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Clemente T, Diotallevi S, Lolatto R, Gagliardini R, Giacomelli A, Fiscon M, Ferrara M, Cervo A, Calza L, Maggiolo F, Rusconi S, Santoro MM, Castagna A, Spagnuolo V. Risk of virological failure after drug burden reduction in people with 4-class drug-resistant HIV on virological suppression: a retrospective cohort analysis of data from the PRESTIGIO Registry. Int J Antimicrob Agents 2024:107195. [PMID: 38734216 DOI: 10.1016/j.ijantimicag.2024.107195] [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] [Received: 12/05/2023] [Revised: 03/23/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Tommaso Clemente
- Vita-Salute San Raffaele University, via Stamira D'Ancona, 20, 20127, Milan, Italy; Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy.
| | - Sara Diotallevi
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Riccardo Lolatto
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Roberta Gagliardini
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Andrea Giacomelli
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Marta Fiscon
- Infectious Diseases Unit, AULSS9 Scaligera, Verona, Italy
| | - Micol Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Adriana Cervo
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Leonardo Calza
- Unit of Infectious Diseases, Department of Medical and Surgical Sciences, S. Orsola Hospital, "Alma Mater Studiorum" University of Bologna, Bologna, Italy
| | - Franco Maggiolo
- Department of Infectious Diseases, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Stefano Rusconi
- Infectious Diseases Unit, ASST Ovest Milanese, Legnano General Hospital, Legnano, Italy; DIBIC, University of Milan, Milan, Italy
| | | | - Antonella Castagna
- Vita-Salute San Raffaele University, via Stamira D'Ancona, 20, 20127, Milan, Italy; Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Vincenzo Spagnuolo
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, via Stamira D'Ancona, 20, 20127, Milan, Italy
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Clemente T, Galli L, Lolatto R, Gagliardini R, Lagi F, Ferrara M, Cattelan AM, Focà E, Di Biagio A, Cervo A, Calza L, Maggiolo F, Marchetti G, Cenderello G, Rusconi S, Zazzi M, Santoro MM, Spagnuolo V, Castagna A. Cohort profile: PRESTIGIO, an Italian prospective registry-based cohort of people with HIV-1 resistant to reverse transcriptase, protease and integrase inhibitors. BMJ Open 2024; 14:e080606. [PMID: 38341206 PMCID: PMC10862296 DOI: 10.1136/bmjopen-2023-080606] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024] Open
Abstract
PURPOSE The PRESTIGIO Registry was established in 2017 to collect clinical, virological and immunological monitoring data from people living with HIV (PLWH) with documented four-class drug resistance (4DR). Key research purposes include the evaluation of residual susceptibility to specific antiretrovirals and the validation of treatment and monitoring strategies in this population. PARTICIPANTS The PRESTIGIO Registry collects annual plasma and peripheral blood mononuclear cell samples and demographic, clinical, virological, treatment and laboratory data from PLWH followed at 39 Italian clinical centres and characterised by intermediate-to-high genotypic resistance to ≥1 nucleoside reverse transcriptase inhibitors, ≥1 non-nucleoside reverse transcriptase inhibitors, ≥1 protease inhibitors, plus either intermediate-to-high genotypic resistance to ≥1 integrase strand transfer inhibitors (INSTIs) or history of virological failure to an INSTI-containing regimen. To date, 229 people have been recorded in the cohort. Most of the data are collected from the date of the first evidence of 4DR (baseline), with some prebaseline information obtained retrospectively. Samples are collected from the date of enrollment in the registry. FINDINGS TO DATE The open-ended cohort has been used to assess (1) prognosis in terms of survival or development of AIDS-related or non-AIDS-related clinical events; (2) long-term efficacy and safety of different antiretroviral regimens and (3) virological and immunological factors predictive of clinical outcome and treatment efficacy, especially through analysis of plasma and cell samples. FUTURE PLANS The registry can provide new knowledge on how to implement an integrated approach to study PLWH with documented resistance to the four main antiretroviral classes, a population with a limited number of individuals characterised by a high degree of frailty and complexity in therapeutic management. Given the scheduled annual updates of PLWH data, the researchers who collaborate in the registry can send study proposals at any time to the steering committee of the registry, which evaluates every 3 months whether the research studies can be conducted on data and biosamples from the registry and whether they are aimed at a better understanding of a specific health condition, the emergence of comorbidities or the effect of potential treatments or experimental drugs that may have an impact on disease progression and quality of life. Finally, the research studies should aim to be inclusive, innovative and in touch with the communities and society as a whole. TRIAL REGISTRATION NUMBER NCT04098315.
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Affiliation(s)
- Tommaso Clemente
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Galli
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Lolatto
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberta Gagliardini
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Filippo Lagi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Micol Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Anna Maria Cattelan
- Infectious Diseases Unit, Department of Molecular Medicine, Padua University Hospital, Padua, Italy
| | - Emanuele Focà
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, ASST Spedali di Brescia, Brescia, Italy
| | - Antonio Di Biagio
- Clinic of Infectious Diseases, IRCCS Policlinico San Martino Hospital, University of Genoa, Genoa, Italy
| | - Adriana Cervo
- Infectious Diseases Unit, Policlinico di Modena, Università Degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Leonardo Calza
- Unit of Infectious Diseases, Department of Medical and Surgical Sciences, S. Orsola Hospital, "Alma Mater Studiorum" University of Bologna, Bologna, Italy
| | - Franco Maggiolo
- Unit of HIV-related Diseases and Experimental Therapies, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Giulia Marchetti
- Clinic of Infectious Diseases, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | | | - Stefano Rusconi
- Infectious Diseases Unit, ASST Ovest Milanese, Legnano General Hospital, Legnano, Italy
- DIBIC, University of Milan, Milan, Italy
| | - Maurizio Zazzi
- Department of Medical Biotechnology, University of Siena, Siena, Italy
| | | | - Vincenzo Spagnuolo
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Boskovic S, Merli M, Dapavo P, Siliquini N, Borriello S, Sciamarrelli N, Aquino C, Mastorino L, Burzi L, Drappero E, Ferrara M, Ribero S, Quaglino P. A case of treatment-refractory psoriasis as the first manifestation of an HIV-infection. Ital J Dermatol Venerol 2024; 159:68-69. [PMID: 38015571 DOI: 10.23736/s2784-8671.23.07656-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
- Sara Boskovic
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy -
| | - Martina Merli
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy
| | - Paolo Dapavo
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy
| | - Niccolò Siliquini
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy
| | - Silvia Borriello
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy
| | - Nadia Sciamarrelli
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy
| | - Carola Aquino
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy
| | - Luca Mastorino
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy
| | - Lorenza Burzi
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy
| | - Emanuele Drappero
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Micol Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Simone Ribero
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin, Italy
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4
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Manca A, De Nicolò A, De Vivo ED, Ferrara M, Oh S, Khalili S, Higgins N, Deiss RG, Bonora S, Cusato J, Palermiti A, Mula J, Gianella S, D’Avolio A. A Novel UHPLC-MS/MS Method for the Quantification of Seven Opioids in Different Human Tissues. Pharmaceuticals (Basel) 2023; 16:903. [PMID: 37375850 PMCID: PMC10300969 DOI: 10.3390/ph16060903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Opioids are considered the cornerstone of pain management: they show good efficacy as a first-line therapy for moderate to severe cancer pain. Since pharmacokinetic/pharmacodynamic information about the tissue-specific effect and toxicity of opioids is still scarce, their quantification in post-mortem autoptic specimens could give interesting insights. METHODS We describe an ultra-high-performance liquid chromatography coupled with tandem mass spectrometry method for the simultaneous quantification of methadone, morphine, oxycodone, hydrocodone, oxymorphone, hydromorphone and fentanyl in several tissues: liver, brain, kidney, abdominal adipose tissue, lung and blood plasma. The presented method has been applied on 28 autoptic samples from different organs obtained from four deceased PLWH who used opioids for palliative care during terminal disease. RESULTS Sample preparation was based on tissue weighing, disruption, sonication with drug extraction medium and a protein precipitation protocol. The extracts were then dried, reconstituted and injected onto the LX50 QSight 220 (Perkin Elmer, Milan, Italy) system. Separation was obtained by a 7 min gradient run at 40 °C with a Kinetex Biphenyl 2.6 µm, 2.1 × 100 mm. Concerning the analyzed samples, higher opioids concentrations were observed in tissues than in plasma. Particularly, O-MOR and O-COD showed higher concentrations in kidney and liver than other tissues (>15-20 times greater) and blood plasma (>100 times greater). CONCLUSIONS Results in terms of linearity, accuracy, precision, recovery and matrix effect fitted the recommendations of FDA and EMA guidelines, and the sensitivity was high enough to allow successful application on human autoptic specimens from an ethically approved clinical study, confirming its eligibility for post-mortem pharmacological/toxicological studies.
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Affiliation(s)
- Alessandra Manca
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy; (A.M.)
| | - Amedeo De Nicolò
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy; (A.M.)
| | - Elisa Delia De Vivo
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy; (A.M.)
| | - Micol Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy
| | - Sharon Oh
- San Diego Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92037, USA
| | - Sahar Khalili
- San Diego Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92037, USA
| | - Niamh Higgins
- San Diego Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92037, USA
| | - Robert G. Deiss
- San Diego Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92037, USA
| | - Stefano Bonora
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy
| | - Jessica Cusato
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy; (A.M.)
| | - Alice Palermiti
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy; (A.M.)
| | - Jacopo Mula
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy; (A.M.)
- CoQua Lab s.r.l., 10149 Turin, Italy
| | - Sara Gianella
- San Diego Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92037, USA
| | - Antonio D’Avolio
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy; (A.M.)
- CoQua Lab s.r.l., 10149 Turin, Italy
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5
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Di Girolamo L, Ferrara M, Trevisan G, Longo BM, Allice T, Burdino E, Alladio F, Fantino S, Di Perri G, Calcagno A, Bonora S. Transient plasma viral rebound after SARS-CoV-2 vaccination in an exceptional HIV-1 elite controller woman. Virol J 2023; 20:123. [PMID: 37312093 DOI: 10.1186/s12985-023-02086-z] [Citation(s) in RCA: 3] [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: 03/21/2023] [Accepted: 05/28/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Elite controllers are able to control viral replication without antiretroviral therapy. Exceptional elite controllers do not show disease progression for more than 25 years. Different mechanisms have been proposed and several elements of both innate and adaptive immunity are implicated. Vaccines are immune stimulating agents that can promote HIV-RNA transcription; transient plasma HIV-RNA detectability has been described within 7-14 days after different vaccinations. The most reliable mechanism involved in virosuppressed people living with HIV is a generalized inflammatory response that activates bystander cells harboring latent HIV. So far no data about viral load increase in elite controllers after SARS-CoV-2 vaccination are reported in literature. CASE PRESENTATION We report the case of a 65-year-old woman of European ancestry, diagnosed with HIV-1/HCV co-infection more than 25 years ago. Since then, HIV-RNA remained undetectable and she never received ARV therapy. In 2021 she was vaccinated with mRNA-BNT162b2 vaccine (Pfizer-BioNTech®). She was administered with three doses in June, July and October 2021, respectively. The last available viral load was undetectable in March 2021. We observed an increase of VL at 32 cp/ml and 124 cp/mL, two and seven months after the second vaccine dose, respectively. During monthly follow-up, HIV-RNA gradually and spontaneously dropped becoming undetectable without ARV intervention. COVID-19 serology was positive with IgG 535 BAU/mL, showing response to vaccination. We measured total HIV-DNA at different time-points and we found it detectable both at the time of the higher plasma HIV-RNA (30 cp/10^6 PBMCs) and when it was undetectable (13 cp/10^6 PBMCs), in reduction. CONCLUSIONS This case is the first report, to our knowledge, describing a rebound of plasma HIV-RNA in an elite controller after three doses of mRNA-BNT162b2 vaccine for SARS-CoV-2. Concomitantly with a spontaneous reduction of plasma HIV-RNA ten months after the third dose of mRNA-BNT162b2 vaccine (Pfizer-BioNTech®) without antiretroviral therapy intervention, we observed a reduction of total HIV-DNA in peripheral mononuclear cells. The potential role of vaccinations in altering HIV reservoir, even in elite controllers when plasma HIV-RNA is undetectable, could be a valuable aspect to take into account for the future HIV eradication interventions.
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Affiliation(s)
- L Di Girolamo
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Corso Svizzera 164, Turin, 10149, Italy
| | - M Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Corso Svizzera 164, Turin, 10149, Italy.
| | - G Trevisan
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Corso Svizzera 164, Turin, 10149, Italy
| | - B M Longo
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Corso Svizzera 164, Turin, 10149, Italy
| | - T Allice
- Laboratory of Microbiology and Virology, Amedeo di Savoia Hospital ASL Città di Torino, Turin, Italy
| | - E Burdino
- Laboratory of Microbiology and Virology, Amedeo di Savoia Hospital ASL Città di Torino, Turin, Italy
| | - F Alladio
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Corso Svizzera 164, Turin, 10149, Italy
| | - S Fantino
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Corso Svizzera 164, Turin, 10149, Italy
| | - G Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Corso Svizzera 164, Turin, 10149, Italy
| | - A Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Corso Svizzera 164, Turin, 10149, Italy
| | - S Bonora
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Corso Svizzera 164, Turin, 10149, Italy
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6
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Scollo P, Pecorino B, Scibilia G, Guardalà VFM, Ferrara M, Mereu L, D'Agate MG. Scollo's symmetric lateral levator myorrhaphy (SLLM) for correction of rectocele in six steps. Tech Coloproctol 2023; 27:497-498. [PMID: 36333612 DOI: 10.1007/s10151-022-02726-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Affiliation(s)
- P Scollo
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy
| | - B Pecorino
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy.
| | - G Scibilia
- Department of Obstetrics and Gynecology, "Giovanni Paolo II" Hospital, Ragusa, Italy
| | - V F M Guardalà
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy
| | - M Ferrara
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy
| | - L Mereu
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy
| | - M G D'Agate
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy
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Cusato J, Manca A, Palermiti A, Mula J, Costanzo M, Antonucci M, Chiara F, De Vivo ED, Maiese D, Ferrara M, Bonora S, Di Perri G, D'Avolio A, Calcagno A. COVID-19: Focusing on the Link between Inflammation, Vitamin D, MAPK Pathway and Oxidative Stress Genetics. Antioxidants (Basel) 2023; 12:antiox12051133. [PMID: 37237997 DOI: 10.3390/antiox12051133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
An uncontrolled inflammatory response during SARS-CoV-2 infection has been highlighted in several studies. This seems to be due to pro-inflammatory cytokines whose production could be regulated by vitamin D, ROS production or mitogen-activated protein kinase (MAPK). Several genetic studies are present in the literature concerning genetic influences on COVID-19 characteristics, but there are few data on oxidative stress, vitamin D, MAPK and inflammation-related factors, considering gender and age. Therefore, the aim of this study was to evaluate the role of single nucleotide polymorphisms in these pathways, clarifying their impact in affecting COVID-19-related clinical features. Genetic polymorphisms were evaluated through real-time PCR. We prospectively enrolled 160 individuals: 139 patients were positive for SARS-CoV-2 detection. We detected different genetic variants able to affect the symptoms and oxygenation. Furthermore, two sub-analyses were performed considering gender and age, showing a different impact of polymorphisms according to these characteristics. This is the first study highlighting a possible contribution of genetic variants of these pathways in affecting COVID-19 clinical features. This may be relevant in order to clarify the COVID-19 etiopathogenesis and to understand the possible genetic contribution for further SARS infections.
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Affiliation(s)
- Jessica Cusato
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy
| | - Alessandra Manca
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy
| | - Alice Palermiti
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy
| | - Jacopo Mula
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy
| | - Martina Costanzo
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy
| | - Miriam Antonucci
- ASL Città di Torino, Amedeo di Savoia Hospital, 10149 Turin, Italy
| | - Francesco Chiara
- Laboratory of Clinical Pharmacology S.Luigi A.O.U., Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole, Orbassano, 10043 Turin, Italy
| | - Elisa Delia De Vivo
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy
| | - Domenico Maiese
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy
| | - Micol Ferrara
- ASL Città di Torino, Amedeo di Savoia Hospital, 10149 Turin, Italy
| | - Stefano Bonora
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy
| | - Antonio D'Avolio
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, 10149 Turin, Italy
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy
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8
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Cusato J, Manca A, Palermiti A, Mula J, Costanzo M, Antonucci M, Trunfio M, Corcione S, Chiara F, De Vivo ED, Ianniello A, Ferrara M, Di Perri G, De Rosa FG, D'Avolio A, Calcagno A. COVID-19: A Possible Contribution of the MAPK Pathway. Biomedicines 2023; 11:biomedicines11051459. [PMID: 37239131 DOI: 10.3390/biomedicines11051459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/03/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND COVID-19 is characterized by an uncontrolled inflammatory response with high pro-inflammatory cytokine production through the activation of intracellular pathways, such as mitogen-activated protein kinase (MAPK). Viruses are able to exploit the MAPK pathway to their advantage; this pathway relevance to severe COVID-19 is poorly described. The aim of this study was to quantify biomarkers involved in the MAPK pathway and to clarify its possible role in affecting some COVID-19-related clinical features. METHODS H-RAS, C-RAF, MAPK1, MAPK2, and ERK were quantified through ELISA, and genetic polymorphisms were evaluated through real-time PCR. RESULTS We prospectively recruited 201 individuals (158 positive and 43 negative for SARS-CoV-2): 35 were male, and their median age was 65 years. MAPK-related biomarker levels were increased in SARS-CoV-2-positive participants (n = 89) compared to negative ones (n = 29). Dyspnea was reported by 48%; this symptom was associated with PBMC C-RAF levels in positive participants (p = 0.022) and type of ventilation (p = 0.031). The highest degree of ventilation was used by 8% for invasive ventilation and 41% for continuous positive airway pressure (CPAP). CONCLUSIONS This is the first study that showed a possible contribution of MAPK-related biomarkers in affecting COVID-19 clinical features, and this may be relevant for identifying COVID-19 positive participants at risk of serious complications.
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Affiliation(s)
- Jessica Cusato
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
| | - Alessandra Manca
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
| | - Alice Palermiti
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
| | - Jacopo Mula
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
| | - Martina Costanzo
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
| | - Miriam Antonucci
- ASL Città di Torino, Amedeo di Savoia Hospital, 10149 Turin, Italy
| | - Mattia Trunfio
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
| | - Silvia Corcione
- Unit of Infectious Diseases, Department of Medical Sciences, City of Health and Life Sciences, University of Turin, 10126 Turin, Italy
| | - Francesco Chiara
- Laboratory of Clinical Pharmacology S. Luigi A.O.U., Department of Clinical and Biological Sciences, University of Turin, 10043 Turin, Italy
| | - Elisa Delia De Vivo
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
| | - Alice Ianniello
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
| | - Micol Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
| | - Francesco Giuseppe De Rosa
- Unit of Infectious Diseases, Department of Medical Sciences, City of Health and Life Sciences, University of Turin, 10126 Turin, Italy
| | - Antonio D'Avolio
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy
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9
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Orgiani P, Chaluvadi SK, Chalil SP, Mazzola F, Jana A, Dolabella S, Rajak P, Ferrara M, Benedetti D, Fondacaro A, Salvador F, Ciancio R, Fujii J, Panaccione G, Vobornik I, Rossi G. Dual pulsed laser deposition system for the growth of complex materials and heterostructures. Rev Sci Instrum 2023; 94:033903. [PMID: 37012774 DOI: 10.1063/5.0138889] [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] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/12/2023] [Indexed: 06/19/2023]
Abstract
Here, we present an integrated ultra-high-vacuum (UHV) apparatus for the growth of complex materials and heterostructures. The specific growth technique is the Pulsed Laser Deposition (PLD) by means of a dual-laser source based on an excimer KrF ultraviolet and solid-state Nd:YAG infra-red lasers. By taking advantage of the two laser sources-both lasers can be independently used within the deposition chambers-a large number of different materials-ranging from oxides to metals, to selenides, and others-can be successfully grown in the form of thin films and heterostructures. All of the samples can be in situ transferred between the deposition chambers and the analysis chambers by using vessels and holders' manipulators. The apparatus also offers the possibility to transfer samples to remote instrumentation under UHV conditions by means of commercially available UHV-suitcases. The dual-PLD operates for in-house research as well as user facility in combination with the Advanced Photo-electric Effect beamline at the Elettra synchrotron radiation facility in Trieste and allows synchrotron-based photo-emission as well as x-ray absorption experiments on pristine films and heterostructures.
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Affiliation(s)
- P Orgiani
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - S K Chaluvadi
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - S Punathum Chalil
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - F Mazzola
- Department of Molecular Sciences and Nanosystems, Ca' Foscari University of Venice, 30172 Venice, Italy
| | - A Jana
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - S Dolabella
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - P Rajak
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - M Ferrara
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - D Benedetti
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - A Fondacaro
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - F Salvador
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - R Ciancio
- AREA Science Park, Padriciano 99, I-34149 Trieste, Italy
| | - J Fujii
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - G Panaccione
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - I Vobornik
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - G Rossi
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
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10
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Saladini F, Giammarino F, Maggiolo F, Ferrara M, Cenderello G, Celesia BM, Martellotta F, Spagnuolo V, Corbelli GM, Gianotti N, Santoro MM, Rusconi S, Zazzi M, Castagna A. Residual phenotypic susceptibility to doravirine in multidrug-resistant HIV-1 from subjects enrolled in the PRESTIGIO Registry. Int J Antimicrob Agents 2023; 61:106737. [PMID: 36708743 DOI: 10.1016/j.ijantimicag.2023.106737] [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: 10/24/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Doravirine shows a rather distinct resistance profile within the nonnucleoside reverse transcriptase inhibitor (NNRTI) class. This study aimed to evaluate the phenotypic susceptibility to doravirine, rilpivirine and etravirine in a panel of multidrug-resistant (MDR) HIV-1 isolates collected from people living with HIV (PLWH) enrolled in the PRESTIGIO Registry. METHODS Recombinant viruses expressing PLWH-derived protease, reverse transcriptase coding regions were generated from plasma samples at virological failure with documented resistance to protease inhibitors, nucleoside reverse transcriptase inhibitors, NNRTIs and integrase strand transfer inhibitors. In vitro susceptibility was assessed through a phenotypic assay measuring fold-change values with respect to the reference NL4-3 virus. Genotypic susceptibility was computed by the Stanford HIVdb algorithm 8.9-1. RESULTS Plasma samples were collected from 22 PLWH: 20 (91%) were male, median age 55 years (IQR 50-58), time since HIV-1 diagnosis 27 years (23-31) and time on antiretroviral treatment 23 years (22-26). Median doravirine, etravirine and rilpivirine fold-change values were 9.8 (2.9-40.4), 42.9 (3.1-100.0) and 100.0 (17.9-100.0), respectively. According to the fold-change cut-offs, full susceptibility was observed in five (23%), four (18%) and one (5%) cases with doravirine, etravirine and rilpivirine, respectively. Irrespective of the presence of specific doravirine mutations, higher numbers of NNRTI mutations correlated with higher fold-change values for doravirine. By comparing the distribution of fold-change values with the Stanford HIVdb predicted susceptibility, a significant correlation was detected for doravirine and rilpivirine but not etravirine. CONCLUSION Despite extensive cross-resistance among NNRTIs, doravirine can be a valid option in a proportion of PLWH with MDR HIV-1. Doravirine activity appeared to be inferred with fair accuracy by the HIVdb algorithm.
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Affiliation(s)
- Francesco Saladini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.
| | | | | | - Micol Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | | | | | | | | | | | | | | | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Antonella Castagna
- San Raffaele Scientific Institute, Milan, Italy; San Raffaele Vita-Salute University, Milan, Italy
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11
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Ferrara M, Cusato J, Salvador E, Trentalange A, Alcantarini C, Trunfio M, Cannizzo ES, Bono V, Nozza S, De Nicolò A, Ianniello A, De Vivo E, D'Avolio A, Di Perri G, Bonora S, Marchetti G, Calcagno A. Inflammation and intracellular exposure of dolutegravir, darunavir, tenofovir and emtricitabine in people living with HIV. Br J Clin Pharmacol 2023; 89:1020-1026. [PMID: 36115063 DOI: 10.1111/bcp.15538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 08/03/2022] [Accepted: 08/25/2022] [Indexed: 11/30/2022] Open
Abstract
AIMS Antiretroviral (ARV) therapy reduces inflammation and immune activation in people with HIV, but not down to the levels observed in people without HIV. Limited drug penetration within tissues has been argued as a potential mechanism of persistent inflammation. Data on the inflammation role on ARV plasma/intracellular (IC) pharmacokinetics (PK) through to expression of cytochrome P450 3A/membrane transporters are limited. The aim of this study was to investigate the correlation between inflammation markers (IM) and plasma/IC PK of ARV regimen in HIV-positive patients. METHODS We included ART-experienced patients switching to three different ARV regimens. Plasma and IC ARV drug concentration means at the end of dosing interval (T0 ), IM on samples concomitantly with ARV PK determination: sCD14, CRP, IL-6 and LPS were analysed. RESULTS Plasma and IC drug concentrations were measured in 60 samples. No significative differences between CRP, sCD14, IL-6 and LPS values in the three arms were observed. A significant inverse correlation between tenofovir plasma concentration and sCD14 (rho = -0.79, P < .001), and between DRV IC/plasma ratio and Log10 IL-6 concentrations (rho = -0.36, P = .040), and a borderline statistically significant positive trend between DRV plasma concentration and sCD14 (rho = 0.31, P = .070) were suggested. Furthermore, a borderline statistically significant inverse trend between DTG IC concentrations and sCD14 (rho = -0.34, P = .090) was observed in 24 patients on DTG-based triple therapy. CONCLUSIONS Our preliminary data support the hypothesis of lower DRV and DTG IC concentrations and lower TFV plasma exposure in patients with higher plasma IM suggesting an interplay between HIV drug penetration and persistent inflammation in cART-treated HIV-positive patients.
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Affiliation(s)
- Micol Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Jessica Cusato
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Elena Salvador
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Alice Trentalange
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Chiara Alcantarini
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mattia Trunfio
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Elvira Stefania Cannizzo
- Department of Health Sciences, Clinic of Infectious Diseases, ASST, Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Valeria Bono
- Department of Health Sciences, Clinic of Infectious Diseases, ASST, Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Silvia Nozza
- Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Amedeo De Nicolò
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Alice Ianniello
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Elisa De Vivo
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Antonio D'Avolio
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Stefano Bonora
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giulia Marchetti
- Department of Health Sciences, Clinic of Infectious Diseases, ASST, Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
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12
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Gigliotti F, Di Santo F, Cesario S, Esposito D, Manti F, Galosi S, Ferrara M, Leuzzi V, Baglioni V. Psychogenic non-epileptic seizures and functional motor disorders in developmental age: A comparison of clinical and psychopathological features. Epilepsy Behav 2023; 140:109117. [PMID: 36804846 DOI: 10.1016/j.yebeh.2023.109117] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Psychogenic Non-Epileptic Seizures (PNES) and Functional Motor Disorders (FMDs) commonly represent the main clinical manifestations of Functional Neurological Disorders (FNDs). Despite their high prevalence in pediatric neurological services, literature on this topic is still spare for this population. The present study aimed to deepen the clinical knowledge of a pediatric FNDs sample through a demographic and clinical characterization of the most recurrent clinical patterns during the pediatric age. Moreover, a comparison of neuropsychological and psychopathological profiles of PNES and FMD patients was carried out to identify specific vulnerabilities and therapeutic targets linked with these different clinical manifestations. MATERIALS AND METHODS A total of 43 FNDs patients (age range 7-17 years old) were retrospectively included in our study, enrolled in two subgroups: 20 with FMDs and 23 with PNES diagnosis. They were inpatients and outpatients referred over a period of 5 years and a standardized neurological, neuropsychological (WISC-IV/WAIS-IV), and psychiatric (CDI-2, MASC-2, ADES, DIS-Q, PID-5) evaluation was assessed. RESULTS In PNES patients the most common clinical phenotypes were functional tonic-clonic (52%) and atonic (32%) manifestations while in the FMDs group were gait alterations (60%), functional myoclonus (35%), and tremor (35%). A higher frequency of cognitive impairment was reported in PNES patients with higher anxiety-depressive symptom rates than FMDs patients. CONCLUSIONS Notably, specific neurocognitive and psychopathological profiles were described in PNES and FMDs, highlighting higher cognitive and psychiatric vulnerabilities in PNES, suggesting as well different strategy for therapeutic approaches.
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Affiliation(s)
- F Gigliotti
- Division of Child and Adolescent Neurology and Psychiatry, Department of Human Neurosciences, Sapienza University of Rome, Italy.
| | - F Di Santo
- Division of Child and Adolescent Neurology and Psychiatry, Department of Human Neurosciences, Sapienza University of Rome, Italy.
| | - S Cesario
- Division of Child and Adolescent Neurology and Psychiatry, Department of Human Neurosciences, Sapienza University of Rome, Italy.
| | - D Esposito
- Division of Child and Adolescent Neurology and Psychiatry, Department of Human Neurosciences, Sapienza University of Rome, Italy.
| | - F Manti
- Division of Child and Adolescent Neurology and Psychiatry, Department of Human Neurosciences, Sapienza University of Rome, Italy.
| | - S Galosi
- Division of Child and Adolescent Neurology and Psychiatry, Department of Human Neurosciences, Sapienza University of Rome, Italy.
| | - M Ferrara
- Division of Child and Adolescent Neurology and Psychiatry, Department of Human Neurosciences, Sapienza University of Rome, Italy.
| | - V Leuzzi
- Division of Child and Adolescent Neurology and Psychiatry, Department of Human Neurosciences, Sapienza University of Rome, Italy.
| | - V Baglioni
- Division of Child and Adolescent Neurology and Psychiatry, Department of Human Neurosciences, Sapienza University of Rome, Italy.
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13
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Pennati F, Calza S, Di Biagio A, Mussini C, Rusconi S, Bonora S, Borghetti A, Quiros‐Roldan E, Sarteschi G, Menozzi M, Ferrara M, Celotti A, Ciccullo A, Giacomet V, Izzo I, Dotta L, Badolato R, Castelli F, Focà E. Reduced probability of improving viro-immunological state in subjects with vertical transmission of HIV reaching adult age: A multicenter retrospective cohort study. Immun Inflamm Dis 2023; 11:e778. [PMID: 36840488 PMCID: PMC9910169 DOI: 10.1002/iid3.778] [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: 09/30/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Young adults with vertical transmission (VT) of human immunodeficiency virus (HIV) represent a fragile population. This study evaluates factors associated with viro-immunological outcome of these patients. METHODS We performed a multicenter study including HIV-infected subjects with VT ≥ 18 years old from six Italian clinics. Subjects were observed from birth to death, lost to follow-up, or last visit until December 31, 2019. Condition of "optimal viro-immunological status" (OS) was defined as the simultaneous presence of HIV ribonucleic acid (RNA) < 50 copies/mL, CD4+ > 500 cells/mm3 , and CD4+/CD8+ ratio ≥ 1. RESULTS A total of 126 subjects were enrolled. At 18 years of age, 52/126 (44.4%) had HIV-RNA > 50 copies/mL, 47/126 (38.2%) had CD4+ < 500/mm3 , and 78/126 (67.2%) had CD4+/CD8+ < 1; 28 subjects (23.7%) presented in the condition of OS. Having a CD4+/CD8+ ratio ≥ 1 at 18 years of age was related with an increased probability of shift from suboptimal viro-immunological status (SOS) to OS (HR: 7.7, 95% confidence interval [CI]: 4.23-14.04), and a reduced risk of shift from the OS to the SOS (HR: 0.49, 95% CI: 0.26-0.92). Acquired immunodeficiency syndrome (AIDS) diagnosis significantly reduced the probability of shift from a viro-immunological SOS to OS (HR: 0.09, 95% CI: 0.03-0.30). Subjects who had not achieved an OS at 18 years of age had an increased risk of discontinuation of combination antiretroviral therapy (cART, p = .019). CONCLUSIONS Only a small proportion of subjects with VT of HIV reached the adult age with "OS". Transition to the adult care with a compromised viro-immunological condition represents a negative driver for future optimal infection control, with a higher risk of discontinuation of cART and a reduced probability to improve the immunological status later in the years.
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Affiliation(s)
- Francesca Pennati
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Stefano Calza
- Unit of Biostatistics, Department of Molecular and Translational MedicineUniversity of BresciaBresciaItaly
| | - Antonio Di Biagio
- Clinic of Infectious and Tropical DiseasesUniversity of Genova and “San Martino” HospitalGenoaItaly
| | - Cristina Mussini
- Department of Infectious DiseasesUniversity of Modena and Reggio Emilia and Modena PolyclinicModenaItaly
| | - Stefano Rusconi
- Unit of Infectious DiseasesUniversity of Milano and ASST Fatebenefratelli “L. Sacco” HospitalMilanItaly
| | - Stefano Bonora
- Department of Infectious DiseasesUniversity of Torino and “Amedeo di Savoia” HospitalTurinItaly
| | - Alberto Borghetti
- Infectious Diseases UnitFondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
| | - Eugenia Quiros‐Roldan
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Giovanni Sarteschi
- Clinic of Infectious and Tropical DiseasesUniversity of Genova and “San Martino” HospitalGenoaItaly
| | - Marianna Menozzi
- Department of Infectious DiseasesUniversity of Modena and Reggio Emilia and Modena PolyclinicModenaItaly
| | - Micol Ferrara
- Department of Infectious DiseasesUniversity of Torino and “Amedeo di Savoia” HospitalTurinItaly
| | - Anna Celotti
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Arturo Ciccullo
- Department of Safety and Bioethics, Section of Infectious DiseasesCatholic University of the Sacred HeartRomeItaly
| | - Vania Giacomet
- Unit of PediatricsUniversity of Milano and ASST Fatebenefratelli “L. Sacco” HospitalMilanItaly
| | - Ilaria Izzo
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Laura Dotta
- Unit of PediatricsUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Raffaele Badolato
- Unit of PediatricsUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Francesco Castelli
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
| | - Emanuele Focà
- Unit of Infectious and Tropical DiseasesUniversity of Brescia and ASST Spedali Civili HospitalBresciaItaly
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14
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Alfonsi V, Scarpelli S, Gorgoni M, Di Muzio M, Pazzaglia M, Giannini A, Ferrara M, Lucidi F, De Gennaro L. The cost of fast-rotating backward-shift work among nurses. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Salfi F, D'Atri A, Arnone B, Amicucci G, Viselli L, Corigliano D, Tempesta D, Ferrara M. Boosting vocabulary learning during sleep via a portable closed-loop targeted memory reactivation system in a home setting: a pilot study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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16
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Annarumma L, Gorgoni M, Reda F, Scarpelli S, D'Atri A, Alfonsi V, Ferrara M, De Gennaro L. The ages of sleep onset: spatio-temporal eeg patterns in preadolescents, young and older adults. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Salfi F, Amicucci G, D'Atri A, Viselli L, Corigliano D, Tempesta D, Ferrara M. Lo smart working durante la pandemia di COVID-19 rimuove la vulnerabilità ai problemi di sonno delle persone con cronotipo serotino e ne allevia la predisposizione alla depressione. Sleep Med 2022. [PMCID: PMC9300191 DOI: 10.1016/j.sleep.2022.05.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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18
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Lazzari J, Scatena A, Milone V, Ferrara M. The evolution of the autopsy over the years. Clin Ter 2022; 173:301-303. [PMID: 35857045 DOI: 10.7417/ct.2022.2437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Autopsy has played an extremely important role in both the forensic and clinical fields for many years. In recent years, clinical autopsy has become less important, but today, thanks to the pandemic, this importance has been rediscovered. Conversely, forensic autopsy has never lost its importance, but it would need to be updated.
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Affiliation(s)
- J Lazzari
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, Pisa, Italy
| | - A Scatena
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, Pisa, Italy
| | - V Milone
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - M Ferrara
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
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19
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Maffucci A, Cesario S, Mammarella V, Colafrancesco G, Ferrara M, Raballo A, Monducci E. Correlation between psychotic risk and depressive “cognitive” symptoms in adolescence. Eur Psychiatry 2022. [PMCID: PMC9567960 DOI: 10.1192/j.eurpsy.2022.1753] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction Prevention of disorders has become a central element of psychiatric research and clinic. Currently, Ultra High Risk (UHR) criteria are internationally recognized for psychiatric risk assessment. Self Disorders (SD) aroused particular interest because they were found to be specific to schizophrenic spectrum disorders and a marker of vulnerability for psychotic onset. Objectives To evaluate the correlation between psychotic risk and depressive symptoms in at-risk adolescent population. Methods We collected data from 80 patients, aged 14-18, with sufficient skills in the Italian language and an IQ ≥70, excluding patients with disorders related to direct effects of a general medical condition or substance. Psychodiagnostic evaluation included K-SADS-PL, SIPS/SOPS, EASE (for the assessment of SDs) and the CDSS (for the assessment of Depression). Results 35 subjects have UHR criteria, while 45 do not have a psychotic risk syndrome or psychotic features. Between the two groups there is a significant difference in the total SCORE of EASE, in domains 1, 2 and 5. In addition, a positive correlation between SDs and depressive symptoms emerged, in particular with pathological guilt and with reference ideas of guilt. Conclusions The results confirm the validity of SDs for early detection of psychosis. Depressive features appear to be associated with the presence of abnormalities of experience. This results suggest a close care and monitoring of depressive symptoms in adolescence, because they can mask disorders of different nature, particularly pathological guilt and guilty ideas of reference that are depressive “cognitive” symptoms more correlate with psychotic risk. Disclosure No significant relationships.
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Focà E, Calcagno A, Calza S, Renzetti S, Chiesa A, Siano M, De Socio G, Piconi S, Orofino G, Madeddu G, Cattelan AM, Nozza S, Ferrara M, Milic J, Celesia BM, Castelli F, Guaraldi G. Durability of Integrase STrand Inhibitor (InSTI)-based regimen in geriatric people living with HIV in the GEPPO cohort. PLoS One 2021; 16:e0258533. [PMID: 34644336 PMCID: PMC8513889 DOI: 10.1371/journal.pone.0258533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 09/29/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the durability of the first integrase inhibitor-based regimen in a HIV geriatric multicentric prospective cohort and to explore the reasons of regimen discontinuation. DESIGN This is an analysis conducted on the Geriatric Patients Living with HIV/AIDS (GEPPO) cohort, an Italian prospective observational multicentre cohort of people living with HIV with 65 years of age or more. METHODS The analysis was performed using R (version 4.0.2). The tests performed were two sided assuming a 5% significance level (Kruskal-Wallis test, Chi-squared test, log-rank test and a Cox Proportional Hazard model). The proportion of participants discontinuing the three regimens was displayed using cumulative curves. RESULTS Among 1531 patients enrolled between 2017 and 2019 in the GEPPO cohort, we included 822 participants in this analysis. At baseline, median age was 69.8, the immunovirological profile good, multimorbidity was present in 42.3% of participants, while 27.4% were on polypharmacy. Overall, 483, 243 and 96 participants received DTG, RAL and EVG/c respectively as first InSTI. At the end of the follow up 6.4%, 21.1% and 22.9% participants discontinued DTG, RAL and EVG/c respectively. Using a log-rank test, EVG showed a significantly lower durability than DTG (p<0.001) or RAL (p 0.05) or both, DTG and RAL (p<0.001). Among participants who discontinued their regimen we found 0 virological failure and 56.7% simplification/deprescription. CONCLUSIONS The three integrase inhibitors considered showed a good durability and no virological failures in geriatric patients such as those enrolled in the GEPPO cohort when used in a two or three drug regimen.
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Affiliation(s)
- Emanuele Focà
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Stefano Calza
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- BDbiomed lab, University of Brescia, Brescia, Italy
| | - Stefano Renzetti
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- BDbiomed lab, University of Brescia, Brescia, Italy
| | - Annacarla Chiesa
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy
| | - Matteo Siano
- 3rd Division of Infectious Diseases, University of Milano, L. Sacco Hospital, Milano, Italy
| | - Giuseppe De Socio
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria di Perugia, Perugia, Italy
| | - Stefania Piconi
- 1st Division of Infectious Diseases Unit, University of Milano, L. Sacco Hospital, Milano, Italy
| | - Giancarlo Orofino
- Unit of Infectious Diseases, ’Divisione A’, Amedeo di Savoia Hospital, ASLTO2, Torino, Italy
| | - Giordano Madeddu
- Unit of Infectious and Tropical Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Anna Maria Cattelan
- Unit of Infectious Diseases, Department of Internal Medicine, Azienda Ospedaliero-Universitaria di Padova, Padova, Italy
| | - Silvia Nozza
- Department of Infectious Diseases, San Raffaele Scientific Institute, Milano, Italy
| | - Micol Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Jovana Milic
- Department of Mother, Child and Adult Medicine and Surgical Science, Infectious Disease Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Benedetto Maurizio Celesia
- Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, University of Catania, ARNAS Garibaldi, Catania, Italy
| | - Francesco Castelli
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy
| | - Giovanni Guaraldi
- Department of Mother, Child and Adult Medicine and Surgical Science, Infectious Disease Clinic, University of Modena and Reggio Emilia, Modena, Italy
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Santini D, Armento G, Giusti R, Ferrara M, Moro C, Fulfaro F, Bossi P, Arena F, Ripamonti CI. Management of orphan symptoms: ESMO Clinical Practice Guidelines for diagnosis and treatment †. ESMO Open 2021; 5:e000933. [PMID: 33208491 PMCID: PMC7674109 DOI: 10.1136/esmoopen-2020-000933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/13/2020] [Accepted: 08/15/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- D Santini
- Department of Clinical Oncology, University Campus Bio-Medico of Rome, Oncologia Medica, Italy
| | - G Armento
- Department of Clinical Oncology, University Campus Bio-Medico of Rome, Oncologia Medica, Italy
| | - R Giusti
- Department of Oncology, Azienda Ospedaliero-Universitaria Sant'Andrea, Rome, Italy
| | - M Ferrara
- Oncology- Supportive Care in Cancer Unit, Department of Medical Oncology & Haematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - C Moro
- Department of Clinical Oncology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - F Fulfaro
- Department of Clinical Oncology, Policlinico Paolo Giaccone, Palermo, Italy
| | - P Bossi
- Medical Oncology, University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | - F Arena
- Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy
| | - C I Ripamonti
- Oncology- Supportive Care in Cancer Unit, Department of Medical Oncology & Haematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Cammisa L, Pacifici S, Fegatelli DA, Calderoni D, Fantini F, Ferrara M, Terrinoni A. Non-suicidal self-injury and suicide attempt: A continuum or separated identities? Eur Psychiatry 2021. [PMCID: PMC9471579 DOI: 10.1192/j.eurpsy.2021.463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction Non-suicidal self-injury (NSSI) has been proposed as diagnostic entity and was added in the section 3 of the DSM 5. However, little is known about the long-term course of the disorder: NSSI and suicide attempt (SA) often lie on a continuum of self-harm, but it’s still unclear if they represent two different nosografical entities. Both these groups are commonly enclosed in the term of Deliberate self-harm (DSH), also including self-harm with suicidal intent conditions. Objectives This study aims to explore differences between two clinical samples (NSSI and SA) to highlight the possible connection between these two categories, to better understand the risk of progression from NNSI into suicidal intent conditions. Methods 102 inpatients with DSH (62 NNSI; 40 SA; age range: 12 to 18 years) were assessed by self-report questionnaires: the Deliberate Self-Harm Inventory (DSHI) and the Repetitive Non-suicidal Self-Injury Questionnaire (R-NSSI-Q) to explore the severity and repetitiveness of self-injurious behaviors and by the Beck Hopelessness Scale (BHS) and Multi-Attitude Suicide Tendency scale (MAST), as indirect measures of suicidal risk. Results Preliminary results showed that inpatients with NSSI (62) presented high scores of indirect suicide risk, similar to SA sample (40). Conclusions This result highlights the possibility to consider NSSI and SA in a continuum of psychopathology and that repetitive self-harm even in the absence of clear suicidal intentions represent a significant risk factor in the development of suicidality in adolescence. Disclosure No significant relationships.
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Severi S, Bongiovanni A, Ferrara M, Nicolini S, Di Mauro F, Sansovini M, Lolli I, Tardelli E, Cittanti C, Di Iorio V, Mezzenga E, Scarpi E, Ibrahim T, Paganelli G, Zovato S. Peptide receptor radionuclide therapy in patients with metastatic progressive pheochromocytoma and paraganglioma: long-term toxicity, efficacy and prognostic biomarker data of phase II clinical trials. ESMO Open 2021; 6:100171. [PMID: 34139487 PMCID: PMC8219772 DOI: 10.1016/j.esmoop.2021.100171] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 01/15/2021] [Revised: 04/22/2021] [Accepted: 05/08/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Pheochromocytoma and paraganglioma (PPGL) have currently only limited treatment options available for patients in the metastatic phase (mPPGL) in either post-surgery or inoperable settings. However, these rare tumors overexpress somatostatin receptors and can thus be treated with peptide receptor radionuclide therapy (PRRT). We present data about our 10-year experience treating 46 consecutive mPPGL patients with 90Y-DOTATOC or 177Lu-DOTATATE. PATIENTS AND METHODS All patients (20 men and 26 women, median age 52 years) showed positive scintigraphic imaging at 111In-octreotide or 68Ga-DOTATOC positron emission tomography/computed tomography (PET/CT). 90Y-DOTATOC was administered in 12 patients, with cumulative dosages ranging from 7.4 to 11 GBq, while 34 patients received 18.5 or 27.5GBq of 177Lu-DOTATATE. We used Southwest Oncology Group Response Evaluation Criteria in Solid Tumors criteria to evaluate treatment efficacy and Common Terminology Criteria for Adverse Events criteria to assess toxicity. The prognostic role of primary tumor site, hormone secretion, succinate dehydrogenase (SDHx) mutation, and metastatic involvement was also evaluated. RESULTS Both 90Y-DOTATOC and 177Lu-DOTATATE PRRT were well tolerated by patients without significant renal or bone marrow toxicity. The median follow-up was 73 months (range 5-146 months). The overall disease control rate (DCR) was 80% [95% confidence interval (CI) 68.9% to 91.9%] with a mean five cycles of therapy. However, 177Lu-DOTATATE patients showed a longer median overall survival (mOS) than those receiving 90Y-Dotatoc and a better DCR when higher dosages were administered, even if a direct comparison was not carried out. Syndromic patients had a poorer mOS. SDHx mutations did not interfere with treatment efficacy. CONCLUSIONS PRRT is safe and effective for the treatment of patients with progressive mPPGL, especially at higher dosages. The longer mOS of 177Lu-DOTATATE-treated patients in our protocols indicates the former radiopharmaceutical as the better candidate for further clinical application.
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Affiliation(s)
- S Severi
- Nuclear Medicine Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - A Bongiovanni
- Osteoncology and Rare Tumors Center (CDO-TR), IRCCS IRST 'Dino Amadori', Meldola, Italy
| | - M Ferrara
- Familial Cancer Clinic, Istituto Oncologico Veneto (IOV) IRCCS, Padua, Italy
| | - S Nicolini
- Nuclear Medicine Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - F Di Mauro
- Nuclear Medicine, Ospedale 'M. Bufalini', Cesena, Italy
| | - M Sansovini
- Nuclear Medicine Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - I Lolli
- Medical Oncology, Ospedale IRCCS 'S. De Bellis', Castellana Grotte, Italy
| | - E Tardelli
- Nuclear Medicine Unit, Department of Diagnostic Imaging, Ospedale 'San Luca', Lucca, Italy
| | - C Cittanti
- Nuclear Medicine Unit, University of Ferrara, Ferrara, Italy
| | - V Di Iorio
- Oncology Pharmacy, IRCCS IRST 'Dino Amadori', Meldola, Italy
| | - E Mezzenga
- Medical Physics Unit, IRCCS IRST 'Dino Amadori', Meldola, Italy
| | - E Scarpi
- Unit of Biostatistics and Clinical Trials, IRCCS IRST 'Dino Amadori', Meldola, Italy
| | - T Ibrahim
- Familial Cancer Clinic, Istituto Oncologico Veneto (IOV) IRCCS, Padua, Italy
| | - G Paganelli
- Nuclear Medicine Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy.
| | - S Zovato
- Familial Cancer Clinic, Istituto Oncologico Veneto (IOV) IRCCS, Padua, Italy
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Calcagno A, Cusato J, Ferrara M, De Nicolò A, Lazzaro A, Manca A, D'Avolio A, Di Perri G, Bonora S. Antiretroviral concentrations in the presence and absence of valproic acid. J Antimicrob Chemother 2021; 75:1969-1971. [PMID: 32211890 DOI: 10.1093/jac/dkaa094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES An unexpected drug-drug interaction has been recently reported between dolutegravir, an HIV integrase inhibitor, and valproic acid. Despite there being several potential underlying mechanisms, plasma protein displacement has been suggested. The aim of this study was to assess plasma concentrations of several antiretrovirals when administered with or without valproic acid. METHODS We performed a therapeutic drug monitoring registry analysis and identified patients concomitantly taking antiretrovirals and valproic acid and without clinical affecting conditions or interacting drugs. RESULTS One hundred and thirty-four patients were identified. Median (IQR) age and BMI were 49.7 years (45-56) and 23.4 kg/m2 (20.8-26.3) and 78 were male (58.2%). Despite small groups, we observed no major effect on antiretroviral exposure, even when considering highly protein-bound compounds (such as etravirine), with the exception of dolutegravir trough concentrations [median (IQR) = 132 ng/mL (62-227) in individuals on valproic acid versus 760 ng/mL (333-1407) in those not receiving valproic acid]. CONCLUSIONS Valproic acid does not have a major effect on antiretrovirals other than dolutegravir. The mechanism of this unexpected drug-drug interaction may be the combination of protein displacement, reduced absorption and CYP3A4 induction.
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Affiliation(s)
- A Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - J Cusato
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - M Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - A De Nicolò
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - A Lazzaro
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - A Manca
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - A D'Avolio
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - G Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - S Bonora
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
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Calcagno A, de Nicolò A, Pizzi C, Trunfio M, Tettoni C, Ferrara M, Alcantarini C, Trentini L, D'Avolio A, Di Perri G, Bonora S. Medication burden and clustering in people living with HIV undergoing therapeutic drug monitoring. Br J Clin Pharmacol 2021; 87:4432-4438. [PMID: 33890312 DOI: 10.1111/bcp.14869] [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: 02/03/2021] [Revised: 03/19/2021] [Accepted: 04/11/2021] [Indexed: 11/28/2022] Open
Abstract
AIM People living with HIV (PLWH) have a high burden of comorbidities and concomitant medication use. The aim of this study was to analyse the prevalence, predictors and patterns of polypharmacy (PP) in a large therapeutic drug monitoring (TDM) registry. METHODS We searched our TDM registry and categorized co-medications into 26 drug classes. We included patients with at least one medication recorded: PP and severe polypharmacy (sPP) were defined as the concomitant use of ≥5 or ≥10 nonantiretroviral/nonantitubercular drugs. Multivariable binary logistic analysis were conducted for identifying PP/sPP predictors. A hierarchical average-linkage cluster analysis was performed among drug classes. RESULTS We included 2432 participants (1158 PLWH) aged 49.6 years (± 14.4) in the 2016-2020 period. A higher number of concomitant medications (4 vs 3.1, P < .001) and a higher prevalence of PP (26.1% vs 21.8%, P = .015) were recorded in controls. At multivariable binary logistic analysis older age, female gender and HIV-positive serostatus (P = .015) were independent predictors of PP; older age and year of inclusion were independent predictors of sPP. Cluster analysis showed that patients receiving oral drug for type 2 diabetes have a high probability of receiving several other drugs; a cluster of co-medications was observed with opioids, diuretics and central nervous system-affecting drugs. CONCLUSION We observed a moderately high prevalence of polypharmacy in middle-aged PLWH: advanced age and female gender were associated with the greatest prevalence. The observation of co-medication clusters suggests groups of comorbidities but also identifies groups of patients at risk of similar drug-to-drug interactions.
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Affiliation(s)
- Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Amedeo de Nicolò
- Laboratory and Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Mattia Trunfio
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Cristina Tettoni
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Micol Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Chiara Alcantarini
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Laura Trentini
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Antonio D'Avolio
- Laboratory and Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Stefano Bonora
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
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Monducci E, Colafrancesco G, Perrotti G, De Vita G, Quadrana L, Ferrara M. Looking at Self-Disorders through the Minnesota Multiphasic Personality Inventory (MMPI): An empirical exploration of the MMPI-derived Self-Disorder Scale. Eur Psychiatry 2021. [PMCID: PMC9479993 DOI: 10.1192/j.eurpsy.2021.2027] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Trait-like anomalies of subjective experience have been empirically identified as schizophrenia-specific markers of vulnerability in several clinical and genetic high-risk populations. Recently, Parnas and colleagues have identified and preliminarily explored a composite score (i.e. Self-Disorder Scale, SDO) within the Minnesota Multiphasic Personality Inventory (MMPI) that approximates such construct). SDO differs from the MMPI psychoticism scale, and includes presents items very similar to Self Disorder investigated by EASE (Examination of Anomalous Self-experience). Objectives This study is a confirmatory analysis of the correspondence of Self-Disorder Scale (SDO) of the MMPI with some items of EASE, in a population of adolescents. These items are present in psychotic and in at risk mental state subjects. Methods We administered MMPI and EASE to 34 help seeker adolescent patients and correlate all dimensions of MMPI with EASE total score and its domains. Results MMPI SDO scores significantly correlated with schizophrenia-spectrum diagnosis and high-risk mental states. Conclusions SDO is an MMPI analogous of Self Disorders and can be used as a useful screener to detect patients at potential risk for schizophrenia spectrum disorders, that could be further explored with the EASE. Disclosure No significant relationships.
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Baglioni V, Cesario S, Gigliotti F, Galosi S, Maggio CD, Ferrara M, Leuzzi V, Santo FD. Functional neurological disorders in childhood and adolescence: Epidemiology and phenomenology of an emerging diagnostic and clinical challenge. Eur Psychiatry 2021. [PMCID: PMC9528464 DOI: 10.1192/j.eurpsy.2021.664] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Literature on childhood Functional Neurological Disorders (FNDs) is spare. Clinical presentations are vaguely characterized and often misdiagnosed in younger ages. Their main neurological features enrol: Psychogenic non-epileptic seizures (PNES), Functional movement disorders (FMDs), sensory alterations, cephalgia and feeding problems. Objectives The study was aimed to better characterize the childhood population of FND, because of they represent an emerging challenge for clinicians, giving its higher presentation in the younger age and the difficulties of an early and differential diagnosis as well as an effective management. Methods
Our study retrospectively examined the characteristics of 82 FNDs children and adolescents (8 to 16 y.o.; 13 males; 29 females) referred as neurological inpatients of an urban academic neuropsychiatric department, from 2014 to 2019. Three main clinical aspects were analysed: type and pattern of symptoms manifestations (DSM-5 criteria); Life Events; family functioning. Results
FND accounted for 2% of 5-years consultations of neurological inpatients (M: F=1:2). The clinical presentation was characterized in 70% by pattern of co-expressed neurological symptoms: FMDs (9.5%); PNES (12%); dizziness/lipothymia (12%); paraesthesia/anaesthesia (16%). Generalized pain was associated in 38% of the reported patterns while cephalgia in 44%. Sleep disorders were reported in 40%. Previous psychiatric diagnoses were uncommon (2 out 82). Antecedent stressors were identified in 97% of patients for personal illness history and in the 93% for chronic illness in the family anamnesis. Family problems were in 25% of cases. Conclusions Our data contributes to better characterize the childhood population of FND, describing clinical patterns of presentation, highlighting putative antecedent stressors and risk factors
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Maggio CD, Massullo C, Imperatori C, Palazzolo O, Farina B, Brinciotti M, Ferrara M, Guidetti V, Terrinoni A. Triple network in adolescents with borderline personality disorder, early traumatic experiences and dissociative symptoms: An eloreta study. Eur Psychiatry 2021. [PMCID: PMC9471494 DOI: 10.1192/j.eurpsy.2021.384] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Triple Network Model (TNM), which considers the dynamic interaction between Default Mode (DMN), Salience (SN), and Central Executive (CEN) networks, explains clinical features in mental disorders from a neurophysiological perspective. Some studies highlight the increased connectivity in TNM in adults with Borderline Personality Disorder (BPD), but little is known about adolescents. Objectives The aim of our preliminary study was to investigate TN functional connectivity (FC) in BPD adolescents with a history of traumatic experiences, and its correlation with dissociative symptoms. Methods 15 BPD adolescents (DSM-5 criteria) with early traumatic experiences were compared to 15 healthy controls, matched for sex and age. Dissociation Questionnaire (DIS-Q) was administered. Eyes-closed resting-state (RS) EEG recordings were performed (19 electrodes; 10- 20 system) and analyzed using Exact Low-Resolution Electromagnetic Tomography software (eLORETA). FC was computed for all frequency bands and 9 Regions of Interest for TNM. Results BPD adolescents showed a hyper-connection between CEN and DMN [dorso-lateral prefrontal cortex (dlPFC) and posterior cingulate cortex (PCC); PCC and left posterior parietal cortex (PPC)] and within the CEN (left and right PPC). The strength of PCC-dlPFC and left-right PPC connections was correlated with dissociative symptoms severity. Conclusions FC alterations can already be identified in BPD adolescents, supporting the need for early diagnosis. Normally DMN and CEN show opposite functioning. In our BPD adolescents, the absence of this “anti-correlation” reflects the typical confusion between internal and external mental states, which clarify their difficulties in metacognition or mentalization. Moreover, in dissociative symptoms, two CEN nodes are also involved, not only DMN as previously described. Disclosure No significant relationships.
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Monducci E, Colafrancesco G, Masillo A, Brandizzi M, Nastro PF, Ferrara M. Exploring depression in adolescents: How depression changes in early onset psychosis (EOP), clinical high risk (UHR) and clinical control (CC) patients. Eur Psychiatry 2021. [PMCID: PMC9471227 DOI: 10.1192/j.eurpsy.2021.253] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Depression is very common in adolescent patients and impacts on their quality of life and functioning. Indeed, depression is an important clinical aspect for treatment, outcome, and prognosis. Objectives This pilot study investigated the factorial structure of the Calgary depression scale for schizophrenia (CDSS) in a sample of help seeking adolescent patients, stratified in three clinical diagnostic subgroups: early onset psychosis (EOP), clinical high risk (UHR) and clinical control (CC). The relationships between these factors and SIPS domains and subjective experiences were also explored. Methods Sixty-nine subjects were examined to assess the severity of depressive symptoms and the degree of subjectively felt cognitive-affective vulnerability (i.e. basic symptoms) Results Principal component analysis revealed CDSS to include two main factors, namely: “guilty idea of reference-pathological guilt” (factor I), “depression-hopelessness” (factor II). Two factors revealed multiple correlations with SIPS domains and subjective experiences. Conclusions The results confirm the dual factorial structure of CDSS previously reported in the literature in adult samples, further increase our knowledge of the psychopathological components of depression in adolescents, and strongly suggest that CDSS can also be used in early diagnostic settings Disclosure No significant relationships.
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Vita GD, Terrinoni A, Santo FD, Calderoni D, Rainò E, Anichini A, Ferrara M. Maintaining therapeutic continuity in adolescent psychiatric day hospital programs during the COVID-19 lockdown. Eur Psychiatry 2021. [PMCID: PMC9471308 DOI: 10.1192/j.eurpsy.2021.276] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction The COVID-19 social lockdown imposed important limitation to non-emergency health care services in Italy, between March and May 2020, with many difficulties in the mental health assistance of those chronic conditions needing a continuative therapeutic support. Objectives Our study aimed to describe how therapeutic activities have been carried on by remote services in two Adolescent Psychiatric Day Hospital Units (Rome and Turin) and the outcome of these assistance interventions in youths with subacute psychopathology. Methods The patient cohort includes 162 adolescents (12-19 years old; QI>70) DH outpatients presenting a complete clinical and neuropsychiatric assessment before the lockdown. During the several phases of COVID-19 quarantine all patients were monitored and supported by telemedicine interventions. All data were recorded and standardized every 15 days: symptom severity was rated by global severity (CGI-S) and stress level by self-reported measures of stress (IES-R). Results Among patients, CGI score remained stable, IES-R score declined over time: higher IES-R score was significantly associated with female gender and but no differences was observed related with the primary diagnosis. 5 patients presented a clinical acute state needing a hospitalization. The rate of hospitalization was not significantly different compared with the rate observed in the same period of 2019. Conclusions In youth with psychopathological conditions, remote assistance for psychiatric cares resulted effective and it was associated with a clinical stability with decreasing stress levels. Disclosure No significant relationships.
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Monducci E, Colafrancesco G, Battaglia C, Masini E, De Vita G, Ferrara M. The relationship between self-disorders (SDS) and depressive/anxious symptoms in a clinical sample of adolescents. Eur Psychiatry 2021. [PMCID: PMC9475677 DOI: 10.1192/j.eurpsy.2021.1225] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionSelf-disorders (SDs) have been described as a core feature of schizophrenia-spectrum disorders. Previous studies conducted on heterogeneous clinical adult and adolescents samples demonstrated that SDs aggregate selectively in the schizophrenia spectrum disorders compared to other disorders.ObjectivesTo examine the specificity of SDs for schizophrenia spectrum disorders in adolescent inpatient sample.MethodsFifty-five adolescent inpatients admitted to the Child Psychiatry Unit at the Sapienza University in Rome were assessed for psychopathology using Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL), Structured Interview for Prodromal Syndromes (SIPS/SOPS),Examination of Anomalous Self-Experiences (EASE), Multidimensional Anxiety Scale for Children (MASC), Calgary depression scale for schizophrenia (CDSS)ResultsPatients, aged 14-18 years, were divided in four diagnostic groups: schizophrenia spectrum disorders (5 pts.), mood disorders (19 pts.), anxiety disorders (27 pts.) and other disorders (4 pts.). Frequency of self-disorders was different among the 4 groups. Including patients schizotypal personality disorder in the schizophrenia-spectrum disorder group, the difference is still significant. Mann-Whitney U test shows no differences between EOP and UHR patients in SD. Furthermore, correlations between EASE total score and Calgary and MASC total scores were significant.ConclusionsOur results confirm the specificity of SDs for schizophrenia spectrum disorders and also the belonging of schizotypal personality disorder to schizophrenia-spectrum.
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Ferrara M, Bumpus NN, Ma Q, Ellis RJ, Soontornniyomkij V, Fields JA, Bharti A, Achim CL, Moore DJ, Letendre SL. Antiretroviral drug concentrations in brain tissue of adult decedents. AIDS 2020; 34:1907-1914. [PMID: 32694413 PMCID: PMC10768889 DOI: 10.1097/qad.0000000000002628] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Determine concentrations of antiretroviral therapy (ART) drugs in the human brain. DESIGN Cohort study of persons with HIV who consented to antemortem assessment and postmortem autopsy. METHODS Eleven persons with HIV who were taking ART at the time of death and had detectable concentrations of at least one ART drug in intracardiac aspirate at autopsy were evaluated. Autopsies were performed within 24 h of death and brain tissue was stored at -80 °C. Concentrations of 11 ART drugs were measured in three brain regions (globus pallidus, cortical gray matter, white matter) by HPLC tandem mass spectrometry with a lower limit of quantification of 25 ng/ml. RESULTS Participants were mostly men (82%) with a mean age of 40.4 years. Drug concentrations in brain tissue were highly variable and exceeded published concentrations in cerebrospinal fluid for several drugs, including for tenofovir, efavirenz, and lopinavir. Drug concentrations correlated most strongly between cortical gray matter and globus pallidus (rho = 0.70) but less well between globus pallidus and white matter (rho = 0.43). Combining all drugs and brain regions (n = 89), higher drug concentrations in brain were associated with longer estimated duration of HIV infection (P = 0.015), lower HIV RNA in plasma (P = 0.0001), lower nadir CD4 T-cell count (P = 0.053), and worse neurocognitive performance (P = 0.017). CONCLUSION This is the first analysis of ART drug concentrations in human brain tissue. Concentrations of several drugs in this analysis were similar to published concentrations in cerebrospinal fluid but others exceeded published concentrations. The association between higher drug concentrations in the brain and worse neurocognitive performance may indicate ART neurotoxicity.
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Affiliation(s)
| | | | - Qing Ma
- University at Buffalo, Buffalo, New York
| | - Ronald J Ellis
- University of California, San Diego, San Diego, California, USA
| | | | - Jerel A Fields
- University of California, San Diego, San Diego, California, USA
| | - Ajay Bharti
- University of California, San Diego, San Diego, California, USA
| | | | - David J Moore
- University of California, San Diego, San Diego, California, USA
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Mancosu P, Signori C, Clerici E, Comito T, De Rose F, Ferrante S, Ferrara M, Galdieri C, Iftode C, Navarria P, Stravato A, Scorsetti M. PD-0546: Ten years critical re-evaluation of a Failure mode effect analysis in a radiotherapy department. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00568-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Boietti E, Bert F, Savatteri A, Scattaglia M, Ferrara M, Langiano E, De Vito E, Lo Moro G, Gualano MR, Siliquini R. Prevalence and predictors of stress, suicidal thoughts and depression in Italian university students. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.055] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Depression is a major public health issue in Europe. The prevalence of depressive symptoms (DS) in university students (US) is considerably higher than in the general population.
Since few data on DS among Italian US exist, this study aimed to estimate perceived stress (PS) and DS prevalence and assess associated factors in Italian US.
Methods
A cross-sectional study was performed in the Social Sciences and Educational Sciences degree courses at University of Cassino through self-administered questionnaires including socio-demographic items, Beck Depression Inventory-II (BDI-II) scale and Perceived Stress Scale. Primary outcomes were DS presence (BDI-II score≥14), suicidal thoughts (ST) and PS. Multivariable analysis and linear logistic regressions were performed.
Results
Globally, 203 questionnaires were collected (23 BDI-II missing). DS and ST prevalence was 30.6% and 11.3 %. PS median score was 20 (IQR=11) and 87.7% reported moderate/severe PS. Family history of psychiatric disorders and not being a freshman (attending first years of courses) were significantly (p < 0.05) related to DS, while not thinking that University hinders carrying out personal activities was protective. High PS and having a chronic disease were significantly associated with ST, while family cohesion appears to be protective. High PS was significantly associated with: female gender, family history of psychiatric disorders, thinking that University hinders resting and relaxing, being under psychiatric/psychological care and having chosen university for Intellectual curiosity. Having no worries about future was linked to a lower PS.
Conclusions
This study found an alarmingly high prevalence of DS and ST in Italian US. Further longitudinal studies need to define risk factors for depression and stress in US. Public health actions such as offering preventive treatment interventions could improve health in European US.
Key messages
Depressive symptoms can be widespread up to 30% of university students and European policies should afford this issue with a strong commitment in order to reduce harmful consequences. Predictors of depressive symptoms, such as university workload and family cohesion, are recognizable and can be a target for European strategies aimed to improve university students’ mental health.
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Affiliation(s)
- E Boietti
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - F Bert
- Department of Public Health Sciences, University of Turin, Turin, Italy
- Molinette Hospital, University of Turin, Turin, Italy
| | - A Savatteri
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - M Scattaglia
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - M Ferrara
- Department of Human, Social and Health Sciences, University of Cassino, Cassino, Italy
| | - E Langiano
- Department of Human, Social and Health Sciences, University of Cassino, Cassino, Italy
| | - E De Vito
- Department of Human, Social and Health Sciences, University of Cassino, Cassino, Italy
| | - G Lo Moro
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - M R Gualano
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - R Siliquini
- Department of Public Health Sciences, University of Turin, Turin, Italy
- Molinette Hospital, University of Turin, Turin, Italy
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Oliva M, Calia C, Ferrara M, D'Addabbo P, Scrascia M, Mulè G, Monno R, Pazzani C. Antimicrobial resistance gene shuffling and a three-element mobilisation system in the monophasic Salmonella typhimurium strain ST1030. Plasmid 2020; 111:102532. [PMID: 32853586 DOI: 10.1016/j.plasmid.2020.102532] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/30/2022]
Abstract
In this study we describe the genetic elements and the antimicrobial resistance units (RUs) harboured by the Salmonella Typhimurium monophasic variant 1,4,[5],12:i:- strain ST1030. Of the three identified RUs two were chromosomal, RU1 (IS26-blaTEM-1-IS26-strAB-sul2- IS26) and RU2 (IS26-tetR(B)-tetA(B)-ΔIS26), and one, RU3 (a sul3-associated class 1 integron with cassette array dfrA12-orfF-aadA2-cmlA1-aadA1), was embedded in a Tn21-derived element harboured by the conjugative I1 plasmid pST1030-1A. IS26 elements mediated the antimicrobial resistance gene (ARG) shuffling and this gave rise to pST1030-1A derivatives with different sets of ARGs. ST1030 also harboured two ColE1-like plasmids of which one, pST1030-2A, was mobilisable and the target of an intracellular translocation of the Tn21-derived element; the second (pST1030-3) was an orphan mob-associated oriT plasmid co-transferred with pST1030-1A and pST1030-2A. pST1030-2A and pST1030-3 also carried a parA gene and a type III restriction modification system, respectively. Overall analysis of our data reinforces the role played by IS26, Tn21-derived elements and non-conjugative plasmids in the spread of ARGs and supplies the first evidence, at least in Salmonella, for the identification of a natural isolate harbouring a three-element mobilisation system in the same cell.
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Affiliation(s)
- M Oliva
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - C Calia
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - M Ferrara
- Institute of Sciences of Food Production, National Research Council of Italy (ISPA-CNR), Via G. Amendola 122/O, 70126 Bari, Italy
| | - P D'Addabbo
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - M Scrascia
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - G Mulè
- Institute of Sciences of Food Production, National Research Council of Italy (ISPA-CNR), Via G. Amendola 122/O, 70126 Bari, Italy
| | - R Monno
- Department of Basic Medical Sciences Neurosciences and Sense Organs Medical Faculty, University of Bari Piazza G. Cesare Policlinico, 70124 Bari, Italy
| | - C Pazzani
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy.
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Tabernero J, Fernandez EE, Ghiringhelli F, Folprecht G, Curigliano G, Siena S, Cremolini C, Sobrero A, Kwiatek M, Keränen SR, Ahn D, Punt C, Laurent D, Ferrara M, Pellacani A, Capriati A. P-79 C-PRECISE-01 study: A phase Ib/II trial of MEN1611, a PI3K inhibitor, and cetuximab in patients with PIK3CA mutated metastatic colorectal cancer failing irinotecan, oxaliplatin, 5-FU and anti-EGFR containing regimens. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.161] [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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Taramasso L, Fabbiani M, Nozza S, De Benedetto I, Bruzzesi E, Mastrangelo A, Pinnetti C, Calcagno A, Ferrara M, Bozzi G, Focà E, Quiros-Roldan E, Ripamonti D, Campus M, Celesia BM, Torti C, Cosco L, Di Biagio A, Rusconi S, Marchetti G, Mussini C, Gulminetti R, Cingolani A, d'Ettorre G, Madeddu G, Franco A, Orofino G, Squillace N, Muscatello A, Gori A, Antinori A, Tambussi G, Bandera A. Predictors of incomplete viral response and virologic failure in patients with acute and early HIV infection. Results of Italian Network of ACuTe HIV InfectiON (INACTION) cohort. HIV Med 2020; 21:523-535. [PMID: 32578947 DOI: 10.1111/hiv.12885] [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] [Accepted: 05/13/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the factors that can influence an incomplete viral response (IVR) after acute and early HIV infection (AEHI). METHODS This was a retrospective, observational study including patients with AEHI (Fiebig stages I-V) diagnosed between January 2008 and December 2014 at 20 Italian centres. IVR was defined by: (1) viral blip (51-1000 HIV-1 RNA copies/mL after achievement of < 50 HIV-1 RNA copies/mL); (2) virologic failure [> 1000 copies/mL after achievement of < 200 copies/mL, or ≥ 200 copies/mL after 24 weeks on an antiretroviral therapy (ART)]; (3) suboptimal viral response (> 50 copies/mL after 48 weeks on ART or two consecutive HIV-1 RNA levels with ascending trend during ART). Cox regression analysis was used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for IVR. RESULTS In all, 263 patients were studied, 227 (86%) males, with a median [interquartile range (IQR)] age of 38 (30-46) years. During a median follow-up of 13.0 (5.7-31.1) months, 38 (14.4%) had IVR. The presence of central nervous system (CNS) symptoms was linked to a higher risk of IVR (HR = 4.70, 95% CI: 1.56-14.17), while a higher CD4/CD8 cell count ratio (HR = 0.13, 95% CI: 0.03-0.51 for each point increase) and first-line ART with three-drug regimens recommended by current guidelines (HR = 0.40, 95% CI: 0.18-0.91 compared with other regimens including four or five drugs, older drugs or non-standard backbones) were protective against IVR. CONCLUSIONS Patients with lower CD4/CD8 ratio and CNS symptoms could be at a higher risk of IVR after AEHI. The use of recommended ART may be relevant for improving short-term viral efficacy in this group of patients.
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Affiliation(s)
- L Taramasso
- Infectious Diseases Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Policlinico Maggiore Hospital, Milan, Italy
| | - M Fabbiani
- Infectious Diseases Unit, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - S Nozza
- Clinic of Infectious Diseases, San Raffaele Hospital, University Vita Salute, Milan, Italy
| | - I De Benedetto
- Department of Medical Sciences, Unit of Infectious Diseases, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - E Bruzzesi
- Clinic of Infectious Diseases, San Raffaele Hospital, University Vita Salute, Milan, Italy
| | - A Mastrangelo
- Clinic of Infectious Diseases, San Raffaele Hospital, University Vita Salute, Milan, Italy
| | - C Pinnetti
- National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - A Calcagno
- Department of Medical Sciences, Unit of Infectious Diseases, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - M Ferrara
- Department of Medical Sciences, Unit of Infectious Diseases, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - G Bozzi
- Infectious Diseases Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Policlinico Maggiore Hospital, Milan, Italy
| | - E Focà
- Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - E Quiros-Roldan
- Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - D Ripamonti
- Infectious Disease Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - M Campus
- Infectious Diseases Unit, SS Trinità Hospital, ASSL Cagliari, Cagliari, Italy
| | - B M Celesia
- Unit of Infectious Diseases, Garibaldi Hospital, Catania, Italy
| | - C Torti
- Unit of Infectious Diseases, Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - L Cosco
- Infectious Diseases Unit, "Pugliese-Ciaccio" Hospital, Catanzaro, Italy
| | - A Di Biagio
- Department of Infectious Diseases, Policlinico San Martino Hospital, Genoa, Italy
| | - S Rusconi
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences, "Luigi Sacco" Hospital, University of Milan, Milan, Italy
| | - G Marchetti
- Clinic of Infectious Diseases, Department of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milan, Italy
| | - C Mussini
- Clinic of Infectious Diseases, Modena Hospital, University of Modena and Reggio Emilia, Modena, Italy
| | - R Gulminetti
- Infectious Diseases Unit, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - A Cingolani
- Institute of Clinical Infectious Diseases, Agostino Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy
| | - G d'Ettorre
- Infectious Diseases Unit, Umberto I Hospital, La Sapienza University, Rome, Italy
| | - G Madeddu
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A Franco
- Infectious Diseases Unit, ASP Siracusa, Siracusa, Italy
| | - G Orofino
- Unit of Infectious Diseases, Divisione A, Amedeo di Savoia Hospital, Turin, Italy
| | - N Squillace
- Infectious Diseases Unit, Department of Internal Medicine, ASST San Gerardo, Monza, Italy.,University of Milano-Bicocca, Milan, Italy
| | - A Muscatello
- Infectious Diseases Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Policlinico Maggiore Hospital, Milan, Italy
| | - A Gori
- Infectious Diseases Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Policlinico Maggiore Hospital, Milan, Italy.,School of Medicine and Surgery, University of Milan, Milan, Italy
| | - A Antinori
- National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy
| | - G Tambussi
- Clinic of Infectious Diseases, San Raffaele Hospital, University Vita Salute, Milan, Italy
| | - A Bandera
- Infectious Diseases Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Policlinico Maggiore Hospital, Milan, Italy.,School of Medicine and Surgery, University of Milan, Milan, Italy
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Di Cristo V, Adorni F, Maserati R, Annovazzi Lodi M, Bruno G, Maggi P, Volpe A, Vitiello P, Abeli C, Bonora S, Ferrara M, Cossu MV, Oreni ML, Colella E, Rusconi S. 96-week results of a dual therapy with darunavir/ritonavir plus rilpivirine once a day vs triple therapy in patients with suppressed viraemia: virological success and non-HIV related morbidity evaluation. HIV Res Clin Pract 2020; 21:34-43. [PMID: 32129161 DOI: 10.1080/25787489.2020.1734752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Antiretroviral therapies have been tested with the goal of maintaining virological suppression with a particular attention in limiting drug-related toxicity. With this aim we designed the DUAL study: a randomized, open-label, multicenter, 96 weeks-long pilot exploratory study in virologically suppressed HIV-1+ patients with the aim of evaluating the immunovirological success and the impact on non-HIV related morbidity of switching to a dual therapy with darunavir-ritonavir (DRV/r) and rilpivirine (RPV). We recruited patients who received a PI/r-containing HAART for ≥6 months, HIV-RNA < 50 cp/mL for ≥3 months, eGFR > 60 mL/min/1,73m2, without DRV or RPV RAMs. We randomized patients in arm A: RPV + DRV/r QD or arm B: ongoing triple therapy. The primary endpoint has been defined as the percentage of patients with HIV-RNA < 50 cp/mL at week 48 (ITT). VACS index, Framingham CVD risk (FRS) and urinary RBP (uRBP) were calculated. We used Chi-square or Fisher statistics for categorical variables and Mann-Whitney U for continuous ones. Forty-one patients were enrolled (22 in arm A, 14 in arm B, plus 5 screening failures): 30 patients reached 96 weeks: 100% had HIV-RNA < 50 cp/mL in arm A versus 91.7% in arm B. Similar changes were observed in median CD4/mL between baseline and week 96 (+59 versus - 31, p: n.s.). Thirty-one in arm A and 23 in arm B adverse events took place, whereas only 1 was serious (arm A: turbinate hypertrophy, unrelated to HAART). Among the 6 discontinuations (3 in A, 3 in B), only 1 was related to adverse event (arm A: G3 depression, insomnia, weakness). VACS index, median FRS and median uRBP values did not vary from baseline to week 96. At 96-weeks all patients switched to a QD 2-drug regimen based on DRV/r + RPV maintained HIV-RNA suppression, but a single patient who showed a virological failure at week 4. CD4 counts increased overtime without significant differences between the two arms. The novel dual regimen was well tolerated with the same amount of discontinuation as the control arm. VACS index, FRS and uRBP did not differ between arms at week 96.
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Affiliation(s)
- Valentina Di Cristo
- Infectious Diseases Unit, DIBIC Luigi Sacco, University of Milan, Milan, Italy
| | | | - Renato Maserati
- Infectious Diseases Unit, Policlinico San Matteo Foundation, IRCCS, Pavia, Italy
| | - Marco Annovazzi Lodi
- Infectious Diseases Unit, Policlinico San Matteo Foundation, IRCCS, Pavia, Italy
| | - Giuseppe Bruno
- Infectious Diseases Unit, University of Bari, Bari, Italy
| | - Paolo Maggi
- Infectious Diseases Unit, University of Bari, Bari, Italy
| | - Anna Volpe
- Infectious Diseases Unit, University of Bari, Bari, Italy
| | - Paola Vitiello
- Infectious Diseases Unit, ASST Valle Olona, Ospedale di Circolo, Busto Arsizio, VA, Italy
| | - Clara Abeli
- Infectious Diseases Unit, ASST Valle Olona, Ospedale di Circolo, Busto Arsizio, VA, Italy
| | - Stefano Bonora
- Infectious Diseases Unit, University of Turin, Turin, Italy
| | - Micol Ferrara
- Infectious Diseases Unit, University of Turin, Turin, Italy
| | | | - Maria Letizia Oreni
- Infectious Diseases Unit, DIBIC Luigi Sacco, University of Milan, Milan, Italy
| | - Elisa Colella
- Infectious Diseases Unit, DIBIC Luigi Sacco, University of Milan, Milan, Italy
| | - Stefano Rusconi
- Infectious Diseases Unit, DIBIC Luigi Sacco, University of Milan, Milan, Italy
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Muscatello A, Nozza S, Fabbiani M, De Benedetto I, Ripa M, Dell'acqua R, Antinori A, Pinnetti C, Calcagno A, Ferrara M, Focà E, Quiros-Roldan E, Ripamonti D, Campus M, Maurizio Celesia B, Torti C, Cosco L, Di Biagio A, Rusconi S, Marchetti G, Mussini C, Gulminetti R, Cingolani A, D'ettorre G, Madeddu G, Franco A, Orofino G, Squillace N, Gori A, Tambussi G, Bandera A. Enhanced Immunological Recovery With Early Start of Antiretroviral Therapy During Acute or Early HIV Infection-Results of Italian Network of ACuTe HIV InfectiON (INACTION) Retrospective Study. Pathog Immun 2020; 5:8-33. [PMID: 32258852 PMCID: PMC7104556 DOI: 10.20411/pai.v5i1.341] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 10/27/2019] [Accepted: 01/20/2020] [Indexed: 01/13/2023] Open
Abstract
Background Viral load peak and immune activation occur shortly after exposure during acute or early HIV infection (AEHI). We aimed to define the benefit of early start of antiretroviral treatment (ART) during AEHI in terms of immunological recovery, virological suppression, and treatment discontinuation. Setting Patients diagnosed with AEHI (Fiebig stages I-V) during 2008-2014 from an analysis of 20 Italian centers. Methods This was an observational, retrospective, and multicenter study. We investigated the effect of early ART (defined as initiation within 3 months from AEHI diagnosis) on time to virological suppression, optimal immunological recovery (defined as CD4 count ≥500/µL, CD4 ≥30%, and CD4/CD8 ≥1), and first-line ART regimen discontinuation by Cox regression analysis. Results There were 321 patients with AEHI included in the study (82.9% in Fiebig stage III-V). At diagnosis, the median viral load was 5.67 log10 copies/mL and the median CD4 count was 456 cells/µL. Overall, 70.6% of patients started early ART (median time from HIV diagnosis to ART initiation 12 days, IQR 6-27). Higher baseline viral load and AEHI diagnosis during 2012-2014 were independently associated with early ART. HBV co-infection, baseline CD4/CD8 ≥1, lower baseline HIV-RNA, and AEHI diagnosis in recent years (2012-2014) were independently associated with a shorter time to virological suppression. Early ART emerged as an independent predictor of optimal immunological recovery after adjustment for baseline CD4 (absolute and percentage count) and CD4/CD8 ratio. The only independent predictor of first-line ART discontinuation was an initial ART regimen including > 3 drugs. Conclusions In a large cohort of well-characterized patients with AEHI, we confirmed the beneficial role of early ART on CD4+ T-cell recovery and on rates of CD4/CD8 ratio normalization. Moreover, we recognized baseline CD4/CD8 ratio as an independent factor influencing time to virological response in the setting of AEHI, thus giving new insights into research of immunological markers associated with virological control.
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Affiliation(s)
- Antonio Muscatello
- Infectious Diseases Unit; Department of Internal Medicine; IRCCS Ca' Granda Foundation Maggiore Hospital; Milan, Italy
| | - Silvia Nozza
- Clinic of Infectious Diseases; San Raffaele Hospital; University Vita Salute; Milan, Italy
| | - Massimiliano Fabbiani
- Infectious and Tropical Diseases Unit; Azienda Ospedaliero-Universitaria Senese; Siena, Italy
| | - Ilaria De Benedetto
- Department of Medical Sciences; Unit of Infectious Diseases; University of Turin; Amedeo di Savoia Hospital; Turin, Italy
| | - Marco Ripa
- Clinic of Infectious Diseases; San Raffaele Hospital; University Vita Salute; Milan, Italy
| | - Raffaele Dell'acqua
- Clinic of Infectious Diseases; San Raffaele Hospital; University Vita Salute; Milan, Italy
| | - Andrea Antinori
- National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS; Rome, Italy
| | - Carmela Pinnetti
- National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS; Rome, Italy
| | - Andrea Calcagno
- Department of Medical Sciences; Unit of Infectious Diseases; University of Turin; Amedeo di Savoia Hospital; Turin, Italy
| | - Micol Ferrara
- Department of Medical Sciences; Unit of Infectious Diseases; University of Turin; Amedeo di Savoia Hospital; Turin, Italy
| | - Emanuele Focà
- Division of Infectious and Tropical Diseases; University of Brescia; ASST Spedali Civili Hospital; Brescia, Italy
| | - Eugenia Quiros-Roldan
- Division of Infectious and Tropical Diseases; University of Brescia; ASST Spedali Civili Hospital; Brescia, Italy
| | - Diego Ripamonti
- Infectious Disease Unit; ASST Papa Giovanni XXIII; Bergamo, Italy
| | - Marco Campus
- Infectious Diseases Unit; SS Trinità Hospital; ASSL Cagliari, Italy
| | | | - Carlo Torti
- Unit of Infectious Diseases; Department of Medical and Surgical Sciences; University "Magna Graecia;" Catanzaro, Italy
| | - Lucio Cosco
- Infectious Diseases Unit; "Pugliese-Ciaccio" Hospital; Catanzaro, Italy
| | - Antonio Di Biagio
- Department of Infectious Diseases; IRCCS AOU San Martino IST; (DISSAL); University of Genoa; Genoa, Italy
| | - Stefano Rusconi
- Infectious Diseases Unit; Department of Biomedical and Clinical Sciences "Luigi Sacco" Hospital; University of Milan, Italy
| | - Giulia Marchetti
- Clinic of Infectious Diseases; Department of Health Sciences; University of Milan; ASST Santi Paolo e Carlo; Milan, Italy
| | - Cristina Mussini
- Clinic of Infectious Diseases; University of Modena and Reggio Emilia; Modena Hospital; Italy
| | - Roberto Gulminetti
- Department of Medical Sciences; Unit of Infectious Diseases; University of Turin; Amedeo di Savoia Hospital; Turin, Italy
| | - Antonella Cingolani
- Institute of Clinical Infectious Diseases; Agostino Gemelli Hospital; Catholic University of Sacred Heart; Rome, Italy
| | - Gabriella D'ettorre
- Infectious Diseases Unit; Umberto I Hospital; La Sapienza University; Rome, Italy
| | - Giordano Madeddu
- Department of Clinical and Experimental Medicine; Unit of Infectious Diseases; University of Sassari, Italy
| | | | - Giancarlo Orofino
- Unit of Infectious Diseases; Divisione A; Amedeo di Savoia Hospital; Turin, Italy
| | - Nicola Squillace
- Infectious Diseases Unit; Department of Internal Medicine; ASST San Gerardo; Monza, Italy, University of Milano-Bicocca; Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit; Department of Internal Medicine; IRCCS Ca' Granda Foundation Maggiore Hospital; Milan, Italy.,School of Medicine and Surger; University of Milan, Italy
| | - Giuseppe Tambussi
- Clinic of Infectious Diseases; San Raffaele Hospital; University Vita Salute; Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit; Department of Internal Medicine; IRCCS Ca' Granda Foundation Maggiore Hospital; Milan, Italy.,School of Medicine and Surger; University of Milan, Italy
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Di Noia V, Carbone C, Vita E, Ferrara M, D'Argento E, Lucchetti D, Damiano P, Virtuoso A, Ribelli M, Cannella A, Battaglia A, Fattorossi A, Sgambato A, Tortora G, Bria E. P1.01-69 Blood Serum Amyloid A as Potential Predictor of Response to First-Line Pembrolizumab in Patients with Advanced Non-Small-Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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41
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Salahshour S, Ahmadian A, Salimi M, Ferrara M, Baleanu D. Asymptotic solutions of fractional interval differential equations with nonsingular kernel derivative. Chaos 2019; 29:083110. [PMID: 31472490 DOI: 10.1063/1.5096022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/12/2019] [Indexed: 06/10/2023]
Abstract
Realizing the behavior of the solution in the asymptotic situations is essential for repetitive applications in the control theory and modeling of the real-world systems. This study discusses a robust and definitive attitude to find the interval approximate asymptotic solutions of fractional differential equations (FDEs) with the Atangana-Baleanu (A-B) derivative. In fact, such critical tasks require to observe precisely the behavior of the noninterval case at first. In this regard, we initially shed light on the noninterval cases and analyze the behavior of the approximate asymptotic solutions, and then, we introduce the A-B derivative for FDEs under interval arithmetic and develop a new and reliable approximation approach for fractional interval differential equations with the interval A-B derivative to get the interval approximate asymptotic solutions. We exploit Laplace transforms to get the asymptotic approximate solution based on the interval asymptotic A-B fractional derivatives under interval arithmetic. The techniques developed here provide essential tools for finding interval approximation asymptotic solutions under interval fractional derivatives with nonsingular Mittag-Leffler kernels. Two cases arising in the real-world systems are modeled under interval notion and given to interpret the behavior of the interval approximate asymptotic solutions under different conditions as well as to validate this new approach. This study highlights the importance of the asymptotic solutions for FDEs regardless of interval or noninterval parameters.
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Affiliation(s)
- S Salahshour
- Young Researchers and Elite Club, Mobarakeh Branch, Islamic Azad University, Mobarakeh, Iran
| | - A Ahmadian
- Institute for Mathematical Research, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - M Salimi
- Department of Law, Economics and Human Sciences & Decisions Lab, University Mediterranea of Reggio Calabria, 89125 Reggio Calabria, Italy
| | - M Ferrara
- Department of Law, Economics and Human Sciences & Decisions Lab, University Mediterranea of Reggio Calabria, 89125 Reggio Calabria, Italy
| | - D Baleanu
- Department of Mathematics, Faculty of Arts and Sciences, Cankaya University, 06530 Balgat, Ankara, Turkey
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Livelli A, Vaida F, Ellis RJ, Ma Q, Ferrara M, Clifford DB, Collier AC, Gelman BB, Marra CM, McArthur JC, McCutchan JA, Morgello S, Sacktor N, Simpson DM, Grant I, Letendre SL. Correlates of HIV RNA concentrations in cerebrospinal fluid during antiretroviral therapy: a longitudinal cohort study. Lancet HIV 2019; 6:e456-e462. [PMID: 31208949 DOI: 10.1016/s2352-3018(19)30143-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/26/2018] [Accepted: 04/03/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Few large projects have evaluated the factors that influence the HIV RNA concentrations (viral load) in cerebrospinal fluid (CSF) during antiretroviral therapy (ART) over time. We aimed to determine the correlates of HIV RNA in CSF in a large cohort. METHODS We analysed longitudinal data from adults living with HIV in the US CHARTER cohort. Participants in the CHARTER study were recruited from six US academic medical centres-in Baltimore (MD), Galveston (TX), New York (NY), St Louis (MO), San Diego (C92A), and Seattle (WA). Participants in this study had been assessed at least three times between Sept 4, 2003, and Sept 14, 2010, and were taking ART and underwent venous and lumbar puncture with measurement of HIV RNA concentration at all assessments. The lower limit of quantification of the HIV RNA assays was 50 copies per mL. Data were analysed with longitudinal mixed effects logistic regression to identify correlates of HIV RNA concentration (as a binary [detectable or not] and as a continuous variable) in CSF over time. We tested demographic characteristics, plasma HIV RNA, nadir and current CD4 cell count in blood, current CD8 cell count in blood, estimated duration of HIV infection, AIDS diagnosis, duration of ART, adherence to ART, ART characteristics, and CSF characteristics as potential correlates. FINDINGS At the time of analysis, 2207 assessments from 401 participants met the criteria for inclusion in this study. Mean duration of observation was 33·7 months (range 12-84). HIV RNA concentrations in 710 (32·2%) plasma specimens and in 255 (11·6%) CSF specimens were greater than the lower limit of quantification. The best multivariate model of HIV RNA concentration in CSF greater than the lower limit of quantification over time included increased plasma HIV RNA concentration (odds ratio 18·0 per 1 log10 copy per mL, 95% CI 11·3 to 28·8; p<0·0001), increased CSF leucocyte count (2·01 per 5 cells per μL, 1·61 to 2·39; p<0·0001), decreased CD4 cell count (0·53 per 5 square-root cells per μL, 0·35 to 0·79; p=0·0025), decreased CNS penetration-effectiveness value (0·71 per unit, 0·56 to 0·92; p=0·0078), increased CD8 cell count (1·51 per 5 square-root cells, 1·11 to 2·06; p=0·0089), and protease inhibitor use (3·26, 1·04 to 10·23; p=0·039; model R2=0·22, p<0·0001). Analyses of continuous HIV RNA concentration in CSF that accounted for censoring below the lower limit of quantification had similar findings, although increased HIV RNA concentrations in CSF were also associated with black ethnicity (change in log10 HIV RNA concentration in CSF 0·205, 0·0367 to 0·3733; p=0·017), increased total protein in CSF (0·0025, -0·0002 to 0·0052; p=0·069), and the presence of addictive-drug metabolites in urine (0·103, -0·013 to 0·219; p=0·081). INTERPRETATION The identified correlates of HIV RNA concentration in CSF during ART could strengthen clinical prediction of risk for failure to achieve or maintain HIV RNA suppression in CSF. Because most participants in this analysis were ART-experienced and were taking a three-drug regimen that did not include an integrase inhibitor, future research should focus on participants who are taking their first ART regimens or regimens that include integrase inhibitors or two drugs. FUNDING The work was supported by the National Institute of Mental Health and the National Institute of Neurological Disorders and Stroke.
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Affiliation(s)
- Alessandro Livelli
- Department of Psychology, Università degli Studi di Torino, Torino, Italy
| | - Florin Vaida
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Ronald J Ellis
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | - Qing Ma
- Department of Pharmacy Practice, University at Buffalo, Buffalo, NY, USA
| | - Micol Ferrara
- Department of Medical Sciences, Università degli Studi di Torino, Torino, Italy
| | - David B Clifford
- Department of Neurology, Washington University, St Louis, MO, USA
| | - Ann C Collier
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Benjamin B Gelman
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Justin C McArthur
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - J Allen McCutchan
- Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Susan Morgello
- Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA; Department of Pathology, and Department of Neuroscience, Mount Sinai School of Medicine, New York, NY, USA
| | - Ned Sacktor
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - David M Simpson
- Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA
| | - Igor Grant
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Scott L Letendre
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Department of Medicine, University of California San Diego, San Diego, CA, USA.
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Di Noia V, D’Argento E, Vita E, Ferrara M, Damiano P, Ribelli M, Cannella A, Virtuoso A, Tortora G, Bria E. Monitoring of blood serum amyloid (SAA) to predict outcome of first-line pembrolizumab (P) in patients (pts) with advanced non-small cell lung cancer (ANSCLC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Calcagno A, Fiumanò M, Zugna D, Cusato J, Montrucchio C, Marinaro L, Trentini L, Ferrara M, D'Avolio A, Pizzi C, Di Perri G, Bonora S. Tenofovir disoproxil fumarate discontinuation for renal outcomes: any room for treatment personalization? Pharmacogenomics J 2018; 19:65-71. [PMID: 30405212 DOI: 10.1038/s41397-018-0064-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/19/2018] [Accepted: 09/27/2018] [Indexed: 12/17/2022]
Abstract
Tenofovir disoproxil fumarate (TDF) is a very effective antiviral drug that has been associated with tubular dysfunction. The aim of this study was to analyze the demographic, pharmacokinetic, and pharmacogenetic variables associated with TDF discontinuation for renal outcomes in stable HIV-positive patients using multivariable analyses. Three hundred and four patients were included (73% male, with median age and eCrCl of 45.3 years and 90.9 mL/min, respectively). After a median follow-up of 28.3 months, 27 patients discontinued TDF for renal adverse events [persistent urinary abnormalities (n = 21) or eCrCl < 60 mL/min (n = 6)] providing an incidence of 3.77 events per 100 patient-year. The probability of TDF discontinuation was higher with several features (male gender, older age, not Caucasians ancestry, absence of intravenous drug abuse, protease inhibitors, previous indinavir, HCV-positivity, lower CD4 cell count, detectable HIV-RNA, lower eCrCl, spot-urine proteinuria) and higher tenofovir concentrations but not genetic variants. Tenofovir plasma concentrations were prognostic of TDF discontinuation for renal adverse events suggesting that dose-adjustment may be warranted for long-term safety.
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Affiliation(s)
- A Calcagno
- Unit of Infectious Diseases, University of Torino, Torin, Italy. .,Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy.
| | - M Fiumanò
- Unit of Infectious Diseases, University of Torino, Torin, Italy.,Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - D Zugna
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - J Cusato
- Unit of Infectious Diseases, University of Torino, Torin, Italy.,Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - C Montrucchio
- Unit of Infectious Diseases, University of Torino, Torin, Italy.,Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - L Marinaro
- Unit of Infectious Diseases, University of Torino, Torin, Italy.,Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - L Trentini
- Unit of Infectious Diseases, University of Torino, Torin, Italy.,Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - M Ferrara
- Unit of Infectious Diseases, University of Torino, Torin, Italy.,Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - A D'Avolio
- Unit of Infectious Diseases, University of Torino, Torin, Italy.,Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - C Pizzi
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - G Di Perri
- Unit of Infectious Diseases, University of Torino, Torin, Italy.,Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - S Bonora
- Unit of Infectious Diseases, University of Torino, Torin, Italy.,Unit of Cancer Epidemiology, Department of Medical Sciences, University of Torino, Torino, Italy
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Castagna A, Ferrara M, Galli L, Comi L, Sterrantino G, Cenderello G, Zaccarelli M, Focà E, Roncadori A, Lazzarin A. Long-term efficacy of dolutegravir in treatment-experienced subjects failing therapy with HIV-1 integrase strand inhibitor-resistant virus. J Antimicrob Chemother 2018; 73:177-182. [PMID: 29077927 DOI: 10.1093/jac/dkx371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 09/12/2017] [Indexed: 11/14/2022] Open
Abstract
Objectives This study evaluated the virological efficacy of dolutegravir 50 mg twice daily in 190 HIV-1 failing antiretroviral-experienced patients with previous exposure to first-generation integrase strand transfer inhibitor (INSTI) over a 5 year follow-up using data from clinical practice. Patients and methods This analysis included HIV-1-infected patients who were ≥18 years of age, treatment experienced, had HIV-1 RNA >50 copies/mL, with INSTI-resistant virus, who started dolutegravir 50 mg twice daily plus optimized background therapy (OBT), recorded in the national prospective database PRESTIGIO (www.progettoprestigio.it). Follow-up accrued from the start of dolutegravir 50 mg twice daily + OBT until virological failure (VF) or dolutegravir discontinuation for any reason or the last treatment visit on dolutegravir 50 mg twice daily treatment. VF was defined by the lack of achievement of HIV-1 RNA <50 copies/mL by 6 months and thereafter, or the occurrence of two consecutive HIV-1 RNA ≥50 copies/mL after achievement of undetectable viral load. Results The estimated VF probabilities were 17% (95% CI = 12%-24%), 28% (95% CI = 21%-37%), 33% (95% CI = 25%-43%), 39% (95% CI = 29%-51%) and 52% (95% CI = 39%-67%) at 12, 24, 36, 48 and 60 months since baseline, respectively. A higher risk of VF was independently associated with baseline viral load >100000 copies/mL (adjusted HR = 4.73, 95% CI = 1.33-16.78, P = 0.016) and with ≥1 INSTI mutations plus Q148H/K/R/N and the G140S/A/C as compared with other subjects (adjusted HR = 4.18, 95% CI = 1.32-13.23, P = 0.015). Conclusions Our data showed a favourable long-term efficacy of dolutegravir 50 mg twice daily in association with OBT in treatment-experienced failing subjects, with INSTI-resistant virus, in the real world. A close monitoring of adherence is crucial for maintenance of virological response in this fragile subgroup of subjects.
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Affiliation(s)
- Antonella Castagna
- Clinic of Infectious Diseases, Vita-Salute San Raffaele University, Milano, Italy
| | - Micol Ferrara
- Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Laura Galli
- Clinic of Infectious Diseases, Istituto Scientifico San Raffaele, Milano, Italy
| | - Laura Comi
- Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Mauro Zaccarelli
- Istituto Nazionale per le Malattie Infettive, Lazzaro Spallanzani, IRCCS, Roma, Italy
| | - Emanuele Focà
- Università degli Studi di Brescia - Spedali Civili di Brescia, Brescia, Italy
| | - Andrea Roncadori
- Healthcare Systems Department, CINECA, Casalecchio di Reno, Bologna, Italy
| | - Adriano Lazzarin
- Clinic of Infectious Diseases, Istituto Scientifico San Raffaele, Milano, Italy
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Bruno MT, Ferrara M, Fava V, Barrasso G, Panella MM. A prospective study of women with ASCUS or LSIL pap smears at baseline and HPV E6/E7 mRNA positive: a 3-year follow-up. Epidemiol Infect 2018; 146:612-618. [PMID: 29465024 PMCID: PMC9134523 DOI: 10.1017/s0950268818000250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 01/19/2018] [Accepted: 01/24/2018] [Indexed: 01/02/2023] Open
Abstract
Human papillomavirus (HPV) testing is used in the triage of women with a borderline smear result. The efficiency of testing women with a low-grade squamous intraepithelial lesion (LSIL) and atypical squamous cells of undetermined significance (ASCUS) is less clear. For this reason we used a new HPV test that detects E6/E7 messenger RNA (mRNA), which might have a higher specificity. The objective of this prospective study was to assess whether HPV E6/E7 mRNA positivity in women with ASCUS and LSIL at baseline, is able to predict those women who have a high risk of developing a histological cervical intraepithelial neoplasia (CIN2) or worse lesion. We took into consideration the women's age and HPV DNA genotype and followed them up for 3 years. Cervical samples from women with high-risk HPV (HR-HPV) DNA-positive ASCUS (n = 90) or LSIL (n = 222) were tested for the presence of HR-HPV E6/E7 mRNA and the women were monitored for the development of histopathologically verified CIN2+. Thirteen patients with ASCUS and 17 with LSIL did not complete follow-up. All patients with LSIL and ASCUS, enrolled in this study, had confirmed lesions at the colposcopic examination. Follow-up was available for 312 women, 193 were positive in the HR-HPV DNA test and 93 had a HPV E6/E7 mRNA positive test. Finally, 22 women positive in the HPV DNA test for high-risk genotypes and with positive E6/E7 mRNA had a histologically confirmed CIN2+. Only two cases with negative HPV E6/E7 mRNA had CIN2+. The study shows that women positive in the HPV E6/E7 mRNA test have a greater risk of malignant progression of cervical lesions and therefore deserve greater attention and earlier check-ups.
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Affiliation(s)
- M. T. Bruno
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic of the Policlinico universitario, via s.sofia 78, 95124, Catania, Italy
| | - M. Ferrara
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic of the Policlinico universitario, via s.sofia 78, 95124, Catania, Italy
| | - V. Fava
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic of the Policlinico universitario, via s.sofia 78, 95124, Catania, Italy
| | - G. Barrasso
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic of the Policlinico universitario, via s.sofia 78, 95124, Catania, Italy
| | - M. M. Panella
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic of the Policlinico universitario, via s.sofia 78, 95124, Catania, Italy
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Musat D, Milstein N, Bhatt A, Preminger M, Sichrovsky T, Flynn L, Ferrara M, Shaw R, Mittal S. P850Incidence, Duration, and Pattern of DeNovo Atrial Fibrillation Detected Using an Implantable Loop Recorder Following Ablation of the Cavotricuspid Isthmus. Europace 2018. [DOI: 10.1093/europace/euy015.453] [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: 11/13/2022] Open
Affiliation(s)
- D Musat
- The Valley Hospital, Ridgewood, United States of America
| | - N Milstein
- The Valley Hospital, Ridgewood, United States of America
| | - A Bhatt
- The Valley Hospital, Ridgewood, United States of America
| | - M Preminger
- The Valley Hospital, Ridgewood, United States of America
| | - T Sichrovsky
- The Valley Hospital, Ridgewood, United States of America
| | - L Flynn
- The Valley Hospital, Ridgewood, United States of America
| | - M Ferrara
- The Valley Hospital, Ridgewood, United States of America
| | - R Shaw
- The Valley Hospital, Ridgewood, United States of America
| | - S Mittal
- The Valley Hospital, Ridgewood, United States of America
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Gorgoni M, Reda F, Lauri G, Truglia I, Cordone S, Scarpelli S, Mangiaruga A, D'Atri A, Bartolacci C, Alfonsi V, Schiappa C, Ferrara M, Rossini P, De Gennaro L. K-complexes and slow wave activity during nrem sleep in patients with Alzheimer's disease. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Vallerio P, D'Alessio I, Maloberti A, Caracciolo M, De Chiara B, Pansera F, Spada E, Carbonaro M, Peretti A, Maggioni S, Cantu' V, Ferrara M, Palmieri B, Lista A, Giannattasio C. P5190Endovascular repair for blunt thoracic aortic injury: subsequent heart structure and vascular function. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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