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Marino M, Deutsch A, Kline T, Smith A, Li Q, Beizer J, McMullen T. Reliability and Validity of the Minimum Data Set 3.0 Standardized Self-Care and Mobility Data Elements Among Long-Stay Nursing Home Residents. Res Gerontol Nurs 2024; 17:57-64. [PMID: 38285909 DOI: 10.3928/19404921-20240112-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
PURPOSE To assess the reliability and validity of a subset of the Minimum Data Set (MDS) 3.0 Section GG data elements (i.e., standardized self-care, mobility) among 147 long-stay nursing home residents in seven nursing homes in five states. METHOD Trained clinicians assessed residents' functional abilities using select Section GG items and Section G activities of daily living items. We examined the reliability and construct validity of the data using Cronbach's alpha, correlations between Section G and Section GG items, confirmatory factor analysis (CFA), and Rasch measurement analysis. RESULTS We observed acceptable internal consistency values for all (0.98), self-care (0.93), and mobility (0.98) standardized items. Correlations between conceptually related Section G and Section GG items ranged from -0.53 to -0.84. CFA findings found acceptable values for all fit indices. Rasch analysis showed most items had acceptable fit statistics, except for the easiest and most difficult activities. CONCLUSION These findings establish the feasibility of data collection, internal consistency reliability, and construct validity of the selected Section GG items among long-stay nursing home residents. Use of the same standardized data elements in post-acute and long-term care populations can support improved coding of function and enhance our understanding of resident functioning. [Research in Gerontological Nursing, 17(2), 57-64.].
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Caruso C, Ciasca G, Baglivo I, Di Santo R, Gasbarrini A, Firinu D, Bagnasco D, Passalacqua G, Schiappoli M, Caminati M, Canonica GW, Heffler E, Crimi C, Intravaia R, Basile V, Marino M, Colantuono S, Del Giacco S. Immunoglobulin free light chains in severe asthma patient: Could they be a new biomarker? Allergy 2024. [PMID: 38425088 DOI: 10.1111/all.16082] [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: 08/03/2023] [Revised: 01/31/2024] [Accepted: 02/08/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Increasing evidence is available about the presence of increased serum concentration of immunoglobulin (Ig) free light chains (FLCs) in both atopic and non-atopic inflammatory diseases, including severe asthma, providing a possible new biomarker of disease. METHODS We analyzed clinical and laboratory data, including FLCs, obtained from a cohort of 79 asthmatic subjects, clinically classified into different GINA steps. A control group of 40 age-matched healthy donors (HD) was considered. Particularly, HD have been selected according to the absence of monoclonal components (in order to exclude paraproteinemias), were tested for total IgE (that were in the normal ranges) and were negative for aeroallergens specific IgE. Moreover, no abnormality of common inflammatory markers (i.e., erythrocyte sedimentation rate and C-reactive protein) was detectable. RESULTS FLC-k levels were significantly increased in the asthmatic population, compared to the control group. Despite the absence of statistically significant differences in FLC-λ levels, the FLC-k/FLC-λ ratio displayed remarkable differences between the two groups. A positive correlation between FLC-κ and FLC-λ levels was found. FLC- λ level displayed a significant negative correlation with the FEV1 value. Moreover, the FLC-κ /FLC- λ ratio was negatively correlated with the SNOT-22 score and a positive correlation was observed between FLCs and Staphylococcus Aureus IgE enterotoxins sensitization. CONCLUSIONS Our findings confirmed the role of FLCs in asthma as a potential biomarker in an inflammatory disease characterized by different endotypes and phenotypes. In particular, FLC-κ and FLC-k/FLC-λ ratio could be a qualitative indicator for asthma, while FLC-λ levels could be a quantitative indicator for clinical severity parameters.
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Affiliation(s)
- C Caruso
- UOSD DH Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Ciasca
- Dipartimento di Neuroscienze, Sezione di Fisica, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - I Baglivo
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Di Santo
- Dipartimento di Neuroscienze, Sezione di Fisica, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - A Gasbarrini
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - D Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - D Bagnasco
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
| | - M Schiappoli
- Allergy and Asthma Unit, Verona University Hospital, Verona, Italy
| | - M Caminati
- Department of Medicine, Asthma, Allergy and Clinical Immunology Section, University of Verona, Verona, Italy
| | - G W Canonica
- Personalized Medicine, Asthma and Allergy-IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - E Heffler
- Personalized Medicine, Asthma and Allergy-IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - C Crimi
- Respiratory Medicine Unit, Policlinico "G. Rodolico-San Marco" University Hospital, Catania, Italy
| | - R Intravaia
- Unit of Cardiology, University Hospital Paolo Giaccone, University of Palermo, Palermo
| | - V Basile
- Clinical Pathology Unit and Cancer Biobank, Department of research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Marino
- Sezione di Patologia Generale, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - S Colantuono
- UOSD DH Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Baron G, Altomare A, Della Vedova L, Gado F, Quagliano O, Casati S, Tosi N, Bresciani L, Del Rio D, Roda G, D'Amato A, Lammi C, Macorano A, Vittorio S, Vistoli G, Fumagalli L, Carini M, Leone A, Marino M, Del Bo' C, Miotto G, Ursini F, Morazzoni P, Aldini G. Unraveling the parahormetic mechanism underlying the health-protecting effects of grapeseed procyanidins. Redox Biol 2024; 69:102981. [PMID: 38104483 PMCID: PMC10770607 DOI: 10.1016/j.redox.2023.102981] [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: 11/06/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023] Open
Abstract
Proanthocyanidins (PACs), the predominant constituents within Grape Seed Extract (GSE), are intricate compounds composed of interconnected flavan-3-ol units. Renowned for their health-affirming properties, PACs offer a shield against a spectrum of inflammation associated diseases, such as diabetes, obesity, degenerations and possibly cancer. While monomeric and dimeric PACs undergo some absorption within the gastrointestinal tract, their larger oligomeric and polymeric counterparts are not bioavailable. However, higher molecular weight PACs engage with the colonic microbiota, fostering the production of bioavailable metabolites that undergo metabolic processes, culminating in the emergence of bioactive agents capable of modulating physiological processes. Within this investigation, a GSE enriched with polymeric PACs was employed to explore in detail their impact. Through comprehensive analysis, the present study unequivocally verified the gastrointestinal-mediated transformation of medium to high molecular weight polymeric PACs, thereby establishing the bioaccessibility of a principal catabolite termed 5-(3',4'-dihydroxyphenyl)-γ-valerolactone (VL). Notably, our findings, encompassing cell biology, chemistry and proteomics, converge to the proposal of the notion of the capacity of VL to activate, upon oxidation to the corresponding quinone, the nuclear factor E2-related factor 2 (Nrf2) pathway-an intricate process that incites cellular defenses and mitigates stress-induced responses, such as a challenge brought by TNFα. This mechanistic paradigm seamlessly aligns with the concept of para-hormesis, ultimately orchestrating the resilience to stress and the preservation of cellular redox equilibrium and homeostasis as benchmarks of health.
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Affiliation(s)
- G Baron
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - A Altomare
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - L Della Vedova
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - F Gado
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - O Quagliano
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - S Casati
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133, Milan, Italy
| | - N Tosi
- Human Nutrition Unit, Department of Food & Drug, University of Parma, Via Volturno 39, 43125, Parma, Italy
| | - L Bresciani
- Human Nutrition Unit, Department of Food & Drug, University of Parma, Via Volturno 39, 43125, Parma, Italy
| | - D Del Rio
- Human Nutrition Unit, Department of Food & Drug, University of Parma, Via Volturno 39, 43125, Parma, Italy
| | - G Roda
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - A D'Amato
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - C Lammi
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - A Macorano
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - S Vittorio
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - G Vistoli
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - L Fumagalli
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - M Carini
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy
| | - A Leone
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Via Sandro Botticelli 21, 20133, Milan, Italy; Department of Food, Environmental and Nutritional Sciences (DeFENS), Division of Human Nutrition, Università degli Studi di Milano, Via Luigi Mangiagalli 25, 20133, Milan, Italy
| | - M Marino
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Division of Human Nutrition, Università degli Studi di Milano, Via Luigi Mangiagalli 25, 20133, Milan, Italy
| | - C Del Bo'
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Division of Human Nutrition, Università degli Studi di Milano, Via Luigi Mangiagalli 25, 20133, Milan, Italy
| | - G Miotto
- Department of Molecular Medicine, Viale G. Colombo, 3, University of Padova, 35121, Padova, Italy
| | - F Ursini
- Department of Molecular Medicine, Viale G. Colombo, 3, University of Padova, 35121, Padova, Italy
| | - P Morazzoni
- Divisione Nutraceutica, Distillerie Umberto Bonollo S.p.A, 35035, Mestrino, Italy
| | - G Aldini
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133, Milan, Italy.
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Natali P, Debbia D, Cucinelli MR, Nasillo V, Riva G, Cigliana G, Carnazzo V, Trenti T, Marino M, Basile U. A new challenge for urinary free light chains: assessment of the upper reference limit in healthy subjects. Eur Rev Med Pharmacol Sci 2023; 27:8915-8923. [PMID: 37782200 DOI: 10.26355/eurrev_202309_33812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Free light chains (FLCs) can be measured in both urine (uFLC) and serum (sFLC) in immunochemistry. We aim to compare FLC levels in serum and urine assessed among healthy volunteers and measured upper reference limits (URLs) of urinary FLC to creatinine ratio (uFLC/uCr) in mg/g to compare with the manufacturer's recommended URLs. PATIENTS AND METHODS Eligibility criteria: normal serum and urine FLC measure and negative serum/urinary immunofixation. Immunoturbidimetry was used to assess both κ and λ FLCs. The URLs were calculated with the 97.5th percentile of uFLC concentrations according to the Clinical and Laboratory Standards Institute recommendations. RESULTS 126 healthy subjects (median age 46 years, 62% females) met the inclusion criteria. Median concentrations of κ and λ sFLCs were similar both for males and females without significant differences. κ and λ uFLCs were significantly higher in males than in females (p < 0.001 and p = 0.004, respectively). Slower clearance for λ FLC compared to κ FLC was observed with an increased κ/λ uFLC ratio in both males and females. URLs for male and female subjects: κ uFLC mg/g uCr = 34.35 vs. 23.18, and λ uFLC mg/g uCr = 3.59 vs. 1.96, respectively compared well with manufacturer's URLs. CONCLUSIONS FLC catabolism is gender-dependent and occurs less rapidly in λ FLC than in κ FLC. The determination of the URL of uFLC, as uFLC/uCr, in healthy subjects in morning urine, proved to be consistent with the manufacturer's recommendations, but with a significant difference according to gender.
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Affiliation(s)
- P Natali
- Department of Laboratory Medicine and Pathology, Azienda Ospedaliero Universitaria e Azienda Unità Sanitaria Locale di Modena, Modena, Italy.
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr K, Garrod R, Makia F, Eldeeb F, Abdekader R, Gomaa A, Kandasamy S, Maruthanayagam R, Nadar SK, Nakad G, Nair R, Mota P, Prior P, Mcdonald S, Rand J, Schumacher N, Abraheem A, Clark M, Coulding M, Qamar N, Turner V, Negahban AQ, Crew A, Hope S, Howson J, Jones S, Lancaster N, Nicholson A, Wray G, Donnelly P, Gierlotka M, Hammond L, Hammond S, Regan S, Watkin R, Papadopoulos C, Ludman P, Hutton K, Macdonald S, Nilsson A, Roberts S, Monteiro S, Garg S, Balachandran K, Mcdonald J, Singh R, Marsden K, Davies K, Desai H, Goddard W, Iqbal N, Chalil S, Dan GA, Galasko G, Assaf O, Benham L, Brown J, Collins S, Fleming C, Glen J, Mitchell M, Preston S, Uttley A, Radovanovic M, Lindsay S, Akhtar N, Atkinson C, Vinod M, Wilson A, Clifford P, Firoozan S, Yashoman M, Bowers N, Chaplin J, Reznik EV, Harvey S, Kononen M, Lopesdesousa G, Saraiva F, Sharma S, Cruddas E, Law J, Young E, Hoye A, Harper P, Balghith M, Rowe K, Been M, Cummins H, French E, Gibson C, Abraham JA, Hobson S, Kay A, Kent M, Wilkinson A, Mohamed A, Clark S, Duncan L, Ahmed IM, Khatiwada D, Mccarrick A, Wanda I, Read P, Afsar A, Rivers V, Theobald T, Cercek M, Bell S, Buckman C, Francis R, Peters G, Stables R, Morgan M, Noorzadeh M, Taylor B, Twiss S, Widdows P, Brozmannová D, Wilkinson V, Black M, Clark A, Clarkson N, Currie J, George L, Mcgee C, Izzat L, Lewis T, Omar Z, Aytekin V, Phillips S, Ahmed F, Mackie S, Oommen A, Phillips H, Sherwood M, Aleti S, Charles T, Jose M, Kolakaluri L, Ingabire P, Karoudi RA, Deery J, Hazelton T, Knight A, Price C, Turney S, Kardos A, Williams F, Wren L, Bega G, Alyavi B, Scaletta D, Kunadian V, Cullen K, Jones S, Kirkup E, Ripley DP, Matthews IG, Mcleod A, Runnett C, Thomas HE, Cartasegna L, Gunarathne A, Burton J, King R, Quinn J, Sobolewska J, Munt S, Porter J, Christenssen V, Leng K, Peachey T, Gomez VN, Temple N, Wells K, Viswanathan G, Taneja A, Cann E, Eglinton C, Hyams B, Jones E, Reed F, Smith J, Beltrano C, Affleck DC, Turner A, Ward T, Wilmshurst N, Stirrup J, Brunton M, Whyte A, Smith S, Murray V, Walker R, Novas V, Weston C, Brown C, Collier D, Curtis K, Dixon K, Wells T, Trim F, Ghosh J, Mavuri M, Barman L, Dumont C, Elliott K, Harrison R, Mallinson J, Neale T, Smith J, Toohie J, Turnbull A, Parker E, Hossain R, Cheeseman M, Balparda H, Hill J, Hood M, Hutchinson D, Mellows K, Pendlebury C, Storey RF, Barker J, Birchall K, Denney H, Housley K, Cardona M, Middle J, Kukreja N, Gati S, Kirk P, Lynch M, Srinivasan M, Szygula J, Baker P, Cruz C, Derigay J, Cigalini C, Lamb K, Nembhard S, Price A, Mamas M, Massey I, Wain J, Delaney J, Junejo S, Martin K, Obaid D, Hoyle V, Brinkworth E, Davies C, Evans D, Richards S, Thomas C, Williams M, Dayer M, Mills H, Roberts K, Goodchild F, Dámaso ES, Greig N, Kundu S, Donaldson D, Tonks L, Beekes M, Button H, Hurford F, Motherwell N, Summers-Wall J, Felmeden D, Tapia V, Keeling P, Sheikh U, Yonis A, Felmeden L, Hughes D, Micklewright L, Summerhayes A, Sutton J, Panoulas V, Prendergast C, Poghosyan K, Rogers P, Barker LN, Batin P, Conway D, Exley D, Fletcher A, Wright J, Nageh T, Hadebe B, Kunhunny S, Mkhitaryan S, Mshengu E, Karthikeyan VJ, Hamdan H, Cooper J, Dandy C, Parkinson V, Paterson P, Reddington S, Taylor T, Tierney C, Adamyan M, Jones KV, Broadley A, Beesley K, Buckley C, Hellyer C, Pippard L, Pitt-Kerby T, Azam J, Hayes C, Freshwater K, Boyadjian S, Johnson L, Mcgill Y, Redfearn H, Russell M, Alyavi A, Alyavi B, Uzokov J, Hayrapetyan H, Azaryan K, Tadevosyan M, Poghosyan H, Kzhdryan H, Vardanyan A, Huber K, Geppert A, Ahmed A, Weidinger F, Derntl M, Hasun M, Schuh-Eiring T, Riegler L, Haq MM, Cader FA, Dewan MAM, Fatema ME, Hasan AS, Islam MM, Khandoker F, Mayedah R, Nizam SU, Azam MG, Arefin MM, Jahan J, Schelfaut D, De Raedt H, Wouters S, Aerts S, Batjoens H, Beauloye C, Dechamps M, Pierard S, Van Caenegem O, Sinnaeve F, Claeys MJ, Snepvangers M, Somers V, Gevaert S, Schaubroek H, Vervaet P, Buysse M, Renders F, Dumoulein M, Hiltrop N, De Coninck M, Naessens S, Senesael I, Hoffer E, Pourbaix S, Beckers J, Dugauquier C, Jacquet S, Malmendier D, Massoz M, Evrard P, Collard L, Brunner P, Carlier S, Blockmans M, Mayne D, Timiras E, Guédès A, Demeure F, Hanet C, Domange J, Jourdan K, Begic E, Custovic F, Dozic A, Hrvat E, Kurbasic I, Mackic D, Subo A, Durak-Nalbantic A, Dzubur A, Rebic D, Hamzic-Mehmedbasic A, Redzepovic A, Djokic-Vejzovic A, Hodzic E, Hujdur M, Musija E, Gljiva-Gogic Z, Serdarevic N, Bajramovic NS, Brigic L, Halilcevic M, Cibo M, Hadžibegic N, Kukavica N, Begic A, Iglica A, Osmanagic A, Resic N, Grgurevic MV, Zvizdic F, Pojskic B, Mujaric E, Selimovic H, Ejubovic M, Pojskic L, Stimjanin E, Sut M, Zapata PS, Munoz CG, Andrade LAF, Upegui MPT, Perez LE, Chavarria J, Quesada D, Alvarado K, Zaputovic L, Tomulic V, Gobic D, Jakljevic T, Lulic D, Bacic G, Bastiancic L, Avraamides P, Eftychiou C, Eteocleous N, Ioannou A, Lambrianidi C, Drakomathioulakis M, Groch L, Hlinomaz O, Rezek M, Semenka J, Sitar J, Beranova M, Kramarikova P, Pesl 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S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Ryan CM, Shapiro GD, Rencken CA, Griggs C, Jeng JC, Hickerson WL, Marino M, Goverman J, Kazis LE, Schneider JC. The Impact of Burn Size on Community Participation: A Life Impact Burn Recovery Evaluation (LIBRE) Study. Ann Surg 2022; 276:1056-1062. [PMID: 33351466 PMCID: PMC8265012 DOI: 10.1097/sla.0000000000004703] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the association of burn size and community participation as measured by the LIBRE Profile. SUMMARY OF BACKGROUND DATA Burn size is an established clinical predictor of survival after burn injury. It is often a factor in guiding decisions surrounding early medical interventions; however, literature is inconclusive on its relationship to quality of life outcomes. METHODS This is a secondary data analysis of a cross-sectional survey of adult burn survivors. Self-reported data were collected between October 2014 and December 2015 from 601 burn survivors aged ≥18 years with ≥5% total body surface area (TBSA) or burns to critical areas. Sociodemographic characteristics were compared between participants with small burns (≤40% TBSA burned) and large burns (>40% TBSA burned). Ordinary least squares regression models examined associations between burn size and LIBRE Profile scale scores with adjustments for sex, current work status, burns to critical areas, and time since burn injury. RESULTS The analytic sample comprised 562 participants with data available for burn size. 42% of respondents had large burns (>40% TBSA burned) and 58% reported smaller burns (TBSA ≤40%). In adjusted regression models, patients with large burns tended to score lower on the Social Activities and Work & Employment scales ( P < 0.05) and higher on the Family & Friends scale ( P < 0.05). Participants with burns >40% TBSA scored lower for several individual items in the Social Activities scale and one item in the Work & Employment scale ( P < 0.05). CONCLUSIONS Increasing burn size was found to be negatively associated with selected items of Work & Employment and Social Activities, but positively associated with aspects of Family & Friend Relationships. Future longitudinal studies are necessary to assess and understand the long-term social impact of burn injuries on adult populations.
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Affiliation(s)
- Colleen M. Ryan
- Department of Surgery, Massachusetts General Hospital, Boston, MA
- Shriners Hospitals for Children – Boston, Boston, MA
- Harvard Medical School, Boston, MA
| | - Gabriel D. Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | | | - Cornelia Griggs
- New York Presbyterian/Morgan Stanley Children’s Hospital Department of Pediatric Radiology and Surgery, New York, NY, USA
| | - James C. Jeng
- Nathan Speare Regional Burn Treatment Center, Crozer-Chester Medical Center, Upland, PA
| | | | - Molly Marino
- Quality Measurement and Health Policy Program, RTI International, Waltham, MA
| | - Jeremy Goverman
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Lewis E. Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Jeffrey C. Schneider
- Harvard Medical School, Boston, MA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA
- Spaulding Research Institute, Boston, MA
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Kukavica D, Mazzanti A, Trancuccio A, Giannini G, Marino M, Memmi M, Gambelli P, Bloise R, Morini M, Ortiz-Genga M, Napolitano C, Priori SG. Catecholaminergic polymorphic ventricular tachycardia: risk modulators in patients treated with beta-blockers. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Due to the catecholaminergic nature of arrhythmias that define the Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT), beta-blockers (BBs) represent the first line therapy for this severe arrhythmogenic syndrome. Despite optimal BB therapy, a proportion of patients continue to suffer breakthrough life-threatening arrhythmias (LAE).
Purpose
To evaluate the role different classes of BBs (β1-selective vs. non-selective) in LAE reduction and to identify risk factors for breakthrough LAE while on BB monotherapy.
Methods
We studied 238 consecutive patients with CPVT and treated with BB monotherapy followed-up prospectively. CPVT was diagnosed according to the 2015 European Society of Cardiology Guidelines. The endpoint was the occurrence of the first LAE (sudden cardiac death, aborted cardiac arrest, or hemodynamically non-tolerated ventricular tachycardia) in BB monotherapy. The follow-up for each patient was calculated from BB therapy start to the occurrence of the endpoint, death from non-arrhythmic cause, the date of last visit, or the initiation of other treatments (i.e.: other antiarrhythmics or left cardiac sympathetic denervation [LCSD]), whichever occurred first.
Multivariable Cox proportional hazards model was used to evaluate the effects of history of LAE before diagnosis of CPVT, occurrence of unexplained syncope before diagnosis of CPVT, genotype, and type of BB therapy, as a time-dependent variable, on the risk of experiencing an LAE during BB monotherapy.
Results
We enrolled 238 CPVT patients (135 probands, 135 females): 226 with typical CPVT (n=216 RYR2; n=10 CASQ2) and 12 with atypical CPVT (n=5 RYR2-Loss-of-Function, n=4 TRDN and n=3 TECRL).
Prior to BB monotherapy, 48/238 (20%) patients had survived an LAE, and 110/238 (46%) patients had experienced an unexplained syncope.
During 1,629 person-years of follow-up during BB monotherapy, 35 patients experienced an LAE (annual LAE rate 2.1%, 95% CI: 1.5%–3.0%; Figure A). Five-year cumulative probability of experiencing an LAE during BB monotherapy was 11.9% (95% CI: 7.0%-16.6%). In this population, multivariable analysis showed that history of LAE before diagnosis (HR 3.6; 95% CI: 1.6–8.1; p=0.002) and syncope before diagnosis (HR 6.1; 95% CI: 2.5–14.9; p<0.001) were clinical risk factors for LAE occurrence. Patients with TRDN mutations were significantly more likely to suffer LAE (HR 20.9; 95% CI: 2.2–196.3; p=0.008). Using nadolol as the gold standard, the use of β1-selective BBs (HR 3.4; 95% CI: 1.4–8.6; p=0.009), but not propranolol (HR: 0.9; 95% CI: 0.2–3.8; p=0.887), was associated with poorer outcome during BB monotherapy (Figure B).
Conclusions
In patients with CPVT, selective BBs are associated with a higher risk of LAE as compared to nadolol. Patients who have survived an LAE and/or experienced an unexplained syncope prior to diagnosis, as well as carriers of TRDN mutations are at high risk of BB failure.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ricerca Corrente Funding scheme of the Italian Ministry of Health and Italian Ministry of Research and University Dipartimenti di Eccellenza 2018–2022 grant to the Molecular Medicine Department (University of Pavia).
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Trancuccio A, Mazzanti A, Kukavica D, Giannini G, Memmi M, Gambelli P, Bloise R, Marino M, Morini M, Ortiz-Genga M, Napolitano C, Priori SG. Natural History of Patients with Typical and Atypical Catecholaminergic Polymorphic Ventricular Tachycardia. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Recently, a novel genetic-based classification for Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) has been proposed to distinguish “typical” (RYR2 and CASQ2 genes) and “atypical” (TRDN, TECRL, CALM1–3, RYR2 loss-of-function [RYR2-LoF]) CPVT variants. Although some genetic forms were reported as malignant forms of CPVT, natural history data comparing typical and atypical CPVT variants are lacking.
Purpose
We compared the natural history of “typical” and “atypical” forms of CPVT in a large cohort of patients with genetically confirmed CPVT.
Methods
CPVT was diagnosed according to the criteria defined in the 2015 European Society of Cardiology Guidelines. Based on the genetic background, we classified the patients in two groups: 1) “Typical” CPVT (i.e., carriers of pathogenic or likely pathogenic mutations in RYR2 and CASQ2 genes); 2) “Atypical” CPVT (i.e., carriers of pathogenic or likely pathogenic mutations in TRDN, TECRL, CALM1–3 and RYR2-LoF). Patients with mutations in the CALM1, CALM2 or CALM3 were not identified in our cohort. The outcome was the occurrence of a life-threatening arrhythmic event (LAE), defined as: sudden cardiac death, aborted cardiac arrest or hemodynamically non-tolerated ventricular tachycardia. The Kaplan-Meier life-table method was used to determine the cumulative probability of experiencing a first LAE before the age of 40 years and in the absence of treatment. Outcomes in two groups were compared using the log-rank test.
Results
The study cohort included 238 patients (56% females, median age at diagnosis 14 years [IQR: 9–28 years]), of whom 226/238 (95%) patients with “typical” CPVT (216 RYR2, 10 CASQ2), and 12/238 (5%) patients with “atypical” CPVT (5 RYR2-LoF, 4 TRDN, 3 TECRL). In the entire population, the cumulative probability of experiencing a first LAE between birth and the diagnosis of CPVT was 2.3%, 21.2 and 40.8% at 5, 20, and 40 years, respectively. At any given age, the probability of a first LAE in the absence of therapy was significantly higher in patients with atypical CPVT (25%, 36%, and 100% at 5, 20, and 40 years, respectively), as compared to patients with typical CPVT (1%, 20%, and 39% at 5, 20, and 40 years, respectively; p=0.003, Figure 1). Patients with atypical CPVT suffered LAEs in early childhood (i.e., by the age of 5 years) significantly more often than patients with typical CPVT (3/5 patients [60%] in atypical CPVT vs. 2/43 patients [5%] in typical CPVT, p<0.001; Figure 2).
Conclusions
The natural history of CPVT is modulated by the genetic cause. Atypical CPVT variants are rare but are characterized by a worse outcome and a greater likelihood of experiencing an LAE since the early childhood, as compared to typical CPVT.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ricerca Corrente funding scheme of the Italian Ministry of Health
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Affiliation(s)
| | | | | | | | - M Memmi
- Istituti Clinici Scientifici Maugeri IRCCS , Pavia , Italy
| | - P Gambelli
- Istituti Clinici Scientifici Maugeri IRCCS , Pavia , Italy
| | - R Bloise
- Istituti Clinici Scientifici Maugeri IRCCS , Pavia , Italy
| | - M Marino
- Istituti Clinici Scientifici Maugeri IRCCS , Pavia , Italy
| | - M Morini
- Istituti Clinici Scientifici Maugeri IRCCS , Pavia , Italy
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Mazzanti A, Trancuccio A, Kukavica D, Marino M, Giannini G, Rossetti L, Memmi M, Bloise R, Morini M, Napolitano C, Priori SG. Efficacy and safety of the ICD in patients with catecholaminergic polymorphic ventricular tachycardia. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) is a potentially fatal genetic arrhythmia syndrome and, despite optimal beta-blocker (BB) therapy, patients often experience life-threatening arrhythmic events (LAE). The role of implantable cardioverter defibrillators (ICD) on reducing mortality in patients with CPVT is debated.
Purpose
1) To assess the survival benefit of ICD in the overall CPVT population; 2) to investigate the benefit-to-harm ratio in the population of CPVT patients carriers of ICD.
Methods
We followed-up consecutive patients with genetically-proven CPVT, treated with optimal BB mono-therapy. The probability of surviving at the occurrence of a first LAE (defined as: sudden cardiac death, aborted cardiac arrest or hemodynamically non-tolerated ventricular tachycardia) during BB mono-therapy was compared between ICD carriers and non-ICD carriers.
In the cohort of ICD carriers, we assessed the rate of a first major complication (i.e., a complication requiring surgical intervention) and we calculated the benefit-to-harm ratio of ICD (defined as rate of appropriate shocks on LAE over rate of major complications).
Results
We enrolled 228 CPVT patients with a pathogenic RYR2 (n=216) or CASQ2 (n=12) mutation, of whom 87 (38%) had an ICD implanted. Overall, during 1,558 person-years of follow-up, 31/228 (14%) patients experienced a first LAE on BB mono-therapy (annual LAE rate 2.0%, 95% CI: 1.4–2.8%).
Of the 31 individuals who experienced an LAE, 21 patients had an ICD when the LAE occurred, and all survived after ICD intervention. Of the remaining 10 patients who were not carriers of an ICD, 6/10 (60%) survived after external defibrillation or spontaneous arrhythmia termination, while 4/10 (40%) died suddenly. The probability of surviving at the occurrence of a first LAE in BB mono-therapy was thirty-fold higher (Odds Ratio: 30.0, 95% CI: 1.4–629.0; p=0.029) in patients with an ICD, as compared to patients without an ICD.
Overall, 15/87 (17%) patients with an ICD experienced a first major complication over 602 person-years of follow-up (2.5% per year, 95% CI: 1.4%-4.1%). Importantly, no patient died for a pro-arrhythmic effect or complications related to ICD. Comparing the rate of major complications to the rate of appropriate ICD shocks on LAE (LAE rate 4.7% per year, 95% CI: 3.1–7.0%), the benefit-to-harm ratio was 1.9, thus favouring the benefit of ICD therapy.
Conclusions
In our population, ICD therapy conferred a significant survival benefit in patients with CPVT at the occurrence of a first LAE. Overall, the benefit of ICD implant outweighed the harm, as shown by almost two times greater benefit-to-harm ratio. This study provides evidence supporting ICD implantation in patients with high-risk CPVT.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ricerca Corrente Funding Scheme of the Italian Ministry of Health
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Affiliation(s)
- A Mazzanti
- IRCCS ICS Maugeri, Molecular Cardiology , Pavia , Italy
| | - A Trancuccio
- University of Pavia, Molecular Medicine , Pavia , Italy
| | - D Kukavica
- University of Pavia, Molecular Medicine , Pavia , Italy
| | - M Marino
- IRCCS ICS Maugeri, Molecular Cardiology , Pavia , Italy
| | - G Giannini
- University of Pavia, Molecular Medicine , Pavia , Italy
| | - L Rossetti
- University of Pavia, Molecular Medicine , Pavia , Italy
| | - M Memmi
- IRCCS ICS Maugeri, Molecular Cardiology , Pavia , Italy
| | - R Bloise
- IRCCS ICS Maugeri, Molecular Cardiology , Pavia , Italy
| | - M Morini
- IRCCS ICS Maugeri, Molecular Cardiology , Pavia , Italy
| | - C Napolitano
- University of Pavia, Molecular Medicine , Pavia , Italy
| | - S G Priori
- University of Pavia, Molecular Medicine , Pavia , Italy
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Natali P, Cigliana G, Napodano C, Basile V, Debbia D, Pocino K, Savoia M, Marino M, Gulli F, Basile U. The dark side of current analytic methods for Bence Jones Proteinuria. Eur Rev Med Pharmacol Sci 2022; 26:6777-6786. [PMID: 36196726 DOI: 10.26355/eurrev_202209_29779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Bence Jones proteinuria (BJP) refers to monoclonal free immunoglobulin light chains detected in urine, deriving from the clonal expansion of plasma cells in the bone marrow in patients with plasma cell dyscrasias, associated with monoclonal gammopathies of uncertain origin. This review summarizes routinely diagnostic procedures to assess BJP highlighting critical steps of pre-analytical, analytical, and post-analytical phases. QUALITATIVE AND QUANTITATIVE METHODS The best option for BJP detection is the first morning void urine sample and immunofixation electrophoresis detection technique (IFE) the recommended method, with the employment of specific polyvalent antisera. Other qualitative tests for a quick evaluation of BJP are currently available. Densitometric analysis performed on the 24-hour urine is the recommended method to quantify BJP. To overcome the 24-hour collection, it is possible to use morning urine sample and correlate the assessed value of BJP to creatininuria. In addition to the traditional ones, we here reviewed screening methods currently used to avoid false negatives and reduce the time around test (TAT), together with immunochemical quantification methods for increased sensitivity, after checking BJP by IFE. Mass spectrometry emerges as a new challenge in the determination of BJP. CONCLUSIONS The employment of different based-assays methods may be useful for diagnostic purposes to improve the accuracy of BJP monitoring in monoclonal gammopathies.
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Affiliation(s)
- P Natali
- Department of Laboratory Medicine, Azienda Ospedaliero-Universitaria and Azienda Unità Sanitaria Locale, Ospedale Civile di Baggiovara, Modena, Italy.
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Giovannini I, Cereser L, Tinazzi I, Cicciò C, Murru FM, Bramuzzo M, Marino M, Tullio A, De Vita S, Zabotti A. AB1347 ASYMPTOMATIC SACROILIITIS DETECTED BY MAGNETIC RESONANCE ENTEROGRAPHY IN PATIENTS AFFECTED BY CROHN’S DISEASE: PREVALENCE AND ASSOCIATION WITH CLINICAL DATA IN A MULTICENTER STUDY OF ADULT AND PEDIATRIC POPULATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundMagnetic resonance enterography (MRE) is usually performed in patients with Crohn’s disease (CD) for evaluating small bowel involvement. Inflammatory bowel disease (IBD) mainly affect the gastrointestinal tract, although patients may present extraintestinal manifestations (1). Musculoskeletal symptoms are the most frequent extraintestinal manifestation in IBD, especially in CD. Furthermore, sacroiliitis at imaging occurs in about 6-46% of CD patients and may correlate with axial spondyloarthritis (2,3).ObjectivesThe primary aim of our study was to assess the prevalence of sacroiliitis in adult and pediatric patients affected by CD who performed MRE. We also evaluated the inter-rater agreement for MRE sacroiliitis and the association between sacroiliitis and patients’ clinical data.MethodsWe included consecutive patients with CD diagnosis (4), who underwent an MRE in the period between December 2012 and May 2020. We excluded patients with a known diagnosis of SpA; patients with confirmed or suspected inflammatory back pain; and patients treated at the time of MRE with systemic Disease-Modifying Antirheumatic Drugs (DMARDs), which influence both bowel and joint disease (i.e., conventional DMARDs, and biologic DMARDs).Two radiologists assessed the prevalence of sacroiliitis at MRE. We evaluated the inter-rater agreement for sacroiliitis and assessed the correlation between sacroiliitis and demographic, clinical, and endoscopic data.ResultsWe retrospectively identified 100 adult and 30 pediatric patients. The prevalence of sacroiliitis at MRE was 20% in adults and 6.7% in pediatric patients. The inter-rater agreement for sacroiliitis was substantial (k=0.62, p<0.001) in the adults, and moderate (k=0.46, p=0.011) in the pediatric cohort. Age ≥50 years and the time between CD diagnosis and MRE (≥86.5 months) were significantly associated with sacroiliitis in adult patients (p=0.049 and p=0.038, respectively).ConclusionAsymptomatic sacroiliitis at MRE is a frequent and reliable abnormality in adult patients with CD, associated with age of the patients ≥ 50 years and CD duration. Detecting sacroiliitis at MRE in patients affected by CD may help the appropriate and early referral to the rheumatologist.References[1]Vavricka SR, Schoepfer A, Scharl M, Lakatos PL, Navarini A, Rogler G. Extraintestinal Manifestations of Inflammatory Bowel Disease. Inflammatory Bowel Diseases. 2015 Aug 1;21(8):1982–92.[2]Salvarani C, Fries W. Clinical features and epidemiology of spondyloarthritides associated with inflammatory bowel disease. World J Gastroenterol. 2009 May 28;15(20):2449–55.[3]Fragoulis GE, Liava C, Daoussis D, Akriviadis E, Garyfallos A, Dimitroulas T. Inflammatory bowel diseases and spondyloarthropathies: From pathogenesis to treatment. World J Gastroenterol. 2019 May 14;25(18):2162–76.[4]Maaser C, Sturm A, Vavricka SR, Kucharzik T, Fiorino G, Annese V, et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. Journal of Crohn’s and Colitis. 2019 Feb 1;13(2):144–64.Disclosure of InterestsIvan Giovannini Speakers bureau: not relevant for this study, Lorenzo Cereser: None declared, Ilaria Tinazzi: None declared, Carmelo Cicciò: None declared, Floria Maria Murru: None declared, Matteo Bramuzzo Speakers bureau: not relevant for this study, Marco Marino Speakers bureau: not relevant for this study, Annarita Tullio: None declared, Salvatore De Vita Speakers bureau: not relevant for this study, Alen Zabotti Speakers bureau: not relevant for this study
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Song Z, Kannan S, Gambrel RJ, Marino M, Vaduganathan M, Clapp MA, Seiglie JA, Bloom PP, Malik AN, Resnick MJ. Physician Practice Pattern Variations in Common Clinical Scenarios Within 5 US Metropolitan Areas. JAMA Health Forum 2022; 3:e214698. [PMID: 35977237 PMCID: PMC8903123 DOI: 10.1001/jamahealthforum.2021.4698] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/19/2021] [Indexed: 11/29/2022] Open
Abstract
Question To what extent do physician-level variations in the appropriateness or quality of care exist within metropolitan areas, notably among specialists? Findings In this cross-sectional study of 8788 physicians across 7 specialties in 5 US metropolitan areas, sizeable physician-level practice pattern variations were evident across 14 common clinical scenarios where practice guidelines and clinical evidence can help discern, on average, the appropriateness or quality of clinical decisions. Variations were robust to adjustment for patient and area-level characteristics, and measure reliability was generally high. Meaning Within-area physician-level variations in practice patterns were qualitatively similar across clinical scenarios, despite practice guidelines designed to reduce variation. Importance While variations in quality of care have been described between US regions, physician-level practice pattern variations within regions remain poorly understood, notably among specialists. Objective To examine within-area physician-level variations in decision-making in common clinical scenarios where guidelines specifying appropriateness or quality of care exist. Design, Setting, and Participants This cross-sectional study used 2016 through 2019 data from a large nationwide network of commercial insurers, provided by Health Intelligence Company, LLC, within 5 metropolitan statistical areas (MSAs). Physician-level variations in appropriateness and quality of care were measured using 14 common clinical scenarios involving 7 specialties. The measures were constructed using public quality measure definitions, clinical guidelines, and appropriateness criteria from the clinical literature. Physician performance was calculated using a multilevel model adjusted for patient age, sex, risk score, and socioeconomic status with physician random effects. Measure reliability for each physician was calculated using the signal-to-noise approach. Within-MSA variation was calculated between physician quintiles adjusted for patient attributes, with the first quintile denoting highest quality or appropriateness and the fifth quintile reflecting the opposite. Data were analyzed March through October 2021. Main Outcomes and Measures Fourteen measures of quality or appropriateness of care, with 2 measures each in the domains of cardiology, endocrinology, gastroenterology, pulmonology, obstetrics, orthopedics, and neurosurgery. Results A total of 8788 physicians were included across the 5 MSAs, and about 2.5 million unique patient-physician pairs were included in the measures. Within the 5 MSAs, on average, patients in the measures were 34.7 to 40.7 years old, 49.1% to 52.3% female, had a mean risk score of 0.8 to 1.0, and more likely to have an employer-sponsored insurance plan that was either self-insured or fully insured (59.8% to 97.6%). Within MSAs, physician-level variations were qualitatively similar across measures. For example, statin therapy in patients with coronary artery disease ranged from 54.3% to 70.9% in the first quintile of cardiologists to 30.5% to 42.6% in the fifth quintile. Upper endoscopy in patients with gastroesophageal reflux disease without alarm symptoms spanned 14.6% to 16.9% in the first quintile of gastroenterologists to 28.2% to 33.8% in the fifth quintile. Among patients with new knee or hip osteoarthritis, 2.1% to 3.4% received arthroscopy in the first quintile of orthopedic surgeons, whereas 25.5% to 30.7% did in the fifth quintile. Appropriate prenatal screening among pregnant patients ranged from 82.6% to 93.6% in the first quintile of obstetricians to 30.9% to 65.7% in the fifth quintile. Within MSAs, adjusted differences between quintiles approximated unadjusted differences. Measure reliability, which can reflect consistency and reproducibility, exceeded 70.0% across nearly all measures in all MSAs. Conclusions and Relevance In this cross-sectional study of 5 US metropolitan areas, sizeable physician-level practice variations were found across common clinical scenarios and specialties. Understanding the sources of these variations may inform efforts to improve the value of care.
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Affiliation(s)
- Zirui Song
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Massachusetts General Hospital, Boston
| | - Sneha Kannan
- Department of Medicine, Massachusetts General Hospital, Boston
| | | | | | - Muthiah Vaduganathan
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Mark A. Clapp
- Department of Obstetrics & Gynecology, Massachusetts General Hospital, Boston
| | - Jacqueline A. Seiglie
- Department of Medicine, Massachusetts General Hospital, Boston
- Diabetes Unit, Massachusetts General Hospital, Boston
| | | | - Athar N. Malik
- Department of Neurosurgery, Massachusetts General Hospital, Boston
| | - Matthew J. Resnick
- Embold Health, Nashville, Tennessee
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
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13
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Perrone A, Aruta SF, Crucitti G, Gualandi P, Malaspina E, Marino M, Franzoni E, Parmeggiani A. Pervasive refusal syndrome or anorexia nervosa: a case report with a successful behavioural treatment. Eat Weight Disord 2021; 26:2089-2093. [PMID: 32816207 PMCID: PMC7439801 DOI: 10.1007/s40519-020-00991-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/12/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Pervasive refusal syndrome (PRS) is a rare psychiatric disease that affects children. It was first described by Lask in 1991 (Arch Dis Child 66:866-869, 1991). Recently, Otasowie and Collaborators reported a systematic review about PRS. Despite this, PRS has not yet been classified in DSM-5 and ICD-11 and the lack of evidence-based treatment makes this syndrome a real challenge for clinicians. The aim of this paper is to present our experience through the description of a case report and its treatment. METHODS AND RESULTS The case reported is a girl aged 11 years that fits the clinical picture described in the literature of PRS. In previous reports, behavioural treatment was not used or appreciated; our case adds new knowledge regarding the PRS diagnosis and the successful behavioural treatment during hospitalization, which we describe in all its phases. CONCLUSION PRS is a rare, life-threatening syndrome; it would be extremely important to have an official and evidence-based treatment guide. LEVEL OF EVIDENCE Level V, case report.
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Affiliation(s)
- A Perrone
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
| | - S F Aruta
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
| | - G Crucitti
- Regional Centre for Feeding and Eating Disorders, Child Neurology and Psychiatry Unit, S. Orsola Malpighi Hospital, Bologna, Italy
| | - P Gualandi
- Regional Centre for Feeding and Eating Disorders, Child Neurology and Psychiatry Unit, S. Orsola Malpighi Hospital, Bologna, Italy
| | - E Malaspina
- Regional Centre for Feeding and Eating Disorders, Child Neurology and Psychiatry Unit, S. Orsola Malpighi Hospital, Bologna, Italy
| | - M Marino
- Clinical Nutrition and Metabolism Unit, S. Orsola Malpighi Hospital, Bologna, Italy
| | - E Franzoni
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Antonia Parmeggiani
- Regional Centre for Feeding Eating Disorders, Child Neurology and Psychiatry Unit, Department of Medical and Surgical Sciences, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
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14
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Basile U, Miele L, Napodano C, Ciasca G, Gulli F, Pocino K, De Matthaeis N, Liguori A, De Magistris A, Marrone G, Biolato M, Marino M, Di Giacinto F, Gasbarrini A, Grieco A, Rapaccini GL. The diagnostic performance of PIVKA-II in metabolic and viral hepatocellular carcinoma: a pilot study. Eur Rev Med Pharmacol Sci 2021; 24:12675-12685. [PMID: 33378014 DOI: 10.26355/eurrev_202012_24165] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Hepatocellular carcinoma (HCC) is a primary liver tumor derived from metabolic or viral chronic hepatitis, with few treatment options in advanced cases. New biomarkers that allow improving diagnosis and staging are widely desired. Here, we aim to evaluate the performance of Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) in combination with α-fetoprotein (AFP), in the diagnosis of HCC in patients with metabolic or viral hepatitis. PATIENTS AND METHODS We enrolled 60 HCC patients (20 metabolic and 40 viral) and 20 healthy subjects (HS) as negative controls. PIVKA-II, AFP, Matrix metalloproteinase-9 (MMP-9) and Fibroblast growth factor (FGF) serum levels were assessed by immunoassays. RESULTS AFP and PIVKA-II levels were obviously higher in patients than in HS. AFP displayed a better diagnostic performance than PIVKA-II for viral HCC while PIVKA-II was better for metabolic HCC. The combination of the two biomarkers did not improve the discriminating ability. CONCLUSIONS PIVKA-II may be considered an independent predictor of macrovascular invasion from HCC cells and it can be used to better stratify HCC patients and should be evaluated in prospective studies for early detection of advanced HCC in metabolic subjects.
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Affiliation(s)
- U Basile
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy.
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15
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Basile U, Napodano C, Pocino K, Barini A, Marino M, Santini SA, Barini A, Stefanile A, Basile V, Callà CA, Cattani P, Gasbarrini A, Rapaccini GL, Gulli F. Lack of association between Vitamin D status and free light chains profile with different chronic HCV-related liver and extrahepatic disorders. Eur Rev Med Pharmacol Sci 2020; 23:8506-8514. [PMID: 31646582 DOI: 10.26355/eurrev_201910_19164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE A still uncertain association between vitamin D levels and HCV chronic liver diseases has been reported. Increased levels of serum-free light chains (FLCs) and an altered k/λ FLC ratio correlate with Mixed Cryoglobulinemia (MC) vasculitis and/or B-cell non-Hodgkin's lymphoma in HCV-positive patients. We aimed to investigate the possible role of vitamin D, vitamin D Binding Protein (DBP), and FLCs levels as a tool for discriminating different stages of HCV- related MC and chronic liver diseases. PATIENTS AND METHODS Sixty-five untreated patients were retrospectively enrolled and 21 healthy blood donors (HBD) were used as controls. Vitamin D, DBP, FLCs, and cryoglobulins levels were measured. Based on cryoglobulins, patients were divided in three subgroups (without cryoglobulins, type II, and type III). RESULTS We didn't find any significant differences in vitamin D and DBP levels between HCV patients' main groups and HBD. Serum FLCs levels were significantly higher in HCV patients than in HBD. FLCs ratio among patients' subgroups did not reveal differences. CONCLUSIONS Our results confirm the presence of an increased serum level of FLCs in HCV patients and suggest that nor vitamin D and DBP or FLC levels can be considered reliable biomarkers for discriminating different stages of HCV-associated chronic liver diseases and/or HCV-associated extrahepatic manifestation. We confirm that serological FLCs levels are significantly higher in patients than in HBD as a signature of B cell activation in course of HCV infection.
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Affiliation(s)
- U Basile
- Area Diagnostica di Laboratorio, Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
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16
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Mazzanti A, Chargeishvili T, Kukavica D, Marino M, Morini M, Trancuccio A, Marelli S, Monteforte N, Bloise R, Napolitano C, Priori S. Is mexiletine ready for prime time in patients with Type 2 Long QT Syndrome? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Mexiletine has been proven effective in shortening the duration of ventricular repolarization and reducing the arrhythmic events in type 3 Long QT Syndrome (LQT3). Initial reports indicate that mexiletine might also be effective in patients with type 2 Long QT Syndrome (LQT2, caused by loss-of-functions variants on KCNH2 gene, coding for HERG potassium channel), but this issue has not been investigated in detail.
Purpose
We quantified the electrocardiographic (ECG) effects of mexiletine in a cohort of LQT2 patients.
Methods
Twelve-lead ECGs were collected before and after the administration of mexiletine to evaluate the drug's effect on the heart rate-corrected QT interval (QTc). QTc intervals were classified as being (1) at “high-risk” if >500 ms or (2) “normal” if <460 ms, before and after the administration of the drug. KCNH2 variants were defined as (1) trafficking-deficient or (2) non-trafficking-deficient, based on functional studies.
Results
We tested the maximum tolerated dose of mexiletine in 20 patients (11 males, 55%), who were 17±16 years old at diagnosis, affected by genetically established LQT2. The mean age at the beginning of mexiletine administration was 23±15 years and the mean daily dose administered was 9±2 mg/kg/day.
Before mexiletine, the mean QTc interval was 527±53 ms and 10/20 (50%) patients had high-risk QTc values (i.e. QTc >500 ms).
After mexiletine, the mean QTc interval shortened to 484±47 ms in the overall population (p=0.001). In the majority of patients (18/20, 90%; Figure 1) QTc interval shortened, with a mean shortening of 42±28 ms, and a high-interindividual variability (range of shortening from 86 ms to 8 ms). Just 2 (10%) patients did not show any reduction of the QTc, despite receiving the highest adult dosages of mexiletine in our cohort (up to 10 mg/kg/day).
As compared to baseline conditions, after mexiletine the proportion of patients with high risk QTc values (>500 ms) decreased non-significantly from 50% to 35% (p=0.52). Furthermore, in only 6/20 (30%) patients the QTc normalized (i.e. QTc <460 ms) after the initiation of treatment.
The effect of mexiletine was not influenced by gender (p=0.89) or by the functional effect of the KCNH2 mutation (trafficking-deficient vs. non-trafficking-deficient variants, p=0.41).
The effect of mexiletine in LQT2 patients was inferior to the one previously observed in a cohort of 34 LQT3 patients, who had similar QTc values at baseline and received similar dosages of mexiletine, but showed a significantly higher reduction of the average QTc interval (63±37 ms in LQT3 vs. 42±28 ms in LQT2, p=0.02).
Conclusions
Mexiletine induces a reduction of the QTc interval in most LQT2 patients, but many patients remain with high-risk QTc values after receiving the drug. The demonstration that an average QTc shortening of 42 ms is enough to reduce arrhythmic events is necessary, before the introduction of mexiletine in clinical practice for LQT2.
Figure 1
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Italian Ministry of Research and University Dipartimenti di Eccellenza 2018–2022 grant to the Molecular Medicine Department (University of Pavia)
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Affiliation(s)
| | | | | | - M Marino
- ICS Maugeri - IRCCS, Pavia, Italy
| | - M Morini
- ICS Maugeri - IRCCS, Pavia, Italy
| | | | | | | | - R Bloise
- ICS Maugeri - IRCCS, Pavia, Italy
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17
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Marelli S, Kukavica D, Mazzanti A, Chargeishvili T, Trancuccio A, Monteforte N, Bloise R, Marino M, Napolitano C, Priori S. Automated screening tool for Subcutaneous Implantable Defibrillator in Brugada syndrome has a high eligibility rate which is predicted by simple electrocardiographic parameters. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Manual electrocardiographic (ECG) screening tools for the use of subcutaneous cardiac defibrillator (S-ICD) have been associated with high ineligibility rates in Brugada syndrome patients (BrS). Although recent works identified ECG parameters for S-ICD eligibility in general population, automated screening tool (AST) for S-ICD eligibility have not even been assessed in large series of patients with BrS.
Purpose
This study evaluates the AST-derived eligibility rates for an S-ICD in patients with BrS, and ECG parameters associated with S-ICD eligibility.
Methods
Screening for S-ICD eligibility was performed using AST in 194 consecutive patients with BrS. Eligibility was defined when at least one of the three vectors was acceptable both in supine and standing position. Twelve-lead ECGs were registered during the screening. ECG parameters associated with AST eligibility were identified using multivariable logistical regression.
Results
Our study population consisted of 194 patients, with male preponderance (n=165/194; 85%); and were 43±12 years old at the time of screening. Majority of patients presented a spontaneous type 1 pattern during screening (n=128/194; 66%), with an average pattern height of 3±3 mm.
Remarkably, 93% of patients passed the screening with AST. No differences in eligibility rates in terms of gender (93% males vs. 93% females eligible; p=1) and age (48±9 years non-eligible vs. 42±12 eligible; p=0.07) existed. Notably, our eligibility rate was 2.5 times higher than rates reported in literature when using manual screening tools (p=0.023). Independent 12-lead ECG parameters (Table) associated with AST eligibility were duration of S wave <80 ms in aVF and R/T ratio ≥3 in lead II (Figure), which have a high positive predictive value (97% and 99%, respectively) for screening eligibility.
Conclusions
Most BrS patients (93%) are eligible for S-ICD when AST is used. S wave <80 ms in aVF, and R/T ratio ≥3 in lead II have a high positive predictive value for S-ICD eligibility.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Italian Ministry of Research and University Dipartimenti di Eccellenza 2018–2022 grant to the Molecular Medicine Department (University of Pavia)
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Affiliation(s)
| | | | | | | | | | | | - R Bloise
- ICS Maugeri - IRCCS, Pavia, Italy
| | - M Marino
- ICS Maugeri - IRCCS, Pavia, Italy
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18
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Chargeishvili T, Mazzanti A, Kukavica D, Marelli S, Trancuccio A, Monteforte N, Bloise R, Marino M, Morini M, Napolitano C, Priori S. Characterization of arrhythmic presentation in patients with arrhythmogenic cardiomyopathy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Arrhythmogenic cardiomyopathy (ACM) is one of the most arrhythmogenic conditions known to man. ACM is caused by desmosomal mutations in most cases, resulting in progressive replacement of the myocardium by adipose and fibrous tissue. It comes as no surprise that ACM is one of the leading causes of sudden cardiac death (SCD). Nonetheless, the characteristics of arrhythmic manifestations have not dissected after the release of most recent criteria.
Purpose
This study investigates different types of ventricular tachyarrhythmias which had occurred at first arrhythmic event in patients with ACM.
Methods
We investigated 91 consecutive patients with documented evidence of sustained ventricular tachyarrhythmias from 291 ACM patients followed at our center up to this date. Diagnosis of ACM was made using 2010 Task Force Criteria, and patients were defined as having an advanced disease if they had more than 4 TFC points at diagnosis. Presenting ventricular tachyarrhythmias were divided into (1) life-threatening arrhythmic event (LAE; ventricular fibrillation or hemodynamically unstable polymorphic ventricular tachycardia) and (2) hemodynamically stable monomorphic ventricular tachycardia (MMVT). Right ventricular (RV) involvement was defined as a presence of RV wall motion abnormalities and RV dilation at transthoracic echocardiography or cardiac magnetic resonance.
Results
Our study population was constituted of a predictably higher number of males (n=68; 75%), with an average age at the first arrhythmic event of 38±15 years of age.
At first documented arrhythmia, majority of patients studied experienced a stable MMVT (n=53; 58%), while 38 patients experienced an LAE (n=38; 42%). The patients suffering an LAE as first arrhythmic event were slightly younger than the patients who experienced a stable MMVT (35±14 years vs. 40±15 years; p=0.076) but there were no statistically significant gender differences (28/38 males with LAE vs. 40/53 males with stable MMVT; p= n.s.).
Interestingly, patients who presented with stable MMVT were more likely to have an advanced disease at diagnosis (OR=6.52; 95% CI 2.02–20.99; p=0.002). This is supported by the fact that RV involvement was significantly more common in patients presenting with stable MMVT (OR=4.38; 95% CI 1.26–15.26; p=0.021). Additionally, patients with stable MMVT were more commonly carriers of variants on PKP2 gene (OR=3.6; 95% CI 1.1–11.91; p=0.021).
Conclusions
Our data suggest that two types of arrhythmia reflect the two different stages of the disease. The early stage of the ACM is characterized by LAE in absence of RV structural involvement; while, stable MMVT is typical of PKP2 carriers and advanced stage of ACM with RV involvement.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Italian Ministry of Research and University Dipartimenti di Eccellenza 2018–2022 grant to the Molecular Medicine Department (University of Pavia)
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Affiliation(s)
| | | | | | | | | | | | - R Bloise
- ICS Maugeri - IRCCS, Pavia, Italy
| | - M Marino
- ICS Maugeri - IRCCS, Pavia, Italy
| | - M Morini
- ICS Maugeri - IRCCS, Pavia, Italy
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Trancuccio A, Mazzanti A, Kukavica D, Marino M, Monteforte N, Bloise R, Braghieri L, Memmi M, Morini M, Napolitano C, Priori S. Mutation site-specific risk profile in patients with Type 1 Long QT Syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Type 1 Long QT Syndrome (LQT1) is an arrhythmogenic disorder, caused by loss-of-function mutations on KCNQ1 gene, coding for Kv7.1 potassium channel. Although LQT1 is described as the most benign form of LQTS, patients still experience arrhythmic events and there is an unmet need for personalized risk stratification. Attempts have been made to correlate the location of mutations with outcome, but the results are unequivocal.
Purpose
We provide in the present study a new mutation site-specific risk profile obtained from a large cohort of LQT1 patients.
Methods
We gathered data on 963 patients with the diagnosis of LQT1 and divided the Kv7.1 channel into 5 functional regions: the N-terminus (NT), the voltage sensor (VS, including transmembrane segments S1 to S4), the cytoplasmic loops (CL), the pore (PO, including the transmembrane segments S5, S6 and the S5-S6 extracellular linker), the C-terminus (CT).
Results
We studied 963 LQT1 patients: 518 (54%) females; average age 20±17 years; mean QTc at baseline ECG 465±38ms. During a mean follow-up of 8±7 years, 172 (18%) patients experienced arrhythmic events: 31 (3%) experienced one or more cardiac arrests, while 141 (15%) experienced one or more syncopal spells. We identified 188 different variants in the KCNQ1 gene, with the following distribution: 15 (8%) in the NT, 33 (18%) in the VS, 27 (14%) in the CL, 43 (23%) in the PO, 70 (37%) in the CT. The frequency of pathogenic variants per number of amino acids (a.a.) was higher in the CL region, as compared to the other domains (1 mutation every 1.4 a.a.). The duration of QTc interval was significantly longer for patients with mutations in the PO region (473±40 ms) and in the CL region (468±38 ms) as compared to the other regions (p<0.01).
Importantly, in a multivariate analysis PO and CL regions were associated with a higher probability of experiencing arrhythmic events (OR 2.89, 95% CI 1.95–4.29, p=0.019 and OR 1.61, 95% CI 1.0–2.49, p=0.05, respectively. Figure) than the other regions. Interestingly, the risk was independent from QTc interval duration.
Conclusions
Mutations affecting the PO and the CL region of the Kv7.1. channel are associated with a higher probability of experiencing arrhythmic events. This finding is clinically relevant, because it will allow for a more personalized, mutation site-specific risk stratification.
Mutation site and arrhythmic events
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Italian Ministry of Research and University Dipartimenti di Eccellenza 2018–2022 grant to the Molecular Medicine Department (University of Pavia)
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Affiliation(s)
| | | | | | - M Marino
- ICS Maugeri - IRCCS, Pavia, Italy
| | | | - R Bloise
- ICS Maugeri - IRCCS, Pavia, Italy
| | | | - M Memmi
- ICS Maugeri - IRCCS, Pavia, Italy
| | - M Morini
- ICS Maugeri - IRCCS, Pavia, Italy
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Basile U, Gulli F, Isgrò MA, Napodano C, Pocino K, Santini SA, Gragnani L, Conti L, Rossi E, Cordone I, Zignego AL, Rapaccini GL, Cigliana G, Berruti F, Todi L, Marino M, Di Stasio E. A novel biomarker score for the screening and management of patients with plasma cell proliferative disorders. Eur Rev Med Pharmacol Sci 2020; 23:4293-4302. [PMID: 31173301 DOI: 10.26355/eurrev_201905_17934] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Monoclonal plasma cell proliferative disorders comprise a wide spectrum of diseases associated to clonal B-cell expansion. Serum protein electrophoretic profile (SPEP) and circulating free light chains (FLCs) levels are the mainstay of diseases management. Recently, soluble (s) Syndecan-1 (SDC1, CD138) produced by myeloma plasma cells has been suggested in the monitoring and follow-up of patients with myeloma. The aim of our study is to evaluate sCD138 in addition with FLCs and SPEP for the screening of patients with different evolutive disease pathways. PATIENTS AND METHODS Sera from 73 patients with monoclonal gammopathy of undetermined significance (MGUS), 120 smoldering and 42 multiple myeloma (SMM and MM, respectively), 70 HCV-related mixed cryoglobulinemia (MC), 35 B-cell non-Hodgkin's lymphoma (B-NHL) and sera from 50 healthy donors (HD), were tested for sCD138, FLCs (assessed by means of ELISA and turbidimetric assay, respectively) and electrophoresis pattern (performed on Capillarys system) for the generation of a novel biomarker score (BS). RESULTS Our results were grouped according to the two main lines of disease progression (vs. MM or B-NHL): in one group we found BS mean values of 0.2, 3.4, 5.3, 7.1 for HD, MGUS, SMM and MM, respectively; in the other group of 0.2, 4.4, 6.7 for HD, MC and B-NHL. CONCLUSIONS We showed that BS mean values follow the ingravescence disease status towards the two main lines of progression to cancerous conditions; it could represent an additional useful tool in the management of screening and/or follow-up.
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Affiliation(s)
- U Basile
- Area Diagnostica di Laboratorio, UOC Chimica, Biochimica e Biologia Molecolare Clinica, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy.
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21
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Gulli F, Marino M, Napodano C, Pocino K, Pandolfi F, Gasbarrini A, Rapaccini GL, Basile U. Biomarkers in HCV-related mixed cryoglobulinemia patients withnon-Hodgkin lymphoma. Eur Rev Med Pharmacol Sci 2020; 24:8067-8074. [PMID: 32767333 DOI: 10.26355/eurrev_202008_22490] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Chronic Hepatitis C virus (HCV) infection can cause severe extrahepatic manifestations, such as mixed cryoglobulins (MC), up to the development of B cell nonHodgkin's lymphoma (B-NHL). Mechanisms transforming of HCV infection into lymphoproliferative and/or autoimmune disorders are still poorly understood. In course of HCV infection, the sustained virus-driven antigenic stimulation may probably induce a B-cell clonal expansion. Measurements of serum free light chains (FLCs) levels, considered as a direct marker of B cell activity, are analyzed with increasing interest in clinical practice, for diagnosis, monitoring and follow-up of plasma cell dyscrasia. Syndecan-1 (CD138) is a transmembrane heparan sulfate proteoglycan expressed and actively shed by most myeloma cells. Membrane CD138 represents the major receptor protein for HCV attachment to the hepatocyte surface and high levels of circulating sCD138 levels are detected in patients at early stage of B-cell chronic lymphocytic leukemia. This study is aimed to evaluate sCD138 and FLC levels as diagnostic biomarkers of HCV-related MC with B-NHL. PATIENTS AND METHODS We enrolled 35 HCV-MC-NHL patients, characterized for the specific type of cryoglobulins, and 25 healthy blood donors (HBD) as negative control. Serum sCD138 levels were determined using ELISA kits specific for human sCD138. Serum FLCs were assessed by means of the turbidimetric assay. RESULTS We found that serum levels of sCD138, as well as FLCs, were significantly higher in patients than in HBD (p<0.001). CONCLUSIONS In agreement with the definition of HCV-driven lymphoproliferative disorders as the consequence of a multifactorial and multistep pathogenetic process, we suggest that sCD138 and FLCs could be considered putative independent markers of worsening progression of the disease.
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Affiliation(s)
- F Gulli
- Laboratorio di Patologia Clinica, Ospedale Madre Giuseppina Vannini, Rome, Italy.
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22
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Saulle R, Sinopoli A, De Paula Baer A, Mannocci A, Marino M, De Belvis AG, Federici A, La Torre G. The PRECEDE-PROCEED model as a tool in Public Health screening: a systematic review. Clin Ter 2020; 171:e167-e177. [PMID: 32141490 DOI: 10.7417/ct.2020.2208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJETCTIVE The aim of this systematic review was to summarize the scientific literature concerning the use of the Precede-Proceed model (PPM) applied to educational programs and health screenings contextsV. STUDY DESIGN Systematic review. METHODS The search process was based on a selection of publications listed in Medline and Scopus. The keywords used were "Precede-Proceed" AND ("screening" OR "educational programs"). Studies included in the systematic review were subdivided into those applying the model in a screening context, and those applying it within educational programs. RESULTS Twenty-seven studies were retrieved, mostly performed in the USA and, generally, the promoting center was the University. In the context of cancer screening, the PPM model was most of all applied to Mammography Screening (5 of 13 studies in cancer screening), and Cervical Cancer Screening (5 of 13). Another three studies within the cancer field investigated Menopause-Inducing Cancer Treatments, Oral cancer prevention, and cancer screening in general. In the remaining studies, the model was applied in various screening areas, particularly chronic and degenerative diseases. There were many different study designs, most of which cross-sectional (8), though several RTCs (8) and focus groups (5) were also found. For the cross-sectional studies the methodological quality varied between 3/10 and 9/10, whilst for the RCTs it ranged from 2/5 to 3/5. CONCLUSIONS The PPM provides an excellent framework for health intervention programs especially in screening contexts, and could improve the understanding of the relationship between variables such as knowledge and screening. Given the complexity of a behavioral change process, certain important predisposing factors could be measured in future studies, and during health intervention planning.
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Affiliation(s)
- R Saulle
- Department of Public Health and Infectious Diseases "Sapienza" University of Rome, Rome, Italy
| | - A Sinopoli
- Department of Public Health and Infectious Diseases "Sapienza" University of Rome, Rome, Italy
| | - A De Paula Baer
- Department of Public Health and Infectious Diseases "Sapienza" University of Rome, Rome, Italy - Faculty of medicine, University of São Paulo, Brasil
| | - A Mannocci
- Department of Public Health and Infectious Diseases "Sapienza" University of Rome, Rome, Italy
| | - M Marino
- Department of Public Health, Catholic University of the Sacred Heart, Rome
| | - A G De Belvis
- Department of Public Health, Catholic University of the Sacred Heart, Rome
| | - A Federici
- Ministero della Salute, Direzione Generale della Prevenzione, Rome, Italy
| | - G La Torre
- Department of Public Health and Infectious Diseases "Sapienza" University of Rome, Rome, Italy
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23
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Ohrtman EA, Shapiro GD, Simko LC, Dore E, Slavin MD, Saret C, Amaya F, Lomelin-Gascon J, Ni P, Acton A, Marino M, Kazis LE, Ryan CM, Schneider JC. Social Interactions and Social Activities After Burn Injury: A Life Impact Burn Recovery Evaluation (LIBRE) Study. J Burn Care Res 2020; 39:1022-1028. [PMID: 30016442 DOI: 10.1093/jbcr/iry038] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Social interactions and activities are key components of social recovery following burn injuries. The objective of this study is to determine the predictors of these areas of social recovery. This study provides a secondary analysis of a cross-sectional survey of adult burn survivors. The Life Impact Burn Recovery Evaluation-192 was administered to 601 burn survivors for the field-testing of the Life Impact Burn Recovery Evaluation Profile. Survivors aged 18 years and older with injuries ≥5% total BSA or burns to critical areas (hands, feet, face, or genitals) were eligible to participate. Multivariate linear regression analyses were used to determine predictors of the Social Activities and Social Interactions scale scores. A total of 599 people completed the Social Interactions and Social Activities scales. Of these, 77% identified as White Non-Hispanic, 55% were female, 55% were unmarried, and 80% had burns to critical areas. Participants had a mean age of 45 years, a mean time since burn injury of 15 years, and a mean burn size of 41% total BSA. Younger age (P < .01) and being married/living with a significant other (P ≤ .01) were associated with higher Social Activities and Social Interactions scale scores. Individual item responses reveal that survivors had lower scores on items related to participating in outdoor activities (30.4%) or feeling uncomfortable with their appearance (32.4% report dressing to avoid stares). Social interactions and activities are long-term challenges for burn survivors. It is important for clinicians to identify patients who may struggle with social recovery in order to focus on future community-based interventions.
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Affiliation(s)
- Emily A Ohrtman
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gabriel D Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Laura C Simko
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emily Dore
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Mary D Slavin
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Cayla Saret
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Flor Amaya
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - J Lomelin-Gascon
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Pengsheng Ni
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Amy Acton
- Phoenix Society for Burn Survivors, Grand Rapids, Michigan
| | - Molly Marino
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Lewis E Kazis
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Massachusetts General Hospital, Shriners Hospitals for Children, Harvard Medical School, Boston
| | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
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24
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Picarelli A, Borghini R, Marino M, Casale R, Di Tola M, Lubrano C, Piermattei A, Gualdi G, Bella A, Donato G, Masselli G. Visceral and subcutaneous adipose tissue as markers of local and systemic inflammation: a comparison between celiac and obese patients using MRI. Tech Coloproctol 2020; 24:553-562. [PMID: 32112244 DOI: 10.1007/s10151-020-02173-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 02/08/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Celiac disease (CD) is a systemic inflammatory disease, which primarily affects the gastrointestinal tract. It has been recently demonstrated that adipose-tissue infiltration by proinflammatory immune cells causes a chronic low-grade inflammation in obese patients. Magnetic resonance imaging (MRI) has already proved to be useful in evaluation of inflammatory states. The aim of the present study was to determine whether alterations of visceral and subcutaneous adipose tissue, identified with MRI, could serve as markers of local and systemic inflammation in patients with CD. METHODS A pilot study was conducted comparing alterations in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in CD patients vs obese patients and healthy controls. Fifty patients were enrolled and assigned to one of the following groups: Group A: 11 active CD patients; Group B: 11 CD patients in remission; Group C: 16 obese patients; Group D: 12 healthy controls. A 3-T MRI unit was used and T2-weighted TSE images of VAT and SAT were obtained in specific regions of interest. Serum cytokine concentrations (TNF-α, IL-6, adiponectin, leptin, IL-2, IFN-γ) were determined. RESULTS There was a significant difference in VAT T2 relaxation time between Group A and B (p < 0.001), A and D (p < 0.01), B and C (p < 0.001). There was a statistically significant difference in SAT T2 relaxation time between Group A and B (p < 0.001), A and C (p < 0.05), A and D (p < 0.001), B and C (p < 0.01). In addition, VAT/SAT T2 relaxation time ratio showed a statistically significant difference between Group A and C (p < 0.05) and between Group B and C (p < 0.01). Only TNF-α and IL-6 significantly correlated with both VAT and VAT/SAT ratio in active CD. CONCLUSIONS MRI showed similar increased visceral inflammatory signals in patients with active CD and obese patients. However, subcutaneous inflammatory signals were higher in active CD than in all the other groups. These data show that there is a systemic inflammatory state in active CD, whereas chronic inflammation appears confined to VAT in obesity. These data were only partially confirmed by serological cytokine profiles, which showed less specificity than MRI.
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Affiliation(s)
- A Picarelli
- Department of Translational and Precision Medicine, Gastroenterology Unit, Policlinico Umberto I, Sapienza University, Viale del Policlinico, 155, 00161, Rome, Italy
| | - R Borghini
- Department of Translational and Precision Medicine, Gastroenterology Unit, Policlinico Umberto I, Sapienza University, Viale del Policlinico, 155, 00161, Rome, Italy.
| | - M Marino
- Department of Translational and Precision Medicine, Gastroenterology Unit, Policlinico Umberto I, Sapienza University, Viale del Policlinico, 155, 00161, Rome, Italy
| | - R Casale
- Department of Translational and Precision Medicine, Gastroenterology Unit, Policlinico Umberto I, Sapienza University, Viale del Policlinico, 155, 00161, Rome, Italy
| | - M Di Tola
- Department of Translational and Precision Medicine, Gastroenterology Unit, Policlinico Umberto I, Sapienza University, Viale del Policlinico, 155, 00161, Rome, Italy
| | - C Lubrano
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A Piermattei
- Department of Surgical Sciences, "F. Durante" Section, Sapienza University, Rome, Italy
| | - G Gualdi
- Department of Radiology, Sapienza University, Rome, Italy
| | - A Bella
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - G Donato
- Department of Clinical Medicine, Sapienza University, Rome, Italy
| | - G Masselli
- Department of Radiology, Sapienza University, Rome, Italy
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25
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Fubini L, Pasqualini O, Ferro E, Marino M, Santoro S, Tosco E, Gilardi L. Injury narratives in occupational safety and health prevention in Italy. Occup Med (Lond) 2019; 69:500-503. [PMID: 31677390 DOI: 10.1093/occmed/kqz135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Storytelling is an effective information source when coupled with technical-scientific evidence. It can promote a structured relationship between evidence-based knowledge and field experience of workplace safety and prevention services (WSPS) inspectors. This is key to identifying the causes of workplace injuries and to set priorities for prevention strategies. AIMS The main aim was to describe and report how story collection can be used for deriving validated indications for injury prevention. The specific objectives were to report the results of the creation and dissemination on the web of the story collection and the experience of setting up a community of practice (CoP) to develop preventive recommendations. METHODS WSPS inspectors from local health boards in Piedmont (northwest Italy) were asked to write injury stories. They identified the key elements of their stories and developed a narrative of witness accounts to explore the critical issues identified during the investigation. In sessions with the CoP, the inspectors validated the indications for prevention elaborated in each story to reduce bias and standardize recommendations. RESULTS Between 2012 and 2017, 60 WSPS inspectors wrote 53 injury stories which were collected and published on the institutional website. Twenty-two stories were selected for discussion during peer review sessions in the CoP and the indications for prevention were transformed as preventive solutions. CONCLUSIONS Occupational safety and health prevention can benefit from a narrative-based approach that provides a more comprehensive look at health and safety by facilitating knowledge improvement and sharing.
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Affiliation(s)
- L Fubini
- DoRS - Centro di Documentazione per la Promozione della Salute, ASL TO3 - Regione Piemonte, Grugliasco (TO), Italy
| | - O Pasqualini
- SC a DU Servizio di Epidemiologia, ASL TO3 - Regione Piemonte, Grugliasco (TO), Italy
| | - E Ferro
- DoRS - Centro di Documentazione per la Promozione della Salute, ASL TO3 - Regione Piemonte, Grugliasco (TO), Italy
| | - M Marino
- SC a DU Servizio di Epidemiologia, ASL TO3 - Regione Piemonte, Grugliasco (TO), Italy
| | - S Santoro
- DoRS - Centro di Documentazione per la Promozione della Salute, ASL TO3 - Regione Piemonte, Grugliasco (TO), Italy
| | - E Tosco
- DoRS - Centro di Documentazione per la Promozione della Salute, ASL TO3 - Regione Piemonte, Grugliasco (TO), Italy
| | - L Gilardi
- DoRS - Centro di Documentazione per la Promozione della Salute, ASL TO3 - Regione Piemonte, Grugliasco (TO), Italy
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26
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Deutsch A, Marino M, Smith L, McMullen T. Comment On: Relationship Between Functional Improvement and Cognition in Short-stay Nursing Home Residents. J Am Geriatr Soc 2019; 68:448-449. [PMID: 31778216 DOI: 10.1111/jgs.16268] [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: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Anne Deutsch
- RTI International, Shirley Ryan AbilityLab, Northwestern University, Chicago, Illinois
| | | | | | - Tara McMullen
- Centers for Medicare and Medicaid Services, Center for Clinical Standards and Quality, Baltimore, Maryland
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27
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Perri G, Righini M, Tullio A, Del Pin M, Maifreni M, Marino M, Fedele MC, Parpinel M. Customer satisfaction survey in Friuli Venezia Giulia university canteens. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Customer satisfaction represents an innovative approach to measure strengths and weaknesses of an organization and is useful for a customer-focused management and culture development. Our survey’s aim was to investigate perceived quality and needs of customers in the university canteen sector.
Methods
Between April and June 2018, an anonymous online questionnaire was distributed by “agenzia regionale per il diritto agli studi superiori” (ARDISS) among university students in Friuli Venezia Giulia, Italy. The questions covered 3 thematic areas: attendance of the service, quality of services and opinions on new initiatives. Furthermore, there was an open question to collect students’ suggestions or proposals to improve the service. Satisfaction about the service was evaluated through five topics: environments, hygiene, staff, meals, global satisfaction. Collected data were analyzed with descriptive, univariate and multivariate analyses. Statistical analyses were performed using 9.4 SAS software.
Results
Response rate was 20.5% (1933/9404). Multiple logistic regression analyses showed a difference in meal choice (entire vs reduced) between institutional canteen and partner cafeterias users (p < 0.0001) and that male (p < 0.0001) and foreign students (p 0.0003) prefer entire meal instead of reduced. Percentage of students who prefer entire meal is reduced (p < 0.0001) if price range increases. Univariate and multivariate analyses showed that high quality perception is associated with lower price range and no suggestions about food and environments (p < 0.0001); multivariate analyses also showed an association between high quality perception and high canteen attendance (p < 0.05).
Conclusions
The survey showed an association between meal choice and students’ profile and between perceived quality and customer’s features. These data and further analyses may help to select areas where an intervention could improve service quality and, therefore, customer satisfaction.
Key messages
Customer satisfaction is an important tool to measure and improve university canteen service quality. These results helped us to identify services’ strengths and weaknesses according to students’ opinions; this could be useful to select improvement areas.
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Affiliation(s)
- G Perri
- Department of Medicine, University of Udine, University of Udine, Udine, Italy
| | - M Righini
- Department of Medicine, University of Udine, University of Udine, Udine, Italy
| | - A Tullio
- Hygiene and Clinical Epidemiology Unit, “Santa Maria della Misericordia” University Hospital, Udine, Italy
| | - M Del Pin
- Department of Medicine, University of Udine, University of Udine, Udine, Italy
| | - M Maifreni
- Department of AgriFood, Environmental and Animal Science, University of Udine, Udine, Italy
| | - M Marino
- Department of AgriFood, Environmental and Animal Science, University of Udine, Udine, Italy
| | - M C Fedele
- Agenzia Regionale per il Diritto agli Studi Superiori (ARDISS), Trieste, Italy
| | - M Parpinel
- Department of Medicine, University of Udine, University of Udine, Udine, Italy
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28
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Marino M, Spadea A, Furia G, Frisicale EM, Michelazzo MB, Valentini F, Consoli C, Forte U, Bracci S, Goletti M. Vaccination of classmates for an immunosuppressed child’s protection in a school in the LHA Roma 1. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue/problem
One of the duty of a State is to guarantee the protection of the health of all citizens, both safeguarding the sick individual needing care and protecting the healthy individual. An important objective of the vaccination prevention programs is to protect people most at risk of contracting infections because of their health conditions.
Description of the problem
In April 2019 the District 14 of Local Health Autority Roma 1 was asked by a father of an immunosuppressed child (6 years old), worried about infectious diseases, to verify the safeness of his child school attendance (the first class of primary school). First, a list of the class mates was asked to the school, in order to check their vaccination status by interrogating the web based regional vaccination register. Then, the District asked to the school to plan a meeting with classmates’ parents and teachers, in order to inform about the importance of a complete immunization both for the classmates and the immunosuppressed child protection.
Results
Preliminary results show that, among 18 classmates, 77.8% had full vaccination coverage for the second dose measles and fourth dose whooping cough (not mandatory for children aged less than 7 years), 22.2% were immunized for chicken pox. Among the parents attending the meeting, 15 agreed to complete their children vaccination cycle, all the teachers agreed to undergo whooping cough and chicken pox vaccination in order to allow a safe school attendance to the immunosuppressed child. Parents and teachers were given an appointment in a vaccination center for the week following the meeting.
Lessons
It is important to promote a real ’vaccination culture’ starting from the school, in order to develop greater citizenship awareness about the potential of vaccinations and to contrast fake news and ignorance leading to dangerous prejudices.
Key messages
The active collaboration between institutions (sanitary and school) allows, through the integration between different competences, to achieve health objectives to protect the community. Talking to pupils’ parents about infectious diseases and their prevention makes it possible to increase knowledge and therefore awareness of the importance of adult and children health protection.
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Affiliation(s)
- M Marino
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - A Spadea
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - G Furia
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - E M Frisicale
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
- Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M B Michelazzo
- Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Valentini
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - C Consoli
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - U Forte
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - S Bracci
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - M Goletti
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
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29
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Spadea A, Marino M, Valentini F, Furia G, Frisicale EM, Michelazzo MB, Consoli C, Forte U, Bracci S, Goletti M. A vaccination campaign in a Roma community in Rome: an experience of the Local Health Autority Roma1. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue/problem
About 8,000 Roma and Sinti live in the city of Rome, distributed in 33 settlements. This population is particularly at risk of health problems, due to social marginality and reduced access to health and social services. An important challenge for public health is therefore to guarantee and improve the right to health and the availability of health care. In Italy, a new vaccination law was approved in July 2017 and 10 vaccinations became mandatory for minors attending schools.
Description of the problem
In 2018 the District 14 of the Local Health Authority Rome1 (LHA Rome1) organized a vaccination campaign for the Roma and Sinti community being in its area. The aim of the campaign was to analyse the vaccination status of children under-18 living in the camp, based on the local police census data, crossed with the web based regional vaccination registry, to offer free vaccination for those without a regular status, in order to allow school attendance.
Results
Among 109 children living in the targeted Roma and Sinti camp, only 6 (5.5%) had a regular vaccination status according to the Italian law. Two different vaccination opportunity were offered to the community during 2018: a dedicated vaccination session in the local vaccination center, during which 6 children were vaccinated; four vaccination days offered directly at the Roma camp (a total of 53 children were vaccinated). At the end of 2018, the new Police census identified 114 minors resident in the camp instead of 109; of these, 48 (42.1%) had reached a regular vaccination status.
Lessons
Addressing hard-to-reach communities in order to improve the access to health and social services is one of the LHA objectives. The intervention performed in the Roma camp was also an opportunity to promote the importance of vaccination and to inform the target community about various LHA services, in particular maternal and infant services, including those for Temporarily Present Foreigners.
Key messages
The interventions performed straight into communities living in unfavorable health and social conditions are useful to improve the access to health and social services. Vaccination of people living in a social marginality is an important challenge for public health in order to guarantee specific protection measures and promoting the right to health.
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Affiliation(s)
- A Spadea
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - M Marino
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - F Valentini
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - G Furia
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - E M Frisicale
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
- Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M B Michelazzo
- Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Consoli
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - U Forte
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - S Bracci
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
| | - M Goletti
- Distretto 14, Local Health Authority - ASL Roma 1, Rome, Italy
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30
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Gulli F, Napodano C, Marino M, Ciasca G, Pocino K, Basile V, Visentini M, Stefanile A, Todi L, De Spirito M, Rapaccini GL, Basile U. Serum immunoglobulin free light chain levels in systemic autoimmune rheumatic diseases. Clin Exp Immunol 2019; 199:163-171. [PMID: 31618438 DOI: 10.1111/cei.13385] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2019] [Indexed: 12/19/2022] Open
Abstract
Several reports have highlighted the abnormal increments of serum immunoglobulin free light chains (FLCs) in the course of systemic autoimmune rheumatic diseases (SARD), but a comparative analysis among different conditions is still lacking. A strong association between elevated FLC and hepatitis C virus (HCV)-related mixed cryoglobulinaemia (HCVMC) has been well established. Here, we aimed to analyse serum FLC levels in patients with four different SARD in comparison with HCVMC. Using a turbidimetric assay, free κ and λ chains were quantified in sera from 198 SARD patients (37 rheumatoid arthritis, RA; 47 systemic lupus erythematosus, SLE; 52 anti-phospholipid syndrome, APS; 62 primary Sjogren's syndrome, pSS), 62 HCVMC and 50 healthy blood donors (HD). All patient groups showed increased κ levels when compared to HD: 33·5 ± 2·6 mg/l in HCVMC, 26·7 ± 2·3 mg/l in RA, 29·7 ± 1·9 mg/l in SLE, 23·8 ± 1·1 mg/l in APS, 24·2 ± 1·1 mg/l in pSS; 10·1 ± 0·6 mg/l in HD. Free λ levels displayed a significant increase only for HCVMC (20·4 ± 1·4 mg/l) and SLE (18·4 ± 1·0 mg/l) compared to HD (13·6 ± 0·9 mg/l). The increase of κ compared to λ takes into account a κ /λ ratio of 1·6 for all groups. Our results substantially analyse and strengthen the association between FLC and SARD focusing the questions regarding their role in the pathogenesis and diagnosis of human diseases. Unfortunately, the biochemical differences distinguishing normal from pathological FLC have not been identified. Production of different isotypes is probably connected to still-unknown pathways.
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Affiliation(s)
- F Gulli
- Dipartimento di Medicina di Laboratorio, Ospedale Madre Giuseppina Vannini, Rome, Italy
| | - C Napodano
- Istituto di Medicina Interna, Università Cattolica del Sacro Cuore, Rome, Italy.,Area di Gastroenterologia e Oncologia medica, Fondazione Policlinico Universitario 'A. Gemelli' - I.R.C.C.S, Rome, Italy
| | - M Marino
- Istituto di Patologia Generale, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario 'A. Gemelli' - I.R.C.C.S, Rome, Italy
| | - G Ciasca
- Fondazione Policlinico Universitario 'A. Gemelli' - I.R.C.C.S, Rome, Italy.,Istituto di Fisica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - K Pocino
- Istituto di Medicina Interna, Università Cattolica del Sacro Cuore, Rome, Italy.,Area di Gastroenterologia e Oncologia medica, Fondazione Policlinico Universitario 'A. Gemelli' - I.R.C.C.S, Rome, Italy
| | - V Basile
- Dipartimento di Medicina di Laboratorio, Università di Tor Vergata, Rome, Italy
| | - M Visentini
- Dipartimento di Medicina Traslazionale e di Precisione, Università di Roma La Sapienza, Rome, Italy
| | - A Stefanile
- Area Diagnostica di Laboratorio, Fondazione Policlinico Universitario 'A. Gemelli', IRCCS, Rome, Italy
| | - L Todi
- Istituto di Patologia Generale, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario 'A. Gemelli' - I.R.C.C.S, Rome, Italy
| | - M De Spirito
- Fondazione Policlinico Universitario 'A. Gemelli' - I.R.C.C.S, Rome, Italy.,Istituto di Fisica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G L Rapaccini
- Istituto di Medicina Interna, Università Cattolica del Sacro Cuore, Rome, Italy.,Area di Gastroenterologia e Oncologia medica, Fondazione Policlinico Universitario 'A. Gemelli' - I.R.C.C.S, Rome, Italy
| | - U Basile
- Area Diagnostica di Laboratorio, Fondazione Policlinico Universitario 'A. Gemelli', IRCCS, Rome, Italy
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Sachdeva N, Fan I, Babcock E, Burghoff M, Chupp TE, Degenkolb S, Fierlinger P, Haude S, Kraegeloh E, Kilian W, Knappe-Grüneberg S, Kuchler F, Liu T, Marino M, Meinel J, Rolfs K, Salhi Z, Schnabel A, Singh JT, Stuiber S, Terrano WA, Trahms L, Voigt J. New Limit on the Permanent Electric Dipole Moment of ^{129}Xe Using ^{3}He Comagnetometry and SQUID Detection. Phys Rev Lett 2019; 123:143003. [PMID: 31702217 DOI: 10.1103/physrevlett.123.143003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Indexed: 06/10/2023]
Abstract
We report results of a new technique to measure the electric dipole moment of ^{129}Xe with ^{3}He comagnetometry. Both species are polarized using spin-exchange optical pumping, transferred to a measurement cell, and transported into a magnetically shielded room, where SQUID magnetometers detect free precession in applied electric and magnetic fields. The result from a one week measurement campaign in 2017 and a 2.5 week campaign in 2018, combined with detailed study of systematic effects, is d_{A}(^{129}Xe)=(1.4±6.6_{stat}±2.0_{syst})×10^{-28} e cm. This corresponds to an upper limit of |d_{A}(^{129}Xe)|<1.4×10^{-27} e cm (95% C.L.), a factor of 5 more sensitive than the limit set in 2001.
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Affiliation(s)
- N Sachdeva
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - I Fan
- Physikalisch-Technische Bundesanstalt (PTB) Berlin, 10587 Berlin, Germany
| | - E Babcock
- Jülich Center for Neutron Science, 85748 Garching, Germany
| | - M Burghoff
- Physikalisch-Technische Bundesanstalt (PTB) Berlin, 10587 Berlin, Germany
| | - T E Chupp
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - S Degenkolb
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
- Institut Laue-Langevin, 38042 Grenoble, France
| | - P Fierlinger
- Excellence Cluster Universe and Technische Universität München, 85748 Garching, Germany
| | - S Haude
- Physikalisch-Technische Bundesanstalt (PTB) Berlin, 10587 Berlin, Germany
| | - E Kraegeloh
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
- Excellence Cluster Universe and Technische Universität München, 85748 Garching, Germany
| | - W Kilian
- Physikalisch-Technische Bundesanstalt (PTB) Berlin, 10587 Berlin, Germany
| | - S Knappe-Grüneberg
- Physikalisch-Technische Bundesanstalt (PTB) Berlin, 10587 Berlin, Germany
| | - F Kuchler
- Excellence Cluster Universe and Technische Universität München, 85748 Garching, Germany
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T Liu
- Physikalisch-Technische Bundesanstalt (PTB) Berlin, 10587 Berlin, Germany
| | - M Marino
- Excellence Cluster Universe and Technische Universität München, 85748 Garching, Germany
| | - J Meinel
- Excellence Cluster Universe and Technische Universität München, 85748 Garching, Germany
| | - K Rolfs
- Physikalisch-Technische Bundesanstalt (PTB) Berlin, 10587 Berlin, Germany
| | - Z Salhi
- Jülich Center for Neutron Science, 85748 Garching, Germany
| | - A Schnabel
- Physikalisch-Technische Bundesanstalt (PTB) Berlin, 10587 Berlin, Germany
| | - J T Singh
- National Superconducting Cyclotron Laboratory and Department of Physics & Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Stuiber
- Excellence Cluster Universe and Technische Universität München, 85748 Garching, Germany
| | - W A Terrano
- Excellence Cluster Universe and Technische Universität München, 85748 Garching, Germany
| | - L Trahms
- Physikalisch-Technische Bundesanstalt (PTB) Berlin, 10587 Berlin, Germany
| | - J Voigt
- Physikalisch-Technische Bundesanstalt (PTB) Berlin, 10587 Berlin, Germany
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32
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Palmer L, Marino M, McMullen T, Vaughan M, Deutsch A. Pre-Hospital Living Situation and Functional Improvement for Patients Discharged From Inpatient Rehabilitation. Arch Phys Med Rehabil 2019. [DOI: 10.1016/j.apmr.2019.08.057] [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: 11/16/2022]
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33
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Casini B, Gallo E, Melis E, Cecere F, Laquintana V, Cerasoli V, Facciolo F, Pescarmona E, Fazi F, Marino M. MS08.04 Novel Biomarkers for Thymic Carcinoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mazzanti A, Marelli S, Chargeishvili T, Trancuccio A, Marino M, Bulian F, Monteforte N, Bloise R, Napolitano C, Priori SG. 6123A novel ECG parameter predicts lack of eligibility for Subcutaneous Implantable Cardioverter Defibrillator (S-ICD) in patients with Brugada Syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A conclusive estimate of the eligibility rate for the use of subcutaneous implantable cardioverter defibrillators (S-ICD) in patients with Brugada Syndrome (BrS) is lacking.
Objective
We aimed to: 1) evaluate the eligibility for S-ICD in patients with BrS using a novel automated tool; 2) investigate predictors of ineligibility for S-ICD, based on baseline 12-lead electrocardiogram.
Methods
Automated screening for S-ICD was performed in 118 consecutive BrS patients using the programmer provided by the S-ICD producer. The system automatically assessed the acceptability of each of the three sense vectors used by the S-ICD for the detection of cardiac rhythm. Eligibility was defined when at least one vector was acceptable both in supine and standing position.
Results
The clinical characteristics of 118 BrS patients were as follow: age 43±11 years; 89% males; 2% with aborted cardiac arrest; 14% with a history of syncope; 81% with spontaneous type 1 ECG pattern; 21% with a familial history of sudden cardiac death; 24% with an SCN5A mutation. No patients had an indication for pacing. Only 8/118 (7%) patients were ineligible for S-ICD. Of note, 5/8 (63%) patients who failed the screening exhibited a slurred S wave of ≥80 ms duration in the peripheral lead aVF on the 12-lead baseline electrocardiogram, vs. 4/110 (4%) of those who passed the screening (sensitivity of S wave in aVF for screening failure 63%, specificity 97%; p<0.001). Remarkably, the presence of a slurred S wave of ≥80 ms duration in lead aVF remained significantly associated to the failure of eligibility for S-ICD (odds ratio 50, p<0.001) in a multivariable analysis that included the previous history of symptoms, the presence of a spontaneous type 1 ECG pattern, the gender and the presence of SCN5A mutations.
ECG predictor of S-ICD screening
Conclusion
Up to 93% of BrS patients are eligible for S-ICD when the automated screening tool is used. The presence of a slurred S wave in lead aVF on the 12-lead electrocardiogram is a powerful predictor of screening failure.
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Affiliation(s)
- A Mazzanti
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - S Marelli
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | | | - A Trancuccio
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - M Marino
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - F Bulian
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - N Monteforte
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - R Bloise
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - C Napolitano
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - S G Priori
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
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Mazzanti A, Tenuta E, Marino M, Pagan E, Morini M, Memmi M, Curcio A, Monteforte N, Bloise R, Napolitano C, Bagnardi V, Priori SG. 6081Efficacy and limitations of quinidine therapy in patients with Brugada Syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Quinidine at high-dose is used in patients with Brugada Syndrome (BrS), but its efficacy to prevent life-threatening arrhythmic events (LAE) in BrS is unproven and its use is limited by side effects.
Objective
We assessed whether low-dose quinidine in BrS patients reduces: 1) the occurrence of a first LAE; 2) the arrhythmic burden in the high-risk group of cardiac arrest survivors.
Methods
We first compared the clinical course of 53 BrS patients treated with quinidine to that of 441 untreated controls, matched by sex, age, and symptoms. Furthermore, we calculated the annual incidence of LAEs off- and on-quinidine in 123 BrS patients who had survived a cardiac arrest.
Results
First, we compared the clinical course of 53 BrS patients treated with quinidine (i.e. “cases”: 89% males, median age 40 years) to that of 441 untreated, clinically-matched BrS patients (i.e. “controls”: 91% males, median age 41 years) present in our database of patients with inherited arrhythmias. Cases received quinidine (median dose of 450 mg per day) for 5.0±3.7 years. Quinidine was interrupted in only 3/53 cases (6%) for side effects and it conferred a nonsignificant reduction of the risk of a first LAE in cases versus controls (HR 0.74, 95% CI 0.22–2.48, P=0.62).
Secondly, we calculated the annual recurrence of LAE off- and on-quinidine in 123 BrS cardiac arrest survivors, 27 of whom were treated with quinidine for 7.0±3.5 years. The annual rate of recurrent LAEs decreased significantly from 14.7% while off-quinidine to 3.9% while on-quinidine (P=0.03). Notably, recurrent life-threatening arrhythmic events were recorded in 4/27 (15%) symptomatic patients while on-quinidine.
Conclusion
We demonstrated for the first time in the long-term that low-dose quinidine reduces the recurrence of life-threatening arrhythmias in symptomatic BrS patients, with few side effects. Remarkably, about one-fifth of symptomatic patients experience life-threatening arrhythmias while on-treatment, suggesting that quinidine cannot replace implantable defibrillators in high-risk subjects.
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Affiliation(s)
| | - E Tenuta
- ICS Maugeri - IRCCS, Pavia, Italy
| | - M Marino
- ICS Maugeri - IRCCS, Pavia, Italy
| | - E Pagan
- University of Milan-Bicocca, Department of Statistics and Quantitative Methods, Milan, Italy
| | - M Morini
- ICS Maugeri - IRCCS, Pavia, Italy
| | - M Memmi
- ICS Maugeri - IRCCS, Pavia, Italy
| | - A Curcio
- ICS Maugeri - IRCCS, Pavia, Italy
| | | | - R Bloise
- ICS Maugeri - IRCCS, Pavia, Italy
| | | | - V Bagnardi
- University of Milan-Bicocca, Department of Statistics and Quantitative Methods, Milan, Italy
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Saret CJ, Ni P, Marino M, Dore E, Ryan CM, Schneider JC, Kazis LE. Social Participation of Burn Survivors and the General Population in Work and Employment: A Life Impact Burn Recovery Evaluation (LIBRE) Profile Study. J Burn Care Res 2019; 40:669-677. [PMID: 31069384 DOI: 10.1093/jbcr/irz076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Work integration and retention after burn injury is a key outcome. Little is known about how burn survivors reintegrate into the workplace. This article compares scores on the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a burn-specific measure of social participation, between burn survivors and general population samples, focusing on the Work and Employment domain. METHODS Convenience samples of burn survivors and the U.S. population were obtained. Differences in demographic and clinical characteristics and LIBRE Profile scores were assessed. To examine work and employment, we compared family and friends, social activities, and social interactions scores among working vs nonworking burn survivors. RESULTS Six hundred and one burn survivors (320 employed) and 2000 U.S. residents (1101 employed) were surveyed. The mean age (P = .06), distributions of sex (P = .35), and Hispanic ethnicity (P = .07) did not differ significantly. Distributions of race (P < .01) and education (P = .01) differed significantly. The burn survivor sample had higher scores, demonstrating higher participation, for work and employment (mean = 49.5, SD = 9.42) than the general sample (mean = 46.94, SD = 8.94; P < .0001), which persisted after adjusting for demographic characteristics. Scores on the three domains administered to all respondents were higher (P < .001) for working than nonworking burn survivors. CONCLUSION Distributions indicated higher social participation in the burn survivor sample than the general sample. Possible explanations include sample bias; resilience, posttraumatic growth, or response-shift of survivors; and limitations of using items in the general sample. Working burn survivors scored higher than those not working. Future work can explore factors that mediate higher scores and develop interventions.
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Affiliation(s)
- Cayla J Saret
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Pengsheng Ni
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Molly Marino
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Emily Dore
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts.,Shriners Hospitals for Children-Boston®, Massachusetts
| | - Jeffrey C Schneider
- Harvard Medical School, Boston, Massachusetts.,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
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Cartwright S, Saret C, Shapiro GD, Ni P, Sheridan RL, Lee AF, Marino M, Acton A, Kazis LE, Schneider JC, Ryan CM. Burn survivors injured as children exhibit resilience in long-term community integration outcomes: A life impact burn recovery evaluation (LIBRE) study. Burns 2019; 45:1031-1040. [DOI: 10.1016/j.burns.2019.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 01/31/2019] [Accepted: 02/07/2019] [Indexed: 12/20/2022]
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Meterko M, Marino M, Ni P, Marfeo E, McDonough CM, Jette A, Peterik K, Rasch E, Brandt DE, Chan L. Psychometric Evaluation of the Improved Work-Disability Functional Assessment Battery. Arch Phys Med Rehabil 2019; 100:1442-1449. [PMID: 30578775 PMCID: PMC8787773 DOI: 10.1016/j.apmr.2018.09.125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/16/2018] [Accepted: 09/06/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To assess psychometric properties of the improved Work Disability Functional Assessment Battery (WD-FAB 2.0). DESIGN Longitudinal study. SETTING Community. PARTICIPANTS Three samples of working-age (21-66) adults (N=1006): (1) unable to work because of a physical condition (n=375); (2) unable to work because of a mental health condition (n=296); (3) general United States working age sample (n=335). INTERVENTION NA. MAIN OUTCOME MEASURES All samples completed the WD-FAB 2.0; the second administration came 5 days after the first. Construct validity was examined by convergent and divergent correlational analysis using legacy measures. Test-retest reliability was assessed by intraclass correlation coefficients (ICC3,1). Standard error of the mean (SEM) and minimal detectable change (MDC90) were calculated to measure scale precision and sensitivity. RESULTS Physical function ICCs ranged from 0.69 to 0.77 in the general sample, and 0.66 to 0.86 in the disability sample. Mental health function scales ICCs ranged from 0.62 to 0.73 in the general sample, and 0.74 to 0.76 in the disability sample. SEMs for all scales indicated good discrimination; those for the physical function scales were generally lower than those for the mental health scales. MDC90 values ranged from 3.41 to 10.55. Correlations between all WD-FAB 2.0 scales and legacy measures were in the expected direction. CONCLUSIONS The study provides substantial support for the reliability and construct validity of the WD-FAB 2.0 among 3 diverse samples. Although initially developed for use within the Social Security Administration (SSA), these results suggest that the WD-FAB 2.0 could be used for assessment and measurement of work-related physical and mental health function in other contexts as well.
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Affiliation(s)
- Mark Meterko
- VHA Office of Reporting, Analytics, Performance, Improvement and Deployment (RAPID), Washington, DC; Boston University School of Public Health, Department of Health Law Policy and Management, Boston, MA.
| | - Molly Marino
- Boston University School of Public Health, Department of Health Law Policy and Management, Boston, MA
| | - Pengsheng Ni
- Boston University School of Public Health, Department of Health Law Policy and Management, Boston, MA
| | | | - Christine M McDonough
- Boston University School of Public Health, Department of Health Law Policy and Management, Boston, MA
| | - Alan Jette
- Boston University School of Public Health, Department of Health Law Policy and Management, Boston, MA
| | - Kara Peterik
- Boston University School of Public Health, Department of Health Law Policy and Management, Boston, MA
| | - Elizabeth Rasch
- National Institutes of Health Rehabilitation Medicine Department, Bethesda, MD
| | - Diane E Brandt
- National Institutes of Health Rehabilitation Medicine Department, Bethesda, MD
| | - Leighton Chan
- National Institutes of Health Rehabilitation Medicine Department, Bethesda, MD
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Marino M, Scala I, Scicolone O, Strisciuglio P, Bravaccio C. Distribution and age of onset of psychopathological risk in a cohort of children with Down syndrome in developmental age. Ital J Pediatr 2019; 45:92. [PMID: 31349869 PMCID: PMC6660693 DOI: 10.1186/s13052-019-0672-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/03/2019] [Indexed: 12/11/2022] Open
Abstract
Background Aim of the study is to intercept specific characteristics and psychiatric comorbidity in Down Syndrome (DS). The study describes the distribution and the age of specific aspects of behavioral phenotype in a sample of subjects with DS. Methods Psychopathological risk has been evaluated in a 97 DS patient cohort, aged 1 to 18 years, during regular follow-up neuropsychiatric visit and through administration of Child Behavior Checklist (CBCL); Childhood Autism Rating Scale (CARS-T) was assessed to verify the presence of autistic behaviors. Results The results show the presence of specific psychopathological risk factors in 90% of the sample. 7% of sample presents autistic features. The risk of psychopathology is independent of the degree of intellectual disability. Conclusion The high frequency of psychopathological risk factors indicates the need for accurate monitoring to intercept specific characteristics, such as in the case of comorbidity for autism. The search for specific psychopathological factors is a little explored aspect to date, as evidenced by the literature. Despite the studies available to date highlight the presence of psychopathological vulnerability in DS, so far there are only few reports that explore this issue systematically.
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Affiliation(s)
- M Marino
- Department of Medical and Translational Science, Federico II University Hospital, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - I Scala
- Department of Medical and Translational Science, Federico II University Hospital, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - O Scicolone
- Department of Medical and Translational Science, Federico II University Hospital, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - P Strisciuglio
- Department of Medical and Translational Science, Federico II University Hospital, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - C Bravaccio
- Department of Medical and Translational Science, Federico II University Hospital, Via Sergio Pansini, 5, 80131, Naples, Italy
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40
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Napodano C, Pocino K, Basile U, Gulli F, Marino M, Gragnani L, Conti L, Rossi E, Cordone I, Zignego A, Rapaccini G, Cigliana G. A novel biomarkers score for the screening and management of patients with plasma cell proliferative disorders. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.328] [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: 11/27/2022]
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41
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Napodano C, Basile U, Pocino K, Marino M, Gragnani L, Gulli F, Lorini S, Stefanile A, Santini S, Rapaccini G, Zignego A. IGG subclasses, free light chains and vascular endothelial growth factor in HCV-related mixed cryoglobulinemic syndrome. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.329] [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: 11/28/2022]
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42
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Ni P, Marino M, Dore E, Sonis L, Ryan CM, Schneider JC, Jette AM, Kazis LE. Extreme response style bias in burn survivors. PLoS One 2019; 14:e0215898. [PMID: 31059527 PMCID: PMC6502351 DOI: 10.1371/journal.pone.0215898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 04/10/2019] [Indexed: 11/29/2022] Open
Abstract
This paper explores extreme response style to the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a measure of social participation in burn survivors. We fit a Multidimensional Generalized Partial Credit Model (MGPCM) with a positive extreme response style (PERS) factor and compared this model with the original MGPCM, estimated the impact that PERS has on scores, and examined the personal characteristics that may result in an individual more likely to respond in a fashion that would inflate their true low scores. The average impact of the PERS, based upon the root mean squared bias, ranged from 0.27 to 0.50 of a standard deviation of the scale. Individuals who were older, had participated in a burn survivor support group, and had selected to self-administer the measure were less likely to have a high PERS bias that masks low scores. Future work can consider PERS when measuring the psychosocial impacts of burn injuries and other health conditions.
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Affiliation(s)
- Pengsheng Ni
- Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, Massachusetts, United States of America
- * E-mail:
| | - Molly Marino
- Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, Massachusetts, United States of America
| | - Emily Dore
- Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, Massachusetts, United States of America
| | - Lily Sonis
- Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, Massachusetts, United States of America
| | - Colleen M. Ryan
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Shriners Hospitals for Children–Boston, Boston, Massachusetts, United States of America
| | - Jeffrey C. Schneider
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts, United States of America
| | - Alan M. Jette
- MGH Institute of Health Professions, Boston, Massachusetts, United States of America
| | - Lewis E. Kazis
- Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, Massachusetts, United States of America
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Pugliese N, Circella E, Marino M, De Virgilio C, Cocciolo G, Lozito P, Cafiero MA, Camarda A. Circulation dynamics of Salmonella enterica subsp. enterica ser. Gallinarum biovar Gallinarum in a poultry farm infested by Dermanyssus gallinae. Med Vet Entomol 2019; 33:162-170. [PMID: 30160309 DOI: 10.1111/mve.12333] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 07/07/2018] [Accepted: 07/11/2018] [Indexed: 06/08/2023]
Abstract
Dermanyssus gallinae (Mesostigmata: Dermanyssidae, De Geer, 1778) is an ectoparasite of poultry, suspected to play a role as a vector of Salmonella enterica subsp. enterica ser. Gallinarum. Despite an association between them being reported, the actual dynamics in field remain unclear. Therefore, the present study aimed to confirm the interactions among mites, pathogen and chickens. The study was carried out in an industrial poultry farm infested by D. gallinae, during an outbreak of fowl typhoid. The presence of S. Gallinarum in mites was assessed and quantified by a semi-nested polymerase chain reaction (PCR) and real-time PCR, respectively, in mites collected during two subsequent productive cycles and the sanitary break. The anti-group D Salmonella antibodies were quantified by an enzyme-linked immunosorbent assay. During the outbreak and the sanitary break, S. Gallinarum was constantly present in mites. In the second cycle, scattered positivity was observed, although hens did not exhibit signs of fowl typhoid, as a result of the vaccination with BIO-VAC SGP695 (Fatro, Ozzano Emilia Bo, Italy). The data strongly suggest that D. gallinae acts as reservoir of S. Gallinarum, thus allowing the pathogen to persist in farms. Furthermore, the present study has highlighted the interactions among D. gallinae, S. Gallinarum and hens with respect to enhancing the mite-mediated circulation of S. Gallinarum in an infested poultry farm.
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Affiliation(s)
- N Pugliese
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari 'Aldo Moro', Bari, Italy
| | - E Circella
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari 'Aldo Moro', Bari, Italy
| | - M Marino
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari 'Aldo Moro', Bari, Italy
| | - C De Virgilio
- Dipartimento di Bioscienze, Biotecnologie e Biofarmaceutica, Università degli Studi di Bari 'Aldo Moro', Bari, Italy
| | - G Cocciolo
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari 'Aldo Moro', Bari, Italy
| | | | - M A Cafiero
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Foggia, Italy
| | - A Camarda
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari 'Aldo Moro', Bari, Italy
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44
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Sinopoli A, Saulle R, Marino M, De Belvis AG, Federici A, La Torre G. The PRECEDE–PROCEED model as a tool in Public Health screening. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Sinopoli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - R Saulle
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - M Marino
- Department of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - AG De Belvis
- Department of Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - A Federici
- Ministry of Health, General Direction of Prevention, Rome, Italy
| | - G La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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45
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Gavrilovic N, Mohamed A, Marino M, Watkins S, Moschetta JM, Benard E. Avian-inspired energy-harvesting from atmospheric phenomena for small UAVs. Bioinspir Biomim 2018; 14:016006. [PMID: 30457112 DOI: 10.1088/1748-3190/aaec61] [Citation(s) in RCA: 1] [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] [Indexed: 06/09/2023]
Abstract
Fixed-wing small, unmanned aerial vehicles usually fly in atmospheric boundary layers that are often under the influence of turbulent environments. Inspired by nature's flyers, an application of an energy-harvesting flight strategy for increasing the energy state of the aircraft is presented. This paper provides basic longitudinal flight dynamic model exposing the physics behind the process. It shows significant power savings in flight with a sinusoidal and stochastic wind profile with active control of energy-harvesting. The active control based on optimized proportional gains was implemented for energy extraction from realistic atmospheric conditions, leading to significant energy savings for a 'bird-sized' vehicle. The paper reveals the equipment and necessary preparations for the flight test campaign. Moreover, it describes the design of a custom controller and its calibration in the wind tunnel against roll movements during pitching maneuvers. Finally, it investigates the benefits and potential of the automated process of energy-harvesting with simple proportional control through flight tests in a turbulent environment, validating the concept through the increased energy state of the aircraft.
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Affiliation(s)
- N Gavrilovic
- ISAE-SUPAERO, Université de Toulouse, 31400 Toulouse, France
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46
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Greco C, D'Agnano I, Vitelli G, Vona R, Marino M, Mottolese M, Zuppi C, Capoluongo E, Ameglio F. C-Myc Deregulation is Involved in Melphalan Resistance of Multiple Myeloma: Role of PDGF-BB. Int J Immunopathol Pharmacol 2018. [DOI: 10.1177/205873920601900107] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Oncogenes are important regulators of cancer growth and progression and their action may be modulated by proteins of the growth factor family, such as angiogenic cytokines, known to be strongly involved in neoplastic evolution. Reciprocal interactions between oncogenes and angiogenic modulators may represent, in haematological neoplasms, including multiple myeloma (MM), a possible mechanism of drug resistance. The aim of this work is to investigate in vitro and in vivo whether or not c-myc deregulation is involved in the melphalan resistance elicited by myeloma patients and consequently to clarify the role of the angiogenic factor PDGF-BB in modulating c-myc protein expression. Fifty-one MM patients on chemotherapy with melphalan were analyzed for structural alterations of the c-myc gene, c-Myc protein expression, as well as for serum PDGF-BB release. For the in vitro study, two M14-derived established cell clones, differing for the c-Myc protein expression (c-Myc low -expressing or constitutively expressing clones) were used. Our results show that PDGF-BB is able to up-regulate Myc expression and reduce melphalan sensitivity of tumor cell clones, constitutively expressing c-myc gene product. In addition, down-regulation of c-Myc protein induces the expression of PDGF-β receptor molecules and reduces PDGF-BB release. In agreement with these results, in vivo data show that melphalan-resistant MM patients present overexpressed c-Myc protein and higher serum PDGF-β receptor levels compared to minor responding patients.
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Affiliation(s)
- C. Greco
- Clinical Pathology Service, Regina Elena Cancer Institute, Rome
| | - I. D'Agnano
- Pharmacology Dept, University of Milan, Regina Elena Cancer Institute, Rome
- Institute of Biomedical Technology-CNR, Milan
| | - G. Vitelli
- Clinical Pathology Service, Regina Elena Cancer Institute, Rome
| | - R. Vona
- Clinical Pathology Service, Regina Elena Cancer Institute, Rome
- Dept of Drug Research and Evaluation Section of Cell Aging and Degeneration, 1st. Superiore di Sanita', Rome, Italy
| | - M. Marino
- Pathological Anatomy Service, Regina Elena Cancer Institute, Rome
| | - M. Mottolese
- Pathological Anatomy Service, Regina Elena Cancer Institute, Rome
| | - C. Zuppi
- Institute of Biochemistry and Clinical Biochemistry, Catholic University of Sacred Heart, Rome
| | - E. Capoluongo
- Institute of Biochemistry and Clinical Biochemistry, Catholic University of Sacred Heart, Rome
| | - F. Ameglio
- Institute of Biochemistry and Clinical Biochemistry, Catholic University of Sacred Heart, Rome
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47
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Di Maio P, Garitta S, You J, Mazzone G, Marino M, Vallone E. On the thermal-hydraulic optimization of DEMO divertor plasma facing components cooling circuit. Fusion Engineering and Design 2018. [DOI: 10.1016/j.fusengdes.2018.05.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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48
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Levi B, Kraft CT, Shapiro GD, Trinh NHT, Dore EC, Jeng J, Lee AF, Acton A, Marino M, Jette A, Armstrong EA, Schneider JC, Kazis LE, Ryan CM. The Associations of Gender With Social Participation of Burn Survivors: A Life Impact Burn Recovery Evaluation Profile Study. J Burn Care Res 2018; 39:915-922. [PMID: 29733365 PMCID: PMC6198731 DOI: 10.1093/jbcr/iry007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Burn injury can be debilitating and affect survivors' quality of life in a profound fashion. Burn injury may also lead to serious psychosocial challenges that have not been adequately studied and addressed. Specifically, there has been limited research into the associations of burn injury on community reintegration based on gender. This work analyzed data from 601 burn survivors who completed field testing of a new measure of social participation for burn survivors, the Life Impact Burn Recovery Evaluation (LIBRE) Profile. Differences in item responses between men and women were examined. Scores on the six LIBRE Profile scales were then compared between men and women using analysis of variance and adjusted linear multivariate regression modeling. Overall, men scored significantly better than women on four of the six LIBRE Profile scales: Sexual Relationships, Social Interactions, Work & Employment, and Romantic Relationships. Differences were not substantially reduced after adjustment for demographic characteristics and burn size. Men scored better than women in most of the areas measured by the LIBRE Profile. These gender differences are potentially important for managing burn patients during the post-injury recovery period.
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Affiliation(s)
- Benjamin Levi
- Division of Plastic Surgery, University of Michigan, Ann Arbor
| | - Casey T Kraft
- Department of Plastic Surgery, Ohio State University, Columbus
| | - Gabriel D Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University Montreal, Quebec, Canada
| | - Nhi-Ha T Trinh
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Emily C Dore
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - James Jeng
- Mount Sinai Healthcare System, New York, New York
| | - Austin F Lee
- Department of Surgery, Massachusetts General Hospital, Boston
- School of Insurance and Economics, University of International Business and Economics, Beijing, China
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Amy Acton
- Phoenix Society for Burn Survivors, Grand Rapids, Michigan
| | - Molly Marino
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Alan Jette
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | | | - Jeffrey C Schneider
- Department of Surgery, Massachusetts General Hospital, Spaulding Rehabilitation Hospital, Harvard Medical School, Shriners Hospitals for Children-Boston
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Spaulding Rehabilitation Hospital, Harvard Medical School, Shriners Hospitals for Children-Boston
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49
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Ferlini M, Musumeci G, Grieco N, Rossini R, Demarchi A, Cornara S, Somaschini A, Colombo P, Cardile A, Calchera I, Marino M, Ielasi A, Pedretti R, Lettieri C, Oltrona Visconti L. 2227Perceived or calculated bleeding risk in patients undergoing percutaneous coronary intervention: inside the post-pci prospective registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- M Ferlini
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - N Grieco
- Niguarda Ca' Granda Hospital, Milan, Italy
| | - R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - A Demarchi
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - S Cornara
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Somaschini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - P Colombo
- Niguarda Ca' Granda Hospital, Milan, Italy
| | - A Cardile
- AO Ospedale Treviglio, Treviglio, Italy
| | | | - M Marino
- Maggiore Hospital of Crema, Crema, Italy
| | - A Ielasi
- Bolognini Hospital, Seriate, Italy
| | - R Pedretti
- Fondazione Salvatore Maugeri, Tradate, Italy
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50
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Mazzanti A, Maragna R, Vacanti G, Monteforte N, Bloise R, Marino M, Pagan E, Napolitano C, Bagnardi V, Priori SG. P3814A novel risk stratification scheme for long QT syndrome based on genetic substrate and QTc duration. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Mazzanti
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - R Maragna
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - G Vacanti
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - N Monteforte
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - R Bloise
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - M Marino
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - E Pagan
- University of Milan-Bicocca, Department of Statistics and Quantitative Methods, Milan, Italy
| | - C Napolitano
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
| | - V Bagnardi
- University of Milan-Bicocca, Department of Statistics and Quantitative Methods, Milan, Italy
| | - S G Priori
- IRCCS ICS Maugeri, Molecular Cardiology, Pavia, Italy
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