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1. COVID-19 and the impact on the cranio-oro-facial trauma care in Italy:An epidemiological retrospective cohort study

Author

Alessandro Sindoni, Gaetano Di Vita, Giorgio Lo Giudice, Fausto Famà, Roberto Lo Giudice, João Paulo Mendes Tribst, Fama F., Lo Giudice R., Di Vita G., Tribst J.P.M., Lo Giudice G., Sindoni A., and Oral Regenerative Medicine (ORM)

Subjects
Retrospective cohort study, medicine.medical_specialty, Health, Toxicology and Mutagenesis, Population, Traumatology, Article, 03 medical and health sciences, 0302 clinical medicine, Trauma Centers, SDG 3 - Good Health and Well-being, Epidemiology, Pandemic, Health care, medicine, Humans, 030212 general & internal medicine, education, COVID-19, cranio-oro-facial traumatology, retrospective cohort study, Pandemics, Retrospective Studies, education.field_of_study, business.industry, SARS-CoV-2, Public health, Public Health, Environmental and Occupational Health, Glasgow Coma Scale, 030206 dentistry, Italy, Emergency medicine, Cranio-oro-facial traumatology, Medicine, business, Emergency Service, Hospital
Abstract

The coronavirus disease 2019 (COVID-19) has deeply modified the organization of hospitals, health care centers, and the patient’s behavior. The aim of this epidemiological retrospective cohort study is to evaluate if and how the COVID-19 pandemic has determined a modification in cranio-oro-facial traumatology service. Methods: The dataset included hospital emergency room access of a six-month pre-pandemic period and six months into pandemic outbreak. The variables collected were: patient age, gender, type of emergency access with relative color code, Glasgow Coma Scale Score, type of discharge. Results: 537 vs. 237 (pre-pandemic vs. pandemic) patients accessed the hospital emergency room and the mean age decreased from 60.79 ± 25.34 to 56.75 ± 24.50 year. Yellow and green code access went from 28.9% and 66.1% to 37.5% and 57.7% (pre-pandemic vs. pandemic). Glasgow Coma Scale (GCS) shows an increase of 16.6% vs. 27.8% of 15 grade score, a 28.7% vs. 28.5% of the 14 grade score and reduction of 13 and 12 grade 40.2% and 14.5% vs. 37.1 and 9.7% (pre-pandemic vs. pandemic). Conclusions: Since the COVID-19 outbreak continues, epidemiological data are still necessary to perform public health intervention strategies and to appropriately predict the population needs, in order to properly manage the COVID-19 related to oral pathologies as well as the most common health problems.

Published
2021

2. COVID-19: opinions and behavior of Italian general population during the first epidemic phase

Author

Genovese, C., La Fauci, V., Di Pietro, A., Trimarchi, G., Odone, A., Casuccio, A., Costantino, C., Restivo, V., Fantini, M., Gori, D., Azzara, A., Deiana, G., Castaldi, S., Righi, E., Palandri, L., Panciroli, G., Bianco, A., Licata, F., Cosentino, S., Mistretta, A., Marranzano, M., Ragusa, R., Gabutti, G., Stefanati, A., Prato, R., Fortunato, F., Martinelli, D., Icardi, G., Panatto, D., Amicizia, D., Fabiani, L., Moretti, A., Di Risio, D., Siliquini, R., Voglino, G., Bert, F., Lorini, C., Bonaccorsi, G., Torre, I., Pennino, F., Pavia, M., Di Giuseppe, G., Paolantonio, A., Villari, P., Marzuillo, C., Messina, G., Rivieri, C., Nante, N., Majori, S., Tardivo, S., Moretti, F., D'Amato, S., Mazzitelli, F., Giunta, I., Lo Giudice, D., Panto, G., Signorelli, C., Squeri, R., Genovese, Cristina, La Fauci, Vincenza, Di Pietro, Angela, Trimarchi, Giuseppe, Odone, Anna, Casuccio, Alessandra, Costantino, Claudio, Restivo, Vincenzo, Fantini, Mariapia, Gori, Davide, Azara, Antonio, Deiana, Giovanna, Castaldi, Silvana, Righi, Elena, Palandri, Lucia, Panciroli, Giovanni, Bianco, Aida, Licata, Francesca, Cosentino, Sofia, Mistretta, Antonio, Marranzano, Marina, Ragusa, Rosalia, Gabutti, Giovanni, Stefanati, Armando, Prato, Rosa, Fortunato, Francesca, Martinelli, Domenico, Icardi, Giancarlo, Panatto, Donatella, Amicizia, Daniela, Fabiani, Leila, Moretti, Annalucia, Di Risio, Damiana, Siliquini, Roberta, Voglino, Gianluca, Bert, Fabrizio, Lorini, Chiara, Bonaccorsi, Guglielmo, Torre, Ida, Pennino, Francesca, Pavia, Maria, Di Giuseppe, Gabriella, Paolantonio, Andrea, Villari, Paolo, Marzuillo, Carolina, Messina, Gabriele, Rivieri, Cesare, Nante, Nicola, Majori, Silvia, Tardivo, Stefano, Moretti, Francesca, D'Amato, Smeralda, Mazzitelli, Francesco, Giunta, Ioselita, Lo Giudice, Daniela, Pantò, Giuseppe, Signorelli, Carlo, Squeri, Raffaele, Genovese C., La Fauci V., Di Pietro A., Trimarchi G., Odone A., Casuccio A., Costantino C., Restivo V., Fantini M., Gori D., Azzara A., Deiana G., Castaldi S., Righi E., Palandri L., Panciroli G., Bianco A., Licata F., Cosentino S., Mistretta A., Marranzano M., Ragusa R., Gabutti G., Stefanati A., Prato R., Fortunato F., Martinelli D., Icardi G., Panatto D., Amicizia D., Fabiani L., Moretti A., Di Risio D., Siliquini R., Voglino G., Bert F., Lorini C., Bonaccorsi G., Torre I., Pennino F., Pavia M., Di Giuseppe G., Paolantonio A., Villari P., Marzuillo C., Messina G., Rivieri C., Nante N., Majori S., Tardivo S., Moretti F., D'amato S., Mazzitelli F., Giunta I., Lo Giudice D., Panto G., Signorelli C., and Squeri R.

Subjects
risk perception, Male, knowledge, SARS-CoV-2, attitude, COVID-19, perception, population, attitude, COVID-19, knowledge, perception, population, risk perception, Attitude, Humans, Female, Public Health, Epidemics, Human
Abstract

Background and aim: On January 9, 2020, the World Health Organization (WHO) declared that Chinese health authorities had identified a new coronavirus strain never before isolated in humans, the 2019-nCoV later redefined SARS-CoV-2, that still today represent a public health problem. The present survey started on 10 February 2020 with the aim of a) assessing the risk perception in healthcare workers and young students, following the evolution of attitudes, perception and knowledge over time, b) provide useful information to the general population during survey. Results: A study sample consisting of 4116 Italian in-dividuals of both sexes was enrolled. High levels of risk perception, low perception of self-efficacy and low levels of knowledge scores (24.55 ± 5.76 SD) were obtained indicating the need for continuous population monitoring as well as further communication strategies carried out at institution levels. Conclusion: The results of the present study could help public health authorities in carrying out informative campaigns for general population and could be an important tool in evaluating public knowledge and misperceptions during the management of the COVID-19. (www.actabiomedica.it).

Published
2022

3. Wrist Photoplethysmography Signal Quality Assessment for Reliable Heart Rate Estimate and Morphological Analysis

Author

Serena Moscato, Stella Lo Giudice, Giulia Massaro, Lorenzo Chiari, Moscato, Serena, Lo Giudice, Stella, Massaro, Giulia, and Chiari, Lorenzo

Subjects
quality assessment, Reproducibility of Results, Signal Processing, Computer-Assisted, morphological analysi, heart rate, morphological analysis, photoplethysmography, wearable devices, Wrist, Biochemistry, Atomic and Molecular Physics, and Optics, Analytical Chemistry, Heart Rate, Humans, Electrical and Electronic Engineering, Artifacts, Photoplethysmography, Instrumentation, Algorithms
Abstract

Photoplethysmographic (PPG) signals are mainly employed for heart rate estimation but are also fascinating candidates in the search for cardiovascular biomarkers. However, their high susceptibility to motion artifacts can lower their morphological quality and, hence, affect the reliability of the extracted information. Low reliability is particularly relevant when signals are recorded in a real-world context, during daily life activities. We aim to develop two classifiers to identify PPG pulses suitable for heart rate estimation (Basic-quality classifier) and morphological analysis (High-quality classifier). We collected wrist PPG data from 31 participants over a 24 h period. We defined four activity ranges based on accelerometer data and randomly selected an equal number of PPG pulses from each range to train and test the classifiers. Independent raters labeled the pulses into three quality levels. Nineteen features, including nine novel features, were extracted from PPG pulses and accelerometer signals. We conducted ten-fold cross-validation on the training set (70%) to optimize hyperparameters of five machine learning algorithms and a neural network, and the remaining 30% was used to test the algorithms. Performances were evaluated using the full features and a reduced set, obtained downstream of feature selection methods. Best performances for both Basic- and High-quality classifiers were achieved using a Support Vector Machine (Acc: 0.96 and 0.97, respectively). Both classifiers outperformed comparable state-of-the-art classifiers. Implementing automatic signal quality assessment methods is essential to improve the reliability of PPG parameters and broaden their applicability in a real-world context.

Published
2022
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4. Botulinum toxin type A injections for masticatory muscles hypertrophy: A systematic review

Author

Raffaele Rauso, Nicola Zerbinati, Romolo Fragola, Giorgio Lo Giudice, Giovanni Francesco Nicoletti, and Gianpaolo Tartaro

Subjects
Botulinum Toxins, BoNTA, Injections, Intramuscular, Temporal muscle, Injections, Type A, Muscle hypertrophy, Masseter muscle, Botulinum toxin, Masseter hypertrophy, Masticatory muscles hypertrophy, MMH, Humans, Hypertrophy, Masseter Muscle, Masticatory Muscles, Botulinum Toxins, Type A, Neuromuscular Agents, medicine, In patient, Intramuscular, business.industry, Masticatory muscle hypertrophy, Masticatory force, Otorhinolaryngology, Anesthesia, Surgery, Oral Surgery, business, Botulinum toxin type, medicine.drug
Abstract

The aim of this study is to compare the efficacy of single-point injection of botulinum toxin A versus multi-point operative protocols found in the literature in reducing hypertrophy in patients with masticatory muscle hypertrophy. A systematic review was performed in accordance with the Park et al., 2018 guidelines, selecting articles from PubMed, Google Scholar, Web of Science and Ovid databases up to July 8, 2020.28 studies met the eligibility criteria. 748 patients were treated for masseter hypertrophy (MH) and 4 patients for temporal muscle hypertrophy. As for MH: in 45.2% of cases 3 injection sites (IS) were used, in 18.8% 1 IS, in 16.2% 2 IS, in 13% 5 IS, in 4.1% 6 IS, 2.7% 4 IS. At three months, the mean reduction in masseter muscle thickness is 26–31% when 1 IS was used, 28% in 2 IS, 12–27% in 3 IS and 22–30% in 6 IS. Heterogeneity of results, high bias level and selective reports led to a difficult efficacy comparison of the injection techniques described. Data suggest that the lowest number of IS possible should be used until stronger evidences are presented. Homogeneity in pre- and post-operative protocols is needed to establish a reliable setting for the condition under study.

Published
2022

5. Assessment of the accuracy of imaging software for 3D rendering of the upper airway, usable in orthodontic and craniofacial clinical settings

Author

Antonino Lo Giudice, Vincenzo Ronsivalle, Giorgio Gastaldi, Rosalia Leonardi, Lo Giudice, A., Ronsivalle, V., Gastaldi, G., and Leonardi, R.

Subjects
Imaging, Three-Dimensional, Upper airway, Cone-beam computed tomography, Humans, Reproducibility of Results, OSAS, Orthodontics, Nose, 3D rendering, Software
Abstract

Background Several semi-automatic software are available for the three-dimensional reconstruction of the airway from DICOM files. The aim of this study was to evaluate the accuracy of the segmentation of the upper airway testing four free source and one commercially available semi-automatic software. A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of the upper airway. The software tested were Invesalius, ITK-Snap, Dolphin 3D, 3D Slicer and Seg3D. The same upper airway models were manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the upper airway model obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the upper airway models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analyzed for software comparisons. Results Statistically significant differences were found in the volumetric dimensions of the upper airway models and in the matching percentage among the tested software (p 3; matching = 90.05%) followed by ITK-Snap (mean bias = − 2.52 cm3; matching = 84.44%), Seg 3D (mean bias = 3.21 cm3, matching = 87.36%), 3D Slicer (mean bias = − 4.77 cm3; matching = 82.08%) and Dolphin 3D (difference mean = − 6.06 cm3; matching = 78.26%). According to the color-coded map, the dis-matched area was mainly located at the most anterior nasal region of the airway. Volumetric data showed excellent inter-software reliability (GS vs semi-automatic software), with coefficient values ranging from 0.904 to 0.993, confirming proportional equivalence with manual segmentation. Conclusion Despite the excellent inter-software reliability, different semi-automatic segmentation algorithms could generate different patterns of inaccuracy error (underestimation/overestimation) of the upper airway models. Thus, is unreasonable to expect volumetric agreement among different software packages for the 3D rendering of the upper airway anatomy.

Published
2022

6. Nanophysical Mapping of Inflammasome Activation by Nanoparticles via Specific Cell Surface Recognition Events

Author

Cristina Lo Giudice, Jinsung Yang, Mégane A. Poncin, Laurent Adumeau, Martin Delguste, Melanie Koehler, Koen Evers, Andra C. Dumitru, Kenneth A. Dawson, David Alsteens, and UCL - SST/LIBST - Louvain Institute of Biomolecular Science and Technology

Subjects
Inflammasomes, Macrophages, NLR Family, Pyrin Domain-Containing 3 Protein, General Engineering, Humans, Nanoparticles, General Physics and Astronomy, General Materials Science, Silicon Dioxide, Immunity, Innate
Abstract

Silica nanoparticles (SiNP) trigger a range of innate immune responses in relevant essential organs, such as the liver and the lungs. Inflammatory reactions, including NLRP3 inflammasome activation, have been linked to particulate materials; however, the molecular mechanisms and key actors remain elusive. Although many receptors, including several scavenger receptors, were suggested to participate in SiNP cellular uptake, mechanistic evidence of their role on innate immunity is lacking. Here we present an atomic force microscopy-based approach to physico-mechanically map the specific interaction occurring between nanoparticles and scavenger receptor A1 (SRA1) in vitro on living lung epithelial cells. We find that SiNP recognition by SRA1 on human macrophages plays a key role in mediating NLRP3 inflammasome activation, and we identify cellular mechanical changes as clear indicators of inflammasome activation in human macrophages, greatly advancing our knowledge on the interplay among nanomaterials and innate immunity.

Published
2021

7. Comparison of operative and postoperative characteristics and outcomes between thoracoscopic segmentectomy and lobectomy for non-small-cell lung cancer: a propensity score matching study from the Italian VATS Group Registry

Author

Dell'Amore, A., Lomangino, I., Cannone, G., Terzi, S., Pangoni, A., Lorenzoni, G., Nicotra, S., Schiavon, M., Zuin, A., Gregori, D., Crisci, R., Curcio, C., Rea, F., Mancuso, M., Pernazza, F., Refai, M., Bortolotti, L., Rizzardi, G., Solli, P., Brandolini, I., Perkmann, R., Zaraca, F., Benvenuti, M., Gavezzoli, D., Cherchi, R., Ferrari, P., Mucilli, F., Camplese, P., Melloni, G., Mazza, F., Cavallesco, G., Maniscalco, P., Voltolini, L., Gonfiotti, A., Stella, F., Argnani, D., Pariscenti, G. L., Iurilli, S., Surrente, C., Lopez, C., Droghett, A., Giovanardi, M., Breda, C., Lo Giudice, F., Alloisio, M., Bottoni, E., Spaggiari, L., Gasparri, R., Torre, M., Rinaldo, A., Nosotti, M., Rosso, L., Negri, G. P., Bandiera, A., Stefani, A., Natali, P., Scarci, M., Pirondini, E., Amore, D., Baietto, G., Casadio, C., Bertani, A., Russo, E., Ampollini, L., Carbognani, P., Puma, F., Vinci, D., Andreetti, C., Poggi, C., Cardillo, G., Margaritora, S., Meacci, E., Luzzi, L., Ghisalberti, M., Zaccagna, G., Lausi, P., Guerrera, F., Fontana, D., Della Beffa, V., Morelli, A., Londero, F., Imperatori, N., Rotolo, A., Terzi, A., Viti, A., Infante, M., and Benato, C.

Subjects
Segmentectomy, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, medicine.medical_treatment, VATS lobectomy, Video-assisted thoracic surgery, Context (language use), Mastectomy, Segmental, Postoperative outcome, Postoperative Complications, Lobectomy, Non-small-cell lung cancer, Carcinoma, Non-Small-Cell Lung, Humans, Medicine, Registries, Thoracotomy, Pneumonectomy, Propensity Score, Lung cancer, Retrospective Studies, Thoracic Surgery, Video-Assisted, business.industry, Confounding, Postoperative complication, General Medicine, medicine.disease, Surgery, Propensity score matching, Non small cell, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVES Only few studies compared the surgical morbidity and mortality of thoracoscopic segmentectomy versus lobectomy for non-small-cell lung cancer, in particular, by relating the segmental resections with the corresponding anatomical lobes. METHODS We enrolled a total of 7487 patients who underwent VATS lobectomy (7269) or segmentectomy (218) from January 2014 to July 2019. A propensity score matching approach was used to account for potential confounding factors between the 2 groups. After matching, 349 lobectomies and 208 segmentectomies were included in the analysis. We analysed the operative and postoperative outcomes of video-assisted anatomical segmentectomy compared with video-assisted lobectomy and, in details, the results of segmentectomy with its corresponding lobectomy in a large cohort of patients from the Italian VATS Group Registry. RESULTS The overall conversion rate to thoracotomy was not statistically different between the groups (27 patients 8% vs 7 patients 3%, P = 0.1). The lobectomy group had a greater number of resected lymph nodes (median 11 vs 8, P = 0.006). No significant differences were detected in 30-day mortality (1.4%, 5 patients vs 0.9%, 2 patients), overall complications (18%, 62 patients vs 14%, 29 patients) and prolonged air leakage (31 patients, 9% vs 12 patients, 6%) between lobectomy and segmentectomy, respectively. No statistical differences were found regarding the median duration of drainage (3.2 days, P = 1) and the overall median length of hospital stay (6.4 days, P = 0.1) between the 2 groups. In the context of segmentectomy versus corresponding lobectomy, the right upper lobectomy compared with right upper segmentectomy showed a higher number of resected lymph nodes (P = 0.027). No statistical differences were reported in terms of conversion rate and postoperative complication and mortality. CONCLUSIONS Segmentectomy could be considered a safe procedure without significant differences compared to thoracoscopic lobectomy in terms of postoperative morbidity and mortality.

Published
2021

8. Hemodynamics and risk assessment 2 years after the initiation of upfront ambrisentan‒tadalafil in pulmonary arterial hypertension

Author

Silvia Papa, Valentina Mercurio, Alessandra Greco, Francesco Lo Giudice, Patrizio Vitulo, Michele D'Alto, Alessandro Tayar, Paola Argiento, Michele Correale, Robert Naeije, Stefano Ghio, Roberto Badagliacca, Marco Corda, Maria Giovanna Russo, Carmine Dario Vizza, Giuseppe Paciocco, Gavino Casu, Emanuele Romeo, Mariangela Lattanzio, Renato Prediletto, Paolo Golino, D'Alto, M., Badagliacca, R., Lo Giudice, F., Argiento, P., Casu, G., Corda, M., Correale, M., Ghio, S., Greco, A., Lattanzio, M., Mercurio, V., Paciocco, G., Papa, S., Prediletto, R., Romeo, E., Russo, M. G., Tayar, A., Vitulo, P., Vizza, C. D., Golino, P., and Naeije, R.

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Time Factors, Ambrisentan, Combination therapy, Vasodilator Agents, combination therapy, european risk score, prognosis, pulmonary arterial hypertension, reveal risk score, risk assessment, antihypertensive agents, drug therapy, combination, female, follow-up studies, hemodynamics, humans, male, middle aged, phenylpropionates, Pulmonary Arterial Hypertension, Pyridazines, Retrospective Studies, Risk Assessment, Tadalafil, Treatment Outcome, Hemodynamics, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine.artery, medicine, combination, Transplantation, Framingham Risk Score, business.industry, Stroke volume, drug therapy, 030228 respiratory system, Pulmonary artery, Cardiology, Drug Therapy, Combination, Surgery, Cardiology and Cardiovascular Medicine, business, Risk assessment, prognosi, medicine.drug
Abstract

BACKGROUND: Upfront combination therapy with ambrisentan and tadalafil has been reported to improve the condition of patients with pulmonary arterial hypertension (PAH) more than with either drug alone. However, little is known about the long-term associated changes in hemodynamics and risk assessment scores. METHODS: This was a multicenter, retrospective analysis of clinical data in 106 patients with newly diagnosed PAH. Clinical evaluations, including demographics, medical history, World Health Organization (WHO) functional class (FC) and 6-minute walk distance (6MWD), right heart catheterization, and Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL) risk score 2.0, were assessed over 48 months of ambrisentan‒tadalafil therapy. RESULTS: At baseline, 9 patients (9%) showed a low (8) REVEAL risk score. At a median follow-up of 2 years, 45 patients (43%) showed a low, 47 patients (44%) showed an intermediate, and 14 patients (13%) showed a high REVEAL score, along with improvements in WHO FC, 6MWD and a decrease in mean pulmonary artery pressure and N-terminal pro brain natriuretic peptide (all p < 0.001). Pulmonary vascular resistance (PVR) decreased by 37% from 11.5 ± 6.5 to 7.2 ± 4.1 Wood units (p < 0.001). A total of 61 patients (57%) remained in intermediate-risk or high-risk categories. Low-risk patients had either a decrease in PVR of >50% or a stroke volume within the limits of normal. CONCLUSIONS: Initial combination therapy with ambrisentan and tadalafil in PAH improves the REVEAL risk score in proportion to decreased PVR and preserved stroke volume but still insufficiently so in approximately 50% of the patients.

Published
2020

9. Alar cinch sutures in orthognathic surgery: scoping review and proposal of a classification

Author

Giovanni Francesco Nicoletti, Gianpaolo Tartaro, Romolo Fragola, G. Lo Giudice, Mario Santagata, Raffaele Rauso, Rauso, R., Tartaro, G., Nicoletti, G. F., Fragola, R., Lo Giudice, G., and Santagata, M.

Subjects
Cephalometry, medicine.medical_treatment, Orthognathic surgery, Cochrane Library, cleft lip, Le Fort I osteotomy, nasal cartilage, Suture (anatomy), Nasal Cartilages, Maxilla, Medicine, Humans, Osteotomy, Le Fort, Nasal cartilages, Orthodontics, Le Fort osteotomy, Sutures, business.industry, orthognathic surgery, Suture Techniques, malocclusion, Maxillary Osteotomy, medicine.disease, Otorhinolaryngology, Surgery, maxillary osteotomy, Oral Surgery, Malocclusion, business
Abstract

Orthognathic surgery and the Le Fort I osteotomy result in noticeable alterations to the nasal/nasolabial anatomy. The alar base cinch technique is a surgical technique to control lateralization of the base of the nose and is well described in the literature. The aim of this scoping review was to identify every unique alar cinch suture technique reported in orthognathic surgery and to propose a classification for the different techniques described. A search was conducted in the PubMed, Cochrane Library, and Scopus electronic databases covering the period May 1980 to July 2020, which identified 10 articles that were eligible for this review. Among these, there were several proposals for modifications to the technique, and different studies to show the effectiveness of one type among all others. Despite observing multiple techniques and variations of these while performing this review, the lack of a classification for alar cinch suture was noticed. Therefore, we propose a classification of the alar cinch suture that includes four types, which cover all of the cinching techniques described. It is believed that the use of a standardized classification may be useful to avoid duplicate publishing of techniques and to set a standard for further studies.

Published
2022

10. Echocardiographic Biventricular Coupling Index to Predict Precapillary Pulmonary Hypertension

Author

Stefano Albani, Davide Stolfo, Ashwin Venkateshvaran, Vlad Chubuchny, Federico Biondi, Antonio De Luca, Francesco Lo Giudice, Emilio M. Pasanisi, Christina Petersen, Edoardo Airò, Carolina Bauleo, Marco Ciardetti, Michele Coceani, Bruno Formichi, Jens Spiesshoefer, Gianluigi Savarese, Lars H. Lund, Michele Emdin, Gianfranco Sinagra, Aristomenis Manouras, Alberto Giannoni, Albani, S., Stolfo, D., Venkateshvaran, A., Chubuchny, V., Biondi, F., De Luca, A., Lo Giudice, F., Pasanisi, E. M., Petersen, C., Airo, E., Bauleo, C., Ciardetti, M., Coceani, M., Formichi, B., Spiesshoefer, J., Savarese, G., Lund, L. H., Emdin, M., Sinagra, G., Manouras, A., and Giannoni, A.

Subjects
Cardiac Catheterization, Heart Ventricles, Hypertension, Pulmonary, Biventricular coupling index, Precapillary, Pulmonary arterial hypertension, Right heart catheterization, Right ventricular stroke work index, Tissue Doppler imaging, Echocardiography, Ventricular Function, Right, Humans, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, Retrospective Studies
Abstract

Background: Pulmonary hypertension (PH) is a frequent and detrimental condition. Right heart catheterization (RHC) is the gold standard to identify PH subtype (precapillary from postcapillary PH) and is key for treatment allocation. In this study, the novel echocardiographic biventricular coupling index (BCI), based on the ratio between right ventricular stroke work index and left ventricular E/E′ ratio, was tested for the discrimination of PH subtype using RHC as the comparator. Methods: BCI was derived in 334 consecutive patients who underwent transthoracic echocardiography and RHC for all indications. BCI was then tested in a validation cohort of 1,349 patients. Results: The accuracy of BCI to identify precapillary PH was high in the derivation cohort (area under the curve, 0.82; 95% CI, 0.78-0.88; P < .001; optimal cut point, 1.9). BCI identified patients with precapillary PH with high accuracy also in the validation cohort (area under the curve, 0.87 [95% CI, 0.85-0.89; P < .001]; subgroup with PH: area under the curve, 0.91 [95% CI, 0.89-0.93; P < .001]; cut point, 1.9; sensitivity, 82%; specificity, 89%; positive predictive value, 77%; negative predictive value, 92%). BCI outperformed both the D'Alto score (Z = 3.56; difference between areas = 0.05; 95% CI, 0.02-0.07; P < .001) and the echocardiographic pulmonary–to–left atrial ratio index (Z = 2.88; difference between areas = 0.02; 95% CI, 0.01-0.04; P = .004). Conclusions: BCI is a novel, noninvasive index based on routinely available echocardiographic parameters that identifies with high accuracy patients with precapillary PH. BCI may be of value in the screening workup of patients with PH.

Published
2022

11. Therapeutic and Metagenomic Potential of the Biomolecular Therapies against Periodontitis and the Oral Microbiome: Current Evidence and Future Perspectives

Author

Simona Santonocito, Salvatore Ferlito, Alessandro Polizzi, Vincenzo Ronsivalle, Rossana Sclafani, Alessandra Valletta, Antonino Lo Giudice, Raffaele Cavalcanti, Gianrico Spagnuolo, Gaetano Isola, Santonocito, S., Ferlito, S., Polizzi, A., Ronsivalle, V., Sclafani, R., Valletta, A., Lo Giudice, A., Cavalcanti, R., Spagnuolo, G., and Isola, G.

Subjects
Periodontium, microbial, immunomodulation, Catalysis, antimicrobials, biofilm, Inorganic Chemistry, adjuvant, Humans, host response, periodontiti, genetics, Physical and Theoretical Chemistry, metagenomic, Molecular Biology, periodontitis, Spectroscopy, therapy, Microbiota, Organic Chemistry, General Medicine, Computer Science Applications, adjuvants, Metagenome, Dysbiosis, antimicrobial, Metagenomics, genetic
Abstract

The principles of periodontal therapy are based on the control of microbial pathogens and host factors that contribute to biofilm dysbiosis, with the aim of modulating the progression of periodontitis and periodontal tissue destruction. It is currently known how differently each individual responds to periodontal treatment, depending on both the bacterial subtypes that make up the dysbiotic biofilm and interindividual variations in the host inflammatory response. This has allowed the current variety of approaches for the management of periodontitis to be updated by defining the goals of target strategies, which consist of reducing the periodontopathogenic microbial flora and/or modulating the host-mediated response. Therefore, this review aims to update the current variety of approaches for the management of periodontitis based on recent target therapies. Recently, encouraging results have been obtained from several studies exploring the effects of some targeted therapies in the medium- and long-term. Among the most promising target therapies analyzed and explored in this review include: cell-based periodontal regeneration, mediators against bone resorption, emdogain (EMD), platelet-rich plasma, and growth factors. The reviewed evidence supports the hypothesis that the therapeutic combination of epigenetic modifications of periodontal tissues, interacting with the dysbiotic biofilm, is a key step in significantly reducing the development and progression of disease in periodontal patients and improving the therapeutic response of periodontal patients. However, although studies indicate promising results, these need to be further expanded and studied to truly realize the benefits that targeted therapies could bring in the treatment of periodontitis.

Published
2022

12. Oral Lesions Following Anti-SARS-CoV-2 Vaccination: A Systematic Review

Author

Federica Di Spirito, Alessandra Amato, Maria Pia Di Palo, Maria Contaldo, Francesco D’Ambrosio, Roberto Lo Giudice, Massimo Amato, Di Spirito, F, Amato, A, Di Palo, Mp, Contaldo, M, D'Ambrosio, F, Lo Giudice, R, and Amato, M

Subjects
Vaccines, COVID-19 Vaccines, SARS-CoV-2, coronavirus disease 2019, COVID-19, oral lesions, vaccine, vaccination, Health, Toxicology and Mutagenesis, Public Health, Environmental and Occupational Health, India, oral lesion, Humans, Female, Human, Data Management
Abstract

Increasing evidence relate anti-SARS-CoV-2 vaccinations to orofacial adverse reactions, therefore, the present systematic review aimed to evaluate primary oral lesions diagnosed in adult subjects, following the WHO Emergency Use Listing approved and EMA authorized vaccines, also in relation to cases’ age, gender, comorbidities, and history of COVID-19, and in relation to vaccine type and doses. The study protocol, registered on PROSPERO (CRD42022339032) and compliant with the PRISMA statement, included an electronic search across Scopus, MEDLINE/PubMed, BioMed Central databases, and PROSPERO, ended on 18 June 2022 and succeeded by a manual search, an independent data extraction, and arisk of bias evaluation through ROBINS-I tool. Qualitatively synthesized data from the 13studies included showed an overall low prevalence (16 cases), though higher in females (68.8%), of oral lesions, mainly erosions and ulcers (34.5%). Nine cases were diagnosed following Pfizer-BioNTech, two Moderna, and one AstraZeneca, Serum Institute of India, Sinopharm, and Johnson&Johnson vaccines, respectively; specifically, eight after the first dose and seven after the second. In one case, vaccine type and dose were not specified. Considering newly developing vaccines, presented findings may be updated and further studies needed to highlight factors affecting oral lesion occurrence and specific macro-microscopic phenotypes in relation to cases’ and vaccines’ characteristics.

Published
2022

14. External root resorption (ERR) and rapid maxillary expansion (RME) at post-retention stage: a comparison between tooth-borne and bone-borne RME

Author

Rosalia Leonardi, Vincenzo Ronsivalle, Ersilia Barbato, Manuel Lagravère, Carlos Flores-Mir, and Antonino Lo Giudice

Subjects
Bone-borne RME, Tooth-borne RME, Palatal Expansion Technique, Adolescent, RME, Root Resorption, ERR, Humans, Orthodontics, Tooth Root, Maxillary expansion, Molar
Abstract

Background The study aimed to compare external root resorption (ERR) three-dimensionally in subjects treated with tooth-borne (TB) versus bone-borne (BB) rapid maxillary expansion (RME). Forty subjects who received tooth-borne RME (TB group, average age 13.3 years ± 1.10 years) or bone-borne RME (BB group, average age 14.7 ± 1.15 years) were assessed using CBCT imaging before treatment (T0) and after a 6-month retention period (T1). 3D reconstructions of the radicular anatomy of maxillary first molars (M1), first and second premolars (P1 and P2) were generated to calculate volumetric (mean and percentage values) and shape changes (deviation analysis of the radicular models) obtained at each time point. 2D assessment of radicular length changes was also performed for each tooth. Data were statistically analyzed to perform intra-group (different teeth) and inter-group comparisons. Results In both groups, all the investigated teeth showed a significant reduction in radicular volume and length (p p > 0.05). Based on the deviation analysis from radicular models superimposition, the areas most affected by shape change were the apex and bucco-medial root surface. Overall, the amount of ERR was significantly greater in the TB group (mm3: M1 = 17.03, P1 = 6.42, P2 = 5.26) compared to the BB group (mm3: M1 = 3.11, P1 = 1.04, P2 = 1.24). Conclusions Despite the statistical significance, the difference in the amount of ERR of the posterior maxillary dentition between TB-RME and BB-RME remains clinically questionable.

Published
2022

16. Evaluation of mandibular changes after rapid maxillary expansion: a CBCT study in youngsters with unilateral posterior crossbite using a surface-to-surface matching technique

Author

Vincenzo D'Antò, Khaled Aboulazm, Antonino Lo Giudice, Vincenzo Ronsivalle, Rosalia Leonardi, Gaetano Isola, Manuel O. Lagravère, Leonardi, Rosalia Maria, Aboulazm, Khaled, Lo Giudice, Antonino, Ronsivalle, Vincenzo, D'Anto, Vincenzo, Lagravere, Manuel, and Isola, Gaetano

Subjects
Palatal Expansion Technique, Hyrax, Orthodontics, Mandible, Posterior crossbite, Mandibular asymmetry, Surface matching, 03 medical and health sciences, 0302 clinical medicine, Maxilla, medicine, Orthodontic, Humans, Crossbite, Rapid maxillary expansion, Facial asymmetry, General Dentistry, biology, business.industry, RME, CBCT, Spiral Cone-Beam Computed Tomography, 030206 dentistry, Cone-Beam Computed Tomography, biology.organism_classification, medicine.disease, Morphological asymmetry, 030220 oncology & carcinogenesis, business, Malocclusion, Human, Facial symmetry
Abstract

Objectives: The purpose of this study was to evaluate mandibular asymmetry in youngsters with posterior unilateral crossbite (PUXB), through cone-beam computed tomography and reverse engineering technique, before and after rapid maxillary expansion (RME) treatment. Materials and methods: Forty cone-beam computed tomography (CBCT) images were obtained from all patients at two time points, namely T0 acquired before the placement of a Hyrax expander and T1 after appliance removal. The CBCT scans were segmented and volume rendered into a surface there-dimensional (3D) mesh model. Thereafter, mandibular models were digitally registered by using a “best-fit” algorithm. Surface and volumetric changes, between T0 and T1, were compared by using Student’s t tests. Results: A slight increase of 0.45 cm3 of the total mandibular volume was found at T1 when compared with T0 (p < 0.001). The mandibular hemi-volume on the crossbite side (CB) was slightly smaller than the non-crossbite side both at T0 and T1. However, the mean differences of hemi-volume from the CB (crossbite) and non-CB side between T0 and T1 show a decrease of 0.26 cm3 (p < 0.001). Findings for the surface-to-surface deviation analysis demonstrated a fine percentage of matching at T0 which slightly improved at T1 (p < 0.001). Conclusions: Youngsters affected by PUXB showed a very slight and not statistically significant volumetric and morphological asymmetry between CB side and non-CB side at T0. However, the change in mean differences of 0.26 cm cannot be considered clinically relevant. Clinical relevance: Mandibles in young PUXB patients exhibit only a very mild mandibular asymmetry. Although the statistically significant mean change found right after RME removal cannot be considered clinically relevant, a more consistent sample and a longer follow-up could be of interest in explaining the short-term findings.

Published
2020

17. A Comparative Assessment of the Efficiency of Orthodontic Treatment With and Without Photobiomodulation During Mandibular Decrowding in Young Subjects: A Single-Center, Single-Blind Randomized Controlled Trial

Author

Antonino Lo Giudice, Riccardo Nucera, Gianluigi Caccianiga, Rosalia Leonardi, Alessio Paiusco, Marco Baldoni, Lo Giudice, A, Nucera, R, Leonardi, R, Paiusco, A, Baldoni, M, and Caccianiga, G

Subjects
Adult, Male, Adolescent, Tooth Movement Techniques, Biomedical Engineering, chemical and pharmacologic phenomena, Single Center, law.invention, Photobiomodulation—Original Research, accelerated dental movement, Young Adult, Orthodontic Appliances, Randomized controlled trial, law, photobiomodulation, Humans, Medicine, Single-Blind Method, Radiology, Nuclear Medicine and imaging, Low-Level Light Therapy, Orthodontics, orthodontic treatment, business.industry, fungi, MED/28 - MALATTIE ODONTOSTOMATOLOGICHE, Combined Modality Therapy, Italy, Female, Single blind, business, Malocclusion
Abstract

Objective: To assess if photobiomodulation (PBM) improves the efficiency of orthodontic treatment with fixed appliance during the alignment stage. Methods: Eighty-nine subjects were included in this trial and randomly assigned for treatment with fixed appliance and PBM group or with fixed appliance only (control group). Inclusion criteria were as follows: (1) age between 13 and 30 years, (2) permanent dentition, (3) class I malocclusion, (4) lower 6-6 mild crowding measured on dental cast, (5) no spaces or diastema in the lower arch, (6) no ectopic teeth, (7) nonextractive treatment plan, and (8) no previous orthodontic treatment. PBM was administered in the PBM group every 14 days using the ATP38® (Biotech Dental, Allée de Craponne, Salon de Provence, France) (72 J/cm2 of fluency for each session). Dental alignment was assessed by visual inspection, and treatment time was defined in days as T2 (date of assessment of complete dental alignment)-T1 (date of brackets bonding). The number of monthly scheduled appointments was also recorded. All the data underwent statistical analysis for comparison between groups. Results: Treatment time was significantly shorter (p < 0.001) in the PBM group (203 days) compared with the control (260 days). Consequently, control visits (p < 0.001) were lower in the PBM group (7) compared with the control group (9). Conclusions: The present findings would confirm that PBM can be used to enhance the efficiency of orthodontic treatment during dental decrowding.

Published
2020

18. A systematic review on drugs for synaptic plasticity in the treatment of dementia

Author

P. Piscopo, A. Crestini, E. Carbone, R. Rivabene, A. Ancidoni, M. Lo Giudice, M. Corbo, N. Vanacore, and E. Lacorte

Subjects
Aging, Levetiracetam, Neuronal Plasticity, Pyridines, Bryostatins, Biochemistry, Thiazoles, Neurology, Piperidines, Alzheimer Disease, Benzamides, Humans, Molecular Biology, Biotechnology
Abstract

The aim of the present systematic review (SR) was to provide an overview of all published and unpublished clinical trials investigating the safety and efficacy of disease-modifying drugs targeting synaptic plasticity in dementia. Searches on CT.gov and EuCT identified 27 trials (4 phase-1, 1 phase-1/2, 18 phase-2, 1 phase-2/3, 1 phase-3, 1 phase-4, and 1 not reported). Twenty of them completed, and seven are currently active or enrolling. The structured bibliographic searches yielded 3585 records. A total of 12 studies were selected on Levetiracetam, Masitinib, Saracatinib, BI 40930, Bryostatin 1, PF-04447943 and Edonerpic drugs. We used RoB tool for quality analysis of randomized studies. Efficacy was assessed as a primary outcome in all studies except one and the main scale used was ADAS-Cog (7 studies), MMSE and CDR (4 studies). Safety and tolerability were reported in eleven studies. The incidence of SAEs was similar between treatment and placebo. At the moment, only one molecule reached phase-3. This could suggest that research on these drugs is still preliminary. Of all, three studies reported promising results on Levetiracetam, Bryostatin 1 and Masitinib.

Published
2022

19. Medication-Related Osteonecrosis of the Jaw: 14 Years' Retrospective Study on Pathogenetic Trigger Events

Author

Marino, R., Squillacioti, A., Lo Giudice, G., Cicchiello, S., Scozzaro, C., Mummolo, S., De Ponte, F. S., and Nastro Siniscalchi, E.

Subjects
tooth extraction, Bisphosphonate, drug holiday, medication-related osteonecrosis of the jaw, MRONJ, trigger, Alendronate, Bone Density Conservation Agents, Diphosphonates, General Medicine, Precipitating Factors, Zoledronic Acid, Otorhinolaryngology, Humans, Surgery, Bisphosphonate-Associated Osteonecrosis of the Jaw, Risedronic Acid, Retrospective Studies
Abstract

Although events such as tooth extraction and oral surgery were considered for a while the sole triggering factor for Medication-Related Osteonecrosis of the Jaw (MRONJ), it is still unclear if trigger events may be precipitating factors that accelerate the onset of the disease that would have possibly occurred anyway. Therefore, this research aimed to retrospectively analyze MRONJ cases diagnosed in our tertiary referral hospital during the last 14 years, focusing on the onset of the disease, potential trigger events, and countermeasures to update the knowledge on their pathogenesis. An audit of patients diagnosed with MRONJ attending our department from 2008 to 2021was performed. χ2 test and Fisher exact test were employed to assess the relationship between the medications used and trigger events; χ2 test was also used to assess any relationship between MRONJ localization and drug, drug class, trigger, or trigger type. Seventy-six patients' records were identified. Fifty-two records were selected for analysis. Trigger events for the onset of the disease were found in 35 cases (67.3%). χ2 test showed a correlation between the drug used and trigger event occurrence (P=0.045) confirmed by Fisher exact test (P=0.34). Visual histogram analysis showed positive correlation when Alendronate (12 cases, 85.7%), Zoledronate (12 cases, 75%), and Risedronate (2 cases, 100%) were administered. Subgroup analysis per underlying disease, showed a significant correlation between the drug used and trigger event occurrence in the osteoporosis group (χ2 test, P=0.021; Fisher exact test, P=0.009).

Published
2022

20. Root Canal Cleaning after Different Irrigation Techniques: An Ex Vivo Analysis

Author

Federica Di Spirito, Massimo Pisano, Mario Caggiano, Prashant Bhasin, Roberto Lo Giudice, and Dina Abdellatif

Subjects
Histology, Root Canal Irrigants, cleaning, endodontics, histology, internal heating, ultrasonic activation, Sodium Hypochlorite, Internal heating, Ultrasonic activation, Humans, General Medicine, Dental Pulp Cavity, Endodontics, Root Canal Preparation, Therapeutic Irrigation
Abstract

Background and Objectives: The endodontic space is a complex area on both micro and macro levels; therefore, traditional irrigation techniques may not guarantee a complete cleaning of such a complicated tridimensional system. The presented ex vivo study aimed to evaluate root canal cleanliness, obtained through an equal volume of traditionally applied sodium hypochlorite (NaOCl), compared to ultrasonically activated NaOCl and ultrasonically activated NaOCl that had undergone intracanal heating NaOCl. Materials and Methods: A total of 60 freshly extracted human mandibular premolars underwent root sample length standardization (18 mm), root canal preparation and, based on the irrigation method employed, were randomly and equally assigned to three study groups, composed of root samples treated with ultrasonically activated NaOCl, ultrasonically activated NaOCl that had undergone intracanal heating and traditionally applied NaOCl. The root specimens were subsequently fixated with 4% buffered formalin solution and decalcified in Morse liquid. A total often 6-micron-thick serial cross-sections were obtained, dyed using hematoxylin and eosin and examined through an optical microscope at 40×, 100×, and 200×. Results: Ultrasonically activated NaOCl that had undergone intracanal heating showed a significantly smaller amount of debris compared to ultrasonically activated and traditionally applied NaOCl groups (p value < 0.05). Conclusions: Root canal cleanliness saw significant enhancements by ultrasonically activated NaOCl that had undergone intracanal heating.

Published
2022

21. Fragility fractures in psoriatic arthritis patients: a matched retrospective cohort study

Author

Enrique R. Soriano, John F. Jaramillo Gallego, Luciano F. Lo Giudice, Marina Scolnik, Florencia S. Pierini, and Nicolas M. Marin Zucaro

Subjects
medicine.medical_specialty, Osteoporosis, Cohort Studies, 03 medical and health sciences, Psoriatic arthritis, 0302 clinical medicine, Rheumatology, Internal medicine, Statistical significance, medicine, Humans, 030212 general & internal medicine, Retrospective Studies, 030203 arthritis & rheumatology, Proportional hazards model, business.industry, Incidence, Incidence (epidemiology), Arthritis, Psoriatic, Retrospective cohort study, General Medicine, medicine.disease, Cohort, Spinal Fractures, Female, business, Osteoporotic Fractures
Abstract

To compare incidental fragility fractures in psoriatic arthritis (PsA) patients with matched controls from a university hospital.Consecutive PsA patients were matched (age and sex) with controls (1:2). Follow-up began at index date, defined as the date of PsA diagnosis for cases and their respective controls, until the last hospital visit, death or the end of the study (31 December 2017). Electronic medical records were reviewed for osteoporotic fractures. Incidence rates per 100,000 persons-years (PY) of distinct types of fractures after index dates were calculated and compared between groups. A multivariate Cox regression analysis was performed to investigate determinants of fractures.Ninety-two PsA patients and 184 controls were included. No difference was found in the overall fracture incidence rate per 100,000 PY between PsA and controls (1020 95% CI 510-1930, vs 870 95% CI 520-1390, p = 0.36). Vertebral fractures were numerically more frequent in PsA patients with an incidence rate of 1020 (95% CI 510-1930) per 100,000 PY versus 460 (95% CI 240-920), per 100,000 PY in the control group but it did not reach statistical significance (p = 0.06). In the Cox regression analysis, after adjusting for bisphosphonate use, only age (HR 1.10, 1.05-1.16, p 0.001) and female sex (HR 3.94, 1.11-13.91, p = 0.03) were associated with fractures while PsA diagnosis and use of glucocorticoids were not.In this cohort of PsA patients, no overall increased risk of fractures was found in comparison with matched controls. Key Points • PsA could have different effects on bone, leading to confusing results in bone densitometry readings contributing to the difficulty in establishing the real prevalence of OP in PsA. • Vertebral fractures were more frequent in PsA patients compared to controls, but it did not reach statistical significance. No difference was found in the overall fracture incidence rate.

Published
2020

22. Expression profile of stemness markers cd138, nestin and alpha-sma in ameloblastic tumours

Author

Callisthenis Yiannis, Silvia Varricchio, Massimo Mascolo, Michele D. Mignogna, Rita Paolini, Roberto Lo Giudice, Antonio Celentano, Gaetano De Rosa, Valentina Natella, Cosimo Galletti, Yiannis, C., Mascolo, M., Mignogna, M. D., Varricchio, S., Natella, V., De Rosa, G., Lo Giudice, R., Galletti, C., Paolini, R., and Celentano, A.

Subjects
Pathology, medicine.medical_specialty, Health, Toxicology and Mutagenesis, government.form_of_government, lcsh:Medicine, stemness markers, Mandibular Neoplasms, Article, Malignant transformation, Ameloblastoma, Nestin, 03 medical and health sciences, CD138, 0302 clinical medicine, stomatognathic system, Stroma, medicine, Humans, Alpha-SMA, Actin, lcsh:R, Public Health, Environmental and Occupational Health, 030206 dentistry, Biomarker, medicine.disease, Malignant Odontogenic Neoplasm, Actins, Stemness marker, Ameloblastic carcinoma, 030220 oncology & carcinogenesis, government, Immunohistochemistry, Syndecan-1, Biomarkers, Human
Abstract

Ameloblastic carcinoma is a rare malignant odontogenic neoplasm with a poor prognosis. It can arise de novo or from a pre-existing ameloblastoma. Research into stemness marker expression in ameloblastic tumours is lacking. This study aimed to explore the immunohistochemical expression of stemness markers nestin, CD138, and alpha-smooth muscle actin (alpha-SMA) for the characterisation of ameloblastic tumours. Six cases of ameloblastoma and four cases of ameloblastic carcinoma were assessed, including one case of ameloblastic carcinoma arising from desmoplastic ameloblastoma. In all tumour samples, CD138 was positive, whilst alpha-SMA was negative. Nestin was negative in all but one tumour sample. Conversely, the presence or absence of these markers varied in stroma samples. Nestin was observed in one ameloblastic carcinoma stroma sample, whilst CD138 was positive in one ameloblastoma case, one desmoplastic ameloblastoma case, and in two ameloblastic carcinoma stroma samples. Finally, alpha-SMA was found positive only in the desmoplastic ameloblastoma stroma sample. Our results suggest nestin expression to be an indicator for ameloblastic carcinoma, and CD138 and alpha-SMA to be promising biomarkers for the malignant transformation of ameloblastoma. Our data showed that nestin, CD138, and alpha-SMA are novel biomarkers for a better understanding of the origins and behaviour of ameloblastic tumours.

Published
2021

23. A new software architecture proposal for an evidence-based Decision Support System in dentistry

Author

Roberto Lo Giudice, Giuseppe Lo Giudice, and A. Lizio

Subjects
Flexibility (engineering), Decision support system, Informed Consent, Evidence-based practice, Computer science, business.industry, Dentistry, Software, Dental caries, Prostheses and implants, Preventive dentistry, Humans, Algorithms, Scientific evidence, Variety (cybernetics), Otorhinolaryngology, Informed consent, Surgery, Oral Surgery, business, Software architecture
Abstract

BACKGROUND in dentistry, clinical problems could be resolved using many therapeutic approaches that may results in very different therapies. In order to choose the best option, a good evaluation of therapy long-term survival and success rate is mandatory. The routine use of a decision support analysis software is nowadays limited due to the lack of software's flexibility especially when a variety of possible therapeutic option are present. The aim of this research was to develop a new algorithm model for a Decision Support System software to give diagnosis support in dentistry. METHODS Beta tests were designed to study the computer software in different clinical situations based on clinical data. The therapeutic options can be conservative/endodontic or extractive/prosthetic therapies. In two of clinical situation selected could be possible to choose both therapies. RESULTS in clinical situations tested, the DDS software correctly identified the several therapeutic options. When multiple treatments were possible the beta test showed an output mask that correctly showed a range of options with their corresponding survival and success rate. CONCLUSIONS The software architecture proposed by the authors is technically feasible, can support the clinician choices based on scientific evidence and up-to-date references and gain informed consent based on data easily understandable for the patient.

Published
2021

24. [The management of confirmed cases of Covid-19 infection in schools: the experience of the prevention Department of the Azienda Sanitaria Friuli occidentale in the Pordenone area]

Author

G, Candela, F, Del Bianco, A, Lo Giudice, C, Bolzonello, L, Bomben, C, Sumelli, E, Biasotto, and S, Pilan

Subjects
Schools, Adolescent, Universities, SARS-CoV-2, COVID-19, Humans, Child, Students
Abstract

The SARS-Cov-2 pandemic that exploded in 2020 resulted in an exceptional school closure involving at least 188 countries worldwide, leaving more than 90% of children at home. This event excluded children and teenagers from the opportunity to learn, socialize, experiment and increased early school leaving. In light of these premises, during the summer months of 2020 the Azienda sanitaria Friuli Occidentale (AsFO) decided to set up a working group to accompany schools in the prevention and containment of the spread of the SARS-CoV-2 infection in the course of the school year 2020-21, with the aim of guaranteeing the right to study and favoring teaching activities in presence in the highest conditions of health and safety. The school reality of the Pordenone area is made up of 40 Comprehensive Institutes for a total of about 206 school complexes of all levels (public, equal and private). In total, the local school population is about 33,000 pupils and 4,000 units of school staff (teachers, ATA, etc ...). The activities of the Schools Group were analyzed by monitoring all interventions with carrying out rapid antigen tests at school and by assessing the incidence of infections within schools. From September 2020 to June 2021, the AsFO Schools Group participated in about 35 teaching colleges and more than 10 dedicated meetings with the families of school pupils of all levels. In total, 170 interventions with rapid antigen tests were carried out at school, involving all the schools in the Pordenone area and a total of 206 classes. During the interventions at school, a total of 6,370 rapid antigen tests were carried out, of which 70% concerned pupils (4,458 total tests) and 30% concerned school staff (1,912 total tests). The antigen tests carried out at school found 173 total positivity (equal to 3% of all tests carried out at school). Out of 173 positives found, 121 are students (70% of the total) and 52 are school staff (30% of the total). During the observation period, the results of the interventions with rapid antigen tests carried out at school led to the continuation of the teaching activity in the presence (with respect to the hygiene and behavioral measures defined by the DP) in 69% of cases (118 interventions). In 9% of cases (15 interventions) thequot;crossquot; quarantine was carried out, while in 17% of cases (29 interventions) the quarantine was established for the entire class / section. In 7 circumstances, following the intervention at school, quarantine was established for several classes. Only in 4 circumstances was the institution of quarantine for all school staff, a situation that led to the interruption of all educational activities for the quarantine period.

Published
2021

25. [Evans syndrome and rheumatoid arthritis as autoimmune manifestations of large granular T-cell leukemia]

Author

Agustín M, Muñoz, José A, Orozco Niño, Cristian M, Seehaus, Alberto D, Giménez Conca, Fernando A, Chuliber, Luciano F, Lo Giudice, and Georgina E, Bendek

Subjects
Arthritis, Rheumatoid, Leukemia, Large Granular Lymphocytic, Leukemia, T-Cell, Humans, Female, Anemia, Hemolytic, Autoimmune, Thrombocytopenia, Aged
Abstract

Large granular T-cell leukemia is a rare cytotoxic lymphocyte disorder. These cells play an integral role in the immune system and are divided into 2 lineages: CD3 T positive and natural killer. Its proliferation and uncontrolled cytotoxicity can generate autoimmunity or malignancy. Rheumatoid arthritis is the most common autoimmune disease in individuals with this type of leukemia, however, it has been associated with a wide spectrum of other autoimmune diseases and hematological conditions including hemolytic anemia, pure red blood cell aplasia, and neutropenia, leading to recurring bacterial infections. The following is a case of a 72-year-old female with a history of large granular T-cell leukemia and manifestations compatible with rheumatoid arthritis, which occurs with a severe Evans syndrome with a good initial and sustained response to gamma globulin, corticosteroid therapy, and rituximab.La leucemia de células T grandes granulares es un trastorno poco frecuente de linfocitos citotóxicos. Estas células juegan un rol integral en el sistema inmunológico y se dividen en 2 linajes: T CD3 positivas y natural killer. Su proliferación y citotoxicidad descontrolada puede generar autoinmunidad o malignidad. La artritis reumatoide es la enfermedad autoinmune más común en individuos con este tipo de leucemia, sin embargo, se ha asociado a un amplio espectro de otras enfermedades autoinmunes y afecciones hematológicas incluyendo anemia hemolítica, aplasia pura de glóbulos rojos y neutropenia, que conducen a infecciones bacterianas recurrentes. Se presenta a continuación una paciente de 72 años con antecedentes de leucemia de células T grandes granulares y manifestaciones compatibles con artritis reumatoidea, que intercurre con un Síndrome de Evans grave con buena respuesta inicial y sostenida a gammaglobulina, corticoterapia, y rituximab.

Published
2021

26. Analysis of the Efficacy of Two Treatment Protocols for Patients with Symptomatic Oral Lichen Planus: A Randomized Clinical Trial

Author

Antonino Lo Giudice, Rocco De Pasquale, Vincenzo Ronsivalle, Gaetano Isola, Alessandro Polizzi, and Simona Santonocito

Subjects
Male, medicine.medical_specialty, Administration, Topical, Health, Toxicology and Mutagenesis, Anti-Inflammatory Agents, Mouthwashes, lcsh:Medicine, Disease, Article, law.invention, 03 medical and health sciences, umbelliferone, 0302 clinical medicine, oral lichen planus, Clinical Protocols, Double-Blind Method, Randomized controlled trial, stomatognathic system, law, oligomeric pro-anthocyanidins, Internal medicine, hyaluronic acid, Humans, Medicine, calcium hydroxide, Completely randomized design, Aged, therapy, business.industry, lcsh:R, Public Health, Environmental and Occupational Health, 030206 dentistry, oral solution, Middle Aged, medicine.disease, stomatognathic diseases, clobetasol, Oligomeric proanthocyanidins, 030220 oncology & carcinogenesis, Clobetasol, Quality of Life, Mann–Whitney U test, Thongprasom’s Score, Female, Oral lichen planus, business, Numerical Pain Scale, Lichen Planus, Oral
Abstract

Oral lichen planus (OLP) is a chronic, inflammatory, immune-mediated disease, which can alter the quality of life of patients. The aim of this randomized clinical trial was to compare the therapeutic efficacy of clobetasol oral gel 0.05% versus an anti-inflammatory in oral solution (mouthwash) in the management of patients suffering from symptomatic OLP. The secondary objective was to analyze which one of the two treatments induced a greater risk of developing side effects. Forty patients were assigned (20 patients for group), through a randomized design, to receive clobetasol gel 0.05% or an anti-inflammatory mouthwash, which contains calcium hydroxide, hyaluronic acid, umbelliferone and oligomeric pro-anthocyanidins) for three months. At baseline (T0) and after 3 months (T1), patients underwent dental and dermatological examinations to assess their symptoms (Numerical Pain Scale (NRS) score) and signs (Thongprasom score). Data were calculated using T-test for the dependent variable, Wilcoxon test and Mann-Whitney u test. Both clobetasol and anti-inflammatory resulted in a statistically significant reduction of signs, (p &lt, 0.001 and p = 0.02, respectively) and symptoms (p &lt, 0.001 for clobetasol and p = 0.02 for anti-inflammatory). In conclusion, the results evidenced that, compared to clobetasol, the anti-inflammatory was less effective in determining the reduction of signs and symptom in OLP patients.

Published
2021

27. The Multidisciplinary Approach in Head and Neck Oncology During COVID-19 Pandemic

Author

Raffaele Rauso, Giorgio Lo Giudice, Marianna Caterino, Giuseppe Colella, Lo Giudice, Giorgio, Caterino, Marianna, Rauso, Raffaele, and Colella, Giuseppe

Subjects
2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), SARS-CoV-2, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, General Medicine, Otorhinolaryngology, Head and Neck Neoplasms, Multidisciplinary approach, Correspondence, Pandemic, medicine, Head and neck oncology, Humans, Surgery, Intensive care medicine, business, Pandemics, Neck
Published
2021

28. Role of long non-coding RNAs in Down syndrome patients: a transcriptome analysis study

Author

Corrado Romano, Aldo E. Calogero, Concetta Barone, Maria Grazia Salluzzo, Giovanna Marchese, Rossella Cannarella, Maria Ravo, Michele Salemi, and Mariangela Lo Giudice

Subjects
Adult, DNA Replication, Male, Cancer Research, Down syndrome, DNA Repair, Chromosomes, Human, Pair 21, Developmental Disabilities, mRNAs, Messenger, lncRNAs, Comorbidity, Biology, Chromosomes, Transcriptome, Cohort Studies, Young Adult, Neoplasms, microRNA, Gene expression, medicine, Humans, RNA, Messenger, Gene, Sicily, Oligonucleotide Array Sequence Analysis, Genetics, Gene Expression Profiling, RNA, RNA sequencing, Cell Biology, Middle Aged, medicine.disease, Phenotype, Long Noncoding, Female, RNA, Long Noncoding, Pair 21, Down Syndrome, Nervous System Diseases, Chromosome 21, Human
Abstract

Down syndrome (DS) is defined by the presence of a third copy of chromosome 21. Several comorbidities can be found in these patients, such as intellectual disability (ID), muscle weakness, hypotonia, congenital heart disease, and autoimmune diseases. The molecular mechanisms playing a role in the development of such comorbidities are still unclear. The regulation and expression of genes that map to chromosome 21 are dynamic and complex, so it is important to perform global gene expression studies with high statistical power to fully characterize the transcriptome in DS patients. This study was undertaken to evaluate mRNAs and lncRNA expression in patients with DS versus a matched cohort of healthy subjects. RNA sequencing was used to perform this transcriptome study. Differential expression analysis revealed 967 transcripts with padj ≤ 0.05. Among them, 447 transcripts were differentially expressed in patients with DS compared to controls. Particularly, 203 transcripts were down expressed (151 protein-coding mRNAs, 45 lncRNAs, 1 microRNA, 1 mitochondrial tRNA, 1 ribozyme, and 1 small nuclear RNA) and 244 were over expressed (210 protein-coding mRNAs and 34 lncRNAs). Interestingly, deregulated lncRNAs are involved in pathways that play a role in developmental disorders, neurological diseases, DNA replication and repair mechanisms, and cancer development in DS patients. In conclusion, these results suggest a role of lncRNAs in the phenotype of DS patients.

Published
2021

29. Is Low-Level Laser Therapy an Effective Method to Alleviate Pain Induced by Active Orthodontic Alignment Archwire? A Randomized Clinical Trial

Author

Letizia Perillo, Gianluigi Caccianiga, Antonino Lo Giudice, Riccardo Nucera, Alessio Paiusco, Lo Giudice, A., Nucera, R., Perillo, L., Paiusco, A., Caccianiga, G., Lo Giudice, A, Nucera, R, Perillo, L, Paiusco, A, and Caccianiga, G

Subjects
Adult, Male, Adolescent, medicine.medical_treatment, Dentistry, Pain, Placebo, Placebo group, law.invention, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Incisor, Randomized controlled trial, law, Orthodontic Wires, medicine, Humans, Pain Management, 030212 general & internal medicine, Low-Level Light Therapy, General Dentistry, Low level laser therapy, business.industry, LLLT, 030206 dentistry, Photobiomodulation, Dental crowding, Crowding, medicine.anatomical_structure, Research Design, Diastema, Dentistry (all), Female, Orthodontic treatment, business
Abstract

Objective The aim of this study is to assess if low-level laser therapy (LLLT) alleviates pain after the placement of orthodontic alignment archwire and if there could be a specific indication for the usage of LLLT according to the amount of dental crowding. Materials and Methods Ninety subjects were included and randomly assigned to the tested group (orthodontic treatment and LLLT), placebo group (orthodontic treatment and simulated LLLT), and control group (orthodontic treatment only). Inclusion criteria are age between 13 and 30 years, completely erupted mandibular teeth, and lower crowding of ≥3 mm. Exclusion criteria are spaces or diastema in the lower arch, ectopic teeth, treatment plan including extractions or the use of auxiliary devices, and previous orthodontic treatment. Patients reported the pain experienced by using a numeric rating scale, ranging from 0 to 10, at specific time intervals, that is, 2 hours, 6 hours, 24 hours, and from day 2 to 7. Kruskal–Wallis H Test was used to assess differences in the maximum pain and pain experienced at each time interval among the three groups and in the maximum pain reported among subjects with different degree of crowding. Results The final sample consisted of 84 patients, 41 male and 43 female patients, with a mean age of 16.5 ± 2.8 years. The pain experienced at each time interval and the maximum pain score were significantly lower in the tested group, whereas no differences were found between control and placebo groups. Moreover, no differences were found in the pain experienced among subjects with mild, moderate, and severe incisor crowding in all groups. Conclusions LLLT is effective in alleviating the intensity and duration of pain experienced by patients after the engagement of alignment archwire. However, there is no specific indication for the usage of LLLT according to the amount of crowding.

Published
2019

30. Uniportal and three-portal video-assisted thoracic surgery lobectomy: analysis of the Italian video-assisted thoracic surgery group database

Author

Tosi, D, Nosotti, M, Bonitta, G, Mazzucco, A, Righi, I, Mendogni, P, Rosso, L, Palleschi, A, Rocco, G, Crisci, R, Mancuso, M, Pernazza, F, Refai, M, Bortolotti, L, Rizzardi, G, Gargiulo, G, Dolci, Gp, Perkmann, R, Zaraca, F, Benvenuti, M, Gavezzoli, D, Cherchi, R, Ferrari, P, Mucilli, F, Camplese, P, Melloni, G, Mazza, F, Cavallesco, G, Maniscalco, P, Voltolini, L, Gonfiotti, A, Stella, F, Argnani, D, Pariscenti, Gl, Lurilli, Surrente, C, Lopez, C, Droghetti, A, Giovanardi, M, Breda, C, Lo Giudice, F, Alloisio, M, Bottoni, E, Spaggiari, L, Gasparri, R, Torre, M, Rinaldo, A, Negri, Gp, Bandiera, A, Stefani, A, Natali, P, Scarci, M, Pirondini, E, Curcio, C, Amore, D, Baietto, G, Casadio, C, Nicotra, S, Dell'Amore, A, Bertani, A, Russo, E, Ampollini, L, Carbognani, P, Puma, F, Vinci, D, Andreetti, C, Poggi, C, Cardillo, G, Margaritora, S, Meacci, Elisa, Luzzi, L, Ghisalberti, M, Zaccagna, G, Lausi, P, Guerrera, F, Fontana, D, Della Beffa, V, Morelli, A, Londero, F, Imperatori, A, Rotolo, N, Terzi, A, Viti, A, Infante, M, Benato, C, Tosi, D., Nosotti, M., Bonitta, G., Mazzucco, A., Righi, I., Mendogni, P., Rosso, L., Palleschi, A., Rocco, G., Crisci, R., Mancuso, M., Pernazza, F., Refai, M., Bortolotti, L., Rizzardi, G., Gargiulo, G., Dolci, G. P., Perkmann, R., Zaraca, F., Benvenuti, M., Gavezzoli, D., Cherchi, R., Ferrari, P., Mucilli, F., Camplese, P., Melloni, G., Mazza, F., Cavallesco, G., Maniscalco, P., Voltolini, L., Gonfiotti, A., Stella, F., Argnani, D., Pariscenti, G. L., Surrente, C., Lopez, C., Droghetti, A., Giovanardi, M., Breda, C., Lo Giudice, F., Alloisio, M., Bottoni, E., Spaggiari, L., Gasparri, R., Torre, M., Rinaldo, A., Negri, G, Bandiera, A., Stefani, A., Natali, P., Scarci, M., Pirondini, E., Curcio, C., Amore, D., Baietto, G., Casadio, C., Nicotra, S., Dell'Amore, A., Bertani, A., Russo, E., Ampollini, L., Carbognani, P., Puma, F., Vinci, D., Andreetti, C., Poggi, C., Cardillo, G., Margaritora, S., Meacci, E., Luzzi, L., Ghisalberti, M., Zaccagna, G., Lausi, P., Guerrera, F., Fontana, D., Della Beffa, V., Morelli, A., Londero, F., Imperatori, A., Rotolo, N., Terzi, A., Viti, A., Infante, M., Benato, C., Tosi D., Nosotti M., Bonitta G., Mazzucco A., Righi I., Mendogni P., Rosso L., Palleschi A., Rocco G., Crisci R., Mancuso M., Pernazza F., Refai M., Bortolotti L., Rizzardi G., Gargiulo G., Dolci G.P., Perkmann R., Zaraca F., Benvenuti M., Gavezzoli D., Cherchi R., Ferrari P., Mucilli F., Camplese P., Melloni G., Mazza F., Cavallesco G., Maniscalco P., Voltolini L., Gonfiotti A., Stella F., Argnani D., Pariscenti G.L., Surrente C., Lopez C., Droghetti A., Giovanardi M., Breda C., Lo Giudice F., Alloisio M., Bottoni E., Spaggiari L., Gasparri R., Torre M., Rinaldo A., Negri G.P., Bandiera A., Stefani A., Natali P., Scarci M., Pirondini E., Curcio C., Amore D., Baietto G., Casadio C., Nicotra S., Dell'amore A., Bertani A., Russo E., Ampollini L., Carbognani P., Puma F., Vinci D., Andreetti C., Poggi C., Cardillo G., Margaritora S., Meacci E., Luzzi L., Ghisalberti M., Zaccagna G., Lausi P., Guerrera F., Fontana D., Della Beffa V., Morelli A., Londero F., Imperatori A., Rotolo N., Terzi A., Viti A., Infante M., and Benato C.

Subjects
Male, Lung Neoplasms, Thoracic, Italian VATS Group, computer.software_genre, Postoperative pain, Settore MED/21 - CHIRURGIA TORACICA, Carcinoma, Non-Small-Cell Lung, Lobectomy, Three-portal, Uniportal, Video-assisted thoracic surgery, Aged, Equipment Design, Female, Humans, Neoplasm Staging, Operative Time, Pneumonectomy, Retrospective Studies, Thoracic Surgery, Video-Assisted, Tomography, X-Ray Computed, Stage (cooking), Non-Small-Cell Lung, Tomography, Database, Thoracic Surgery, X-Ray Computed, Cardiothoracic surgery, Cohort, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, Italian VATS Group, Lobectomy, Postoperative pain, Three-portal, Uniportal, Video-assisted thoracic surgery, medicine.medical_specialty, VATS lobectomy, Video-Assisted, NO, medicine, Lung cancer, business.industry, Carcinoma, Odds ratio, medicine.disease, Confidence interval, Propensity score matching, Surgery, business, computer
Abstract

OBJECTIVES This study compares the uniportal with the 3-portal video-assisted thoracic surgery (VATS) by examining the data collected in the Italian VATS Group Database. The primary end point was early postoperative pain; secondary end points were intraoperative and postoperative complications, surgical time, number of dissected lymph nodes and length of stay. METHODS This was an observational, retrospective, cohort, multicentre study on data collected by 49 Italian thoracic units. Inclusion criteria were clinical stage I–II non-small-cell lung cancer, uniportal or 3-portal VATS lobectomy and R0 resection. Exclusion criteria were cT3 disease, previous thoracic malignancy, induction therapy, significant comorbidities and conversion to other techniques. The pain parameter was dichotomized: the numeric rating scale ≤3 described mild pain, whereas the numeric rating scale score >3 described moderate/severe pain. The propensity score-adjusted generalized estimating equation was used to compare the uniportal with 3-portal lobectomy. RESULTS Among 4338 patients enrolled from January 2014 to July 2017, 1980 met the inclusion criteria; 1808 patients underwent 3-portal lobectomy and 172 uniportal surgery. The adjusted generalized estimating equation regression model using the propensity score showed that over time pain decreased in both groups (P CONCLUSIONS Data from the Italian VATS Group Database showed that in clinical practice uniportal lobectomy seems to entail a higher risk of moderate/severe pain on second and third postoperative days.

Published
2019

31. Global Right Heart Assessment with Speckle-Tracking Imaging Improves the Risk Prediction of a Validated Scoring System in Pulmonary Arterial Hypertension

Author

Federico Biondi, Luke Howard, Carolina Bauleo, Stefano Albani, Gianfranco Sinagra, Edoardo Airò, Davide Stolfo, Michele Emdin, Vasiliki Tsampasian, Francesco Lo Giudice, Giulia Barbati, Antonio De Luca, Emilio Pasanisi, Stolfo, Davide, Albani, Stefano, Biondi, Federico, De Luca, Antonio, Barbati, Giulia, Howard, Luke, Lo Giudice, Francesco, Tsampasian, Vasiliki, Pasanisi, Emilio M, Airò, Edoardo, Bauleo, Carolina, Emdin, Michele, and Sinagra, Gianfranco

Subjects
medicine.medical_specialty, Scoring system, Longitudinal strain, Hypertension, Pulmonary, Ventricular Dysfunction, Right, Atrial Function, Right, 030204 cardiovascular system & hematology, Pulmonary arterial hypertension, Right atrial, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Internal medicine, medicine, REVEAL score, Humans, Radiology, Nuclear Medicine and imaging, In patient, Speckle tracking imaging, Right atrium, business.industry, Speckle-tracking, Right ventricle, medicine.disease, Pulmonary hypertension, Right heart, Cardiology, Ventricular Function, Right, Cardiology and Cardiovascular Medicine, business
Abstract

Background: Right ventricular (RV) function and right atrial (RA) remodeling are major determinants of outcome in pulmonary arterial hypertension (PAH). Strain echocardiography is emerging as a valuable approach for the study of RV and RA function. We sought to assess the incremental prognostic value of serial combined speckle-tracking examination of right chambers in newly diagnosed therapy-naive PAH patients.Methods: The study endpoint was a composite of all-cause mortality, hospitalizations due to worsening PAH, and initiation of parenteral prostanoids. Patients were assessed at baseline and at first revaluation after initiation of treatment. Right ventricular free-wall longitudinal strain (FWLS) and RA peak atrial longitudinal strain (PALS) were used as measures of RV and RA function.Results: Eighty-three patients were included. Mean RV-FWLS and RA-PALS were -13.9% +/- 6.1% and 23.1% +/- 11.4%. The best performing prognostic score among the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension, French Pulmonary Hypertension Registry, and Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) scores was the REVEAL (area under the curve = 0.79, P < .001). With the identified cutoffs, both RV-FWLS (hazard ratio for RV-FWLS < -13.2% = 0.366; 95% CI, 0.159-0.842; P = .018) and RA-PALS (hazard ratio for RA-PALS > 20% = 0.399; 95% CI, 0.176-0.905; P = .028) were independently associated with the primary outcome after correction for the REVEAL score. The combined assessment of RV-FWLS and RA-PALS in addition to the REVEAL score determined a net improvement in prediction of 0.439 (95% CI, 0.070-0.888, P = .04). At 5 months (interquartile range, 4-8) of follow-up, RV-FWLS and RA-PALS improved significantly only in patients free from the primary outcome (P < .001 and P = .001, respectively).Conclusions: The combined assessment of RV-FWLS and RA-PALS determined an improvement in outcome prediction of validated prognostic risk scores and should be considered within the multiparametric evaluation of patients with PAH.

Published
2020

32. Accuracy of right atrial pressure estimation using a multi-parameter approach derived from inferior vena cava semi-automated edge-tracking echocardiography: a pilot study in patients with cardiovascular disorders

Author

Gianfranco Sinagra, Luca Mesin, Davide Stolfo, Marco Confalonieri, Massimo Porta, Bruno Pinamonti, Paolo Pasquero, Marco de Scordilli, Giovanni Donato Aquaro, Caterina Gregorio, Stefano Albani, Tatiana Giovinazzo, Francesco Lo Giudice, Andrea Perkan, Enrico Fabris, Giulia Barbati, Pietro Geri, Albani, S., Pinamonti, B., Giovinazzo, T., de Scordilli, M., Fabris, E., Stolfo, D., Perkan, A., Gregorio, C., Barbati, G., Geri, P., Confalonieri, M., Lo Giudice, F., Aquaro, G. D., Pasquero, P., Porta, M., Sinagra, G., and Mesin, L.

Subjects
Male, Right heart catheterization, Cardiac Catheterization, medicine.medical_specialty, Cardiac Caval Index, Pilot Projects, Vena Cava, Inferior, Atrial Function, Right, 030204 cardiovascular system & hematology, Inferior vena cava, Edge-tracking, 03 medical and health sciences, Atrial Pressure, 0302 clinical medicine, Predictive Value of Tests, Edge tracking, Internal medicine, Image Interpretation, Computer-Assisted, medicine, Humans, Radiology, Nuclear Medicine and imaging, In patient, Prospective Studies, Multi parameter, Cardiac imaging, Aged, Right atrial pressure, Caval Index, Respiratory Caval Index, business.industry, Central venous pressure, Reproducibility of Results, Middle Aged, medicine.disease, Pulmonary hypertension, 030228 respiratory system, medicine.vein, Cardiovascular Diseases, Echocardiography, cardiovascular system, Cardiology, Feasibility Studies, Female, Cardiology and Cardiovascular Medicine, business, Algorithms
Abstract

The echocardiographic estimation of right atrial pressure (RAP) is based on the size and inspiratory collapse of the inferior vena cava (IVC). However, this method has proven to have limits of reliability. The aim of this study is to assess feasibility and accuracy of a new semi-automated approach to estimate RAP. Standard acquired echocardiographic images were processed with a semi-automated technique. Indexes related to the collapsibility of the vessel during inspiration (Caval Index, CI) and new indexes of pulsatility, obtained considering only the stimulation due to either respiration (Respiratory Caval Index, RCI) or heartbeats (Cardiac Caval Index, CCI) were derived. Binary Tree Models (BTM) were then developed to estimate either 3 or 5 RAP classes (BTM3 and BTM5) using indexes estimated by the semi-automated technique. These BTMs were compared with two standard estimation (SE) echocardiographic methods, indicated as A and B, distinguishing among 3 and 5 RAP classes, respectively. Direct RAP measurements obtained during a right heart catheterization (RHC) were used as reference. 62 consecutive ‘all-comers’ patients that had a RHC were enrolled; 13 patients were excluded for technical reasons. Therefore 49 patients were included in this study (mean age 62.2 ± 15.2 years, 75.5% pulmonary hypertension, 34.7% severe left ventricular dysfunction and 51% right ventricular dysfunction). The SE methods showed poor accuracy for RAP estimation (method A: misclassification error, ME = 51%, R2 = 0.22; method B: ME = 69%, R2 = 0.26). Instead, the new semi-automated methods BTM3 and BTM5 have higher accuracy (ME = 14%, R2 = 0.47 and ME = 22%, R2 = 0.61, respectively). In conclusion, a multi-parametric approach using IVC indexes extracted by the semi-automated approach is a promising tool for a more accurate estimation of RAP.

Published
2020

33. Dentoalveolar fractures: New orthodontic protocol proposal and pilot study

Author

Luigi Califano, Vincenzo Abbate, Giovanni Dell'Aversana Orabona, Giorgio Lo Giudice, Stefania Perrotta, Rosa Valletta, Tecla Bocchino, Dell'Aversana Orabona, G., Perrotta, S., Lo Giudice, G., Bocchino, T., Valletta, R., Abbate, V., and Califano, L.

Subjects
Splinting, Male, Treatment protocol, Adolescent, Orthodontic Brackets, Jaw Fractures, Pilot Projects, Bone healing, Application time, Periodontal Disease, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Imaging, Three-Dimensional, Orthodontic Bracket, Occlusion, Humans, Medicine, Pilot Project, 030223 otorhinolaryngology, Periodontal Diseases, Orthodontics, Protocol (science), business.industry, Jaw Fracture, 030206 dentistry, General Medicine, Fracture treatment, Dentoalveolar fracture, Regional acceleratory phenomenon, Orthodontic brackets, Otorhinolaryngology, Surgery, Female, Orthodontic treatment, business, Tomography, X-Ray Computed, Human
Abstract

The goal of fracture treatment that includes the dentoalveolar process is to obtain the anatomic bone healing and the pre-injury occlusion restoration with functional and aesthetic recovery, avoiding dental or periodontal lesions. Fractures activates, in the damaged tissue, the Regional Acceleratory Phenomenon, a physiological healing process that can also be activated during orthodontic overloads. Orthodontic treatment in the traumatized area could exploit this phenomenon in order to sustain the cellular activity. The aim of this study is to propose a treatment protocol for dentoalveolar fractures based on the use of orthodontics in order to sustain the physiological healing process known as Regional Acceleratory Phenomenon. The authors present 2 cases of an 18 year old woman and 23 year old man affected by dentoalveolar fracture. The operative protocol the authors applied foresaw three steps of treatment: orthodontic brackets application, surgery, orthodontic treatment. The patients showed complete healing at the 3 months follow-up and were treated up to 18 months for further orthodontic treatment. The operative protocol proposed by the Authors appears to be a rational choice since it allows a single orthodontic device to be an ''active splinting system'', with fast application time, good acceptance by the patient, low complications rate; moreover, it produces any planned dental movements for further orthodontic treatments.

Published
2020

34. Fully automatic segmentation of the mandible based on convolutional neural networks (CNNs)

Author

Rosalia Leonardi, Vincenzo Ronsivalle, Antonino Lo Giudice, and Concetto Spampinato

Subjects
Adult, Male, Matching (statistics), Intraclass correlation, Orthodontics, Mandible, Convolutional neural network, Young Adult, Artificial Intelligence, Image Processing, Computer-Assisted, Humans, Segmentation, Mathematics, business.industry, Deep learning, CBCT, Reproducibility of Results, Mean age, Pattern recognition, 3D rendering, Otorhinolaryngology, Fully automatic, Surgery, Female, Artificial intelligence, Neural Networks, Computer, Oral Surgery, business
Abstract

Objectives To evaluate the accuracy of automatic deep learning-based method for fully automatic segmentation of the mandible from CBCTs. Setting and sample population CBCT-derived mandible fully automatic segmentation. Methods 40 CBCT scans from healthy patients (20 females and 20 males, mean age 23,37 ± 3,34) were collected and a manual mandible segmentation were carried out by using Mimics software. Twenty CBCT scans were randomly selected and used for training the artificial intelligence model file. The remaining 20 CBCT segmentation masks were used to test the accuracy of the CNN automatic method by comparing the segmentation volumes of the 3D models obtained with automatic and manual segmentations. The accuracy of the CNN-based method was also assessed by using the DICE Score coefficient (DSC) and by the surface-to-surface matching technique. The Intraclass correlation coefficient (ICC) and Dahlberg's formula were used respectively to test the intra-observer reliability and method error. Independent Student's t-test was used for between-groups volumetric comparison. Results Measurements were highly correlated with an ICC value of 0,937 while the method error was 0,24 mm3. A difference of 0,71 (± 0,49) cm3 was found between the methodologies but it was not statistically significant (p>0.05). The matching percentage detected was 90.35% (± 1.88) (tolerance 0.5 mm) and 96.32% ± 1.97% (tolerance 1.0 mm). The differences, measured as DSC in percentage, between the assessments done with both methods were, respectively, 2,8% and 3,1%. Conclusion The tested deep learning CNN-based technology is accurate and performs as well as an experienced image reader but at much higher speed, which is of significant clinical relevance.

Published
2021

35. Insulin signaling, androgen receptor and PSMA immunohistochemical analysis by semi-automated tissue microarray in prostate cancer with diabetes (DIAMOND study)

Author

Rosario Caltabiano, Giorgio Ivan Russo, Giuseppe Morgia, Arturo Lo Giudice, Elisabetta Pricoco, Marina Di Mauro, Matteo Ferro, Giuseppe Broggi, and Eliana Piombino

Subjects
Oncology, Glutamate Carboxypeptidase II, Male, medicine.medical_specialty, medicine.medical_treatment, Kaplan-Meier Estimate, Receptor, IGF Type 1, Prostate cancer, Antigens, CD, Physiology (medical), Internal medicine, Diabetes mellitus, medicine, Biomarkers, Tumor, Diabetes Mellitus, Humans, Insulin, Aged, Retrospective Studies, Tissue microarray, biology, business.industry, Biochemistry (medical), Public Health, Environmental and Occupational Health, Prostatic Neoplasms, General Medicine, Hyperplasia, Middle Aged, medicine.disease, Immunohistochemistry, Receptor, Insulin, Androgen receptor, Insulin receptor, Tumor progression, Receptors, Androgen, Tissue Array Analysis, Antigens, Surface, biology.protein, business
Abstract

In the last years, many studies have highlighted the hypothesis that diabetes and hyperglycemia could be relevant for prostate cancer (PC) development and progression. We aimed to identify the prognostic value of tissue expression of androgen receptor (AR), Prostate-Specific Membrane Antigen (PSMA), Ki-67, insulin receptors (IR) α and β, insulin growth factor-1 (IGF-1) receptor, in patients with PC and to evaluate their association with diabetes. We retrospectively collected data from 360 patients who underwent radical prostatectomy for PC or surgery for benign prostatic hyperplasia (BPH), between 2010 and 2020. We constructed tissue microarray for immunohistochemistry (IHC) analysis. In the final cohort (76 BPH and 284 PC), 57 (15.8%) patients had diabetes, 17 (22.37%) in BPH and 40 (14.08%) in PC (P = 0.08). IR-α was more expressed in patients with PC compared to the BPH Group (95.96% vs 4.04%; P

Published
2021

36. The puzzling issue of silica toxicity: are silanols bridging the gaps between surface states and pathogenicity?

Author

Roel P. F. Schins, Cristina Pavan, Christina Ziemann, Massimo Delle Piane, Francesca Filippi, Claire J. Horwell, Dominique Lison, Michelle Wyart-Remy, Bice Fubini, François Huaux, Maria Gullo, Karsten Wegner, Francesco Turci, Peter Hoet, Cristina Lo Giudice, Gianmario Martra, Marialore Sulpizi, Eliseo Montfort, European Association of industrial silica producers (EUROSIL), UCL - SSS/IREC/LTAP - Louvain Centre for Toxicology and Applied Pharmacology, UCL - SST/LIBST - Louvain Institute of Biomolecular Science and Technology, UCL - (SLuc) Service de biochimie médicale, and Publica

Subjects
Atomic force microscopy, Auto-immune diseases, Coating, Lung cancer, Modelling, Silanol, Silica, Silicosis, Spectroscopy, Surface reactivity, Animals, Apoptosis, Cell Membrane, Computational Chemistry, Epithelial Cells, Humans, Immunity, Innate, Molecular Dynamics Simulation, Silanes, Silicon Dioxide, Surface Properties, TRPV Cation Channels, Health, Toxicology and Mutagenesis, lcsh:Industrial hygiene. Industrial welfare, Nanotechnology, Toxicology, 03 medical and health sciences, chemistry.chemical_compound, lcsh:RA1190-1270, Innate, Surface states, lcsh:Toxicology. Poisons, chemistry.chemical_classification, 0303 health sciences, Biomolecule, Immunity, 030311 toxicology, General Medicine, Pathogenicity, Membrane, chemistry, Commentary, Particle, lcsh:HD7260-7780.8
Abstract

Background: Silica continues to represent an intriguing topic of fundamental and applied research across various scientific fields, from geology to physics, chemistry, cell biology, and particle toxicology. The pathogenic activity of silica is variable, depending on the physico-chemical features of the particles. In the last 50 years, crystallinity and capacity to generate free radicals have been recognized as relevant features for silica toxicity. The ‘surface’ also plays an important role in silica toxicity, but this term has often been used in a very general way, without defining which properties of the surface are actually driving toxicity. How the chemical features (e.g., silanols and siloxanes) and configuration of the silica surface can trigger toxic responses remains incompletely understood. Main body: Recent developments in surface chemistry, cell biology and toxicology provide new avenues to improve our understanding of the molecular mechanisms of the adverse responses to silica particles. New physicochemical methods can finely characterize and quantify silanols at the surface of silica particles. Advanced computational modelling and atomic force microscopy offer unique opportunities to explore the intimate interactions between silica surface and membrane models or cells. In recent years, interdisciplinary research, using these tools, has built increasing evidence that surface silanols are critical determinants of the interaction between silica particles and biomolecules, membranes, cell systems, or animal models. It also has become clear that silanol configuration, and eventually biological responses, can be affected by impurities within the crystal structure, or coatings covering the particle surface. The discovery of new molecular targets of crystalline as well as amorphous silica particles in the immune system and in epithelial lung cells represents new possible toxicity pathways. Cellular recognition systems that detect specific features of the surface of silica particles have been identified. Conclusions: Interdisciplinary research bridging surface chemistry to toxicology is progressively solving the puzzling issue of the variable toxicity of silica. Further interdisciplinary research is ongoing to elucidate the intimate mechanisms of silica pathogenicity, to possibly mitigate or reduce surface reactivity. Keywords: Silica, Silicosis, Lung cancer, Auto-immune diseases, Surface reactivity, Silanol, Coating, Modelling, Spectroscopy, Atomic force microscopy

Published
2019

37. Characterization and preventability of adverse drug events as cause of emergency department visits: a prospective 1-year observational study

Author

Aulo Di Grande, Vincenzo Arcoraci, Maria Antonietta Barbieri, Paola Maria Cutroneo, Maria Gioffrè-Florio, Giuseppe Carpinteri, Eleonora Mocciaro, Giuseppe Cicala, Edoardo Spina, Ivan Lo Giudice, and Claudia Giardina

Subjects
Adult, Male, Drug, medicine.medical_specialty, Adolescent, Drug-Related Side Effects and Adverse Reactions, media_common.quotation_subject, Anti-Inflammatory Agents, Logistic regression, 030226 pharmacology & pharmacy, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Fibrinolytic Agents, Interquartile range, lcsh:RA1190-1270, Adverse drug event, Causality, Emergency department, Preventability, Seriousness, Health care, medicine, Humans, Pharmacology (medical), Prospective Studies, Sicily, Aged, media_common, lcsh:Toxicology. Poisons, Aged, 80 and over, Pharmacology, business.industry, lcsh:RM1-950, Middle Aged, Confidence interval, Neurological effects, Anti-Bacterial Agents, lcsh:Therapeutics. Pharmacology, Emergency medicine, Polypharmacy, Female, Observational study, Emergency Service, Hospital, business, Research Article
Abstract

Background Adverse drug events (ADEs) are a significant cause of emergency department (ED) visits, with a major impact on healthcare resource utilization. A multicentre observational study, aimed to describe frequency, seriousness and preventability of ADEs reported in four EDs, was performed in Sicily (Italy) over a 1-year period. Methods Two trained monitors for each ED supported clinicians in identifying ADEs of patients admitted to EDs between June 1st, 2013 and May 31st, 2014 through a systematic interview of patients or their caregivers and with an additional record review. A research team analyzed each case of suspected ADE, to make a causality assessment applying the Naranjo algorithm and a preventability assessment using Schumock and Thornton criteria. Absolute and percentage frequencies with 95% confidence interval (CI) and medians with interquartile ranges (IQR) were estimated. Logistic regression models were used to evaluate independent predictors of serious and certainly preventable ADEs. Results Out of 16,963 ED visits, 575 (3.4%) were associated to ADEs, of which 15.1% resulted in hospitalization. ADEs were classified as probable in 45.9%, possible in 51.7% and definite in 2.4% of the cases. Moreover, ADEs were considered certainly preventable in 12.3%, probably preventable in 58.4%, and not preventable in 29.2% of the cases. Polytherapy influenced the risk to experience a serious, as well as a certainly preventable ADE. Whilst, older age resulted an independent predictor only of serious events. The most common implicated drug classes were antibiotics (34.4%) and anti-inflammatory drugs (22.6%). ADEs due to psycholeptics and antiepileptics resulted preventable in 62.7 and 54.5% of the cases, respectively. Allergic reactions (64%) were the most frequent cause of ADE-related ED visits, followed by neurological effects (10.2%) that resulted preventable in 1.9 and 37.3% of the cases, respectively. Conclusion ADEs are a frequent cause of ED visits. The commonly used antibiotics and anti-inflammatory drugs should be carefully managed, as they are widely involved in mild to severe ADEs. Polytherapy is associated with the occurrence of serious, as well as certainly preventable ADEs, while older age only with serious events. A greater sensitivity to drug monitoring programs among health professionals is needed.

Published
2019

38. Diabetes: Oral Health Related Quality of Life and Oral Alterations

Author

Stefania Marino, Floriana Lauritano, Gabriele Cervino, Cristina Scoglio, Fausto Famà, Roberta Mastroieni, Giulia Amoroso, Roberto Lo Giudice, Antonella Terranova, Rosa De Stefano, Cesare D’Amico, Francesco Catalano, Francesca Gorassini, Enrico Nastro Siniscalchi, Luca Fiorillo, Marco Matarese, and F. Briguglio

Subjects
0301 basic medicine, medicine.medical_specialty, Population, MEDLINE, lcsh:Medicine, Oral Health, Review Article, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Diabetes mellitus, Diabetes Mellitus, medicine, Animals, Humans, Hypoglycemic Agents, Risk factor, Intensive care medicine, education, Glycemic, education.field_of_study, General Immunology and Microbiology, business.industry, lcsh:R, 030206 dentistry, General Medicine, medicine.disease, 030104 developmental biology, Biochemistry, Genetics and Molecular Biology (all), Immunology and Microbiology (all), Inclusion and exclusion criteria, Quality of Life, business, Psychosocial
Abstract

Background and Objectives. About 5% of the world’s population is affected by diabetes; these patients must be further treated during medical and surgical treatments. These patients, due to the glycemic conditions, realize during their life multiorgan changes, in different body districts. Moreover, this condition obliges them to undertake hypoglycemic therapies. Diabetes is a risk factor for many diseases, including those concerning the oral district with immunological implications. Materials and Methods. A comprehensive review of the literature was conducted according to PRISMA guidelines accessing the NCBI PubMed database. Authors conducted the search of articles in English language. The results of the last 10 years have been considered, which present useful information regarding the oral conditions. A total of 17 relevant studies were included in the review. The study evaluated only papers with specific inclusion criteria regarding oral health. The works initially taken into consideration were 782; subsequently applying the inclusion and exclusion criteria, there were 42 works. After a careful analysis of the work obtained by two academics who have worked separately, there have been 17 studies. All data from the studies were compared and many of these confirmed alteration in the oral district. Results. The studies taken into consideration evaluated different factors, such as OHRQoL, QoL, and oral alterations, involving soft tissue, dental structures, and postrehabilitative complications, as well as immunological alterations. Conclusions. We can affirm, in conclusion, that this study has brought to light those that are complications due to diabetic pathology, from different points of view. The psychological and psychosocial alterations, certainly present in these patients, are probably due to local and systemic alterations; this is confirmed by the correlation between oral health and quality of life reported by the patients.

Published
2019

39. Modelling the neuropathology of lysosomal storage disorders through disease-specific human induced pluripotent stem cells

Author

Bálint Jezsó, Phetcharat Phanthong, Kinga Molnár, Poul Hyttel, Maria Lo Giudice, Marianne Hoogeveen-Westerveld, Lajos László, W. Pijnappel, Shuling Zhou, Eszter Varga, Kristine K. Freude, István Bock, Annamária Téglási, Hideyuki Nakanishi, Norbert Varga, Andras Dinnyes, Narisorn Kitiyanant, Julianna Kobolák, and Clinical Genetics

Subjects
0301 basic medicine, Neuronal, Genetic enhancement, Induced Pluripotent Stem Cells, Neuropathology, Vacuole, Biology, Models, Biological, 03 medical and health sciences, symbols.namesake, Storage vacuoles, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Autophagy, Humans, Cells, Cultured, Mucopolysaccharidosis II, LAMP2, iPSC, Cell Differentiation, Cell Biology, Golgi apparatus, Flow Cytometry, In vitro, 3. Good health, Cell biology, 030104 developmental biology, Apoptosis, 030220 oncology & carcinogenesis, symbols, Lysosomes, Endosomal-lysosomal system
Abstract

Mucopolysaccharidosis II (MPS II) is a lysosomal storage disorder (LSD), caused by iduronate 2-sulphatase (IDS) enzyme dysfunction. The neuropathology of the disease is not well understood, although the neural symptoms are currently incurable. MPS II-patient derived iPSC lines were established and differentiated to neuronal lineage. The disease phenotype was confirmed by IDS enzyme and glycosaminoglycan assay. MPS II neuronal precursor cells (NPCs) showed significantly decreased self-renewal capacity, while their cortical neuronal differentiation potential was not affected. Major structural alterations in the ER and Golgi complex, accumulation of storage vacuoles, and increased apoptosis were observed both at protein expression and ultrastructural level in the MPS II neuronal cells, which was more pronounced in GFAP + astrocytes, with increased LAMP2 expression but unchanged in their RAB7 compartment. Based on these finding we hypothesize that lysosomal membrane protein (LMP) carrier vesicles have an initiating role in the formation of storage vacuoles leading to impaired lysosomal function. In conclusion, a novel human MPS II disease model was established for the first time which recapitulates the in vitro neuropathology of the disorder, providing novel information on the disease mechanism which allows better understanding of further lysosomal storage disorders and facilitates drug testing and gene therapy approaches.

Published
2019

40. A Machine Learning Approach to Parkinson’s Disease Blood Transcriptomics

Author

Ester Pantaleo, Alfonso Monaco, Nicola Amoroso, Angela Lombardi, Loredana Bellantuono, Daniele Urso, Claudio Lo Giudice, Ernesto Picardi, Benedetta Tafuri, Salvatore Nigro, Graziano Pesole, Sabina Tangaro, Giancarlo Logroscino, and Roberto Bellotti

Subjects
blood transcriptomics, Parkinson’s disease, machine learning, xgboost, feature selection, oxidative stress, inflammation, mitochondrial dysfunction, Parkinson Disease, Cohort Studies, Machine Learning, Early Diagnosis, Genetics, Humans, Transcriptome, Genetics (clinical)
Abstract

The increased incidence and the significant health burden associated with Parkinson’s disease (PD) have stimulated substantial research efforts towards the identification of effective treatments and diagnostic procedures. Despite technological advancements, a cure is still not available and PD is often diagnosed a long time after onset when irreversible damage has already occurred. Blood transcriptomics represents a potentially disruptive technology for the early diagnosis of PD. We used transcriptome data from the PPMI study, a large cohort study with early PD subjects and age matched controls (HC), to perform the classification of PD vs. HC in around 550 samples. Using a nested feature selection procedure based on Random Forests and XGBoost we reached an AUC of 72% and found 493 candidate genes. We further discussed the importance of the selected genes through a functional analysis based on GOs and KEGG pathways.

Published
2022

41. Impact of Matrix Metalloproteinase-9 during Periodontitis and Cardiovascular Diseases

Author

Giuseppe Palazzo, Alessandro Polizzi, Antonino Lo Giudice, Vincenzo Ronsivalle, Angela Alibrandi, and Gaetano Isola

Subjects
Adult, Male, Saliva, medicine.medical_specialty, Pharmaceutical Science, Gastroenterology, Article, Analytical Chemistry, lcsh:QD241-441, 03 medical and health sciences, 0302 clinical medicine, Periodontal disease, lcsh:Organic chemistry, cardiovascular disease, Internal medicine, Total cholesterol, Drug Discovery, Humans, Medicine, In patient, cardiovascular diseases, Physical and Theoretical Chemistry, periodontitis, Aged, 030304 developmental biology, Periodontitis, 0303 health sciences, saliva, business.industry, Organic Chemistry, Healthy subjects, matrix metalloproteinases, Matrix metalloproteinase 9, clinical trial, 030206 dentistry, Middle Aged, medicine.disease, C-Reactive Protein, Matrix Metalloproteinase 9, Cardiovascular Diseases, Chemistry (miscellaneous), Molecular Medicine, Female, business, serum
Abstract

Matrix metalloproteinase-9 (MMP-9) has been shown to play a key role in endothelial function and perhaps pivotal in the correlation between periodontal disease and cardiovascular disease (CVD). For the study, the impact of MMP-9 of periodontitis and CVD on serum and saliva concentrations was analyzed. For the study patients with periodontitis (n = 31), CVD (n = 31), periodontitis + CVD (n = 31), and healthy patients (n = 31) were enrolled. Clinical and demographic characteristics as well as serum and salivary MMP-9 were evaluated. MMP-9 concentrations in serum and saliva were statistically elevated in patients with CVD (p &lt, 0.01) and in patients with periodontitis plus CVD (p &lt, 0.001) compared to patients with periodontitis and healthy subjects. Multivariate regression analysis showed that c-reactive protein (hs-CRP) was the only significant predictor for MMP-9 serum (p &lt, 0.001), whereas hs-CRP (p &lt, 0.001) and total cholesterol (p = 0.029) were the statistically significant salivary MMP-9 predictors. This study evidenced that patients with CVD and periodontitis + CVD presented elevated MMP-9 concentrations in serum and saliva compared to patients with periodontitis and healthy subjects. Furthermore, hs-CRP was a negative predictor of serum and salivary MMP-9.

Published
2021
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42. Incremental value of cardiopulmonary exercise testing in intermediate-risk pulmonary arterial hypertension

Author

Roberto Badagliacca, Franz Rischard, Francesco Lo Giudice, Luke Howard, Silvia Papa, Gabriele Valli, Giovanna Manzi, Susanna Sciomer, Paolo Palange, Joe G.N. Garcia, Rebecca Vanderpool, Rocco Rinaldo, Beatrice Vigo, Michael Insel, Francesco Fedele, and Carmine Dario Vizza

Subjects
validation, Pulmonary and Respiratory Medicine, Transplantation, Pulmonary Arterial Hypertension, clinical worsening, Hypertension, Pulmonary, cardiopulmonary exercise test, oxygen uptake, pulmonary arterial hypertension, Cohort Studies, Oxygen Consumption, Exercise Test, Humans, Surgery, Familial Primary Pulmonary Hypertension, Cardiology and Cardiovascular Medicine
Abstract

Risk assessment in pulmonary arterial hypertension (PAH) is essential for prognostication. However, the majority of patients end-up in an intermediate risk status, offering insufficient guidance in clinical practice. The added value of cardiopulmonary exercise testing in this setting remains undefined.Two independent cohorts with idiopathic PAH at intermediate risk were used to develop (n = 124) and externally validate (n = 143) the prognostic model. Cross-validation on the overall population was used to strengthen the results of the analysis. Risk assessment was based on the simplified version of the ESC/ERS guidelines score. Discrimination and calibration were assessed.A risk score was constructed based on the beta-coefficient of the cross-validated model, including the stroke volume index (SVI) and the peak oxygen uptake (VOCombinations of VO

Published
2021

43. COVID-19 and its impact on the cardiovascular system

Author

Michael Bellamy, Gulammehdi Haji, Lilit Baghdasaryan, Ghada W. Mikhail, Francesco Lo Giudice, Rodney A. Foale, Brian Wang, Amarjit Sethi, Neil Ruparelia, Ahmed M M Hassan, Perviz Asaria, Poornima Mohan, Petros Nihoyannopoulos, Prapa Kanagaratnam, Darrel P. Francis, Nilesh Sutaria, Andrew Chukwuemeka, Rasha Al-Lamee, Carla M. Plymen, Rachel J. Davies, Gajen Kanaganayagam, Ramzi Khamis, Jon Anderson, Luke Howard, Gemma Bowsher, Iqbal S. Malik, Christopher S. Baker, Richard J. Jabbour, Amanda Varnava, Kevin Fox, Sayan Sen, Bushra Rana, Jaspal S. Kooner, Theodora Bampouri, Saud Ahmed Khawaja, Punam A Pabari, Farhan Huq, Ricardo Petraco, Sukhjinder Nijjer, Graham D. Cole, National Institute for Health Research, British Heart Foundation, and Imperial College Healthcare NHS Trust- BRC Funding

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, myocardial disease, Myocarditis, Cardiac & Cardiovascular Systems, cardiac, Disease, Comorbidity, 030204 cardiovascular system & hematology, acute coronary syndrome, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Epidemiology, London, medicine, Diseases of the circulatory (Cardiovascular) system, Humans, 030212 general & internal medicine, Hospital Mortality, Pandemics, Aged, Retrospective Studies, Science & Technology, business.industry, SARS-CoV-2, Incidence (epidemiology), Incidence, COVID-19, Retrospective cohort study, medicine.disease, Cardiac Risk Factors and Prevention, Survival Rate, Cardiovascular Diseases, RC666-701, Cohort, Cardiovascular System & Cardiology, RNA, Viral, Female, myocarditis, Cardiology and Cardiovascular Medicine, business, Life Sciences & Biomedicine, arrhythmias
Abstract

ObjectivesThe clinical impact of SARS-CoV-2 has varied across countries with varying cardiovascular manifestations. We review the cardiac presentations, in-hospital outcomes and development of cardiovascular complications in the initial cohort of SARS-CoV-2 positive patients at Imperial College Healthcare National Health Service Trust, UK.MethodsWe retrospectively analysed 498 COVID-19 positive adult admissions to our institute from 7 March to 7 April 2020. Patient data were collected for baseline demographics, comorbidities and in-hospital outcomes, especially relating to cardiovascular intervention.ResultsMean age was 67.4±16.1 years and 62.2% (n=310) were male. 64.1% (n=319) of our cohort had underlying cardiovascular disease (CVD) with 53.4% (n=266) having hypertension. 43.2%(n=215) developed acute myocardial injury. Mortality was significantly increased in those patients with myocardial injury (47.4% vs 18.4%, pConclusionHypertension, pre-existing CVD and acute myocardial injury were associated with increased in-hospital mortality in our cohort of COVID-19 patients. However, only a low number of patients required invasive cardiac intervention.

Published
2021

44. SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Author

COVIDSurg Collaborative, GlobalSurg Collaborative, A, M., Abdelhamid, M. H. S., Alhabdan, S., Nekoval, V., Nel, C., Nel, D., Nel, H., Nelihela, P., Nelissen, E., Nelli, T., Nelson, C., Nemeth, M., Nene, A., AlHADAD, M., Neo, E. L., Neo, E. N., Neri, C. M., Neshige, S., Nespoli, L. C., Nessa, A., Nessim, C., Neuerburg, C., Neves, F., Neves, M., Alhaddad, A., Newcomb, A., Newitt, L., Newman, J., Newman, M., Newman, S., Newton, L., Neykov, V., Nezerwa, Y., Nezi, G., Ng, B., Alhaddad, W., Ng, C. S. H., Ng, C. F., Ng, C. E., Ng, D., Ng, D. S. W., Ng, J. C. K., Ng, J. Y., Ng, J., Ng, K. K., Ng, K. C., Alhadeethi, A., Ng, M. Y., Ng, M., Ng, S., Ng We Yong, Y. J., Ng-Kamstra, J., Ngan, T. Y., Ngaserin, S., Ngeruka, M. L., Ngu, J., Alhadi, A., Ngulube, A., Nguyen, A., Nguyen, H. M. N., Nguyen, H., Nguyen, S., Ni Bhroin, O., Nia, A., Niazi, F. A. K., Niazi, M., Alhag, A., Niazi, S. U., Nichani, J., Nichita, M., Nicholas, E., Nicholson, K., Nicholus, M., Nicolaiciuc, S., Nicolas, B., Nicolás-López, T., Niculae, C., Alhaidari, A., Nidaw, M., Nielsen, M. F., Niemeier, A., Nieto Calvache, A. J., Nieto Rodriguez, J. M., Nieto-Moreno, A., Nieto-Moreno, E., Nigalye, N., Nikaj, H., Nikiteas, N., Alhaje, A., Nikolai, K., Nikolaieva, K., Nikolic, S., Nikoloudaki, Z., Nikolouzakis, T., Nikolovska, B., Nikoupour, H., Nikova, A., Nimako, B., Nimako-Mensah, J., Alhajji, Z., Nimale, S., Nimer, B., Ninan, J. E., Ninic, A., Ninkovic, M., Niño Corredor, R. A., Niquen-Jimenez, M., Nirgude, A., Niriella, S., Nisa, K., Abdeljalil, A., AlHajri, N., Nischwitz, S. P., Nishihara, N., Nishikawa, K., Niska, K., Nistor-Ciurba, C. C., Nitschke, C., Nixon, A., Niyongombwa, I., Nizami, M., Niziol, R., Alhakami, N., Njeze, N., Njim, T., Njuki, P. N., Nk, V., Nkole, T., Nkrumah, J., Nkubito, J. M. S., Nkunzimana, E., Nabugwu, I., Najiuba, H., Alhalal, H., Noah, K., Nocera, G., Noda, M., Noe, C., Noel, C., Noël, A., Nofal, S., Noguchi, H., Nogueiro, J., Noguera Roman, L., Alhamid, A., Nogués, A., Noguez Castillo, M., Noiret, B., Nolan, D., Noll, F., Nolte, P., Noltes, M., Noman, H., Nomura, T., Noone, A., Noor, A., Noor, D. F., Noor Mohamed, M. S., Noordin, S., Noori, E., Noori, F., Norawat, R., Nordberg, M., Noreen, D. Z., Noriega, D. C., Alhamid, M., Norman, L., Noro, S., Noronha, W. J., Norouzi, S., Norris, J., Norrish, A., Nortey, M., Norton, J., Norton, S., Norton, W., Alhammad, O., Notario, J., Noton, T., Notz, Q., Nouh, T., Noureen, D. S., Noureldin, Y., Novak, Z., Novello, S., Novembre, D., Novi, A., Alhammali, T., Novikov, D., Novikova, A., Novoa, B., Novotny, H. F. G., Novysedlák, R., Nowak, K., Nowar, M., Nowosielski, Y., Nsaful, J., Nshuti, S., AlHarazi, A., Ntaganda, E., Ntalouka, M., Ntege, A., Ntege, J., Ntezamizero, J., Ntirenganya, F., Ntoto, M. C. O., Ntziovara, A. M., Nubair, S., Nugent, T., Alharthi, B., Nugur, A., Nuh, A., Nunes, R., Nunes, S., Nunes Coelho, M., Nunez, J., Nuñez, J., Nuñez, R., Núñez, A., Núñez, B., Abdelkabir, M., Alharthi, M., Nuñez Del Barrio, H., Núñez Lucic, J., Núñez O'Sullivan, S., Nunez-Garcia, B., Núñez-González, RÁ, Nuño-Escobar, C., Nurgozhin, T., Nuseir, A., Nwabuoku, S. E., Nwachukwu, C., Alharthi, N., Nwachukwu, I., Nwafor, I., Nwagboso, C., Nwaorgu, O., Nwashilli, N., Nwegbu, C., Nwinee, H., Nwosu, D., Nyadu, B., Nyangoh Timoh, K., Alharthi, S., Nyarko, O. O., Nyarko Agyeman, Y., Nyeko-Lacek, M., Nygaard, R. M., Nyirahabakurama, D., Nyirahabimana, J., Nyirimodoka, A., O Connor, C., O'Banion, L. A., O'Brien, S., Alhasan, H., O'Connell, E., O'Connell, R., O'Connor, B., O'Connor, D. B., O'Connor, J., O'Connor, Z., O'Donnell, R., O'Donoghue, C., O'Donoghue, G., O'Farrell, E., ALhassan, A., O'Grady, M., O'Hagan, P., O'Kelly, J., O'Mara-Gardner, K., O'Neill, A., O'Neill, C., O'Neill, R., O'Shea, M., O'Sullivan, E., Obadan, I., Alhassan, B. A. B., Obahiagbon, O., Obaid, K., Obaid, M., Obara, S., Obateru, J., Obbeng, A., Obeidat, R., Obied, H., Obrist, C., Obuekwe, O., Alhassan, B., Obure, R., Ocampo, L., Ocampos, L., Ocampos Hernandez, M., Occhionorelli, S., Ochoa Carrillo, F. J., Ochoa Gaete, K., Ochoa Villalabeitia, B., Ocsan, R. J., Od, S., Alhassoun, T., Odai, E. D., Odedra, A., Odeh, A., Odejinmi, F., Odetto, D., Odeyemi, O., Odeyemi, P. O., Odicino, F., Odigie, P. V., Odonnell, E., Alhathal, N., Oduah, S., Odunafolabi, T., Oduola, O., Odutola, O., Offiong, R., Ofori, B., Ofori, E. O., Ofosu-Barko, B. B., Ogawa, M., Ogden, E., Alhattab, M., Ogenya, R., Ogihara, T., Ogu, R., Ogunade, O., Ogundele, I., Ogundoyin, O., Ogunkeyede, S. A., Ogunlaja, O., Ogunrewo, T., Abdelkader Salama, I., Alhawatmeh, M., Ogunsua, O., Oguttu, B., Oğuz, C., Ohama, S., Ohara, R., Ohazurike, E., Oikonomou, K., Ojeda Rojas, A. M., Ojeda Thies, C., Ojeda Villasboa, D. J., Alhazmi, A., Ojewola, R. W., Ojha, B. K., Ojo, O., Okada, H., Okada, R., Okada, S., Okada, T., Okafor, B., Alhazmi, B., Okail, M. H., Okamura, K., Okamura, Y., Okere, O., Okereke, C., Okhakhu, A., Okolie, L., Okonkwo, I., Okoro, K., Okoye, E., Alhazzaa, N., Okoye, O., Okpani, A., Okpani, C., Okugbo, S., Okunade, K., Okunlola, A., Okunowo, A., Okwara, B., Olabinjo, A., Oladejo, T., Alhefdhi, A., Oladiran, A., Olagunju, N., Olajide, A., Olajide, T. O., Olaogun, J., Olaomi, O., Olaosebikan, R., Olaoye, I., Olasehinde, O., Olatoke, S. A., Alhelal, B., Olave Montaño, V. D., Olawoye, O., Olayiwola, D. O., Olaywah, D., Olaywah, N., Oldani, M., Oldbury, M., Oldrà, G., Olea Vielba, C., Olearo, E., Alhelal, F., Olieman, A., Oliva, A. R., Oliva, J. R., Oliva, R., Olive, R., Oliveira, A., Oliveira, J., Oliveira, J. C. C., Oliver, T., Alhemyari, N., Oliver García, L., Oliver Guillen, J. R., Olivos, M., Ollat, D., Oller, I., Olliff, S., Ollivere, B., Olmedo Bareiro, R. I., Olmi, S., Olori, S., Alherabi, A., Olowogbayi, T., Olson, K. A., Olubayo, O. O., Olugbami, A., Oluka, D. D., Olulana, D., Olusanya, A., Olute, A., Oluwafemi, F., Olvera-Flores, O. E., Alhindi, R., Omar, K., Omar, M., Omar, M. W., Omar, N. G., Omar, O. M., Omar, S., Omar, W., Omar Abunaaja, H., Omara, U., Abdelkareem, M., Alhogbani, M., Omari, R. Y., Ombashi, S., Omeje, U. K., Omer, M. E. A., Ömer, ÖA., Ömeroğlu, S., Omigbodun, A., Omiragi, P., Omisanjo, O., Omotosho, P., Alhossaini, R., Omran, J., Onakoya, P., Onate, J., Oñate, M., Önder, A. B., Öney, M. D., Ong, B. S., Ong, C. F., Ong, D., Ong, J. H., Alhouni, T., Ong, L., Ong, M. T. Y., Ong Vaño, A. M., Oni, O., Oni, S., Onjefu, S., Ono, M., Onochie, E., Onorati, I., Onubogu, I. K., Alhouri, A., Onur, I. U., Onwuagha, I., Onyeagwara, N., Onyeji, J., Onyemaechi, N., Onzi, T. R., Oo, A., Ooi, C., Ooi, R., Ooi, S. Z. Y., ALhumaida, A., Oosterlinck, W., Oosterling, S., Oosthuizen, B., Opandoh, I. N. M., Opano, R., Opincans, J., Opoku Amankwaa, W., Oppah, I., Oppong, P. P., Oputa, V., Alhunaidi, O., Orădan, A., Oranu, E., Orazulike, N., Ordemar, J., Ordoñez, S., Organ, N., Organjee, A., Orgoi, S., Orhan, N., Orhan Sungur, M., Alhussaini, A., Orji, I. J., Orji, M., Ormeño, M., Ornaghi, S., Oropeza, M., Orozco-Chamorro, C. M., Orozco-Perez, J., Orsoo, S., Orta Díaz, M. D., Ortega, N., Alhussein, A., Ortega, S., Ortega Oria de Rueda, M., Ortega Vázquez, I., Ortega-Jiménez, J. A., Ortiz, E. V., Ortiz, L., Ortiz, M. R., Ortiz De La Cruz, F., Ortiz de Solórzano Aurusa, F. J., Ortiz López, D., Alhuthayl, M., Ortiz Silva, C., Ortiz Simón, A., Oruç, M., Oryadi Zanjani, L., Osabutey, A., Osagie, O., Osaki, S., Osborn, T., Osborne, L., Oscarsson, A., Ali, A. A. A., Osea, L., Oseghale, E., Osei-Bonsu, P., Osei-Poku, D., Osei-Tutu, E., Osemwegie, O., Osho, P., Osinaike, B., Osl, A., Osman, A., Abdelkarem, M. M., Ali, A. D., Osman, E., Osman, H., Osman, I., Osman, K., Osman, L., Osman, M., Osman, M. F., Osorio, D., Osorio, W. A., Ali, A. A., Ossman, M. A., Osterberg, E. C., Osterhoff, G., Ostrovsky, I. A., Osuna, L., Osuna-Rubio, J., Osuoji, R., Otaif, W., Otayfah, S., Otchwemah, R., Ali, A., Oteem, A., Oter, V., Othieno Misanga, H., Othiyil Vayoth, S., Othman, A., Othman, A. F., Othman, E., Othman, M., Othman, S., Otieno, J., Otify, M., Otiniano Alvarado, C. E., Otokwala, D. J., Ots, R., Otsuka, Y., Ott, J., Otte, H., Ottl, S., Ou, C. X. Y., Ali, A. M., Ouchi, T., Oudrhiri, M. Y., Ouf, A., Ould Si Amar, A., Ourieff, J., Ourô, S., Ousouss, S., Outani, O., Owaimer, R., Owais, Q., Owens, D., Owens, P., Ower, C., Owiedat, M., Owusu Adae, J., Oyama, T., Oyediji, F., Oyelakin, O., Oyeleye, O., Oyelowo, N., Oyende, O., Oyewole, O., Oyewusi, E., Oyinloye, O., Ozair, A., Özant, A., Ozben, V., Özcan, A., Özçay, N., OZcelık, M. F., Ozdemir, E., Ozdemir, K., Özdoğan, K., Özeller, E., Ozgediz, D., Özgen, U., Ozgur, I., Ozkan, O. F., Ozkent, M. S., Ozmen, M. M., Ozone, C., Özpak, S. S., Oztan, M. O., Ozua, J., P B, H., P L, T., Paal, P., Pabari, A., Pablo, C., Pacheco Sánchez, D., Pachl, M., Pacilio, C. A., Pacilli, M., Padilla-Valverde, D., Padmore, G., Páez, W., Pagano, G., Pagano, L., Page, R., Pagès, N., Abdelkarim, M., Ali, D., Pahalawatta, U., Paiano, L., Paiella, S., Paine, W., Pais, J., Paitici, S., Paiva, J., Paiva Vera, D. A., Paiva-Santos, F., Pajan, H., Pajić, S., Pal, U. S., Palacios, C., Palacios, J., Palapalle, N., Palayan, K., Palazon Bellver, P., Palines, A., Palla, E., Palm, H., Ali, F., Palma, M., Palma Caucig, N., Palmeri, M., Palmerini, E., Palmieri, G., Palmisano, S., Palomares Casasús, S., Palomino, L., Palomino Escalante, F., Palta Uribe, D. A., Ali, G., Paltoglou, N., Palumbo, A., Palumbo, M., Paluso Montero, A. V., Pamias, J., Panagiotidou, S., Panagiotou, P., Panayiotou, Y., Panayotova, G., Panchakshariah, S., Ali, I., Panciani, P. P., Panda, A., Panda, R., Pandey, A., Pandey, H., Pandey, S., Pañeda, L., Panesar, D., Pang, J. H., Panigrahi, S., Panis, C., Panjwani, T., Pannullo, M., Panov, I., Pansani, A., Pant, R., Panteli, C., Pantelidou, M., Pantoja Pachajoa, D. A., Pantos, P., Ali, I. 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M., Eleisawy, M., Elemile, P., Elfadli, M., Elfallal, A., Elfeki, H., ElFiky, M., Elfitori, J., Elford, J., Elgaili, A., ELgamal, O., Elgarf, S., ElGarhy, I., Elgendy, A., Elghany, O., Elghoury, M., Elhadi, A., Elhadi, M., Elhafiz, M. H. Y., Elhajdawe, F., Elhalaby, I., Elhawary, R., Elhence, A., Elhussein, Y., Elias, L., Elisa, B., Elises, C., Eliyas, N., Eljack, H., Eljack, M., Eljali, A. S., ElKased, A. F., Elkhadar, A. A., Elkhafeefi, F., Elkhayat, H., Elkhity, D., Elkouba, E., Elkoundi, A., Ellakwa, H., Ellakwa, T. H., Ellebaek, M. B., Ellebæk, S. B., Ellenbogen, Y., Ellett, T., Elliott, B., Elliott, M., Ellis, C., Ellis, S., Ellojli, I., Elmabrouk, A., Ahmad, B., Elmaghraby, A. E., Elmaghraby, K., Elmahdy, W., Elmahgoub, A., Elmaleh, N., Elmandouh, O., Elmeanawy, A., Elmehrath, A. 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A., Emara, S., Embury-Young, Y., Emerson, H., Emile, S., Emile, T., Emiroglu, M., Emmanuel, K., Emmanuel, M., Emmerson, B., Ahmad, N., Emmy, B., Emran, A., Enaruna, N., Encinas Bascones, A., Encinas Vicente, A., Enciso, J. C., Enciu, O., Enderes, J., Endo, S., Endorf, F., Ahmad, Q. A., Eniola, S., Eniu, D. T., Enjuto, D., Ennab, R., Ennis, B., Enny, L. E., Enoch, E., Enomoto, Y., Enseñat Nora, J., Ensor, D., Ahmad, Q., Enste, A., Enti, E., Enwerem, K., Epifani, A. G., Epton, S., Equisoain Azcona, A., Erabu, W. D., Eraslan, H., Ercan, G., Ercetin, C., Ahmad, R., Ercolani, G., Erdene, S., Erdi Nç, H., Erdoğan, E., Erfanian, R., Erginöz, E., Ergün, S., Ersoz, C., Escalante Ureche, D. P., Escales, M., Abbo, O., Escartin, J., Escobar, A., Escobar, D., Escobar, P., Escobar Vidarte, O. A., Escorcia, E., Escoto, R., Escudero, B., Escudero, M. I., Esguerra, M., Ahmad, S. B., Eshac, F., Eshac, Y., Eshete, M., Eshnaf, M., Eshraghi, M., Eskander, A., Esmael, M., Esmat Mohamed, M., Esparza Arias, N., Ahmad, S., Esparza Estrada, I., Espin-Basany, E., Espinola, C., Espinosa Ruiz, A., Espinosa-Bravo, M., Espitia, H., Esposito, G., Esquivel, C., Essajee, M., Essakalli Hossyni, L., Essam, E., Essameldin, A., Estaire Gómez, M., Estanbouli, M., Estanislao, G. L., Esteban, A., Esteban Agustí, E., Estellés Vidagany, N., Esteves Pires, R., Estevez Tesouro, J., Estigarribia, L., Estraviz, B., Estrella, E., Etchill, E., Ete, G., Etezadpour, M., Eto, M., Etxabe Gurrutxaga, J., Eugene, M., Eugene, N., Eusebio Jimenez, P. I., Evans, B., Evans, D., Evans, J., Evans, R., Evans, V., Evelyn R, N., Eveno, C., Evgeny, A., Ahmad, T., Ewedah, M., Ewington, C., Ewins, E., Eyuboglu, K., Ezanno, A. C., Ezeanochie, M., Ezeme, C., Ezenwa, E., Ezenwankwo, F., Ezeoke, G., Ahmad, Z., Ezomike, U., Ezz, Y., Ezzat, E., Fabbri, E., Fabbri, N., Fabbris, C., Faber, R., Fabian, R., Faboya, O., Fabregas, N., Ahmad Alhami, H., Fabregó Capdevila, B., Faccini Teixeira, M., Fachrian, D., Facundo, H., Facure, L., Fadli, S., Fadrique, B., Fadzli, A. N., Fagan, P., Fagihi, M., Ahmad Haq, Z., Fahadullah, M., Fahd, M., Fahiem-Ul-Hassan, M., Fahim, A., Fahlbusch, T., Fahmy, M., Fahmy, M. M. F., Fahmy, W., Faily, S., Faimali, M., Abbott, D., Ahmad Zaidi, S. M., Faisel, M., Faizi, F., Fakhradiyev, I., Fakhrul-Aldeen, M., Fakih, G., Falara, A., Falaschi, F., Falco, G., Falcón Coronado, M., Falcon Pacheco, G. M., Ahmadi, N., Falconieri, F., Falder, S., Falkensammer, E., Fallah, J. M., Fallis, S., Fallouh, D., Fambrini, M., Familiari, P., Fan, K. F. M., Fancellu, A., Ahmadi, S., Fang, C. E. H., Fantakis, A., Fappiano, F., Faqar-Uz-Zaman, S. F., Far, F., Farag, A., Farag, M., Farah, J. 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L., Filardo, M., Filauro, M., Filipce, V., Filipescu, D., Filipov, E., Filippi, L. T., Filo, E., Filosso, P. L., Findl, O., Findlay, A., Findley, A., Fink, A., Fink, M., Finsterwald, M., Fiore, M., Fiore, J. F., Fiorelli, S., Fiorentini, G., Fiori, E., Fiorini, A., Firat, N., Firdos, K., Firman, F., Ahmed, J., Firouzifar, M., Fischer, A., Fischer, I., Fish, B., Fishman, Y., Fisseha, T., Fisus, A., Fitridge, R., Fitrisyah, A., Fitt, S., Fitzmaurice, L., Fjeld Haugstvedt, A., Flachs Nóbrega, S., Flamant, E., Flamey, N., Flanagan, M., Fleitas, D., Fleming, C., Fleres, F., Ahmed, K., Fletcher, A., Flexman, A., Flint, N., Flis, V., Fliss, S., Flor, J. M., Florean, D., Flores, M. A., Flores Amador, N., Flores Anaya, E. A., Flores Becerril, P., Florian, I. S., Florian, I. A., Florin, I., Fluegen, G., Flumignan, R., Flurschütz, R., Flury, D. V., Flynn, W., Foessleitner, P., Fogarty, A., Fogliati, A., Fokter, S., Foley, E., Foley, K., Foley, N., Folic, M., Fonseca, F., Fonsi, G. B., Fontanella, M., Ahmed, M., Foo, J., Forbes, C., Ford, S., Foreman, J., Forero, J., Forero-Torres, A., Formánek, M., Fornasari, A., Fort-Schaale, A., Forte, B., Ahmed, M. S., Forti Parri, S. N., Fortuna, L., Fortunato, M., Foster, P., Fotopoulou, C., Fouad, M., Fouad Elganainy, M., Fountain, D., Fouquet, O., Fourcade, L., Abd, W., Fowler, A., Fowler, C., Fox, A., Foy, W., Fra Fernández, S., Frade Said, D., Fradelos, E., Fraga, G., Fragkoulidis, G., Fragnaud, H., Fragoulis, S., Fraidenraij, U., Franceschilli, M., Franceschini, G., Francis Xaviour, O., Francisco Fernandes, M., Francone, E., Frank, K., Frankel, A., Ahmed, M. E., Franken, J., Fransvea, P., Franza, M., Franzen, A., Franzini, M., Frasca, D., Fraser, S., Frasson, M., Frati, A., Frattaruolo, C., Fratto, A., Fraz, W., Fredon, F., Freed, E., Freeman, H., Fregatti, P., Freihat, A., Freile Pazmiño, P. A., Freiman, T., Freiria Eiras, M. A., Freitas, M. A. F., Fresilli, S., Fretes, C., Fretes, M., Fretes Gonzalez, W. R., Freudmann, M., Freund, M. R., Freyrie, A., Freyschlag, C., Fricker, R., Ahmed, N. E. A. E., Friedman, D., Friedrich, S., Frigerio, P., Friso, F., Frisoni, T., Frizelle, F., Froiio, C., Frolova, Y., Frongia, F., Frontali, A., Ahmed, N., Frostick, R., Frountzas, M., Frunt, B., Frusca, T., Fruscio, R., Frutos, D., Ftaieh, F., Ftikos, P., Fu, Y. X. J., Fuchs, H., Fuchs-Buder, T., Fuentes, L., Fuentes, T., Fuentes Orozco, C., Fuentes Rivera Lau, L., Fuentes-Martín, A., Függer, R., Fujimoto, A., Fujimoto, Y., Fujita, T., Ahmed, O., Fujiwara, Y., Fukami, Y., Fukushima, S., Fulghum, C., Fulivai, A., Fullarton, M., Fuller, L., Fumagalli Romario, U., Fumoto, K., Funes, T., Fung, C., Fung, S., Furbetta, N., Furkert, C., Furlan, M., Furuhata, Y., Furukawa, T., Furukawa, Y., Fusai, G., Fusario, D., Abd Alghafour, T., Ahmed, S., Fusetti, S., Fusini, F., Fustec, E., Futaba, K., Futyma, K., Fyneface-Ogan, S., G S, A., Gaballa, K., Gabellini, L., Gabersek, A., Gabr, A., Gabr, H., Gabriel Fernández, L., Gabrilovich, S., Gacaferi, H., Gachabayov, M., Gad, D., Gad, E. H., Gaddi, C., Gade, M., Gadea Mateo, R., Gadekar, A., Gadelkareem, R., Gadelkarim, I., Gadelrab, Z., Gadin-Lopez, S. M., Gadouali, T., Gagliardi, F., Gagnier, J., Gagno, P. 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T., Moreno Sierra, J., Moreno Suarez, M., Moreno Y Suárez, T., Moreno-Gutierrez, A., Moret, C., Moretto, G., Moretto, S., Morezzi, D., Alemán, M., Morgan, C., Morgan, E., Morgan, K., Morgan, R., Morgan, S., Morhason-Bello, J., Mori, K., Moriarty, C., Morić, T., Morichau-Beauchant, T., Alemanno, G., Moriche Carretero, M., Moris, D., Morita, T., Moriyama, M., Morla, A. A., Morley, H. L., Morna, M. T., Moro-Valdezate, D., Morochovič, R., Morote, M., Alemu, B., Morović, D., Morris, B., Morris, D., Morris, R., Morrison, J., Morrison-Jones, V., Morsy, A., Morsy, M. S., Mortada, H., Alemu, M., Mortazavi, S. M. J., Mortiers, X., Mortimer, B., Mortini, P., Morton, A., Mosabha, M., Moslemi, M. K., Mosley, F., Mosneaga, R., Mosorin, M. A., Abdelgadir, A., Alen Villamayor, V., Mosos, M., Mosquera Paz, M. S., Moss, J. L., Mossaad, M., Mosshammer, V., Mostafa, A. M. H. A. M., Mostafa, B., Mostafa, M., Mostafa, M. E., Mosteiro-Cadaval, A., Alesmail, A., Mota, C., Motallebzadeh, R., Motas, N., Motasaddi Zarandy, M., Motoyasu, A., Motter, D., Motwani, K., Moug, S., Mougahed, M., Mouhandes, A. E., Alexakis, N., Moujtahid, H., Moukoko, D., Moura, M., Mourad, M., Mouriaux, F., Mourmouris, P., Mousa, M., Moussa, A., Moustafa, E., Moutinho, L., Alexander, D., Mouw, T., Moya-Angeler, J., Moyana Muguto, V., Moyano, P., Moyo, A., Moyo, G., Moyo, N., Mozafari, M., Mozel, M., Mpagi Katassi, L., Alexander, G., Mpirimbanyi, C., Mrad, B., Mrad, M. A., Mraiyan, M., Mshelbwala, P., Msherghi, A., Mtimkulu, W., Muallem-Kalmovich, L., Mubambe, M., Alexander, P., Mubarek, K., Mubarik, A., Mubaydeen, T., Mubezi, I., Mucilli, F., Muduly, D., Muehlbacher, I., Mueller, L. K., Muftah, H., Mufth, M., Alexander, T., Muganga, D., Mughal, A., Mughal, S., Mughal, Z. U., Mugisa, D., Mugla, W., Muguerza, J. M., Muguwu, A., Muhammad, A. B., Muhammad, R., Muhammad, S., Muhammad Daneji, S., Muheilan, M., Muhemi, R., Muhmmed, K., Muhssein, H., Muhtaroğlu, A., Muhtaseb, M., Alexandrou, A., Muirhead, W., Muiru, C., Mujtaba, S. N., Mukase, S., Mukezamfura, R., Mukherjee, P., Mukherjee, S., Mukhtar, I. A., Alexe, V., Mulas Fernández, C., Mulchandani, M., Mulder, W. W., Muleta, L., Muleta, M. B., Mulita, F., Mulla, H., Mulla, O., Muller, B., Müller, A., Abdelgalel, K., Alezabi, B., Müller, K., Müller, S., Müller, T., Mulliri, A., Mulugeta, E., Mulugeta, G., Mumtaz, K., Munanzvi, K., Munarriz, M., AlFakhri, A., Munawwar, F., Muneza, S., Mungazi, S., Muniandy, M., Munini, M., Munir, M. M., Munoz, H., Munoz Abraham, A. S., Muñoz Botero, N. A., Muñoz Camarena, J. M., Alfarah, M., Muñoz de Nova, J. L., Muñoz Fernández, M. E., Muñoz Lindez, I., Muñoz Rodríguez, J. M., Muñoz Sornosa, E., Muñoz Vives, J. M., Muñoz-Bellvis, L., Munro, W., Munshi, F., Muntaka, A. M., Alfaro, H., Muntean, G. O., Muntean, M., Munteanu, A., Munton, H., Munyaneza, E., Munyif, H., Munyika, A., Mura, G., Murad, M., Muraglia, A., Alfaro-Goldaracena, A., Murakawa, T., Murali, S., Muralidharan, V., Muratore, A., Mureko, A., Murgese, A., Murgoitio, U., Muriel, M. E., Muriithi, F. G., Murillo, J., Alfarra, D., Murillo Castellanos, J. A., Murji, B., Murphy, B., Murphy, J., Murphy, M., Murphy, N., Murphy, S., Murray, D., Murray, E., Alfayez, F., Murray, I., Murray, J., Murtaza, G., Murugesan, A., Murugesan, K., Musa, D., Musa, E., Musa, R., Musa, S., Musa Adamu, D. K., Alfeqeeh, A., Musa Kirfi, A., Musaab, M., Musallam, N., Musana, O., Musawa, N., Muscat, E., Muscatello, L., Musetti, S., Musharraf, M. B., Mushawarima, T., Alferdaus, A., Mushiwokufa, W., Mushtaq, A., Mushtaq, H., Musina, A. M., Muslim, M., Muslumov, G., Musrati, F., Mustafa, A., Mustafa, D. F., Mustafa, I., Alfieri, A., Mustafa, N., Mustafa, S., Mustapha, M., Mustea, A., Musthafa, S., Mutabazi, E., Mutalima, N., Mutambanengwe, P. G. T., Mutarello, N., Abdelghafar, M., Alfieri, S., Muthkumaran, G., Muthu, S., Mutimamwiza, I., Mutsonziwa, N., Mutter, D., Mutyaba, F., Muwanga, T., Muwanguzi, P., Muzaffar, N., Muzaffar, R., Alfonso Carrillo, C., Mwachiro, M., Mwale, G., Mwangi, V., Mwaria, C., Myatt, R., Myers, J., Myint, Y., Myintmo, A., Myszkowski, S., N, R., Alford, S., N Mohammad, A., Na, H., Naabo, N., Naar, L., Nabawanuka, A., Nabi, M. S., Nabian, M. H., Nabil, A., Nabil, S., Alfraidy, D., Nachelleh, E., Nachum, E. R., Nacion, A. J. D., Nada, A., Nadal, L. R., Nadal Rodrigues, D., Nadeau, S., Nadeem, A., Nader, N. E., Nadia Maria, N., Älgå, A., Nadkarni, M., Nadreen, M., Naeem, M., Naeem, S., Naegele, F., Nael, A., Naem, A., Naem, J., Naffi, A. A., Nagachandra, G., Algadi, N., Nagamoto, S., Naganathar, S., Naganuma, H., Nagappa, M., Nagar, M., Nagarasa, P., Nagashima, F., Nagassima, K., Nageeb, A., Nageh, M. A., Algar-Yañez, B., Nageh, M., Naghibi, A., Nagiub, M., Nagorni, E. A., Nagpal, P., Nagra, R. N., Nagra, S., Nah, S. A., Nahal, E. A., Nahm, C., Algarni, M., Nahtomi Shick, O., Naieem, M., Naik, P., Nail, D., Naimy, G., Nair, A., Nair, A. K., Nair, D., Nair, G., Algarni, S., Nair, S., Nair, V. P., Naiya, H. I. I., Najafian Motahaver, N., Najera, R., Naji, N., Naji, O., Najjad, M. K. R., Najjar, M. S., Nakagawa, S., Alghamdi, A., Nakamura, Y., Nakanishi, R., Nakano, L., Nakanwagi, C., Nakas, A., Nakata, Y., Nakazawa, H., Nakirijja, T., Namikawa, T., Namrata, D., Abdelhafez, M., Namugenyi, C., Namutosi, E., Nana, G. R., Nanayakkara, A., Nankivell, P., Naoum, N., Napolitano, L., Nappi, F., Nappo, G., Naqi, S. A., Alghamdi, A. A., Naqui, Z., Naqvi, W., Naraen, A., Naranjo, S., Narasiman, V., Narasimhan, G., Narayan, S., Narayanan, V., Narayanasamy, K., Nardi, C., Naredla, P., Narendra, D., Narroway, H., Naseem, H., Naseem, M. Y., Naseer, M., Naseer, M. A., Nashed, E., Nashidengo, P. R., Nasir, A., Alghamdi, I., Nasir, M., Naskar, U., Nasreddin, M., Nasri, M. Z., Nassali, G., Nassanga, R., Nassar, A., Nassef, M. A., Alghamdi, R., Nasser, A., Nasser, N., Nasser, S., Nassif, M., Nassif, Y., Nassimu, M., Natal Álvarez, F., Nataraja, R., Nathan, M., Nathan, S. K., ALghamdi, S., Nathani, R., Nativ, H., Naumeri, F., Naunheim, M., Naureen, S., Nausheen, S., Navaratne, L., Navarrete-Peón, A., Navarro, A., Navarro, D., Alghamdi, S., Navarro, J. C., Navarro Casado, R., Navarro Martínez, S., Navarro-Alean, J., Navarro-Barrios, A., Navarro-Sánchez, A., Nawara, H., Nawawi, A., Nayak, P., Nayen, A., Alghazal, T., Nayyer, F., Naz, F., Nazal, M., Nazar, Z., Nazia, N., Nazimi, A. J., Nazir, S., Nazir, S. F., Nazir, U., Ncogoza, I., Alghazo, A., Ndabvonga, G., Ndatewapo, F., Ndayishyigikiye, M. D., Ndegbu, C., Ndizeye, O., Ndlovu, S., Ndong, A., Neagu, A., Neal, A., Neal, N., Alghuson, L., Neal-Smith, G., Neary, P., Negash, S., Negoi, I., Negreanu, L., Negrete Ocampo, J. R., Negussie, A., Nehe, A., Neidert, N., Collaborative, Covidsurg, Collaborative Dmitri Nepogodiev, Globalsurg, F Simoes, Joana F, Li, Elizabeth, Glasbey, Jame, Picciochi, Maria, K Kamarajah, Sivesh, Gujjuri, Rohan, Bhangu, Aneel, A, Maryam, A Azab, Mohammed, A Janjua, Dratif, A Zahran, Mohammed, A Abdelaziz, Areej, Luglio, Gaetano, Surgery, Medicine and Pharmacy academic/administration, Basic (bio-) Medical Sciences, Clinical sciences, Surgical clinical sciences, Faculty of Medicine and Pharmacy, Medical Oncology, Gastroenterology, Department of Surgery, HUS Abdominal Center, Chiantera, V, Pecoraro, F, COVIDSurg Collaborative, GlobalSurg Collaborative, Paediatric Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, AGEM - Endocrinology, metabolism and nutrition, Graduate School, Amsterdam Reproduction & Development (AR&D), Tytgat Institute for Liver and Intestinal Research, Institut de Recherche sur les Maladies Virales et Hépatiques (IVH), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Laura Alberici, Filippo Antonacci, Alessandro Arena, Angela Belvedere, Fabio Bernagozzi, Paolo Bernante, Pietro Bertoglio, Lorenzo Bianchi, Maria Bisulli, Barbara Bonfanti, Safia Boussedra, Jury Brandolini, Crescenzo Cacciapuoti, Stefano Cardelli, Riccardo Casadei, Matteo Cescon, Alessandro Cipolli, Riccardo Cipriani, Alfredo Conti, Luca Contu, Francesco Costa, Niccolo’ Daddi, Eugenia De Crescenzo, Pierandrea De Iaco, Alessandra De Palma, Massimo Del Gaudio, Anna Nunzia Della Gatta, Giampiero Dolci, Giulia Dondi, Matteo Droghetti, Sergio Nicola Forti Parri, Elena Garelli, Chiara Gelati, Giuliana Germinario, Federico A. Giorgini, Carlo Ingaldi, Elio Jovine, Kenji Kawamukai, Antonio Lanci Lanci, Raffaele Lombardi, Maria Elisa Lozano Miralles, Claudio Marchetti, Michele Masetti, Francesco Minni, Daniele Morezzi, Daniele Parlanti, Alice Pellegrini, Anna Myriam Perrone, Anna paola Pezzuto, Marco Pignatti, Gianluigi Pilu, Valentina Pinto, Gilberto Poggioli, Silvana Bernadetta Puglisi, Diego Raimondo, Matteo Ravaioli, Claudio Ricci, Sara Ricciardi, Francesco Ricotta, Roberta Rizzo, Angela Romano, Matteo Rottoli, Riccardo Schiavina, Renato Seracchioli, Matteo Serenari, Margherita Serra, Leonardo Solaini, Piergiorgio Solli, Gioia Sorbi, Mario Taffurelli, Marta Tanzanu, Achille Tarsitano, Marco Tesei, Gabriele Vago, Tommaso Violante, Simone Zanotti, Tommaso Frisoni, pignatti marco, ERSÖZ, CEVPER, GlobalSurg Collaborative, COVIDSurg Collaborative, Nepogodiev, Dmitri, Simoes, Joana F. F., Glasbey, James C., Alser, Osaid, Boccalatte, Luis A., Calvache, Jose A., Duran, Irani, Elhadi, Muhammed, Elmujtaba, Mohammed, Emile, Sameh, Harrison, Ewen M., Hutchinson, Peter, Allen Ingabire, J. C., Isik, Arda, Kamarajah, Sivesh K., Karandikar, Sharad, Kauppila, Joonas H., Kembuan, Gabriele, Lederhuber, Han, Löffler, Markus W., Mann, Harvinder, Marson, Ella J., Mclean, Kenneth A., Munyaneza, Emmanuel, Norman, Lisa, Omar, Omar M., Pius, Riinu, Pockney, Peter, Rutegård, Martin, Stewart, Grant D., Taylor, Elliott H., Venn, Mary L., Aizza, Giada, Bellio, Gabriele, Bogoni, Selene, Bortul, Marina, Casagranda, Biagio, Cortinovis, Sara, de Manzini, Nicolo', Drigo, Davide, Germani, Paola, Mastronardi, Manuela, Paiano, Lucia, Palmisano, Silvia, Nepogodiev, D, Bhangu, A, Gallo, G, Picciariello, P, Abushanab, M, Fruscio, R, Ornaghi, S, Iovino, C, Rossi, S, and Simonelli, F

Subjects
Male, COVID-19 Vaccine, safe surgery, vaccination modelling, COVID-19, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], MULTICENTER, Comorbidity, 030230 surgery, 0302 clinical medicine, phase 3 clinical trial (topic), Case fatality rate, Prospective Studies, SARS-CoV-2 , Vaccination , Safe surgery, COVID-19/epidemiology, SARS-CoV-2, vaccination, education.field_of_study, case fatality rate, Vaccination, Adolescent, Adult, Aged, COVID-19 Vaccines, Elective Surgical Procedures, Female, Humans, Middle Aged, Postoperative Complications, Preoperative Period, Young Adult, health care policy, 030220 oncology & carcinogenesis, cancer, outcome, mortality, infection, modelling, Cohort study, prospective study, Human, medicine.medical_specialty, Article, 03 medical and health sciences, SARS-CoV-2, vaccination, SDG 3 - Good Health and Well-being, COVID-19 Vaccines/pharmacology, Vaccination/methods, Elective surgery, education, Science & Technology, Elective Surgical Procedure, adult, aged, cancer grading, cancer surgery, computer assisted tomography, elective surgery, female, follow up, human, incidence, infection rate, infection risk, major clinical study, male, middle aged, outcome assessment, preoperative care, sensitivity analysis, seroprevalence, Severe acute respiratory syndrome coronavirus 2, young adult, surgery, Cura preoperatòria, Prospective Studie, Surgery, Human medicine, Postoperative Complication, 610 Medizin und Gesundheit, AcademicSubjects/MED00910, Settore MED/18 - CHIRURGIA GENERALE, Settore MED/29 - CHIRURGIA MAXILLOFACCIALE, ESTUDOS PROSPECTIVOS, Vacunació, Prospective cohort study, Incidence (epidemiology), covid, Elective Surgical Procedures/methods, COVID, vaccination, Original Article, AcademicSubjects/MED00010, Life Sciences & Biomedicine, international prospective cohort study, Postoperative Complications/prevention & control, Population, SARS-CoV-2/immunology, NO, medicine, ddc:610, LS7_4, business.industry, Number needed to vaccinate, Preoperative care, 3126 Surgery, anesthesiology, intensive care, radiology, Settore MED/18, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Emergency medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population., The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous.

Published
2021

45. EmPHasis-10 health-related quality of life score predicts outcomes in patients with idiopathic and connective tissue disease-associated pulmonary arterial hypertension: results from a UK multi-centre study

Author

Robert Lewis, Iain Armstrong, Carmel Bergbaum, Melanie J Brewis, John Cannon, Athanasios Charalampopoulos, A Colin Church, J Gerry Coghlan, Rachel Davies, Konstantinos Dimopoulos, Charlie Elliot, J Simon R Gibbs, Wendy Gin-Sing, Gulam Haji, Abdul G Hameed, Luke S Howard, Martin K Johnson, Aleksander Kempny, David G Kiely, Francesco Lo Giudice, Colm Mccabe, Oyinkansola Peleyeju, Joanna Pepke-Zaba, Gary Polwarth, Laura Price, Ian Sabroe, Benjamin E Schreiber, Karen Sheares, Dolores Taboada, A A Roger Thompson, Mark R Toshner, Ivy Wanjiku, S John Wort, Janelle Yorke, Robin Condliffe, Toshner, Mark [0000-0002-3969-6143], and Apollo - University of Cambridge Repository

Subjects
Pulmonary Arterial Hypertension, Hypertension, Pulmonary, Quality of Life, Humans, Connective Tissue Diseases, United Kingdom
Abstract

Health-related quality of life (HRQoL) scores assess symptom burden in pulmonary arterial hypertension (PAH) but data regarding their role in prognostication and risk stratification are limited. We assessed these relationships using the emPHasis-10 HRQoL measure. 1745 patients with idiopathic or connective tissue disease-associated PAH who had completed emPHasis-10 questionnaires between 2014-17 at 6 UK referral centres were identified. Correlations with exercise capacity and WHO functional class (FC) were assessed, and exploratory risk stratification thresholds were tested. Moderate correlations were seen between emPHasis-10 scores and 6-minute walk distance (r=-0.546), incremental shuttle walking distance (r=-0.504) and WHO FC (r=0.497; p all

Published
2021

46. Analysis of galectin-3 levels as a source of coronary heart disease risk during periodontitis

Author

Alessandro Polizzi, Gaetano Isola, Ray C. Williams, Antonino Lo Giudice, and Angela Alibrandi

Subjects
0301 basic medicine, medicine.medical_specialty, Saliva, Periodontal examination, Galectin 3, Coronary Disease, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, c-reactive protein, Internal medicine, galectin-3, Medicine, Humans, In patient, coronary heart disease, Periodontitis, biology, business.industry, C-reactive protein, Healthy subjects, clinical trial, 030206 dentistry, medicine.disease, Coronary heart disease, 030104 developmental biology, Galectin-3, endothelin-1, Multivariate Analysis, biology.protein, Periodontics, business
Abstract

BACKGROUND AND OBJECTIVE Different evidence has shown that Galectins have a key role as modulators of cell surface functions and signaling in a wide range of inflammatory diseases during their preclinical stages. The aim of this study was to analyze the association and impact of periodontitis and coronary heart disease (CHD) on salivary and serum Galectin-3 in patients with periodontitis and CHD. MATERIALS AND METHODS For the present study, healthy controls (n = 38), periodontitis (n = 40), CHD (n = 39), and a combination of periodontitis +CHD (n = 38) patients were enrolled and analyzed. In each patient, demographic characteristics and a full-mouth clinical periodontal examination were achieved. Moreover, serum and salivary samples were collected to assess Galectin-3 and Endothelin-1 (ET-1) levels. The Jonckheere-Terpstra p-trend and Spearman's correlation tests as well as uni- and linear regression analyses were used to analyze the study data. RESULTS Patients with periodontitis (serum, p = .003; saliva, p

Published
2021

47. Prevalence of HBsAg and HCV antibodies in a cohort of pregnant women: the continuous survey as public health tool against pregnant and neonatal complications

Author

Daniela, Lo Giudice, Sebastiano, Calimeri, Giuseppa, Visalli, Salvatrice, Pino, Angela, Di Pietro, and Alessio, Facciolà

Subjects
Hepatitis B Surface Antigens, Italy, Pregnancy, Seroepidemiologic Studies, Infant, Newborn, Prevalence, Humans, HBV, HCV, Female, Pregnant Women, Public Health, Hepatitis C Antibodies, Pregnancy Complications, Infectious
Abstract

Pregnancy is a very delicate condition and different external factors can alter fetal development. Microorganisms are surely the principal ones. Several studies have shown that HBV and HCV infections could have an impact on pregnancy outcome. We performed a survey of blood samples from pregnant women in order to evaluate the presence of HBsAg and HCV antibodies. 6,896 women were tested from 2016 to 2019. 0.2% of the women in the Italian group and 2.1% among the foreigners tested positive for HBsAg, while 0.2% among the Italians and 0.7% among the foreigners were positive for HCV antibodies. Moreover, an increasing trend for both infections was observed in the foreigners. The results showed that in Italian women the positivity rates for HBV and HCV infections are very low despite the presence of both infections. A different consideration must be made for the foreigners, in whom we observed a higher positivity rate for both infections. Our findings stress the importance of a continuous surveillance of HBV and HCV markers during pregnancy and suggest that there is still much to be done in order to reduce the risk of these infections in this delicate period of a woman's life.

Published
2021

48. SRSF-1 and microvessel density immunohistochemical analysis by semi-automated tissue microarray in prostate cancer patients with diabetes (DIAMOND study)

Author

Elisabetta Pricoco, Giuseppe Morgia, Marina Di Mauro, Eliana Piombino, Giuseppe Broggi, Rosario Caltabiano, Arturo Lo Giudice, Giorgio Ivan Russo, and Maria Giovanna Asmundo

Subjects
0301 basic medicine, Biochemical recurrence, Blood Glucose, Male, medicine.medical_specialty, Urology, medicine.medical_treatment, proliferation, Protein Array Analysis, Cohort Studies, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Diabetes mellitus, androgen receptor, Biomarkers, Tumor, Diabetes Mellitus, Medicine, Humans, risk factors, Aged, Retrospective Studies, Tissue microarray, hormonal therapy, biology, Serine-Arginine Splicing Factors, diabetes, business.industry, Insulin, Prostatic Neoplasms, Original Articles, Hyperplasia, Middle Aged, medicine.disease, srsf1, Insulin receptor, 030104 developmental biology, Ki-67 Antigen, Oncology, 030220 oncology & carcinogenesis, Microvessels, biology.protein, Hormonal therapy, Original Article, business, Microvascular Density
Abstract

Objective To study the association between insulin receptors (isoforms α and β), insulin growth factor‐1 (IGF1) and serine/arginine splicing factor 1 (SRSF‐1) in patients with prostate cancer (PC) and diabetes. Materials and Methods We retrospectively analyzed data from 368 patients who underwent surgery for PC or benign prostatic hyperplasia (BPH) between 2010 and 2020 at the Department of Urology, University of Catania. Tissue microarray slides were constructed and they were stained for androgen receptor (AR), insulin receptor‐α and ‐β, IGF1 (IGF1‐R), Ki‐67, and prostate specific membrane antigen (PSMA) expression using validated score. Results The final cohort was represented by 100 patients with BPH and 268 with PC, with a median age of 68 years. We found that SRSF‐1 expression was associated with AR (odds ratio [OR]: 1.66), PSMA (OR: 2.13), Ki‐67 (OR: 5.99), insulin receptor (IR)‐α (OR: 2.38), IR‐β (OR: 3.48), IGF1‐R (OR: 1.53), and microvascular density (MVD) was associated with PSMA (OR: 3.44), Ki‐67 (OR: 2.23), IR‐α (OR: 2.91), IR‐β (OR: 3.02), IGF1‐R (OR: 2.95), and SRSF‐1 (OR: 2.21). In the sub cohort of PC patients, we found that SRSF‐1 expression was associated with AR (OR: 2.34), Ki‐67 (OR: 6.77), IR‐α (OR: 2.7), and MVD (OR: 1.98). At the Kaplan–Meier analysis, SRSF‐1+ patients had worse 5‐ and 9‐year biochemical recurrence (36% and 6%) respect to SRSF‐1− (67% and 7%; p

Published
2021

49. Three-dimensional assessment of the spheno-occipital synchondrosis and clivus after tooth-borne and bone-borne rapid maxillary expansion

Author

Vincenzo Ronsivalle, Ersilia Barbato, Rosalia Leonardi, Gaetano Isola, Manuel O. Lagravère, and Antonino Lo Giudice

Subjects
Palatal Expansion Technique, Synchondrosis, Orthodontics, Posterior, computer.software_genre, Cranial Fossa, Spheno occipital synchondrosis, Bone-borne RME, Tooth-borne RME, Clivus, Voxel, medicine, Maxilla, Superimposition, Humans, Rapid maxillary expansion, business.industry, Occipital bone, Original Articles, Cone-Beam Computed Tomography, Spheno-occipital synchondrosis, medicine.anatomical_structure, Anterior cranial fossa, Cranial Fossa, Posterior, business, computer, Tooth
Abstract

Objectives To assess changes in spheno-occipital synchondrosis after rapid maxillary expansion (RME) performed with conventional tooth-borne (TB) and bone-borne (BB) appliances. Materials and Methods This study included 40 subjects with transverse maxillary deficiency who received TB RME or BB RME. Cone-beam computed tomography images (CBCT) were taken before treatment (T0), and after a 6-month retention period (T1). Three-dimensional surface models of the spheno-occipital synchondrosis and basilar part of the occipital bone were generated. The CBCTs taken at T0 and T1 were registered at the anterior cranial fossa via voxel-based superimposition. Quantitative evaluation of Basion displacement was performed with linear measurements and Euclidean distances. The volume of the synchndrosis was also calculated for each time point as well as the Nasion-Sella-Basion angle (N-S-Ba°). All data were statistically analyzed to perform inter-timing and intergroup comparisons. Results In both groups, there was a small increment of the volume of the synchondrosis and of N-S-Ba° (P < .05). Basion showed a posterosuperior pattern of displacement. However, no significant differences (P > .05) were found between the two groups. Conclusions Although TB and BB RME seemed to have some effects on the spheno-occipital synchondrosis, differences were very small and clinically negligible.

Published
2021

50. Fully automatic segmentation of sinonasal cavity and pharyngeal airway based on convolutional neural networks

Author

Concetto Spampinato, Silvia Allegrini, Antonino Lo Giudice, Rosalia Leonardi, Vincenzo Ronsivalle, Giuseppe Musumeci, and Marco Farronato

Subjects
Adult, Male, Cone beam computed tomography, Neural Networks, Computer science, Intraclass correlation, Orthodontics, Convolutional neural network, 03 medical and health sciences, Young Adult, Computer, 0302 clinical medicine, Artificial Intelligence, medicine, Humans, Segmentation, Artificial neural network, business.industry, Deep learning, Pharynx, Reproducibility of Results, Pattern recognition, 030206 dentistry, Cone-Beam Computed Tomography, medicine.anatomical_structure, Female, Artificial intelligence, Neural Networks, Computer, business, 030217 neurology & neurosurgery, Student's t-test
Abstract

Introduction This study aimed to test the accuracy of a new automatic deep learning–based approach on the basis of convolutional neural networks (CNN) for fully automatic segmentation of the sinonasal cavity and the pharyngeal airway from cone-beam computed tomography (CBCT) scans. Methods Forty CBCT scans from healthy patients (20 women and 20 men; mean age, 23.37 ± 3.34 years) were collected, and manual segmentation of the sinonasal cavity and pharyngeal subregions were carried out by using Mimics software (version 20.0; Materialise, Leuven, Belgium). Twenty CBCT scans from the total sample were randomly selected and used for training the artificial intelligence model file. The remaining 20 CBCT segmentation masks were used to test the accuracy of the CNN fully automatic method by comparing the segmentation volumes of the 3-dimensional models obtained with automatic and manual segmentations. The accuracy of the CNN-based method was also assessed by using the Dice score coefficient and by the surface-to-surface matching technique. The intraclass correlation coefficient and Dahlberg's formula were used to test the intraobserver reliability and method error, respectively. Independent Student t test was used for between-groups volumetric comparison. Results Measurements were highly correlated with an intraclass correlation coefficient value of 0.921, whereas the method error was 0.31 mm3. A mean difference of 1.93 ± 0.73 cm3 was found between the methodologies, but it was not statistically significant (P >0.05). The mean matching percentage detected was 85.35 ± 2.59 (tolerance 0.5 mm) and 93.44 ± 2.54 (tolerance 1.0 mm). The differences, measured as the Dice score coefficient in percentage, between the assessments done with both methods were 3.3% and 5.8%, respectively. Conclusions The new deep learning–based method for automated segmentation of the sinonasal cavity and the pharyngeal airway in CBCT scans is accurate and performs equally well as an experienced image reader.

Published
2021

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