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Coppi F, Tampieri F, Palazzi G, Boschini M, Gianluca P, Leo G, Morgante V, Melegari G, Arrotti S, Manenti A, Mattioli AV, Boriani G. Letter to the Editor, regarding Rakha S, Hammad A, Elmarsafawy H, Korkor MS, et al. (2023). A deeper look into the functions of right ventricle using three-dimensional echocardiography: the forgotten ventricle in children with systemic lupus erythematosus. Eur J Pediatr. 182:2807-2819. Eur J Pediatr 2024; 183:973-974. [PMID: 38036710 DOI: 10.1007/s00431-023-05303-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 10/18/2023] [Accepted: 10/22/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Francesca Coppi
- Department of Cardiology, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy.
| | - Francesca Tampieri
- Department of Cardiology, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy
| | - Giovanni Palazzi
- Department of Pediatrics, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy
| | - Matteo Boschini
- Department of Engineering, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy
| | - Pagnoni Gianluca
- Department of Cardiology, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy
| | - Giulio Leo
- Department of Cardiology, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy
| | - Vernizia Morgante
- Department of Cardiology, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy
| | - Gabriele Melegari
- Department of Anesthesiology, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy
| | - Salvatore Arrotti
- Department of Cardiology, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy
| | - Antonio Manenti
- Department of Cardiology, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy.
| | - Anna Vittoria Mattioli
- Department of Cardiology, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy
| | - Giuseppe Boriani
- Department of Cardiology, University of Modena and Reggio Emilia, Polyclinic Hospital, v. del Pozzo, 41124, Modena, Italy
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Arrotti S, Sgura FA, Leo G, Vitolo M, Monopoli D, Forzati N, Siena V, Menozzi M, Cataldo P, Stuani M, Morgante V, Magnavacchi P, Gabbieri D, Guiducci V, Benatti G, Vignali L, Rossi R, Boriani G. Atrial fibrillation before and after transcatheter aortic valve implantation: short- and long-term clinical implications. J Cardiovasc Med (Hagerstown) 2024; 25:51-59. [PMID: 38079281 PMCID: PMC10720825 DOI: 10.2459/jcm.0000000000001553] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/09/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Patients with atrial fibrillation (AF) undergoing transcatheter aortic valve implantation (TAVI) have been associated with worse short-term outcomes compared with patients in sinus rhythm but data on long-term outcomes are limited. The aim of our study was to evaluate the association between AF and short- and long-term outcomes in patients undergoing TAVI. METHODS We retrospectively evaluated patients undergoing TAVI between 2012 and 2022 in four tertiary centres. Two different analyses were conducted: (i) in-hospital and (ii) postdischarge analysis. First, we evaluated the association between preexisting AF and short-term outcomes according to VARC-3 criteria. Second, we analyzed the association between AF at discharge (defined as both preexisting and new-onset AF occurring after TAVI) and long-term outcomes at median follow-up of 3.2 years (i.e. all-cause death, hospitalization and major adverse cardiovascular events). RESULTS A total of 759 patients were initially categorized according to the presence of preexisting AF (241 vs. 518 patients). The preexisting AF group had a higher occurrence of acute kidney injury [odds ratio (OR) 1.65; 95%confidence interval ( CI) 1.15-2.38] and major bleeding (OR 1.86, 95% CI 1.06-3.27). Subsequently, the population was categorized according to the presence of AF at discharge. At the adjusted Cox regression analysis, AF was independently associated with an increased risk of all-cause death and cardiovascular hospitalization [adjusted hazard ratio (aHR) 1.42, 95% CI 1.09-1.86], all-cause death and all-cause hospitalization (aHR 1.38, 95% CI 1.06-1.78) and all-cause hospitalization (aHR 1.59, 95% CI 1.14.2.22). CONCLUSIONS In a real-world cohort of patients undergoing TAVI, the presence of AF (preexisting and new-onset) was independently associated with both short- and long-term adverse outcomes.
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Affiliation(s)
- Salvatore Arrotti
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
| | - Fabio Alfredo Sgura
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
| | - Giulio Leo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
| | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia
| | - Daniel Monopoli
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
| | - Nicola Forzati
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
| | - Valerio Siena
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
| | - Matteo Menozzi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
| | - Paolo Cataldo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
| | - Marco Stuani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
| | - Vernizia Morgante
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
| | | | | | | | - Giorgio Benatti
- Cardiology Division, Parma University Hospital, Parma, Italy
| | - Luigi Vignali
- Cardiology Division, Parma University Hospital, Parma, Italy
| | - Rosario Rossi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Moden
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Nemola G, Russi A, Cozzani G, Leo G, Vetrugno L, Sparasci FM, Parlati AL, Della Bella P, Montorfano M, Tresoldi M, Salerno A, Cera M, Mattiello P, Comi G, Maisano F, Zangrillo A, Gaspardone C, Melillo F, Margonato A, Godino C. Baseline Characteristics and 3-Year Outcome of Nonvalvular Atrial Fibrillation Patients Treated with the Four Direct Oral Anticoagulants (DOACs). Am J Cardiol 2023; 206:125-131. [PMID: 37703678 DOI: 10.1016/j.amjcard.2023.07.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 09/15/2023]
Abstract
Direct oral anticoagulants (DOACs) represent the cornerstone therapy for cardioembolic events prevention in patients with nonvalvular atrial fibrillation (NVAF). In practice, the choice of one DOAC over another is guided by the decision-making process of the physician, which considers specific patient and drug characteristics. This study aimed to evaluate the clinical features and long-term outcomes of a real-world population treated with DOACs, where the use of the 4 different DOACs is quite equal. We conducted a retrospective observational, single-center, multidisciplinary study enrolling consecutive NVAF patients treated with one of the 4 DOACs. From an initial number of 753 patients, we excluded 72 patients because of loss to follow-up, at the end we enrolled 681:174 (23%) treated with dabigatran, 175 (23%) with apixaban, 190 (25%) with rivaroxaban, and 214 (29%) with edoxaban. Patients treated with apixaban were significantly older, more women represented (p <0.001), and with a higher cardioembolic and bleeding risk (p <0.001). Dabigatran was preferred in patients with liver failure (p = 0.008), whereas Apixaban and Edoxaban were chosen in chronic kidney disease (p = 0.002). At 3-year follow-up, 20 patients (2.7%) experienced a systemic thromboembolic event without significant differences in the 4 DOACs. In the same period, an International Society of Thrombosis and Hemostasis classification major bleeding event occurred in 26 patients (3.6%), more statistically correlated to edoxaban (6.1%) (p = 0.038). Thromboembolic events or major bleeding were higher in the edoxaban group (10%) compared with the others (p = 0.014). In our single-center real-world experience, the choice of the DOAC for a patient with NVAF was tailored to specific clinical features and drug pharmacokinetics of the patient. As a result, a small number of adverse events were observed.
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Affiliation(s)
- Giulia Nemola
- Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Anita Russi
- Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gianmarco Cozzani
- Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulio Leo
- Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Vetrugno
- Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Paolo Della Bella
- Arrhythmia and Electrophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Montorfano
- Interventional Cardiovascular Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Moreno Tresoldi
- Internal Medicine Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Anna Salerno
- Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Michela Cera
- Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Mattiello
- Data analyst, Database and Data Warehouse Specialist, San Raffaele Scientific Institute, Milan, Italy
| | - Giancarlo Comi
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Maisano
- Cardiac Surgery Unit, Heart Valve Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Zangrillo
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carlo Gaspardone
- Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Melillo
- Echo Lab, Clinica Montevergine, GVM Care and Research, Mercogliano (AV), Italy
| | - Alberto Margonato
- Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cosmo Godino
- Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Heart Valve Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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Melillo F, Leo G, Parlati ALM, Gaspardone C, Bellini B, Della Bella P, Montorfano M, Mazzone P, Nemola G, Cozzani G, Stella S, Ancona F, Ingallina G, Salerno A, Cera M, Agricola E, Margonato A, Godino C. Direct oral anticoagulants versus percutaneous left atrial appendage occlusion in atrial fibrillation: 5-year outcomes. Int J Cardiol 2023; 389:131188. [PMID: 37453454 DOI: 10.1016/j.ijcard.2023.131188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/23/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND LAAO is an emerging option for thromboembolic event prevention in patients with NVAF. We previously reported data on comparison between LAAO and DOAC at two-year follow-up in NVAF patients at HBR (HAS-BLED ≥3). AIMS Limited data are available on long term follow-up. We aimed to evaluate the efficacy and safety of DOACs versus LAAO indication after 5 years. METHODS We enrolled 193 HBR treated with LAAO and 189 HBR patients with DOACs. At baseline, LAAO group had higher HAS-BLED (4.2 vs 3.3, p < 0.001) and lower CHADS-VASc (4.3 vs. 4.7, p = 0.005). After 1:1 PSM, 192 patients were included (LAAO n = 96; DOACs n = 96). RESULTS At 5-year follow-up the rate of the combined safety and effectiveness endpoint (ISTH major bleeding and thromboembolic events) was significantly higher in LAAO group (p = 0.042), driven by a higher number of thromboembolic events (p = 0.047). The rate of ISTH-major bleeding events was similar (p = 0.221). After PSM no significant difference in the primary effectiveness (LAAO 13.3% vs DOACs 9.5%, p = 0.357) and safety endpoint (LAAO 7.5% vs DOACs 7.5%; p = 0.918) were evident. Overall bleeding rate was significantly higher in DOACs group (25.0% vs 13.7%, p = 0.048), while a non-significant higher number of TIA was reported in LAAO group (5.4% vs 1.1%, p = 0.098). All-cause and cardiovascular mortality were higher in LAAO group at both unmatched and matched analysis. CONCLUSION We confirmed safety and effectiveness of both DOAC and LAAO in NVAF patients at HBR, with no significant differences in thromboembolic events or major bleeding were at 5-year follow-up. The observed increased mortality after LAAO warrants further investigations in RCTs.
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Affiliation(s)
- Francesco Melillo
- Cardiology Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy; Echo Lab, Clinica Montevergine, GVM Care and Research, Mercogliano (AV), Italy
| | - Giulio Leo
- Cardiology Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy
| | | | - Carlo Gaspardone
- Cardiology Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy
| | - Barbara Bellini
- Interventional Cardiology Unit, San Raffaele Hospital, Milan, Italy
| | - Paolo Della Bella
- Arrhythmia and Electrophysiology Unit, San Raffaele Hospital, Milan, Italy
| | | | - Patrizio Mazzone
- Arrhythmia and Electrophysiology Unit, San Raffaele Hospital, Milan, Italy
| | - Giulia Nemola
- Cardiology Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy
| | - Gianmarco Cozzani
- Cardiology Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy
| | - Stefano Stella
- Cardiovascular Imaging Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy
| | - Francesco Ancona
- Cardiovascular Imaging Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy
| | - Giacomo Ingallina
- Cardiovascular Imaging Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy
| | - Anna Salerno
- Cardiology Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy
| | - Michela Cera
- Cardiology Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy
| | - Eustachio Agricola
- Cardiovascular Imaging Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Margonato
- Cardiology Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Cosmo Godino
- Cardiology Unit, Heart Valve Center, San Raffaele Hospital, Milan, Italy.
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Arrotti S, Sgura FA, Monopoli DE, Siena V, Leo G, Morgante V, Cataldo P, Magnavacchi P, Gabbieri D, Guiducci V, Benatti G, Vignali L, Boriani G, Rossi R. The Importance of Mehran Score to Predict Acute Kidney Injury in Patients with TAVI: A Large Multicenter Cohort Study. J Cardiovasc Dev Dis 2023; 10:228. [PMID: 37367393 DOI: 10.3390/jcdd10060228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/16/2023] [Accepted: 05/20/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Transcatheter aortic valve implantation (TAVI) has developed as an alternative to surgery for symptomatic high-risk patients with aortic stenosis (AS). An important complication of TAVI is acute kidney injury. The purpose of the study was to investigate if the Mehran Score (MS) could be used to predict acute kidney injury (AKI) in TAVI patients. METHODS This is a multicenter, retrospective, observational study including 1180 patients with severe AS. The MS comprised eight clinical and procedural variables: hypotension, congestive heart failure class, glomerular filtration rate, diabetes, age >75 years, anemia, need for intra-aortic balloon pump, and contrast agent volume use. We assessed the sensitivity and specificity of the MS in predicting AKI following TAVI, as well as the predictive value of MS with each AKI-related characteristic. RESULTS Patients were categorized into four risk groups based on MS: low (≤5), moderate (6-10), high (11-15), and very high (≥16). Post-procedural AKI was observed in 139 patients (11.8%). MS classes had a higher risk of AKI in the multivariate analysis (HR 1.38, 95% CI, 1.43-1.63, p < 0.01). The best cutoff for MS to predict the onset of AKI was 13.0 (AUC, 0.62; 95% CI, 0.57-0.67), whereas the best cutoff for eGFR was 42.0 mL/min/1.73 m2 (AUC, 0.61; 95% CI, 0.56-0.67). CONCLUSIONS MS was shown to be a predictor of AKI development in TAVI patients.
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Affiliation(s)
- Salvatore Arrotti
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Fabio Alfredo Sgura
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Daniel Enrique Monopoli
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Valerio Siena
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Giulio Leo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Vernizia Morgante
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Paolo Cataldo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | | | - Davide Gabbieri
- Cardiac Surgery Division, Hesperia Hospital, 41125 Modena, Italy
| | - Vincenzo Guiducci
- Division of Cardiology, AUSL-IRCCS Reggio Emilia, 42121 Reggio Emilia, Italy
| | - Giorgio Benatti
- Cardiology Division, Parma University Hospital, 44129 Parma, Italy
| | - Luigi Vignali
- Cardiology Division, Parma University Hospital, 44129 Parma, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Rosario Rossi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
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Albini A, Passiatore M, Leo G, Imberti JF, Valenti AC, Coppi F, Sgura FA, Boriani G. 478 VENTRICULAR AND ATRIAL REMODELING AFTER EDGE-TO-EDGE TRANS-CATHETER MITRAL VALVE REPAIR: A PILOT STUDY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.342] [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: 12/23/2022]
Abstract
Abstract
Background
Percutaneous mitral valve repair (PMVR) is an established therapy for mitral regurgitation (MR) in patients at high risk for surgical treatment. The aim of this study was to determine the impact of PMVR on left and right ventricular (LV, RV) and left and right atrial (LA, RA) remodelling according to the mechanism of MR and history of atrial fibrillation (AF).
Methods and results
Twenty-four patients (mean age 78.54 years ± 7.64 SD; 62.5% males) undergoing PMVR at our centre were prospectively enrolled. All the patients underwent echocardiography 1.6 ± 0.9 months before the procedure and after 5.7 ± 3.5 months; functional MR accounted for 54% of cases. Compared to baseline, a statistically significant improvement in LV end-diastolic diameter (LVEDD), LV indexed mass (ILVM), LV end-diastolic and end-systolic volumes (LVEDV, LVESV), indexed LA volume (iLAV) and morpho-functional RV parameters was recorded. LVEDD and LVEDV improved in primary MR cohort whereas in secondary MR a significant reduction in LVEDV and LVESV with a nonsignificant improvement in ejection fraction were found. (Table 1) LA positive remodelling was found in organic MR with a trend toward ameliorated function; in functional MR, with more dilated and dysfunctional LA, no significant improvement was found. (Table 1) Furthermore, a significant reduction of LA volumetry was detected only in patients without history of AF (AF baseline 51.4 mL/m2 IQR 45.6-62.5 mL/m2 f-u 48.9 mL/m2 IQR 42.9-59.2 mL/m2; p=0.101; no AF baseline 43.5 mL/m2 IQR 34.2-60.5 mL/m2 f-u 42.0 mL/m2 IQR 32.0-46.2 mL/m2; p=0.012). As regards right sections, the most relevant positive remodeling was obtained in patients with functional MR with a baseline poorer RV function and more severe RA and RV dilation. (Table 1)
Conclusion
At mid-term follow-up after PMVR, a positive cardiac remodeling is detected in atrial and ventricular chambers also involving the right sections. To deliver a tailored intervention, MR mechanism and history of AF should be considered in view of the impact on remodeling process.
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Affiliation(s)
- Alessandro Albini
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Matteo Passiatore
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Giulio Leo
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Jacopo Francesco Imberti
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
- Liverpool Centre For Cardiovascular Science, University Of Liverpool And Liverpool Heart & Chest Hospital , Liverpool, United Kingdom
| | - Anna Chiara Valenti
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Francesca Coppi
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Fabio Alfredo Sgura
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Giuseppe Boriani
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
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Maisano A, Valenti A, Alessandro A, Cherubini B, Mantovani M, Leo G, Trapanese P, Rampini F, Bertuglia FF, Minnocci M, Boriani G. 711 CROSS-SECTIONAL ANALYSIS OF CARDIOVASCULAR CAUSES OF COMMON PRESENTING SYMPTOMS IN PATIENTS WITH ACTIVE CANCER: THE EXPERIENCE FROM A TERTIARY ONCOLOGICAL CENTRE IN MODENA. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.115] [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: 12/23/2022]
Abstract
Abstract
Background and aim of the study
There is a rising interest in cardio-oncology as an holistic approach to oncological patients with established cardiovascular comorbidities or at increased cardiovascular risk. Symptoms of potential cardiovascular significance are a common cause of cardiologic consultation in patients with active cancer. Moving from this perspective, we analyzed the proportion of cardiovascular conditions underpinning potentially cardiologic presenting symptoms in a cohort of patients with active malignancy referred to the Emergency Department (ER) of a tertiary oncological centre.
Methods and Results
The study included 250 consecutive patients (median age 69 years [IQR 59.7-77.4], 50% female) presenting to the oncologic ER from September 1st 2021 to May 31st 2022. The most common presenting symptoms were fever (26.9%), gastrointestinal symptoms (24.9%), dyspnea (10.4%), hypotension and hypertension (1.6%), syncope (1.2%) and other (11.2%). We considered as symptoms of potential cardiologic significance the following: dyspnea, lipothymia and syncope, palpitations, fever, chest pain, hypotension and hypertension. We found that 101 of 250 patients (40%) presented with symptoms of potential cardiologic significance. Out of them, 14 patients (13.9%) had confirmed cardiologic diseases: pulmonary embolism (21.4%), heart failure (21.4%), pericardial effusion (21.4%), reflex syncope (14.2%), pericarditis (14.2%) and new onset atrial fibrillation (7.1%). As reported in the table, no significant difference was reported in terms of risk profile or history of cardiac diseases when comparing patients with and without cardiovascular cause of presenting symptoms (CV cause vs non-CV cause).
Conclusions
Cardiovascular conditions are not common causes of ER presentation among oncologic patients with active cancer. Nevertheless, when a cardiologic condition is diagnosed, it could be potentially life-threatening. The cardiovascular risk profile and the history of cardiac disease is not a good discriminator to identify a cardiac cause of presenting symptoms in this specific setting.
Table. Characteristics of patients with potentially cardiologic presenting symptoms.
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Affiliation(s)
- Anna Maisano
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Annachiara Valenti
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Albini Alessandro
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Benedetta Cherubini
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Marta Mantovani
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Giulio Leo
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Paola Trapanese
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Francesca Rampini
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Filippo Federico Bertuglia
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Melania Minnocci
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
| | - Giuseppe Boriani
- Cardiology Division, Department Of Biomedical, Metabolic And Neural Sciences, University Of Modena And Reggio Emilia, Policlinico Di Modena , Modena , Italy
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8
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Albini A, Passiatore M, Imberti JF, Valenti AC, Leo G, Vitolo M, Coppi F, Sgura FA, Boriani G. Ventricular and Atrial Remodeling after Transcatheter Edge-to-Edge Repair: A Pilot Study. J Pers Med 2022; 12:jpm12111916. [PMID: 36422092 PMCID: PMC9696184 DOI: 10.3390/jpm12111916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background: The aim of this study was to determine the impact of transcatheter edge-to-edge repair (TEER) on left and right ventricular (LV, RV) and left and right atrial (LA, RA) remodeling according to the mechanism of mitral regurgitation (MR) and history of atrial fibrillation (AF). Methods: Twenty-four patients (mean age 78.54 years ± 7.64 SD; 62.5% males) underwent TEER at our center. All the patients underwent echocardiography 1.6 ± 0.9 months before the procedure and after 5.7 ± 3.5 months; functional MR accounted for 54% of cases. Results: Compared to baseline, a statistically significant improvement in LV end-diastolic diameter (LVEDD), LV indexed mass (ILVM), LV end-diastolic and end-systolic volumes (LVEDV, LVESV), indexed LA volume (iLAV), and morpho-functional RV parameters was recorded. LVEDD and LVEDV improved in primary MR cohort, whereas in secondary MR, a significant reduction in LVEDV and LVESV was found without a significant functional improvement. LA reverse remodeling was found in organic MR with a trend toward ameliorated function. Furthermore, a significant reduction of LA volumetry was detected only in patients without history of AF (AF baseline 51.4 mL/m2 IQR 45.6–62.5 mL/m2 f-u 48.9 mL/m2 IQR 42.9–59.2 mL/m2; p = 0.101; no AF baseline 43.5 mL/m2 IQR 34.2–60.5 mL/m2 f-u 42.0 mL/m2 IQR 32.0–46.2 mL/m2; p = 0.012). As regards right sections, the most relevant reverse remodeling was obtained in patients with functional MR with a baseline poorer RV function and more severe RA and RV dilation. Conclusion: TEER induces reverse remodeling involving both left and right chambers at mid-term follow-up. To deliver a tailored intervention, MR mechanism and history of AF should be considered in view of the impact on remodeling process.
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Affiliation(s)
- Alessandro Albini
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Matteo Passiatore
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Jacopo Francesco Imberti
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Anna Chiara Valenti
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Giulio Leo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Francesca Coppi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Fabio Alfredo Sgura
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy
- Correspondence:
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9
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Bodega F, Russi A, Melillo F, Blunda F, Rubino C, Leo G, Cappelletti A, Mazzone P, Mattiello P, Della Bella P, Castiglioni A, Alfieri O, De Bonis M, Montorfano M, Tresoldi M, Filippi M, Salerno A, Cera M, Zangrillo A, Alberto M, Godino C. Direct oral anticoagulants in patients with nonvalvular atrial fibrillation and extreme body weight. Eur J Clin Invest 2022; 52:e13658. [PMID: 34310688 DOI: 10.1111/eci.13658] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Limited clinical data exist describing the use of direct oral anticoagulants (DOACs) in patient with extreme body weight. Thus, the International Society of Thrombosis and Haemostasis (ISTH) recommends avoiding DOACs in patients with weight >120 Kg, and on the contrary, no restrictions exist for underweight patients. OBJECTIVE To evaluate the effects of extreme body weight on DOAC activity and to compare the clinical outcomes of patients with an extreme body weight versus patients with a normal weight (61-119 Kg) treated with DOACs. METHODS Single tertiary care Italian centre multidisciplinary registry including nonvalvular atrial fibrillation (NVAF) patients treated with DOACs. Based on weight, three subcohorts were defined: (i) underweight patients (≤60 Kg); (ii) patients with a normal weight (61-119 Kg, as control group); and (iii) overweight patients (≥120 Kg). Primary efficacy endpoint was 2-year rate of thromboembolic events. Primary safety endpoint was 2-year rate of major bleeding. Event-free survival curves among groups were compared using Cox-Mantel test. RESULTS 812 NVAF patients were included, 108 patients weighed ≤60 Kg (13%, underweight), 688 weighed between 61 and 119 Kg (85%, normal weight), and 16 weighed ≥120 Kg (2%, overweight). In particular, among underweight patients, dabigatran was prescribed in 26% patients, apixaban in 27%, rivaroxaban in 28% and edoxaban in 22% ones. Instead, among overweight patients, 44% were treated with dabigatran, 25% with apixaban, 25% with rivaroxaban and 4% with edoxaban. Underweight patients were older, more frequently women, with lower creatinine clearance and a history of previous strokes, resulting in higher CHA2DS2-VASc score than in both remaining groups. Up to 2 years, no statistically significant difference was observed between the three groups of weight for thromboembolic events (P = .765) and for overall bleeding (P = .125), but a trend towards decreased overall bleeding rates was noticed as weight increased (24.1% vs 16.7% vs 12.5%, respectively). CONCLUSION In this tertiary care centre registry, 15% of patients treated with DOACs presented an extreme weight. Compared to patients with a normal weight, no significant rates of thromboembolic events were observed for underweight or overweight patients. A trend towards decreased overall bleeding frequency as weight increased was highlighted up to 2 years. The present results should be considered as preliminary and hypothesis generating.
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Affiliation(s)
| | - Anita Russi
- Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Fabiana Blunda
- Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Claudia Rubino
- Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Giulio Leo
- Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Patrizio Mazzone
- Arrhythmia and Electrophysiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Paolo Mattiello
- Information Systems Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Paolo Della Bella
- Arrhythmia and Electrophysiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Ottavio Alfieri
- Cardiac Surgery Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Matteo Montorfano
- Interventional Cardiovascular Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Moreno Tresoldi
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Anna Salerno
- Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Michela Cera
- Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Alberto Zangrillo
- Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Cosmo Godino
- Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
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10
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Falasconi G, Gaspardone C, Godino C, Gaspardone A, Radinovic A, Pannone L, Leo G, Posteraro GA, Slavich M, Melillo F, Marzi A, D'Angelo G, Limite LR, Frontera A, Brugliera L, Agricola E, Margonato A, Della Bella P, Mazzone P. Left atrial appendage closure: a new strategy for cardioembolic events despite oral anticoagulation. Panminerva Med 2021:S0031-0808.21.04446-3. [PMID: 34664480 DOI: 10.23736/s0031-0808.21.04446-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Patients with non-valvular atrial fibrillation (nvAF) who experienced a cardioembolic (CE) event despite adequate oral anticoagulation (OAC) are at high risk of recurrence, and further prevention strategies are deemed necessary. The present study aimed to evaluate the safety and efficacy of off-label use of left atrial appendage closure (LAAC) in this subset of patients. METHODS AND RESULTS Seventy-five consecutive patients with nvAF who experienced a CE event despite adequate OAC therapy were retrospectively enrolled from two Italian centers. Patients were divided according to the treatment strategy following the index event: DOAC group (49 patients who continued OAC therapy with DOACs) and LAAC group (26 patients who underwent LAAC procedure). 1:1 propensity-score matching between the two groups was performed. LAAC group was made up of two subgroups according to the post-procedural pharmacological regimen: (a) dual antiplatelet therapy (DAPT) for 3 months followed by indefinite single antiplatelet therapy (LAAC+SAPT) or (b) aspirin plus DOAC for 3 months followed by indefinite DOAC therapy (LAAC+DOAC). The primary endpoint was a composite of CE event, major bleeding, or procedurerelated major complication. During a median follow-up of 3.4 years (IQR 2.0-5.3), LAAC was a predictor of primary endpoint-free survival (HR 0.28, 95%CI 0.08-0.97; p=0.044); within LAAC group, no procedure-related major complication occurred. Moreover, a trend toward a lower rate of both CE events and major bleedings was observed in LAAC group, particularly in the subgroup LAAC+DOAC. CONCLUSIONS LAAC is a reasonable therapeutic option in nvAF patients who suffered a CE event despite adequate OAC therapy.
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Affiliation(s)
- Giulio Falasconi
- Clinical Cardiology Unit, San Raffaele Hospital, Milan, Italy - .,Vita-Salute University, San Raffaele, Milan, Italy -
| | - Carlo Gaspardone
- Clinical Cardiology Unit, San Raffaele Hospital, Milan, Italy.,Vita-Salute University, San Raffaele, Milan, Italy
| | - Cosmo Godino
- Clinical Cardiology Unit, San Raffaele Hospital, Milan, Italy
| | | | - Andrea Radinovic
- Department of Arrhythmology and Cardiac Electrophysiology, San Raffaele Hospital, Milan, Italy
| | - Luigi Pannone
- Clinical Cardiology Unit, San Raffaele Hospital, Milan, Italy.,Vita-Salute University, San Raffaele, Milan, Italy
| | - Giulio Leo
- Vita-Salute University, San Raffaele, Milan, Italy
| | | | - Massimo Slavich
- Clinical Cardiology Unit, San Raffaele Hospital, Milan, Italy
| | | | - Alessandra Marzi
- Department of Arrhythmology and Cardiac Electrophysiology, San Raffaele Hospital, Milan, Italy
| | - Giuseppe D'Angelo
- Department of Arrhythmology and Cardiac Electrophysiology, San Raffaele Hospital, Milan, Italy
| | - Luca R Limite
- Department of Arrhythmology and Cardiac Electrophysiology, San Raffaele Hospital, Milan, Italy
| | - Antonio Frontera
- Department of Arrhythmology and Cardiac Electrophysiology, San Raffaele Hospital, Milan, Italy
| | - Luigia Brugliera
- Physical Rehabilitation Unit, San Raffaele Hospital, Milan, Italy
| | - Eustachio Agricola
- Vita-Salute University, San Raffaele, Milan, Italy.,Cardiovascular Imaging Unit, San Raffaele Hospital, Milan, Italy
| | - Alberto Margonato
- Clinical Cardiology Unit, San Raffaele Hospital, Milan, Italy.,Vita-Salute University, San Raffaele, Milan, Italy
| | - Paolo Della Bella
- Department of Arrhythmology and Cardiac Electrophysiology, San Raffaele Hospital, Milan, Italy
| | - Patrizio Mazzone
- Department of Arrhythmology and Cardiac Electrophysiology, San Raffaele Hospital, Milan, Italy
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11
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Gili VF, Carletti L, Locatelli A, Rocco D, Finazzi M, Ghirardini L, Favero I, Gomez C, Lemaître A, Celebrano M, De Angelis C, Leo G. Monolithic AlGaAs second-harmonic nanoantennas: erratum. Opt Express 2021; 29:11132. [PMID: 33820231 DOI: 10.1364/oe.425110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Indexed: 06/12/2023]
Abstract
Figure 1(b) in [V. F. Gili et al, Opt. Express24, 15965 (2016)10.1364/OE.24.015965] is corrupted and is corrected in this erratum.
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12
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Roland I, Borne A, Ravaro M, De Oliveira R, Suffit S, Filloux P, Lemaître A, Favero I, Leo G. Frequency doubling and parametric fluorescence in a four-port aluminum gallium arsenide photonic chip. Opt Lett 2020; 45:2878-2881. [PMID: 32412491 DOI: 10.1364/ol.392417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Abstract
In this Letter, we report on the fabrication and characterization of a monolithic III-V semiconductor photonic chip, designed to perform nonlinear parametric optical processes for frequency conversion and non-classical state generation. This chip co-integrates an AlGaAs microdisk that is evanescently coupled to two distinct suspended waveguides designed for light injection and collection around 1600 nm and 800 nm, respectively. Quasi-phase matching provided by the resonator geometry and material symmetry, resonant field enhancement, and confinement ensure efficient nonlinear interactions. We demonstrate second-harmonic generation efficiency of 5%W-1 and a biphoton generation rate of 1.2 kHz/µW through spontaneous down-conversion.
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13
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Panella L, Incorvaia C, Caserta AV, Amata O, Consonni D, Pessina L, Leo G, Caselli I, Callegari C. A bio-psycho-social approach in elderly population: outcome of adapted physical activity in patients with osteoarthritis. Clin Ter 2019; 170:e74-e77. [PMID: 31850488 DOI: 10.7417/ct.2020.2192] [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] [Indexed: 11/20/2022]
Abstract
BACKGROUND The beneficial effect of physical activity on a large spectrum of diseases is well known, with particular importance for elderly people. Among the different types of activity, adapted physical activity (APA) has been applied in a number of disease-related physical deficit. OBJECTIVE The purpose of this study is to determine the outcome of a six months APA program in elder patients with osteoarthritis concerning physical and functional health and as second endpoint to determine the potential effect of AFA on reducing the risk of institutionalization. METHODS The clinical indexes used to assess the outcome included the Blaylock Risk Assessment Screening Score (BRASS), the Psychological General Well Being Index (PGWBI), the Cumulative Illness Rating Scale (CIRS), the Short Physical Performance Battery (SPPB), and the visual analogue scale (VAS). RESULTS A significant difference (p = 0.047) between the pre-APA and the post-APA value was found for BRASS, and highly significant differences (p <0.0001) were found for SPBB and VAS. CONCLUSIONS These findings show that a six months APA program in elder patients with osteoarthritis improves physical function, reduces pain intensity and decreases the risk of institutionalization. Moreover the positive outcome of APA we found in elder patients with osteoarthritis suggests a more frequent use of such rehabilitation approach, also evaluating its economic impact on this disease.
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Affiliation(s)
- L Panella
- Department of Rehabilitation, ASST Pini-CTO Hospital, Milan
| | - C Incorvaia
- Cardiac/Pulmonary Rehabilitation, ASST Pini-CTO, Milan
| | - A V Caserta
- Department of Rehabilitation, ASST Pini-CTO Hospital, Milan
| | - O Amata
- Department of Rehabilitation, ASST Pini-CTO Hospital, Milan
| | - D Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan
| | - L Pessina
- Cardiac/Pulmonary Rehabilitation, ASST Pini-CTO, Milan
| | - G Leo
- Pediatric Allergy and Respiratory Pathophysiology Unit, Department of Pediatrics, Buzzi Children's Hospital, Milan
| | - I Caselli
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy
| | - C Callegari
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy
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14
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Hamoumi M, Allain PE, Hease W, Gil-Santos E, Morgenroth L, Gérard B, Lemaître A, Leo G, Favero I. Microscopic Nanomechanical Dissipation in Gallium Arsenide Resonators. Phys Rev Lett 2018; 120:223601. [PMID: 29906180 DOI: 10.1103/physrevlett.120.223601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/16/2018] [Indexed: 06/08/2023]
Abstract
We report on a systematic study of nanomechanical dissipation in high-frequency (≈300 MHz) gallium arsenide optomechanical disk resonators, in conditions where clamping and fluidic losses are negligible. Phonon-phonon interactions are shown to contribute with a loss background fading away at cryogenic temperatures (3 K). Atomic layer deposition of alumina at the surface modifies the quality factor of resonators, pointing towards the importance of surface dissipation. The temperature evolution is accurately fitted by two-level systems models, showing that nanomechanical dissipation in gallium arsenide resonators directly connects to their microscopic properties. Two-level systems, notably at surfaces, appear to rule the damping and fluctuations of such high-quality crystalline nanomechanical devices, at all temperatures from 3 to 300 K.
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Affiliation(s)
- M Hamoumi
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162, Sorbonne Paris Cité, 75013 Paris, France
| | - P E Allain
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162, Sorbonne Paris Cité, 75013 Paris, France
| | - W Hease
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162, Sorbonne Paris Cité, 75013 Paris, France
| | - E Gil-Santos
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162, Sorbonne Paris Cité, 75013 Paris, France
| | - L Morgenroth
- Institut d'Electronique, de Microélectronique et de Nanotechnologie, UMR CNRS 8520, Avenue Poincaré, 59652, Villeneuve d'Ascq, France
| | - B Gérard
- III-V Lab, 1 Avenue Augustin Fresnel, 91767 Palaiseau, France
| | - A Lemaître
- Centre de Nanosciences et de Nanotechnologies, CNRS, Université Paris Sud, Université Paris-Saclay, C2N-Marcoussis, Route de Nozay, 91460 Marcoussis, France
| | - G Leo
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162, Sorbonne Paris Cité, 75013 Paris, France
| | - I Favero
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162, Sorbonne Paris Cité, 75013 Paris, France
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15
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Liu-Walsh F, Hauschild J, Leo G, Masucci J, Tall A, Tierney N, Capone K. 999 Prebiotic colloidal oatmeal supports the growth of S. epidermidis and enhances the production of lactic acid. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1011] [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: 10/17/2022]
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16
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Morais N, Roland I, Ravaro M, Hease W, Lemaître A, Gomez C, Wabnitz S, De Rosa M, Favero I, Leo G. Directionally induced quasi-phase matching in homogeneous AlGaAs waveguides. Opt Lett 2017; 42:4287-4290. [PMID: 29088145 DOI: 10.1364/ol.42.004287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 09/23/2017] [Indexed: 06/07/2023]
Abstract
We report on the experimental observation of quasi-phase matching in a homogeneous waveguide. By fabricating a monolithic snake-shaped suspended AlGaAs nanowire on a (001) GaAs wafer, we demonstrate the unraveled version of a χ(2) whispering-gallery-mode microdisk, obtaining second-harmonic generation in the optical telecom wavelength range. With a radius of curvature of 50 μm and four spatial oscillations along the (110) average direction, a splitting of the second-harmonic spectrum occurs around the phase-matching wavelength of the corresponding straight waveguide. This splitting, which increases as the radius of curvature decreases, provides a useful degree of freedom for the design of small-footprint nonlinear photonic devices on-chip.
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17
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Carletti L, Rocco D, Locatelli A, De Angelis C, Gili VF, Ravaro M, Favero I, Leo G, Finazzi M, Ghirardini L, Celebrano M, Marino G, Zayats AV. Controlling second-harmonic generation at the nanoscale with monolithic AlGaAs-on-AlOx antennas. Nanotechnology 2017; 28:114005. [PMID: 28205510 DOI: 10.1088/1361-6528/aa5645] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We review recent achievements in the field of nanoscale nonlinear AlGaAs photonics based on all-dielectric optical antennas. After discussing the motivation and main technological challenges for the development of an AlGaAs monolithic platform for χ (2) nonlinear nanophotonics, we present numerical and experimental investigations of the second-order nonlinear response and physical reasons for high efficiency of second-order nonlinear interactions in the AlGaAs nano-antennas. In particular, we emphasize the role of the dipolar resonances at the fundamental frequency and the multipolar resonances at the second harmonic wavelength. We also discuss second-harmonic generation directionality and show possible strategies to engineer the radiation pattern of nonlinear antennas.
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Affiliation(s)
- L Carletti
- Department of Information Engineering, University of Brescia, Via Branze 38, 25123 Brescia, Italy
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18
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Gil-Santos E, Labousse M, Baker C, Goetschy A, Hease W, Gomez C, Lemaître A, Leo G, Ciuti C, Favero I. Light-Mediated Cascaded Locking of Multiple Nano-Optomechanical Oscillators. Phys Rev Lett 2017; 118:063605. [PMID: 28234503 DOI: 10.1103/physrevlett.118.063605] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Indexed: 06/06/2023]
Abstract
Collective phenomena emerging from nonlinear interactions between multiple oscillators, such as synchronization and frequency locking, find applications in a wide variety of fields. Optomechanical resonators, which are intrinsically nonlinear, combine the scientific assets of mechanical devices with the possibility of long distance controlled interactions enabled by traveling light. Here we demonstrate light-mediated frequency locking of three distant nano-optomechanical oscillators positioned in a cascaded configuration. The oscillators, integrated on a chip along a common coupling waveguide, are optically driven with a single laser and oscillate at gigahertz frequency. Despite an initial mechanical frequency disorder of hundreds of kilohertz, the guided light locks them all with a clear transition in the optical output. The experimental results are described by Langevin equations, paving the way to scalable cascaded optomechanical configurations.
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Affiliation(s)
- E Gil-Santos
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162 Sorbonne Paris Cité, 75013 Paris, France
| | - M Labousse
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162 Sorbonne Paris Cité, 75013 Paris, France
| | - C Baker
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162 Sorbonne Paris Cité, 75013 Paris, France
| | - A Goetschy
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162 Sorbonne Paris Cité, 75013 Paris, France
- Institut Langevin, ESPCI Paris, CNRS UMR 7587, PSL Research University, 75005 Paris, France
| | - W Hease
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162 Sorbonne Paris Cité, 75013 Paris, France
- Institut Langevin, ESPCI Paris, CNRS UMR 7587, PSL Research University, 75005 Paris, France
| | - C Gomez
- Centre de Nanosciences et de Nanotechnologies, CNRS, Université Paris Sud, Université Paris-Saclay, C2N-Marcoussis, 91460 Marcoussis, France
| | - A Lemaître
- Centre de Nanosciences et de Nanotechnologies, CNRS, Université Paris Sud, Université Paris-Saclay, C2N-Marcoussis, 91460 Marcoussis, France
| | - G Leo
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162 Sorbonne Paris Cité, 75013 Paris, France
| | - C Ciuti
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162 Sorbonne Paris Cité, 75013 Paris, France
| | - I Favero
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS UMR 7162 Sorbonne Paris Cité, 75013 Paris, France
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Ghirardini L, Carletti L, Gili V, Pellegrini G, Duò L, Finazzi M, Rocco D, Locatelli A, De Angelis C, Favero I, Ravaro M, Leo G, Lemaître A, Celebrano M. Polarization properties of second-harmonic generation in AlGaAs optical nanoantennas. Opt Lett 2017; 42:559-562. [PMID: 28146527 DOI: 10.1364/ol.42.000559] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Manipulating light at the nanoscale by means of dielectric nanoantennas recently received renewed attention thanks to the development of key enabling fabrication tools in semiconductor technology, combined with the extremely low losses exhibited by dielectrics in the optical regime. Nanostructures based on III-V type semiconductors, characterized by an intrinsic broken symmetry down to a single elementary cell, has already demonstrated remarkable nonlinear conversion efficiencies at scales well below the operating wavelength. In this Letter, we thoroughly investigate the emission properties of second-harmonic generation (SHG) in AlGaAs monolithic nanoantennas. Our findings point toward the pivotal role of volume susceptibility in SHG, further unraveling the physics behind the nonlinear processes in these systems. The extremely high SHG efficiency attained, together with the control over the polarized emission in these nanoantennas, constitute key ingredients for the development of tunable nonlinear metasurfaces.
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20
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Gili VF, Carletti L, Locatelli A, Rocco D, Finazzi M, Ghirardini L, Favero I, Gomez C, Lemaître A, Celebrano M, De Angelis C, Leo G. Monolithic AlGaAs second-harmonic nanoantennas. Opt Express 2016; 24:15965-71. [PMID: 27410864 DOI: 10.1364/oe.24.015965] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
We demonstrate monolithic aluminum gallium arsenide (AlGaAs) optical nanoantennas. Using a selective oxidation technique, we fabricated epitaxial semiconductor nanocylinders on an aluminum oxide substrate. Second harmonic generation from AlGaAs nanocylinders of 400 nm height and varying radius pumped with femtosecond pulses delivered at 1554-nm wavelength has been measured, revealing a peak conversion efficiency exceeding 10-5 for nanocylinders with an optimized geometry.
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Monarca R, Madeddu G, Ranieri R, Carbonara S, Leo G, Sardo M, Choroma F, Casari S, Marri D, Muredda AA, Nava FA, Babudieri S. HIV treatment and care among Italian inmates: a one-month point survey. BMC Infect Dis 2015; 15:562. [PMID: 26653247 PMCID: PMC4676105 DOI: 10.1186/s12879-015-1301-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 11/30/2015] [Indexed: 01/14/2023] Open
Abstract
Background HIV infection, with an estimated prevalence be between 2 and 50 times those of the general adult population is a major health challenge for prison authorities worldwide. Since no nationwide surveillance system is present in Italy, data on HIV prevalence and treatment in prisons are limited to only a few and small observational studies. We aimed to estimate HIV prevalence and obtain an overview on diagnostic and therapeutic activities concerning HIV infection in the Italian penitentiary system. Methods We piloted a multi-centre cross-sectional study investigating the prevalence of HIV infection and assessing HIV-related medical activities in Italian correctional institutions. Results A total of 15,675 prisoners from 25 institutions, accounting for approximately one-fourth of the prison inmates in Italy, were included in the study, of whom, 97.7 % were males, 37.1 % foreigners and 27 % had a history of intravenous drug addiction. HIV-tests were available in 42.3 % of the total population, with a known HIV Infection proportion of 5.1 %. In the month prior to the study, 604 of the 1,764 subjects who entered prison were tested for HIV, with a HIV-positive prevalence of 3.3 %. Among the 338 HIV-positive prisoners, 81.4 % were under antiretroviral treatment and 73.5 % showed undetectable HIV-RNA. In 23/338 (6.8 %) a coinfection with HBV and in 189/338 (55.9 %) with HCV was also present. Among the 67 (19.8 %) inmates with HIV who did not receive HIV treatment, 13 (19.5 %) had T-CD4+ count <350 cells/mm3 and 9 (69.2 %) of these had refused the treatment. The majority of the inmates with HIV-infection were on a PI-based (62.5 %) or on NNRTIs-based (24.4 %) regimen. Only a minority of patients received once daily regimens (17.2 %). Conclusions Although clinical and therapeutic management of HIV infection remains difficult in Italian prisons, diagnostics, treatment and care were offered to the majority of HIV-infected inmates. Specific programs should be directed towards the prison population and strict cooperation between prison and health institutions is needed to increase HIV treatment.
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Affiliation(s)
- R Monarca
- Infectious Diseases Unit, Belcolle Hospital, Viterbo, Italy.
| | - G Madeddu
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 35b, 07100, Sassari, Italy.
| | - R Ranieri
- Infectious Diseases Unit, A.O. San Paolo, Milan, Italy.
| | - S Carbonara
- Institute of Infectious Diseases, University of Bari, Bari, Italy.
| | - G Leo
- Infectious Diseases Unit, Amedeo di Savoia Hospital, Torino, Italy.
| | - M Sardo
- Cotugno Hospital, Infectious Diseases Unit, Naples, Italy.
| | - F Choroma
- Infectious Diseases Unit, AUSL, Parma, Italy.
| | - S Casari
- Institute of Infectious Diseases, University of Brescia, Brescia, Italy.
| | - D Marri
- Infectious Diseases Unit, A.O. Santa Maria alle Scotte, Siena, Italy.
| | - A A Muredda
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 35b, 07100, Sassari, Italy.
| | - F A Nava
- Penitentiary Medicine, Padova, Italy.
| | - S Babudieri
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 35b, 07100, Sassari, Italy.
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Carletti L, Locatelli A, Stepanenko O, Leo G, De Angelis C. Enhanced second-harmonic generation from magnetic resonance in AlGaAs nanoantennas. Opt Express 2015; 23:26544-50. [PMID: 26480167 DOI: 10.1364/oe.23.026544] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We designed AlGaAs-on-aluminium-oxide all-dielectric nanoantennas with magnetic dipole resonance at near-infrared wavelengths. These devices, shaped as cylinders of 400nm height and different radii, offer a few crucial advantages with respect to the silicon-on-insulator platform for operation around 1.55μm wavelength: absence of two-photon absorption, high χ((2)) nonlinearity, and the perspective of a monolithic integration with a laser. We analyzed volume χ((2)) nonlinear effects associated to a magnetic dipole resonance in these nanoantennas, and we predict second-harmonic generation exceeding 10(-3) efficiency with 1GW/cm(2) of pump intensity.
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23
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Gil-Santos E, Baker C, Nguyen DT, Hease W, Gomez C, Lemaître A, Ducci S, Leo G, Favero I. High-frequency nano-optomechanical disk resonators in liquids. Nat Nanotechnol 2015; 10:810-6. [PMID: 26237347 DOI: 10.1038/nnano.2015.160] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 06/22/2015] [Indexed: 05/05/2023]
Abstract
Nano- and micromechanical resonators are the subject of research that aims to develop ultrasensitive mass sensors for spectrometry, chemical analysis and biomedical diagnosis. Unfortunately, their merits generally diminish in liquids because of an increased dissipation. The development of faster and lighter miniaturized devices would enable improved performances, provided the dissipation was controlled and novel techniques were available to drive and readout their minute displacement. Here we report a nano-optomechanical approach to this problem using miniature semiconductor disks. These devices combine a mechanical motion at high frequencies (gigahertz and above) with an ultralow mass (picograms) and a moderate dissipation in liquids. We show that high-sensitivity optical measurements allow their Brownian vibrations to be resolved directly, even in the most-dissipative liquids. We investigate their interaction with liquids of arbitrary properties, and analyse measurements in light of new models. Nano-optomechanical disks emerge as probes of rheological information of unprecedented sensitivity and speed, which opens up applications in sensing and fundamental science.
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Affiliation(s)
- E Gil-Santos
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS, Sorbonne Paris Cité, UMR 7162, 10 rue Alice Domon et Léonie Duquet, Paris 75013, France
| | - C Baker
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS, Sorbonne Paris Cité, UMR 7162, 10 rue Alice Domon et Léonie Duquet, Paris 75013, France
| | - D T Nguyen
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS, Sorbonne Paris Cité, UMR 7162, 10 rue Alice Domon et Léonie Duquet, Paris 75013, France
| | - W Hease
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS, Sorbonne Paris Cité, UMR 7162, 10 rue Alice Domon et Léonie Duquet, Paris 75013, France
| | - C Gomez
- Laboratoire de Photonique et Nanostructures, CNRS, Route de Nozay, Marcoussis 91460, France
| | - A Lemaître
- Laboratoire de Photonique et Nanostructures, CNRS, Route de Nozay, Marcoussis 91460, France
| | - S Ducci
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS, Sorbonne Paris Cité, UMR 7162, 10 rue Alice Domon et Léonie Duquet, Paris 75013, France
| | - G Leo
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS, Sorbonne Paris Cité, UMR 7162, 10 rue Alice Domon et Léonie Duquet, Paris 75013, France
| | - I Favero
- Matériaux et Phénomènes Quantiques, Université Paris Diderot, CNRS, Sorbonne Paris Cité, UMR 7162, 10 rue Alice Domon et Léonie Duquet, Paris 75013, France
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Ozanam C, Savanier M, Lemaître A, Almuneau G, Carras M, Favero I, Ducci S, Leo G. AlGaAs guided-wave second-harmonic generation at 2.23 μm from a quantum cascade laser. Appl Opt 2014; 53:5615-5619. [PMID: 25321354 DOI: 10.1364/ao.53.005615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 07/19/2014] [Indexed: 06/04/2023]
Abstract
We demonstrate the frequency doubling of a quantum cascade laser in a multilayered, partially oxidized GaAs/AlOx waveguide. Using the waveguide width to fulfill the phase-matching condition, the second harmonic is generated in the wavelength range between 2.2 and 2.4 μm, where not many semiconductor sources are commercially available to date. We discuss the impact of a few fabrication and experimental parameters on the conversion efficiency, an essential step toward the improvement and practical implementation of this proof-of-principle semiconductor microsystem.
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25
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Mariani S, Andronico A, Lemaître A, Favero I, Ducci S, Leo G. Second-harmonic generation in AlGaAs microdisks in the telecom range. Opt Lett 2014; 39:3062-3065. [PMID: 24978274 DOI: 10.1364/ol.39.003062] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We report on second-harmonic generation in whispering-gallery-mode AlGaAs microcavities suspended on a GaAs pedestal. Frequency doubling of a 1.58 μm pump is observed with 7×10(-4) W(-1) conversion efficiency. This device can be integrated in a monolithic photonic chip for classical and quantum applications in the telecom band.
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Erba PA, Leo G, Sollini M, Tascini C, Boni R, Berchiolli RN, Menichetti F, Ferrari M, Lazzeri E, Mariani G. Radiolabelled leucocyte scintigraphy versus conventional radiological imaging for the management of late, low-grade vascular prosthesis infections. Eur J Nucl Med Mol Imaging 2013; 41:357-68. [DOI: 10.1007/s00259-013-2582-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Accepted: 09/12/2013] [Indexed: 11/28/2022]
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Andronico A, Favero I, Ducci S, Gérard JM, Leo G. Tunable quantum dot parametric source. Opt Express 2013; 21:22367-22373. [PMID: 24104126 DOI: 10.1364/oe.21.022367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We report on the modeling of an electrically pumped nonlinear source for spontaneous parametric down-conversion in an AlGaAs single-sided Bragg waveguide. Laser emission from InAs quantum dots embedded in the waveguide core is designed to excite a Bragg pump mode at 950 nm. This mode is phase matched with two cross-polarized total-internal-reflection fundamental signal and idler modes around 1900 nm. Besides numerically evaluating the source efficiency, we discuss the crucial role played by the quantum dots in the practical implementation of the phase-matching condition along with the tuning capabilities of this promising active device.
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Orieux A, Eckstein A, Lemaître A, Filloux P, Favero I, Leo G, Coudreau T, Keller A, Milman P, Ducci S. Direct Bell states generation on a III-V semiconductor chip at room temperature. Phys Rev Lett 2013; 110:160502. [PMID: 23679588 DOI: 10.1103/physrevlett.110.160502] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Indexed: 06/02/2023]
Abstract
We demonstrate the direct generation of polarization-entangled photon pairs at room temperature and telecom wavelength in an AlGaAs semiconductor waveguide. The source is based on spontaneous parametric down-conversion with a counterpropagating phase-matching scheme. The quality of the two-photon state is assessed by the reconstruction of the density matrix giving a raw fidelity to a Bell state of 0.83; a theoretical model, taking into account the experimental parameters, provides ways to understand and control the amount of entanglement. Its compatibility with electrical injection, together with the high versatility of the generated two-photon state, make this source an attractive candidate for completely integrated quantum photonics devices.
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Affiliation(s)
- A Orieux
- Laboratoire Matériaux et Phénomènes Quantiques, CNRS-UMR 7162, Université Paris Diderot, Sorbonne Paris Cité, Case courrier 7021, 75205 Paris Cedex 13, France
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Carcieri C, Cinnirella G, Bertini S, Salassa B, Bonasso M, Bramato C, Orofino G, Carosella S, Leo G. CPC-131 Switching Strategy. The Pharmacist’s Point of View on Cost, Adherence and Virological Outcome. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.588] [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: 11/04/2022] Open
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Skanjeti A, Penna D, Douroukas A, Cistaro A, Arena V, Leo G, Longo G, Traverso A, Belloro S, Pelosi E. PET in the clinical work-up of patients with spondylodiscitis: a new tool for the clinician? Q J Nucl Med Mol Imaging 2012; 56:569-576. [PMID: 23358410] [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: 06/01/2023]
Abstract
AIM The role of 18F-fluorodeoxyglucose-positron-emission tomography (FDG-PET) in the clinical management of patients with inflammatory diseases (e.g., chronic inflammatory diseases, fever of unknown origin, ostemyelitis, prosthesis infections) is still under investigation. The aim of the present study was to evaluate the usefulness of PET in the diagnostic work-up of patients with spondylodiscitis and to compare it with magnetic resonance imaging (MRI). METHODS This retrospective study included 33 patients with suspected/confirmed spondylodiscitis. Two groups were created: 1) disease definition (n=24); and 2) treatment assessment (N.=16, 21 exams). Disease status was defined on the basis of data collected for symptoms, hematological parameters, imaging studies and histological findings, when available. Qualitative and semiquantitative analysis of the PET images was performed. The minimum duration of follow-up was 6 months. RESULTS For the Disease Definition group, FDG-PET showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 92.9%, 50%, 72.2%, 83.3%, and 75%, respectively, and MRI showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 50%, 76.9%, 100%, and 81.3%, respectively. For the Treatment Assessment group, FDG-PET showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 90%, 81.8%, 81.8%, 90%, and 85.7%, respectively, and MRI showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 16.7%, 58.3%, 100% and 61.5%, respectively. No significant differences were observed between qualitative and semiquantitative evaluation of PET scans. CONCLUSION PET and MRI showed similar accuracy in the diagnosis of spondylodiscitis, indicating that PET can be used when MRI is doubtful or unavailable. PET was more accurate and more specific than MRI in treatment assessment, suggesting that PET should be preferred over MRI for determining when treatment can be safely discontinued.
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Affiliation(s)
- A Skanjeti
- IRMET PET Centre, Euromedic, Turin, Italy
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31
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Marsigliante S, Mottaghi A, Muscella A, Ciardo V, Leo G, Storelli C. Effect of tumor size on the association between ps2 and cathepsin-d in primary breast-cancer. Int J Oncol 2012; 6:69-73. [PMID: 21556503 DOI: 10.3892/ijo.6.1.69] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Previous studies have shown that pS2 and cathepsin D are linked in lymph node positive (N+) tumours, but not in tumours from lymph node negative (N-) patients. The purpose of this study was to understand whether or not size would effect the relationship between pS2 and cathepsin D. Findings were further extended to some subgroups of tumours obtained stratifying for T and N and particularly to the small (TI) but aggressive (N+) cancers (T1/N+) and to those of size greater than 2 cm (T2 and T3) but yet node negative (T2+T3/N-). Oestrogen (ER) and progesterone (PR) receptors, pS2 and cathepsin D concentrations were therefore assayed in 355 primary breast cancers. ER, PR, pS2 and cathepsin D did not correlate to nodal status and size of the tumours; no significant differences in the expression of these four biological factors between infiltrating ductal carcinomas without special features (NOS) and non-NOS carcinomas were found. Multivariate analysis performed among cathepsin D, ER, PR and pS2 indicated that, in T1 tumours, pS2 was the most important variable and the best predictor in cathepsin D determination, while such association was absent in T2 and T3 tumours. pS2 and cathepsin D significantly associated also in tumours obtained from N+ patients, and such correlation was highest in T1 tumours with positive axillary nodes (N+/T1). pS2 and cathepsin D did not associate in tumours taken from N- patients. Considering the NOS carcinomas, correlation between pS2 and cathepsin D in the N+, T1 and N+/T1 subgroups was higher in the poorly differentiated grade 3 with respect to grade 1 and grade 2 cancers. The data suggest that pS2 could have a role in cathepsin D expression and we hypothesise that such control could be an early biological event occurring in the development and progression of particularly aggressive (N+/grade 3), small (T1) breast cancers.
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Andronico A, Mariani S, Ghiglieno F, Claudon J, Munsch M, Gérard JM, Favero I, Ducci S, Leo G. Tuning of a nonlinear THz emitter. Opt Express 2012; 20:17678-17683. [PMID: 23038319 DOI: 10.1364/oe.20.017678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We numerically study a passive THz source based on difference frequency generation between modes sustained by cylindrical AlGaAs microcavities. We show that ring-like structures are advantageous in that they provide additional degrees of freedom for tuning the nonlinear process and for maximizing the nonlinear overlap integral and conversion efficiency.
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Affiliation(s)
- A Andronico
- Univ. Paris Diderot, Sorbonne Paris Cit´e, Laboratoire MPQ, CNRS-UMR 7162 Case courrier 7021, 75205 Paris Cedex 13, France
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33
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Savanier M, Andronico A, Lemaître A, Galopin E, Manquest C, Favero I, Ducci S, Leo G. Large second-harmonic generation at 1.55 μmin oxidized AlGaAs waveguides. Opt Lett 2011; 36:2955-2957. [PMID: 21808370 DOI: 10.1364/ol.36.002955] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We report on CW second-harmonic generation in selectively oxidized AlGaAs multilayer waveguides. Frequency doubling of a 1.55 μm pump is observed with 2.8% W(-1) conversion efficiency and a maximum second-harmonic power around 0.3 mW. This is the strongest second-harmonic generation ever reported in semiconductor waveguides and an encouraging result toward integrated spontaneous parametric downconversion in the telecom range.
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Affiliation(s)
- M Savanier
- Université Paris Diderot, Sorbonne Paris Cité, Laboratoire Matériaux et Phénomènes Quantiques, CNRS-UMR 7162, Case courrier 7021, 75205 Paris Cedex 13, France
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Ciccarese M, Galante MM, Forcignano R, Chiuri VE, Cairo G, Ronzino G, Romano G, Accettura C, Giampaglia M, Pellegrino A, Leo SA, Saracino V, Petrucelli L, Lupo L, Leo G, Pisanò M, Lorusso V. Prognostic and predictive value of HER2 extracellular domain in patients with early and metastatic breast cancer treated with trastuzumab and lapatinib: Correlation with clinicopathological parameters and response. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11123] [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: 11/20/2022] Open
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35
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Agnati LF, Guidolin D, Baluska F, Leo G, Barlow PW, Carone C, Genedani S. A new hypothesis of pathogenesis based on the divorce between mitochondria and their host cells: possible relevance for Alzheimer's disease. Curr Alzheimer Res 2011; 7:307-22. [PMID: 19860724 DOI: 10.2174/156720510791162395] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Accepted: 06/21/2009] [Indexed: 11/22/2022]
Abstract
On the basis of not only the endosymbiotic theory of eukaryotic cell organization and evolution but also of observations of transcellular communication via Tunneling NanoTubes (TNTs), the hypothesis is put forward that when mitochondria, which were once independently living prokaryote-like organisms, are subjected to detrimental genetic, toxic, or environmental conditions, including age-related endogenous factors, they can regress towards their original independent state. At that point, they can become potentially pathogenic intruders within their eukaryotic host cell. Because of the protoplasmic disequilibrium caused by an altered, or mutated, mitochondral population, certain host cells with a minimal capacity for self-renewal, such as dopaminergic neurons, risk a loss of function and degenerate. It is also proposed that altered mitochondria, as well as their mutated mtDNA, can migrate, via TNTs, into adjacent cells. In this way, neurodegenerative states are propagated between cells (glia and/or neurons) of the Central Nervous System (CNS) and that this leads to conditions such as Alzheimer's and Parkinson's disease. This proposal finds indirect support from observations on rotenone-poisoned glioblastoma cells which have been co-cultured with non-poisoned cells. Immunocytochemical techniques revealed that mitochondria, moving along the TNTs, migrated from the poisoned cells towards the healthy cells. It has also been demonstrated by means of immunocytochemistry that, in glioblastoma cell cultures, Amyloid Precursor Protein (APP) is present in TNTs, hence it may migrate from one cell to neighbouring cells. This datum may be of high relevance for a better understanding of Alzheimer's Disease (AD) since molecular, cellular, and animal model studies have revealed that the formation of amyloid beta (Abeta) and other derivatives of the APP are key pathogenic factors in AD, causing mitochondrial dysfunction, free radical generation, oxidative damage, and inflammation. Furthermore, the present data demonstrate the presence of alpha-synuclein (alpha-syn) within TNTs, hence a similar pathogenic mechanism to the one surmised for AD, but centred on alpha-syn rather than on Abeta, may play a role in Parkinson's Disease (PD). As a matter of fact, alpha-syn can enter mitochondria and interact with complex I causing respiratory deficiency and increased oxygen free radical production. In agreement with this view, it has been demonstrated that, in comparison with normal subjects, PD patients show a significant accumulation of alpha-syn at Substantia Nigra and Striatal level, predominantly associated with the inner mitochondrial membrane,. These observations suggest that potentially neuropathogenic proteins, such as Abeta and alpha-syn, can not only diffuse via the extracellular space but also move from cell to cell also via TNTs where they can cause mitochondrial damage and cell degeneration. A mathematical model (see Appendix) is proposed to simulate the pathogenic consequences of the migration of altered mitochondria and/or of their mtDNA via TNTs. The results of the present simulation is compatible with the proposal that mutated mitochondrial agents behave as though they were infectious particles migrating through a continuum of interconnected cells.
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Affiliation(s)
- L F Agnati
- Department of BioMedical Sciences, University of Modena and IRCCS Lido, Venezia, Italy.
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Tinelli A, Mezzolla V, Leo G, Pisanò M, Storelli F, Alemanno G, Malvasi A, Tommasi S, Ronzino G, Lorusso V. Microsatellite instability (MSI) as genomic markers in endometrial cancer: toward scientific evidences. Mini Rev Med Chem 2011; 10:1356-65. [PMID: 20937028 DOI: 10.2174/138955710793564098] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 09/10/2010] [Indexed: 11/22/2022]
Abstract
Endometrial Cancer is the most frequent tumor in western world nations, with 142,000 new cases each year and 42,000 casualties. This form of cancer typically affects women between 55 and 65 years of age, and ranks fourth among female tumors. Endogenous predisposing conditions to endometrial cancer development are: late menopause, early menarche and hyperestrogenism, while hormone replacement therapy, obesity, alcohol, diabetes, and a diet rich in animal fats as well as chronic liver disease, are the exogenous factors. This tumor may also have an hereditary predisposition, as in the Lynch Syndrome or in HNPCC (Hereditary NonPolyposis Colorectal Cancer), since genetic modifications induced by the "MisMatch Repair" genes lead to a tumoral development susceptibility, not only in the colon. The phenotypical consequences of these genetic modifications may be found in the microsatellite instability (MSI) and in the loss of heterozygosity (LOH), which generate the replication errors in positive phenotypes repeats. These express the incapability to repair short nucleotide insertions or deletions, generated by a wrong DNA replication. Due to such genetic modifications, new allelic variants arise in the endometrial tissue, confirming the high degree of this genetic disorder. Recent studies showed that the MSI and LOH in endometrial cells may be associated with the possible loss in the expression of cellular control and with the possible degeneration of the cell growth phenomenon. There is also a possibility of utilizing these new genetic markers in the endometrial mucosa to study these tissues and to detect any possible neoplastic transformations, thanks to Genomics.
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Affiliation(s)
- A Tinelli
- Department of Obstetrics and Gynaecology, Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy & Technology, Vito Fazzi Hospital, Lecce, Italy.
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37
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Leo G, Incorvaia C, Masieri S, Triulzi F. Imaging criteria for diagnosis of chronic rhinosinusitis in children. Eur Ann Allergy Clin Immunol 2010; 42:199-204. [PMID: 21287942] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Symptoms of chronic rhinosinusitis (CRS) are nasal blockage, nasal discharge, postnasal drip, facial pain, headache, and reduction or loss of smell, but they are often subtle and make it difficult to obtain a firm diagnosis based only on clinical data, and especially to distinguish CRS from persistent rhinitis. A diagnosis of certainty of CRS relies upon either direct observation by nasal fibroendoscopy of nasal turbinates, middle meatus, and rhinopharynx, detecting mucopurulent discharge from the middle meatus, and/or oedema or mucosal obstruction, or by imaging of the rhinosinusal cavities. Imaging techniques such as computed tomography (CT) scanning and magnetic resonance (MR) are currently recommended in consensus documents, while plain radiography is considered of poor diagnostic value. However, recent studies indicated that radiography by the Waters'projection had a sensitivity of 84.2% and a specificity of 76.6%, which suggests to use it routinely in suspected CRS, limiting the number of more expensive imaging investigations. This seems important in the current economic landscape that requires a cost-effectiveness evaluation in each diagnostic procedure.
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Affiliation(s)
- G Leo
- Pediatric Allergy and Respiratory Pathophysiology Unit, Buzzi Children's Hospital, Milan, Italy.
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Shah D, Lambert H, Langenkamp A, Vanenkov Y, Leo G, Gentil-Baron P, Walpoth B. Catheter tip force required for mechanical perforation of porcine cardiac chambers. Europace 2010; 13:277-83. [DOI: 10.1093/europace/euq403] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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39
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Leo G, Incorvaia C. Current management of allergic asthma in children. Minerva Pediatr 2010; 62:475-484. [PMID: 20940681] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Asthma in children is characterized by recurring symptoms such as wheezing, breathlessness, and cough, by airflow obstruction and bronchial hyperresponsiveness, and by underlying inflammation. The presence of allergic sensitization, and allergic rhinitis in particular, is strongly associated with asthma. The goal of management of asthma is to achieve and maintain control of the clinical manifestations of the disease. This can be obtained by drug treatment, education of patients and care givers, and, in allergic asthma, by allergen avoidance and specific immunotherapy. The drugs used in asthma can be classified as controllers - such as inhaled corticosteroids (ICS) and leukotriene receptor antagonists - or relievers (bronchodilators to be used during acute exacerbations of asthma). ICS are the most effective anti-inflammatory controllers for the management of persistent asthma in children of all ages, but there is no consensus about the optimal starting dose. Dose-response studies reported marked and rapid improvement in clinical symptoms and lung function at low doses of ICS, and mild asthma is well controlled by such doses in most children, this ensuring good safety. If there is no improvement with the initial low dose of ICS, an increased ICS dose or additional therapy with leukotriene receptor antagonists or long-acting inhaled β2-agonists should be considered. When asthma is caused by allergy to aeroallergens, specific immunotherapy must be taken into account, in its two forms of subcutaneous or sublingual immunotherapy. The former has complete evidence of efficacy, but the sublingual route is safer and more easily accepted by children.
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Affiliation(s)
- G Leo
- Pediatric Allergy and Respiratory Pathophysiology Unit, V. Buzzi Children's Hospital, Istituti Clinici di Perfezionamento Milan, Italy.
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Genedani S, Agnati LF, Leo G, Buzzega D, Maccari F, Carone C, Andreoli N, Filaferro M, Volpi N. beta-Amyloid fibrillation and/or hyperhomocysteinemia modify striatal patterns of hyaluronic acid and dermatan sulfate: Possible role in the pathogenesis of Alzheimer's disease. Curr Alzheimer Res 2010; 7:150-7. [PMID: 19860722 DOI: 10.2174/156720510790691074] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Accepted: 04/02/2009] [Indexed: 11/22/2022]
Abstract
A key event in Alzheimer's disease (AD) pathogenesis is the formation of insoluble peptides beta-amyloid aggregates and this process is favoured by a condition of hyperhomocysteinemia. To date, there is growing evidence that implicates glycosaminoglycans (GAGs) in the pathophysiology of amyloidosis but no data are available on the characterization of brain GAGs involved in the enhancing beta-amyloid fibrillogenesis in relationship to their structure and physico-chemical properties. Furthermore, few studies have been performed on the relationship between hyperhomocysteinemia and extracellular matrix (ECM) modifications. The aim of this study was to evaluate the amount and chemical structure of GAGs in rat striatal areas where beta-amyioid fibrillogenesis was induced, and in conditions of hyperhomocysteinemia. The intrastriatal injection of beta-amyloid produced a significant decrease (-40.8%) in the hyaluronic acid (HA) percentage and an increase (+14.5%) in the dermatan sulfate (DS) with a total charge density increasing of 14.9%. A significant decrease (-19.5%) in the HA percentage and an increase (+6.9%) in the DS % was also observed in striata obtained from the hyperhomocysteinemic animals. The total charge density increased by 6.8%. Quite the same trend was observed in rats after intrastriatal injection of beta-amyloid and in a condition of hyperhomocysteinemia. The observed increase of DS concentration and the correspondent decrease of the nonsulfated polymer HA after in vivo treatment with beta-amyloid and in a condition of hyperhocysteinemia support the hypothesis that an increase in local production of sulfated GAGs may reduce beta-amyloid neurotoxicity. However, the consequent modification of the ECM network might impair the extracellular diffusion pathways of different signal molecules and participate in the progression of AD.
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Affiliation(s)
- S Genedani
- Department of Biomedical Sciences, University of Modena & Reggio Emilia, Italy
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Caillet X, Orieux A, Lemaître A, Filloux P, Favero I, Leo G, Ducci S. Two-photon interference with a semiconductor integrated source at room temperature. Opt Express 2010; 18:9967-9975. [PMID: 20588851 DOI: 10.1364/oe.18.009967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We experimentally demonstrate an integrated semiconductor ridge microcavity source of counterpropagating twin photons at room temperature in the telecom range. Based on type II parametric down conversion with a counterpropagating phase-matching, pump photons generate photon pairs with an efficiency of about 10(-11) and a spectral linewidth of 0.3 nm for a 1 mm long sample. The indistiguishability of the photons of the pair is measured via a Hong-Ou-Mandel two-photon interference experiment showing a visibility of 85 %. This work opens a route towards new guided-wave semiconductor quantum devices.
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Affiliation(s)
- X Caillet
- Laboratoire Matériaux et Phénomènes Quantiques, UMR 7162 CNRS-Université Paris, Diderot, Paris Cedex 13, France
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Agnati L, Guidolin D, Baluska F, Leo G, Barlow P, Carone C, Genedani S. A New Hypothesis of Pathogenesis Based on the Divorce between Mitochondria and their Host Cells: Possible Relevances for the Alzheimer's Disease. Curr Alzheimer Res 2010. [DOI: 10.2174/1567210198607242050] [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: 11/22/2022]
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Genedani S, Agnati LF, Leo G, Buzzega D, Maccari F, Carone C, Andreoli N, Filaferro M, Volpi N. β-Amyloid Fibrillation and/or Hyperhomocysteinemia Modify Striatal Patterns of Hyaluronic Acid and Dermatan Sulfate: Possible Role in the Pathogenesis of Alzheimer's Disease. Curr Alzheimer Res 2010. [DOI: 10.2174/1567210198607222050] [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: 11/22/2022]
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Vergara D, Tinelli A, Martignago R, Malvasi A, Chiuri V, Leo G. Biomolecular Pathogenesis of Borderline Ovarian Tumors: Focusing Target Discovery Through Proteogenomics. Curr Cancer Drug Targets 2010; 10:107-16. [DOI: 10.2174/156800910790980269] [Citation(s) in RCA: 13] [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] [Received: 02/14/2009] [Accepted: 09/17/2009] [Indexed: 11/22/2022]
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Cunsolo E, Marchioni D, Leo G, Incorvaia C, Presutti L. Functional anatomy of the Eustachian tube. Int J Immunopathol Pharmacol 2010; 23:4-7. [PMID: 20152070] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
The Eustachian tube (ET) is divided in 3 portions: a bony portion, a cartilaginous portion, and a junctional portion. From an anatomical-functional point of view, the bony portion of ET is the region of ventilation and clearance of secretions, and is lined by pseudostratified, ciliated, columnar epithelium, with an anti-gravitational direction of the drainage. The ET in the bony portion is in a state of forced opening. The cartilaginous portion is instead the heart of this dynamic system tube, because the mechanism of opening and closing of the tube is at this level. ET is normally closed, and it opens only during swallowing, being essential for good functioning of the middle ear, because it provides ventilation from the nasopharynx to the middle ear, and, at the same time, clearance of secretions from the middle ear-mastoid unit to the nasopharynx. Moreover, the ET protects the middle ear against nasopharyngeal pressure variations, ascending secretions, and microorganisms. The ability to develop all these functions makes the tube a complex organ.
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Affiliation(s)
- E Cunsolo
- Otolaryngology Department, University Hospital, Modena, Italy.
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46
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Incorvaia C, Leo G. Treatment of rhinosinusitis: other medical options. Int J Immunopathol Pharmacol 2010; 23:70-73. [PMID: 20152086] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Medical options other than antibiotics or corticosteroids for treating rhinosinusitis include non-specific treatments such as nasal decongestants, naso-sinusal washings, antihistamines, antileukotrienes, mucolytic agents, immunomodulators and immunostimulants, as well as specific agents such as antimycotics in fungal sinusitis or antireflux agents in sinusitis associated to gastroesophageal reflux. In subjects with chronic sinusitis and/or nasal polyposis related to aspirin hypersensitivity protocols of desensitization are available. The available scientific evidence is good for naso-sinus washings with saline solutions, antihistamines in acute allergic rhinosinusitis, antileukotrienes in chronic sinusitis, bacterial lysates for prevention of recurrent sinusitis, and aspirin desensitisation in subjects with aspirin-exacerbated respiratory disease with chronic sinusitis and nasal polyposis. The other treatment options are still in search of scientific demonstration.
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Affiliation(s)
- C Incorvaia
- Allergy/Pulmonary Rehabilitation, Istituti Clinici di Perfezionamento, Milan, Italy
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Leo G, Incorvaia C. The clinical spectrum of rhinosinusitis in children. Int J Immunopathol Pharmacol 2010; 23:24-28. [PMID: 20152075] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Rhinosinusitis is an extremely common disease that is often underreported, especially in children. Its clinical spectrum includes acute rhinosinusitis (ARS) which may present in the forms of ARS with persistent symptoms and ARS with severe symptoms and chronic rhinosinusitis (CRS), characterized by a duration longer than 12 weeks and prevalence of symptoms such as nasal congestion and cough. Moreover, rhinosinusitis may present with associated disorders, that are nasal polyposis and aspirin sensitivity, asthma, otitis media with effusion, and gastroesophageal reflux. A particular form is fungal rhinosinusitis, presenting in an invasive and noninvasive form, the latter including allergic fungal sinusitis, which is the most common form of fungal rhinosinusitis and should be suspected in children with nasal polyposis and atopy.
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Affiliation(s)
- G Leo
- Pediatric Allergy and Respiratory Pathophysiology Unit, Istituti Clinici di Perfezionamento, Milan, Italy.
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Cazzavillan A, Gaini RM, Pignataro L, Piacentini E, Leo G. Treatment of rhinosinusitis: the role of surgery. Int J Immunopathol Pharmacol 2010; 23:74-77. [PMID: 20152087] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
The treatment of rhinosinusitis in children is mostly medical. Surgery is indicated in few but important exceptions: orbital or intracranial complications of acute rhinosinusitis not responding to medical therapy, chronic rhinosinusitis (CRS) with persisting sinonasal infection and purulent discharge, cystic fibrosis, ciliary diskinesia, dacryocystitis due to sinusitis and resistant to medical treatment, fungal rhinosinusitis. According to recent data, 50 percent of ENT specialist perform an adenoidectomy to manage CRS before endoscopic sinus surgery (ESS). ESS techniques introduced in mid 90s, has significantly modified the treatment of complications of acute rhinosinusitis and of selected cases of chronic recurrent infections. ESS consists of minimally invasive surgical procedure as middle meatal antrostomy and anterior ethmoidectomy. Evidence suggests that adenoidectomy and ESS are the most frequent surgical procedure performed in RS management.
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Affiliation(s)
- A Cazzavillan
- ENT Pediatric Unit, Istituti Clinici di Perfezionamento, Ospedale Buzzi, Milan, Italy.
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Incorvaia C, Fuiano N, Leo G. Sublingual immunotherapy for treating respiratory allergy: a review on its effectiveness and suitability. Clin Ter 2010; 161:543-547. [PMID: 21181085] [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: 05/30/2023]
Abstract
Sublingual immunotherapy (SLIT) was introduced in the treatment of respiratory allergy as an option to subcutaneous immunotherapy (SCIT), which is clinically effective but has the problem of adverse systemic reactions, quite rare but sometimes life-threatening. A large number of trials, globally evaluated in several meta-analyses, demonstrated that SLIT is an efficacious treatment for allergic rhinitis and allergic asthma and has a satisfactory safety profile, severe reactions being extremely rare, though an increased risk is apparent in subjects undergoing SLIT because of previous systemic reactions to SCIT. The suitability of SLIT is ensured by a good compliance, higher than reported for SCIT, the injections being a major factor for noncompliance with the latter, and by its cost-effectiveness performances. In fact, a number of studies showed that SLIT may be very beneficial to the healthcare system, especially after its stopping, when there is no more the cost of the treatment but its efficacy on symptoms persists.
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Affiliation(s)
- C Incorvaia
- Allergy/Pulmonary Rehabilitation, Istituti Clinici di Perfezionamento, Via Bignami 1, Milan, Italy.
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Leo G. [Clinical and diagnostic aspects of rhino-sinusitis]. Minerva Pediatr 2009; 61:702-705. [PMID: 19935529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- G Leo
- U.O. di Allergologia Pediatrica e Fisiopatologia, Respiratoria, Istituti Clinici di Perfezionamento. Milano
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