15 results on '"Bernasconi D"'
Search Results
2. Improving predictive accuracy in primary biliary cholangitis: A new genetic risk score
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Gerussi, A, Cappadona, C, Bernasconi, D, Cristoferi, L, Valsecchi, M, Carbone, M, Invernizzi, P, Asselta, R, Gerussi A., Cappadona C., Bernasconi D. P., Cristoferi L., Valsecchi M. G., Carbone M., Invernizzi P., Asselta R., Gerussi, A, Cappadona, C, Bernasconi, D, Cristoferi, L, Valsecchi, M, Carbone, M, Invernizzi, P, Asselta, R, Gerussi A., Cappadona C., Bernasconi D. P., Cristoferi L., Valsecchi M. G., Carbone M., Invernizzi P., and Asselta R.
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Background and AimsGenetic variants influence primary biliary cholangitis (PBC) risk. We established and tested an accurate polygenic risk score (PRS) using these variants. MethodsData from two Italian cohorts (OldIT 444 cases, 901 controls; NewIT 255 cases, 579 controls) were analysed. The latest international genome-wide meta-analysis provided effect size estimates. The PRS, together with human leukocyte antigen (HLA) status and sex, was included in an integrated risk model. ResultsStarting from 46 non-HLA genes, 22 variants were selected. PBC patients in the OldIT cohort showed a higher risk score than controls: -.014 (interquartile range, IQR, -.023, .005) versus -.022 (IQR -.030, -.013) (p < 2.2 x 10(-16)). For genetic-based prediction, the area under the curve (AUC) was .72; adding sex increased the AUC to .82. Validation in the NewIT cohort confirmed the model's accuracy (.71 without sex, .81 with sex). Individuals in the top group, representing the highest 25%, had a PBC risk approximately 14 times higher than that of the reference group (lowest 25%; p < 10(-6)). ConclusionThe combination of sex and a novel PRS accurately discriminated between PBC cases and controls. The model identified a subset of individuals at increased risk of PBC who might benefit from tailored monitoring.
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- 2024
3. Patient perceptions of altering chemotherapy treatment due to peripheral neuropathy
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Hertz, D, Tofthagen, C, Rossi, E, Bernasconi, D, Lim, J, Carlson, M, Sheffield, K, Nekhlyudov, L, Grech, L, Von Ah, D, Mayo, S, Ruddy, K, Chan, A, Alberti, P, Lustberg, M, Tanay, M, Hertz, Daniel L, Tofthagen, Cindy, Rossi, Emanuela, Bernasconi, Davide Paolo, Lim, Jiyoon, Carlson, Martha, Sheffield, Katharine E, Nekhlyudov, Larissa, Grech, Lisa, Von Ah, Diane, Mayo, Samantha J, Ruddy, Kathryn J, Chan, Alexandre, Alberti, Paola, Lustberg, Maryam B, Tanay, Mary, Hertz, D, Tofthagen, C, Rossi, E, Bernasconi, D, Lim, J, Carlson, M, Sheffield, K, Nekhlyudov, L, Grech, L, Von Ah, D, Mayo, S, Ruddy, K, Chan, A, Alberti, P, Lustberg, M, Tanay, M, Hertz, Daniel L, Tofthagen, Cindy, Rossi, Emanuela, Bernasconi, Davide Paolo, Lim, Jiyoon, Carlson, Martha, Sheffield, Katharine E, Nekhlyudov, Larissa, Grech, Lisa, Von Ah, Diane, Mayo, Samantha J, Ruddy, Kathryn J, Chan, Alexandre, Alberti, Paola, Lustberg, Maryam B, and Tanay, Mary
- Abstract
Purpose: Clinical practice guidelines recommend altering neurotoxic chemotherapy treatment in patients experiencing intolerable chemotherapy-induced peripheral neuropathy (CIPN). The primary objective of this survey was to understand patient’s perspectives on altering neurotoxic chemotherapy treatment, including their perceptions of the benefits of preventing irreversible CIPN and the risks of reducing treatment efficacy. Methods: A cross-sectional online survey was distributed via social networks to patients who were currently receiving or had previously received neurotoxic chemotherapy for cancer. Survey results were analyzed using descriptive statistics and qualitative analysis. Results: Following data cleaning, 447 participants were included in the analysis. The median age was 57 years, 93% were white, and most were from the UK (53%) or USA (38%). Most participants who were currently or recently treated expected some CIPN symptom resolution (86%), but 45% of those who had completed treatment more than a year ago reported experiencing no symptom resolution. Participants reported that they would discontinue chemotherapy treatment for less severe CIPN if they knew their symptoms would be permanent than if symptoms would disappear after treatment. Most patients stated that the decision to alter chemotherapy or not was usually made collaboratively between the patient and their treating clinician (61%). The most common reason participants were reluctant to talk with their clinician about CIPN was fear that treatment would be altered. Participants noted a need for improved understanding of CIPN symptoms and their permanence, better patient education relating to CIPN prior to and after treatment, and greater clinician understanding and empathy around CIPN. Conclusions: This survey highlights the importance of shared decision-making, including a consideration of both the long-term benefits and risks of altering neurotoxic chemotherapy treatment due to CIPN. Additional wo
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- 2024
4. Prenatal use of indomethacin for preterm labor and renal function among very low birth weight infants
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Sinelli, M, Ornaghi, S, Doni, D, Paterlini, G, Locatelli, A, Bernasconi, D, Vergani, P, Ventura, M, Bernasconi, DP, Ventura, ML, Sinelli, M, Ornaghi, S, Doni, D, Paterlini, G, Locatelli, A, Bernasconi, D, Vergani, P, Ventura, M, Bernasconi, DP, and Ventura, ML
- Abstract
BACKGROUND: Indomethacin is administered as a tocolytic agent for threatening preterm labor <28weeks of gestation. Only a few, not conclusive, studies have investigated its nephrotoxicity in very low birth weight (VLBW) infants. We investigated whether indomethacin increases the incidence of acute kidney injury (AKI) among VLBW infants. METHODS: This is a retrospective study including all VLBW infants born at our center between January 1, 2005, and December 31, 2013. Indomethacin was administered to women with preterm labor and intact membranes. Neonatal AKI was defined according to KDIGO classification. Univariate analyses were performed comparing VLBW infants exposed to and not exposed to indomethacin. In the multivariable model, the association of indomethacin and AKI was adjusted for patent ductus arteriosus, use of nephrotoxic medications, birth weight, and gestational age. RESULTS: Five hundred seventy-five VLBW infants were included, 49 (8.5%) of whom were exposed to indomethacin in utero. The univariate analysis showed that infants exposed to indomethacin had lower birth weight, lower gestational age, and higher incidence of AKI than infants not exposed. The multivariable model adjusted for confounding factors confirmed an increased risk of AKI in relation to gestational age at birth <27 weeks, but not to indomethacin. CONCLUSIONS: Our data suggest that extreme prematurity, but not the use of indomethacin, is associated with AKI.
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- 2024
5. Quantitative CT scan and response to pronation in COVID-19 ARDS
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Zadek, F, Berta, L, Zorzi, G, Ubiali, S, Bonaiuti, A, Tundo, G, Brunoni, B, Marrazzo, F, Giudici, R, Rossi, A, Rizzetto, F, Bernasconi, D, Vanzulli, A, Colombo, P, Fumagalli, R, Torresin, A, Langer, T, Zadek, Francesco, Berta, Luca, Zorzi, Giulia, Ubiali, Stefania, Bonaiuti, Amos, Tundo, Giulia, Brunoni, Beatrice, Marrazzo, Francesco, Giudici, Riccardo, Rossi, Anna, Rizzetto, Francesco, Bernasconi, Davide Paolo, Vanzulli, Angelo, Colombo, Paola Enrica, Fumagalli, Roberto, Torresin, Alberto, Langer, Thomas, Zadek, F, Berta, L, Zorzi, G, Ubiali, S, Bonaiuti, A, Tundo, G, Brunoni, B, Marrazzo, F, Giudici, R, Rossi, A, Rizzetto, F, Bernasconi, D, Vanzulli, A, Colombo, P, Fumagalli, R, Torresin, A, Langer, T, Zadek, Francesco, Berta, Luca, Zorzi, Giulia, Ubiali, Stefania, Bonaiuti, Amos, Tundo, Giulia, Brunoni, Beatrice, Marrazzo, Francesco, Giudici, Riccardo, Rossi, Anna, Rizzetto, Francesco, Bernasconi, Davide Paolo, Vanzulli, Angelo, Colombo, Paola Enrica, Fumagalli, Roberto, Torresin, Alberto, and Langer, Thomas
- Abstract
Background: The use of the prone position (PP) has been widespread during the COVID-19 pandemic. While it has demonstrated benefits, including improved oxygenation and lung aeration, the factors influencing the response in terms of gas exchange to PP remain unclear. In particular, the association between baseline quantitative Computed Tomography (qCT) scan results and gas exchange response to PP in intubated, mechanically ventilated subjects with COVID-19 ARDS is unknown. The present study aimed to compare baseline qCT results between subjects responding to PP in terms of oxygenation or carbon dioxide (CO2) clearance and those who did not.Methods: This was a single-center, retrospective observational study, including critically ill, intubated, mechanically ventilated subjects with COVID-19 related acute respiratory distress syndrome admitted to the ICUs of Niguarda Hospital between March 2020 and November 2021. Blood-gas samples were collected before and after PP. Subjects in whom the PaO2/FiO2 increase was ≥ 20 mmHg after PP were defined as Oxygen responders (Oxy-R). CO2-responders (CO2R) were defined when the ventilatory ratio (VR) decreased during PP. Automated qCT analyses were performed to obtain tissue mass and density of the lungs.Results: One hundred twenty-five subjects were enrolled, of which 116 (93%) were Oxy-R and 51 (41%) CO2R. No difference in qCT characteristics and oxygen were observed between Oxy-R and Oxygen Non Responders (Tissue mass 1532 ±396 vs. 1654 ±304 g, p= .28; density -544±109 vs. -562±58 HU, p= .42). Similar findings were observed when dividing the population according to CO2 response (Tissue mass 1551±412 vs. 1534±377 g, p= .89; density -545±123 vs. -546±94 HU, p= .99).Conclusions: Most COVID-19 related ARDS subjects improve their oxygenation at the first pronation cycle. The study suggests that baseline qCT scan data are not associated with the response to PP in oxygenation or CO2 in mechanically ventilated COVID-19 related ARDS subje
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- 2024
6. Are there any benefits of prolonged hypothermic oxygenated perfusion? - Results from a national retrospective study.
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De Carlis R, Lauterio A, Schlegel A, Gringeri E, Patrono D, Camagni S, Dondossola D, Pezzati D, Olivieri T, Pagano D, Bongini M, Montanelli P, Ravaioli M, Bernasconi D, Valsecchi MG, Baccarani U, Cescon M, Andorno E, Mazzaferro V, Gruttadauria S, Di Benedetto F, Ghinolfi D, Caccamo L, Pinelli D, Romagnoli R, Cillo U, and De Carlis L
- Abstract
Background: Dual hypothermic oxygenated perfusion (DHOPE) is increasingly being used to extend liver preservation to improve transplant logistics. However, little is known about its benefits in high-risk liver grafts. This study aimed to investigate whether prolonged DHOPE provides benefits other than improved logistics in all liver types., Methods: We performed a national retrospective cohort study of 177 liver transplants from 12 Italian centers preserved with DHOPE for ≥4h between 2015 and 2022. A control group of 177 DHOPEs of <4h during the same period was created using 1:1 propensity score matching. The impact of risk profiles and preservation times on the outcomes was assessed using univariable and multivariable regression models., Results: No significant differences in post-transplant outcomes were found between prolonged and short DHOPEs. However, the prolonged group had a significantly lower incidence of post-transplant acute kidney injury (AKI) compared to the short group (30.5% vs. 44.6%, p=0.008). Among prolonged DHOPEs, no differences in transplant outcomes were observed according to donor risk index (DRI), Eurotransplant definition for marginal grafts, and balance of risk (BAR) score. DHOPE duration was associated with a lower risk of AKI in multivariable models adjusted for DRI, Eutrotransplant marginal grafts, and BAR score. Prolonged HOPE confirmed its protective effect against AKI in a multivariable model adjusted for donor and recipient risk factors [OR: 0.412, 95%CI: 0.200-0.850, p=0.016]., Conclusions: Prolonged DHOPE is widely used to improve transplant logistics, provides good results with high-risk grafts, and appears to be associated with a lower risk of post-transplant AKI. These results provide further insight into the important role of DHOPE in preventing post-transplant complications., (Copyright © 2024 American Association for the Study of Liver Diseases.)
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- 2024
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7. Long-term prognostic performance of cardiac magnetic resonance imaging markers versus complicated clinical presentation after an acute myocarditis.
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Ammirati E, Varrenti M, Sormani P, Bernasconi D, Moro C, Grosu A, D'Elia S, Raineri C, Quattrocchi G, Milazzo A, Turco A, Maestroni A, Valsecchi MG, Oliva F, Garascia A, Giannattasio C, Camici PG, and Pedrotti P
- Abstract
Background: Identifying markers associated with adverse events after acute myocarditis (AM) is relevant to plan follow-up. We assessed the prognostic performance of previously described cardiac magnetic resonance imaging (CMRI) markers and their combination: septal late gadolinium enhancement (LGE) localization and left ventricular ejection fraction (LVEF) < 50 % on baseline CMRI versus complicated clinical presentation (CCP: the presence of sustained ventricular tachycardia, or LVEF<50 % on the first echocardiogram or fulminant presentation)., Methods: We retrospectively assessed 248 AM patients (median age of 34 years, 87.1 % male) from 6 hospitals with onset of cardiac symptoms<30 days, increased troponin, and CMRI/histology consistent with myocarditis to identify those at risk of major cardiac events (cardiac death, heart transplantation, aborted sudden cardiac death, sustained ventricular tachycardia, or heart failure hospitalization)., Results: Thirteen patients (5.2 %) experienced at least one major cardiac event after a median follow-up of 4.7 years with a significant hazard ratio of 35.8 for CCP vs. 9.2 for septal LGE vs. 12.4 for LVEF<50 % on baseline CMRI (p = 0.001). CCP had the best c-index to identify patients with events: 0.836 vs. 0.786 for septal LGE and 0.762 for LVEF<50 %, while the combination of CCP plus LVEF<50 % or septal LGE has the highest c-index of 0.866. All 3 markers had high negative predictive value (NPV) of ≥0.98., Conclusions: Major cardiac events after an AM are relatively low, and CCP, septal LGE, and LVEF<50 % are significantly associated with events. These markers have especially high NPV to identify patients without events after an AM. These observations can help clinicians to monitor the patients after an AM., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier B.V.)
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- 2024
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8. Serum and CSF biomarkers in asymptomatic patients during primary HIV infection: a randomized study.
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Calcagno A, Cusato J, Cinque P, Marchetti G, Bernasconi D, Trunfio M, Bruzzesi E, Rusconi S, Gabrieli A, Muscatello A, Antinori A, Ripamonti D, Gulminetti R, Antonucci M, and Nozza S
- Abstract
It is debated whether central nervous system involvement begins during acute HIV infection in persons without meningitis/encephalitis and if specific antiretroviral drugs or combinations would be beneficial. Neurologically asymptomatic participants enrolled in a randomized and controlled study comparing three combination antiretroviral regimens (tenofovir alafenamide/emtricitabine plus dolutegravir, darunavir or both) during primary HIV infection were enrolled. Serum and cerebrospinal fluid (CSF) were collected at baseline, 12 and 48 (serum only) weeks after treatment initiation. Single Molecule Array was used to measure neurofilament light chain (NFL), total tau protein (Tau), Brain-Derived Neurotrophic Factor (BDNF), Glial Fibrillary Acidic Protein (GFAP), Ubiquitin C-terminal Hydrolase (UCH-L1). We assessed the longitudinal change in biomarkers over time as well as the change in the prevalence of serum NFL concentrations above previously published age-adjusted cut-offs (7 pg/mL if 5-18 years, 10 pg/mL if 18-51 years, 15 pg/mL if 51-61 years, 20 pg/mL if 61-70 years and 35 pg/mL if >70 years). Serum was available from 47 participants at all time points while CSF was in 13 and 7 participants (baseline/W12). We observed a significant direct serum-to-CSF correlation for NFL (rho = 0.692, p = 0.009), GFAP (rho = 0.659, p = 0.014) and BDNF (rho = 0.587, p = 0.045). Serum (rho = 0.560, p = 0.046) and CSF NFL (rho = 0.582, p = 0.037) concentrations were directly associated with CSF HIV RNA levels. We observed a significant decrease over time in serum NFL (p = 0.006) and GFAP (p = 0.006) but not in the other biomarkers. No significant difference was observed among the treatment arms. At baseline, serum and CSF age-adjusted NFL levels were above age-adjusted cut-offs in 23 (48.9%) and 4 participants (30.8%); considering serum NFL, this proportion was lower at weeks 12 (31.9%, p = 0.057) and 48 (27.7%, p = 0.13). A relevant proportion of neurologically asymptomatic participants had abnormal CSF and serum NFL levels during primary HIV infection. NFL and GFAP decreased in serum following combination antiretroviral therapy without significant differences among the treatment arms., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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9. Single large hepatocellular carcinoma > 5 cm with surgical indication: is it mandatory a major hepatectomy? a propensity-score weighted analysis.
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Garancini M, Serenari M, Famularo S, Cipriani F, Ardito F, Russolillo N, Conci S, Nicolini D, Perri P, Zanello M, Iaria M, Lai Q, Romano M, La Barba G, Molfino S, Germani P, Dominioni T, Zimmiti G, Conticchio M, Fumagalli L, Zago M, Troci A, Sciannamea I, Ferrari C, Scotti MA, Griseri G, Antonucci A, Crespi M, Pinotti E, Chiarelli M, Memeo R, Hilal MA, Maestri M, Tarchi P, Baiocchi G, Ercolani G, Zanus G, Rossi M, Valle RD, Jovine E, Frena A, Patauner S, Grazi GL, Vivarelli M, Ruzzenente A, Ferrero A, Giuliante F, Aldrighetti L, Torzilli G, Cescon M, Bernasconi D, and Romano F
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- Humans, Male, Female, Retrospective Studies, Middle Aged, Aged, Postoperative Complications etiology, Treatment Outcome, Survival Rate, Adult, Hepatectomy methods, Carcinoma, Hepatocellular surgery, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular mortality, Liver Neoplasms surgery, Liver Neoplasms pathology, Liver Neoplasms mortality, Propensity Score
- Abstract
Purpose: Single large hepatocellular carcinoma >5cm (SLHCC) traditionally requires a major liver resection. Minor resections are often performed with the goal to reduce morbidity and mortality. Aim of the study was to establish if a major resection should be considered the best treatment for SLHCC or a more limited resection should be preferred., Methods: A multicenter retrospective analysis of the HE.RC.O.LE.S. Group register was performed. All collected patients with surgically treated SLHCC were divided in 5 groups of treatment (major hepatectomy, sectorectomy, left lateral sectionectomy, segmentectomy, non-anatomical resection) and compared for baseline characteristics, short and long-term results. A propensity-score weighted analysis was performed., Results: 535 patients were enrolled in the study. Major resection was associated with significantly increased major complications compared to left lateral sectionanectomy, segmentectomy and non-anatomical resection (all p<0.05) and borderline significant increased major complications compared to sectorectomy (p=0.08). Left lateral sectionectomy showed better overall survival compared to major resection (p=0.02), while other groups of treatment resulted similar to major hepatectomy group for the same item. Absence of oncological benefit after major resection and similar outcomes among the 5 groups of treatment was confirmed even in the sub-population excluding patients with macrovascular invasion., Conclusion: Major resection was associated to increased major post-operative morbidity without long-term survival benefit; when technically feasible and oncologically adequate, minor resections should be preferred for the surgical treatment of SLHCC., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2024
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10. Ventilation strategies in cardiogenic shock: Insights from the AltShock-2 registry.
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Sacco A, Montisci A, Tavecchia G, Frea S, Bernasconi D, Colombo CNJ, Bertolin S, Viola G, Villanova L, Briani M, Patrini L, Bocchino PP, Sorini Dini C, D'Ettore N, Bertaina M, Iannaccone M, Potena L, Bertoldi L, Valente S, Camporotondo R, Marini M, Pagnesi M, Metra M, De Ferrari G, Oliva F, Morici N, Pappalardo F, and Tavazzi G
- Abstract
Aims: To describe the use and the relation to outcome of different ventilation strategies in a contemporary, large, prospective registry of cardiogenic shock patients., Methods and Results: Among 657 patients enrolled from March 2020 to November 2023, 198 (30.1%) received oxygen therapy (OT), 96 (14.6%) underwent non-invasive ventilation (NIV), and 363 (55.3%) underwent invasive mechanical ventilation (iMV). Patients in the iMV group were significantly younger compared to those in the NIV and OT groups (63 vs. 69 years, p < 0.001). There were no significant differences between groups regarding cardiovascular risk factors. Patients with SCAI B and C were more frequently treated with OT and NIV compared to iMV (65.1% and 65.4% vs. 42.6%, respectively, p > 0.001), while the opposite trend was observed in SCAI D patients (12% and 12.2% vs. 30.9%, respectively, p < 0.001). All-cause mortality at 24 h did not differ amongst the three groups. The 60-day mortality rates were 40.2% for the iMV group, 26% for the OT group, and 29.3% for the NIV group (p = 0.005), even after excluding patients with cardiac arrest at presentation. In the multivariate analysis including SCAI stages, NIV was not associated with worse mortality compared to iMV (hazard ratio 1.97, 95% confidence interval 0.85-4.56), even in more severe SCAI stages such as D., Conclusions: Compared to previous studies, we observed a rising trend in the utilization of NIV among cardiogenic shock patients, irrespective of aetiology and SCAI stages. In this clinical scenario, NIV emerges as a safe option for appropriately selected patients., (© 2024 The Author(s). European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
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- 2024
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11. Reply to: "Outcome of in situ split liver transplantation in Italy over the last 25 years: An alternative analysis and personal view".
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Lauterio A, Cillo U, De Carlis R, Bernasconi D, De Carlis L, Colledan M, and Andorno E
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- Humans, Treatment Outcome, Italy, Tissue Donors, Graft Survival, Liver Transplantation, Tissue and Organ Procurement
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- 2024
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12. Early administration of nirmatrelvir/ritonavir leads to faster negative SARS-CoV-2 nasal swabs than monoclonal antibodies in COVID 19 patients at high-risk for severe disease.
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Colaneri M, Scaglione G, Fassio F, Galli L, Lai A, Bergna A, Gabrieli A, Tarkowski M, Ventura CD, Colombo V, Cordier L, Bernasconi D, Corbellino M, Dedivitiis G, Borghetti S, Visigalli D, Sollima S, Casalini G, Rizzardini G, Gori A, Antinori S, Riva A, and Schiavini M
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- Humans, Antibodies, Monoclonal therapeutic use, Ritonavir therapeutic use, COVID-19 Vaccines, Retrospective Studies, COVID-19 Drug Treatment, Antiviral Agents therapeutic use, SARS-CoV-2, COVID-19, Lactams, Leucine, Nitriles, Proline
- Abstract
Purpose: Besides the well-established efficacy in preventing severe COVID-19, the impact of early treatments, namely antivirals and monoclonal antibodies (mAbs), on the time length to negativization of SARS-CoV-2 nasal swabs is still unclear. The aim of this study was to compare the efficacy of different early treatments in reducing the SARS-CoV-2 viral shedding, identifying a single drug that might potentially lead to a more rapid negativization of SARS-CoV-2 nasal swab., Methods: This was a single-centre, retrospective, observational study conducted at Ospedale Luigi Sacco in Milan. Data of high-risk COVID-19 patients who received early treatments between 23 December 2021 and March 2023 were extracted. The comparison across treatments was conducted using the Kruskall-Wallis test for continuous variables. Dunn's test with Bonferroni adjustment was performed for post-hoc comparisons of days to negativization. Secondly, a negative binomial regression adjusted for age, sex, number of comorbidities, immunosuppression, and SARS-CoV-2 vaccination status was implemented., Results: Data from 428 patients receiving early treatments were collected. The majority were treated with Nirmatrelvir/Ritonavir and were affected by SARS-CoV-2 Omicron infection with BA.2 sublineage. The median length time to SARS-CoV-2 nasal swab negativization was 9 days [IQR 7-13 days]. We found that Nirmatrelvir/Ritonavir determined a significant decrease of the length time to SARS-CoV-2 nasal swab negativization compared to mAbs (p = 0.003), but not compared to Remdesivir (p = 0.147) and Molnupiravir (p = 0.156)., Conclusion: Our findings highlight the importance of promptly treating high-risk COVID-19 patients with Nirmatrelvir/Ritonavir, as it also contributes to achieving a faster time to negative SARS-CoV-2 nasal swabs., (© 2024. The Author(s).)
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- 2024
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13. Unveiling the gender gap in ST-elevation myocardial infarction: a retrospective analysis of a single Italian center gender disparities in STEMI-ACS.
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Garatti L, Tavecchia G, Milani M, Rizzi I, Tondelli D, Bernasconi D, Maloberti A, Oliva F, and Sacco A
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- Humans, Retrospective Studies, Sex Factors, Italy epidemiology, Treatment Outcome, ST Elevation Myocardial Infarction therapy, Acute Coronary Syndrome, Percutaneous Coronary Intervention, Non-ST Elevated Myocardial Infarction diagnostic imaging, Non-ST Elevated Myocardial Infarction therapy
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- 2024
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14. Ultrasound-Assisted, Catheter-Directed Thrombolysis for Acute Intermediate/High-Risk Pulmonary Embolism: Design of the Multicenter USAT IH-PE Registry and Preliminary Results.
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Colombo C, Capsoni N, Russo F, Iannaccone M, Adamo M, Viola G, Bossi IE, Villanova L, Tognola C, Curci C, Morelli F, Guerrieri R, Occhi L, Chizzola G, Rampoldi A, Musca F, De Nittis G, Galli M, Boccuzzi G, Savio D, Bernasconi D, D'Angelo L, Garascia A, Chieffo A, Montorfano M, Oliva F, and Sacco A
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Catheter-based revascularization procedures were developed as an alternative to systemic thrombolysis for patients with intermediate-high- and high-risk pulmonary embolisms. USAT IH-PE is a retrospective and prospective multicenter registry of such patients treated with ultrasound-facilitated, catheter-directed thrombolysis, whose preliminary results are presented in this study. The primary endpoint was the incidence of pulmonary hypertension (PH) at follow-up. Secondary endpoints were short- and mid-term changes in the echocardiographic parameters of right ventricle (RV) function, in-hospital and all-cause mortality, and procedure-related bleeding events. Between March 2018 and July 2023, 102 patients were included. The majority were at intermediate-high-risk PE (86%), were mostly female (57%), and had a mean age of 63.7 ± 14.5 years, and 28.4% had active cancer. Echocardiographic follow-up was available for 70 patients, and in only one, the diagnosis of PH was confirmed by right heart catheterization, resulting in an incidence of 1.43% (CI 95%, 0.036-7.7). RV echocardiographic parameters improved both at 24 h and at follow-up. In-hospital mortality was 3.9% (CI 95%, 1.08-9.74), while all-cause mortality was 11% (CI 95%, 5.4-19.2). Only 12% had bleeding complications, of whom 4.9% were BARC ≥ 3. Preliminary results from the USAT IH-PE registry showed a low incidence of PH, improvement in RV function, and a safe profile.
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- 2024
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15. Type 2 diabetes mellitus pharmacological remission with dapagliflozin plus oral semaglutide.
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Lunati ME, Cimino V, Bernasconi D, Gandolfi A, Morpurgo PS, Tinari C, Lazzaroni E, Baruffaldi L, Muratori M, Montefusco L, Pastore I, Rossi A, Franzetti IG, Muratori F, Manfrini R, Disoteo OE, Terranova R, Desenzani P, Girelli A, Ghelardi R, D'Addio F, Ben Nasr M, Berra C, Folli F, Bucciarelli L, and Fiorina P
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- Humans, Benzhydryl Compounds therapeutic use, Blood Glucose, Body Weight, Creatinine, Glucose, Glycated Hemoglobin, Hypoglycemic Agents therapeutic use, Treatment Outcome, Diabetes Mellitus, Type 2 drug therapy, Glucagon-Like Peptides, Glucosides, Sodium-Glucose Transporter 2 Inhibitors therapeutic use
- Abstract
Dapagliflozin, a sodium-glucose co-transporter-2 inhibitor and semaglutide, a glucagon-like peptide 1 receptor agonist, have both demonstrated efficacy in glycemic control, reducing blood pressure, body weight, risk of renal and heart failure in type 2 diabetes mellitus. In this observational, real-world, study we aimed to investigate the efficacy of the combination therapy with those two agents over glycemic control. We thus obtained the data of 1335 patients with type 2 diabetes followed by 11 Diabetes centers in Lombardia, Italy. A group of 443 patients was treated with dapagliflozin alone, the other group of 892 patients was treated with the combination therapy of dapagliflozin plus oral semaglutide. We analyzed changes in glycated hemoglobin from baseline to 6 months of follow-up, as well as changes in fasting glycemia, body weight, body mass index, systolic and diastolic pressure, heart rate, creatinine, estimated glomerular filtration rate and albuminuria. Both groups of patients showed an improvement of glycometabolic control after 6 months of treatment; indeed, the treatment with dapagliflozin plus oral semaglutide showed a reduction of glycated hemoglobin of 1.2% as compared to the 0.5% reduction observed in the dapagliflozin alone group. Significant changes were observed in body mass index, fasting plasmatic glucose, blood pressure, total cholesterol, LDL and albumin to creatinine ratio, with a high rate (55%) of near-normalization of glycated hemoglobin. Our real world data confirmed the potential of the oral combination therapy dapagliflozin with semaglutide in inducing pharmacological remission of type 2 diabetes mellitus., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023. Published by Elsevier Ltd.)
- Published
- 2024
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