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1. Occupational class differences in ankle-brachial index and pulse wave velocity measurements to detect subclinical vascular disease

Author

Ferrario, M., Martire, G., Gianfagna, F., Lasalvia, P., Cremonesi, F., Tozzi, M., Franchin, M., Campana, F., Roncaioli, M., Cavicchiolo, M., Borchini, R., Iacoviello, L., and Veronesi, G.

Subjects
Male, Arterial stiffness, Atherosclerosis, Cardiovascular prevention, Socio-occupational classes, Work settings, Ankle Brachial Index, Cross-Sectional Studies, Female, Humans, Pulse Wave Analysis, Risk Factors, Vascular Diseases, Vascular Stiffness, cardiovascular prevention, work settings, arterial stiffness, cardiovascular system, Original Article, cardiovascular diseases, atherosclerosis
Abstract

Background: High pulse wave velocity (PWV) and low ankle brachial index (ABI) have been proposed as surrogate end-points for cardiovascular disease (CVD). Objectives: In a cross-sectional setting, we aimed at assessing the distributions of PWV and ABI among occupational classes (OC) in a population-based ever-employed salaried sample. Methods: We enrolled 1388 salaried CVD-free workers attending a CVD population-based survey, the RoCAV study, and classified them into four OC, based on current or last job title: manager/director (MD), non-manual (NMW), skilled-manual (SMW) and (UMW) unskilled-manual workers. We derived brachial-ankle PWV and ABI from four-limb blood pressures measurements, then carotid-femoral PWV (cfPWV) was estimated. We estimated the OC gradients in cfPWV and ABI using linear and logistic regression models. Results: Compared to MD (reference category), UMW had higher age- and BMI-adjusted cfPWV mean values both in men (0.63 m/s; 95%CI:0.11-1.16) and women (1.60 m/s; 0.43-2.77), only marginally reduced when adjusting for CVD risk factors. Decreased ABI mean values were also detected in lower OC. The overall detection rate of abnormal cfPWV (≥12 m/s) or ABI (≤0.9) values was 28%. Compared to MD, the prevalence of abnormal cfPWV or ABI was higher in NMW (OR=1.77; 95%CI:1.12-2.79), SMW (1.71; 1.05-2.78) and UMW (2.72; 1.65-4.50). Adjustment for CVD risk factors used in risk score equations did not change the results. Discussion: We found a higher prevalence of abnormal values of arterial stiffness measures in lower OC, and these differences were not explained by traditional CVD risk factors. These may be presumably determined by additional work- and environmental-related risk factors.

Published
2021

2. Predicting early mortality following single-stage coronary artery or valve surgery and carotid endarterectomy

Author

Franchin, M., Dorigo, W., Benussi, S., Speziali, S., Pulli, R., Bonardelli, S., Bashir, M., Piffaretti, G., Ferrarese, S., Tozzi, M., Stefano, P., Paro, B., and Zanotti, C.

Subjects
Pulmonary and Respiratory Medicine, Endarterectomy, Carotid, Coronary Artery Disease, Stroke, Treatment Outcome, Postoperative Complications, Risk Factors, single stage intervention, carotid endarterectomy and coronary artery bypass graft surgery, carotid endarterectomy and valve surgery, postoperative stroke, Humans, Carotid Stenosis, Surgery, Cardiology and Cardiovascular Medicine, Retrospective Studies
Abstract

Surgical management of coexisting cardiac disease and extra-cranial carotid artery disease is a controversial area of debate. Thus, in this challenging scenario, risk stratification may play a key role in surgical decision making.To report the results of single-stage coronary/valve surgery (CVS) and carotid endarterectomy (CEA), and to identify predictive factors associated with 30-day mortality.This was a multicenter, retrospective study of prospectively maintained data from three academic tertiary referral hospitals. For this study, only patients treated with single-stage CVS, meaning coronary artery bypass surgery or valve surgery, and CEA between March 1, 2000 and March 30, 2020, were included. Primary outcome measure of interest was 30-day mortality. Secondary outcomes were neurologic events rate, and a composite endpoint of postoperative stroke/death rate.During the study period, there were 386 patients who underwent the following procedures: CEA with isolated coronary artery bypass graft in 243 (63%) cases, with isolated valve surgery in 40 (10.4%), and combination of coronary artery bypass grafting and valve surgery in 103 (26.7%). Postoperative neurologic event rate was 2.6% (n = 10) which includes 5 (1.3%) transient ischemic attacks and 5 (1.3%) strokes (major n = 3, minor n = 2). The 30-day mortality rate was 3.9% (n = 15). Predictors of 30-day mortality included preoperative left heart insufficiency (odds ratio [OR]: 5.44, 95% confidence interval [CI]: 1.63-18.17, p = .006), and postoperative stroke (OR: 197.11, 95% CI: 18.28-2124.93, p .001). No predictor for postoperative stroke and for composite endpoint was identified.Considering that postoperative stroke rate and mortality was acceptably low, single-stage approach is an effective option in such selected high-risk patients.

Published
2022

3. Prophylactic heparin and risk of orotracheal intubation or death in patients with mild or moderate COVID-19 pneumonia

Author

Vergori, A., Lorenzini, P., Cozzi-Lepri, A., Donno, D. R., Gualano, G., Nicastri, E., Iacomi, F., Marchioni, L., Campioni, P., Schinina, V., Cicalini, S., Agrati, C., Capobianchi, M. R., Girardi, E., Ippolito, G., Vaia, F., Petrosillo, N., Antinori, A., Taglietti, F., The ReCOVeRI Study Group: Abbonizio, M. A., Abdeddaim, A., Agostini, E., Albarello, F., Amadei, G., Amendola, A., Antonica, M. A., Antonini, M., Bartoli, T. A., Baldini, F., Barbaro, R., Bartolini, B., Bellagamba, R., Benigni, M., Bevilacqua, N., Biava, G., Bibas, M., Bordi, L., Bordoni, V., Boumis, E., Branca, M., Buonomo, R., Busso, D., Camici, M., Canichella, F., Capone, A., Caporale, C., Caraffa, E., Caravella, I., Carletti, F., Castilletti, C., Cataldo, A., Cerilli, S., Cerva, C., Chiappini, R., Chinello, P., Cianfarani, M. A., Ciaralli, C., Cimaglia, C., Cinicola, N., Ciotti, V., Colavita, F., Corpolongo, A., Cristofaro, M., Curiale, S., D'Abramo, A., Dantimi, C., De Angelis, A., De Angelis, G., De Palo, M. G., De Zottis, F., Di Bari, V., Di Lorenzo, R., Di Stefano, F., D'Offizi, G., Evangelista, F., Faraglia, F., Farina, A., Ferraro, F., Fiorentini, L., Frustaci, A., Fusetti, M., Fusto, M., Galati, V., Gagliardini, R., Galli, P., Garotto, G., Gaviano, I., Tekle, S. G., Giancola, M. L., Giansante, F., Giombini, E., Granata, G., Greci, M. C., Grilli, E., Grisetti, S., Iaconi, M., Iannicelli, G., Inversi, C., Lalle, E., Lamanna, M. E., Lanini, S., Lapa, D., Lepore, L., Libertone, R., Lionetti, R., Liuzzi, G., Loiacono, L., Lucia, A., Lufrani, F., Macchione, M., Maffongelli, G., Marani, A., Mariano, A., Marini, M. C., Maritti, M., Mastrobattista, A., Mastrorosa, I., Matusali, G., Mazzotta, V., Mencarini, P., Meschi, S., Messina, F., Micarelli, S., Mogavero, G., Mondi, A., Montalbano, M., Montaldo, C., Mosti, S., Murachelli, S., Musso, M., Nardi, M., Navarra, A., Nocioni, M., Noto, P., Noto, R., Oliva, A., Onnis, I., Ottou, S., Palazzolo, C., Pallini, E., Palmieri, F., Palombi, G., Pareo, C., Passeri, V., Pelliccioni, F., Penna, G., Petrecchia, A., Petrone, A., Pianura, E., Pinnetti, C., Pisciotta, M., Piselli, P., Pittalis, S., Pontarelli, A., Proietti, C., Puro, V., Ramazzini, P. M., Rianda, A., Rinonapoli, G., Rosati, S., Rubino, D., Rueca, M., Ruggeri, A., Sacchi, A., Sampaolesi, A., Sanasi, F., Santagata, C., Scarabello, A., Scarcia, S., Scognamiglio, P., Scorzolini, L., Stazi, G., Strano, G., Taibi, C., Taloni, G., Nardi, T., Tonnarini, R., Topino, S., Tozzi, M., Vairo, F., Valli, M. B., Vincenzi, L., Visco-Comandini, U., Vita, S., Vittozzi, P., Zaccarelli, M., Zanetti, A., Zito, S., Vergori, A., Lorenzini, P., Cozzi-Lepri, A., Donno, D. R., Gualano, G., Nicastri, E., Iacomi, F., Marchioni, L., Campioni, P., Schinina, V., Cicalini, S., Agrati, C., Capobianchi, M. R., Girardi, E., Ippolito, G., Vaia, F., Petrosillo, N., Antinori, A., Taglietti, F., Abbonizio, M. A., Abdeddaim, A., Agostini, E., Albarello, F., Amadei, G., Amendola, A., Antonica, M. A., Antonini, M., Bartoli, T. A., Baldini, F., Barbaro, R., Bartolini, B., Bellagamba, R., Benigni, M., Bevilacqua, N., Biava, G., Bibas, M., Bordi, L., Bordoni, V., Boumis, E., Branca, M., Buonomo, R., Busso, D., Camici, M., Canichella, F., Capone, A., Caporale, C., Caraffa, E., Caravella, I., Carletti, F., Castilletti, C., Cataldo, A., Cerilli, S., Cerva, C., Chiappini, R., Chinello, P., Cianfarani, M. A., Ciaralli, C., Cimaglia, C., Cinicola, N., Ciotti, V., Colavita, F., Corpolongo, A., Cristofaro, M., Curiale, S., D'Abramo, A., Dantimi, C., De Angelis, A., De Angelis, G., De Palo, M. G., De Zottis, F., Di Bari, V., Di Lorenzo, R., Di Stefano, F., D'Offizi, G., Evangelista, F., Faraglia, F., Farina, A., Ferraro, F., Fiorentini, L., Frustaci, A., Fusetti, M., Fusto, M., Galati, V., Gagliardini, R., Galli, P., Garotto, G., Gaviano, I., Tekle, S. G., Giancola, M. L., Giansante, F., Giombini, E., Granata, G., Greci, M. C., Grilli, E., Grisetti, S., Iaconi, M., Iannicelli, G., Inversi, C., Lalle, E., Lamanna, M. E., Lanini, S., Lapa, D., Lepore, L., Libertone, R., Lionetti, R., Liuzzi, G., Loiacono, L., Lucia, A., Lufrani, F., Macchione, M., Maffongelli, G., Marani, A., Mariano, A., Marini, M. C., Maritti, M., Mastrobattista, A., Mastrorosa, I., Matusali, G., Mazzotta, V., Mencarini, P., Meschi, S., Messina, F., Micarelli, S., Mogavero, G., Mondi, A., Montalbano, M., Montaldo, C., Mosti, S., Murachelli, S., Musso, M., Nardi, M., Navarra, A., Nocioni, M., Noto, P., Noto, R., Oliva, A., Onnis, I., Ottou, S., Palazzolo, C., Pallini, E., Palmieri, F., Palombi, G., Pareo, C., Passeri, V., Pelliccioni, F., Penna, G., Petrecchia, A., Petrone, A., Pianura, E., Pinnetti, C., Pisciotta, M., Piselli, P., Pittalis, S., Pontarelli, A., Proietti, C., Puro, V., Ramazzini, P. M., Rianda, A., Rinonapoli, G., Rosati, S., Rubino, D., Rueca, M., Ruggeri, A., Sacchi, A., Sampaolesi, A., Sanasi, F., Santagata, C., Scarabello, A., Scarcia, S., Scognamiglio, P., Scorzolini, L., Stazi, G., Strano, G., Taibi, C., Taloni, G., Nardi, T., Tonnarini, R., Topino, S., Tozzi, M., Vairo, F., Valli, M. B., Vincenzi, L., Visco-Comandini, U., Vita, S., Vittozzi, P., Zaccarelli, M., Zanetti, A., and Zito, S.

Subjects
Male, medicine.medical_treatment, Rome, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Severity of Illness Index, 0302 clinical medicine, Retrospective Studie, Coagulopathy, Clinical endpoint, Intubation, Respiratory function, 030212 general & internal medicine, Multidisciplinary, Middle Aged, Medicine, Female, Human, medicine.medical_specialty, Patients, medicine.drug_class, Science, Low molecular weight heparin, Risk Assessment, Article, NO, 03 medical and health sciences, Internal medicine, Severity of illness, medicine, Intubation, Intratracheal, Humans, Retrospective Studies, Aged, business.industry, SARS-CoV-2, COVID-19, Thrombocytopenia, Retrospective cohort study, Heparin, Low-Molecular-Weight, medicine.disease, Respiration, Artificial, COVID-19 Drug Treatment, respiratory tract diseases, Pneumonia, Viral infection, business
Abstract

Prophylactic low molecular weight heparin (pLMWH) is currently recommended in COVID-19 to reduce the risk of coagulopathy. The aim of this study was to evaluate whether the antinflammatory effects of pLMWH could translate in lower rate of clinical progression in patients with COVID-19 pneumonia. Patients admitted to a COVID-hospital in Rome with SARS-CoV-2 infection and mild/moderate pneumonia were retrospectively evaluated. The primary endpoint was the time from hospital admission to orotracheal intubation/death (OTI/death). A total of 449 patients were included: 39% female, median age 63 (IQR, 50–77) years. The estimated probability of OTI/death for patients receiving pLMWH was: 9.5% (95% CI 3.2–26.4) by day 20 in those not receiving pLMWH vs. 10.4% (6.7–15.9) in those exposed to pLMWH; p-value = 0.144. This risk associated with the use of pLMWH appeared to vary by PaO2/FiO2 ratio: aHR 1.40 (95% CI 0.51–3.79) for patients with an admission PaO2/FiO2 ≤ 300 mmHg and 0.27 (0.03–2.18) for those with PaO2/FiO2 > 300 mmHg; p-value at interaction test 0.16. pLMWH does not seem to reduce the risk of OTI/death mild/moderate COVID-19 pneumonia, especially when respiratory function had already significantly deteriorated. Data from clinical trials comparing the effect of prophylactic vs. therapeutic dosage of LMWH at various stages of COVID-19 disease are needed.

Published
2021

4. Referral from vascular surgery to cardiovascular rehabilitation and related outcomes in patients with peripheral arterial disease: the THINKPAD-RELOADED survey

Author

Ambrosetti M., Faggiano P., Greco C., Mureddu G. F., Temporelli P. L., Pedretti R. F. E., Cremona V., Passera M., Tozzi M., Angrisano G., Piffaretti G., Riccobono S. P., Giannattasio C., Ferrari A., Lista A., Romani F., Dal Corso L., Favretto G., Nicolai L., Galeazzi E., Passaretti B., Orlando M., Barzaghi M. E., Setti M., Palvarini M., Frisinghelli A., Mazzucco G., Massucco S., Bardile A. F., Aloi T., Salerno M., Bonardelli S., Farina A., Febo O., Ambrosetti, M, Faggiano, P, Greco, C, Mureddu, G, Temporelli, P, Pedretti, R, Cremona, V, Passera, M, Tozzi, M, Angrisano, G, Piffaretti, G, Riccobono, S, Giannattasio, C, Ferrari, A, Lista, A, Romani, F, Dal Corso, L, Favretto, G, Nicolai, L, Galeazzi, E, Passaretti, B, Orlando, M, Barzaghi, M, Setti, M, Palvarini, M, Frisinghelli, A, Mazzucco, G, Massucco, S, Bardile, A, Aloi, T, Salerno, M, Bonardelli, S, Farina, A, and Febo, O

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Acute coronary syndrome, Referral, medicine.medical_treatment, Population, lcsh:Medicine, Revascularization, rehabilitation, Exercise, Peripheral arterial disease, Referral, Rehabilitation, Aged, Cardiovascular Diseases, Exercise Therapy, Facilities and Services Utilization, Female, Health Care Surveys, Humans, Intermittent Claudication, Ischemia, Lower Extremity, Male, Middle Aged, Peripheral Arterial Disease, Postoperative Complications, Prospective Studies, Risk Factors, Secondary Prevention, Vascular Surgical Procedures, Cardiac Rehabilitation, Referral and Consultation, Peripheral Arterial Disease, Postoperative Complications, Ischemia, Risk Factors, Internal medicine, Secondary Prevention, medicine, Humans, Prospective Studies, Prospective cohort study, education, Referral and Consultation, Aged, education.field_of_study, Cardiac Rehabilitation, exercise, business.industry, lcsh:R, Intermittent Claudication, Middle Aged, Vascular surgery, medicine.disease, Comorbidity, Intermittent claudication, Exercise Therapy, Lower Extremity, Cardiovascular Diseases, Health Care Surveys, referral, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Vascular Surgical Procedures, Facilities and Services Utilization
Abstract

The utilization of cardiovascular rehabilitation (CR) programmes in patients with Lower Extremity Peripheral Artery Disease (LEPAD) is generally poor, with limited evidence of current policies for referral. The aim of the study was to evaluate, within a cohesive network of CR and vascular surgery facilities with facilitated referral process, the clinical characteristic of LEPAD patients referred to CR and related outcomes, as compared to patients not referred. The present is an observational prospective study of consecutive patients recruited at vascular surgery facilities. Out of 329 patients observed, the average referral rate to CR was 34% (28% and 39% in patients with and without recent peripheral revascularization, p

Published
2019

5. Prevalence of abdominal aortic aneurysms and its relation with cardiovascular risk stratification: protocol of the Risk of Cardiovascular diseases and abdominal aortic Aneurysm in Varese (RoCAV) population based study

Author

Francesco Gianfagna, Veronesi G, Bertù L, Tozzi M, Tarallo A, Mm, Ferrario, Castelli P, and RoCAV Project Investigators

Subjects
Male, 030204 cardiovascular system & hematology, 030230 surgery, Electrocardiography, Study Protocol, 0302 clinical medicine, Risk Factors, Prevalence, Family history, Vascular diseases, Pulse wave velocity, Ultrasonography, education.field_of_study, PWV, Framingham Risk Score, Population based study, Middle Aged, Abdominal aortic aneurysm, Italy, Cardiovascular Diseases, Population Surveillance, Screening, Cardiology, Female, Public Health, ABI, Cardiology and Cardiovascular Medicine, Risk assessment, medicine.medical_specialty, Population, Cardiovascular risk, Diet, Spirometry, Risk Assessment, 03 medical and health sciences, Age Distribution, Internal medicine, medicine, Humans, Sex Distribution, education, Aged, Retrospective Studies, Angiology, business.industry, medicine.disease, Blood pressure, business, Aortic Aneurysm, Abdominal
Abstract

Background Recent meta-analyses suggested that screening program for abdominal aortic aneurysms (AAA) in 65-year old males is cost-effective at prevalence of about 1%. Since some events occur also in females and among the youngers, screening could be feasible among those at higher risk, such as smokers or individuals with a family history of AAA. The RoCAV (Risk of Cardiovascular diseases and abdominal aortic Aneurysms in Varese) Project is a population-based study aimed to evaluate AAA prevalence in Northern Italy in males over-65 years as well as among females and younger males, and to identify new markers for risk stratification by collecting a large set of CVD risk factors. The aims of the project are: (i) cross-sectional evaluation of AAA prevalence (ii); evaluation of standard CVD risk score as criteria for selecting subgroup at higher risk to be included in a screening program; (iii) identification of new risk markers and risk score algorithm for AAA and CVD risk stratification; (iv) cost-effective evaluation during the follow-up. Methods Males aged 50–75 years and females aged 60–75 years, resident in the city of Varese (Lombardy Region), were randomly selected from the civil registry. Among 5198 successfully invited, 3777 subjects accepted to participate and were finally recruited (participation rate 63.8%) from June 2013 to May 2016. Trained operators administered a computerized anamnestic questionnaire, measured anthropometric parameters (BMI, body circumferences, skinfolds), blood pressure, ankle-brachial index, pulse wave velocity and performed abdominal aortic ultrasound scan, ECG and spirometry. All methods were internationally validated. A blood sample was collected and stored in biobank. A follow-up will be carried out through linkage with electronic records. Discussion Participation rate and data quality assessment were as expected and will reasonably allow to reach the project aims. The expected impact in public health of the RoCAV project will be the potential implementation of a AAA screening program to the whole region as well as the formulation of new criteria for risk assessment of AAA and CVD.

Published
2016

6. Clinical experience with Angiojet: A comprehensive review

Author

Ierardi, A. M., Xhepa, G., Piffaretti, G., Bacuzzi, A., Tozzi, M., Carbone, M., Antonio BARILE, Squillaci, E., Fonio, P., Brunese, L., and Carrafiello, G.

Subjects
Thrombectomy, Vascular access devices, Cardiology and Cardiovascular Medicine, Humans, Mesenteric Ischemia, Pulmonary Embolism, Thrombosis, Treatment Outcome
Abstract

The development of various sophisticated mechanical thrombectomy devices and the amassed experience of physicians in minimal invasive therapy produced a paradigm shift in vascular access management toward percutaneous declotting procedures, using pharmaceutical thrombolysis, mechanical thrombectomy, balloon thrombectomy, and a combination of the above techniques. In this setting, in the last years, AngioJet™ (Possis, Minneapolis, MN, USA) rheolytic thrombectomy (RT) showed an increasing use in emergency and election patients. The purpose of this review is to present the current status of percutaneous rheolytic thrombectomy in different fields of applications.

Published
2015

7. Efficacy of anti-CD20 monoclonal antibodies (Mabthera) in patients with progressed hairy cell leukemia

Author

Lauria, F., Lenoci, M., Annino, L., Raspadori, D., Marotta, G., Bocchia, M., Forconi, F., Gentili, S., La Manda, M., Marconcini, S., Tozzi, M., Baldini, L., PIER LUIGI ZINZANI, and Foà, R.

Subjects
Adult, Murine-Derived, Male, Hairy Cell, administration /&/ dosage/pharmacokinetics, Antineoplastic Agents, anti-cd20, hcl, Antibodies, immunology, Antibodies, Monoclonal, Murine-Derived, rituximab, Monoclonal, 2-cda, Humans, CD20, Antigens, Aged, Leukemia, Hairy Cell, Leukemia, Adult, Aged, Antibodies, Murine-Derived, Antibodies, administration /&/ dosage/pharmacokinetics/therapeutic use, Antigens, immunology, Antineoplastic Agents, administration /&/ dosage/pharmacokinetics, Female, Humans, Leukemia, drug therapy, Male, Middle Aged, Remission Induction, Therapeutic Equivalency, Treatment Outcome, Remission Induction, dcf, Antibodies, Monoclonal, Middle Aged, Antigens, CD20, administration /&/ dosage/pharmacokinetics/therapeutic use, drug therapy, Treatment Outcome, Therapeutic Equivalency, Female
Abstract

Recently, a chimeric monoclonal antibody (MoAb) directed against the CD20 antigen (rituximab) has been successfully introduced in the treatment of several CD20-positive B-cell neoplasias and particularly of follicular lymphomas. Based on these premises we evaluated the efficacy and the toxicity of chimeric anti-CD20 monoclonal antibody (MoAb) in relapsed/progressed hairy cell leukemia (HCL).Ten patients with relapsed/progressed HCL entered the study. Eight patients were males and two females with a median age of 55 years (range 41-78) and all of them had been previously treated with 2-chlorodeoxyadenosine and/or deoxycoformycin and a-interferon. Two out of 10 patients were anemic (Hb10 g/dL), 4 thrombocytopenic (Plt100 x 10(9)/L), 3 had fewer than 1.0 x 10(9)/L neutrophils and 3 had circulating hairy cells (HC). All patients received 375 mg/m2 i.v. of anti-CD20 MoAb once a week for 4 doses.All patients were evaluable for response, one patient showing a complete remission and 4 a partial response. Adverse reactions, such as fever, chills, bone pain, hypotension and thrombocytopenia, were transient and mild (grade 1-2) and occurred only during the first course of treatment. One month after the last infusion, patients who had had anemia, neutropenia or thrombocytopenia, recovered normal peripheral blood values. Circulating HC also disappeared within one month. Immunostained bone marrow biopsies were checked 1, 3 and 6 months after the end of therapy and in 5 out of 10 patients a50% reduction of bone marrow HC infiltration was recorded.On the basis of these preliminary results observed in 10 patients with progressed HCL, it appears that treatment with anti-CD20 MoAb is safe and effective in at least 50% of patients, particularly in those with a less evident bone marrow infiltration (50%) and in those previously splenectomized.

Published
2001

8. [Spondylitis in infancy. A case report]

Author

Smacchia, Maria Paola, Bacchin, E., Matrunola, M., Tozzi, M. C., and Bruni, L.

Subjects
Child, Preschool, Humans, Female, Intervertebral Disc, Magnetic Resonance Imaging, Spondylitis
Abstract

The authors report on a case of a spondylodiskitis in three year old child. Diskitis is an inflammatory process of the intervertebral disk space, not often described in pediatric age. The etiology is infective and generally presents with lumbar spine localization. Clinically it is characterized by lumbar pain at times radiating to a lower extremity. Symptoms are aspecific and radiological signs do not appear for several weeks after the onset of symptoms. Interest in this pathology derives from the fact that it may be more common than previously recognized. This case offered us the opportunity to review principal symptoms of diskitis and to describe the main diagnostic technics used.

Published
1996

9. Down syndrome with unusual chromosome translocation: case report and review

Author

Bruni, L., Capolino, R., Tozzi, M. C., Colloridi, Fiorenza, and Smacchia, Maria Paola

Subjects
Male, Chromosomes, Human, Pair 21, 21), familial, Infant, Translocation, Genetic, trisomy 21, Meiosis, Karyotyping, Chromosomes, Human, Pair 5, Humans, t(5, Down Syndrome
Abstract

We report a case of Down syndrome with unusual chromosome translocation. The proband is a 1 year old male with 47, XY, der (5) t(5;21) (q11:q21), + der (5) t(5;21). The mother's karyotype was 46 XX, der (5) t(5,21) (q11:q21). The chromosome imbalance resulted from 3:1 meiotic segregation.

Published
1996

10. Trisomy 9 mosaicism syndrome. A case report and review of the literature

Author

Tarani, Luigi, Colloridi, Fiorenza, Raguso, G., Rizzuti, A., Bruni, L., Tozzi, M. C., Palermo, D., Panero, Alessandra, and Vignetti, P.

Subjects
Male, Mosaicism, Karyotyping, Humans, Abnormalities, Multiple, Trisomy, Syndrome, Chromosomes, Human, Pair 9
Abstract

The authors report on a case of trisomy 9 mosaicism syndrome, a rare chromosome abnormality. The common features of this syndrome are growth and mental retardation, low-set malformed ears, wide sutures and fontanelles, bulbous nose, short palpebral fissures, micrognathia, microphthalmia and enophthalmos, abnormal hands and feet, hip dislocation, joint limitation, cardiovascular defects and urogenital abnormalities. Our patient presented some unusual characteristics, such as 13 pairs of ribs, a vertebral malformation, a hemivertebra and a Dandy-Walker syndrome. They compare their clinical findings with the few cases previously described and they try to contribute to the further clinical definition of the syndrome. It is possible that there is a correlation between the variability of the phenotype and the percentage of trisomic cells in the patient.

Published
1994

11. Properties of erythrocyte membrane in obese children

Author

Ciancarelli-Tozzi, M. G., Tozzi, E., Antonio DI GIULIO, D Alfonso, A., Troiani-Sevi, E., Matteis, F., and Oratore, A.

Subjects
Reference Values, Erythrocyte Membrane, Humans, Obesity, Blood Viscosity, Child

12. Endovascular repair for thoracic aortic arch aneurysms

Author

Caronno, R., Piffaretti, G., Tozzi, M., Lomazzi, C., Cuffari, S., Sala, A., and Patrizio Castelli

Subjects
Aged, 80 and over, Male, Reoperation, Analysis of Variance, Time Factors, Aortic Aneurysm, Thoracic, Carotid Artery, Common, Angioplasty, Subclavian Artery, Middle Aged, Survival Rate, Aortic Dissection, Blood Vessel Prosthesis Implantation, Postoperative Complications, Treatment Outcome, Italy, Cause of Death, Humans, Female, Stents, Hospital Mortality, Vascular Patency, Aged, Follow-Up Studies, Retrospective Studies
Abstract

The aim of this study was to report our experience with total and subtotal endovascular stent-grafting combined with aortic arch branch surgical revascularization for thoracic aortic arch aneurysms in high-risk patients.From December 2000 to June 2005, among 38 patients treated with thoracic stent-grafts in our department, 10 patients (9 men; mean age 71+/-6 years) at high risk for open repair were candidates for endovascular repair and/or aortic arch branch extra-anatomical reconstruction due to inadequate proximal landing zones. The left subclavian artery was over-stented 6 cases for zone 2 aneurysms, and partial or total arch stent-grafting with simultaneous revascularization of the arch branches was performed in 4 cases for zones 0-1 aneurysms.Primary technical success rate was 100%. In-hospital mortality rate was 10%. Neither paraplegia, nor acute renal failure were recorded. Immediate or late surgical conversion was never required. One type 1b was successfully treated with additional stent-graft and 2 type-2 endoleaks were sealed by coil embolization. Mean follow-up was 21-months (range 3-48 months); overall, survival rate at 12, 26, and 36 months was 90%, 60%, and 30%, respectively.Endovascular repair for thoracic aortic arch aneurysms is feasible. However, our experience suggests stent-grafting is not free of risk, and long-term and larger follow-up is required.

13. Mid-term results of endovascular reconstruction for aorto-iliac obstructive disease

Author

Piffaretti, G., Tozzi, M., Lomazzi, C., Rivolta, N., Domenico LAGANÀ, Carrafiello, G., Caronno, R., and Castelli, P.

Subjects
Male, Ultrasonography, Doppler, Duplex, Time Factors, Patient Selection, Aortic Diseases, Angiography, Digital Subtraction, Arterial Occlusive Diseases, Kaplan-Meier Estimate, Middle Aged, Prosthesis Design, Radiography, Interventional, Iliac Artery, Femoral Artery, Treatment Outcome, Humans, Female, Popliteal Artery, Stents, Tomography, X-Ray Computed, Angioplasty, Balloon, Vascular Patency, Aged, Follow-Up Studies, Retrospective Studies
Abstract

Aorto-iliac obstructive disease has been traditionally treated with endarterectomy and/or a surgical bypass graft. Kissing-stents technique has been proposed to reconstruct the aorto-iliac bifurcation for complex aorto-iliac lesions.We report 43 patients with complex aorto-iliac occlusions managed with endovascular repair. Between March 1999 and October 2005, a total of 43 patients with a mean age of 66+/-10 years underwent endovascular treatment for aorto-iliac obstructive disease. Lesions were classified C (n=34) and D (n=9), accordingly to the Trans-Atlantic Inter-Society Consensus (TASC) classification. All endovascular interventions were performed in the theatre under regional anesthesia. Predilation with kissing-balloons angioplasty was usually performed; the bifurcation was then eventually reconstructed using bilateral stents placed with the kissing technique. Clinical examination and duplex scans or computed tomography-angiography (CT-A) were performed at discharge and 1, 6, and 12 months after the procedure, with yearly studies thereafter.Kissing-stents technique was selectively used in 30 cases (69.7%); the remainder cases were treated with kissing-balloons. Major complications occurred in 2 patients (4.6%). Overall, mean hospitalization was 4.1+/-2.8 days (median 3 days). Mean follow-up was 32.4 months (range 1-84 months; median 36 months). During the follow-up, 2 patients (4.6%) died. Duplex and/or CT-A examination detected 4 re-occlusions. Primary patency rates at 12, 24, and 60 months were 92%, 85.7%, and 80.7%, respectively; overall secondary patency rate was 40/43 patients.We consider this approach most appropriate for patients deemed at high operative risk for conventional repair or for those who refuse surgery.

14. Low-grade non Hodgkin's lymphomas in the elderly: impact of a low-dose fludarabine-based combination regimen (mini-FLEC)

Author

Bocchia, M., Gentili, S., Francesco Forconi, Le Naci, M., Tozzi, M., and Lauria, F.

Subjects
Aged, 80 and over, Male, therapeutic use/toxicity, Lymphoma, Lymphoma, Non-Hodgkin, Non-Hodgkin, administration /&/ dosage/analogs /&/ derivatives/toxicity, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols, 80 and over, Humans, Female, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, therapeutic use/toxicity, Female, Humans, Lymphoma, complications/drug therapy, Male, Treatment Outcome, Vidarabine, complications/drug therapy, Vidarabine, Aged

15. Endovascular treatment for para-anastomotic abdominal aortic and iliac aneurysms following aortic surgery

Author

Gabriele Piffaretti, Tozzi, M., Lomazzi, C., Rivolta, N., Caronno, R., and Castelli, P.

Subjects
Male, Reoperation, Anastomosis, Surgical, Angiography, Digital Subtraction, Comorbidity, Risk Assessment, Survival Rate, Blood Vessel Prosthesis Implantation, Postoperative Complications, Treatment Outcome, Iliac Aneurysm, Surgical Wound Dehiscence, Humans, Stents, Tomography, X-Ray Computed, Vascular Patency, Aged, Aortic Aneurysm, Abdominal, Follow-Up Studies
Abstract

The aim of this study was to report our experience with endovascular repair of anastomotic aneurysms occurring after graft replacement for abdominal aortic aneurysms or aorto-iliac obstructive disease.Between January 2000 and April 2006, 19 consecutive male patients (median age 73 years) underwent endovascular repair for 22 anastomotic aneurysms [proximal aortic (n=15), iliac (n=4), concomitant aortic and iliac (n=3)], occurring 3 months to 18 years (mean 8.6 years) after open surgery. Three patients (15.7%) underwent emergency treatment for rupture. No patient had symptoms or positive blood tests for infection of the original graft. Twelve patients were treated with a bifurcated stent-graft, 4 patients with a proximal stent-graft cuff, 2 patients with a tube iliac stent-graft, and 1 patient with a mono-iliac stent-graft.Stent-grafts were successfully deployed in all patients. Procedure-related complications or death were not observed; open conversion was never required. Median hospitalisation was 9 days (range 3-45). During a median follow-up of 16 Euro-months (range, 2-44) all anastomotic aneurysms maintained excluded: 4 patients (21%) died. We observed 1 major complication (5.2%): an iliac branch occlusion occurred 1 month after the procedure, successfully treated with catheter-directed thrombolysis. Overall, survival rates at 6, 12, 18 and 36-months were 92.8%, 84.4%, 72.3%, and 57.8% respectively.Our experience confirms that endovascular stent-grafts can be used successfully to exclude anastomotic aortic aneurysms after open surgery. Endovascular repair seems to be effective at mid-term follow-up.

16. Regional Survey in Lombardy, Northern Italy, on Vascular Surgery Intervention Outcomes During The COVID-19 Pandemic

Author

Raffaello Bellosta, Gabriele Piffaretti, Stefano Bonardelli, Patrizio Castelli, Roberto Chiesa, Dalmazio Frigerio, Gaetano Lanza, Stefano Pirrelli, Giovanni Rossi, Santi Trimarchi, Franco Briolini, Pietro Cefali, Roberto Caronno, Aldo Arzini, Domenico Diaco, Vittorio Baratta, Stefano Aiello, Alessandro C.L. Molinari, Francesca Giovannini, Anna Maria Socrate, Matteo Ferraris, Antonino Silvestro, Gianluca Canu, Emidio Costantini, Davide Logaldo, Federico Romani, Alfredo Lista, Cristina Busoni, Marco Setti, Roberto Mezzetti, Piergiorgio Sala, Luca Bassi, Luca Luzzani, Matteo A. Pegorer, Luca Attisani, Claudio Carugati, Monica Vescovi, Piero Trabattoni, Stefano Zoli, Andrea Rignano, Clara Magri, Pierluigi Vandone, Sergio Losa, Efrem Civilini, Giovanni Nano, Daniela Mazzaccaro, Valerio Tolva, Jessica Lanza, Ruggiero Curci, Giovanna Simonetti, Chiara Lomazzi, Viviana Grassi, Daniele Bissacco, Andrea Kahlberg, Daniele Mascia, Raffaello Dallatana, Michele Carmo, Franco Ragni, Enrico M. Marone, Antonio Bozzani, Matteo Tozzi, Marco Franchin, Gianluca Lussardi, Vittorio Segramora, Gaetano Deleo, Matteo Crippa, Tiziano Porretta, Marco Viani, Silvia Stegher, Davide Foresti, Giovanni Bonalumi, Bellosta, R., Piffaretti, G., Bonardelli, S., Castelli, P., Chiesa, R., Frigerio, D., Lanza, G., Pirrelli, S., Rossi, G., Trimarchi, S., Briolini, F., Cefali, P., Caronno, R., Arzini, A., Diaco, D., Baratta, V., Aiello, S., Molinari, A. C. L., Giovannini, F., Socrate, A. M., Ferraris, M., Silvestro, A., Canu, G., Costantini, E., Logaldo, D., Romani, F., Lista, A., Busoni, C., Setti, M., Mezzetti, R., Sala, P., Bassi, L., Luzzani, L., Pegorer, M. A., Attisani, L., Carugati, C., Vescovi, M., Trabattoni, P., Zoli, S., Rignano, A., Magri, C., Vandone, P., Losa, S., Civilini, E., Nano, G., Mazzaccaro, D., Tolva, V., Lanza, J., Curci, R., Simonetti, G., Lomazzi, C., Grassi, V., Bissacco, D., Kahlberg, A., Mascia, D., Dallatana, R., Carmo, M., Ragni, F., Marone, E. M., Bozzani, A., Tozzi, M., Franchin, M., Lussardi, G., Segramora, V., Deleo, G., Crippa, M., Porretta, T., Viani, M., Stegher, S., Foresti, D., and Bonalumi, G.

Subjects
Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), COVID-19, acute limb ischaemia, vascular surgery activities, Cohort Studies, Postoperative Complications, Intervention (counseling), Pandemic, Humans, Medicine, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Outbreak, Middle Aged, Vascular surgery, Northern italy, Treatment Outcome, Italy, Health Care Surveys, Emergency medicine, Female, Surgery, Cardiology and Cardiovascular Medicine, business, Complication, Vascular Surgical Procedures, Cohort study
Abstract

Objective: The characteristics and outcomes of patients undergoing vascular surgery hospitalised and managed in Lombardy are described with a comparison of patients tested positive for COVID-19 (CV19-pos) vs. those tested negative (CV19-neg). Methods: This was a multicentre, retrospective, observational cohort study which involved all vascular surgery services in Lombardy, Northern Italy. Data were retrospectively merged into a combined dataset covering the nine weeks of the Italian COVID-19 pandemic phase 1 (8 March 2020 to 3 May 2020). The primary outcome was freedom from in hospital death, secondary outcomes were re-thrombosis rate after peripheral revascularisation, and freedom from post-operative complication. Results: Among 674 patients managed during the outbreak, 659 (97.8%) were included in the final analysis: 121 (18.4%) were CV19-pos. CV19-pos status was associated with a higher rate of complications (OR 4.5; p < .001, 95% CI 2.64 – 7.84), and a higher rate of re-thrombosis after peripheral arterial revascularisation (OR 2.2; p = .004, 95% CI 1.29 – 3.88). In hospital mortality was higher in CV19-pos patients (24.8% vs. 5.6%; OR 5.4, p < .001;95% CI 2.86 – 8.92). Binary logistic regression analysis identified CV19-pos status (OR 7.6; p < .001, 95% CI 3.75 – 15.28) and age > 80 years (OR 3.2; p = .001, 95% CI 1.61 – 6.57) to be predictors of in hospital death. Conclusion: In this experience of the vascular surgery group of Lombardy, COVID-19 infection was a marker of poor outcomes in terms of mortality and post-operative complications for patients undergoing vascular surgery treatments.

Published
2021

17. Managing Peripheral Artery Disease in Diabetic Patients: A Questionnaire Survey from Vascular Centers of the Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS)

Author

G Bajardi, Francesco Setacci, Emad Hussein, Giancarlo Bracale, Olivier Goëau-Brissonnière, Ben R. Saleem, E Dinoto, Liborio Ferrante, Jamal J. Hoballah, Gianmarco de Donato, Maurizio Taurino, Bruno Gossetti, F Pecoraro, Bianca Pane, Anna Giribono, Raffaele Pulli, Vincenzo De Luca, Tarek Sraieb, Carlo Setacci, Andrea Stella, Umberto Bracale, Matteo Tozzi, Raffaele Pio Ammollo, Mohamed N. Bouayed, Patrizio Castelli, Maddalena Illario, Bracale U.M., Ammollo R.P., Hussein E.A., Hoballah J.J., Goeau-Brissonniere O., Taurino M., Setacci C., Pecoraro F., Bracale G., Giribono A.M., Ferrante L., de Donato G., Dinoto E., Bajardi G., Illario M., Bouayed M.N., Saleem B.R., Pulli R., Gossetti B., Pane B., Castelli P., Tozzi M., Sraieb T., Setacci F., Stella A., De Luca V., Bracale, Umberto Marcello, Ammollo, Raffaele Pio, Hussein, Emad A, Hoballah, Jamal J, Goeau-Brissonniere, Olivier, Taurino, Maurizio, Setacci, Carlo, Pecoraro, Felice, and Bracale, Giancarlo

Subjects
medicine.medical_treatment, Psychological intervention, 030204 cardiovascular system & hematology, vascular surgery, Settore MED/22 - Chirurgia Vascolare, 030218 nuclear medicine & medical imaging, Wound care, 0302 clinical medicine, Ischemia, Practice Patterns, Physicians', Response rate (survey), Practice Patterns, Nurses', diabetes, Mediterranean Region, Endovascular Procedures, vascular medicine, General Medicine, Treatment Outcome, Cardiology and Cardiovascular Medicine, Vascular Surgical Procedures, diabetic foot, management, Specialization, Reoperation, medicine.medical_specialty, Revascularization, Nurse's Role, Amputation, Surgical, 03 medical and health sciences, peripheral arterial disease, Mediterranean Sea, medicine, Humans, Training, Healthcare Disparities, Endovascular Surgery, Vascular Surgery, Physician's Role, Patient Care Team, Wound Healing, business.industry, General surgery, Vascular surgery, medicine.disease, Diabetic foot, Amputation, Health Care Surveys, Orthopedic surgery, Surgery, business, wound care
Abstract

Background The Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS) was founded on October 1, 2018, to enhance cooperation among vascular professionals within Mediterranean countries. Due to its prominent social and economic impact on national health systems, diabetic arteriopathy has been selected as the very first topic to be investigated by the federation. Methods MeFAVS members were asked to reply to a questionnaire on the management of diabetic ischemic foot. Results were collected and analyzed statistically. The questionnaire consisted of 15 multiple choice answers regarding diabetic foot (DF) diagnosis and treatment. The questionnaire was submitted to 21 centers on April 20, 2019. Results Response rate was 62%. The survey revealed that vascular surgeons, diabetologists, and wound care nurses made-up the core of the diabetic teams present in 76.9%, 69.3%, and 92.3% of the centers, respectively. Diabetic teams were most often led by vascular surgeons (53.8%) and diabetologists (42.2%), but only in 7.9% of cases by nurses. Duplex ultrasonography and computed tomographic angiography were the most commonly available tools used to assess diabetic peripheral arterial disease (PAD). Surgical wound care was undertaken by vascular surgeons in the majority of cases, and only in 46.2% of the cases to orthopedic or plastic surgeons, while nonsurgical wound care was handled by specialized nurses (76.6%) and diabetologists (53.8%). First-line revascularization was preferred over conservative treatment (61.5% vs 53.8%) and endovascular strategy (45.3%) over open (33.7%) or hybrid (21.0%) surgery. Vascular surgeons and interventional radiologists were found to be the most common performers of endovascular revascularization (92.3% and 53.8%, respectively). Amputations had an overall rate of 16.6% (range 4–30%) and a mean reintervention rate of 22.5%, and were usually performed by vascular surgeons for both minor and major interventions (84.6%) followed by orthopedic surgeons (15.4% minor and 30.8% major). The availability of a DF clinic (84.6%) and endovascular (53.8%) and open surgery (46.2%) capabilities were considered fundamental to reduce amputation rates. Conclusions Especially since the introduction and spreading of new endovascular techniques for the treatment of DF, it is a common consensus amongst vascular surgeons that a standardized approach to the discipline is necessary in order to improve outcomes such as amputation-free survival and mortality and it is with this perspective and purpose that transnational cooperation amongst vascular professionals and residents in training are aiming for greater proficiency in endovascular and open surgery.

Published
2020

18. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Author

Alison Halliday, Richard Bulbulia, Leo H Bonati, Johanna Chester, Andrea Cradduck-Bamford, Richard Peto, Hongchao Pan, John Potter, Hans Henning Eckstein, Barbara Farrell, Marcus Flather, Averil Mansfield, Boby Mihaylova, Kazim Rahimi, David Simpson, Dafydd Thomas, Peter Sandercock, Richard Gray, Andrew Molyneux, Cliff P Shearman, Peter Rothwell, Anna Belli, Will Herrington, Parminder Judge, Peter Leopold, Marion Mafham, Michael Gough, Piergiorgio Cao, Sumaira MacDonald, Vasha Bari, Clive Berry, S Bradshaw, Wojciech Brudlo, Alison Clarke, Robin Cox, Susan Fathers, Kamran Gaba, Mo Gray, Elizabeth Hayter, Constance Holliday, Rijo Kurien, Michael Lay, Steffi le Conte, Jessica McManus, Zahra Madgwick, Dylan Morris, Andrew Munday, Sandra Pickworth, Wiktor Ostasz, Michiel Poorthuis, Sue Richards, Louisa Teixeira, Sergey Tochlin, Lynda Tully, Carol Wallis, Monique Willet, Alan Young, Renato Casana, Chiara Malloggi, Andrea Odero Jr, Vincenzo Silani, Gianfranco Parati, Giuseppe Malchiodi, Giovanni Malferrari, Francesco Strozzi, Nicola Tusini, Enrico Vecchiati, Gioacchino Coppi, Antonio Lauricella, Roberto Moratto, Roberto Silingardi, Jessica Veronesi, Andrea Zini, Emanuele Ferrero, Michelangelo Ferri, Andrea Gaggiano, Carmelo Labate, Franco Nessi, Daniele Psacharopulo, Andrea Viazzo, Giovanni Malacrida, Daniela Mazzaccaro, Giovanni Meola, Alfredo Modafferi, Giovanni Nano, Maria Teresa Occhiuto, Paolo Righini, Silvia Stegher, Stefano Chiarandini, Filippo Griselli, Sandro Lepidi, Fabio Pozzi Mucelli, Marcello Naccarato, Mario D'Oria, Barbara Ziani, Andrea Stella, Mortalla Dieng, Gianluca Faggioli, Mauro Gargiulo, Sergio Palermo, Rodolfo Pini, Giovanni Maria Puddu, Andrea Vacirca, Domenico Angiletta, Claudio Desantis, Davide Marinazzo, Giovanni Mastrangelo, Guido Regina, Raffaele Pulli, Paolo Bianchi, Lea Cireni, Elisabetta Coppi, Rocco Pizzirusso, Filippo Scalise, Giovanni Sorropago, Valerio Tolva, Valeria Caso, Enrico Cieri, Paola DeRango, Luca Farchioni, Giacomo Isernia, Massimo Lenti, Gian Battista Parlani, Guglielmo Pupo, Grazia Pula, Gioele Simonte, Fabio Verzini, Federico Carimati, Maria Luisa Delodovici, Federico Fontana, Gabriele Piffaretti, Matteo Tozzi, Efrem Civilini, Giorgio Poletto, Bernhard Reimers, Barbara Praquin, Sonia Ronchey, Laura Capoccia, Wassim Mansour, Enrico Sbarigia, Francesco Speziale, Pasqualino Sirignano, Danilo Toni, Roberto Galeotti, Vincenzo Gasbarro, Francesco Mascoli, Tiberio Rocca, Elpiniki Tsolaki, Giulia Bernardini, Ester DeMarco, Alessia Giaquinta, Francesco Patti, Massimiliano Veroux, Pierfrancesco Veroux, Carla Virgilio, Nicola Mangialardi, Matteo Orrico, Vincenzo Di Lazzaro, Nunzio Montelione, Francesco Spinelli, Francesco Stilo, Carlo Cernetti, Sandro Irsara, Giuseppe Maccarrone, Diego Tonello, Adriana Visonà, Beniamino Zalunardo, Emiliano Chisci, Stefano Michelagnoli, Nicola Troisi, Maela Masato, Massimo Dei Negri, Andrea Pacchioni, Salvatore Saccà, Giovanni Amatucci, Alfredo Cannizzaro, Federico Accrocca, Cesare Ambrogi, Renzo Barbazza, Giustino Marcucci, Andrea Siani, Guido Bajardi, Giovanni Savettieri, Angelo Argentieri, Riccardo Corbetta, Attilio Odero, Pietro Quaretti, Federico Z Thyrion, Alessandro Cappelli, Domenico Benevento, Gianmarco De Donato, Maria Agnese Mele, Giancarlo Palasciano, Daniela Pieragalli, Alessandro Rossi, Carlo Setacci, Francesco Setacci, Domenico Palombo, Maria Cecilia Perfumo, Edoardo Martelli, Aldo Paolucci, Santi Trimarchi, Viviana Grassi, Luigi Grimaldi, Giuliana La Rosa, Domenico Mirabella, Matteo Scialabba, Leonildo Sichel, Costantino L D'Angelo, Gian Franco Fadda, Holta Kasemi, Mario Marino, Francesco Burzotta, Francesco Alberto Codispoti, Angela Ferrante, Giovanni Tinelli, Yamume Tshomba, Claudio Vincenzoni, Deborah Amis, Dawn Anderson, Martin Catterson, Mike Clarke, Michelle Davis, Anand Dixit, Alexander Dyker, Gary Ford, Ralph Jackson, Sreevalsan Kappadath, David Lambert, Tim Lees, Stephen Louw, James McCaslin, Noala Parr, Rebecca Robson, Gerard Stansby, Lucy Wales, Vera Wealleans, Lesley Wilson, Michael Wyatt, Hardeep Baht, Ibrahim Balogun, Ilse Burger, Tracy Cosier, Linda Cowie, Gunaratnam Gunathilagan, David Hargroves, Robert Insall, Sally Jones, Hannah Rudenko, Natasha Schumacher, Jawaharlal Senaratne, George Thomas, Audrey Thomson, Tom Webb, Ellen Brown, Bernard Esisi, Ali Mehrzad, Shane MacSweeney, Norman McConachie, Alison Southam, Wayne Sunman, Ahmed Abdul-Hamiq, Jenny Bryce, Ian Chetter, Duncan Ettles, Raghuram Lakshminarayan, Kim Mitchelson, Christopher Rhymes, Graham Robinson, Paul Scott, Alison Vickers, Ray Ashleigh, Stephen Butterfield, Ed Gamble, Jonathan Ghosh, Charles N McCollum, Mark Welch, Sarah Welsh, Leszek Wolowczyk, Mary Donnelly, Stephen D'Souza, Anselm A Egun, Bindu Gregary, Thomas Joseph, Christine Kelly, Shuja Punekar, M Asad Rahi, Sonia Raj, Dare Seriki, George Thomson, James Brown, Ragunath Durairajan, Iris Grunwald, Paul Guyler, Paula Harman, Matthew Jakeways, Christopher Khuoge, Ashish Kundu, Thayalini Loganathan, Nisha Menon, Raji O Prabakaran, Devesh Sinha, Vicky Thompson, Sharon Tysoe, Dennis Briley, Chris Darby, Linda Hands, Dominic Howard, Wilhelm Kuker, Ursula Schulz, Rachel Teal, David Barer, Andrew Brown, Susan Crawford, Paul Dunlop, Ramesh Krishnamurthy, Nikhil Majmudar, Duncan Mitchell, Min P Myint, Richard O'Brien, Janice O'Connell, Naweed Sattar, Shanmugam Vetrivel, Jonathan Beard, Trevor Cleveland, Peter Gaines, John Humphreys, Alison Jenkins, Craig King, Daniel Kusuma, Ralph Lindert, Robbie Lonsdale, Raj Nair, Shah Nawaz, Faith Okhuoya, Douglas Turner, Graham Venables, Paul Dorman, Andrea Hughes, Deborah Jones, David Mendelow, Helen Rodgers, Aidas Raudoniitis, Peter Enevoldson, Hans Nahser, Imelda O'Brien, Francesco Torella, Dave Watling, Richard White, Pauline Brown, Dipankar Dutta, Lorraine Emerson, Paula Hilltout, Sachin Kulkarni, Jackie Morrison, Keith Poskitt, Fiona Slim, Sarah Smith, Amanda Tyler, Joanne Waldron, Mark Whyman, Milda Bajoriene, Lucy Baker, Amanda Colston, Bekky Eliot-Jones, Gita Gramizadeh, Catherine Lewis-Clarke, Laura McCafferty, Deborah Oliver, Debbie Palmer, Abhijeet Patil, Suzannah Pegler, Gopi Ramadurai, Aisling Roberts, Tracey Sargent, Shivaprasad Siddegowda, Ravi Singh-Ranger, Akintunde Williams, Lucy Williams, Steve Windebank, Tadas Zuromskis, Lanka Alwis, Jane Angus, Asaipillai Asokanathan, Caroline Fornolles, Diana Hardy, Sophy Hunte, Frances Justin, Duke Phiri, Marie Mitabouana-Kibou, Lakshmanan Sekaran, Sakthivel Sethuraman, Margaret L Tate, Joyce Akyea-Mensah, Stephen Ball, Angela Chrisopoulou, Elizabeth Keene, Alison Phair, Steven Rogers, John V Smyth, Colin Bicknell, Jeremy Chataway, Nicholas Cheshire, Andrew Clifton, Caroline Eley, Richard Gibbs, Mohammad Hamady, Beth Hazel, Alex James, Michael Jenkins, Nyma Khanom, Austin Lacey, Maz Mireskandari, Joanna O'Reilly, Antony Pereira, Tina Sachs, John Wolfe, Philip Davey, Gill Rogers, Gemma Smith, Gareth Tervit, Ian Nichol, Andrew Parry, Gavin Young, Simon Ashley, James Barwell, Francis Dix, Azlisham M Nor, Chris Parry, Angela Birt, Paul Davies, Jim George, Anne Graham, Leon Jonker, Nicci Kelsall, Caroline Potts, Toni Wilson, Jamie Crinnion, Larissa Cuenoud, Nikola Aleksic, Srdan Babic, Nenad Ilijevski, Đorde Radak, Dragan Sagic, Slobodan Tanaskovic, Momcilo Colic, Vladimir Cvetic, Lazar Davidovic, Dejana R Jovanovic, Igor Koncar, Perica Mutavdžic, Miloš Sladojevic, Ivan Tomic, Eike S Debus, Ulrich Grzyska, Dagmar Otto, Götz Thomalla, Jessica Barlinn, Johannes Gerber, Kathrin Haase, Christian Hartmann, Stefan Ludwig, Volker Pütz, Christian Reeps, Christine Schmidt, Norbert Weiss, Sebastian Werth, Simon Winzer, Janine Gemper, Albrecht Günther, Bianka Heiling, Elisabeth Jochmann, Panagiota Karvouniari, Carsten Klingner, Thomas Mayer, Julia Schubert, Friederike Schulze-Hartung, Jürgen Zanow, Yvonne Bausback, Franka Borger, Spiridon Botsios, Daniela Branzan, Sven Bräunlich, Henryk Hölzer, Janin Lenzer, Christopher Piorkowski, Nadine Richter, Johannes Schuster, Dierk Scheinert, Andrej Schmidt, Holger Staab, Matthias Ulrich, Martin Werner, Hermann Berger, Gábor Biró, Hans-Henning Eckstein, Michael Kallmayer, Kornelia Kreiser, Alexander Zimmermann, Bärbel Berekoven, Klaus Frerker, Vera Gordon, Giovanni Torsello, Sebastian Arnold, Cora Dienel, Martin Storck, Bernhard Biermaier, Hans Martin Gissler, Christof Klötzsch, Tomas Pfeiffer, Ralph Schneider, Leander Söhl, Michael Wennrich, Angelika Alonso, Michael Keese, Christoph Groden, Andreas Cöster, Andreas Engelhardt, Christoph-Maria Ratusinski, Bengt Berg, Martin Delle, Johan Formgren, Peter Gillgren, Lotta Jarl, Torbjörn B Kall, Peter Konrad, Niklas Nyman, Claes Skiöldebrand, Johnny Steuer, Rabbe Takolander, Jonas Malmstedt, Stefan Acosta, Katarina Björses, Kerstin Brandt, Nuno Dias, Anders Gottsäter, Jan Holst, Thorarinn Kristmundsson, Tobias Kühme, Tilo Kölbel, Bengt Lindblad, Mats Lindh, Martin Malina, Tomas Ohrlander, Tim Resch, Viola Rönnle, Björn Sonesson, Margareta Warvsten, Zbigniew Zdanowski, Erik Campbell, Per Kjellin, Hans Lindgren, Johan Nyberg, Björn Petersen, Gunnar Plate, Håkan Pärsson, Peter Qvarfordt, Pavel Ignatenko, Andrey Karpenko, Vladimir Starodubtsev, Mikhail A Chernyavsky, Maria S Golovkova, Boris B Komakha, Nikolay N Zherdev, Andrey Belyasnik, Pavel Chechulov, Dmitry Kandyba, Igor Stepanishchev, Csaba Csobay-Novák, Edit Dósa, László Entz, Balázs Nemes, Zoltán Szeberin, Pál Barzó, Mihaly Bodosi, Eniko Fákó, Béla Fülöp, Tamás Németh, Szilárd Pazdernyik, Krisztina Skoba, Erika Vörös, Eleni Chatzinikou, Athanasios Giannoukas, Christos Karathanos, Stylianos Koutsias, Georgios Kouvelos, Miltiadis Matsagkas, Styliani Ralli, Christos Rountas, Nikolaos Rousas, Konstantinos Spanos, Elias Brountzos, John D Kakisis, Andreas Lazaris, Konstantinos G Moulakakis, Leonidas Stefanis, Georgios Tsivgoulis, Spyros Vasdekis, Constantine N Antonopoulos, Ion Bellenis, Dimitrios Maras, Antonios Polydorou, Victoria Polydorou, Antonios Tavernarakis, Nikolaos Ioannou, Maria Terzoudi, Miltos Lazarides, Michalis Mantatzis, Kostas Vadikolias, Lukasz Dzieciuchowicz, Marcin Gabriel, Zbigniew Krasinski, Grzegorz Oszkinis, Fryderyk Pukacki, Maciej Slowinski, Michal-Goran Stanišic, Ryszard Staniszewski, Jolanta Tomczak, Maciej Zielinski, Piotr Myrcha, Dorota Rózanski, Stanislaw Drelichowski, Wojciech Iwanowski, Katarzyna Koncewicz, Pawel Bialek, Zbigniew Biejat, Wojciech Czepel, Anna Czlonkowska, Anatol Dowzenko, Julia Jedrzejewska, Adam Kobayashi, Jerzy Leszczynski, Andrzej Malek, Jerzy Polanski, Robert Proczka, Maciej Skorski, Mieczyslaw Szostek, Piotr Andziak, Maciej Dratwicki, Robert Gil, Miroslaw Nowicki, Jaroslaw Pniewski, Jaroslaw Rzezak, Piotr Seweryniak, Pawel Dabek, Michal Juszynski, Grzegorz Madycki, Bartosz Pacewski, Witold Raciborski, Piotr Slowinski, Walerian Staszkiewicz, Martin Bombic, Vladimír Chlouba, Jirí Fiedler, Karel Hes, Petr Koštál, Jindrich Sova, Zdenek Kríž, Mojmír Prívara, Michal Reif, Robert Staffa, Robert Vlachovský, Bohuslav Vojtíšek, Tomáš Hrbác, Martin Kuliha, Václav Procházka, Martin Roubec, David Školoudík, David Netuka, Anna Šteklácová, Vladimír Beneš III, Pavel Buchvald, Ladislav Endrych, Miroslav Šercl, Walter Campos Jr, Ivan B Casella, Nelson de Luccia, André E V Estenssoro, Calógero Presti, Pedro Puech-Leão, Celso R B Neves, Erasmo S da Silva, Cid J Sitrângulo Jr, José A T Monteiro, Gisela Tinone, Marcelo Bellini Dalio, Edwaldo E Joviliano, Octávio M Pontes Neto, Mauricio Serra Ribeiro, Patrick Cras, Jeroen M H Hendriks, Mieke Hoppenbrouwers, Patrick Lauwers, Caroline Loos, Laetitia Yperzeele, Mia Geenens, Dimitri Hemelsoet, Isabelle van Herzeele, Frank Vermassen, Parla Astarci, Frank Hammer, Valérie Lacroix, André Peeters, Robert Verhelst, Silvana Cirelli, Pol Dormal, Annelies Grimonprez, Bart Lambrecht, Philipe Lerut, Eddy Thues, Guy De Koster, Quentin Desiron, Alain Maertens de Noordhout, Danielle Malmendier, Mireille Massoz, Georges Saad, Marc Bosiers, Joren 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Crawford S., Dunlop P., Krishnamurthy R., Majmudar N., Mitchell D., Myint M.P., O'Brien R., O'Connell J., Sattar N., Vetrivel S., Beard J., Cleveland T., Gaines P., Humphreys J., Jenkins A., King C., Kusuma D., Lindert R., Lonsdale R., Nair R., Nawaz S., Okhuoya F., Turner D., Venables G., Dorman P., Hughes A., Jones D., Mendelow D., Rodgers H., Raudoniitis A., Enevoldson P., Nahser H., O'Brien I., Torella F., Watling D., White R., Brown P., Dutta D., Emerson L., Hilltout P., Kulkarni S., Morrison J., Poskitt K., Slim F., Smith S., Tyler A., Waldron J., Whyman M., Bajoriene M., Baker L., Colston A., Eliot-Jones B., Gramizadeh G., Lewis-Clarke C., McCafferty L., Oliver D., Palmer D., Patil A., Pegler S., Ramadurai G., Roberts A., Sargent T., Siddegowda S., Singh-Ranger R., Williams A., Williams L., Windebank S., Zuromskis T., Alwis L., Angus J., Asokanathan A., Fornolles C., Hardy D., Hunte S., Justin F., Phiri D., Mitabouana-Kibou M., Sekaran L., Sethuraman S., Tate M.L., Akyea-Mensah 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Golovkova M.S., Komakha B.B., Zherdev N.N., Belyasnik A., Chechulov P., Kandyba D., Stepanishchev I., Csobay-Novak C., Dosa E., Entz L., Nemes B., Szeberin Z., Barzo P., Bodosi M., Fako E., Fulop B., Nemeth T., Pazdernyik S., Skoba K., Voros E., Chatzinikou E., Giannoukas A., Karathanos C., Koutsias S., Kouvelos G., Matsagkas M., Ralli S., Rountas C., Rousas N., Spanos K., Brountzos E., Kakisis J.D., Lazaris A., Moulakakis K.G., Stefanis L., Tsivgoulis G., Vasdekis S., Antonopoulos C.N., Bellenis I., Maras D., Polydorou A., Polydorou V., Tavernarakis A., Ioannou N., Terzoudi M., Lazarides M., Mantatzis M., Vadikolias K., Dzieciuchowicz L., Gabriel M., Krasinski Z., Oszkinis G., Pukacki F., Slowinski M., Stanisic M.-G., Staniszewski R., Tomczak J., Zielinski M., Myrcha P., Rozanski D., Drelichowski S., Iwanowski W., Koncewicz K., Bialek P., Biejat Z., Czepel W., Czlonkowska A., Dowzenko A., Jedrzejewska J., Kobayashi A., Leszczynski J., Malek A., Polanski J., Proczka R., Skorski M., Szostek M., Andziak P., Dratwicki M., Gil R., Nowicki M., Pniewski J., Rzezak J., Seweryniak P., Dabek P., Juszynski M., Madycki G., Pacewski B., Raciborski W., Slowinski P., Staszkiewicz W., Bombic M., Chlouba V., Fiedler J., Hes K., Kostal P., Sova J., Kriz Z., Privara M., Reif M., Staffa R., Vlachovsky R., Vojtisek B., Hrbac T., Kuliha M., Prochazka V., Roubec M., Skoloudik D., Netuka D., Steklacova A., Benes III V., Buchvald P., Endrych L., Sercl M., Campos W., Casella I.B., de Luccia N., Estenssoro A.E.V., Presti C., Puech-Leao P., Neves C.R.B., da Silva E.S., Sitrangulo C.J., Monteiro J.A.T., Tinone G., Bellini Dalio M., Joviliano E.E., Pontes Neto O.M., Serra Ribeiro M., Cras P., Hendriks J.M.H., Hoppenbrouwers M., Lauwers P., Loos C., Yperzeele L., Geenens M., Hemelsoet D., van Herzeele I., Vermassen F., Astarci P., Hammer F., Lacroix V., Peeters A., Verhelst R., Cirelli S., Dormal P., Grimonprez A., Lambrecht B., Lerut P., Thues E., De Koster G., Desiron Q., Maertens de 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Gizewski E., Gruber I., Knoflach M., Kiechl S., Rantner B., Abdulamit T., Bergeron P., Padovani R., Trastour J.-C., Cardon J.-M., Le Gallou-Wittenberg A., Allaire E., Becquemin J.-P., Cochennec-Paliwoda F., Desgranges P., Hosseini H., Kobeiter H., Marzelle J., Almekhlafi M.A., Bal S., Barber P.A., Coutts S.B., Demchuk A.M., Eesa M., Gillies M., Goyal M., Hill M.D., Hudon M.E., Jambula A., Kenney C., Klein G., McClelland M., Mitha A., Menon B.K., Morrish W.F., Peters S., Ryckborst K.J., Samis G., Save S., Smith E.E., Stys P., Subramaniam S., Sutherland G.R., Watson T., Wong J.H., Zimmel L., Flis V., Matela J., Miksic K., Milotic F., Mrdja B., Stirn B., Tetickovic E., Gasparini M., Grad A., Kompara I., Milosevic Z., Palmiste V., Toomsoo T., Aidashova B., Kospanov N., Lyssenko R., Mussagaliev D., Beyar R., Hoffman A., Karram T., Kerner A., Nikolsky E., Nitecki S., Andonova S., Bachvarov C., Petrov V., Cvjetko I., Vidjak V., Haluzan D., Petrunic M., Liu B., Liu C.-W., Bartko D., Beno P., Rusnak F., Zelenak K., Ezura M., Inoue T., Kimura N., Kondo R., Matsumoto Y., Shimizu H., Endo H., Furui E., Bakke S., Krohg-Sorensen K., Nome T., Skjelland M., Tennoe B., Albuquerque e Castro J., Alves G., Bastos Goncalves F., de Aragao Morais J., Garcia A.C., Valentim H., Vasconcelos L., Belcastro F., Cura F., Zaefferer P., Abd-Allah F., Eldessoki M.H., Heshmat Kassem H., Soliman Gharieb H., Colgan M.P., Haider S.N., Harbison J., Madhavan P., Moore D., Shanik G., Kazan V., Nazzal M., Ramsey-Williams V., and Gargiulo M

Subjects
Male, medicine.medical_specialty, Time Factors, Time Factor, medicine.medical_treatment, Carotid Stenosi, MEDLINE, Carotid endarterectomy, Rate ratio, Risk Assessment, Asymptomatic, law.invention, Randomized controlled trial, law, Risk Factors, carotid artery stenting (CAS), carotid endarterectomy (CEA), Stent, medicine, Humans, Carotid Stenosis, Stroke, Endarterectomy, Aged, Endarterectomy, Carotid, business.industry, carotid artery, Risk Factor, Articles, General Medicine, trial, medicine.disease, Settore MED/22 - CHIRURGIA VASCOLARE, Surgery, Stenosis, Treatment Outcome, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Female, Stents, Human medicine, medicine.symptom, business, Human
Abstract

Summary Background Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding UK Medical Research Council and Health Technology Assessment Programme.

Published
2021

19. Risk and predictive factors of prolonged viral RNA shedding in upper respiratory specimens in a large cohort of COVID-19 patients admitted in an Italian Reference Hospital

Author

Annalisa Mondi, Patrizia Lorenzini, Concetta Castilletti, Roberta Gagliardini, Eleonora Lalle, Angela Corpolongo, Maria Beatrice Valli, Fabrizio Taglietti, Stefania Cicalini, Laura Loiacono, Francesco Di Gennaro, Gianpiero D’Offizi, Fabrizio Palmieri, Emanuele Nicastri, Chiara Agrati, Nicola Petrosillo, Giuseppe Ippolito, Francesco Vaia, Enrico Girardi, Maria Rosaria Capobianchi, Andrea Antinori, Sara Zito, Maria Alessandra Abbonizio, Amina Abdeddaim, Elisabetta Agostini, Fabrizio Albarello, Gioia Amadei, Alessandra Amendola, Maria Assunta Antonica, Mario Antonini, Tommaso Ascoli Bartoli, Francesco Baldini, Raffaella Barbaro, Barbara Bartolini, Rita Bellagamba, Martina Benigni, Nazario Bevilacqua, Gianluigi Biava, Michele Bibas, Licia Bordi, Veronica Bordoni, Evangelo Boumis, Marta Branca, Rosanna Buonomo, Donatella Busso, Marta Camici, Paolo Campioni, Flaminia Canichella, Alessandro Capone, Cinzia Caporale, Emanuela Caraffa, Ilaria Caravella, Fabrizio Carletti, Adriana Cataldo, Stefano Cerilli, Carlotta Cerva, Roberta Chiappini, Pierangelo Chinello, Maria Assunta Cianfarani, Carmine Ciaralli, Claudia Cimaglia, Nicola Cinicola, Veronica Ciotti, Francesca Colavita, Massimo Cristofaro, Salvatore Curiale, Alessandra D’Abramo, Cristina Dantimi, Alessia De Angelis, Giada De Angelis, Maria Grazia De Palo, Federico De Zottis, Virginia Di Bari, Rachele Di Lorenzo, Federica Di Stefano, Davide Donno, Francesca Evangelista, Francesca Faraglia, Anna Farina, Federica Ferraro, Lorena Fiorentini, Andrea Frustaci, Matteo Fusetti, Vincenzo Galati, Paola Gallì, Gabriele Garotto, Ilaria Gaviano, Saba Gebremeskel Tekle, Maria Letizia Giancola, Filippo Giansante, Emanuela Giombini, Guido Granata, Maria Cristina Greci, Elisabetta Grilli, Susanna Grisetti, Gina Gualano, Fabio Iacomi, Marta Iaconi, Giuseppina Iannicelli, Carlo Inversi, Maria Elena Lamanna, Simone Lanini, Daniele Lapa, Luciana Lepore, Raffaella Libertone, Raffaella Lionetti, Giuseppina Liuzzi, Andrea Lucia, Franco Lufrani, Manuela Macchione, Gaetano Maffongelli, Alessandra Marani, Luisa Marchioni, Andrea Mariano, Maria Cristina Marini, Micaela Maritti, Annelisa Mastrobattista, Ilaria Mastrorosa, Giulia Matusali, Valentina Mazzotta, Paola Mencarini, Silvia Meschi, Francesco Messina, Sibiana Micarelli, Giulia Mogavero, Marzia Montalbano, Chiara Montaldo, Silvia Mosti, Silvia Murachelli, Maria Musso, Michela Nardi, Assunta Navarra, Martina Nocioni, Pasquale Noto, Roberto Noto, Alessandra Oliva, Ilaria Onnis, Sandrine Ottou, Claudia Palazzolo, Emanuele Pallini, Giulio Palombi, Carlo Pareo, Virgilio Passeri, Federico Pelliccioni, Giovanna Penna, Antonella Petrecchia, Ada Petrone, Elisa Pianura, Carmela Pinnetti, Maria Pisciotta, Pierluca Piselli, Silvia Pittalis, Agostina Pontarelli, Costanza Proietti, Vincenzo Puro, Paolo Migliorisi Ramazzini, Alessia Rianda, Gabriele Rinonapoli, Silvia Rosati, Dorotea Rubino, Martina Rueca, Alberto Ruggeri, Alessandra Sacchi, Alessandro Sampaolesi, Francesco Sanasi, Carmen Santagata, Alessandra Scarabello, Silvana Scarcia, Vincenzo Schininà, Paola Scognamiglio, Laura Scorzolini, Giulia Stazi, Giacomo Strano, Chiara Taibi, Giorgia Taloni, Tetaj Nardi, Roberto Tonnarini, Simone Topino, Martina Tozzi, Francesco Vairo, Alessandra Vergori, Laura Vincenzi, Ubaldo Visco-Comandini, Serena Vita, Pietro Vittozzi, Mauro Zaccarelli, Antonella Zanetti, Mondi, A., Lorenzini, P., Castilletti, C., Gagliardini, R., Lalle, E., Corpolongo, A., Valli, M. B., Taglietti, F., Cicalini, S., Loiacono, L., Di Gennaro, F., D'Offizi, G., Palmieri, F., Nicastri, E., Agrati, C., Petrosillo, N., Ippolito, G., Vaia, F., Girardi, E., Capobianchi, M. R., Antinori, A., Zito, S., Abbonizio, M. A., Abdeddaim, A., Agostini, E., Albarello, F., Amadei, G., Amendola, A., Antonica, M. A., Antonini, M., Bartoli, T. A., Baldini, F., Barbaro, R., Bartolini, B., Bellagamba, R., Benigni, M., Bevilacqua, N., Biava, G., Bibas, M., Bordi, L., Bordoni, V., Boumis, E., Branca, M., Buonomo, R., Busso, D., Camici, M., Campioni, P., Canichella, F., Capone, A., Caporale, C., Caraffa, E., Caravella, I., Carletti, F., Cataldo, A., Cerilli, S., Cerva, C., Chiappini, R., Chinello, P., Cianfarani, M. A., Ciaralli, C., Cimaglia, C., Cinicola, N., Ciotti, V., Colavita, F., Cristofaro, M., Curiale, S., D'Abramo, A., Dantimi, C., De Angelis, A., De Angelis, G., De Palo, M. G., De Zottis, F., Di Bari, V., Di Lorenzo, R., Di Stefano, F., Donno, D., Evangelista, F., Faraglia, F., Farina, A., Ferraro, F., Fiorentini, L., Frustaci, A., Fusetti, M., Galati, V., Galli, P., Garotto, G., Gaviano, I., Tekle, S. G., Giancola, M. L., Giansante, F., Giombini, E., Granata, G., Greci, M. C., Grilli, E., Grisetti, S., Gualano, G., Iacomi, F., Iaconi, M., Iannicelli, G., Inversi, C., Lamanna, M. E., Lanini, S., Lapa, D., Lepore, L., Libertone, R., Lionetti, R., Liuzzi, G., Lucia, A., Lufrani, F., Macchione, M., Maffongelli, G., Marani, A., Marchioni, L., Mariano, A., Marini, M. C., Maritti, M., Mastrobattista, A., Mastrorosa, I., Matusali, G., Mazzotta, V., Mencarini, P., Meschi, S., Messina, F., Micarelli, S., Mogavero, G., Montalbano, M., Montaldo, C., Mosti, S., Murachelli, S., Musso, M., Nardi, M., Navarra, A., Nocioni, M., Noto, P., Noto, R., Oliva, A., Onnis, I., Ottou, S., Palazzolo, C., Pallini, E., Palombi, G., Pareo, C., Passeri, V., Pelliccioni, F., Penna, G., Petrecchia, A., Petrone, A., Pianura, E., Pinnetti, C., Pisciotta, M., Piselli, P., Pittalis, S., Pontarelli, A., Proietti, C., Puro, V., Ramazzini, P. M., Rianda, A., Rinonapoli, G., Rosati, S., Rubino, D., Rueca, M., Ruggeri, A., Sacchi, A., Sampaolesi, A., Sanasi, F., Santagata, C., Scarabello, A., Scarcia, S., Schinina, V., Scognamiglio, P., Scorzolini, L., Stazi, G., Strano, G., Taibi, C., Taloni, G., Nardi, T., Tonnarini, R., Topino, S., Tozzi, M., Vairo, F., Vergori, A., Vincenzi, L., Visco-Comandini, U., Vita, S., Vittozzi, P., Zaccarelli, M., and Zanetti, A.

Subjects
Male, 0301 basic medicine, Time Factors, medicine.medical_treatment, Respiratory System, coronavirus, Infectious and parasitic diseases, RC109-216, Severity of Illness Index, Cohort Studies, 0302 clinical medicine, risk factors, 030212 general & internal medicine, Respiratory disease, General Medicine, Middle Aged, Virus Shedding, Infectious Diseases, symbols, RNA, Viral, Female, Coronavirus, COVID-19, viral clearance, viral shedding, Risk factors, SARS-CoV-2, Cohort study, Adult, Microbiology (medical), medicine.medical_specialty, viral shedding, Coronaviru, 030106 microbiology, Article, NO, 03 medical and health sciences, symbols.namesake, Internal medicine, Severity of illness, medicine, Humans, Poisson regression, Aged, Proportional Hazards Models, Mechanical ventilation, business.industry, Proportional hazards model, COVID-19, Retrospective cohort study, medicine.disease, Respiratory failure, Risk factor, business, viral clearance
Abstract

Background Few data about predictors and outcomes associated with prolonged SARS-CoV-2 RNA shedding (VS) are available. Methods Retrospective study including all patients admitted with COVID-19 in an Italian reference hospital for infectious diseases between March 1 and July 1, 2020. Predictors of viral clearance (VC) and prolonged VS from upper respiratory tract were assessed by Poisson regression and logistic regression analyses. The causal relation between duration of VS and probability of clinical outcomes was evaluated through inverse probability weighted Cox model. Results 536 subjects were included. Median duration of VS from symptoms onset was 18 days (IQR 12-26). The estimated 30-day probability of VC was 70.2% (95%CI:65-75). At multivariable analysis, patients with comorbidities (aIRR = 0.88, p = 0.004), lymphopenia at hospital admission (aIRR = 0.75, p = 0.032) and with moderate/severe respiratory disease (aIRR = 0.42, p 1000 ng/mL at admission (aOR = 1.76, p = 0.035) independently predicted prolonged VS. The achievement of VC doubled the chance of clinical recovery (aHR = 2.17, p

Published
2021

20. Continuous infusion versus intermittent administration of meropenem in critically ill patients (MERCY): A multicenter randomized double-blind trial. Rationale and design

Author

Ingrid Marcela Pabon, Barbara Azzali, Mattia Bozzetti, Vincenzo Pota, Antonio De Sio, Andrey Yavorovskiy, Natascia D'Andrea, Rosetta Lobreglio, Andrea Della Selva, Evgeny Fominskiy, Federico Canavosio, Barbara Ferrara, Vittorio Pazzanese, Francesca Gallicchio, Nicola Pasculli, Valery Likhvantsev, Eugenio Garofalo, Sergio Colombo, Anna Mara Scandroglio, Felice Eugenio Agrò, Margherita Tozzi, Gianluca Paternoster, Francesco Corradi, Tiziana Bove, Filippo Palmesino, Elena Momesso, Luigi Vetrugno, Francesco Giuseppe Nisi, Giorgia Montrucchio, Daniela Missio, Mara Bernasconi, Giacomo Monti, Mariano Ballestra, Marco Gemma, Giovanni Marino, Silvia Ajello, Alberto Zangrillo, Rosalba Lembo, Maria Grazia Calabrò, Romina Perone, Andrea Bruni, Pavel Nogtev, Alberto Cappelletti, Gabriele Finco, Daniele Cristadoro, Leonarda Pia Cantatore, Marina Pieri, Sofia Ananiadou, Italo Calamai, Chiara Millin, A. Mattei, Luca Cabrini, Marina Petrova, Valentina Paola Plumari, Nicoletta Boffa, Davide Maraggia, Elena Moizo, Gianna Curci, Giovanni Landoni, Giuseppe Biondi-Zoccai, Giuseppe Giardina, Giacomo Iapichino, Carola Galbiati, Fabio Guarracino, Antonella Cotoia, Matteo Marzaroli, Nikola Bradic, Umberto Benedetto, Giorgio Gallioli, Fabrizio D'Ascenzo, Francesco Forfori, Fabio Toffoletto, Milena Mucci, Manuela Mainetti, Monti, G., Galbiati, C., Toffoletto, F., Calabro, M. G., Colombo, S., Ferrara, B., Giardina, G., Lembo, R., Marzaroli, M., Moizo, E., Mucci, M., Pasculli, N., Plumari, V. P., Scandroglio, A. M., Tozzi, M., Momesso, E., Boffa, N., Lobreglio, R., Montrucchio, G., Guarracino, F., Benedetto, U., Biondi-Zoccai, G., D'Ascenzo, F., D'Andrea, N., Paternoster, G., Ananiadou, S., Ballestra, M., De Sio, A., Pota, V., Cotoia, A., Della Selva, A., Bruni, A., Iapichino, G., Bradic, N., Corradi, F., Gemma, M., Nogtev, P., Petrova, M., Agro, F. E., Cabrini, L., Forfori, F., Likhvantsev, V., Bove, T., Finco, G., Landoni, G., Zangrillo, A., Ajello, S., Cappelletti, A. M., Fominskiy, E., Nisi, F. G., Pazzanese, V., Pieri, M., Canavosio, F., Palmesino, F., Bernasconi, M., Gallioli, G., Marino, G., Vetrugno, L., Millin, C., Missio, D., Gallicchio, F., Azzali, B., Bozzetti, M., Cristadoro, D., Perone, R., Cantatore, L. P., Curci, G., Pabon, I. M., Garofalo, E., Mainetti, M., Calamai, I., Maraggia, D., Mattei, A., Yavorovskiy, A., Monti, Giacomo, Galbiati, Carola, Toffoletto, Fabio, Calabrò, Maria Grazia, Colombo, Sergio, Ferrara, Barbara, Giardina, Giuseppe, Lembo, Rosalba, Marzaroli, Matteo, Moizo, Elena, Mucci, Milena, Pasculli, Nicola, Plumari, Valentina, Scandroglio, Anna Mara, Tozzi, Margherita, Momesso, Elena, Boffa, Nicoletta, Lobreglio, Rosetta, Montrucchio, Giorgia, Guarracino, Fabio, Benedetto, Umberto, Biondi-Zoccai, Giuseppe, D'Ascenzo, Fabrizio, D'Andrea, Natascia, Paternoster, Gianluca, Ananiadou, Sofia, Ballestra, Mariano, De Sio, Antonio, Pota, Vincenzo, Cotoia, Antonella, Selva, Andrea Della, Bruni, Andrea, Iapichino, Giacomo, Bradić, Nikola, Corradi, Francesco, Gemma, Marco, Nogtev, Pavel, Petrova, Marina, Agrò, Felice Eugenio, Cabrini, Luca, Forfori, Francesco, Likhvantsev, Valery, Bove, Tiziana, Finco, Gabriele, Landoni, Giovanni, and Zangrillo, Alberto

Subjects
medicine.medical_specialty, Randomization, Critical Care, Antibiotic resistance, Critical patients, Critical Illness, Population, meropenem, intermitent or continuous infusion, critically ill, Intensive care unit, Meropenem, Mortality, Multi-drug resistant pathogens, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Sepsis, medicine, Clinical endpoint, polycyclic compounds, Humans, Pharmacology (medical), 030212 general & internal medicine, education, Antibacterial agent, education.field_of_study, 030505 public health, Septic shock, business.industry, Critical patient, General Medicine, medicine.disease, Anti-Bacterial Agents, Emergency medicine, 0305 other medical science, business, medicine.drug
Abstract

Objective Meropenem is a β-lactam, carbapenem antibacterial agent with antimicrobial activity against gram-negative, gram-positive and anaerobic micro-organisms and is important in the empirical treatment of serious infections in Intensive Care Unit (ICU) patients. Multi-drug resistant gram-negative organisms, coupled with scarcity of new antibiotic classes, forced healthcare community to optimize the therapeutic potential of available antibiotics. Our aim is to investigate the effect of continuous infusion of meropenem against bolus administration, as indicated by a composite outcome of reducing death and emergence of extensive or pan drug-resistant pathogens in a population of ICU patients. Design Double blind, double dummy, multicenter randomized controlled trial (1:1 allocation ratio). Setting Tertiary and University hospitals. Interventions 600 ICU patients with sepsis or septic shock, needing by clinical judgment antibiotic therapy with meropenem, will be randomized to receive a continuous infusion of meropenem 3 g/24 h or an equal dose divided into three daily boluses (i.e. 1g q8h). Measurements The primary endpoint will be a composite outcome of reducing death and emergence of extensive or pan drug-resistant pathogens. Secondary endpoints will be death from any cause at day 90, antibiotic-free days at day 28, ICU-free days at day 28, cumulative SOFA-free (Sequential Organ Failure Assessment) score from randomization to day 28 and the two, separate, components of the primary endpoint. We expect a primary outcome reduction from 52 to 40% in the continuous infusion group. Conclusions The trial will provide evidence for choosing intermittent or continuous infusion of meropenem for critically ill patients with multi-drug resistant gram-negative infections.

Published
2021

21. Clinical and neurophysiological serial assessments of brentuximab vedotin-associated peripheral neuropathy

Author

Marco Turatti, Fabio Benedetti, Cristina Tecchio, Guido Cavaletti, Marco Sorio, Salvatore Monaco, Sergio Ferrari, Laura Bertolasi, Maria Chiara Tozzi, Sara Mariotto, Mariotto, S, Tecchio, C, Sorio, M, Bertolasi, L, Turatti, M, Tozzi, M, Benedetti, F, Cavaletti, G, Monaco, S, and Ferrari, S

Subjects
Male, Cancer Research, peripheral neuropathy, CD30, assessment, adverse event, Pharmacology, chemistry.chemical_compound, 0302 clinical medicine, Antineoplastic Agents, Immunological, immune system diseases, hemic and lymphatic diseases, Medicine, Prospective Studies, Brentuximab vedotin, Brentuximab Vedotin, integumentary system, biology, Lymphoma, Non-Hodgkin, Peripheral Nervous System Diseases, Hematology, Middle Aged, Prognosis, Hodgkin Disease, Oncology, Monomethyl auristatin E, 030220 oncology & carcinogenesis, Female, Antibody, medicine.drug, Adult, brentuzimab vedotin, neurotoxicity, peripheral nerve, 03 medical and health sciences, Young Adult, Humans, Adverse effect, Aged, therapy, business.industry, brentuximab vedotin (BV), Neurotoxicity, medicine.disease, Peripheral neuropathy, chemistry, Cancer cell, biology.protein, Neoplasm Recurrence, Local, business, 030215 immunology, Follow-Up Studies
Abstract

Brentuximab vedotin (BV) is an anti-CD30 antibody acting against CD30+ cancer cells through the release of the conjugated microtubule-disrupting agent monomethyl auristatin E (MMAE). BV is currentl...

Published
2019

22. Hybrid arteriovenous graft for hemodialysis vascular access in a multicenter registry

Author

Filippo Benedetto, Domenico Spinelli, Narayana Pipitò, Mirko Menegolo, Matteo Tozzi, Michele Giubbolini, Umberto Marcello Bracale, Dalmazio Frigerio, Andrea Agostinucci, Antonino Scolaro, Angela Alibrandi, Carlo Pratesi, Carlo Setacci, Graziana Derone, Franco Grego, Marco Franchin, Gabriele Piffaretti, Patrizio Castelli, Walter Morale, Elena Giacomelli, Alessandro Alessi Innocenti, Giulia Mazzitelli, Giambattista Gagliardo, Benedetto, F., Spinelli, D., Pipito, N., Menegolo, M., Tozzi, M., Bracale, U. M., Frigerio, D., Agostinucci, A., Scolaro, A., Alibrandi, A., Pratesi, C., Setacci, C., Derone, G., Grego, F., Franchin, M., Piffaretti, G., Castelli, P., Morale, W., Giacomelli, E., Innocenti, A. A., Mazzitelli, G., Giubbolini, M., and Gagliardo, G.

Subjects
Male, medicine.medical_treatment, 030204 cardiovascular system & hematology, Prosthesis, 0302 clinical medicine, Interquartile range, Surgical, 80 and over, Vascular hybrid graft, 030212 general & internal medicine, Registries, Polytetrafluoroethylene, Aged, 80 and over, Nitinol-reinforced section, Patency, Arteriovenous Shunt, Arteriovenous graft, Hemodialysis, Middle Aged, Thrombosis, Female, Hemodialysi, Cardiology and Cardiovascular Medicine, Vascular Access Devices, Adult, medicine.medical_specialty, Vascular access, Prosthesis Design, 03 medical and health sciences, Young Adult, Arteriovenous Shunt, Surgical, Renal Dialysis, Diabetes mellitus, medicine, Humans, Vascular Patency, Aged, Retrospective Studies, business.industry, Proportional hazards model, Ptfe graft, medicine.disease, United States, Surgery, Blood Vessel Prosthesis, Arteriovenous graft, Hemodialysis, Nitinol-reinforced section, Patency, Vascular hybrid graft, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Polytetrafluoroethylene, Prosthesis Design, Retrospective Studies, United States, Vascular Patency, Young Adult, Arteriovenous Shunt, Surgical, Blood Vessel Prosthesis, Registries, Renal Dialysis, Vascular Access Devices, business
Abstract

The aim of our study was to identify patients' characteristics that predicted a higher chance of arteriovenous graft patency in patients undergoing Gore Hybrid Vascular Graft (GHVG; W. L. Gore & Associates, Flagstaff, Ariz) implantation for hemodialysis access. The GHVG is a polytetrafluroethylene (PTFE) prosthesis with a nitinol-reinforced section (NRS) at the venous end. METHODS: All consecutive patients undergoing GHVG implantation for hemodialysis access at 10 tertiary referral centers between December 2013 and January 2018 were included in the study and compared with a control group of patients undergoing standard PTFE graft implantation. Selection of patients for hybrid graft implantation was based on the impossibility of autogenous vascular access creation. RESULTS: There were 145 patients included in the GHVG group and 218 in the PTFE group. In the GHVG and the PTFE groups, the mean age was 67 ± 13 years and 65 ± 13 years, and male patients totaled 52% and 46%, respectively. The technical success was 99%. The mean duration of the intervention was 100 minutes (median, 95 minutes; interquartile range, 80-120 minutes). The brachial-axillary configuration was used in the majority of cases (n = 78 [54%]). The 5-cm NRS length was prevalent (n = 108 [75%]). The median NRS oversize was 14% (interquartile range, 0%-21%). Mean follow-up was 13 months (range, 0-55 months). Seventy-one patients (49%) underwent at least one reintervention. Primary, assisted primary, and secondary patency estimates at 12 months were 44% ± 5%, 47% ± 5%, and 65% ± 4% for the GHVG group and 41% ± 4%, 53% ± 4%, and 75% ± 3% for the control group, respectively (P = NS). One-year survival was 90% ± 3%. On multivariable Cox regression analysis, hypotension (P < .001; hazard ratio [HR], 5.8; confidence interval [CI], 2.6-13) and diabetes (P = .024; HR, 1.9; CI, 1.1-3.2) were significant predictors of GHVG loss. A larger graft size was protective against GHVG loss (P = .042; HR, 0.73; CI, 0.54-0.99). The 10-cm-long graft showed a tendency toward improved patency but did not reach statistical significance (P = .074; HR, 0.48; CI, 0.21-1.07). CONCLUSIONS: Diabetes and hypotension were predictors of loss of hybrid arteriovenous access. Smaller diameters of NRS were more prone to thrombosis, whereas the 10-cm length seemed to perform better than the 5-cm one.

Published
2019

23. A novel computational method for automatic segmentation, quantification and comparative analysis of immunohistochemically labeled tissue sections

Author

Antonello Villa, Elena Casiraghi, Matteo Tozzi, Licia Rivoltini, Barbara Vergani, Biagio Eugenio Leone, Marco Frasca, Mara Cossa, Veronica Huber, Casiraghi, E, Huber, V, Frasca, M, Cossa, M, Tozzi, M, Rivoltini, L, Leone, B, Villa, A, and Vergani, B

Subjects
0301 basic medicine, Support Vector Machine, Computer science, Image Processing, Biochemistry, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Computer-Assisted, Structural Biology, Histochemical and immunohistochemical image analysis, Digital image processing, Image Processing, Computer-Assisted, Segmentation, lcsh:QH301-705.5, Tumor, Comparative analysi, Applied Mathematics, Comparative analysis, Computer Science Applications1707 Computer Vision and Pattern Recognition, Immunohistochemistry, Histochemical and immunohistochemical image analysi, Computer Science Applications, Algorithm, Statistical analysis, lcsh:R858-859.7, Algorithms, Human, Supervised learning methods, Decision Tree, Statistical analysi, lcsh:Computer applications to medicine. Medical informatics, Intersection (Euclidean geometry), 03 medical and health sciences, Histogram, Biomarkers, Tumor, Humans, Computational Biology, Decision Trees, Software, Staining and Labeling, Molecular Biology, business.industry, Supervised learning, Pattern recognition, Support vector machine, 030104 developmental biology, Tissue sections, lcsh:Biology (General), Artificial intelligence, business, Supervised learning method, Biomarkers
Abstract

Background In the clinical practice, the objective quantification of histological results is essential not only to define objective and well-established protocols for diagnosis, treatment, and assessment, but also to ameliorate disease comprehension. Software The software MIAQuant_Learn presented in this work segments, quantifies and analyzes markers in histochemical and immunohistochemical images obtained by different biological procedures and imaging tools. MIAQuant_Learn employs supervised learning techniques to customize the marker segmentation process with respect to any marker color appearance. Our software expresses the location of the segmented markers with respect to regions of interest by mean-distance histograms, which are numerically compared by measuring their intersection. When contiguous tissue sections stained by different markers are available, MIAQuant_Learn aligns them and overlaps the segmented markers in a unique image enabling a visual comparative analysis of the spatial distribution of each marker (markers’ relative location). Additionally, it computes novel measures of markers’ co-existence in tissue volumes depending on their density. Conclusions Applications of MIAQuant_Learn in clinical research studies have proven its effectiveness as a fast and efficient tool for the automatic extraction, quantification and analysis of histological sections. It is robust with respect to several deficits caused by image acquisition systems and produces objective and reproducible results. Thanks to its flexibility, MIAQuant_Learn represents an important tool to be exploited in basic research where needs are constantly changing.

Published
2018

24. MIAQuant, a novel system for automatic segmentation, measurement, and localization comparison of different biomarkers from serialized histological slices

Author

Matteo Tozzi, Veronica Huber, Mara Cossa, Antonello Villa, Elena Casiraghi, Barbara Vergani, Licia Rivoltini, Casiraghi, E, Cossa, M, Huber, V, Tozzi, M, Rivoltini, L, Villa, A, and Vergani, B

Subjects
0301 basic medicine, Histology, Source code, Computer science, media_common.quotation_subject, Statistical analysi, Biophysics, Bioinformatics, digital image processing, 03 medical and health sciences, Automation, Software, statistical analysis, Robustness (computer science), Histochemical and immunohistochemical image analysis, Digital image processing, Humans, MATLAB, Artificial intelligence, Statistical analysis, Cell Biology, lcsh:QH301-705.5, computer.programming_language, media_common, Commercial software, Original Paper, Staining and Labeling, business.industry, Visual comparison, Pattern recognition, artificial intelligence, Histochemical and immunohistochemical image analysi, 030104 developmental biology, Biophysic, lcsh:Biology (General), Chromogenic Compounds, business, computer, Biomarkers
Abstract

In the clinical practice, automatic image analysis methods quickly quantizing histological results by objective and replicable methods are getting more and more necessary and widespread. Despite several commercial software products are available for this task, they are very little flexible, and provided as black boxes without modifiable source code. To overcome the aforementioned problems, we employed the commonly used MATLAB platform to develop an automatic method, MIAQuant, for the analysis of histochemical and immunohistochemical images, stained with various methods and acquired by different tools. It automatically extracts and quantifies markers characterized by various colors and shapes; furthermore, it aligns contiguous tissue slices stained by different markers and overlaps them with differing colors for visual comparison of their localization. Application of MIAQuant for clinical research fields, such as oncology and cardiovascular disease studies, has proven its efficacy, robustness and flexibility with respect to various problems; we highlight that, the flexibility of MIAQuant makes it an important tool to be exploited for basic researches where needs are constantly changing. MIAQuant software and its user manual are freely available for clinical studies, pathological research, and diagnosis.

Published
2017

25. Endovascular repair of a pseudo-aneurysm of the common femoral artery after revision total hip arthroplasty

Author

Roberto Caronno, Fabio D'Angelo, Patrizio Castelli, Gianpaolo Carrafiello, Gabriele Piffaretti, G. Zatti, Matteo Tozzi, D'Angelo, F, Piffaretti, G, Carrafiello, G, Tozzi, M, Caronno, R, Castelli, P, and Zatti, G

Subjects
Reoperation, medicine.medical_specialty, Arthroplasty, Replacement, Hip, medicine.medical_treatment, Femoral artery, Blood Vessel Prosthesis Implantation, Postoperative Complications, medicine.artery, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Device Removal, Coil embolization, business.industry, Endovascular repair, Pseudo-aneurysm, Total hip arthroplasty, Angiography, Digital Subtraction, Stent, Middle Aged, Pseudo aneurysm, MED/33 - MALATTIE APPARATO LOCOMOTORE, Surgery, Femoral Artery, surgical procedures, operative, Arterial haemorrhage, Emergency Medicine, Female, Stents, Radiology, business, Aneurysm, False, Total hip arthroplasty
Abstract

Vascular injuries with acute arterial haemorrhage are rare but the infrequency of these complications may make their diagnosis and treatment challenging for surgeons unfamiliar with their management. In the past, surgery or coil embolisation has been used to treat these lesions; we describe the case of a pseudo-aneurysm of the common femoral artery developed during a total hip arthroplasty, promptly managed with an endovascular stent graft.

Published
2007

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