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Lax A, Nicolini A, DE Chiara F, Diaz DE Teran T, Gonzalez M, Ferraioli G, Compalati E, Fagetti L, Banfi P, Solidoro P. Prevalence of airflow obstruction in an apparently healthy population sample: a preliminary Italian study. Panminerva Med 2023; 65:402-404. [PMID: 37021979 DOI: 10.23736/s0031-0808.23.04852-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Affiliation(s)
- Agata Lax
- Unit of Respiratory Rehabilitation, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Antonello Nicolini
- Unit of Respiratory Rehabilitation, Fondazione Don Carlo Gnocchi, Milan, Italy -
| | | | - Teresa Diaz DE Teran
- Unit of Sleep and Ventilation, Department of Pneumology, Marqués de Valdecilla University Hospital, Cantabria University, Santander, Spain
| | - Monica Gonzalez
- Unit of Sleep and Ventilation, Department of Pneumology, Marqués de Valdecilla University Hospital, Cantabria University, Santander, Spain
| | - Gianluca Ferraioli
- Unit of Respiratory Diseases, Hospital of Sestri Levante, Sestri Levante, Genoa, Italy
| | - Elena Compalati
- Unit of Respiratory Rehabilitation, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Laura Fagetti
- Unit of Respiratory Rehabilitation, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Paolo Banfi
- Unit of Respiratory Rehabilitation, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Paolo Solidoro
- Unit of Pneumology, Department of Cardiovascular and Thoracic, Molinette Hospital, Città della Salute e della Scienza, University of Turin, Turin, Italy
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Volpi V, Volpato E, Compalati E, Pierucci P, Nicolini A, Lax A, Fagetti L, Annunziata A, Cauteruccio R, Fiorentino G, Banfi P. Is Intermittent Abdominal Pressure Ventilation Still Relevant? A Multicenter Retrospective Pilot Study. J Clin Med 2023; 12:jcm12072453. [PMID: 37048537 PMCID: PMC10095348 DOI: 10.3390/jcm12072453] [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: 01/25/2023] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 04/14/2023] Open
Abstract
Non-invasive ventilatory support (NVS) is a technique used to reduce respiratory work in neuromuscular diseases, preventing the progression of respiratory failure. NVS is usually administered via a nasal or an oronasal mask, causing discomfort, especially in patients ventilated for more than 16 h/day. Intermittent abdominal pressure ventilation (IAPV) differs completely from conventional NVS and consists of a portable ventilator and a corset with Velcro closures as the interface. In our study, the practicability and efficacy of IAPV were studied in three Italian centers monitoring 28 neuromuscular patients using IAPV who were then retrospectively analyzed. The primary outcomes were an improvement in hypoxemia and the normalization of hypercapnia, and the secondary outcome was an improvement in quality of life. Data were collected at baseline (T0) and after two hours of ventilation (T1), with follow-ups at three months (T2) and six months (T3). Statistical significance was found for PaCO2 over time (F (2.42) = 7.63, p = 0.001) and PaO2 (W = 0.539, p = 0.033). The time of NVS usage also significantly affected the quality of life (F (2.14) = 6.90, p = 0.010), as seen when comparing T0 and T3. As an alternative ventilation method, IAPV is still relevant today and could become a key part of daytime support, especially for patients who do not tolerate standard daytime NVS with an oral interface.
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Affiliation(s)
- Valeria Volpi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Eleonora Volpato
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
| | - Elena Compalati
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Paola Pierucci
- Cardiothoracic Department, Respiratory and Critical Care Unit, Bari Policlinic University Hospital, 70121 Bari, Italy
- Section of Respiratory Diseases, Department of Basic Medical Science Neuroscience and Sense Organs, University of Bari 'Aldo Moro', 70122 Bari, Italy
| | | | - Agata Lax
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Laura Fagetti
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Anna Annunziata
- Department of Respiratory Pathophysiology and Rehabilitation Monaldi-A.O. Dei Colli, 80131 Naples, Italy
| | - Rosa Cauteruccio
- Department of Intensive Care, Azienda Ospedaliera di Rilievo Nazionale dei Colli, 80131 Naples, Italy
| | - Giuseppe Fiorentino
- Department of Respiratory Pathophysiology and Rehabilitation Monaldi-A.O. Dei Colli, 80131 Naples, Italy
| | - Paolo Banfi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
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Saresella M, Trabattoni D, Marventano I, Piancone F, La Rosa F, Caronni A, Lax A, Bianchi L, Banfi P, Navarro J, Bolognesi E, Zanzottera M, Guerini FR, Clerici M. NK Cell Subpopulations and Receptor Expression in Recovering SARS-CoV-2 Infection. Mol Neurobiol 2021; 58:6111-6120. [PMID: 34453271 PMCID: PMC8397607 DOI: 10.1007/s12035-021-02517-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/03/2021] [Indexed: 01/15/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the pandemic of coronavirus disease (COVID-19). Whereas in most cases COVID-19 is asymptomatic or pauci-symptomatic, extremely severe clinical forms are observed. In this case, complex immune dysregulations and an excessive inflammatory response are reported and are the main cause of morbidity and mortality. Natural killer cells are key players in the control of viral infection, and their activity is regulated by a tight balance between activating and inhibitory receptors; an alteration of NK activity was suggested to be associated with the development of severe forms of COVID-19. In this study, we analyzed peripheral NK cell subpopulations and the expression of activating and inhibitory receptors in 30 patients suffering from neurological conditions who recovered from mild, moderate, or severe SARS-CoV-2 infection, comparing the results to those of 10 SARS-CoV-2-uninfected patients. Results showed that an expansion of NK subset with lower cytolytic activity and an augmented expression of the 2DL1 inhibitory receptor, particularly when in association with the C2 ligand (KIR2DL1-C2), characterized the immunological scenario of severe COVID-19 infection. An increase of NK expressing the ILT2 inhibitory receptor was instead seen in patients recovering from mild or moderate infection compared to controls. Results herein suggest that the KIR2DL1-C2 NK inhibitory complex is a risk factor toward the development of severe form of COVID-19. Our results confirm that a complex alteration of NK activity is present in COVID-19 infection and offer a molecular explanation for this observation.
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Affiliation(s)
- Marina Saresella
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy.
| | - Daria Trabattoni
- Department of Biomedical and Clinical Sciences "L. Sacco,", University of Milan, Milan, Italy
| | - Ivana Marventano
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy
| | - Federica Piancone
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy
| | - Francesca La Rosa
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy
| | - Antonio Caronni
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy
| | - Agata Lax
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy
| | - Luca Bianchi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy
| | - Paolo Banfi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy
| | - Jorge Navarro
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy
| | - Elisabetta Bolognesi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy
| | - Milena Zanzottera
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy
| | - Franca Rosa Guerini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy
| | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro, 66, 20148, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Carlomagno C, Bertazioli D, Gualerzi A, Picciolini S, Banfi PI, Lax A, Messina E, Navarro J, Bianchi L, Caronni A, Marenco F, Monteleone S, Arienti C, Bedoni M. COVID-19 salivary Raman fingerprint: innovative approach for the detection of current and past SARS-CoV-2 infections. Sci Rep 2021; 11:4943. [PMID: 33654146 PMCID: PMC7925543 DOI: 10.1038/s41598-021-84565-3] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/15/2021] [Indexed: 12/20/2022] Open
Abstract
The pandemic of COVID-19 is continuously spreading, becoming a worldwide emergency. Early and fast identification of subjects with a current or past infection must be achieved to slow down the epidemiological widening. Here we report a Raman-based approach for the analysis of saliva, able to significantly discriminate the signal of patients with a current infection by COVID-19 from healthy subjects and/or subjects with a past infection. Our results demonstrated the differences in saliva biochemical composition of the three experimental groups, with modifications grouped in specific attributable spectral regions. The Raman-based classification model was able to discriminate the signal collected from COVID-19 patients with accuracy, precision, sensitivity and specificity of more than 95%. In order to translate this discrimination from the signal-level to the patient-level, we developed a Deep Learning model obtaining accuracy in the range 89-92%. These findings have implications for the creation of a potential Raman-based diagnostic tool, using saliva as minimal invasive and highly informative biofluid, demonstrating the efficacy of the classification model.
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Affiliation(s)
- C Carlomagno
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy.
| | - D Bertazioli
- Università di Milano-Bicocca, Viale Sarca 366, 20126, Milan, Italy
| | - A Gualerzi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - S Picciolini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - P I Banfi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - A Lax
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - E Messina
- Università di Milano-Bicocca, Viale Sarca 366, 20126, Milan, Italy
| | - J Navarro
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - L Bianchi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - A Caronni
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - F Marenco
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - S Monteleone
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - C Arienti
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy
| | - M Bedoni
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148, Milan, Italy.
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Vazquez Andres D, Hernandez Vicente A, Diez Diez M, Gomez Molina M, Quintas A, Vazquez E, Dopazo A, Asensio Lopez M, Lax A, Sanchez Perez M, Fer E, De La Barrera J, Sanchez Cabo F, Fuster J, Pascual Figal D. Prevalence and prognostic impact of somatic mutations in patients with heart failure and reduced ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Somatic mutations in hematopoietic cells are associated with age and have been associated with higher mortality in apparently healthy adults, especially due to atherosclerotic disease. In animal models, somatic mutations are associated with atherosclerosis progression and myocardial dysfunction, especially when gene TET2 is affected. Preliminary clinical data, referred to ischemic heart failure (HF), have associate the presence of these acquired mutations with impaired prognosis.
Purpose
To study the prevalence of somatic mutations in patients with heart failure with reduced ejection fraction (HFrEF) and their impact on long-term prognosis.
Methods
We studied a cohort of elderly patients (more than 60 years old) hospitalized with HFrEF (LVEF<45%). The presence of somatic mutations was assessed using next generation sequencing (Illumina HiSeq 2500), with a mutated allelic fraction of at least 2% and a panel of 55 genes related with clonal hematopoiesis. Patients were followed-up for a median of three years. The study endpoint was a composite of death or readmission for worsening HF. Kaplan-Meier analysis (log-rank test) and Cox proportional hazards regression models were performed adjusting for age, sex and LVEF.
Results
A total of 62 patients (46 males (74.2%), age 74±7.5 years) with HFrEF (LVEF 29.7±7.8%) were enrolled in the study. The ischemic etiology was present in 54% of patients. Somatic mutations in Dnmt3a or Tet2 were present in 11 patients (17.7%). No differences existed in baseline characteristics except for a higher prevalence of atrial fibrillation in patients with somatic mutations (70% vs. 40%, p=0.007). During the follow-up period, 40 patients (64.5%) died and 38 (61.3%) had HF re-admission. The KM survival analysis for the combined event is shown in Figure 1. Compared with patients without somatic mutations and after adjusting for covariates, there was an increased risk of adverse outcomes when the somatic mutations were present (HR 3.6, 95% CI [1.6, 7.8], p=0.0014). This results remains considering death as a competing risk (Gray's test p=0.0097) and adjusting for covariates (HR = 2.21 95% CI [0.98, 5], p=0.0556).
Conclusions
Somatic mutation are present in patients with HFrEF and determine a higher risk of adverse events in the follow-up. Further studies are needed to assess the clinical implications of these findings.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | - M Diez Diez
- National Centre for Cardiovascular Research (CNIC), Madrid, Spain
| | - M Gomez Molina
- University Hospital Clinic Virgen de la Arrixaca, Murcia, Spain
| | - A Quintas
- National Centre for Cardiovascular Research (CNIC), Madrid, Spain
| | - E Vazquez
- National Centre for Cardiovascular Research (CNIC), Madrid, Spain
| | - A Dopazo
- National Centre for Cardiovascular Research (CNIC), Madrid, Spain
| | | | - A Lax
- University Hospital Clinic Virgen de la Arrixaca, Murcia, Spain
| | | | - E Fer
- University Hospital Clinic Virgen de la Arrixaca, Murcia, Spain
| | - J De La Barrera
- National Centre for Cardiovascular Research (CNIC), Madrid, Spain
| | - F Sanchez Cabo
- National Centre for Cardiovascular Research (CNIC), Madrid, Spain
| | - J.J Fuster
- National Centre for Cardiovascular Research (CNIC), Madrid, Spain
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Banfi P, Pierucci P, Volpato E, Nicolini A, Lax A, Robert D, Bach J. Daytime noninvasive ventilatory support for patients with ventilatory pump failure: a narrative review. Multidiscip Respir Med 2019; 14:38. [PMID: 31798866 PMCID: PMC6884796 DOI: 10.1186/s40248-019-0202-7] [Citation(s) in RCA: 10] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/31/2019] [Indexed: 12/12/2022] Open
Abstract
Over the past three decades, the use of noninvasive ventilation or "NIV" to assuage symptoms of hypoventilation for patients with early onset or mild ventilatory pump failure has been extended to up to the use of continuous noninvasive ventilatory support (CNVS) at full ventilatory support settings as a definitive alternative to tracheostomy mechanical ventilation. NVS, along with mechanical insufflation-exsufflation, now provides a noninvasive option for the management of both chronic and acute respiratory failure for these patients. The most common diagnoses for which these methods are useful include chest wall deformities, neuromuscular diseases, morbid obesity, high level spinal cord injury and idiopathic, primary or secondary disorders of the ventilatory control. Thus, NVS is being used in diverse settings: critical care units, medical wards, at home, and in extended care. The aim of this review is to examine the techniques used for daytime support.
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Affiliation(s)
- Paolo Banfi
- IRCCS Fondazione Don Carlo Gnocchi, via Capecelatro, 66 20148 Milan, Italy
| | - Paola Pierucci
- Cardio Thoracic Department, Respiratory and Sleep Disorders Unit, Bari Policlinic, Bari, Italy
| | - Eleonora Volpato
- IRCCS Fondazione Don Carlo Gnocchi, via Capecelatro, 66 20148 Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Antonello Nicolini
- Respiratory Rehabilitation Unit, ASL 4 Chiavarese, Hospital of Sestri Levante, Sestri Levante, Italy
| | - Agata Lax
- IRCCS Fondazione Don Carlo Gnocchi, via Capecelatro, 66 20148 Milan, Italy
| | - Dominique Robert
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Réanimation Médicale, Lyon, France
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - John Bach
- Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, USA
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Banfi P, Pierucci P, Volpato E, Nicolini A, Lax A, Robert D, Bach J. Daytime noninvasive ventilatory support for patients with ventilatory pump failure: a narrative review. Multidiscip Respir Med 2019. [DOI: 10.4081/mrm.2019.486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Over the past three decades, the use of noninvasive ventilation or “NIV” to assuage symptoms of hypoventilation for patients with early onset or mild ventilatory pump failure has been extended to up to the use of continuous noninvasive ventilatory support (CNVS) at full ventilatory support settings as a definitive alternative to tracheostomy mechanical ventilation. NVS, along with mechanical insufflation-exsufflation, now provides a noninvasive option for the management of both chronic and acute respiratory failure for these patients. The most common diagnoses for which these methods are useful include chest wall deformities, neuromuscular diseases, morbid obesity, high level spinal cord injury and idiopathic, primary or secondary disorders of the ventilatory control. Thus, NVS is being used in diverse settings: critical care units, medical wards, at home, and in extended care. The aim of this review is to examine the techniques used for daytime support.
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Sferrazza Papa GF, Pellegrino GM, Shaikh H, Lax A, Lorini L, Corbo M. Respiratory muscle testing in amyotrophic lateral sclerosis: a practical approach. Minerva Med 2019; 109:11-19. [PMID: 30642145 DOI: 10.23736/s0026-4806.18.05920-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In amyotrophic lateral sclerosis (ALS), respiratory muscle weakness leads to respiratory failure and death. Non-invasive positive pressure ventilation (NIPPV) appears to reduce lung function decline, thus improving survival and quality-of-life of patients affected by the disease. Unfortunately, clinical features and timing to start NIPPV are not well defined. Starting from recent findings, we examine established and novel tests of respiratory muscle function that could help clinicians decide whether and when to start NIPPV in ALS. Non-invasive tests estimate the function of inspiratory, expiratory, and bulbar muscles, whereas clinical examination allows to assess the overall neurologic and respiratory symptoms and general conditions. Most of the studies recommend that together with a thorough clinical evaluation of the patient according to current guidelines, vital capacity, maximal static and sniff nasal inspiratory pressures, maximal static expiratory pressures and peak cough expiratory flow, and nocturnal pulse oximetry be measured. A sound understanding of physiology can guide the physician also through the current armamentarium for additional supportive treatments for ALS, such as symptomatic drugs and new treatments to manage sialorrhea and thickened saliva, cough assistance, air stacking, and physiotherapy. In conclusion, careful clinical and functional evaluation of respiratory function and patient's preference are key determinants to decide "when" and "to whom" respiratory treatments can be provided.
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Affiliation(s)
- Giuseppe F Sferrazza Papa
- Department of Neurorehabilitation Sciences, Casa di Cura Privata del Policlinico, Milan, Italy - .,Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy -
| | - Giulia M Pellegrino
- Department of Neurorehabilitation Sciences, Casa di Cura Privata del Policlinico, Milan, Italy.,Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Hameeda Shaikh
- Division of Pulmonary and Critical Care Medicine, Loyola University of Chicago Stritch School of Medicine, Maywood, IL, USA.,Edward Hines Jr. Veterans Administration Hospital Hines, Chicago, IL, USA
| | - Agata Lax
- IRCCS Don Carlo Gnocchi Foundation, Milan, Italy
| | - Luca Lorini
- Unit of Neurosurgical Intensive Care, Department of Anesthesia and Critical Care Medicine, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura Privata del Policlinico, Milan, Italy
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9
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Vitacca M, Montini A, Lunetta C, Banfi P, Bertella E, De Mattia E, Lizio A, Volpato E, Lax A, Morini R, Paneroni M. Impact of an early respiratory care programme with non-invasive ventilation adaptation in patients with amyotrophic lateral sclerosis. Eur J Neurol 2018; 25:556-e33. [PMID: 29266547 DOI: 10.1111/ene.13547] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [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: 09/05/2017] [Accepted: 12/04/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Forced vital capacity (FVC) <80% is one of the key indications for starting non-invasive ventilation (NIV) in amyotrophic lateral sclerosis (ALS). It was hypothesized that a very early start of NIV could lengthen the free interval before death compared to later-start NIV; as a secondary outcome, the survival rate of patients on NIV without tracheotomy was also evaluated. METHODS This retrospective study was conducted on 194 ALS patients, divided into a later group (LG) with FVC <80% at NIV prescription (n = 129) and a very early group (VEG) with FVC ≥80% at NIV prescription (n = 65). Clinical and respiratory functional data and time free to death between groups over a 3-year follow-up were compared. RESULT At 36 months from diagnosis, mortality was 35% for the VEG versus 52.7% for the LG (P = 0.022). Kaplan-Meier survival curves adjusted for tracheotomy showed a lower probability of death (P = 0.001) for the VEG as a whole (P = 0.001) and for the non-bulbar (NB) subgroup (P = 0.007). Very early NIV was protective of survival for all patients [hazard ratio (HR) 0.45; 95% confidence interval (CI) 0.28-0.74; P = 0.001] and for the NB subgroup (HR 0.43; 95% CI 0.23-0.79; P = 0.007), whilst a tracheotomy was protective for all patients (HR 0.27; 95% CI 0.15-0.50; P = 0.000) and both NB (HR 0.26; 95% CI 0.12-0.56; P = 0.001) and bulbar subgroups (HR 0.29; 95% CI 0.11-0.77; P = 0.013). Survival in VEG patients on NIV without tracheotomy was three times that for the LG (43.1% vs. 14.7%). CONCLUSION Very early NIV prescription prolongs the free time from diagnosis to death in NB ALS patients whilst tracheotomy reduces the mortality risk in all patients.
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Affiliation(s)
- M Vitacca
- Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - A Montini
- Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - C Lunetta
- NEMO Clinical Centre, Fondazione Serena Onlus, Milano, Italy
| | - P Banfi
- Don Gnocchi Foundation IRCCS - Onlus, Milano, Italy
| | - E Bertella
- Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - E De Mattia
- NEMO Clinical Centre, Fondazione Serena Onlus, Milano, Italy
| | - A Lizio
- NEMO Clinical Centre, Fondazione Serena Onlus, Milano, Italy
| | - E Volpato
- Don Gnocchi Foundation IRCCS - Onlus, Milano, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - A Lax
- Don Gnocchi Foundation IRCCS - Onlus, Milano, Italy
| | - R Morini
- Neurorehabilitation Division, ICS Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - M Paneroni
- Respiratory Rehabilitation Division, ICS Maugeri IRCCS, Lumezzane, Brescia, Italy
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10
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Sánchez-Más J, Saura-Guillén E, Asensio-López MC, Soriano-Filiu Á, Carmen Sánchez-Pérez M, Hernandez-Martinez AM, Lax A, Pascual-Figal D. Temporal characterization of cardiac expression of glucose transporters SGLT and GLUT in an experimental model of myocardial infarction. Diabetes Metab 2017; 45:201-204. [PMID: 29097004 DOI: 10.1016/j.diabet.2017.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/25/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
Affiliation(s)
- J Sánchez-Más
- Departamento de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Moncada, Valencia, Spain
| | - E Saura-Guillén
- Servicio de Endocrinología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - M C Asensio-López
- IMIB-Arrixaca, Facultad de Medicina, Universidad de Murcia, Muricia, Spain
| | - Á Soriano-Filiu
- IMIB-Arrixaca, Facultad de Medicina, Universidad de Murcia, Muricia, Spain
| | | | | | - A Lax
- IMIB-Arrixaca, Facultad de Medicina, Universidad de Murcia, Muricia, Spain.
| | - D Pascual-Figal
- IMIB-Arrixaca, Facultad de Medicina, Universidad de Murcia, Muricia, Spain; Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain; CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.
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11
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Banfi P, Volpato E, Valota C, D'Ascenzo S, Alunno CB, Lax A, Nicolini A, Ticozzi N, Silani V, Bach JR. Use of Noninvasive Ventilation During Feeding Tube Placement. Respir Care 2017; 62:1474-1484. [PMID: 28807987 DOI: 10.4187/respcare.05031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Parenteral nutrition is indicated in amyotrophic lateral sclerosis (ALS) when dysphagia, loss of appetite, and difficulty protecting the airways cause malnutrition, severe weight loss, dehydration, and increased risk of aspiration pneumonia. The aim of this review is to compare percutaneous endoscopic gastrostomy (PEG), radiologically inserted G-tube (RIG), and percutaneous radiologic gastrostomy (PRG) in patients with ALS, performed with or without noninvasive ventilation (NIV). We searched PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the EBSCO Online Research Database, and Scopus up to December 2015. A priori selection included all randomized controlled trials (RCTs), quasi-randomized trials, and prospective and retrospective studies. The primary outcome was 30-d survival. We found no RCTs or quasi-RCTs. Seven studies about the implementation of the PEG/RIG procedure during the use of NIV and 5 studies without NIV were included. In another study of 59 subjects undergoing open gastrostomy, all with vital capacity < 30% of normal, 18 of whom were dependent on continuous NIV at full ventilatory support settings, there were no respiratory complications. Thus, the use of NIV during the implementation of these procedures, especially when used at full ventilatory support settings of pressure preset 18-25 cm H2O, can support alveolar ventilation before, during, and after the procedures and prevent respiratory complications. The procedures investigated appear equivalent, but the methodological quality of the studies could be improved. Possible benefits with regard to nutrition parameters, quality of life, and psychological features need to be further investigated.
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Affiliation(s)
- Paolo Banfi
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
| | - Eleonora Volpato
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Chiara Valota
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | | | - Agata Lax
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Antonello Nicolini
- Respiratory Rehabilitation Unit, ASL 4 Chiavarese, Hospital of Sestri Levante, Italy
| | - Nicola Ticozzi
- Unit of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico and the Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Silani
- Unit of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico and the Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy
| | - John R Bach
- Department of Physical Medicine and Rehabilitation, Rutgers University-New Jersey Medical School, Newark, New Jersey
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12
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Asensio-Lopez MC, Lax A, Sanchez-Mas J, Avellaneda A, Planes J, Pascual-Figal DA. Reformulated meat products protect against ischemia-induced cardiac damage. Food Funct 2016; 7:992-1001. [PMID: 26751429 DOI: 10.1039/c5fo01189b] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The protective effects of the antioxidants present in food are of great relevance for cardiovascular health. This study evaluates whether the extracts from reformulated meat products with a reduction in fat and/or sodium content exert a cardioprotective effect against ischemia-induced oxidative stress in cardiomyocytes, compared with non-meat foods. Ischemic damage caused loss of cell viability, increased reactive oxygen species and lipid peroxidation and decreased the antioxidant activity. Pretreatment for 24 h with digested or non-digested extracts from reformulated meat products led to protection against ischemia-induced oxidative damage: increased cell viability, reduced oxidative stress and restored the antioxidant activity. Similar results were obtained using extracts from tuna fish, but not with the extracts of green peas, salad or white beans. These results suggest that reformulated meat products have a beneficial impact in protecting cardiac cells against ischemia, and they may represent a source of natural antioxidants with benefits for cardiovascular health.
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Affiliation(s)
- M C Asensio-Lopez
- Cardiology Department, University Hospital Virgen de la Arrixaca and Department of Internal Medicine, School of Medicine, University of Murcia, Spain.
| | - A Lax
- Cardiology Department, University Hospital Virgen de la Arrixaca and Department of Internal Medicine, School of Medicine, University of Murcia, Spain.
| | - J Sanchez-Mas
- Cardiology Department, University Hospital Virgen de la Arrixaca and Department of Internal Medicine, School of Medicine, University of Murcia, Spain.
| | - A Avellaneda
- R&D Department, ElPozo Alimentación S.A., Alhama de Murcia, Spain
| | - J Planes
- R&D Department, ElPozo Alimentación S.A., Alhama de Murcia, Spain
| | - D A Pascual-Figal
- Cardiology Department, University Hospital Virgen de la Arrixaca and Department of Internal Medicine, School of Medicine, University of Murcia, Spain.
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13
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Lax A, Colamartino S, Banfi P, Nicolini A. Sleep-related breathing disorders and non-invasive ventilation. Ital J Med 2015. [DOI: 10.4081/itjm.2015.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Non-invasive mechanical ventilation (NPPV) was originally used in patients with acute respiratory impairment or exacerbations of chronic respiratory diseases, as an alternative to the endotracheal tube. Over the last thirty years NPPV has been also used at night in patients with stable chronic lung disease such as obstructive sleep apnea, the overlap syndrome (chronic obstructive pulmonary disease and obstructive sleep apnea), neuromuscular disorders, obesity-hypoventilation syndrome, and in other conditions such as sleep disorders associated with congestive heart failure (Cheyne-Stokes respiration). In this no-systematic review we discuss the different types of NPPV, the specific conditions in which they can be used and the indications, recommendations and evidence supporting the efficacy of NPPV. Optimizing patient acceptance and adherence to non-invasive ventilation treatment is challenging. The treatment of sleep-related disorders is a life-threatening condition. The optimal level of treatment should be determined in a sleep laboratory. Side effects directly affecting the patient’s adherence to treatment are known. The most common are nasopharyngeal symptoms including increased congestion and rhinorrhea; these effects are related to reduced humidity of inspired gas. Humidification of delivered gas may improve these symptoms.
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14
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Castellano F, Lax A, Gamba G, Santambrogio J, Tremolada M, Amidani F, Rossetti A, Capuzzi E, Crocamo C, Nava R, Carrà G, Papagno C, Clerici M. Facial Emotion Recognition and Disorganization in Subjects with Schizophrenia and Alcohol, Substance Use Disorder. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30968-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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15
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Abstract
Sialorrhea or drooling represents quite a common problem in patients with amyotrophic lateral sclerosis (ALS). In this review, we describe the possible treatments for this issue. Current medical management is not always effective: anticholinergic drugs (atropine, glycopyrrolate, amitriptyline, hyoscyamine, and transdermal scopolamine) are often used, but there is very little evidence of their effectiveness in patients with ALS. More invasive treatments, such as botulinum toxin injections and/or radiation therapy in the salivary glands, can be considered when anticholinergic drugs are not effective. In this review, we also explore the possible surgical options for treatment of sialorrhea. Although no specific studies have been conducted on patients with ALS, surgical therapies might represent a valid option for treatment of sialorrhea since there is no tachyphylaxis or need for repeated therapeutic sessions.
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Affiliation(s)
| | - Nicola Ticozzi
- Unit of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy and the Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy
| | - Agata Lax
- Don Carlo Gnocchi Foundation, Milan, Italy
| | - Giulia Andrea Guidugli
- San Giuseppe Hospital, Ospedale Classificato, Istituto di Ricovero e Cura a Carattere Scientifico Multimedica, Milan, Italy
| | | | - Vincenzo Silani
- Unit of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy and the Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy
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16
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Nicolini A, Banfi P, Grecchi B, Lax A, Walterspacher S, Barlascini C, Robert D. Non-invasive ventilation in the treatment of sleep-related breathing disorders: A review and update. Rev Port Pneumol 2014; 20:324-35. [PMID: 24954545 DOI: 10.1016/j.rppneu.2014.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 02/08/2014] [Accepted: 03/29/2014] [Indexed: 12/14/2022] Open
Abstract
Non-invasive mechanical ventilation (NIV) was originally used in patients with acute respiratory compromises or exacerbations of chronic respiratory diseases as an alternative to intubation. Over the last thirty years NIV has been used during the night in patients with stable chronic lung diseases such as obstructive sleep apnea, the overlap syndrome (COPD and obstructive sleep apnea), neuromuscular disorders, obesity-hypoventilation syndrome and in other conditions such as sleep disorders associated with congestive heart failure. In this review we discuss the different types of NIV, the specific conditions in which they can be used as well as the indications, recommendations, and evidence supporting the efficacy of NIV.
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Affiliation(s)
- A Nicolini
- Respiratory Diseases Unit, Hospital of Sestri Levante, Italy.
| | - P Banfi
- Neuromuscular Diseases Unit, Don Gnocchi Foundation, Milan, Italy
| | - B Grecchi
- Rehabilitation Department ASL 4 Chiavarese, Italy
| | - A Lax
- Neuromuscular Diseases Unit, Don Gnocchi Foundation, Milan, Italy
| | - S Walterspacher
- Department of Pulmonology, University Hospital, Freiburg, Germany
| | | | - D Robert
- Emeritus Professor of Medicine, Claude Bernard University Lyon, France
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17
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Sanchez-Mas J, Lax A, Asensio-Lopez MC, Fernandez-Del Palacio MJ, Caballero L, Garrido IP, Pastor F, Januzzi JL, Pascual-Figal DA. Galectin-3 expression in cardiac remodeling after myocardial infarction. Int J Cardiol 2014; 172:e98-e101. [PMID: 24433619 DOI: 10.1016/j.ijcard.2013.12.129] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 12/22/2013] [Indexed: 12/31/2022]
Affiliation(s)
- J Sanchez-Mas
- Cardiology Department, University Hospital Virgen de la Arrixaca, Spain; Department of Internal Medicine, School of Medicine, University of Murcia, Spain.
| | - A Lax
- Cardiology Department, University Hospital Virgen de la Arrixaca, Spain; Department of Internal Medicine, School of Medicine, University of Murcia, Spain
| | - M C Asensio-Lopez
- Cardiology Department, University Hospital Virgen de la Arrixaca, Spain; Department of Internal Medicine, School of Medicine, University of Murcia, Spain
| | - M J Fernandez-Del Palacio
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Surgery, University of Murcia, Murcia, Spain
| | - L Caballero
- Cardiology Department, University Hospital Virgen de la Arrixaca, Spain; Department of Internal Medicine, School of Medicine, University of Murcia, Spain
| | - I P Garrido
- Cardiology Department, University Hospital Virgen de la Arrixaca, Spain; Department of Internal Medicine, School of Medicine, University of Murcia, Spain
| | - F Pastor
- Cardiology Department, University Hospital Virgen de la Arrixaca, Spain; Department of Internal Medicine, School of Medicine, University of Murcia, Spain
| | - J L Januzzi
- Cardiology Division, Massachusetts General Hospital, Boston, MA, United States
| | - D A Pascual-Figal
- Cardiology Department, University Hospital Virgen de la Arrixaca, Spain; Department of Internal Medicine, School of Medicine, University of Murcia, Spain
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18
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Asensio-Lopez MC, Lax A, Pascual-Figal DA, Fernandez-Del Palacio MJ, Santarelli G, Abenza S, Caballero L, Perez-Martinez MT, Valdes-Chavarri M, Sanchez-Mas J. Galectin-3 signaling pathway is modulated by mineralocorticoid receptor antagonists in chronic heart failure. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Pefani E, Panoskaltsis N, Mantalaris A, Georgiadis MC, Pistikopoulos EN, Aguilar-Mahecha A, Lafleur J, Seguin C, Rosenbloom M, Przybytkowski E, Pelmus M, Diaz Z, Batist G, Basik M, Tavernier J, Brunet L, Bazot J, Chemelle M, Dalban C, Guiu S, di Martino C, Lehtio J, Branca M, Johansson H, Orre M, Granholm V, Forshed J, Perez-Bercoff M, Kall L, Nielsen KV, Andresen L, Muller S, Matthiesen S, Schonau A, Oktriani R, Wahyono A, Haryono S, Utomo A, Aryandono T, Diaz Z, Gagnon-Kugler T, Rousseau C, Aguilar-Mahecha A, Alcindor T, Aloyz R, Assouline S, Basik M, Bachvarov D, Belanger L, Camlioglu E, Cartillone M, Chabot B, Christodoulopoulos R, Courtemanche C, Constantin A, Benlimame N, Dao I, Dalfen R, Gosselin L, Habbab F, Hains M, Haliotis T, Nielsen TH, Joncas M, Kavan P, Klink R, Langlaben A, Lebel M, Lesperance B, Mann K, Masson J, Metrakos P, McNamara S, Miller WH, Orain M, Panasci L, Paquet E, Phillie M, Qureshi S, Rodrigue D, Salman A, Spatz A, Tetu B, Tosikyan A, Tsatoumas M, Vuong T, Batist G, Ruijtenbeek R, Houtman R, de Wijn R, Boender P, Hilhorst R, Cohen Y, Onn A, Lax A, Yosepovich A, Litz S, Kalish S, Felemovicius R, Hout-Silony G, Gutman M, Shabtai M, Rosin D, Valeanu A, Winkler E, Sklair-Levy M, Kaufman B, Barshack I, Canu V, Sacconi A, Biagioni F, Mori F, di Benedetto A, Lorenzon L, di Agostino S, Cambria A, Germoni S, Grasso G, Blandino R, Panebianco V, Ziparo V, Federici O, Muti P, Strano S, Carboni F, Mottolese M, Diodoro MG, Pescarmona E, Garofalo A, Blandino G, Ho T, Feng L, Lintula S, Orpana KA, Stenman J, El Messaoudi S, Mouliere F, del Rio M, Guedj AS, Gongora C, Molina FM, Lamy PJ, Lopez-Crapez E, Rolet F, Mathonnet M, Ychou M, Pezet D, Thierry AR, Manuarii M, Tredan O, Bachelot T, Clapisson G, Courtier A, Parmentier G, Rabeony T, Grives A, Perez S, Mouret JF, Perol D, Chabaud S, Ray-Coquard I, Labidi-Galy I, Heudel P, Pierga JY, Caux C, Blay JY, Pasqual N, Menetrier-Caux C. Technology & tools development. Ann Oncol 2012. [DOI: 10.1093/annonc/mds163] [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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21
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Cohen Y, Onn A, Lax A, Yosepovich A, Litz S, Kalish S, Felemovicius R, Hout-Silony G, Gutman M, Shabtai M, Rosin D, Valeanu A, Winkler E, Sklair-Levy M, Kaufman B, Barshack I. P3.09 Sheba Medical Center's Breast Repository. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)31362-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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22
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Lax A. Relationship between coronary atherosclerosis and left ventricular hypertrophy in hypertensive patients undergoing coronary angiography. Am J Hypertens 2000. [DOI: 10.1016/s0895-7061(00)00835-9] [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: 11/24/2022] Open
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23
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24
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Durham PJ, Lax A, Johnson RH. Pathological and virological studies of experimental parvoviral enteritis in calves. Res Vet Sci 1985; 38:209-19. [PMID: 2988093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Calves held in isolation showed a progressive decline in maternally derived antibody titres to bovine parvovirus but low concentrations of inhibitors resistant to heat and kaolin treatment persisted as the animals matured. These inhibitors had both haemagglutination inhibition and plaque neutralising activity and were considered to be of non-specific origin. Following oral challenge with bovine parvovirus, calves developed mild to moderate diarrhoea, with lymphopenia and viraemia. Sequential virological and immunofluorescent studies showed that the virus initially infected tonsils and intestinal tract, subsequently spreading to systemic lymphoid tissues. Histological and scanning electron microscopic examinations revealed moderate small intestinal villus atrophy and fusion due to crypt damage, together with lymphoid necrosis predominantly associated with the intestinal tract and thymus. Although the disease was not very severe, this may have been because the low parasite burden in the animals reduced mitotic activity in susceptible tissues.
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25
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26
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Vajola SF, Romei E, Lax A, Jacovella G. [Effect of single dose administration of a new beta-blockader (pindolol) prior to onset of angina pectoris as evaluated by exercise tests on a bicycle ergometer]. Clin Ter 1980; 92:257-67. [PMID: 7449312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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27
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Lax A, Ceci V, Jacovella G. [Unfavourable effects of the sublingual isosorbide dinitrate. Osbervations on nine personal cases (author's transl)]. G Ital Cardiol 1977; 7:816-17. [PMID: 913938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Nine among our patients have shown some phenomena of intolerance owing to the engagement of the sublingual isosorbide dinitrate. Even if these troubles are comparatively rare (no more than 10% of the cases we have examined), nevertheless we deem it necessary to exhort to some prudence in the administration of this drug, at least for the first time.
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