23 results on '"Cenderello, Giovanni"'
Search Results
2. The Multidimensional Prognostic Index predicts incident delirium among hospitalized older patients with COVID-19: a multicenter prospective European study.
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Morganti, Wanda, Custodero, Carlo, Veronese, Nicola, Topinkova, Eva, Michalkova, Helena, Polidori, M. Cristina, Cruz‐Jentoft, Alfonso J., von Arnim, Christine A. F., Azzini, Margherita, Gruner, Heidi, Castagna, Alberto, Cenderello, Giovanni, Custureri, Romina, Seminerio, Emanuele, Zieschang, Tania, Padovani, Alessandro, Sanchez‐Garcia, Elisabet, Pilotto, Alberto, Barbagallo, Mario, and Barbagelata, Marina
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Key summary points: Aim: Testing the role of the Multidimensional Prognostic Index (MPI), based on the Comprehensive Geriatric Assessment (CGA), in predicting the risk of incident delirium in hospitalized older patients with COVID-19. Findings: The MPI showed a good accuracy in predicting incident delirium (AUC = 0.71). Its accuracy is higher than the ones of two validated predictive models (AWOL delirium risk-stratification score's AUC = 0.63; Martinez Model's AUC = 0.61; p < 0.0001 for both comparisons). Message: The MPI is a sensitive tool for risk-stratification of the incident delirium in hospitalized older COVID-19 patients. Purpose: Incident delirium is a frequent complication among hospitalized older people with COVID-19, associated with increased length of hospital stay, higher morbidity and mortality rates. Although delirium is preventable with early detection, systematic assessment methods and predictive models are not universally defined, thus delirium is often underrated. In this study, we tested the role of the Multidimensional Prognostic Index (MPI), a prognostic tool based on Comprehensive Geriatric Assessment, to predict the risk of incident delirium. Methods: Hospitalized older patients (≥ 65 years) with COVID-19 infection were enrolled (n = 502) from ten centers across Europe. At hospital admission, the MPI was administered to all the patients and two already validated delirium prediction models were computed (AWOL delirium risk-stratification score and Martinez model). Delirium occurrence during hospitalization was ascertained using the 4A's Test (4AT). Accuracy of the MPI and the other delirium predictive models was assessed through logistic regression models and the area under the curve (AUC). Results: We analyzed 293 patients without delirium at hospital admission. Of them 33 (11.3%) developed delirium during hospitalization. Higher MPI score at admission (higher multidimensional frailty) was associated with higher risk of incident delirium also adjusting for the other delirium predictive models and COVID-19 severity (OR = 12.72, 95% CI = 2.11–76.86 for MPI-2 vs MPI-1, and OR = 33.44, 95% CI = 4.55–146.61 for MPI-3 vs MPI-1). The MPI showed good accuracy in predicting incident delirium (AUC = 0.71) also superior to AWOL tool, (AUC = 0.63) and Martinez model (AUC = 0.61) (p < 0.0001 for both comparisons). Conclusions: The MPI is a sensitive tool for early identification of older patients with incident delirium. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Use of Cefiderocol in Adult Patients: Descriptive Analysis from a Prospective, Multicenter, Cohort Study
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Giacobbe, Daniele Roberto, Labate, Laura, Russo Artimagnella, Chiara, Marelli, Cristina, Signori, Alessio, Di Pilato, Vincenzo, Aldieri, Chiara, Bandera, Alessandra, Briano, Federica, Cacopardo, Bruno, Calabresi, Alessandra, Capra Marzani, Federico, Carretta, Anna, Cattelan, Annamaria, Ceccarelli, Luca, Cenderello, Giovanni, Corcione, Silvia, Cortegiani, Andrea, Cultrera, Rosario, De Rosa, Francesco Giuseppe, Del Bono, Valerio, Del Puente, Filippo, Fanelli, Chiara, Fava, Fiorenza, Francisci, Daniela, Geremia, Nicholas, Graziani, Lucia, Lombardi, Andrea, Losito, Angela Raffaella, Maida, Ivana, Marino, Andrea, Mazzitelli, Maria, Merli, Marco, Monardo, Roberta, Mularoni, Alessandra, Oltolini, Chiara, Pallotto, Carlo, Pontali, Emanuele, Raffaelli, Francesca, Rinaldi, Matteo, Ripa, Marco, Santantonio, Teresa Antonia, Serino, Francesco Saverio, Spinicci, Michele, Torti, Carlo, Trecarichi, Enrico Maria, Tumbarello, Mario, Mikulska, Malgorzata, Giacomini, Mauro, Marchese, Anna, Vena, Antonio, and Bassetti, Matteo
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Introduction: Cefiderocol is a siderophore cephalosporin showing activity against various carbapenem-resistant Gram-negative bacteria (CR-GNB). No data currently exist about real-world use of cefiderocol in terms of types of therapy (e.g., empirical or targeted, monotherapy or combined regimens), indications, and patient characteristics. Methods: In this multicenter, prospective study, we aimed at describing the use of cefiderocol in terms of types of therapy, indications, and patient characteristics. Results: Cefiderocol was administered as empirical and targeted therapy in 27.5% (55/200) and 72.5% (145/200) of cases, respectively. Overall, it was administered as monotherapy in 101/200 cases (50.5%) and as part of a combined regimen for CR-GNB infections in the remaining 99/200 cases (49.5%). In multivariable analysis, previous isolation of carbapenem-resistant Acinetobacter baumanniiodds ratio (OR) 2.56, with 95% confidence interval (95% CI) 1.01–6.46, p= 0.047] and previous hematopoietic stem cell transplantation (OR 8.73, 95% CI 1.05–72.54, p= 0.045) were associated with administration of cefiderocol as part of a combined regimen, whereas chronic kidney disease was associated with cefiderocol monotherapy (OR 0.38 for combined regimen, 95% CI 0.16–0.91, p= 0.029). Cumulative 30-day mortality was 19.8%, 45.0%, 20.7%, and 22.7% in patients receiving targeted cefiderocol for infections by Enterobacterales, A. baumannii, Pseudomonas aeruginosa, and any metallo-β-lactamase producers, respectively. Conclusions: Cefiderocol is mainly used for targeted treatment, although empirical therapies account for more than 25% of prescriptions, thus requiring dedicated standardization and guidance. The almost equal distribution of cefiderocol monotherapy and cefiderocol-based combination therapies underlines the need for further study to ascertain possible differences in efficacy between the two approaches.
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- 2024
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4. Neutralizing monoclonal antibodies for the prevention of severe COVID-19: a retrospective study during Omicron BA.1 variant surge
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Bartalucci, Claudia, Limongelli, Alessandro, Nicolini, Laura Ambra, Ponzano, Marta, Tigano, Stefania, Farinella, Sara Tita, Carrega, Giuliana, Malerba, Gemma, Magnè, Federica, Balletto, Elisa, Giacobbe, Daniele Roberto, Riccio, Giovanni, Cenderello, Giovanni, Taramasso, Lucia, Bruzzone, Bianca, Vena, Antonio, Di Biagio, Antonio, Mikulska, Malgorzata, De Maria, Andrea, Dentone, Chiara, and Bassetti, Matteo
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AbstractAmong treatment options for Coronavirus disease 2019 (COVID-19), monoclonal antibodies (mAbs) showed to be effective in preventing disease progression, but real-world data during the Omicron variant surge are still lacking. Multicentre retrospective study evaluating the effectiveness of sotrovimab and casirivimab-imdevimab in fragile patients with mild SARS-CoV-2 infection between November 2021 and March 2022. Unfavourable outcome was defined as increased need for oxygen supplementation and/or death. Of 268 study-participants, 12 (4.48%) previously needed supplemental oxygen, while 6 (2.24%) had active solid neoplasia (2.24%); 186 (69%) have previously received SARS-CoV-2 vaccination. Overall, 22 (8%) had unfavourable outcomes (42% versus 6% of patients with and without previous oxygen need and 50% versus 7% of patients with and without active solid neoplasia). Both supplemental oxygen therapy before SARS-CoV-2 infection and solid malignant tumour have shown to be risk factors for treatment failure. Log-rank test did not identify differences between sotrovimab and casirivimab-imdevimab treatment. Despite diffusion of Omicron variant, the rate of unfavourable outcome was higher than expected. The presence of underlying risk factors, including solid cancer and previous oxygen therapy are independently associated with risk of COVID-19 progression, suggesting the need for antiviral treatments not limited to mAbs and implementation of vaccine campaign.
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- 2024
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5. Epidemiology, aetiology and treatment of skin and soft tissue infections: final report of a prospective multicentre national registry
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Esposito, Silvano, Pagliano, Pasquale, De Simone, Giuseppe, Pan, Angelo, Brambilla, Paola, Gattuso, Gianni, Mastroianni, Claudio, Kertusha, Blertha, Contini, Carlo, Massoli, Lorenzo, Francisci, Daniela, Priante, Giulia, Libanore, Marco, Bicocchi, Roberto, Borgia, Guglielmo, Maraolo, Alberto Enrico, Brugnaro, Pierluigi, Panese, Sandro, Calabresi, Alessandra, Amendola, Giovanni, Savalli, Francesca, Geraci, Consuelo, Tedesco, Andrea, Fossati, Sara, Carretta, Anna, Santantonio, Teresa, Cenderello, Giovanni, Crisalli, Maria Paola, Schiaroli, Elisabetta, Rovere, Pierangelo, Masini, Giulia, Ferretto, Roberto, Cascio, Antonio, Colomba, Claudia, Gioè, Claudia, Tumbarello, Mario, Losito, Angela Raffaella, Foti, Giuseppe, Prestileo, Tullio, Buscemi, Calogero, Iaria, Chiara, Iacobello, Carmelo, Sonia, Sofia, Starnini, Giulio, Ialungo, Anna, and Sapienza, Mauro
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AbstractSkin and soft tissue infections (SSTIs) represent a heterogenous group of pathological conditions involving the skin or the underlying subcutaneous tissues, fascia and muscle, characterised by a considerable variety of clinical presentations, severity and possible aetiological pathogens. Although previous analyses on restricted types of SSTIs and population have already been published, we conducted a large nationwide surveillance program on behalf of the Italian Society of Infectious and Tropical Diseases to assess the clinical and microbiological characteristics of the whole SSTI spectrum, from mild to severe life-threatening infections, in both inpatients and outpatients and their management. Twenty-nine Infectious Diseases (ID) Centres throughout Italy collected prospectively data concerning both the clinical and microbiological diagnosis of patients affected by SSTIs via an electronic case report form. We included in our database all cases managed by ID specialists participating to the study, independently from their severity or the setting of consultation. Here, we integrated previous preliminary results analysing and reporting data referring to a 3-year period (October 2016–October 2019). During this period, the study population included 478 adult patients with diagnosis of SSTI. The type of infection diagnosed, the aetiological agent involved and some notes on antimicrobial susceptibilities were collected and reported herein. We also analysed the most common co-morbidities, the type and duration of therapy executed, before and after ID intervention and the length of stay. The results of our study provide information to better understand the national epidemiologic data and the current clinical management of SSTIs in Italy.
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- 2022
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6. Safety evaluation of current therapies for high-risk severely ill patients with carbapenem-resistant infections
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Bassetti, Matteo, Falletta, Antonio, Cenderello, Giovanni, Giacobbe, Daniele R., and Vena, Antonio
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ABSTRACTIntroductionInfections due to carbapenem-resistant Gram-negative bacteria (CR-GNB) are increasingly frequent events, which are associated with a high mortality rate. Traditionally, combination regimens including high doses of “old antibiotics” such as polymyxins, tigecycline, and aminoglycosides have been used to treat these infections, but they were often associated with low efficacy and high excess of side effects and toxicity, especially nephrotoxicity. Along with the development of new compounds, the last decade has seen substantial improvements in the management of CR infections.Areas coveredIn this review, we aimed to discuss the safety characteristics and tolerability of different new options for treatment of CR infections.Expert opinionThe availability of new drugs showing a potent in vitroactivity against CR-GNB represents a unique opportunity to face the threat of resistance, while potentially reducing toxicity. A thorough understanding of the safety profile from clinical trials may guide the use of these new drugs in critically ill patients at high risk for the development of adverse events. Future data coming from real-life studies for drugs targeting CR infections are crucial to confirm the safety profile observed in pivotal trials.
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- 2022
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7. HCMV-controlling NKG2C+ NK cells originate from novel circulating inflammatory precursors.
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Bozzano, Federica, Della Chiesa, Mariella, Pelosi, Andrea, Antonini, Francesca, Ascierto, Maria Libera, Del Zotto, Genny, Moretta, Francesca, Muccio, Letizia, Luganini, Anna, Gribaudo, Giorgio, Cenderello, Giovanni, Dentone, Chiara, Nicolini, Laura, Moretta, Alessandro, Moretta, Lorenzo, and De Maria, Andrea
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There is limited knowledge on the origin and development from CD34
+ precursors of the ample spectrum of human natural killer (NK) cells, particularly of specialized NK subsets. This study sought to characterize the NK-cell progeny of CD34+ DNAM-1bright CXCR4+ and of other precursors circulating in the peripheral blood of patients with chronic viral infections (eg, HIV, hepatitis C virus, cytomegalovirus reactivation). Highly purified precursors were obtained by flow cytometric sorting and cultured in standard NK-cell differentiation media (ie, SCF, FLT3, IL-7, IL-15). Phenotypic and functional analyses on progenies were performed by multiparametric cytofluorimetric assays. Transcriptional signatures of NK-cell progenies were studied by microarray analysis. Inhibition of cytomegalovirus replication was studied by PCR. Unlike conventional CD34+ precursors, Lin− CD34+ DNAM-1bright CXCR4+ precursors from patients with chronic infection, rapidly differentiate into cytotoxic, IFN-γ–secreting CD94/NKG2C+ KIR+ CD57+ NK-cell progenies. An additional novel subset of common lymphocyte precursors was identified among Lin− CD34− CD56− CD16+ cells and characterized by expression of CXCR4 and lack of perforin and CD94. Lin− CD34− CD56− CD16+ Perf− CD94− CXCR4+ precursors are also endowed with generation potential toward memory-like NKG2C+ NK cells. Maturing NK-cell progenies mediated strong human cytomegalovirus–inhibiting activity. Microarray analysis confirmed a transcriptional signature compatible with NK-cell progenies and with maturing adaptive NK cells. During viral infections, precursors of adaptive NK cells are released and circulate in the peripheral blood. [Display omitted] [ABSTRACT FROM AUTHOR]- Published
- 2021
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8. Effect of Tocilizumab vs Standard Care on Clinical Worsening in Patients Hospitalized With COVID-19 Pneumonia: A Randomized Clinical Trial
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Salvarani, Carlo, Dolci, Giovanni, Massari, Marco, Merlo, Domenico Franco, Cavuto, Silvio, Savoldi, Luisa, Bruzzi, Paolo, Boni, Fabrizio, Braglia, Luca, Turrà, Caterina, Ballerini, Pier Ferruccio, Sciascia, Roberto, Zammarchi, Lorenzo, Para, Ombretta, Scotton, Pier Giorgio, Inojosa, Walter Omar, Ravagnani, Viviana, Salerno, Nicola Duccio, Sainaghi, Pier Paolo, Brignone, Alessandro, Codeluppi, Mauro, Teopompi, Elisabetta, Milesi, Maurizio, Bertomoro, Perla, Claudio, Norbiato, Salio, Mario, Falcone, Marco, Cenderello, Giovanni, Donghi, Lorenzo, Del Bono, Valerio, Colombelli, Paolo Luigi, Angheben, Andrea, Passaro, Angelina, Secondo, Giovanni, Pascale, Renato, Piazza, Ilaria, Facciolongo, Nicola, and Costantini, Massimo
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IMPORTANCE: The coronavirus disease 2019 (COVID-19) pandemic is threatening billions of people worldwide. Tocilizumab has shown promising results in retrospective studies in patients with COVID-19 pneumonia with a good safety profile. OBJECTIVE: To evaluate the effect of early tocilizumab administration vs standard therapy in preventing clinical worsening in patients hospitalized with COVID-19 pneumonia. DESIGN, SETTING, AND PARTICIPANTS: Prospective, open-label, randomized clinical trial that randomized patients hospitalized between March 31 and June 11, 2020, with COVID-19 pneumonia to receive tocilizumab or standard of care in 24 hospitals in Italy. Cases of COVID-19 were confirmed by polymerase chain reaction method with nasopharyngeal swab. Eligibility criteria included COVID-19 pneumonia documented by radiologic imaging, partial pressure of arterial oxygen to fraction of inspired oxygen (Pao2/Fio2) ratio between 200 and 300 mm Hg, and an inflammatory phenotype defined by fever and elevated C-reactive protein. INTERVENTIONS: Patients in the experimental arm received intravenous tocilizumab within 8 hours from randomization (8 mg/kg up to a maximum of 800 mg), followed by a second dose after 12 hours. Patients in the control arm received supportive care following the protocols of each clinical center until clinical worsening and then could receive tocilizumab as a rescue therapy. MAIN OUTCOME AND MEASURES: The primary composite outcome was defined as entry into the intensive care unit with invasive mechanical ventilation, death from all causes, or clinical aggravation documented by the finding of a Pao2/Fio2 ratio less than 150 mm Hg, whichever came first. RESULTS: A total of 126 patients were randomized (60 to the tocilizumab group; 66 to the control group). The median (interquartile range) age was 60.0 (53.0-72.0) years, and the majority of patients were male (77 of 126, 61.1%). Three patients withdrew from the study, leaving 123 patients available for the intention-to-treat analyses. Seventeen patients of 60 (28.3%) in the tocilizumab arm and 17 of 63 (27.0%) in the standard care group showed clinical worsening within 14 days since randomization (rate ratio, 1.05; 95% CI, 0.59-1.86). Two patients in the experimental group and 1 in the control group died before 30 days from randomization, and 6 and 5 patients were intubated in the 2 groups, respectively. The trial was prematurely interrupted after an interim analysis for futility. CONCLUSIONS AND RELEVANCE: In this randomized clinical trial of hospitalized adult patients with COVID-19 pneumonia and Pao2/Fio2 ratio between 200 and 300 mm Hg who received tocilizumab, no benefit on disease progression was observed compared with standard care. Further blinded, placebo-controlled randomized clinical trials are needed to confirm the results and to evaluate possible applications of tocilizumab in different stages of the disease. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04346355; EudraCT Identifier: 2020-001386-37
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- 2021
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9. Epidemiology and Microbiology of Skin and Soft Tissue Infections: Preliminary Results of a National Registry
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Esposito, Silvano, De Simone, Giuseppe, Pan, Angelo, Brambilla, Paola, Gattuso, Gianno, Mastroianni, Claudio, Kertusha, Blerta, Contini, Carlo, Massoli, Lorenzo, Francisci, Daniela, Priante, Giulia, Libanore, Marco, Bicocchi, Roberto, Borgia, Guglielmo, Maraolo, Alberto Enrico, Brugnaro, Pierluigi, Panese, Sandro, Calabresi, Alessandra, Amendola, Giovanni, Savalli, Francesca, Geraci, Consuelo, Tedesco, Andrea, Fossati, Sara, Carretta, Anna, Santantonio, Teresa, Cenderello, Giovanni, Crisalli, Maria Paola, Schiaroli, Elisabetta, Rovere, Pierangelo, Masini, Giulia, Ferretto, Roberto, Cascio, Antonio, Colomba, Claudia, Gioè, Claudia, Tumbarello, Mario, Losito, Angela Raffaella, Foti, Giuseppe, Prestileo, Tullio, Buscemi, Calogero, Chiara, Iaria, Iacobello, Carmelo, Sonia, Sofia, Starnini, Giulio, Ialungo, Anna, and Sapienza, Mauro
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Skin and soft tissue infections (SSTIs) represent a wide range of clinical conditions characterized by a considerable variety of clinical presentations and severity. Their aetiology can also vary, with numerous possible causative pathogens. While other authors previously published analyses on several types of SSTI and on restricted types of patients, we conducted a large nationwide surveillance programme on behalf of the Italian Society of Infectious and Tropical Diseases to assess the clinical and microbiological characteristics of the whole SSTI spectrum, from mild to severe life-threatening infections, in both inpatients and outpatients. Twenty-five Infectious Diseases (ID) Centres throughout Italy collected prospectively data concerning both the clinical and microbiological diagnosis of patients affected by SSTIs via an electronic case report form. All the cases included in our database, independently from their severity, have been managed by ID specialists joining the study while SSTIs from other wards/clinics have been excluded from this analysis. Here, we report the preliminary results of our study, referring to a 12-month period (October 2016–September 2017). During this period, the study population included 254 adult patients and a total of 291 SSTI diagnoses were posed, with 36 patients presenting more than one SSTIs. The type of infection diagnosed, the aetiological micro-organisms involved and some notes on their antimicrobial susceptibilities were collected and are reported herein. The enrichment of our registry is ongoing, but these preliminary results suggest that further analysis could soon provide useful information to better understand the national epidemiologic data and the current clinical management of SSTIs in Italy.
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- 2019
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10. Hypertensive Versus HIV-infected Patients: Who Has the Greatest Target Organ Damage? Comparison of Carotid Plaque Prevalence, Intima Media Thickness and Renal Resistive Index in the Two Groups of Patients
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Taramasso, Lucia, Mirabella, Michele, Cappadona, Francesca, Bonino, Barbara, Riccardi, Niccolo, Cenderello, Giovanni, Socio, Giuseppe V. De, Viscoli, Claudio, Viazzi, Francesca, and Di Biagio, Antonio
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Objectives: to compare the prevalence of target-organ damage (TOD), defined as carotid plaque, or intima media thickness, cIMT, >0.9 mm, and that of increased renal resistive index (RRI), among HIV-1-infected patients and uninfected hypertensive patients (HT-non HIV). Methods: HIV-infected patients aged ≥ 18 years and virologically suppressed were matched with pair-age, sex and BMI HT-non HIV. Patients on antihypertensive treatment were excluded. All patients' cIMT and RRI were evaluated with ultrasonography. Data were analysed throughout 2 test, analysis of variance and logistic regression. Results: Fifty-nine HIV-infected patients were enrolled (71% men) and matched with 59 HT-non HIV. No differences were found in cIMT values (p=0.827) and in the prevalence of TOD between HIV-infected patients and HT-non HIV (36% vs 38%, p= 0.79). Among HIV-infected patients, those hypertensive had significantly higher prevalence of TOD (46% vs 21%, P< 0.05) and higher cIMT (0.747 ± 0.104 vs 0.654 ±0.100 mm, p = 0.0185). Patients with TOD were older (p= 0.004) and more frequently current smokers (p= 0.022). At the logistic regression analysis, TOD was significantly related to age (p=0.04, 95%CI 1.0-1.1) and smoke, current (p=0.178, 95%CI1.2-12.8) or previous (p=0.04, 95%CI 1.0-7.2). Mean RRI were identical for both HIV-1 infected and uninfected patients (0.60, SD± 0.05 and 0.60, SD± 0.04, respectively, p=0.996). Conclusions: In our study TOD was associated to hypertension, older age and smoke, but not to HIV serostatus itself, confirming the major importance of traditional risk factors and the need of risk assessment and cardiovascular prevention measures in HIV-infected patients.
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- 2018
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11. Salvage Therapy or Simplification of Salvage Regimens with Dolutegravir plus Ritonavir-Boosted Darunavir Dual Therapy in Highly cART-Experienced Subjects: An Italian Cohort
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Capetti, Amedeo F, Sterrantino, Gaetana, Cossu, Maria V, Cenderello, Giovanni, Cattelan, Anna M, Socio, Giuseppe V De, Rusconi, Stefano, Riccardi, Niccolò, Baldin, Gian M, Cima, Serena, Niero, Fosca P, Rizzardini, Giuliano, and Sasset, Lolita
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Background Dolutegravir plus darunavir provide a high genetic barrier to HIV-1 resistance and are suitable for simple salvage regimens.Methods All HIV-1-infected subjects treated with dolutegravir plus boosted darunavir dual therapy between March 2011 and September 2015 were included in an observational cohort. Data were collected at baseline and at weeks 4, 12, 24 and 48.Results We enrolled 113 subjects. After week 24, one was lost at follow-up, one dropped out for grade 2 elevation of liver enzymes, one died from illicit drug abuse and one from cancer-related sepsis. The mean age was 51, 26.5% were female and 9.7% were non-Caucasian. Twenty had never experienced failure. A total of 99 had reverse-transcriptase (RT) mutations, 87 had protease inhibitor mutations and 12 had integrase strand transfer inhibitor (INSTI) mutations. Viraemic patients declined from baseline to week 24 from 43.4% to 6.2%, the remainder being due to high baseline viraemia or adherence issues. The proportion of subjects with viraemia 1–49 copies/ml remained at 20.4% while those in whom no virus was detected (NVD) increased from 36.3% to 73.5% by week 24. All the 47 subjects who had a 48-week follow-up had <50 copies/ml and 42 (89.4%) had NVD. 18 subjects had reduced sensitivity to darunavir (Stanford median score 15, range 15–40), but none rebounded, 6 having a 24-week and 7 a 48-week follow-up. The median variation in serum creatinine was -0.01 (range +0.2 to -0.21) mg/dl.Conclusions This dual regimen provides a simple salvage regimen and proved safe and effective in this cohort.
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- 2017
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12. Increased CD38 expression on T lymphocytes as a marker of HIV dissemination into the central nervous system.
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Dentone, Chiara, Fenoglio, Daniela, Schenone, Eva, Cenderello, Giovanni, Prinapori, Roberta, Signori, Alessio, Parodi, Alessia, Kalli, Francesca, Battaglia, Florinda, Feasi, Marcello, Bruzzone, Bianca, Viscoli, Claudio, Filaci, Gilberto, and Di Biagio, Antonio
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DIAGNOSIS of HIV infections ,HIV-positive persons ,CD38 antigen ,GENE expression ,T cells ,BIOMARKERS ,CENTRAL nervous system physiology - Abstract
Cross-sectional analysis on 20 HIV-1 patients with neurological symptoms admitted to two infectious disease units. Cut-off of HIV-RNA (VL) was 20 copies/ml for plasma and cerebral spinal fluid (CSF). Flow cytometry was used to analyze the phenotype of circulating and CSF T lymphocytes. CD38 mean fluorescence intensity (MFI) was higher on circulating CD4
+ T lymphocytes from patients with VL >20 copies/ml in plasma ( P = 0.001) or CSF ( P = 0.001). The frequency of circulating CD8+ CD38+ T cells and CD38 MFI on these cells were higher in patients with VL >20 copies/ml than in those with undetectable plasma VL ( P = 0.030 and P = 0.023). The frequency of CSF CD4+ CD38+ T, as well as their CD38 and CD95 MFI, were increased in patients with detectable than non-detectable plasma VL ( P = 0.01, P = 0.03, and P = 0.05). The % CD38+ CD8+ T in CSF correlated with time of virological suppression (ρ = − 0.462, P = 0.040) and the CNS penetration-effectiveness (CPE) score (ρ = − 0.467, P = 0.038). In conclusion, (a) the expression of CD38+ on both CD4+ , CD8+ T lymphocytes from peripheral blood and CSF discriminated between viremic and non-viremic patients and (b) T cell activation/apoptosis markers inversely correlated with CPE to remark the importance for therapy to restore immunological functions. [ABSTRACT FROM AUTHOR]- Published
- 2015
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13. Inpatient admissions of patients living with HIV in two European centres (UK and Italy); comparisons and contrasts.
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Cenderello, Giovanni, Tittle, Victoria, Pasa, Ambra, Dentone, Chiara, Artioli, Stefania, Setti, Maurizio, Giacomini, Mauro, Fraccaro, Paolo, Viscoli, Claudio, Cassola, Giovanni, Di Biagio, Antonio, Barbour, Alison, and Nelson, Mark
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- 2015
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14. Genotypic Determination of HIV Tropism in a Cohort of Patients Perinatally Infected With HIV-1 and Exposed to Antiretroviral Therapy.
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Di Biagio, Antonio, Parisini, Andrea, Bruzzone, Bianca, Prinapori, Roberta, Lauriola, Marinella, Paolucci, Stefania, Signori, Alessio, Barresi, Renata, Icardi, Giancarlo, Calderisi, Silvia, Meini, Genny, Dentone, Chiara, Cenderello, Giovanni, Guerra, Michele, Maccabruni, Anna, Rusconi, Stefano, and Viscoli, Claudio
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The aim of this study was to determine the coreceptor tropism by performing genotypic HIV-1 tropism testing in a cohort of patients perinatally infected with HIV-1 and exposed to antiretroviral therapy. Genotypic coreceptor tropism was determined in patients with HIV-1 RNA<100 copies/mL using PBMC samples by gp120 V3 sequencing followed by geno2pheno interpretation (set at a false positive rate [FPR] of 20%) and in patients with >⃒100 copies/mL using plasma samples (set at a FPR of 20%), according to European guidelines. Out of 55 patients, 50 had an HIV-1 subtype B strain, and mean (SD) age was 18.2 (4.6) years. The median duration of antiretroviral therapy was 13 years (range, 3-23). Thirty-three (60%) patients harbored the R5 virus. At the time of the testing, the median CD4+ T lymphocyte cell count and percentage were 705 cells/mm3 (474-905) and 32.5% in group R5 and 626 cells/mm3 (450-755) and 31.7% in group X4/D-M, respectively. The nadir of CD4+ T-cell count in groups R5 and X4/D-M were 322 cells/mm3 (230-427) and 340 cells/mm3 (242-356), respectively. These differences were not statistically significant. Fifteen patients had HIV-1 RNA >⃒50 copies/mL. The median HIV-1 RNA and HIV-1 DNA were comparable in both groups without a statistical difference. The study provides an overview of the prevalence of coreceptor tropism in a cohort of patients who were vertically infected with HIV-1. The high prevalence of X4/D-M-tropic strains may simply reflect the long-term exposure to HIV. [ABSTRACT FROM AUTHOR]
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- 2014
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15. Correction: Salvage Therapy or Simplification of Salvage Regimens with Dolutegravir plus Ritonavir-Boosted Darunavir Dual Therapy in Highly cART-Experienced Subjects: An Italian Cohort
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Capetti, Amedeo F, Sterrantino, Gaetana, Cossu, Maria V, Cenderello, Giovanni, Cattelan, Anna M, De Socio, Giuseppe V, Rusconi, Stefano, Riccardi, Niccolò, Baldin, Gian M, Cima, Serena, Niero, Fosca P, Rizzardini, Giuliano, and Sasset, Lolita
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- 2017
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16. Innate immunity cell activation in virologically suppressed HIV-infected maraviroc-treated patients
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Dentone, Chiara, Di Biagio, Antonio, Parodi, Alessia, Bozzano, Federica, Fraccaro, Paolo, Signori, Alessio, Cenderello, Giovanni, Mantia, Eugenio, Orofino, Giancarlo, De Maria, Andrea, Filaci, Gilberto, and Fenoglio, Daniela
- Abstract
This is a cross-sectional, case–control study analyzing the effect of antiretroviral therapy (ART) including or not maraviroc, on circulating monocytes and natural killer cells. Sixty-eight HIV-positive patients virologically suppressed receiving ART at least 6 months were subdivided as receiving (group 1) or not (group 2) maraviroc in their ART. Frequency of monocytes and natural killer cells, as well as their activation markers, were studied. Modulation of innate immune cells may be differently affected by combined ART.
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- 2014
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17. Five-Year Retrospective Italian Multicenter Study of Visceral Leishmaniasis Treatment
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Di Masi, Francesco, Ursini, Tamara, Iannece, Maria Donata, Chianura, Leonardo, Baldasso, Francesco, Foti, Giuseppe, Di Gregorio, Pietro, Casabianca, Angelo, Storaci, Nunzio, Nigro, Luciano, Colomba, Claudia, Marazzi, Maria Grazia, Todaro, Giovanni, Tordini, Giacinta, Zanelli, Giacomo, Cenderello, Giovanni, Acone, Nicola, Polilli, Ennio, Migliore, Simona, Almi, Paolo, Pizzigallo, Eligio, Sagnelli, Evangelista, Mazzotta, Francesco, Russo, Rosario, Manzoli, Lamberto, and Parruti, Giustino
- Abstract
ABSTRACTThe treatment of visceral leishmaniasis (VL) is poorly standardized in Italy in spite of the existing evidence. All consecutive patients with VL admitted at 15 Italian centers as inpatients or outpatients between January 2004 and December 2008 were retrospectively considered; outcome data at 1 year after treatment were obtained for all but 1 patient. Demographic characteristics, underlying diseases, diagnostic procedures, treatment regimens and outcomes, as well as side effects were recorded. A confirmed diagnosis of VL was reported for 166 patients: 120 (72.3%) immunocompetent, 21 (12.6%) patients with immune deficiencies other than HIV infection, and 25 (15.1%) coinfected with HIV. Liposomal amphotericin B (L-AmB) was the drug almost universally used for treatment, administered to 153 (92.2%) patients. Thirty-seven different regimens, including L-AmB were used. The mean doses were 29.4 ± 7.9 mg/kg in immunocompetent patients, 32.9 ± 8.6 mg/kg in patients with non-HIV-related immunodeficiencies, and 40.8 ± 6.7 mg/kg in HIV-infected patients (P< 0.001). The mean numbers of infusion days were 7.8 ± 3.1 in immunocompetent patients, 9.6 ± 3.9 in non-HIV-immunodeficient patients, and 12.0 ± 3.4 in HIV-infected patients (P< 0.001). Mild and reversible adverse events were observed in 12.2% of cases. Responsive patients were 154 (93.3%). Successes were 98.4% among immunocompetent patients, 90.5% among non-HIV-immunodeficient patients, and 72.0% among HIV-infected patients. Among predictors of primary response to treatment, HIV infection and age held independent associations in the final multivariate models, whereas the doses and duration of L-AmB treatment were not significantly associated. Longer treatments and higher doses of L-AmB were not able to significantly modify treatment outcomes either in the immunocompetent or in the immunocompromised population.
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- 2013
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18. Comparison of the In Vivo Pharmacokinetics and In Vitro Dissolution of Branded Versus Generic Efavirenz Formulation in HIV-Infected Patients
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Gervasoni, Cristina, Baldelli, Sara, Cerea, Matteo, Cenderello, Giovanni, Bini, Teresa, Vimercati, Stefania, Iardino, Rosaria, Gazzaniga, Andrea, D'Arminio Monforte, Antonella, Clementi, Emilio, and Cattaneo, Dario
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- 2016
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19. Linezolid treatment of prosthetic hip infections due to methicillin-resistant Staphylococcus aureus (MRSA)
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Bassetti, Matteo, Di Biagio, Antonio, Cenderello, Giovanni, Del Bono, Valerio, Palermo, Augusto, Molfetta, Luigi, Pipino, Francesco, and Bassetti, Dante
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Abstract: Prosthetic joint infection is an infrequent but serious complication of total joint arthroplasty. Complete removal of all foreign material is essential, however when prosthesis removal is not possible or is contraindicated, suppressive antibiotic therapy with retention of the functioning hip arthroplasty may be considered. Linezolid, the first approved oxazolidinone, appears to be a promising new agent for the treatment of serious gram-positive infections. We report two cases of prosthetic hip infections with methicillin-resistant Staphylococcus aureus (MRSA) that were successfully treated with long courses of linezolid. This observation suggests that linezolid is a promising drug for the treatment of prosthetic joint infections due to MRSA or other gram-positive bacteria, particularly when other therapeutic approaches are not feasible or a long-term antibiotic therapy is required.
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- 2000
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20. From Liguria HIV Web to Liguria Infectious Diseases Network: How a Digital Platform Improved Doctors' Work and Patients' Care.
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Giannini, Barbara, Riccardi, Niccolò, Cenderello, Giovanni, Di Biagio, Antonio, Dentone, Chiara, and Giacomini, Mauro
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- 2018
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21. Does simplification to dolutegravir-based dual regimens impact on the CD4+/CD8+T-cell ratio?
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Capetti, Amedeo F., Orofino, GianCarlo, Paladini, Laura, Sterrantino, Gaetana, DiGiambenedetto, Simona, De Socio, Giuseppe V., Cenderello, Giovanni, Cossu, Maria V., and Rizzardini, Giuliano
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- 2018
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22. CD8+CD28−CD127loCD39+ regulatory T-cell expansion: A new possible pathogenic mechanism for HIV infection?
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Fenoglio, Daniela, Dentone, Chiara, Signori, Alessio, Di Biagio, Antonio, Parodi, Alessia, Kalli, Francesca, Nasi, Giorgia, Curto, Monica, Cenderello, Giovanni, De Leo, Pasqualina, Bartolacci, Valentina, Orofino, Giancarlo, Nicolini, Laura Ambra, Taramasso, Lucia, Fiorillo, Edoardo, Orrù, Valeria, Traverso, Paolo, Bruzzone, Bianca, Ivaldi, Federico, and Mantia, Eugenio
- Abstract
Background HIV-associated immunodeficiency is related to loss of CD4 + T cells. This mechanism does not explain certain manifestations of HIV disease, such as immunodeficiency events in patients with greater than 500 CD4 + T cells/μL. CD8 + CD28 − CD127 lo CD39 + T cells are regulatory T (Treg) lymphocytes that are highly concentrated within the tumor microenvironment and never analyzed in the circulation of HIV-infected patients. Objectives We sought to analyze the frequency of CD8 + CD28 − CD127 lo CD39 + Treg cells in the circulation of HIV-infected patients. Methods The frequency of circulating CD8 + CD28 − CD127 lo CD39 + Treg cells was analyzed and correlated with viral load and CD4 + T-cell counts/percentages in 93 HIV-1–infected patients subdivided as follows: naive (n = 63), elite controllers (n = 19), long-term nonprogressors (n = 7), and HIV-infected patients affected by tumor (n = 4). The same analyses were performed in HIV-negative patients with cancer (n = 53), hepatitis C virus–infected patients (n = 17), and healthy donors (n = 173). Results HIV-infected patients had increased circulating levels of functional CD8 + CD28 − CD127 lo CD39 + Treg cells. These cells showed antigen specificity against HIV proteins. Their frequency after antiretroviral therapy (ART) correlated with HIV viremia, CD4 + T-cell counts, and immune activation markers, suggesting their pathogenic involvement in AIDS- or non–AIDS-related complications. Their increase after initiation of ART heralded a lack of virologic or clinical response, and hence their monitoring is clinically relevant. Conclusion HIV infection induces remarkable expansion of CD8 + CD28 − CD127 lo CD39 + Treg cells, the frequency of which correlates with both clinical disease and signs of chronic immune cell activation. Monitoring their frequency in the circulation is a new marker of response to ART when effects on viremia and clinical response are not met. [ABSTRACT FROM AUTHOR]
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- 2018
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23. Unusual Presentation of Visceral Leishmaniasis in an HIV-Infected Patient.
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Cenderello, Giovanni, Pontali, Emanuele, Ruggeri, Corrado, Dusi, Andrea, and De Maria, Andrea
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The article presents a case study of a 55-year-old man who had HIV and was hospitalized because of persistent fever and leucopenia. It reports that during hospitalization splenomegaly and enlargement of lymph nodes were detected and his lymph node biopsy showed the presence of Leishmania species. It further informs that the patient was treated with liposomal amphotericin B drug and rapidly recovered.
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- 2014
- Full Text
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