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Aiello M, Marchi L, Calzetta L, Speroni S, Frizzelli A, Ghirardini M, Celiberti V, Sverzellati N, Majori M, Mori PA, Ranzieri S, Pisi R, Pelà G, Corradi M, Chetta A. Coronavirus Disease 2019: COSeSco - A Risk Assessment Score to Predict the Risk of Pulmonary Sequelae in COVID-19 Patients. Respiration 2021; 101:272-280. [PMID: 34673642 PMCID: PMC9059039 DOI: 10.1159/000519385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/18/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The presence of interstitial pneumonia in coronavirus disease 2019 (COVID-19) patients, as diagnosed through laboratory, functional, and radiological data, provides potential predicting factors of pulmonary sequelae. OBJECTIVES The objectives were the creation of a risk assessment score for pulmonary sequelae at high-resolution computed tomography (HRCT) through the assessment of laboratory data, lung function, and radiological changes in patients after the onset of COVID-19 interstitial pneumonia and the identification of predictive factors. METHODS We enrolled 121 subjects hospitalized due to COVID-19 pneumonia in our study. Clinical features, Charlson Comorbidity Index (CCI) score, HRCT score, and blood chemistry data at hospital admission, as well as HRCT score, pulmonary function testing values, exercise capacity by means of a 6-Minute Walk Test (6MWT), and dyspnea perception by the modified Medical Research Council (mMRC) at 4-month follow-up, were all recorded. The variables were elaborated in order to create a predictive model to identify patients at high risk of pulmonary sequelae at HRCT. RESULTS At the time of follow-up visit, 63% of patients had functional abnormality (diffusion lung capacity and/or total lung capacity <80% of predicted). Age, BMI, CCI, D-dimer, 6MWT, and mMRC were included in the COVID-19 Sequelae Score (COSeSco, ranging 0-15), which was able to individuate COVID-19 patients with radiologic sequelae (HRCT score >10%) at follow-up. The most revelatory COSeSco value that was found to intercept the highest sensitivity (100%) and specificity (77%) was 2. CONCLUSION The COSeSco - comprising age, BMI, comorbidities, D-dimer, walking distance, and dyspnea perception - makes it possible to identify particularly at-risk COVID-19 patients who are likely to develop pulmonary sequelae assessed by HRCT.
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Affiliation(s)
- Marina Aiello
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Laura Marchi
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Luigino Calzetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Silvia Speroni
- Department of Medicine and Surgery, Occupational Medicine Unit, University of Parma, Parma, Italy
| | - Annalisa Frizzelli
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Marianna Ghirardini
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Valentina Celiberti
- Department of Medicine and Surgery, Occupational Medicine Unit, University of Parma, Parma, Italy
| | - Nicola Sverzellati
- Department of Medicine and Surgery, Section of Radiology, Unit of Surgical Sciences, University of Parma, Parma, Italy
| | - Maria Majori
- Cardio-Thoracic-Vascular Department, Unit of Pulmonology and Thoracic Endoscopy, University Hospital of Parma, Parma, Italy
| | - Pier Anselmo Mori
- Cardio-Thoracic-Vascular Department, Unit of Pulmonology and Thoracic Endoscopy, University Hospital of Parma, Parma, Italy
| | - Silvia Ranzieri
- Department of Medicine and Surgery, Occupational Medicine Unit, University of Parma, Parma, Italy
| | - Roberta Pisi
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Giovanna Pelà
- Department of Medicine and Surgery, and Department of General and Specialistic Medicine, University-Hospital of Parma, University of Parma, Parma, Italy
| | - Massimo Corradi
- Department of Medicine and Surgery, Occupational Medicine Unit, University of Parma, Parma, Italy
| | - Alfredo Chetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
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Marzio L, Di Felice F, Celiberti V, Pieramico O, Grossi L, DiGioacchino M, Imbimbo BP, Cuccurullo F. Effects of cimetropium bromide on gallbladder contraction in response to oral and intraduodenal olive oil. Eur J Clin Pharmacol 1990; 39:369-72. [PMID: 2076720 DOI: 10.1007/bf00315412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
To evaluate the influence of the stomach and the cholinergic system on gallbladder contraction induced by physiological stimuli, the reduction in gallbladder volume in 7 healthy volunteers has been studied by real-time ultrasonography after the oral and intraduodenal administration of olive oil, preceded by pretreatment with cimetropium bromide or placebo. After an overnight fast, each subject swallowed 50 ml olive oil or it was administered through a naso-duodenal tube in the proximal duodenum. Cimetropium bromide 5 mg or placebo was given intravenously under double-blind control. After the placebo pretreatment, gallbladder contraction was greater and faster after intraduodenal oil than after oral oil. Cimetropium bromide decreased the extent, velocity and duration of gallbladder contraction induced by intraduodenal olive oil but it only reduced the velocity of the contraction induced by oil given orally. It is concluded that in normal human subjects the stomach modulates the extent and velocity of postprandial gallbladder contraction and that anticholinergic agents antagonize the gastric and duodenal phases of the response of the gallbladder to a meal.
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Affiliation(s)
- L Marzio
- Istituto di Fisiopatologia Medica, University of Chieti, Italy
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Dragani L, Colozzi A, Schiavone C, Obletter G, Celiberti V, Radico S, Vecchiet L. [A heparin-glucuronylglucosaminoglycan combination for topical use. An evaluation of the therapeutic effects in induced experimental muscle damage and in minor sports injuries]. Minerva Med 1989; 80:397-403. [PMID: 2657500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The aim of the study was to evaluate the clinical efficacy of the association of heparin and sulodexide on experimental pain and on "small sport traumatology". In the experimental part of the study, cutaneous pain threshold and subcutaneous tissue ticking were measured after the induction of an algogenic focus in deep somatic side. In the clinical part of the study, pain intensity (by A.V. scale), athletic performance and therapy duration, in athletes from muscular or articular posttraumatic injuries, were also assessed. After the therapy with the examined drug, a less significant lowering of cutaneous pain threshold and a less subcutaneous tissue thickening were found in the experimental study; in the clinical study a significant reduction of pain intensity and a quick restore of athletic performance were revealed. These results allow to conclude that the drug in effective to reduce painful symptomatology in both experimental and clinical conditions, by the limitation of some aspects of inflammation.
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Affiliation(s)
- L Dragani
- Università degli Studi G. D'Annunzio, Chieti
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Marzio L, Di Felice F, Celiberti V, Di Gioacchino M, Mezzetti A, Cuccurullo F, Innocenti P. Gallbladder emptying in duodenal ulcer patients having undergone Billroth II gastrectomy. Digestion 1988; 41:223-8. [PMID: 3243382 DOI: 10.1159/000199794] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
There is an increased incidence of gallstones in patients who have undergone Billroth II (BII) gastrectomy for duodenal ulcer. To explore the mechanisms underlying this, we examined changes in gallbladder volume induced by a meal and by intravenous administration of cerulein, in 13 BII patients and in 13 normal subjects. Gallbladder volume was measured by real-time ultrasonography. In the fasting state, gallbladder volumes were significantly larger in BII patients than in controls. The percent decrease in gallbladder volume after the meal was significantly less and maximum volume reduction observed throughout the study occurred sooner in BII patients than in controls. In contrast, the kinetics and magnitude of the reduction in gallbladder volume induced by cerulein were similar in the two groups. These findings suggest that the altered gallbladder response to a meal is due to impaired postprandial stimulation of gallbladder following BII gastrojejunostomy.
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Affiliation(s)
- L Marzio
- Istituto di Fisiopatologia Medica, Università di Chieti, Italia
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Marzio L, Capone F, Neri M, di Felice F, Celiberti V, Mezzetti A, Giorgi D, Cuccurullo F. Effect of cholinergic agonists and antagonists on gallbladder volume in fasting man. Eur J Clin Pharmacol 1987; 33:151-3. [PMID: 3319641 DOI: 10.1007/bf00544559] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The effect of direct cholinergic stimulation and blockade on gallbladder volume, determined by real-time ultrasonography (RUS), was evaluated in twenty normal, fasting subjects. Eleven subjects received atropine sulphate or placebo and 9 subjects a series of 3 injection of prostigmine, bethanechol or placebo, randomly assigned, at intervals of 24 h. RUS was performed under basal conditions after fasting for 12 h and every 5 min after drug injection up to 45 min in the atropine study and up to 60 min after prostigmine and bethanechol. There was no significant variation from fasting gallbladder volume after placebo in either group. After atropine sulphate gallbladder volume at first decreased and then significantly increased. With bethanechol and prostigmine, the volume fell significantly to a trough after 30 to 35 min, and then it returned to the basal value within 60 min. It is suggested that cholinergic mediation is involved in maintaining fasting tone in the gallbladder and that cholinergic stimulation causes contraction of the gallbladder by a direct effect.
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Affiliation(s)
- L Marzio
- Istituto di Fisiopatologia Medica, Università di Chieti, Italy
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