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Calò L, Crescenzi C, Martino A, Casella M, Romeo F, Cappelletto C, Bressi E, Panattoni G, Stolfo D, Targetti M, Toso E, Musumeci MB, Tini G, Ciabatti M, Stefanini M, Silvetti E, Stazi A, Danza ML, Rebecchi M, Canestrelli S, Fedele E, Lanzillo C, Fusco A, Sangiuolo FC, Oliviero G, Radesich C, Perotto M, Pieroni M, Golia P, Mango R, Gasperetti A, Autore C, Merlo M, de Ruvo E, Russo AD, Olivotto I, Sinagra G, Gaita F. The Diagnostic Value of the 12-Lead ECG in Arrhythmogenic Left Ventricular Cardiomyopathy: Novel ECG Signs. JACC Clin Electrophysiol 2023; 9:2615-2627. [PMID: 37768253 DOI: 10.1016/j.jacep.2023.08.020] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Electrocardiographic (ECG) findings in arrhythmogenic left ventricular cardiomyopathy (ALVC) are limited to small case series. OBJECTIVES This study aimed to analyze the ECG characteristics of ALVC patients and to correlate ECG with cardiac magnetic resonance and genotype data. METHODS We reviewed data of 54 consecutive ALVC patients (32 men, age 39 ± 15 years) and compared them with 84 healthy controls with normal cardiac magnetic resonance. RESULTS T-wave inversion was often noted (57.4%), particularly in the inferior and lateral leads. Low QRS voltages in limb leads were observed in 22.2% of patients. The following novel ECG findings were identified: left posterior fascicular block (LPFB) (20.4%), pathological Q waves (33.3%), and a prominent R-wave in V1 with a R/S ratio ≥0.5 (24.1%). The QRS voltages were lower in ALVC compared with controls, particularly in lead I and II. At receiver-operating characteristic analysis, the sum of the R-wave in I to II ≤8 mm (AUC: 0.909; P < 0.0001) and S-wave in V1 plus R-wave in V6 ≤12 mm (AUC: 0.784; P < 0.0001) effectively discriminated ALVC patients from controls. It is noteworthy that 4 of the 8 patients with an apparently normal ECG were recognized by these new signs. Transmural late gadolinium enhancement was associated to LPFB, a R/S ratio ≥0.5 in V1, and inferolateral T-wave inversion, and a ringlike pattern correlated to fragmented QRS, SV1+RV6 ≤12 mm, low QRS voltage, and desmoplakin alterations. CONCLUSIONS Pathological Q waves, LPFB, and a prominent R-wave in V1 were common ECG signs in ALVC. An R-wave sum in I to II ≤8 mm and SV1+RV6 ≤12 mm were specific findings for ALVC phenotypes compared with controls.
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Affiliation(s)
- Leonardo Calò
- Division of Cardiology, Policlinico Casilino, Rome, Italy.
| | | | | | - Michela Casella
- Cardiology and Arrhythmology Clinic, University Cardiology Hospital Ospedali Riuniti, Ancona, Italy
| | - Fabiana Romeo
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Chiara Cappelletto
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Edoardo Bressi
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | | | - Davide Stolfo
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Mattia Targetti
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Elisabetta Toso
- Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Maria Beatrice Musumeci
- Cardiology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Giacomo Tini
- Cardiology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | | | | | - Elisa Silvetti
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | | | | | - Marco Rebecchi
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | | | - Elisa Fedele
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | | | - Armando Fusco
- Division of Radiology, Policlinico Casilino, Rome, Italy
| | | | - Giada Oliviero
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Cinzia Radesich
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Maria Perotto
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | | | - Paolo Golia
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Ruggiero Mango
- Cardiology Unit, Department of Emergency and Critical Care, Policlinico Tor Vergata, Rome, Italy
| | | | - Camillo Autore
- Cardiology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Marco Merlo
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | | | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, University Cardiology Hospital Ospedali Riuniti, Ancona, Italy
| | - Iacopo Olivotto
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy; Cardiology Unit, Meyer University Children Hospital IRCCS, University of Florence, Florence, Italy
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Fiorenzo Gaita
- Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
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Castelli L, Iacovelli C, Loreti C, Malizia AM, Barone Ricciardelli I, Tomaino A, Fusco A, Biscotti L, Padua L, Giovannini S. Robotic-assisted rehabilitation for balance in stroke patients (ROAR-S): effects of cognitive, motor and functional outcomes. Eur Rev Med Pharmacol Sci 2023; 27:8198-8211. [PMID: 37750648 DOI: 10.26355/eurrev_202309_33580] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
OBJECTIVE Due to the aging population, the incidence of stroke is steadily increasing. In patients with stroke outcomes, sensory, motor and cognitive problems limit the performance of activities of daily living. The development of new technologies in rehabilitation is improving the quality and efficiency of functional recovery. Hunova robotic platform (Movendo Technology, srl, Genoa, Italy) is a robotic device for functional assessment and rehabilitation of balance. The purpose of this study is to evaluate the effects of rehabilitation with Hunova on cognitive function and balance in older adults with stroke. PATIENTS AND METHODS This is a randomized, controlled, single-blind study. Twenty-four older adults with stroke outcomes were randomized into the Hunova group (HuG), which performed a specific rehabilitation program for balance using Hunova for 12 sessions in addition to conventional rehabilitation, and the control group (CoG), which performed only conventional rehabilitation. All patients underwent a clinical cognitive, balance, quality of life and fatigue assessment, and an instrumental balance assessment with Hunova at the beginning and end of treatment. RESULTS Statistical analysis showed significant improvements in most clinical scales in both groups. Comparing the groups, HuG showed greater improvements in executive functions, speed of information processing, attention and discrimination of multiple stimuli, static and dynamic balance and autonomy in daily activities, standing postural sway, and trunk control in static and dynamic conditions. CONCLUSIONS Data analysis showed that elderly with stroke who underwent balance technology treatment with Hunova in combination with conventional treatment had a greater improvement in cognitive functions, balance and reduced risk of falling.
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Affiliation(s)
- L Castelli
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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De Zan G, Calò L, Borrelli A, Guglielmo M, De Ruvo E, Rier S, van Driel V, Ramanna H, Patti G, Rebecchi M, Fusco A, Stefanini M, Simonetti G, van der Bilt I. Cardiac magnetic resonance-guided cardiac ablation: a case series of an early experience. Eur Heart J Suppl 2023; 25:C265-C270. [PMID: 37125279 PMCID: PMC10132610 DOI: 10.1093/eurheartjsupp/suad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Radiofrequency (RF) catheter ablation has become a widely used therapeutic approach. However, long-term results in terms of arrhythmia recurrence are still suboptimal. Cardiac magnetic resonance (CMR) could offer a valuable tool to overcome this limitation, with the possibility of targeting the arrhythmic substrate and evaluating the location, depth, and possible gaps of RF lesions. Moreover, real-time CMR-guided procedures offer a radiation-free approach with an evaluation of anatomical structures, substrates, RF lesions, and possible complications during a single procedure. The first steps in the field have been made with cavotricuspid isthmus ablation, showing similar procedural duration and success rate to standard fluoroscopy-guided procedures, while allowing visualization of anatomic structures and RF lesions. These promising results open the path for further studies in the context of more complex arrhythmias, like atrial fibrillation and ventricular tachycardias. Of note, setting up an interventional CMR (iCMR) centre requires safety and technical standards, mostly related to the need for CMR-compatible equipment and medical staff's educational training. For the cardiac imagers, it is fundamental to provide correct CMR sequences for catheter tracking and guide RF delivery. At the same time, the electrophysiologist needs a rapid interpretation of CMR images during the procedures. The aim of this paper is first to review the logistic and technical aspects of setting up an iCMR suite. Then, we will describe the experience in iCMR-guided flutter ablations of two European centres, Policlinico Casilino in Rome, Italy, and Haga Teaching Hospital in The Hague, the Netherlands.
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Affiliation(s)
- Giulia De Zan
- Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Corso Mazzini 18, Novara 28100, Italy
- Cardiology Division, Department of Cardiology, Haga Teaching Hospital, Els Borst-Eilersplein 275, Postbus 40551, The Hague 2504 LN, The Netherlands
| | - Leonardo Calò
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Alessio Borrelli
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Marco Guglielmo
- Cardiology Division, Department of Cardiology, Haga Teaching Hospital, Els Borst-Eilersplein 275, Postbus 40551, The Hague 2504 LN, The Netherlands
- Department of Cardiology, Division of Heart and Lungs, Utrecht University, Utrecht University Medical Center, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands
| | - Ermenegildo De Ruvo
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Sophie Rier
- Cardiology Division, Department of Cardiology, Haga Teaching Hospital, Els Borst-Eilersplein 275, Postbus 40551, The Hague 2504 LN, The Netherlands
| | - Vincent van Driel
- Cardiology Division, Department of Cardiology, Haga Teaching Hospital, Els Borst-Eilersplein 275, Postbus 40551, The Hague 2504 LN, The Netherlands
| | - Hemanth Ramanna
- Cardiology Division, Department of Cardiology, Haga Teaching Hospital, Els Borst-Eilersplein 275, Postbus 40551, The Hague 2504 LN, The Netherlands
- Department of Medical Technology, The Hague University of Applied Sciences, Johanna Westerdijkplein 75, The Hague 2521 EN, The Netherlands
| | - Giuseppe Patti
- Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Corso Mazzini 18, Novara 28100, Italy
| | - Marco Rebecchi
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Armando Fusco
- Department of Radiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Matteo Stefanini
- Department of Radiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Giovanni Simonetti
- Department of Radiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
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Crescenzi C, Silvetti E, Romeo F, Martino A, Bressi E, Panattoni G, Stefanini M, Stazi A, Danza ML, Rebecchi M, Canestrelli S, Fedele E, Lanza O, Lanzillo C, Fusco A, Golia P, De Ruvo E, Calò L. The electrocardiogram in non-ischaemic-dilated cardiomyopathy. Eur Heart J Suppl 2023; 25:C179-C184. [PMID: 37125290 PMCID: PMC10132560 DOI: 10.1093/eurheartjsupp/suad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
This article summarizes the main electrocardiogram (ECG) findings in dilated cardiomyopathy (DCM) patients. Recent reports are described in the great 'pot' of DCM peculiar ECG patterns that are typical of specific forms of DCM. Patients with late gadolinium enhancement on CMR, who are at greatest arrhythmic risk, have also distinctive ECG features. Future studies in large DCM populations should evaluate the diagnostic and prognostic value of the ECG.
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Affiliation(s)
- Cinzia Crescenzi
- Corresponding author. Tel: +39 06 23188406, Fax: +39 06 23188410,
| | - Elisa Silvetti
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Fabiana Romeo
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Annamaria Martino
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Edoardo Bressi
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Germana Panattoni
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Matteo Stefanini
- Division of Radiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Alessandra Stazi
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Maria Ludovica Danza
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Marco Rebecchi
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Stefano Canestrelli
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Elisa Fedele
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Oreste Lanza
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Chiara Lanzillo
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Armando Fusco
- Division of Radiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Paolo Golia
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Ermenegildo De Ruvo
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
| | - Leonardo Calò
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Roma, Italy
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Fusco A, De Ruvo E, Stefanini M, Borrelli A, Ferrazza A, De Luca L, Simonetti G, Calò L. MR guided cardiac ablation: how to build an interventional magnetic resonance suite and what's the role of the imaging. Eur Heart J Suppl 2023; 25:C185-C188. [PMID: 37125310 PMCID: PMC10132626 DOI: 10.1093/eurheartjsupp/suad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Magnetic resonance (MR) represents a new interesting imaging approach for guiding electrophysiology (EP)-based ablation procedures of atrial flutter and typical atrial fibrillation. This new approach permits to reach good results if compared with conventional EP ablation. Tissue characterization by MR permits to detect cardiac anatomy and pathological substrate like myocardial scars well visualized with late gadolinium enhancement (LGE) sequences. Intra-procedural imaging is useful to real-time follow the catheter during the ablation procedure and at the same time to visualize cardiac anatomy in addition to understanding if the ablation is correctly performed using oedema sequences. Performing cardiac ablations inside an MR room permits to reduce radiation exposure and occupational illnesses.
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Affiliation(s)
| | | | - Matteo Stefanini
- Department of Diagnostic Imaging and Interventional Radiology, Casilino Hospital, Via Casilina 1049, Rome, Italy
| | - Alessio Borrelli
- Department of Cardiology, Casilino Hospital, Via Casilina 1049, Rome, Italy
| | - Alessandro Ferrazza
- Department of Diagnostic Imaging and Interventional Radiology, Casilino Hospital, Via Casilina 1049, Rome, Italy
| | - Lucia De Luca
- Department of Cardiology, Casilino Hospital, Via Casilina 1049, Rome, Italy
| | - Giovanni Simonetti
- Department of Diagnostic Imaging and Interventional Radiology, Casilino Hospital, Via Casilina 1049, Rome, Italy
| | - Leonardo Calò
- Department of Diagnostic Imaging and Interventional Radiology, Casilino Hospital, Via Casilina 1049, Rome, Italy
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Calò L, Oliviero G, Crescenzi C, Romeo F, Martino A, Bressi E, Stefanini M, Silvetti E, Danza L, Rebecchi M, Canestrelli S, Fedele E, Lanzillo C, Fusco A, De Ruvo E. Electrocardiogram in arrhytmogenic cardiomyopathy. Eur Heart J Suppl 2023; 25:C169-C172. [PMID: 37125311 PMCID: PMC10132580 DOI: 10.1093/eurheartjsupp/suad019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Criteria for diagnosis of arrhythmogenic cardiomyopathy (ACM) were first proposed in 1994 and subsequently revised in 2010 and in 2020 by an international task force. According to the last consensus of 2020, ACM is defined as a heart muscle disease affecting right ventricle, left ventricle or both, whose principal pathologic feature is fibrofatty myocardial replacement that impairs systolic ventricular function and predisposes to lethal ventricular arrhythmias. ECG findings not only could help to early recognize affected patients but also could identify the ones with maximum risk of ventricular arrhythmias and sudden cardiac death.
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Affiliation(s)
- Leonardo Calò
- Corresponding author. Tel: +39 06 23188406, Fax: +39 06 23188410,
| | - Giada Oliviero
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Cinzia Crescenzi
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Fabiana Romeo
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Annamaria Martino
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Edoardo Bressi
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Matteo Stefanini
- Division of Radiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Elisa Silvetti
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Ludovica Danza
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Marco Rebecchi
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Stefano Canestrelli
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Elisa Fedele
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Chiara Lanzillo
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Armando Fusco
- Division of Radiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Ermenegildo De Ruvo
- Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
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Lanzillo C, Fedele E, Martino A, Ferrazza A, Fusco A, Silvetti E, Canestrelli S, Romeo F, Canali E, De Luca L, Golia P, Crescenzi C, Stefanini M, Calò L. Cardiac magnetic resonance in Fabry disease. Eur Heart J Suppl 2023; 25:C200-C204. [PMID: 37125302 PMCID: PMC10132562 DOI: 10.1093/eurheartjsupp/suad045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Fabry disease (FD) is a rare X-linked inherited lysosomal storage disorder caused by deficient a-galactosidase A activity that leads to an accumulation of glycolipids, mainly globotriaosylceramide (Gb3) and globotriaosylsphingosine, in affected tissues, including the heart. Cardiovascular involvement usually manifests as left ventricular hypertrophy (LVH), myocardial fibrosis, heart failure, and arrhythmias, which limit the quality of life and represent the most common causes of death. Following the introduction of enzyme replacement therapy, early diagnosis and treatment have become essential in slowing down the disease progression and preventing major cardiac complications. Recent advances in the understanding of FD pathophysiology suggest that in addition to Gb3 accumulation, other mechanisms contribute to the development of cardiac damage. FD cardiomyopathy is characterized by an earlier stage of glycosphingolipid accumulation and a later one of hypertrophy. Morphological and functional aspects are not specific in the echocardiographic evaluation of Anderson-Fabry disease. Cardiac magnetic resonance with tissue characterization capability is an accurate technique for the differential diagnosis of LVH. Progress in imaging techniques has improved the diagnosis and staging of FD-related cardiac disease: a decreased myocardial T1 value is specific of FD. Late gadolinium enhancement is typical of the later stage of cardiac involvement but as in other cardiomyopathy is also valuable to predict the outcome and cardiac response to therapy.
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Affiliation(s)
| | - Elisa Fedele
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Annamaria Martino
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Alessandro Ferrazza
- Department of Radiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Armando Fusco
- Department of Radiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Elisa Silvetti
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Stefano Canestrelli
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Fabiana Romeo
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Emanuele Canali
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Lucia De Luca
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Paolo Golia
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Cinzia Crescenzi
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Matteo Stefanini
- Department of Radiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
| | - Leonardo Calò
- Department of Cardiology, Policlinico Casilino, Via Casilina 1049, Rome 00169, Italy
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Rovere G, Fusco A, Smakaj A, De Mauro D, De Vitis R, Padua L, Meccariello L, Fidanza A, Erasmo R, Peresson M, Noia G, Maccagnano G, Maccauro G, Liuzza F. Preliminary data on the neurophysiological evaluation of male sexual dysfunction in patients with pelvic ring fractures: a multicenter retrospective study. Eur Rev Med Pharmacol Sci 2023; 27:3457-3466. [PMID: 37140295 DOI: 10.26355/eurrev_202304_32116] [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: 05/05/2023]
Abstract
OBJECTIVE Traumatic pelvic ring fractures include several comorbidities due to the close anatomical relationship between the skeletal system, pelvic organs, and neurovascular structures. In this retrospective multicenter study, we evaluated patients complaining of sexual dysfunction following pelvic ring fractures, assessed through different neuro-physiological examinations. PATIENTS AND METHODS Patients were enrolled one year after the injury according to their reported ASEX scores and evaluated on the basis of the Tile's type of pelvic fracture. Lower limb and sacral somatosensory evoked potentials, pelvic floor electromyography, bulbocavernosus reflex and pelvic floor motor evoked potentials were recorded, according to the neurophysiological indications. RESULTS A total of 14 male patients (mean age 50.4; 8 subjects Tile-type B and 6 Tile-type C) were enrolled. The ages between the Tile B group and the Tile C group of patients were not significantly different (p=0.187), while the ASEX scores were significantly different (p=0.014). In 57% of patients (n=8), no alterations in nerve conduction and/or pelvic floor neuromuscular responses were found. In 6 patients, electromyographic signs of denervation were revealed (2 patients), and alterations of the sacral efferent nerve component were detected in 4 patients. CONCLUSIONS Sexual dysfunctions after a traumatic pelvic ring fracture are more common in Tile-type B. Our preliminary data did not reveal a significant association with neurogenic aetiology. Other causes could explain the complaining impairments.
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Affiliation(s)
- G Rovere
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, UOC Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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Giovannini S, Brau F, Iacovelli C, Gerardino L, Bellieni A, Fusco A, Loreti C, Biscotti L, Bernabei R. A snapshot of geriatric rehabilitation: one year experience. Eur Rev Med Pharmacol Sci 2022; 26:6995-7006. [PMID: 36263547 DOI: 10.26355/eurrev_202210_29883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
OBJECTIVE Frailty is a common condition in older adults, characterized by multimorbidity, physical weakness and nutritional deficit. Frailty can be detected early and a prehabilitation treatment could reduce the incidence of disability. PATIENTS AND METHODS Two-hundred-fifteen elderly patients were admitted to the Rehabilitation and Physical Medicine Unit of Policlinico Gemelli for one year. Patients were clinically assessed by Charlson Comorbidity Index (CCI) and blood sample values. Numerical Pain Rating Scale (NRS) and Hand Grip Test were assessed before (T0) and after (T1) hospitalization. Number of drugs and number of infections were recorded. RESULTS Patients were originally hospitalized in orthopaedic, neurology and medical ward. Most patients (68%) after discharge return home. Negative correlations between albumin and CCI and between total protein and CCI were recorded. Positive correlation between CCI cognitive subscore and number of drugs and a negative correlation between that subscore and Vitamin D were detected. An improvement in NRS and in the handgrip strength was recorded. At discharge an increase in the number of drugs and the number of infections was noted. CONCLUSIONS The handgrip strength improvement increases quality of life. Pain management and NRS indicate a better recovery of activities of daily living. Malnutrition is a real problem; albumin is the principal negative acute-phase reactant and is related to a worse clinical condition and low vitamin D levels are associated with worse cognitive function. The goal of a Rehabilitation Unit is to create an effective multidisciplinary transitional care plan, involving the patient and caregivers, creating a continuity of care after discharge and a sustainable project.
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Affiliation(s)
- S Giovannini
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy.
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Mattera A, Brignoli M, Coscia V, Fusco A, Diana V, Chianese R, De Michele A, Concilio C, Pariggiano I, Viscusi M, Calabrò P. P236 LONG TERM FOLLOW UP WITH A DRASTIC REDUCTION OF HOSPITALIZATION IN HEART FAILURE PATIENT WITH MULTIPLE AETIOLOGIES TREATED WITH CARDIAC CONTRACTILITY MODULATION THERAPY: A CASE REPORT. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aims
Cardiac contractility modulation (CCM) shows to be a concrete therapeutic option in patients with symptomatic HF despite optimal medical therapy (OMT), with Left Ventricular Ejection Fraction (LVEF) between 25% and 45%, with narrow QRS complex (<130ms) for reduction of hospitalization and improvement Quality of life (QoL). This case aims to explore the effectiveness of CCM therapy in a patient affected by concomitant ischemic cardiomyopathy and cardiac amyloidosis (CA)
Methods
A 42–year–old man with Chronic HF secondary to both post–ischemic due to spontaneous coronary artery dissection (SCAD) and post alcoholic dilated cardiomyopathy was hospitalized at our department in February 2020 due to worsening HF (3rd HF hospitalization in the same year). The patient was a NYHA class III, with chronic kidney failure, a narrow QRS complex (100 ms) and a LVEF of 27% with familiar history of sudden death, already implanted with ICD. The patient resulted untreatable with Sacubitril/Valsartan, as it elicited strong hypotension. During current hospitalization the BNP value was 942,60 pg/ml, and the Quality of Life (QoL) evaluated from Minnesota Living with Heart Failure Questionnaire (MLHFQ) score was 72 points. Moreover, the patient underwent umbilical biopsy that confirmed the presence of amyloidosis. Thus, the CCM therapy device (Optimizer® Smart, Impulse Dynamics) was implanted to try to reduce HF symptoms and hospitalizations (Fig 1 A/B).
Results
The patient significantly improved as early as the first period after implantation. The 10–month in–office FU performed on December 2020 revealed in addition to the absence of new HF hospitalizations, a significant improvement in QoL and HF–symptoms, with a MLWHFQ score of 42, an enhancement to NHYA class II and even a slight decrease of BNP of 767 pg/ml. The echo exam revealed no significant changes in the EF, with an improvement of global longitudinal strain and no worsening of other hemodynamic parameters. A further FU performed in June 2021 showed continuous improvement of QoL (MLWHFQ = 25) e no HF hospitalizations.
Conclusions
In this patient affected by multiple cardiomyopathies, including CA, CCM therapy proved to improve its QoL with no HF hospital admissions since the implantation. The absence of significant echocardiographic worsening is a positive aspect, considering the patient’s status, the concomitant aetiologies, and the presence of amyloidosis, given its progressive and infiltrative nature.
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Affiliation(s)
- A Mattera
- AORN SANT‘ANNA E SAN SEBASTIANO, CASERTA; UNIVERSITÀ DELLA CAMPANIA – VANVITELLI, CASERTA
| | - M Brignoli
- AORN SANT‘ANNA E SAN SEBASTIANO, CASERTA; UNIVERSITÀ DELLA CAMPANIA – VANVITELLI, CASERTA
| | - V Coscia
- AORN SANT‘ANNA E SAN SEBASTIANO, CASERTA; UNIVERSITÀ DELLA CAMPANIA – VANVITELLI, CASERTA
| | - A Fusco
- AORN SANT‘ANNA E SAN SEBASTIANO, CASERTA; UNIVERSITÀ DELLA CAMPANIA – VANVITELLI, CASERTA
| | - V Diana
- AORN SANT‘ANNA E SAN SEBASTIANO, CASERTA; UNIVERSITÀ DELLA CAMPANIA – VANVITELLI, CASERTA
| | - R Chianese
- AORN SANT‘ANNA E SAN SEBASTIANO, CASERTA; UNIVERSITÀ DELLA CAMPANIA – VANVITELLI, CASERTA
| | - A De Michele
- AORN SANT‘ANNA E SAN SEBASTIANO, CASERTA; UNIVERSITÀ DELLA CAMPANIA – VANVITELLI, CASERTA
| | - C Concilio
- AORN SANT‘ANNA E SAN SEBASTIANO, CASERTA; UNIVERSITÀ DELLA CAMPANIA – VANVITELLI, CASERTA
| | - I Pariggiano
- AORN SANT‘ANNA E SAN SEBASTIANO, CASERTA; UNIVERSITÀ DELLA CAMPANIA – VANVITELLI, CASERTA
| | - M Viscusi
- AORN SANT‘ANNA E SAN SEBASTIANO, CASERTA; UNIVERSITÀ DELLA CAMPANIA – VANVITELLI, CASERTA
| | - P Calabrò
- AORN SANT‘ANNA E SAN SEBASTIANO, CASERTA; UNIVERSITÀ DELLA CAMPANIA – VANVITELLI, CASERTA
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11
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Savioli G, Lapia F, Bosoni T, Alunno G, Rigano G, Coppola L, Fusco A, Lo Bello A, Brattoli M, Fumoso F, Novelli V, Muzzi A, Mugellini A, Martignoni A, Cutti S, Di Sabatino A. P341 DANTE (DIAGNOSTIC ACUTE PATIENT TOOL IN EMERGENCY) & BEATRICE (BEDSIDE ECHOCARDIOGRAPHIC ASSESMENT FOR IMPROVE CLINICAL EVALUATION) FOR GERIATRIC PATIENTS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objectives
To determine whether comprehensive quantitative bed side echocardiogram could be used as a usual assessment tool in acute geriatric patients and to assess its effect on patient care.
Design
Retrospective. Setting: DEA di II livello IRCSS Policlinico san Matteo.
Patients
Acute ill medical, trauma and surgical patients. A doctor enrolled in the discipline of emergency medicine was assigned to perform bedside echocardiograms of acute inpatients. This work took only geriatric patients into consideration. (> 65aa). Interventions: The Bedside Echocardiographic AssesmenT foR Improve Clinical Evaluetion (BEATRICE), a comprehensive transthoracic echocardiogram was performed.
Measurements and Main Results
6–month period, 369 BEATRICEs were performed. The mean patient age was 76.2 (±14.3) years. 95% were hospitalized in medical departments and 5% in surgical ward. In 97.4% of cases BEATRICE was performed in a timely manner. The ejection fraction, cardiac index and the volumetric indices of the left ventricle is reported in 97% of the reports. Estimated stroke volume, longitudinal systolic function with tissue Doppler and atrium study is reported in 99.7%, 98.6% and 98.9% of BEATRICE studies. The study of diastolic and atrium function is reported in 99.3% and 98.9% of the reports respectively. Estimated left ventricular filling pressures are reported in 98.3% of the measurements. Information on the vena cava reported for 98%. Right heart function was assessed for 91.8%. Mean or systolic right ventricular pressures, or both, were also estimated in 91.9% of the reports. The BEATRICE was judged to be useful by the consulting primary care team in over 96% of cases, BEATRICEs allow the modification of therapy or the diagnostic process in over 40% of cases (in 27% of cases they allow to significantly modify the therapy and in 16% of cases they allow to significantly modify the diagnostic therapeutic procedure) and speeding up the diagnostic process in over 30% of cases.
Conclusions
The BEATRICE is feasible and alters care in the intensive care unit by providing clinical data not otherwise available at the bedside. Further studies are warranted to assess the impact of comprehensive echocardiogram–directed resuscitation on patient outcomes.
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Affiliation(s)
- G Savioli
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - F Lapia
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - T Bosoni
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - G Alunno
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - G Rigano
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - L Coppola
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - A Fusco
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - A Lo Bello
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - M Brattoli
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - F Fumoso
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - V Novelli
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - A Muzzi
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - A Mugellini
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - A Martignoni
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - S Cutti
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - A Di Sabatino
- EMERGENCY DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA; UNIVERSITY OF PAVIA, PAVIA; DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; INTERNAL MEDICINE IRCCS POLICLINICO SAN MATTEO, DIREZIONE MEDICA DI PRESIDIO IRCCS POLICLINICO SAN MATTEO, PAVIA; DIRECTOR OF INTERNAL MEDICINE DEPARTMENT, IRCCS POLICLINICO SAN MATTEO, PAVIA
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12
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Palmiero G, Rubino M, Lioncino M, Monda E, Vetrano E, Verrillo F, Dongiglio F, Fusco A, Cirillo A, Caiazza M, Ascione L, Caso P, Limongelli G. Pathophysiological, haemodynamic and prognostic implications of left atrial dysfunction in cardiac amyloidosis and other cardiomyopathies with hypertrophic phenotype. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND & PURPOSE. Left atrial function (LAF) is a determinant of clinical status and outcome in many cardiac disorders, including cardiac amyloidosis (CA). Aim of this study is to explores the LAF in CA and other cardiomyopathies with hypertrophic phenotype, and its consequences on cardiovascular haemodynamics, right ventricular function and survival.
METHODS. We enrolled 50 patients with CA (26 AL and 24 wtATTR) and 75 with hypertrophic phenotype (LVH group) [25 hypertrophic cardiomyopathy (HCM) pts, 25 hypertensive pts (HypCM), and 25 pts with aortic stenosis (AS)]. LAF was analysed using the phasic method [LAEI as reservoir, LAPEF as conduit, LAAEF as active pump and TLAEF as total emptying function; see figure 1] by LA volumes determination.
RESULTS. ATTR patients showed higher LA dimensions and impaired reservoir and total LA emptying function (TLAEF) compared to AL without differences LAF. Compared to the LVH group, CA patients showed higher LA dimension with impaired LAF in all phasic parameters, higher LV filling pressures and reduced biventricular function. We further divided CA and LVH patients into four subgroups based on the presence or absence of LA dysfunction (LADys+ for TLAEF values below the median: <50.2%; range 9.3-70.9%]. Among the groups, patients with CA/LADys+ showed worst clinical status, higher pulmonary pressures (sPAP) and lower TAPSE and TAPSE/sPAP ratio values. After a median follow-up of 24 months, 19 patients died from cardiovascular (CV) causes (15 in CA/LADys+ group and 4 in LVH/LADys+). The overall survival free of CV death was 64% in CA/LADys+ and 85% in LVH/LADys+ (4/26) group [log-rank χ2 29.6; p < 0.0001]. A sequential multivariate model was employed to assess whether LAF could predict CV deaths: TLAEF was entered together with established clinical and echocardiographic parameters (NYHA functional class, LAVI, E/Em, sPAP, TAPSE and TAPSE/sPAP ratio). At the final backward analysis, LAVI, TAPSE/sPAP and TLAEF were independent prognosticators of CV death.
CONCLUSIONS. LAF is significantly more impaired in CA than LVH group and is associated with worst clinical status, RV dysfunction and higher LV filling and pulmonary pressure. Moreover, LADys is a frequent feature of CA and significantly associated with higher CV mortality. We suggests that LADys in LVH group could results from chronic pressure overload due to LA"s exposure to high LV diastolic pressure (impaired LV compliance). In CA, LADys could also be determined by direct LA infiltration. The pathophysiological result is a progressive LA remodelling with increased LA pressure, consequent backward transmission to the pulmonary venous system and, ultimately, RV dysfunction. TLAEF is parameter of LAF that correlates with increased pulmonary vascular resistance (measured elsewhere with cardiac catheterisation) and RV dysfunction. In CA, it seems promising as marker of the haemodynamic consequences of LADys and CV mortality. Abstract Figure 1 Abstract Figure 2
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Affiliation(s)
- G Palmiero
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - M Rubino
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - M Lioncino
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - E Monda
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - E Vetrano
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - F Verrillo
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - F Dongiglio
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - A Fusco
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - A Cirillo
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - M Caiazza
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - L Ascione
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - P Caso
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - G Limongelli
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
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13
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Palmiero G, Rubino M, Monda E, Lioncino M, Verrillo F, Vetrano E, Caiazza M, Fusco A, Cirillo A, Dongiglio F, Ascione L, Caso P, Limongelli G. Diagnostic and prognostic implications of myocardial work in cardiac amyloidosis and in genetic and non-genetic cardiomyopathies with hypertrophic phenotype. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND & PURPOSE. Cardiac amyloidosis (CA) is an infiltrative disorder characterized by left ventricular (LV) thickening with early systolic and diastolic dysfunction. Due to it poor prognosis, and the beneficial impact of novel treatments when started in early stages of disease, its forward detection is crucial. Aim of this study is comparing the diagnostic accuracy of classical and novel echocardiographic parameters in detecting CA among other forms of genetic and non-genetic cardiomyopathies with hypertrophic phenotype.
METHODS. We enrolled 50 pts with CA (26 AL and 24 wtATTR) and 75 phenocopies (LVH group) [25 hypertrophic cardiomyopathy (HCM) pts, 25 hypertensive (HypCM) pts, and 25 pts with non-severe aortic stenosis (AS)]. Standard and novel LV morpho-functional echo parameters [LV ejection fraction (LVEF), myocardial contraction fraction (MCF), global longitudinal strain (GLS), relative regional strain ratio (RRSR), ejection fraction on strain ratio (EFSR)], and novel Myocardial Work (MW) parameters [Global Work Index (GWI), Global Constructive Work (GCW), Global Wasted Work (GWW), Global Work Efficiency (GWE)] were analyzed.
RESULTS. LV standard, novel and MW-derived systolic parameters were more impaired in CA compared to LVH group. At ROC curve analysis, GCW showed the best performance in discriminating CA from other forms of LVH (AUC 0.886; 95% CI: 0.819-0.954; P < 0.0001), with a cut-off value < 1473 mmHg% showing 90% of sensitivity and 82% of specificity). At linear regression analysis, GCW correlated with many echocardiographic parameters (IVSD, PWD, RWT ratio, LVMi, MCF, LVESV, LVEF, EFSR and RRSR). At multivariate analysis, PWD (P < 0,029) and RWT ratio (p < 0,014) were the only parameters associated with GCW. At 24 months follow-up, there were 15 deaths in CA and 4 in LVH group. At Kaplan-Meier analysis the overall survival free of cardiovascular death was reduced in the lowest GCW interquartile ranges (log-rank χ2 21.5; p < 0.0001). At Cox hazard ratio analysis, GCW was the only prognostic parameter associated with cardiovascular mortality (β 1.006; 95% CI: 1.003-1.009; P < 0.0001).
CONCLUSIONS. Despite CA and LVH patients shows a similar phenotype, the systolic function differs greatly. In the present study, the GCW showed the best ability in detecting CA among other forms of LVH. Its reduction in CA seems reflect the infiltrative burden and its consequences on myocardial deformation properties, while its reduction in LVH group has been attributed elsewhere to fibrotic derangement. GCW showed to be a promising novel diagnostic and prognostic factor in this setting. Abstract Figure 1 Abstract Table 1
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Affiliation(s)
- G Palmiero
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - M Rubino
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - E Monda
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - M Lioncino
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - F Verrillo
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - E Vetrano
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - M Caiazza
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - A Fusco
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - A Cirillo
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - F Dongiglio
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - L Ascione
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - P Caso
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - G Limongelli
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
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14
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Palmiero G, Rubino M, Monda E, Lioncino M, Verrillo F, Dongiglio F, Caiazza M, Vetrano E, Cirillo A, Fusco A, Ascione L, Caso P, Limongelli G. Diagnostic and prognostic implications of right ventricular-arterial coupling in cardiac amyloidosis and in genetic and non-genetic cardiomyopathies with hypertrophic phenotype. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND & PURPOSE. Right ventricular (RV) dysfunction in cardiomyopathies is a consequence of chronic overload (i.e. aortic stenosis, AS) or direct involvement of systemic disorders (i.e. cardiac amyloidosis, CA). The Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure (TAPSE/sPAP) ratio has been recently proposed as a surrogate of RV-arterial coupling (RVAC). This study aims to compare RVAC between CA subgroups and between CA and other forms of genetic and non-genetic cardiomyopathies with hypertrophic phenotype.
METHODS. We enrolled 50 patients with CA (26 AL and 24 wtATTR) and 75 cardiomyopathies with hypertrophy phenotype (LVH group) [25 pts with hypertrophic cardiomyopathy (HCM), 25 hypertensive pts(HypCM), and 25 pts with AS]. Besides routine echocardiographic measurements, we analysed right chambers dimensions and classical and novel parameters of RV function [TAPSE, TAPSE/sPAP, St wave, global (RVGLS) and free-wall (RVFWS) strain].
RESULTS. Compared to AL, the ATTR group showed higher right chambers dimensions, without differences in all RV systolic parameters. Compared to the LVH group, CA patients showed no differences in RV dimensions while RV systolic parameters, including the TAPSE/sPAP ratio, were significantly reduced in the presence of significantly higher LV filling pressures. At ROC curve analysis, TAPSE (AUC 0.877; 95% CI: 0.811-0.943; p < 0,0001) and TAPSE/sPAP ratio (AUC 0.859; 95% CI: 0.783-0.935; p < 0,0001) showed the best ability in discriminating CA among other forms of LVH (cut-off 20.5 mm for TAPSE with sensibility of 80.5% and specificity of 78.8%, respectively; cut-off 0.62 for TAPSE/sPAP ratio with sensibility of 85.4% and specificity 81.8%). At 24 months follow-up, there were 15 deaths in CA (30%) and 4 in LVH group (5%). At Kaplan-Meier estimation, the TAPSE/sPAP ratio showed progressively a significantly reduced survival in the lowest interquartile ranges. Moreover, at multivariate analysis, TAPSE/sPAP was the only independent prognostic factor (β -5,644; 95% IC: 0,000-0,522; p < 0,027).
CONCLUSIONS. The RVAC is significantly impaired in CA compared to the LVH group but not between CA subgroups. Its reduction seems attributable to both increase LV filling pressure, due to the restrictive nature of the infiltrative cardiomyopathy, and reduced RV systolic function, due to either indirect RV chronic overload and direct myocardial infiltration. The TAPSE/sPAP ratio is a surrogate of RVAC and proved to be a novel echocardiographic parameter useful in both discriminating CA among genetic and non-genetic forms of LVH, and stratifying the prognosis. Abstract Table 1 Abstract Figure 1
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Affiliation(s)
- G Palmiero
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - M Rubino
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - E Monda
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - M Lioncino
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - F Verrillo
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - F Dongiglio
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - M Caiazza
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - E Vetrano
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - A Cirillo
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - A Fusco
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - L Ascione
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - P Caso
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
| | - G Limongelli
- AORN Ospedali dei Colli - Monaldi Hospital, Department of Cardiology, Naples, Italy
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15
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Rice CE, Carpenter LA, Morrier MJ, Lord C, DiRienzo M, Boan A, Skowyra C, Fusco A, Baio J, Esler A, Zahorodny W, Hobson N, Mars A, Thurm A, Bishop S, Wiggins LD. Defining in Detail and Evaluating Reliability of DSM-5 Criteria for Autism Spectrum Disorder (ASD) Among Children. J Autism Dev Disord 2022; 52:5308-5320. [PMID: 34981308 DOI: 10.1007/s10803-021-05377-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 12/24/2022]
Abstract
This paper describes a process to define a comprehensive list of exemplars for seven core Diagnostic and Statistical Manual (DSM) diagnostic criteria for autism spectrum disorder (ASD), and report on interrater reliability in applying these exemplars to determine ASD case classification. Clinicians completed an iterative process to map specific exemplars from the CDC Autism and Developmental Disabilities Monitoring (ADDM) Network criteria for ASD surveillance, DSM-5 text, and diagnostic assessments to each of the core DSM-5 ASD criteria. Clinicians applied the diagnostic exemplars to child behavioral descriptions in existing evaluation records to establish initial reliability standards and then for blinded clinician review in one site (phase 1) and for two ADDM Network surveillance years (phase 2). Interrater reliability for each of the DSM-5 diagnostic categories and overall ASD classification was high (defined as very good .60-.79 to excellent ≥ .80 Kappa values) across sex, race/ethnicity, and cognitive levels for both phases. Classification of DSM-5 ASD by mapping specific exemplars from evaluation records by a diverse group of clinician raters is feasible and reliable. This framework provides confidence in the consistency of prevalence classifications of ASD and may be further applied to improve consistency of ASD diagnoses in clinical settings.
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Affiliation(s)
- C E Rice
- Emory University, Atlanta, GA, USA. .,Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - L A Carpenter
- Medical University of South Carolina, Charleston, SC, USA
| | | | - C Lord
- University of California Los Angeles, Los Angeles, CA, USA
| | - M DiRienzo
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Boan
- Medical University of South Carolina, Charleston, SC, USA
| | - C Skowyra
- Washington University in St. Louis, St. Louis, MO, USA
| | - A Fusco
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - J Baio
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Esler
- University of Minnesota, Minneapolis, MN, USA
| | - W Zahorodny
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - N Hobson
- Independent Consultant, Keller, TX, USA
| | - A Mars
- Hunterdon Healthcare System, Flemington, NJ, USA
| | - A Thurm
- National Institute of Mental Health, Bethesda, MD, USA
| | - S Bishop
- University of California San Francisco, San Francisco, CA, USA
| | - L D Wiggins
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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16
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Monda E, Verrillo F, Altobelli I, Lioncino M, Caiazza M, Rubino M, Cirillo A, Fusco A, Di Fraia F, Pacileo R, Gragnano F, Passariello A, Calabro' P, Russo MG, Limongelli G. Natural history of left ventricular hypertrophy in infants of diabetic mothers. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Left ventricular hypertrophy (LVH) in infants of diabetic mothers (IDMs) has been generally considered a benign condition, which usually regresses as the stimulus for the insulin production disappears, resulting in normalized left ventricular wall thickness in the 6 months of life. However, these conclusions have been based on small, mostly outdated cohort studies. Indeed, it has been recently shown that increased left ventricular mass persists in late infancy (6 to 12 months), long after the intrauterine exposure has been removed, suggesting that other factors may potentially contribute.
Purpose
This study sought to describe the characteristics and the natural course of LVH in a well-characterized consecutive cohort of IDMs.
Methods
Sixty consecutive IDMs with LVH have been retrospectively identified and enrolled in the study. All IDMs were evaluated at baseline and every 6 months until LV wall thickness regression, defined as the decrease of wall thickness measurement into the normal reference range for cardiac parameters (z-score >−2 and <2). A comprehensive assessment was performed in those patients with diagnostic markers suggestive of a different cause and/or without significant reduction of the LVH during follow-up.
Results
At 1-year follow-up, all IDMs showed a significant reduction of maximal wall thickness (MWT) (MWT-mm: 6.67±2.37 vs. 5.83±1.70, p-value<0.001; MWT-z-score: 6.67±4.71 vs. 2.39±2.55, p-value<0.001) and left ventricular outflow tract (LVOT) gradient (15.35±15.58 vs. 11.22±8.14, p-value<0.004), compared to baseline, and all patients showed LV wall thickness regression or residual mild or moderate LVH (57%, 28%, and 12%, respectively) (Figure 1), except 2 patients with persistent severe LVH, that after a comprehensive clinical-genetic assessment were diagnosed as Noonan syndrome with multiple lentigines.
At multivariate analysis, MWT was significantly associated with LV wall thickness regression at 1-year follow-up (MWT-mm: OR 0.48 [0.29–0.79], p-value=0.004; MWT-z-score: OR 0.71 [0.56–0.90], p-value=0.004) in an inversely proportional fashion.
Overall, 59%, 72% and 79% of IDMs with LVH showed a complete LV wall thickness regression at 1-year, 2-year and 3-year follow-up, respectively (Figure 2). Excluding the two patients with a different cause of LVH, all IDMs showed a LV wall thickness regression in the first 6 years of life.
Conclusions
LVH in IDMs represents a benign condition with complete regression during the first years of life. In those patients without LV wall thickness regression, combined with clinical markers suggesting a specific disease, a complete work-up is required for a definite diagnosis.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- E Monda
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - F Verrillo
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - I Altobelli
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - M Lioncino
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - M Caiazza
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - M Rubino
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - A Cirillo
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - A Fusco
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - F Di Fraia
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - R Pacileo
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - F Gragnano
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - A Passariello
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - P Calabro'
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - M G Russo
- University della Campania Luigi Vanvitelli, Naples, Italy
| | - G Limongelli
- University della Campania Luigi Vanvitelli, Naples, Italy
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17
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Leggio M, Fusco A, Coraci D, Villano A, Filardo G, Mazza A, Loreti C, Serafini E, Biscotti L, Bernabei R, Padua L, Giovannini S. Exercise training and atrial fibrillation: a systematic review and literature analysis. Eur Rev Med Pharmacol Sci 2021; 25:5163-5175. [PMID: 34486691 DOI: 10.26355/eurrev_202108_26530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE There are concerns in maintaining adequate levels of physical activity in patients with atrial fibrillation (AF). This could be related to the type of exercise delivered, different among studies, as the words used to describe it as treatment. We have analysed the state-of-art of the role of the exercise in AF by a mathematical analysis. This analysis documented the connections between topics and updated the available evidence through a systematic review of the current literature. MATERIALS AND METHODS A literature search was conducted using specific terms for studies published between 2000 and 2019. For the descriptive analysis of the current literature, we used the LExical Network analysed by the Graph THeory (LENGTH) method, while to perform our review we followed the PRISMA statement. Downs and Black Quality Index was also used to assess the quality of studies. The LENGTH approach indicated nonspecific terms as "exercise", "physical" and "activity" as more representative than "rehabilitation" to describe the intervention. RESULTS The systematic review identified nine studies on 882 patients of moderate (n=4) to good (n=5) quality. Training consisted of a combination of supervised ambulatory and home-based outpatient programs, focused on aerobic elements (endurance and resistance training, walking, treadmill and bicycle ergometer). Significant improvements in 6-minute walking test distance and peak oxygen uptake and in quality of life were obtained, with high adherence to training and no serious/significant adverse events. Only one trial was based on cardiac rehabilitation principles. CONCLUSIONS Adequate exercise training can get a favourable cardiovascular outcome in patients with AF.
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Affiliation(s)
- M Leggio
- Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit, San Filippo Neri Hospital, Rome, Italy.
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18
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Fornaro M, Novello S, Fusco A, Anastasia A, De Prisco M, Mondin AM, Mosca P, Iasevoli F, de Bartolomeis A. Clinical features associated with early drop-out among outpatients with unipolar and bipolar depression. J Psychiatr Res 2021; 136:522-528. [PMID: 33127073 DOI: 10.1016/j.jpsychires.2020.10.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/08/2020] [Accepted: 10/16/2020] [Indexed: 11/26/2022]
Abstract
Drop-out from follow-up visits carries significant burden for people diagnosed with depression. The present study assesses multiple clinical moderators of drop-out among depressed outpatients. We retrospectively followed-up 131 outpatients over 6 months: 78 major depressive disorder (MDD), and 53 bipolar disorder (BD-I = 24; BD-II = 29) patients diagnosed according to the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. Participants were assessed with standard rating scales administered by experienced psychiatrists. Upon descriptive and Cox regression analyses, 17/53 BDs (32%) dropped-out; the overall survival time until drop-out was 57.94 ± 17.79 days. BD drop-outs were younger, had an earlier age at onset, shorter illness duration, lower rates of lifetime obsessive-compulsive disorder/suicidal behavior, higher rates of substance use disorder (SUD), anxious and mixed features of depression compared to BDs attending up to six months. Among MDD patients, 10/78 cases (13%) dropped-out by month-6 with an average survival of 42.40 ± 16.45 days. Earlier age of onset, younger age, positive family history for mood disorders, lower rates of lifetime generalized anxiety disorder were significantly more frequent among drop-outs than completers, as opposite to SUD, and lifetime recurrent depression. Older age predicted lower drop-out among BDs and MDDs, although with almost null hazard ratio (HR) = 0.928, p < 0.01 vs. HR = 0.941, p < 0.01, respectively. Higher rates of lifetime SUD predicted higher drop-out rates by month-6 among MDDs (HR = 5.477, p = 0.02). Limitations of the study: retrospective design, small sample size, lack of objective measures of treatment-adherence/mood rating during follow-up. Drop-out is common in the real-world setting, warranting specific interventions since the beginning of the treatment.
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Affiliation(s)
- M Fornaro
- Section of Psychiatry - Unit on Treatment-Resistant Disorders, Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - S Novello
- National Healthcare System, Milan, Italy.
| | - A Fusco
- National Healthcare System, Naples, Italy.
| | | | - M De Prisco
- Section of Psychiatry - Unit on Treatment-Resistant Disorders, Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - A M Mondin
- Section of Psychiatry - Unit on Treatment-Resistant Disorders, Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - P Mosca
- Section of Psychiatry - Unit on Treatment-Resistant Disorders, Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - F Iasevoli
- Section of Psychiatry - Unit on Treatment-Resistant Disorders, Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - A de Bartolomeis
- Section of Psychiatry - Unit on Treatment-Resistant Disorders, Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
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19
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Leggio M, Villano A, Fusco A, Mazza A. Hyperlipidemia management during the COVID-19 pandemic: PCSK9 inhibitors to enhance the antiviral action of interferon. Eur Rev Med Pharmacol Sci 2021; 25:2166-2167. [PMID: 33755951 DOI: 10.26355/eurrev_202103_25205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M Leggio
- Clinical and Rehabilitative Cardiology Unit, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy.
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20
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Crescenzi C, Zorzi A, Vessella T, Martino A, Panattoni G, Cipriani A, De Lazzari M, Perazzolo Marra M, Fusco A, Sciarra L, Sperandii F, Guerra E, Tranchita E, Fossati C, Pigozzi F, Sarto P, Calò L, Corrado D. Predictors of Left Ventricular Scar Using Cardiac Magnetic Resonance in Athletes With Apparently Idiopathic Ventricular Arrhythmias. J Am Heart Assoc 2020; 10:e018206. [PMID: 33381977 PMCID: PMC7955495 DOI: 10.1161/jaha.120.018206] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background In athletes with ventricular arrhythmias (VA) and otherwise unremarkable clinical findings, cardiac magnetic resonance (CMR) may reveal concealed pathological substrates. The aim of this multicenter study was to evaluate which VA characteristics predicted CMR abnormalities. Methods and Results We enrolled 251 consecutive competitive athletes (74% males, median age 25 [17‐39] years) who underwent CMR for evaluation of VA. We included athletes with >100 premature ventricular beats/24 h or ≥1 repetitive VA (couplets, triplets, or nonsustained ventricular tachycardia) on 12‐lead 24‐hour ambulatory ECG monitoring and negative family history, ECG, and echocardiogram. Features of VA that were evaluated included number, morphology, repetitivity, and response to exercise testing. Left‐ventricular late gadolinium‐enhancement was documented by CMR in 28 (11%) athletes, mostly (n=25) with a subepicardial/midmyocardial stria pattern. On 24‐hour ECG monitoring, premature ventricular beats with multiple morphologies or with right‐bundle‐branch‐block and intermediate/superior axis configuration were documented in 25 (89%) athletes with versus 58 (26%) without late gadolinium‐enhancement (P<0.001). More than 3300 premature ventricular beats were recorded in 4 (14%) athletes with versus 117 (53%) without positive CMR (P<0.001). At exercise testing, nonsustained ventricular tachycardia occurred at peak of exercise in 8 (29%) athletes with late gadolinium‐enhancement (polymorphic in 6/8, 75%) versus 17 athletes (8%) without late gadolinium‐enhancement (P=0.002), (P<0.0001). At multivariable analysis, all 3 parameters independently correlated with CMR abnormalities. Conclusions In athletes with apparently idiopathic VA, simple characteristics such as number and morphology of premature ventricular beats on 12‐lead 24‐hour ambulatory ECG monitoring and response to exercise testing predicted the presence of concealed myocardial abnormalities on CMR. These findings may help cost‐effective CMR prescription.
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Affiliation(s)
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health University of Padova Italy
| | | | | | | | - Alberto Cipriani
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health University of Padova Italy
| | - Manuel De Lazzari
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health University of Padova Italy
| | - Martina Perazzolo Marra
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health University of Padova Italy
| | - Armando Fusco
- Department of Radiology Policlinico Casilino Rome Italy
| | - Luigi Sciarra
- Division of Cardiology Policlinico Casilino Rome Italy
| | - Fabio Sperandii
- Division of Cardiology Policlinico Casilino Rome Italy.,Department of Movement, Human and Health Sciences University of Rome 'Foro Italico' Rome Italy
| | - Emanuele Guerra
- Division of Cardiology Policlinico Casilino Rome Italy.,Department of Movement, Human and Health Sciences University of Rome 'Foro Italico' Rome Italy
| | - Eliana Tranchita
- Department of Movement, Human and Health Sciences University of Rome 'Foro Italico' Rome Italy
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences University of Rome 'Foro Italico' Rome Italy
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences University of Rome 'Foro Italico' Rome Italy.,Villa Stuart Sport Clinic FIFA Medical Centre of Excellence Rome Italy
| | - Patrizio Sarto
- Center for Sports Medicine ULSS2 Marca Trevigiana Treviso Italy
| | - Leonardo Calò
- Division of Cardiology Policlinico Casilino Rome Italy.,Villa Stuart Sport Clinic FIFA Medical Centre of Excellence Rome Italy
| | - Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health University of Padova Italy
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21
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Oliva F, Vittadini F, Frizziero A, Costantino C, Fusco A, Giai Via A, Foti C, Nanni G, Forte A, Biz C, Vulpiani M, De Carli A, Berardi A, Fini M, Padulo J, Maffulli N. I.S.Mu.L.T. Reccomendations for Intra and Periarticular Injections during COVID19 Pandemic. Muscles Ligaments Tendons J 2020. [DOI: 10.32098/mltj.03.2020.00] [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: 11/05/2022]
Affiliation(s)
- F. Oliva
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - F. Vittadini
- Department of Physical and Rehabilitation Medicine, Casa di Cura Policlinico San Marco, Venice, Italy
| | - A. Frizziero
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - C. Costantino
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - A. Fusco
- Clinical Laboratory of Experimental Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome, Italy
| | - A. Giai Via
- Department of Emergency and Acceptance, Orthopaedics and Traumatology Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | - C. Foti
- Physical and Rehabilitation Medicine, University of Rome Tor Vergata, Rome, Italy
| | - G. Nanni
- Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - A. Forte
- Biomedical Research Centre, Gruppo Forte, Salerno, Italy
| | - C. Biz
- Department of Surgery, Oncology and Gastroenterology DiSCOG, Orthopedic Clinic, University of Padova, Padova, Italy
| | - M.C. Vulpiani
- Physical Medicine and Rehabilitation Unit, SantAndrea Hospital, Sapienza University of Rome, Rome, Italy
| | - A. De Carli
- Physical Medicine and Rehabilitation Unit, SantAndrea Hospital, Sapienza University of Rome, Rome, Italy
| | - A. Berardi
- UOC Immunohematology and Transfusion Medicine Laboratories, Laboratory of Stem Cells, Spirito Santo Hospital, Pescara, Italy
| | - M. Fini
- Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopedic Institute, Bologna, Italy
| | - J. Padulo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - N. Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy
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22
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Di Bella G, Imazio M, Bogaert J, Pizzino F, Camastra G, Monti L, Dellegrottaglie S, Donato R, Moro C, Pepe A, Lanzillo C, Pontone G, Marra MP, Fusco A, Scatteia A, Pingitore A, Aquaro GD. Clinical Value and Prognostic Impact of Pericardial Involvement in Acute Myocarditis. Circ Cardiovasc Imaging 2019; 12:e008504. [PMID: 30755055 DOI: 10.1161/circimaging.118.008504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Gianluca Di Bella
- Clinical and Experimental Department of Medicine, University of Messina, Italy (G.D.B., R.D.)
| | - Massimo Imazio
- Cardiology Department, Maria Vittoria Hospital, Torino, Italy (M.I.).,Department of Public Health and Pediatrics, University of Torino, Italy (M.I.)
| | - Jan Bogaert
- Department of Radiology, UZ Leuven, Belgium (J.B.)
| | - Fausto Pizzino
- Cardiology Department, Gabriele Monasterio Foundation-Consiglio Nazionale delle Ricerche Region Toscana, Pisa, Italy (F.P., G.D.A.).,Scuola Superiore Sant'Anna di studi e di Perfezionamento Universiario, Institute of Life Sciences, Pisa, Italy (F.P.)
| | | | - Lorenzo Monti
- Radiology Department, Humanitas Research Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy (L.M.)
| | - Santo Dellegrottaglie
- Division of Cardiology, Villa dei Fiori, Acerra, Napoli, Italy (S.D.).,Mount Sinai School of Medicine, New York, NY (S.D.)
| | - Rocco Donato
- Clinical and Experimental Department of Medicine, University of Messina, Italy (G.D.B., R.D.)
| | - Claudio Moro
- UO Cardiologia e UTIC, ASST Monza, PO Desio (C.M.)
| | - Alessia Pepe
- Clinical and Experimental Department of Medicine, University of Messina, Italy (G.D.B., R.D.)
| | - Chiara Lanzillo
- Cardiology Department, Policlinico Casilino, Rome, Italy (C.L., A.F.)
| | - Gianluca Pontone
- Cardiac Department, Centro Cardiologico Monzino, Milano, Italy (G.P.)
| | - Martina Perazzolo Marra
- Division of Cardiology, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Italy (M.P.M.)
| | - Armando Fusco
- Cardiology Department, Policlinico Casilino, Rome, Italy (C.L., A.F.)
| | - Alessandra Scatteia
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (A.S.)
| | - Alessandro Pingitore
- Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy (A.P.)
| | - Giovanni Donato Aquaro
- Cardiology Department, Gabriele Monasterio Foundation-Consiglio Nazionale delle Ricerche Region Toscana, Pisa, Italy (F.P., G.D.A.)
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23
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Affiliation(s)
- M Leggio
- Cardiology Operative Unit, San Filippo Neri Hospital, Rome, Italy
| | - A Villano
- Institute of Cardiology, Catholic University of the Sacred Heart, University Hospital Policlinic A. Gemelli Foundation, Rome, Italy
| | - A Fusco
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
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24
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Della Pepa G, Monti S, Vetrani C, Vitale M, Izzo A, Lombardi G, Salamone D, Fusco A, Tommasone M, Clemente G, Bozzetto L, Annuzzi G, Mancini M, Mirabelli P, Salvatore M, Riccardi G, Rivellese A. Treating Non-Alcoholic Fatty Liver Disease In Patients With Type 2 Diabetes By Targeting Multiple Dietary Components: The Portfolio Diet. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.340] [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: 10/26/2022]
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25
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Scala E, Di Caprio R, Cacciapuoti S, Caiazzo G, Fusco A, Tortorella E, Fabbrocini G, Balato A. A new T helper 17 cytokine in hidradenitis suppurativa: antimicrobial and proinflammatory role of interleukin-26. Br J Dermatol 2019; 181:1038-1045. [PMID: 30829398 DOI: 10.1111/bjd.17854] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Interleukin (IL)-26 is a signature T helper 17 cytokine described as a proinflammatory and antimicrobial mediator. So far, IL-26 has been reported in several immune-mediated inflammatory diseases, but its involvement in inflammatory skin disorders is poorly known. OBJECTIVES To investigate the role of IL-26 in hidradenitis suppurativa (HS), through its involvement in antimicrobial activity. METHODS IL-26 was assessed in patients with HS through gene expression and protein analysis at skin and circulating levels. Ex vivo HS organ skin cultures, together with IL-26 antibody treatment, were performed to determine the IL-26 activity. Peripheral blood mononuclear cells (PBMCs) from patients with HS and healthy controls were either silenced or not with IL-26 small interfering (si)RNA in order to measure its antimicrobial, cytotoxic and phagocytic activities against Staphylococcus aureus. RESULTS Firstly, we observed that IL-26 is able to modulate the proinflammatory response at the immune cell level. IL-26 was increased in the plasma of patients with HS compared with healthy controls. Subsequently, we explored the bactericidal, cytotoxic and phagocytic activities of PBMCs against S. aureus in patients with HS and healthy controls. These activities were lower in patients with HS than in controls. Remarkably, the killing activities were reduced when healthy control PBMCs were transfected with IL-26 siRNA. However, the transfection did not affect the killing activity of HS PBMCs, supporting the idea that IL-26 lacks efficacy in HS. CONCLUSIONS Our findings suggest that infection susceptibility in HS might be related to IL-26. Although the role of bacteria remains controversial in HS, this paper supports that there is a defect of antimicrobial response in these patients. What's already known about this topic? Interleukin (IL)-26 is a T helper 17 cytokine described as an antimicrobial and proinflammatory mediator. IL-26 has been reported in immune-mediated inflammatory diseases, but its involvement in inflammatory skin disorders remains unclear. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterized by deficiency of IL-20 and IL-22 (a close homologue of IL-26), which causes antimicrobial peptide pauperization leading to severe and recurrent skin infections. What does this study add? IL-26 plasma levels are higher in patients with HS than in healthy control individuals. The antimicrobial activity of IL-26 might be ineffective in patients with HS. What is the translational message? Cutaneous antimicrobial incompetence in HS could be related to IL-26.
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Affiliation(s)
- E Scala
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - R Di Caprio
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - S Cacciapuoti
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - G Caiazzo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - A Fusco
- Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - E Tortorella
- Institute of Protein Biochemistry, National Research Council, Naples, Italy
| | - G Fabbrocini
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - A Balato
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
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Monzo L, Lanzillo C, Tota C, Lino S, Fusco A, Minati M, Martino A, Calò L. Sacubitril/valsartan effect on left ventricular remodeling: the case of a super-responder. Curr Med Res Opin 2019; 35:3-6. [PMID: 30894032 DOI: 10.1080/03007995.2019.1598704] [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] [Indexed: 10/27/2022]
Abstract
Sacubitril/valsartan has been shown to improve clinical outcomes in patients with heart failure and reduced ejection fraction (HFrEF), but its effects on left ventricular (LV) systolic function and reverse remodeling parameters remain to be established. We hereby describe the case of a 41 year old man with HFrEF and severe reduction of left ventricular ejection fraction (LVEF). The patient was first treated with triple HF therapy (beta-blocker, angiotensin converting enzyme inhibitor and mineralocorticoid antagonist), but after three months he was still symptomatic and with an LVEF firmly low. In consideration of poor response to therapy, we switched angiotensin converting enzyme inhibitor to sacubitril/valsartan to the maximum tolerated dose (49/51 mg bid) with a marked improvement in LV systolic function and reduction in LV volumes at follow-up. In light of the almost normalized LVEF the patient was also removed from the list for the implantation of a cardiac resynchronization therapy defibrillator. In conclusion, our case showed a strong beneficial effect of sacubitril/valsartan on reverse remodeling and LVEF beyond the benefits of concomitant optimal medical therapy. This result is particular noteworthy because it was obtained although the patient wasn't able to reach the full dose of the drug. Physicians should always consider this drug effect when more demanding therapeutic strategies are needed for their HF patients.
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Affiliation(s)
- Luca Monzo
- a Department of Cardiology , Policlinico Casilino - Rome , Italy
- b Department of Cardiovascular, Respiratory, Nephrological and Geriatric Sciences , "Sapienza" University - Rome , Italy
| | - Chiara Lanzillo
- a Department of Cardiology , Policlinico Casilino - Rome , Italy
| | - Claudia Tota
- a Department of Cardiology , Policlinico Casilino - Rome , Italy
| | - Stefano Lino
- a Department of Cardiology , Policlinico Casilino - Rome , Italy
| | - Armando Fusco
- c Department of Radiology , Policlinico Casilino - Rome , Italy
| | - Monia Minati
- a Department of Cardiology , Policlinico Casilino - Rome , Italy
| | | | - Leonardo Calò
- a Department of Cardiology , Policlinico Casilino - Rome , Italy
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Leggio M, Fusco A, Villano A, Limongelli G, Mazza A. Anti-inflammatory diet to reduce mortality: is it time for a precision medicine approach? J Intern Med 2019; 285:469-471. [PMID: 30450654 DOI: 10.1111/joim.12851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- M Leggio
- Cardiology Operative Unit, San Filippo Neri Hospital, Rome, Italy
| | - A Fusco
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - A Villano
- Institute of Cardiology, Catholic University of the Sacred Heart, University Hospital Policlinic A. Gemelli Foundation, Rome, Italy
| | - G Limongelli
- Cardiology Operative Unit, San Filippo Neri Hospital, Rome, Italy
| | - A Mazza
- Cardiology Division, Santa Maria della Stella Hospital, Orvieto, Italy
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28
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Castellano E, Attanasio R, Giagulli VA, Boriano A, Terzolo M, Papini E, Guastamacchia E, Monti S, Aglialoro A, Agrimi D, Ansaldi E, Babini AC, Blatto A, Brancato D, Casile C, Cassibba S, Crescenti C, De Feo ML, Del Prete A, Disoteo O, Ermetici F, Fiore V, Fusco A, Gioia D, Grassi A, Gullo D, Lo Pomo F, Miceli A, Nizzoli M, Pellegrino M, Pirali B, Santini C, Settembrini S, Tortato E, Triggiani V, Vacirca A, Borretta G. The basal to total insulin ratio in outpatients with diabetes on basal-bolus regimen. J Diabetes Metab Disord 2019; 17:393-399. [PMID: 30918874 PMCID: PMC6405380 DOI: 10.1007/s40200-018-0358-2] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 09/24/2018] [Indexed: 12/28/2022]
Abstract
Objective To evaluate the basal/total ratio of daily insulin dose (b/T) in outpatients with diabetes type 1 (DM1) and type 2 (DM2) on basal-bolus regimen, by investigating whether there is a relationship with HbA1c and episodes of hypoglycemia. Methods Multicentric, observational, cross-sectional study in Italy. Adult DM1 (n = 476) and DM2 (n = 541) outpatients, with eGFR >30 mL/min/1.73 m2, on a basal-bolus regimen for at least six months, were recruited from 31 Italian Diabetes services between March and September 2016. Clinicaltrials.govID: NCT03489031. Results Total daily insulin dose was significantly higher in DM2 patients (52.3 ± 22.5 vs. 46 ± 20.9 U/day), but this difference disappeared when insulin doses were normalized for body weight. The b/T ratio was lower than 0.50 in both groups: 0.46 ± 0.14 in DM1 and 0.43 ± 0.15 in DM2 patients (p = 0.0011). The b/T was significantly higher in the patients taking metformin in both groups, and significantly different according to the type of basal insulin (Degludec, 0.48 in DM1 and 0.44 in DM2; Glargine, 0.44 in DM1 and 0.43 in DM2; Detemir, 0.45 in DM1 and 0.39 in DM2). The b/T ratio was not correlated in either group to HbA1c or incidence of hypoglycemia (<40 mg/dL, or requiring caregiver intervention, in the last three months). In the multivariate analysis, metformin use and age were independent predictors of the b/T ratio in both DM1 and DM2 patients, while the type of basal insulin was an independent predictor only in DM1. Conclusion The b/T ratio was independent of glycemic control and incidence of hypoglycemia.
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Affiliation(s)
- Elena Castellano
- 1Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Via Michele Coppino 26, 12100 Cuneo, Italy
| | - R Attanasio
- 2Endocrinology Service, Galeazzi Institute, IRCCS, Milan, Italy
| | - V A Giagulli
- Outpatient Clinic for Endocrinology and Metabolic Diseases, Conversano Hospital, Conversano, Italy
| | - A Boriano
- 4Medical Physics Department, Santa Croce and Carle Hospital, Cuneo, Italy
| | - M Terzolo
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Hospital, Orbassano, Italy
| | - E Papini
- 6Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Albano Laziale, Italy
| | - E Guastamacchia
- Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Bari, Italy
| | - S Monti
- 8Endocrinology, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Rome, Italy
| | - A Aglialoro
- 9Metabolism and Diabetes Unit, San Martino Hospital, Genoa, Italy
| | - D Agrimi
- District Hospital, Azienda Sanitaria Locale, Brindisi, Italy
| | - E Ansaldi
- Department of Endocrinology and Diabetes, Santissimi Antonio e Biagio Hospital, Alessandria, Italy
| | - A C Babini
- Medical Division, Rimini Hospital, Rimini, Italy
| | - A Blatto
- 13Department of Endocrinology, Maria Vittoria Hospital, Torino, Italy
| | - D Brancato
- Department of Internal Medicine and Diabetology, Hospital of Partinico, Partinico, Italy
| | - C Casile
- 15Internal Medicine Department, Papardo Hospital, Messina, Italy
| | - S Cassibba
- 16Endocrinology and Diabetes, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - C Crescenti
- Department of Endocrinology and Diabetes, San Giovanni di Dio Hospital, Florence, Italy
| | - M L De Feo
- 18Endocrinology Unit, Careggi Hospital, Florence, Italy
| | - A Del Prete
- Outpatient Clinic for Diabetes, Azienda Sanitaria Locale, Civita Castellana, Italy
| | - O Disoteo
- 20Diabetology Department, Niguarda Hospital, Milan, Italy
| | - F Ermetici
- 21Endocrinology and Metabolism, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - V Fiore
- Angelucci Hospital, Subiaco, Italy
| | - A Fusco
- 23Antidiabetic Center AID, Garibaldi Hospital, Naples, Italy
| | - D Gioia
- Department of Endocrinology, Villa Sofia Hospital, Palermo, Italy
| | - A Grassi
- 25Division of Endocrinology, Mauriziano Umberto I Hospital, Torino, Italy
| | - D Gullo
- Endocrinology, Department of Clinical and Experimental Medicine, Garibaldi-Nesima Medical Center, Catania, Italy
| | - F Lo Pomo
- 27Division of Endocrinology, San Carlo Hospital, Potenza, Italy
| | - A Miceli
- 15Internal Medicine Department, Papardo Hospital, Messina, Italy
| | - M Nizzoli
- Department of Endocrinology, Morgagni Hospital, Forlì, Italy
| | - M Pellegrino
- 1Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Via Michele Coppino 26, 12100 Cuneo, Italy
| | - B Pirali
- 29Unit of Internal Medicine, Humanitas Mater Domini, Castellanza, Italy
| | - C Santini
- 30Department of Endocrinology and Diabetology, Bufalini Hospital, Cesena, Italy
| | - S Settembrini
- Diabetology Service, Azienda Sanitaria Locale Na 1, Naples, Italy
| | - E Tortato
- Diabetology Service, Augusto Murri Hospital, Fermo, Italy
| | - V Triggiani
- Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Bari, Italy
| | - A Vacirca
- Department of Internal Medicine, Imola Hospital, Imola, Italy
| | - G Borretta
- 1Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Via Michele Coppino 26, 12100 Cuneo, Italy
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Leggio M, Fusco A, D'Emidio S, Severi P, Lombardi M, Caldarone E, Armeni M, Mereu D, Bendini MG, Mazza A. Management of oral anticoagulation in patients with atrial fibrillation: newer agents, newer conundrums? J Intern Med 2018; 284:697-699. [PMID: 29658167 DOI: 10.1111/joim.12755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Leggio
- Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit, San Filippo Neri Hospital - Salus Infirmorum Clinic, Rome, Italy
| | - A Fusco
- Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy
| | - S D'Emidio
- Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy
| | - P Severi
- Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit, San Filippo Neri Hospital - Salus Infirmorum Clinic, Rome, Italy.,Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy
| | - M Lombardi
- Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy
| | - E Caldarone
- Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy
| | - M Armeni
- Department of Research, EDUCAM (C.R.O.M.O.N., S.Os.I, A.I.R.O.P.), Rome, Italy
| | - D Mereu
- Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy
| | - M G Bendini
- Cardiology Division, Santa Maria della Stella Hospital, Orvieto, Italy
| | - A Mazza
- Cardiology Division, Santa Maria della Stella Hospital, Orvieto, Italy
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30
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Castellano E, Attanasio R, Giagulli VA, Boriano A, Terzolo M, Papini E, Guastamacchia E, Monti S, Aglialoro A, Agrimi D, Ansaldi E, Babini AC, Blatto A, Brancato D, Casile C, Cassibba S, Crescenti C, De Feo ML, Del Prete A, Disoteo O, Ermetici F, Fiore V, Fusco A, Gioia D, Grassi A, Gullo D, Lo Pomo F, Miceli A, Nizzoli M, Pellegrino M, Pirali B, Santini C, Settembrini S, Tortato E, Triggiani V, Vacirca A, Borretta G. Correction to: The basal to total insulin ratio in outpatients with diabetes on basal-bolus regimen. J Diabetes Metab Disord 2018; 17:401-402. [PMID: 30919831 PMCID: PMC6405401 DOI: 10.1007/s40200-018-0370-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
[This corrects the article DOI: 10.1007/s40200-018-0358-2.].
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Affiliation(s)
- Elena Castellano
- 1Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Via Michele Coppino 26, 12100 Cuneo, Italy
| | - R Attanasio
- 2Endocrinology Service, Galeazzi Institute, IRCCS, Milan, Italy
| | - V A Giagulli
- Outpatient Clinic for Endocrinology and Metabolic Diseases, Conversano Hospital, Conversano, Italy
| | - A Boriano
- 4Medical Physics Department, Santa Croce and Carle Hospital, Cuneo, Italy
| | - M Terzolo
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Hospital, Orbassano, Italy
| | - E Papini
- 6Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Albano Laziale, Italy
| | - E Guastamacchia
- Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Bari, Italy
| | - S Monti
- 8Endocrinology, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Rome, Italy
| | - A Aglialoro
- 9Metabolism and Diabetes Unit, San Martino Hospital, Genoa, Italy
| | - D Agrimi
- District Hospital, Azienda Sanitaria Locale, Brindisi, Italy
| | - E Ansaldi
- Department of Endocrinology and Diabetes, Santissimi Antonio e Biagio Hospital, Alessandria, Italy
| | - A C Babini
- Medical Division, Rimini Hospital, Rimini, Italy
| | - A Blatto
- 13Department of Endocrinology, Maria Vittoria Hospital, Torino, Italy
| | - D Brancato
- Department of Internal Medicine and Diabetology, Hospital of Partinico, Partinico, Italy
| | - C Casile
- 15Internal Medicine Department, Papardo Hospital, Messina, Italy
| | - S Cassibba
- 16Endocrinology and Diabetes, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - C Crescenti
- Department of Endocrinology and Diabetes, San Giovanni di Dio Hospital, Florence, Italy
| | - M L De Feo
- 18Endocrinology Unit, Careggi Hospital, Florence, Italy
| | - A Del Prete
- Outpatient Clinic for Diabetes, Azienda Sanitaria Locale, Civita Castellana, Italy
| | - O Disoteo
- 20Diabetology Department, Niguarda Hospital, Milan, Italy
| | - F Ermetici
- 21Endocrinology and Metabolism, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - V Fiore
- Angelucci Hospital, Subiaco, Italy
| | - A Fusco
- 23Antidiabetic Center AID, Garibaldi Hospital, Naples, Italy
| | - D Gioia
- Department of Endocrinology, Villa Sofia Hospital, Palermo, Italy
| | - A Grassi
- 25Division of Endocrinology, Mauriziano Umberto I Hospital, Torino, Italy
| | - D Gullo
- Endocrinology, Department of Clinical and Experimental Medicine, Garibaldi-Nesima Medical Center, Catania, Italy
| | - F Lo Pomo
- 27Division of Endocrinology, San Carlo Hospital, Potenza, Italy
| | - A Miceli
- 15Internal Medicine Department, Papardo Hospital, Messina, Italy
| | - M Nizzoli
- Department of Endocrinology, Morgagni Hospital, Forlì, Italy
| | - M Pellegrino
- 1Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Via Michele Coppino 26, 12100 Cuneo, Italy
| | - B Pirali
- 29Unit of Internal Medicine, Humanitas Mater Domini, Castellanza, Italy
| | - C Santini
- 30Department of Endocrinology and Diabetology, Bufalini Hospital, Cesena, Italy
| | - S Settembrini
- Diabetology Service, Azienda Sanitaria Locale Na 1, Naples, Italy
| | - E Tortato
- Diabetology Service, Augusto Murri Hospital, Fermo, Italy
| | - V Triggiani
- Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Bari, Italy
| | - A Vacirca
- Department of Internal Medicine, Imola Hospital, Imola, Italy
| | - G Borretta
- 1Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Via Michele Coppino 26, 12100 Cuneo, Italy
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Fornaro M, Iasevoli F, Novello S, Fusco A, Anastasia A, De Berardis D, Valchera A, de Bartolomeis A. Predictors of hospitalization length of stay among re-admitted treatment-resistant Bipolar Disorder inpatients. J Affect Disord 2018; 228:118-124. [PMID: 29245092 DOI: 10.1016/j.jad.2017.12.009] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/08/2017] [Accepted: 12/05/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Hospitalization accounts for significant health care resource utilization for treatment-resistant Bipolar Disorder (BD), especially among frequent users of acute inpatient psychiatric units. Appraisal of the clinical features and predictive role of selected variables is therefore crucial in such population, representing the aim of the present research. METHODS A hundred and nineteen BD inpatients with an established history of pharmacological treatment resistance for either mania or bipolar depression were classified as long hospitalization cases (LOS+) and their controls and compared against each other for a number of demographic, clinical, and psychopathological features. RESULTS Overall, female sex, current second-generation atypical antipsychotic (SGA)/mood stabilizer other than lithium as well as antidepressant treatment at the admission occurred statistically more frequently among LOS+ cases, concordant with higher scores at the Hamilton scales for depression and anxiety. Lithium utilization at the time of hospitalization did not differ between cases and controls (LOS-, n = 81/119), as predominant affective temperament and other psychopathological rating did not. Overall, the time of admission, use of SGA, anticonvulsant (other than lithium), antidepressant, lifetime alcohol dependence, and BD Type (-I or -II), but not current mood polarity at the time of hospitalization, correctly predicted LOS+ grouping 68.2% of the times: Exp(B) = 3.151, p042. LIMITATIONS Post-hoc, cross-sectional study, relatively small sample size, recall and selection bias on some diagnoses. CONCLUSIONS Overall, LOS+ treatment-resistant BD inpatients characterize for higher severity and greater pharmaco-utilization use, which warrants replication studies to include additional predictors to shed further light on the matter.
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Affiliation(s)
- M Fornaro
- Unit on Treatment Resistant Disorders, Department of Neuroscience, Reproductive Sciences and Odontostomatology University School of Medicine Federico II, Naples, Via Pansini 5, 80131 Napoli, Italy.
| | - F Iasevoli
- Unit on Treatment Resistant Disorders, Department of Neuroscience, Reproductive Sciences and Odontostomatology University School of Medicine Federico II, Naples, Via Pansini 5, 80131 Napoli, Italy.
| | - S Novello
- Unit on Treatment Resistant Disorders, Department of Neuroscience, Reproductive Sciences and Odontostomatology University School of Medicine Federico II, Naples, Via Pansini 5, 80131 Napoli, Italy.
| | - A Fusco
- Unit on Treatment Resistant Disorders, Department of Neuroscience, Reproductive Sciences and Odontostomatology University School of Medicine Federico II, Naples, Via Pansini 5, 80131 Napoli, Italy.
| | - A Anastasia
- Unit on Treatment Resistant Disorders, Department of Neuroscience, Reproductive Sciences and Odontostomatology University School of Medicine Federico II, Naples, Via Pansini 5, 80131 Napoli, Italy.
| | - D De Berardis
- NHS, Department of Mental Health ASL Teramo, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Teramo, Italy.
| | - A Valchera
- Villa San Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy.
| | - A de Bartolomeis
- Unit on Treatment Resistant Disorders, Department of Neuroscience, Reproductive Sciences and Odontostomatology University School of Medicine Federico II, Naples, Via Pansini 5, 80131 Napoli, Italy.
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De Biase D, Esposito F, Piegari G, Iovane V, Palma G, Arra C, Papparella S, Fusco A, Paciello O. Characterization of the Inflammatory Infiltrate of Ulcerative Dermatitis in Mice. J Comp Pathol 2018. [DOI: 10.1016/j.jcpa.2017.10.019] [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: 10/18/2022]
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Fedele M, Paciello O, De Biase D, Monaco M, Vitiello M, Rea D, Luciano A, Arra C, Fusco A. Hmga2 Cooperates with Either p27 Deficiency or Cdk4 R24C Mutation in Pituitary Tumourigenesis. J Comp Pathol 2018. [DOI: 10.1016/j.jcpa.2017.10.106] [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: 10/18/2022]
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Sergiacomi G, Pugliese L, Ricci F, Floris R, Fusco A. High-resolution computed tomography and magnetic resonance imaging protocols in the diagnosis of fibrotic interstitial lung disease: overview for "non-radiologists". Sarcoidosis Vasc Diffuse Lung Dis 2017; 34:300-306. [PMID: 32476862 DOI: 10.36141/svdld.v34i4.5792] [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] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 08/10/2017] [Indexed: 11/02/2022]
Abstract
Fibrotic interstitial lung diseases (ILDs) include a number of pulmonary disorders characterized by infiltration of inflammatory cells in lung parenchyma and fibrosis resulting in decreased lung compliance. Idiopathic pulmonary fibrosis (IPF) represents the most common ILD. ILDs can be divided in two anatomo-pathological and radiographic patterns: usual interstitial pneumonitis (UIP) and non-specific interstitial pneumonitis (NSIP). The different radiological features of UIP and NSIP are discussed. The American Thoracic Society, the European Respiratory Society, the Japanese Respiratory Society, and the Latin American Thoracic Association guidelines for the diagnosis and management of IPF have identified several characteristic high-resolution computed tomography (HRCT) features of UIP. However, even if these guidelines recommend to avoid surgical lung biopsy in case of confident UIP diagnosis on HRCT, they present some limitations, the most important of which is represented by interobserver agreement. Magnetic resonance imaging (MRI) can be considered as a radiation-free alternative to HRCT for several lung diseases. However, the clinical value of MRI for IPF diagnosis remains to be proven. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 300-306).
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Affiliation(s)
- Gianluigi Sergiacomi
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome "Tor Vergata", Rome, Italy
| | - Luca Pugliese
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Ricci
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome "Tor Vergata", Rome, Italy
| | - Roberto Floris
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome "Tor Vergata", Rome, Italy
| | - Armando Fusco
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome "Tor Vergata", Rome, Italy
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Hoyos JM, Ferraro A, Sacchetti S, Keller S, De Martino I, Borbone E, Pallante P, Fedele M, Montanaro D, Esposito F, Cserjesi P, Chiariotti L, Troncone G, Fusco A. Erratum: HAND1 gene expression is negatively regulated by the High Mobility Group A1 proteins and is drastically reduced in human thyroid carcinomas. Oncogene 2016; 35:5930. [DOI: 10.1038/onc.2016.137] [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: 11/09/2022]
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Ciancarella P, Fusco A, Citraro D, Sperandio M, Floris R. Multimodality imaging evaluation of a primary cardiac lymphoma. J Saudi Heart Assoc 2016; 29:128-135. [PMID: 28373787 PMCID: PMC5366660 DOI: 10.1016/j.jsha.2016.09.001] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/26/2016] [Accepted: 09/03/2016] [Indexed: 11/24/2022] Open
Abstract
Primary cardiac lymphoma is a rare form of non-Hodgkin lymphoma that involves the heart with extension to pericardium and great vessels. Prognosis is poor in the absence of a prompt diagnosis and adequate therapy. Differential diagnosis includes malignant neoplasms such as angiosarcoma or metastatic carcinoma and melanoma. Clinical manifestations may be heterogeneous. Multimodality imaging work-up represents the best method for tumor detection and evaluation of its size and extension: echocardiography, computed tomography, magnetic resonance imaging, and nuclear imaging are the best imaging tools. Definitive diagnosis is achieved with cytological and histological evaluation. We report the case of a 76-year-old woman admitted to our emergency department with symptoms of congestive heart failure. Multimodality imaging work-up showed a mediastinal bulky tumor involving heart and pericardium. Pathology revealed a large B-cell primary cardiac lymphoma.
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Affiliation(s)
- Paolo Ciancarella
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, University of Tor Vergata, Rome, aItaly
| | - Armando Fusco
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, University of Tor Vergata, Rome, aItaly
| | - Daniele Citraro
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, University of Tor Vergata, Rome, aItaly
| | - Massimiliano Sperandio
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, University of Tor Vergata, Rome, aItaly
| | - Roberto Floris
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, University of Tor Vergata, Rome, aItaly
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Visone R, Pallante P, Vecchione A, Cirombella R, Ferracin M, Ferraro A, Volinia S, Coluzzi S, Leone V, Borbone E, Liu CG, Petrocca F, Troncone G, Calin GA, Scarpa A, Colato C, Tallini G, Santoro M, Croce CM, Fusco A. Specific microRNAs are downregulated in human thyroid anaplastic carcinomas. Oncogene 2016; 35:5214. [PMID: 27345412 DOI: 10.1038/onc.2016.139] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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38
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Di Pietro G, Capuani S, Manenti G, Vinicola V, Fusco A, Baldi J, Scimeca M, Hagberg G, Bozzali M, Simonetti G, Tarantino U. Bone Marrow Lipid Profiles from Peripheral Skeleton as Potential Biomarkers for Osteoporosis: A 1H-MR Spectroscopy Study. Acad Radiol 2016; 23:273-83. [PMID: 26774740 DOI: 10.1016/j.acra.2015.11.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 09/22/2015] [Accepted: 11/01/2015] [Indexed: 10/22/2022]
Abstract
RATIONALE AND OBJECTIVES To characterize the lipidic profile of bone marrow in the calcaneus and femoral neck of healthy, osteopenic, and osteoporotic women, by using magnetic resonance spectroscopy (MRS) at 3T. The final goal was to identify specific metabolites with the potential ability to discriminate between healthy, osteopenic, and osteoporotic subjects. MATERIALS AND METHODS Sixty-two and thirty three postmenopausal women recruited to investigate calcaneus and femoral neck, respectively, underwent a bone mineral density (BMD) measurement to be classified as healthy subjects (n = 22), osteopenic (n = 45), or osteoporotic (n = 28) patients. MRS spectra were used to quantify and compare bone marrow fat resonances between the three BMD groups. Between-group differences were tested using a Welch analysis of variance. Multiple comparisons were made with the Games-Howell correction. Relationships between pairs of variables were assessed with linear correlation analysis. Reproducibility analysis was performed for all the lipid resonances in both sites. RESULTS The reproducibility was satisfactory. In femoral neck, methylene (L13), glycerol (L41, L43), and total lipid resonances were significantly lower in healthy as compared to osteoporotic subjects. On the other hand, in calcaneus, L13/glycerol significantly discriminated between osteopenic and osteoporotic subjects whereas L13/(unsaturated lipid) discriminated between healthy and osteopenic group. However, the reproducibility of both unsaturated lipid and glycerol resonances were less optimal. CONCLUSIONS MRS of bone marrow lipid profiles from peripheral skeletal sites may be a promising tool for screening of large population to identify individuals with or at risk for developing osteoporosis. Moreover, it provides information about the metabolic changes occurring in bone marrow with the development of osteoporosis, which are skeletal site dependent.
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Abstract
Schizophrenia is a severe psychiatric disorder with an estimate prevalence of 0.3-0.7%. Studies on family aggregation showed a higher incidence of disease among family members of affected people. This observation lead to formulate the hypothesis that schizophrenia could be inheritable, but twin studies have shown a concordance of disease between monozygotic twins only of 50%, indicating the concomitant role of environmental factors in the pathogenesis of schizophrenia. Researches in molecular biology field have allowed the identification of genes that confer susceptibility to schizophrenia on chromosomes 1, 2, 3, 5, 6, 8, 10, 11, 13, 14, 20 and 22. Epigenetic modifications of gene expression, that not involve the primary DNA sequence, may also predispose to schizophrenia, in particular the methylation of genes involved in neurotransmission (RELN, GAD1, MARLIN-1, and NR3B GRIA2, VGLUT1 and 2, 5HT2a, COMT and BDNF), the histone modifications and the action of non-coding RNAs. This review deals with the results of a bibliographic retrieval on PubMed, carried out, using the key words: schizophrenia, genetics, epigenetics. From the epitomized results it can be derived that schizophrenia seems to be a multifactorial disease. Environmental factors, that can cause epigenetic modifications, are important in its pathogenesis, acting on a biological inheritable vulnerability.
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Affiliation(s)
- E Fabi
- Dipartimenti di ¹Neurologia e Psichiatria, Università "Sapienza" di Roma
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40
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Martino Cinnera A, Bonnì S, Iosa M, Ponzo V, Fusco A, Caltagirone C, Koch G. Clinical effects of non-invasive cerebellar magnetic stimulation treatment combined with neuromotor rehabilitation in traumatic brain injury. A single case study. FN 2016. [PMID: 27358225 DOI: 10.11138/fneur/2016.31.2.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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41
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De Luca C, Bonano M, Casu F, Fusco A, Lanari R, Manunta M, Manzo M, Pepe A, Zinno I. Automatic and Systematic Sentinel-1 SBAS-DInSAR Processing Chain for Deformation Time-series Generation. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.procs.2016.09.275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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42
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Anzilotti S, Tornincasa M, Gerlini R, Conte A, Brancaccio P, Cuomo O, Bianco G, Fusco A, Annunziato L, Pignataro G, Pierantoni GM. Genetic ablation of homeodomain-interacting protein kinase 2 selectively induces apoptosis of cerebellar Purkinje cells during adulthood and generates an ataxic-like phenotype. Cell Death Dis 2015; 6:e2004. [PMID: 26633710 PMCID: PMC4720876 DOI: 10.1038/cddis.2015.298] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/27/2015] [Accepted: 08/28/2015] [Indexed: 12/12/2022]
Abstract
Homeodomain-interacting protein kinase 2 (HIPK2) is a multitalented coregulator of an increasing number of transcription factors and cofactors involved in cell death and proliferation in several organs and systems. As Hipk2−/− mice show behavioral abnormalities consistent with cerebellar dysfunction, we investigated whether Hipk2 is involved in these neurological symptoms. To this aim, we characterized the postnatal developmental expression profile of Hipk2 in the brain cortex, hippocampus, striatum, and cerebellum of mice by real-time PCR, western blot analysis, and immunohistochemistry. Notably, we found that whereas in the brain cortex, hippocampus, and striatum, HIPK2 expression progressively decreased with age, that is, from postnatal day 1 to adulthood, it increased in the cerebellum. Interestingly, mice lacking Hipk2 displayed atrophic lobules and a visibly smaller cerebellum than did wild-type mice. More important, the cerebellum of Hipk2−/− mice showed a strong reduction in cerebellar Purkinje neurons during adulthood. Such reduction is due to the activation of an apoptotic process associated with a compromised proteasomal function followed by an unpredicted accumulation of ubiquitinated proteins. In particular, Purkinje cell dysfunction was characterized by a strong accumulation of ubiquitinated β-catenin. Moreover, our behavioral tests showed that Hipk2−/− mice displayed muscle and balance impairment, indicative of Hipk2 involvement in cerebellar function. Taken together, these results indicate that Hipk2 exerts a relevant role in the survival of cerebellar Purkinje cells and that Hipk2 genetic ablation generates cerebellar dysfunction compatible with an ataxic-like phenotype.
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Affiliation(s)
| | - M Tornincasa
- Institute of Endocrinology and Experimental Oncology of National Research Council and Department of Molecular Medicine and Medical Biotechnology, School of Medicine, 'Federico II' University of Naples, Naples, Italy
| | - R Gerlini
- Institute of Endocrinology and Experimental Oncology of National Research Council and Department of Molecular Medicine and Medical Biotechnology, School of Medicine, 'Federico II' University of Naples, Naples, Italy
| | - A Conte
- Institute of Endocrinology and Experimental Oncology of National Research Council and Department of Molecular Medicine and Medical Biotechnology, School of Medicine, 'Federico II' University of Naples, Naples, Italy
| | - P Brancaccio
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, 'Federico II' University of Naples, Naples, Italy
| | - O Cuomo
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, 'Federico II' University of Naples, Naples, Italy
| | - G Bianco
- Institute of Endocrinology and Experimental Oncology of National Research Council and Department of Molecular Medicine and Medical Biotechnology, School of Medicine, 'Federico II' University of Naples, Naples, Italy
| | - A Fusco
- Institute of Endocrinology and Experimental Oncology of National Research Council and Department of Molecular Medicine and Medical Biotechnology, School of Medicine, 'Federico II' University of Naples, Naples, Italy
| | - L Annunziato
- SDN IRCCS, Naples, Italy.,Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, 'Federico II' University of Naples, Naples, Italy
| | - G Pignataro
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, 'Federico II' University of Naples, Naples, Italy
| | - G M Pierantoni
- Institute of Endocrinology and Experimental Oncology of National Research Council and Department of Molecular Medicine and Medical Biotechnology, School of Medicine, 'Federico II' University of Naples, Naples, Italy
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De Vecchis R, Baldi C, Cioppa C, Giasi A, Fusco A. Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure. Results of a meta-analysis of randomized controlled trials. Herz 2015; 41:63-75. [PMID: 26292805 DOI: 10.1007/s00059-015-4345-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 04/26/2015] [Revised: 07/09/2015] [Accepted: 07/09/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND The guidelines of the Scientific Societies of Cardiology recommend limiting fluid intake as a nonpharmacological measure for the management of chronic heart failure (HF). However, many patients with HF may suffer from severe thirst. A meta-analysis was performed to evaluate the effect of limiting fluid consumption based on various clinical and laboratory outcomes in patients with chronic HF. METHODS Only randomized controlled trials comparing liberal and restricted fluid oral intake in patients with HF were included. Primary outcomes were HF hospitalizations and all-cause mortality. Secondary outcomes were the sensation of thirst, the duration of therapy with intravenous diuretics, and the serum levels of creatinine, sodium, and B-type natriuretic peptide (BNP). RESULTS Six studies met the inclusion criteria. Significant heterogeneity was detected for the majority of outcomes. In 5 studies, patients with restricted fluid intake compared to patients with free consumption of beverages had similar rehospitalization and mortality rates. There were no differences regarding patients' sense of thirst (4 studies), duration of intravenous diuretic treatment (2 studies), serum creatinine levels (5 studies), and serum sodium levels (5 studies). Serum BNP levels were significantly higher in the group with free fluid intake (4 studies). CONCLUSION In patients with HF, liberal fluid consumption does not seem to exert an unfavorable impact on HF rehospitalizations or all-cause mortality. Further randomized controlled trials are warranted to definitively confirm the present findings.
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Affiliation(s)
- R De Vecchis
- Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy.
| | - C Baldi
- Heart Department, Interventional Cardiology, A.O.U. "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - C Cioppa
- Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy
| | - A Giasi
- Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy
| | - A Fusco
- Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", via P.Gaurico 21, 80125, Napoli, Italy
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Pezzuto G, Claroni G, Puxeddu E, Fusco A, Cavalli F, Altobelli S, Portalone S, Zompatori M, Simonetti G, Saltini C, Sergiacomi G. Structured multidisciplinary discussion of HRCT scans for IPF/UIP diagnosis may result in indefinite outcomes. Sarcoidosis Vasc Diffuse Lung Dis 2015; 32:32-36. [PMID: 26237353] [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] [Received: 10/09/2014] [Accepted: 01/19/2015] [Indexed: 06/04/2023]
Abstract
Recent ATS/ERS/JRS/ALAT guidelines for the diagnosis and management of Idiopathic Pulmonary Fibrosis (IPF) have defined key features and specific high-resolution computerized tomography (HRCT) patterns for the diagnosis of UIP. The aim is the sorting of patients with suspected IPF into three subgroups, confident, possible or inconsistent with UIP patterns, after a multidisciplinary discussion (MDD). Specialists in respiratory diseases, radiologists and pathologists should reach IPF diagnosis based on either patients' clinical, radiological and laboratory data, either submitting patients to surgical biopsy. After ATS/ERS/JRS/ALAT recommendations have been applied, it has been identified a subgroup of patients showing uniform apical-basal distribution of honeycombing and reticular abnormalities that could not be categorized as confident, or possible nor inconsistent with UIP. These patients were subsequently diagnosed with IPF after MDD and lung biopsy. Inclusion of this pattern in the recommendation for IPF diagnosis would be worth considering.
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Masala S, Fiori R, Raguso M, Calabria E, Cuzzolino A, Fusco A, Simonetti G. Pulse-dose radiofrequency can reduce chronic pain in trapezio-metacarpal osteoarthritis: A mini-invasive therapeutic approach. Int J Rheum Dis 2015; 20:309-316. [PMID: 25990465 DOI: 10.1111/1756-185x.12635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To assess the efficiency of pulse-dose radiofrequency (PDRF) in the management of chronic pain in patients with trapezio-metacarpal osteoarthritis (OA). METHODS Seventy-five patients with trapezio-metacarpal OA were treated with the PDRF between October 2011 and September 2013. A 22-gauge cannula with a 5-cm length was introduced with percutaneous access in the lateral region of the affected trapezio-metacarpal joint. The PDRF procedure was performed with 1200 pulses at 45 V and 20 msec duration, followed by a 480 msec silent phase. The follow-up visits were performed at 1 month, 3 and 6 months after the PDRF procedure. All patients underwent a second treatment between 7 and 9 months after the first PDRF procedure with a new follow-up scheme at 1, 3, 6 and 9 months. RESULTS Mean visual analogue scale (VAS) scores before the procedures was 8.5 ± 1.1. A great reduction in pain intensity was reported at 3 months after the PDRF procedure (mean VAS scores 3.1 ± 0.9, P < 0.05). Pain intensity began to increase back to pre-procedural values after 4 months (mean VAS scores at 6 months was 7.9 ± 1.3, P < 0.05). After the second PDRF treatment the mean VAS scores decreased to 3.3 ± 0.8 at 3 months, but increased to 8.1 ± 1.6 at 9 months. (P < 0.05). No complications after the procedures were observed. CONCLUSIONS The PDRF may be a safe, repeatable and effective short-term pain management technique in patients with trapezio-metacarpal OA. Larger, randomized controlled studies are indicated to better clarify the efficacy and utility of the PDRF.
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Affiliation(s)
- Salvatore Masala
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome "Tor Vergata", Rome, Italy
| | - Roberto Fiori
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome "Tor Vergata", Rome, Italy
| | - Mario Raguso
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome "Tor Vergata", Rome, Italy
| | - Eros Calabria
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome "Tor Vergata", Rome, Italy
| | - Alessandro Cuzzolino
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome "Tor Vergata", Rome, Italy
| | - Armando Fusco
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome "Tor Vergata", Rome, Italy
| | - Giovanni Simonetti
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome "Tor Vergata", Rome, Italy
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Elias K, Fusco A, Kang S, Michaud D, Berkowitz R, Horowitz N, Frendl G. A prospective phase 0 study on the effects of anesthetic selection on serum miRNA profiles during primary cytoreductive surgery for suspected ovarian cancer. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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47
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Agabiti N, Porretta MA, Bauleo L, Coppola A, Sergiacomi G, Fusco A, Cavalli F, Zappa MC, Vignarola R, Carlone S, Facchini G, Mariotta S, Palange P, Valente S, Pasciuto G, Pezzuto G, Orlandi A, Fusco D, Davoli M, Saltini C, Puxeddu E. Idiopathic Pulmonary Fibrosis (IPF) incidence and prevalence in Italy. Sarcoidosis Vasc Diffuse Lung Dis 2014; 31:191-197. [PMID: 25363218] [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] [Received: 06/25/2014] [Accepted: 06/25/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Studies of Idiopathic Pulmonary Fibrosis (IPF) epidemiology show regional variations of incidence and prevalence; no epidemiological studies have been carried out in Italy. OBJECTIVE To determine incidence and prevalence rates of IPF in the population of a large Italian region. METHODS in this cross-sectional study study data were collected on all patients of 18 years of age and older admitted as primary or secondary idiopathic fibrosing alveolitis (ICD9-CM 516.3) to Lazio hospitals, from 1/1/2005 to 31/12/2009, using regional hospital discharge, population and cause of death databases. Reporting accuracy was assessed on a random sample of hospital charts carrying the ICD9-CM 516.3, 516.8, 516.9 and 515 codes, by reviewing radiology and pathology findings to define cases as IPF "confident", "possible" or "inconsistent". RESULTS Annual prevalence and incidence of IPF were estimated at 25.6 per 100,000 and 7.5 per 100,000 using the ICD9-CM code 516.3 without chart audit while they were estimated at 31.6 per 100,000 and at 9,3 per 100,000 for the IPF "confident" definition after hospital chart audit. CONCLUSION The data provide a first estimate of IPF incidence in Italy and indicate that incidence and prevalence in southern European regions may be similar to those observed in northern Europe and North America.
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Affiliation(s)
- Nera Agabiti
- Departement of Epidemiology, Regional Health Service of Lazio, Rome.
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Romagnoli A, Ricci A, Morosetti D, Fusco A, Citraro D, Simonetti G. Congenital left ventricular diverticulum: Multimodality imaging evaluation and literature review. J Saudi Heart Assoc 2014; 27:61-7. [PMID: 25544824 DOI: 10.1016/j.jsha.2014.07.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/24/2014] [Accepted: 07/18/2014] [Indexed: 12/17/2022] Open
Abstract
Congenital ventricular diverticulum is a rare cardiac malformation. We present the case of a 57-year-old man who underwent cardiac catheterization for suspected unstable angina. No coronary artery disease was diagnosed and a left ventricular diverticulum was incidentally found. Coronary CT and cardiac MRI were performed in order to confirm the diagnosis of a muscular type diverticulum and to exclude a post-ischemic aneurysm.
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Affiliation(s)
- Andrea Romagnoli
- University Hospital "Tor Vergata", Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Viale Oxford 81, 00133 RomaItaly
| | - Aurora Ricci
- University Hospital "Tor Vergata", Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Viale Oxford 81, 00133 RomaItaly
| | - Daniele Morosetti
- University Hospital "Tor Vergata", Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Viale Oxford 81, 00133 RomaItaly
| | - Armando Fusco
- University Hospital "Tor Vergata", Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Viale Oxford 81, 00133 RomaItaly
| | - Daniele Citraro
- University Hospital "Tor Vergata", Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Viale Oxford 81, 00133 RomaItaly
| | - Giovanni Simonetti
- University Hospital "Tor Vergata", Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Viale Oxford 81, 00133 RomaItaly
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Ciccarelli M, Sorriento D, Franco A, Anastasio A, Del Giudice C, Fusco A, Campiglia P, Trimarco B, Iaccarino G. P501GRK2 inhibition with small peptide improves cardiac function during heart failure. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu091.174] [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: 11/14/2022] Open
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Paoletti I, Fusco A, Grimaldi E, Perillo L, Coretti L, Di Domenico M, Cozza V, Contaldo M, Serpico R, Guida A, Donnarumma G. Assessment of host defence mechanisms induced by Candida species. Int J Immunopathol Pharmacol 2014; 26:663-72. [PMID: 24067462 DOI: 10.1177/039463201302600309] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Some species of Candida are opportunistic pathogens that can cause disease in a host immunocompromised by underlying local or systemic pathological processes. C. albicans is the species most often associated with oral lesions, but other species of Candida, including C. glabrata, C. tropicalis and C. parapsilosis, have also been isolated in the saliva of subjects with and without candidiasis. In the present study we evaluated the host defence mechanisms induced by Candida albicans and other Candida species in monocytes and oral epithelial cells in order to establish the existence of a species-specific cellular response. Our results indicated that, during Candida species infection, the epithelial cells actively participate in the host defence by producing antimicrobial peptides and proinflammatory cytokines. Moreover, in infections caused by Candida tropicalis and Candida glabrata, the host defence may be strengthened by the release of perforin and granzyme by polymorphonuclear leukocytes recruited at the site of infection.
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Affiliation(s)
- I Paoletti
- Department of Experimental Medicine, Microbiology and Clinical Microbiology Section, Second University of Naples, Naples, Italy
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