mascia C, Del Borgo C, Mengoni F, Sauzullo I, d'Ettorre G, D'Agostino C, Massetti AP, Vullo V. Severe and persistent depletion of circulating plasmacytoid dendritic cells in patients with 2009 pandemic H1N1 infection. PLoS One 2011; 6:e19872. [PMID: 21625541 PMCID: PMC3098245 DOI: 10.1371/journal.pone.0019872] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Accepted: 04/06/2011] [Indexed: 11/25/2022] Open
Abstract
Background Dysregulation of host immune responses plays a critical role in the pathogenesis of severe 2009 pandemic H1N1 infection. Whether H1N1 virus could escape innate immune defense in vivo remains to be investigated. The aim of this study was to evaluate the pattern of innate immune response during human 2009 H1N1 infection. We performed the enumeration of circulating myeloid dendritic cells (mDC) and plasmacytoid DC (pDC) in blood from patients with H1N1 pneumonia shortly after the onset of symptoms and during follow-up at different intervals of time. The analysis of CD4 and CD8 count, CD38 T-cell activation marker and serum cytokine/chemokine plasma levels was also done. Methodology/Principal Findings Blood samples were collected from 13 hospitalized patients with confirmed H1N1-related pneumonia at time of admission and at weeks 1, 4, and 16 of follow-up. 13 healthy donors were enrolled as controls. In the acute phase of the disease, H1N1-infected patients exhibited a significant depletion in both circulating pDC and mDC in conjunction with a decrease of CD4 and CD8 T cell count. In addition, we found plasmatic hyperproduction of IP-10 and RANTES, whereas increase in T-cell immune activation was found at all time points. When we assessed the changes in DC count over time, we observed a progressive normalization of mDC number. On the contrary, H1N1-infected patients did not achieve a complete recovery of pDC count as values remained lower than healthy controls even after 16 weeks of follow-up. Conclusions H1N1 disease is associated with a profound depletion of DC subsets. The persistence of pDC deficit for several weeks after disease recovery could be due to H1N1 virus itself or to a preexisting impairment of innate immunity.
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Affiliation(s)
- Miriam Lichtner
- Infectious Diseases Unit, “Sapienza” University, Polo Pontino, SM Goretti Hospital, Latina, Italy
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci-Bolognetti, “Sapienza” University, Rome, Italy
| | - Claudio M. Mastroianni
- Infectious Diseases Unit, “Sapienza” University, Polo Pontino, SM Goretti Hospital, Latina, Italy
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci-Bolognetti, “Sapienza” University, Rome, Italy
- * E-mail:
| | - Raffaella Rossi
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci-Bolognetti, “Sapienza” University, Rome, Italy
| | - Gianluca Russo
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci-Bolognetti, “Sapienza” University, Rome, Italy
| | - Valeria Belvisi
- Infectious Diseases Unit, “Sapienza” University, Polo Pontino, SM Goretti Hospital, Latina, Italy
| | - Raffaella Marocco
- Infectious Diseases Unit, “Sapienza” University, Polo Pontino, SM Goretti Hospital, Latina, Italy
| | - Claudia Mascia
- Infectious Diseases Unit, “Sapienza” University, Polo Pontino, SM Goretti Hospital, Latina, Italy
| | - Cosmo Del Borgo
- Infectious Diseases Unit, “Sapienza” University, Polo Pontino, SM Goretti Hospital, Latina, Italy
| | - Fabio Mengoni
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci-Bolognetti, “Sapienza” University, Rome, Italy
| | - Ilaria Sauzullo
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci-Bolognetti, “Sapienza” University, Rome, Italy
| | - Gabriella d'Ettorre
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci-Bolognetti, “Sapienza” University, Rome, Italy
| | - Claudia D'Agostino
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci-Bolognetti, “Sapienza” University, Rome, Italy
| | - Anna P. Massetti
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci-Bolognetti, “Sapienza” University, Rome, Italy
| | - Vincenzo Vullo
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci-Bolognetti, “Sapienza” University, Rome, Italy
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Rago A, Lichtner M, Mecarocci S, Marocco R, Cenfra N, Belvisi V, Del Borgo C, Cimino G, Mastroianni CM. Antiviral treatment including entecavir plus tenofovir disoproxil fumarate for HBV reactivation following a rituximab-based regimen. Antivir Ther 2010; 15:929-32. [PMID: 20834107 DOI: 10.3851/imp1633] [Citation(s) in RCA: 17] [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: 12/13/2022]
Abstract
Entecavir and tenofovir disoproxil fumarate are potent and effective antiviral drugs that now represent recommended treatment options for chronic HBV infection. However, no or very limited clinical evidence is currently available on these drugs for the management of HBV reactivation in patients with haematological malignancies. Herein, we report a case of HBV reactivation in a patient with non-Hodgkin's lymphoma following a rituximab-based regimen, and who was successfully treated with a combination antiviral treatment including entecavir and tenofovir disoproxil fumarate.
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Affiliation(s)
- Angela Rago
- Sapienza University, Polo Pontino, Latina, Italy
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14
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Del Borgo C, Gianfreda R, Belvisi V, Citton R, Soscia F, Notarianni E, Tieghi T, Mastroianni CM. Pulmonary embolism and acute cytomegalovirus infection in an immunocompetent patient. Infez Med 2010; 18:270-272. [PMID: 21196823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A case of an immunocompetent man with acute CMV infection associated with a pulmonary embolism is described. Acute CMV infection could be a risk factor for developing thromboembolism. Pulmonary embolism should be included in differential diagnosis in patients with acute CMV infections and pulmonary opacities.
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15
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Del Borgo C, Urigo C, Marocco R, Belvisi V, Pisani L, Citton R, Cianni R, Soscia F, Lichtner M, Mastroianni CM. Diagnostic and therapeutic approach in a rare case of primary bilateral adrenal tuberculosis. J Med Microbiol 2010; 59:1527-1529. [PMID: 20798213 DOI: 10.1099/jmm.0.020461-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Here, we report a case of a febrile patient with primary bilateral adrenalitis who was successfully treated with an antituberculous regimen. Primary isolated tubercular adrenalitis is a very rare clinical entity but it should be considered in cases of fever and enlargement of the adrenal glands. Integration of radiological pattern data with epidemiological, clinical and immunological data has high accuracy and specificity, even without histological examination.
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Affiliation(s)
- Cosmo Del Borgo
- Infectious Diseases, Santa Maria Goretti Hospital, Latina, Italy
| | - Carlo Urigo
- Radiology Department, Santa Maria Goretti Hospital, Latina, Italy
| | - Raffaella Marocco
- Infectious Diseases Unit, Sapienza University, Polo Pontino, Latina, Italy
| | - Valeria Belvisi
- Infectious Diseases Unit, Sapienza University, Polo Pontino, Latina, Italy
| | - Luisa Pisani
- Radiology Department, Santa Maria Goretti Hospital, Latina, Italy
| | - Rita Citton
- Infectious Diseases, Santa Maria Goretti Hospital, Latina, Italy
| | - Roberto Cianni
- Radiology Department, Santa Maria Goretti Hospital, Latina, Italy
| | - Fabrizio Soscia
- Infectious Diseases, Santa Maria Goretti Hospital, Latina, Italy
| | - Miriam Lichtner
- Infectious Diseases Unit, Sapienza University, Polo Pontino, Latina, Italy
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Marocco R, Martini H, Belvisi V, Tieghi T, Cesareo R, Del Borgo C, Lichtner M, Mastroianni CM. Quantitative ultrasound (QUS) in HIV-infected patients: a reliable and low-cost technique for bone health assessment. J Int AIDS Soc 2010. [PMCID: PMC3113106 DOI: 10.1186/1758-2652-13-s4-p98] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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17
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Belvisi V, Fabietti P, Del Borgo C, Marocco R, DI Vincenzo E, Soscia F, Mastroianni CM. Successful treatment of Stenotrophomonas maltophilia soft tissue infection with tigecycline: a case report. J Chemother 2009; 21:367-8. [PMID: 19567363 DOI: 10.1179/joc.2009.21.3.367] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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18
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Sauzullo I, Belvisi V, Chiarini F, Lichtner M, Mastroianni CM, Mengoni F, Rossi R, Vullo V. CXCL10/IP10 is a novel potential in vitro marker of TB infection. Microbiol Med 2009. [DOI: 10.4081/mm.2009.2535] [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: 11/23/2022] Open
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