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Marelli S, Micaglio E, Taurino J, Salvi P, Rurali E, Perrucci GL, Dolci C, Udugampolage NS, Caruso R, Gentilini D, Trifiro' G, Callus E, Frigiola A, De Vincentiis C, Pappone C, Parati G, Pini A. Marfan Syndrome: Enhanced Diagnostic Tools and Follow-up Management Strategies. Diagnostics (Basel) 2023; 13:2284. [PMID: 37443678 DOI: 10.3390/diagnostics13132284] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
Marfan syndrome (MFS) is a rare inherited autosomic disorder, which encompasses a variety of systemic manifestations caused by mutations in the Fibrillin-1 encoding gene (FBN1). Cardinal clinical phenotypes of MFS are highly variable in terms of severity, and commonly involve cardiovascular, ocular, and musculoskeletal systems with a wide range of manifestations, such as ascending aorta aneurysms and dissection, mitral valve prolapse, ectopia lentis and long bone overgrowth, respectively. Of note, an accurate and prompt diagnosis is pivotal in order to provide the best treatment to the patients as early as possible. To date, the diagnosis of the syndrome has relied upon a systemic score calculation as well as DNA mutation identification. The aim of this review is to summarize the latest MFS evidence regarding the definition, differences and similarities with other connective tissue pathologies with severe systemic phenotypes (e.g., Autosomal dominant Weill-Marchesani syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome) and clinical assessment. In this regard, the management of MFS requires a multidisciplinary team in order to accurately control the evolution of the most severe and potentially life-threatening complications. Based on recent findings in the literature and our clinical experience, we propose a multidisciplinary approach involving specialists in different clinical fields (i.e., cardiologists, surgeons, ophthalmologists, orthopedics, pneumologists, neurologists, endocrinologists, geneticists, and psychologists) to comprehensively characterize, treat, and manage MFS patients with a personalized medicine approach.
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Affiliation(s)
- Susan Marelli
- Cardiovascular-Genetic Center, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Emanuele Micaglio
- Arrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Jacopo Taurino
- Cardiovascular-Genetic Center, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Paolo Salvi
- Istituto Auxologico Italiano, Cardiology Unit, IRCCS, 20133 Milan, Italy
| | - Erica Rurali
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
| | - Gianluca L Perrucci
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
| | - Claudia Dolci
- Laboratory of Functional Anatomy of the Stomatognathic System (LAFAS), Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
| | | | - Rosario Caruso
- Clinical Research Service, IRCCS Policlinico San Donato, 20097 Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Davide Gentilini
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Bioinformatics and Statistical Genomics Unit, Istituto Auxologico Italiano IRCCS, Cusano Milanino, University of Milano-Bicocca, 20095 Milan, Italy
| | - Giuliana Trifiro'
- Cardiovascular-Genetic Center, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Edward Callus
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
- Clinical Psychology Service, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Alessandro Frigiola
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
- Association "Bambini Cardiopatici nel Mondo" Non-Governmental Organization (NGO), 20123 Milan, Italy
| | - Carlo De Vincentiis
- Department of Cardiothoracic, Vascular Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Carlo Pappone
- Arrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, 20097 Milan, Italy
- Institute of Molecular and Translational Cardiology, IRCCS Policlinico San Donato, 20097 Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Gianfranco Parati
- Istituto Auxologico Italiano, Cardiology Unit, IRCCS, 20133 Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
| | - Alessandro Pini
- Cardiovascular-Genetic Center, IRCCS Policlinico San Donato, 20097 Milan, Italy
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Taurino J, Micaglio E, Russo Raucci A, Zanussi M, Chessa M, Udugampolage NS, Carrera P, Pappone C, Pini A. Case report: Complex arterial findings in vascular ehlers-danlos syndrome with a novel COL3A1 variant and death at young age. Front Cardiovasc Med 2023; 10:1110392. [PMID: 37404745 PMCID: PMC10315819 DOI: 10.3389/fcvm.2023.1110392] [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: 11/28/2022] [Accepted: 05/30/2023] [Indexed: 07/06/2023] Open
Abstract
Vascular Ehlers-Danlos syndrome (vEDS) is a genetic disease caused by a pathogenic mutation in the COL3A1 gene. Despite its severe course, the rarity and extreme clinical variability of the disease can pose significant obstacles to a timely diagnosis. Early and accurate diagnosis may lead to improved patient outcomes by providing access to targeted pharmacological treatments like celiprolol and enhancing the management of vEDS-related complications. Herein, we report a patient harboring a novel de novo COL3A1 missense variant, in which the diagnosis was only possible belatedly due to delayed referral for genetic evaluation. The patient developed pulmonary complications, aneurysms, and vascular malformations, and died at the age of 26 years due to massive pulmonary bleeding.
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Affiliation(s)
- Jacopo Taurino
- Cardiovascular-Genetic Center, IRCCS Policlinico San Donato, Milan, Italy
| | - Emanuele Micaglio
- Arrhythmology & Electrophysiology, IRCCS Policlinico San Donato, Milan, Italy
| | - Annalisa Russo Raucci
- Laboratory of Clinical Genomics, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Monica Zanussi
- Laboratory of Clinical Genomics, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Chessa
- ACHD Unit - Pediatric and Adult Congenital Heart Centre, IRCCS-Policlinico San Donato, Milan, Italy
- Vita & Salute San Raffaele University, Milan, Italy
| | | | - Paola Carrera
- Laboratory of Clinical Genomics, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Genomics for the Diagnosis of Human Pathologies, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carlo Pappone
- Arrhythmology & Electrophysiology, IRCCS Policlinico San Donato, Milan, Italy
- Vita & Salute San Raffaele University, Milan, Italy
| | - Alessandro Pini
- Cardiovascular-Genetic Center, IRCCS Policlinico San Donato, Milan, Italy
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Panetta M, Bianchetti A, Udugampolage NS, Taurino J, Caruso R, Pini A, Callus E. Discussing psychological and psychotherapeutic support for patients with Marfan syndrome (MFS) and their family: an example of a structured program in Italy. Front Psychol 2023; 14:1176692. [PMID: 37397303 PMCID: PMC10307951 DOI: 10.3389/fpsyg.2023.1176692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Affiliation(s)
- Mariangela Panetta
- Cardiovascular-Genetic Centre, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Alessandra Bianchetti
- Cardiovascular-Genetic Centre, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Jacopo Taurino
- Cardiovascular-Genetic Centre, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Alessandro Pini
- Cardiovascular-Genetic Centre, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Edward Callus
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy
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Udugampolage NS, Pini A, Magon A, Conte G, Callus E, Taurino J, Caruso R. COVID-19 Vaccine Hesitancy in Italian Adults with Marfan Syndrome: Insights from a Secondary Analysis of a Cross-Sectional Study. Vaccines (Basel) 2023; 11:vaccines11040734. [PMID: 37112646 PMCID: PMC10143721 DOI: 10.3390/vaccines11040734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/19/2023] [Accepted: 03/26/2023] [Indexed: 03/29/2023] Open
Abstract
Although vaccine hesitancy has been reported in many patient groups and countries, there is a lack of data on vaccine hesitancy in patients with Marfan syndrome (MFS). MFS is a rare genetic disorder that can lead to cardiovascular, ocular, and musculoskeletal issues. Because MFS patients may face an increased risk of COVID-19 complications, vaccination is crucial for this population. This brief report aims to describe vaccine hesitancy rates in MFS patients and compare the characteristics of patients who are hesitant and those who are not to gain a better understanding of this specific population. This study analyzes previously published cross-sectional data that examined mental health, sociodemographic, and clinical factors associated with PTSD, depression, anxiety, and insomnia in MFS patients during the third wave of the COVID-19 pandemic in Lombardy, Italy. Of the 112 MFS patients who participated, 26 (23.9%) reported vaccine hesitancy. Vaccine hesitancy may be associated mainly with younger age and not be related to other patient characteristics. Therefore, this report found no differences in individual-level variables, such as sex, education, comorbidities, and mental health symptoms, between those who were hesitant and those who were not. The study findings are insightful and suggest that interventions to address vaccine hesitancy in this population may need to focus on attitudes and beliefs related to vaccination rather than targeting specific sociodemographic or clinical factors.
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Dellafiore F, Caruso R, Bonavina L, Udugampolage NS, Villa G, Russo S, Vangone I, BaronI I, Di Pasquale C, Nania T, Manara DF, Arrigoni C. Risk factors and pooled incidence of intestinal stoma complications: systematic review and Meta-analysis. Curr Med Res Opin 2022; 38:1103-1113. [PMID: 35608158 DOI: 10.1080/03007995.2022.2081455] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The present systematic review aimed to identify, critically assess and summarize which risk factors might determine the onset of ostomy complications, describing a pooled incidence and stratified incidences by each identified risk factor. METHODS A systematic literature review with a meta-analysis of observational studies was performed by following the PRISMA statement and flow chart. The quality assessment of the included articles was performed through the Newcastle-Ottawa Scale (NOS). RESULTS Sixteen articles published between 1990 and 2018 focused on the risk factors related to intestinal stomal complications, and the performed analysis led to identifying influenceable and non-influenceable risk factors. The median of the NOS evaluation was 6 (IQR = 5.75-6). Among 10,520 included patients, the pooled incidence of stomal complications was 35%, ranging from 9% to 63%, regardless of the nature of the complications. Analysis of the sub-groups highlighted obesity and ostomy surgery performed via laparoscopy or emergency conditions have significant incidences, respectively, of 66% and 68%. CONCLUSIONS The pooled incidence of stomal complications requires greater attention for its relevant epidemiology. From the clinical point of view, patients with obesity and chronic conditions require more attention to prevent complications, possibly employing accurate educational interventions to enhance proper stoma management.
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Affiliation(s)
- Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Luigi Bonavina
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Division of General Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
| | - Sara Russo
- ItalyVascular Surgery Unit, IRCCS Policlinic San Matteo Foundation, Nursing degree course, University of Pavia, section Istituti Clinici di Pavia e Vigevano S.p.A., Pavia, Italy
| | - Ida Vangone
- Department of Oncology and Hematology-Oncology, Istituto Europeo Oncologia, Milan, Italy
| | - Irene BaronI
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| | | | - Tiziana Nania
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Duilio F Manara
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
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Dellafiore F, Bascapè B, Caruso R, Conte G, Udugampolage NS, Carenzi L, Arrigoni C. What is the relations between dysgeusia and alterations of the nutritional status? A metanarrative analysis of integrative review. Acta Biomed 2021; 92:e2021023. [PMID: 34328144 PMCID: PMC8383223 DOI: 10.23750/abm.v92is2.11015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/09/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Dysgeusia is an altered or damaged tasting perception of a multifactorial etiology, from polypharmacy, infections to chemotherapy and radiotherapy. Approximately 5% of the population suffer from a diminished taste sensation, which unfortunately remains underestimated by the affected person, creating the conditions for a dramatic underestimation of the incidence of the symptom. The aim of this study is to summarize the evidences present in literature on the relations between Dysgeusia and alterations of the nutritional status Methods: an integrative review with metanarrative analysis of the articles included was carried out in August 2020. PubMed, Scopus, Embase and CINAHL databases were examined with keywords and methodological strings. PRISMA flow-chart along with a qualitative evaluation grid (JBI-QARI) were applied in the selection of the studies with a time limitation to the last ten years. RESULTS 10 articles resulted from the literature review process were divided into two macro-categories. Eight articles reported dysgeusia linked to weight loss. The second macro-category showed two studies relating to dysgeusia in patients with altered nutritional status associated with body weight gain. CONCLUSIONS this review represents an initial contribution to summarize the best evidence and knowledge in relation to dysgeusia, with the aim of enabling the identification and treatment of this symptom and facilitating targeted educational interventions.
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Dellafiore F, Rosa D, Udugampolage NS, Villa G, Albanesi B. Professional values and nursing self-efficacy in the Italian context. Correlational descriptive study. Scand J Caring Sci 2021; 36:142-149. [PMID: 33751624 DOI: 10.1111/scs.12971] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 08/17/2020] [Revised: 12/23/2020] [Accepted: 01/31/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Nurses' professional values (NPVs) and self-efficacy (SE) are two fundamental elements in nursing care that influence its professional identity, competences, resulting in changing the behaviour of professionals and their response to the patient's health needs. The various studies produced so far have not investigated a possible relationship between these two areas. Therefore, the objective of the following study is to identify and deepen the relationship between NPV and SE, in order to improve the knowledge of these issues. MATERIALS AND METHODS An observational, correlational and multicentric study has been carried out through a questionnaire based survey. The sampling was conventional. The data collection took place through Nursing Professional Values Scale, version 3 (NPVS-3), which investigates professional values; and Nursing Professional Self-Efficacy Scale (NPSES), which investigates self-efficacy and a socio-demographic questionnaire. RESULTS The total sample was 532 nurses and 65.6% was female, with a median age of 42 years and a median of 15 working years. Positive statistically significant correlations between the various domains of the NPVS-3 and NPSES scales were found. These relationships also emerged in the analyses between geographical areas. Overall, the relationships between self-efficacy and values were similar in all the analyses. DISCUSSION As the professional values of nurses increase in their response to the patient's health needs, self-efficacy perceived by them increases and vice versa, significantly effecting the clinic and care outcomes of the patients and improving nursing outcomes. The stratification of the sample by geographical area regarding the relationship between age, years of work and professional values indicated that these variables strongly influence the NPV and SE of nurses. Therefore, in some contexts, more support in maintaining a stable value structure may be needed; moreover, it is necessary to incentivise nurses with more effective interventions, as an example and a basis of motivation for future generations.
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Affiliation(s)
- Federica Dellafiore
- Area of Research and Development of Health Professions, IRCCS Policlinico San Donato, Milan, Italy
| | - Debora Rosa
- S. Luca Hospital, Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | | | - Giulia Villa
- Health Professions Research and Development Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Beatrice Albanesi
- Department of Medicine and Psychology, Università la Sapienza, Rome, Italy
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Albanesi B, Nania T, Barello S, Villa G, Rosa D, Caruso R, Udugampolage NS, Casole L, Dellafiore F. Lived experience of patients in
ICU
after cardiac surgery: A phenomenological study. Nurs Crit Care 2020; 27:204-213. [DOI: 10.1111/nicc.12562] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/21/2020] [Accepted: 09/24/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Beatrice Albanesi
- Department of Medicine and Psychology Sapienza University Rome Italy
| | - Tiziana Nania
- Health Professions Research and Development Unit IRCCS Policlinico San Donato Milan Italy
| | - Serena Barello
- Department of Psychology, EngageMinds Hub Research Center Università Cattolica del Sacro Cuore Milan Italy
| | | | - Debora Rosa
- IRCCS Istituto Auxologico Italiano Milan Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit IRCCS Policlinico San Donato Milan Italy
| | | | - Lorenzo Casole
- Health Professions Research and Development Unit IRCCS Policlinico San Donato Milan Italy
| | - Federica Dellafiore
- Health Professions Research and Development Unit IRCCS Policlinico San Donato Milan Italy
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