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7. Baseline plasma SARS-CoV-2 RNA detection predicts an adverse COVID-19 evolution in moderate to severe hospitalized patients

Author

Rizzi, M., Patrucco, F., Trevisan, M., Faolotto, G., Mercandino, A., Strola, C., Ravanini, P., Costanzo, M., Tonello, S., Matino, E., Casciaro, G. F., Croce, A., Rizzi, E., Zecca, E., Pedrinelli, A., Vassia, V., Landi, R., Bellan, M., Castello, L. M., Minisini, R., Mallela, V. R., Avanzi, G. C., Pirisi, M., Lilleri, D., Solidoro, P., Gavelli, F., and Sainaghi, P. P.

Subjects
General Medicine
Abstract

SARS-CoV-2 is a single-stranded RNA virus, known to be the causative agent of COVID-19. As the resulting disease shows a very heterogeneous range of clinical manifestations, the identification of early biomarkers allowing patients stratification according to the expected disease severity is still an unmet clinical need.In this observational prospective cohort study, 137 consecutive patients, testing positive for SARS-CoV-2 infection by nasopharyngeal swab RT-PCR or antigenic test, were enrolled to evaluate their plasma viral load at the time of hospitalization.Even if all of them had a molecular diagnosis of COVID-19, only 29 patients showed a detectable plasma SARS-CoV-2 RNAemia. Such viremic patients also showed other clinical and laboratory finding alterations (increased troponin I, IL-6, RDW-CV, and creatinine levels along with decreased platelet count and glomerular filtration rate). A plasma detectable RNA viral load predicted in hospital death or ICU admission with an odds ratio of 3.53 (CI: 1.44-8.64, P=0.0058), while the lack of a detectable viral load was associated with a faster recovery, with an odds ratio of 4.06 (CI: 1.72-9.59, P=0.0014). These findings were confirmed in multivariate models including age, sex and baseline National Early Warning Score 2 and arterial oxygen tension over inspired oxygen fraction ratio.Our data thus suggest that plasma viral RNA load at the time of hospital admission could represent a useful independent biomarker allowing early patients' stratification according to the expected disease evolution, and driving clinical decisions tailored on the specific needs of the individual patient.

Published
2022
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8. Presenting features and early mortality from SARS-CoV-2 infection in cancer patients during the initial stage of the COVID-19 pandemic in Europe

Author

Pinato, D, Lee, A, Biello, F, Segui, E, Aguilar-Company, J, Carbo, A, Bruna, R, Bower, M, Rizzo, G, Benafif, S, Carmona, C, Chopra, N, Cruz, C, D'Avanzo, F, Evans, J, Galazi, M, Garcia-Fructuoso, I, Pria, A, Newsom-Davis, T, Ottaviani, D, Patriarca, A, Reyes, R, Sharkey, R, Sng, C, Wong, Y, Ferrante, D, Scotti, L, Avanzi, G, Bellan, M, Castello, L, Marco-Hernandez, J, Molla, M, Pirisi, M, Ruiz-Camps, I, Sainaghi, P, Gaidano, G, Brunet, J, Tabernero, J, Prat, A, Gennari, A, Pinato D. J., Lee A. J. X., Biello F., Segui E., Aguilar-Company J., Carbo A., Bruna R., Bower M., Rizzo G., Benafif S., Carmona C., Chopra N., Cruz C. A., D'avanzo F., Evans J. S., Galazi M., Garcia-Fructuoso I., Pria A. D., Newsom-Davis T., Ottaviani D., Patriarca A., Reyes R., Sharkey R., Sng C. C. T., Wong Y. N. S., Ferrante D., Scotti L., Avanzi G. C., Bellan M., Castello L. M., Marco-Hernandez J., Molla M., Pirisi M., Ruiz-Camps I., Sainaghi P. P., Gaidano G., Brunet J., Tabernero J., Prat A., Gennari A., Pinato, D, Lee, A, Biello, F, Segui, E, Aguilar-Company, J, Carbo, A, Bruna, R, Bower, M, Rizzo, G, Benafif, S, Carmona, C, Chopra, N, Cruz, C, D'Avanzo, F, Evans, J, Galazi, M, Garcia-Fructuoso, I, Pria, A, Newsom-Davis, T, Ottaviani, D, Patriarca, A, Reyes, R, Sharkey, R, Sng, C, Wong, Y, Ferrante, D, Scotti, L, Avanzi, G, Bellan, M, Castello, L, Marco-Hernandez, J, Molla, M, Pirisi, M, Ruiz-Camps, I, Sainaghi, P, Gaidano, G, Brunet, J, Tabernero, J, Prat, A, Gennari, A, Pinato D. J., Lee A. J. X., Biello F., Segui E., Aguilar-Company J., Carbo A., Bruna R., Bower M., Rizzo G., Benafif S., Carmona C., Chopra N., Cruz C. A., D'avanzo F., Evans J. S., Galazi M., Garcia-Fructuoso I., Pria A. D., Newsom-Davis T., Ottaviani D., Patriarca A., Reyes R., Sharkey R., Sng C. C. T., Wong Y. N. S., Ferrante D., Scotti L., Avanzi G. C., Bellan M., Castello L. M., Marco-Hernandez J., Molla M., Pirisi M., Ruiz-Camps I., Sainaghi P. P., Gaidano G., Brunet J., Tabernero J., Prat A., and Gennari A.

Abstract

We describe the outcomes in cancer patients during the initial outbreak of the COVID-19 in Europe from the retrospective, multi-center observational OnCovid study. We identified 204 cancer patients from eight centers in the United Kingdom, Italy, and Spain aged > 18 (mean = 69) and diagnosed with COVID-19 between February 26th and April 1st, 2020. A total of 127 (62%) were male, 184 (91%) had a diagnosis of solid malignancy, and 103 (51%) had non-metastatic disease. A total of 161 (79%) had > 1 co-morbidity. A total of 141 (69%) patients had > 1 COVID-19 complication. A total of 36 (19%) were escalated to high-dependency or intensive care. A total of 59 (29%) died, 53 (26%) were discharged, and 92 (45%) were in-hospital survivors. Mortality was higher in patients aged > 65 (36% versus 16%), in those with > 2 co-morbidities (40% versus 18%) and developing > 1 complication from COVID-19 (38% versus 4%, p = 0.004). Multi-variable analyses confirmed age > 65 and > 2 co-morbidities to predict for patient mortality independent of tumor stage, active malignancy, or anticancer therapy. During the early outbreak of SARS-CoV-2 infection in Europe co-morbid burden and advancing age predicted for adverse disease course in cancer patients. The ongoing OnCovid study will allow us to compare risks and outcomes in cancer patients between the initial and later stages of the COVID-19 pandemic.

Published
2020

9. Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients

Author

Bellan, M, Patti, G, Hayden, E, Azzolina, D, Pirisi, M, Acquaviva, A, Aimaretti, G, Aluffi Valletti, P, Angilletta, R, Arioli, R, Avanzi, G, Avino, G, Balbo, P, Baldon, G, Baorda, F, Barbero, E, Baricich, A, Barini, M, Barone-Adesi, F, Battistini, S, Beltrame, M, Bertoli, M, Bertolin, S, Bertolotti, M, Betti, M, Bobbio, F, Boffano, P, Boglione, L, Borre, S, Brucoli, M, Calzaducca, E, Cammarata, E, Cantaluppi, V, Cantello, R, Capponi, A, Carriero, A, Casciaro, F, Castello, L, Ceruti, F, Chichino, G, Chirico, E, Cisari, C, Cittone, M, Colombo, C, Comi, C, Croce, E, Daffara, T, Danna, P, Della Corte, F, De Vecchi, S, Dianzani, U, Di Benedetto, D, Esposto, E, Faggiano, F, Falaschi, Z, Ferrante, D, Ferrero, A, Gagliardi, I, Gaidano, G, Galbiati, A, Gallo, S, Garavelli, P, Gardino, C, Garzaro, M, Gastaldello, M, Gavelli, F, Gennari, A, Giacomini, G, Giacone, I, Giai Via, V, Giolitti, F, Gironi, L, Gramaglia, C, Grisafi, L, Inserra, I, Invernizzi, M, Krengli, M, Labella, E, Landi, I, Landi, R, Leone, I, Lio, V, Lorenzini, L, Maconi, A, Malerba, M, Manfredi, G, Martelli, M, Marzari, L, Marzullo, P, Mennuni, M, Montabone, C, Morosini, U, Mussa, M, Nerici, I, Nuzzo, A, Olivieri, C, Padelli, S, Panella, M, Parisini, A, Pasche, A, Pau, A, Pedrinelli, A, Percivale, I, Re, R, Rigamonti, C, Rizzi, E, Rognoni, A, Roveta, A, Salamina, L, Santagostino, M, Saraceno, M, Savoia, P, Sciarra, M, Schimmenti, A, Scotti, L, Spinoni, E, Smirne, C, Tarantino, V, Tillio, P, Vaschetto, R, Vassia, V, Zagaria, D, Zavattaro, E, Zeppegno, P, Zottarelli, F, Sainaghi, P, Bellan M., Patti G., Hayden E., Azzolina D., Pirisi M., Acquaviva A., Aimaretti G., Aluffi Valletti P., Angilletta R., Arioli R., Avanzi G. C., Avino G., Balbo P. E., Baldon G., Baorda F., Barbero E., Baricich A., Barini M., Barone-Adesi F., Battistini S., Beltrame M., Bertoli M., Bertolin S., Bertolotti M., Betti M., Bobbio F., Boffano P., Boglione L., Borre S., Brucoli M., Calzaducca E., Cammarata E., Cantaluppi V., Cantello R., Capponi A., Carriero A., Casciaro F. G., Castello L. M., Ceruti F., Chichino G., Chirico E., Cisari C., Cittone M. G., Colombo C., Comi C., Croce E., Daffara T., Danna P., Della Corte F., De Vecchi S., Dianzani U., Di Benedetto D., Esposto E., Faggiano F., Falaschi Z., Ferrante D., Ferrero A., Gagliardi I., Gaidano G., Galbiati A., Gallo S., Garavelli P. L., Gardino C. A., Garzaro M., Gastaldello M. L., Gavelli F., Gennari A., Giacomini G. M., Giacone I., Giai Via V., Giolitti F., Gironi L. C., Gramaglia C., Grisafi L., Inserra I., Invernizzi M., Krengli M., Labella E., Landi I. C., Landi R., Leone I., Lio V., Lorenzini L., Maconi A., Malerba M., Manfredi G. F., Martelli M., Marzari L., Marzullo P., Mennuni M., Montabone C., Morosini U., Mussa M., Nerici I., Nuzzo A., Olivieri C., Padelli S. A., Panella M., Parisini A., Pasche A., Pau A., Pedrinelli A. R., Percivale I., Re R., Rigamonti C., Rizzi E., Rognoni A., Roveta A., Salamina L., Santagostino M., Saraceno M., Savoia P., Sciarra M., Schimmenti A., Scotti L., Spinoni E., Smirne C., Tarantino V., Tillio P. A., Vaschetto R., Vassia V., Zagaria D., Zavattaro E., Zeppegno P., Zottarelli F., Sainaghi P. P., Bellan, M, Patti, G, Hayden, E, Azzolina, D, Pirisi, M, Acquaviva, A, Aimaretti, G, Aluffi Valletti, P, Angilletta, R, Arioli, R, Avanzi, G, Avino, G, Balbo, P, Baldon, G, Baorda, F, Barbero, E, Baricich, A, Barini, M, Barone-Adesi, F, Battistini, S, Beltrame, M, Bertoli, M, Bertolin, S, Bertolotti, M, Betti, M, Bobbio, F, Boffano, P, Boglione, L, Borre, S, Brucoli, M, Calzaducca, E, Cammarata, E, Cantaluppi, V, Cantello, R, Capponi, A, Carriero, A, Casciaro, F, Castello, L, Ceruti, F, Chichino, G, Chirico, E, Cisari, C, Cittone, M, Colombo, C, Comi, C, Croce, E, Daffara, T, Danna, P, Della Corte, F, De Vecchi, S, Dianzani, U, Di Benedetto, D, Esposto, E, Faggiano, F, Falaschi, Z, Ferrante, D, Ferrero, A, Gagliardi, I, Gaidano, G, Galbiati, A, Gallo, S, Garavelli, P, Gardino, C, Garzaro, M, Gastaldello, M, Gavelli, F, Gennari, A, Giacomini, G, Giacone, I, Giai Via, V, Giolitti, F, Gironi, L, Gramaglia, C, Grisafi, L, Inserra, I, Invernizzi, M, Krengli, M, Labella, E, Landi, I, Landi, R, Leone, I, Lio, V, Lorenzini, L, Maconi, A, Malerba, M, Manfredi, G, Martelli, M, Marzari, L, Marzullo, P, Mennuni, M, Montabone, C, Morosini, U, Mussa, M, Nerici, I, Nuzzo, A, Olivieri, C, Padelli, S, Panella, M, Parisini, A, Pasche, A, Pau, A, Pedrinelli, A, Percivale, I, Re, R, Rigamonti, C, Rizzi, E, Rognoni, A, Roveta, A, Salamina, L, Santagostino, M, Saraceno, M, Savoia, P, Sciarra, M, Schimmenti, A, Scotti, L, Spinoni, E, Smirne, C, Tarantino, V, Tillio, P, Vaschetto, R, Vassia, V, Zagaria, D, Zavattaro, E, Zeppegno, P, Zottarelli, F, Sainaghi, P, Bellan M., Patti G., Hayden E., Azzolina D., Pirisi M., Acquaviva A., Aimaretti G., Aluffi Valletti P., Angilletta R., Arioli R., Avanzi G. C., Avino G., Balbo P. E., Baldon G., Baorda F., Barbero E., Baricich A., Barini M., Barone-Adesi F., Battistini S., Beltrame M., Bertoli M., Bertolin S., Bertolotti M., Betti M., Bobbio F., Boffano P., Boglione L., Borre S., Brucoli M., Calzaducca E., Cammarata E., Cantaluppi V., Cantello R., Capponi A., Carriero A., Casciaro F. G., Castello L. M., Ceruti F., Chichino G., Chirico E., Cisari C., Cittone M. G., Colombo C., Comi C., Croce E., Daffara T., Danna P., Della Corte F., De Vecchi S., Dianzani U., Di Benedetto D., Esposto E., Faggiano F., Falaschi Z., Ferrante D., Ferrero A., Gagliardi I., Gaidano G., Galbiati A., Gallo S., Garavelli P. L., Gardino C. A., Garzaro M., Gastaldello M. L., Gavelli F., Gennari A., Giacomini G. M., Giacone I., Giai Via V., Giolitti F., Gironi L. C., Gramaglia C., Grisafi L., Inserra I., Invernizzi M., Krengli M., Labella E., Landi I. C., Landi R., Leone I., Lio V., Lorenzini L., Maconi A., Malerba M., Manfredi G. F., Martelli M., Marzari L., Marzullo P., Mennuni M., Montabone C., Morosini U., Mussa M., Nerici I., Nuzzo A., Olivieri C., Padelli S. A., Panella M., Parisini A., Pasche A., Pau A., Pedrinelli A. R., Percivale I., Re R., Rigamonti C., Rizzi E., Rognoni A., Roveta A., Salamina L., Santagostino M., Saraceno M., Savoia P., Sciarra M., Schimmenti A., Scotti L., Spinoni E., Smirne C., Tarantino V., Tillio P. A., Vaschetto R., Vassia V., Zagaria D., Zavattaro E., Zeppegno P., Zottarelli F., and Sainaghi P. P.

Abstract

Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk.

Published
2020

15. Simple parameters from complete blood count predict in-hospital mortality in covid-19

Author

Bellan, M., Azzolina, D., Hayden, E., Gaidano, G., Pirisi, M., Acquaviva, A., Aimaretti, G., Valletti, P. A., Angilletta, R., Arioli, R., Avanzi, G. C., Avino, G., Balbo, P. E., Baldon, G., Baorda, F., Barbero, E., Baricich, A., Barini, M., Barone-Adesi, F., Battistini, S., Beltrame, M., Bertoli, M., Bertolin, S., Bertolotti, M., Betti, M., Bobbio, F., Boffano, P., Boglione, L., Borre, S., Brucoli, M., Calzaducca, E., Cammarata, E., Cantaluppi, V., Cantello, R., Capponi, A., Carriero, A., Casciaro, G. F., Castello, L. M., Ceruti, F., Chichino, G., Chirico, E., Cisari, C., Cittone, M. G., Colombo, C., Comi, C., Croce, E., Daffara, T., Danna, P., Corte, F. D., de Vecchi, S., Dianzani, U., Benedetto, D. D., Esposto, E., Faggiano, F., Falaschi, Z., Ferrante, D., Ferrero, A., Gagliardi, I., Galbiati, A., Gallo, S., Garavelli, P. L., Gardino, C. A., Garzaro, M., Gastaldello, M. L., Gavelli, F., Gennari, A., Giacomini, G. M., Giacone, I., Via, V. G., Giolitti, F., Gironi, L. C., Gramaglia, C., Grisafi, L., Inserra, I., Invernizzi, M., Krengli, M., Labella, E., Landi, I. C., Landi, R., Leone, I., Lio, V., Lorenzini, L., Maconi, A., Malerba, M., Manfredi, G. F., Martelli, M., Marzari, L., Marzullo, P., Mennuni, M., Montabone, C., Morosini, U., Mussa, M., Nerici, I., Nuzzo, A., Olivieri, C., Padelli, S. A., Panella, M., Parisini, A., Pasche, A., Patrucco, F., Patti, G., Pau, A., Pedrinelli, A. R., Percivale, I., Ragazzoni, L., Re, R., Rigamonti, C., Rizzi, E., Rognoni, A., Roveta, A., Salamina, L., Santagostino, M., Saraceno, M., Savoia, P., Sciarra, M., Schimmenti, A., Scotti, L., Spinoni, E., Smirne, C., Tarantino, V., Tillio, P. A., Tonello, S., Vaschetto, R., Vassia, V., Zagaria, D., Zavattaro, E., Zeppegno, P., Zottarelli, F., Sainaghi, P. P., Aiosa, G., Airoldi, A., Barco, A., Bargiacchi, O., Bazzano, S., Berni, P., Bianchi, B., Bianco, S., Biffi, S., Binda, V., Bolgeo, T., Bolla, C., Bonato, V., Bonizzoni, G., Bragantini, A., Brustia, D., Bullara, V., Burlone, M., Brustia, F., Caccia, S., Calareso, A., Cammarota, G., Cancelliere, L., Carbone, R., Cassinari, A., Ceriani, E., Cena, T., Clivati, E., Collimedaglia, L., Colombatto, A., Cornella, C., Costanzo, M., Croce, A., de Benedittis, C., Delorenzi, S., Dionisio, R., Donato, P., Esposito, M., Fangazio, S., Feggi, A., Ferrillo, S., Foci, V., Fra, G. P., Gaggino, C., Gambaro, E., Gattoni, E., Gattoni, L., Giacchero, F., Gianfreda, R., Giubertoni, A., Grecu, L., Grossi, F., Guglielmetti, G., Guido, S., Iannantuoni, G., Ingrao, S., Jona, A., Lazzarich, E., Lissandrin, R., Maduli, E., Magne, F., Mantia, E., Marangon, D., Massara, M., Matino, E., Mauri, M. G., Menegatti, M., Moglia, R., Molinari, R., Morelli, S., Morlino, P., Naldi, P., Nebbiolo, C., Omodeo, P., Palmieri, D., Panero, A., Parodi, M., Pedrazzoli, R., Pelazza, C., Penpa, S., Perucca, R., Pirovano, A., Pittau, S., Pochetti, P., Poletti, F., Polla, B., Prandi, P., Prodam, F., Prosperini, P., Puma, A., Quaglia, M., Raie, A., Rapetti, R., Ravera, S., Re, A., Reale, M., Rossati, A., Rossi, M., Rossi, P., Rostagno, R., Salomoni, G., Sama, M. T., Sarchi, E., Sarcoli, M., Sarda, C., Sguazzotti, I., Soddu, D., Sola, D., Stobbione, P., Todoerti, M., Vallese, G. C., Varrasi, C., Veia, A., Vignazia, G. L., Zanotti, I., Zecca, E., Zichittella, D., Zisa, G., and Zoppis, E.

Subjects
Adult, Male, medicine.medical_specialty, Medicine (General), Multivariate analysis, Article Subject, Clinical Decision Rules, COVID-19, Prognosis, Blood Cell Count, Hospital Mortality, Severity of Illness Index, Clinical Biochemistry, Asymptomatic, Severity of Illness Index, NO, R5-920, Internal medicine, Clinical Decision Rules, Severity of illness, Genetics, 80 and over, Medicine, Humans, Hospital Mortality, Molecular Biology, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Biochemistry (medical), Complete blood count, COVID-19, Retrospective cohort study, Red blood cell distribution width, General Medicine, Odds ratio, Middle Aged, Prognosis, Female, Italy, Multivariate Analysis, Blood Cell Count, Cohort, medicine.symptom, business, Research Article
Abstract

Introduction. The clinical course of Coronavirus Disease 2019 (COVID-19) is highly heterogenous, ranging from asymptomatic to fatal forms. The identification of clinical and laboratory predictors of poor prognosis may assist clinicians in monitoring strategies and therapeutic decisions. Materials and Methods. In this study, we retrospectively assessed the prognostic value of a simple tool, the complete blood count, on a cohort of 664 patients ( F 260; 39%, median age 70 (56-81) years) hospitalized for COVID-19 in Northern Italy. We collected demographic data along with complete blood cell count; moreover, the outcome of the hospital in-stay was recorded. Results. At data cut-off, 221/664 patients (33.3%) had died and 453/664 (66.7%) had been discharged. Red cell distribution width (RDW) ( χ 2 10.4; p < 0.001 ), neutrophil-to-lymphocyte (NL) ratio ( χ 2 7.6; p = 0.006 ), and platelet count ( χ 2 5.39; p = 0.02 ), along with age ( χ 2 87.6; p < 0.001 ) and gender ( χ 2 17.3; p < 0.001 ), accurately predicted in-hospital mortality. Hemoglobin levels were not associated with mortality. We also identified the best cut-off for mortality prediction: a NL ratio > 4.68 was characterized by an odds ratio for in-hospital mortality OR = 3.40 (2.40-4.82), while the OR for a RDW > 13.7 % was 4.09 (2.87-5.83); a platelet count > 166,000 /μL was, conversely, protective (OR: 0.45 (0.32-0.63)). Conclusion. Our findings arise the opportunity of stratifying COVID-19 severity according to simple lab parameters, which may drive clinical decisions about monitoring and treatment.

Published
2021

21. Microzonazione sismica di livello 3: il caso del centro abitato di Fivizzano (MS)

Author

Baglione, M, D’Intinosante, V, Fabbroni, P, Nistri, L, Vannini, F, D'Amato Avanzi, G, Puccinelli, A, Naso, G, Cavuoto, G, Di Fiore, V, Pelosi, N, Punzo, M, Tarallo, D, Moscatelli, M, Simionato, M, Pileggi, D, Avalle, A, Pagliaroli, A, Vessia, G, Piscitelli, S, Perrone, A, Bellanova, J, Calamita, G, Ginesi, G, Bramerini, F, Castenetto, Galli, P, Pallone, F, and Albarello, D

Subjects
Microzonazione sismica, rischio sismico, terremoto, Garfagnana e Lunigiana (LU e MS), rischio sismico, terremoto, Microzonazione sismica, Garfagnana e Lunigiana (LU e MS)
Published
2019

24. Osteopontin in the Cerebrospinal Fluid of Patients with Severe Aneurysmal Subarachnoid Hemorrhage

Author

Abate, M, Moretto, L, Licari, I, Esposito, T, Capuano, L, Olivieri, C, Benech, A, Brucoli, M, Avanzi, G, Cammarota, G, Dianzani, U, Clemente, N, Panzarasa, G, Citerio, G, Carfagna, F, Cappellano, G, Della Corte, F, Vaschetto, R, Abate, MG, Avanzi, GC, Abate, M, Moretto, L, Licari, I, Esposito, T, Capuano, L, Olivieri, C, Benech, A, Brucoli, M, Avanzi, G, Cammarota, G, Dianzani, U, Clemente, N, Panzarasa, G, Citerio, G, Carfagna, F, Cappellano, G, Della Corte, F, Vaschetto, R, Abate, MG, and Avanzi, GC

Abstract

Aneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality. In SAH patients, plasma osteopontin (OPN) has been shown to independently predict poor outcome. The aim of the study is to investigate, in a selected population with severe SAH, OPN time course in cerebrospinal fluid (CSF) and plasma during the first week after aneurism rupture, and OPN prognostic value. We included 44 patients with the following criteria: (1) age 18 and 80 years, (2) diagnosis of SAH from cerebral aneurysm rupture, (3) insertion of external ventricular drain. Plasma and CSF were sampled at day 1, 4, and 8. OPN levels, in CSF and plasma, displayed a weak correlation on day 1 and were higher, in CSF, in all time points. Only in poor prognosis patients, OPN levels in CSF significantly increased at day 4 and day 8. Plasma OPN at day 1 and 4 was predictor of poor outcome. In conclusion, plasma and CSF OPN displays a weak correlation, on day 1. The higher levels of OPN found in the CSF compared to plasma, suggest OPN production within the CNS after SAH. Furthermore, plasma OPN, at day 1 and 4, seems to be an independent predictor of poor outcome.

Published
2019

25. Effects of the type of inventory on landslides susceptibility estimated by data-driven methods

Author

Bordoni, M., Persichillo, M. G., Meisina, C., Bartelletti, C., Giannecchini, R., D’Amato Avanzi, G., Galanti, Y., Barsanti, M., Cevasco, A., Brandolini, P., Cavalli, M., Crema, S., and Galve, J. P.

Subjects
data-driven methods, landslide inventories, landslide inventories, landslide susceptibility analysis, data-driven methods, landslide susceptibility analysis
Published
2018

27. Integrating sediment connectivity into the assessment of landslides susceptibility for road network

Author

Bordoni M., Persichillo M. G., Cavalli M., Crema S., Meisina C., Bartelletti C., Galanti Y., Barsanti M., Giannecchini R., and D'Amato Avanzi G.

Subjects
Susceptibility, Shallow landslides, data-driven models, Sediment connectivity, Roads
Abstract

Landslides provoke significant direct and indirect economic losses to infrastructures, in particular along road networks. Thus, it is fundamental identifying the route sectors that could be affected by landslides, in order to reduce the risk level for the population and the economic cost of road damaging. Moreover, several researches conducted in different contexts stressed that the exposure of road networks to slope instabilities could increase because of ongoing climate change and as a consequence of growing economy in several countries. For these reasons, the present work aims to develop and test a data-driven model, based on Genetic Algorithm Method (GAM), for the identification of the sectors road network sectors that are susceptible to be affected by landslides triggered upstream the infrastructure. This work quantifies, also, the impact of sediment connectivity on the susceptibility evaluation in the case studies. The study area corresponds to the north-eastern area of Oltrepò Pavese (northern Italy), a zone very prone to shallow landslides causing severe damages to the road networks. This work shows that the effectiveness of the model in the identification of the most susceptible routes increases including sediment connectivity in the predisposing factors. This parameter, indeed, characterizes runout and the travel distance of a slope instability, improving the ability in identifying the road sectors hit by landslides. The modeled susceptible roads are, then, mapped correctly by the methodology, furnishing an important tool for land use planning and for implementing tools able to reduce the risk for the infrastructures.

Published
2018

30. Early or delayed bronchoscopy in patients admitted to the emergency department for mild-to-moderate hemoptysis?

Author

Patrucco, F, Gavelli, F, Avanzi, G, Stainer, A, Bodini, B, Castello, L, Balbo, P, Avanzi, GC, Bodini, BD, Castello, LM, Balbo, PE, Patrucco, F, Gavelli, F, Avanzi, G, Stainer, A, Bodini, B, Castello, L, Balbo, P, Avanzi, GC, Bodini, BD, Castello, LM, and Balbo, PE

Abstract

BacKGrOUNd: The correct timing for bronchoscopy in massive hemoptysis is well established, whereas in mild-to-moderate hemoptysis there still is uncertainty. The aim of our study was to evaluate if performing a fibrobronchoscopy (FBS) within 48 hours after the onset of mild-to-moderate hemoptysis was related to a higher possibility to identify the site and the cause of bleeding, compared to a delayed one. meTHOdS: We conducted a retrospective study over one-year period from march 2015, in which consecutive patients admitted to the emergency department underwent FBS for spontaneous mild-to-moderate hemoptysis in our medium-size teaching hospital. RESULTS: We included 69 patients. Definitive diagnosis was achieved in 52 cases (75%) combining clinical, imaging and endoscopic data (neoplastic diseases 22%, infections 20%, alveolar hemorrhage 13%). FBS was performed within 48 hours of symptoms onset in 41 patients (59%). The site of bleeding was identified in 28 cases (41%), 64% of which underwent FBS within 48 hours. Endoscopic diagnosis was reached in 45 patients (65%), 60% of which underwent FBS within 48 hours. No statistical association with localization (P=0.62) or diagnosis (P=1.00) was found with early FBS. Despite a high prevalence in our cohort of patients treated with anticoagulant or antiplatelet drugs (39%), we found no statistical association with bronchoscopy localization (P=0.12) and diagnosis (P=0.21). cONcLUSiONS: in conclusion, in case of mild to moderate hemoptysis, an early bronchoscopy in the emergency department setting does not seem to improve the possibility to find neither the cause nor the localization of the bleeding source.

Published
2018

39. Therapeutic Plasma Adsorption. A Review

Author

Avanzi G, F. Cepparrone, Lombardo R, and Di Pietro G

Subjects
New horizons, medicine.medical_treatment, 030232 urology & nephrology, Biomedical Engineering, Medicine (miscellaneous), Bioengineering, 030204 cardiovascular system & hematology, law.invention, Biomaterials, 03 medical and health sciences, 0302 clinical medicine, Adsorption, law, medicine, Humans, Filtration, Chromatography, Chemistry, Therapeutic plasmapheresis, Plasmapheresis, General Medicine, Clinical Practice, Dextran sulphate, Absorption (chemistry)
Abstract

Alternative techniques to the traditional plasma exchange are emerging in clinical practice for the treatment of different pathological conditions, particularly autoimmune diseases. Filtration is a technique used to separate blood cells from plasma, which may be further “treated” with other filters or columns. The case for cascade filtration and absorption onto a column is becoming stronger and stronger and the patient population is increasing. Alongside the “historical” techniques of adsorption onto a column, new systems (pairs of self-regenerating columns) and new products (columns with dextran sulphate, tryptophane, anti-human lipoprotein antibodies) are now available. Protein A in particular seems to open up new horizons; in therapeutic plasmapheresis, there are two versions, one Swedish and the other American, based on different theoretical premises and obtaining different results, with different biocompatibilities but good clinical results.

Published
1993
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