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Collini V, De Martino M, Andreis A, De Biasio M, Gaspard F, Paneva E, Tomat M, Deferrari GM, Isola M, Imazio M. Efficacy and safety of colchicine for the treatment of myopericarditis. Heart 2024; 110:735-739. [PMID: 38238076 PMCID: PMC11103299 DOI: 10.1136/heartjnl-2023-323484] [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: 09/22/2023] [Accepted: 12/18/2023] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVE Clinical trials have evaluated the efficacy and safety of colchicine only in simple pericarditis, excluding cases of concomitant myocarditis. The aim of this paper is to evaluate the efficacy and safety of colchicine for the treatment of the first attack of acute pericarditis with concomitant myocardial involvement. METHODS Double-centre retrospective cohort study analysing consecutive patients admitted for first attack of pericarditis with myocarditis and treated with or without colchicine. The primary efficacy end point was the time to the first recurrence. Propensity score matching was used to generate two groups of patients with similar baseline characteristics. Colchicine-associated side effects were analysed as safety end-point. RESULTS A total of 175 patients (mean age 46.2±20.1 years, 25.1% females, 88.6% with idiopathic/viral aetiology) were included. Seventy-nine (45.1%) patients were treated with colchicine. After a median follow-up of 25.3 (IQR 8.3-45.6) months, 58 (33.1%) patients had recurrences. The propensity score generated two groups of 73 patients with similar baseline characteristics but the use of colchicine. Patients treated with colchicine had a lower incidence of recurrences (respectively, 19.2% vs 43.8%; p=0.001) and a longer event-free survival (p=0.005). In multivariable analysis, women (HR 1.97, 95% CI 1.04 to 3.73; p=0.037) and corticosteroid use (HR 2.27, 95% CI 1.15 to 4.47; p=0.018) were independent risk factors for recurrences. Colchicine-associated side effects were mild and occurred in 3 (1.7%) patients. CONCLUSION In patients with first attack of pericarditis associated with myocardial involvement, colchicine was safe and efficacious for the reduction of recurrences.
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Affiliation(s)
- Valentino Collini
- Cardiothoracic Department, Santa Maria della Misericordia University Hospital, Udine, Italy
| | | | - Alessandro Andreis
- Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Marzia De Biasio
- Cardiothoracic Department, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesca Gaspard
- Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Elena Paneva
- Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Mariacristina Tomat
- Cardiothoracic Department, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Gaetano Maria Deferrari
- Department of Medical Sciences, Division of Cardiology, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Miriam Isola
- University of Udine, Udine, Friuli-Venezia Giulia, Italy
| | - Massimo Imazio
- Cardiothoracic Department, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medicine, University of Udine, Udine, Italy
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Pravisani R, De Martino M, Mocchegiani F, Melandro F, Patrono D, Lauterio A, Di Francesco F, Ravaioli M, Zambelli MF, Bosio C, Dondossola D, Lai Q, Zanchetta M, Dingfelder J, Toti L, Iacomino A, Nicolae S, Ghinolfi D, Romagnoli R, De Carlis L, Gruttadauria S, Cescon M, Colledan M, Carraro A, Caccamo L, Vivarelli M, Rossi M, Nadalin S, Gyori G, Tisone G, Vennarecci G, Rostved A, De Simone P, Isola M, Baccarani U. Recipient hepatectomy technique may affect oncological outcomes of liver transplantation for hepatocellular carcinoma. Liver Transpl 2024:01445473-990000000-00356. [PMID: 38551397 DOI: 10.1097/lvt.0000000000000373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/14/2024] [Indexed: 05/08/2024]
Abstract
To date, caval sparing (CS) and total caval replacement (TCR) for recipient hepatectomy in liver transplantation (LT) have been compared only in terms of surgical morbidity. Nonetheless, the CS technique is inherently associated with an increased manipulation of the native liver and later exclusion of the venous outflow, which may increase the risk of intraoperative shedding of tumor cells when LT is performed for HCC. A multicenter, retrospective study was performed to assess the impact of recipient hepatectomy (CS vs. TCR) on the risk of posttransplant HCC recurrence among 16 European transplant centers that used either TCR or CS recipient hepatectomy as an elective protocol technique. Exclusion criteria comprised cases of non-center-protocol recipient hepatectomy technique, living-donor LT, HCC diagnosis suspected on preoperative imaging but not confirmed at the pathological examination of the explanted liver, HCC in close contact with the IVC, and previous liver resection for HCC. In 2420 patients, CS and TCR approaches were used in 1452 (60%) and 968 (40%) cases, respectively. Group adjustment with inverse probability weighting was performed for high-volume center, recipient age, alcohol abuse, viral hepatitis, Child-Pugh class C, Model for End-Stage Liver Disease score, cold ischemia time, clinical HCC stage within Milan criteria, pre-LT downstaging/bridging therapies, pre-LT alphafetoprotein serum levels, number and size of tumor nodules, microvascular invasion, and complete necrosis of all tumor nodules (matched cohort, TCR, n = 938; CS, n = 935). In a multivariate cause-specific hazard model, CS was associated with a higher risk of HCC recurrence (HR: 1.536, p = 0.007). In conclusion, TCR recipient hepatectomy, compared to the CS approach, may be associated with some protective effect against post-LT tumor recurrence.
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Affiliation(s)
- Riccardo Pravisani
- Liver-Kidney Transplant Unit, Department of Medicine, University of Udine, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistic, Department of Medicine, University of Udine, Udine, Italy
| | - Federico Mocchegiani
- HPB and Transplantation Unit, Department of Experimental and Clinical Medicine, United Hospital of Ancona, Polytechnic University of Marche, Ancona, Italy
| | - Fabio Melandro
- Division of Hepatic Surgery and Liver Transplantation, University Hospital of Pisa, Pisa, Italy
| | - Damiano Patrono
- General Surgery 2U, Liver Transplant Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Torino, Italy
| | - Andrea Lauterio
- Department of Transplantation, Division of General Surgery and Transplantation, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Fabrizio Di Francesco
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT, UPMC (University of Pittsburgh Medical Center), Palermo, Italy
| | - Matteo Ravaioli
- General Surgery and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | | | - Daniele Dondossola
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Università degli Studi di Milano, Milano, Italy
| | - Quirino Lai
- General Surgery and Organ Transplantation Unit, AOU Policlinico Umberto I, Sapienza University of Rome, Roma, Italy
| | - Matteo Zanchetta
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tubingen, Germany
| | - Jule Dingfelder
- Department of General Surgery, Division of Transplantation, Medical University of Vienna, Vienna, Austria
| | - Luca Toti
- Transplant and HPB Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Roma, Italy
| | - Alessandro Iacomino
- UOC Hepato-biliary Surgery and Liver Transplant Centre, AORN Antonio Cardarelli, Napoli, Italy
| | - Sermed Nicolae
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Davide Ghinolfi
- Division of Hepatic Surgery and Liver Transplantation, University Hospital of Pisa, Pisa, Italy
| | - Renato Romagnoli
- General Surgery 2U, Liver Transplant Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Torino, Italy
| | - Luciano De Carlis
- Department of Transplantation, Division of General Surgery and Transplantation, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Salvatore Gruttadauria
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT, UPMC (University of Pittsburgh Medical Center), Palermo, Italy
- Department of Surgery, Medical and Surgical Specialties, University of Catania, Catania, Italy
| | - Matteo Cescon
- General Surgery and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Michele Colledan
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Lucio Caccamo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milano, Italy
| | - Marco Vivarelli
- HPB and Transplantation Unit, Department of Experimental and Clinical Medicine, United Hospital of Ancona, Polytechnic University of Marche, Ancona, Italy
| | - Massimo Rossi
- General Surgery and Organ Transplantation Unit, AOU Policlinico Umberto I, Sapienza University of Rome, Roma, Italy
| | - Silvio Nadalin
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tubingen, Germany
| | - Georg Gyori
- Department of General Surgery, Division of Transplantation, Medical University of Vienna, Vienna, Austria
| | - Giuseppe Tisone
- Transplant and HPB Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Roma, Italy
| | - Giovanni Vennarecci
- UOC Hepato-biliary Surgery and Liver Transplant Centre, AORN Antonio Cardarelli, Napoli, Italy
| | - Andreas Rostved
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Paolo De Simone
- Department of Surgical, Medical, Biochemical Pathology and Intensive Care, University of Pisa, Pisa, Italy
| | - Miriam Isola
- Division of Medical Statistic, Department of Medicine, University of Udine, Udine, Italy
| | - Umberto Baccarani
- Liver-Kidney Transplant Unit, Department of Medicine, University of Udine, Udine, Italy
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Peghin M, De Martino M, Palese A, Chiappinotto S, Fonda F, Gerussi V, Sartor A, Curcio F, Grossi PA, Isola M, Tascini C. Antibody response and risk of reinfection over 2 years among the patients with first wave of COVID-19. Clin Microbiol Infect 2024; 30:522-530. [PMID: 38141821 DOI: 10.1016/j.cmi.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES To describe the dynamics and factors related to natural and hybrid humoral response against the SARS-CoV-2 and risk of reinfection among first-wave patients. METHODS A prospective longitudinal study with periodic serological follow-up after acute onset of all recovered patients with SARS-CoV-2 infection cared in Udine Hospital (March-May 2020). Nucleocapsid (N) protein and spike receptor-binding domain (S-RBD) antibody tests were used to distinguish natural and vaccine-induced response. RESULTS Overall, 153 patients (66 men, mean age 56 years) were followed for a median of 27.3 (interquartile range 26.9-27.8) months. Seroreversion was 98.5% (95% CI: 96.8-99.4) for SARS-CoV-2-N IgM at 1 year and 57.4% (95% CI: 51.5-63.5) for SARS-CoV-2-N IgG at 2 years. Initial serological response (hazard ratio [HR]: 0.99, 95% CI: 0.99-0.99, p 0.002 for IgM and HR: 0.97, 95% CI: 0.97-0.98, p < 0.001 for IgG) and severity of acute infection (HR: 0.62, 95% CI: 0.39-0.96, p 0.033 for IgM and HR: 0.60, 95% CI: 0.37-0.99, p < 0.001 for IgG) were independently associated with persistent SARS-CoV-2-N IgM/IgG response. Older age and smoker status were associated with long-term SARS-CoV-2-N IgM and SARS-CoV-2-N IgG, respectively (HR: 0.75, 95% CI: 0.57-0.98, p 0.038; HR: 1.77, 95% CI: 1.19-2.61, p 0.004 respectively). All patients maintained SARS-CoV-2-S-RBD IgG response at 24-month follow-up. Reinfections occurred in 25 of 153 (16.3%) patients, mostly during the omicron circulation. Reinfection rates did not differ significantly between SARS-CoV-2-N IgG seronegative and seropositive patients (14/89, 15.7% vs. 10/62, 16.1%, p 0.947). Unvaccinated patients had higher risk of reinfection (4/7, 57.1% vs. vaccinated 21/146, 14.4%, p 0.014). DISCUSSION First-wave patients had durable natural humoral immunity in 40% and anti-S-RBD response in 100% up to 2 years after infection. Natural humoral response alone was not protective against reinfections with omicron SARS-CoV-2 variants, whereas vaccination was effective to reduce the risk of a new infection.
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Affiliation(s)
- Maddalena Peghin
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy
| | - Maria De Martino
- Division of Medical Statistics, Department of Medicine, University of Udine, Udine, Italy.
| | - Alvisa Palese
- Department of Medicine, University of Udine, Udine, Italy
| | | | - Federico Fonda
- Department of Medicine, University of Udine, Udine, Italy
| | - Valentina Gerussi
- Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, Italy
| | - Assunta Sartor
- Institute of Clinical Pathology, Department of Laboratory Medicine, University of Udine, ASUFC, Udine, Italy
| | - Francesco Curcio
- Institute of Clinical Pathology, Department of Laboratory Medicine, University of Udine, ASUFC, Udine, Italy
| | - Paolo Antonio Grossi
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy
| | - Miriam Isola
- Division of Medical Statistics, Department of Medicine, University of Udine, Udine, Italy
| | - Carlo Tascini
- Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, Italy
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Collini V, Andreis A, De Biasio M, De Martino M, Isola M, Croatto N, Lepre V, Cantarini L, Merlo M, Sinagra G, Abbate A, Lazaros G, Brucato A, Klein AL, Imazio M. Efficacy of colchicine in addition to anakinra in patients with recurrent pericarditis. Open Heart 2024; 11:e002599. [PMID: 38490715 PMCID: PMC10946365 DOI: 10.1136/openhrt-2023-002599] [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: 12/31/2023] [Accepted: 02/26/2024] [Indexed: 03/17/2024] Open
Abstract
AIM Anakinra, an anti IL-1 agent targeting IL-1 alfa and beta, is available for the treatment of recurrent pericarditis in cases with corticosteroid dependence and colchicine resistance after failure of conventional therapies. However, it is unclear if the combination with colchicine, a non-specific inhibitor of the inflammasome targeting the same inflammatory pathway of IL-1, could provide additional benefit to prevent further recurrences. The aim of the present observational study is to assess whether the addition of colchicine on top of anakinra could prolong the time to first recurrence and prevent recurrences better than anakinra alone. METHODS International, all-comers, multicentre, retrospective observational cohort study analysing all consecutive patients treated with anakinra for corticosteroid-dependent and colchicine-resistant recurrent pericarditis. The efficacy endpoint was recurrence rate and the time to the first recurrence. RESULTS A total of 256 patients (mean age 45.0±15.4 years, 65.6% females, 80.9% with idiopathic/viral aetiology) were included. 64 (25.0%) were treated with anakinra as monotherapy while 192 (75.0%) with both anakinra and colchicine. After a follow-up of 12 months, 56 (21.9%) patients had recurrences. Patients treated with colchicine added to anakinra had a lower incidence of recurrences (respectively, 18.8% vs 31.3%; p=0.036) and a longer event-free survival (p=0.025). In multivariable analysis, colchicine use prevented recurrences (HR 0.52, 95% CI 0.29 to 0.91; p=0.021). CONCLUSIONS The addition of colchicine on top of anakinra treatment could be helpful to reduce recurrences and prolong the recurrence-free survival.
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Affiliation(s)
- Valentino Collini
- Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alessandro Andreis
- Division of Cardiology, Department of Medical Sciences, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Marzia De Biasio
- Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Maria De Martino
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Miriam Isola
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Nicole Croatto
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Veronica Lepre
- Cardiology Specialty School, University of Trieste, Trieste, Italy
| | | | - Marco Merlo
- Cardiology Specialty School, University of Trieste, Trieste, Italy
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), Trieste, Italy
| | - Gianfranco Sinagra
- Cardiology Specialty School, University of Trieste, Trieste, Italy
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), Trieste, Italy
| | - Antonio Abbate
- Virginia Commonwealth University, Richmond, Virginia, USA
| | - George Lazaros
- Department of Cardiology, University of Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Antonio Brucato
- Department of Biomedical and Clinical Sciences "Sacco", University of Milano, Milano, Italy
| | - Allan L Klein
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Massimo Imazio
- Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medicine (DMED), University of Udine, Udine, Italy
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5
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Treppo E, Isola M, De Martino M, Padoan R, Giollo A, Urban ML, Monti S, Sartorelli S, Fassio A, Argolini LM, Marvisi C, Gattamelata A, Regola F, Ferro F, Cassone G, Motta F, Berti A, Conticini E, Guiducci S, Matucci-Cerinic M, Lo Gullo A, Manfredi A, Frediani B, Bortolotti R, Selmi C, Baldini C, Franceschini F, Conti F, Caporali R, Rossini M, Dagna L, Montecucco C, Emmi G, Schiavon F, Salvarani C, Quartuccio L. Validation of the Italian version of the ANCA-associated vasculitis patient-reported outcome (AAV-PRO) questionnaire. Rheumatol Adv Pract 2024; 8:rkae001. [PMID: 38515585 PMCID: PMC10956719 DOI: 10.1093/rap/rkae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 03/23/2024] Open
Abstract
Objectives The primary objective of this study was the translation and validation of the ANCA-associated vasculitis patient-reported outcome (AAV-PRO) questionnaire into Italian, denoted as AAV-PRO_ita. The secondary objective was to evaluate the impact of ANCA-associated vasculitis (AAV) on quality of life (QoL) and work impairment in a large cohort of Italian patients. Methods The study design took a prospective cohort study approach. First, the AAV-PRO was translated into Italian following the step guidelines for translations. The new AAV-PRO_ita questionnaire covered three disease domains: organ-specific and systemic symptoms and signs; physical function; and social and emotional impact. Second, Italian-speaking AAV patients were recruited from 17 Italian centres belonging to the Italian Vasculitis Study Group. Participants completed the AAV-PRO_ita questionnaire at three time points. Participants were also requested to complete the work productivity and activity impairment: general health questionnaire. Results A total of 276 AAV patients (56.5% women) completed the questionnaires. The AAV-PRO_ita questionnaire demonstrated a good internal consistency and test-retest reliability. Female AAV patients scored higher (i.e. worse) in all thee domains, especially in the social and emotional impact domain (P < 0.001). Patients on glucocorticoid therapy (n = 199) had higher scores in all domains, especially in the physical function domain (P < 0.001), compared with patients not on glucocorticoid therapy (n = 77). Furthermore, patients who had at least one relapse of disease (n = 114) had higher scores compared with those who had never had one (n = 161) in any domain (P < 0.05). Finally, nearly 30% of the patients reported work impairment. Conclusion The AAV-PRO_ita questionnaire is a new 29-item, disease-specific patient-reported outcome measuring tool that can be used in AAV research in the Italian language. Sex, glucocorticoids and relapsing disease showed the greatest impact on QoL.
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Affiliation(s)
- Elena Treppo
- Division of Rheumatology, Department of Medicine, University of Udine, Udine, Italy
| | - Miriam Isola
- Institute of Statistics, Department of Medicine, University of Udine, Udine, Italy
| | - Maria De Martino
- Institute of Statistics, Department of Medicine, University of Udine, Udine, Italy
| | - Roberto Padoan
- Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padova, Italy
| | - Alessandro Giollo
- Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padova, Italy
| | - Maria Letizia Urban
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Sara Monti
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy
- Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Silvia Sartorelli
- IRCCS San Raffaele Scientific Institute, Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), Milano, Italy
| | - Angelo Fassio
- Rheumatology Unit, University of Verona, Verona, Italy
| | | | - Chiara Marvisi
- Azienda USL-IRCCS di Reggio Emilia and University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Angelica Gattamelata
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Rheumatology Unit, Sapienza University of Rome, Rome, Italy
| | - Francesca Regola
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Francesco Ferro
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Cassone
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Motta
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center—IRCCS, Rozzano, Milano, Italy
| | - Alvise Berti
- Center for Medical Sciences (CISMed), University of Trento, and Rheumatology Unit, Santa Chiara Hospital, APSS Trento, Italy
| | - Edoardo Conticini
- Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Serena Guiducci
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Italy
| | - Marco Matucci-Cerinic
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Italy
| | | | - Andreina Manfredi
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Bruno Frediani
- Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Roberto Bortolotti
- Center for Medical Sciences (CISMed), University of Trento, and Rheumatology Unit, Santa Chiara Hospital, APSS Trento, Italy
| | - Carlo Selmi
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center—IRCCS, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Milano, Italy
| | - Chiara Baldini
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Franco Franceschini
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili, and Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fabrizio Conti
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Rheumatology Unit, Sapienza University of Rome, Rome, Italy
| | - Roberto Caporali
- Division of Clinical Rheumatology, ASST Istituto Gaetano Pini—CTO, Milano, Italy
| | | | - Lorenzo Dagna
- IRCCS San Raffaele Scientific Institute, Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), Milano, Italy
| | - Carlomaurizio Montecucco
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy
- Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria, Australia
| | - Franco Schiavon
- Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padova, Italy
| | - Carlo Salvarani
- Azienda USL-IRCCS di Reggio Emilia and University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Luca Quartuccio
- Division of Rheumatology, Department of Medicine, University of Udine, Udine, Italy
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Marcon C, Bertone A, Mauro S, Mestroni R, Battaglia G, Pizzano U, Facchin G, De Martino M, Isola M, Patriarca F, Barillari G, Savignano C. Stem Cells mobilization and collection in allogeneic related and unrelated donors: a single center experience with focus on plerixafor. Transfus Apher Sci 2023; 62:103845. [PMID: 37953206 DOI: 10.1016/j.transci.2023.103845] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Poor CD34 + cells mobilization in allogeneic donors could affect transplant outcome. In a subgroup of patient mobilization with granulocyte colony-stimulating factor (G-CSF) alone is unsatisfactory, and Plerixafor could be used to enhance CD34 + cells release from bone marrow niche. MATERIALS AND METHODS We conducted a retrospective single-center, cohort study on healthy allogeneic donors both related and unrelated, treated by Udine Transfusion Center over the last 10 years (2012-2022). In the 195 allogeneic donors treated we analyzed age, sex, body weight, BMI, comorbidities, G-CSF dosage and even baseline white blood cell count as possible predictor of insufficient CD34 + cells mobilization on day 5. In the subgroup of related donors we evaluated even baseline CD34 + cells (measured before mobilization start). Processed donor blood volume, collection efficiency and apheresis product were examined. Additionally a comparative analysis was conducted between G-CSF alone treated donors and poor mobilizing ones, in which Plerixafor was administered at a dose of 0.24 mg/kg as a pre-emptive or rescue agent. RESULTS In 9 donors, due to poor mobilization (defined as CD34 + < 20/µL or estimated yield < 1 ×106 kg/recipient body weight), the use of plerixafor was necessary. PLX at a dose of 0.24 mg/kg was administered 5 h before collection, inducing an average increase of 5.1 (1.7-12.6) in CD34 + circulating cells. In this subgroup of patients, BMI and weight were significantly lower (p = 0.03). Interestingly, baseline CD34 + cells (measured before the onset of mobilization) also seems to predict poor mobilization (p = 0.003). In donors additionally treated with Plerixafor compared to those who received G-CSF alone, collection efficiency was higher (p = 0.02) and CD34 + cells collected were comparable (p = 0.2). Side effects related to the administration of plerixafor, if they occurred, were well tolerated. CONCLUSIONS Plerixafor is a safe and effective drug in the rescue and prevention of poor mobilization. New prospective studies on allogeneic donors should be performed to increase the treatable population to avoid inadequate collection and mobilization. New laboratory predictors such as baseline CD34 + cells should be investigated in larger cohorts and then used as early screening.
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Affiliation(s)
- Chiara Marcon
- Departement of Blood Transfusion Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Division of Hematology, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Antonella Bertone
- Departement of Blood Transfusion Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Sara Mauro
- Departement of Blood Transfusion Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Rosalba Mestroni
- Division of Hematology, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Giulia Battaglia
- Division of Hematology, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Umberto Pizzano
- Division of Hematology, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Gabriele Facchin
- Division of Hematology, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Maria De Martino
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Miriam Isola
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Francesca Patriarca
- Division of Hematology, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Giovanni Barillari
- Departement of Blood Transfusion Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Chiara Savignano
- Departement of Blood Transfusion Medicine, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
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Vendramin I, Lechiancole A, Piani D, Sponga S, Bressan M, Auci E, Isola M, De Martino M, Bortolotti U, Livi U. Influence of a regional network combined with a systematic multidisciplinary approach on the outcomes of patients with acute type A aortic dissection. Int J Cardiol 2023; 391:131278. [PMID: 37598911 DOI: 10.1016/j.ijcard.2023.131278] [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: 01/15/2023] [Revised: 08/01/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Whether in patients with acute type A aortic dissection reduction of intervals between onset of symptoms and diagnosis influences patient outcomes is still not completely defined. METHODS In 199 patients with acute type A aortic dissection, the efficacy of a systematic multidisciplinary approach and institution of a regional network were evaluated; 90 patients operated before 2016 (Group1) were compared with 109 repaired after 2016 (Group2) for early and late outcomes. RESULTS Mortality was reduced from 13% in Group1 to 4% in Group2 (p = 0.013). In Group2 a more patients (46%) had arch replacement compared to Group1 (29%)(p = 0.06). In Group2 axillary artery cannulation was almost routinely used (91% vs 67%, p < 0.001) with shorter circulatory arrest time (37 vs 44 min, p < 0.001). The interval from diagnosis to surgery dropped from 210 min in Group1 to 160 min in Group2 (p < 0.001); this reduction was evident both in patients admitted to the emergency department of a spoke and/or a hub center. Patients presenting with or developing shock were reduced from Group1 to Group2 and in particular those reaching the hub center from spoke centers. Survival at 1 and 5 years was 82 ± 4% and 70 ± 5% in Group1 vs 92 ± 3% and 87 ± 8% in Group2 (p = 0.007). CONCLUSIONS Outcomes of patients with acute type A aortic dissection improved using a systematic multidisciplinary approach while a network between spoke and hub centers reduced intervals between diagnosis, transportation to hub center and repair, limiting the incidence of tamponade and shock.
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Affiliation(s)
- Igor Vendramin
- Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
| | - Andrea Lechiancole
- Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Daniela Piani
- Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Sandro Sponga
- Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Marilyn Bressan
- Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Elisabetta Auci
- Department of Anesthesia, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Miriam Isola
- Department of Medical Area, University of Udine, Udine, Italy
| | | | - Uberto Bortolotti
- Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Ugolino Livi
- Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Department of Medical Area, University of Udine, Udine, Italy
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Danielewicz AL, Lazzer S, Marra A, Abbruzzese L, D’Alleva M, Martino MD, Isola M, Avelar NCP, Mendonça VA, Lacerda ACR, Sartorio A. Prediction of resting energy expenditure in Italian older adults with severe obesity. Front Endocrinol (Lausanne) 2023; 14:1283155. [PMID: 38027183 PMCID: PMC10663312 DOI: 10.3389/fendo.2023.1283155] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background In the last decade a large number of studies proposed and/or validated equations to estimate the Resting Energy Expenditure (REE) in adults and/or older adults, however, no equation currently available showed good accuracy for older adults with severe obesity. Thus, this study aimed to develop and validate new predictive equations for REE, based on data from the indirect calorimetry, in Italian older adults with severe obesity. Methods A retrospective study was as conducted with 764 Caucasian older adults with severe obesity (age range: 60-74 years and BMI ≥ 35 kg/m/²). Four models were used to test the accuracy of anthropometry and body composition variables in multivariable prediction of REE. All models were derived by stepwise multiple regression analysis using a calibration group of 382 subjects [295 females and 87 males] and the equations were cross-validated in the remaining 382 subjects [295 females and 87 males] as validation group. The new prediction equations and the other published equations were tested using the Bland-Altman method. Prediction accuracy was defined as the percentage of subjects whose REE was predicted within ± 10% of measured REE. Results All the equations analyzed predicted higher energy requirements for males than females, and most of them underestimated the energy requirement values of our sample. The highest accuracy values were observed in the new equations, with 62% in the anthropometric model and 63% in the body composition model. Conclusion Although the accuracy of our equations was slightly higher in comparison with the other taken into consideration, they cannot be considered completely satisfactory for predicting REE in Italians older adults with severe obesity. When predicting equations cannot guarantee precise or acceptable values of REE, the use of indirect calorimetry (if available) should be always recommended, especially in clinical practice.
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Affiliation(s)
- Ana Lúcia Danielewicz
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-endocrinological Research, Piancavallo-Verbania, Italy
- Department of Health Sciences, Graduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Stefano Lazzer
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Science, University of Udine, Udine, Italy
| | - Alice Marra
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-endocrinological Research, Piancavallo-Verbania, Italy
| | - Laura Abbruzzese
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Division of Eating and Nutrition Disorders, Piancavallo-Verbania, Italy
| | - Mattia D’Alleva
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Science, University of Udine, Udine, Italy
| | | | - Miriam Isola
- Department of Medicine, University of Udine, Udine, Italy
| | - Núbia Carelli Pereira Avelar
- Department of Health Sciences, Graduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Vanessa Amaral Mendonça
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-endocrinological Research, Piancavallo-Verbania, Italy
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Vetrugno L, Castaldo N, Fantin A, Deana C, Cortegiani A, Longhini F, Forfori F, Cammarota G, Grieco DL, Isola M, Navalesi P, Maggiore SM, Bassetti M, Chetta A, Confalonieri M, De Martino M, Ferrari G, Francisi D, Luzzati R, Meini S, Scozzafava M, Sozio E, Tascini C, Bassi F, Patruno V, De Robertis E, Aldieri C, Ball L, Baratella E, Bartoletti M, Boscolo A, Burgazzi B, Catalanotti V, Confalonieri P, Corcione S, De Rosa FG, De Simoni A, Bono VD, Tria RD, Forlani S, Giacobbe DR, Granozzi B, Labate L, Lococo S, Lupia T, Matellon C, Mehrabi S, Morosi S, Mongodi S, Mura M, Nava S, Pol R, Pettenuzzo T, Quyen NH, Rescigno C, Righi E, Ruaro B, Salton F, Scabini S, Scarda A, Sibani M, Tacconelli E, Tartaglione G, Tazza B, Vania E, Viale P, Vianello A, Visentin A, Zuccon U, Meroi F, Buonsenso D. Ventilatory associated barotrauma in COVID-19 patients: A multicenter observational case control study (COVI-MIX-study). Pulmonology 2023; 29:457-468. [PMID: 36669936 PMCID: PMC9684110 DOI: 10.1016/j.pulmoe.2022.11.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/25/2022] [Accepted: 11/02/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The risk of barotrauma associated with different types of ventilatory support is unclear in COVID-19 patients. The primary aim of this study was to evaluate the effect of the different respiratory support strategies on barotrauma occurrence; we also sought to determine the frequency of barotrauma and the clinical characteristics of the patients who experienced this complication. METHODS This multicentre retrospective case-control study from 1 March 2020 to 28 February 2021 included COVID-19 patients who experienced barotrauma during hospital stay. They were matched with controls in a 1:1 ratio for the same admission period in the same ward of treatment. Univariable and multivariable logistic regression (OR) were performed to explore which factors were associated with barotrauma and in-hospital death. RESULTS We included 200 cases and 200 controls. Invasive mechanical ventilation was used in 39.3% of patients in the barotrauma group, and in 20.1% of controls (p<0.001). Receiving non-invasive ventilation (C-PAP/PSV) instead of conventional oxygen therapy (COT) increased the risk of barotrauma (OR 5.04, 95% CI 2.30 - 11.08, p<0.001), similarly for invasive mechanical ventilation (OR 6.24, 95% CI 2.86-13.60, p<0.001). High Flow Nasal Oxygen (HFNO), compared with COT, did not significantly increase the risk of barotrauma. Barotrauma frequency occurred in 1.00% [95% CI 0.88-1.16] of patients; these were older (p=0.022) and more frequently immunosuppressed (p=0.013). Barotrauma was shown to be an independent risk for death (OR 5.32, 95% CI 2.82-10.03, p<0.001). CONCLUSIONS C-PAP/PSV compared with COT or HFNO increased the risk of barotrauma; otherwise HFNO did not. Barotrauma was recorded in 1.00% of patients, affecting mainly patients with more severe COVID-19 disease. Barotrauma was independently associated with mortality. TRIAL REGISTRATION this case-control study was prospectively registered in clinicaltrial.gov as NCT04897152 (on 21 May 2021).
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Affiliation(s)
- Luigi Vetrugno
- Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy; Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.
| | - Nadia Castaldo
- Pulmonology Unit, Department of Cardiothoracic Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy
| | - Alberto Fantin
- Pulmonology Unit, Department of Cardiothoracic Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy
| | - Cristian Deana
- Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Udine, Italy
| | - Andrea Cortegiani
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy; Department of Anesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy
| | - Federico Longhini
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Francesco Forfori
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, AOUP-Pisa, Italy
| | - Gianmaria Cammarota
- Anesthesia and Intensive Care Service 2, University Hospital of Perugia, Perugia, Italy; Department of Medicine and Surgery, Universiy of Perugia, Perugia, Italy
| | - Domenico Luca Grieco
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Rome, Italy; Department of Anesthesia, Emergency and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Miriam Isola
- Department of Medicine, University of Udine, Udine, Italy
| | - Paolo Navalesi
- Institute of Anaesthesia and Intensive Care, Padua University Hospital, Padua, Italy; Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Salvatore Maurizio Maggiore
- Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy; Department of Innovative Technologies in Medicine and Dentistry, Gabriele d'Annunzio University of Chieti Pescara, Chieti, Italy
| | - Matteo Bassetti
- Infectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Alfredo Chetta
- Respiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Marco Confalonieri
- Department of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy
| | | | - Giovanni Ferrari
- Pneumologia e Unità di Terapia Semi Intensiva Respiratoria, AO Umberto I Mauriziano, Turin, Italy
| | - Daniela Francisi
- Department of Infectious Disease "S. Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Roberto Luzzati
- Infectious Disease Unit, University of Trieste, Trieste, Italy
| | - Simone Meini
- U.O. Medicina Interna, Felice Lotti Hospital, Azienda USL Toscana Nord-Ovest, Pontedera, Italy
| | | | - Emanuela Sozio
- Infectious Diseases Division, Health Integrated Agency of Friuli Centrale, Udine, Italy
| | - Carlo Tascini
- Department of Medicine, University of Udine, Udine, Italy; Infectious Diseases Division, Health Integrated Agency of Friuli Centrale, Udine, Italy
| | - Flavio Bassi
- Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Udine, Italy
| | - Vincenzo Patruno
- Pulmonology Unit, Department of Cardiothoracic Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy
| | - Edoardo De Robertis
- Anesthesia and Intensive Care Service 2, University Hospital of Perugia, Perugia, Italy; Department of Medicine and Surgery, Universiy of Perugia, Perugia, Italy
| | - Chiara Aldieri
- Division of Infectious Diseases, Department of Medicine, Hospital Santa Croce e Carle, Cuneo, Italy
| | - Lorenzo Ball
- Anesthesia and Intensive Care, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Elisa Baratella
- Department of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy
| | - Michele Bartoletti
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy
| | - Annalisa Boscolo
- Institute of Anaesthesia and Intensive Care, Padua University Hospital, Padua, Italy
| | - Barbara Burgazzi
- Respiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Vito Catalanotti
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy
| | - Paola Confalonieri
- Department of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy
| | - Silvia Corcione
- Department of Medical Sciences, University of Turin, Infectious Diseases, City of Health and Sciences, Turin, Italy
| | - Francesco Giuseppe De Rosa
- Infectious Diseases Unit, Cardinal Massaia Hospital, Asti, Italy; Infectious Diseases Unit, Cardinal Massaia Hospital, Asti, Italy
| | - Alessandro De Simoni
- Respiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Valerio Del Bono
- Division of Infectious Diseases, Department of Medicine, Hospital Santa Croce e Carle, Cuneo, Italy
| | - Roberta Di Tria
- Pneumologia e Unità di Terapia Semi Intensiva Respiratoria, AO Umberto I Mauriziano, Turin, Italy
| | - Sara Forlani
- Pulmonary Medicine Unit, Lodi General Hospital, Lodi, Italy
| | - Daniele Roberto Giacobbe
- Infectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Bianca Granozzi
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy
| | - Laura Labate
- Infectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Sara Lococo
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Tommaso Lupia
- Infectious Diseases Unit, Cardinal Massaia Hospital, Asti, Italy
| | - Carola Matellon
- Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Udine, Italy
| | - Sara Mehrabi
- Infectious Diseases Division, Diagnostics and Public Health Department, University of Verona, Verona, Italy
| | - Sabrina Morosi
- Department of Infectious Disease "S. Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Silvia Mongodi
- Anaesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Maddalena Mura
- U.O. Medicina Interna, Felice Lotti Hospital, Azienda USL Toscana Nord-Ovest, Pontedera, Italy
| | - Stefano Nava
- Department of Clinical, Integrated and Experimental Medicine (DIMES), University of Bologna, Bologna, Italy; Respiratory and Critical Care Unit, Sant Orsola University Hospital, Bologna, Italy
| | - Riccardo Pol
- Infectious Disease Unit, University of Trieste, Trieste, Italy
| | - Tommaso Pettenuzzo
- Institute of Anaesthesia and Intensive Care, Padua University Hospital, Padua, Italy
| | - Nguyen Hoang Quyen
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Carolina Rescigno
- UOC Malattie Infettive ad Indirizzo Neurologico, AORN Ospedali dei Colli, P.O. "D. Cotugno", Naples, Italy
| | - Elda Righi
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Barbara Ruaro
- Department of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy
| | - Francesco Salton
- Department of Pulmonology, University Hospital of Cattinara, Trieste, Italy; University of Trieste, Trieste, Italy
| | - Silvia Scabini
- Department of Medical Sciences, University of Turin, Infectious Diseases, City of Health and Sciences, Turin, Italy
| | - Angelo Scarda
- Respiratory Disease Unit, "Santa Maria degli Angeli" Hospital, Pordenone, Italy
| | - Marcella Sibani
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Evelina Tacconelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Gennaro Tartaglione
- Respiratory Disease Unit, "Santa Maria degli Angeli" Hospital, Pordenone, Italy
| | - Beatrice Tazza
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy
| | - Eleonora Vania
- Infectious Diseases Division, Health Integrated Agency of Friuli Centrale, Udine, Italy
| | - Pierluigi Viale
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola, Bologna, Italy
| | - Andrea Vianello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Alessandro Visentin
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Umberto Zuccon
- Respiratory Disease Unit, "Santa Maria degli Angeli" Hospital, Pordenone, Italy
| | | | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Palese A, Chiappinotto S, Fonda F, Visintini E, Peghin M, Colizzi M, Balestrieri M, De Martino M, Isola M, Tascini C. Lessons learnt while designing and conducting a longitudinal study from the first Italian COVID-19 pandemic wave up to 3 years. Health Res Policy Syst 2023; 21:111. [PMID: 37907957 PMCID: PMC10617212 DOI: 10.1186/s12961-023-01055-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 09/23/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Several scientific contributions have summarized the "lessons learnt" during the coronavirus disease 2019 (COVID-19) pandemic, but only a few authors have discussed what we have learnt on how to design and conduct research during a pandemic. The main intent of this study was to summarize the lessons learnt by an Italian multidisciplinary research group that developed and conducted a longitudinal study on COVID-19 patients infected during the first wave in March 2020 and followed-up for 3 years. METHODS A qualitative research approach embedded into the primary CORonavirus MOnitoRing study (CORMOR) study was developed, according to the the consolidated criteria for reporting qualitative research. Multiple data collection strategies were performed: each member was invited to report the main lessons learnt according to his/her perspective and experience from the study design throughout its conduction. The narratives collected were summarized and discussed in face-to-face rounds. The narratives were then thematically analysed according to their main topic in a list that was resent to all members to check the content and their organization. The list of the final "lessons learnt" has been agreed by all members, as described in a detailed fashion. RESULTS Several lessons were learnt while designing and conducting a longitudinal study during the COVID-19 pandemic and summarised into ten main themes: some are methodological, while others concern how to conduct research in pandemics/epidemics/infectious disease emergencies. CONCLUSIONS The multidisciplinary approach, which also included patients' perspective, helped us to protect the consistency and quality of the research provided in pandemic times. The lesson learnt suggest that our research approach may benefit from changes in education, clinical practice and policies.
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Affiliation(s)
- Alvisa Palese
- Department of Medicine (DAME), University of Udine, Udine, Italy.
| | | | - Federico Fonda
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Erica Visintini
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Maddalena Peghin
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy
| | - Marco Colizzi
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Maria De Martino
- Medical Statistics Division, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Miriam Isola
- Medical Statistics Division, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Carlo Tascini
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, Udine, Italy
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Zingaretti N, Albanese R, Pisano G, Isola M, Giusti A, De Martino M, De Francesco F, Riccio M, Parodi PC. Evaluation of Kinesio Taping for Edema, Ecchymosis, and Pain After Liposuction: A Prospective Pilot Study. Aesthet Surg J 2023; 43:NP787-NP796. [PMID: 37378563 DOI: 10.1093/asj/sjad203] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/15/2023] [Accepted: 06/26/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Liposuction is a safe, simple, and effective method of body contouring. Pain, ecchymosis, and edema are often local complications at the removal site, especially in the first weeks after surgery. Several studies have shown that kinesiology (kinesio) taping improves blood and lymphatic flow, removing congestions of lymphatic fluid and alleviating hemorrhage. However, there are limited data on the effect of kinesio taping in mitigating local complications at fat grafting donor sites. OBJECTIVES The aim of this pilot study was to evaluate the impact of kinesio taping in reducing postoperative edema, pain, and ecchymosis in the liposuction area. METHODS Over a period of 18 months (January 2021-June 2022), 52 patients underwent liposuction of both flanks with subsequent breast fat grafting. Immediately after the surgery, kinesio taping was used on the right abdomen flank in all patients. Degree of edema as well as ecchymosis and pain were quantified at 7, 14, and 21 days after surgery. RESULTS There were statistically significant differences in the taping area for ecchymosis at 7 days after surgery, edema at 14 and 21 days after surgery, and in pain, rated on a visual analog scale, at 7, 14 and 21 days after surgery. CONCLUSIONS Kinesio taping, as used in this study, is beneficial in the reduction of edema and pain and the resolution of ecchymosis after liposuction. LEVEL OF EVIDENCE: 3
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Vetrugno L, Sala A, Deana C, Meroi F, Grandesso M, Maggiore SM, Isola M, De Martino M, Restaino S, Vizzielli G, Bove T, Driul L. Quality of life 1 year after hospital discharge in unvaccinated pregnant women with COVID-19 respiratory symptoms: a prospective observational study (ODISSEA-PINK study). Front Med (Lausanne) 2023; 10:1225648. [PMID: 37746068 PMCID: PMC10516577 DOI: 10.3389/fmed.2023.1225648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Little is known about Quality of Life within the first court of unvaccinated COVID-19 pregnant women exposed to the pandemic stressor. Primary aim of this study was to evaluate 1 year after hospital discharge HRQoL in a cohort of COVID-19 unvaccinated pregnant patients with COVID-19. Methods in this prospective observational study, all COVID-19 positive pregnant women at any gestational age, admitted to the Obstetric Department at the University Hospital of Udine, Italy, from 1 March 2020 to 1 March 2021, requiring or not oxygen supplementation due to SARS-CoV2 pneumonia were evaluated. Patients with a history of neurological or psychiatric disease, those with a previous abortion, and those who refused to provide written informed consent were excluded from the study. We investigated pregnant positive COVID-19 women Health-related quality of life (HRQoL) with the Short-Form Health Survey-36 (SF-36) and Post-traumatic Stress-Disorder (PTSD) with the Impact of Event Scale-Revised (IES-R). Results 62 pregnant women respected the inclusion criteria of the study, and data from 33 patients were analyzed. The mean age was 32 ± 6 years, with a median gestational age of 38 weeks [IQR 34-40]. 15.2% of patients required oxygen therapy through noninvasive respiratory support (with high flow nasal cannula) for a median of 9 days [IQR 6-12]. The median Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were 50.2 [IQR 46.7-53.7] and 56.0 [IQR 46.8-60.6] respectively. Ten patients out of 33 (30%) tested positive for PTSD. Maternal age, gestational age, and history of cardiac-pulmonary-kidney disease significantly affected HRQoL at multivariable analysis. Discussion In COVID-19 pregnant unvaccinated women some physical impairments reducing HRQoL are still present 1 year after hospital discharge. Previous medical history such as history of cardiac-pulmonary-kidney disease significantly affected HRQoL. Long and repeated follow-up should be pursued in this category of patients.Clinical trial registration:ClinicalTrials.gov, Identifier NCT04860687.
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Affiliation(s)
- Luigi Vetrugno
- Department of Medical, Oral, and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
- Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy
| | - Alessia Sala
- Department of Medical Area (DAME), University of Udine, Udine, Italy
- Department of Obstetrics and Gynaecology, ASUFC, Ospedale Santa Maria Della Misericordia, Udine, Italy
| | - Cristian Deana
- Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy
| | - Francesco Meroi
- Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy
| | - Maria Grandesso
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Salvatore Maurizio Maggiore
- Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy
- Department of Innovative Technologies in Medicine and Dentistry, Gabriele d'Annunzio University of Chieti Pescara, Chieti, Italy
| | - Miriam Isola
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Maria De Martino
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Stefano Restaino
- Department of Obstetrics and Gynaecology, ASUFC, Ospedale Santa Maria Della Misericordia, Udine, Italy
| | - Giuseppe Vizzielli
- Department of Medical Area (DAME), University of Udine, Udine, Italy
- Department of Obstetrics and Gynaecology, ASUFC, Ospedale Santa Maria Della Misericordia, Udine, Italy
| | - Tiziana Bove
- Department of Medical Area (DAME), University of Udine, Udine, Italy
- Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy
| | - Lorenza Driul
- Department of Medical Area (DAME), University of Udine, Udine, Italy
- Department of Obstetrics and Gynaecology, ASUFC, Ospedale Santa Maria Della Misericordia, Udine, Italy
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Colizzi M, Peghin M, De Martino M, Bontempo G, Chiappinotto S, Fonda F, Isola M, Tascini C, Balestrieri M, Palese A. COVID-19 Survivors Are Still in Need of Neuropsychiatric Support Two Years after Infection. Brain Sci 2023; 13:1034. [PMID: 37508966 PMCID: PMC10377179 DOI: 10.3390/brainsci13071034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
COVID-19 survivors have been reported to be at risk of long-term neuropsychiatric sequalae; however, prospective evidence in this regard is lacking. We prospectively assessed the occurrence of mental-health-domain-related symptoms over a 24-month period following COVID-19 onset in a cohort of 230 patients. Of them, 36.1% were still presenting with at least one symptom 24 months later. Across the study period, a significant reduction in overall symptoms from the onset was observed (p < 0.001); however, symptom prevalence was unchanged between the 12- and 24-month follow-ups across most symptomatic domains. At the 24-month follow-up, mental-health-domain-related symptoms only were higher than at the onset and were the most frequently reported symptoms. Dyspnea at the onset predicted both symptoms of psychiatric disorders (OR = 3.26, 95% CI = 1.22-8.70, and p = 0.019) and a lack of concentration and focus (OR = 3.17, 95% CI = 1.40-7.16, and p = 0.005) 24 months post-infection, with the number of comorbidities at the onset also predicting the occurrence of a lack of concentration and focus (OR = 1.52, 95% CI = 1.12-2.08, and p = 0.008). The findings of this study may have important public health implications, as they underlie the fact that COVID-19 survivors are still in need of neuropsychiatric support two years after infection.
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Affiliation(s)
- Marco Colizzi
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Maddalena Peghin
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, and Friuli Centrale University Health Service (ASUFC), 33100 Udine, Italy
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, 21110 Varese, Italy
| | - Maria De Martino
- Division of Medical Statistic, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Giulia Bontempo
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, and Friuli Centrale University Health Service (ASUFC), 33100 Udine, Italy
| | - Stefania Chiappinotto
- Department of Medicine (DAME), School of Nursing, University of Udine, 33100 Udine, Italy
| | - Federico Fonda
- Department of Medicine (DAME), School of Nursing, University of Udine, 33100 Udine, Italy
| | - Miriam Isola
- Division of Medical Statistic, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Carlo Tascini
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, and Friuli Centrale University Health Service (ASUFC), 33100 Udine, Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Alvisa Palese
- Department of Medicine (DAME), School of Nursing, University of Udine, 33100 Udine, Italy
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Peghin M, De Martino M, Palese A, Chiappinotto S, Fonda F, Gerussi V, Sartor A, Curcio F, Grossi PA, Isola M, Tascini C. Post-COVID-19 Syndrome 2 Years After the First Wave: The Role of Humoral Response, Vaccination and Reinfection. Open Forum Infect Dis 2023; 10:ofad364. [PMID: 37520419 PMCID: PMC10372856 DOI: 10.1093/ofid/ofad364] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Background The aim of this study was to describe the long-term evolution of post-COVID-19 syndrome over 2 years after the onset of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) in survivors of the first wave. Methods This prospective study was based on interviews and investigated post-COVID-19 syndrome 6, 12, and 24 months after the disease onset in all adult in- and outpatients with COVID-19 followed at Udine Hospital (Italy) during the first wave (March-May 2020). Humoral response, vaccination status, and reinfection were assessed. Results Overall, 230 patients (53.5% female; mean age 54.7 years) were interviewed 2.3 years (standard deviation = 0.11) after acute onset. Post-COVID-19 syndrome was observed in 36.1% of patients (n = 83) at 2 years. The most common persistent symptoms were fatigue (14.4%), rheumatological (14.4%), and psychiatric symptoms (9.6%). Overall, 55.4% (46 of 83) of long haulers searched for healthcare system support and 21 (45.7%) were visited by a specialist. Female gender (odds ratio [OR] = 2.50, P = .005), a proportional increase in the number of symptoms during acute COVID-19 (OR = 1.40, P = .001), and the presence of comorbidities (OR = 1.57, P = .004) were all independent risk factors for post-COVID-19 syndrome. Vaccination and reinfection had no impact on post-COVID-19 syndrome dynamics. The presence of receptor-binding domain (RBD) SARS-CoV-2 immunoglobulin G (IgG) and non-RBD SARS-CoV-2 IgG titers were not associated with the occurrence of post-COVID-19 syndrome. Conclusions Two years after COVID-19, the burden of persistent symptoms remains high among in- and outpatients' population infected during the first wave. Post-COVID-19 dynamic does not seem to be influenced by SARS-CoV-2 immunization status and reinfection.
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Affiliation(s)
- Maddalena Peghin
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy
| | - Maria De Martino
- Division of Medical Statistic, Department of Medicine, University of Udine, Udine, Italy
| | - Alvisa Palese
- Department of Medicine, University of Udine, Udine, Italy
| | | | - Federico Fonda
- Department of Medicine, University of Udine, Udine, Italy
| | - Valentina Gerussi
- Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy
| | - Assunta Sartor
- Institute of Clinical Pathology, Department of Laboratory Medicine, University of Udine, ASUFC,Udine, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Francesco Curcio
- Institute of Clinical Pathology, Department of Laboratory Medicine, University of Udine, ASUFC,Udine, Italy
| | - Paolo Antonio Grossi
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy
| | - Miriam Isola
- Division of Medical Statistic, Department of Medicine, University of Udine, Udine, Italy
| | - Carlo Tascini
- Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy
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Girometti R, Giannarini G, De Martino M, Caregnato E, Cereser L, Soligo M, Rozze D, Pizzolitto S, Isola M, Zuiani C. Multivariable stratification of PI-RADS version 2.1 categories for the risk of false-positive target biopsy: Impact on prostate biopsy decisions. Eur J Radiol 2023; 165:110897. [PMID: 37300933 DOI: 10.1016/j.ejrad.2023.110897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/30/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE To identify clinical and multiparametric magnetic resonance imaging (mpMRI) factors predicting false positive target biopsy (FP-TB) of prostate imaging reporting and data system version 2.1 (PI-RADSv2.1) ≥ 3 findings. METHOD We retrospectively included 221 men with and without previous negative prostate biopsy who underwent 3.0 T/1.5 T mpMRI for suspicious clinically significant prostate cancer (csPCa) between April 2019-July 2021. A study coordinator revised mpMRI reports provided by one of two radiologists (experience of > 1500/>500 mpMRI examinations, respectively) and matched them with the results of transperineal systematic biopsy plus fusion target biopsy (TB) of PI-RADSv2.1 ≥ 3 lesions or PI-RADSv2.1 ≤ 2 men with higher clinical risk. A multivariable model was built to identify features predicting FP-TB of index lesions, defined as the absence of csPCa (International Society of Urogenital Pathology [ISUP] ≥ 2). The model was internally validated with the bootstrap technique, receiving operating characteristics (ROC) analysis, and decision analysis. RESULTS Features significantly associated with FP-TB were age < 65 years (odds ratio [OR] 2.77), prostate-specific antigen density (PSAD) < 0.15 ng/mL/mL (OR 2.45), PI-RADS 4/5 category vs. category 3 (OR 0.15/0.07), and multifocality (OR 0.46), with a 0.815 area under the curve (AUC) in assessing FP-TB. When adjusting PI-RADSv2.1 categorization for the model, mpMRI showed 87.5% sensitivity and 79.9% specificity for csPCa, with a greater net benefit in triggering biopsy compared to unadjusted categorization or adjustment for PSAD only at decision analysis, from threshold probability ≥ 15%. CONCLUSION Adjusting PI-RADSv2.1 categories for a multivariable risk of FP-TB is potentially more effective in triggering TB of index lesions than unadjusted PI-RADS categorization or adjustment for PSAD alone.
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Affiliation(s)
- Rossano Girometti
- Institute of Radiology, Department of Medicine (DAME), University of Udine, University Hospital S. Maria della Misericordia - Azienda Sanitaria-Universitaria Friuli Centrale (ASU FC), p.le S. Maria ella Misericordia, 15, 33100 Udine, Italy.
| | - Gianluca Giannarini
- Urology Unit, University Hospital S. Maria della Misericordia - Azienda Sanitaria-Universitaria Friuli Centrale (ASU FC), p.le S. Maria della Misericordia, 15, 33100 Udine, Italy
| | - Maria De Martino
- Division of Medical Statistics, Department of Medicine (DAME), University of Udine, Udine, Italy, pl.le Kolbe, 4, 33100 Udine, Italy
| | - Elena Caregnato
- Institute of Radiology, Department of Medicine (DAME), University of Udine, University Hospital S. Maria della Misericordia - Azienda Sanitaria-Universitaria Friuli Centrale (ASU FC), p.le S. Maria ella Misericordia, 15, 33100 Udine, Italy
| | - Lorenzo Cereser
- Institute of Radiology, Department of Medicine (DAME), University of Udine, University Hospital S. Maria della Misericordia - Azienda Sanitaria-Universitaria Friuli Centrale (ASU FC), p.le S. Maria ella Misericordia, 15, 33100 Udine, Italy
| | - Matteo Soligo
- Urology Unit, University Hospital S. Maria della Misericordia - Azienda Sanitaria-Universitaria Friuli Centrale (ASU FC), p.le S. Maria della Misericordia, 15, 33100 Udine, Italy
| | - Davide Rozze
- Pathology Unit, University Hospital S. Maria della Misericordia - Azienda Sanitaria-Universitaria Friuli Centrale (ASU FC), p.le S. Maria della Misericordia, 15, 33100 Udine, Italy
| | - Stefano Pizzolitto
- Pathology Unit, University Hospital S. Maria della Misericordia - Azienda Sanitaria-Universitaria Friuli Centrale (ASU FC), p.le S. Maria della Misericordia, 15, 33100 Udine, Italy
| | - Miriam Isola
- Division of Medical Statistics, Department of Medicine (DAME), University of Udine, Udine, Italy, pl.le Kolbe, 4, 33100 Udine, Italy
| | - Chiara Zuiani
- Institute of Radiology, Department of Medicine (DAME), University of Udine, University Hospital S. Maria della Misericordia - Azienda Sanitaria-Universitaria Friuli Centrale (ASU FC), p.le S. Maria ella Misericordia, 15, 33100 Udine, Italy
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Vetrugno L, Deana C, Castaldo N, Fantin A, Belletti A, Sozio E, De Martino M, Isola M, Palumbo D, Longhini F, Cammarota G, Spadaro S, Maggiore SM, Bassi F, Tascini C, Patruno V. Barotrauma during Noninvasive Respiratory Support in COVID-19 Pneumonia Outside ICU: The Ancillary COVIMIX-2 Study. J Clin Med 2023; 12:jcm12113675. [PMID: 37297869 DOI: 10.3390/jcm12113675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Noninvasive respiratory support (NIRS) has been extensively used during the COVID-19 surge for patients with acute respiratory failure. However, little data are available about barotrauma during NIRS in patients treated outside the intensive care unit (ICU) setting. METHODS COVIMIX-2 was an ancillary analysis of the previous COVIMIX study, a large multicenter observational work investigating the frequencies of barotrauma (i.e., pneumothorax and pneumomediastinum) in adult patients with COVID-19 interstitial pneumonia. Only patients treated with NIRS outside the ICU were considered. Baseline characteristics, clinical and radiological disease severity, type of ventilatory support used, blood tests and mortality were recorded. RESULTS In all, 179 patients were included, 60 of them with barotrauma. They were older and had lower BMI than controls (p < 0.001 and p = 0.045, respectively). Cases had higher respiratory rates and lower PaO2/FiO2 (p = 0.009 and p < 0.001). The frequency of barotrauma was 0.3% [0.1-1.3%], with older age being a risk factor for barotrauma (OR 1.06, p = 0.015). Alveolar-arterial gradient (A-a) DO2 was protective against barotrauma (OR 0.92 [0.87-0.99], p = 0.026). Barotrauma required active treatment, with drainage, in only a minority of cases. The type of NIRS was not explicitly related to the development of barotrauma. Still, an escalation of respiratory support from conventional oxygen therapy, high flow nasal cannula to noninvasive respiratory mask was predictive for in-hospital death (OR 15.51, p = 0.001). CONCLUSIONS COVIMIX-2 showed a low frequency for barotrauma, around 0.3%. The type of NIRS used seems not to increase this risk. Patients with barotrauma were older, with more severe systemic disease, and showed increased mortality.
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Affiliation(s)
- Luigi Vetrugno
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
- Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, 66100 Chieti, Italy
| | - Cristian Deana
- Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Venezia Giulia, Piazzale Santa Maria della Misericordia 15, 33100 Udine, Italy
| | - Nadia Castaldo
- Pulmonology Unit, Department of Cardio-Thoracic Surgery, Health Integrated Agency of Friuli Venezia Giulia, 33100 Udine, Italy
| | - Alberto Fantin
- Pulmonology Unit, Department of Cardio-Thoracic Surgery, Health Integrated Agency of Friuli Venezia Giulia, 33100 Udine, Italy
| | - Alessandro Belletti
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Emanuela Sozio
- Infectious Disease Unit, Health Integrated Agency of Friuli Venezia Giulia, 33100 Udine, Italy
| | - Maria De Martino
- Department of Medical Area, University of Udine, 33100 Udine, Italy
| | - Miriam Isola
- Department of Medical Area, University of Udine, 33100 Udine, Italy
| | - Diego Palumbo
- Department of Radiology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Federico Longhini
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, University Hospital Mater, Domini, Magna Graecia University, 88100 Catanzaro, Italy
| | - Gianmaria Cammarota
- Anesthesiology and Intensive Care, Department of Translational medicine, Faculty of Medicine and Surgery, University of Ferrara, 44121 Ferrara, Italy
| | - Savino Spadaro
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Salvatore Maurizio Maggiore
- Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, 66100 Chieti, Italy
- Department of Innovative Technologies in Medicine and Dentistry, Gabriele d'Annunzio University of Chieti Pescara, 66100 Chieti, Italy
| | - Flavio Bassi
- Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Venezia Giulia, Piazzale Santa Maria della Misericordia 15, 33100 Udine, Italy
| | - Carlo Tascini
- Infectious Disease Unit, Health Integrated Agency of Friuli Venezia Giulia, 33100 Udine, Italy
- Department of Medical Area, University of Udine, 33100 Udine, Italy
| | - Vincenzo Patruno
- Pulmonology Unit, Department of Cardio-Thoracic Surgery, Health Integrated Agency of Friuli Venezia Giulia, 33100 Udine, Italy
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Lazzer S, D'Alleva M, Isola M, De Martino M, Caroli D, Bondesan A, Marra A, Sartorio A. Cardiometabolic Index (CMI) and Visceral Adiposity Index (VAI) Highlight a Higher Risk of Metabolic Syndrome in Women with Severe Obesity. J Clin Med 2023; 12:jcm12093055. [PMID: 37176497 PMCID: PMC10179486 DOI: 10.3390/jcm12093055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Recent evidence shows that simple and inexpensive anthropometric measurements can be used to identify, at an early stage, women with obesity at increased risk of developing metabolic syndrome (MetS). Thus, the aim of this study was to compare the accuracy of five different indexes of adiposity and/or body composition in identifying MetS in a group of 876 women (mean age ± SD: 52.1 ± 13.8 years; body mass index (BMI): 43.6 ± 6.1 kg m-2). The following indexes were determined for each subject: waist-to-hip ratio (WHR), waist-to-height ratio (WtHR), body mass fat index (BMFI), visceral adiposity index (VAI), and cardiometabolic index (CMI). Overall, the presence of MetS was detected in 544 patients (62%). Pearson correlation coefficients were calculated to evaluate the relationships between body composition indexes and metabolic characteristics of the women. Receiver operating characteristic (ROC) analysis was used to determine the best predictor for each adiposity index among metabolic risk factors. The ROC analysis showed VAI (AUC = 0.84) and CMI (AUC = 0.86) showed the best performance in predicting MetS. Differences were found between the ROC area of CMI and VAI with all other indexes (p < 0.05). The optimal cutoff point for early diagnosis of MetS was >0.92 for WHR, >0.76 for WtHR, >30.1 kg m-1 for BMFI, >1.94 for VAI, and >0.84 for CMI. In addition, VAI and CMI were the most sensitive and specific indexes compared with other indexes. In conclusion, VAI and CMI represent the most useful and reliable indexes to be used for detecting MetS in women suffering from obesity in clinical practice.
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Affiliation(s)
- Stefano Lazzer
- Department of Medicine, University of Udine, 33100 Udine, Italy
- School of Sport Science, University of Udine, 33100 Udine, Italy
| | - Mattia D'Alleva
- Department of Medicine, University of Udine, 33100 Udine, Italy
- School of Sport Science, University of Udine, 33100 Udine, Italy
| | - Miriam Isola
- Department of Medicine, University of Udine, 33100 Udine, Italy
| | | | - Diana Caroli
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo-Verbania, Italy
| | - Adele Bondesan
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo-Verbania, Italy
| | - Alice Marra
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo-Verbania, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo-Verbania, Italy
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 20145 Milan, Italy
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Stinco G, Errichetti E, Figini M, Guglielmo A, Fazzi B, Quartuccio L, Zabotti A, De Vita S, Isola M, De Martino M, Rossi S, Lucis R, Fabris M, Beltrami AP, Curcio F, D'Aurizio F. Seroconversion and neutralizing antibodies production after completion of Pfizer-BioNTech BNT 162b2 vaccination scheme among psoriatic patients receiving biological or topical treatment: A prospective observational cohort study. J Eur Acad Dermatol Venereol 2023; 37:e447-e448. [PMID: 36477939 PMCID: PMC9877773 DOI: 10.1111/jdv.18809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Giuseppe Stinco
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Enzo Errichetti
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Matteo Figini
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alba Guglielmo
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Benedetta Fazzi
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Luca Quartuccio
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Rheumatology Clinic, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alen Zabotti
- Rheumatology Clinic, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Salvatore De Vita
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Rheumatology Clinic, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Miriam Isola
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Division of Medical Statistics, University of Udine, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistics, University of Udine, Udine, Italy
| | - Silvia Rossi
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Riccardo Lucis
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Martina Fabris
- Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Antonio Paolo Beltrami
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Francesco Curcio
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Federica D'Aurizio
- Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
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Deana C, Pez S, Ius T, Furlan D, Nilo A, Isola M, De Martino M, Mauro S, Verriello L, Lettieri C, Tomasino B, Valente M, Skrap M, Vetrugno L, Pauletto G. Effect of Dexmedetomidine versus Propofol on Intraoperative Seizure Onset During Awake Craniotomy: A Retrospective Study. World Neurosurg 2023; 172:e428-e437. [PMID: 36682527 DOI: 10.1016/j.wneu.2023.01.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The effect of dexmedetomidine (DEX) compared with propofol on intraoperative seizures (IOSs) detected using electrocorticography during awake craniotomy for resection of brain tumors is unknown. This investigation aimed to compare IOS rate in patients receiving DEX versus propofol as sedative agent. METHODS In this retrospective single-center study, awake craniotomies performed from January 2014 to December 2019 were analyzed. All IOSs detected by electrocorticography along with vital signs were recorded. RESULTS Of 168 adults enrolled in the study, 58 were administered DEX and 110 were administered propofol. IOSs occurred more frequently in the DEX group (22%) versus the propofol group (11%) (P = 0.046). A higher incidence of bradycardia was also observed in the DEX group (P < 0.001). Higher incidence of hypertension and a higher mean heart rate were recorded in the propofol group (P = 0.006 and P < 0.001, respectively). No serious adverse events requiring active drug administration were noted in either group. At univariate regression analysis, DEX demonstrated a tendency to favor IOS onset but without statistical significance (odds ratio = 2.36, P = 0.051). Patients in both groups had a similar epilepsy outcome at the 1-year postoperative follow-up. CONCLUSIONS IOSs detected with electrocorticography during awake craniotomy occurred more frequently in patients receiving DEX than propofol. However, patients receiving DEX were not shown to be at a statistically significant greater risk for IOS onset. DEX is a valid alternative to propofol during awake craniotomy in patients affected by tumor-related epilepsy.
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Affiliation(s)
- Cristian Deana
- Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy.
| | - Sara Pez
- Department of Medicine, University of Udine, Udine, Italy
| | - Tamara Ius
- Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy; Department of Neuroscience, Mental Health and Sense Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Davide Furlan
- Department of Medicine, University of Udine, Udine, Italy
| | - Annacarmen Nilo
- Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy
| | - Miriam Isola
- Division of Medical Statistic, Department of Medicine, University of Udine, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistic, Department of Medicine, University of Udine, Udine, Italy
| | - Stefano Mauro
- Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy
| | - Lorenzo Verriello
- Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy
| | - Christian Lettieri
- Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy
| | - Barbara Tomasino
- Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy; Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy
| | - Mariarosaria Valente
- Department of Medicine, University of Udine, Udine, Italy; Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy
| | - Miran Skrap
- Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy
| | - Luigi Vetrugno
- Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, Chieti, Italy; Department of Medical, Oral and Biotechnological Sciences, D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Giada Pauletto
- Department of Neurological Sciences, Health Integrated Agency of Friuli Centrale, Academic Hospital of Udine, Udine, Italy
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Meini S, Bracalente I, Bontempo G, Longo B, De Martino M, Tascini C. Early 3-day course of remdesivir to prevent progression to severe Covid-19 in high-risk patients with hospital-acquired SARS-CoV-2 infection: preliminary results from two Italian outbreaks. New Microbiol 2022; 45:304-307. [PMID: 36538294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022]
Abstract
In multimorbid, unvaccinated and non-hospitalized patients, early administration of remdesivir, nirmatrelvir/ritonavir and molnupiravir was effective in reducing the risk of hospitalization or death from any cause. Similar data are lacking with regard to patients already hospitalized and who acquire in-hospital SARS-CoV-2 infection. We conducted a retrospective study during two outbreaks of SARS-CoV-2 infections involving 90 inpatients already hospitalized for medical or surgical conditions, in order to assess the effectiveness of early administration of remdesivir. Forty-seven cases were treated with a 3-day course of remdesivir (200 mg on day 1 and 100 mg on days 2 and 3) within a median time of 1.4 day from testing positive, and were compared to a matched case-control cohort of 43 untreated patients; matching was based on age, sex, vaccination status, previous symptomatic infections by SARS-CoV-2, reasons for hospitalization (no significant differences). No case presented adverse events to remdesivir or death from COVID-19. No significant difference in overall in-hospital mortality was observed in cases compared to controls (17% vs 16.3%, p=0.925), but progression to severe pneumonia, although the difference was still not significant, showed an evident trend of a better outcome (8.5% vs 16.3%, p=0.261). Moreover, cases had a median discharge delay of 3 days (p=0.008).
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Affiliation(s)
- Simone Meini
- Internal Medicine Unit, Felice Lotti Hospital, Pontedera, Azienda USL Toscana Nord-Ovest, Italy
| | - Irene Bracalente
- Internal Medicine Unit, Felice Lotti Hospital, Pontedera, Azienda USL Toscana Nord-Ovest, Italy
| | - Giulia Bontempo
- Infectious Disease Unit, Department of Medicine, University of Udine, Italy
| | - Benedetta Longo
- Internal Medicine Unit, Felice Lotti Hospital, Pontedera, Azienda USL Toscana Nord-Ovest, Italy
| | - Maria De Martino
- Division of Medical Statistics, Department of Medicine (DAME), University of Udine, Italy
| | - Carlo Tascini
- Infectious Disease Unit, Department of Medicine, University of Udine, Italy
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Savoia M, Miletic P, De Martino M, Morassutti FR. Lung ultrasound score follows the chronic pulmonary insufficiency of prematurity trajectory in early infancy. Eur J Pediatr 2022; 181:4157-4166. [PMID: 36166097 DOI: 10.1007/s00431-022-04629-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/03/2022] [Revised: 09/05/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Abstract
Extremely preterm birth is associated with a high risk of chronic pulmonary insufficiency of prematurity (CPIP). Lung ultrasound score (LUS) proved capable to characterise CPIP progression beyond the acute setting, but still, post-discharge data remain lacking. We hypothesised a priori that LUS in both BPD and no-BPD infants declines with postnatal age from birth through early infancy. This observational retrospective cohort study included preterm infants < 32 gestational weeks, who underwent the follow-up for CPIP. LUS was assessed from birth to 8 months postnatal age, over antero-lateral (LUS) and posterior (pLUS) pulmonary areas, placing the transducer longitudinally over the midclavicular and midaxillary lines and medial to the scapular line respectively. Extended LUS (eLUS) including LUS and pLUS was calculated. The primary outcome was LUS time course. Secondary outcomes included the correlation between LUS and pLUS. Sixty-two infants were included: 22 (35.5%) in the BPD group and 40 (64.5%) in the no-BPD group. BPD group infants were smaller (weight 841 g (± 228) vs 1226 (± 328), p < 0.001) and younger (26.8 weeks (± 2.0) vs 28.9 (± 1.9), p < 0.001). LUS declined over time in the entire population (ß = - 1.75, p < 0.001) and in both no-BPD and BPD groups (ß = - 1.64, p < 0.001 and ß = - 1.93, p < 0.001, respectively). eLUS declined correspondingly (p < 0.001). LUS and likewise eLUS were significantly different between BPD and no-BPD groups over time (p < 0.001). Conclusion: LUS trajectory progressively decreased from birth to early infancy. BPD cohort tracked higher, implying a worse respiratory status. pLUS had a similar timepoint course, adding no further information to LUS. To the best of our knowledge, this is the first study that describes preterm LUS time course after discharge. LUS may help track the CPIP progression. What is Known: • Extremely preterm birth is associated with high risk of chronic pulmonary insufficiency of prematurity (CPIP). • Several studies investigated the ability of lung ultrasound score (LUS) to characterize CPIP progression beyond the acute setting, still post-discharge data remain lacking. What is New: • LUS trajectory progressively decreases from birth to early infancy; BPD cohort tracks higher, implying a worse respiratory status. pLUS has similar timepoint course, adding no further information to LUS. • The use of LUS may contribute to better characterising and monitoring CPIP in BPD and no-BPD infants.
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Affiliation(s)
- Marilena Savoia
- Neonatal Intensive Care Unit, Santa Maria Della Misericordia Hospital, Piazzale Santa Maria della Misericordia, 15, 33100, Udine, Italy.
| | - Patrik Miletic
- Neonatal Intensive Care Unit, Santa Maria Della Misericordia Hospital, Piazzale Santa Maria della Misericordia, 15, 33100, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistic, University of Udine, Udine, Italy
| | - Francesca Rech Morassutti
- Neonatal Intensive Care Unit, Santa Maria Della Misericordia Hospital, Piazzale Santa Maria della Misericordia, 15, 33100, Udine, Italy
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22
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Tomasino B, Guarracino I, Pauletto G, Pez S, Ius T, Furlan D, Nilo A, Isola M, De Martino M, Mauro S, Verriello L, Lettieri C, Gigli GL, Valente M, Deana C, Skrap M. Performing real time neuropsychological testing during awake craniotomy: are dexmedetomidine or propofol the same? A preliminary report. J Neurooncol 2022; 160:707-716. [DOI: 10.1007/s11060-022-04191-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022]
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23
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Peghin M, Bontempo G, De Martino M, Palese A, Gerussi V, Graziano E, Fabris M, D’Aurizio F, Sbrana F, Ripoli A, Curcio F, Isola M, Tascini C. Evaluation of qualitative and semi-quantitative cut offs for rapid diagnostic lateral flow test in relation to serology for the detection of SARS-CoV-2 antibodies: findings of a prospective study. BMC Infect Dis 2022; 22:810. [PMCID: PMC9619007 DOI: 10.1186/s12879-022-07786-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background: There is limited information to compare the qualitative and semi-quantitative performance of rapid diagnostic tests (RDT) and serology for the assessment of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therefore, the objective of the study was (a) to compare the efficacy of SARS-CoV-2 antibody detection between RDT and laboratory serology, trying to identify appropriate semi-quantitative cut-offs for RDT in relation with quantitative serology values and to (b) evaluate diagnostic accuracy of RDT compared to the NAAT gold standard in an unselected adult population. Methods: SARS-CoV-2 antibodies were simultaneously measured with lateral flow immunochromatographic assays (LFA), the Cellex qSARS-CoV-2 IgG/IgM Rapid Test (by capillary blood), the iFlash-SARS-CoV-2 IgG/IgM chemiluminescent immunoassay (CLIA) (by venous blood) and the nucleic acid amplification test (NAAT) in samples from in- and out-patients with confirmed, suspected and negative diagnosis of coronavirus disease 2019 (COVID-19) attending Udine Hospital (Italy) (March-May 2020). Interpretation of RDT was qualitative (positive/negative) and semi-quantitative based on a chromatographic intensity scale (negative, weak positive, positive). Results: Overall, 720 paired antibody measures were performed on 858 patients. The qualitative and semiquantitative agreement analysis performed in the whole sample between LFA and CLIA provided a Kendall’s tau of 0.578 (p < 0.001) and of 0.623 (p < 0.001), respectively, for IgM and IgG. In patients with a diagnosis of COVID-19, accordance between LFA and CLIA was maintained as a function of time from the onset of COVID-19 disease and the severity of disease both for qualitative and semi-quantitative assessments. RDT compared to the NAAT gold standard in 858 patients showed 78.5% sensitivity (95% CI 75.1%-81.7%) and 94.1% specificity (95% CI 90.4%-96.8%), with variable accordance depending on the timing from symptom onset. Conclusion: The RDT used in our study can be a non-invasive and reliable alternative to serological tests and facilitate both qualitative and a semi-quantitative antibody detection in COVID-19.
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Affiliation(s)
- Maddalena Peghin
- grid.5390.f0000 0001 2113 062XInfectious Diseases Division, Department of Medicine, University of Udine and Azienda sanitaria universitaria Friuli Centrale (ASUFC), Udine, Italy ,grid.18147.3b0000000121724807Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy ,Infectious Diseases Division , Azienda sanitaria universitaria Friuli Centrale (ASUFC), Presidio Ospedaliero Universitario Santa Maria della Misericordia, Piazzale Santa Maria della Misericordia 15, 33010 Udine, Italy
| | - Giulia Bontempo
- grid.5390.f0000 0001 2113 062XInfectious Diseases Division, Department of Medicine, University of Udine and Azienda sanitaria universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Maria De Martino
- grid.5390.f0000 0001 2113 062XDivision of Medical Statistics, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Alvisa Palese
- grid.5390.f0000 0001 2113 062XDepartment of Medical Sciences, School of Nursing, University of Udine, Udine, Italy
| | - Valentina Gerussi
- grid.5390.f0000 0001 2113 062XInfectious Diseases Division, Department of Medicine, University of Udine and Azienda sanitaria universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Elena Graziano
- grid.5390.f0000 0001 2113 062XInfectious Diseases Division, Department of Medicine, University of Udine and Azienda sanitaria universitaria Friuli Centrale (ASUFC), Udine, Italy ,grid.18147.3b0000000121724807Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy
| | - Martina Fabris
- Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Federica D’Aurizio
- Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Francesco Sbrana
- grid.452599.60000 0004 1781 8976U.O. Lipoapheresis and Center for Inherited Dyslipidemias - Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Andrea Ripoli
- grid.452599.60000 0004 1781 8976Bioengineering Department, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Francesco Curcio
- Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Miriam Isola
- grid.5390.f0000 0001 2113 062XDivision of Medical Statistics, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Carlo Tascini
- grid.5390.f0000 0001 2113 062XInfectious Diseases Division, Department of Medicine, University of Udine and Azienda sanitaria universitaria Friuli Centrale (ASUFC), Udine, Italy
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Zuccarelli L, Baldassarre G, De Martino M, Isola M, Lippe G, Grassi B. Mitochondrial Sensitivity To Submaximal ADP Concentrations Following Bed Rest: A Double Exponential Model Analysis. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000877244.21920.a8] [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: 11/21/2022]
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25
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Pellitteri G, Surcinelli A, De Martino M, Fabris M, Janes F, Bax F, Marini A, Milanic R, Piani A, Isola M, Gigli GL, Valente M. Sleep alterations following COVID-19 are associated with both neuroinflammation and psychological disorders, although at different times. Front Neurol 2022; 13:929480. [PMID: 36062000 PMCID: PMC9428349 DOI: 10.3389/fneur.2022.929480] [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: 04/26/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionBy the end of 2019, severe acute respiratory syndrome coronavirus 2 rapidly spread all over the world impacting mental health and sleep habits. Insomnia, impaired sleep quality, and circadian rhythm alterations were all observed during the pandemic, especially among healthcare workers and in patients with acute and post-acute COVID-19. Sleep disruption may induce a pro-inflammatory state associated with an impairment of immune system function.ObjectiveWe investigated the relationship between sleep alterations, psychological disorders, and inflammatory blood biomarkers in patients with post-acute COVID-19.MethodsWe enrolled 47 subjects diagnosed with COVID-19 pneumonia at Santa Maria della Misericordia University Hospital (Udine, Italy) between March and May 2020. Selected patients were evaluated at 2 months (T1) and 10 months (T2) after discharge. Each time, we collected clinical interviews, neurological examinations, and self-administered questionnaires to assess sleep and life quality, anxiety, depression, and post-traumatic stress disorder. Blood biomarkers of endothelial activation, neuroinflammation, and inflammatory cytokines were also measured at each follow-up. Collected variables were analyzed using comparisons between groups and linear regression models.ResultsPrevalence of insomnia increased from 10.6% up to 27.3% after COVID-19. Poor sleep quality was found in 41.5% of patients at both study visits. At T1 follow-up, poor sleepers showed higher levels of neurofilament light chain, vascular cell adhesion molecule 1, and interleukin 10; no significant associations were found between sleep quality and psychological disorders. At T2 follow-up, lower sleep quality was associated with higher levels of vascular cell adhesion molecule 1 and interleukin 8, but also with higher scores for anxiety, depression, and post-traumatic stress disorder.ConclusionOur results suggest an association of poor sleep quality with both psychological disorders and neuroinflammation, although at different times, in previously hospitalized patients with moderate-to-critical COVID-19.
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Affiliation(s)
- Gaia Pellitteri
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- *Correspondence: Gaia Pellitteri
| | - Andrea Surcinelli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Martina Fabris
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Janes
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Bax
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | | | - Romina Milanic
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Antonella Piani
- Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Miriam Isola
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Gian Luigi Gigli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
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Russo AG, De Martino M, Elia A, Di Salle F, Esposito F. Negative correlation between word-level surprisal and intersubject neural synchronization during narrative listening. Cortex 2022; 155:132-149. [DOI: 10.1016/j.cortex.2022.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 02/10/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022]
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27
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Graziano E, Peghin M, De Martino M, De Carlo C, Da Porto A, Bulfone L, Casarsa V, Sozio E, Fabris M, Cifù A, Grassi B, Curcio F, Isola M, Sechi LA, Tascini C, Croatto L, Ditaranto P, Ditaranto LM. The impact of body composition on mortality of COVID-19 hospitalized patients: A prospective study on abdominal fat, obesity paradox and sarcopenia. Clin Nutr ESPEN 2022; 51:437-444. [PMID: 36184240 PMCID: PMC9295328 DOI: 10.1016/j.clnesp.2022.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Abstract
Background & aims Obesity has been described as a predisposing risk factor to severe forms of COVID-19, but conflicting results are emerging on its real impact on the mortality of COVID-19. We aimed to compare clinical outcomes and mortality among COVID-19 patients according to obesity, metabolic syndrome and adiposity distribution. Methods We conducted a prospective observational study of all consecutive adult patients with a confirmed diagnosis of SARS-CoV-2 infection admitted to the Infectious Diseases Clinic at Udine Hospital, Italy, from January 2021 to February 2021. At admission, the study population was submitted to specific anthropometric, laboratory and bioimpedance analysis (BIA) measurements and divided into five groups according to: 1) BMI < or >30 kg/m2; 2) waist circumference (WC) < or >98 cm for women, < or >102 cm for men; 3) presence or absence of metabolic syndrome (MS); 4) visceral adipose tissue (VAT) distribution; and 5) presence or absence of sarcopenia (SP) both based on BIA. We then compared clinical outcomes (ventilatory support, intensive care unit (ICU) admission, ICU length of stay, total hospital length of stay and mortality), immune and inflammatory makers and infectious and non-infectious acute complications within the five groups. Results A total of 195 patients were enrolled in the study. The mean age of patients was 71 years (IQR 61–80) and 64.6% (126) were male. The most common comorbidities were hypertension (55.9%) and MS (55.4%). Overall mortality was 19.5%. Abdominal adiposity, measured both with WC and with BIA, and SP were significantly associated with need for increased ventilator support (p = 0.013 for WC; p = 0.037, 0.027 and 0.009 for VAT; p = 0.004 and 0.036 for FMI; and p = 0.051 for SP), but not with ICU admission (WC p = 0.627, VAT p = 0.153, FMI p = 0.519 and SP p = 0.938), length of stay (WC p = 0.345, VAT p = 0.650, FMI p = 0.159 and SP p = 0.992) and mortality (WC p = 0.277, VAT p = 0.533, FMI p = 0.957 and SP p = 0.211). Obesity and MS did not discriminate for the intensity of ventilatory outcome (p = 0.142 and p = 0.198, respectively), ICU admission (p = 0.802 and p = 0.947, respectively), length of stay (p = 0.471 and p = 0.768, respectively) and mortality (p = 0.495 and p = 0.268, respectively). We did not find significant differences in inflammatory markers and secondary complications within the five groups. Conclusions In patients admitted with COVID-19, increased WC, visceral abdominal fat and SP are associated with higher need for ventilatory support. However, obesity, MS, SP and abdominal adiposity are not sensitive predictive factors for mortality.
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Colizzi M, Peghin M, De Martino M, Bontempo G, Gerussi V, Palese A, Isola M, Tascini C, Balestrieri M. Mental health symptoms one year after acute COVID-19 infection: Prevalence and risk factors. Rev Psiquiatr Salud Ment 2022; 16:38-46. [PMID: 35755492 PMCID: PMC9212931 DOI: 10.1016/j.rpsm.2022.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/17/2022] [Indexed: 01/27/2023]
Abstract
Introduction Emerging evidence suggests that mental health symptoms in COVID-19 survivors are higher than expected, possibly indicating that such symptoms are more likely to develop post-infection than just persist as a residual component of the acute phase. It is thus imperative to investigate the potential development of a post-COVID mental health syndrome in the longer-term and identify its risk factors. Material and methods A prospective study investigated mental health symptoms associated with COVID-19 and its determinants over a 12-month period following the disease onset in all consecutive adult inpatients and outpatients with COVID-19 attending a tertiary referral hospital from March to May 2020. Results A total of 479 patients (female, 52.6%) were followed-up for 12 months after COVID-19 onset. Of them, 47.2% were still presenting with at least one symptom. While most symptoms subsided as compared to COVID-19 onset (all p < 0.001), a significant increase was observed only for symptoms of psychiatric disorders (10.2%) and lack of concentration and focus (20%; all p < 0.001). Patients presenting with symptoms related to multiple body systems 12 months after contracting COVID-19 (all p ≤ 0.034) were more likely to suffer from mental health domain-related symptoms at follow-up. Also, a higher risk of presenting with lack of concentration and focus 12 months post infection was found in those suffering of psychiatric symptoms at COVID-19 onset (p = 0.005). Conclusions Findings of this study may have important public health implications, as they underlie the increased need for mental health support in COVID-19 survivors.
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Affiliation(s)
- Marco Colizzi
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Maddalena Peghin
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, and Friuli Centrale University Health Service (ASUFC), 33100 Udine, Italy.,Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy
| | - Maria De Martino
- Division of Medical Statistic, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Giulia Bontempo
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, and Friuli Centrale University Health Service (ASUFC), 33100 Udine, Italy
| | - Valentina Gerussi
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, and Friuli Centrale University Health Service (ASUFC), 33100 Udine, Italy
| | - Alvisa Palese
- School of Nursing, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Miriam Isola
- Division of Medical Statistic, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Carlo Tascini
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, and Friuli Centrale University Health Service (ASUFC), 33100 Udine, Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
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Vendramin I, Isola M, Piani D, Onorati F, Salizzoni S, D'Onofrio A, Di Marco L, Gatti G, De Martino M, Faggian G, Rinaldi M, Gerosa G, Pacini D, Pappalardo A, Livi U. Surgical management and outcomes in patients with acute type A aortic dissection and cerebral malperfusion. JTCVS Open 2022; 10:22-33. [PMID: 36004262 PMCID: PMC9390217 DOI: 10.1016/j.xjon.2022.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 03/01/2022] [Indexed: 12/05/2022]
Abstract
Objective The study objective was to evaluate the surgical results in patients with acute type A aortic dissection and cerebral malperfusion. Methods From 2000 to 2019, 234 patients with type A aortic dissection and cerebral malperfusion were stratified into 3 groups: 50 (21%) with syncope (group 1), 152 (65%) with persistent loss of focal neurological function (group 2), and 32 (14%) with coma (group 3). Results were evaluated and compared by univariable and multivariable analyses. Results Median age was higher in group 1, and incidence of cardiogenic shock was higher in group 3. The femoral artery was the most common cannulation site, whereas the axillary artery was used in 18% of group 1, 30% of group 2, and 25% of group 3 patients (P = .337). Antegrade cerebral perfusion was performed in more than 80% of patients, and ascending aorta/arch replacement was performed in 40% of group 1, 27% of group 2, and 31% of group 3 (P = .21). In-hospital mortality was 18% in group 1, 27% in group 2, and 56% in group 3 (P = .001). Survival at 5 years is 57.0% in group 1, 57.7% in group 2, and 38.7% in group 3 (P = .0005). On multivariable analysis, age, cardiopulmonary bypass time, and group 3 versus group 2 were independent risk factors for mortality, whereas axillary cannulation was a protective factor. Conclusions Patients with aortic dissection and cerebral malperfusion without preoperative coma showed acceptable mortality, and those with coma had a high in-hospital mortality regardless of the type of brain protection. Overall axillary artery cannulation appeared to be a protective factor.
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Affiliation(s)
- Igor Vendramin
- Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Udine, Italy
- Address for reprints: Igor Vendramin, MD, Division of Cardiac Surgery, Cardiothoracic Department, P. le S.M. Misericordia 15, Udine, Italy.
| | - Miriam Isola
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Daniela Piani
- Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Udine, Italy
| | | | | | | | - Luca Di Marco
- Azienda Ospedaliera-Università di Bologna, Bologna, Italy
| | - Giuseppe Gatti
- Azienda Sanitaria Universitaria Giuliana Isontina, Trieste, Italy
| | - Maria De Martino
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | | | - Mauro Rinaldi
- Azienda Ospedaliero-Universitaria di Torino, Torino, Italy
| | - Gino Gerosa
- Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Davide Pacini
- Azienda Ospedaliera-Università di Bologna, Bologna, Italy
| | | | - Ugolino Livi
- Azienda Sanitaria Universitaria Friuli Centrale, Cardiothoracic Department, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
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Girometti R, Blandino A, Zichichi C, Cicero G, Cereser L, De Martino M, Isola M, Zuiani C, Ficarra V, Valotto C, Bertolotto M, Giannarini G. Inter-reader agreement of the Prostate Imaging Quality (PI-QUAL) score: A bicentric study. Eur J Radiol 2022; 150:110267. [PMID: 35325773 DOI: 10.1016/j.ejrad.2022.110267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/08/2022] [Accepted: 03/16/2022] [Indexed: 12/26/2022]
Abstract
PURPOSE To investigate the inter-reader agreement of the Prostate imaging quality (PI-QUAL) for multiparametric magnetic resonance imaging (mpMRI). METHODS We included 66 men who underwent 1.5 T mpMRI in June 2020-July 2020 in center 1, with no exclusion criteria. mpMRI included multiplanar T2-weighted imaging (T2WI), Diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCE). Two readers from center 2 (experience <1000 to >1500 examinations), blinded to clinical history but not to acquisition parameters, independently assessed PI-QUAL qualitative/anatomical items of each mpMRI sequence, final PI-QUAL score (1-5), and the Prostate imaging reporting and data system version 2.1 (PI-RADSv2.1) category of the index lesion. Cohen's kappa statistics (k) or prevalence-adjusted-bias-adjusted kappa (PABAK) were used to calculate the inter-reader agreement in assessing the PI-QUAL (1-to-5 scale and 1-2 versus 3 versus 4-5), the diagnostic quality of each mpMRI sequence, qualitative/anatomical items, and PI-RADSv2.1 category. RESULTS The inter-reader agreement for PI-QUAL category was moderate upon 1-5 scale (k = 0.55; 95%CI 0.39-0.71) or 1-3 scale (k = 0.51; 95%CI 0.29-0.72), with 90.9% examinations categorized PI-QUAL ≥ 3 by readers. The agreement in assessing a sequence as diagnostic was higher for T2WI (k = 0.76) than DCE (PABAK = 0.61) and DWI (k = 0.46), ranging moderate-to-substantial for most of the items. Readers provided comparable PI-RADSv2.1 categorization (k = 0.88 [excellent agreement]; 95%CI 0.81-0.96), with most PI-RADSv2.1 ≥ 3 assignments found in PI-QUAL ≥ 3 examinations (43/46 by reader 1, and 47/47 by reader 2). CONCLUSIONS The reproducibility of PI-QUAL was moderate. Higher PI-QUAL scores were associated with excellent inter-reader agreement for PI-RADSv2.1 categorization.
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Affiliation(s)
- Rossano Girometti
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital S. Maria della Misericordia, p.le S. Maria della Misericordia n. 15, 33100 Udine, Italy.
| | - Alfredo Blandino
- Department of Biomedical Sciences and Morphological and Functional Imaging, Policlinico Universitario G. Martino, University of Messina, Via Consolare Valeria n. 1, 98100, Messina, Italy.
| | - Clara Zichichi
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital S. Maria della Misericordia, p.le S. Maria della Misericordia n. 15, 33100 Udine, Italy
| | - Giuseppe Cicero
- Department of Biomedical Sciences and Morphological and Functional Imaging, Policlinico Universitario G. Martino, University of Messina, Via Consolare Valeria n. 1, 98100, Messina, Italy.
| | - Lorenzo Cereser
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital S. Maria della Misericordia, p.le S. Maria della Misericordia n. 15, 33100 Udine, Italy.
| | - Maria De Martino
- Division of Medical Statistic, Department of Medicine, University of Udine, p.le Kolbe n. 4, 33100 Udine, Italy.
| | - Miriam Isola
- Division of Medical Statistic, Department of Medicine, University of Udine, p.le Kolbe n. 4, 33100 Udine, Italy.
| | - Chiara Zuiani
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital S. Maria della Misericordia, p.le S. Maria della Misericordia n. 15, 33100 Udine, Italy.
| | - Vincenzo Ficarra
- Department of Human and Paediatric Pathology "Gaetano Barresi", Urologic Section, University of Messina, Via Consolare Valeria n. 1 - 98100, Messina, Italy.
| | - Claudio Valotto
- Urology Unit, University Hospital Santa Maria della Misericordia, p.le S. Maria della Misericordia n. 15, 33100 Udine, Italy.
| | - Michele Bertolotto
- Department of Radiology, University of Trieste, University Hospital Cattinara, Strada di Fiume n. 447, 34149 Trieste, Italy.
| | - Gianluca Giannarini
- Urology Unit, University Hospital Santa Maria della Misericordia, p.le S. Maria della Misericordia n. 15, 33100 Udine, Italy.
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Bulfoni M, Sozio E, Marcon B, De Martino M, Cesselli D, De Carlo C, Martinella R, Migotti A, Vania E, Zanus-Fortes A, De Piero J, Nencioni E, Tascini C, Isola M, Curcio F. Validation of a Saliva-Based Test for the Molecular Diagnosis of SARS-CoV-2 Infection. Dis Markers 2022; 2022:6478434. [PMID: 35035611 PMCID: PMC8759915 DOI: 10.1155/2022/6478434] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/22/2021] [Accepted: 12/13/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Since the beginning of the pandemic, clinicians and researchers have been searching for alternative tests to improve the screening and diagnosis of the SARS-CoV-2 infection. Currently, the gold standard for virus identification is the nasopharyngeal (NP) swab. Saliva samples, however, offer clear, practical, and logistical advantages but due to a lack of collection, transport, and storage solutions, high-throughput saliva-based laboratory tests are difficult to scale up as a screening or diagnostic tool. With this study, we aimed to validate an intralaboratory molecular detection method for SARS-CoV-2 on saliva samples collected in a new storage saline solution, comparing the results to NP swabs to determine the difference in sensitivity between the two tests. METHODS In this study, 156 patients (cases) and 1005 asymptomatic subjects (controls) were enrolled and tested simultaneously for the detection of the SARS-CoV-2 viral genome by RT-PCR on both NP swab and saliva samples. Saliva samples were collected in a preservative and inhibiting saline solution (Biofarma Srl). Internal method validation was performed to standardize the entire workflow for saliva samples. RESULTS The identification of SARS-CoV-2 conducted on saliva samples showed a clinical sensitivity of 95.1% and specificity of 97.8% compared to NP swabs. The positive predictive value (PPV) was 81% while the negative predictive value (NPV) was 99.5%. Test concordance was 97.6% (Cohen's Kappa = 0.86; 95% CI 0.81-0.91). The LoD of the test was 5 viral copies for both samples. CONCLUSIONS RT-PCR assays conducted on a stored saliva sample achieved similar performance to those on NP swabs, and this may provide a very effective tool for population screening and diagnosis. Collection of saliva in a stabilizing solution makes the test more convenient and widely available; furthermore, the denaturing properties of the solution reduce the infective risks belonging to sample manipulation.
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Affiliation(s)
- Michela Bulfoni
- Department of Medicine, University of Udine, Udine, Italy
- Institute of Pathology, ASU FC, Udine, Italy
| | - Emanuela Sozio
- Infectious Disease Unit, Department of Medicine, ASU FC, Udine, Italy
| | | | | | - Daniela Cesselli
- Department of Medicine, University of Udine, Udine, Italy
- Institute of Pathology, ASU FC, Udine, Italy
| | - Chiara De Carlo
- Infectious Disease Unit, Department of Medicine, ASU FC, Udine, Italy
| | | | | | - Eleonora Vania
- Infectious Disease Unit, Department of Medicine, ASU FC, Udine, Italy
| | | | - Jessica De Piero
- Infectious Disease Unit, Department of Medicine, ASU FC, Udine, Italy
| | | | - Carlo Tascini
- Department of Medicine, University of Udine, Udine, Italy
- Infectious Disease Unit, Department of Medicine, ASU FC, Udine, Italy
| | - Miriam Isola
- Department of Medicine, University of Udine, Udine, Italy
| | - Francesco Curcio
- Department of Medicine, University of Udine, Udine, Italy
- Department of Laboratory Medicine, ASU FC, Udine, Italy
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De Martino M, Talacchi A, Capasso R, Mazzotta A, Miceli G. Language Assessment in Multilingualism and Awake Neurosurgery. Front Hum Neurosci 2021; 15:750013. [PMID: 34899217 PMCID: PMC8660632 DOI: 10.3389/fnhum.2021.750013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/28/2021] [Indexed: 11/28/2022] Open
Abstract
Multilingualism has become a worldwide phenomenon that poses critical issues about the language assessment in patients undergoing awake neurosurgery in eloquent brain areas. The accuracy and sensitivity of multilingual perioperative language assessment procedures is crucial for a number of reasons: they should be appropriate to detect deficits in each of the languages spoken by the patient; they should be suitable to identify language-specific cortical regions; they should ensure that each of the languages of a multilingual patient is tested at an adequate and comparable level of difficulty. In clinical practice, a patient-tailored approach is generally preferred. This is a necessary compromise since it is impossible to predict all the possible language combinations spoken by individuals and thus the availability of standardized testing batteries is a potentially unattainable goal. On the other hand, this leads to high inconsistency in how different neurosurgical teams manage the linguistic features that determine similarity or distance between the languages spoken by the patient and that may constrain the neuroanatomical substrate of each language. The manuscript reviews the perioperative language assessment methodologies adopted in awake surgery studies on multilingual patients with brain tumor published from 1991 to 2021 and addresses the following issues: (1) The language selected for the general neuropsychological assessment of the patient. (2) The procedures adopted to assess the dimensions that may constrain language organization in multilingual speakers: age and type of acquisition, exposure, proficiency, and use of the different languages. (3) The type of preoperative language assessment used for all the languages spoken by the patient. (4) The linguistic tasks selected in the intraoperative setting. The reviewed data show a great heterogeneity in the perioperative clinical workup with multilingual patients. The only exception is the task used during language mapping, as the picture naming task is highly preferred. The review highlights that an objective and accurate description of both the linguistic profile of multilingual patients and the specific properties of the languages under scrutiny can profitably support clinical management and decision making in multilingual awake neurosurgery settings.
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Affiliation(s)
- Maria De Martino
- Department of Political and Communication Sciences (POLICOM), University of Salerno, Fisciano, Italy
| | | | | | - Annapina Mazzotta
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Gabriele Miceli
- Center for Mind/Brain Sciences, University of Trento, Trento, Italy
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Girometti R, Giannarini G, Panebianco V, Maresca S, Cereser L, De Martino M, Pizzolitto S, Pecoraro M, Ficarra V, Zuiani C, Valotto C. Comparison of different thresholds of PSA density for risk stratification of PI-RADSv2.1 categories on prostate MRI. Br J Radiol 2021; 95:20210886. [PMID: 34762506 PMCID: PMC8978227 DOI: 10.1259/bjr.20210886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To compare the effect of different PSA density (PSAD) thresholds on the accuracy for clinically significant prostate cancer (csPCa) of the Prostate Imaging Reporting And Data System v.2.1 (PI-RADSv2.1). METHODS We retrospectively included 123 biopsy-naïve men who underwent multiparametric magnetic resonance imaging (mpMRI) and transperineal mpMRI-targeted and systematic prostate biopsy between April 2019 and October 2020. mpMRI, obtained on a 3.0T magnet with a PI-RADSv2.1-compliant protocol, was read by two radiologists (>1500/>500 mpMRI examinations). csPCa was defined as International Society of Urogenital Pathology grading group ≥2. Receiver operating characteristic analysis was used to calculate per-index lesion sensitivity, specificity, and area under the curve (AUC) of PI-RADSv.2.1 categories after adjusting for PSAD ≥0.10,≥0.15, and ≥0.20 ng/mL ml-1. Per-adjusted category cancer detection rate (CDR) was calculated, and decision analysis performed to compare PSAD-adjusted PI-RADSv.2.1 categories as a biopsy trigger. RESULTS csPCa prevalence was 43.9%. PSAD-adjustment increased the CDR of PI-RADSv2.1 category 4. Sensitivity/specificity/AUC were 92.6%/53.6%/0.82 for unadjusted PI-RADS, and 85.2%/72.4%/0.84, 62.9%/85.5%/0.83, and 92.4%/53.6%/0.82 when adjusting PI-RADS categories for a 0.10, 0.15, and 0.20 ng/ml ml-1 PSAD threshold, respectively. Triggering biopsy for PI-RADS four lesions and PSAD ≥0.10 ng/mL ml-1 was the strategy with greatest net benefit at 30 and 40% risk probability (0.307 and 0.271, respectively). CONCLUSIONS PI-RADSv2.1 category four with PSAD ≥0.10 ng/mL ml-1 was the biopsy-triggering cut-off with the highest net benefit in the range of expected prevalence for csPCa. ADVANCES IN KNOWLEDGE 0.10 ng/mL ml-1 is the PSAD threshold with higher clinical utility in stratifying the risk for prostate cancer of PI-RADSv.2.1 categories.
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Affiliation(s)
- Rossano Girometti
- Department of Medicine, Institute of Radiology, University of Udine, Santa Maria dellaMisericordia University Hospital, Udine, Italy
| | - Gianluca Giannarini
- Urology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Valeria Panebianco
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Silvio Maresca
- Department of Medicine, Institute of Radiology, University of Udine, Santa Maria dellaMisericordia University Hospital, Udine, Italy
| | - Lorenzo Cereser
- Department of Medicine, Institute of Radiology, University of Udine, Santa Maria dellaMisericordia University Hospital, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistic, Department of Medicine, University of Udine, Udine, Italy
| | - Stefano Pizzolitto
- Pathology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Martina Pecoraro
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Ficarra
- Department of Human and Paediatric Pathology "Gaetano Barresi", Urologic Section,University of Messina, Messina, Italy
| | - Chiara Zuiani
- Department of Medicine, Institute of Radiology, University of Udine, Santa Maria dellaMisericordia University Hospital, Udine, Italy
| | - Claudio Valotto
- Urology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
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Peghin M, Bouza E, Fabris M, De Martino M, Palese A, Bontempo G, Graziano E, Gerussi V, Bressan V, Sartor A, Isola M, Tascini C, Curcio F. Low risk of reinfections and relation with serological response after recovery from the first wave of COVID-19. Eur J Clin Microbiol Infect Dis 2021; 40:2597-2604. [PMID: 34378086 PMCID: PMC8354681 DOI: 10.1007/s10096-021-04335-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/05/2021] [Indexed: 12/17/2022]
Abstract
The aim of the study was to assess reinfection rates in relation to long-term antibody dynamics against SARS-CoV-2 after the first wave. A prospective longitudinal study with monthly serological follow-up during the first 4 months, and then at 6, 8, and 10 months after the disease onset of all recovered adult in- and outpatients with COVID-19 attending Udine Hospital (Italy) from March to May 2020. During the follow-up, reinfections were collected. A total of 546 unselected individuals with COVID-19 acquired from March to May 2020 were included (292 female, mean age 53 years). After a median follow-up of 10 months (IQR 6.2–10.4), reinfection occurred in 6 (1.1%) patients, median age of 44.5 years (IQR 33‒49). All had a previous history of mild COVID-19 (all were healthcare workers) and reinfection occurred a median of 9 months (IQR 8.2‒10.2) after the onset of the first episode. Patients with reinfection were either seronegative (2/56, n = 3.6%), seroreverted (2/137, 1.5%), or seropositive (2/353, 0.6%) (p = 0.085). All reinfections were mild (n = 5) or asymptomatic (n = 1). After reinfection, none of patients developed IgM response and only two had a transitory boosted IgG immunization response. In an unselected population after the first wave of COVID-19, after a prolonged observation period (mean 10 months), reinfection was very uncommon; occurred in patients with a previous history of mild infection, mostly with weak or absent serological response; and manifested with mild or asymptomatic clinical presentation.
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Affiliation(s)
- Maddalena Peghin
- Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Presidio Ospedaliero Universitario Santa Maria della Misericordia Piazzale Santa Maria della Misericordia 15 33010, Udine, Italy.
| | - Emilio Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Gregorio Marañón Health Research Institute, Madrid, Spain
- CIBER of Respiratory Diseases (CIBERES CB06/06/0058), Madrid, Spain
| | - Martina Fabris
- Institute of Clinical Pathology, Department of Laboratory Medicine, University of Udine, ASUFC, Udine, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistics, Department of Medicine (DAME), University of Udine 33100, Udine, Italy
| | - Alvisa Palese
- Department of Medical Sciences, School of Nursing, University of Udine 33100, Udine, Italy
| | - Giulia Bontempo
- Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Presidio Ospedaliero Universitario Santa Maria della Misericordia Piazzale Santa Maria della Misericordia 15 33010, Udine, Italy
| | - Elena Graziano
- Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Presidio Ospedaliero Universitario Santa Maria della Misericordia Piazzale Santa Maria della Misericordia 15 33010, Udine, Italy
| | - Valentina Gerussi
- Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Presidio Ospedaliero Universitario Santa Maria della Misericordia Piazzale Santa Maria della Misericordia 15 33010, Udine, Italy
| | - Valentina Bressan
- Department of Medical Sciences, School of Nursing, University of Udine 33100, Udine, Italy
| | - Assunta Sartor
- Institute of Clinical Pathology, Department of Laboratory Medicine, University of Udine, ASUFC, Udine, Italy
| | - Miriam Isola
- Division of Medical Statistics, Department of Medicine (DAME), University of Udine 33100, Udine, Italy
| | - Carlo Tascini
- Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Presidio Ospedaliero Universitario Santa Maria della Misericordia Piazzale Santa Maria della Misericordia 15 33010, Udine, Italy
| | - Francesco Curcio
- Institute of Clinical Pathology, Department of Laboratory Medicine, University of Udine, ASUFC, Udine, Italy
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Gerussi V, Peghin M, Palese A, Bressan V, Visintini E, Bontempo G, Graziano E, De Martino M, Isola M, Tascini C. Vaccine Hesitancy among Italian Patients Recovered from COVID-19 Infection towards Influenza and Sars-Cov-2 Vaccination. Vaccines (Basel) 2021; 9:172. [PMID: 33670661 PMCID: PMC7922251 DOI: 10.3390/vaccines9020172] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 11/17/2022] Open
Abstract
We aimed to assess the attitude towards influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations among coronavirus disease 2019 (COVID-19) recovered patients. We performed a cross-sectional study consisting of a standardized telephone interview carried out between September and November 2020 targeting a cohort of adult in- and out-patients that had recovered from COVID-19 after the first wave (March-May 2020) at Udine Hospital (Italy). Overall, 599 people participated (320 female, median age 53 years) and most had experienced an acute COVID-19 with mild illness (409, 68.3%). The majority were hesitant or undecided towards influenza (327, 54.6%) and SARS-CoV-2 (353, 59.2%) vaccines. Older age, public work exposure, and previous 2019 flu shots were the main factors associated with a positive attitude toward both vaccinations (p < 0.05). Being hospitalized during the acute COVID-19 phase was associated with the willingness to get a flu shot (94/272, 34.5%) but not SARS-CoV-2 vaccine (70/244, 28.7%). Vaccine hesitancy is diffuse and multifactorial also among COVID-19 recovered.
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Affiliation(s)
- Valentina Gerussi
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, 33100 Udine, Italy; (V.G.); (G.B.); (E.G.); (C.T.)
| | - Maddalena Peghin
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, 33100 Udine, Italy; (V.G.); (G.B.); (E.G.); (C.T.)
| | - Alvisa Palese
- Department of Medical Sciences, School of Nursing, University of Udine, 33100 Udine, Italy; (A.P.); (V.B.); (E.V.)
| | - Valentina Bressan
- Department of Medical Sciences, School of Nursing, University of Udine, 33100 Udine, Italy; (A.P.); (V.B.); (E.V.)
| | - Erica Visintini
- Department of Medical Sciences, School of Nursing, University of Udine, 33100 Udine, Italy; (A.P.); (V.B.); (E.V.)
| | - Giulia Bontempo
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, 33100 Udine, Italy; (V.G.); (G.B.); (E.G.); (C.T.)
| | - Elena Graziano
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, 33100 Udine, Italy; (V.G.); (G.B.); (E.G.); (C.T.)
| | - Maria De Martino
- Department of Medicine, University of Udine, 33100 Udine, Italy; (M.D.M.); (M.I.)
| | - Miriam Isola
- Department of Medicine, University of Udine, 33100 Udine, Italy; (M.D.M.); (M.I.)
| | - Carlo Tascini
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, 33100 Udine, Italy; (V.G.); (G.B.); (E.G.); (C.T.)
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Russo AG, De Martino M, Mancuso A, Iaconetta G, Manara R, Elia A, Laudanna A, Di Salle F, Esposito F. Semantics-weighted lexical surprisal modeling of naturalistic functional MRI time-series during spoken narrative listening. Neuroimage 2020; 222:117281. [PMID: 32828929 DOI: 10.1016/j.neuroimage.2020.117281] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/22/2020] [Accepted: 08/13/2020] [Indexed: 11/16/2022] Open
Abstract
Probabilistic language models are increasingly used to provide neural representations of linguistic features under naturalistic settings. Word surprisal models can be applied to continuous fMRI recordings during task-free listening of narratives, to detect regions linked to language prediction and comprehension. Here, to this purpose, a novel semantics-weighted lexical surprisal is applied to naturalistic fMRI data. FMRI was performed at 3 Tesla in 31 subjects during task-free listening to a 12-minute audiobook played in both original and word-reversed (control) version. Lexical-only and semantics-weighted lexical surprisal models were estimated for the original and control word series. The two series were alternatively chosen to build the predictor of interest in the first-level general linear model and were compared in the second-level (group) analysis. The addition of the surprisal predictor to the stimulus-related predictors significantly improved the fitting of the neural signal. In average, the semantics-weighted model yielded lower surprisal values and, in some areas, better fitting of the fMRI data compared to the lexical-only model. The two models produced both overlapping and distinct activations: while lexical-only surprisal activated secondary auditory areas in the superior temporal gyri and the cerebellum, semantics-weighted surprisal additionally activated the left inferior frontal gyrus. These results confirm the usefulness of surprisal models in the naturalistic fMRI analysis of linguistic processes and suggest that the use of semantic information may increase the sensitivity of a probabilistic language model in higher-order language-related areas, with possible implications for future naturalistic fMRI studies of language under normal and (clinically or pharmacologically) modified conditions.
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Affiliation(s)
- Andrea G Russo
- Department of Political and Communication Sciences, University of Salerno, Fisciano, Salerno, Italy; Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy.
| | - Maria De Martino
- Department of Political and Communication Sciences, University of Salerno, Fisciano, Salerno, Italy
| | - Azzurra Mancuso
- Department of Political and Communication Sciences, University of Salerno, Fisciano, Salerno, Italy
| | - Giorgio Iaconetta
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy; Department of Diagnostic Imaging, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Renzo Manara
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy; Department of Diagnostic Imaging, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Annibale Elia
- Department of Political and Communication Sciences, University of Salerno, Fisciano, Salerno, Italy
| | - Alessandro Laudanna
- Department of Political and Communication Sciences, University of Salerno, Fisciano, Salerno, Italy
| | - Francesco Di Salle
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy; Department of Diagnostic Imaging, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Fabrizio Esposito
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy; Department of Diagnostic Imaging, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
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De Martino M, Santini B, Cappelletti G, Mazzotta A, Rasi M, Bulgarelli G, Annicchiarico L, Marcocci A, Talacchi A. The quality of measurement properties of neurocognitive assessment in brain tumor clinical trials over the last 30 years: a COSMIN checklist-based approach. Neurol Sci 2020; 41:3105-3121. [PMID: 32656714 DOI: 10.1007/s10072-020-04477-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/20/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To provide an exhaustive review of the neuropsychological examination as conducted in brain tumor clinical trials over the last 30 years and to provide objective ratings about the reliability and suitability of such tests in neurooncological research and clinical practice. METHODS Methodologies and tools provided by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) were exploited in order to assess the measurement properties of questionnaires and performance-based instruments used to evaluate cognitive functioning in brain tumor clinical trials from 1997 to 2017. RESULTS Twenty-six brain tumor clinical trials were analyzed and an overall set of 10 neuropsychological tests was identified. A list of 24 studies concerning the reliability of such tests was analyzed. Reliability and level of evidence scores for each study and for each test were obtained. The results revealed relevant faults about the quality of measurements and the suitability of the neurocognitive assessment batteries most commonly used in brain tumor clinical trials. CONCLUSION Our findings suggest that the cognitive assessment in brain tumor clinical trials should be implemented according to specific endpoints and should be addressed to investigate all the cognitive domains known to be affected by brain tumor and treatment.
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Affiliation(s)
- Maria De Martino
- Department of Political and Communication Sciences, University of Salerno, Via Giovanni Paolo II, 132, (SA), 84084, Fisciano, Italy.
| | - Barbara Santini
- Section of Neurosurgery, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Giovanna Cappelletti
- Section of Neurosurgery, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Annapina Mazzotta
- Section of Neurosurgery, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Matteo Rasi
- Section of Neurosurgery, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Giorgia Bulgarelli
- Section of Neurosurgery, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Luciano Annicchiarico
- Section of Neurosurgery, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Alessandro Marcocci
- Unit of Othorinolaringology, Merano Hospital, Via Rossini, 5, 39012, Merano (BZ), Italy
| | - Andrea Talacchi
- Section of Neurosurgery, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
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De Martino M, Sasso L, Pirozzi F, Bonaduce D. Systemic capillary leak syndrome or Clarkson's disease: a case report. Intern Emerg Med 2009; 4:357-8. [PMID: 19526356 DOI: 10.1007/s11739-009-0257-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 04/27/2009] [Indexed: 11/30/2022]
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Colombo L, Laudanna A, De Martino M, Brivio C. Regularity and/or consistency in the production of the past participle? Brain Lang 2004; 90:128-142. [PMID: 15172531 DOI: 10.1016/j.bandl.2003.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/02/2003] [Indexed: 05/24/2023]
Abstract
In the present study we have investigated the acquisition of the past participle of Italian verbs of the second (including mostly irregular verbs) and third (including mostly regular verbs) conjugations in school age children, and with simulations with an artificial neural network. We aimed to verify the extent to which children are sensitive to regularity, as opposed to the consistency in the mapping from the infinitive to the past participle. In particular, we predicted that children would learn at some point that verbs of the second conjugation tend to be irregular, and therefore they would be more likely to produce irregularizations for verbs of this class, compared to the verbs of the third conjugation. However, they should also show sensitivity to the phonological mapping consistency within each subclass, learning to produce correct forms on the basis of phonological similarity. In contrast, children should be more likely to produce regular forms for verbs of the third conjugation. Thus, a larger regularity effect would be expected for verbs of the third than of the second conjugation, leading to the prediction of a regularity by conjugation interaction.
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Affiliation(s)
- Lucia Colombo
- Department of Psychology, University of Padua, Via Venezia 8, 35131 Padua, Italy.
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Laudanna A, Gazzellini S, De Martino M. Representation of grammatical properties of Italian verbs in the mental lexicon. Brain Lang 2004; 90:95-105. [PMID: 15172528 DOI: 10.1016/s0093-934x(03)00423-1] [Citation(s) in RCA: 2] [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] [Accepted: 12/02/2003] [Indexed: 05/24/2023]
Abstract
The present study focuses on the representation of verbs in the Italian mental lexicon and investigates some grammatical properties: inflectional class, mood, tense, and person. Two experiments based on free recall of single inflected forms are reported. The patterns of recall and error are taken as evidence for the grammatical and morphological information exploited in the access to the verb forms. The pattern of results provides support for the hypothesis that in the mental lexicon the information about conjugation and mood is an organizational criterion for the representation of verbal forms. An interaction between mood and conjugation, likely to arise from the difference in productivity between conjugations, is also observed.
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Korn GP, Martino MD, Mimica IM, Mimica LJ, Chiavone PA, Musolino LR. High frequency of colonization and absence of identifiable risk factors for methicillin-resistant Staphylococcus aureus (MRSA)in intensive care units in Brazil. Braz J Infect Dis 2001; 5:1-7. [PMID: 11290308 DOI: 10.1590/s1413-86702001000100001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Colonization of hospitalized patients with methicillin-resistant Staphylococcus aureus (MRSA) is of increasing concern. To evaluate this problem in Intensive Care Units (ICUs) in Brazil, we studied 100 patients admitted to two ICUs from April to June, 1997. Of the 100 patients, 70 were male, 53 were age 60 years or older, 55 were previously hospitalized, 78 were transferred to the ICU from other hospital units, 49 had received antibiotic therapy, and 66 had undergone recent surgery. Nasal and axillary swab cultures were obtained on admission and every 48 hours thereafter until discharge. MRSA were identified by plating any cultured S. aureus on Mueller-Hinton agar containing 6 microg/ml of oxacillin. At the time of admission, 46 (46%) of the patients were colonized with MRSA. No associated risk factors for acquiring MRSA (age, previous hospitalization, prior surgery) could be identified. Of the 54 patients negative for MRSA on admission, 28 (52%) became colonized while in the ICU. Sixteen (22%) of the 74 colonized patients (colonized either on admission or during ICU stay) had associated respiratory or urinary tract infections due to MRSA, and 9 (56%) died. No correlation with special risk factors (invasive procedures, antibiotic use, age, chronic disease) was identified. MRSA occurred frequently, but there was minimal evidence of associated risk factors. Thus, control of MRSA cannot be accomplished by targeting special factors alone, but requires attention to preventing microbial spread in all areas. Of special concern is the high frequency of acquiring the organism in the ICU (52%). Education concerning the importance of hand washing, environmental surface cleaning, and barrier protection from infected patients is needed.
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Affiliation(s)
- G P Korn
- Medical School of Santa Casa de São Paulo, São Paulo, Brazil.
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Ayroza-Galvão PA, Milstein-Kuschnaroff TM, Mimica IM, Maassen S, Barbosa Júnior SP, Cavalcante NJ, Lorenco R, Mimica LM, Martino MD. Aztreonam in the treatment of bacterial meningitis. Chemotherapy 1989; 35 Suppl 1:39-44. [PMID: 2731449 DOI: 10.1159/000238719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The monobactam aztreonam was used to treat 22 young patients with meningitis caused by gram-negative bacilli. Haemophilus influenzae was isolated from the CSF of 21 patients and Salmonella heidelberg from the CSF of 1. Dosages ranged from 100 to 200 mg/kg/day in 4 doses at 6-hour intervals. Minimal inhibitory concentrations were determined by the broth dilution method for all isolated strains, and values ranged from 0.05 to 2.0 micrograms/ml. Blood and CSF drug levels were determined by a microbiologic plate diffusion method, and mean values for CSF and blood were 1.4 and 14.9 micrograms/ml, respectively. The outcome was good in 21 patients; 1 patient died. Complications were mild; subdural effusion occurred in 6 cases and was managed clinically; asymptomatic hydrocephalus was seen in 4; seizure during the acute phase occurred in 6 cases; hypoacusis was noted in 2, and motor impairment was detected at the follow-up in 1 case. Aztreonam achieved good blood and CSF penetration and performed well in the treatment of 20 cases of H. influenzae meningitis and in the one case of S. heidelberg meningitis.
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