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Biondi G, Marrano N, Borrelli A, Rella M, D’Oria R, Genchi VA, Caccioppoli C, Cignarelli A, Perrini S, Laviola L, Giorgino F, Natalicchio A. The p66 Shc Redox Protein and the Emerging Complications of Diabetes. Int J Mol Sci 2023; 25:108. [PMID: 38203279 PMCID: PMC10778847 DOI: 10.3390/ijms25010108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
Diabetes mellitus is a chronic metabolic disease, the prevalence of which is constantly increasing worldwide. It is often burdened by disabling comorbidities that reduce the quality and expectancy of life of the affected individuals. The traditional complications of diabetes are generally described as macrovascular complications (e.g., coronary heart disease, peripheral arterial disease, and stroke), and microvascular complications (e.g., diabetic kidney disease, retinopathy, and neuropathy). Recently, due to advances in diabetes management and the increased life expectancy of diabetic patients, a strong correlation between diabetes and other pathological conditions (such as liver diseases, cancer, neurodegenerative diseases, cognitive impairments, and sleep disorders) has emerged. Therefore, these comorbidities have been proposed as emerging complications of diabetes. P66Shc is a redox protein that plays a role in oxidative stress, apoptosis, glucose metabolism, and cellular aging. It can be regulated by various stressful stimuli typical of the diabetic milieu and is involved in various types of organ and tissue damage under diabetic conditions. Although its role in the pathogenesis of diabetes remains controversial, there is strong evidence regarding the involvement of p66Shc in the traditional complications of diabetes. In this review, we will summarize the evidence supporting the role of p66Shc in the pathogenesis of diabetes and its complications, focusing for the first time on the emerging complications of diabetes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Francesco Giorgino
- Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, 70124 Bari, Italy (M.R.); (R.D.); (V.A.G.)
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Palladino R, Balsamo F, Mercogliano M, Sorrentino M, Monzani M, Egidio R, Piscitelli A, Borrelli A, Bifulco G, Triassi M. Impact of SARS-CoV-2 Positivity on Delivery Outcomes for Pregnant Women between 2020 and 2021: A Single-Center Population-Based Analysis. J Clin Med 2023; 12:7709. [PMID: 38137777 PMCID: PMC10744135 DOI: 10.3390/jcm12247709] [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: 11/07/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Despite the existing body of evidence, there is still limited knowledge about the impact of SARS-CoV-2 positivity on delivery outcomes. We aimed to assess the impact of SARS-CoV-2 infection in women who gave birth at the University Hospital "Federico II" of Naples, Italy, between 2020 and 2021. We conducted a retrospective single-center population-based observational study to assess the differences in the caesarean section and preterm labor rates and the length of stay between women who tested positive for SARS-CoV-2 and those who tested negative at the time of labor. We further stratified the analyses considering the time period, dividing them into three-month intervals, and changes in SARS-CoV-2 as the most prevalent variant. The study included 5236 women with 353 positive cases. After vaccination availability, only 4% had undergone a complete vaccination cycle. The Obstetric Comorbidity Index was higher than 0 in 41% of the sample. When compared with negative women, positive ones had 80% increased odds of caesarean section, and it was confirmed by adjusting for the SARS-CoV-2 variant. No significant differences were found in preterm birth risks. The length of stay was 11% higher in positive cases but was not significant after adjusting for the SARS-CoV-2 variant. When considering only positive women in the seventh study period (July-September 2021), they had a 61% decrease in the odds of receiving a caesarean section compared to the fourth (October-December 2020). Guidelines should be implemented to improve the safety and efficiency of the delivery process, considering the transition of SARS-CoV-2 from pandemic to endemic. Furthermore, these guidelines should aim to improve the management of airborne infections in pregnant women.
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Affiliation(s)
- Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
- Department of Primary Care and Public Health, Imperial College School of Public Health, London SW7 2BX, UK
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, 80131 Naples, Italy
| | - Federica Balsamo
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
| | - Michelangelo Mercogliano
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
| | - Michele Sorrentino
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
| | - Marco Monzani
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
| | - Rosanna Egidio
- Clinical Directorate, Academic Hospital “Federico II” of Naples, 80131 Naples, Italy
| | - Antonella Piscitelli
- Azienda Ospedaliera di Rilievo Nazionale (AORN) Dei Colli, Vincenzo Monaldi Hospital, 80122 Naples, Italy
| | - Anna Borrelli
- Clinical Directorate, Academic Hospital “Federico II” of Naples, 80131 Naples, Italy
| | - Giuseppe Bifulco
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, 80131 Naples, Italy
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Di Minno G, Spadarella G, Maldonato NM, De Lucia N, Castaman G, De Cristofaro R, Santoro C, Peyvandi F, Borrelli A, Lupi A, Follino M, Guerrino G, Morisco F, Di Minno M. Awareness of individual goals, preferences, and priorities of persons with severe congenital haemophilia A for a tailored shared decision-making approach to liver-directed gene therapy. A practical guideline. Blood Rev 2023; 62:101118. [PMID: 37544828 DOI: 10.1016/j.blre.2023.101118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/26/2023] [Accepted: 07/30/2023] [Indexed: 08/08/2023]
Abstract
In clinical medicine, shared decision making (SDM) is a well-recognized strategy to enhance engagement of both patients and clinicians in medical decisions. The success of liver-directed gene therapy (GT) to transform severe congenital haemophilia A (HA) from an incurable to a curable disease has launched a shift beyond current standards of treatment. However, GT acceptance remains low in the community of HA persons. We argue for both persons with haemophilia (PWH) and specialists in HA care including clinicians, as needing SDM-oriented educational programs devoted to GT. Here, we provide an ad hoc outline to implement education to SDM and tailor clinician information on GT to individual PWHs. Based on routine key components of SDM: patient priorities; recommendations based on individual risk reduction; adverse effects; drug-drug interactions; alternatives to GT; and ongoing re-assessment of the objectives as risk factors (and individual priorities) change, this approach is finalized to exploit efficacious communication.
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Affiliation(s)
| | - Gaia Spadarella
- Dipartimento di Scienze Mediche Traslazionali, Naples, Italy.
| | - Nelson Mauro Maldonato
- Dipartimento di Neuroscienze e di Scienze Riproduttive e Odontostomatologiche, "Federico II" University, Naples, Italy
| | - Natascia De Lucia
- Dipartimento di Neuroscienze e di Scienze Riproduttive e Odontostomatologiche, "Federico II" University, Naples, Italy.
| | - Giancarlo Castaman
- Center for Bleeding Disorders and Coagulation, Careggi University Hospital, Florence, Italy.
| | - Raimondo De Cristofaro
- Section of Haemorrhagic and Thrombotic Diseases, Department of Medicine and Translational Surgery, Sacred Heart University, Rome, Italy..
| | - Cristina Santoro
- Ematologia, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.
| | - Flora Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy; Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy.
| | - Anna Borrelli
- Direzione Sanitaria, AOU "Federico II" Napoli, Italy
| | - Angelo Lupi
- Federazione delle Associazioni Emofilici (FedEmo), Milan, Italy.
| | | | | | | | - Matteo Di Minno
- Dipartimento di Medicina Clinica e Chirurgia, Naples, Italy.
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4
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Cerruti F, Borrelli A, Degiovanni A, Mengozzi G, Borella F, Cascio P. Detection and biochemical characterization of circulating proteasomes in dog plasma. Res Vet Sci 2023; 162:104950. [PMID: 37453228 DOI: 10.1016/j.rvsc.2023.104950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/22/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
A growing body of evidence convincingly indicates that proteasomes are not located exclusively within cells but also in different extracellular compartments. In humans, in fact, this large multimeric protease has been identified in many body fluids and secretions such as blood, urine, tears, sweat, saliva, milk, and cerebrospinal and pericardial fluid. Intriguingly, the exact origins of these extracellular proteasomes as well as the specific biological functions they perform are largely unknown. As no data on this important subject is yet available in domestic animals, the present study was undertaken to investigate the presence of extracellular proteasomes in canine blood. As a result, for the first time, circulating proteasomes could be clearly detected in the plasma of a cohort of 20 healthy dogs. Furthermore, all three main proteasomal peptidase activities were measured and characterized using fluorogenic peptides and highly specific inhibitors. Finally, the effect of ATP and PA28 family activators on this circulating proteasome was investigated. Collectively, our data indicate that at least a part of the proteasome present in dog plasma consists of a particle that in vitro displays the enzymatic properties of the 20S proteasome.
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Affiliation(s)
- F Cerruti
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini, 2, 10095, Grugliasco, Turin, Italy
| | - A Borrelli
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini, 2, 10095, Grugliasco, Turin, Italy
| | - A Degiovanni
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini, 2, 10095, Grugliasco, Turin, Italy
| | - G Mengozzi
- Department of Public Health and Pediatric Sciences, University of Turin, C.so Bramante, 88/90, 10100 Turin, Italy
| | - F Borella
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini, 2, 10095, Grugliasco, Turin, Italy
| | - P Cascio
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini, 2, 10095, Grugliasco, Turin, Italy.
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Renda M, Barreca M, Borrelli A, Spanò V, Montalbano A, Raimondi MV, Bivacqua R, Musante I, Scudieri P, Guidone D, Buccirossi M, Genovese M, Venturini A, Bandiera T, Barraja P, Galietta LJV. Novel tricyclic pyrrolo-quinolines as pharmacological correctors of the mutant CFTR chloride channel. Sci Rep 2023; 13:7604. [PMID: 37165082 PMCID: PMC10172366 DOI: 10.1038/s41598-023-34440-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 04/29/2023] [Indexed: 05/12/2023] Open
Abstract
F508del, the most frequent mutation in cystic fibrosis (CF), impairs the stability and folding of the CFTR chloride channel, thus resulting in intracellular retention and CFTR degradation. The F508del defect can be targeted with pharmacological correctors, such as VX-809 and VX-445, that stabilize CFTR and improve its trafficking to plasma membrane. Using a functional test to evaluate a panel of chemical compounds, we have identified tricyclic pyrrolo-quinolines as novel F508del correctors with high efficacy on primary airway epithelial cells from CF patients. The most effective compound, PP028, showed synergy when combined with VX-809 and VX-661 but not with VX-445. By testing the ability of correctors to stabilize CFTR fragments of different length, we found that VX-809 is effective on the amino-terminal portion of the protein that includes the first membrane-spanning domain (amino acids 1-387). Instead, PP028 and VX-445 only show a stabilizing effect when the second membrane-spanning domain is included (amino acids 1-1181). Our results indicate that tricyclic pyrrolo-quinolines are a novel class of CFTR correctors that, similarly to VX-445, interact with CFTR at a site different from that of VX-809. Tricyclic pirrolo-quinolines may represent novel CFTR correctors suitable for combinatorial pharmacological treatments to treat the basic defect in CF.
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Affiliation(s)
- Mario Renda
- Telethon Institute of Genetics and Medicine (TIGEM), Via Campi Flegrei 34, 80078, Pozzuoli, NA, Italy
| | - Marilia Barreca
- Department of Biological, Chemical, and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Via Archirafi 32, 90123, Palermo, Italy
| | - Anna Borrelli
- Telethon Institute of Genetics and Medicine (TIGEM), Via Campi Flegrei 34, 80078, Pozzuoli, NA, Italy
| | - Virginia Spanò
- Department of Biological, Chemical, and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Via Archirafi 32, 90123, Palermo, Italy
| | - Alessandra Montalbano
- Department of Biological, Chemical, and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Via Archirafi 32, 90123, Palermo, Italy
| | - Maria Valeria Raimondi
- Department of Biological, Chemical, and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Via Archirafi 32, 90123, Palermo, Italy
| | - Roberta Bivacqua
- Department of Biological, Chemical, and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Via Archirafi 32, 90123, Palermo, Italy
| | - Ilaria Musante
- U.O.C. Genetica Medica, IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy
| | - Paolo Scudieri
- U.O.C. Genetica Medica, IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy
| | - Daniela Guidone
- Telethon Institute of Genetics and Medicine (TIGEM), Via Campi Flegrei 34, 80078, Pozzuoli, NA, Italy
| | - Martina Buccirossi
- Telethon Institute of Genetics and Medicine (TIGEM), Via Campi Flegrei 34, 80078, Pozzuoli, NA, Italy
| | - Michele Genovese
- Telethon Institute of Genetics and Medicine (TIGEM), Via Campi Flegrei 34, 80078, Pozzuoli, NA, Italy
| | - Arianna Venturini
- Telethon Institute of Genetics and Medicine (TIGEM), Via Campi Flegrei 34, 80078, Pozzuoli, NA, Italy
| | - Tiziano Bandiera
- D3 PharmaChemistry, Istituto Italiano di Tecnologia (IIT), Genova, Italy
| | - Paola Barraja
- Department of Biological, Chemical, and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Via Archirafi 32, 90123, Palermo, Italy.
| | - Luis J V Galietta
- Telethon Institute of Genetics and Medicine (TIGEM), Via Campi Flegrei 34, 80078, Pozzuoli, NA, Italy.
- Department of Translational Medical Sciences (DISMET), University of Naples "Federico II", Naples, Italy.
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Charlier B, Coglianese A, De Rosa F, Cozzolino A, Boccia G, Borrelli A, Capunzo M, Genovese G, De Caro F, Filippelli A, Dal Piaz F, Izzo V. A LC-MS/MS based methodology for the environmental monitoring of healthcare settings contaminated with antineoplastic agents. J Public Health Res 2023; 12:22799036231160629. [PMID: 36923326 PMCID: PMC10009035 DOI: 10.1177/22799036231160629] [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: 12/14/2022] [Accepted: 02/13/2023] [Indexed: 03/13/2023] Open
Abstract
Background Adverse health events associated with the exposure of healthcare workers to antineoplastic drugs are well documented in literature and are often related to the chemical contamination of work surfaces. It is therefore crucial for healthcare professionals to validate the efficiency of safety procedures by periodic biological and environmental monitoring activities where the main methodological limitations are related to the complexity, in terms of chemical-physical features and chemical-biological stability, of the drugs analyzed. Materials and methods Here we describe the evaluation and application of a UHPLC-MS/MS based protocol for the environmental monitoring of hospital working areas potentially contaminated with methotrexate, iphosphamide, cyclophosphamide, doxorubicin, irinotecan, and paclitaxel. This methodology was used to evaluate working areas devoted to the preparation of chemotherapeutics and combination regimens at the University Hospital "San Giovanni di Dio e Ruggi d'Aragona" in Salerno (Italy). Results Our analyses allowed to uncover critical aspects in both working protocols and workspace organization, which highlighted, among others, cyclophosphamide and iphosphamide contamination. Suitable adjustments adopted after our environmental monitoring campaign significantly reduced the exposure risk for healthcare workers employed in the unit analyzed. Conclusion The use of sensitive analytical approaches such as LC-MS/MS coupled to an accurate wiping procedure in routine environmental monitoring allows to effectively improve chemical safety for exposed workers.
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Affiliation(s)
- Bruno Charlier
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Campania, Italy.,University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno (SA), Italy.,Graduate School in Clinical Pharmacology and Toxicology, University of Salerno, Baronissi, Campania, Italy
| | - Albino Coglianese
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Campania, Italy.,Graduate School in Clinical Pathology and Clinical Biochemistry, University of Salerno, Baronissi, Campania, Italy
| | - Federica De Rosa
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Campania, Italy.,Graduate School in Clinical Pharmacology and Toxicology, University of Salerno, Baronissi, Campania, Italy
| | - Armando Cozzolino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Campania, Italy.,Graduate School in Clinical Pharmacology and Toxicology, University of Salerno, Baronissi, Campania, Italy
| | - Giovanni Boccia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Campania, Italy.,University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno (SA), Italy
| | - Anna Borrelli
- Medical School and Hospital "Secondo Policlinico," University Federico II of Naples, Italy
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Campania, Italy.,University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno (SA), Italy
| | - Giovanni Genovese
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno (SA), Italy
| | - Francesco De Caro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Campania, Italy.,University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno (SA), Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Campania, Italy.,University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno (SA), Italy
| | - Fabrizio Dal Piaz
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Campania, Italy.,University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno (SA), Italy
| | - Viviana Izzo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Campania, Italy.,University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno (SA), Italy
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7
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Scala A, Borrelli A, Improta G. Predictive analysis of lower limb fractures in the orthopedic complex operative unit using artificial intelligence: the case study of AOU Ruggi. Sci Rep 2022; 12:22153. [PMID: 36550192 PMCID: PMC9780352 DOI: 10.1038/s41598-022-26667-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
The length of stay (LOS) in hospital is one of the main parameters for evaluating the management of a health facility, of its departments in relation to the different specializations. Healthcare costs are in fact closely linked to this parameter as well as the profit margin. In the orthopedic field, the provision of this parameter is increasingly complex and of fundamental importance in order to be able to evaluate the planning of resources, the waiting times for any scheduled interventions and the management of the department and related surgical interventions. The purpose of this work is to predict and evaluate the LOS value using machine learning methods and applying multiple linear regression, starting from clinical data of patients hospitalized with lower limb fractures. The data were collected at the "San Giovanni di Dio e Ruggi d'Aragona" hospital in Salerno (Italy).
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Affiliation(s)
- Arianna Scala
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, University of Naples “Federico II”, Naples, Italy
| | - Anna Borrelli
- San Giovanni di Dio e Ruggi d’Aragona” University Hospital, Salerno, Italy
| | - Giovanni Improta
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, University of Naples “Federico II”, Naples, Italy ,Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
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8
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Genovese M, Guidone D, Buccirossi M, Borrelli A, Rodriguez-Gimeno A, Bertozzi F, Bandiera T, Galietta LJV. Pharmacological potentiators of the calcium signaling cascade identified by high-throughput screening. PNAS Nexus 2022; 2:pgac288. [PMID: 36712939 PMCID: PMC9830948 DOI: 10.1093/pnasnexus/pgac288] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
Pharmacological modulators of the Ca2+ signaling cascade are important research tools and may translate into novel therapeutic strategies for a series of human diseases. We carried out a screening of a maximally diverse chemical library using the Ca2+-sensitive Cl- channel TMEM16A as a functional readout. We found compounds that were able to potentiate UTP-dependent TMEM16A activation. Mechanism of action of these compounds was investigated by a panel of assays that looked at intracellular Ca2+ mobilization triggered by extracellular agonists or by caged-IP3 photolysis, PIP2 breakdown by phospholipase C, and ion channel activity on nuclear membrane. One compound appears as a selective potentiator of inositol triphosphate receptor type 1 (ITPR1) with a possible application for some forms of spinocerebellar ataxia. A second compound is instead a potentiator of the P2RY2 purinergic receptor, an activity that could promote fluid secretion in dry eye and chronic obstructive respiratory diseases.
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Affiliation(s)
- Michele Genovese
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, 80078 Naples, Italy
| | - Daniela Guidone
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, 80078 Naples, Italy
| | - Martina Buccirossi
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, 80078 Naples, Italy
| | - Anna Borrelli
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, 80078 Naples, Italy
| | | | - Fabio Bertozzi
- D3 PharmaChemistry, Italian Institute of Technology (IIT), Via Morego, 3016163, Genoa, Italy
| | - Tiziano Bandiera
- D3 PharmaChemistry, Italian Institute of Technology (IIT), Via Morego, 3016163, Genoa, Italy
| | - Luis J V Galietta
- To whom correspondence should be addressed. Telethon Institute of Genetics and Medicine (TIGEM), Via Campi Flegrei 34, 80078 Pozzuoli (NA), Italy.
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9
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Colella Y, Di Laura D, Borrelli A, Triassi M, Amato F, Improta G. Overcrowding analysis in emergency department through indexes: a single center study. BMC Emerg Med 2022; 22:181. [PMID: 36401158 PMCID: PMC9673888 DOI: 10.1186/s12873-022-00735-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 10/27/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Overcrowding in the Emergency Department (ED) is one of the major issues that must be addressed in order to improve the services provided in emergency circumstances and to optimize their quality. As a result, in order to help the patients and professionals engaged, hospital organizations must implement remedial and preventative measures. Overcrowding has a number of consequences, including inadequate treatment and longer hospital stays; as a result, mortality and the average duration of stay in critical care units both rise. In the literature, a number of indicators have been used to measure ED congestion. EDWIN, NEDOCS and READI scales are considered the most efficient ones, each of which is based on different parameters regarding the patient management in the ED. Methods In this work, EDWIN Index and NEDOCS Index have been calculated every hour for a month period from February 9th to March 9th, 2020 and for a month period from March 10th to April 9th, 2020. The choice of the period is related to the date of the establishment of the lockdown in Italy due to the spread of Coronavirus; in fact on 9 March 2020 the Italian government issued the first decree regarding the urgent provisions in relation to the COVID-19 emergency. Besides, the Pearson correlation coefficient has been used to evaluate how much the EDWIN and NEDOCS indexes are linearly dependent. Results EDWIN index follows a trend consistent with the situation of the first lockdown period in Italy, defined by extreme limitations imposed by Covid-19 pandemic. The 8:00–20:00 time frame was the most congested, with peak values between 8:00 and 12:00. on the contrary, in NEDOCS index doesn’t show a trend similar to the EDWIN one, resulting less reliable. The Pearson correlation coefficient between the two scales is 0,317. Conclusion In this study, the EDWIN Index and the NEDOCS Index were compared and correlated in order to assess their efficacy, applying them to the case study of the Emergency Department of “San Giovanni di Dio e Ruggi d’Aragona” University Hospital during the Covid-19 pandemic. The EDWIN scale turned out to be the most realistic model in relation to the actual crowding of the ED subject of our study. Besides, the two scales didn’t show a significant correlation value.
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Affiliation(s)
- Ylenia Colella
- grid.4691.a0000 0001 0790 385XDepartment of Electrical Engineering and Information Technologies, University of Naples “Federico II”, Naples, Italy
| | - Danilo Di Laura
- grid.4691.a0000 0001 0790 385XDepartment of Electrical Engineering and Information Technologies, University of Naples “Federico II”, Naples, Italy
| | - Anna Borrelli
- “San Giovanni Di Dio E Ruggi d’Aragona” University Hospital, Salerno, Italy
| | - Maria Triassi
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, University of Naples “Federico II”, Naples, Italy ,grid.4691.a0000 0001 0790 385XInterdepartmental center for research in healthcare management and innovation in healthcare (CIRMIS), University of Naples “Federico II”, Naples, Italy
| | - Francesco Amato
- grid.4691.a0000 0001 0790 385XDepartment of Electrical Engineering and Information Technologies, University of Naples “Federico II”, Naples, Italy
| | - Giovanni Improta
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, University of Naples “Federico II”, Naples, Italy ,grid.4691.a0000 0001 0790 385XInterdepartmental center for research in healthcare management and innovation in healthcare (CIRMIS), University of Naples “Federico II”, Naples, Italy
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10
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Crispo A, Rivieccio G, Cataldo L, Coluccia S, Luongo A, Coppola E, Grimaldi M, Montagnese C, Nocerino F, Celentano E, Saviano R, Bastone A, Baglio G, De Angelis C, Ciardiello F, Avallone A, Cassata A, Costanzo R, Morabito A, Maione P, Gridelli C, Cigolari S, Borrelli A, De Placido S, Schiavone F, Bianchi AAM, Pignata S, Aquino A, Bonito C, Buonerba C, Caccavallo F, Carlomagno C, Cavaliere M, Centonze S, Damiano S, De Divitiis C, De Nardo R, Del Deo Vito A, D'Errico D, Esposito G, Esposito L, Famiglietti V, Formisano L, Formisano L, Franzese E, Gaeta V, Gragnano E, Grimaldi R, Iovane G, Lauria R, Migliore G, Mirto M, Napoletano A, Napoli D, Vitale P, Pepe S, Rambaldo MP, Renato M, Rescigno M, Rossi E, Santabarbara G, Stanzione C. New approach to implement cancer patient care: The valutazione percorso rete oncologica campana (ValPeROC)‐experience from an Italian oncology network. Eur J Cancer Care (Engl) 2022; 31:e13736. [PMID: 37039607 DOI: 10.1111/ecc.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The primary goal of the Campania Oncology Network (ROC) was to reduce cancer delay and care fragmentation through the establishment of cancer-specific multidisciplinary oncologic groups (GOMs) and diagnostic and therapeutic assistance paths (PDTAs). METHODS Five cancer centres of the ROC, with their own cancer specific GOM, were selected. In our analysis, we have focused on four neoplasms: lung, colon, ovarian and prostate cancers. The median time for pre-GOM and GOM Times was calculated for each tumour site. Univariate and multivariate logistic regressions were performed to individuate risk factors for pre-GOM and GOM Time. RESULTS Significant differences were observed for prostate cancer compared to other patients either for pre-GOM or GOM Times. Significant risks were found for ovarian and prostate cancers in pre-GOM time and for prostate cancer in GOM-Time. CONCLUSIONS This experience will produce knowledge and data to guide decision-making and to manage more effectively the challenges of fighting cancer in Campania region. The Valutazione Percorso Rete Oncologica Campana (ValPeROC) study evaluates, for the first time, the ROC activity, through the analysis of key performance indices. Pre-GOM and GOM Time represent the quality of the entire regional health system and are useful to define models, which can evaluate the performance of the ROC over time.
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Affiliation(s)
- Anna Crispo
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Giorgia Rivieccio
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Luca Cataldo
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Sergio Coluccia
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Assunta Luongo
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Elisabetta Coppola
- Department of Urology and Gynecology Istituto Nazionale Tumori IRCCS ‘Fondazione G. Pascale’ Naples Italy
| | - Maria Grimaldi
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Concetta Montagnese
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Flavia Nocerino
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Rocco Saviano
- National Cancer Institute IRCCS Pascale Foundation Naples Italy
| | - Anna Bastone
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Giovanni Baglio
- AGENAS ‐ Italian National Agency for Regional Healthcare Services Rome Italy
| | - Carmine De Angelis
- Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Fortunato Ciardiello
- Oncologia Medica, Dipartimento di Medicina di Precisione Università degli Studi della Campania ‘L. Vanvitelli’ Naples Italy
| | - Antonio Avallone
- Experimental Clinical Abdominal Oncology Unit Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Antonino Cassata
- Medical Oncology Unit Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Raffaele Costanzo
- Thoracic Department Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Alessandro Morabito
- Thoracic Department Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Paolo Maione
- Division of Medical Oncology S.G. Moscati Hospital Avellino Italy
| | - Cesare Gridelli
- Division of Medical Oncology S.G. Moscati Hospital Avellino Italy
| | - Silvio Cigolari
- Hospital Health Direction Azienda Ospedaliera Universitaria ‘San Giovanni di Dio e Ruggi d'Aragona’ Salerno Italy
| | - Anna Borrelli
- Hospital Health Direction Azienda Ospedaliera Universitaria ‘San Giovanni di Dio e Ruggi d'Aragona’ Salerno Italy
| | - Sabino De Placido
- Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Francesco Schiavone
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Attilio A. M. Bianchi
- Directorate‐General for Management Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Sandro Pignata
- Department of Urology and Gynecology Istituto Nazionale Tumori IRCCS ‘Fondazione G. Pascale’ Naples Italy
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11
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Silverio A, Cancro FP, Di Maio M, Bellino M, Esposito L, Centore M, Carrizzo A, Di Pietro P, Borrelli A, De Luca G, Vecchione C, Galasso G. Lipoprotein(a) levels and risk of adverse events after myocardial infarction in patients with and without diabetes. J Thromb Thrombolysis 2022; 54:382-392. [PMID: 36125640 PMCID: PMC9553824 DOI: 10.1007/s11239-022-02701-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/21/2022] [Indexed: 11/27/2022]
Abstract
Introduction: The aim of this study was to evaluate the association of lipoprotein(a) [Lp(a)] levels with long-term outcome in patients with recent history of myocardial infarction (MI), and to investigate if diabetes may influence this association. Methods: Consecutive MI patients who underwent urgent/emergent coronary angiography from February 2013 to June 2019 were prospectively collected. The primary outcome was the composite of MI recurrence and all-cause death. The propensity score weighting technique was used to account for covariates potentially influencing the relationship between Lp(a) levels and the study outcomes. Results: The study population consisted of 1018 post-MI patients (median age 63 years). Diabetes was reported in 280 patients (27.5%), who showed lower Lp(a) levels than patients without diabetes (p = 0.026). At a median follow-up of 1121 days, the primary outcome was reported in 182 patients (17.9%). At univariable Cox regression analysis, Lp(a) was associated with the risk of the primary outcome in the overall population and in non-diabetic patients, but not in diabetics. The adjusted Cox regression analysis confirmed the independent association between Lp(a) values and the primary outcome in non-diabetic patients, but not in diabetics. Lp(a) levels > 70 mg/dL were independently associated with the risk of the primary outcome in non-diabetic patients (adjusted HR: 2.839; 95% CI, 1.382–5.832), but not in diabetics. Conclusions: In this real-world post-MI population, increasing Lp(a) levels were significantly associated with the risk of recurrent MI and all-cause death, and very high Lp(a) serum concentration independently predicted long-term outcome in non-diabetic patients, but not in diabetics.
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Affiliation(s)
- Angelo Silverio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy
| | - Francesco Paolo Cancro
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy
| | - Marco Di Maio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy
| | - Michele Bellino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy.
- Department of Medicine, Surgery and Dentistry, University of Salerno, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Largo Città di Ippocrate, 84131, Salerno, Italy.
| | - Luca Esposito
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy
| | - Mario Centore
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy
- Vascular Pathophysiology Unit, IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Paola Di Pietro
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy
| | - Anna Borrelli
- San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Giuseppe De Luca
- Clinical and Experimental Cardiology, AOU Sassari, Sassari, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy
- Vascular Pathophysiology Unit, IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy
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12
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Biondi G, Marrano N, Dipaola L, Borrelli A, Rella M, D'Oria R, Genchi VA, Caccioppoli C, Porreca I, Cignarelli A, Perrini S, Marchetti P, Vincenti L, Laviola L, Giorgino F, Natalicchio A. The p66Shc Protein Mediates Insulin Resistance and Secretory Dysfunction in Pancreatic β-Cells Under Lipotoxic Conditions. Diabetes 2022; 71:1763-1771. [PMID: 35612429 DOI: 10.2337/db21-1066] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/16/2022] [Indexed: 11/13/2022]
Abstract
We evaluated the role of the p66Shc redox adaptor protein in pancreatic β-cell insulin resistance that develops under lipotoxic conditions and with excess body fat. Prolonged exposure to palmitate in vitro or the presence of overweight/obesity augmented p66Shc expression levels and caused an impaired ability of exogenous insulin to increase cellular insulin content and secreted C-peptide levels in INS-1E cells and human and murine islets. In INS-1E cells, p66Shc knockdown resulted in enhanced insulin-induced augmentation of insulin content and C-peptide secretion and prevented the ability of palmitate to impair these effects of insulin. Conversely, p66Shc overexpression impaired insulin-induced augmentation of insulin content and C-peptide secretion in both the absence and presence of palmitate. Under lipotoxic condition, the effects of p66Shc are mediated by a p53-induced increase in p66Shc protein levels and JNK-induced p66Shc phosphorylation at Ser36 and appear to involve the phosphorylation of the ribosomal protein S6 kinase at Thr389 and of insulin receptor substrate 1 at Ser307, resulting in the inhibition of insulin-stimulated protein kinase B phosphorylation at Ser473. Thus, the p66Shc protein mediates the impaired β-cell function and insulin resistance induced by saturated fatty acids and excess body fat.
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Affiliation(s)
- Giuseppina Biondi
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Nicola Marrano
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Lucia Dipaola
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Anna Borrelli
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Martina Rella
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Rossella D'Oria
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Valentina A Genchi
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Cristina Caccioppoli
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Immacolata Porreca
- Genetic Research Centre "Gaetano Salvatore" BioGeM, Ariano Irpino, Italy
| | - Angelo Cignarelli
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Sebastio Perrini
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Piero Marchetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Leonardo Vincenti
- Division of General Surgery, University Hospital Polyclinic, Bari, Italy
| | - Luigi Laviola
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Francesco Giorgino
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Annalisa Natalicchio
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
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Trunfio TA, Scala A, Giglio C, Rossi G, Borrelli A, Romano M, Improta G. Multiple regression model to analyze the total LOS for patients undergoing laparoscopic appendectomy. BMC Med Inform Decis Mak 2022; 22:141. [PMID: 35610697 PMCID: PMC9131683 DOI: 10.1186/s12911-022-01884-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/16/2022] [Indexed: 11/10/2022] Open
Abstract
Background The rapid growth in the complexity of services and stringent quality requirements present a challenge to all healthcare facilities, especially from an economic perspective. The goal is to implement different strategies that allows to enhance and obtain health processes closer to standards. The Length Of Stay (LOS) is a very useful parameter for the management of services within the hospital and is an index evaluated for the management of costs. In fact, a patient's LOS can be affected by a number of factors, including their particular condition, medical history, or medical needs. To reduce and better manage the LOS it is necessary to be able to predict this value. Methods In this study, a predictive model was built for the total LOS of patients undergoing laparoscopic appendectomy, one of the most common emergency procedures. Demographic and clinical data of the 357 patients admitted at “San Giovanni di Dio e Ruggi d’Aragona” University Hospital of Salerno (Italy) had used as independent variable of the multiple linear regression model. Results The obtained model had an R2 value of 0.570 and, among the independent variables, the significant variables that most influence the total LOS were Age, Pre-operative LOS, Presence of Complication and Complicated diagnosis. Conclusion This work designed an effective and automated strategy for improving the prediction of LOS, that can be useful for enhancing the preoperative pathways. In this way it is possible to characterize the demand and to be able to estimate a priori the occupation of the beds and other related hospital resources.
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Affiliation(s)
- Teresa Angela Trunfio
- Department of Advanced Biomedical Sciences, University Hospital of Naples 'Federico II', Naples, Italy
| | - Arianna Scala
- Department of Public Health, University of Naples "Federico II", Naples, Italy.
| | | | - Giovanni Rossi
- "San Giovanni di Dio e Ruggi d'Aragona" University Hospital, Salerno, Italy
| | - Anna Borrelli
- "San Giovanni di Dio e Ruggi d'Aragona" University Hospital, Salerno, Italy
| | - Maria Romano
- Department of Electrical Engineering and Information Technology, University of Study of Naples "Federico II", Naples, Italy
| | - Giovanni Improta
- Department of Public Health, University of Naples "Federico II", Naples, Italy.,Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy
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Biondi G, Marrano N, Borrelli A, Rella M, Palma G, Calderoni I, Siciliano E, Lops P, Giorgino F, Natalicchio A. Adipose Tissue Secretion Pattern Influences β-Cell Wellness in the Transition from Obesity to Type 2 Diabetes. Int J Mol Sci 2022; 23:ijms23105522. [PMID: 35628332 PMCID: PMC9143684 DOI: 10.3390/ijms23105522] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 04/22/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 12/10/2022] Open
Abstract
The dysregulation of the β-cell functional mass, which is a reduction in the number of β-cells and their ability to secure adequate insulin secretion, represents a key mechanistic factor leading to the onset of type 2 diabetes (T2D). Obesity is recognised as a leading cause of β-cell loss and dysfunction and a risk factor for T2D. The natural history of β-cell failure in obesity-induced T2D can be divided into three steps: (1) β-cell compensatory hyperplasia and insulin hypersecretion, (2) insulin secretory dysfunction, and (3) loss of β-cell mass. Adipose tissue (AT) secretes many hormones/cytokines (adipokines) and fatty acids that can directly influence β-cell function and viability. As this secretory pattern is altered in obese and diabetic patients, it is expected that the cross-talk between AT and pancreatic β-cells could drive the maintenance of the β-cell integrity under physiological conditions and contribute to the reduction in the β-cell functional mass in a dysmetabolic state. In the current review, we summarise the evidence of the ability of the AT secretome to influence each step of β-cell failure, and attempt to draw a timeline of the alterations in the adipokine secretion pattern in the transition from obesity to T2D that reflects the progressive deterioration of the β-cell functional mass.
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Improta G, Borrelli A, Triassi M. Machine Learning and Lean Six Sigma to Assess How COVID-19 Has Changed the Patient Management of the Complex Operative Unit of Neurology and Stroke Unit: A Single Center Study. Int J Environ Res Public Health 2022; 19:ijerph19095215. [PMID: 35564627 PMCID: PMC9103695 DOI: 10.3390/ijerph19095215] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/19/2022] [Accepted: 04/23/2022] [Indexed: 02/04/2023]
Abstract
Background: In health, it is important to promote the effectiveness, efficiency and adequacy of the services provided; these concepts become even more important in the era of the COVID-19 pandemic, where efforts to manage the disease have absorbed all hospital resources. The COVID-19 emergency led to a profound restructuring—in a very short time—of the Italian hospital system. Some factors that impose higher costs on hospitals are inappropriate hospitalization and length of stay (LOS). The length of stay (LOS) is a very useful parameter for the management of services within the hospital and is an index evaluated for the management of costs. Methods: This study analyzed how COVID-19 changed the activity of the Complex Operative Unit (COU) of the Neurology and Stroke Unit of the San Giovanni di Dio e Ruggi d’Aragona University Hospital of Salerno (Italy). The methodology used in this study was Lean Six Sigma. Problem solving in Lean Six Sigma is the DMAIC roadmap, characterized by five operational phases. To add even more value to the processing, a single clinical case, represented by stroke patients, was investigated to verify the specific impact of the pandemic. Results: The results obtained show a reduction in LOS for stroke patients and an increase in the value of the diagnosis related group relative weight. Conclusions: This work has shown how, thanks to the implementation of protocols for the management of the COU of the Neurology and Stroke Unit, the work of doctors has improved, and this is evident from the values of the parameters taken into consideration.
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Affiliation(s)
- Giovanni Improta
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy;
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II”, 80131 Naples, Italy
- Correspondence:
| | - Anna Borrelli
- “San Giovanni di Dio e Ruggi d’Aragona” University Hospital, 84121 Salerno, Italy;
| | - Maria Triassi
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy;
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II”, 80131 Naples, Italy
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16
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Ricciardi C, Ponsiglione AM, Scala A, Borrelli A, Misasi M, Romano G, Russo G, Triassi M, Improta G. Machine Learning and Regression Analysis to Model the Length of Hospital Stay in Patients with Femur Fracture. Bioengineering (Basel) 2022; 9:bioengineering9040172. [PMID: 35447732 PMCID: PMC9029792 DOI: 10.3390/bioengineering9040172] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 02/16/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/27/2022] Open
Abstract
Fractures of the femur are a frequent problem in elderly people, and it has been demonstrated that treating them with a diagnostic–therapeutic–assistance path within 48 h of admission to the hospital reduces complications and shortens the length of the hospital stay (LOS). In this paper, the preoperative data of 1082 patients were used to further extend the previous research and to generate several models that are capable of predicting the overall LOS: First, the LOS, measured in days, was predicted through a regression analysis; then, it was grouped by weeks and was predicted with a classification analysis. The KNIME analytics platform was applied to divide the dataset for a hold-out cross-validation, perform a multiple linear regression and implement machine learning algorithms. The best coefficient of determination (R2) was achieved by the support vector machine (R2 = 0.617), while the mean absolute error was similar for all the algorithms, ranging between 2.00 and 2.11 days. With regard to the classification analysis, all the algorithms surpassed 80% accuracy, and the most accurate algorithm was the radial basis function network, at 83.5%. The use of these techniques could be a valuable support tool for doctors to better manage orthopaedic departments and all their resources, which would reduce both waste and costs in the context of healthcare.
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Affiliation(s)
- Carlo Ricciardi
- Department of Electrical Engineering and Information Technology, University of Naples “Federico II”, 80125 Naples, Italy;
| | - Alfonso Maria Ponsiglione
- Department of Electrical Engineering and Information Technology, University of Naples “Federico II”, 80125 Naples, Italy;
- Correspondence:
| | - Arianna Scala
- Department of Public Health, University Hospital of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (M.T.); (G.I.)
| | - Anna Borrelli
- Health Department, University Hospital of Salerno “San Giovanni di Dio e Ruggi d′Aragona”, 84126 Salerno, Italy;
| | - Mario Misasi
- Department of the Orthopaedics, National Hospital (A.O.R.N.) Antonio Cardarelli, 80131 Naples, Italy; (M.M.); (G.R.)
| | - Gaetano Romano
- Department of the Orthopaedics, National Hospital (A.O.R.N.) Antonio Cardarelli, 80131 Naples, Italy; (M.M.); (G.R.)
| | - Giuseppe Russo
- National Hospital (A.O.R.N.) Antonio Cardarelli, 80131 Naples, Italy;
| | - Maria Triassi
- Department of Public Health, University Hospital of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (M.T.); (G.I.)
- Interdepartmental Center for Research in Healthcare, Management and Innovation in Healthcare (CIRMIS), University of Study of Naples “Federico II”, 80131 Naples, Italy
| | - Giovanni Improta
- Department of Public Health, University Hospital of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (M.T.); (G.I.)
- Interdepartmental Center for Research in Healthcare, Management and Innovation in Healthcare (CIRMIS), University of Study of Naples “Federico II”, 80131 Naples, Italy
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17
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Manente R, Santella B, Pagliano P, Santoro E, Casolaro V, Borrelli A, Capunzo M, Galdiero M, Franci G, Boccia G. Prevalence and Antimicrobial Resistance of Causative Agents to Ocular Infections. Antibiotics (Basel) 2022; 11:antibiotics11040463. [PMID: 35453215 PMCID: PMC9032492 DOI: 10.3390/antibiotics11040463] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 02/04/2023] Open
Abstract
Bacterial ocular infections are a worldwide health problem and, if untreated, can damage the structure of the eye and contribute to permanent disability. Knowledge of the prevalence and antimicrobial susceptibility patterns of the main causative agents involved in ocular infections is necessary for defining an optimal antibiotic therapy. The aim of this study was to analyse bacterial species involved in ocular infections and the antimicrobial susceptibility patterns. Conjunctival swab samples were collected from patients with bacterial conjunctivitis at the University Hospital San Giovanni di Dio e Ruggi d’Aragona between January 2015 and December 2019. The identification and antibiotic sensitivity tests were performed using the VITEK 2 system. A total of 281 causative agents of ocular infections were isolated, 81.8% of which were Gram-positive bacteria. Coagulase-negative staphylococci (CoNS) were the most commonly isolated species among Gram-positive bacteria, followed by Staphylococcus aureus. In contrast, Pseudomonas spp. and Escherichia coli were the main species isolated among Gram-negative bacteria (18.2%). Overall, linezolid, teicoplanin, tigecycline and vancomycin were the most effective antimicrobials. Analysis of resistance rates over time highlighted increasing resistance for azithromycin, clarithromycin and erythromycin among CoNS, and clindamycin and erythromycin among Staphylococcus aureus. This study has identified the profiles of the major pathogens involved in ocular infection and their susceptibility patterns, which will help improve the treatments and the choice of antibiotics in ocular infections.
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Affiliation(s)
- Roberta Manente
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (R.M.); (B.S.); (M.G.)
| | - Biagio Santella
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (R.M.); (B.S.); (M.G.)
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
| | - Emanuela Santoro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
| | - Vincenzo Casolaro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
| | - Anna Borrelli
- Azienda Ospedaliero Universitaria San Giovanni di Dio e Ruggi D’Aragona, 84131 Salerno, Italy;
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica e Microbiologica, Azienda Ospedaliero-Universitaria S. Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
| | - Massimiliano Galdiero
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (R.M.); (B.S.); (M.G.)
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica e Microbiologica, Azienda Ospedaliero-Universitaria S. Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
- Correspondence: (G.F.); (G.B.)
| | - Giovanni Boccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica e Microbiologica, Azienda Ospedaliero-Universitaria S. Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
- Correspondence: (G.F.); (G.B.)
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18
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Boccella M, Santella B, Pagliano P, De Filippis A, Casolaro V, Galdiero M, Borrelli A, Capunzo M, Boccia G, Franci G. Prevalence and Antimicrobial Resistance of Enterococcus Species: A Retrospective Cohort Study in Italy. Antibiotics (Basel) 2021; 10:antibiotics10121552. [PMID: 34943764 PMCID: PMC8698357 DOI: 10.3390/antibiotics10121552] [Citation(s) in RCA: 15] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 12/28/2022] Open
Abstract
Antimicrobial resistance represents one of the main threats to healthy ecosystems. In recent years, among the multidrug-resistant microorganisms responsible for nosocomial infections, the Enterococcus species have received much attention. Indeed, Enterococcus have peculiar skills in their ability to acquire resistance genes and to cause severe diseases, such as endocarditis. This study showed the prevalence and antimicrobial resistance rate of Enterococcus spp. isolated from clinical samples, from January 2015 to December 2019 at the University Hospital "San Giovanni di Dio e Ruggi d'Aragona" in Salerno, Italy. A total of 3236 isolates of Enterococcus faecalis (82.2%) and Enterococcus faecium (17.8%) were collected from urine cultures, blood cultures, catheters, respiratory tract, and other samples. Bacterial identification and antibiotic susceptibility were performed with VITEK 2. E. faecium showed a high resistance rate against ampicillin (84.5%), ampicillin/sulbactam (82.7%), and imipenem (86.7%), while E. faecalis showed the highest resistance rate against gentamicin and streptomycin high level, but both were highly sensitive to such antibiotics as tigecycline and vancomycin. Studies of surveillance are an important tool to detect changes in the resistance profiles of the main pathogens. These antimicrobial susceptibility patterns are necessary to improve the empirical treatment guideline of infections.
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Affiliation(s)
- Mariarosaria Boccella
- Department of Laboratory and Infectious Disease Sciences, Agostino Gemelli University Hospital IRCCS, 00168 Rome, Italy;
| | - Biagio Santella
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (B.S.); (M.G.)
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (V.C.); (M.C.); (G.B.)
| | - Anna De Filippis
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Vincenzo Casolaro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (V.C.); (M.C.); (G.B.)
| | - Massimiliano Galdiero
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (B.S.); (M.G.)
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Anna Borrelli
- Azienda Ospedaliero Universitaria San Giovanni di Dio e Ruggi D’Aragona, 84131 Salerno, Italy;
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (V.C.); (M.C.); (G.B.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica E Microbiologica, A.O.U. San Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
| | - Giovanni Boccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (V.C.); (M.C.); (G.B.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica E Microbiologica, A.O.U. San Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (V.C.); (M.C.); (G.B.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica E Microbiologica, A.O.U. San Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
- Correspondence:
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19
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Silverio A, Di Maio M, Scudiero F, Russo V, Esposito L, Attena E, Pezzullo S, Parodi G, D'Andrea A, Damato A, Silvestro A, Iannece P, Bellino M, Di Vece D, Borrelli A, Citro R, Vecchione C, Galasso G. Clinical conditions and echocardiographic parameters associated with mortality in COVID-19. Eur J Clin Invest 2021; 51:e13638. [PMID: 34287861 PMCID: PMC8420215 DOI: 10.1111/eci.13638] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a recently recognized viral infective disease which can be complicated by acute respiratory stress syndrome (ARDS) and cardiovascular complications including severe arrhythmias, acute coronary syndromes, myocarditis and pulmonary embolism. The aim of the present study was to identify the clinical conditions and echocardiographic parameters associated with in-hospital mortality in COVID-19. METHODS This is a multicentre retrospective observational study including seven Italian centres. Patients hospitalized with COVID-19 from 1 March to 22 April 2020 were included into study population. The association between baseline variables and risk of in-hospital mortality was assessed through multivariable logistic regression and competing risk analyses. RESULTS Out of 1401 patients admitted at the participating centres with confirmed diagnosis of COVID-19, 226 (16.1%) underwent transthoracic echocardiography (TTE) and were included in the present analysis. In-hospital death occurred in 68 patients (30.1%). At multivariable analysis, left ventricular ejection fraction (LVEF, P < .001), tricuspid annular plane systolic excursion (TAPSE, P < .001) and ARDS (P < .001) were independently associated with in-hospital mortality. At competing risk analysis, we found a significantly higher risk of mortality in patients with ARDS vs those without ARDS (HR: 7.66; CI: 3.95-14.8), in patients with TAPSE ≤17 mm vs those with TAPSE >17 mm (HR: 5.08; CI: 3.15-8.19) and in patients with LVEF ≤50% vs those with LVEF >50% (HR: 4.06; CI: 2.50-6.59). CONCLUSIONS TTE might be a useful tool in risk stratification of patients with COVID-19. In particular, reduced LVEF and reduced TAPSE may help to identify patients at higher risk of death during hospitalization.
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Affiliation(s)
- Angelo Silverio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Marco Di Maio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy.,Division of Cardiology, Eboli Hospital, Salerno, Italy
| | | | - Vincenzo Russo
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" - Monaldi and Cotugno Hospital, Naples, Italy
| | - Luca Esposito
- Division of Cardiology, Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Emilio Attena
- Division of Cardiology, San Giuliano Hospital, Naples, Italy
| | | | - Guido Parodi
- Division of Interventional Cardiology, University Hospital of Sassari, Sassari, Italy
| | - Antonello D'Andrea
- Department of Cardiology and Intensive Coronary Unit, "Umberto I" Hospital, Nocera Inferiore, Italy
| | - Antonio Damato
- Department of Vascular Physiopathology, IRCCS Neuromed, Pozzilli, Italy
| | | | - Patrizia Iannece
- Department of Chemistry and Biology, University of Salerno, Fisciano, Italy
| | - Michele Bellino
- Division of Cardiology, Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Davide Di Vece
- Division of Cardiology, Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy.,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Anna Borrelli
- San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Rodolfo Citro
- Division of Cardiology, Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy.,Department of Vascular Physiopathology, IRCCS Neuromed, Pozzilli, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
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20
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Moccia G, Carpinelli L, Savarese G, Borrelli A, Boccia G, Motta O, Capunzo M, De Caro F. Perception of Health, Mistrust, Anxiety, and Indecision in a Group of Italians Vaccinated against COVID-19. Vaccines (Basel) 2021; 9:612. [PMID: 34200347 PMCID: PMC8228609 DOI: 10.3390/vaccines9060612] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 05/10/2021] [Revised: 06/04/2021] [Accepted: 06/05/2021] [Indexed: 01/11/2023] Open
Abstract
The objectives of this study were to evaluate the psychological factors of health perception, mistrust, anxiety, fear, and indecision of Italians vaccinated against COVID-19, and conduct an analysis of the relationships between these factors and other variables: sex, vaccine priority ministerial categories, and the type and dose of vaccine. The participants included 1564 subjects who joined the vaccination campaign at the COVID-19 Vaccination Center in Salerno, Italy. A survey was conducted in the reference period March-April 2021 using a brief anamnestic questionnaire. In addition, the following standardized scales were used: the State-Trait Anxiety Inventory (STAI-Y) and the Short Form Health Survey (SF-12). The results showed that, in terms of the type of vaccine received, the interviewees felt more confident in having received the Comirnaty (Pfizer-BioNTech, 23.5%) and Vaxzevria (AstraZeneca, 18.6%) vaccines-feeling less tense (2.1%; Vaxzevria (AstraZeneca) = 3.2%), frightened (1%; Vaxzevria (AstraZeneca) = 1.4%), not at all nervous (61.1%; Vaxzevria (AstraZeneca), 43.6%), and not at all/undecided (67.9%; Vaxzevria (AstraZeneca), 58.6%). Regarding the mood and psychological states considered at the different vaccine administration times, other important differences emerged as the interviewees reported higher levels of tension, nervousness, and fear during the first phase of vaccine administration. Specifically, 40.7% (second dose, 32.7%) felt somewhat tense at the first dose, 26.4% felt frightened (second dose, 21.8%), and 33.8% felt nervous (second dose, 26.8%). The perceived state of health also increased at the end of the vaccination cycle, as, at the second dose, 15.4% of the sample reported an evaluation of "excellent" (first dose, 12.4%).
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Affiliation(s)
- Giuseppina Moccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (G.M.); (L.C.); (G.B.); (O.M.); (M.C.); (F.D.C.)
- A.U.O. “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy;
| | - Luna Carpinelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (G.M.); (L.C.); (G.B.); (O.M.); (M.C.); (F.D.C.)
| | - Giulia Savarese
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (G.M.); (L.C.); (G.B.); (O.M.); (M.C.); (F.D.C.)
| | - Anna Borrelli
- A.U.O. “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy;
| | - Giovanni Boccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (G.M.); (L.C.); (G.B.); (O.M.); (M.C.); (F.D.C.)
- A.U.O. “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy;
| | - Oriana Motta
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (G.M.); (L.C.); (G.B.); (O.M.); (M.C.); (F.D.C.)
- A.U.O. “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy;
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (G.M.); (L.C.); (G.B.); (O.M.); (M.C.); (F.D.C.)
- A.U.O. “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy;
| | - Francesco De Caro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (G.M.); (L.C.); (G.B.); (O.M.); (M.C.); (F.D.C.)
- A.U.O. “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy;
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21
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Capurro V, Tomati V, Sondo E, Renda M, Borrelli A, Pastorino C, Guidone D, Venturini A, Giraudo A, Mandrup Bertozzi S, Musante I, Bertozzi F, Bandiera T, Zara F, Galietta LJV, Pedemonte N. Partial Rescue of F508del-CFTR Stability and Trafficking Defects by Double Corrector Treatment. Int J Mol Sci 2021; 22:ijms22105262. [PMID: 34067708 PMCID: PMC8156943 DOI: 10.3390/ijms22105262] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 02/06/2023] Open
Abstract
Deletion of phenylalanine at position 508 (F508del) in the CFTR chloride channel is the most frequent mutation in cystic fibrosis (CF) patients. F508del impairs the stability and folding of the CFTR protein, thus resulting in mistrafficking and premature degradation. F508del-CFTR defects can be overcome with small molecules termed correctors. We investigated the efficacy and properties of VX-445, a newly developed corrector, which is one of the three active principles present in a drug (Trikafta®/Kaftrio®) recently approved for the treatment of CF patients with F508del mutation. We found that VX-445, particularly in combination with type I (VX-809, VX-661) and type II (corr-4a) correctors, elicits a large rescue of F508del-CFTR function. In particular, in primary bronchial epithelial cells of CF patients, the maximal rescue obtained with corrector combinations including VX-445 was close to 60–70% of CFTR function in non-CF cells. Despite this high efficacy, analysis of ubiquitylation, resistance to thermoaggregation, protein half-life, and subcellular localization revealed that corrector combinations did not fully normalize F508del-CFTR behavior. Our study indicates that it is still possible to further improve mutant CFTR rescue with the development of corrector combinations having maximal effects on mutant CFTR structural and functional properties.
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Affiliation(s)
- Valeria Capurro
- U.O.C. Genetica Medica, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy; (V.C.); (V.T.); (E.S.); (C.P.); (I.M.); (F.Z.)
| | - Valeria Tomati
- U.O.C. Genetica Medica, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy; (V.C.); (V.T.); (E.S.); (C.P.); (I.M.); (F.Z.)
| | - Elvira Sondo
- U.O.C. Genetica Medica, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy; (V.C.); (V.T.); (E.S.); (C.P.); (I.M.); (F.Z.)
| | - Mario Renda
- Telethon Institute of Genetics and Medicine (TIGEM), 80078 Pozzuoli, Italy; (M.R.); (A.B.); (D.G.); (A.V.)
| | - Anna Borrelli
- Telethon Institute of Genetics and Medicine (TIGEM), 80078 Pozzuoli, Italy; (M.R.); (A.B.); (D.G.); (A.V.)
| | - Cristina Pastorino
- U.O.C. Genetica Medica, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy; (V.C.); (V.T.); (E.S.); (C.P.); (I.M.); (F.Z.)
| | - Daniela Guidone
- Telethon Institute of Genetics and Medicine (TIGEM), 80078 Pozzuoli, Italy; (M.R.); (A.B.); (D.G.); (A.V.)
| | - Arianna Venturini
- Telethon Institute of Genetics and Medicine (TIGEM), 80078 Pozzuoli, Italy; (M.R.); (A.B.); (D.G.); (A.V.)
| | - Alessandro Giraudo
- D3-PharmaChemistry, Fondazione Istituto Italiano di Tecnologia, 16163 Genova, Italy; (A.G.); (F.B.); (T.B.)
| | - Sine Mandrup Bertozzi
- Analytical Chemistry Lab, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy;
| | - Ilaria Musante
- U.O.C. Genetica Medica, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy; (V.C.); (V.T.); (E.S.); (C.P.); (I.M.); (F.Z.)
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genova, Italy
| | - Fabio Bertozzi
- D3-PharmaChemistry, Fondazione Istituto Italiano di Tecnologia, 16163 Genova, Italy; (A.G.); (F.B.); (T.B.)
| | - Tiziano Bandiera
- D3-PharmaChemistry, Fondazione Istituto Italiano di Tecnologia, 16163 Genova, Italy; (A.G.); (F.B.); (T.B.)
| | - Federico Zara
- U.O.C. Genetica Medica, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy; (V.C.); (V.T.); (E.S.); (C.P.); (I.M.); (F.Z.)
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genova, Italy
| | - Luis J. V. Galietta
- Telethon Institute of Genetics and Medicine (TIGEM), 80078 Pozzuoli, Italy; (M.R.); (A.B.); (D.G.); (A.V.)
- Department of Translational Medical Sciences (DISMET), University of Naples Federico II, 80131 Naples, Italy
- Correspondence: (L.J.V.G.); (N.P.)
| | - Nicoletta Pedemonte
- U.O.C. Genetica Medica, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy; (V.C.); (V.T.); (E.S.); (C.P.); (I.M.); (F.Z.)
- Correspondence: (L.J.V.G.); (N.P.)
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22
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Masarone M, Vaccaro E, Sciorio R, Torre P, Della Vecchia A, Aglitti A, Caliulo R, Borrelli A, Persico M. Characterisation of asymptomatic patients and efficacy of preventive measures for SARS-CoV-2 infection in a large population of Southern Italy: a cohort study. BMJ Open 2021; 11:e043112. [PMID: 33972332 PMCID: PMC8111874 DOI: 10.1136/bmjopen-2020-043112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 03/26/2021] [Accepted: 04/17/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic has infected millions of people and has caused more than 2.30 million deaths worldwide to date. Several doubts arise about the role of asymptomatic carriers in virus transmission. During the first epidemic outbreak in Italy a large screening with nasopharyngeal swab (NS) was performed in those who were considered 'suspect' for infection. AIMS To report the results of the SARS-CoV-2 screening in a province in Southern Italy and to provide data on the COVID-19 epidemic and the burden of asymptomatic subjects. PATIENTS AND METHODS A retrospective cohort study was set up in all healthcare facilities of the province (12 hospitals and 13 sanitary districts: primary, secondary and tertiary centres) with the aim to analyse the results of NS performed on all subjects suspected to be infected with SARS-CoV-2, either because they presented symptoms suggestive of SARS-CoV-2 infection, they were 'contacts' of positive subjects, they came from areas with high prevalence or they were healthcare workers. NS were performed and managed as indicated by international guidelines. The specimens were processed for SARS-CoV-2 detection by real-time PCR. RESULTS A total of 20 325 NS were performed from 13 March to 9 May 2020. Of these, 638 (3.14%) were positive. 470 were asymptomatic, or 75.3% of persons who were positive. They were mostly among 'contacts' of symptomatic cases (428 of 470, 91%) and were in domiciliary isolation. Expression of three SARS-CoV-2 genes did not differ between asymptomatic and symptomatic subjects. The strict measures with regard to social distancing led to a continuous decrease in cases during phase 1. CONCLUSIONS In a large area in Southern Italy, 3.14% (638 of 20 325) of the total subjects tested were positive for SARS-CoV-2. Most of them were asymptomatic (470 of 624, 75.3%), and of these 91% (428 of 470) were 'close contacts' of symptomatic subjects. The combination of social distancing together with the systematic screening of close contacts of COVID-19-positive symptomatic subjects seems to be an efficacious approach to limit the spread of the epidemic.
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Affiliation(s)
- Mario Masarone
- Internal Medicine and Hepatology Unit, Azienda Ospedaliera Universitaria 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Emilia Vaccaro
- Molecular Biology Unit, Azienda Ospedaliera Universitaria 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Roberta Sciorio
- Internal Medicine and Hepatology Unit, Azienda Ospedaliera Universitaria 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Pietro Torre
- Internal Medicine and Hepatology Unit, Azienda Ospedaliera Universitaria 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Antonio Della Vecchia
- Hospital Health Direction, Azienda Ospedaliera Universitaria 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Andrea Aglitti
- Internal Medicine and Hepatology Unit, Azienda Ospedaliera Universitaria 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Rita Caliulo
- Molecular Biology Unit, Azienda Ospedaliera Universitaria 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Anna Borrelli
- Hospital Health Direction, Azienda Ospedaliera Universitaria 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Marcello Persico
- Internal Medicine and Hepatology Unit, Azienda Ospedaliera Universitaria 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
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Charlier B, Coglianese A, De Rosa F, De Caro F, Piazza O, Motta O, Borrelli A, Capunzo M, Filippelli A, Izzo V. Chemical risk in hospital settings: Overview on monitoring strategies and international regulatory aspects. J Public Health Res 2021; 10. [PMID: 33849259 PMCID: PMC8018262 DOI: 10.4081/jphr.2021.1993] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 10/13/2020] [Accepted: 02/17/2021] [Indexed: 01/21/2023] Open
Abstract
Chemical risk in hospital settings is a growing concern that health professionals and supervisory authorities must deal with daily. Exposure to chemical risk is quite different depending on the hospital department involved and might origin from multiple sources, such as the use of sterilizing agents, disinfectants, detergents, solvents, heavy metals, dangerous drugs, and anesthetic gases. Improving prevention procedures and constantly monitoring the presence and level of potentially toxic substances, both in workers (biological monitoring) and in working environments (environmental monitoring), might significantly reduce the risk of exposure and contaminations. The purpose of this article is to present an overview on this subject, which includes the current international regulations, the chemical pollutants to which medical and paramedical personnel are mainly exposed, and the strategies developed to improve safety conditions for all healthcare workers.
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Affiliation(s)
- Bruno Charlier
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi (SA).
| | - Albino Coglianese
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi (SA).
| | - Federica De Rosa
- University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno.
| | - Francesco De Caro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi (SA).
| | - Ornella Piazza
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi (SA).
| | - Oriana Motta
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi .
| | - Anna Borrelli
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno.
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi (SA).
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi (SA).
| | - Viviana Izzo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi (SA).
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Carrizzo A, Basilicata MG, Pepe G, Sørensen KK, Ciccarelli M, Sarno VD, Damato A, Venturini E, Borrelli A, Musella S, Abate M, Pietro PD, Ostacolo C, Campiglia P, Vecchione C. A Novel Vasoactive Peptide "PG1" from Buffalo Ice-Cream Protects from Angiotensin-Evoked High Blood Pressure. Antioxidants (Basel) 2021; 10:antiox10030441. [PMID: 33809389 PMCID: PMC8002072 DOI: 10.3390/antiox10030441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/24/2021] [Accepted: 03/08/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Arterial hypertension is the most important risk factor for cardiovascular diseases, myocardial infarction, heart failure, renal failure and peripheral vascular disease. In the last decade, milk-derived bioactive peptides have attracted attention for their beneficial cardiovascular properties. Methods: Here, we combined in vitro chemical assay such as LC-MS/MS analysis of buffalo ice cream, ex vivo vascular studies evaluating endothelial and smooth muscle responses using pressure myograph, and translational assay testing in vivo the vascular actions of PG1 administration in murine models. Results: We demonstrate that a novel buffalo ice-cream-derived pentapeptide “QKEPM”, namely PG1, is a stable peptide that can be obtained at higher concentration after gastro-intestinal digestions (GID) of buffalo ice-cream (BIC). It owns potent vascular effect in counteract the effects of angiotensin II-evoked vasoconstriction and high blood pressure levels. Its effects are mediated by the inhibitory effect on AT1 receptor leading to a downregulation of p-ERK½/Rac1-GTP and consequent reduction of oxidative stress. Conclusions: These results strongly candidate PG1, as a novel bioactive peptide for the prevention and management of hypertension, thus expanding the armamentarium of preventive strategies aimed at reducing the incidence and progression of hypertension and its related cardiovascular complications.
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Affiliation(s)
- Albino Carrizzo
- Department of Medicine and Surgery, University of Salerno, 84081 Baronissi, SA, Italy; (A.C.); (M.C.); (M.A.); (P.D.P.)
- IRCCS Neuromed, Vascular Pathophysiology Unit, 86077 Pozzilli, IS, Italy; (A.D.); (E.V.)
| | | | - Giacomo Pepe
- Department of Pharmacy, University of Salerno, 84084 Fisciano, SA, Italy; (M.G.B.); (G.P.); (V.D.S.)
| | - Kasper K. Sørensen
- Department of Chemistry, University of Copenhagen, 1870 Frederiksberg, Denmark;
- Biomolecular Nanoscale Engineering Center, University of Copenhagen, 1870 Frederiksberg, Denmark
| | - Michele Ciccarelli
- Department of Medicine and Surgery, University of Salerno, 84081 Baronissi, SA, Italy; (A.C.); (M.C.); (M.A.); (P.D.P.)
| | - Veronica Di Sarno
- Department of Pharmacy, University of Salerno, 84084 Fisciano, SA, Italy; (M.G.B.); (G.P.); (V.D.S.)
| | - Antonio Damato
- IRCCS Neuromed, Vascular Pathophysiology Unit, 86077 Pozzilli, IS, Italy; (A.D.); (E.V.)
| | - Eleonora Venturini
- IRCCS Neuromed, Vascular Pathophysiology Unit, 86077 Pozzilli, IS, Italy; (A.D.); (E.V.)
| | - Anna Borrelli
- University Hospital “San Giovanni di Dio e Ruggi D’Aragona”, via S. Leonardo, 1, 84131 Salerno, SA, Italy;
| | - Simona Musella
- European Biomedical Research Institute of Salerno, 84131 Salerno, SA, Italy;
| | - Mario Abate
- Department of Medicine and Surgery, University of Salerno, 84081 Baronissi, SA, Italy; (A.C.); (M.C.); (M.A.); (P.D.P.)
| | - Paola Di Pietro
- Department of Medicine and Surgery, University of Salerno, 84081 Baronissi, SA, Italy; (A.C.); (M.C.); (M.A.); (P.D.P.)
| | - Carmine Ostacolo
- Department of Pharmacy, University of Naples Federico II, 80131 Napoli, NA, Italy;
| | - Pietro Campiglia
- Department of Pharmacy, University of Salerno, 84084 Fisciano, SA, Italy; (M.G.B.); (G.P.); (V.D.S.)
- Correspondence: (P.C.); (C.V.); Tel.: +39-089-969242 (P.C.); +39-08-996-5069 (C.V.)
| | - Carmine Vecchione
- Department of Medicine and Surgery, University of Salerno, 84081 Baronissi, SA, Italy; (A.C.); (M.C.); (M.A.); (P.D.P.)
- IRCCS Neuromed, Vascular Pathophysiology Unit, 86077 Pozzilli, IS, Italy; (A.D.); (E.V.)
- Correspondence: (P.C.); (C.V.); Tel.: +39-089-969242 (P.C.); +39-08-996-5069 (C.V.)
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Scala A, Ponsiglione AM, Loperto I, Della Vecchia A, Borrelli A, Russo G, Triassi M, Improta G. Lean Six Sigma Approach for Reducing Length of Hospital Stay for Patients with Femur Fracture in a University Hospital. Int J Environ Res Public Health 2021; 18:ijerph18062843. [PMID: 33799518 PMCID: PMC8000325 DOI: 10.3390/ijerph18062843] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 11/30/2022]
Abstract
Surgical intervention within 48 h of hospital admission is the gold standard procedure for the management of elderly patients with femur fractures, since the increase in preoperative waiting time is correlated with the onset of complications and longer overall length of stay (LOS) in the hospital. However, national evidence demonstrates that there is still the need to provide timely intervention for this type of patient, especially in some regions of central southern Italy. Here we discuss the introduction of a diagnostic–therapeutic assistance pathway (DTAP) to reduce the preoperative LOS for patients undergoing femur fracture surgery in a university hospital. A Lean Six Sigma methodology, based on the DMAIC cycle (Define, Measure, Analyze, Improve, Control), is implemented to evaluate the effectiveness of the DTAP. Data were retrospectively collected and analyzed from two groups of patients before and after the implementation of DTAP over a period of 10 years. The statistics of the process measured before the DTAP showed an average preoperative LOS of 5.6 days (standard deviation of 3.2), thus confirming the need for corrective actions to reduce the LOS in compliance with the national guidelines. The influence of demographic and anamnestic variables on the LOS was evaluated, and the impact of the DTAP was measured and discussed, demonstrating the effectiveness of the improvement actions implemented over the years and leading to a significant reduction in the preoperative LOS, which decreased to an average of 3.5 days (standard deviation of 3.60). The obtained reduction of 39% in the average LOS proved to be in good agreement with previously developed DTAPs for femur fracture available in the literature.
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Affiliation(s)
- Arianna Scala
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (I.L.); (M.T.); (G.I.)
| | - Alfonso Maria Ponsiglione
- Department of Electrical Engineering and Information Technology, University of Naples “Federico II”, 80125 Naples, Italy
- Correspondence:
| | - Ilaria Loperto
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (I.L.); (M.T.); (G.I.)
| | - Antonio Della Vecchia
- Hospital Directorate, “San Giovanni di Dio e Ruggi d’Aragona” University Hospital of Salerno, 84125 Salerno, Italy; (A.D.V.); (A.B.)
| | - Anna Borrelli
- Hospital Directorate, “San Giovanni di Dio e Ruggi d’Aragona” University Hospital of Salerno, 84125 Salerno, Italy; (A.D.V.); (A.B.)
| | - Giuseppe Russo
- Hospital Directorate, National Hospital A.O.R.N. “Antonio Cardarelli” of Naples, 80131 Naples, Italy;
| | - Maria Triassi
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (I.L.); (M.T.); (G.I.)
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II”, 80131 Naples, Italy
| | - Giovanni Improta
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (I.L.); (M.T.); (G.I.)
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II”, 80131 Naples, Italy
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26
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Motta O, Charlier B, De Caro F, Coglianese A, De Rosa F, Moccia G, Pironti C, Capunzo M, Borrelli A, Filippelli A, Izzo V. Environmental and biological monitoring of formaldehyde inside a hospital setting: a combined approach to manage chemical risk in workplaces. J Public Health Res 2021; 10. [PMID: 33849255 PMCID: PMC7967491 DOI: 10.4081/jphr.2021.2012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/14/2021] [Indexed: 11/22/2022] Open
Abstract
Background: The safety of healthcare workers exposed to formaldehyde remains a great matter of concern for healthcare management units. This work aimed at describing the results of a combined monitoring approach (environmental and biological) to manage occupational exposure to formaldehyde in a hospital setting. Design and Methods: Environmental monitoring of working spaces and biological monitoring of urinary formaldehyde in 16 exposed healthcare workers of the Anatomic Pathology Unit of a University Hospital in Southern Italy was performed on a fouryear timescale (2016-2019). Results: Values of aero-dispersed formaldehyde identified were on average low; although workers’ urinary formaldehyde levels were also minimal, the statistical analysis highlighted a slight weekly accumulation. Conclusions: Our data confirm that both environmental and biological monitoring are important to identify risk situations, in particular when values of hazardous compounds are below the accepted occupational exposure levels. Significance for public health Health workers' regular exposure to formaldehyde may be responsible for long-term health issues; unfortunately, threshold limits of this compound are not harmonized between different government agencies. The combination of environmental and biological monitoring thus becomes an invaluable tool to preserve worker's safety and effectively assess chemical risk in hospital settings.
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Affiliation(s)
- Oriana Motta
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi; University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno .
| | - Bruno Charlier
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi; University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno .
| | - Francesco De Caro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi; University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno .
| | - Albino Coglianese
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi .
| | - Federica De Rosa
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno.
| | - Giuseppina Moccia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi; University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno .
| | - Concetta Pironti
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno.
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi; University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno .
| | - Anna Borrelli
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno.
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi; University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno .
| | - Viviana Izzo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi .
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Marrano N, Biondi G, Borrelli A, Cignarelli A, Perrini S, Laviola L, Giorgino F, Natalicchio A. Irisin and Incretin Hormones: Similarities, Differences, and Implications in Type 2 Diabetes and Obesity. Biomolecules 2021; 11:286. [PMID: 33671882 PMCID: PMC7918991 DOI: 10.3390/biom11020286] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 12/11/2022] Open
Abstract
Incretins are gut hormones that potentiate glucose-stimulated insulin secretion (GSIS) after meals. Glucagon-like peptide-1 (GLP-1) is the most investigated incretin hormone, synthesized mainly by L cells in the lower gut tract. GLP-1 promotes β-cell function and survival and exerts beneficial effects in different organs and tissues. Irisin, a myokine released in response to a high-fat diet and exercise, enhances GSIS. Similar to GLP-1, irisin augments insulin biosynthesis and promotes accrual of β-cell functional mass. In addition, irisin and GLP-1 share comparable pleiotropic effects and activate similar intracellular pathways. The insulinotropic and extra-pancreatic effects of GLP-1 are reduced in type 2 diabetes (T2D) patients but preserved at pharmacological doses. GLP-1 receptor agonists (GLP-1RAs) are therefore among the most widely used antidiabetes drugs, also considered for their cardiovascular benefits and ability to promote weight loss. Irisin levels are lower in T2D patients, and in diabetic and/or obese animal models irisin administration improves glycemic control and promotes weight loss. Interestingly, recent evidence suggests that both GLP-1 and irisin are also synthesized within the pancreatic islets, in α- and β-cells, respectively. This review aims to describe the similarities between GLP-1 and irisin and to propose a new potential axis-involving the gut, muscle, and endocrine pancreas that controls energy homeostasis.
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Affiliation(s)
| | | | | | | | | | | | - Francesco Giorgino
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, I-70124 Bari, Italy; (N.M.); (G.B.); (A.B.); (A.C.); (S.P.); (L.L.); (A.N.)
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28
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Moccia G, De Caro F, Pironti C, Boccia G, Capunzo M, Borrelli A, Motta O. Development and Improvement of an Effective Method for Air and Surfaces Disinfection with Ozone Gas as a Decontaminating Agent. Medicina (Kaunas) 2020; 56:E578. [PMID: 33143010 PMCID: PMC7694113 DOI: 10.3390/medicina56110578] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022]
Abstract
Background and objectives: Ozone has been one of the most investigated and discussed sanitization methods. This paper reports a procedure to sanitize air hospital environments, in particular chirurgical surgery rooms that require high levels of disinfection. The purpose of this work was the development and implementation of a cleansing and sanitizing procedure for critical clinical settings with ozone, to prevent hospital infections by the elimination of all toxic and harmful microorganisms in the air, and ensure safe use for operators and patients. Materials and Methods: The protocol for the study involved a structured selection of a representative environment of healthcare structures such as high, medium, and low-risk settings in air and examples of hospital furniture. Results: The concentration of ozone was measured during sanitization treatment and the estimation of the total microbial count in the air and on different surfaces before and after the sanitization operations was performed. The results demonstrated a significant reduction in the microbial count that always fell below the threshold value. Conclusions: Currently, there are no air treatment strategies available for inactivating airborne organisms during hospital outbreaks, which is most probably due to the lack of approved protocols.
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Affiliation(s)
- Giuseppina Moccia
- Department of Medicine Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, via S. Allende 1, 84081 Baronissi (SA), Italy; (G.M.); (F.D.C.); (G.B.); (M.C.); (O.M.)
| | - Francesco De Caro
- Department of Medicine Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, via S. Allende 1, 84081 Baronissi (SA), Italy; (G.M.); (F.D.C.); (G.B.); (M.C.); (O.M.)
| | - Concetta Pironti
- Department of Medicine Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, via S. Allende 1, 84081 Baronissi (SA), Italy; (G.M.); (F.D.C.); (G.B.); (M.C.); (O.M.)
- University Hospital “San Giovanni di Dio e Ruggi D’Aragona”, via S. Leonardo, 1, 84131 Salerno, Italy;
| | - Giovanni Boccia
- Department of Medicine Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, via S. Allende 1, 84081 Baronissi (SA), Italy; (G.M.); (F.D.C.); (G.B.); (M.C.); (O.M.)
| | - Mario Capunzo
- Department of Medicine Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, via S. Allende 1, 84081 Baronissi (SA), Italy; (G.M.); (F.D.C.); (G.B.); (M.C.); (O.M.)
| | - Anna Borrelli
- University Hospital “San Giovanni di Dio e Ruggi D’Aragona”, via S. Leonardo, 1, 84131 Salerno, Italy;
| | - Oriana Motta
- Department of Medicine Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, via S. Allende 1, 84081 Baronissi (SA), Italy; (G.M.); (F.D.C.); (G.B.); (M.C.); (O.M.)
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29
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De Caro F, Moccia G, Borrelli A, Annecchiarico A, Cioffi G, Campanella A, Motta O, Caputo V, Boccia G, Capunzo M. SARS-CoV-2: Sanitize a hospital. Eur J Public Health 2020. [PMCID: PMC7543395 DOI: 10.1093/eurpub/ckaa166.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Issue During the SARS-CoV-2 pandemic, several critical issues emerged. One of these was to identify which was the best terminal disinfection strategy for hospital rooms of a COVID-19. Description of the problem. Our University Hospital adopted ozone disinfection two years ago, recognized internationally as a 'safe gas' and is an excellent disinfectant for its characteristics of attacking and oxidizing each type of organic and inorganic compound and specifically also works against SARS-CoV-2. Results 23 ozone generators were purchased, 20 ozonizers were assigned to departments with high environmental sanitation needs, 3 ozonizers supplied to the ozonator team. For the correct use of the equipment, 200 operators were trained in a certified way. The rooms are ozonated with pre-established frequency and whenever a COVID-19 patient is cared for. The ozonation team sanitizes rooms in wards that are not equipped but that may have hosted patients with carriers. Indications have been given in all the wards to create the ozonation room, that can be used as an ozone disinfection chamber, where it is possible to place garrisons and furnishings, even large-sized, that cannot be disinfected in other ways (in addition to sanitization with hypochlorite). The team also provides for the ozonation of ambulances with a predetermined periodicity or in the case of transport of patient carrying SARS-CoV-2. All activities are monitored with a special traceability card. Lessons Terminal disinfection of environments that have hosted patients with COVID-19. Terminal disinfection of the devices used on patients with COVID-19. Increased safety for operators carrying out environmental sanitation. Key messages Fight SARS-COV-2 with ozone. Disinfecting with ozone is safety for everyone.
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Affiliation(s)
- F De Caro
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
- Department of Hygiene and Valutative Medicine, University Hospital, Salerno, Italy
| | - G Moccia
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | | | - A Annecchiarico
- Department of Hygiene and Valutative Medicine, University Hospital, Salerno, Italy
| | - G Cioffi
- University Hospital, Salerno, Italy
| | | | - O Motta
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
- Department of Hygiene and Valutative Medicine, University Hospital, Salerno, Italy
| | - V Caputo
- University Hospital, Salerno, Italy
| | - G Boccia
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
- Department of Hygiene and Valutative Medicine, University Hospital, Salerno, Italy
| | - M Capunzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
- Department of Hygiene and Valutative Medicine, University Hospital, Salerno, Italy
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30
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Giudice V, Pagliano P, Vatrella A, Masullo A, Poto S, Polverino BM, Gammaldi R, Maglio A, Sellitto C, Vitale C, Serio B, Cuffa B, Borrelli A, Vecchione C, Filippelli A, Selleri C. Combination of Ruxolitinib and Eculizumab for Treatment of Severe SARS-CoV-2-Related Acute Respiratory Distress Syndrome: A Controlled Study. Front Pharmacol 2020; 11:857. [PMID: 32581810 PMCID: PMC7291857 DOI: 10.3389/fphar.2020.00857] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [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: 05/01/2020] [Accepted: 05/25/2020] [Indexed: 12/23/2022] Open
Abstract
To date, there are no specific therapeutic strategies for treatment of COVID-19. Based on the hypothesis that complement and coagulation cascades are activated by viral infection, and might trigger an acute respiratory distress syndrome (ARDS), we report clinical outcomes of 17 consecutive cases of SARS-CoV-2-related ARDS treated (N = 7) with the novel combination of ruxolitinib, a JAK1/2 inhibitor, 10 mg/twice daily for 14 days and eculizumab, an anti-C5a complement monoclonal antibody, 900 mg IV/weekly for a maximum of three weeks, or with the best available therapy (N = 10). Patients treated with the combination showed significant improvements in respiratory symptoms and radiographic pulmonary lesions and decrease in circulating D-dimer levels compared to the best available therapy group. Our results support the use of combined ruxolitinib and eculizumab for treatment of severe SARS-CoV-2-related ARDS by simultaneously turning off abnormal innate and adaptive immune responses.
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Affiliation(s)
- Valentina Giudice
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, Baronissi, Italy.,Clinical Pharmacology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, Baronissi, Italy.,Infectious Disease Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Alessandro Vatrella
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, Baronissi, Italy.,Intensive Care Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Alfonso Masullo
- Infectious Disease Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Sergio Poto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, Baronissi, Italy.,Intensive Care Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Benedetto Maria Polverino
- Respiratory Disease Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Renato Gammaldi
- Respiratory Endoscopy Unit, Hospital "Giovanni Da Procida", University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Angelantonio Maglio
- Intensive Care Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, Baronissi, Italy.,Clinical Pharmacology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Carolina Vitale
- Intensive Care Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Bianca Serio
- Hematology and Transplant Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Bianca Cuffa
- Hematology and Transplant Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Anna Borrelli
- Executive Board, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, Baronissi, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, Baronissi, Italy.,Clinical Pharmacology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Carmine Selleri
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno, Baronissi, Italy.,Hematology and Transplant Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
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31
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Minati M, Bencivenga S, De Ruvo E, Bressi E, Cicogna F, Martino AM, De Luca L, Fagagnini A, Bruni G, Grieco D, Borrelli A, Scara A, Milo M, Lino S, Calo" L. P1133Impact of mid-septal versus apical pacing on the right ventricle performance of patients with right bundle branch block undergoing pacemaker implantation. Europace 2020. [DOI: 10.1093/europace/euaa162.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
pacemaker induced cardiomyopathy or transient impairment of the left ventricle (LV) function could be common collateral effects of the prolonged right ventricle (RV) pacing in patients with a pacemaker (PM) and pre-existing intra-ventricular conduction disturbances. However, the impact of RV pacing-site on RV performance of patients with right bundle branch block(RBBB) is still under-investigated.
Purpose
to study the effects of RV pacing in the mid-septal versus apical site on the morpho-functional performance of RV in patients undergoing permanent PM implantation.
Methods
We prospectively enrolled consecutive patients with a pre-existent complete RBBB and undergoing dual-chamber PM implantation in our institution. We randomized the patients 1:1 to receive the RV catheter fixed either in the apex or in the mid-septal position. Patients with LV systolic dysfunction (LVEF <50%), severe valvulopathies, left bundle branch block (LBBB), or preserved intraventricular conduction were excluded. Patients who received PM implantation were evaluated both at baseline and after two months with a 12-lead ECG, 2D, and 3D echocardiogram with analysis focused on RV performance according to the guidelines of the European Association of Cardiovascular Imaging.
Results
a total of 22 patients were randomized in the study, 11 (50%) received RV catheter positioned in the apex and 11 (50%) in the mid-septum, respectively. No baseline differences were recorded between the two groups in clinical characteristics, ECG and echocardiographic parameters. At 2 months follow up, there were no statistically significant difference in the % of RV pacing between the two groups. Nonetheless, RV mid-septal group showed significantly shorter duration of the stimulated QRS (146 ± 12 msec vs. 161 ± 20 msec, p = 0.05), significantly reductions in the RV dimensions (pre: 42 ± 8 mm vs. post: 37 ± 7 mm, p = 0.05) telediastolic area (pre: 12 ± 3 cm2/m2 vs post: 9 ± 4 cm2/ m2, p = 0.02) telediastolic volume (pre: 55 ± 16 ml/m2 vs post: 50 ± 17 ml/m2, p = 0.02) and a significant improvement of RV ejection fraction (pre: 54 ± 9% vs post: 57 ± 11%, p = 0.02) than patients in the RV-apical group. Moreover, patients in the RV-apical group showed significant lowering in the GLS of the LV (pre: -16 ± 3% vs post: -11.7 ± 3%, p <0.001) and in the TAPSE (pre: 23 ± 5 mm vs post: 21 ± 2, p = 0.07) at follow up.
Conclusions
In this study, mid-septal pacing seems associated with a better morpho-functional RV performance than apical pacing in patients with pre-existent RBBB undergoing permanent PM implantation.
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Affiliation(s)
- M Minati
- POLYCLINIC CASILINO, Rome, Italy
| | | | | | - E Bressi
- POLYCLINIC CASILINO, Rome, Italy
| | | | | | | | | | - G Bruni
- POLYCLINIC CASILINO, Rome, Italy
| | - D Grieco
- POLYCLINIC CASILINO, Rome, Italy
| | | | - A Scara
- POLYCLINIC CASILINO, Rome, Italy
| | - M Milo
- POLYCLINIC CASILINO, Rome, Italy
| | - S Lino
- POLYCLINIC CASILINO, Rome, Italy
| | - L Calo"
- POLYCLINIC CASILINO, Rome, Italy
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De Ruvo E, Cicogna F, Bressi E, Tota C, Monzo L, Mennuni S, Bruni G, Fagagnini A, Borrelli A, Scara A, Panuccio M, Grieco D, Politano A, Sciarra L, Calo L. P1151Impact of ARNI (LCZ696) on patients selection for ICD implantation in SCD primary prevention: a real-world experience. Europace 2020. [DOI: 10.1093/europace/euaa162.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
ICD implantation is recommended for primary prevention in patients with symptomatic NYHA II-III heart failure with reduced ejection fraction (< 35%) (HFrEF) and without left ventricle ejection fraction (LVEF) improvement despite at least three months of guideline-directed therapy. The use of angiotensin receptor-neprilysin inhibition with LCZ696 has shown to ameliorate left ventricle function and to reduce the ventricular arrhythmias burden in patients with HFrEF.
Purpose
The profile of patients with HFrEF who may benefit from therapy with LCZ696 without further requiring an ICD in primary prevention is still unknown. We aimed to assess the prevalence of these patients and to find potential clinical predictors of responsiveness to this treatment.
Methods
We enrolled consecutive patients that started LCZ696 treatment for medical therapy optimization in the heart failure clinic of our institution. All of them were previously implanted with an ICD before LCZ696 availability (from 2009 to 2015). A cardiologist evaluated their home medications, clinical, and echocardiographic characteristics both at baseline (before starting LCZ696) and during follow up. The patients were grouped also according to the etiology of HF (ischemic/non-ischemic) and by gender. Patients were excluded if candidates to cardiac resynchronization therapy. Responsiveness to LCZ696 treatment was defined as an increase of LVEF to values > 35% at follow up (FU).
Results
A total of 49 patients (67.1 ± 9.8 years of age) were enrolled in this study and followed in the heart failure clinic of our institution (mean follow up 11.5 ± 4.9 months). Among them, 19 patients (38%) showed an increase in LVEF to values > 35% at follow up and a significant improvement in LVEF was appreciated (baseline LVEF: 31.2 ± 4.5 vs. follow up LVEF: 35.4 ± 8.0; p 0.003). No significant differences were recorded at baseline in LVEF within HF etiology and gender groups. At follow up, we found a significant increase in post-therapy LVEF only in the non-ischemic etiology group (from 31.5 ± 4.4 to 37.1 ± 8.1, p = 0.001) and in the male group (from 31.4 ± 4.5 to 34.9 ± 7.9, p = 0.005) in comparison with the ischemic etiology and the female group, respectively. No significant statistical differences were appreciated between responders and non-responders neither in terms of home medications nor in the LCZ696 doses, both at baseline and follow up.
Conclusion
This study suggests a potential impact of angiotensin receptor-neprilysin inhibition therapy in the selection of patients with HFrEF candidates to ICD in primary prevention. In this real-world experience from our HF clinic, we found a significant LVEF improvement in approximately 40% of patients treated with LCZ696. These patients, in FU evaluation, would not have needed for an ICD implantation. This benefit appears related to the non-ischemic etiology of HF and the male gender.
Abstract Figure. LVEF VARIATIONS
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Affiliation(s)
| | | | - E Bressi
- POLYCLINIC CASILINO, Rome, Italy
| | - C Tota
- POLYCLINIC CASILINO, Rome, Italy
| | - L Monzo
- POLYCLINIC CASILINO, Rome, Italy
| | | | - G Bruni
- POLYCLINIC CASILINO, Rome, Italy
| | | | | | - A Scara
- POLYCLINIC CASILINO, Rome, Italy
| | | | - D Grieco
- POLYCLINIC CASILINO, Rome, Italy
| | | | | | - L Calo
- POLYCLINIC CASILINO, Rome, Italy
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Genovese M, Borrelli A, Venturini A, Guidone D, Caci E, Viscido G, Gambardella G, di Bernardo D, Scudieri P, Galietta LJV. TRPV4 and purinergic receptor signalling pathways are separately linked in airway epithelia to CFTR and TMEM16A chloride channels. J Physiol 2019; 597:5859-5878. [PMID: 31622498 DOI: 10.1113/jp278784] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/09/2019] [Indexed: 01/09/2023] Open
Abstract
KEY POINTS Eact is a putative pharmacological activator of TMEM16A. Eact is strongly effective in recombinant Fischer rat thyroid (FRT) cells but not in airway epithelial cells with endogenous TMEM16A expression. Transcriptomic analysis, gene silencing and functional studies in FRT cells reveal that Eact is actually an activator of the Ca2+ -permeable TRPV4 channel. In airway epithelial cells TRPV4 and TMEM16A are expressed in separate cell types. Intracellular Ca2+ elevation by TRPV4 stimulation leads to CFTR channel activation. ABSTRACT TMEM16A is a Ca2+ -activated Cl- channel expressed in airway epithelial cells, particularly under conditions of mucus hypersecretion. To investigate the role of TMEM16A, we used Eact, a putative TMEM16A pharmacological activator. However, in contrast to purinergic stimulation, we found little effect of Eact on bronchial epithelial cells under conditions of high TMEM16A expression. We hypothesized that Eact is an indirect activator of TMEM16A. By a combination of approaches, including short-circuit current recordings, bulk and single cell RNA sequencing, intracellular Ca2+ imaging and RNA interference, we found that Eact is actually an activator of the Ca2+ -permeable TRPV4 channel and that the modest effect of this compound in bronchial epithelial cells is due to a separate expression of TMEM16A and TRPV4 in different cell types. Importantly, we found that TRPV4 stimulation induced activation of the CFTR Cl- channel. Our study reveals the existence of separate Ca2+ signalling pathways linked to different Cl- secretory processes.
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Affiliation(s)
- Michele Genovese
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Anna Borrelli
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Arianna Venturini
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Daniela Guidone
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Emanuela Caci
- UOC Genetica Medica, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Gaetano Viscido
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | | | - Diego di Bernardo
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Paolo Scudieri
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Luis J V Galietta
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy.,Department of Translational Medical Sciences (DISMET), Università di Napoli Federico II, Napoli, Italy
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Albi E, Borrelli A, Cataldi S, Ceccarini M, Nakashidze I, Codini M, Conte C, Fioretti B, Ferri I, Laurenti M, Patria F, Beccari T, Mancini A, Impiombato FA, Curcio F. Protective effect of rMnSOD in mice exposed to cosmonaut simulation radiation: involvement of vitamin D receptor. J Biotechnol 2019. [DOI: 10.1016/j.jbiotec.2019.05.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ricciardi C, Fiorillo A, Valente AS, Borrelli A, Verdoliva C, Triassi M, Improta G. Lean Six Sigma approach to reduce LOS through a diagnostic-therapeutic-assistance path at A.O.R.N. A. Cardarelli. TQM 2019. [DOI: 10.1108/tqm-02-2019-0065] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The rise of the mean age incremented the occurrence of femur fractures with respect to the past, leading thus to serious consequences, as regards morbidity and socio-economic impact. The direction of the A.O.R.N. Cardarelli of Naples has introduced a DTAP whose aim was the reduction of LOS. The paper aims to discuss this issue.
Design/methodology/approach
The aim of this paper is to analyze the introduction of DTAP, employing Lean Thinking and Six Sigma methodology based on the DMAIC cycle. To evaluate the effectiveness of DTAP, two groups of patients have been observed for 14 months (before and after the implementation of DTAP).
Findings
Statistical tests were performed on the groups and graphics were provided to visualize the decrease of LOS (29.9 per cent). The overall population was also divided in subgroups according to six variables potentially influencing LOS.
Research limitations/implications
Authors considered six variables of influences; yet, others could be taken into account in the future.
Practical implications
The decrease of costs due to the management of elderly patients with femur fracture, the optimization of care processes in hospitals and a faster recovery for patients is the tangible contribute of DTAP.
Originality/value
The implementation of DTAP allowed the hospital to obtain a significant reduction of LOS with a consequently decrease of costs alleviating the hospital and the society from the socio-economic burden and the morbidity of this pathology.
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Paolacci S, Borrelli A, Stuppia L, Campanile FC, Dallavilla T, Krajčovič J, Veselenyiova D, Beccari T, Unfer V, Bertelli M. Mendelian obesity, molecular pathways and pharmacological therapies: a review. Eur Rev Med Pharmacol Sci 2019; 23:1357-1378. [PMID: 30779104 DOI: 10.26355/eurrev_201902_17031] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE In this qualitative review we analyze the major pathways and mechanisms involved in the onset of genetically-determined obesity (Mendelian obesity), identifying possible pharmacological treatments and trials. MATERIALS AND METHODS We searched PubMed with the keywords (obesity[Title/Abstract]) AND mutation[Title/Abstract], and OMIM with the keyword "obesity". In both cases, we selected non-syndromic Mendelian obesity. We then searched ClinicalTrials.gov with the following criteria: "recruitment status: active, not recruiting and completed"; "study type: interventional (clinical trial)"; "study results: with results"; type of intervention: "drug or dietary supplement". RESULTS From the PubMed and OMIM searches we obtained a total of 15 genes associated with monogenic Mendelian obesity. From ClinicalTrials.gov we retrieved 46 completed or active trials of pharmacological treatments. CONCLUSIONS We summarized the molecular bases of Mendelian obesity and searched for any clinical trials completed or underway for the treatment of severe forms of obesity. Most Mendelian obesities are linked to dysfunctions in the leptin/melanocortin signaling pathway, and most of the possible drugs target this pathway in order to improve energy expenditure and reduce food intake.
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Affiliation(s)
- S Paolacci
- MAGI'S Lab, Genetic Testing Laboratory, Rovereto (TN), Italy.
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Improta G, Romano M, Di Cicco MV, Ferraro A, Borrelli A, Verdoliva C, Triassi M, Cesarelli M. Lean thinking to improve emergency department throughput at AORN Cardarelli hospital. BMC Health Serv Res 2018; 18:914. [PMID: 30509286 PMCID: PMC6276250 DOI: 10.1186/s12913-018-3654-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [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: 05/08/2018] [Accepted: 10/26/2018] [Indexed: 11/14/2022] Open
Abstract
Background Throughout the world, emergency departments (ED) are characterized by overcrowding and excessive waiting times. Furthermore, the related delays significantly increase patient mortality and make inefficient use of resources to the detriment of the satisfaction of employees and patients. In this work, lean thinking is applied to the ED of Cardarelli Hospital of Naples with the aim of increasing patient flow, improving the processes that contribute to facilitating the flow of patients through the various stages of medical treatment and eliminating all bottlenecks (queue) as well as all activities that generate waste. Methods This project was performed at National Hospital A.O.R.N. A. Cardarelli of Naples. The historical times of access to the ED were analysed from January 2015 to June 2015, for a total of 16,563 records. Subsequently, starting in November 2015, corrective actions were implemented according to the Lean Approach. Data collected after the introduced improvements were collected from April 2016 to June 2016 and compared to those collected during the starting period. Results The results acquired before application of the Lean Thinking strategy illustrated the as-is process with its drawbacks. An analysis of the non-added value activities was performed to identify the procedures that need to be improved. After implementation of the corrective actions, we observed a positive increase in the performance of the ED, quantified as percentages of hospitalized patients according to triage codes and waiting times. Conclusion This work demonstrates the applicability of Lean Thinking to ED processes and its effectiveness in terms of increasing the efficiency of services and reducing waste (waiting times).
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Affiliation(s)
- Giovanni Improta
- Department of Public Health, School of Medicine and Surgery, University of Naples 'Federico II', Naples, Italy.
| | - Maria Romano
- Department of Medical and Surgical Sciences, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy.,Scientific Clinical Institutes Maugeri IRCCS, Telese, Italy
| | - Maria Vincenza Di Cicco
- Department of Public Health, School of Medicine and Surgery, University of Naples 'Federico II', Naples, Italy
| | - Anna Ferraro
- Department of Public Health, School of Medicine and Surgery, University of Naples 'Federico II', Naples, Italy
| | - Anna Borrelli
- Responsible for the Programming and Health Planning Unit, Hospital "Antonio Cardarelli", Naples, Italy
| | | | - Maria Triassi
- Department of Public Health, School of Medicine and Surgery, University of Naples 'Federico II', Naples, Italy
| | - Mario Cesarelli
- Department of Electrical Engineering and Information Technology (DIETI), University of Naples 'Federico II', Naples, Italy.,Scientific Clinical Institutes Maugeri IRCCS, Telese, Italy
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38
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Miniscalco B, Poggi A, Martini V, Morello E, Sulce M, Melega M, Borrelli A, Tarducci A, Riondato F. Flow Cytometric Characterization of S-phase Fraction and Ploidy in Lymph Node Aspirates from Dogs with Lymphoma. J Comp Pathol 2018; 161:34-42. [PMID: 30173856 DOI: 10.1016/j.jcpa.2018.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/27/2018] [Accepted: 04/28/2018] [Indexed: 11/26/2022]
Abstract
Canine lymphoma is a multifaceted disease encompassing numerous entities with different prognosis. Objective assessment of the proliferation rate is of importance from the pathological and clinical perspectives. Different methods have been described in the literature to assess proliferation rate, including evaluation of Ki67 expression in fresh lymph node (LN) aspirates measured by flow cytometry (FC). This test has a high accuracy in discriminating between low- and high-grade lymphomas, and provides prognostic information among high-grade B-cell lymphomas. DNA content analysis is less expensive and suitable for well-preserved samples. We describe DNA-content analysis using LN aspirates from 112 dogs with lymphoma. S-phase fraction (SPF) accurately discriminated between low- and high-grade lymphomas, with 3.15% being the best discriminating cut-off value. SPF values strongly correlated with Ki67 expression as assessed by FC. Survival analyses were restricted to 33 dogs with high-grade B-cell lymphoma receiving standardized multi-agent chemotherapy, but no significant result was obtained for SPF. We also describe a subset of aneuploid cases and their respective follow-up. We conclude that DNA content analysis may be combined with morphological examination of LN aspirates to improve the objectivity in lymphoma subtype classification in dogs. Further studies are needed to assess the possible prognostic role of SPF and ploidy status within specific lymphoma subtypes in dogs.
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Affiliation(s)
- B Miniscalco
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco, Turin, Italy
| | - A Poggi
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco, Turin, Italy
| | - V Martini
- Department of Veterinary Medicine, University of Milan, Via Celoria 10, Milan, Italy
| | - E Morello
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco, Turin, Italy
| | - M Sulce
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco, Turin, Italy
| | - M Melega
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco, Turin, Italy
| | - A Borrelli
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco, Turin, Italy
| | - A Tarducci
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco, Turin, Italy
| | - F Riondato
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco, Turin, Italy.
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Pagani E, Tarducci A, Borrelli A, Iotti B, Tursi M, Zanatta R. Accuracy of Ultrasonographic Measurements of Adrenal Glands in Dogs: Comparison with Necroscopic Findings. Anat Histol Embryol 2016; 46:187-194. [DOI: 10.1111/ahe.12256] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 09/20/2016] [Indexed: 11/30/2022]
Affiliation(s)
- E. Pagani
- Section of Clinical Sciences; Department of Veterinary Sciences; University of Turin; L. Paolo Braccini 2 10095 Grugliasco TO Italy
| | - A. Tarducci
- Section of Clinical Sciences; Department of Veterinary Sciences; University of Turin; L. Paolo Braccini 2 10095 Grugliasco TO Italy
| | - A. Borrelli
- Section of Clinical Sciences; Department of Veterinary Sciences; University of Turin; L. Paolo Braccini 2 10095 Grugliasco TO Italy
| | - B. Iotti
- Section of Epidemiology; Department of Veterinary Sciences; University of Turin; L. Paolo Braccini 2 10095 Grugliasco TO Italy
| | - M. Tursi
- Section of Anatomic Pathology; Department of Veterinary Sciences; University of Turin; L. Paolo Braccini 2 10095 Grugliasco TO Italy
| | - R. Zanatta
- Section of Clinical Sciences; Department of Veterinary Sciences; University of Turin; L. Paolo Braccini 2 10095 Grugliasco TO Italy
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40
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Riondato F, Martini V, Poggi A, Rota A, Comazzi S, Sulce M, Bruno B, Borrelli A, Miniscalco B. Identification of a suitable internal control for fluorescence analysis on canine peripheral blood samples. Vet Immunol Immunopathol 2016; 172:38-42. [PMID: 27032501 DOI: 10.1016/j.vetimm.2016.03.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 03/03/2016] [Accepted: 03/05/2016] [Indexed: 11/16/2022]
Abstract
Reliable detection of fluorescence intensity (FI) by flow cytometry (FC) is fundamental. FI depends on instrument settings and sample processing procedures: thus, measurements should be done using internal controls with known FI. Commercially available beads-based standards are expensive, thus reducing their usability in the veterinary practice. Cell subsets with stable mean FI (MFI) within the population have been proposed as acceptable surrogates in human medicine. In veterinary medicine, no data exist about stability of antigen expression among different subjects or upon sample storage. The aim of the present study was to evaluate MFI variability of main lymphocytes antigens among the lymphoid cells within each subject, among different subjects, and upon 24-h storage, in order to identify the antigen most suitable as stable internal control in MFI analyses. Peripheral blood samples from 18 healthy dogs were analysed by FC within 3h from sampling to assess the expression of CD3, CD5, CD4, CD8, CD21 and cyCD79b using conjugated monoclonal antibodies. Analyses were restricted to the lymphoid population. Fluorescent microbeads were added to each tube, and antigen MFI was calculated as Relative Fluorescence Intensity RFI (CD/beads). Fluorescence histogram CV (fhCV) for each CD was regarded as an index of the variability of expression among lymphocytes within each subject (cell-to-cell variability); whereas the CV of RFI was regarded as an index of inter-subjects variability (dog-to-dog variability). In 11 cases, FC analyses were repeated after 24h storage at 4°C and RFI and CVs of fresh and stored samples were compared to assess variability linked to storage. CD4 was identified as the best antigen to be used as an internal control for MFI analyses in canine peripheral blood samples because of low cell-to-cell and dog-to-dog variability, and optimal stability upon 24-h storage. Blood samples from a second group of 21 healthy dogs were labelled only with CD4, in order to assess the influence of breed, sex and age on the expression of CD4 in a larger case series. Based on univariate GLMs, none of these variables influenced CD4 RFI. Normalizing fluorescence data using lymphoid CD4 MFI as a reference would improve the comparison of results obtained by different laboratories, patients or times in diagnostic and research analyses of FI. Further studies are needed to confirm our results with different FC approaches.
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Affiliation(s)
- F Riondato
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Turin, Italy.
| | - V Martini
- Department of Veterinary Sciences and Public Health, University of Milan, Via Celoria 10, 20133 Milan, Italy
| | - A Poggi
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Turin, Italy
| | - A Rota
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Turin, Italy
| | - S Comazzi
- Department of Veterinary Sciences and Public Health, University of Milan, Via Celoria 10, 20133 Milan, Italy
| | - M Sulce
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Turin, Italy
| | - B Bruno
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Turin, Italy
| | - A Borrelli
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Turin, Italy
| | - B Miniscalco
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Turin, Italy
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Vitale M, Fedelini P, Paladino F, Romano L, Minelli S, Nappi O, Marano A, Massa R, Carotenuto F, Borrelli A, Cartenì G. A path for diagnosis, therapy, follow up and research of kidney cancer: a continuous quality improvement. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv341.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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42
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Pica A, Di Santi A, D'angelo V, Iannotta A, Ramaglia M, Di Martino M, Pollio M, Schiattarella A, Borrelli A, Mancini A, Indolfi P, Casale F. Effect of rMnSOD on Survival Signaling in Pediatric High Risk T-Cell Acute Lymphoblastic Leukaemia. J Cell Physiol 2015; 230:1086-93. [DOI: 10.1002/jcp.24840] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 05/08/2014] [Indexed: 01/03/2023]
Affiliation(s)
- A. Pica
- Department of Biology; University of Naples Federico II; Naples Italy
| | - A. Di Santi
- Department of Biology; University of Naples Federico II; Naples Italy
| | - V. D'angelo
- Department of Woman, Child and General and Specialized Surgery; Pediatric Oncology Service-Second University of Naples; Naples Italy
| | - A. Iannotta
- Department of Woman, Child and General and Specialized Surgery; Pediatric Oncology Service-Second University of Naples; Naples Italy
| | - M. Ramaglia
- Department of Woman, Child and General and Specialized Surgery; Pediatric Oncology Service-Second University of Naples; Naples Italy
| | - M. Di Martino
- Department of Woman, Child and General and Specialized Surgery; Pediatric Oncology Service-Second University of Naples; Naples Italy
| | - M.L. Pollio
- Department of Biology; University of Naples Federico II; Naples Italy
| | - A. Schiattarella
- Molecular Biology and Viral Oncology Unit; Department of Experimental Oncology; “Istituto Nazionale Tumori Fondazione G. Pascale”-Irccs; Naples Italy
| | - A. Borrelli
- Molecular Biology and Viral Oncology Unit; Department of Experimental Oncology; “Istituto Nazionale Tumori Fondazione G. Pascale”-Irccs; Naples Italy
| | - A. Mancini
- LaedhexaBiotechnologies Inc. QB3 Partners; San Francisco California
| | - P. Indolfi
- Department of Woman, Child and General and Specialized Surgery; Pediatric Oncology Service-Second University of Naples; Naples Italy
| | - F. Casale
- Department of Woman, Child and General and Specialized Surgery; Pediatric Oncology Service-Second University of Naples; Naples Italy
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43
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Cortese F, Vergari M, Bocci T, Borrelli A, Barbieri S, Priori A. P651: Dorsal transcutaneous spinal direct current stimulation (tsDCS) induces remote effects on the Ia-motoneuron connections in the cervical spinal segments. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50745-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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44
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Coppola G, Carità P, Corrado E, Borrelli A, Rotolo A, Guglielmo M, Nugara C, Ajello L, Santomauro M, Novo S. ST segment elevations: always a marker of acute myocardial infarction? Indian Heart J 2014; 65:412-23. [PMID: 23993002 DOI: 10.1016/j.ihj.2013.06.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 06/19/2013] [Indexed: 10/26/2022] Open
Abstract
Chest pain is one of the chief presenting complaints among patients attending Emergency department. The diagnosis of acute myocardial infarction may be a challenge. Various tools such as anamnesis, blood sample (with evaluation of markers of myocardial necrosis), ultrasound techniques and coronary computed tomography could be useful. However, the interpretation of electrocardiograms of these patients may be a real concern. The earliest manifestations of myocardial ischemia typically interest T waves and ST segment. Despite the high sensitivity, ST segment deviation has however poor specificity since it may be observed in many other cardiac and non-cardiac conditions. Therefore, when ST-T abnormalities are detected the physicians should take into account many other parameters (such as risk factors, symptoms and anamnesis) and all the other differential diagnoses. The aim of our review is to overview of the main conditions that may mimic a ST segment Elevation Myocardial Infarction (STEMI).
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Affiliation(s)
- G Coppola
- O.U. of Cardiology, A.O.U. Policlinico "P. Giaccone", University of Palermo, Italy
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45
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Borrelli A, Giantesio G, Patria M. ON THE NUMERICAL SOLUTIONS OF THREE-DIMENSIONAL MHD STAGNATION-POINT FLOW OF A NEWTONIAN FLUID. ACTA ACUST UNITED AC 2013. [DOI: 10.12732/ijpam.v86i2.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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46
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Biolatti C, Bellino C, Borrelli A, Capucchio M, Gianella P, Maurella C, Miniscalco B, Nebbia P, Zoppi S, Cagnasso A, D'Angelo A. Sepsis and bacterial suppurative meningitis-meningoencephalitis in critically ill neonatal Piedmontese calves: clinical approach and laboratory findings. SCHWEIZ ARCH TIERH 2012; 154:239-46. [PMID: 22653698 DOI: 10.1024/0036-7281/a000339] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Sepsis (S) and bacterial suppurative meningitis-meningoencephalitis (M-ME) are common causes of death in bovine neonates. The aim of this prospective study was to evaluate the prevalence of S and M-ME in critically ill neonatal Piedmontese calves. Critically ill animals up to 15 days old referred by practitioners were registered according to their status and subsequently assigned to clinical standardized score. Calves with a clinical score > = 5 were further assessed under a clinical and clinical-pathological protocol to strengthen the suspicion of S and M-ME. Critically ill neonatal calves sent for necropsy were included in the study as well. Fifty-nine calves were investigated, 26 of which referred alive and 33 dead. Ten out of the 26 clinically evaluated calves were classified as suspicious of S on the basis of the clinical and clinical-pathological protocols. S was confirmed by positive bacteriologic culture in 7 cases and in 3 cases on the basis of necroptic lesions. Concomitant suppurative M-ME suspected in 6 of these 10 calves was subsequently confirmed by CSF analysis or histological findings. Of the 33 calves examined only post-mortem, 20 showed pathognomonic findings of S and 14 signs of M-ME. The prevalence of S and M-ME was 46 and 36 %, respectively. Clinical signs of S were confirmed to be vague and overlapping with other diseases. The developed protocol was highly accurate in predicting S in these neonatal calves.
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Affiliation(s)
- C Biolatti
- Department of Animal Pathology, Clinical Section, University of Torino, Grugliasco (TO), Italy
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47
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Rettori M, Feroci F, Borrelli A, Ottaviano A, Coppola A, Castagnoli A, Scatizzi M. [A single effective way to reduce post-thyroidectomy discomfort: a clinical trial]. MINERVA CHIR 2011; 66:197-205. [PMID: 21666556] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM Nausea, with or without vomiting (postoperative nausea and vomiting, PONV), occurs up to 60-76% after thyroidectomy and other head and neck surgeries. Due to the fact that patients typically have only mild-to-moderate pain after thyroid or parathyroid surgery, PONV might be the main source of discomfort, and it may be perceived as the most unpleasant aspect of postoperative recovery. This study aims to assess the effects of a preoperative single dose of 8 mg dexamethasone on the nausea, vomiting, pain, and subjective vocal function after thyroidectomy in patients undergoing surgery for benign disease. METHODS Seventy patients operated on for thyroidectomy were randomized in two groups: Group A, 8 mg/2 mL of dexamethasone administered in 100 mL of physiologic saline given intravenously (i.v.) 20 minutes before the induction of anesthesia; group B, 2 mL NaCl 0.9% in 100 mL of physiologic saline. Postoperative therapy has been standardized. PONV have been evaluated with a scale of 4, degrees (0-3), pain by a Visual Analog Scale (0-100) and subjective vocal function by a Visual Analog Scale (0-100) at 8, 24, 32 and 48 hours after surgery. RESULTS The severity of nausea was less in patients of group A (P=0.0001); Dexamethasone patients reported significantly less pain (P=0.008); no differences were noted about the subjective voice analysis (P=0.693). No steroid-related complications occurred. CONCLUSION Dexamethasone 8 mg i.v. is a safe and effective method to reduce PONV and pain after thyroid resection and we advise its routine use.
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Affiliation(s)
- M Rettori
- General Surgery Unit, Misericordia and Dolce Hospital, Prato, Italy
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48
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Pelo S, Marianetti TM, Cacucci L, Di Nardo F, Borrelli A, Di Rocco C, Tamburrini G, Moro A, Gasparini G, Deli R. Occlusal alterations in unilateral coronal craniosynostosis. Int J Oral Maxillofac Surg 2011; 40:805-9. [PMID: 21466946 DOI: 10.1016/j.ijom.2011.02.023] [Citation(s) in RCA: 10] [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] [Received: 04/09/2010] [Revised: 01/11/2011] [Accepted: 02/17/2011] [Indexed: 10/18/2022]
Abstract
There are few studies on maxillomandibular skeletal alterations. Twenty-one patients with unilateral coronal craniosynostosis were analysed and compared with controls. Landmarks analysed were: sella-nasion-point A and B angles, point A-nasion-point B angle, interincisal angle, angle of superior incisor axis on the sella-nasion plane, lower incisor to mandibular plane angle, Frankfort mandibular plane angle, zygomatic-frontal suture (Z), point on the most concave part of pyramidal apophysis of the upper maxilla (Mx), antegonial incisure (AG), upper (UMT) and lower (LMT) molar teeth. Differences were significant for class II dentoskeletal occlusion (p<0.0001), mandibular hyperdivergence (p<0.0001), lingualization of superior incisor (p<0.005), deviation of inferior interincisal contralateral line to the synostosis (p<0.0001) in the plagiocephalic population. Compared with contralateral counterpoints, Z (p<0.05), Mx (p<0.005) and UMT (p<0.0005) on the affected side were closer to the midline; AG (p<0.0005) and LMT (p<0.05) were further from it. On the frontal plane, Z, Mx, UMT, LMT and AG on the affected side were higher. Vertical and transversal contraction of the jaw of the synostotic side and laterodeviation of the mandibular interincisal line of the contralateral synostotic were clear. The altered position of the glenoid cavity, anteriorized in unilateral coronal craniosynostosis, could be the cause of mandibular dentoskeletal asymmetry.
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Affiliation(s)
- S Pelo
- Department of Maxillo-Facial Surgery, Complesso Integrato Columbus, Catholic University of Rome, Rome, Italy.
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49
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Feroci F, Lenzi E, Kröning KC, Moraldi L, Cantafio S, Borrelli A, Giaconi G, Scatizzi M. [Feasibility and effectiveness of laparoscopic right colectomy with extracorporeal anastomosis]. MINERVA CHIR 2011; 66:41-48. [PMID: 21389923] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM Despite the laparoscopic right hemicolectomy has been validated by many randomized prospective trials, clear evidences on the validity of the totally mini-invasive technique, namely, through intracorporeal anastomosis, are still lacking. The aim of this study was the assessment of short-term outcome within three months from laparoscopic right colectomy with intra- or extra-corporeal anastomosis. METHODS With no exclusion, all patients undergoing laparoscopic right hemicolectomy at our institution have been enrolled in this study. Group A included patients undergoing laparoscopic right hemicolectomy with extracorporeal anastomosis (LAC) and Group B, included patients undergoing laparoscopic right hemicolectomy with intracorporeal anastomosis (TLC). Patients' data, surgery details, results of postoperative period and histological tests have been prospectively recorded in a database and analysed. RESULTS Between December 2006 and December 2008, 45 patients underwent right hemicolectomy, 21 with extracorporeal anastomosis and 24 had intracorporeal ones. As to patients' characteristics and histopathological results there are no difference between the groups. Anastomotic dehiscence occurred one in group A and one in group B (P>0.05). Both patients underwent reoperation. We recorded 6 postoperative ileus with vomiting in the LAC group and only 1 in the TLC group (P<0.05). The incidence of Non-Surgical Site Complications (NSSC) was of 4.54% in LAC group and 8.33% in TLC group (P>0.05). Hospitalization was of 5 days for both groups. CONCLUSION In conclusion, we believe that this technique is feasible in terms of safety; it doesn't significatively affect the length of surgical procedure and guarantees maintenance of oncological radicality standards of reference. Besides it significatively improves quality of the post-operative period.
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Affiliation(s)
- F Feroci
- Unità Operativa di Chirurgia Generale, Ospedale Misericordia e Dolce, Prato, Italia.
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50
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Feroci F, Kröning KC, Moraldi L, Borrelli A, Ottaviano A, De Prizio M, Scatizzi M. [A new effective method to reduce pain after laparoscopic cholecystectomy]. G Chir 2010; 31:423-428. [PMID: 20939947] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The primary aim of this randomized controlled prospective study (www.clinicaltrials.gov NCT00599144) was assessing effectiveness on pain control after videolaparoscopic cholecystectomy (VLC) of 0.5% Bupivacaine-soaked sheet of regenerated oxidized cellulose positioned in the gallbladder bed. PATIENTS AND METHODS We randomized in three equal groups 45 patients that underwent elective videolaparoscopic cholecystectomy: group A - Bupivacaine-soaked sheet of regenerated oxidized cellulose positioned in the gallbladder bed; group B - Bupivacaine infiltrated in the muscular fasciae of the trocars' seat; group C - control group, not using local anesthetic. Six and 24 hours after the intervention we recorded the type of the pain and its intensity, using a visual analog scale (VAS). RESULTS We observed no statistically significant difference in pain intensity. Considering the type of pain, 55,56% of patients referred visceral pain, 62,22% parietal pain and 44,44% shoulder pain. Group A shows, at both endpoints, a statistically significant reduction (p < 0.05) of visceral and shoulder pain versus other groups. Moreover, the use of a local anesthetic significantly reduces the use of post-operative pain drugs, both for group A and B. CONCLUSION A Bupivacaine-soaked sheet of regenerated oxidized cellulose positioned in the gallbladder bed post-VLC is safe and not economically demanding, and can give advantages in increasing post-operative comfort.
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Affiliation(s)
- F Feroci
- Ospedale Misericodia e Dole, Prato (PO) UO Chirurgia Generale
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