86 results on '"Pomponio G"'
Search Results
2. EFFICACY OF IMATINIB IN STEROID-REFRACTORY CHRONIC GRAFT-VERSUS-HOST DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS: PH-AB248
- Author
-
Olivieri, J., Pomponio, G., Manfredi, L., Postacchini, L., Tedesco, S., Cimminiello, M., Saraceni, F., Leoni, P., Bacigalupo, A., and Olivieri, A.
- Published
- 2014
3. S.13.1 Safety and efficacy of rituximab in SSc: an analysis from the European Scleroderma Trial and Research Group
- Author
-
Fraticelli, P., Pomponio, G., Gabrielli, B., Riboldi, P., Ferraccioli, G., Valentini, G., Bombardieri, S., Malorni, W., Gerli, R., Lunardi, C., Faggioli, P., Corvetta, A., and Gabrielli, A.
- Published
- 2012
4. Re: Surgery in rheumatoid arthritis
- Author
-
Pomponio, G., Ghattas, L., and Mascella, F.
- Published
- 2006
5. Hand surgery in rheumatoid arthritis: state of the art and suggestions for research
- Author
-
Ghattas, L., Mascella, F., and Pomponio, G.
- Published
- 2005
6. Expression and production of the long pentraxin PTX3 in rheumatoid arthritis (RA)
- Author
-
LUCHETTI, M. M., PICCININI, G., MANTOVANI, A., PERI, G., MATTEUCCI, C., POMPONIO, G., FRATINI, M., FRATICELLI, P., SAMBO, P., DI LORETO, C., DONI, A., INTRONA, M., and GABRIELLI, A.
- Published
- 2000
7. Tocilizumab in COVID‐19 interstitial pneumonia.
- Author
-
Pomponio, G., Ferrarini, A., Bonifazi, M., Moretti, M., Salvi, A., Giacometti, A., Tavio, M., Titolo, G., Morbidoni, L., Frausini, G., Onesta, M., Amico, D., Rocchi, M. L. B., Menzo, S., Zuccatosta, L., Mei, F., Menditto, V., Svegliati, S., Donati, A., and D'Errico, M. M.
- Subjects
- *
PULMONARY fibrosis , *COVID-19 , *TOCILIZUMAB - Abstract
Background: Published reports on tocilizumab in COVID‐19 pneumonitis show conflicting results due to weak designs or heterogeneity in critical methodological issues. Methods: This open‐label trial, structured according to Simon's optimal design, aims to identify factors predicting which patients could benefit from anti‐IL6 strategies and to enhance the design of unequivocal and reliable future randomized trials. A total of 46 patients with COVID‐19 pneumonia needing of oxygen therapy to maintain SO2 > 93% and with recent worsening of lung function received a single infusion of tocilizumab. Clinical and biological markers were measured to test their predictive values. Primary end point was early and sustained clinical response. Results: Twenty‐one patients fulfilled pre‐defined response criteria. Lower levels of IL‐6 at 24 h after tocilizumab infusion (P = 0.049) and higher baseline values of PaO2/FiO2 (P = 0.008) predicted a favourable response. Conclusions: Objective clinical response rate overcame the pre‐defined threshold of 30%. Efficacy of tocilizumab to improve respiratory function in patients selected according to our inclusion criteria warrants investigations in randomized trials. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
8. S.13.1 Safety and efficacy of rituximab in SSc: an analysis from the European Scleroderma Trial and Research Group
- Author
-
Jordan, S., Distler, J., Maurer, B., Allanore, Y., Van Laar, J., Distler, O., Fraticelli, P., Pomponio, G., Gabrielli, B., Riboldi, P., Ferraccioli, G., Valentini, G., Bombardieri, S., Malorni, W., Gerli, R., Lunardi, C., Faggioli, P., Corvetta, A., Gabrielli, A., Ghassemi, P., Baron, M., Blati, M., Kapoor, M., Della Rossa, A., Casigliani, S., Doveri, M., D'Ascanio, A., Tavoni, A., and Bazzichi, L.
- Abstract
Objectives. Objective of this multicentre, observational study was to assess effects and safety of rituximab (RTX) using the European Scleroderma Trial and Research Group (EUSTAR) cohort. Methods. EUSTAR centres were asked to provide specific data about SSc patients treated with RTX. Primary endpoints were predefined for different disease manifestations and compared between baseline and follow-up. Normally distributed data, analysed by paired t-test, are shown as mean (s.d.), and non-parametric data, analysed by Wilcoxon matched paired signed-rank test, are shown as median and interquartile range. Results. Data on 72 SSc patients treated with RTX were captured from 27 EUSTAR centres (51 females/21 males, 52 diffuse/19 limited, age 51 (44-60) years, disease duration 6 (3-10) years, 47 anti-Scl-70 positive). The most frequent RTX application scheme was 1000 mg × 2 within 2 weeks (57/72 patients). Co-treatment with other immunosuppressive drugs was reported in 28 patients. The modified Rodnan skin score (mRSS) significantly decreased vs baseline at 7 (5-9) months follow-up (n = 47, 18.2 + 10.9 vs 14.5 + 9.9, P = 0.0002). This was true for both patients with later disease stages and also for patients with earlier, extended skin fibrosis (dSSc with mRSS >16 at baseline, n = 26; 26.5 + 6.8 vs 20.4 + 8.9, P < 0.0001, reduction by 29.9%). S-HAQ was unchanged, but the European SSc activity score improved after rituximab treatment [n = 10; 3.7 (2.6-6.4) vs 1.7 (0.9-2.5), P = 0.01]. RTX had no effects on lung fibrosis (FVC, DLCO, TLC, HRCT score) in n = 11 patients with evidence for SSc-ILD. In SSc-polyarthritis patients, the DAS-28 declined at 6 months follow-up without reaching statistical significance [n = 8; 4.8 (2.5-7.5) vs 3.7 (2.6-6.6); p = 0.3]. Of 8, 5patients were RF and/or anti-CCP antibody positive. Similar results were obtained for secondary outcome measures (tender and swollen joint count, VAS, CRP, ESR). Additional positive effects of RTX were seen on SSc-related myopathy (CK levels, 273 + 177 vs 184 + 139; n = 12, P = 0.03) and on digital ulcers [total number per patient 1 (1-3) vs 0 (0-1); n = 23; P = 0.0086]. During RTX treatment 14 patients had infections, 3 serum sickness, 2 allergic reactions and 1 lung fibrosis aggravation, 29 fatigue and 9 nausea. Four patients died, one possibly related to RTX treatment (pneumonia and cardiac failure 1.5 months after RTX infusion). Conclusion. This large EUSTAR cohort study points at positive effects of RTX in particular on skin fibrosis, and suggests randomized controlled trial in SSc patients
- Published
- 2017
9. Tocilizumab in the treatment of patients with rheumatoid arthritis in real clinical practice: results of an Italian observational study
- Author
-
Sarzi-Puttini, P., Bianchino, L., Francesca Benaglio, Tirri, R., Salaffi, F., Pomponio, G., Cerinic, M. Matucci, Govoni, M., Gerli, R., Ferraccioli, G., Bombardieri, S., Idolazzi, L., and Caporali, R.
- Subjects
Adult ,Male ,rheumatoid arthritis ,tocilizumab, rheumatoid arthritis, clinical practice ,Tumor Necrosis Factor-alpha ,TRUST study ,Middle Aged ,Antibodies, Monoclonal, Humanized ,Tocilizumab, rheumatoid arthritis, TRUST study ,Receptors, Interleukin-6 ,NO ,clinical practice ,Arthritis, Rheumatoid ,tocilizumab ,Antirheumatic Agents ,Humans ,Female ,Aged - Abstract
To describe the effectiveness and safety of tocilizumab (TCZ), an interleukin-6 receptor inhibitor, in a cohort of patients with rheumatoid arthritis (RA) recruited in clinical practice.TRUST was an observational study in RA patients who started treatment with TCZ in the 6 months prior to site activation and were still on treatment at start of study; patients were followed up to 12 months after the first TCZ infusion.322 RA patients were enrolled in 59 Italian centres (mean age: 55.8 years; mean disease duration: 120.5 months; baseline DAS28: 5.3). After 6 months of TCZ treatment, patients achieving low disease activity (DAS28 ≤3.2; 57.52%) or disease remission (DAS282.6; 38.05%) were 216 out of 226 patients with available DAS28 (p0.001). No statistically significant differences were found in mean DAS28 and HAQ score changes from baseline (start of TCZ treatment) to study end between patients previously inadequately responding to disease-modifyinganti-rheumatic drugs (DMARD-IR) or to DMARDs plus tumour necrosis factor inhibitors (DMARD +TNFi-IR): both patient populations responded to TCZ. A statistically significant decrease in mean VAS Fatigue score (48.4 vs. 34.7; p=0.0025) at month 6 was observed. In patients treated with TCZ as monotherapy (32.61%), DAS28, VAS fatigue and HAQ scores decreased from baseline to any post-baseline time point. Overall, 62 patients (19.3%) prematurely discontinued TCZ treatment, 24 (7.5%) for safety reasons. Drug-related adverse events occurred in 92 patients (28.6%) (mostly 3 hypercholesterolaemia and leucopenia) and drug-related serious adverse events in 11 patients (3.4%).This study confirms the good effectiveness and safety profile of TCZ in real life RA patient care.
- Published
- 2017
10. Tocilizumab in the treatment of patients with rheumatoid arthritis in real clinical practice: Results of an Italian observational study
- Author
-
Caporali, R., Idolazzi, L., Bombardieri, S., Ferraccioli, G., Gerli, R., Govoni, M., Matucci-Cerinic, M., Pomponio, G., Salaffi, F., Tirri, R., Benaglio, F., Bianchino, L., Sarzi-Puttini, P., Adami, S., Afeltra, A., Altomonte, L., Arrigoni, E., Bagnato, G., Bianchi, G., Bucci, R. N., Caminiti, M., Cantini, F., Caputo, D., Carlino, G., Clerico, P., Colombelli, P., Corsaro, S. M., D Alessandro, G., Riso, L., Silva, S., D Errico, T., Di Matteo, L., Ferri, C., Foti, R., Fusaro, E., Gabrielli, A., Giacomelli, R., Lunardi, C., Malavolta, N., Martin Martin, L. S., Massarotti, M. S., Mazzone, A., Meschini, C., Migliore, A., Minisola, G., Monti, G., Muratore, M., Paoletti, F., Pappone, N., Passiu, G., Mario Pirisi, Pistone, G., Pozzi, M. R., Prandini, P., Provenzano, G., Ricioppo, A., Romeo, N., Russo, R., Saviola, G., Semeraro, A., Tartarelli, G., Tomietto, P., Valentini, G., Zuccaro, C., Caporali, Roberto, Idolazzi, Luca, Bombardieri, Stefano, Ferraccioli, Gianfranco, Gerli, Roberto, Govoni, Marcello, Matucci-Cerinic, Marco, Pomponio, Giovanni, Salaffi, Fausto, Tirri, Rosella, Benaglio, Francesca, Bianchino, Laura, Sarzi-Puttini, Piercarlo, Caporali, R., Adami, S., Afeltra, A., Altomonte, L., Arrigoni, E., Bagnato, G., Bianchi, G., Bombardieri, S., Bucci, R. N., Caminiti, M., Cantini, F., Caputo, D., Carlino, G., Clerico, P., Colombelli, P., Corsaro, S. M., D'Alessandro, G., De Riso, L., De Silva, S., D'Errico, T., Di Matteo, L., Ferraccioli, G., Ferri, C., Foti, R., Fusaro, E., Gabrielli, A., Gerli, R., Giacomelli, R., Govoni, M., Lunardi, C., Malavolta, N., Martin Martin, L. S., Massarotti, M. S., Matucci-Cerinic, M., Mazzone, A., Meschini, C., Migliore, A., Minisola, G., Monti, G., Muratore, M., Paoletti, F., Pappone, N., Passiu, G., Pirisi, M., Pistone, G., Pozzi, M. R., Prandini, P., Provenzano, G., Ricioppo, A., Romeo, N., Russo, R., Salaffi, F., Sarzi-Puttini, P., Saviola, G., Semeraro, A., Tartarelli, G., Tomietto, P., Valentini, G., and Zuccaro, C.
- Subjects
Rheumatology ,Interleukin-6 ,Immunology ,Immunology and Allergy ,Tocilizumab ,Monotherapy ,Rheumatoid arthriti - Abstract
Objective To describe the effectiveness and safety of tocilizumab (TCZ), an interleukin-6 receptor inhibitor, in a cohort of patients with rheumatoid arthritis (RA) recruited in clinical practice. Methods TRUST was an observational study in RA patients who started treatment with TCZ in the 6 months prior to site activation and were still on treatment at start of study; patients were followed up to 12 months after the first TCZ infusion. Results 322 RA patients were enrolled in 59 Italian centres (mean age: 55.8 years; mean disease duration: 120.5 months; baseline DAS28: 5.3). After 6 months of TCZ treatment, patients achieving low disease activity (DAS28 ≤3.2; 57.52%) or disease remission (DAS28 < 2.6; 38.05%) were 216 out of 226 patients with available DAS28 (p < 0.001). No statistically significant differences were found in mean DAS28 and HAQ score changes from baseline (start of TCZ treatment) to study end between patients previously inadequately responding to disease-modifyinganti-rheumatic drugs (DMARD-IR) or to DMARDs plus tumour necrosis factor inhibitors (DMARD +TNFi-IR): both patient populations responded to TCZ. A statistically significant decrease in mean VAS Fatigue score (48.4 vs. 34.7; p=0.0025) at month 6 was observed. In patients treated with TCZ as monotherapy (32.61%), DAS28, VAS fatigue and HAQ scores decreased from baseline to any post-baseline time point. Overall, 62 patients (19.3%) prematurely discontinued TCZ treatment, 24 (7.5%) for safety reasons. Drug-related adverse events occurred in 92 patients (28.6%) (mostly 3 hypercholesterolaemia and leucopenia) and drug-related serious adverse events in 11 patients (3.4%). Conclusion This study confirms the good effectiveness and safety profile of TCZ in real life RA patient care.
- Published
- 2017
11. Psychometric properties of an index of three patient reportedoutcome (PRO) measures, termed the CLinical ARthritis Activity (PRO-CLARA) inpatients with rheumatoid arthritis. The NEW INDICES study
- Author
-
Salaffi F, Migliore A, Scarpellini M, Corsaro SM, Laganà B, Mozzani F, Varcasia G, Pusceddu M, Pomponio G, Romeo N, Maier A, Foti R, Gasparini S, Bombardieri S., SCARPA, RAFFAELE, Salaffi, F, Migliore, A, Scarpellini, M, Corsaro, Sm, Laganà, B, Mozzani, F, Varcasia, G, Pusceddu, M, Pomponio, G, Romeo, N, Maier, A, Foti, R, Scarpa, Raffaele, Gasparini, S, and Bombardieri, S.
- Subjects
Psychometric properties ,rheumatoid arthriti ,CLinical ARthritis Activity - Published
- 2010
12. Terminal Complement Complex C 5b-9: Role in the early diagnosis of infection in critically ill patients
- Author
-
Donati, A., Cola, L., Danieli, R., Achilli, D., Kalagy, E., Pomponio, G., Fratini, M., Gabrielli, A., and Pietropaoli, P.
- Published
- 1996
- Full Text
- View/download PDF
13. DUO Registry Group. Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry
- Author
-
Guillevin, L, Hunsche, E, Denton, Cp, Krieg, T, Schwierin, B, Rosenberg, D, Matucci Cerinic, M, DUO Registry Group Collaborators Raffier, B, Hirschi, M, Trautinger, F, Schmidt, P, Stetter, M, Hundstorfer, M, Reinhart, V, Monshi, B, Pirkhammer, D, Richter, L, Hamberger, N, Metz, S, Feldmann, R, Semmelweis, K, Lackner, K, Tomi, N, Kolle, H, Hafner, F, Brodmann, M, Kuen Spiegel, M, Minmair, G, Heil, Pm, Broil, H, Holzer, G, Illmer, X, Rintelen, B, Sautner, J, Takacs, M, Thun, M, Zemanova, I, Soukup, T, Smrzova, A, Bohmova, J, Prochazkova, L, Nemec, P, Fojtik, Z, Suchy, D, Becvar, R, Olsen, Ab, Sondergaard, Kh, Luosu jarvi, R, Vidqvist, Kl, Madaule, S, Beneton, N, Maillard, H, Charlanne, H, Granelbrocard, F, Hachulla, E, Hatron, Py, Jourdain, N, Lambert, M, Launay, D, Morell, S, Woijtasik, G, Skowron, F, Zenone, T, Dadban, A, Lok, C, Ferrandiz, D, Magybertrand, N, Moiton, Mp, Taieb, A, Balquiere, S, Belin, E, Droitcourt, C, Julien, S, Prey, S, Boulon, C, Constans, J, Doutre, Ms, Kostrzwewa, E, Richez, C, Greco, M, Misery, L, Sassolas, B, Collet, E, Berthier, S, Leguy Seguin, V, Imbert, B, Carpentier, P, Blaise, S, Couraud, A, Doeffel Hantz, V, Spars, A, Bezanahary, H, Boussely, N, Dumonteil, S, Fauchais, Al, Goudran, G, Loustaud Ratti, V, Manea, P, Vidal, E, Coppere, B, Desmursclavel, H, Girard Madoux MH, Hot, A, Ninet, J, Granel, B, Cohen, Jd, Keynote, A, Khau van Kien, A, Le Quellec, A, Riviere, S, Rullier, P, Bessis, D, Farcas, C, Bravetti, V, Moline, T, Wahl, D, Zuily, S, Granel Brocard, F, Agard, C, Durant, C, Fuzibet, Jg, Queyrel, V, Berezne, A, Mouthon, L, Cabane, J, Tiev, K, Toledano, C, Lazareth, I, Michon Pasturel, U, Priollet, P, Reguiai, Z, Cazaletslacoste, C, Jego, P, Letremy, A, Perlat, A, Duval Modeste AB, Chatelus, E, Chiffot, H, Sibillia, J, Sordet, C, Adoue, D, Couret, B, Moulis, G, Pugnet, G, Sailler, L, Diot, E, Gaches, F, Farge, D, Keshtmand, H, Frances, C, von Elling, A, Bora, D, Ebel, J, Ahmadi Simab, K, Klein, E, Hahn, K, Schulze, K, Rasche, C, Riemekasten, G, Lee, Hh, Deuschle, K, Mattat, K, Becker, M, Worm, M, Mensing, C, Klings, D, Mensing, H, Messall, J, Zuper, R, Eilbacher, P, Saar, P, Kaufmann, P, Hallermann, C, Schmidt, K, Wahn, H, Schildt, K, Schuart, T, Kaczmarczyk, A, Kellner, C, von Oelhafen, J, Baron von Bildering, P, Kunze, S, Kleiner, Hj, Alsheimer, B, Schuetz, N, Miirker Hermann, E, Gottl, Kh, Weiss, E, Reischel, N, Kern, S, Goettl, Kh, Goetheuniversitiitsklinikum, Jw, Himsel, A, Henkemeier, U, Schwarting, A, Hazenbiller, A, Nichelmann, V, Rumbaur, C, Boesenberg, I, Schmeiser, T, Mueller Ladner, U, Unholzer, A, Starz, H, Welzel, J, Plaumann, K, Stoeckl, F, Sperling, S, Podda, M, Wagner, N, Rapprich, H, Niedermeier, A, Messer, G, Sardy, M, Bekou, V, Dill MUller, D, Wlodarz, M, Belloni, B, Huettig, B, Ziai, M, Hein, R, Kneitz, C, Federow, I, Schneider, K, Semmler, M, Hapke, S, Metzler, C, Stein, T, Enderlein, M, Kayser, M, Werthmann, M, Guenther, Cu, Neul, S, Hellmich, B, Loeffler, C, Pflugfelder, J, Karaenke, P, Mueglich, C, Tony, Hp, Marina, P, Popp, M, Mittag, M, Baumann, C, Scheib, Eg, Brand, H, Wilhelm, Hu, Bohm, J, Dyballa, J, Boehm, J, Taggeselle, J, Luthke, K, Wuerzburg, I, Niefanger, K, Mayer, L, Drabek, J, Harmuth, W, Dietl, S, Moritz, D, Gause, A, Gaubitz, M, Hallecker, A, Krupp, E, Rumpel, H, Moosig, F, Frey, P, Kahl, S, Linke, M, Merk, B, Bloching, Hh, Ochs, W, Kurthen, R, Eiden, E, Guertler, I, Aries, Pm, Kirchberg, S, Jahnke, K, Mettler, S, Toeller, S, Zwenger, S, Langer, He, Deininger, F, Hartmann, F, Neeck, G, Neek, G, Wernitzsch, H, Meier, L, Herr, U, Meier, U, Aaig, W, Bruckner, L, Sheikh, N, Wollenhaupt, J, Krog, B, Wollersdorfer, E, Hall, R, Diehm, C, Tiggers, C, Peters, J, Kirschke, J, Schroeder, Jo, Zeuner, R, Uhlig, S, Barth, S, Huegel, R, Glaeser, R, Schaefer, C, Monshausen, M, Mengden, T, Funkert, A, Blank, N, Lupaschko, S, Voss, B, Megahed, M, Sadeghlar, F, Seidel, M, Wasmuth, Jc, Kreuter, A, Vosswinkel, J, Pfoehler, C, Gerber, A, Haust, M, Hoff, Np, Mota, R, Akanay Diesel, S, Homey, B, Katzemich, A, Erfurt Berge, C, Sticherling, M, Beyer, C, Distler, J, Mitchell, A, Freundlieb, C, Rushentsova, U, Hermanns, G, Blaschke, S, Fiene, M, Wessel, C, Norgauer, J, Rabe, B, Schuster, J, Scholz, J, Kremer, K, Robakidze Torbahn, M, Moinzadeh, P, Dohse, A, Muhlack, A, Schultz, L, Schult, S, Frambach, Y, Kruse, S, Kettenbach, A, Fell, I, Schweda, K, Steinbrink, K, Podobinska, M, Fieri beck, G, Schanz, S, Pfeiffer, C, Hassel, R, Herrgott, I, Sunderkoetter, C, Guenzel, J, Athanassiou, P, Dimitroulas, T, Settas, L, Kritikos, I, Tsifetaki, N, Garyfallos, A, Vasilopoulos, D, Boura, P, Kamali, S, Aslanidis, S, Vlachoyannopoulos, P, Galanopoulo, V, Sakkas, L, Koutroubas, A, Elezoglou, T, Galanopoulos, N, Grier, A, Murray, M, O'Rourke, M, Del Papa, N, Maglione, W, Zeni, S, Foti, R, Benenati, A, De Vita, S, Ferraccioli, G, Grassi, W, de Angeli, R, Pomponio, G, Mussi, A, Colonna, L, Airo, P, Zingarelli, S, Scorza, R, Serverino, A, Puppo, F, Negrini, S, Roma, I, Salsano, F, Triolo, G, Mazzuca, S, Carignola, R, Gatti, S, Lunardi, G, Riccieri, V, Salvarani, C, Bajocchi, G, Varcasia, G, Marasini, B, Belloll, L, de Luca, R, Stisi, S, Bellissimo, S, Fusaro, E, Pellerito, R, Cozzi, F, Rizzo, M, Bartoluzzi, A, Trotta, F, Cantatore, F, Corrado, A, Ferri, Claudio, Colaci, M, Malavolta, N, Mule, R, Galeazzi, M, Lapadula, G, Mathieu, A, Vacca, A, Giacomelli, Roberto, Cipriani, Paola, Montecucco, Cm, Codullo, V, Bucci, R, Battaglia, E, Valentini, G, Cuomo, G, Terlizzi, N, Serafino, L, Reumatologia, Uo, Bombardieri, S, Della Rossa, A, Doveri, M, Perricone, R, de Mattia, M, Pallotta, S, Groenendael, Jh, Seys, P, Goekoop, Rj, Han, Kh, Wlarvens, M, Bonte Mineur, F, de Bois MH, de Beus WM, van Zeben, D, Vonk, M, Knaapen, Hk, Smit, A, Bootsma, H, Ton, E, Voskuyl, A, Dutmer, Ea, Stalk, Jn, Madland, Tm, Seip, M, Hoffmann Vold AM, Bitter, H, Stocklund Thomsen, R, Resende, C, Ponte, C, Martinho, S, Silva, F, Ferreira, P, Grilo, A, Riso, N, Santos, C, Camara, I, Costa, J, Alves, J, Oliveira, S, Almeida, I, Silva, I, Cordeiro, A, Coelho, P, Lukac, J, Dolnicar, As, Espinosa, G, Mejia, Jc, Ramos, M, Plasin Rodriguez MA, Mera, A, Blanco, Js, Diaz, Jj, Losada, L, Perez, E, Maneiro, Jr, Caamano, M, Fermindez, S, Insua, Sa, Barbado, J, Fonseca, Em, Nufio, Fj, Castellvi, I, Garcia de Ia Pena, P, Bellido, D, Paulino, M, Garcia, Pv, Salas, V, Minguez, Md, Sanchez, Ma, Urrego, C, Martin, I, Rueda, A, Calvo, J, Ripoll, Mm, Torres, Mc, Corteguera, M, Maceiras, F, Cruz, J, Mosquera, Ja, Gomez, R, Area, B, Carrio, I, Rubio, M, Castellvi Barranco, I, Santos, P, Simeon, Cp, Fonollosa, V, Egurbide, Mv, Garcia de Vicuna, R, Vicente, E, Villaverde, V, Fernandez, C, Garcia, E, Uson, J, Miguelez, R, Callejas, Jl, Ortego, N, Roman, J, Alegre Sancho JJ, Robles, A, Rios, Jj, Bonilla, Mg, Sanchez Andrade, A, Vazquez, Tr, Miranda, Ja, Saez, L, Zea, A, De la Puente, C, Martinez, Fg, Aguirre, Ma, Collado, P, Cruz, A, Crespo, M, Sanchez Roman, J, Castillo, Mj, Garcia, Am, Muniz, G, Hedin, Pj, Stahl, C, Bracin, T, Nordin, A, Albertsson, K, Rydvald, Y, Thorsson, C, Hermansson, E, Maurer, B, Verner, D, Schmidt Bosshard, R, Hall, F, Murphy, K, Lamb, J, Anderson, M, Moots, R, Buch, M, Bissell, L, Madhok, R, Hampson, R, D'Cruz, D, Choong, Lm, Gordon, P, Dobson, J, Salerno, R, Nisar, M, Williams, C, Wilcox, L, Denton, C, Ochiel, R, Ngcozana, T, Parker, L, Vincent, R, Mchugh, N, Cole, S, Brown, S, James, J, Herrick, A, Manning, J, Moore, T, Faizal, A, Skyes, H, Smythe, A, and Hamilton, A.
- Published
- 2013
14. Low-Dose Imatinib in the Treatment of Scleroderma Pulmonary Involvement: Results of a Phase II Pilot Study
- Author
-
Fraticelli, P., Pomponio, G., Gabrielli, B., Riboldi, P., Ferraccioli, G., Giacomelli, Roberto, Del Papa, N., Bombardieri, S., Malorni, W., Gerli, R., Lunardi, C., Faggioli, P., Corvetta, A., Valentini, G., and Gabrielli, A.
- Published
- 2013
15. Psychometric properties of an index of three patient reported outcome (PRO) measures, termed the CLinical ARthritis Activity (PRO-CLARA) in patients with rheumatoid arthritis. The NEW INDICES study
- Author
-
Salaffi, F, Migliore, A, Scarpellini, M, Corsaro, Sm, Laganà, B, Mozzani, F, Varcasia, G, Pusceddu, M, Pomponio, G, Romeo, N, Maier, A, Foti, R, Scarpa, R, Gasparini, S, and Bombardieri, Stefano
- Published
- 2010
16. Recommendations for the management of biofilm: a consensus document.
- Author
-
Bianchi, T., Wolcott, R. D., Peghetti, A., Leaper, D., Cutting, K., Polignano, R., Rita, Z. Rosa, Moscatelli, A., Greco, A., Romanelli, M., Pancani, S., Bellingeri, A., Ruggeri, V., Postacchini, L., Tedesco, S., Manfredi, L., Camerlingo, Maria, Rowan, S., Gabrielli, A., and Pomponio, G.
- Subjects
WOUND infections ,WOUND care ,BIOFILMS ,CINAHL database ,CONSENSUS (Social sciences) ,EXPERTISE ,INFORMATION storage & retrieval systems ,MEDICAL databases ,MEDICAL information storage & retrieval systems ,MEDICAL personnel ,MEDICAL protocols ,MEDLINE ,ONLINE information services ,RESEARCH funding ,SYSTEMATIC reviews ,DECISION making in clinical medicine ,PREVENTION ,SOCIETIES - Abstract
The potential impact of biofilm on healing in acute and chronic wounds is one of the most controversial current issues in wound care. A significant amount of laboratory-based research has been carried out on this topic, however, in 2013 the European Wound Management Association (EWMA) pointed out the lack of guidance for managing biofilms in clinical practice and solicited the need for guidelines and further clinical research. In response to this challenge, the Italian Nursing Wound Healing Society (AISLeC) initiated a project which aimed to achieve consensus among a multidisciplinary and multiprofessional international panel of experts to identify what could be considered part of 'good clinical practice' with respect to the recognition and management of biofilms in acute and chronic wounds. The group followed a systematic approach, developed by the GRADE working group, to define relevant questions and clinical recommendations raised in clinical practice. An independent librarian retrieved and screened approximately 2000 pertinent published papers to produce tables of levels of evidence. After a smaller focus group had a multistep structured discussion, and a formal voting process had been completed, ten therapeutic interventions were identified as being strongly recommendable for clinical practice, while another four recommendations were graded as being 'weak'. The panel subsequently formulated a preliminary statement (although with a weak grade of agreement): 'provided that other causes that prevent optimal wound healing have been ruled out, chronic wounds are chronically infected'. All members of the panel agreed that there is a paucity of reliable, well-conducted clinical trials which have produced clear evidence related to the effects of biofilm presence. In the meantime it was agreed that expert-based guidelines were needed to be developed for the recognition and management of biofilms in wounds and for the best design of future clinical trials. This is a fundamental and urgent task for both laboratory-based scientists and clinicians Declaration of interest: David Leaper was a paid lecturer/consultant advisor within the last two years for Johnson and Johnson, CareFusion and Pfizer. Andrea Bellingeri, consultant advisor in the last two years for Coloplast, Angelini. Keith Cutting: has received honoraria as a member of speakers bureaus and advisory boards and received travel and accommodation expenses from a number of wound products companies. All the other authors have no conflict of interest to declare. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
17. Abstract-to-publication ratio for papers presented at Italian emergency medicine meeting: A retrospective study
- Author
-
Menditto, V.G., Tedesco, S., Barbadoro, P., Pomponio, G., and Gabrielli, A.
- Published
- 2013
- Full Text
- View/download PDF
18. Improving quality is not simple: Results of a clinical audit project about patients with Community-Acquired Pneumonia (CAP)
- Author
-
Tedesco, S., Marcosignori, M., Postacchini, L., Manfredi, L., Pomponio, G., and Gabrielli, A.
- Published
- 2013
- Full Text
- View/download PDF
19. A management of blunt thoracic trauma in an emergency department observation unit: pre-post observational study.
- Author
-
Menditto VG, Gabrielli B, Marcosignori M, Screpante F, Pupita G, Polonara S, Salvi A, Raggetti GM, and Pomponio G
- Published
- 2012
- Full Text
- View/download PDF
20. Consolidation therapy for adult acute myeloid leukemia: A systematic analysis according to evidence based medicine.
- Author
-
Visani, G., Olivieri, A., Malagola, M., Brunori, M., Piccaluga, P. P., Capelli, D., Pomponio, G., Martinelli, G., Isidori, A., Sparaventi, G., and Leoni, P.
- Subjects
ACUTE myeloid leukemia ,EVIDENCE-based medicine ,STEM cell transplantation ,ACUTE leukemia ,MYELOID leukemia ,CELL transplantation - Abstract
Post-remission therapy in acute myeloid leukemia (AML) remains problematic. It has been demonstrated that younger patients can maintain longer complete remissions (CR) with aggressive post-remission therapies after induction treatment: allogeneic (allo), autologous (auto) stem cell transplantation (SCT), or intensive chemotherapy (ICC). The purpose of our study was to identify the most important randomized and controlled studies comparing these three therapeutic options, in order to draw conclusions and possible suggestions for post-remission therapy of AML, according to the evidence based medicine (EBM) rules. We performed an exhaustive analysis of the literature, searching either in electronic databases or among the references of the identified articles (hand searching). We searched the MEDLINE computer database for reports from 1985 through January 2005 and selected for analysis the clinical trials conducted over adults affected by newly diagnosed AML aged less than 65 years. The study design had to satisfy strict methodological criteria and must consider global mortality and/or disease free survival as primary outcomes. Overall we found 7750 papers; by using the limits “clinical trial” as publication type, “all adults 19+ years”, we were able to select 344 papers. Among these, a further selection was made, based on two main clinical queries: 1) is auto-SCT superior to ICC/no other therapy in improving DFS and/or OS in adult AML patients in first CR? 2) is allo-SCT superior to auto-SCT/other therapeutic options in improving DFS and/or OS in adult AML patients in first CR? Concerning the first query, a possible advantage of auto-SCT over ICC was not clearly supported by data from clinical trials; there is no evidence that auto-SCT is superior in terms of OS to chemotherapy. Nevertheless, the reported TRM has been significantly reduced within the past years. Thus, the percentage of patients suitable for auto-SCT in CR has increased. Moreover, the scarce data concerning the comparison between auto-SCT and chemotherapy in different subsets of patients are unable to suggest a differentiated approach in patients with high-risk, standard-risk or low-risk AML. Data from the literature show that patients with unfavorable risk disease are more often addressed to allo-SCT and patients with low-risk disease receive more often intensive consolidation chemotherapy. Concerning the second query, interpretation of data from the main prospective studies about the role of allo-SCT in previously untreated AML is not easy. The first problem is the lack of real randomized clinical trials; in fact, according to the reported studies, AML patients generally receive allo-SCT on the basis of donor availability (the so called “genetic randomization”). The second problem is the frequent absence of intention to treat analysis. Despite methodological limitations, it was possible to compare allo-SCT with auto-SCT on a donor versus no-donor analysis and within risk groups. No overall benefit of allo-grafting on survival was demonstrated by any trial. In conclusion, the EBM approach highlighted the limitations observed in the published studies concerning consolidation therapy in AML; some suggestions, emerging from non-randomized, as well as randomized studies, are adequate, but not conclusive. This point, coupled with the intrinsic complexity to study AML biological heterogeneity, is probably a major obstacle to draw conclusive evidences for consolidation therapy in AML. These observations should plan to address new randomized studies on AML therapy; however, due to the emergence of genetic subgroups and new drugs targeting specific abnormalities, these trials should probably be designed directly focusing on the single entities. In this way, the cure of AML could eventually become the cure of each specific AML subset with its peculiar biological, molecular and prognostic features. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
21. P.1.229: EVALUATION OF SOME COLONOSCOPY QUALITY INDICATORS IN THREE ITALIAN SECONDARY LEVEL ENDOSCOPIC UNITS: PRELIMINARY RESULTS FROM A CLINICAL AUDIT
- Author
-
Marcosignori, M., Lorenzini, I., Mosca, P., Tomarelli, L.M., Benedetti, A., Gabrielli, B., and Pomponio, G.
- Published
- 2011
- Full Text
- View/download PDF
22. Therapeutic approach with IVIG in patients affected by connective tissue disease
- Author
-
Corvetta, A., Luchetti, M.M., Pomponio, G., Rinaldi, N., and Spaeth, P.J.
- Published
- 1992
- Full Text
- View/download PDF
23. Circulating miR-320b and miR-483-5p levels are associated with COVID-19 in-hospital mortality
- Author
-
Angelica Giuliani, Giulia Matacchione, Deborah Ramini, Mirko Di Rosa, Anna Rita Bonfigli, Jacopo Sabbatinelli, Vladia Monsurrò, Rina Recchioni, Fiorella Marcheselli, Francesca Marchegiani, Francesco Piacenza, Maurizio Cardelli, Roberta Galeazzi, Giovanni Pomponio, Alessia Ferrarini, Armando Gabrielli, Silvia Svegliati Baroni, Marco Moretti, Riccardo Sarzani, Piero Giordano, Antonio Cherubini, Andrea Corsonello, Roberto Antonicelli, Antonio Domenico Procopio, Manuela Ferracin, Massimiliano Bonafè, Fabrizia Lattanzio, Fabiola Olivieri, Giuliani A., Matacchione G., Ramini D., Di Rosa M., Bonfigli A.R., Sabbatinelli J., Monsurro V., Recchioni R., Marcheselli F., Marchegiani F., Piacenza F., Cardelli M., Galeazzi R., Pomponio G., Ferrarini A., Gabrielli A., Svegliati Baroni S., Moretti M., Sarzani R., Giordano P., Cherubini A., Corsonello A., Antonicelli R., Procopio A.D., Ferracin M., Bonafe M., Lattanzio F., and Olivieri F.
- Subjects
Male ,Aging ,Time Factors ,Risk Assessment ,Article ,Predictive Value of Tests ,Risk Factors ,80 and over ,Humans ,Circulating MicroRNA ,Hospital Mortality ,RNA-Seq ,Aged ,Aged, 80 and over ,COVID-19 ,MiR-320b ,MicroRNA ,Prognosis ,Up-Regulation ,Hospitalization ,MicroRNAs ,In-hospital mortality ,Female ,MiR-483-5p ,Biomarkers ,Developmental Biology - Abstract
The stratification of mortality risk in COVID-19 patients remains extremely challenging for physicians, especially in older patients. Innovative minimally invasive molecular biomarkers are needed to improve the prediction of mortality risk and better customize patient management. In this study, aimed at identifying circulating miRNAs associated with the risk of COVID-19 in-hospital mortality, we analyzed serum samples of 12 COVID-19 patients by small RNA-seq and validated the findings in an independent cohort of 116 COVID-19 patients by qRT-PCR. Thirty-four significantly deregulated miRNAs, 25 downregulated and 9 upregulated in deceased COVID-19 patients compared to survivors, were identified in the discovery cohort. Based on the highest fold-changes and on the highest expression levels, 5 of these 34 miRNAs were selected for the analysis in the validation cohort. MiR-320b and miR-483-5p were confirmed to be significantly hyper-expressed in deceased patients compared to survived ones. Kaplan-Meier and Cox regression models, adjusted for relevant confounders, confirmed that patients with the 20% highest miR-320b and miR-483-5p serum levels had three-fold increased risk to die during in-hospital stay for COVID-19. In conclusion, high levels of circulating miR-320b and miR-483-5p can be useful as minimally invasive biomarkers to stratify older COVID-19 patients with an increased risk of in-hospital mortality.
- Published
- 2022
24. Decreased serum levels of the inflammaging marker miR-146a are associated with clinical non-response to tocilizumab in COVID-19 patients
- Author
-
Marco Moretti, Silvia Baroni, Giovanni Pomponio, Antonio Domenico Procopio, Giulia Matacchione, Fabiola Olivieri, Manuela Ferracin, Marianna Pavani, Massimiliano Bonafè, Noemi Laprovitera, Angelica Giuliani, Alessia Ferrarini, Jacopo Sabbatinelli, Silvia Latini, Armando Gabrielli, Sabbatinelli J., Giuliani A., Matacchione G., Latini S., Laprovitera N., Pomponio G., Ferrarini A., Svegliati Baroni S., Pavani M., Moretti M., Gabrielli A., Procopio A.D., Ferracin M., Bonafè M., and Olivieri F.
- Subjects
0301 basic medicine ,Male ,Aging ,chemistry.chemical_compound ,0302 clinical medicine ,Global health ,Medicine ,media_common ,biology ,microRNA ,Tocilizumab ,Middle Aged ,Biomarker (medicine) ,Female ,medicine.symptom ,Human ,Drug ,Adult ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,media_common.quotation_subject ,Inflammation ,Antibodies, Monoclonal, Humanized ,Article ,03 medical and health sciences ,Internal medicine ,Humans ,Circulating MicroRNA ,Interleukin 6 ,Pandemics ,Aged ,Pandemic ,business.industry ,SARS-CoV-2 ,interleukin-6 ,COVID-19 ,Biomarker ,Inflammaging ,COVID-19 Drug Treatment ,Clinical trial ,MicroRNAs ,Ageing ,030104 developmental biology ,chemistry ,biology.protein ,business ,030217 neurology & neurosurgery ,Biomarkers ,Developmental Biology - Abstract
Highlights • Tocilizumab (TCZ) is currently being tested in COVID‐19‐induced cytokine storm. • COVID-19 patients responding to TCZ have higher post-treatment levels of circulating miR-146a. • Low levels of miR-146a are associated with death in COVID-19 patients not responding to TCZ. • MicroRNAs can represent biomarkers of response to anti-inflammatory interventions in COVID-19., Current COVID-19 pandemic poses an unprecedented threat to global health and healthcare systems. The most amount of the death toll is accounted by old people affected by age-related diseases that develop a hyper-inflammatory syndrome. In this regard, we hypothesized that COVID-19 severity may be linked to inflammaging. Here, we examined 30 serum samples from patients enrolled in the clinical trial NCT04315480 assessing the clinical response to a single-dose intravenous infusion of the anti-IL-6 receptor drug Tocilizumab (TCZ) in COVID-19 patients with multifocal interstitial pneumonia. In these serum samples, as well as in 29 age- and gender-matched healthy control subjects, we assessed a set of microRNAs that regulate inflammaging, i.e. miR-146a-5p, miR-21-5p, and miR-126-3p, which were quantified by RT-PCR and Droplet Digital PCR. We showed that COVID-19 patients who did not respond to TCZ have lower serum levels of miR-146a-5p after the treatment (p = 0.007). Among non-responders, those with the lowest serum levels of miR-146a-5p experienced the most adverse outcome (p = 0.008). Our data show that a blood-based biomarker, such as miR-146a-5p, can provide clues about the molecular link between inflammaging and COVID-19 clinical course, thus allowing to better understand the use of biologic drug armory against this worldwide health threat.
- Published
- 2021
- Full Text
- View/download PDF
25. Increased prevalence of small airways dysfunction in patients with systemic sclerosis as determined by impulse oscillometry
- Author
-
Stefano Gasparini, Carlo La Vecchia, Armando Gabrielli, Paolo Fraticelli, Massimo Mattioli, Venerino Poletti, Eva Negri, Valeria Seletti, Nicola Sverzellati, Luca Paolini, Matteo Bonini, Matteo Franchi, Irene Tramacere, Martina Bonifazi, Giovanni Pomponio, Bonifazi, M, Sverzellati, N, Negri, E, Pomponio, G, Seletti, V, Bonini, M, Fraticelli, P, Paolini, L, Mattioli, M, Franchi, M, Tramacere, I, Poletti, V, La Vecchia, C, Gasparini, S, Gabrielli, A, Bonifazi, Martina, Sverzellati, Nicola, Negri, Eva, Pomponio, Giovanni, Seletti, Valeria, Bonini, Matteo, Fraticelli, Paolo, Paolini, Luca, Mattioli, Massimo, Franchi, Matteo, Tramacere, Irene, Poletti, Venerino, La Vecchia, Carlo, Gasparini, Stefano, and Gabrielli, Armando
- Subjects
Adult ,Male ,medicine.medical_specialty ,Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO ,Systemic scleroderma ,03 medical and health sciences ,respiratory-related quality of life ,0302 clinical medicine ,Rheumatology ,Quality of life ,Internal medicine ,Oscillometry ,medicine ,Prevalence ,Humans ,interstitial lung diseases ,Pharmacology (medical) ,scleroderma ,small airway dysfunction ,Respiratory system ,impulse oscillometry ,Lung ,Aged ,030203 arthritis & rheumatology ,interstitial lung disease ,Scleroderma, Systemic ,business.industry ,Middle Aged ,medicine.disease ,Impulse Oscillometry ,medicine.anatomical_structure ,030228 respiratory system ,Case-Control Studies ,Cohort ,Cardiology ,Quality of Life ,Female ,business ,Airway ,Lung Diseases, Interstitial - Abstract
Objectives The prevalence and clinical implications of small airways involvement in SSc are still to be fully elucidated. The goal of the present work is to assess the prevalence of small airways dysfunction by impulse oscillometry and to determine whether it correlates with selected disease-related features and respiratory-related quality of life. Methods Ninety-four SSc patients and 93 healthy controls were studied by impulse oscillometry measurements. Small airways dysfunction was defined as the difference between resistance at low frequency, i.e. 5 Hz, and resistance at high frequency, i.e. 20 Hz, termed ‘R5-R20’, ⩾0.07 kPa/l/s. The St George’s Respiratory Questionnaire was used to measure health impairment in SSc patients. Radiological features of small airways disease and parenchymal abnormalities on high resolution CT chest scans were jointly assessed by two thoracic radiologists. Results Small airways dysfunction was present in 21.5% of the SSc patient cohort, with a prevalence almost 5-fold higher compared with controls, and it was significantly associated with worse respiratory-related quality of life. Radiological features consistent with small airways abnormalities were detected in 25% of SSc patients, mostly in the absence of interstitial lung changes. Combining functional and radiological evaluations, one-third of the SSc cohort showed at least one feature of small airways involvement, which was associated with the lcSSc phenotype and with longer disease duration. Conclusion The current study strengthens the hypothesis that small airway dysfunction might be a feature of SSc-related lung involvement, providing the first data on its significant impact on respiratory-related quality of life. A full assessment of lung function in SSc patients should include impulse oscillometry as a complementary technique, due to potential clinical and therapeutic implications.
- Published
- 2020
26. Abstract-to-publication ratio and predictors for publication success for papers presented at the Italian Emergency Medicine Meeting: A cross-sectional study.
- Author
-
Menditto, V.G., Tedesco, S., Manfredi, L., Postacchini, L., and Pomponio, G.
- Subjects
- *
CROSS-sectional method , *EMERGENCY medicine , *MEDICAL publishing , *MEDICAL periodicals , *PERIODICAL publishing , *PUBLISHING - Published
- 2015
- Full Text
- View/download PDF
27. Oxidative stress and the pathogenesis of scleroderma: the Murrell's hypothesis revisited
- Author
-
Gianluca Moroncini, Mariarosaria Santillo, Giovanni Pomponio, Armando Gabrielli, Silvia Svegliati, Enrico V. Avvedimento, Gabrielli, A., Svegliati, S., Moroncini, G., Pomponio, G., Santillo, Mariarosaria, and Avvedimento, VITTORIO ENRICO
- Subjects
EXHALED NITRIC-OXIDE ,Systemic disease ,Pathology ,medicine.medical_specialty ,GROWTH-FACTOR ,SMOOTH-MUSCLE-CELLS ,Immunology ,Disease ,medicine.disease_cause ,Autoantigens ,Scleroderma ,Pathogenesis ,HUMAN ENDOTHELIAL-CELLS ,Fibrosis ,Humans ,Immunology and Allergy ,Medicine ,Receptors, Platelet-Derived Growth Factor ,skin and connective tissue diseases ,Autoantibodies ,Autoimmune disease ,Scleroderma, Systemic ,RAYNAUDS-PHENOMENON SECONDARY ,integumentary system ,business.industry ,medicine.disease ,Connective tissue disease ,HUMAN LUNG FIBROBLASTS ,Oxidative Stress ,ANGIOTENSIN-II ,SUPEROXIDE ANION PRODUCTION ,REACTIVE OXYGEN ,Reactive Oxygen Species ,business ,SYSTEMIC-SCLEROSIS PATIENTS ,Oxidative stress ,Signal Transduction - Abstract
Systemic sclerosis (SSc, scleroderma) is a devastating, immune-mediated, multisystem disorder characterized by microvasculature damage, circulating autoantibodies, and fibroblast activation, leading to massive fibrosis of skin, vessels, muscles, and visceral organs. Scleroderma causes disability and death as the result of end-stage organ failure. At present, no specific diagnostic nor therapeutic tools are available to handle the disease. In spite of significant effort, the etiology and pathogenesis of SSc remain obscure and, consequently, the disease outcome is unpredictable. Several years ago, Murrell suggested a unifying hypothesis linking the pathogenesis of scleroderma to the generation of a large excess of reactive oxygen species. This hypothesis has been substantiated by several reports indicating the presence of an abnormal redox state in patients with scleroderma. This review will summarize the available evidence supporting the link between free radicals and the main pathological features of scleroderma.
- Published
- 2008
28. Consolidation therapy for adult acute myeloid leukemia: A systematic analysis according to evidence based medicine
- Author
-
Debora Capelli, P. Leoni, Attilio Olivieri, Michele Malagola, Alessandro Isidori, Pier Paolo Piccaluga, Giuseppe Visani, Giovanni Martinelli, Giovanni Pomponio, Giovanni Sparaventi, Marino Brunori, Visani G, Olivieri A, Malagola M, Brunori M, Piccaluga PP, Capelli D, Pomponio G, Martinelli G, Isidori A, Sparaventi G, and Leoni P.
- Subjects
Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,MEDLINE ,Antineoplastic Agents ,THERAPY ,Disease-Free Survival ,ADULT ,Internal medicine ,hemic and lymphatic diseases ,Medicine ,Humans ,Transplantation, Homologous ,Chemotherapy ,Clinical Trials as Topic ,Evidence-Based Medicine ,business.industry ,Remission Induction ,Age Factors ,Myeloid leukemia ,Adult Acute Myeloid Leukemia ,Hematology ,Evidence-based medicine ,Surgery ,Transplantation ,Clinical trial ,Leukemia, Myeloid, Acute ,Treatment Outcome ,Oncology ,Research Design ,Stem cell ,ACUTE MYELOID LEUKEMIA ,business ,Stem Cell Transplantation - Abstract
Post-remission therapy in acute myeloid leukemia (AML) remains problematic. It has been demonstrated that younger patients can maintain longer complete remissions (CR) with aggressive post-remission therapies after induction treatment: allogeneic (allo), autologous (auto) stem cell transplantation (SCT), or intensive chemotherapy (ICC). The purpose of our study was to identify the most important randomized and controlled studies comparing these three therapeutic options, in order to draw conclusions and possible suggestions for post-remission therapy of AML, according to the evidence based medicine (EBM) rules. We performed an exhaustive analysis of the literature, searching either in electronic databases or among the references of the identified articles (hand searching). We searched the MEDLINE computer database for reports from 1985 through January 2005 and selected for analysis the clinical trials conducted over adults affected by newly diagnosed AML aged less than 65 years. The study design had to satisfy strict methodological criteria and must consider global mortality and/or disease free survival as primary outcomes. Overall we found 7750 papers; by using the limits "clinical trial" as publication type, "all adults 19+ years", we were able to select 344 papers. Among these, a further selection was made, based on two main clinical queries: 1) is auto-SCT superior to ICC/no other therapy in improving DFS and/or OS in adult AML patients in first CR? 2) is allo-SCT superior to auto-SCT/other therapeutic options in improving DFS and/or OS in adult AML patients in first CR? Concerning the first query, a possible advantage of auto-SCT over ICC was not clearly supported by data from clinical trials; there is no evidence that auto-SCT is superior in terms of OS to chemotherapy. Nevertheless, the reported TRM has been significantly reduced within the past years. Thus, the percentage of patients suitable for auto-SCT in CR has increased. Moreover, the scarce data concerning the comparison between auto-SCT and chemotherapy in different subsets of patients are unable to suggest a differentiated approach in patients with high-risk, standard-risk or low-risk AML. Data from the literature show that patients with unfavorable risk disease are more often addressed to allo-SCT and patients with low-risk disease receive more often intensive consolidation chemotherapy. Concerning the second query, interpretation of data from the main prospective studies about the role of allo-SCT in previously untreated AML is not easy. The first problem is the lack of real randomized clinical trials; in fact, according to the reported studies, AML patients generally receive allo-SCT on the basis of donor availability (the so called "genetic randomization"). The second problem is the frequent absence of intention to treat analysis. Despite methodological limitations, it was possible to compare allo-SCT with auto-SCT on a donor versus no-donor analysis and within risk groups. No overall benefit of allo-grafting on survival was demonstrated by any trial. In conclusion, the EBM approach highlighted the limitations observed in the published studies concerning consolidation therapy in AML; some suggestions, emerging from non-randomized, as well as randomized studies, are adequate, but not conclusive. This point, coupled with the intrinsic complexity to study AML biological heterogeneity, is probably a major obstacle to draw conclusive evidences for consolidation therapy in AML. These observations should plan to address new randomized studies on AML therapy; however, due to the emergence of genetic subgroups and new drugs targeting specific abnormalities, these trials should probably be designed directly focusing on the single entities. In this way, the cure of AML could eventually become the cure of each specific AML subset with its peculiar biological, molecular and prognostic features.
- Published
- 2006
29. Abstract-to-publication ratio for papers presented at Italian emergency medicine meeting: A retrospective study.
- Author
-
Anonymous, Tedesco, S., Barbadoro, P., Pomponio, G., and Gabrielli, A.
- Published
- 2013
- Full Text
- View/download PDF
30. Improving quality is not simple: Results of a clinical audit project about patients with Community-Acquired Pneumonia (CAP).
- Author
-
Anonymous, Marcosignori, M., Postacchini, L., Manfredi, L., Pomponio, G., and Gabrielli, A.
- Published
- 2013
- Full Text
- View/download PDF
31. Traumatic Brain Injury in Patients under Anticoagulant Therapy: Review of Management in Emergency Department.
- Author
-
Menditto VG, Rossetti G, Sampaolesi M, Buzzo M, and Pomponio G
- Abstract
The best management of patients who suffer from traumatic brain injury (TBI) while on oral anticoagulants is one of the most disputed problems of emergency services. Indeed, guidelines, clinical decision rules, and observational studies addressing this topic are scarce and conflicting. Moreover, relevant issues such as the specific treatment (and even definition) of mild TBI, rate of delayed intracranial injury, indications for neurosurgery, and anticoagulant modulation are largely empiric. We reviewed the most recent evidence on these topics and explored other clinically relevant aspects, such as the promising role of dosing brain biomarkers, the strategies to assess the extent of anticoagulation, and the indications of reversals and tranexamic acid administration, in cases of mild TBI or as a bridge to neurosurgery. The appropriate timing of anticoagulant resumption was also discussed. Finally, we obtained an insight into the economic burden of TBI in patients on oral anticoagulants, and future directions on the management of this subpopulation of TBI patients were proposed. In this article, at the end of each section, a "take home message" is stated.
- Published
- 2024
- Full Text
- View/download PDF
32. Minor head injury in anticoagulated patients: performance of biomarkers S100B, NSE, GFAP, UCH-L1 and Alinity TBI in the detection of intracranial injury. A prospective observational study.
- Author
-
Menditto VG, Moretti M, Babini L, Mattioli A, Giuliani AR, Fratini M, Pallua FY, Andreoli E, Nitti C, Contucci S, Gabrielli A, Rocchi MBL, and Pomponio G
- Subjects
- Humans, Prospective Studies, Male, Female, Aged, Middle Aged, Aged, 80 and over, S100 Calcium Binding Protein beta Subunit blood, Ubiquitin Thiolesterase blood, Biomarkers blood, Glial Fibrillary Acidic Protein blood, Phosphopyruvate Hydratase blood, Craniocerebral Trauma blood, Craniocerebral Trauma diagnosis, Tomography, X-Ray Computed, Anticoagulants therapeutic use
- Abstract
Objectives: Data in literature indicate that in patients suffering a minor head injury (MHI), biomarkers serum levels could be effective to predict the absence of intracranial injury (ICI) on head CT scan. Use of these biomarkers in case of patients taking oral anticoagulants who experience MHI is very limited. We investigated biomarkers as predictors of ICI in anticoagulated patients managed in an ED., Methods: We conducted a single-cohort, prospective, observational study in an ED. Our structured clinical pathway included a first head CT scan, 24 h observation and a second CT scan. The outcome was delayed ICI (dICI), defined as ICI on the second CT scan after a first negative CT scan. We assessed the sensitivity (SE), specificity (SP), negative predictive value (NNV) and positive predictive value (PPV) of the biomarkers S100B, NSE, GFAP, UCH-L1 and Alinity TBI in order to identify dICI., Results: Our study population was of 234 patients with a negative first CT scan who underwent a second CT scan. The rate of dICI was 4.7 %. The NPV for the detection of dICI were respectively (IC 95 %): S100B 92.7 % (86.0-96.8 %,); ubiquitin C-terminal hydrolase-L1 (UCH-L1) 91.8 % (83.8-96.6 %); glial fibrillary protein (GFP) 100 % (83.2-100 %); TBI 100 % (66.4-100 %). The AUC for the detection of dICI was 0.407 for S100B, 0.563 for neuron-specific enolase (NSE), 0.510 for UCH-L1 and 0.720 for glial fibrillary acidic protein (GFAP), respectively., Conclusions: The NPV of the analyzed biomarkers were high and they potentially could limit the number of head CT scan for detecting dICI in anticoagulated patients suffering MHI. GFAP and Alinity TBI seem to be effective to rule out a dCI, but future trials are needed., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)
- Published
- 2024
- Full Text
- View/download PDF
33. Early administration of tofacitinib in COVID-19 pneumonitis: An open randomised controlled trial.
- Author
-
Ferrarini A, Vacca A, Solimando AG, Tavio M, Acquaviva R, Rocchi M, Nitti C, Salvi A, Menditto V, Luchetti Gentiloni MM, Russo A, Moretti M, Pavani M, Giacometti A, Bonifazi M, Zuccatosta L, Romani L, Racanelli V, Moroncini G, Gabrielli A, and Pomponio G
- Subjects
- Humans, SARS-CoV-2, COVID-19 Drug Treatment, Treatment Outcome, COVID-19, Respiratory Insufficiency
- Abstract
Background: Controversies on sub-populations most sensitive to therapy and the best timing of starting the treatment still surround the use of immunomodulatory drugs in COVID-19., Objectives: We designed a multicentre open-label randomised controlled trial to test the effect of prompt adding of tofacitinib to standard therapy for hospitalised patients affected by mild/moderate COVID-19 pneumonitis., Methods: Patients admitted to three Italian hospitals affected by COVID-19 pneumonitis not requiring mechanical ventilation were randomised to receive standard treatment alone or tofacitinib (10 mg/bid) for 2 weeks, starting within the first 24 h from admission., Results: A total of 116 patients were randomised; 49 in the experimental arm completed the 14-day treatment period, 9 discontinued tofacitinib as the disease worsened and were included in the analysis, and 1 died of respiratory failure. All 58 control patients completed the study. Clinical and demographic characteristics were similar between the study groups. In the tofacitinib group, 9/58 (15.5%) patients progressed to noninvasive ventilation (CPAP) to maintain SO
2 > 93%, invasive mechanical ventilation or death by day 14 was 15.5%, significantly less than in the control group (20/58, 34.4%, RR 0,45, RRR -55%, NNT 5; p = .018). No differences in severe adverse effect incidence had been observed across the groups., Conclusion: High-dose tofacitinib therapy in patients with COVID pneumonitis is safe and may prevent deterioration to respiratory failure., (© 2022 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)- Published
- 2023
- Full Text
- View/download PDF
34. Circulating miR-320b and miR-483-5p levels are associated with COVID-19 in-hospital mortality.
- Author
-
Giuliani A, Matacchione G, Ramini D, Di Rosa M, Bonfigli AR, Sabbatinelli J, Monsurrò V, Recchioni R, Marcheselli F, Marchegiani F, Piacenza F, Cardelli M, Galeazzi R, Pomponio G, Ferrarini A, Gabrielli A, Svegliati Baroni S, Moretti M, Sarzani R, Giordano P, Cherubini A, Corsonello A, Antonicelli R, Procopio AD, Ferracin M, Bonafè M, Lattanzio F, and Olivieri F
- Subjects
- Aged, Aged, 80 and over, Biomarkers blood, COVID-19 diagnosis, COVID-19 genetics, Circulating MicroRNA genetics, Female, Humans, Male, MicroRNAs genetics, Predictive Value of Tests, Prognosis, RNA-Seq, Risk Assessment, Risk Factors, Time Factors, Up-Regulation, COVID-19 blood, COVID-19 mortality, Circulating MicroRNA blood, Hospital Mortality, Hospitalization, MicroRNAs blood
- Abstract
The stratification of mortality risk in COVID-19 patients remains extremely challenging for physicians, especially in older patients. Innovative minimally invasive molecular biomarkers are needed to improve the prediction of mortality risk and better customize patient management. In this study, aimed at identifying circulating miRNAs associated with the risk of COVID-19 in-hospital mortality, we analyzed serum samples of 12 COVID-19 patients by small RNA-seq and validated the findings in an independent cohort of 116 COVID-19 patients by qRT-PCR. Thirty-four significantly deregulated miRNAs, 25 downregulated and 9 upregulated in deceased COVID-19 patients compared to survivors, were identified in the discovery cohort. Based on the highest fold-changes and on the highest expression levels, 5 of these 34 miRNAs were selected for the analysis in the validation cohort. MiR-320b and miR-483-5p were confirmed to be significantly hyper-expressed in deceased patients compared to survived ones. Kaplan-Meier and Cox regression models, adjusted for relevant confounders, confirmed that patients with the 20% highest miR-320b and miR-483-5p serum levels had three-fold increased risk to die during in-hospital stay for COVID-19. In conclusion, high levels of circulating miR-320b and miR-483-5p can be useful as minimally invasive biomarkers to stratify older COVID-19 patients with an increased risk of in-hospital mortality., (Copyright © 2022 Elsevier B.V. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
35. Rituximab for eosinophilic granulomatosis with polyangiitis: a systematic review of observational studies.
- Author
-
Menditto VG, Rossetti G, Olivari D, Angeletti A, Rocchi M, Gabrielli A, and Pomponio G
- Subjects
- Humans, Observational Studies as Topic, Remission Induction, Treatment Outcome, Granulomatosis with Polyangiitis drug therapy, Immunosuppressive Agents therapeutic use, Rituximab therapeutic use
- Abstract
Objective: To analyse the available evidence about the use of rituximab (RTX) and other biologic agents in eosinophilic granulomatosis with polyangiitis (EGPA) patients and to provide useful findings to inform the design of future, reliable clinical trials., Methods: A systematic review was performed. A systematic search was conducted in PubMed/MEDLINE, Scopus, Web of Science and the Cochrane library databases on RTX, and an extensive literature search was conducted on other biologic agents., Results: Forty-five papers pertinent to our questions were found: 16 retrospective cohort studies, 8 case series, 3 prospective cohort studies and 18 single case reports, for a total of 368 EGPA patients. More than 80% of evaluable patients achieved complete or partial remission with a tendency towards a higher rate of complete response in the pANCA-positive subgroup., Conclusion: Although the majority of the evaluable EGPA patients treated with RTX appears to achieve complete remission, we strongly believe that a number of sources of heterogeneity impair a clear interpretation of results and limit their transferability in clinical practice. Differences in design, enrolment criteria, outcome definition and measurement make a comparison among data obtained from studies on RTX and other biologic agents unreliable., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2021
- Full Text
- View/download PDF
36. Veno-occlusive Disease in HSCT Patients: Consensus-based Recommendations for Risk Assessment, Diagnosis, and Management by the GITMO Group.
- Author
-
Bonifazi F, Sica S, Angeletti A, Marktel S, Prete A, Iori AP, Olivari D, Rossetti G, Bertaina A, Botti S, Busca A, Carella AM, Cerretti R, Gargiulo G, Grassi A, Gualandi F, Irrera G, Milone G, Risitano AM, Santarone S, Vassallo E, Zecca M, Ciceri F, and Pomponio G
- Subjects
- Consensus, Evidence-Based Medicine, Hepatic Veno-Occlusive Disease diagnostic imaging, Hepatic Veno-Occlusive Disease etiology, Humans, Polydeoxyribonucleotides adverse effects, Predictive Value of Tests, Risk Assessment, Risk Factors, Transplantation, Homologous, Treatment Outcome, Ursodeoxycholic Acid adverse effects, Hematopoietic Stem Cell Transplantation adverse effects, Hepatic Veno-Occlusive Disease therapy, Polydeoxyribonucleotides therapeutic use, Ursodeoxycholic Acid therapeutic use
- Abstract
Variation in clinical practice affects veno-occlusive disease management, mainly in patients who undergo allogeneic hematopoietic stem cell transplantation. Disputes about diagnostic criteria, treatment, and prophylaxis, due to the lack of high-quality data, are at the base of this variability. With the aim of limiting inconsistency in clinical care, thus improving both patient outcomes and data collection reliability, the Italian Society of Stem cell transplant (Gruppo Italiano Trapianto Midollo Osseo e Terapia Cellulare) launched a collaborative effort to formulate recommendations based on integration of available evidence and expert's consensus. A systematic method, according to US National Institute of Health guidelines and Italian National System for Guidelines, was used. Twenty-nine recommendations were approved with a strong (20) or weak (9) level of agreement, while 26 were rejected. In particular, the panel pointed out the need to achieve an early diagnosis, encouraging the adoption of European Society for Blood and Marrow Transplantation criteria and the prompt use of ultrasonography. Moreover, our experts strongly recommended in favor of prophylactic use of ursodeoxycholic acid. As soon as a veno-occlusive disease diagnosis is established, treatment with defibrotide should be started for at least 21 days. A number of areas of uncertainty, particularly concerning risk stratification and use of diagnostic tools such as elastography has been identified and discussed., Competing Interests: The authors declare no funding or conflicts of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
37. Decreased serum levels of the inflammaging marker miR-146a are associated with clinical non-response to tocilizumab in COVID-19 patients.
- Author
-
Sabbatinelli J, Giuliani A, Matacchione G, Latini S, Laprovitera N, Pomponio G, Ferrarini A, Svegliati Baroni S, Pavani M, Moretti M, Gabrielli A, Procopio AD, Ferracin M, Bonafè M, and Olivieri F
- Subjects
- Adult, Aged, Biomarkers blood, Female, Humans, Inflammation blood, Inflammation drug therapy, Inflammation epidemiology, Male, Middle Aged, Antibodies, Monoclonal, Humanized administration & dosage, COVID-19 blood, COVID-19 epidemiology, Circulating MicroRNA blood, MicroRNAs blood, Pandemics, SARS-CoV-2, COVID-19 Drug Treatment
- Abstract
Current COVID-19 pandemic poses an unprecedented threat to global health and healthcare systems. The most amount of the death toll is accounted by old people affected by age-related diseases that develop a hyper-inflammatory syndrome. In this regard, we hypothesized that COVID-19 severity may be linked to inflammaging. Here, we examined 30 serum samples from patients enrolled in the clinical trial NCT04315480 assessing the clinical response to a single-dose intravenous infusion of the anti-IL-6 receptor drug Tocilizumab (TCZ) in COVID-19 patients with multifocal interstitial pneumonia. In these serum samples, as well as in 29 age- and gender-matched healthy control subjects, we assessed a set of microRNAs that regulate inflammaging, i.e. miR-146a-5p, miR-21-5p, and miR-126-3p, which were quantified by RT-PCR and Droplet Digital PCR. We showed that COVID-19 patients who did not respond to TCZ have lower serum levels of miR-146a-5p after the treatment (p = 0.007). Among non-responders, those with the lowest serum levels of miR-146a-5p experienced the most adverse outcome (p = 0.008). Our data show that a blood-based biomarker, such as miR-146a-5p, can provide clues about the molecular link between inflammaging and COVID-19 clinical course, thus allowing to better understand the use of biologic drug armory against this worldwide health threat., (Copyright © 2020 Elsevier B.V. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
38. Heel Pressure Injuries: Consensus-Based Recommendations for Assessment and Management.
- Author
-
Rivolo M, Dionisi S, Olivari D, Ciprandi G, Crucianelli S, Marcadelli S, Zortea RR, Bellini F, Martinato M, Gabrielli A, and Pomponio G
- Subjects
- Adult, Ankle Brachial Index methods, Anti-Infective Agents therapeutic use, Bandages, Cardiology methods, Child, Consensus, Diabetic Foot physiopathology, Female, Heel microbiology, Heel pathology, Humans, Infant, Newborn, Interdisciplinary Research ethics, Practice Guidelines as Topic standards, Pressure Ulcer diagnosis, Pressure Ulcer pathology, Reproducibility of Results, Evidence-Based Medicine methods, Heel injuries, Pressure adverse effects, Pressure Ulcer therapy
- Abstract
Significance: A systematic approach to develop experts-based recommendations could have a favorable impact on clinical problems characterized by scarce and low-quality evidence as heel pressure ulcers. Recent Advances: A systematic approach was used to conduce a formal consensus initiative. A multidisciplinary panel of experts identified relevant clinical questions, performed a systematic search of the literature, and created a list of statements. GRADE Working Group guidelines were followed. An independent international jury reviewed and voted recommendations for clinical practice. Consent was developed according to Delphi rules and GRADE method was used to attribute grade of strength. Critical Issues: The extensive search of the literature retrieved 42 pertinent articles (26 clinical studies, 7 systematic reviews or meta-analysis, 5 other reviews, 2 consensus-based articles, and 2 in vitro studies). Thirty-five recommendations and statements were created. Only 1 of 35, concerning ankle-brachial pressure index reliability in diabetic patients, was rejected by the panel. No sufficient agreement was achieved on toe brachial index test to rule out the orphan heel syndrome, removing dry eschar in adult patients without vascular impairment, and using an antimicrobial dressing in children with infected heel pressure injuries. Eleven recommendations were approved with a weak grade of strength. Experts strongly endorsed 20 recommendations. Offloading, stages I and II pressure injuries, and referral criteria were areas characterized by higher level of agreement. Future Directions: We believe that the results of our effort could improve practice, especially in areas where clear and shared opinions emerged. Barriers and limits that could hinder implementation are also discussed in the article.
- Published
- 2020
- Full Text
- View/download PDF
39. Increased prevalence of small airways dysfunction in patients with systemic sclerosis as determined by impulse oscillometry.
- Author
-
Bonifazi M, Sverzellati N, Negri E, Pomponio G, Seletti V, Bonini M, Fraticelli P, Paolini L, Mattioli M, Franchi M, Tramacere I, Poletti V, La Vecchia C, Gasparini S, and Gabrielli A
- Subjects
- Adult, Aged, Case-Control Studies, Female, Humans, Lung physiopathology, Lung Diseases, Interstitial etiology, Lung Diseases, Interstitial physiopathology, Male, Middle Aged, Prevalence, Quality of Life, Scleroderma, Systemic complications, Lung Diseases, Interstitial epidemiology, Oscillometry, Scleroderma, Systemic physiopathology
- Abstract
Objectives: The prevalence and clinical implications of small airways involvement in SSc are still to be fully elucidated. The goal of the present work is to assess the prevalence of small airways dysfunction by impulse oscillometry and to determine whether it correlates with selected disease-related features and respiratory-related quality of life., Methods: Ninety-four SSc patients and 93 healthy controls were studied by impulse oscillometry measurements. Small airways dysfunction was defined as the difference between resistance at low frequency, i.e. 5 Hz, and resistance at high frequency, i.e. 20 Hz, termed 'R5-R20', ⩾0.07 kPa/l/s. The St George's Respiratory Questionnaire was used to measure health impairment in SSc patients. Radiological features of small airways disease and parenchymal abnormalities on high resolution CT chest scans were jointly assessed by two thoracic radiologists., Results: Small airways dysfunction was present in 21.5% of the SSc patient cohort, with a prevalence almost 5-fold higher compared with controls, and it was significantly associated with worse respiratory-related quality of life. Radiological features consistent with small airways abnormalities were detected in 25% of SSc patients, mostly in the absence of interstitial lung changes. Combining functional and radiological evaluations, one-third of the SSc cohort showed at least one feature of small airways involvement, which was associated with the lcSSc phenotype and with longer disease duration., Conclusion: The current study strengthens the hypothesis that small airway dysfunction might be a feature of SSc-related lung involvement, providing the first data on its significant impact on respiratory-related quality of life. A full assessment of lung function in SSc patients should include impulse oscillometry as a complementary technique, due to potential clinical and therapeutic implications., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
- Full Text
- View/download PDF
40. An Early Tailored Approach Is the Key to Effective Rehabilitation in the Intensive Care Unit.
- Author
-
Chiarici A, Andrenelli E, Serpilli O, Andreolini M, Tedesco S, Pomponio G, Gallo MM, Martini C, Papa R, Coccia M, and Ceravolo MG
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Continuity of Patient Care, Evidence-Based Medicine, Female, Goals, Humans, Length of Stay statistics & numerical data, Male, Middle Aged, Patient Care Team organization & administration, Patient Discharge, Prospective Studies, Retrospective Studies, Critical Illness rehabilitation, Intensive Care Units organization & administration
- Abstract
Objective: To investigate the effectiveness, feasibility, and safety of an evidence-based rehabilitation care pathway in the intensive care unit (ICU) in different patient populations., Design: Observational prospective cohort study, with retrospective controls., Setting: ICUs of a university hospital., Participants: Patients admitted between April 1, 2015, and June 30, 2015, were compared to a retrospective cohort admitted to the same ICUs during the same 3-month period in 2014. The number of patients studied (N=285) included 152 in the prospective group and 133 in the retrospective group., Interventions: The prospective cohort benefited of a rehabilitation care pathway based on (1) interdisciplinary teamwork; (2) early customized and goal-oriented rehabilitation; (3) daily functional monitoring and treatment revision; (4) agreed discharge policy; and (5) continuity of care. The retrospective cohort underwent usual care., Main Outcome Measures: Included the following: (1) proportions of patients undergoing rehabilitation team evaluation; (2) latency between patient admission to ICUs and rehabilitation team assessment; (3) proportions of patients undergoing rehabilitation treatment during ICU stay; (4) latency between the patient admission to ICUs and rehabilitation start; (5) ICU stay and total acute hospital stay; and (5) proportion of ventilator-free days out of ICU stay., Results: The novel rehabilitation care pathway led to (1) an increased proportion of patients receiving rehabilitative assessment (P<.0001); (2) a decreased latency from ICU admission to both rehabilitation team assessment and rehabilitation start (P<.0001); (3) an increased proportion of patients undergoing rehabilitation (P<.0001); (4) a shorter length of stay in ICUs (P<.0001) and in hospital (P=.047); and (5) a shorter mechanical ventilation duration (P<.02). A direct relationship between rehabilitation start latency and ICU length of stay was observed., Conclusions: An early, interdisciplinary team approach, providing a customized dynamic planning of physiotherapy programs, increases ventilator-free time and reduces total hospital stay, especially in patients admitted to the ICU after general surgery. This rehabilitation care pathway can be generalized to different geopolitical scenarios, being feasible, safe and cost effective., (Copyright © 2019 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
41. Clinical and patient reported outcomes of the multidisciplinary management in patients with inflammatory bowel disease-associated spondyloarthritis.
- Author
-
Luchetti MM, Benfaremo D, Bendia E, Bolognini L, Fava G, Marini F, Di Sario A, Ciferri M, Di Nicola F, Marconi V, Perini L, Manfredi L, Pomponio G, Mosca P, Benedetti A, and Gabrielli A
- Subjects
- Adult, Antirheumatic Agents adverse effects, Antirheumatic Agents therapeutic use, Biological Products adverse effects, Biological Products therapeutic use, Colitis, Ulcerative diagnosis, Critical Pathways, Crohn Disease diagnosis, Female, Humans, Male, Middle Aged, Patient Care Team, Patient Reported Outcome Measures, Quality of Life, Remission Induction, Spondylarthritis diagnosis, Time Factors, Treatment Outcome, Workflow, Colitis, Ulcerative drug therapy, Crohn Disease drug therapy, Spondylarthritis drug therapy
- Abstract
Objective: Arthritis is the most frequent extra-intestinal manifestation in patients with inflammatory bowel diseases (IBD). The coexistence of intestinal and articular inflammation advocates the need for a multidisciplinary management of patients with IBD-associated spondyloarthritis., Methods: Consecutive IBD patients were evaluated jointly by the gastroenterologist and the rheumatologist in a combined clinic. All the patients were assessed and screened for articular involvement, disease activity and health related quality of life. After the prescription of a shared treatment, patients with spondyloarthritis were followed up for 24 months., Results: Two hundred sixty-two IBD patients, including 80 who were classified as affected by spondyloarthritis according to the ASAS criteria, were included in the study. At baseline, patients with both IBD and spondyloarthritis showed worse quality of life in both the physical and mental domains. The multidisciplinary management provided a significant improvement of gastrointestinal and articular manifestations, as well as the health-related quality of life. Moreover, global and gastrointestinal-specific quality of life significantly correlated with articular disease activity., Conclusion: The multidisciplinary management significantly improves both articular and gastrointestinal disease activities and the quality of life of patients with IBD-associated spondyloarthritis. An appropriate screening strategy and the integrated management of these patients should be encouraged and employed in clinical practice., (Copyright © 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
42. Pulmonary embolism: a retrospective comparative study between patients with atypical vs typical clinical presentation
- Author
-
Menditto VG, Mei F, Postacchini L, Manfredi L, Tedesco S, Pomponio G, Gabrielli A, and Salvi A
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Chest Pain etiology, Dyspnea etiology, Emergency Service, Hospital, Female, Hemoptysis etiology, Hospitalization statistics & numerical data, Humans, Length of Stay, Male, Middle Aged, Prognosis, Pulmonary Embolism physiopathology, Retrospective Studies, Tomography, X-Ray Computed, Ventricular Dysfunction, Right epidemiology, Young Adult, Chest Pain epidemiology, Dyspnea epidemiology, Hemoptysis epidemiology, Pulmonary Embolism diagnosis
- Abstract
Background: Natural history and outcomes of patients with pulmonary embolism (PE) without typical symptoms (atypical PE) remain unclear. The aim of the study is to compare the clinical characteristics and the prognosis between typical PE and atypical PE., Methods: We retrospectively analyzed data from consecutive patients admitted to the Emergency Department (ED) because of a diagnosis of PE and classified them in two groups: typical PE and atypical PE. We defined PE to be typical in presence of almost one of the following symptoms or signs: dyspnea, chest pain, hemoptysis or signs of deep vein thrombosis., Results: Of the 191 patients with PE, 154 (81%) had typical PE and 37 (19%) had atypical PE. Patients with atypical and typical PE seemed to had similar prognostic factor such as high risk sPESI (73% vs 65%, p=0.3), right ventricular dysfunction (30% vs 26%, p=0.6) and central PE at chest CT scan (38% vs 36%, p=0.8). The rate of 30 day mortality was 7% in the typical group and 8% in the atypical group (p=0.8). The length of stay in hospital was the same in the two groups (6 days; p=0.2)., Conclusions: We found that atypical and typical PE seem to be related diseases with a similar short term prognosis. Therefore, we could speculate that a missed diagnosis of PE in ED could expose the patients to a worsen prognosis. Further perspective studies are required for better investigate this diagnostic challenge.
- Published
- 2019
- Full Text
- View/download PDF
43. Improving the quality of clinical research on chronic wound infection treatment: expert-based recommendations.
- Author
-
Pomponio G, Tedesco S, Peghetti A, Bianchi T, Rowan S, Greco A, Cutting K, Price P, Moore Z, Gabrielli A, and Wolcott R
- Subjects
- Chronic Disease therapy, Europe, Humans, Quality Improvement, Research, United States, Wound Healing, Dermatology, Practice Patterns, Physicians' standards, Wound Infection therapy
- Abstract
Objective:: To produce recommendations for the design of reliable and informative clinical investigations in chronic wound infection., Method:: A multidisciplinary panel of international experts from four countries (Italy, UK, Ireland and the US) were involved in a detailed, semi-structured discussion on how to better select and describe a target population, interventions and outcomes, and which infection-related criteria to apply in order to achieve a high-quality trial. Consent among the experts was measured using the Delphi method and GRADE Working Group suggestions. The project was fully supported by AISLeC 2016 (Italian Nursing Society for Wound Care Study)., Results:: In total, 37 recommendations achieved substantial agreement among the experts; 10 concerned the most appropriate description and selection of a target population, four related to interventions and 15 to outcomes. A further eight statements about critical methodological points were approved., Conclusion:: Developing recommendations in a systematic manner through a representative group of experts could generate tools for improving the design of clinical trials in this challenging area.
- Published
- 2019
- Full Text
- View/download PDF
44. Management of spontaneous soft-tissue hemorrhage secondary to anticoagulant therapy: A cohort study.
- Author
-
Menditto VG, Fulgenzi F, Lombardi S, Dimitriadou A, Mincarelli C, Rosati M, Candelari R, Pomponio G, Salvi A, and Gabrielli A
- Subjects
- Adult, Aged, Aged, 80 and over, Angiography, Digital Subtraction, Embolization, Therapeutic methods, Female, Hemorrhage mortality, Humans, Italy, Male, Middle Aged, Muscular Diseases mortality, Retrospective Studies, Tomography, X-Ray Computed, Anticoagulants adverse effects, Hemorrhage chemically induced, Hemorrhage therapy, Muscular Diseases chemically induced, Muscular Diseases therapy
- Abstract
Study Objective: The optimal management of patients receiving heparin, warfarin or direct anti-coagulant therapy who experience spontaneous, severe, life-threatening soft-tissue hemorrhage (SSTH) is unclear. The purpose of this study is to investigate efficacy and safety of the interventional protocol implemented in our department., Methods: In this retrospective cohort study, we analyzed data from 80 consecutive patients with SSTH secondary to anticoagulation therapy diagnosed by the appropriate computed tomography scan. All patients received a structured clinical pathway, including aggressive resuscitation, reversal of coagulopathy when indicated, Interventional Radiology procedures by transcatheter embolization (TE), clinical observation and repeated laboratory controls., Results: We enrolled 80 patients from 2013 to 2017. Angiography was performed in 60 patients (75%). It revealed the bleeding site in 46 cases, and a TE was performed in all. The rates of technical success of TE, primary clinical success and bleeding control were 98% (45/46), 91% (73/80) and 89% (71/80) respectively. In 5 patients (6%) the control of the bleeding was obtained with a second TE. Short-term and 30-day mortality was 5% (4 patients) and 11% (9 patients), respectively. No adverse events were observed., Conclusion: A structured clinical pathway, including TE seems to be an effective and safe method to manage the patients with SSTH due to anticoagulant treatment., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
45. Global longitudinal strain measured by speckle tracking identifies subclinical heart involvement in patients with systemic sclerosis.
- Author
-
Guerra F, Stronati G, Fischietti C, Ferrarini A, Zuliani L, Pomponio G, Capucci A, Danieli MG, and Gabrielli A
- Subjects
- Adult, Aged, Asymptomatic Diseases, Cardiomyopathies etiology, Cardiomyopathies physiopathology, Case-Control Studies, Cross-Sectional Studies, Early Diagnosis, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Scleroderma, Systemic diagnosis, Cardiomyopathies diagnostic imaging, Echocardiography, Myocardial Contraction, Scleroderma, Systemic complications, Ventricular Function, Left, Ventricular Function, Right
- Abstract
Background Systemic sclerosis is characterised by progressive cutaneous and organ fibrosis. Among all organs, a subclinical heart involvement is difficult to detect through conventional imaging. Design We evaluated whether speckle tracking-derived global longitudinal strain could help detect early subclinical systolic dysfunction in systemic sclerosis patients without overt clinical involvement. Methods A case-control, single-centre study on 52 systemic sclerosis patients and 52 age and gender-matched controls. Patients with structural heart disease, heart failure, atrial fibrillation and pulmonary hypertension were excluded. For every patient, standard echocardiographic and speckle tracking-derived variables for the systolic and diastolic function of the left ventricle and right ventricle were acquired. Results Traditional parameters of left and right systolic function did not differ between systemic sclerosis patients and controls (all P = ns). Left and right ventricular global longitudinal strain was significantly impaired in patients with systemic sclerosis when compared to controls (-19.2% vs. -21.1%; P = 0.009 and -18.2% vs. -22.3%; P = 0.012, respectively). Systemic sclerosis patients had a 2.5-fold increased risk of subclinical left ventricular systolic impairment (odds ratio 2.5, 95% confidence interval 1.1-5.5; P = 0.027) and a 3.3-fold increased risk of subclinical right ventricular systolic impairment when compared to controls (odds ratio 3.3, 95% confidence interval 1.4-7.7; P = 0.004). Alterations in the myocardial deformation pattern of systemic sclerosis patients were homogeneous in the right ventricle and eccentric in the left ventricle. Conclusions While traditional echocardiographic parameters are ineffective in detecting subclinical systolic impairment, reduced global longitudinal strain is common in patients with systemic sclerosis and significant for both ventricles. Global longitudinal strain could become a low-cost, non-invasive and reliable tool in order to detect early cardiac involvement in systemic sclerosis patients.
- Published
- 2018
- Full Text
- View/download PDF
46. Combination therapy with rituximab and mycophenolate mofetil in systemic sclerosis. A single-centre case series study.
- Author
-
Fraticelli P, Fischetti C, Salaffi F, Carotti M, Mattioli M, Pomponio G, and Gabrielli A
- Subjects
- Adult, Aged, Drug Therapy, Combination, Female, Humans, Immunosuppressive Agents adverse effects, Italy, Lung immunology, Lung physiopathology, Lung Diseases, Interstitial diagnosis, Lung Diseases, Interstitial immunology, Lung Diseases, Interstitial physiopathology, Male, Middle Aged, Mycophenolic Acid adverse effects, Prospective Studies, Recovery of Function, Rituximab adverse effects, Scleroderma, Systemic diagnosis, Scleroderma, Systemic immunology, Scleroderma, Systemic physiopathology, Skin immunology, Skin physiopathology, Skin Diseases diagnosis, Skin Diseases immunology, Skin Diseases physiopathology, Time Factors, Treatment Outcome, Young Adult, Immunosuppressive Agents therapeutic use, Lung drug effects, Lung Diseases, Interstitial drug therapy, Mycophenolic Acid therapeutic use, Rituximab therapeutic use, Scleroderma, Systemic drug therapy, Skin drug effects, Skin Diseases drug therapy
- Abstract
Objectives: To describe a single centre experience using combination therapy with rituximab (RTX) and mycophenolate mofetil (MMF) in a prospective series of systemic sclerosis (SSc) patients with pulmonary and cutaneous involvement, rapidly progressive or resistant to conventional therapy., Methods: RTX was administered in two different regimens (1000 mg fortnightly x 2 or 375 mg/m2/week for 4 consecutive weeks) at baseline and after 6 months, associated with MMF 2000 mg/day continuously. Cutaneous fibrosis was evaluated assessing modified Rodnan Skin Score (mRSS) and pulmonary involvement was evaluated performing pulmonary function tests, diffusing lung capacity for carbon monoxide and chest high-resolution computed tomography (HRCT). The radiological extension of the interstitial lung disease (ILD) at HRCT, was assessed with the conventional visual reader-based score (CoVR) and with a computerised-aided method (CaM) using a DICOM soft- ware., Results: Eighteen SSc patients underwent combination therapy (F/M: 10/8, median age 51 years, median duration of disease 27 months). Data from fifteen patients were available at 12-month follow-up. The mRSS showed a significant improvement; a significant increase in forced vital capacity and forced expiratory volume in the first second were also observed. In addition, a signi cant reduction of the extension of ILD was detected when evaluated with CaM. No serious adverse events were observed during the follow-up period., Conclusions: Despite preliminary results and limited to a small number of patients, our data suggest that therapy with RTX and MMF is well tolerated, safe, and potentially effective for cutaneous and pulmonary involvement in SSc.
- Published
- 2018
47. Sustained clinical response after single course of rituximab as first-line monotherapy in adult-onset asthma and periocular xanthogranulomas syndrome associated with IgG4-related disease: A case report.
- Author
-
Pomponio G, Olivari D, Mattioli M, Angeletti A, Rossetti G, Goteri G, and Gabrielli A
- Subjects
- Adult, Asthma complications, Female, Glucocorticoids therapeutic use, Humans, Immunoglobulin G blood, Magnetic Resonance Imaging, Middle Aged, Necrobiotic Xanthogranuloma complications, Plasma Cells, Tomography, X-Ray Computed, Asthma drug therapy, Autoimmune Diseases drug therapy, Immunologic Factors therapeutic use, Necrobiotic Xanthogranuloma drug therapy, Rituximab therapeutic use
- Abstract
Rationale: IgG4-related disease (IgG4-RD) is an emerging immune-mediated disease characterized by multi-organ involvement and variable clinical behavior., Patient Concerns: We describe the case of a 50-year-old woman affected by a rare variant of IgG4-RD, characterized by eyelid xanthelasmas, adult-onset asthma and salivary and lacrimal glands enlargement. Multiple lymphadenopathies and a pulmonary mass were present at initial evaluation., Inteventions: After a single course of rituximab (2g in 2 refracted doses), an almost complete clinical remission was achieved without chronic steroid administration., Outcomes: Magnetic resonance imaging (MRI), high-resolution computed tomography (HRCT) of the thorax, and positron emission tomography (18FDG-PET-CT) confirmed good response to treatment. Circulating plasmablasts dropped to undetectable levels as well. Xanthelasmas only remained unchanged. Remission persisted at 1-year follow-up., Lessons: Steroid therapy is still considered standard first-line therapy in IgG4-RD. However, high doses are generally required and relapses are common during the tapering phase. Rituximab is a well described steroid-sparing strategy, so far reserved to refractory cases only. In our experience, rituximab has been used as first-line monotherapy, showing great and sustained efficacy and optimal tolerability. The peculiar variant of IgG4-RD affecting our patient, the relatively low baseline plasmablast concentration, and the early placement of rituximab therapy may have facilitated the good response.
- Published
- 2018
- Full Text
- View/download PDF
48. Tocilizumab in the treatment of patients with rheumatoid arthritis in real clinical practice: results of an Italian observational study.
- Author
-
Caporali R, Idolazzi L, Bombardieri S, Ferraccioli G, Gerli R, Govoni M, Matucci Cerinic M, Pomponio G, Salaffi F, Tirri R, Benaglio F, Bianchino L, and Sarzi-Puttini P
- Subjects
- Adult, Aged, Antibodies, Monoclonal, Humanized adverse effects, Antirheumatic Agents, Female, Humans, Male, Middle Aged, Tumor Necrosis Factor-alpha antagonists & inhibitors, Antibodies, Monoclonal, Humanized therapeutic use, Arthritis, Rheumatoid drug therapy, Receptors, Interleukin-6 antagonists & inhibitors
- Abstract
Objectives: To describe the effectiveness and safety of tocilizumab (TCZ), an interleukin-6 receptor inhibitor, in a cohort of patients with rheumatoid arthritis (RA) recruited in clinical practice., Methods: TRUST was an observational study in RA patients who started treatment with TCZ in the 6 months prior to site activation and were still on treatment at start of study; patients were followed up to 12 months after the first TCZ infusion., Results: 322 RA patients were enrolled in 59 Italian centres (mean age: 55.8 years; mean disease duration: 120.5 months; baseline DAS28: 5.3). After 6 months of TCZ treatment, patients achieving low disease activity (DAS28 ≤3.2; 57.52%) or disease remission (DAS28 <2.6; 38.05%) were 216 out of 226 patients with available DAS28 (p<0.001). No statistically significant differences were found in mean DAS28 and HAQ score changes from baseline (start of TCZ treatment) to study end between patients previously inadequately responding to disease-modifyinganti-rheumatic drugs (DMARD-IR) or to DMARDs plus tumour necrosis factor inhibitors (DMARD +TNFi-IR): both patient populations responded to TCZ. A statistically significant decrease in mean VAS Fatigue score (48.4 vs. 34.7; p=0.0025) at month 6 was observed. In patients treated with TCZ as monotherapy (32.61%), DAS28, VAS fatigue and HAQ scores decreased from baseline to any post-baseline time point. Overall, 62 patients (19.3%) prematurely discontinued TCZ treatment, 24 (7.5%) for safety reasons. Drug-related adverse events occurred in 92 patients (28.6%) (mostly 3 hypercholesterolaemia and leucopenia) and drug-related serious adverse events in 11 patients (3.4%)., Conclusions: This study confirms the good effectiveness and safety profile of TCZ in real life RA patient care.
- Published
- 2017
49. In vitro kinetics of amiodarone and its major metabolite in two human liver cell models after acute and repeated treatments.
- Author
-
Pomponio G, Savary CC, Parmentier C, Bois F, Guillouzo A, Romanelli L, Richert L, Di Consiglio E, and Testai E
- Subjects
- Amiodarone metabolism, Cell Line, Cytochrome P-450 CYP3A genetics, Cytochrome P-450 CYP3A metabolism, Drug Administration Schedule, Gene Expression Regulation, Enzymologic drug effects, Hepatocytes metabolism, Humans, Amiodarone pharmacokinetics, Hepatocytes drug effects
- Abstract
The limited value of in vitro toxicity data for the in vivo extrapolation has been often attributed to the lack of kinetic data. Here the in vitro kinetics of amiodarone (AMI) and its mono-N-desethyl (MDEA) metabolite was determined and modelled in primary human hepatocytes (PHH) and HepaRG cells, after single and repeated administration of clinically relevant concentrations. AMI bioavailability was influenced by adsorption to the plastic and the presence of protein in the medium (e.g. 10% serum protein reduced the uptake by half in HepaRG cells). The cell uptake was quick (within 3h), AMI metabolism was efficient and a dynamic equilibrium was reached in about a week after multiple dosing. In HepaRG cells the metabolic clearance was higher than in PHH and increased over time, as well as CYP3A4. The interindividual variability in MDEA production in PHHs was not proportional to the differences in CYP3A4 activities, suggesting the involvement of other CYPs and/or AMI-related CYP inhibition. After repeated treatment AMI showed a slight potential for bioaccumulation, whereas much higher intracellular MDEA levels accumulated over time, especially in the HepaRG cells, associated with occurrence of phospholipidosis. The knowledge of in vitro biokinetics is important to transform an actual in vitro concentration-effect into an in vivo dose-effect relationship by using appropriate modelling, thus improving the in vitro-to-in vivo extrapolation., (Copyright © 2014 Elsevier Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
50. Amiodarone biokinetics, the formation of its major oxidative metabolite and neurotoxicity after acute and repeated exposure of brain cell cultures.
- Author
-
Pomponio G, Zurich MG, Schultz L, Weiss DG, Romanelli L, Gramowski-Voss A, Di Consiglio E, and Testai E
- Subjects
- Amiodarone administration & dosage, Animals, Anti-Arrhythmia Agents administration & dosage, Cells, Cultured, Dose-Response Relationship, Drug, Embryo, Mammalian cytology, Mice, Neurons metabolism, Rats, Rats, Sprague-Dawley, Amiodarone pharmacokinetics, Anti-Arrhythmia Agents pharmacokinetics, Brain cytology, Neurons drug effects
- Abstract
The difficulty in mimicking nervous system complexity and cell-cell interactions as well as the lack of kinetics information has limited the use of in vitro neurotoxicity data. Here, we assessed the biokinetic profile as well as the neurotoxicity of Amiodarone after acute and repeated exposure in two advanced rodent brain cell culture models, consisting of both neurons and glial cells organized in 2 or 3 dimensions to mimic the brain histiotypic structure and function. A strategy was applied to evidence the abiotic processes possibly affecting Amiodarone in vitro bioavailability, showing its ability to adsorb to the plastic devices. At clinically relevant Amiodarone concentrations, known to induce neurotoxicity in some patients during therapeutic treatment, a complete uptake was observed in both models in 24 h, after single exposure. After repeated treatments, bioaccumulation was observed, especially in the 3D cell model, together with a greater alteration of neurotoxicity markers. After 14 days, Amiodarone major oxidative metabolite (mono-N-desethylamiodarone) was detected at limited levels, indicating the presence of active drug metabolism enzymes (i.e. cytochrome P450) in both models. The assessment of biokinetics provides useful information on the relevance of in vitro toxicity data and should be considered in the design of an Integrated Testing Strategy aimed to identify specific neurotoxic alerts, and to improve the neurotoxicity assay predictivity for human acute and repeated exposure., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.