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Rinaldi M, Pezone A, Quadrini GI, Abbadessa G, Laezza MP, Passaro ML, Porcellini A, Costagliola C. Targeting shared pathways in tauopathies and age-related macular degeneration: implications for novel therapies. Front Aging Neurosci 2024; 16:1371745. [PMID: 38633983 PMCID: PMC11021713 DOI: 10.3389/fnagi.2024.1371745] [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: 01/16/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
The intricate parallels in structure and function between the human retina and the central nervous system designate the retina as a prospective avenue for understanding brain-related processes. This review extensively explores the shared physiopathological mechanisms connecting age-related macular degeneration (AMD) and proteinopathies, with a specific focus on tauopathies. The pivotal involvement of oxidative stress and cellular senescence emerges as key drivers of pathogenesis in both conditions. Uncovering these shared elements not only has the potential to enhance our understanding of intricate neurodegenerative diseases but also sets the stage for pioneering therapeutic approaches in AMD.
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Affiliation(s)
- Michele Rinaldi
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Antonio Pezone
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Gaia Italia Quadrini
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Gianmarco Abbadessa
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Maria Paola Laezza
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Maria Laura Passaro
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | | | - Ciro Costagliola
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
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Cennamo G, Rinaldi M, Malvone E, Costagliola C. Choroidal Thickness and brolucizumab intravitreal injection: cause or effect of intraocular inflammation? Photodiagnosis Photodyn Ther 2024:104072. [PMID: 38556186 DOI: 10.1016/j.pdpdt.2024.104072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/19/2024] [Accepted: 03/29/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE to analyze the structural changes of choroidal thickness in patients with brolucizumab-related exudative vitritis after intravitreal injection, using EDI-OCT. METHODS One hundred eyes of one hundred patients, affected by exudative age related-macular degeneration treated with brolucizumab intravitreal injection between January 2022 and august 2023 at Eye clinic of University of Federico II Naples, were enrolled. All eyes underwent macular examination using Enhanced Deep Imaging-OCT (Spectralis, Heidelberg Engineering inc.) preoperatively and at each postoperative check (1, 3, 6, 12 months). Anterior segment evaluation at slit lamp before and after injection was performed. RESULTS Of the 100 treated eyes, 4 showed inflammatory signs related to exudative vitreitis, with inflammation signs at slit lamp examination and confirmed by OCT and B scan ecography. EDI-OCT revealed, in all of these 4 patients, a significant increase of choroidal thickness compared to baseline. CONCLUSION choroidal thickness could be correlated in the inflammatory response generated in patients undergoing treatment with brolucizumab.
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Affiliation(s)
- Gilda Cennamo
- Department of Neuro sciences, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy..
| | - Michele Rinaldi
- Department of Neuro sciences, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - Emanuele Malvone
- Department of Neuro sciences, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - Ciro Costagliola
- Department of Neuro sciences, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
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Cennamo G, Rinaldi M, Concilio M, Costagliola C. Congenital Optic Disc Anomalies: Insights from Multimodal Imaging. J Clin Med 2024; 13:1509. [PMID: 38592429 PMCID: PMC10932420 DOI: 10.3390/jcm13051509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 04/10/2024] Open
Abstract
In this comprehensive review, we delve into the significance of multimodal imaging in diagnosing and managing complications of congenital optic disc anomalies. While the fundus examination is the gold standard tool in the diagnosis of these pathologies, spectral domain (SD) optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) could shed light on the pathogenesis and treatment. Moreover, this review seeks to offer a comprehensive insight into the multimodal approach of these rare congenital pathologies. In conclusion, congenital anomalies of the optic nerve represent a major challenge for ophthalmologists. Further research could be useful to clarify the pathophysiology of these diseases and define a correct and more specific treatment approach.
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Affiliation(s)
- Gilda Cennamo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80138 Napoli, Italy;
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80138 Napoli, Italy
| | - Michele Rinaldi
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80138 Napoli, Italy;
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80138 Napoli, Italy
| | - Marina Concilio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Ciro Costagliola
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80138 Napoli, Italy;
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Passaro ML, Matarazzo F, Abbadessa G, Pezone A, Porcellini A, Tranfa F, Rinaldi M, Costagliola C. Reply to Wostyn, P. Targeting the Cerebrospinal Fluid Compartment in Glaucoma: Still the Dark Side of the Moon? Comment on "Passaro et al. Glaucoma as a Tauopathy-Is It the Missing Piece in the Glaucoma Puzzle? J. Clin. Med. 2023, 12, 6900". J Clin Med 2024; 13:1332. [PMID: 38592163 PMCID: PMC10932097 DOI: 10.3390/jcm13051332] [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: 02/06/2024] [Revised: 02/18/2024] [Accepted: 02/23/2024] [Indexed: 04/10/2024] Open
Abstract
We are grateful to the author of the comment [...].
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Affiliation(s)
- Maria Laura Passaro
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
| | | | - Gianmarco Abbadessa
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Antonio Pezone
- Department of Biology, University of Naples “Federico II”, 80126 Naples, Italy; (A.P.); (A.P.)
| | - Antonio Porcellini
- Department of Biology, University of Naples “Federico II”, 80126 Naples, Italy; (A.P.); (A.P.)
| | - Fausto Tranfa
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
| | - Michele Rinaldi
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
| | - Ciro Costagliola
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
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Rinaldi M, Cennamo G, Passaro ML, Costagliola C. Changes in macular pigment optical density after full-thickness macular hole closure using inverted flap technique. Photodiagnosis Photodyn Ther 2024; 45:103950. [PMID: 38145775 DOI: 10.1016/j.pdpdt.2023.103950] [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: 10/24/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 12/27/2023]
Abstract
Full-thickness macular hole (FTMH) is a debilitating retinal disorder, particularly in its advanced forms, necessitating surgical intervention for vision restoration. This case report details the successful closure of a large FTMH using the inverted flap technique, highlighting the essential role of multimodal imaging, and particularly macular pigment optical density (MPOD) assessment, in preoperative and postoperative evaluation. A 55-year-old patient presented with severe vision loss in one eye due to a large FTMH. Surgery was performed by an expert vitreoretinal surgeon, resulting in significant postoperative improvements in visual acuity and retinal architecture. Multimodal imaging, including MPOD assessment, played a pivotal role in preoperative evaluation and postoperative monitoring. The notable increase in MPOD following successful surgery suggests its potential role as a valuable adjunctive biomarker associated with a good visual prognosis following this type of macular hole surgical interventions.
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Affiliation(s)
- Michele Rinaldi
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Gilda Cennamo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy.
| | - Maria Laura Passaro
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Ciro Costagliola
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
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Tecce N, Cennamo G, Rinaldi M, Costagliola C, Colao A. Exploring the Impact of Glycemic Control on Diabetic Retinopathy: Emerging Models and Prognostic Implications. J Clin Med 2024; 13:831. [PMID: 38337523 PMCID: PMC10856421 DOI: 10.3390/jcm13030831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
This review addresses the complexities of type 1 diabetes (T1D) and its associated complications, with a particular focus on diabetic retinopathy (DR). This review outlines the progression from non-proliferative to proliferative diabetic retinopathy and diabetic macular edema, highlighting the role of dysglycemia in the pathogenesis of these conditions. A significant portion of this review is devoted to technological advances in diabetes management, particularly the use of hybrid closed-loop systems (HCLSs) and to the potential of open-source HCLSs, which could be easily adapted to different patients' needs using big data analytics and machine learning. Personalized HCLS algorithms that integrate factors such as patient lifestyle, dietary habits, and hormonal variations are highlighted as critical to reducing the incidence of diabetes-related complications and improving patient outcomes.
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Affiliation(s)
- Nicola Tecce
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, 80131 Napoli, Italy; (N.T.); (A.C.)
| | - Gilda Cennamo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy;
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, 80131 Naples, Italy
| | - Michele Rinaldi
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy;
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, 80131 Naples, Italy
| | - Ciro Costagliola
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Annamaria Colao
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, 80131 Napoli, Italy; (N.T.); (A.C.)
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Rinaldi M, Tranfa F, Chiosi F, Campagna G, De Bernardo M, Gioia M, Natale F, Caiazza M, Dongiglio F, Verrillo F, Palmiero G, Limongelli G, Costagliola C. OCT angiography indices and the choroidal vascularity index in wild-type transthyretin (TTR) amyloidosis (ATTRwt). Front Med (Lausanne) 2024; 10:1174643. [PMID: 38288300 PMCID: PMC10823855 DOI: 10.3389/fmed.2023.1174643] [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: 02/26/2023] [Accepted: 11/27/2023] [Indexed: 01/31/2024] Open
Abstract
Purpose Retinal angiopathy represents a well-known ocular manifestation of hereditary transthyretin amyloidosis (ATTRv). Until recently, there have been no reports on retinal changes in ATTRwt. In this retrospective observational clinical study, we aimed to determine whether vessel density (VD) indices and the choroidal vascularity index (CVI) could offer insights into retinal and choroidal vascular changes among patients affected by ATTRwt. Methods Eighteen patients with a confirmed diagnosis of ATTRwt underwent structural optical coherence tomography (OCT) and OCT angiography (OCTA). We established a control group consisting of 16 healthy subjects for statistical comparisons. The 3D OCT and OCTA datasets were analyzed to assess retinal and choroidal thickness and VD. For measuring CVI, we obtained measurements for the total choroid area (TCA), luminal area (LA), and stromal area (SA). Results The mean VD exhibited a statistically significant reduction in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) among the ATTRwt group in comparison to the control group (p < 0.0001). Notably, ATTRwt patients displayed decreased choroidal thickness (p = 0.08). Additionally, the median CVI was lower in the ATTRwt group than in the control group (p = 0.04). Conclusion The indices from OCTA and CVI have the potential to serve as non-invasive biomarkers for the quantitative evaluation of retinal and choroidal vascular involvement in patients with ATTRwt.
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Affiliation(s)
- Michele Rinaldi
- Department of Ophthalmology, Università degli studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Fausto Tranfa
- Department of Neuroscience, Reproductive and Dentistry Sciences, Federico II University of Naples, Naples, Italy
| | - Flavia Chiosi
- Department of Ophthalmology, Azienda Ospedaliera dei Colli, Monaldi Hospital, Naples, Italy
| | - Giuseppe Campagna
- Department of Medical-Surgical Sciences and Translational Medicine, University of Rome “Sapienza”, Rome, Italy
| | - Maddalena De Bernardo
- Eye Unit, Department of Medicine Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Marco Gioia
- Eye Unit, Department of Medicine Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Francesco Natale
- Department of Cardiothoracic Sciences, Università degli studi della Campania “Luigi Vanvitelli”, Monaldi Hospital, Naples, Italy
| | - Martina Caiazza
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, Naples, Italy
| | - Francesca Dongiglio
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, Naples, Italy
| | - Federica Verrillo
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, Naples, Italy
| | - Giuseppe Palmiero
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, Naples, Italy
| | - Giuseppe Limongelli
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, Naples, Italy
| | - Ciro Costagliola
- Department of Neuroscience, Reproductive and Dentistry Sciences, Federico II University of Naples, Naples, Italy
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8
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Tomasicchio G, Giove C, Dezi A, Picciariello A, Lantone V, Martines G, De Fazio M, Rinaldi M. The management of low trans-sphincteric anal fistula during the COVID-19 pandemic: revisiting the role of the seton. Updates Surg 2024; 76:163-167. [PMID: 38123906 DOI: 10.1007/s13304-023-01713-2] [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: 09/01/2023] [Accepted: 11/18/2023] [Indexed: 12/23/2023]
Abstract
The management of trans-sphincteric anal fistula (TAF) includes several surgical options; however, during the COVID-19 pandemic, the access to the operating rooms was severely limited, leaving only the choice of minimally invasive procedures. This study aimed to evaluate the safety and effectiveness of the slow cutting seton technique for TAF performed in an outpatient setting during the COVID-19 pandemic.Patients treated for TAF between January 2020 and July 2022 and followed-up for at least 12 months were retrospectively evaluated. A vascular silicone tie used as seton was positioned in the fistula tract using a Lockhart-Mummery fistula probe. The seton was maintained in moderate tension until the sphincter muscle was passed. Percentage and time for healing, recurrence, SF-36, VAS and Vaizey's Score were recorded.Fifty-eight patients [36 male/22 female, median age 56.5 years (IQR 41.25-65.75) [with TAF were included. After a median time of 4 months, complete healing occurred in 53 cases (91.5%), the anal pain VAS decreased from 6 to 0, the anal incontinence scores did not change significantly and the QoL improved significantly in all the SF36 domains. No complications were recorded, but the fistula recurred in five cases (8.5%). Two of them had additional seton treatment, and three underwent other surgical procedures after the COVID-19 emergency.The slow cutting seton technique is a safe and effective treatment for outpatient procedure with minimal patient discomfort. This treatment option in healthcare delivery for TAF should be reconsidered, even outside the limited in-hospital access during the COVID-19 pandemic.
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Affiliation(s)
- G Tomasicchio
- Surgical Unit "M. Rubino", Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University Aldo Moro of Bari, Bari, Italy
| | - C Giove
- Surgical Unit "M. Rubino", Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University Aldo Moro of Bari, Bari, Italy
| | - A Dezi
- Surgical Unit "M. Rubino", Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University Aldo Moro of Bari, Bari, Italy.
| | - A Picciariello
- Department of Experimental Medicine, University of Salento, Lecce, Italy
| | - V Lantone
- Surgical Unit "M. Rubino", Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University Aldo Moro of Bari, Bari, Italy
| | - G Martines
- Surgical Unit "M. Rubino", Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University Aldo Moro of Bari, Bari, Italy
| | - M De Fazio
- Surgical Unit "M. Rubino", Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University Aldo Moro of Bari, Bari, Italy
| | - M Rinaldi
- Surgical Unit "M. Rubino", Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University Aldo Moro of Bari, Bari, Italy
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Passaro ML, Matarazzo F, Abbadessa G, Pezone A, Porcellini A, Tranfa F, Rinaldi M, Costagliola C. Glaucoma as a Tauopathy-Is It the Missing Piece in the Glaucoma Puzzle? J Clin Med 2023; 12:6900. [PMID: 37959365 PMCID: PMC10650423 DOI: 10.3390/jcm12216900] [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: 09/22/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Glaucoma is a chronic neurodegenerative disorder affecting the visual system which can result in vision loss and blindness. The pathogenetic mechanisms underlying glaucomatous optic neuropathy are ultimately enigmatic, prompting ongoing investigations into its potential shared pathogenesis with other neurodegenerative neurological disorders. Tauopathies represent a subclass of neurodegenerative diseases characterized by the abnormal deposition of tau protein within the brain and consequent microtubule destabilization. The extended spectrum of tauopathies includes conditions such as frontotemporal dementias, progressive supranuclear palsy, chronic traumatic encephalopathy, and Alzheimer's disease. Notably, recent decades have witnessed emerging documentation of tau inclusion among glaucoma patients, providing substantiation that this ocular disease may similarly manifest features of tauopathies. These studies found that: (i) aggregated tau inclusions are present in the somatodendritic compartment of RGCs in glaucoma patients; (ii) the etiology of the disease may affect tau splicing, phosphorylation, oligomerization, and subcellular localization; and (iii) short interfering RNA against tau, administered intraocularly, significantly decreased retinal tau accumulation and enhanced RGC somas and axon survival, demonstrating a crucial role for tau modifications in ocular hypertension-induced neuronal injury. Here, we examine the most recent evidence surrounding the interplay between tau protein dysregulation and glaucomatous neurodegeneration. We explore the novel perspective of glaucoma as a tau-associated disorder and open avenues for cross-disciplinary collaboration and new treatment strategies.
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Affiliation(s)
- Maria Laura Passaro
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
| | | | - Gianmarco Abbadessa
- Division of Neurology, Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Antonio Pezone
- Department of Biology, University of Naples “Federico II”, 80126 Naples, Italy; (A.P.); (A.P.)
| | - Antonio Porcellini
- Department of Biology, University of Naples “Federico II”, 80126 Naples, Italy; (A.P.); (A.P.)
| | - Fausto Tranfa
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
| | - Michele Rinaldi
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
| | - Ciro Costagliola
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, 80131 Naples, Italy; (M.L.P.); (F.T.); (C.C.)
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Rinaldi L, Giorgione C, Mormone A, Esposito F, Rinaldi M, Berretta M, Marfella R, Romano C. Non-Invasive Measurement of Hepatic Fibrosis by Transient Elastography: A Narrative Review. Viruses 2023; 15:1730. [PMID: 37632072 PMCID: PMC10459581 DOI: 10.3390/v15081730] [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: 07/10/2023] [Revised: 08/04/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Transient elastography by FibroScan® (Echosens, Paris, France) is a non-invasive method that can provide a reliable measurement of liver fibrosis through the evaluation of liver stiffness. Despite its limitations and risks, liver biopsy has thus far been the only procedure able to provide data to quantify fibrosis. Scientific evidence and clinical practice have made it possible to use FibroScan® in the diagnostic work-up of several liver diseases to monitor patients' long-term treatment response and for complication prevention. For these reasons, this procedure is widely used in clinical practice and is still being investigated for further applications. The aim of this narrative review is to provide a comprehensive overview of the main applications of transient elastography in the current clinical practice.
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Affiliation(s)
- Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, Italy; (L.R.); (R.M.)
| | - Chiara Giorgione
- Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, Italy; (L.R.); (R.M.)
| | - Andrea Mormone
- Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, Italy; (L.R.); (R.M.)
| | - Francesca Esposito
- Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, Italy; (L.R.); (R.M.)
| | - Michele Rinaldi
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University of Naples, 80131 Naples, Italy;
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, University of Messina, 98121 Messina, Italy;
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, Italy; (L.R.); (R.M.)
| | - Ciro Romano
- Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, Italy; (L.R.); (R.M.)
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Demal TJ, Detter C, von Kodolitsch Y, Mariscalco G, Gatti G, Peterss S, Büch J, Onorati F, Perrotti A, Fiore A, Pettinari M, Dell'aquila AM, Pol M, Field M, Vendramin I, Rinaldi M, Lega JR, Juvonen T, Onorati F, Quintana E, Pinto AG, Nappi F, Di Perna D, Reichenspurner H, Biancari F, Conradi L. Predictor Analysis for Acute Type A Aortic Dissection in Small Aortic Diameters. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- T. J. Demal
- University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | - C. Detter
- University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | | | | | - G. Gatti
- Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - S. Peterss
- LMU Klinikum München, München, Deutschland
| | - J. Büch
- LMU Klinikum München, München, Deutschland
| | | | - A. Perrotti
- Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France
| | - A. Fiore
- Hôpital Henri-Mondor Ap-Hp, Créteil, France
| | | | | | - M. Pol
- Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - M. Field
- Liverpool Cardiovascular Surgery, Liverpool, United Kingdom
| | | | | | - J. R. Lega
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - T. Juvonen
- University of Helsinki, Helsinki, Finland
| | | | | | - A. G. Pinto
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - F. Nappi
- Centre Cardiologique du Nord, Saint-Denis, Paris, France
| | - D. Di Perna
- University of Reims Champagne-Ardenne, Reims, France
| | | | | | - L. Conradi
- University Heart and Vascular Center Hamburg, Hamburg, Deutschland
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Magli A, Esposito Veneruso P, Rinaldi M, Caputo R, Tranfa F, Costagliola C. Long-term effects of early/late-onset visual deprivation on macular and retinal nerve fibers layer structure: A pilot study. PLoS One 2023; 18:e0283423. [PMID: 36952524 PMCID: PMC10035877 DOI: 10.1371/journal.pone.0283423] [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: 03/12/2022] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND/AIMS Tomographic analysis of macular and peripapillary retinal nerve fibers layer (RNFL) thickness in patients with history of congenital (CC) and developmental cataract (DC). METHODS Analysis of macular and RNFL thickness using a spectral-domain optical coherence tomography was performed. Retinal layers thickness was measured using the internal segmentation software. Measurements of affected (unilateral and bilateral), contralateral eyes and control eyes were compared. RESULTS Patients with history of CC or DC (n = 13 and 11 respectively) and 35 healthy control subjects were enrolled. Thicker inner and outer nuclear layers (INL, ONL) and thicker ONL were found when CC and DC group when compared to controls respectively. Bilateral CC showed the most relevant differences. Slight thickening of CC inner retinal layers were found when compared to DC. Increased superonasal RNFL thickness was found in CC group when compared to DC and controls. Thickening of RNFL of contralateral unaffected eyes of unilateral CC were found when compared to controls. CONCLUSION Significant macular and RNFL thickness changes between CC, DC patients and controls that partially involve also contralateral unaffected eyes of unilateral congenital cataract were found. CC and DC groups show significant differences only in inner retinal layers thickness. Our data suggest that early visual deprivation may influence retinal arrangements occurring during development involving predominantly the outer nuclear layer and para/perifoveal inner retinal layers, and confirm that early treatment of CC allow to achieve better long-term visual outcome. Moreover functional and structural data support the hypothesis that unilateral amblyopia is not exclusively an unilateral issue.
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Affiliation(s)
- Adriano Magli
- Department of Ophthalmology, Orthoptic and Pediatric Ophthalmology, University of Salerno, Salerno, Italy
| | | | - Michele Rinaldi
- Pediatric Ophthalmology Unit, A. Meyer Children's Hospital, Florence, Italy
| | - Roberto Caputo
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fausto Tranfa
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Ciro Costagliola
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
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Tomasicchio G, Dezi A, Picciariello A, Altomare DF, Giove C, Martines G, De Fazio M, Rinaldi M. Safety and efficacy of Levorag emulgel in the treatment of anal fissures using a validated scoring system. Front Surg 2023; 10:1145170. [PMID: 37035554 PMCID: PMC10073417 DOI: 10.3389/fsurg.2023.1145170] [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: 01/15/2023] [Accepted: 03/08/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Anal fissure is one of the most common anal disease characterized by intense anal pain, and deterioration of patients quality of life. Treatment is mainly based on the topical administration of calcium antagonist or nitric oxide ointments, and in cases refractory to medical treatment patients can undergo surgery. This study aims to assess the efficacy and safety of Levorag emulgel in the treatment of acute and chronic fissures using of a validated scoring system. Material and Methods A prospective observational study was carried out on patients with anal fissures between February and May 2022. The efficacy of the treatment was evaluated using the REALISE score, a new validated scoring system that rates VAS for pain, NSAID use, pain duration, bleeding, and quality of life (QoL), recorded after 10, 20 and 30 days from the beginning of treatment. Results Forty patients (median age 46 years, IQR 29-57, 70% women) with acute (22, 55%) or chronic (18, 45%) anal fissures entered the study. The median anal pain score according to the VAS scale decreased significantly from 7 (IQR 4.7-8) at baseline to 1 (IQR 0-3.2, p = 0.05) after 20 days. At the 30-day proctological examination, 22 patients (61%) were pain free (median VAS of 0, IQR 0-1.2, p < 0.05). Pain duration after defecation measured according to the REALISE score, showed a significant decrease after 10 days, from a median value of 2 (IQR 1-4) to 1 (IQR 1-1.2) (p < 0.005). The median value of the REALISE score decreased significantly, from 15 (IQR 11-19.25) at first proctological evaluation to 4 (IQR 4-6, p = 0.139) after 30 days of treatment. At day 30, complete fissure healing was achieved in 30 patients (80%). The healing rate was 82% and 78% in patients with acute and chronic anal fissures, respectively. Conclusion The use of Levorag® Emulgel may represent a safe and effective non-invasive first line treatment in patients affected by acute or chronic anal fissure.
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr K, Garrod R, Makia F, Eldeeb F, Abdekader R, Gomaa A, Kandasamy S, Maruthanayagam R, Nadar SK, Nakad G, Nair R, Mota P, Prior P, Mcdonald S, Rand J, Schumacher N, Abraheem A, Clark M, Coulding M, Qamar N, Turner V, Negahban AQ, Crew A, Hope S, Howson J, Jones S, Lancaster N, Nicholson A, Wray G, Donnelly P, Gierlotka M, Hammond L, Hammond S, Regan S, Watkin R, Papadopoulos C, Ludman P, Hutton K, Macdonald S, Nilsson A, Roberts S, Monteiro S, Garg S, Balachandran K, Mcdonald J, Singh R, Marsden K, Davies K, Desai H, Goddard W, Iqbal N, Chalil S, Dan GA, Galasko G, Assaf O, Benham L, Brown J, Collins S, Fleming C, Glen J, Mitchell M, Preston S, Uttley A, Radovanovic M, Lindsay S, Akhtar N, Atkinson C, Vinod M, Wilson A, Clifford P, Firoozan S, Yashoman M, Bowers N, Chaplin J, Reznik EV, Harvey S, Kononen M, Lopesdesousa G, Saraiva F, Sharma S, Cruddas E, Law J, Young E, Hoye A, Harper P, Balghith M, Rowe K, Been M, Cummins H, French E, Gibson C, Abraham JA, Hobson S, Kay A, Kent M, Wilkinson A, Mohamed A, Clark S, Duncan L, Ahmed IM, Khatiwada D, Mccarrick A, Wanda I, Read P, Afsar A, Rivers V, Theobald T, Cercek M, Bell S, Buckman C, Francis R, Peters G, Stables R, Morgan M, Noorzadeh M, Taylor B, Twiss S, Widdows P, Brozmannová D, Wilkinson V, Black M, Clark A, Clarkson N, Currie J, George L, Mcgee C, Izzat L, Lewis T, Omar Z, Aytekin V, Phillips S, Ahmed F, Mackie S, Oommen A, Phillips H, Sherwood M, Aleti S, Charles T, Jose M, Kolakaluri L, Ingabire P, Karoudi RA, Deery J, Hazelton T, Knight A, Price C, Turney S, Kardos A, Williams F, Wren L, Bega G, Alyavi B, Scaletta D, Kunadian V, Cullen K, Jones S, Kirkup E, Ripley DP, Matthews IG, Mcleod A, Runnett C, Thomas HE, Cartasegna L, Gunarathne A, Burton J, King R, Quinn J, Sobolewska J, Munt S, Porter J, Christenssen V, Leng K, Peachey T, Gomez VN, Temple N, Wells K, Viswanathan G, Taneja A, Cann E, Eglinton C, Hyams B, Jones E, Reed F, Smith J, Beltrano C, Affleck DC, Turner A, Ward T, Wilmshurst N, Stirrup J, Brunton M, Whyte A, Smith S, Murray V, Walker R, Novas V, Weston C, Brown C, Collier D, Curtis K, Dixon K, Wells T, Trim F, Ghosh J, Mavuri M, Barman L, Dumont C, Elliott K, Harrison R, Mallinson J, Neale T, Smith J, Toohie J, Turnbull A, Parker E, Hossain R, Cheeseman M, Balparda H, Hill J, Hood M, Hutchinson D, Mellows K, Pendlebury C, Storey RF, Barker J, Birchall K, Denney H, Housley K, Cardona M, Middle J, Kukreja N, Gati S, Kirk P, Lynch M, Srinivasan M, Szygula J, Baker P, Cruz C, Derigay J, Cigalini C, Lamb K, Nembhard S, Price A, Mamas M, Massey I, Wain J, Delaney J, Junejo S, Martin K, Obaid D, Hoyle V, Brinkworth E, Davies C, Evans D, Richards S, Thomas C, Williams M, Dayer M, Mills H, Roberts K, Goodchild F, Dámaso ES, Greig N, Kundu S, Donaldson D, Tonks L, Beekes M, Button H, Hurford F, Motherwell N, Summers-Wall J, Felmeden D, Tapia V, Keeling P, Sheikh U, Yonis A, Felmeden L, Hughes D, Micklewright L, Summerhayes A, Sutton J, Panoulas V, Prendergast C, Poghosyan K, Rogers P, Barker LN, Batin P, Conway D, Exley D, Fletcher A, Wright J, Nageh T, Hadebe B, Kunhunny S, Mkhitaryan S, Mshengu E, Karthikeyan VJ, Hamdan H, Cooper J, Dandy C, Parkinson V, Paterson P, Reddington S, Taylor T, Tierney C, Adamyan M, Jones KV, Broadley A, Beesley K, Buckley C, Hellyer C, Pippard L, Pitt-Kerby T, Azam J, Hayes C, Freshwater K, Boyadjian S, Johnson L, Mcgill Y, Redfearn H, Russell M, Alyavi A, Alyavi B, Uzokov J, Hayrapetyan H, Azaryan K, Tadevosyan M, Poghosyan H, Kzhdryan H, Vardanyan A, Huber K, Geppert A, Ahmed A, Weidinger F, Derntl M, Hasun M, Schuh-Eiring T, Riegler L, Haq MM, Cader FA, Dewan MAM, Fatema ME, Hasan AS, Islam MM, Khandoker F, Mayedah R, Nizam SU, Azam MG, Arefin MM, Jahan J, Schelfaut D, De Raedt H, Wouters S, Aerts S, Batjoens H, Beauloye C, Dechamps M, Pierard S, Van Caenegem O, Sinnaeve F, Claeys MJ, Snepvangers M, Somers V, Gevaert S, Schaubroek H, Vervaet P, Buysse M, Renders F, Dumoulein M, Hiltrop N, De Coninck M, Naessens S, Senesael I, Hoffer E, Pourbaix S, Beckers J, Dugauquier C, Jacquet S, Malmendier D, Massoz M, Evrard P, Collard L, Brunner P, Carlier S, Blockmans M, Mayne D, Timiras E, Guédès A, Demeure F, Hanet C, Domange J, Jourdan K, Begic E, Custovic F, Dozic A, Hrvat E, Kurbasic I, Mackic D, Subo A, Durak-Nalbantic A, Dzubur A, Rebic D, Hamzic-Mehmedbasic A, Redzepovic A, Djokic-Vejzovic A, Hodzic E, Hujdur M, Musija E, Gljiva-Gogic Z, Serdarevic N, Bajramovic NS, Brigic L, Halilcevic M, Cibo M, Hadžibegic N, Kukavica N, Begic A, Iglica A, Osmanagic A, Resic N, Grgurevic MV, Zvizdic F, Pojskic B, Mujaric E, Selimovic H, Ejubovic M, Pojskic L, Stimjanin E, Sut M, Zapata PS, Munoz CG, Andrade LAF, Upegui MPT, Perez LE, Chavarria J, Quesada D, Alvarado K, Zaputovic L, Tomulic V, Gobic D, Jakljevic T, Lulic D, Bacic G, Bastiancic L, Avraamides P, Eftychiou C, Eteocleous N, Ioannou A, Lambrianidi C, Drakomathioulakis M, Groch L, Hlinomaz O, Rezek M, Semenka J, Sitar J, Beranova M, Kramarikova P, Pesl L, Sindelarova S, Tousek F, Warda HM, Ghaly I, Habiba S, Habib A, Gergis MN, Bahaa H, Samir A, Taha HSE, Adel M, Algamal HM, Mamdouh M, Shaker AF, Shokry K, Konsoah A, Mostafa AM, Ibrahim A, Imam A, Hafez B, Zahran A, Abdelhamid M, Mahmoud K, Mostafa A, Samir A, Abdrabou M, Kamal A, Sallam S, Ali A, Maghraby K, Atta AR, Saad A, Ali M, Lotman EM, Lubi R, Kaljumäe H, Uuetoa T, Kiitam U, Durier C, Ressencourt O, El Din AA, Guiatni A, Bras ML, Mougenot E, Labeque JN, Banos JL, Capendeguy O, Mansourati J, Fofana A, Augagneur M, Bahon L, Pape AL, Batias-Moreau L, Fluttaz A, Good F, Prieur F, Boiffard E, Derien AS, Drapeau I, Roy N, Perret T, Dubreuil O, Ranc S, Rio S, Bonnet JL, Bonnet G, Cuisset T, Deharo P, Mouret JP, Spychaj JC, Blondelon A, Delarche N, Decalf V, Guillard N, Hakme A, Roger MP, Biron Y, Druelles P, Loubeyre C, Lucon A, Hery P, Nejjari M, Digne F, Huchet F, Neykova A, Tzvetkov B, Larrieu M, Quaino G, Armangau P, Sauguet A, Bonfils L, Dumonteil N, Fajadet J, Farah B, Honton B, Monteil B, Philippart R, Tchetche D, Cottin M, Petit F, Piquart A, Popovic B, Varlot J, Maisuradze D, Sagirashvili E, Kereselidze Z, Totladze L, Ginturi T, Lagvilava D, Hamm C, Liebetrau C, Haas M, Hamm C, Koerschgen T, Weferling M, Wolter JS, Maier K, Nickenig G, Sedaghat A, Zachoval C, Lampropoulos K, Mpatsouli A, Sakellaropoulou A, Tyrovolas K, Zibounoumi N, Argyropoulos K, Toulgaridis F, Kolyviras A, Tzanis G, Tzifos V, Milkas A, Papaioannou S, Kyriazopoulos K, Pylarinou V, Kontonassakis I, Kotakos C, Kourgiannidis G, Ntoliou P, Parzakonis N, Pipertzi A, Sakalidis A, Ververeli CL, Kafkala K, Sinanis T, Diakakis G, Grammatikopoulos K, Papoutsaki E, Patialiatos T, Mamaloukaki M, Papadaki ST, Kanellos IE, Antoniou A, Tsinopoulos G, Goudis C, Giannadaki M, Daios S, Petridou M, Skantzis P, Koukis P, Dimitriadis F, Savvidis M, Styliadis I, Sachpekidis V, Pilalidou A, Stamatiadis N, Fotoglidis A, Karakanas A, Ruzsa Z, Becker D, Nowotta F, Gudmundsdottir I, Libungan B, Skuladottir FB, Halldorsdottir H, Shetty R, Iyengar S, Bs C, G S, Lakshmana S, S R, Tripathy N, Sinha A, Choudhary B, Kumar A, Kumar A, Raj R, Roy RS, Dharma S, Siswanto BB, Farhan HA, Yaseen IF, Al-Zaidi M, Dakhil Z, Amen S, Rasool B, Rajeeb A, Amber K, Ali HH, Al-Kinani T, Almyahi MH, Al-Obaidi F, Masoumi G, Sadeghi M, Heshmat-Ghahdarijani K, Roohafza H, Sarrafzadegan N, Shafeie M, Teimouri-Jervekani Z, Noori F, Kyavar M, Sadeghipour P, Firouzi A, Alemzadeh-Ansari MJ, Ghadrdoost B, Golpira R, Ghorbani A, Ahangari F, Salarifar M, Jenab Y, Biria A, Haghighi S, Mansouri P, Yadangi S, Kornowski R, Orvin K, Eisen A, Oginetz N, Vizel R, Kfir H, Pasquale GD, Casella G, Cardelli LS, Filippini E, Zagnoni S, Donazzan L, Ermacora D, Indolfi C, Polimeni A, Curcio A, Mongiardo A, De Rosa S, Sorrentino S, Spaccarotella C, Landolina M, Marino M, Cacucci M, Vailati L, Bernabò P, Montisci R, Meloni L, Marchetti MF, Biddau M, Garau E, Barbato E, Morisco C, Strisciuglio T, Canciello G, Lorenzoni G, Casu G, Merella P, Novo G, D'Agostino A, Di Lisi D, Di Palermo A, Evola S, Immordino F, Rossetto L, Spica G, Pavan D, Mattia AD, Belfiore R, Grandis U, Vendrametto F, Spagnolo C, Carniel L, Sonego E, Gaudio C, Barillà F, Biccire FG, Bruno N, Ferrari I, Paravati V, Torromeo C, Galasso G, Peluso A, Prota C, Radano I, Benvenga RM, Ferraioli D, Anselmi M, Frigo GM, Sinagra G, Merlo M, Perkan A, Ramani F, Altinier A, Fabris E, Rinaldi M, Usmiani T, Checco L, Frea S, Mussida M, Matsukawa R, Sugi K, Kitai T, Furukawa Y, Masumoto A, Miyoshi Y, Nishino S, Assembekov B, Amirov B, Chernokurova Y, Ibragimova F, Mirrakhimov E, Ibraimova A, Murataliev T, Radzhapova Z, Uulu ES, Zhanyshbekova N, Zventsova V, Erglis A, Bondare L, Zaliunas R, Gustiene O, Dirsiene R, Marcinkeviciene J, Sakalyte G, Virbickiene A, Baksyte G, Bardauskiene L, Gelmaniene R, Salkauskaite A, Ziubryte G, Kupstyte-Kristapone N, Badariene J, Balciute S, Kapleriene L, Lizaitis M, Marinskiene J, Navickaite A, Pilkiene A, Ramanauskaite D, Serpytis R, Silinskiene D, Simbelyte T, Staigyte J, Philippe F, Degrell P, Camus E, Ahmad WAW, Kassim ZA, Xuereb RG, Buttigieg LL, Camilleri W, Pllaha E, Xuereb S, Popovici M, Ivanov V, Plugaru A, Moscalu V, Popovici I, Abras M, Ciobanu L, Litvinenco N, Fuior S, Dumanschi C, Ivanov M, Danila T, Grib L, Filimon S, Cardaniuc L, Batrinac A, Tasnic M, Cozma C, Revenco V, Sorici G, Dagva M, Choijiljav G, Dandar E, Khurelbaatar MU, Tsognemekh B, Appelman Y, Den Hartog A, Kolste HJT, Van Den Buijs D, Van'T Hof A, Pustjens T, Houben V, Kasperski I, Ten Berg J, Azzahhafi J, Bor W, Yin DCP, Mbakwem A, Amadi C, Kushimo O, Kilasho M, Oronsaye E, Bakracheski N, Bashuroska EK, Mojsovska V, Tupare S, Dejan M, Jovanoska J, Razmoski D, Marinoski T, Antovski A, Jovanovski Z, Kocho S, Markovski R, Ristovski V, Samir AB, Biserka S, Kalpak O, Peovska IM, Taleska BZ, Pejkov H, Busljetik O, Zimbakov Z, Grueva E, Bojovski I, Tutic M, Poposka L, Vavlukis M, Al-Riyami A, Nadar SK, Abdelmottaleb W, Ahmed S, Mujtaba MS, Al-Mashari S, Al-Riyami H, Laghari AH, Faheem O, Ahmed SW, Qamar N, Furnaz S, Kazmi K, Saghir T, Aneel A, Asim A, Madiha F, Sobkowicz B, Tycinska A, Kazimierczyk E, Szyszkowska A, Mizia-Stec K, Wybraniec M, Bednarek A, Glowacki K, Prokopczuk J, Babinski W, Blachut A, Kosiak M, Kusinska A, Samborski S, Stachura J, Szastok H, Wester A, Bartoszewska D, Sosnowska-Pasiarska B, Krzysiek M, Legutko J, Nawrotek B, Kasprzak JD, Klosinska M, Wiklo K, Kurpesa M, Rechcinski T, Cieslik-Guerra U, Gierlotka M, Bugajski J, Feusette P, Sacha J, Przybylo P, Krzesinski P, Ryczek R, Karasek A, Kazmierczak-Dziuk A, Mielniczuk M, Betkier-Lipinska K, Roik M, Labyk A, Krakowian M, Machowski M, Paczynska M, Potepa M, Pruszczyk P, Budaj A, Ambroziak M, Omelanczuk-Wiech E, Torun A, Opolski G, Glowczynska R, Fojt A, Kowalik R, Huczek Z, Jedrzejczyk S, Roleder T, Brust K, Gasior M, Desperak P, Hawranek M, Farto-Abreu P, Santos M, Baptista S, Brizida L, Faria D, Loureiro J, Magno P, Monteiro C, Nédio M, Tavares J, Sousa C, Almeida I, Almeida S, Miranda H, Santos H, Santos AP, Goncalves L, Monteiro S, Baptista R, Ferreira C, Ferreira J, Goncalves F, Lourenço C, Monteiro P, Picarra B, Santos AR, Guerreiro RA, Carias M, Carrington M, Pais J, de Figueiredo MP, Rocha AR, Mimoso J, De Jesus I, Fernandes R, Guedes J, Mota T, Mendes M, Ferreira J, Tralhão A, Aguiar CT, Strong C, Da Gama FF, Pais G, Timóteo AT, Rosa SAO, Mano T, Reis J, Selas M, Mendes DE, Satendra M, Pinto P, Queirós C, Oliveira I, Reis L, Cruz I, Fernandes R, Torres S, Luz A, Campinas A, Costa R, Frias A, Oliveira M, Martins V, Castilho B, Coelho C, Moura AR, Cotrim N, Dos Santos RC, Custodio P, Duarte R, Gomes R, Matias F, Mendonca C, Neiva J, Rabacal C, Almeida AR, Caeiro D, Queiroz P, Silva G, Pop-Moldovan AL, Darabantiu D, Mercea S, Dan GA, Dan AR, Dobranici M, Popescu RA, Adam C, Sinescu CJ, Andrei CL, Brezeanu R, Samoila N, Baluta MM, Pop D, Tomoaia R, Istratoaie O, Donoiu I, Cojocaru A, Oprita OC, Rocsoreanu A, Grecu M, Ailoaei S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [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] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Picciariello A, Rinaldi M, Grossi U, Trompetto M, Graziano G, Altomare DF, Gallo G. Time trend in the surgical management of obstructed defecation syndrome: a multicenter experience on behalf of the Italian Society of Colorectal Surgery (SICCR). Tech Coloproctol 2022; 26:963-971. [PMID: 36104607 DOI: 10.1007/s10151-022-02705-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
Abstract
Background
Surgical management of obstructed defecation syndrome (ODS) is challenging, with several surgical options showing inconsistent functional results over time. The aim of this study was to evaluate the trend in surgical management of ODS in a 10-year timeframe across Italian referral centers.
Methods
Surgeons from referral centers for the management of pelvic floor disorders and affiliated to the Italian Society of Colorectal Surgery provided data on the yearly volume of procedures for ODS from 2010 to 2019. Six common clinical scenarios of ODS were captured, including details on patient’s anal sphincter function and presence of rectocele and/or rectal intussusception. Perineal repair, ventral rectopexy (VRP), transanal repair (internal Delorme), stapled transanal rectal resection (STARR), Contour Transtar, and transvaginal repair were considered in each clinical scenario.
Results
Twenty-five centers were included providing data on 2943 surgical patients. Procedure volumes ranged from 10–20 (54%) to 21–50 (46%) per year across centers. The most performed techniques in patients with good sphincter function were transanal repair for isolated rectocele (243/716 [34%]), transanal repair for isolated rectal intussusception (287/677 [42%]) and VRP for combined abnormalities (464/976 [48%]). When considering poor sphincter function, these were perineal repair (112/194 [57.8%]) for isolated rectocele, and VRP for the other two scenarios (60/120 [50%] and 97/260 [37%], respectively). The use of STARR and Contour Transtar decreased over time in patients with impaired sphincter function.
Conclusions
The complexity of ODS treatment is confirmed by the variety of clinical scenarios that can occur and by the changing trend of surgical management over the last 10 years.
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Chiosi F, Campagna G, Rinaldi M, Manzi G, dell'Omo R, Fiorentino G, Toro M, Tranfa F, D'Andrea L, Rejdak M, Costagliola C. Optical Coherence Tomography Angiography Analysis of Vessel Density Indices in Early Post-COVID-19 Patients. Front Med (Lausanne) 2022; 9:927121. [PMID: 35836940 PMCID: PMC9273855 DOI: 10.3389/fmed.2022.927121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 05/30/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose A hypercoagulable state has been reported to cause potential sight-threatening ischemia in patients suffering from Coronavirus disease 2019 (COVID-19). This study aimed to determine whether vessel density (VD), as measured by optical coherence tomography angiography (OCT-A), has insights into retinal and choriocapillaris vascular changes in patients affected by SARS-CoV-2 infection. Methods Hundred and fifty two patients positive for SARS-CoV-2 infection were enrolled in this observational, retrospective, controlled study. A control group of 60 healthy subjects was selected for statistical comparisons. Raw OCT and OCT-A data were exported and 3D datasets were analyzed to determine VD. Results Hundred and forty eyes (92.1%) were included for final analysis. The VD of the superficial capillary plexus (SCP) did not differ between the two groups. The mean VD of the deep capillary plexus (DCP) and the choriocapillaris (CC) was significantly lower in the foveal sector of the COVID-19 group compared to healthy controls. Within the post-COVID-19 group, the lowest DCP and CC foveal VD values were recorded in patients treated with antiviral therapy; no differences were observed among COVID-19 patients with other comorbidities (hypertension, diabetes, thyroid disease) or taking antiplatelet therapy. DCP and CC foveal VD were significantly lower in patients hospitalized in an intensive care unit (ICU) than asymptomatic patients. Conclusion Foveal vessel density at the level of DCP and CC was reduced in post-COVID-19 patients. Further studies evaluating these changes over time will be needed to corroborate the hypothesis of a microvascular retinal impairment in individuals who have recently recovered from SARS-CoV-2 infection.
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Affiliation(s)
- Flavia Chiosi
- Department of Ophthalmology, Azienda Ospedaliera dei Colli–Ospedale Monaldi, Naples, Italy
- *Correspondence: Flavia Chiosi
| | - Giuseppe Campagna
- Department of Medical-Surgical Sciences and Translational Medicine, University of Rome “Sapienza”, Rome, Italy
| | - Michele Rinaldi
- Department of Ophthalmology, Università della Campania Luigi Vanvitelli, Naples, Italy
| | - Gianluigi Manzi
- Department of Ophthalmology, Azienda Ospedaliera dei Colli–Ospedale Monaldi, Naples, Italy
| | - Roberto dell'Omo
- Department of Medicine and Health Science “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Giuseppe Fiorentino
- Respiratory semi-intensive Care Unit (UTSIR) COVID, Azienda Ospedaliera dei Colli–D. Cotugno, Naples, Italy
| | - Mario Toro
- Department of Ophthalmology, Università degli Studi Federico II, Naples, Italy
| | - Fausto Tranfa
- Department of Ophthalmology, Università degli Studi Federico II, Naples, Italy
| | - Luca D'Andrea
- Department of Ophthalmology, Università degli Studi Federico II, Naples, Italy
| | - Magdalena Rejdak
- Department of Ophthalmology, University Hospital of Zurich, Zurich, Switzerland
| | - Ciro Costagliola
- Department of Ophthalmology, Università degli Studi Federico II, Naples, Italy
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Gatto M, Dominici T, Rinaldi M, Rinaldi D, Percoco F, Tung M, Pontiroli C, Persi A, Ciccaglioni L, Kol A. C24 TWIDDLER SYNDROME AND HEART FAILURE: INTEGRATION OF REMOTE MONITORING AND CARDIOLOGY TELECONSULTATION FOR OPTIMAL MANAGEMENT. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
The prevalence of heart failure in the population and the COVID pandemic have rendered increasingly necessary the integration of remote monitoring with cardiology teleconsultation. A patient with dilated cardimiopathy was subjected to ICD implantation (Boston Scientific Perciva DR) with remote monitoring (LatitudeTM). One month after implant, remote monitoring recorded an increase in the HeartLogicTM heart failure index, a decrease of right ventricular and atrial sensing, contextually to fluctuations of the impedance values of the two leads (Fig. 1). The patient reported having performed shoulder’s rehabilitation therapy with probable manipulation of the ICD pocket. Chest X–ray showed dislocation of both leads with distal end of right atrial catheter in superior vena cava and distal end of right ventricular catheter in right atrium (Fig. 2A) and kinking of proximal segments (Fig. 2B), a picture compatible with diagnosis of Twiddler‘s syndrome. Implant revision confirmed lead kinking in the subcutaneous pocket (Fig. 3A). The atrial catheter, given the amount of tissue deposited at its distal end (Fig.3B) which prevented its active fixation, was replaced. Following discharge, an increase in the HeartLogicTM Heart Failure Index was detected. The outpatient visit showed the presence of pleural effusion and medical therapy was therefore optimized. In order to avoid frequent ambulatory visits to the patient, a cardiology teleconsultation was planned, which enabled to verify the clinical benefit of therapy’s variation. Remote device monitoring confirmed HeartLogicTM Heart Failure Index normalization. In conclusion, the integration of remote monitoring with cardiology teleconsultation, enables to timely detect device malfunctions and prevent episodes of heart failure, avoiding further hospitalizations. This integration is even more useful and necessary in geographically disadvantaged areas, strengthening the link between the territory and the hospital, improving patients compliance and therapeutic adherence and thus allowing a progressive improvement of the symptoms and quality of life of heart failure patients.
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Affiliation(s)
- M Gatto
- P.O. SAN CAMILLO DE LELLIS, RIETI; UOC CARDIOLOGIA, OSPEDALE SAN CAMILLO DE LELLIS, ASL RIETI, RIETI
| | - T Dominici
- P.O. SAN CAMILLO DE LELLIS, RIETI; UOC CARDIOLOGIA, OSPEDALE SAN CAMILLO DE LELLIS, ASL RIETI, RIETI
| | - M Rinaldi
- P.O. SAN CAMILLO DE LELLIS, RIETI; UOC CARDIOLOGIA, OSPEDALE SAN CAMILLO DE LELLIS, ASL RIETI, RIETI
| | - D Rinaldi
- P.O. SAN CAMILLO DE LELLIS, RIETI; UOC CARDIOLOGIA, OSPEDALE SAN CAMILLO DE LELLIS, ASL RIETI, RIETI
| | - F Percoco
- P.O. SAN CAMILLO DE LELLIS, RIETI; UOC CARDIOLOGIA, OSPEDALE SAN CAMILLO DE LELLIS, ASL RIETI, RIETI
| | - M Tung
- P.O. SAN CAMILLO DE LELLIS, RIETI; UOC CARDIOLOGIA, OSPEDALE SAN CAMILLO DE LELLIS, ASL RIETI, RIETI
| | - C Pontiroli
- P.O. SAN CAMILLO DE LELLIS, RIETI; UOC CARDIOLOGIA, OSPEDALE SAN CAMILLO DE LELLIS, ASL RIETI, RIETI
| | - A Persi
- P.O. SAN CAMILLO DE LELLIS, RIETI; UOC CARDIOLOGIA, OSPEDALE SAN CAMILLO DE LELLIS, ASL RIETI, RIETI
| | - L Ciccaglioni
- P.O. SAN CAMILLO DE LELLIS, RIETI; UOC CARDIOLOGIA, OSPEDALE SAN CAMILLO DE LELLIS, ASL RIETI, RIETI
| | - A Kol
- P.O. SAN CAMILLO DE LELLIS, RIETI; UOC CARDIOLOGIA, OSPEDALE SAN CAMILLO DE LELLIS, ASL RIETI, RIETI
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18
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Gaiero L, Vairo A, Fioravanti F, Piroli F, Gallone G, D‘Ascenzo F, Desalvo P, Marro M, Sebastiano V, Alunni G, De Ferrari G, Rinaldi M, Salizzoni S. P102 NEW THREE–DIMENSIONAL ECHOCARDIOGRAPHIC PREDICTING PARAMETERS IN TRANS–VENTRICULAR HEART–BEATING MITRAL VALVE REPAIR WITH NEOCHORDAE: A MONOCENTRIC RETROSPECTIVE STUDY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.099] [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: 11/14/2022]
Abstract
Abstract
Background
Trans–ventricular off pump mitral valve (MV) repair with neochordae implantation (Neochord procedure) is a minimally invasive surgical technique for correction of degenerative mitral regurgitation (MR) due to prolapse or flail. The aim of this study was to evaluate mid–term results of patients undergoing this procedure and find new three–dimensional pre–operative echocardiographic parameters to predict MR recurrence at follow–up.
Methods
We performed a retrospective analysis of 72 consecutive patients with severe MR due to prolapse or flail who underwent Neochord procedure at our hospital from March 2015 to February 2021. MV pre–operative anatomical parameters were assessed using 2D TEE, 3D TEE and dedicated three–dimensional (3D) post–processing analysis with dedicated software (QLAB, Philips). TTE follow–up and clinical evaluation were performed at 3 months, 6 months, 1 year and then annually.
Results
Twenty–seven patients were female (37.5%), mean age was 77±9 years. The average preoperative EuroSCORE II was 2.2%±1.5%. Twenty–three patients (32%) had an history of paroxysmal or persistent atrial fibrillation. Procedural success at discharge was achieved in sixty–eight patients (94.5%). Mean follow–up was 30±16 months. Three years follow–up was completed by fifty patients. At three years thirteen patients (26%) presented with recurrence of severe MR or underwent new surgical operation. Prevalence of mild or trace MR at three years follow–up visit was 70%. End–systolic annulus area (12.5±2.5 cm2 vs 14.1±2.6 cm2; p = 0.038), end–systolic annulus diameter (13.2±1.2 cm vs 14±1.3 cm; p = 0.042) and indexed left atrial volume (59±17 ml/m2 vs 76±37 ml/m2; p = 0.041) were lower in patients with residual MR less than moderate (MR < 3+/4+). Three–dimensional indexes specifically focused on coaptation reserve and annular disfunction were the best predictors of MR < 3+/4+ at follow–up, in particular diastolic sum of the leaflets/end–systolic annulus area ([AUC] 0.74; p = 0.029) and systo–diastolic annulus area fractional change ([AUC] 0.743; p = 0.035). Furthermore, each of these annular parameters, calculated using dedicated 3D software, were predictive of residual MR, whereas annular 2D dimensions were not (p = 0.347).
Conclusion
In patients with degenerative MR treated with Neochord procedure, 3D analysis focused on annular measures and coaptation indexes, that included 3D annular dimensions, predicts better MR relapse than conventional 2D parameters.
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Affiliation(s)
- L Gaiero
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - A Vairo
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - F Fioravanti
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - F Piroli
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - G Gallone
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - F D‘Ascenzo
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - P Desalvo
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - M Marro
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - V Sebastiano
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - G Alunni
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - G De Ferrari
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - M Rinaldi
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
| | - S Salizzoni
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE GIOVANNI BOSCO, TORINO; CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO
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19
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Vairo A, Alunni G, Franchin L, Fortuni F, Gaiero L, Desalvo P, Avondo S, Marro M, Sebastiano V, De Ferrari G, Rinaldi M, Salizzoni S. C40 THREE–DIMENSIONAL FINGER TEST: A NEW ECHOCARDIOGRAPHIC METHOD TO LOCATE THE BEST ACCESS SITE DURING NEOCHORD PROCEDURE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.039] [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]
Abstract
Abstract
Background
The NeoChord procedure is a trans–ventricular, beating–heart chordal implantation for severe degenerative mitral valve regurgitation due to prolapse or flail leaflet and it is performed using a dedicated device (DS 1000 system, NeoChord, Inc. St. Louis Park, MN). The use of the transesophageal echocardiography (TEE) is crucial to guide the procedure. Bi–dimensional (2D) imaging completed with simultaneous biplane view during surgeon finger pushing on the LV wall (finger test) is currently used to choose the LV access, which is usually on the mid–distal infero–lateral wall (ILW), between the papillary muscles (PMs) at the inferior level of their insertion on LV wall. This simulation helps the operators to evaluate the safe distance to PMs to minimize the risk of damaging the sub–valvular apparatus during the insertion of the device. We aimed to compare a new 3D method with the conventional one in terms of safety and better localization of the desired entry site.
Methods
During the procedure finger test has been performed with conventional 2D imaging and simultaneous biplane method. It has been completed using the real time 3D TEE placing the sample box in the bi–commissural view of the LV including the PMs and the apex. The resulting 3D volume was subsequently edited to visualize the LV from above (surgical view) to localize the bulge of the operator finger pushing on the desired segment of the LV wall. We asked the first operator, the second operator and the cardiac surgery fellow, separately, to evaluate location of their finger pushing, in terms of desired position and safety of access, both with 2D method and the 3D method to estimate the inter–operator concordance.
Results
From March 2019 to September 2021 42 consecutive cases have been performed using finger test completed with 3D method without complications related to the trans–ventricular access. Regarding the choice of the right and safe entry site, the percentage of agreement between operators was higher using LV real time 3D rendering compared to the conventional finger test [82 + 21% Vs 59% + 29%, IC 95%, p: 0,04].
Conclusion
Three–dimensional finger test is easy to perform and decreases inter–operator variability of image interpretation facilitating the surgeons to choose the best entry site in term of anatomical localization and safety.
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Affiliation(s)
- A Vairo
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
| | - G Alunni
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
| | - L Franchin
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
| | - F Fortuni
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
| | - L Gaiero
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
| | - P Desalvo
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
| | - S Avondo
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
| | - M Marro
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
| | - V Sebastiano
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
| | - G De Ferrari
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
| | - M Rinaldi
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
| | - S Salizzoni
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO; OSPEDALE SAN GIOVANNI BATTISTA, FOLIGNO
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20
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Chiosi F, Rinaldi M, Campagna G, Manzi G, De Angelis V, Calabrò F, D’Andrea L, Tranfa F, Costagliola C. Effect of a Fixed Combination of Curcumin, Artemisia, Bromelain, and Black Pepper Oral Administration on Optical Coherence Tomography Angiography Indices in Patients with Diabetic Macular Edema. Nutrients 2022; 14:nu14071520. [PMID: 35406133 PMCID: PMC9002511 DOI: 10.3390/nu14071520] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 03/23/2022] [Accepted: 04/01/2022] [Indexed: 02/01/2023] Open
Abstract
Background: To investigate the effects of a fixed combination of Curcumin (200 mg), Artemisia (80 mg), Bromelain (80 mg), and Black pepper (2 mg) on vascular parameters in mild to moderate diabetic macular edema (DME). Design: Prospective, case-control study. Methods: Fifty-six patients affected by diabetes mellitus type II were enrolled in the study. Twenty-eight patients with DME received 2 tablets/day, before meals of a dietary complementary supplement containing in fixed combination Curcumin (200 mg), Artemisia (80 mg), Bromelain (80 mg), and Black pepper (2 mg) (Intravit®, OFFHEALTH Spa, Firenze, Italy) for 6 months. Twenty-eight age-matched subjects affected by diabetes mellitus type II were given placebo and served as control group. Patients underwent best correct visual acuity (BCVA), swept optical coherence tomography (OCT), and OCT-Angiography (OCTA). OCTA images of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were obtained for each eye. By the end of the follow-up patients were defined responder to the therapy when a decrease of more than 30 μm was registered in central retinal thickness (CRT) measurement, while a poor responder was determined by the absence of reduction or an increase in central retinal thickness at 6 months. We assessed the foveal avascular zone (FAZ) area, vessel density and quantified the number of microaneurysms in each layer. Results: A significant improvement of BCVA and CRT reduction was recorded at 6 months follow-up in the dietary complementary supplementation group compared to control (respectively p = 0.028 and p = 0.0003). VD of the total capillary plexus, microaneurysms count, glycaemia and HbA1c did not vary over the follow-up period between groups. Within the Intravit® group, poor responders tended to show a larger FAZ area, more microaneurysms, and a lower VD in the DCP compared to the good responders group (p < 0.0001). Conclusions: A fixed combination of Curcumin, Artemisia, Bromelain, and Black pepper oral administration may have a positive impact on central retinal thickness, visual acuity, and VD of the DCP in compensated type 2 diabetic patients with mild DME.
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Affiliation(s)
- Flavia Chiosi
- Department of Ophthalmology, Monaldi Hospital, Azienda Ospedaliera dei Colli Via Leonardo Bianchi, 8013 Napoli, Italy;
- Correspondence: ; Tel.: +39-339-5333929; Fax: +39-0817064209
| | - Michele Rinaldi
- Department of Ophthalmology, University of Campania “Luigi Vanvitelli”, 80100 Napoli, Italy;
| | - Giuseppe Campagna
- Department of Medical-Surgical Sciences and Translational Medicine, University of Rome “La Sapienza”, 00161 Roma, Italy;
| | - Gianluigi Manzi
- Department of Ophthalmology, Monaldi Hospital, Azienda Ospedaliera dei Colli Via Leonardo Bianchi, 8013 Napoli, Italy;
| | - Vincenzo De Angelis
- Eye Clinic, Azienda Ospedaliera A. Cardarelli, 80131 Naples, Italy; (V.D.A.); (F.C.)
| | - Francesco Calabrò
- Eye Clinic, Azienda Ospedaliera A. Cardarelli, 80131 Naples, Italy; (V.D.A.); (F.C.)
| | - Luca D’Andrea
- Eye Clinic, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Napoli “Federico II”, 80138 Napoli, Italy; (L.D.); (F.T.); (C.C.)
| | - Fausto Tranfa
- Eye Clinic, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Napoli “Federico II”, 80138 Napoli, Italy; (L.D.); (F.T.); (C.C.)
| | - Ciro Costagliola
- Eye Clinic, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Napoli “Federico II”, 80138 Napoli, Italy; (L.D.); (F.T.); (C.C.)
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21
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Picciariello A, Rinaldi M, Dibra R, Trigiante G, Tomasicchio G, Lantone G, De Fazio M. Ageing with sacral nerve modulation for fecal incontinence: how many patients get benefit after more than 10 years? Updates Surg 2022; 74:185-191. [PMID: 34982410 PMCID: PMC8724665 DOI: 10.1007/s13304-021-01229-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/24/2021] [Indexed: 11/15/2022]
Abstract
Sacral nerve modulation (SNM) has represented a major advancement in the minimally invasive management of patients with fecal incontinence (FI). Although the success rate in the short–medium term has widely been demonstrated, the very long-term outcomes are poorly investigated. This study aims to assess the effectiveness of SNM in a cohort of patients with a follow-up longer than 10 years. Clinical records of patients submitted to SNM for FI in our tertiary referral colorectal Unit between 1998 and 2010 were retrospectively reviewed looking for status of the implantable pulse generator (IPG), follow-up duration, severity of FI by the St Marks’ score and quality of life. 58 patients fulfilled the entry criteria and 36 (58%, median follow-up, 12 years) accepted to take part to the telephone interview, while 22 (38%) were lost to the follow-up. Nineteen patients had their IPG removed (Group A) while 17 (27%) had the SNM still active after a median follow-up of 13 years (Group B). In the group A, the median baseline St Marks’ score was 13 and did not change after the IPG removal. In group B, the median baseline St Marks’ score was 14, at last IPG substitution, it was of 7 and at the last follow-up dropped to 4. In the group A, the median SF-12 physical and mental scores did not change significantly while they improved significantly in group B. A progressive deterioration of the success rate of SNM with the time has been documented after a very long-term follow-up.
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Affiliation(s)
- A Picciariello
- Surgical Unit "M. Rubino", Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy.
| | - M Rinaldi
- Surgical Unit "M. Rubino", Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
| | - R Dibra
- Surgical Unit "M. Rubino", Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
| | - G Trigiante
- Surgical Unit "M. Rubino", Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
| | - G Tomasicchio
- Surgical Unit "M. Rubino", Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
| | - G Lantone
- Surgical Unit "M. Rubino", Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
| | - M De Fazio
- Surgical Unit "M. Rubino", Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
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22
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Abstract
since the beginning of 2020, a new virus named COVID-19 has rapidly spread to a global pandemic. The world economy has been strongly affected and early evidence suggests that its impact has involved all the sectors and business functions. In such context, logistics activities have been severely affected by the COVID-19 pandemic because of the introduction of new strict prevention rules; moreover, purchasing behaviours of customers have changed and systems had to rapidly adapt to unexpected events. This paper aims to investigate the impact of the sanitary emergency on logistics activities. A logistic provider specialized in the food and fast moving consumer goods sector has been involved in the research in order to analyse its activities and the main changes caused by the pandemic. A quantitative survey has been conducted, combining numerical data and qualitative answers. Results confirm strong effects on some sectors and an economic loss mainly due to the new procedures adopted to face the emergency.
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Affiliation(s)
- M Rinaldi
- Department of Engineering, University of Campania "Luigi Vanvitelli", Italy
| | - T Murino
- Department of Chemical, Materials and Industrial Production Engineering (DICMAPI), University of Naples "Federico II", Italy
| | - E Bottani
- Department of Engineering and Architecture, University of Parma, Italy
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23
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Montone RA, Rinaldi M, Del Buono M, Camilli M, Gurgoglione F, La Vecchia G, Iannaccone G, Russo M, Caffe' A, Trani C, Lanza GA, Niccoli G, Crea F. Incidence, predictors and prognostic role of complications occurring during provocative testing with acetylcholine in patients with myocardial ischemia and non-obstructive coronary arteries. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Coronary provocative test with acetylcholine (ACh) is of utmost importance and increasingly used in patients with myocardial ischemia and non-obstructive coronary arteries. However, data on safety, predictors and prognostic role of complications during intracoronary provocative testing are scarce.
Purpose
We assessed the safety of ACh provocative test in patients with myocardial ischemia and non-obstructive coronary arteries. Moreover, we evaluated the predictors and the prognostic implications of complications occurring during the provocative test.
Methods
We prospectively enrolled consecutive patients undergoing intracoronary ACh provocative test for suspected myocardial ischaemia with angiographic evidence of non-obstructive coronary arteries. Complications during the ACh test were collected. Occurrence of major adverse cardiac events (MACE), arrhythmic events at 24-hours ECG dynamic Holter monitoring and angina status were assessed at follow-up.
Results
We enrolled 310 patients (mean age 60.6±11.9; 169 [54.5%] chronic coronary syndromes [CCS] and 141 [45.5%] with myocardial infarction and non-obstructive coronary arteries [MINOCA]). The overall incidence of complications was low (9%) with a similar incidence in MINOCA and CCS (10 [7.1%] vs 18 [10.7%], p=0.276, respectively). At multivariate logistic regression analysis, a previous history of paroxysmal atrial fibrillation (Odds Ratio [OR] 12.324, Confidence Interval [CI] 95% [4.641; 32.722], p=0.015) and moderate/severe diastolic dysfunction (OR 3.827, CI95% [1.296; 11.304], p=0.015) were independent predictors for occurrence of complications. The occurrence of complications was not associated with a worse clinical outcome at follow-up (median follow-up 22 months) in terms of both MACE, arrhythmic events and angina burden.
Conclusion
Intracoronary provocative testing with ACh test is safe in patients with myocardial ischemia and non-obstructive coronary arteries, without differences between MINOCA and CCS. History of paroxysmal atrial fibrillation and moderate/severe diastolic dysfunction predicted the occurrence of complications during ACh test. Of importance, our data can reassure clinicians, as the occurrence of complications did not portend a worse prognosis at follow-up in terms of MACE, arrhythmic events and angina burden.
Funding Acknowledgement
Type of funding sources: None. Complications and clinical presentationClinical outcome at follow-up
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Affiliation(s)
- R A Montone
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - M Rinaldi
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - M Del Buono
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - M Camilli
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - F Gurgoglione
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - G La Vecchia
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - G Iannaccone
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - M Russo
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - A Caffe'
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - C Trani
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - G A Lanza
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - G Niccoli
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
| | - F Crea
- Fondazione Policlinico Universitario Gemelli IRCCS, Catholic University, Rome, Italy
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24
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Imazio M, Pivetta E, Andreis A, Serra C, Ottino M, Brucato A, Giustetto C, Rinaldi M, Lupia E, De Ferrari GM, Adler Y. Incessant pericarditis as a risk factor for complicated pericarditis and hospital admission. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Incessant pericarditis is defined as pericarditis with persistent symptoms without a symptom-free interval of 4 to 6 weeks despite therapy. On the contrary, recurrent pericarditis is characterized by recurring symptoms after a symptom-free interval of at least 4 to 6 weeks, allowing the completion of therapy.
Aims
The aim of this study is to assess the risk of complicated pericarditis and related hospitalizations according to the clinical pattern of incessant or recurrent pericarditis.
Methods
From January 2017 to December 2018, all consecutive patients admitted to AOU Città della Salute (Turin, IT) for pericarditis were included in a prospective cohort study with a clinical and echocardiographic follow-up at 1, 3, and 6 months, and then every 6 months.
Results
We included 147 patients (median age, 50.9 years [IQR, 28.5]; 49.7% women, 89% had idiopathic aetiology, 11% had pericarditis related to systemic inflammatory disease/postcardiac injury syndrome, 80% had pericardial effusion, and 62% had elevated C-reactive protein >5 mg/L). Patients were treated according to ESC guidelines. After a median follow-up of 14 months (IQR, 9 months), adverse events were recorded in 54/147 patients (36.7%): nonidiopathic/viral aetiology in 16 of 147 cases (10.9%), recurrent pericarditis/persistent symptoms in 53 of 147 cases (36.1%), cardiac tamponade in 4/147 cases (2.7%), persistent CP in 4/147 cases (2.7%), and hospitalization related to pericarditis in 38/147 cases (25.9%). An incessant course was reported in 18 of 147 cases (12%). The risk of complications was higher in patients with incessant pericarditis (Figure) – especially CP – compared to nonincessant course (22.2% versus 0%, respectively; P<0.001). Patients with incessant pericarditis more commonly had echocardiographic evidence of CP (77.8% vs. 9.3%; P<0.001) and thickened pericardium on multimodality imaging (66.7% vs. 4.7%; P<0.001). These findings were reversible with medical therapy with the use of anakinra (100 mg/d) and colchicine in all but 4 cases that progressed to persistent CP, which were referred for pericardiectomy. An analysis of risk factors for complicated pericarditis and hospitalization using Cox proportional hazards regression analysis identified the following risk factors: large pericardial effusion (hazard ratio, 7.63 [95% CI, 3.09–18.83]), elevated C-reactive protein >5 mg/L (hazard ratio, 5.55 [95% CI, 1.87–16.44]), and incessant course (HR, 17.10 [95% CI, 7.63–38.33]).
Conclusions
This study highlights that an incessant course of pericarditis is a possible new risk factor for complications and especially for developing constriction. In clinical practice, the detection of an incessant course, as well as imaging findings of constriction and pericardial thickening, should prompt more diagnostic testing, a close follow-up, and more aggressive therapy to prevent complications and persistent constriction.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- M Imazio
- University Hospital Santa Maria della Misericordia, Cardiology, Cardiothoracic Department, Udine, Italy
| | - E Pivetta
- A.O.U. Citta della Salute e della Scienza di Torino, Emergency Medicine Department, Turin, Italy
| | - A Andreis
- AOU Città della Salute e della Scienza di Torino, University Cardiology, Torino, Italy
| | - C Serra
- AOU Città della Salute e della Scienza di Torino, University Cardiology, Torino, Italy
| | - M Ottino
- A.O.U. Citta della Salute e della Scienza di Torino, Emergency Medicine Department, Turin, Italy
| | - A Brucato
- Fatebenefratelli Hospital, Dipartimento Scienze Biomediche e Cliniche, Milan, Italy
| | - C Giustetto
- AOU Città della Salute e della Scienza di Torino, University Cardiology, Torino, Italy
| | - M Rinaldi
- A.O.U. Citta della Salute e della Scienza di Torino, University Cardiac Surgery, Cardiovascular Department, Turin, Italy
| | - E Lupia
- A.O.U. Citta della Salute e della Scienza di Torino, Emergency Medicine Department, Turin, Italy
| | - G M De Ferrari
- AOU Città della Salute e della Scienza di Torino, University Cardiology, Torino, Italy
| | - Y Adler
- Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv, Israel
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25
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Bruno F, Elia E, D'Ascenzo F, Marengo G, De Filippo O, Gallone G, Andreis A, Fortuni F, Salizzoni S, Rinaldi M, La Torre M, Conrotto F, De Ferrari GM. Valve-in-valve transcatheter aortic valve replacement or re-surgical aortic valve replacement in degenerated bioprostheses: a systematic review and meta-analysis of short and mid-term results. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Despite limited to short and mid-term outcomes, Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) has emerged as a less invasive alternative to redo surgery for high and intermediate-risk patients with good outcomes across different surgical risk profiles.
Purpose
The aim of the resent meta-analysis is to compare short and mid-term outcomes of VIV and surgical redo fo patients with a degenerative aortic bioprosthesis.
Methods
All studies comparing with multivariate adjustment between ViV TAVI and re-SAVR were screened. All-cause mortality at 30-day and at follow-up were the primary endpoints, while Valve Academy research Consortium (VARC) endpoints at 30 days including stroke, myocardial infarction (MI), major vascular complications, major bleeding, new onset atrial fibrillation (AF) and permanent pacemaker implantation (PPI) during the index hospitalization were the secondary endpoints. Subgroup analysis were performed according to the surgical risk. All the analyses were stratified according to the design of the study (observational vs propensity-matched study).
Results
We obtained data from 11 studies, encompassing 8570 patients, 4224 undergoing ViV TAVI and 4346 re-SAVR. Four studies included intermediate-risk patients and seven high-risk patients. Mean age was 76 and 71.5 years in the ViV and re-SAVR group respectively, with a 60.2% and 61.3% of male. For the ViV procedure, BE prostheses were used in the 49.6% of patients and SE prostheses in the 45.8%. The ViV group have higher prevalence of previous CAD (53.8% vs 41.1%) and CABG (35% vs 23.6%) and more history of HF (72.1% vs 65.6%), CKD (26.6% vs 14.8%) and COPD (25.4 vs 14.8%). 30-day all-cause and CV mortality were significantly lower in ViV (OR 0.43, 0.29–0.64 and OR 0.44, 0.26–0.73 respectively), while after a mean follow-up of 717 (180–1825) days, there were no difference between the two groups (OR 1.04, 0.87–1.25 and OR 1.05, 0.78–1.43 respectively). The result were consistent both in intermediate and high-risk classes. The risk of stroke (OR 1.03, 0.59–1.82), MI (OR 0.70, 0.34–1.44), major vascular complications (OR 0.92, 0.50–1.67) and permanent pacemaker implantation (OR 0.67, 0.36–1.25) at 30 days did not differ, while major bleedings and new onset atrial fibrillation were significantly lower in ViV patients (OR 0.41, 0.25–0.67 and OR 0.23, 0.12–0.42 respectively, all CI 95%).
Conclusions
In patients with a degenerated aortic bioprosthesis, ViV TAVI is associated with better short-term outcomes, including all-cause mortality, without any difference in all-cause and cardiovascular mortality at mid-term follow-up compared to surgical redo.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Bruno
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - E Elia
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - F D'Ascenzo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - G Marengo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - O De Filippo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - G Gallone
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - A Andreis
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - F Fortuni
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - S Salizzoni
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - M Rinaldi
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - M La Torre
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - F Conrotto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - G M De Ferrari
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
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Filippelli M, dell'Omo R, Gelso A, Rinaldi M, Bartollino S, Napolitano P, Russo A, Campagna G, Costagliola C. Effects of topical low-dose preservative-free hydrocortisone on intraocular pressure in patients affected by ocular surface disease with and without glaucoma. Graefes Arch Clin Exp Ophthalmol 2021; 260:247-253. [PMID: 34406502 DOI: 10.1007/s00417-021-05345-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/28/2020] [Revised: 07/05/2021] [Accepted: 07/26/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This study aims to investigate the safety and efficacy of short-term treatment for ocular surface disease (OSD) with topical low-dose (1,005 mg) preservative-free hydrocortisone in one hundred patients with and without glaucoma. METHODS This was an open label non-randomized clinical trial. Patients with OSD with and without primary open-angle glaucoma (POAG) received topical low-dose (1,005 mg) preservative-free hydrocortisone twice daily in each eye for 2 weeks. All patients underwent a complete ophthalmological examination at baseline (T0) and at 1 (T1) and 2 (T2) weeks post-treatment. At each visit, the intraocular pressure (IOP) and the ocular surface disease index (OSDI) questionnaire scores were recorded; the Schirmer test was performed only at T0 and T2. RESULTS The OSDI score significantly decreased in both the POAG and no-POAG groups (both p < 0.0001) after hydrocortisone treatment, with no difference between the two groups (p = 0.72). There were no significant differences in IOP and Schirmer test results between T0 and T2 in both treatment groups (p = 0.68 and p = 0.83, respectively). CONCLUSIONS Topical low-dose (1,005 mg) preservative-free hydrocortisone is safe and effective for improving OSD symptoms both in patients with and without POAG. TRIAL REGISTRATION The trial was registered at clinicaltrials.gov under NCT04536129 on 01/09/2020 ("retrospectively registered").
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Affiliation(s)
- M Filippelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
| | - R dell'Omo
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - A Gelso
- "Villa Dei Fiori" Hospital, Acerra, Naples, Italy
| | - M Rinaldi
- Department of Ophthalmology, University Della Campania Luigi Vanvitelli, Naples, Italy
| | - S Bartollino
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - P Napolitano
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - A Russo
- "Villa Dei Fiori" Hospital, Acerra, Naples, Italy
| | - G Campagna
- Department of Medical-Surgical Sciences and Translational Medicine, University of Rome "La Sapienza", Rome, Italy
| | - C Costagliola
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
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Ratier-Cruz A, Smith JG, Firn M, Rinaldi M. Staff attitudes to completely smoke-free policies and smoking cessation practices in a mental health setting. J Public Health (Oxf) 2021; 42:403-411. [PMID: 32128592 DOI: 10.1093/pubmed/fdaa033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 10/18/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Mental health trusts in England were expected to become completely smoke-free and embed smoking cessation practices by 2018. Such policies are fraught with concerns and have received mixed support from mental health staff. Understanding staff attitudes to these practices prior to enforcement of the policy could help design an effective implementation strategy. METHODS A cross-sectional survey was conducted with clinical and non-clinical staff in a Mental Health Trust to understand smoking cessation practices and attitudes to the implementation of a completely smoke-free policy. RESULTS There were 631 responses. Most participants disagreed with the policy on wards (59.6%) and throughout all mental health settings (57.4%). Clinicians expressed significantly lower organizational policy support (P = 0.001) than non-clinicians (P = 0.001). Psychiatrists were more supportive of the organizational items than nurses and allied health professionals. Clinicians' attitudes towards smoking cessation practices were less positive for those who were current smokers (P < 0.001), but more positive for clinicians who had received or were interested in attending smoking cessation training (P < 0.001). CONCLUSIONS Partial and completely smoke-free policies remain unsupported by staff in mental health settings. Smoking cessation training appears to reinforce rather than alter attitudes towards smoking cessation.
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Affiliation(s)
- A Ratier-Cruz
- South West London & St George's Mental Health NHS Trust, Springfield University Hospital, London SW17 7DJ, UK
| | - J G Smith
- Population Health Research Institute, St George's, University of London, London SW17 0RE, UK
| | - M Firn
- South West London & St George's Mental Health NHS Trust, Springfield University Hospital, London SW17 7DJ, UK
| | - M Rinaldi
- South West London & St George's Mental Health NHS Trust, Springfield University Hospital, London SW17 7DJ, UK
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Van den Borre C, Rinaldi M, De Neef B, Loomans NAJ, Nout E, Van Doorne L, Naert I, Politis C, Schouten H, Klomp G, Beckers L, Freilich MM, Mommaerts MY. Patient- and clinician-reported outcomes for the additively manufactured sub-periosteal jaw implant (AMSJI) in the maxilla: a prospective multicentre one-year follow-up study. Int J Oral Maxillofac Surg 2021; 51:243-250. [PMID: 34074574 DOI: 10.1016/j.ijom.2021.05.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
The clinical outcomes of maxillary rehabilitation with the additively manufactured sub-periosteal jaw implant (AMSJI; CADskills BV) were evaluated in edentulous patients with a Cawood-Howell atrophy classification ≥5 in all regions of the maxilla. Fifteen consecutive patients were included in the study and followed up for 1 year. They were interviewed using a survey protocol and were examined clinically and radiographically preoperatively (T0) and at 1 (T1), 6 (T2), and 12 (T3) months after permanent upper prosthesis placement. The patients reported an increased oral health-related quality of life. The overall mean Oral Health Impact Profile-14 score at T0 was 17.20 (standard deviation (SD) 6.42). When results at T0 were compared to those at T1 (mean 8.93, SD 5.30), a statistically significant difference was seen (P = 0.001). At T3, the mean value was 5.80 (SD 4.18). Compared to T0, there was also a statistically significant difference at T3 (P = 0.001). General satisfaction based on the numerical rating scale was a mean 49.93 at T1, which was less than patient expectation prior to treatment at T0 (52.13). A higher overall value was seen at T3 (53.20) when compared to T0. Within the constraints of the short follow-up, the AMSJI appears to be a promising tool for patients with extreme jaw atrophy. The high patient expectations were met without complications.
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Affiliation(s)
- C Van den Borre
- Doctoral School of Life Sciences and Medicine, Vrije Universiteit Brussel, Brussels, Belgium.
| | | | - B De Neef
- Department of Oro-Maxillo-Facial Surgery, General Hospital Oudenaarde, Oudenaarde, Belgium
| | - N A J Loomans
- Private Clinic Face Ahead Antwerp, Antwerp, Belgium; Division of Oro-Maxillo-Facial Surgery, GZA Hospitals, Antwerp, Belgium
| | - E Nout
- Oral and Maxillofacial Surgery, ETZ Hospitals, Tilburg, The Netherlands
| | - L Van Doorne
- Oral and Maxillofacial Surgery Cosmipolis Clinic Brugge, Ghent University Hospital, AZ Zeno, Knokke-Blankenberge, Belgium
| | - I Naert
- Department of Prosthetic Dentistry, KU Leuven, Leuven, Belgium
| | - C Politis
- OMFS-IMPATH Research Group, Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - H Schouten
- Department of Oral and Maxillofacial Surgery, Rode Kruis Ziekenhuis Beverwijk, Beverwijk, The Netherlands
| | - G Klomp
- Oral and Maxillofacial Surgery, ETZ Hospitals, Tilburg, The Netherlands
| | | | - M M Freilich
- Private Practice, Toronto, Canada; OMFS, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Humber River Hospital, Toronto, Canada
| | - M Y Mommaerts
- Private Clinic Orthoface Ghent, Ghent, Belgium; European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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Picciariello A, Lobascio P, Spazzafumo L, Rinaldi M, Dibra R, Trigiante G, Laforgia R, Pezzolla A, Altomare DF. The REALISE score: a new statistically validated scoring system to assess the severity of anal fissures. Tech Coloproctol 2021; 25:935-940. [PMID: 33987779 PMCID: PMC8289784 DOI: 10.1007/s10151-021-02459-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/04/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Anal fissure (AF) is a common, painful disease that strongly affects patients' quality of life, however, no scoring system to assess the severity of AF is available in the literature. The aim of this study was to set up and validate a reliable scoring system to quantify the severity of AF, to be used in prospective trials comparing the efficacy and the outcomes of surgical or medical treatments. METHODS The study was conducted on patients with acute or chronic AF and a control group in a tertiary centre for coloproctology in June 2020-September 2020. Two researchers independently carried out a structured interviewer-led questionnaire at two different time points (T1/T2). The questionnaire consisted of five items selected according to the most commonly reported symptoms for AF: the item pain, was scored from 0 to 10 using a visual analogue scale, and quality of life, duration of pain, use of painkillers, and bleeding were scored from 1 to 5 using Likert-scale questions. The scoRing systEm for AnaL fIsSurE (REALISE) score was the sum of the points. Patients with AF and a control group of patients with haemorrhoids, anal fistula, or obstructed defecation syndrome entered the study. Main outcome measures were reliability, inter-/intraobserver agreement, and repeatability. RESULTS One hundred and fifty well-matched patients (75 with AF and 75 controls) were enrolled. A significant difference was found between the mean REALISE score for patients with AF and controls (p < 0.001). The two REALISE scores were highly correlated (r = 0.99). The coefficient of repeatability was 1.45 in T1 and 1.18 in T2. CONCLUSIONS The REALISE score may have an important role in the assessment and management of AF, in grading the severity of AF and comparing results of different treatments.
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Affiliation(s)
- A Picciariello
- Surgical Unit "M. Rubino" Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy. .,Unit of Laparoscopic Surgery, Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy.
| | - P Lobascio
- Surgical Unit "M. Rubino" Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
| | - L Spazzafumo
- Agenzia Regionale Sanitaria (The Regional Agency for Health), Marche Region, Ancona, Italy
| | - M Rinaldi
- Surgical Unit "M. Rubino" Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
| | - R Dibra
- Surgical Unit "M. Rubino" Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
| | - G Trigiante
- Surgical Unit "M. Rubino" Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
| | - R Laforgia
- Surgical Unit "M. Rubino" Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
| | - A Pezzolla
- Surgical Unit "M. Rubino" Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
| | - D F Altomare
- Surgical Unit "M. Rubino" Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy
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Petrillo F, Pignataro D, Di Lella FM, Reibaldi M, Fallico M, Castellino N, Parisi G, Trotta MC, D’Amico M, Santella B, Folliero V, Della Rocca MT, Rinaldi M, Franci G, Avitabile T, Galdiero M, Boccia G. Antimicrobial Susceptibility Patterns and Resistance Trends of Staphylococcus aureus and Coagulase-Negative Staphylococci Strains Isolated from Ocular Infections. Antibiotics (Basel) 2021; 10:antibiotics10050527. [PMID: 34063711 PMCID: PMC8147806 DOI: 10.3390/antibiotics10050527] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 04/09/2021] [Revised: 04/28/2021] [Accepted: 05/01/2021] [Indexed: 11/16/2022] Open
Abstract
Ocular bacterial infections represent a serious problem that affecting people of all age and genders. These infections can lead to visual impairment and blindness if not properly treated. The current study evaluates the antimicrobial resistance profiles and the resistance trend of both Staphylococcus aureus (S. aureus) and coagulase-negative staphylococci (CoNS), the main pathogens involved in eye infections. A total of 322 isolates of S. aureus and CoNS, were collected from patients with bacterial conjunctivitis and keratitis at the "Luigi Vanvitelli" University Hospital of Campania in Naples, Italy, between 2017 and 2020. The isolated bacteria showed a high percentage of resistance to methicillin and other antibiotics commonly used for the treatment of ocular infections. Trends in antibiotic resistance were not encouraging, recording-especially among CoNS strains-an increase of more than 20% in resistance to methicillin and aminoglycosides during the study period. Instead, the resistance rates to tetracycline had a significant decrease in CoNS isolates while no changes in their susceptibility to fluoroquinolones and macrolides were observed. However, all isolates showed no resistance to trimethoprim/sulfamethoxazole and chloramphenicol. In this scenario, preventive identification of the infection causative agents and the evaluation of the antimicrobial susceptibility patterns are essential to set up an ocular infection effective drug treatment and also prevent antibiotic resistance.
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Affiliation(s)
- Francesco Petrillo
- Section of Ophthalmology, University Hospital “Policlinico-Vittorio Emanuele”, 95123 Catania, Italy; (F.P.); (M.F.); (N.C.); (T.A.)
| | - Danilo Pignataro
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (D.P.); (F.M.D.L.); (B.S.); (V.F.); (M.T.D.R.)
| | - Federica Maria Di Lella
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (D.P.); (F.M.D.L.); (B.S.); (V.F.); (M.T.D.R.)
| | - Michele Reibaldi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122 Turin, Italy; (M.R.); (G.P.)
| | - Matteo Fallico
- Section of Ophthalmology, University Hospital “Policlinico-Vittorio Emanuele”, 95123 Catania, Italy; (F.P.); (M.F.); (N.C.); (T.A.)
| | - Niccolò Castellino
- Section of Ophthalmology, University Hospital “Policlinico-Vittorio Emanuele”, 95123 Catania, Italy; (F.P.); (M.F.); (N.C.); (T.A.)
| | - Guglielmo Parisi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122 Turin, Italy; (M.R.); (G.P.)
| | - Maria Consiglia Trotta
- Department of Experimental Medicine, Division of Pharmacology, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.C.T.); (M.D.)
| | - Michele D’Amico
- Department of Experimental Medicine, Division of Pharmacology, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.C.T.); (M.D.)
| | - Biagio Santella
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (D.P.); (F.M.D.L.); (B.S.); (V.F.); (M.T.D.R.)
| | - Veronica Folliero
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (D.P.); (F.M.D.L.); (B.S.); (V.F.); (M.T.D.R.)
| | - Maria Teresa Della Rocca
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (D.P.); (F.M.D.L.); (B.S.); (V.F.); (M.T.D.R.)
| | - Michele Rinaldi
- Department of Ophthalmology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy;
| | - Teresio Avitabile
- Section of Ophthalmology, University Hospital “Policlinico-Vittorio Emanuele”, 95123 Catania, Italy; (F.P.); (M.F.); (N.C.); (T.A.)
| | - Marilena Galdiero
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (D.P.); (F.M.D.L.); (B.S.); (V.F.); (M.T.D.R.)
- Correspondence: (M.G.); (G.B.)
| | - Giovanni Boccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy;
- Correspondence: (M.G.); (G.B.)
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Saeed D, Potapov E, Loforte A, Morshuis M, Schibilsky D, Zimpfer D, Riebandt J, Pappalardo F, Attisani M, Rinaldi M, Haneya A, Ramjankhan F, Donker D, Jorde U, Stein J, Tsyganenko D, Jawad K, Wieloch R, Ayala R, Cremer J, Borger M, Lichtenberg A, Gummert J. Neurological Complications in Patients Requiring Durable VAD Systems after ECLS Support. On Behalf of ECLS- Durable MCS Study Group. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Loforte A, Gliozzi G, Attisani M, Montalto A, Iacovoni A, Onorati F, Maiani M, Scandroglio M, Terzi A, De Bonis M, Faggian G, Livi U, Musumeci F, Rinaldi M, Pacini D. Multicenter Italian Study on Radial Mechanically Assisted Circulatory Support (MIRAMACS): Preliminary Results. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Altomare DF, Picciariello A, Di Ciaula A, Rinaldi M, De Fazio M, Portincasa P. Effects of temporary sacral nerve stimulation on gastrointestinal motility and function in patients with chronic refractory slow-transit constipation. Tech Coloproctol 2021; 25:291-297. [PMID: 33185809 PMCID: PMC7932968 DOI: 10.1007/s10151-020-02367-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Received: 07/02/2020] [Accepted: 10/23/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The efficacy of sacral nerve stimulation (SNS) on patients with chronic refractory slow-transit constipation is controversial and its mechanism of action on gastrointestinal motility and transit is not fully understood. The aim of this study was to document the effects of temporary SNS on the gastrointestinal and biliary tract motility and on gastrointestinal transit in patients with refractory slow-transit constipation. METHODS This was a prospective interventional study. Patients with slow-transit chronic constipation, unresponsive to any conservative treatment, were enrolled between January 2013 and December 2018. Patients' quality of life [patient assessment of constipation quality of life (PAC-QOL) questionnaire], constipation scores (Cleveland Clinic Constipation Score) colonic transit time (CTT), orocecal transit time (OCTT), gastric and gallbladder kinetics, together with the assessment of the autonomic nerve function were evaluated before and during temporary SNS. RESULTS 14 patients (12 females, median age 38 years, range 24-42 years) had temporary SNS. The Cleveland Clinic Constipation Score did not change compared to baseline (23 ± 3 vs 21.4; p = 070). The PAC-QOL did not improve significantly during the stimulation period. Gallbladder/stomach motility (half-emptying time) did not change significantly before and after SNS. OCTT was delayed at baseline, as compared to standard internal normal values, and did not change during SNS. CTT did not improve significantly, although in two patients it decreased substantially from 97 to 53 h, and from 100 to 65 h. CONCLUSIONS Temporary SNS did not have any effect on upper/lower gastrointestinal motility and transit in patients with severe constipation.
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Affiliation(s)
- D F Altomare
- Department of Emergency and Organ Transplantation, University "Aldo Moro", Bari, Italy.
- IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy.
| | - A Picciariello
- Department of Emergency and Organ Transplantation, University "Aldo Moro", Bari, Italy
| | - A Di Ciaula
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University "Aldo Moro", Bari, Italy
| | - M Rinaldi
- Department of Emergency and Organ Transplantation, University "Aldo Moro", Bari, Italy
| | - M De Fazio
- Department of Emergency and Organ Transplantation, University "Aldo Moro", Bari, Italy
| | - P Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University "Aldo Moro", Bari, Italy.
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Filippelli M, Campagna G, Vito P, Zotti T, Ventre L, Rinaldi M, Bartollino S, dell'Omo R, Costagliola C. Anti-inflammatory Effect of Curcumin, Homotaurine, and Vitamin D3 on Human Vitreous in Patients With Diabetic Retinopathy. Front Neurol 2021; 11:592274. [PMID: 33633656 PMCID: PMC7901953 DOI: 10.3389/fneur.2020.592274] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/03/2020] [Indexed: 01/01/2023] Open
Abstract
Purpose: To determine the levels of pro-inflammatory cytokines and soluble mediators (TNF-α, IL6, IL2, and PDGF-AB) in 28 vitreous biopsies taken from patients with proliferative diabetic retinopathy (PDR) and treated with increasing doses of curcumin (0. 5 and 1 μM), with or without homotaurine (100 μM) and vitamin D3 (50 nM). Materials and Methods: ELISA tests were performed on the supernatants from 28 vitreous biopsies that were incubated with bioactive molecules at 37°C for 20 h. The concentration of the soluble mediators was calculated from a calibration curve and expressed in pg/mL. Shapiro-Wilk test was used to verify the normality of distribution of the residuals. Continuous variables among groups were compared using the General Linear Model (GLM). Homoscedasticity was verified using Levene and Brown-Forsythe tests. Post-hoc analysis was also performed with the Tukey test. A p ≤ 0.05 was considered statistically significant. Results: The post-hoc analysis revealed statistically detectable changes in the concentrations of TNF-α, IL2, and PDGF-AB in response to the treatment with curcumin, homotaurine, and vitamin D3. Specifically, the p-values for between group comparisons are as follows: TNF-α: (untreated vs. curcumin 0.5 μM + homotaurine 100 μM + vitamin D3 50 nM) p = 0.008, (curcumin 0.5 μM vs. curcumin 0.5 μM + homotaurine 100 μM + vitamin D3 50 nM) p = 0.0004, (curcumin 0.5 μM vs. curcumin 1 μM + homotaurine 100 μM + vitamin D3 50 nM) p = 0.02, (curcumin 1 μM vs. curcumin 0.5 μM + homotaurine 100 μM + vitamin D3 50 nM) p = 0.025, and (homotaurine 100 μM + vitamin D3 50 nM vs. curcumin 0.5 μM + homotaurine 100 μM + vitamin D3 50 nM) p = 0.009; IL2: (untreated vs. curcumin 0.5 μM + homotaurine 100 μM + vitamin D3 50 nM) p = 0.0023, and (curcumin 0.5 μM vs. curcumin 0.5 μM+ homotaurine 100 μM + vitamin D3 50 nM) p = 0.0028; PDGF-AB: (untreated vs. curcumin 0.5 μM + homotaurine 100 μM + vitamin D3 50 nM) p = 0.04, (untreated vs. curcumin 1 μM + homotaurine 100 μM + vitamin D3 50 nM) p = 0.0006, (curcumin 0.5 μM vs. curcumin 1 μM + homotaurine 100 μM + vitamin D3 50 nM) p = 0.006, and (homotaurine 100 μM + vitamin D3 50 nM vs. curcumin 1 μM + homotaurine 100 μM + vitamin D3 50 nM) p = 0.022. IL6 levels were not significantly affected by any treatment. Conclusions: Pro-inflammatory cytokines are associated with inflammation and angiogenesis, although there is a discrete variability in the doses of the mediators investigated among the different vitreous samples. Curcumin, homotaurine, and vitamin D3 individually have a slightly appreciable anti-inflammatory effect. However, when used in combination, these substances are able to modify the average levels of the soluble mediators of inflammation and retinal damage. Multi-target treatment may provide a therapeutic strategy for diabetic retinopathy in the future. Clinical Trial Registration : The trial was registered at clinical trials.gov as NCT04378972 on 06 May 2020 ("retrospectively registered") https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid = S0009UI8&selectaction = Edit&uid = U0003RKC&ts = 2&cx = dstm4o.
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Affiliation(s)
- Mariaelena Filippelli
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
| | - Giuseppe Campagna
- Department of Medical-Surgical Sciences and Translational Medicine, University of Rome "La Sapienza", Rome, Italy
| | - Pasquale Vito
- Sannio Tech Consortium, Apollosa, Italy.,Department of Science and Technology, University of Sannio, Benevento, Italy
| | - Tiziana Zotti
- Sannio Tech Consortium, Apollosa, Italy.,Department of Science and Technology, University of Sannio, Benevento, Italy
| | - Luca Ventre
- Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University Eye Clinic, Turin, Italy
| | - Michele Rinaldi
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Silvia Bartollino
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
| | - Roberto dell'Omo
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
| | - Ciro Costagliola
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.,Sannio Tech Consortium, Apollosa, Italy
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Bruno F, D'Ascenzo F, Marengo G, Manfredi R, Conrotto F, Gallone G, Omede P, Montefusco A, Pennone M, Salizzoni S, Rinaldi M, Giustetto C, De Ferrari G. Fractional flow reserve (FFR) guided vs angiography guided coronary artery bypass graft (CABG): a systematic review and meta-analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
A strategy of percutaneous coronary intervention (PCI) driven by FFR (Fractional Flow Reserve) has demonstrated to reduce adverse events through the “deferring” of unnecessary stenting procedures compared to PCI guided by angiographic evaluation of stenosis. Coronary Artery Bypass Graft (CABG) represents another option for revascularization, being superior to PCI in patients with diffuse disease. In this setting, some evidence has been provided about physiological driven CABG procedures, but studies reported contrasting results regarding clinical benefits and outcomes at follow up.
The aim of this meta-analysis is to evaluate clinical and procedural impact of FFR versus angiographic guided surgical revascularization and assess outcomes at follow up.
Methods
All randomized controlled trials (RCTs) or observational studies with multivariable adjustment or propensity matching were included. MACE (Major Adverse Cardiac Events) was the primary end point, while its single components (death, myocardial infarction and revascularization) along with number of grafts and percent of off-pump CABG were the secondary ones. Of 86 studies identified, 4 articles were included in this review, representing a combined total of 777 patients (426 angio-guided and 351 FFR-guided). Mean age was 66±2.1, 80% man, 74% hypertension, 71% hyperlipidemia, 33% diabetes, 39% smokers. Mean EuroSCORE I was 2.7. 18% a prior MI, and 25% a prior PCI. Coronary lesions were allocated as follow: 36% left anterior descending artery, 32% circumflex artery, 27% right coronary artery. Mean follow up was 30 months. At the follow up, rates of MACE did not differ (MACE OR 1.31:0.88–1.96), as those of death (OR 1.47:0.86–2.51), of MI (OR 1.80:0.89–3.63), and of target vessel revascularization (1.03: 0.54–1.97.). FFR-guided CABG was associated with more off-pump surgical procedure (OR 0.58, IC 0.34–0.97) and shorter hospitalization time (8.2±2.49 vs 8,87±3,25 p<0.01). FFR- guided CABG was associated more frequently with off-pump surgical procedure (OR 0.58:0.34–0.97) with fewer anastomes (2.5 vs 3), leading to higher rates of global arteria revascularization in FFR group (56% vs. 45%) and higher rates of venous grafts in angio-guided group (55% vs. 44%). Shorter hospitalization time was recorded in FFR patients (8.2±2.49 vs 8,87±3,25 days, p<0.01). Graft patency at follow up was not statistically higher in the FFR guided group (OR 0.67, CI 95% 0.32–1,39, all CI 95%).
Conclusions
FFR-guided surgical revascularization is associated with more off-pump procedures, a lower number of surgical anastomoses and more arterial grafts compared to angiography guided CABG. These differences lead to a shorter hospitalization time in the FFR-guided group compared to the angiography-guided group. No difference between two groups in MACE, overall death and MI was observed during the follow up. RCT with longer follow up are needed to evaluate long term outcomes.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- F Bruno
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - F D'Ascenzo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - G Marengo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - R Manfredi
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - F Conrotto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - G Gallone
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - P Omede
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - A Montefusco
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - M Pennone
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - S Salizzoni
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - M Rinaldi
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - C Giustetto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - G De Ferrari
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
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Morone MV, Zannella C, Rinaldi M, Micali C, Salvatore T. Comment on: Stathmin1 overexpression associated with polyploidy, tumor-cell invasion, early recurrence, and poor prognosis in human hepatoma. Eur Rev Med Pharmacol Sci 2020; 24:10313-10315. [PMID: 33155256 DOI: 10.26355/eurrev_202010_23377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M V Morone
- Department of Experimental Medicine, University of Campania, Luigi Vanvitelli, Naples, Italy.
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Bellettini M, Pidello S, Gallone G, Frea S, Masetti M, Sabatino M, Boschi S, Giustetto C, Boffini M, Rinaldi M, Potena L, De Ferrari G. Prognostic value and usefulness of Pulmonary Artery Pulsatility index (PAPi) in evaluation of heart transplant candidates. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Heart transplantation (HTx) is considered the best available treatment for patients with end stage heart failure. Candidate evaluation with right heart catheterization (RHC) is fundamental in order to exclude pulmonary hypertension with irreversible high pulmonary vascular resistance (PVR), which is associated with elevated post-HTx mortality. PVR, rather than directly measured, is derived by cardiac output and pulmonary artery pressures, which are strictly dependent on right ventricular (RV) function. The pulmonary artery pulsatility index (PAPi) is a hemodynamic parameter integrating the information of RV function and of pulmonary circulation, which could be useful in pre-HTx evaluation.
Purpose
We designed this study to evaluate the potential predictive influence of pre-HTx PAPi on post-HTx survival and to assess whether this index could add useful information in the pre-HTx evaluation of patients with advanced heart failure.
Methods
Consecutive adult HTx recipient at two medium-large tranplant centers between 2000 and 2017 with available data on pre-HTx RHC were retrospectively included. PAPi was calculated as the ratio of pulmonary artery pulse pressure to right atrial pressure. PAPi values in the lowest quartile were defined as reduced (PAPi<1.67). The primary endpoint was all-cause mortality at 1-year post-HTx. The association of reduced PAPi with the primary endpoint was evaluated. Cox regression was used to adjust for clinical and hemodynamic variables. Analyses stratified by PVR status (≥3 WU vs. <3 WU) were also performed.
Results
Among 655 HTx recipients (female 20,8%, age 53±11 years), median pre-HTx PAPi was 3.0 (interquartile range 1.67–5.32). Patients in the lowest versus the remaining PAPi quartiles had significantly reduced 1-year survival (78.0% vs 87.2%, p=0.006), also after adjusting for age, estimated glomerular filtration rate, total bilirubin, high PVR and urgent transplantation (adj-hazard ratio: 0.64; 95% confidence interval 0.51–0.82). When stratifying patients by estimated PVR status, reduced PAPi was associated with worse 1-year survival among patients with normal PVR (78.3% vs. 88.3% p=0.011), but not in those with increased PVR (78.0% vs. 82.6%, p=0.36) (Figure 1).
Conclusions
Pre-HTx PAPi, integrating information of RV function and pulmonary circulation, provides incremental prognostic value over traditional clinical and hemodynamic parameters among HTx recipient. The prognostic value appears important among patients with normal estimated PVR, possibly due to an underestimation of PVR in patients with impaired RV function. The integration of PAPi in the pre-HTx evaluation may lead to better patient selection and post-HTx survival.
Figure 1. 1 year survival stratified by PVR status
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Bellettini
- A.O.U. Citta della Salute e della Scienza di Torino, Division of Cardiology, Department of Medical Sciences, Turin, Italy
| | - S Pidello
- A.O.U. Citta della Salute e della Scienza di Torino, Division of Cardiology, Department of Medical Sciences, Turin, Italy
| | - G Gallone
- A.O.U. Citta della Salute e della Scienza di Torino, Division of Cardiology, Department of Medical Sciences, Turin, Italy
| | - S Frea
- A.O.U. Citta della Salute e della Scienza di Torino, Division of Cardiology, Department of Medical Sciences, Turin, Italy
| | - M Masetti
- University Hospital Policlinic S. Orsola-Malpighi, Heart Failure and Heart Transplant Program, Bologna, Italy
| | - M Sabatino
- University Hospital Policlinic S. Orsola-Malpighi, Heart Failure and Heart Transplant Program, Bologna, Italy
| | - S Boschi
- University Hospital Policlinic S. Orsola-Malpighi, Heart Failure and Heart Transplant Program, Bologna, Italy
| | - C Giustetto
- University Hospital Policlinic S. Orsola-Malpighi, Heart Failure and Heart Transplant Program, Bologna, Italy
| | - M Boffini
- A.O.U. Citta della Salute e della Scienza di Torino, Department of Cardiovascular and Thoracic Surgery, Turin, Italy
| | - M Rinaldi
- A.O.U. Citta della Salute e della Scienza di Torino, Department of Cardiovascular and Thoracic Surgery, Turin, Italy
| | - L Potena
- University Hospital Policlinic S. Orsola-Malpighi, Heart Failure and Heart Transplant Program, Bologna, Italy
| | - G.M De Ferrari
- A.O.U. Citta della Salute e della Scienza di Torino, Division of Cardiology, Department of Medical Sciences, Turin, Italy
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Spargias K, Szerlip M, Kar S, Makkar R, Kipperman R, O'Neill W, Ng M, Fam N, Rinaldi M, Smith R, Walters D, Schafer U, Latib A, Marcoff L, Webb J. Six-month and one-year outcomes with the PASCAL transcatheter valve repair system for patients with mitral regurgitation from the multicentre, prospective CLASP study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Transcatheter mitral valve repair has emerged as a viable option for treating mitral regurgitation (MR). We report results from the multicentre, prospective, single arm CLASP study with the PASCAL transcatheter valve repair system.
Methods
109 patients with clinically significant MR deemed candidates for transcatheter repair by the local heart team were treated in the CLASP study. The study evaluated safety, performance, clinical and echocardiographic outcomes and included an independent clinical events committee and echocardiographic core lab. The primary safety endpoint was a composite MAE rate at 30 days of cardiovascular mortality, stroke, MI, new need for renal replacement therapy, severe bleeding, and re-intervention for study device-related complications.
Results
Mean age was 76 years, 54% male, 57% NYHA Class III/IV, 100% MR grade ≥3+ with 62% functional, 31% degenerative, 7% mixed etiology. Successful implantation was achieved in 95% of patients. At 30 days, the MAE rate was 8.3% including one cardiovascular mortality due to cardiogenic shock as a result of severe bleeding at the contralateral arterial access site for hemodynamic monitoring further complicated by disseminated intravascular coagulation, one stroke, and one conversion to mitral valve replacement surgery. In paired analysis, 88% of patients were in NYHA Class I/II (p<0.001), MR grade was ≤1+ in 79% of patients and ≤2+ in 96% of patients. Significant improvements in 6MWD (+27 m, p<0.001) and KCCQ (+16 points, p<0.001) were observed. The six-month data will be available for presentation. In addition, we report one-year follow up of the first 62 patients (ITT): 93% one-year survival rate (Kaplan-Meier estimate), no stroke, no late reintervention, one late MI. In paired analysis, MR grade was ≤1+ in 82% of patients and ≤2+ in 100% of patients. 88% of patients were in NYHA Class I/II (p<0.001), 6MWD improved by 21 m (p=0.124) and KCCQ improved by 13 points (p<0.001).
Conclusions
This study demonstrates the PASCAL transcatheter valve repair system is safe and resulted in robust MR reduction with 100% of patients achieving MR ≤2+, and ∼ 80% MR ≤1+, sustained at one year. Results show high survival and low complication rates, and sustained improvements in functional status, exercise capacity, and quality of life at one year in patients with clinically significant, symptomatic MR. The CLASP IID/IIF pivotal trial is underway.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Edwards Lifesciences (Irvine, CA)
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Affiliation(s)
| | - M Szerlip
- The Heart Hospital Baylor, Plano, United States of America
| | - S Kar
- Los Robles Hospital and Medical Center, Thousand Oaks, United States of America
| | - R Makkar
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - R Kipperman
- Morristown Medical Center, Morristown, United States of America
| | - W O'Neill
- Henry Ford Hospital, Detroit, United States of America
| | - M Ng
- Royal Prince Alfred Hospital, Camperdown, Australia
| | - N Fam
- St. Michael's Hospital, Toronto, Canada
| | - M Rinaldi
- Sanger Heart and Vascular Institute, Charlotte, United States of America
| | - R Smith
- The Heart Hospital Baylor, Plano, United States of America
| | - D Walters
- Prince Charles Hospital, Chermside, Australia
| | | | - A Latib
- Montefiore Medical Center, New York, United States of America
| | - L Marcoff
- Morristown Medical Center, Morristown, United States of America
| | - J Webb
- St Paul's Hospital, Vancouver, Canada
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Andreis A, Imazio M, Brucato A, De Ferrari G, Rinaldi M, Adler Y. Interleukin-1 blockade in patients with pericardial constriction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Recurrent pericarditis is very difficult to treat, especially when symptoms become refractory to conventional treatments (nonsteroidal anti-inflammatory drugs,colchicine,corticosteroids). Interleukin-1 (IL-1) blockade with anakinra has been proved to be useful in this setting. Indeed, persistent inflammation of the pericardium may lead to pericardial constriction, worsening prognosis.
Purpose
This study was aimed to assess the incidence and clinical course of pericardial constriction in patients with corticosteroid-dependent, colchicine-resistant recurrent pericarditis (CCRP) undergoing anti IL-1 treatment.
Methods
We selected patients included in the IRAP (International Registry of Anakinra for Pericarditis). A subgroup of 39 CCRP patients enrolled at the coordinating center underwent echocardiographic and clinical assessment for pericardial constriction.
Results
Thirty-nine patients were assessed, aged 42±12 years old, 67% females, 74% idiopathic etiology, with a median disease duration of 12 months (IQR 9–20) and a recurrence rate of 2.79 flares-patient/year before starting anakinra. Echocardiographic signs of pericardial constriction were demonstrated in 8 patients (21%). After starting anakinra, in 5/8 patients (63%) a complete resolution of pericardial constriction was observed within a median of 1.2 months,IQR 1–4. In other 3/8 patients (37%) pericardial constriction persisted and became chronic, requiring pericardiectomy within a median of 2.8 months, IQR 2–5.
Compared with others, the 8 patients with pericardial constriction hadn't had a greater burden of pericardial flares before anakinra (3.87 flares-patient/year vs. 2.62/patient-year, p=0.07) and after anakinra (0.71 flares-patient/year vs. 0.72/patient-year, p=0.99). However, among 11 patients (28%) with incessant symptoms, an higher incidence of pericardial constriction was observed, compared with patients with recurrent symptoms (respectively 64% vs. 3.6%, RR=47, 95% CI 4.5–492, p<0.01).
Conclusions
In CCRP patients, pericardial constriction may be reversed by anti IL-1 agents. The risk of pericardial constriction is associated with incessant symptoms rather than simple recurrent course.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Andreis
- Città della Salute e della Scienza di Torino Hospital, Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Imazio
- Città della Salute e della Scienza di Torino Hospital, Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - A Brucato
- ASST Fatebenefratelli - Sacco, University of Milan, Department of Biomedical and Clinical Sciences “L. Sacco”, Milan, Italy
| | - G.M De Ferrari
- Città della Salute e della Scienza di Torino Hospital, Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Rinaldi
- Città della Salute e della Scienza di Torino Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Y Adler
- Leviev Heart Center, Chaim Sheba Medical Center (affiliated to Tel Aviv University), Israel, Tel Aviv, Israel
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40
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De Filippo O, D'Ascenzo F, Elia E, Doronzo M, Montefusco A, Pennone M, Angelini F, Franchin L, Bruno F, Salizzoni S, Gaudino M, Rinaldi M, De Ferrari G. Percutaneous vs. surgical revascularization for patients with unprotected left main stenosis: a meta-analysis of 5 years follow-up RCTs. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
5-year survival of patients with ULM (Unprotected Left Main) stenosis according to the choice of revascularization (percutaneous vs. surgical) remains to be defined.
Methods and results
Randomized Controlled Trials (RTCs) comparing Percutaneous Coronary Intervention (PCI) vs. Coronary Artery Bypass Graft (CABG) with a follow-up of at least 5 years were included. All-cause death was the primary endpoint. MACCE (a composite endpoint of all-cause mortality, myocardial infarction [MI], stroke and repeat revascularization) along with its single components and cardiovascular (CV) death were the secondary ones. Analyses were stratified according to use of first vs. last generation coronary stents. Subgroup comparisons were performed according to Syntax Score (below or above 33) and to age (using cutoffs of each trial's subgroup analysis). 4 RCTs with 4394 patients were identified: 2197 were treated with CABG, 657 with first generation and 1540 with last generation stents. At 5 years rates of all-cause death did not differ (OR 0.93: 0.71–1.21), as those of CV death and stroke. CABG reduced rates of MACCE (OR 0.69: 0.60–0.79), mainly driven by MI (OR 0.48: 0.36–0.65) and revascularization (OR 0.53: 0.45–0.64). Benefit of CABG for MACCE was consistent, although with different extent, across values of Syntax Score (OR 0.76: 0.59–0.97 for values <32 and OR 0.63: 0.47–0.84 for values ≥33) while was not evident for “younger” patients (OR 0.83: 0.65–1.07 vs. OR 0.65: 0.51–0.84 for “older” patients, all CI 95%).
Conclusion
For patients with ULM disease, PCI and CABG yielded same survival benefit at 5 years. CABG reduced risk of MI, revascularization and MACCE especially in older patients and in those with diffuse coronary disease.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- O De Filippo
- City of Health and Science of Turin, Turin, Italy
| | - F D'Ascenzo
- City of Health and Science of Turin, Turin, Italy
| | - E Elia
- City of Health and Science of Turin, Turin, Italy
| | - M.P Doronzo
- City of Health and Science of Turin, Turin, Italy
| | - A Montefusco
- City of Health and Science of Turin, Turin, Italy
| | - M Pennone
- City of Health and Science of Turin, Turin, Italy
| | - F Angelini
- City of Health and Science of Turin, Turin, Italy
| | - L Franchin
- City of Health and Science of Turin, Turin, Italy
| | - F Bruno
- City of Health and Science of Turin, Turin, Italy
| | - S Salizzoni
- City of Health and Science of Turin, Turin, Italy
| | - M Gaudino
- New York-Presbyterian Hospital-Weill Cornell Medical Center, New York, United States of America
| | - M Rinaldi
- City of Health and Science of Turin, Turin, Italy
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Bruno F, D'Ascenzo F, Giordana F, Saglietto A, Conrotto F, De Filippo O, Grosso Marra W, Salizzoni S, Trompeo A, La Torre M, D'Amico M, Rinaldi M, Giustetto C, De Ferrari G. Incidence, predictors and outcomes of Valve-in-valve (ViV) Transcatheter aortic valve replacement (TAVR): a systematic review and meta-analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Surgical aortic valve replacement has been the treatment of choice for patients with aortic valve disease before the arrival of transcatheter aortic valve replacement (TAVI), although limited by degeneration of the bioprosthesis. “Redo” intervention itself is burdened by high risk of complications and valve-in-valve (ViV) TAVI could be a valid strategy of redo for patients with comorbidities. The aim of this meta-analysis is to give an overview of the state of the art of ViV TAVI in high-risk patients, analyzing efficacy, safety, intra-hospital outcomes and 1-year outcomes and assess predictors of survival at short and mid-term follow up.
Methods
Two independent reviewers screened all studies investigating patients undergoing ViV TAVI. PubMed database was searched for reports published in English according to the following highly sensitive strategy: (Transcatheter[All Fields] AND “aortic”[All Fields]) AND valve-in-valve[All Fields] AND “implantation”[All Fields] NOT (review[pt] OR editorial[pt] OR letter[pt])AND “humans”[MeSH Terms]). Mortality at 30 days and at 1 year were the primary end point, while procedural and short-term outcomes and echocardiographic parameters at hospital discharge were the secondary end points.
Results
Of 286 studies identified, 26 articles were included, with a total of 1448 patients. Median age was 78.8 years, 57.7% of the patients were male. Median STS-predicted risk of mortality was 9.4% while median Logistic EuroSCORE was 31.3%. Median age of bioprosthesis was 10 years with 84.6% of stented valves. Stenosis (45%), followed by regurgitation (31%) and mixed defects (21%) were the causes of prosthesis failure. Diameter of the degenerated valve was ≤21 mm in 25.4%, 22–25 mm in 55% and >25mm in 11.7% of the patients. Transfemoral approach was preferred (76%), with a prevalence of balloon expandable valve (73.3%). Mean post procedural gradient was 16.7±0.8 mmHg. Mean follow up was 376 days. Overall and cardiovascular mortality at 30 days was 6.5% and 5.5% respectively, while at 1 year it was 14.5% and 8.9% respectively. Regarding short-term outcomes, overall bleeding (10.4%), pacemaker implantation (9.4%) and vascular complications (8.3%) were the most common peri-procedural complications, while stroke (2.3%), myocardial infarction (2.7%) and coronary obstruction (2.8%) were less frequent. At meta-regression analysis study year (p<0.001), Logistic Euroscore (p<0.01) and valve diameter ≤21 mm (p<0.05) at 30 days, and stenosis as reason for failure (p=0.05) at 1 year were identified as possible predictors of survival.
Conclusions
Percutaneous valve-in-valve aortic valve implantation offers a valid strategy to treat high risk patients with a degenerative bioprosthesis. Short and mid-term outcomes are substantially superimposable to those of TAVI, except for coronary obstruction which appears more frequent. Future studies are needed to find predictors of long- term survival and outcomes in lower risk patients.
Outcome of VIV TAVI
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- F Bruno
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - F D'Ascenzo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - F Giordana
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - A Saglietto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - F Conrotto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - O De Filippo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - W Grosso Marra
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - S Salizzoni
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - A Trompeo
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - M La Torre
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - M D'Amico
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - M Rinaldi
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiosurgery, Turin, Italy
| | - C Giustetto
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
| | - G De Ferrari
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Cardiology, Turin, Italy
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Perrella A, Carannante N, Berretta M, Rinaldi M, Maturo N, Rinaldi L. Novel Coronavirus 2019 (Sars-CoV2): a global emergency that needs new approaches? Eur Rev Med Pharmacol Sci 2020; 24:2162-2164. [PMID: 32141586 DOI: 10.26355/eurrev_202002_20396] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- A Perrella
- VII Division of Infectious Diseases and Immunology, P.O. "D. Cotugno", AORN Ospedali dei Colli, Naples, Italy.
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Bonfiglio V, Ortisi E, Scollo D, Reibaldi M, Russo A, Pizzo A, Faro G, Macchi I, Fallico M, Toro MD, Rejdak R, Nowomiejska K, Toto L, Rinaldi M, Cillino S, Avitabile T, Longo A. Vascular changes after vitrectomy for rhegmatogenous retinal detachment: optical coherence tomography angiography study. Acta Ophthalmol 2020; 98:e563-e569. [PMID: 31773840 DOI: 10.1111/aos.14315] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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: 06/28/2019] [Accepted: 10/31/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To analyse the postoperative foveal avascular zone (FAZ) area, superficial vessel density (SVD) and deep vessel density (DVD) and their correlation with functional (best-corrected visual acuity, BCVA) and anatomical outcomes (foveal macular thickness, FMT) after surgery for rhegmatogenous retinal detachment (RRD) repair. METHOD Patients with RRD eyes, successfully treated with a single pars plana vitrectomy (PPV) with gas tamponade and a minimum 12 months follow-up, were re-examined. Foveal avascular zone (FAZ) area, SVD, DVD and FMT were evaluated by using optical coherence tomography angiography (OCTA) and compared to fellow eye. RESULTS Fifty-six patients with macula-on and 37 with macula-off RRD were included in the study. In both groups, no difference in FMT and FAZ area was found compared to fellow eyes. In macula-on RRD eyes, a lower parafoveal DVD (p = 0.001) was detected; FAZ area was related to FMT (p = 0.025), and the postoperative BCVA was correlated with parafoveal DVD (p = 0.010) and FAZ area (p = 0.003). In macula-off RRD eyes, lower parafoveal SDV (p = 0.012), and foveal and parafoveal DVD (p = 0.012 and p < 0.001, respectively) were observed. BCVA was related to FAZ area (p = 0.012), foveal SVD (p = 0.005) and parafoveal DVD (p = 0.010). CONCLUSION Rhegmatogenous retinal detachment eyes successfully treated with PPV had lower vessel density in the superficial and deep retinal plexus compared to fellow healthy eyes; BCVA was related to FAZ area and vessel density.
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Affiliation(s)
| | - Elina Ortisi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Davide Scollo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Michele Reibaldi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Alessandra Pizzo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Giuseppe Faro
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Iacopo Macchi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Matteo Fallico
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Mario D Toro
- Department of Ophthalmology, University of Catania, Catania, Italy.,Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland
| | | | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Michele Rinaldi
- Department of Ophthalmology, Second University of Napoli, Naples, Italy
| | - Salvatore Cillino
- Department of Experimental Biomedicine and Clinical Neuroscience, Ophthalmology Section, University of Palermo, Palermo, Italy
| | | | - Antonio Longo
- Department of Ophthalmology, University of Catania, Catania, Italy
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Cocci A, Salvi M, Di Trapani E, Musi G, Cozzi G, De Cobelli O, Rinaldi M, Minafra P, De Rienzo G, Cimino S, Verze P, Mirone V, Morgera V, Bianchi L, Borghesi M, Guerra M, Schiavina R, Brunocilla E, Polloni G, Tuccio A, Gacci M, Serni S, Minervini A, Carini M, Russo G. Aquablation-image-guided robot-assisted waterjet ablation of the prostate: Preliminary results of a non-selected, consecutive, patients cohort of a national multicentre clinical experience. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34285-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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45
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Picciariello A, Rinaldi M, De Fazio M, Trigiante G, Papagni V, Bucaria V, Altomare DF. Restorative perineal anorectal amputation for a locally advanced desmoid tumour. Int J Colorectal Dis 2020; 35:1333-1334. [PMID: 32358720 DOI: 10.1007/s00384-020-03598-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Arcangelo Picciariello
- Department of Emergency and Organ Transplantation, University "Aldo Moro" of Bari, Piazza G Cesare, 11, 70124, Bari, Italy.
| | - M Rinaldi
- Department of Emergency and Organ Transplantation, University "Aldo Moro" of Bari, Piazza G Cesare, 11, 70124, Bari, Italy
| | - M De Fazio
- Department of Emergency and Organ Transplantation, University "Aldo Moro" of Bari, Piazza G Cesare, 11, 70124, Bari, Italy
| | - G Trigiante
- Department of Emergency and Organ Transplantation, University "Aldo Moro" of Bari, Piazza G Cesare, 11, 70124, Bari, Italy
| | - V Papagni
- Department of Emergency and Organ Transplantation, University "Aldo Moro" of Bari, Piazza G Cesare, 11, 70124, Bari, Italy
| | - V Bucaria
- IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - D F Altomare
- Department of Emergency and Organ Transplantation, University "Aldo Moro" of Bari, Piazza G Cesare, 11, 70124, Bari, Italy.,IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
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Matera MG, Belardo C, Rinaldi M, Rinaldi B, Cazzola M. Emerging muscarinic receptor antagonists for the treatment of asthma. Expert Opin Emerg Drugs 2020; 25:123-130. [PMID: 32312134 DOI: 10.1080/14728214.2020.1758059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The increased acetylcholine signaling in asthma pathophysiology offers the rationale for the use of LAMAs in the treatment of asthmatic patients. Tiotropium is still the only LAMA approved for use in asthma but there is a real interest in developing novel LAMAs for the treatment of asthma, or at least to extend this indication to other LAMAs already on the market. AREAS COVERED We examined and discussed trials and research that have studied or are evaluating the role of LAMAs already on the market in asthma and possible novel muscarinic acetylcholine receptor antagonists. EXPERT OPINION Glycopyrronium and umeclidinium will soon be included in the GINA strategy with the same current indications of tiotropium. It is likely that the choice of the LAMA will be influenced not so much by its pharmacological profile as by the type of triple therapy chosen. It is extremely difficult to identify a new LAMA that is more effective than tiotropium, but is it plausible that new technologies that will allow delivering the drug in a more targeted way and with a lower risk of adverse effects may represent the real progress in the use of LAMAs in asthma in the coming years.
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Affiliation(s)
- Maria Gabriella Matera
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Carmela Belardo
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Michele Rinaldi
- Multidisciplnary Department of Medical-Surgical and Dental Specialities, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Barbara Rinaldi
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Mario Cazzola
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata" , Rome, Italy
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Cocci A, Salvi M, Di Trapani E, Musi G, Cozzi G, De Cobelli O, Rinaldi M, Minafra P, De Rienzo G, Cimino S, Verze P, Mirone V, Verrienti P, Morgera V, Bianchi L, Borghesi M, Guerra M, Schiavina R, Brunocilla E, Polloni G, Tuccio A, Gacci M, Serni S, Minervini A, Carini M, Russo G. VS-1-1 Waterablation of the Prostate for the Treatment of Lower Urinary Tract Symptoms in Men With Benign Prostatic Hyperplasia: First Italian Multicenter Experience. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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48
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Santella B, Pignataro D, Lavano MA, Rinaldi M, Galdiero F. Comment on: Expressions of MiR-132 in patients with chronic hepatitis B, posthepatitic cirrhosis and hepatitis B virus-related hepatocellular carcinoma. Eur Rev Med Pharmacol Sci 2020; 23:1384-1385. [PMID: 30840257 DOI: 10.26355/eurrev_201902_17093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- B Santella
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
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Merico E, Grasso FM, Cesari D, Decesari S, Belosi F, Manarini F, De Nuntiis P, Rinaldi M, Gambaro A, Morabito E, Contini D. Characterisation of atmospheric pollution near an industrial site with a biogas production and combustion plant in southern Italy. Sci Total Environ 2020; 717:137220. [PMID: 32092819 DOI: 10.1016/j.scitotenv.2020.137220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/31/2020] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
Although biogas production can have some benefits, there is a research gap on potential influence of biogas plant emissions on local air quality, thus an accurate and comprehensive evaluation of impacts of this technology is needed. This study deals with this issue by means of a characterisation of air pollution near an industrial area including a biogas production (from biomass) and combustion plant located in South Italy. The methodology consists in advanced statistical analysis on concentration of gaseous pollutants, particles concentration and size distribution in number and mass, and PM2.5 chemical composition. High-temporal resolution measurements, supported by ancillary meteorological parameters, and source apportionment of PM2.5 using Positive Matrix Factorization (PMF) receptor model, are performed. The integrated approach provides the emissive picture consisting in different anthropogenic sources (i.e. traffic, biomass burning, and industrial facilities) with particular focus on biogas plant emissions. Results showed that CO and nitrogen oxides were influenced by vehicular traffic and biomass combustion, however, a contribution of the plant to NO was observed. SO2 was influenced mainly by transport from the industrial zone, but a second local contribution compatible with the emissions of the biogas plant was detected. Number particle concentrations were analysed in four size ranges: nanoparticles (D < 0.05 μm), ultrafine particles (D < 0.3 μm), accumulation (0.3 < D < 1 μm) and coarse particles (D > 1 μm). Nanoparticles and ultrafine particles were mainly influenced by vehicular traffic and biomass burning, instead, a contribution of the plant was individuated in the accumulation mode. PMF5 identified the contribution of six sources: crustal (14.7% ± 2.1% of measured PM2.5); marine aerosol (aged) (12.9% ± 2.3%); biomass burning (32.8% ± 1.4%); secondary sulphate (19.7% ± 2.4%); primary industrial emissions (5.4% ± 2.3%); traffic and secondary nitrate (17.0% ± 3.9%). The plant is likely to contribute to both sources, the industrial and the traffic plus secondary nitrate.
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Affiliation(s)
- E Merico
- Institute of Atmospheric Sciences and Climate, ISAC-CNR, Str. Prv. Lecce-Monteroni km 1.2, 73100 Lecce, Italy.
| | - F M Grasso
- Institute of Atmospheric Sciences and Climate, ISAC-CNR, Str. Prv. Lecce-Monteroni km 1.2, 73100 Lecce, Italy
| | - D Cesari
- Institute of Atmospheric Sciences and Climate, ISAC-CNR, Str. Prv. Lecce-Monteroni km 1.2, 73100 Lecce, Italy
| | - S Decesari
- Institute of Atmospheric Sciences and Climate, ISAC-CNR, Via Piero Gobetti, 101, 40129 Bologna, Italy
| | - F Belosi
- Institute of Atmospheric Sciences and Climate, ISAC-CNR, Via Piero Gobetti, 101, 40129 Bologna, Italy
| | - F Manarini
- Institute of Atmospheric Sciences and Climate, ISAC-CNR, Via Piero Gobetti, 101, 40129 Bologna, Italy
| | - P De Nuntiis
- Institute of Atmospheric Sciences and Climate, ISAC-CNR, Via Piero Gobetti, 101, 40129 Bologna, Italy
| | - M Rinaldi
- Institute of Atmospheric Sciences and Climate, ISAC-CNR, Via Piero Gobetti, 101, 40129 Bologna, Italy
| | - A Gambaro
- Department of Environmental Sciences, Informatics and Statistics, (DAIS), Ca' Foscari University of Venice, Via Torino, 155, 30172 Venice, Mestre, Italy
| | - E Morabito
- Department of Environmental Sciences, Informatics and Statistics, (DAIS), Ca' Foscari University of Venice, Via Torino, 155, 30172 Venice, Mestre, Italy
| | - D Contini
- Institute of Atmospheric Sciences and Climate, ISAC-CNR, Str. Prv. Lecce-Monteroni km 1.2, 73100 Lecce, Italy
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50
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Bartoletti M, Rinaldi M, Pasquini Z, Scudeller L, Piano S, Giacobbe DR, Maraolo AE, Bussini L, Del Puente F, Incicco S, Angeli P, Giannella M, Baldassarre M, Caraceni P, Campoli C, Morelli MC, Cricca M, Ambretti S, Gentile I, Bassetti M, Viale P. Risk factors for candidaemia in hospitalized patients with liver cirrhosis: a multicentre case-control-control study. Clin Microbiol Infect 2020; 27:276-282. [PMID: 32360775 DOI: 10.1016/j.cmi.2020.04.030] [Citation(s) in RCA: 6] [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: 02/04/2020] [Revised: 04/20/2020] [Accepted: 04/23/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the risk factors for candidaemia in patients with liver cirrhosis. METHODS This was a case-control-control (1:2:2) study performed in four Italian tertiary centres from 2006 to 2015. Cases were patients with liver cirrhosis developing candidaemia. For every case of candidaemia we enrolled two additional patients undergoing blood cultures for suspected infection yielding isolation of a bacterial pathogen (control A) and two additional patients undergoing blood cultures for suspected infection yielding negative results (control B). Patients were matched according to age, sex and model for end stage liver disease at hospital admission. RESULTS During the study period 90 cases, 180 controls A and 180 controls B were included. At multivariate analysis assessed by means of multinomial conditional regression models, factors independently associated with candidaemia were previous (<30 days) acute-on-chronic liver failure (relative risk ratio (RRR) 2.22 (95% confidence interval (CI) 1.09-4.54), p = 0.046), previous(<30 days) gastrointestinal endoscopy (RRR 2.38 (95% CI 1.19-4.78) p = 0.014), previous(<30 days) antibiotic treatment for at least 7 days (RRR 2.74 (95% CI 1.00-7.48), p = 0.049), presence of central venous catheter (RRR 2.77 (95% CI 1.26-6.09, p = 0.011), total parenteral nutrition (RRR 3.90 (95% CI 1.62-9.40), p = 0.002) at infection onset and length of in-hospital stay >15 days (RRR 4.63 (95% CI 2.11-10.18), p <0.001] Conversely, rifaximin treatment was associated with lower rate of candidaemia (RRR 0.38 (95% CI 0.19-0.77), p = 0.007). Multivariable analysis for 30-day mortality showed that patients with isolation of Candida spp. from blood cultures had worse outcome when compared with controls even though the difference did not reach a statistical significance (hazard ratio 1.64 (95% 0.97-2.75) p = 0.06). CONCLUSIONS We identified previous antibiotic use, gastrointestinal endoscopy or acute-on-chronic liver failure and presence of central venous catheter especially for parenteral nutrition as independent factors associated with candidaemia. Surprisingly, chronic rifaximin use was a protective factor.
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Affiliation(s)
- M Bartoletti
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
| | - M Rinaldi
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Z Pasquini
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, Azienda Ospedaliera Universitaria, Ospedali Riuniti Umberto I-Lancisi-Salesi, Ancona, Italy
| | - L Scudeller
- Scientific Direction IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milano, Italy
| | - S Piano
- Unit of Internal Medicine and Hepatology Department of Medicine-DIMED University of Padova, Padova, Italy
| | - D R Giacobbe
- Department of Health Sciences, University of Genoa, Genoa, Italy; Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | - A E Maraolo
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - L Bussini
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - F Del Puente
- Department of Health Sciences, University of Genoa, Genoa, Italy; Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | - S Incicco
- Unit of Internal Medicine and Hepatology Department of Medicine-DIMED University of Padova, Padova, Italy
| | - P Angeli
- Unit of Internal Medicine and Hepatology Department of Medicine-DIMED University of Padova, Padova, Italy
| | - M Giannella
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - M Baldassarre
- Sant'Orsola-Malpighi University Hospital, Center for Applied Biomedical Research (CRBA), University of Bologna, Bologna, Italy
| | - P Caraceni
- Sant'Orsola-Malpighi University Hospital, Center for Applied Biomedical Research (CRBA), University of Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - C Campoli
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - M C Morelli
- End-stage liver disease Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - M Cricca
- Operative Unit of Microbiology Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - S Ambretti
- Operative Unit of Microbiology Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - I Gentile
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - M Bassetti
- Department of Health Sciences, University of Genoa, Genoa, Italy; Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | - P Viale
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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