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1. Asthma in patients admitted to emergency department for COVID-19: prevalence and risk of hospitalization

Author

Gabrielli, Maurizio, Pignataro, Giulia, Candelli, Marcello, Sacco Fernandez, Marta, Bizzarri, Martina, Esperide, Alessandra, Franceschi, Francesco, Abbate, Valeria, Nicola, Acampora, Addolorato, Giovanni, Agostini, Fabiana, Ainora, Maria Elena, Akacha, Karim, Amato, Elena, Andreani, Francesca, Andriollo, Gloria, Annetta, Maria Giuseppina, Annicchiarico, Brigida Eleonora, Mariangela, Antonelli, Antonucci, Gabriele, Marco, Anzellotti Gian, Armuzzi, Alessandro, Baldi, Fabiana, Barattucci, Ilaria, Barillaro, Christian, Fabiana, Barone, Bellantone, Rocco Domenico Alfonso, Andrea, Bellieni, Bello, Giuseppe, Benicchi, Andrea, Benvenuto, Francesca, Berardini, Ludovica, Berloco, Filippo, Bernabei, Roberto, Bianchi, Antonio, Biasucci, Daniele Guerino, Biasucci, Luigi Marzio, Stefano, Bibbò, Bini, Alessandra, Alessandra, Bisanti, Biscetti, Federico, Bocci, Maria Grazia, Nicola, Bonadia, Bongiovanni, Filippo, Borghetti, Alberto, Bosco, Giulia, Bosello, Silvia Laura, Bove, Vincenzo, Bramato, Giulia, Brandi, Vincenzo, Teresa, Bruni, Bruno, Carmine, Bruno, Dario, Bungaro, Maria Chiara, Buonomo, Alessandro, Livia, Burzo, Angelo, Calabrese, Rosaria, Calvello Maria, Andrea, Cambieri, Cambise, Chiara, Camma, Giulia, Gennaro, Canistro, Antonello, Cantanale, Capalbo, Gennaro, Capaldi, Lorenzo, Capone, Emanuele, Capristo, Esmeralda, Carbone, Luigi, Silvia, Cardone, Carelli, Simone, Carfi', Angelo, Annamaria, Carnicelli, Caruso, Cristiano, Antonio, Casciaro Francesco, Catalano, Lucio, Cauda, Roberto, Cecchini, Andrea Leonardo, Cerrito, Lucia, Melania, Cesarano, Chiarito, Annalisa, Cianci, Rossella, Cicetti, Marta, Cicchinelli, Sara, Arturo, Ciccullo, Ciciarello, Francesca, Cingolani, Antonella, Cipriani, Maria Camilla, Consalvo, Ludovica Maria, Coppola, Gaetano, Corbo, Giuseppe Maria, Corsello, Andrea, Costante, Federico, Matteo, Costanzi, Covino, Marcello, Davide, Crupi, Lucio, Cutuli Salvatore, D'Addio, Stefano, D'Alessandro, Alessia, D'Alfonso, Maria Elena, D'Angelo, Emanuela, Francesca, D’Aversa, Damiano, Fernando, De Maria, Berardinis Gian, De Cunzo, Tommaso, De Gaetano Donati, Katleen, De Luca, Giulio, De Matteis, Giuseppe, De Pascale, Gennaro, De Paolo, Santis, De Martina, Siena, De Francesco, Vito, Del Valeria, Gatto, Del Paola, Giacomo, Del Fabio, Zompo, Maria, Dell’Anna Antonio, Della Davide, Polla, Di Luca, Gialleonardo, Di Simona, Giambenedetto, Di Roberta, Luca, Di Luca, Maurizio, Di Mariangela, Muro, Alex, Dusina, Davide, Eleuteri, Alessandra, Esperide, Daniele, Facheci, Domenico, Faliero, Cinzia, Falsiroli, Massimo, Fantoni, Annalaura, Fedele, Daniela, Feliciani, Cristina, Ferrante, Giuliano, Ferrone, Rossano, Festa, Chiara, Fiore Maria, Andrea, Flex, Evelina, Forte, Francesco, Franceschi, Alessandra, Francesconi, Laura, Franza, Barbara, Funaro, Mariella, Fuorlo, Domenico, Fusco, Maurizio, Gabrielli, Eleonora, Gaetani, Claudia, Galletta, Antonella, Gallo, Giovanni, Gambassi, Matteo, Garcovich, Antonio, Gasbarrini, Irene, Gasparrini, Silvia, Gelli, Antonella, Giampietro, Laura, Gigante, Gabriele, Giuliano, Giorgia, Giuliano, Bianca, Giupponi, Elisa, Gremese, Luca, Grieco Domenico, Manuel, Guerrera, Valeria, Guglielmi, Caterina, Guidone, Antonio, Gullì, Amerigo, Iaconelli, Aurora, Iafrati, Ianiro, Gianluca, Angela, Iaquinta, Michele, Impagnatiello, Riccardo, Inchingolo, Enrica, Intini, Raffaele, Iorio, Maria, Izzi Immacolata, Tamara, Jovanovic, Cristina, Kadhim, Rosa, La Macchia, Ignazio, La Milia Daniele, Francesco, Landi, Giovanni, Landi, Rosario, Landi, Raffaele, Landolfi, Massimo, Leo, Maria, Leone Paolo, Laura, Levantesi, Antonio, Liguori, Rosa, Liperoti, Maria, Lizzio Marco, Rita, Lo Monaco Maria, Pietro, Locantore, Francesco, Lombardi, Gianmarco, Lombardi, Loris, Lopetuso, Valentina, Loria, Raffaella, Losito Angela, Patricia, Lucia Mothanje Barbara, Francesco, Macagno, Noemi, Macerola, Giampaolo, Maggi, Giuseppe, Maiuro, Francesco, Mancarella, Francesca, Mangiola, Alberto, Manno, Debora, Marchesini, Marco, Maresca Gian, Giuseppe, Marrone, Ilaria, Martis, Maria, Martone Anna, Marzetti, Emanuele, Chiara, Mattana, Valeria, Matteo Maria, Riccardo, Maviglia, Ada, Mazzarella, Carmen, Memoli, Luca, Miele, Alessio, Migneco, Irene, Mignini, Alessandro, Milani, Domenico, Milardi, Massimo, Montalto, Giuliano, Montemurro, Flavia, Monti, Montini, Luca, Christian, Morena Tony, Vincenzina, Morra, Davide, Moschese, Ambra, Murace Celeste, Martina, Murdolo, Rita, Murri, Marco, Napoli, Elisabetta, Nardella, Gerlando, Natalello, Daniele, Natalini, Maria, Navarra Simone, Antonio, Nesci, Alberto, Nicoletti, Rocco, Nicoletti, Filippo, Nicoletti Tommaso, Rebecca, Nicolò, Nicola, Nicolotti, Celestino, Nista Enrico, Eugenia, Nuzzo, Marco, Oggiano, Veronica, Ojetti, Cosimo, Pagano Francesco, Gianfranco, Paiano, Cristina, Pais, Federico, Paolillo, Federico, Pallavicini, Andrea, Palombo, Alfredo, Papa, Domenico, Papanice, Giovanni, Papparella Luigi, Mattia, Paratore, Giuseppe, Parrinello, Giuliana, Pasciuto, Pierpaolo, Pasculli, Giovanni, Pecorini, Simone, Perniola, Erika, Pero, Luca, Petricca, Martina, Petrucci, Chiara, Picarelli, Andrea, Piccioni, Annalisa, Piccolo, Edoardo, Piervincenzi, Giulia, Pignataro, Raffaele, Pignataro, Gabriele, Pintaudi, Luca, Pisapia, Marco, Pizzoferrato, Fabrizio, Pizzolante, Roberto, Pola, Caterina, Policola, Maurizio, Pompili, Flavia, Pontecorvi, Valerio, Pontecorvi, Francesca, Ponziani, Valentina, Popolla, Enrica, Porceddu, Angelo, Porfidia, Maria, Porro Lucia, Annalisa, Potenza, Francesca, Pozzana, Giuseppe, Privitera, Daniela, Pugliese, Gabriele, Pulcini, Simona, Racco, Francesca, Raffaelli, Vittoria, Ramunno, Ludovico, Rapaccini Gian, Richeldi, Luca, Rinninella, Emanuele, Sara, Rocchi, Bruno, Romanò, Stefano, Romano, Federico, Rosa, Laura, Rossi, Raimondo, Rossi, Enrica, Rossini, Elisabetta, Rota, Fabiana, Rovedi, Carlotta, Rubino, Gabriele, Rumi, Andrea, Russo, Luca, Sabia, Andrea, Salerno, Sara, Salini, Lucia, Salvatore, Dehara, Samori, Sandroni, Claudio, Maurizio, Sanguinetti, Luca, Santarelli, Paolo, Santini, Danilo, Santolamazza, Angelo, Santoliquido, Francesco, Santopaolo, Cosimo, Santoro Michele, Francesco, Sardeo, Caterina, Sarnari, Angela, Saviano, Luisa, Saviano, Scaldaferri, Franco, Roberta, Scarascia, Tommaso, Schepis, Francesca, Schiavello, Giancarlo, Scoppettuolo, Davide, Sedda, Flaminio, Sessa, Luisa, Sestito, Carlo, Settanni, Matteo, Siciliano, Valentina, Siciliano, Rossella, Sicuranza, Benedetta, Simeoni, Jacopo, Simonetti, Andrea, Smargiassi, Maurizio, Soave Paolo, Chiara, Sonnino, Domenico, Staiti, Claudia, Stella, Leonardo, Stella, Eleonora, Stival, Eleonora, Taddei, Rossella, Talerico, Elio, Tamburello, Enrica, Tamburrini, Sofia, Tanzarella Eloisa, Elena, Tarascio, Claudia, Tarli, Alessandra, Tersali, Pietro, Tilli, Jacopo, Timpano, Enrico, Torelli, Flavia, Torrini, Matteo, Tosato, Alberto, Tosoni, Luca, Tricoli, Marcello, Tritto, Mario, Tumbarello, Maria, Tummolo Anita, Sole, Vallecoccia Maria, Federico, Valletta, Francesco, Varone, Francesco, Vassalli, Giulio, Ventura, Lucrezia, Verardi, Lorenzo, Vetrone, Giuseppe, Vetrugno, Elena, Visconti, Felicia, Visconti, Andrea, Viviani, Raffaella, Zaccaria, Carmelina, Zaccone, Lorenzo, Zelano, Lorenzo, Zileri Dal Verme, and Giuseppe, Zuccalà

Subjects
2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Emergency department, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, asthma, medicine.disease, Hospitalization, Emergency medicine, CE-Research Letter to the Editor, SARS-CoV2, Emergency Medicine, Internal Medicine, medicine, Prevalence, Humans, In patient, business, Emergency Service, Hospital, Asthma, Retrospective Studies
Published
2021

2. COVID-19 and intestinal inflammation: Role of fecal calprotectin

Author

Veronica Ojetti, Angela Saviano, Marcello Covino, Nicola Acampora, Eliana Troiani, Francesco Franceschi, Valeria Abbate, Giovanni Addolorato, Fabiana Agostini, Maria Elena Ainora, Karim Akacha, Elena Amato, Francesca Andreani, Gloria Andriollo, Maria Giuseppina Annetta, Brigida Eleonora Annicchiarico, Mariangela Antonelli, Gabriele Antonucci, Gian Marco Anzellotti, Alessandro Armuzzi, Fabiana Baldi, Ilaria Barattucci, Christian Barillaro, Fabiana Barone, Rocco Domenico Alfonso Bellantone, Andrea Bellieni, Giuseppe Bello, Andrea Benicchi, Francesca Benvenuto, Ludovica Berardini, Filippo Berloco, Roberto Bernabei, Antonio Bianchi, Daniele Guerino Biasucci, Luigi Marzio Biasucci, Stefano Bibbò, Alessandra Bini, Alessandra Bisanti, Federico Biscetti, Maria Grazia Bocci, Nicola Bonadia, Filippo Bongiovanni, Alberto Borghetti, Giulia Bosco, Silvia Bosello, Vincenzo Bove, Giulia Bramato, Vincenzo Brandi, Teresa Bruni, Carmine Bruno, Dario Bruno, Maria Chiara Bungaro, Alessandro Buonomo, Livia Burzo, Angelo Calabrese, Maria Rosaria Calvello, Andrea Cambieri, Chiara Cambise, Giulia Cammà, Marcello Candelli, Gennaro Canistro, Antonello Cantanale, Gennaro Capalbo, Lorenzo Capaldi, Emanuele Capone, Esmeralda Capristo, Luigi Carbone, Silvia Cardone, Simone Carelli, Angelo Carfì, Annamaria Carnicelli, Cristiano Caruso, Francesco Antonio Casciaro, Lucio Catalano, Roberto Cauda, Andrea Leonardo Cecchini, Lucia Cerrito, Melania Cesarano, Annalisa Chiarito, Rossella Cianci, Sara Cicchinelli, Arturo Ciccullo, Marta Cicetti, Francesca Ciciarello, Antonella Cingolani, Maria Camilla Cipriani, Maria Ludovica Consalvo, Gaetano Coppola, Giuseppe Maria Corbo, Andrea Corsello, Federico Costante, Matteo Costanzi, Davide Crupi, Salvatore Lucio Cutuli, Stefano D'Addio, Alessia D'Alessandro, Maria ElenaEmanuela D'AlfonsoD'Angelo, Francesca D'Aversa, Fernando Damiano, Gian Maria De Berardinis, Tommaso De Cunzo, Donati Katleen De Gaetano, Giulio De Luca, Giuseppe De Matteis, Gennaro De Pascale, Paolo De Santis, Martina De Siena, Francesco De Vito, Valeria Del Gatto, Paola Del Giacomo, Fabio Del Zompo, Antonio Maria Dell'Anna, Davide Della Polla, Luca Di Gialleonardo, Simona Di Giambenedetto, Roberta Di Luca, Luca Di Maurizio, Mariangela Di Muro, Alex Dusina, Davide Eleuteri, Alessandra Esperide, Daniele Fachechi, Domenico Faliero, Cinzia Falsiroli, Massimo Fantoni, Annalaura Fedele, Daniela Feliciani, Cristina Ferrante, Giuliano Ferrone, Rossano Festa, Maria Chiara Fiore, Andrea Flex, Evelina Forte, Alessandra Francesconi, Laura Franza, Barbara Funaro, Mariella Fuorlo, Domenico Fusco, Maurizio Gabrielli, Eleonora Gaetani, Claudia Galletta, Antonella Gallo, Giovanni Gambassi, Matteo Garcovich, Antonio Gasbarrini, Irene Gasparrini, Silvia Gelli, Antonella Giampietro, Laura Gigante, Gabriele Giuliano, Giorgia Giuliano, Bianca Giupponi, Elisa Gremese, Domenico Luca Grieco, Manuel Guerrera, Valeria Guglielmi, Caterina Guidone, Antonio Gullì, Amerigo Iaconelli, Aurora Iafrati, Gianluca Ianiro, Angela Iaquinta, Michele Impagnatiello, Riccardo Inchingolo, Enrica Intini, Raffaele Iorio, Immacolata Maria Izzi, Tamara Jovanovic, Cristina Kadhim, Rosa La Macchia, Daniele Ignazio La Milia, Francesco Landi, Giovanni Landi, Rosario Landi, Raffaele Landolfi, Massimo Leo, Paolo Maria Leone, Laura Levantesi, Antonio Liguori, Rosa Liperoti, Marco Maria Lizzio, Maria Rita Lo Monaco, Pietro Locantore, Francesco Lombardi, Gianmarco Lombardi, Loris Lopetuso, Valentina Loria, Angela Raffaella Losito, Mothanje Barbara Patricia Lucia, Francesco Macagno, Noemi Macerola, Giampaolo Maggi, Giuseppe Maiuro, Francesco Mancarella, Francesca Mangiola, Alberto Manno, Debora Marchesini, Gian Marco Maresca, Giuseppe Marrone, Ilaria Martis, Anna Maria Martone, Emanuele Marzetti, Chiara Mattana, Maria Valeria Matteo, Riccardo Maviglia, Ada Mazzarella, Carmen Memoli, Luca Miele, Alessio Migneco, Irene Mignini, Alessandro Milani, Domenico Milardi, Massimo Montalto, Giuliano Montemurro, Flavia Monti, Luca Montini, Tony Christian Morena, Vincenzina Morra, Chiara Morretta, Davide Moschese, Celeste Ambra Murace, Martina Murdolo, Rita Murri, Marco Napoli, Elisabetta Nardella, Gerlando Natalello, Daniele Natalini, Simone Maria Navarra, Antonio Nesci, Alberto Nicoletti, Rocco Nicoletti, Tommaso Filippo Nicoletti, Rebecca Nicolò, Nicola Nicolotti, Enrico Celestino Nista, Eugenia Nuzzo, Marco Oggiano, Francesco Cosimo Pagano, Gianfranco Paiano, Cristina Pais, Federico Pallavicini, Andrea Palombo, Federico Paolillo, Alfredo Papa, Domenico Papanice, Luigi Giovanni Papparella, Mattia Paratore, Giuseppe Parrinello, Giuliana Pasciuto, Pierpaolo Pasculli, Giovanni Pecorini, Simone Perniola, Erika Pero, Luca Petricca, Martina Petrucci, Chiara Picarelli, Andrea Piccioni, Annalisa Piccolo, Edoardo Piervincenzi, Giulia Pignataro, Raffaele Pignataro, Gabriele Pintaudi, Luca Pisapia, Marco Pizzoferrato, Fabrizio Pizzolante, Roberto Pola, Caterina Policola, Maurizio Pompili, Flavia Pontecorvi, Valerio Pontecorvi, Francesca Ponziani, Valentina Popolla, Enrica Porceddu, Angelo Porfidia, Lucia Maria Porro, Annalisa Potenza, Francesca Pozzana, Giuseppe Privitera, Daniela Pugliese, Gabriele Pulcini, Simona Racco, Francesca Raffaelli, Vittoria Ramunno, Gian Ludovico Rapaccini, Luca Richeldi, Emanuele Rinninella, Sara Rocchi, Bruno Romanò, Stefano Romano, Federico Rosa, Laura Rossi, Raimondo Rossi, Enrica Rossini, Elisabetta Rota, Fabiana Rovedi, Carlotta Rubino, Gabriele Rumi, Andrea Russo, Luca Sabia, Andrea Salerno, Sara Salini, Lucia Salvatore, Dehara Samori, Claudio Sandroni, Maurizio Sanguinetti, Luca Santarelli, Paolo Santini, Danilo Santolamazza, Angelo Santoliquido, Francesco Santopaolo, Michele Cosimo Santoro, Francesco Sardeo, Caterina Sarnari, Luisa Saviano, Franco Scaldaferri, Roberta Scarascia, Tommaso Schepis, Francesca Schiavello, Giancarlo Scoppettuolo, Davide Sedda, Flaminio Sessa, Luisa Sestito, Carlo Settanni, Matteo Siciliano, Valentina Siciliano, Rossella Sicuranza, Benedetta Simeoni, Jacopo Simonetti, Andrea Smargiassi, Paolo Maurizio Soave, Chiara Sonnino, Domenico Staiti, Claudia Stella, Leonardo Stella, Eleonora Stival, Eleonora Taddei, Rossella Talerico, Elio Tamburello, Enrica Tamburrini, Eloisa Sofia Tanzarella, Elena Tarascio, Claudia Tarli, Alessandra Tersali, Pietro Tilli, Jacopo Timpano, Enrico Torelli, Flavia Torrini, Matteo Tosato, Alberto Tosoni, Luca Tricoli, Marcello Tritto, Mario Tumbarello, Anita Maria Tummolo, Maria Sole Vallecoccia, Federico Valletta, Francesco Varone, Francesco Vassalli, Giulio Ventura, Lucrezia Verardi, Lorenzo Vetrone, Giuseppe Vetrugno, Elena Visconti, Felicia Visconti, Andrea Viviani, Raffaella Zaccaria, Carmelina Zaccone, Lorenzo Zelano, Lorenzo Zileri Dal Verme, and Giuseppe Zuccalà

Subjects
Adult, Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Settore MED/12 - GASTROENTEROLOGIA, Pneumonia, Viral, Severity of Illness Index, Gastroenterology, Betacoronavirus, Feces, Intestinal mucosa, Intestinal inflammation, Internal medicine, Settore MED/41 - ANESTESIOLOGIA, medicine, Humans, Viral, Intestinal Mucosa, Letter to the Editor, Pandemics, Leukocyte L1 Antigen Complex, Hepatology, SARS-CoV-2, business.industry, Settore MED/09 - MEDICINA INTERNA, COVID-19, Pneumonia, Middle Aged, fecal calprotectin, Case-Control Studies, Female, Calprotectin, Coronavirus Infections, business, Biomarkers
Published
2020

3. When the heart gets the flu

Author

Nicolas Bréchot, Jean Chastre, Ania Nieszkowska, Matthieu Schmidt, Pascal Leprince, Tamara Jovanovic, Alain Combes, Guillaume Lebreton, Sébastien Besset, Jean-Louis Trouillet, Charles-Edouard Luyt, and Guillaume Hékimian

Subjects
Oseltamivir, medicine.medical_specialty, Myocarditis, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Cardiogenic shock, Fulminant, Mortality rate, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, medicine.disease, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Bronchoalveolar lavage, chemistry, Internal medicine, Pandemic, medicine, Extracorporeal membrane oxygenation, 030212 general & internal medicine, business
Abstract

Purpose To describe patients with refractory cardiogenic shock related to influenza B virus myocarditis rescued by venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO). Material and methods Consecutive patients hospitalized in our unit for influenza-associated myocarditis were prospectively included. We also conducted a systematic MEDLINE database literature review through the PubMed search engine, between 1946 and 2017. Results We report the cases of 4 young patients with fulminant myocarditis requiring VA-ECMO for 6 [5–8] days. Influenza B virus was detected in all patients, either in nasopharyngeal sampling or bronchoalveolar lavage fluid. The 4 patients received oseltamivir. Heart function recovery allowed ECMO device removal without cardiac sequelae in all 4 patients. Systematic review retrieved 184 cases of influenza-associated myocarditis, most cases associated with H1N1 type-A infection during the 2009 pandemic. Forty eight cases of influenza myocarditis-associated cardiogenic shock requiring mechanical circulatory support including 3 cases due to influenza B virus were described. Mean duration of mechanical circulatory support was 8.5 ± 6 days and mortality rate was 33%. Conclusions Influenza myocarditis is a rare but reversible cause of cardiogenic shock amenable to VA-ECMO rescue. Early antiviral therapy and ECMO support should be considered for patients with fulminant myocarditis during an influenza epidemic.

Published
2018
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4. Diaphragm myoclonus-induced autotriggering during neurally adjusted ventilatory assist

Author

Giovanna Cammareri, Tamara Jovanovic, Domenico Luca Grieco, Antonio Maria Dell'Anna, Luca S Menga, and Massimo Antonelli

Subjects
medicine.medical_specialty, business.industry, Pain medicine, 030208 emergency & critical care medicine, Critical Care and Intensive Care Medicine, Diaphragm (structural system), 03 medical and health sciences, 0302 clinical medicine, Anesthesia, Anesthesiology, Neurally adjusted ventilatory assist, Medicine, medicine.symptom, business, Myoclonus, 030217 neurology & neurosurgery
Published
2018
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5. Management of Anaesthesia

Author

Massimiliano Visocchi, Federica Tosi, Tamara Jovanovic, and Orazio Genovese

Subjects
03 medical and health sciences, 0302 clinical medicine, Spine surgery, business.industry, medicine.medical_treatment, Anesthesia, Gold standard, Medicine, Airway management, business, Surgical treatment, 030217 neurology & neurosurgery, 030218 nuclear medicine & medical imaging
Abstract

Surgical treatment of the craniovertebral junction (CVJ) requires excellent management by the anaesthetist. Patients undergoing this type of surgery have a wide range of concomitant diseases. Therefore, before proceeding to CVJ surgery, it is recommended to analyse the clinical aspects of the patient that could complicate the outcome of the surgical procedure.In this paper we aim to establish what constitutes the best surgical and anaesthesia management of these patients. We consider airway management, trying to identify the gold standard for the patient. We also consider the most appropriate intraoperative approach to guarantee the best management of the patient.

Published
2019
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6. Gabexate Mesylate as Treatment in the Course of ANCA-Negative Microscopic Polyangiitis

Author

Antonietta Gigante, Liborio Sardo, Tamara Jovanovic, Antonio Amoroso, Biagio Barbano, Rosario Cianci, Marta Liberatori, Konstantinos Giannakakis, and Maria Ludovica Gasperini

Subjects
Male, Pathology, medicine.medical_specialty, Gabexate, medicine.medical_treatment, Microscopic Polyangiitis, Critical Care and Intensive Care Medicine, Gastroenterology, chemistry.chemical_compound, Internal medicine, medicine, Humans, Rapidly progressive glomerulonephritis, cardiovascular diseases, immunosuppressive treatment, disseminated intravascular coagulation, microscopic polyangiitis, anca, gabexate mesylate, Aged, Anti-neutrophil cytoplasmic antibody, Disseminated intravascular coagulation, medicine.diagnostic_test, business.industry, Anticoagulants, General Medicine, medicine.disease, chemistry, Nephrology, Plasmapheresis, Renal biopsy, Vasculitis, business, Microscopic polyangiitis
Abstract

Patients with small vessel vasculitis present fluctuating antineutrophil cytoplasmic antibodies (ANCA) levels to the point that positive ANCA may be missed even if only up to 10% of patients with microscopic polyangiitis (MPA) are ANCA-negative. The first-line treatment of MPA is the association of steroids and cyclophosphamide, especially in the presence of a rapidly progressive glomerulonephritis. Plasmapheresis, intravenous immunoglobulins, and tumor necrosis factor inhibitors have been proposed as alternative to standard therapy. Disseminated intravascular coagulation (DIC) is a possible event in the course of small vessel vasculitis. Gabexate mesylate is a protease inhibitor able to suppress endothelial cell injury, and it may be administered to treat DIC related to different diseases. In ANCA-associated vasculitis, cytokines play a key role in promoting endothelial damage. DIC-related thrombocytopenia may be misinterpreted as drug-induced because of the immunosuppressive properties of cyclophosphamide. Two cases of ANCA-positive MPA associated with DIC and treated with gabexate are reported in the literature with improvement of both hematological disorder and renal function. Our patient presented a rapidly progressive glomerulonephritis, and the renal biopsy showed MPA, in the absence of ANCA. After two weeks of steroid treatment, our patient developed a DIC. This case represents the first report of ANCA-negative MPA managed with gabexate, which showed improvement of coagulation disorders and kidney function. In conclusion, the anti-inflammatory properties of gabexate could be helpful in MPA at increased bleeding risk when immunosuppressive treatment is contraindicated, even in ANCA-negative vasculitis.

Published
2013
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7. Brain injury during venovenous extracorporeal membrane oxygenation

Author

Charles Edouard Luyt, Matthieu Schmidt, Pierre Demondion, Pascal Leprince, Nicolas Bréchot, Guillaume Lebreton, Jean-Louis Trouillet, Ania Nieszkowska, Jean Chastre, Guillaume Hékimian, Alain Combes, Tamara Jovanovic, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de Chirurgie cardiaque et thoracique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and HAL-UPMC, Gestionnaire

Subjects
Adult, Male, medicine.medical_specialty, Pain medicine, medicine.medical_treatment, Hospital mortality, 030204 cardiovascular system & hematology, Cerebral stroke, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Anesthesiology, Epidemiology, medicine, Extracorporeal membrane oxygenation, Humans, Hospital Mortality, cerebral stroke, intracranial brain hemorrhage, business.industry, 030208 emergency & critical care medicine, hypercapnia, Middle Aged, extracorporeal membrane oxygenation, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Intensive Care Units, surgical procedures, operative, acute lung injury, Brain Injuries, Anesthesia, Female, medicine.symptom, business, Hypercapnia
Abstract

International audience; PurposeThe frequency of neurological events and their impact on patients receiving venovenous extracorporeal membrane oxygenation (VV-ECMO) are unknown. We therefore study the epidemiology, risk factors, and impact of cerebral complications occurring in VV-ECMO patients.MethodsObservational study conducted in a tertiary referral center (2006–2012) on patients developing a neurological complication (ischemic stroke or intracranial bleeding) while on VV-ECMO versus those who did not, and a systematic review on this topic.ResultsAmong 135 consecutive patients who had received VV-ECMO, 18 (15 assessable) developed cerebral complications on ECMO: cerebral bleeding in 10 (7.5 %), ischemic stroke in 3 (2 %), or diffuse microbleeds in 2 (2 %), occurring after respective medians (IQR) of 3 (1–11), 21 (10–26), and 36 (8–63) days post-ECMO onset. Intracranial bleeding was independently associated with renal failure at intensive care unit admission and rapid PaCO2 decrease at ECMO initiation, but not with age, comorbidities, or hemostasis disorders. Seven (70 %) patients with intracranial bleeding and one (33 %) with ischemic stroke died versus 40 % of patients without neurological event. A systematic review found comparable intracranial bleeding rates (5 %).ConclusionsNeurological events occurred frequently in patients on VV-ECMO. Intracranial bleeding, the most frequent, occurred early and was associated with higher mortality. Because it was independently associated with rapid hypercapnia decrease, the latter should be avoided at ECMO onset, but its exact role remains to be determined. These findings may have major implications for the care of patients requiring VV-ECMO.

Published
2016
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