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Parato V, Galieni M, Marcelli S, Fioroni A. P306 COVID–19 RELATED PERICARDITIS. CLINICAL IMPLICATIONS AND ROLE OF CARDIAC REHABILITATION IN SUBSEQUENT LONG–COVID SYNDROME. Eur Heart J Suppl 2022. [PMCID: PMC9384007 DOI: 10.1093/eurheartj/suac012.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Acute pericarditis is considered one of the cardiovascular complications of COVID–19.
Aim of the Study
The aim was to evaluate the prevalence and clinical implications of acute pericarditis diagnosed through the presence of pericardial effusion in patients with COVID–19.
Methods
The investigation is a retrospective observational study enrolling patients admitted to ICU of Madonna del Soccorso Hospital (San Benedetto del Tronto, Italy) because of a SARS–Cov2 induced severe acute respiratory syndrome. N.170 patients, admitted from 1st april 2020 to 30th april 2021, were enrolled. All patients presented a variable picture of bilateral ground glass opacifications at HR– Chest CT. Some patients underwent oro–tracheal intubation+invasive ventilation. All patients underwent cardiological consultation including a transthoracic bedside echocardiogram, using ultrasound E9–GE machine (Boston, MA, USA). Demographic, laboratory and clinical data were collected for all enrolled patients.The diagnosis of acute pericarditis was defined by different degrees of pericardial effusion. All patient were divided in two groups: 1) pericarditis group (A); 2) pericarditis–free group (B).
Results
Of 170 enrolled patient, 51 were females (30%) and 119 were males (70%). Median age for all patients was 67,6 + 13,3 (females: 70,5 + 16,2; males: 66,4 + 11,7). Of 170, n. 60 patients had a diagnosis of acute pericarditis (32,2%) and were included into Group A [age 69,2 + 12,6; 39 (65%) males aged 69,3 + 10,6, 21 (35%) females aged 69,1 + 16,0]. Of 60, only 6 had a pericardial effusion >10 mm (10%); the remaining group A–patients (90%) had a mild pericardial effusion (<10 mm). No patient had tamponade picture. Group B (pericarditis–free) included 110 patients, aged 66,7 + 13,7, 80 (72,7%) males aged 65,0 + 12,1, 30 (27,3%) females aged 71,4 + 16,6. Group A–patients had more days of intubation and a prolonged hospital stay compared with group B, with a significant difference (p < 0.02 and p < 0,03 rispectively). N. 21 of 60 group A patients underwent a 7 weeks of CARDIAC REHABILITATION (CR) because of a LONG–COVID picture. In these patient a 6MWT was performed before and after CR. A significant increase of the walked distance after CR was found (from 352 + 21 to 498 + 31 – p < 0.03 – delta=41%).
Conclusion
Pericarditis is a frequent cardiovascular complication of COVID–19 (32,2% in our study) with clinical and prognostic implications. CR is essential for long–term recovery in these patients.
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Affiliation(s)
- V Parato
- CARDIOLOGY UNIT AT MADONNA DEL SOCCORSO HOSPITAL, SAN BENEDETTO DEL TRONTO; NURSING COURSE OF POLITECNICA DELLE MARCHE UNIVERSITY, ASCOLI PICENO; REHABILITATION UNIT AT MADONNA DEL SOCCORSO HOSPITAL, SAN BENEDETTO DEL TRONTO
| | - M Galieni
- CARDIOLOGY UNIT AT MADONNA DEL SOCCORSO HOSPITAL, SAN BENEDETTO DEL TRONTO; NURSING COURSE OF POLITECNICA DELLE MARCHE UNIVERSITY, ASCOLI PICENO; REHABILITATION UNIT AT MADONNA DEL SOCCORSO HOSPITAL, SAN BENEDETTO DEL TRONTO
| | - S Marcelli
- CARDIOLOGY UNIT AT MADONNA DEL SOCCORSO HOSPITAL, SAN BENEDETTO DEL TRONTO; NURSING COURSE OF POLITECNICA DELLE MARCHE UNIVERSITY, ASCOLI PICENO; REHABILITATION UNIT AT MADONNA DEL SOCCORSO HOSPITAL, SAN BENEDETTO DEL TRONTO
| | - A Fioroni
- CARDIOLOGY UNIT AT MADONNA DEL SOCCORSO HOSPITAL, SAN BENEDETTO DEL TRONTO; NURSING COURSE OF POLITECNICA DELLE MARCHE UNIVERSITY, ASCOLI PICENO; REHABILITATION UNIT AT MADONNA DEL SOCCORSO HOSPITAL, SAN BENEDETTO DEL TRONTO
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Marcelli S, Aso J. Preliminary outcomes and comparison of polytech POLYtxt Ⓡ and MESMOsensitive Ⓡ breast implants with focus on late seroma: Single-surgeon, retrospective cohort study on 621 consecutive aesthetic breast surgery cases. J Plast Reconstr Aesthet Surg 2021; 74:2217-2226. [PMID: 33582050 DOI: 10.1016/j.bjps.2020.12.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 11/29/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Recent history shows incomplete understanding of the long-term interaction between breast implants and biological tissues. Although complications of silicone-textured implants have been previously reported, conclusive data are still controversial due to the lack of reduced bias, long-term, comparative studies. We present our preliminary outcomes of 3 years aesthetic use of POLYTECH silicone POLYtxtⓇ and MESMO SensitiveⓇ implants. METHODS This article is a retrospective analysis of 621 patients who have undergone primary aesthetic breast surgery (breast augmentation (BA) or augmentation mastopexy). The surgeries were performed by a single surgeon using Polytech microtextured silicone implants (POLYtxt and MESMO). Complications, with main focus on late seroma, were assessed and compared based on texturization type. RESULTS From January 2015 to September 2018, 358 patients were treated with POLYtxt and 263 with MESMO-textured implants. Incidence of complications, such as hematoma, infection, early seroma, capsular contraction and malposition/rotation was comparable between the two groups. Incidence of late seroma was, respectively, 6.4% (POLYtxt) and 0% (MESMO) resulting in a statistically significant difference between the two groups. Overall complications and reinterventions were 12.5%-9.2% (POLYtxt) and 4.5%-3.8% (MESMO), respectively, showing a significantly lower occurrence in the MESMO group. CONCLUSIONS This reduced bias study shows an increased risk in overall complications and reoperations with POLYtxt surface implants compared with MESMO. Furthermore, we registered an exceptionally high rate of late seroma when the more "aggressive" POLYtxt texturization was used. Conversely, a significantly low incidence of adverse events was registered with the MESMO surface, which has turned this device in our first choice in daily practice.
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Affiliation(s)
- S Marcelli
- Private Practice, Calle de Núñez de Balboa, 107, 28006, Madrid, Spain.
| | - J Aso
- Private Practice, Calle de Núñez de Balboa, 107, 28006; Madrid Spain. Department of Plastic Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain
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Mango D, Braksator E, Battaglia G, Marcelli S, Mercuri NB, Feligioni M, Nicoletti F, Bashir ZI, Nisticò R. Acid-sensing ion channel 1a is required for mGlu receptor dependent long-term depression in the hippocampus. Pharmacol Res 2017; 119:12-19. [PMID: 28137639 DOI: 10.1016/j.phrs.2017.01.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 05/09/2016] [Revised: 01/24/2017] [Accepted: 01/25/2017] [Indexed: 01/18/2023]
Abstract
Acid-sensing ion channels (ASICs), members of the degenerin/epithelial Na+ channel superfamily, are widely distributed in the mammalian nervous system. ASIC1a is highly permeable to Ca2+ and are thought to be important in a variety of physiological processes, including synaptic plasticity, learning and memory. To further understand the role of ASIC1a in synaptic transmission and plasticity, we investigated metabotropic glutamate (mGlu) receptor-dependent long-term depression (LTD) in the hippocampus. We found that ASIC1a channels mediate a component of LTD in P30-40 animals, since the ASIC1a selective blocker psalmotoxin-1 (PcTx1) reduced the magnitude of LTD induced by application of the group I mGlu receptor agonist (S)-3,5-Dihydroxyphenylglycine (DHPG) or induced by paired-pulse low frequency stimulation (PP-LFS). Conversely, PcTx1 did not affect LTD in P13-18 animals. We also provide evidence that ASIC1a is involved in group I mGlu receptor-induced increase in action potential firing. However, blockade of ASIC1a did not affect DHPG-induced polyphosphoinositide hydrolysis, suggesting the involvement of some other molecular partners in the functional crosstalk between ASIC1a and group I mGlu receptors. Notably, PcTx1 was able to prevent the increase in GluA1 S845 phosphorylation at the post-synaptic membrane induced by group I mGlu receptor activation. These findings suggest a novel function of ASIC1a channels in the regulation of group I mGlu receptor synaptic plasticity and intrinsic excitability.
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Affiliation(s)
- D Mango
- European Brain Research Institute, Rita Levi-Montalcini Foundation, Rome, Italy.
| | - E Braksator
- University of Bristol, Bristol BS8 1TD, United Kingdom
| | | | - S Marcelli
- European Brain Research Institute, Rita Levi-Montalcini Foundation, Rome, Italy; Sapienza University of Rome, Rome, Italy
| | - N B Mercuri
- University of Rome Tor Vergata, Rome, Italy; I.R.C.C.S. Santa Lucia Foundation, Rome, Italy
| | - M Feligioni
- European Brain Research Institute, Rita Levi-Montalcini Foundation, Rome, Italy; Casa Cura Policlinico (CCP), Department of Neurorehabilitation Sciences, Milan, Italy
| | - F Nicoletti
- I.R.C.C.S. Neuromed, Pozzilli, Italy; Sapienza University of Rome, Rome, Italy
| | - Z I Bashir
- University of Bristol, Bristol BS8 1TD, United Kingdom
| | - R Nisticò
- European Brain Research Institute, Rita Levi-Montalcini Foundation, Rome, Italy; University of Rome Tor Vergata, Rome, Italy.
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Leone F, Benanti E, Marchesi A, Marcelli S, Gazzola R, Vaienti L. Surgical excision of Infantile Haemangiomas: a technical refinement to prevent bleeding complications. Pediatr Med Chir 2014; 36:7. [PMID: 25573642 DOI: 10.4081/pmc.2014.7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 11/13/2014] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The aim of the study is to improve operative speed and precision of haemangiomas excision. METHODS CASE-REPORT haemangioma is a common affection of the 8% of the population during the neonatal period. In complicated cases and involution sequelae surgical treatment is the first choice. The Authors propose a surgical refinement to prevent intraoperative bleeding. METHODS several suture stitches were placed around the hemangioma. The edges of the lesion became more defined, thus allowing accurate excision. RESULTS AND CONCLUSIONS Haemangiomas are characterized by rich blood supply. Surgery is often hindered by massive bleeding and Temporary placement of full-thickness sutures, surrounding the hemangioma, allowed a noticeable improvement in hemostasis precision and greater definition of the margins of the hemangioma.
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Affiliation(s)
- F Leone
- Plastic Surgery Department, Università degli Studi di Milano, IRCCS Policlinico San Donato Milanese, Milano.
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Picchio M, Mansueto M, Crivellaro C, Guerra L, Marcelli S, Arosio M, Sironi S, Gianolli L, Grimaldi A, Messa C. PET/CT and contrast enhanced CT in single vs. two separate sessions: a cost analysis study. Q J Nucl Med Mol Imaging 2012; 56:309-316. [PMID: 22510702] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM Aim of the study was to quantify the economic impact of PET/CT and contrast enhanced (c.e.) CT performed in a single session examination vs. stand-alone modalities in oncological patients. METHODS One-hundred-forty-five cancer patients referred to both PET/CT and c.e. CT, to either stage (N.=46) or re-stage (N.=99) the disease, were included. Seventy-two/145 performed both studies in a single session (innovative method) and 73/145 in two different sessions (traditional method). The cost-minimization analysis was performed by evaluating: 1) institutional costs, data obtained by hospital accountability (staff, medical materials, equipment maintenance and depreciation, departments utilities); 2) patients costs, data obtained by a specific survey provided to patients (travel, food, accommodation costs, productivity loss). RESULTS Economic data analysis showed that the costs for innovative method was lower than those of traditional method, both for Institution (106 € less per test) and for patient (21 € less per patient). The loss of productivity for patient and caregivers resulted lower for the innovative method than the traditional method (3 work-hour less per person). CONCLUSION PET/CT and c.e. CT performed in a single session is more cost-effective than stand-alone modalities, by reducing both Institutional and patients costs. These advantages are mainly due to lower Institutional cost (single procedure) and to lower cost related to travel and housing.
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Affiliation(s)
- M Picchio
- Nuclear Medicine Department, San Raffaele Scientific Institute, Milan, Italy
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Friedman HS, Johnson SP, Dong Q, Schold SC, Rasheed BK, Bigner SH, Ali-Osman F, Dolan E, Colvin OM, Houghton P, Germain G, Drummond JT, Keir S, Marcelli S, Bigner DD, Modrich P. Methylator resistance mediated by mismatch repair deficiency in a glioblastoma multiforme xenograft. Cancer Res 1997; 57:2933-6. [PMID: 9230204] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A methylator-resistant human glioblastoma multiforme xenograft, D-245 MG (PR), in athymic nude mice was established by serially treating the parent xenograft D-245 MG with procarbazine. D-245 MG xenografts were sensitive to procarbazine, temozolomide, N-methyl-N-nitrosourea, 1,3-bis(2-chloroethyl)-1-nitrosourea, 9-aminocamptothecin, topotecan, CPT-11, cyclophosphamide, and busulfan. D-245 MG (PR) xenografts were resistant to procarbazine, temozolomide, N-methyl-N-nitrosourea, and busulfan, but they were sensitive to the other agents. Both D-245 MG and D-245 MG (PR) xenografts displayed no O6-alkylguanine-DNA alkyltransferase activity, and their levels of glutathione and glutathione-S-transferase were similar. D-245 MG xenografts expressed the human mismatch repair proteins hMSH2 and hMLH1, whereas D-245 MG (PR) expressed hMLH1 but not hMSH2.
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Affiliation(s)
- H S Friedman
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina 27710, USA
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Moynihan K, Elion GB, Ali-Osman F, Marcelli S, Keir S, Bigner DD, Friedman HS. Enhancement of melphalan activity by inhibition of DNA polymerase-alpha and DNA polymerase-beta. Cancer Chemother Pharmacol 1996; 38:349-54. [PMID: 8674158 DOI: 10.1007/s002800050494] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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] [Indexed: 02/01/2023]
Abstract
Our previous studies exploring melphalan resistance in the human rhabdomyosarcoma xenograft TE-671 MR revealed elevation of DNA polymerase-alpha and DNA polymerase-beta. The present study evaluated the alteration of melphalan activity in TE-671 (melphalan-sensitive) and TE-671 MR (melphalan-resistant) subcutaneous xenografts in nude mice after DNA polymerase-alpha was inhibited using aphidicolin glycinate (AG) and DNA polymerase-beta was inhibited using dideoxycytidine (DDC). Administration of AG or DDC did not produce toxicity or demonstrate antineoplastic activity when given alone. AG (90 mg/m2) enhanced the activity of melphalan against TE-671, with growth delays increasing by 8.4, 15.8, and 21.2 days over the regimen with melphalan only. AG (180 mg/m2) only modestly increased melphalan activity against TE-671 MR, with the growth delays increasing from 9.6 and 12.1 days using melphalan alone to 12.1 and 14.5 days using melphalan plus AG. AG (180 mg/m2) plus melphalan (the dose lethal to 10% of animals) produced greater weight loss compared with melphalan alone, whereas DDC plus melphalan produced no additional toxicity. DDC modestly enhanced the activity of melphalan plus AG against TE-671 MR. AG plus O6-benzylguanine did not increase the activity of 1,3-bis(2-chloroethyl)-1-nitrosourea against TE-671 or TE-671 MR. AG (90 mg/m2 and 180 mg/m2) inhibited DNA polymerase-alpha to 80% and 72% of control in TE-671 and 64% and 37% in TE-671 MR, and DDC inhibited DNA polymerase-beta to 59% in TE-671 and 48% in TE-671 MR. These results suggest a role for AG-mediated enhancement of melphalan activity, particularly in the treatment of newly diagnosed, melphalan-sensitive tumors.
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Affiliation(s)
- K Moynihan
- Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA
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Friedman HS, Dolan ME, Pegg AE, Marcelli S, Keir S, Catino JJ, Bigner DD, Schold SC. Activity of temozolomide in the treatment of central nervous system tumor xenografts. Cancer Res 1995; 55:2853-7. [PMID: 7796412] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The activity of 8-carbamoyl-3-methylimidazo[5,1-d]-1,2,3,5-tetrazin- 4(3H)-one (temozolomide) in the treatment of a panel of xenografts derived from ependymoma, medulloblastoma, and childhood and adult high-grade glioma was evaluated in athymic nude mice bearing s.c. and intracranial tumors. Temozolomide administered daily for a total of five doses demonstrated marked activity against a panel of Mer+ xenografts despite marginal to moderate activity of 1,3-bis(2-chloroethyl)-1-nitrosourea. The growth delays produced by temozolomide in these xenografts were 1.8-7.5-fold greater than those produced by procarbazine. Although temozolomide demonstrated marginal activity against the Mer+ cell line D341 Med when a 5-day schedule was used, a high-dose 1-day schedule resulted in moderate activity. Temozolomide produced increases in median survival of 1285% (adult glioma D-54 MG), 323% (childhood glioma D-456 MG), and 68% (ependymoma D612 EP). Pretreatment of mice with O6-benzylguanine increased temozolomide-induced mortality, requiring reduction of the dosage from 1200 to 750 mg/m2 on the single-day regimen. O6-Benzylguanine pretreatment of mice bearing Mer+ D341 Med increased the growth delay of temozolomide, in duplicate experiments, from -3.1 to 4.8 and 1.1 to 4.9 days. These studies suggest that temozolomide may be active in the treatment of a broad spectrum of central nervous system cancers, including Mer+ tumors resistant to 1,3-bis(2-chloroethyl)-1-nitrosourea.
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Affiliation(s)
- H S Friedman
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina 27710, USA
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