Author: "Antonello Pietrangelo" / Topic: internal medicine - Searchworks@Jio Institute Digital Library Search Results

Your search keyword '"Antonello Pietrangelo"' showing total 109 results

Start Over Author "Antonello Pietrangelo" Topic internal medicine

109 results on '"Antonello Pietrangelo"'

1. An unusual dyspnea in an 87-year old woman affected by Sjögren’s syndrome

Author: Carlo Grendene, Anna Francesca Guerra, Stefania Cerri, Antonello Pietrangelo, and Massimo Fiorini
Subjects: sjögren, lymphocytic, interstitial, pneumonia, cysts, Internal medicine, RC31-1245
Abstract: Primary Sjögren’s syndrome (pSS) is a progressive autoimmune disease and is characterized by eye and mouth dryness due to lymphocytic infiltration in lacrimal and salivary glands leading to tissue destruction, but it can also present systemic manifestations including lung involvement. Respiratory manifestations in pSS have a prevalence of 9-20% and can be due to airway and/or lung parenchyma involvement, such as in particular in interstitial lung diseases like lymphocytic interstitial pneumonia (LIP). LIP is an inflammatory diffuse parenchymal lung disease, which is almost invariably associated with other conditions, such as autoimmune diseases and immunodeficiency states, and usually affects women with a mean age of 50 years. We described a case of patient with LIP who was referred to our Internal Medicine Unit and the diagnostic issues related to the patient age and comorbidities.
Published: 2021
Full Text: View/download PDF

2. The impact of COVID-19 pandemic on well-being of Italian physicians: a report from the Italian Society of Internal Medicine (SIMI) national survey

Author: Giulio Francesco, Romiti, Leonardo, Bencivenga, Rosanna, Villani, Sebastiano, Cicco, Antonio, Cimellaro, Andrea, Dalbeni, Giovanni, Talerico, Antonello, Pietrangelo, Giorgio, Sesti, and Vincenzo, Zaccone
Subjects: sars-cov-2, covid-19, well-being, work-related stress, Emergency Medicine, Internal Medicine, healthcare
Abstract: Over the past few years, COVID-19 pandemic has imposed a high toll worldwide, with a high burden of morbidity and mortality. Healthcare practitioners (HCPs) have been in the frontline since the beginning of the outbreak, and the high level of stress have affected their physical and mental status, as well as their relationships. We aimed at exploring the self-reported changes in comprehensive well-being in a cohort of Italian physicians. An online-based survey was administered to the members of the Italian Society of Internal Medicine (SIMI) between March and June 2021. The survey was based on 32 multiple-choice questions exploring self-reported physical and mental well-being, as well as changes in workloads, work-related feelings and physicians’ relationship with patients, colleagues and families. 228 physicians (mean age: 35.7 ± 9.8 years) participated in the survey; 120 (52.6%) were residents, 196 (86.0%) worked in COVID-19 units and 65 (28.5%) had COVID-19 during the pandemic. A significant proportion of respondents reported to have experience onset or worsening of physical and mental symptoms, with insomnia/sleep disorders (58.3%) and mood swings (47.8%) being the most common, respectively. The burden of physical and mental consequences was broadly higher among residents compared to specialists, with the former reporting more frequently an increase in the number of worked hours (p = 0.020) and being more frequently infected with COVID-19 (35.0% vs. 21.3, p = 0.032). Moreover, familiar and doctor–patient relationships were also considerably affected. Physicians have been suffering a wide spectrum of physical, mental and relational consequences during COVID-19 pandemic, with youngest doctors being more likely to present several physical and mental health symptoms. Further studies are needed to evaluate long-term consequences of COVID-19 pandemic on the well-being of HCPs, and potential preventive strategies.
Published: 2022

3. Better prognosis in females with severe COVID-19 pneumonia: possible role of inflammation as potential mediator

Author: Cristina Mussini, Alessandro Cozzi-Lepri, Marianna Menozzi, Marianna Meschiari, Erica Franceschini, Carlotta Rogati, Gianluca Cuomo, Andrea Bedini, Vittorio Iadisernia, Sara Volpi, Jovana Milic, Roberto Tonelli, Lucio Brugioni, Antonello Pietrangelo, Massimo Girardis, Andrea Cossarizza, Enrico Clini, Giovanni Guaraldi, Erica Bacca, Vanni Borghi, Giulia Burastero, Federica Carli, Giacomo Ciusa, Luca Corradi, Margherita Di Gaetano, Matteo Faltoni, Giacomo Franceschi, Gabriella Orlando, Francesco Pellegrino, Cinzia Puzzolante, Alessandro Raimondi, Antonella Santoro, Marco Tutone, Dina Yaacoub, Alberto Andreotti, Emanuela Biagioni, Filippo Bondi, Stefano Busani, Giovanni Chierego, Marzia Scotti, Lucia Serio, Caterina Bellinazzi, Rebecca Borella, Sara De Biasi, Anna De Gaetano, Lucia Fidanza, Lara Gibellini, Anna Iannone, Domenico Lo Tartaro, Marco Mattioli, Annamaria Paolini, Rossella Fogliani, Grazia Righini, and Mario Lugli
Subjects: Male, sex differences, 0301 basic medicine, Microbiology (medical), Mediation (statistics), medicine.medical_specialty, medicine.medical_treatment, 030106 microbiology, Context (language use), Pathogenesis, Cohort Studies, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Risk Factors, Internal medicine, Humans, Medicine, 030212 general & internal medicine, Respiratory system, female sex, Survival analysis, Aged, Retrospective Studies, Inflammation, Mechanical ventilation, SARS-CoV-2, business.industry, Absolute risk reduction, COVID-19, General Medicine, Middle Aged, Prognosis, medicine.disease, Respiration, Artificial, Hospitalization, Pneumonia, Infectious Diseases, SARS-CoV-2, COVID-19, female sex, prognosis, inflammation, inflammation, Commentary, Female, prognosis, CRP, business, Cohort study
Abstract: Objectives Sex differences in COVID-19 severity and mortality have been described. Key aims of this analysis were to compare the risk of invasive mechanical ventilation (IMV) and mortality by sex and to explore whether variation in specific biomarkers could mediate this difference. Methods This was a retrospective, observational cohort study among patients with severe COVID-19 pneumonia. A survival analysis was conducted to compare time to the composite endpoint of IMV or death by sex. Interaction was formally tested to compare the risk difference by sex in subsets. Mediation analysis with a binary endpoint IMV or death (yes/no) by end of follow-up for a number of inflammation/coagulation biomarkers in the context of counterfactual prediction was also conducted. Results Among 415 patients, 134 were females (32%) and 281 males (67%), median age 66 years (IQR 54-77). At admission, females showed a significantly less severe clinical and respiratory profiles with a higher PaO2/FiO2 (254 mmHg vs 191 mmHg; p=0.023). By 28 days from admission, 49.2% (95% CI: 39.6-58.9%) of males vs. 31.7% (17.9-45.4%) of females underwent IMV or death (log-rank p-value Conclusions Our analysis confirms a difference in the risk of COVID-19 clinical progression by sex and provides a hypothesis for potential mechanisms leading to this. CRP showed a predominant role to mediate the difference in risk by sex.
Published: 2021

4. Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry

Author: Salvatore, Corrao, Alessandro, Nobili, Giuseppe, Natoli, Pier Mannuccio Mannucci, Francesco, Perticone, Antonello, Pietrangelo, Christiano, Argano, Giuseppe, Licata, Francesco, Violi, Gino Roberto Corazza, Alessandra, Marengoni, Francesco, Salerno, Matteo, Cesari, Mauro, Tettamanti, Luca, Pasina, Carlotta, Franchi, Laura, Cortesi, Gabriella, Miglio, Ilaria, Ardoino, Alessio, Novella, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Cenci, Caterina, Gianni, Biolo, Michela, Zanetti, Martina, Guadagni, Michele, Zaccari, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Graziana, Lupattelli, Elmo, Mannarino, Vanessa, Bianconi, Francesco, Paciullo, Riccardo, Alcidi, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Floriana, Cocita, Vincenza, Beneduce, Lidia, Plances, Salvatore, Mularo, Massimo, Raspanti, Marco, Zoli, Ilaria, Lazzari, Mattia, Brunori, Elisa, Fabbri, Donatella, Magalotti, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Giuseppe, Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Diletta, Maira, Valeria Di Stefano, Giovanna, Fabio, Sonia, Seghezzi, Marta, Mancarella, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Paolo Dionigi Rossi, Sarah, Damanti, Marta, Clerici, Federica, Conti, Giulia, Bonini, Barbara Brignolo Ottolini, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Emanuele, Valeriani, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Chiara, Pes, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Gabriella, D'Aurizio, Giuseppe, Romanelli, Alberto, Zucchelli, Francesca, Manzoni, Andrea, Volpini, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Chiara, Dell'Unto, Giorgio, Annoni, Maurizio, Corsi, Giuseppe, Bellelli, Sara, Zazzetta, Paolo, Mazzola, Hajnalka, Szabo, Alessandra, Bonfanti, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Bruno, Tassone, Giorgio, Sesti, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Antonio, Brucato, Silvia, Ghidoni, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Elisabetta, Cosi, Paolo, Scarinzi, Annalisa, Amabile, Elisabetta, Omenetto, Tancredi, Prandini, Manfredini, Roberto, Fabbian, Fabio, Boari, Benedetta, DE GIORGI, Alfredo, Tiseo, Ruana, DE GIORGIO, Roberto, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Andrea, Schilardi, Francesca, Loparco, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Luigi, Fenoglio, Andrea, Falcetta, Christian, Bracco, Anna, L Fracanzani Silvia Fargion, Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Raffaella, Rossio, Barbara, Ferrari, Giulia, Colombo, Pasquale, Agosti, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Giuliana, Ceriani, Giada, Pallini, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Lara, Caserza, Kassem, Salam, Nicola Lucio Liberato, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Elena, Spazzini, Camillo, Ferrandina, Giuseppe, Montrucchio, Paolo, Petitti, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Raffaella, Salmi, Piergiorgio, Gaudenzi, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Giulia, Dondi, Elisa, Pellegrini, Lucia, Carulli, Matteo, Galassi, Yasmine, Grassi, Maria, Perticone, Rosa, Battaglia, Marco, Filice, Raffaele, Maio, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara Del Vecchio, Andrea, Salvi, Roberto, Leonardi, Giampaolo, Damiani, William, Capeci, Armando, Gabrielli, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Riccardo, Ghio, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Samuele, Pignataro, Alfio, Gennaro, Julien, Blanco, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Carlo, Vigorito, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesca, Gasparini, Silvia, Prolo, Gloria, Pina, Alberto, Ballestrero, Fabio, Ferrando, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella, Gruden, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Giuseppe, Scattolin, Sergio, Martinelli, Mauro, Turrin, Leonardo, Sechi, Cristina, Catena, Gianluca, Colussi, Nicola, Passariello, Luca, Rinaldi, Franco, Berti, Giuseppe, Famularo, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta, Morganti, Andrea, Artoni, Stefano Del Giacco, Davide, Firinu, Francesca, Losa, Giovanni, Paoletti, Giulia, Costanzo, Giuseppe, Montalto, Anna, Licata, Valentina, Malerba, Filippo Alessandro Montalto, Antonino, Lasco, Giorgio, Basile, Antonino, Catalano, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Fulvio, Lauretani, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, Giorgio, Scanzi, Caterina, Mengoli, Stella, Provini, Laura, Ricevuti, Emilio, Simeone, Rosa, Scurti, Fabio, Tolloso, Roberto, Tarquini, Alice, Valoriani, Silvia, Dolenti, Giulia, Vannini, Alberto, Tedeschi, Lucia, Trotta, Riccardo, Volpi, Pietro, Bocchi, Alessandro, Vignali, Sergio, Harari, Chiara, Lonati, Mara, Cattaneo, Federico, Napoli., Corrao S, Nobili A, Natoli G, Mannucci PM, Perticone F, Pietrangelo A, Argano C, REPOSI Investigator, Borghi C, Corrao S., Nobili A., Natoli G., Mannucci P.M., Perticone F., Pietrangelo A., Argano C., Licata G., Violi F., Corazza G.R., Marengoni A., Salerno F., Cesari M., Tettamanti M., Pasina L., Franchi C., Cortesi L., Miglio G., Ardoino I., Novella A., Prisco D., Silvestri E., Emmi G., Bettiol A., Caterina C., Biolo G., Zanetti M., Guadagni M., Zaccari M., Chiuch M., Vanoli M., Grignani G., Pulixi E.A., Bernardi M., Bassi S.L., Santi L., Zaccherini G., Lupattelli G., Mannarino E., Bianconi V., Paciullo F., Alcidi R., Nuti R., Valenti R., Ruvio M., Cappelli S., Palazzuoli A., Girelli D., Busti F., Marchi G., Barbagallo M., Dominguez L., Cocita F., Beneduce V., Plances L., Mularo S., Raspanti M., Zoli M., Lazzari I., Brunori M., Fabbri E., Magalotti D., Arno R., Pasini F.L., Capecchi P.L., Palasciano G., Modeo M.E., Di Gennaro C., Cappellini M.D., Maira D., Di Stefano V., Fabio G., Seghezzi S., Mancarella M., De Amicis M.M., De Luca G., Scaramellini N., Rossi P.D., Damanti S., Clerici M., Conti F., Bonini G., Ottolini B.B., Di Sabatino A., Miceli E., Lenti M.V., Pisati M., Dominioni C.C., Murialdo G., Marra A., Cattaneo F., Pontremoli R., Beccati V., Nobili G., Secchi M.B., Ghelfi D., Anastasio L., Sofia L., Carbone M., Cipollone F., Guagnano M.T., Valeriani E., Rossi I., Mancuso G., Calipari D., Bartone M., Delitala G., Berria M., Pes C., Delitala A., Muscaritoli M., Molfino A., Petrillo E., Zuccala G., D'Aurizio G., Romanelli G., Zucchelli A., Manzoni F., Volpini A., Picardi A., Gentilucci U.V., Gallo P., Dell'Unto C., Annoni G., Corsi M., Bellelli G., Zazzetta S., Mazzola P., Szabo H., Bonfanti A., Arturi F., Succurro E., Rubino M., Tassone B., Sesti G., Serra M.G., Bleve M.A., Gasbarrone L., Sajeva M.R., Brucato A., Ghidoni S., Fabris F., Bertozzi I., Bogoni G., Rabuini M.V., Cosi E., Scarinzi P., Amabile A., Omenetto E., Prandini T., Manfredini R., Fabbian F., Boari B., De Giorgi A., Tiseo R., De Giorgio R., Paolisso G., Rizzo M.R., Borghi C., Strocchi E., Ianniello E., Soldati M., Sabba C., Vella F.S., Suppressa P., Schilardi A., Loparco F., De Vincenzo G.M., Comitangelo A., Amoruso E., Fenoglio L., Falcetta A., Bracco C., Fargion A.L.F.S., Tiraboschi S., Cespiati A., Oberti G., Sigon G., Peyvandi F., Rossio R., Ferrari B., Colombo G., Agosti P., Monzani V., Savojardo V., Folli C., Ceriani G., Pallini G., Dallegri F., Ottonello L., Liberale L., Caserza L., Salam K., Liberato N.L., Tognin T., Bianchi G.B., Giaquinto S., Purrello F., Di Pino A., Piro S., Rozzini R., Falanga L., Spazzini E., Ferrandina C., Montrucchio G., Petitti P., Peasso P., Favale E., Poletto C., Salmi R., Gaudenzi P., Perri L., Landolfi R., Montalto M., Mirijello A., Guasti L., Castiglioni L., Maresca A., Squizzato A., Campiotti L., Grossi A., Bertolotti M., Mussi C., Lancellotti G., Libbra M.V., Dondi G., Pellegrini E., Carulli L., Galassi M., Grassi Y., Perticone M., Battaglia R., FIlice M., Maio R., Stanghellini V., Ruggeri E., del Vecchio S., Salvi A., Leonardi R., Damiani G., Capeci W., Gabrielli A., Mattioli M., Martino G.P., Biondi L., Pettinari P., Ghio R., Col A.D., Minisola S., Colangelo L., Cilli M., Labbadia G., Afeltra A., Marigliano B., Pipita M.E., Castellino P., Zanoli L., Pignataro S., Gennaro A., Blanco J., Saracco V., Fogliati M., Bussolino C., Mete F., Gino M., Cittadini A., Vigorito C., Arcopinto M., Salzano A., Bobbio E., Marra A.M., Sirico D., Moreo G., Gasparini F., Prolo S., Pina G., Ballestrero A., Ferrando F., Berra S., Dassi S., Nava M.C., Graziella B., Baldassarre S., Fragapani S., Gruden G., Galanti G., Mascherini G., Petri C., Stefani L., Girino M., Piccinelli V., Nasso F., Gioffre V., Pasquale M., Scattolin G., Martinelli S., Turrin M., Sechi L., Catena C., Colussi G., Passariello N., Rinaldi L., Berti F., Famularo G., Tarsitani P., Castello R., Pasino M., Ceda G.P., Maggio M.G., Morganti S., Artoni A., Del Giacco S., Firinu D., Losa F., Paoletti G., Costanzo G., Montalto G., Licata A., Malerba V., Montalto F.A., Lasco A., Basile G., Catalano A., Malatino L., Stancanelli B., Terranova V., Di Marca S., Di Quattro R., La Malfa L., Caruso R., Mecocci P., Ruggiero C., Boccardi V., Meschi T., Lauretani F., Ticinesi A., Nouvenne A., Minuz P., Fondrieschi L., Pirisi M., Fra G.P., Sola D., Porta M., Riva P., Quadri R., Larovere E., Novelli M., Scanzi G., Mengoli C., Provini S., Ricevuti L., Simeone E., Scurti R., Tolloso F., Tarquini R., Valoriani A., Dolenti S., Vannini G., Tedeschi A., Trotta L., Volpi R., Bocchi P., Vignali A., Harari S., Lonati C., Cattaneo M., Napoli F., Corrao, S., Nobili, A., Natoli, G., Mannucci, P. M., Perticone, F., Pietrangelo, A., Argano, C., Licata, G., Violi, F., Corazza, G. R., Marengoni, A., Salerno, F., Cesari, M., Tettamanti, M., Pasina, L., Franchi, C., Cortesi, L., Miglio, G., Ardoino, I., Novella, A., Prisco, D., Silvestri, E., Emmi, G., Bettiol, A., Caterina, C., Biolo, G., Zanetti, M., Guadagni, M., Zaccari, M., Chiuch, M., Vanoli, M., Grignani, G., Pulixi, E. A., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Lupattelli, G., Mannarino, E., Bianconi, V., Paciullo, F., Alcidi, R., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Girelli, D., Busti, F., Marchi, G., Barbagallo, M., Dominguez, L., Cocita, F., Beneduce, V., Plances, L., Mularo, S., Raspanti, M., Zoli, M., Lazzari, I., Brunori, M., Fabbri, E., Magalotti, D., Arno, R., Pasini, F. L., Capecchi, P. L., Palasciano, G., Modeo, M. E., Di Gennaro, C., Cappellini, M. D., Maira, D., Di Stefano, V., Fabio, G., Seghezzi, S., Mancarella, M., De Amicis, M. M., De Luca, G., Scaramellini, N., Rossi, P. D., Damanti, S., Clerici, M., Conti, F., Bonini, G., Ottolini, B. B., Di Sabatino, A., Miceli, E., Lenti, M. V., Pisati, M., Dominioni, C. C., Murialdo, G., Marra, A., Cattaneo, F., Pontremoli, R., Beccati, V., Nobili, G., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Cipollone, F., Guagnano, M. T., Valeriani, E., Rossi, I., Mancuso, G., Calipari, D., Bartone, M., Delitala, G., Berria, M., Pes, C., Delitala, A., Muscaritoli, M., Molfino, A., Petrillo, E., Zuccala, G., D'Aurizio, G., Romanelli, G., Zucchelli, A., Manzoni, F., Volpini, A., Picardi, A., Gentilucci, U. V., Gallo, P., Dell'Unto, C., Annoni, G., Corsi, M., Bellelli, G., Zazzetta, S., Mazzola, P., Szabo, H., Bonfanti, A., Arturi, F., Succurro, E., Rubino, M., Tassone, B., Sesti, G., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Fabris, F., Bertozzi, I., Bogoni, G., Rabuini, M. V., Cosi, E., Scarinzi, P., Amabile, A., Omenetto, E., Prandini, T., Manfredini, R., Fabbian, F., Boari, B., De Giorgi, A., Tiseo, R., De Giorgio, R., Paolisso, G., Rizzo, M. R., Borghi, C., Strocchi, E., Ianniello, E., Soldati, M., Sabba, C., Vella, F. S., Suppressa, P., Schilardi, A., Loparco, F., De Vincenzo, G. M., Comitangelo, A., Amoruso, E., Fenoglio, L., Falcetta, A., Bracco, C., Fargion, A. L. F. S., Tiraboschi, S., Cespiati, A., Oberti, G., Sigon, G., Peyvandi, F., Rossio, R., Ferrari, B., Colombo, G., Agosti, P., Monzani, V., Savojardo, V., Folli, C., Ceriani, G., Pallini, G., Dallegri, F., Ottonello, L., Liberale, L., Caserza, L., Salam, K., Liberato, N. L., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Ferrandina, C., Montrucchio, G., Petitti, P., Peasso, P., Favale, E., Poletto, C., Salmi, R., Gaudenzi, P., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Campiotti, L., Grossi, A., Bertolotti, M., Mussi, C., Lancellotti, G., Libbra, M. V., Dondi, G., Pellegrini, E., Carulli, L., Galassi, M., Grassi, Y., Perticone, M., Battaglia, R., Filice, M., Maio, R., Stanghellini, V., Ruggeri, E., del Vecchio, S., Salvi, A., Leonardi, R., Damiani, G., Capeci, W., Gabrielli, A., Mattioli, M., Martino, G. P., Biondi, L., Pettinari, P., Ghio, R., Col, A. D., Minisola, S., Colangelo, L., Cilli, M., Labbadia, G., Afeltra, A., Marigliano, B., Pipita, M. E., Castellino, P., Zanoli, L., Pignataro, S., Gennaro, A., Blanco, J., Saracco, V., Fogliati, M., Bussolino, C., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Gasparini, F., Prolo, S., Pina, G., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Gruden, G., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Passariello, N., Rinaldi, L., Berti, F., Famularo, G., Tarsitani, P., Castello, R., Pasino, M., Ceda, G. P., Maggio, M. G., Morganti, S., Artoni, A., Del Giacco, S., Firinu, D., Losa, F., Paoletti, G., Costanzo, G., Montalto, G., Licata, A., Malerba, V., Montalto, F. A., Lasco, A., Basile, G., Catalano, A., Malatino, L., Stancanelli, B., Terranova, V., Di Marca, S., Di Quattro, R., La Malfa, L., Caruso, R., Mecocci, P., Ruggiero, C., Boccardi, V., Meschi, T., Lauretani, F., Ticinesi, A., Nouvenne, A., Minuz, P., Fondrieschi, L., Pirisi, M., Fra, G. P., Sola, D., Porta, M., Riva, P., Quadri, R., Larovere, E., Novelli, M., Scanzi, G., Mengoli, C., Provini, S., Ricevuti, L., Simeone, E., Scurti, R., Tolloso, F., Tarquini, R., Valoriani, A., Dolenti, S., Vannini, G., Tedeschi, A., Trotta, L., Volpi, R., Bocchi, P., Vignali, A., Harari, S., Lonati, C., Cattaneo, M., Napoli, F., Corrao, S, Nobili, A, Natoli, G, Mannucci, P, Perticone, F, Pietrangelo, A, Argano, C, Licata, G, Violi, F, Corazza, G, Marengoni, A, Salerno, F, Cesari, M, Tettamanti, M, Pasina, L, Franchi, C, Cortesi, L, Miglio, G, Ardoino, I, Novella, A, Prisco, D, Silvestri, E, Emmi, G, Bettiol, A, Caterina, C, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Chiuch, M, Vanoli, M, Grignani, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Lupattelli, G, Mannarino, E, Bianconi, V, Paciullo, F, Alcidi, R, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Girelli, D, Busti, F, Marchi, G, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Mularo, S, Raspanti, M, Zoli, M, Lazzari, I, Brunori, M, Fabbri, E, Magalotti, D, Arno, R, Pasini, F, Capecchi, P, Palasciano, G, Modeo, M, Di Gennaro, C, Cappellini, M, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, De Amicis, M, De Luca, G, Scaramellini, N, Rossi, P, Damanti, S, Clerici, M, Conti, F, Bonini, G, Ottolini, B, Di Sabatino, A, Miceli, E, Lenti, M, Pisati, M, Dominioni, C, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Beccati, V, Nobili, G, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, M, Valeriani, E, Rossi, I, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Pes, C, Delitala, A, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccala, G, D'Aurizio, G, Romanelli, G, Zucchelli, A, Manzoni, F, Volpini, A, Picardi, A, Gentilucci, U, Gallo, P, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Tassone, B, Sesti, G, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, M, Cosi, E, Scarinzi, P, Amabile, A, Omenetto, E, Prandini, T, Manfredini, R, Fabbian, F, Boari, B, De Giorgi, A, Tiseo, R, De Giorgio, R, Paolisso, G, Rizzo, M, Borghi, C, Strocchi, E, Ianniello, E, Soldati, M, Sabba, C, Vella, F, Suppressa, P, Schilardi, A, Loparco, F, De Vincenzo, G, Comitangelo, A, Amoruso, E, Fenoglio, L, Falcetta, A, Bracco, C, Fargion, A, Tiraboschi, S, Cespiati, A, Oberti, G, Sigon, G, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Agosti, P, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, N, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Peasso, P, Favale, E, Poletto, C, Salmi, R, Gaudenzi, P, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Campiotti, L, Grossi, A, Bertolotti, M, Mussi, C, Lancellotti, G, Libbra, M, Dondi, G, Pellegrini, E, Carulli, L, Galassi, M, Grassi, Y, Perticone, M, Battaglia, R, Filice, M, Maio, R, Stanghellini, V, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Capeci, W, Gabrielli, A, Mattioli, M, Martino, G, Biondi, L, Pettinari, P, Ghio, R, Col, A, Minisola, S, Colangelo, L, Cilli, M, Labbadia, G, Afeltra, A, Marigliano, B, Pipita, M, Castellino, P, Zanoli, L, Pignataro, S, Gennaro, A, Blanco, J, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffre, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Tarsitani, P, Castello, R, Pasino, M, Ceda, G, Maggio, M, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Costanzo, G, Montalto, G, Licata, A, Malerba, V, Montalto, F, Lasco, A, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Di Quattro, R, La Malfa, L, Caruso, R, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Nouvenne, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, G, Sola, D, Porta, M, Riva, P, Quadri, R, Larovere, E, Novelli, M, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, Harari, S, Lonati, C, Cattaneo, M, and Napoli, F
Subjects: Registrie, Male, Comorbidity, Diabetes, Disability, Elderly, Hyperglycemia, Mortality, Aged, Aged, 80 and over, Female, Hospital Mortality, Hospitals, Humans, Internal Medicine, Registries, Hospitalization, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Socio-culturale, Renal function, 030204 cardiovascular system & hematology, Diabete, Hospital, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Rating scale, Internal medicine, Diabetes mellitus, 80 and over, medicine, LS4_4, 030212 general & internal medicine, Class III obesity, business.industry, Mortality rate, Comorbidity, Diabetes, Disability, Elderly, Hyperglycemia, Mortality, General Medicine, medicine.disease, Mood disorders, Geriatric Depression Scale, Original Article, business, Human
Abstract: Aims The association between hyperglycemia at hospital admission and relevant short- and long-term outcomes in elderly population is known. We assessed the effects on mortality of hyperglycemia, disability, and multimorbidity at admission in internal medicine ward in patients aged ≥ 65 years. Methods Data were collected from an active register of 102 internal medicine and geriatric wards in Italy (RePoSi project). Patients were recruited during four index weeks of a year. Socio-demographic data, reason for hospitalization, diagnoses, treatment, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), renal function, functional (Barthel Index), and cognitive status (Short Blessed Test) and mood disorders (Geriatric Depression Scale) were recorded. Mortality rates were assessed in hospital 3 and 12 months after discharge. Results Of the 4714 elderly patients hospitalized, 361 had a glycemia level ≥ 250 mg/dL at admission. Compared to subjects with lower glycemia level, patients with glycemia ≥ 250 mg/dL showed higher rates of male sex, smoke and class III obesity. These patients had a significantly lower Barthel Index (p = 0.0249), higher CIRS-SI and CIRS-CI scores (p = 0.0025 and p = 0.0013, respectively), and took more drugs. In-hospital mortality rate was 9.2% and 5.1% in subjects with glycemia ≥ 250 and p = 0.0010). Regression analysis showed a strong association between in-hospital death and glycemia ≥ 250 mg/dL (OR 2.07; [95% CI 1.34–3.19]), Barthel Index ≤ 40 (3.28[2.44–4.42]), CIRS-SI (1.87[1.27–2.77]), and male sex (1.54[1.16–2.03]). Conclusions The stronger predictors of in-hospital mortality for older patients admitted in general wards were glycemia level ≥ 250 mg/dL, Barthel Index ≤ 40, CIRS-SI, and male sex.
Published: 2021

5. Phenotyping congestion in patients with acutely decompensated heart failure with preserved and reduced ejection fraction: The Decongestion duRing therapY for acute decOmpensated heart failure in HFpEF vs HFrEF- DRY-OFF study

Author: Massimo Salvetti, Tiziano Perrone, A Pitino, M.L. Muiesan, Antonello Pietrangelo, Elisa Maria Fiorelli, Federica Leidi, Elisa Ceriani, Patrizia Suppressa, M Gori, G De Matteis, Chiara Cogliati, Giovanni Tripepi, Stefano Perlini, Giovanni Gambassi, Carlo Sabbà, F Ferrara, Anna Ludovica Fracanzani, and Nicola Montano
Subjects: medicine.medical_specialty, Acute decompensated heart failure, medicine.medical_treatment, Population, Renal function, Acutely decompensated heart failure, Inferior vena cava, Pulmonary congestion, Reduced ejection fraction, Internal medicine, Internal Medicine, medicine, Humans, Prospective Studies, education, Prospective cohort study, Diuretics, Intravascular congestion, Lung ultrasound, Preserved ejection fraction, Hospitalization, Prognosis, Stroke Volume, Heart Failure, education.field_of_study, Ejection fraction, business.industry, medicine.disease, medicine.vein, Heart failure, Cardiology, Diuretic, business
Abstract: AIMS To evaluate pulmonary and intravascular congestion at admission and repeatedly during hospitalization for acute decompensated heart failure (ADHF) in HFrEF and HFpEF patients using lung (LUS) and inferior vena cava (IVC) ultrasound. METHODS AND RESULTS Three-hundred-fourteen patients (82±9 years; HFpEF =172; HFrEF=142) admitted to Internal Medicine wards for ADHF were enrolled in a multi-center prospective study. At admission HFrEF presented higher indexes of pulmonary and intravascular congestion (LUS-score: 0.9 ± 0.4 vs 0.7 ± 0.4; p
Published: 2022

6. Internists or specialists-that is the question!

Author: Antonello Pietrangelo
Subjects: Humans, Internal Medicine, Physicians, Specialization
Published: 2022

7. Hyperhomocysteinemia in patients with acute porphyrias: a possible effect of ALAS1 modulation by siRNAm therapy and its control by vitamin supplementation

Author: Matteo Marcacci, Antonello Pietrangelo, Andrea Ricci, Paolo Ventura, and Chiara Cuoghi
Subjects: medicine.medical_specialty, Hyperhomocysteinemia, Homocysteine, Heme, chemistry.chemical_compound, Folic Acid, Internal medicine, Internal Medicine, Medicine, Humans, In patient, Givosiran, Vitamin supplementation, business.industry, ALAS1 siRNAm, Vitamins, medicine.disease, ALAS1, Acute porphyrias, Vitamin B 12, Endocrinology, Vitamin B6, chemistry, Porphyria, Acute Intermittent, Dietary Supplements, Vitamin b6, business
Published: 2021

8. Renal Function, Cardiovascular Diseases, Appropriateness of Drug Prescription and Outcomes in Hospitalized Older Patients

Author: Antonietta, Gigante, Marco, Proietti, Enrico, Petrillo, Pier Mannuccio Mannucci, Alessandro, Nobili, Maurizio, Muscaritoli, Antonello, Pietrangelo, Francesco, Perticone, Francesco, Violi, Gino Roberto Corazza, Salvatore, Corrao, Alessandra, Marengoni, Francesco, Salerno, Matteo, Cesari, Mauro, Tettamanti, Luca, Pasina, Carlotta, Franchi, Laura, Cortesi, Gabriella, Miglio, Ilaria, Ardoino, Alessio, Novella, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Irene, Mattioli, Gianni, Biolo, Michela, Zanetti, Giacomo, Bartelloni, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Graziana, Lupattelli, Vanessa, Bianconi, Riccardo, Alcidi, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Vincenza, Beneduce, Federica, Cacioppo, Giuseppe, Natoli, Salvatore, Mularo, Massimo, Raspanti, Marco, Zoli, Maria Laura Matacena, Giuseppe, Orio, Eleonora, Magnolfi, Giovanni, Serafini, Angelo, Simili, Giuseppe, Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Giovanna, Fabio, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Paolo Dionigi Rossi, Sarah, Damanti, Marta, Clerici, Simona, Leoni, Alessandra Danuta Di Mauro, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Giovanna, Leoncini, Luigi, Anastasio, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Alessandro, Delitala, Alessio, Molfino, Antonella, Giorgi, Christian, Gracian, Giuseppe, Zuccalà, Gabriella, D’Aurizio, Giuseppe, Romanelli, Andrea, Volpini, Daniela, Lucente, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giorgio, Annoni, Maurizio, Corsi, Giuseppe, Bellelli, Alessandra, Bonfanti, Franco, Arturi, Elena, Succurro, Bruno, Tassone, Federica, Giofrè, Maria Grazia Serra, Maria Antonietta Bleve, Antonio, Brucato, Teresa De Falco, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Tancredi, Prandini, Manfredini, Roberto, Fabbian, Fabio, Boari, Benedetta, DE GIORGI, Alfredo, Ruana, Tiseo, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudia, Catalano, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Silvia, Schiavone, Alessio, Bragagni, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Carlo, Custodero, Luigi, Fenoglio, Andrea, Falcetta, Fracanzani, Anna L., Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Raffaella, Rossio, Giulia, Colombo, Pasquale, Agosti, Valter, Monzani, Valeria, Savojardo, Giuliana, Ceriani, Giada, Pallini, Fabrizio, Montecucco, Luciano, Ottonello, Lara, Caserza, Giulia, Vischi, Nicola Lucio Liberato, Tiziana, Tognin, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Maria Stella Pisciotta, Francesco Baffa Bellucci, Stefano, Buffelli, Giuseppe, Montrucchio, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Carl, Margaria, Maura, Sanino, Ludovica, Perri, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Roberto Davide Diprizio, Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Matteo, Galassi, Yasmine, Grassi, Maria, Perticone, Rosa, Battaglia, Marco, Filice, Raffaele, Maio, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara del Vecchio, Andrea, Salvi, Roberto, Leonardi, Giampaolo, Damiani, William, Capeci, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Alfio, Gennaro, Agostino, Gaudio, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Francesca, Mete, Miriam, Gino, Carlo, Vigorito, Antonio, Cittadini, Guido, Moreo, Silvia, Prolo, Gloria, Pina, Alberto, Ballestrero, Fabio, Ferrando, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella, Gruden, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Leonardo, Sechi, Cristiana, Catena, Gianluca, Colussi, Alessandro, Cavarape, Andea Da Porto, Nicola, Passariello, Luca, Rinaldi, Franco, Berti, Giuseppe, Famularo, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta, Morganti, Andrea, Artoni, Margherita, Grossi, Stefano Del Giacco, Davide, Firinu, Giulia, Costanzo, Giacomo, Argiolas, Giuseppe, Montalto, Anna, Licata, Filippo Alessandro Montalto, Francesco, Corica, Giorgio, Basile, Antonino, Catalano, Federica, Bellone, Concetto, Principato, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Giandomenico Nigro Imperiale, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Mattia, Bellan, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, Giorgio, Scanzi, Caterina, Mengoli, Stella, Provini, Laura, Ricevuti, Emilio, Simeone, Rosa, Scurti, Fabio, Tolloso, Roberto, Tarquini, Alice, Valoriani, Silvia, Dolenti, Giulia, Vannini, Riccardo, Volpi, Pietro, Bocchi, Alessandro, Vignali, Sergio, Harari, Chiara, Lonati, Federico, Napoli, Italia, Aiello, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Silvia, Ghidoni, Teresa, Salvatore, Lucio, Monaco, Carmen, Ricozzi, Alberto, Pilotto, Ilaria, Indiano, and Federica, Gandolfo.
Subjects: Drug, medicine.medical_specialty, Hospitalized patients, media_common.quotation_subject, Renal function, Socio-culturale, Kidney, Kidney Function Tests, Drug Prescriptions, Older patients, PEOPLE, Internal medicine, Atrial Fibrillation, Humans, Medicine, Pharmacology (medical), LS4_4, Medical prescription, Aged, media_common, CHRONIC KIDNEY DISEASE, POLYPHARMACY, FRAILTY POPULATION, PEOPLE, ADULTS, DEATH, business.industry, CHRONIC KIDNEY DISEASE, FRAILTY POPULATION, DEATH, ADULTS, Cardiovascular Diseases, Observational study, POLYPHARMACY, Geriatrics and Gerontology, business
Abstract: Reduced estimated creatinine clearance (eCrCl) is prevalent in older patients and impacts on drug prescription. In this study, the burden of eCrCl reduction and its associated factors and impact on outcomes were analyzed. Moreover, the rate of inappropriate drug prescription according to eCrCl and its impact on outcomes were described.Data were obtained from "REgistro POliterapie SIMI" (REPOSI), a prospective observational register enrolling hospitalized patients aged ≥ 65 years. Patients enrolled from 2010-2016 with available data to calculate eCrCl according to the Cockcroft-Gault formula were included in this analysis.A total of 5046 patients were available for analysis. Among these, we found an eCrCl of 45-59 mL/min in 1163 patients (23.0%), an eCrCl of 30-44 mL/min in 1128 (22.4%), an eCrCl of 15-29 mL/min in 702 (13.9%), and an eCrCl 15 mL/min in 152 (3.0%), with several clinical factors associated with decreasing eCrCl. During follow-up, a progressively higher risk for all-cause death, cardiovascular (CV) death, any death/re-hospitalization, and CV death/re-hospitalization was found across the renal function classes. Among patients with hypertension, diabetes mellitus, atrial fibrillation, coronary artery disease, and heart failure, 476 (10.9%) were inappropriately prescribed medications according to eCrCl. During follow-up, inappropriate prescription was associated with increased risk of all-cause death (odds ratio [OR] 1.49, 95% confidence interval [CI] 1.13-1.97) and any death/re-hospitalization (OR 1.30, 95% CI 1.03-1.63).In older hospitalized patients, impaired eCrCl is prevalent and associated with several factors, polypharmacy in particular. Patients with reduced eCrCl have a higher risk of major clinical outcomes, and 10% of them are prescribed an inappropriate drug, with a higher risk for major clinical outcomes.
Published: 2021

9. Impact of implementing a Choosing Wisely educational intervention into clinical practice: The CW-SIMI study (a multicenter-controlled study)

Author: Alessandro Squizzato, Raffaello Furlan, Anna Ludovica Fracanzani, Teresa Salvatore, Roberto Manetti, Vanessa Nunziata, Giovanni Gambassi, Antonello Pietrangelo, Stefania Sella, Christian Bracco, Alfonso Piccoli, Raffaele Manna, Nicola Montano, Gian Marco Podda, Chiara Cogliati, Moreno Tresoldi, Francesco Perticone, Giorgio Costantino, Maria Domenica Cappellini, Alberto Moggi Pignone, Ludovico Furlan, Giovanni Casazza, and Gino Roberto Corazza
Subjects: medicine.medical_specialty, medicine.drug_class, Proton pump inhibitors, medicine.medical_treatment, Proton-pump inhibitor, Antibiotics, Appropriateness, Choosing wisely, Cvc, Less is more, Intervention (counseling), medicine, Internal Medicine, Humans, Medical prescription, business.industry, Anti-Bacterial Agents, Clinical Practice, Italy, Emergency medicine, Administration, Administration, Intravenous, Proton Pump Inhibitors, business, Intravenous, Central venous catheter
Abstract: Objectives To evaluate the impact of an educational intervention based on the Italian Society of Internal Medicine Choosing Wisely (CW-SIMI) recommendations. Design Multicenter, interventional, controlled study. Setting Twenty-three acute-care hospital wards in Italy. Participants 303 Physicians working in internal medicine wards. Intervention An online educational course. Main outcomes The rate of proton pump inhibitor (PPI) prescriptions, the number of days of central venous catheter (CVC) usage, and the duration of intravenous (IV) antibiotic prescriptions evaluated at one month (T1) and at six months (T2) after course completion. Patients admitted and discharged during a 30-day period before the educational intervention (T0, one year before T2) were considered the comparison group. Results A total of 232 physicians completed the course, while 71 did not attend the course. Data from 608, 662, and 555 patients were analyzed at T0, T1, and T2, respectively. The rate of PPI prescriptions declined at one month (RR: 0.67, 95% CI: 0.52–0.87, p = 0.0005) and at six months (RR: 0.62, 95% CI: 0.46–0.84, p = 0.003), and the number of days of CVC usage was reduced at six months (9.13 days at T0 vs. 5.52 days at T2, p = 0.007). The duration of IV antibiotic prescriptions displayed a decreasing trend (7.94 days at T0 vs. 7.42 days at T2, p = 0.081). Conclusions A simple online educational intervention based on the CW-SIMI recommendations was associated with a clinically relevant reduction in the usage of PPIs and CVCs. Further studies are needed to confirm these findings and a possible benefit on patients’ outcomes.
Published: 2021

10. Ceruloplasmin gene variants are associated with hyperferritinemia and increased liver iron in patients with {NAFLD}

Author: Paola Dongiovanni, Antonello Pietrangelo, Raffaela Rametta, Stefania Scarlini, Luca Valenti, Angela Caleffi, Anna Ludovica Fracanzani, Silvia Fargion, Paolo Ventura, Serena Pelusi, Elena Tenedini, Elena Buzzetti, Elena Corradini, Isabella Bernardis, and Enrico Tagliafico
Subjects: 0301 basic medicine, medicine.medical_specialty, Cirrhosis, Anemia, Ferroportin, Gastroenterology, 03 medical and health sciences, Liver disease, 0302 clinical medicine, iron, Internal medicine, medicine, next generation sequencing, Hepatology, biology, business.industry, Fatty liver, ferritin, ceruloplasmin, non-alcoholic fatty liver disease, medicine.disease, Ferritin, 030104 developmental biology, biology.protein, 030211 gastroenterology & hepatology, Liver cancer, Ceruloplasmin, business
Abstract: Background & Aims Non-alcoholic fatty liver disease (NAFLD) is a multifactorial disorder resulting from genetic and environmental factors. Hyperferritinemia has been associated with increased hepatic iron stores and worse outcomes in patients with NAFLD. The aim of this study was to evaluate the prevalence of variants of iron-related genes and their association with hyperferritinemia, hepatic iron stores and liver disease severity in patients with NAFLD. Methods From a cohort of 328 individuals with histological NAFLD, 23 patients with ferritin >750 ng/ml and positive iron staining, and 25 controls with normal ferritin and negative iron staining, were selected. Patients with increased transferrin saturation, anemia, inflammation, β-thalassemia trait, HFE genotype at risk of iron overload and ferroportin mutations were excluded. A panel of 32 iron genes was re-sequenced. Literature and in silico predictions were employed for prioritization of pathogenic mutations. Results Patients with hyperferritinemia had a higher prevalence of potentially pathogenic rare variants (73.9% vs. 20%, p = 0.0002) associated with higher iron stores and more severe liver fibrosis (p Conclusions Variants in non-HFE iron genes, particularly ceruloplasmin, are associated with hyperferritinemia and increased hepatic iron stores in patients with NAFLD. Carriers of such variants have more severe liver fibrosis, suggesting that genetic predisposition to hepatic iron deposition may translate into liver disease. Lay summary Non-alcoholic fatty liver disease (NAFLD) is a common disease which can progress to cirrhosis and liver cancer. Increased levels of serum ferritin are often detected in patients with NAFLD and have been associated with altered iron metabolism and worse patient outcomes. We found that variants of genes related to iron metabolism, particularly ceruloplasmin, are associated with high ferritin levels, hepatic iron deposition and more severe liver disease in an Italian cohort of patients with NAFLD.
Published: 2021

11. Pain and Frailty in Hospitalized Older Adults

Author: Ardoino, Ilaria, Franchi, Carlotta, Nobili, Alessandro, Mannucci, Pier Mannuccio, Corli, Oscar, Pier Mannuccio Mannucci, Alessandro, Nobili, Antonello, Pietrangelo, Francesco, Perticone, Giuseppe, Licata, Francesco, Violi, Gino Roberto Corazza, Salvatore, Corrao, Alessandra, Marengoni, Francesco, Salerno, Matteo, Cesari, Mauro, Tettamanti, Luca, Pasina, Carlotta, Franchi, Laura, Cortesi, Gabriella, Miglio, Ilaria, Ardoino, Alessio, Novella, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Irene, Mattioli, Gianni, Biolo, Michela, Zanetti, Giacomo, Bartelloni, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Graziana, Lupattelli, Vanessa, Bianconi, Riccardo, Alcidi, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Vincenza, Beneduce, Federica, Cacioppo, Giuseppe, Natoli, Salvatore, Mularo, Massimo, Raspanti, Marco, Zoli, Maria Laura Matacena, Giuseppe, Orio, Eleonora, Magnolfi, Giovanni, Serafini, Angelo, Simili, Giuseppe, Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Giovanna, Fabio, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Paolo Dionigi Rossi, Sarah, Damanti, Marta, Clerici, Simona, Leoni, Alessandra Danuta Di Mauro, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Giovanna, Leoncini, Luigi, Anastasio, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Antonella, Giorgi, Christian, Gracin, Giuseppe, Zuccalà, Gabriella, D'Aurizio, Giuseppe, Romanelli, Andrea, Volpini, Daniela, Lucente, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giuseppe, Bellelli, Maurizio, Corsi, Cesare, Antonucci, Chiara, Sidoli, Giulia, Principato, Franco, Arturi, Elena, Succurro, Bruno, Tassone, Federica, Giofrè, Maria Grazia Serra, Maria Antonietta Bleve, Antonio, Brucato, Teresa De Falco, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Tancredi, Prandini, Roberto, Manfredini, Fabio, Fabbian, Benedetta, Boari, Alfredo De Giorgi, Ruana, Tiseo, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudia, Catalano, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Silvia, Schiavone, Alessio, Bragagni, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Carlo, Custodero, Luigi, Fenoglio, Andrea, Falcetta, Anna, L Fracanzani, Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Raffaella, Rossio, Giulia, Colombo, Pasquale, Agosti, Valter, Monzani, Valeria, Savojardo, Giuliana, Ceriani, Giada, Pallini, Montecucco, Fabrizio, Luciano, Ottonello, Lara, Caserza, Giulia, Vischi, Nicola Lucio Liberato, Tiziana, Tognin, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Maria Stella Pisciotta, Francesco Baffa Bellucci, Stefano, Buffelli, Giuseppe, Montrucchio, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Carl, Margaria, Maura, Sanino, Ludovica, Perri, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Roberto Davide Diprizio, Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Matteo, Galassi, Yasmine, Grassi, Alessio, Greco, Angela, Sciacqua, Maria, Perticone, Rosa, Battaglia, Raffaele, Maio, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara Del Vecchio, Andrea, Salvi, Roberto, Leonardi, Giampaolo, Damiani, William, Capeci, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Riccardo, Ghio, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Alfio, Gennaro, Agostino, Gaudio, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Francesca, Mete, Miriam, Gino, Carlo, Vigorito, Antonio, Cittadini, Guido, Moreo, Silvia, Prolo, Gloria, Pina, Alberto, Ballestrero, Fabio, Ferrando, Gonella, Roberta, Domenico, Cerminara, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella, Gruden, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Leonardo, Sechi, Cristiana, Catena, Gianluca, Colussi, Alessandro, Cavarape, Andea Da Porto, Nicola, Passariello, Luca, Rinaldi, Franco, Berti, Giuseppe, Famularo, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta, Morganti, Andrea, Artoni, Margherita, Grossi, Stefano Del Giacco, Davide, Firinu, Giulia, Costanzo, Giacomo, Argiolas, Giuseppe, Montalto, Anna, Licata, Filippo Alessandro Montalto, Francesco, Corica, Giorgio, Basile, Antonino, Catalano, Federica, Bellone, Concetto, Principato, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Giandomenico Nigro Imperiale, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Mattia, Bellan, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, Giorgio, Scanzi, Caterina, Mengoli, Stella, Provini, Laura, Ricevuti, Emilio, Simeone, Rosa, Scurti, Fabio, Tolloso, Roberto, Tarquini, Alice, Valoriani, Silvia, Dolenti, Giulia, Vannini, Riccardo, Volpi, Pietro, Bocchi, Alessandro, Vignali, Sergio, Harari, Chiara, Lonati, Federico, Napoli, Italia, Aiello, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Nome, E Cognome Del Primario, Silvia, Ghidoni, Teresa, Salvatore, Lucio, Monaco, Carmen, Ricozzi, Alberto, Pilotto, Ilaria, Indiano, Federica, Gandolfo, Reposi, Investigator, Ardoino I., Franchi C., Nobili A., Mannucci P.M., Corli O., Pietrangelo A., Perticone F., Licata G., Violi F., Corazza G.R., Corrao S., Marengoni A., Salerno F., Cesari M., Tettamanti M., Pasina L., Cortesi L., Miglio G., Novella A., Prisco D., Silvestri E., Emmi G., Bettiol A., Mattioli I., Biolo G., Zanetti M., Bartelloni G., Vanoli M., Grignani G., Pulixi E.A., Lupattelli G., Bianconi V., Alcidi R., Girelli D., Busti F., Marchi G., Barbagallo M., Dominguez L., Beneduce V., Cacioppo F., Natoli G., Mularo S., Raspanti M., Zoli M., Matacena M.L., Orio G., Magnolfi E., Serafini G., Simili A., Palasciano G., Modeo M.E., Di Gennaro C., Cappellini M.D., Fabio G., De Amicis M.M., De Luca G., Scaramellini N., Rossi P.D., Damanti S., Clerici M., Leoni S., Di Mauro A.D., Di Sabatino A., Miceli E., Lenti M.V., Pisati M., Dominioni C.C., Pontremoli R., Beccati V., Nobili G., Leoncini G., Anastasio L., Carbone M., Cipollone F., Guagnano M.T., Rossi I., Mancuso G., Calipari D., Bartone M., Delitala G., Berria M., Delitala A., Muscaritoli M., Molfino A., Petrillo E., Giorgi A., Gracin C., Zuccala G., D'Aurizio G., Romanelli G., Volpini A., Lucente D., Picardi A., Gentilucci U.V., Gallo P., Bellelli G., Corsi M., Antonucci C., Sidoli C., Principato G., Arturi F., Succurro E., Tassone B., Giofre F., Serra M.G., Bleve M.A., Brucato A., De Falco T., Fabris F., Bertozzi I., Bogoni G., Rabuini M.V., Prandini T., Manfredini R., Fabbian F., Boari B., De Giorgi A., Tiseo R., Paolisso G., Rizzo M.R., Catalano C., Borghi C., Strocchi E., Ianniello E., Soldati M., Schiavone S., Bragagni A., Sabba C., Vella F.S., Suppressa P., De Vincenzo G.M., Comitangelo A., Amoruso E., Custodero C., Fenoglio L., Falcetta A., Fracanzani A.L., Tiraboschi S., Cespiati A., Oberti G., Sigon G., Peyvandi F., Rossio R., Colombo G., Agosti P., Monzani V., Savojardo V., Ceriani G., Pallini G., Montecucco F., Ottonello L., Caserza L., Vischi G., Liberato N.L., Tognin T., Purrello F., Di Pino A., Piro S., Rozzini R., Falanga L., Pisciotta M.S., Bellucci F.B., Buffelli S., Montrucchio G., Peasso P., Favale E., Poletto C., Margaria C., Sanino M., Perri L., Guasti L., Castiglioni L., Maresca A., Squizzato A., Campiotti L., Grossi A., Diprizio R.D., Bertolotti M., Mussi C., Lancellotti G., Libbra M.V., Galassi M., Grassi Y., Greco A., Sciacqua A., Perticone M., Battaglia R., Maio R., Stanghellini V., Ruggeri E., del Vecchio S., Salvi A., Leonardi R., Damiani G., Capeci W., Mattioli M., Martino G.P., Biondi L., Pettinari P., Ghio R., Col A.D., Minisola S., Colangelo L., Cilli M., Labbadia G., Afeltra A., Marigliano B., Pipita M.E., Castellino P., Zanoli L., Gennaro A., Gaudio A., Saracco V., Fogliati M., Bussolino C., Mete F., Gino M., Vigorito C., Cittadini A., Moreo G., Prolo S., Pina G., Ballestrero A., Ferrando F., Gonella R., Cerminara D., Berra S., Dassi S., Nava M.C., Graziella B., Baldassarre S., Fragapani S., Gruden G., Galanti G., Mascherini G., Petri C., Stefani L., Girino M., Piccinelli V., Nasso F., Gioffre V., Pasquale M., Sechi L., Catena C., Colussi G., Cavarape A., Da Porto A., Passariello N., Rinaldi L., Berti F., Famularo G., Tarsitani P., Castello R., Pasino M., Ceda G.P., Maggio M.G., Morganti S., Artoni A., Grossi M., Del Giacco S., Firinu D., Costanzo G., Argiolas G., Montalto G., Licata A., Montalto F.A., Corica F., Basile G., Catalano A., Bellone F., Principato C., Malatino L., Stancanelli B., Terranova V., Di Marca S., Di Quattro R., La Malfa L., Caruso R., Mecocci P., Ruggiero C., Boccardi V., Meschi T., Ticinesi A., Nouvenne A., Minuz P., Fondrieschi L., Imperiale G.N., Pirisi M., Fra G.P., Sola D., Bellan M., Porta M., Riva P., Quadri R., Larovere E., Novelli M., Scanzi G., Mengoli C., Provini S., Ricevuti L., Simeone E., Scurti R., Tolloso F., Tarquini R., Valoriani A., Dolenti S., Vannini G., Volpi R., Bocchi P., Vignali A., Harari S., Lonati C., Napoli F., Aiello I., Landolfi R., Montalto M., Mirijello A., del Primario N.C., Ghidoni S., Salvatore T., Monaco L., Ricozzi C., Pilotto A., Indiano I., Gandolfo F., Ardoino, Ilaria, Franchi, Carlotta, Nobili, Alessandro, Mannucci, Pier Mannuccio, Corli, Oscar, Borghi C, Stanghellini V, Ardoino, I, Franchi, C, Nobili, A, Mannucci, P, Corli, O, Bellelli, G, Ardoino, I., Franchi, C., Nobili, A., Mannucci, P. M., Corli, O., Pietrangelo, A., Perticone, F., Licata, G., Violi, F., Corazza, G. R., Corrao, S., Marengoni, A., Salerno, F., Cesari, M., Tettamanti, M., Pasina, L., Cortesi, L., Miglio, G., Novella, A., Prisco, D., Silvestri, E., Emmi, G., Bettiol, A., Mattioli, I., Biolo, G., Zanetti, M., Bartelloni, G., Vanoli, M., Grignani, G., Pulixi, E. A., Lupattelli, G., Bianconi, V., Alcidi, R., Girelli, D., Busti, F., Marchi, G., Barbagallo, M., Dominguez, L., Beneduce, V., Cacioppo, F., Natoli, G., Mularo, S., Raspanti, M., Zoli, M., Matacena, M. L., Orio, G., Magnolfi, E., Serafini, G., Simili, A., Palasciano, G., Modeo, M. E., Di Gennaro, C., Cappellini, M. D., Fabio, G., De Amicis, M. M., De Luca, G., Scaramellini, N., Rossi, P. D., Damanti, S., Clerici, M., Leoni, S., Di Mauro, A. D., Di Sabatino, A., Miceli, E., Lenti, M. V., Pisati, M., Dominioni, C. C., Pontremoli, R., Beccati, V., Nobili, G., Leoncini, G., Anastasio, L., Carbone, M., Cipollone, F., Guagnano, M. T., Rossi, I., Mancuso, G., Calipari, D., Bartone, M., Delitala, G., Berria, M., Delitala, A., Muscaritoli, M., Molfino, A., Petrillo, E., Giorgi, A., Gracin, C., Zuccala, G., D'Aurizio, G., Romanelli, G., Volpini, A., Lucente, D., Picardi, A., Gentilucci, U. V., Gallo, P., Bellelli, G., Corsi, M., Antonucci, C., Sidoli, C., Principato, G., Arturi, F., Succurro, E., Tassone, B., Giofre, F., Serra, M. G., Bleve, M. A., Brucato, A., De Falco, T., Fabris, F., Bertozzi, I., Bogoni, G., Rabuini, M. V., Prandini, T., Manfredini, R., Fabbian, F., Boari, B., De Giorgi, A., Tiseo, R., Paolisso, G., Rizzo, M. R., Catalano, C., Borghi, C., Strocchi, E., Ianniello, E., Soldati, M., Schiavone, S., Bragagni, A., Sabba, C., Vella, F. S., Suppressa, P., De Vincenzo, G. M., Comitangelo, A., Amoruso, E., Custodero, C., Fenoglio, L., Falcetta, A., Fracanzani, A. L., Tiraboschi, S., Cespiati, A., Oberti, G., Sigon, G., Peyvandi, F., Rossio, R., Colombo, G., Agosti, P., Monzani, V., Savojardo, V., Ceriani, G., Pallini, G., Montecucco, F., Ottonello, L., Caserza, L., Vischi, G., Liberato, N. L., Tognin, T., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Pisciotta, M. S., Bellucci, F. B., Buffelli, S., Montrucchio, G., Peasso, P., Favale, E., Poletto, C., Margaria, C., Sanino, M., Perri, L., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Campiotti, L., Grossi, A., Diprizio, R. D., Bertolotti, M., Mussi, C., Lancellotti, G., Libbra, M. V., Galassi, M., Grassi, Y., Greco, A., Sciacqua, A., Perticone, M., Battaglia, R., Maio, R., Stanghellini, V., Ruggeri, E., del Vecchio, S., Salvi, A., Leonardi, R., Damiani, G., Capeci, W., Mattioli, M., Martino, G. P., Biondi, L., Pettinari, P., Ghio, R., Col, A. D., Minisola, S., Colangelo, L., Cilli, M., Labbadia, G., Afeltra, A., Marigliano, B., Pipita, M. E., Castellino, P., Zanoli, L., Gennaro, A., Gaudio, A., Saracco, V., Fogliati, M., Bussolino, C., Mete, F., Gino, M., Vigorito, C., Cittadini, A., Moreo, G., Prolo, S., Pina, G., Ballestrero, A., Ferrando, F., Gonella, R., Cerminara, D., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Gruden, G., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Sechi, L., Catena, C., Colussi, G., Cavarape, A., Da Porto, A., Passariello, N., Rinaldi, L., Berti, F., Famularo, G., Tarsitani, P., Castello, R., Pasino, M., Ceda, G. P., Maggio, M. G., Morganti, S., Artoni, A., Grossi, M., Del Giacco, S., Firinu, D., Costanzo, G., Argiolas, G., Montalto, G., Licata, A., Montalto, F. A., Corica, F., Basile, G., Catalano, A., Bellone, F., Principato, C., Malatino, L., Stancanelli, B., Terranova, V., Di Marca, S., Di Quattro, R., La Malfa, L., Caruso, R., Mecocci, P., Ruggiero, C., Boccardi, V., Meschi, T., Ticinesi, A., Nouvenne, A., Minuz, P., Fondrieschi, L., Imperiale, G. N., Pirisi, M., Fra, G. P., Sola, D., Bellan, M., Porta, M., Riva, P., Quadri, R., Larovere, E., Novelli, M., Scanzi, G., Mengoli, C., Provini, S., Ricevuti, L., Simeone, E., Scurti, R., Tolloso, F., Tarquini, R., Valoriani, A., Dolenti, S., Vannini, G., Volpi, R., Bocchi, P., Vignali, A., Harari, S., Lonati, C., Napoli, F., Aiello, I., Landolfi, R., Montalto, M., Mirijello, A., del Primario, N. C., Ghidoni, S., Salvatore, T., Monaco, L., Ricozzi, C., Pilotto, A., Indiano, I., Gandolfo, F., Corli, Oscar, Paolisso, Giuseppe, and Rizzo, Maria Rosaria
Subjects: medicine.medical_specialty, Pain medicine, Socio-culturale, Chronic pain, Osteoarthritis, Affect (psychology), Internal medicine and geriatric wards, Musculoskeletal diseases, Older population, Chronic pain, Internal medicine and geriatric wards, Musculoskeletal diseases, Quality of life, Musculoskeletal disease, Anesthesiology, Internal medicine, medicine, RD78.3-87.3, LS4_4, Original Research, business.industry, medicine.disease, Internal medicine and geriatric ward, Anesthesiology and Pain Medicine, Rheumatoid arthritis, Neurology (clinical), Ordered logit, business
Abstract: Introduction Pain and frailty are prevalent conditions in the older population. Many chronic diseases are likely involved in their origin, and both have a negative impact on quality of life. However, few studies have analysed their association. Methods In light of this knowledge gap, 3577 acutely hospitalized patients 65 years or older enrolled in the REPOSI register, an Italian network of internal medicine and geriatric hospital wards, were assessed to calculate the frailty index (FI). The impact of pain and some of its characteristics on the degree of frailty was evaluated using an ordinal logistic regression model after adjusting for age and gender. Results The prevalence of pain was 24.7%, and among patients with pain, 42.9% was regarded as chronic pain. Chronic pain was associated with severe frailty (OR = 1.69, 95% CI 1.38–2.07). Somatic pain (OR = 1.59, 95% CI 1.23–2.07) and widespread pain (OR = 1.60, 95% CI 0.93–2.78) were associated with frailty. Osteoarthritis was the most common cause of chronic pain, diagnosed in 157 patients (33.5%). Polymyalgia, rheumatoid arthritis and other musculoskeletal diseases causing chronic pain were associated with a lower degree of frailty than osteoarthritis (OR = 0.49, 95%CI 0.28–0.85). Conclusions Chronic and somatic pain negatively affect the degree of frailty. The duration and type of pain, as well as the underlying diseases associated with chronic pain, should be evaluated to improve the hospital management of frail older people. Electronic Supplementary Material The online version of this article (10.1007/s40122-020-00202-3) contains supplementary material, which is available to authorized users.
Published: 2020

12. Comorbidity does not mean clinical complexity: evidence from the RePoSI register

Author: Pier Mannuccio Mannucci, Francesco Perticone, Antonello Pietrangelo, Christiano Argano, Salvatore Corrao, Alessandro Nobili, Giuseppe Natoli, Corrao S., Natoli G., Nobili A., Mannucci P.M., Pietrangelo A., Perticone F., and Argano C.
Subjects: Male, medicine.medical_specialty, Cumulative illness rating scale, Comorbidity, Disease, 030204 cardiovascular system & hematology, Age and sex, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Number of comorbidities, Risk Factors, Rating scale, Cause of Death, Internal Medicine, Humans, Medicine, Clinical significance, Hospital Mortality, Registries, 030212 general & internal medicine, Geriatric Assessment, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Multimorbidity, Length of Stay, medicine.disease, Clinical complexity, Clinical Practice, Italy, Emergency medicine, Emergency Medicine, Female, Multiple Chronic Conditions, business, Comorbidity index
Abstract: In the last 2–3decades internists have confronted dramatic changes in the pattern of patients acutely admitted to hospital wards. Internists observed a shift from younger subjects affected by a single organ disease to more complex patients, usually older, with multiple chronic conditions, attended by different specialists, with poor integration and treated with multiple drugs. In this regard, the concept of complex patients is addressed daily in clinical practice even if there is no agreed definition of patient complexity. To try to evaluate clinical complexity different instruments have been proposed. Among these, the number of comorbidities (NoC) was considered a marker of clinical complexity. However, this instrument would not give information about the clinical relevance of each condition. On the contrary, cumulative illness rating scale (CIRS) addresses the problem calculating both CIRS severity index (CIRS-SI) and CIRS comorbidity index (CIRS-CI). In light of this, 4714 patients from the RePoSI register were retrospectively analyzed to show if CIRS assessment of comorbidity burden is different from the simple count of comorbidities in predicting the length of hospital stay (LOS) and all-cause of mortality in hospitalized elderly patients and if NoC could be a valid tool to measure patient’s complexity. CIRS-SI resulted the best predictor of all-cause in-hospital mortality [OR: 2.66 (1.88–3.77)] in comparison with NoC that did not result statistically significant (p = 0.551). CIRS-SI was also the best predictor of all-cause of post-discharge mortality corrected for age and sex [OR: 2.12 (1.53–2.95)]. CIRS-SI (coefficient ± standard error: 1.23 ± 0.59; p < 0.0381) and CIRS-CI (coefficient ± standard error: 0.27 ± 0.10; p < 0.011) were strong predictors of LOS in comparison with NoC that did not result statistically significant (coefficient ± standard error: 0.04 ± 0.06 p < 0.0561). In conclusion, CIRS assessment of comorbidity burden is a better clinical tool in comparison with the simple count of comorbidities especially considering the length of hospital stay and all-cause mortality in hospitalized elderly patients.
Published: 2020

13. Hyperhomocysteinemia in patients with acute porphyrias: A potentially dangerous metabolic crossroad?

Author: Matteo Marcacci, Paolo Ventura, Elena Di Pierro, Antonello Pietrangelo, Stefano Marchini, Elena Corradini, Elena Buzzetti, and Chiara Cuoghi
Subjects: medicine.medical_specialty, Hyperhomocysteinemia, Homocysteine, Variegate porphyria, Cystathionine beta-Synthase, 030204 cardiovascular system & hematology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Acute Porphyrias, Ala-Synthase1, Vitamin B6, Internal medicine, Porphobilinogen, Internal Medicine, medicine, Humans, 030212 general & internal medicine, Heme, Acute intermittent porphyria, biology, business.industry, medicine.disease, Cystathionine beta synthase, ALAS1, Vitamin B 12, Endocrinology, chemistry, Porphyria, Acute Intermittent, biology.protein, business
Abstract: Background Acute porphyrias (AP) are characterized by heme deficiency and induction of hepatic 5-aminolevulinate synthase (ALAS1). Hyperhomocysteinemia (HHcy) is associated with endothelial damage, neurotoxicity and increased risk for vascular diseases. Interestingly, both heme biosynthesis and sulphur amino acid metabolism require vitamin B6, (Pyridoxal-phosphate, PLP) an important cofactor of ALAS1 and of cystathionine β-synthase (CBS) and cystathionine γ-lyase (CGL) enzymes that catabolize homocysteine (Hcy). Moreover, heme itself is an important cofactor for CBS. Aim to assess plasma Hcy status and HHcy main determinants in patients with AP. Materials and methods A total of 46 patients with AP (31 with Acute Intermittent Porphyria,15 with Variegate Porphyria) were assessed for clinical status (symptomatic vs. asymptomatic), serum Hcy, Cysteine (Cys), Vit.B6, Vit.B12, red blood cell folates and urinary delta-aminolevulinic acid (ALA) and porphobilinogen(PBG) levels (mean of six measurements). Results Symptomatic AP patients had significantly higher urinary ALA and PBG levels, plasma Hcy, HHcy prevalence and Hcy/Cys ratio when compared to asymptomatic carriers of AP. Even though no significant correlation was observed between ALA/PBG urinary levels and serum Hcy levels, patients with higher levels of ALA and PBG had significantly higher levels of Hcy, a higher prevalence of moderate-to severe HHcy and serum PLP levels below the 25th percentile of a reference assessment with 300 healthy Italian subjects( Conclusions Most patients with symptomatic AP present HHcy resulting from alterations in sulphur amino acid metabolism. HHcy may represent an indirect marker of ALAS1 induction and its prevalence may be suggestive of a role of HHcy in the pathogenesis and/or comorbidities of AP.
Published: 2020

14. Tocilizumab in patients with severe COVID-19: a retrospective cohort study

Author: Ivana Castaniere, Jovana Milic, Marianna Menozzi, Maddalena Giannella, Marianna Meschiari, Lucio Brugioni, Alessandro Cozzi-Lepri, Massimo Girardis, Cinzia Puzzolante, Enrico Clini, Margherita Di Gaetano, Vanni Borghi, Sara K. Tedeschi, Erica Franceschini, Michele Bartoletti, Gabriella Orlando, Luca Tabbì, Antonella Santoro, Andrea Bedini, Carlo Salvarani, Federica Carli, Federico Pea, Antonello Pietrangelo, Luca Corradi, Gianluca Cuomo, Roberto Tonelli, Pierluigi Viale, Riccardo Fantini, Andrea Cossarizza, Giovanni Guaraldi, Renato Pascale, Cristina Mussini, Marco Massari, Giovanni Dolci, Guaraldi G., Meschiari M., Cozzi-Lepri A., Milic J., Tonelli R., Menozzi M., Franceschini E., Cuomo G., Orlando G., Borghi V., Santoro A., Di Gaetano M., Puzzolante C., Carli F., Bedini A., Corradi L., Fantini R., Castaniere I., Tabbi L., Girardis M., Tedeschi S., Giannella M., Bartoletti M., Pascale R., Dolci G., Brugioni L., Pietrangelo A., Cossarizza A., Pea F., Clini E., Salvarani C., Massari M., Viale P.L., and Mussini C.
Subjects: Mechanical ventilation, medicine.medical_specialty, medicine.drug_class, business.industry, medicine.medical_treatment, Immunology, Low molecular weight heparin, Retrospective cohort study, Azithromycin, medicine.disease, Article, chemistry.chemical_compound, Pneumonia, Tocilizumab, chemistry, Rheumatology, Internal medicine, severe covid-19, tocilizumab, medicine, Clinical endpoint, Immunology and Allergy, business, Letters to the Editor, Cohort study, medicine.drug
Abstract: Background: No therapy is approved for COVID-19 pneumonia. The aim of this study was to assess the role of tocilizumab in reducing the risk of invasive mechanical ventilation and death in patients with severe COVID-19 pneumonia who received standard of care treatment. Methods: This retrospective, observational cohort study included adults (≥18 years) with severe COVID-19 pneumonia who were admitted to tertiary care centres in Bologna and Reggio Emilia, Italy, between Feb 21 and March 24, 2020, and a tertiary care centre in Modena, Italy, between Feb 21 and April 30, 2020. All patients were treated with the standard of care (ie, supplemental oxygen, hydroxychloroquine, azithromycin, antiretrovirals, and low molecular weight heparin), and a non-randomly selected subset of patients also received tocilizumab. Tocilizumab was given either intravenously at 8 mg/kg bodyweight (up to a maximum of 800 mg) in two infusions, 12 h apart, or subcutaneously at 162 mg administered in two simultaneous doses, one in each thigh (ie, 324 mg in total), when the intravenous formulation was unavailable. The primary endpoint was a composite of invasive mechanical ventilation or death. Treatment groups were compared using Kaplan-Meier curves and Cox regression analysis after adjusting for sex, age, recruiting centre, duration of symptoms, and baseline Sequential Organ Failure Assessment (SOFA) score. Findings: Of 1351 patients admitted, 544 (40%) had severe COVID-19 pneumonia and were included in the study. 57 (16%) of 365 patients in the standard care group needed mechanical ventilation, compared with 33 (18%) of 179 patients treated with tocilizumab (p=0·41; 16 [18%] of 88 patients treated intravenously and 17 [19%] of 91 patients treated subcutaneously). 73 (20%) patients in the standard care group died, compared with 13 (7%; p
Published: 2020

15. Clinical impact of application of risk assessment models (Padua Prediction Score and Improve Bleeding Score) on venous thromboembolism, major hemorrhage and health expenditure associated with pharmacologic VTE prophylaxis: a 'real life' prospective and retrospective observational study on patients hospitalized in a Single Internal Medicine Unit (the STIME study)

Author: Antonello Pietrangelo, Marco Marietta, Paolo Ventura, Stefania Scarlini, Elena Corradini, Matteo Marcacci, and Luca Depietri
Subjects: Male, medicine.medical_specialty, Population, 030204 cardiovascular system & hematology, Vte prophylaxis, Risk Assessment, Venous thromboembolism prophylaxis · Risk assessment models · Padua Prediction Score · Improve Bleeding Score · Health expenditure, Statistics, Nonparametric, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Internal Medicine, Humans, Medicine, Prospective Studies, 030212 general & internal medicine, education, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, business.industry, Incidence (epidemiology), Anticoagulants, Retrospective cohort study, Venous Thromboembolism, Middle Aged, medicine.disease, Pulmonary embolism, Clinical trial, Emergency Medicine, Female, Pulmonary Embolism, business, Risk assessment, Venous thromboembolism
Abstract: International guidelines recommend the use of pharmacological prophylaxis in hospitalized medical patients at high risk of venous thromboembolism (VTE). The same international guidelines suggest the employment of standardized risk assessment models (RAMs) when evaluating the administration of pharmacological prophylaxis in acutely ill medical patients. The Padua Prediction Score and the Improve Bleeding Score have been indicated as the best available RAMs to predict thrombotic and haemorrhagic risk in hospitalized medical patients, but it is still unknown whether their combined use may lead to a significant reduction in thrombotic and haemorrhagic events. It is also unclear whether their extensive use can affect to some extent health expenditure associated with pharmacological VTE prophylaxis. The purpose of this single-centre, prospective and retrospective observational study is to investigate these unanswered questions. All patients admitted to our Internal Medicine Department between May 2015 and August 2015, i.e., before the introduction and extensive use of RAMs, were consecutively enrolled (retrospective group). Similarly, all patients admitted between November 2016 and February 2017-once RAMs clinical use became a consolidated practice-have also been consecutively recruited (prospective group). Consecutively, 203 patients were enrolled in the retrospective group and 210 patients were enrolled in the prospective group. Three events of major bleeding and one event of pulmonary embolism were observed in the prospective group; three events of major hemorrhage and two events of pulmonary embolism were observed in the retrospective group (p = not significant). A statistically significant decrease in pharmacological VTE prophylaxis among study groups was detected: 43.3% of prospective group patients and 56.7% of retrospective group patients received pharmacological prophylaxis (p = .028). Overall, 299 drug doses for VTE prophylaxis have been spared after RAMs introduction (p = .0001) and health expenditure decreased by 27.2% (i.e., 1.67 € saved for each single patient). In conclusion, the extensive use of RAMs in our population of hospitalized medical patients did not statistically affect VTE rate or incidence of major bleeding, but it resulted in a significant drop in health expenditure related with pharmacological prophylaxis. Awaiting new clinical trials, a broad use of RAMs may be a safe strategy for reducing health expenditure associated with VTE prophylaxis in hospitalized medical patients.
Published: 2018

16. Prevalence of use and appropriateness of antidepressants prescription in acutely hospitalized elderly patients

Author: Franchi Carlotta, Rossio Raffaella, Ardoino Ilaria, Nobili Alessandro, Mannucci Pier Mannuccio, Pier Mannuccio Mannucci, Alessandro Nobili, Antonello Pietrangelo, Francesco Perticone, Giuseppe Licata, Francesco Violi, Gino Roberto Corazza, Salvatore Corrao, Alessandra Marengoni, Francesco Salerno, Matteo Cesari, Mauro Tettamanti, Luca Pasina, Carlotta Franchi, Laura Cortesi, Gabriella Miglio, Ilaria Ardoino, Alessio Novella, Domenico Prisco, Elena Silvestri, Giacomo Emmi, Alessandra Bettiol, Cenci Caterina, Gianni Biolo, Michela Zanetti, Martina Guadagni, Michele Zaccari, Massimiliano Chiuch, Massimo Vanoli, Giulia Grignani, Edoardo Alessandro Pulixi, Mauro Bernardi, Silvia Li Bassi, Luca Santi, Giacomo Zaccherini, Graziana Lupattelli, Elmo Mannarino, Vanessa Bianconi, Francesco Paciullo, Riccardo Alcidi, Ranuccio Nuti, Roberto Valenti, Martina Ruvio, Silvia Cappelli, Alberto Palazzuoli, Domenico Girelli, Fabiana Busti, Giacomo Marchi, Mario Barbagallo, Ligia Dominguez, Floriana Cocita, Vincenza Beneduce, Lidia Plances, Giuseppe Natoli, Salvatore Mularo, Massimo Raspanti, Federica Cavallaro, Marco Zoli, Ilaria Lazzari, Mattia Brunori, Elisa Fabbri, Donatella Magalotti, Raffaella Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Giuseppe Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Diletta Maira, Valeria Di Stefano, Giovanna Fabio, Sonia Seghezzi, Marta Mancarella, Margherita Migone De Amicis, Giacomo De Luca, Natalia Scaramellini, Paolo Dionigi Rossi, Sarah Damanti, Marta Clerici, Federica Conti, Giulia Bonini, Barbara Brignolo Ottolini, Antonio Di Sabatino, Emanuela Miceli, Marco Vincenzo Lenti, Martina Pisati, Costanza Caccia Dominioni, Giovanni Murialdo, Alessio Marra, Federico Cattaneo, Roberto Pontremoli, Valentina Beccati, Giulia Nobili, Maria Beatrice Secchi, Davide Ghelfi, Luigi Anastasio, Lucia Sofia, Maria Carbone, Francesco Cipollone, Maria Teresa Guagnano, Emanuele Valeriani, Ilaria Rossi, Gerardo Mancuso, Daniela Calipari, Mosè Bartone, Giuseppe Delitala, Maria Berria, Chiara Pes, Alessandro Delitala, Maurizio Muscaritoli, Alessio Molfino, Enrico Petrillo, Giuseppe Zuccalà, Gabriella D’Aurizio, Giuseppe Romanelli, Alberto Zucchelli, Francesca Manzoni, Andrea Volpini, Antonio Picardi, Umberto Vespasiani Gentilucci, Paolo Gallo, Chiara Dell’Unto, Giorgio Annoni, Maurizio Corsi, Giuseppe Bellelli, Sara Zazzetta, Paolo Mazzola, Hajnalka Szabo, Alessandra Bonfanti, Franco Arturi, Elena Succurro, Mariangela Rubino, Bruno Tassone, Giorgio Sesti, Medicina Interna, Maria Grazia Serra, Maria Antonietta Bleve, Laura Gasbarrone, Maria Rosaria Sajeva, Antonio Brucato, Silvia Ghidoni, Fabrizio Fabris, Irene Bertozzi, Giulia Bogoni, Maria Victoria Rabuini, Elisabetta Cosi, Paolo Scarinzi, Annalisa Amabile, Elisabetta Omenetto, Tancredi Prandini, Roberto Manfredini, Fabio Fabbian, Benedetta Boari, Alfredo De Giorgi, Ruana Tiseo, Roberto De Giorgio, Giuseppe Paolisso, Maria Rosaria Rizzo, Claudio Borghi, Enrico Strocchi, Eugenia Ianniello, Mario Soldati, Carlo Sabbà, Francesco Saverio Vella, Patrizia Suppressa, Andrea Schilardi, Francesca Loparco, Giovanni Michele De Vincenzo, Alessio Comitangelo, Emanuele Amoruso, Luigi Fenoglio, Andrea Falcetta, Christian Bracco, Anna L. Fracanzani, Silvia Fargion, Silvia Tiraboschi, Annalisa Cespiati, Giovanna Oberti, Giordano Sigon, Flora Peyvandi, Raffaella Rossio, Barbara Ferrari, Giulia Colombo, Pasquale Agosti, Valter Monzani, Valeria Savojardo, Christian Folli, Giuliana Ceriani, Giada Pallini, Franco Dallegri, Luciano Ottonello, Luca Liberale, Lara Caserza, Kassem Salam, Nicola Lucio Liberato, Tiziana Tognin, Giovanni Battista Bianchi, Sabrina Giaquinto, Francesco Purrello, Antonino Di Pino, Salvatore Piro, Renzo Rozzini, Lina Falanga, Elena Spazzini, Camillo Ferrandina, Giuseppe Montrucchio, Paolo Petitti, Paolo Peasso, Edoardo Favale, Cesare Poletto, Raffaella Salmi, Piergiorgio Gaudenzi, Ludovica Perri, Raffaele Landolfi, Massimo Montalto, Antonio Mirijello, Luigina Guasti, Luana Castiglioni, Andrea Maresca, Alessandro Squizzato, Leonardo Campiotti, Alessandra Grossi, Marco Bertolotti, Chiara Mussi, Giulia Lancellotti, Maria Vittoria Libbra, Giulia Dondi, Elisa Pellegrini, Lucia Carulli, Matteo Galassi, Yasmine Grassi, Maria Perticone, Rosa Battaglia, Marco FIlice, Raffaele Maio, Vincenzo Stanghellini, Eugenio Ruggeri, Sara del Vecchio, Andrea Salvi, Roberto Leonardi, Giampaolo Damiani, William Capeci, Armando Gabrielli, Massimo Mattioli, Giuseppe Pio Martino, Lorenzo Biondi, Pietro Pettinari, Riccardo Ghio, Anna Dal Col, Salvatore Minisola, Luciano Colangelo, Mirella Cilli, Giancarlo Labbadia, Antonella Afeltra, Benedetta Marigliano, Maria Elena Pipita, Pietro Castellino, Luca Zanoli, Samuele Pignataro, Alfio Gennaro, Julien Blanco, Valter Saracco, Marisa Fogliati, Carlo Bussolino, Francesca Mete, Miriam Gino, Antonio Cittadini, Carlo Vigorito, Michele Arcopinto, Andrea Salzano, Emanuele Bobbio, Alberto Maria Marra, Domenico Sirico, Guido Moreo, Francesca Gasparini, Silvia Prolo, Gloria Pina, Alberto Ballestrero, Fabio Ferrando, Sergio Berra, Simonetta Dassi, Maria Cristina Nava, Bruno Graziella, Stefano Baldassarre, Salvatore Fragapani, Gabriella Gruden, Giorgio Galanti, Gabriele Mascherini, Cristian Petri, Laura Stefani, Margherita Girino, Valeria Piccinelli, Francesco Nasso, Vincenza Gioffrè, Maria Pasquale, Giuseppe Scattolin, Sergio Martinelli, Mauro Turrin, Leonardo Sechi, Cristina Catena, Gianluca Colussi, Nicola Passariello, Luca Rinaldi, Franco Berti, Giuseppe Famularo, Patrizia Tarsitani, Roberto Castello, Michela Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta Morganti, Andrea Artoni, Stefano Del Giacco, Davide Firinu, Francesca Losa, Giovanni Paoletti, Giulia Costanzo, Giuseppe Montalto, Anna Licata, Valentina Malerba, Filippo Alessandro Montalto, Antonino Lasco, Giorgio Basile, Antonino Catalano, Lorenzo Malatino, Benedetta Stancanelli, Valentina Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella Caruso, Patrizia Mecocci, Carmelinda Ruggiero, Virginia Boccardi, Tiziana Meschi, Fulvio Lauretani, Andrea Ticinesi, Antonio Nouvenne, Pietro Minuz, Luigi Fondrieschi, Mario Pirisi, Gian Paolo Fra, Daniele Sola, Massimo Porta, Piero Riva, Roberto Quadri, Erica Larovere, Marco Novelli, Giorgio Scanzi, Caterina Mengoli, Stella Provini, Laura Ricevuti, Emilio Simeone, Rosa Scurti, Fabio Tolloso, Roberto Tarquini, Alice Valoriani, Silvia Dolenti, Giulia Vannini, Alberto Tedeschi, Lucia Trotta, Riccardo Volpi, Pietro Bocchi, Alessandro Vignali, Sergio Harari, Chiara Lonati, Mara Cattaneo, Federico Napoli, Carlotta, F., Raffaella, R., Ilaria, A., Alessandro, N., Mannuccio, M. P., Mannucci, P. M., Nobili, A., Pietrangelo, A., Perticone, F., Licata, G., Violi, F., Corazza, G. R., Corrao, S., Marengoni, A., Salerno, F., Cesari, M., Tettamanti, M., Pasina, L., Franchi, C., Cortesi, L., Miglio, G., Ardoino, I., Novella, A., Prisco, D., Silvestri, E., Emmi, G., Bettiol, A., Caterina, C., Biolo, G., Zanetti, M., Guadagni, M., Zaccari, M., Chiuch, M., Vanoli, M., Grignani, G., Pulixi, E. A., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Lupattelli, G., Mannarino, E., Bianconi, V., Paciullo, F., Alcidi, R., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Girelli, D., Busti, F., Marchi, G., Barbagallo, M., Dominguez, L., Cocita, F., Beneduce, V., Plances, L., Natoli, G., Mularo, S., Raspanti, M., Cavallaro, F., Zoli, M., Lazzari, I., Brunori, M., Fabbri, E., Magalotti, D., Arno, R., Pasini, F. L., Capecchi, P. L., Palasciano, G., Modeo, M. E., Gennaro, C. D., Cappellini, M. D., Maira, D., Di Stefano, V., Fabio, G., Seghezzi, S., Mancarella, M., De Amicis, M. M., De Luca, G., Scaramellini, N., Rossi, P. D., Damanti, S., Clerici, M., Conti, F., Bonini, G., Ottolini, B. B., Di Sabatino, A., Miceli, E., Lenti, M. V., Pisati, M., Dominioni, C. C., Murialdo, G., Marra, A., Cattaneo, F., Pontremoli, R., Beccati, V., Nobili, G., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Cipollone, F., Guagnano, M. T., Valeriani, E., Rossi, I., Mancuso, G., Calipari, D., Bartone, M., Delitala, G., Berria, M., Pes, C., Delitala, A., Muscaritoli, M., Molfino, A., Petrillo, E., Zuccala, G., D'Aurizio, G., Romanelli, G., Zucchelli, A., Manzoni, F., Volpini, A., Picardi, A., Gentilucci, U. V., Gallo, P., Dell'Unto, C., Annoni, G., Corsi, M., Bellelli, G., Zazzetta, S., Mazzola, P., Szabo, H., Bonfanti, A., Arturi, F., Succurro, E., Rubino, M., Tassone, B., Sesti, G., Interna, M., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Fabris, F., Bertozzi, I., Bogoni, G., Rabuini, M. V., Cosi, E., Scarinzi, P., Amabile, A., Omenetto, E., Prandini, T., Manfredini, R., Fabbian, F., Boari, B., Giorgi, A. D., Tiseo, R., De Giorgio, R., Paolisso, G., Rizzo, M. R., Borghi, C., Strocchi, E., Ianniello, E., Soldati, M., Sabba, C., Vella, F. S., Suppressa, P., Schilardi, A., Loparco, F., De Vincenzo, G. M., Comitangelo, A., Amoruso, E., Fenoglio, L., Falcetta, A., Bracco, C., Fracanzani, A. L., Fargion, S., Tiraboschi, S., Cespiati, A., Oberti, G., Sigon, G., Peyvandi, F., Rossio, R., Ferrari, B., Colombo, G., Agosti, P., Monzani, V., Savojardo, V., Folli, C., Ceriani, G., Pallini, G., Dallegri, F., Ottonello, L., Liberale, L., Caserza, L., Salam, K., Liberato, N. L., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Ferrandina, C., Montrucchio, G., Petitti, P., Peasso, P., Favale, E., Poletto, C., Salmi, R., Gaudenzi, P., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Campiotti, L., Grossi, A., Bertolotti, M., Mussi, C., Lancellotti, G., Libbra, M. V., Dondi, G., Pellegrini, E., Carulli, L., Galassi, M., Grassi, Y., Perticone, M., Battaglia, R., Filice, M., Maio, R., Stanghellini, V., Ruggeri, E., del Vecchio, S., Salvi, A., Leonardi, R., Damiani, G., Capeci, W., Gabrielli, A., Mattioli, M., Martino, G. P., Biondi, L., Pettinari, P., Ghio, R., Col, A. D., Minisola, S., Colangelo, L., Cilli, M., Labbadia, G., Afeltra, A., Marigliano, B., Pipita, M. E., Castellino, P., Zanoli, L., Pignataro, S., Gennaro, A., Blanco, J., Saracco, V., Fogliati, M., Bussolino, C., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Gasparini, F., Prolo, S., Pina, G., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Gruden, G., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Passariello, N., Rinaldi, L., Berti, F., Famularo, G., Tarsitani, P., Castello, R., Pasino, M., Ceda, G. P., Maggio, M. G., Morganti, S., Artoni, A., Del Giacco, S., Firinu, D., Losa, F., Paoletti, G., Costanzo, G., Montalto, G., Licata, A., Malerba, V., Montalto, F. A., Lasco, A., Basile, G., Catalano, A., Malatino, L., Stancanelli, B., Terranova, V., Di Marca, S., Di Quattro, R., La Malfa, L., Caruso, R., Mecocci, P., Ruggiero, C., Boccardi, V., Meschi, T., Lauretani, F., Ticinesi, A., Nouvenne, A., Minuz, P., Fondrieschi, L., Pirisi, M., Fra, G. P., Sola, D., Porta, M., Riva, P., Quadri, R., Larovere, E., Novelli, M., Scanzi, G., Mengoli, C., Provini, S., Ricevuti, L., Simeone, E., Scurti, R., Tolloso, F., Tarquini, R., Valoriani, A., Dolenti, S., Vannini, G., Tedeschi, A., Trotta, L., Volpi, R., Bocchi, P., Vignali, A., Harari, S., Lonati, C., Cattaneo, M., Napoli, F., Carlotta F., Raffaella R., Ilaria A., Alessandro N., Mannuccio M.P., Mannucci P.M., Nobili A., Pietrangelo A., Perticone F., Licata G., Violi F., Corazza G.R., Corrao S., Marengoni A., Salerno F., Cesari M., Tettamanti M., Pasina L., Franchi C., Cortesi L., Miglio G., Ardoino I., Novella A., Prisco D., Silvestri E., Emmi G., Bettiol A., Caterina C., Biolo G., Zanetti M., Guadagni M., Zaccari M., Chiuch M., Vanoli M., Grignani G., Pulixi E.A., Bernardi M., Bassi S.L., Santi L., Zaccherini G., Lupattelli G., Mannarino E., Bianconi V., Paciullo F., Alcidi R., Nuti R., Valenti R., Ruvio M., Cappelli S., Palazzuoli A., Girelli D., Busti F., Marchi G., Barbagallo M., Dominguez L., Cocita F., Beneduce V., Plances L., Natoli G., Mularo S., Raspanti M., Cavallaro F., Zoli M., Lazzari I., Brunori M., Fabbri E., Magalotti D., Arno R., Pasini F.L., Capecchi P.L., Palasciano G., Modeo M.E., Gennaro C.D., Cappellini M.D., Maira D., Di Stefano V., Fabio G., Seghezzi S., Mancarella M., De Amicis M.M., De Luca G., Scaramellini N., Rossi P.D., Damanti S., Clerici M., Conti F., Bonini G., Ottolini B.B., Di Sabatino A., Miceli E., Lenti M.V., Pisati M., Dominioni C.C., Murialdo G., Marra A., Cattaneo F., Pontremoli R., Beccati V., Nobili G., Secchi M.B., Ghelfi D., Anastasio L., Sofia L., Carbone M., Cipollone F., Guagnano M.T., Valeriani E., Rossi I., Mancuso G., Calipari D., Bartone M., Delitala G., Berria M., Pes C., Delitala A., Muscaritoli M., Molfino A., Petrillo E., Zuccala G., D'Aurizio G., Romanelli G., Zucchelli A., Manzoni F., Volpini A., Picardi A., Gentilucci U.V., Gallo P., Dell'Unto C., Annoni G., Corsi M., Bellelli G., Zazzetta S., Mazzola P., Szabo H., Bonfanti A., Arturi F., Succurro E., Rubino M., Tassone B., Sesti G., Interna M., Serra M.G., Bleve M.A., Gasbarrone L., Sajeva M.R., Brucato A., Ghidoni S., Fabris F., Bertozzi I., Bogoni G., Rabuini M.V., Cosi E., Scarinzi P., Amabile A., Omenetto E., Prandini T., Manfredini R., Fabbian F., Boari B., Giorgi A.D., Tiseo R., De Giorgio R., Paolisso G., Rizzo M.R., Borghi C., Strocchi E., Ianniello E., Soldati M., Sabba C., Vella F.S., Suppressa P., Schilardi A., Loparco F., De Vincenzo G.M., Comitangelo A., Amoruso E., Fenoglio L., Falcetta A., Bracco C., Fracanzani A.L., Fargion S., Tiraboschi S., Cespiati A., Oberti G., Sigon G., Peyvandi F., Rossio R., Ferrari B., Colombo G., Agosti P., Monzani V., Savojardo V., Folli C., Ceriani G., Pallini G., Dallegri F., Ottonello L., Liberale L., Caserza L., Salam K., Liberato N.L., Tognin T., Bianchi G.B., Giaquinto S., Purrello F., Di Pino A., Piro S., Rozzini R., Falanga L., Spazzini E., Ferrandina C., Montrucchio G., Petitti P., Peasso P., Favale E., Poletto C., Salmi R., Gaudenzi P., Perri L., Landolfi R., Montalto M., Mirijello A., Guasti L., Castiglioni L., Maresca A., Squizzato A., Campiotti L., Grossi A., Bertolotti M., Mussi C., Lancellotti G., Libbra M.V., Dondi G., Pellegrini E., Carulli L., Galassi M., Grassi Y., Perticone M., Battaglia R., FIlice M., Maio R., Stanghellini V., Ruggeri E., del Vecchio S., Salvi A., Leonardi R., Damiani G., Capeci W., Gabrielli A., Mattioli M., Martino G.P., Biondi L., Pettinari P., Ghio R., Col A.D., Minisola S., Colangelo L., Cilli M., Labbadia G., Afeltra A., Marigliano B., Pipita M.E., Castellino P., Zanoli L., Pignataro S., Gennaro A., Blanco J., Saracco V., Fogliati M., Bussolino C., Mete F., Gino M., Cittadini A., Vigorito C., Arcopinto M., Salzano A., Bobbio E., Marra A.M., Sirico D., Moreo G., Gasparini F., Prolo S., Pina G., Ballestrero A., Ferrando F., Berra S., Dassi S., Nava M.C., Graziella B., Baldassarre S., Fragapani S., Gruden G., Galanti G., Mascherini G., Petri C., Stefani L., Girino M., Piccinelli V., Nasso F., Gioffre V., Pasquale M., Scattolin G., Martinelli S., Turrin M., Sechi L., Catena C., Colussi G., Passariello N., Rinaldi L., Berti F., Famularo G., Tarsitani P., Castello R., Pasino M., Ceda G.P., Maggio M.G., Morganti S., Artoni A., Del Giacco S., Firinu D., Losa F., Paoletti G., Costanzo G., Montalto G., Licata A., Malerba V., Montalto F.A., Lasco A., Basile G., Catalano A., Malatino L., Stancanelli B., Terranova V., Di Marca S., Di Quattro R., La Malfa L., Caruso R., Mecocci P., Ruggiero C., Boccardi V., Meschi T., Lauretani F., Ticinesi A., Nouvenne A., Minuz P., Fondrieschi L., Pirisi M., Fra G.P., Sola D., Porta M., Riva P., Quadri R., Larovere E., Novelli M., Scanzi G., Mengoli C., Provini S., Ricevuti L., Simeone E., Scurti R., Tolloso F., Tarquini R., Valoriani A., Dolenti S., Vannini G., Tedeschi A., Trotta L., Volpi R., Bocchi P., Vignali A., Harari S., Lonati C., Cattaneo M., Napoli F., Carlotta, F, Raffaella, R, Ilaria, A, Alessandro, N, Mannuccio, M, Mannucci, P, Nobili, A, Pietrangelo, A, Perticone, F, Licata, G, Violi, F, Corazza, G, Corrao, S, Marengoni, A, Salerno, F, Cesari, M, Tettamanti, M, Pasina, L, Franchi, C, Cortesi, L, Miglio, G, Ardoino, I, Novella, A, Prisco, D, Silvestri, E, Emmi, G, Bettiol, A, Caterina, C, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Chiuch, M, Vanoli, M, Grignani, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Lupattelli, G, Mannarino, E, Bianconi, V, Paciullo, F, Alcidi, R, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Girelli, D, Busti, F, Marchi, G, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Natoli, G, Mularo, S, Raspanti, M, Cavallaro, F, Zoli, M, Lazzari, I, Brunori, M, Fabbri, E, Magalotti, D, Arno, R, Pasini, F, Capecchi, P, Palasciano, G, Modeo, M, Gennaro, C, Cappellini, M, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, De Amicis, M, De Luca, G, Scaramellini, N, Rossi, P, Damanti, S, Clerici, M, Conti, F, Bonini, G, Ottolini, B, Di Sabatino, A, Miceli, E, Lenti, M, Pisati, M, Dominioni, C, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Beccati, V, Nobili, G, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, M, Valeriani, E, Rossi, I, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Pes, C, Delitala, A, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccala, G, D'Aurizio, G, Romanelli, G, Zucchelli, A, Manzoni, F, Volpini, A, Picardi, A, Gentilucci, U, Gallo, P, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Tassone, B, Sesti, G, Interna, M, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, M, Cosi, E, Scarinzi, P, Amabile, A, Omenetto, E, Prandini, T, Manfredini, R, Fabbian, F, Boari, B, Giorgi, A, Tiseo, R, De Giorgio, R, Paolisso, G, Rizzo, M, Borghi, C, Strocchi, E, Ianniello, E, Soldati, M, Sabba, C, Vella, F, Suppressa, P, Schilardi, A, Loparco, F, De Vincenzo, G, Comitangelo, A, Amoruso, E, Fenoglio, L, Falcetta, A, Bracco, C, Fracanzani, A, Fargion, S, Tiraboschi, S, Cespiati, A, Oberti, G, Sigon, G, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Agosti, P, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, N, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Peasso, P, Favale, E, Poletto, C, Salmi, R, Gaudenzi, P, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Campiotti, L, Grossi, A, Bertolotti, M, Mussi, C, Lancellotti, G, Libbra, M, Dondi, G, Pellegrini, E, Carulli, L, Galassi, M, Grassi, Y, Perticone, M, Battaglia, R, Filice, M, Maio, R, Stanghellini, V, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Capeci, W, Gabrielli, A, Mattioli, M, Martino, G, Biondi, L, Pettinari, P, Ghio, R, Col, A, Minisola, S, Colangelo, L, Cilli, M, Labbadia, G, Afeltra, A, Marigliano, B, Pipita, M, Castellino, P, Zanoli, L, Pignataro, S, Gennaro, A, Blanco, J, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffre, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Tarsitani, P, Castello, R, Pasino, M, Ceda, G, Maggio, M, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Costanzo, G, Montalto, G, Licata, A, Malerba, V, Montalto, F, Lasco, A, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Di Quattro, R, La Malfa, L, Caruso, R, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Nouvenne, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, G, Sola, D, Porta, M, Riva, P, Quadri, R, Larovere, E, Novelli, M, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, Harari, S, Lonati, C, Cattaneo, M, and Napoli, F
Subjects: Male, medicine.medical_specialty, Socio-culturale, Inappropriate Prescribing, Potentially inappropriate medication, older, Practice Patterns, depression, hospitalized patients, drugs, elderly, drugs, antidepressivi anziano, Polypharmacy | Inappropriate Prescribing | Medications PIMs, antidepressant agent, escitalopram, paroxetine, Internal Medicine, medicine, Hospital discharge, older, Escitalopram, Humans, LS4_4, Medical prescription, Practice Patterns, Physicians', Depression (differential diagnoses), Aged, Polypharmacy, Sertraline, Physicians', antidepressant, business.industry, Trazodone, hospitalized patients, Antidepressive Agents, Hospitalization, Acute Disease, Female, Italy, antidepressants, Emergency medicine, depression, Polypharmacy , Inappropriate Prescribing , Medications, PIM, Delirium, Potentially inappropriate medication, medicine.symptom, business, medicine.drug
Abstract: Depression is often under-recognized in older patients, even if antidepressants (AD) are commonly prescribed, with a prevalence of use that increase with ageing [ 1 ]. Nevertheless, even if a diagnosis of depression is established, inappropriate treatment can occur [ 2 ]. Beers criteria are the most widely screening tools used to detect inappropriate prescription of drugs in people aged 65 years or more [ 3 ]. Since 2010, attempts to adapt the Beers' criteria have been made in Europe [ 4 , 5 ]. Tricyclic drugs are the ADs to be always avoided in the elderly, owing to their anticholinergic side effects, such as cognitive impairment, delirium, urinary retention and falls [ 3 ]. Selective serotonin reuptake inhibitors (SSRIs) should be used with caution because they can cause or exacerbate hyponatraemia [ 3 ]. To our knowledge no studies have been conducted on recent data collected in hospitalized older patients in order to assess the appropriateness of prescription of ADs. With this background, the objectives of this study were to investigate the prevalence of AD use and prescription appropriateness, according to the above-cited criteria, in a large cohort of older patients hospitalized in Italian internal medicine and geriatric wards from 2010 to 2017.
Published: 2019

17. The Natural History of Ferroportin Disease – First Results of the International, Multicenter non-HFE Registry

Author: Raffaela Rametta, André Viveiros, Sebastian Schönherr, E Bardou-Jaquet, Lukas Forer, Alberto Piperno, Sara Pelucchi, Hansi Weissensteiner, Graça Porto, Igor Theurl, Stefania Scarlini, Benedikt Schaefer, John Ryan, O Loreal, F Massimo, Guenter Weiss, Heinz Zoller, Fabiana Busti, Florian Kronenberg, Elena Corradini, Domenico Girelli, Antonello Pietrangelo, Hal Drakesmith, Luca Valenti, and Herbert Tilg
Subjects: Natural history, Oncology, medicine.medical_specialty, business.industry, Internal medicine, Medicine, Ferroportin disease, business
Published: 2019

18. In vitro functional characterization of splicing variants of the APOB gene found in familial hypobetalipoproteinemia

Author: Enza Di Leo, Davide Bocchi, Patrizia Tarugi, Stefano Bertolini, Maria Luisa Simone, Claudio Rabacchi, Antonello Pietrangelo, Livia Pisciotta, Sebastiano Calandra, Sergio D'Addato, Rabacchi C., Simone M.L., Pisciotta L., Di Leo E., Bocchi D., Pietrangelo A., D'Addato S., Bertolini S., Calandra S., and Tarugi P.
Subjects: Adult, Male, Nonsynonymous substitution, Truncated apoB, Apolipoprotein B, Splicing variants, RNA Splicing, Endocrinology, Diabetes and Metabolism, In silico, Intron, 030204 cardiovascular system & hematology, Chlorocebus aethiop, Splicing variant, Hypobetalipoproteinemias, 03 medical and health sciences, Exon, 0302 clinical medicine, COS Cell, Chlorocebus aethiops, Internal Medicine, Animals, Humans, Medicine, 030212 general & internal medicine, Familial hypobetalipoproteinemia, APOB gene, Aged, Genetics, Nutrition and Dietetics, biology, Animal, business.industry, Middle Aged, Introns, Exon skipping, Truncated apoBs, COS Cells, Apolipoprotein B-100, RNA splicing, Codon, Terminator, biology.protein, Female, Cardiology and Cardiovascular Medicine, business, Hypobetalipoproteinemia, Human, Minigene
Abstract: Background: Familial hypobetalipoproteinemia type 1 (FHBL-1) is a codominant disorder characterized by greatly reduced plasma levels of total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B. Rare exonic pathogenic variants of APOB gene (nonsense variants, minute deletions/insertions and nonsynonymous variants) have been frequently reported in subjects with FHBL-1. Also, rare intronic variants of APOB located at intron/exon junctions and assumed to affect splicing have been reported. However, the pathogenicity of most of these intronic variants remains to be established. Objective: The objective of this study was the in vitro functional characterization of six splicing variants of APOB gene identified in seven putative FHBL-1 heterozygotes. Methods: ApoB minigenes harboring each variant were expressed in COS-1 cells and their transcripts were sequenced. Results: Four novel variants (c.237+1G>A, c.818+5G>A, c.3000-1G>T, and c.3842+1G>A), predicted in silico to obliterate splice site activity, were found to generate abnormal transcripts. The abnormal transcripts were generated by the activation of cryptic splice sites or exon skipping. All these transcripts harbored a premature termination codon and were predicted to encode truncated apoBs devoid of function. The predicted translation products were: i) p.(Lys41Serfs*2) and p.(Val80Ilefs*10) for c.237+1G>A; ii) p.(Asn274*) for c.818+5G>A; iii) p.(Leu1001Alafs*10) for c.3000-1G>T, and iv) p.(Ser1281Argfs*2) for c.3842+1G>A. Two previously annotated rare variants (c.905-15C>G and c.1618-4G>A) with uncertain effect in silico were found to generate only wild-type transcripts. Conclusions: These in vitro minigene expression studies support the assignment of pathogenicity to four novel splice site variants of APOB gene found in FHBL-1.
Published: 2019

19. Safety and efficacy of sucrosomal iron in inflammatory bowel disease patients with iron deficiency anemia

Author: Elena Buzzetti, Federica Incerti, Gianluca Abbati, Paolo Ventura, Chiara Boarini, Davide Bocchi, Antonello Pietrangelo, and Francesca Pileri
Subjects: Adult, Male, medicine.medical_specialty, Anemia, Iron, 030204 cardiovascular system & hematology, Inflammatory bowel disease, Gastroenterology, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Hepcidins, Hepcidin, Internal medicine, Internal Medicine, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Adverse effect, biology, Anemia, Iron-Deficiency, business.industry, Middle Aged, IBD, Iron, Sucrosomial, Anemia. Hepcidin, medicine.disease, Inflammatory Bowel Diseases, Ulcerative colitis, digestive system diseases, Regimen, Tolerability, Iron-deficiency anemia, Emergency Medicine, biology.protein, Colitis, Ulcerative, Female, business
Abstract: Iron deficiency anemia (IDA) is one of the most common complications of inflammatory bowel disease (IBD). We planned a prospective study to address tolerability and efficacy of sucrosomial iron, a new oral formulation of ferric pyrophosphate, in IBD patients. Thirty patients with a confirmed diagnosis of Crohn’s Disease (CD) or ulcerative colitis (UC) and mild IDA were enrolled. Patients with severe IBD were excluded. All patients underwent 12 weeks of oral treatment with 30 mg/day of sucrosomial iron. Treatment compliance and adverse events were investigated every 4 weeks. Iron status, hematological parameters and IBD activity scores were determined at baseline and at the end of treatment, as well as serum hepcidin and non-transferrin bound iron (NTBI) levels. Twenty-four (80%) patients took more than 90% of the prescribed regimen. Forty-four adverse events (AEs) were recorded, but none of them is considered certainly or probably related to the study treatment. Interestingly, only eleven gastrointestinal events were recorded in 9 (30%) patients. At the end of treatment, all iron parameters improved significantly and Hb increased in 86% of patients (from 11.67 to 12.37 g/dl, p = 0.001). Serum hepcidin showed a significant increase in 79% of patients and became positively correlated with C-reactive protein (CRP) at the end of the study, while NTBI remained below the detection threshold after iron supplementation. The IBD activity scores improved in both CD and UC. This pilot interventional study supports the therapeutic use of sucrosomial iron in IBD and paves the way for future studies in larger or more difficult IBD populations.
Published: 2019

20. Impact of natural Neuromedin-B receptor variants on iron metabolism

Author: Marica Meroni, Silvia Fargion, Paola Dongiovanni, Anna Ludovica Fracanzani, Annalisa Castagna, Stefania Scarlini, Domenico Girelli, Serena Pelusi, Guido Baselli, Fabiana Busti, Antonello Pietrangelo, Luca Valenti, Elena Corradini, and Raffaela Rametta
Subjects: Adult, Male, medicine.medical_specialty, Iron Overload, Iron, Mutation, Missense, Neuromedin B receptor, Mice, 03 medical and health sciences, 0302 clinical medicine, Non-alcoholic Fatty Liver Disease, Hepcidin, Internal medicine, Animals, Humans, Medicine, iron metabolism, Receptor, Hemochromatosis, Aged, biology, business.industry, Transferrin saturation, Fatty liver, Transferrin, Hematology, Middle Aged, medicine.disease, neuromedin, Receptors, Bombesin, Ferritin, Endocrinology, Amino Acid Substitution, 030220 oncology & carcinogenesis, Hereditary hemochromatosis, Ferritins, biology.protein, Female, business, 030215 immunology
Abstract: Iron overload heritability remains partly unexplained. By performing whole exome sequencing in three patients with a clinical phenotype of hemochromatosis not accounted by known genetic risk factors, we identified in all patients rare variants predicted to alter activity of Neuromedin-B receptor (NMBR). Coding NMBR mutations were enriched in 129 patients with hereditary hemochromatosis or iron overload phenotype, as compared to ethnically matched controls, including 100 local healthy blood donors and 1000Genomes project participants (15.5% vs 5%, P = .0038 at burden test), and were associated with higher transferrin saturation in regular blood donors (P = .04). Consistently, in 191 patients with nonalcoholic fatty liver, the most common low-frequency p.L390 M variant was independently associated with higher ferritin (P = .03). In 58 individuals, who underwent oral iron challenge, carriage of the p.L390 M variant was associated with higher transferrin saturation and lower hepcidin release. Furthermore, the circulating concentration of the natural NMBR ligand, Neuromedin-B, was reduced in response to iron challenge. It was also decreased in individuals carrying the p.L390 M variant and with hemochromatosis in parallel with increased transferrin saturation. In mice, Nmbr was induced by chronic dietary iron overload in the liver, gut, pancreas, spleen, and skeletal muscle, while Nmb was downregulated in gut, pancreas and spleen. Finally, Nmb amplified holo-transferrin dependent induction of hepcidin in primary mouse hepatocytes, which was associated with Jak2 induction and abolished by the NMBR antagonist PD168368. In conclusion, NMBR natural variants were enriched in patients with iron overload, and associated with facilitated iron absorption, possibly related to a defect of iron-induced hepcidin release.
Published: 2019

21. Hyperhomocysteinemia and MTHFR C677T polymorphism in patients with portal vein thrombosis complicating liver cirrhosis

Author: Chiara Cuoghi, Stefano Marchini, Antonello Pietrangelo, Paolo Ventura, Giorgia Venturelli, Matteo Marcacci, and Massimo Fiorini
Subjects: Liver Cirrhosis, Male, medicine.medical_specialty, Hyperhomocysteinemia, Carcinoma, Hepatocellular, Cirrhosis, Homocysteine, Homocysteine Hepatocellular carcinoma Portal vein thrombosis MTHFR status Thrombophilia, Thrombophilia, Polymorphism, Single Nucleotide, Gastroenterology, 03 medical and health sciences, Liver disease, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, Humans, Methylenetetrahydrofolate Reductase (NADPH2), Aged, Retrospective Studies, Venous Thrombosis, biology, Portal Vein, business.industry, Liver Neoplasms, Hematology, Middle Aged, medicine.disease, Thrombosis, digestive system diseases, Portal vein thrombosis, Endocrinology, chemistry, 030220 oncology & carcinogenesis, Methylenetetrahydrofolate reductase, biology.protein, Female, 030211 gastroenterology & hepatology, business
Abstract: Background Portal vein thrombosis (PVT) is serious complication of liver cirrhosis (LC), especially in the presence of hepatocellular carcinoma (HCC). The liver plays a key role in homocysteine (Hcy) metabolism: mild hyperhomocysteinemia (HHcy) has been described in LC. HHcy is a risk factor for deep vein thrombosis. Methylen-tetrahydrofolate-reductase (MTHFR) C677T polymorphism is the commonest determinant of mild HHcy and has been involved also in cancer development. Aim To investigate a possible relation between HHcy, MTHFR status, HCC and PVT in patients affected by LC. Materials and methods 100 patients affected by LC, 38 with (PVT group, 24 with HCC) and 62 without PVT (LC group, 14 with HCC) sex-, age-, liver disease stage and etiology-matched were assessed for thrombophilia, smoking status, plasma Hcy, MTHFRC677T polymorphism and homocysteine-related vitamin status. Results A higher prevalence of HCC, HHcy and MTHFR TT status was observed in PVT group. No significant difference in vitamin status was observed between groups. Patients with HCC showed significantly higher plasma Hcy and higher prevalence of HHcy than patients without HCC. They had also higher prevalence of MTHFR TT status. In patients with TT status ( n = 11) and HCC, 10 had HHcy e 9 had PVT. Conclusions Mild HHcy is associated to LC may have a role in PVT development and assessment of plasma Hcy may be suggested in patients with LC (especially if complicated by HCC). Association between HCC and MTHFR TT status is intriguing, due the postulated role for this polymorphism in cancer: it may represent a possible link between HCC and PVT.
Published: 2016

22. Iron and the liver

Author: Antonello Pietrangelo
Subjects: 0301 basic medicine, medicine.medical_specialty, Iron, Ferroportin, Hepcidin, medicine.disease_cause, 03 medical and health sciences, Liver disease, Hepcidins, NAFLD, Internal medicine, medicine, Humans, Hemochromatosis Protein, Hemochromatosis, Cardiovascular diseases, Diabetes, Hepatology, chemistry.chemical_classification, biology, Liver Diseases, Histocompatibility Antigens Class I, Membrane Proteins, nutritional and metabolic diseases, medicine.disease, 030104 developmental biology, Endocrinology, Liver, chemistry, Transferrin, Immunology, Toxicity, biology.protein, Oxidative stress, Hormone
Abstract: Humans have evolved to retain iron in the body and are exposed to a high risk of iron overload and iron-related toxicity. Excess iron in the blood, in the absence of increased erythropoietic needs, can saturate the buffering capacity of serum transferrin and result in non-transferrin-bound highly reactive forms of iron that can cause damage, as well as promote fibrogenesis and carcinogenesis in the parenchymatous organs. A number of hereditary or acquired diseases are associated with systemic or local iron deposition or iron misdistribution in organs or cells. Two of these, the HFE- and non-HFE hemochromatosis syndromes represent the paradigms of genetic iron overload. They share common clinical features and the same pathogenic basis, in particular, a lack of synthesis or activity of hepcidin, the iron hormone. Before hepcidin was discovered, the liver was simply regarded as the main site of iron storage and, as such, the main target of iron toxicity. Now, as the main source of hepcidin, it appears that the loss of the hepcidin-producing liver mass or genetic and acquired factors that repress hepcidin synthesis in the liver may also lead to iron overload. Usually, there is low-grade excess iron which, through oxidative stress, is sufficient to worsen the course of the underlying liver disease or other chronic diseases that are apparently unrelated to iron, such as chronic metabolic and cardiovascular diseases. In the future, modulation of hepcidin synthesis and activity or hepcidin hormone-replacing strategies may become therapeutic options to cure iron-related disorders.
Published: 2016

23. Luspatercept improves hemoglobin levels and blood transfusion requirements in a study of patients with β-thalassemia

Author: Angela Melpignano, Antonello Pietrangelo, Maria Rita Gamberini, Silverio Perrotta, Xiaosha Zhang, Filomena Longo, Caterina Borgna-Pignatti, Abderrahmane Laadem, Vincenzo Caruso, Aldo Filosa, Kenneth M. Attie, Antonio Piga, Ersi Voskaridou, Immacolata Tartaglione, and Matthew L. Sherman
Subjects: myalgia, Adult, Male, medicine.medical_specialty, Blood transfusion, Anemia, Activin Receptors, medicine.medical_treatment, Thalassemia, Activin Receptors, Type II, Recombinant Fusion Proteins, Immunology, Plenary Paper, Type II, Biochemistry, law.invention, Hemoglobins, Young Adult, Randomized controlled trial, law, Internal medicine, medicine, Humans, Blood Transfusion, Adverse effect, business.industry, Surrogate endpoint, beta-Thalassemia, Cell Biology, Hematology, Middle Aged, medicine.disease, Prognosis, Activins, Erythrocyte Transfusion, Female, Follow-Up Studies, Immunoglobulin Fc Fragments, Hemoglobin, medicine.symptom, business
Abstract: β-thalassemia is a hereditary disorder with limited approved treatment options; patients experience anemia and its complications, including iron overload. The study aim was to determine whether luspatercept could improve anemia and disease complications in patients with β-thalassemia. This open-label, nonrandomized, uncontrolled study consisted of a 24-week dose-finding and expansion stage (initial stage) and a 5-year extension stage, currently ongoing. Sixty-four patients were enrolled; 33 were non–transfusion dependent (mean hemoglobin
Published: 2018

24. Is poor vitamin status a reliable target for treatment of symptomatic patients with hepatic acute porphyrias?

Author: Paolo Ventura, Matteo Marcacci, Chiara Cuoghi, D. Vaccari, Antonello Pietrangelo, and Stefano Marchini
Subjects: Vitamin, Acute porphyrias, medicine.medical_specialty, chemistry.chemical_compound, Hepatology, chemistry, business.industry, Internal medicine, Gastroenterology, Medicine, business
Published: 2019

25. Activin B Induces Noncanonical SMAD1/5/8 Signaling via BMP Type I Receptors in Hepatocytes: Evidence for a Role in Hepcidin Induction by Inflammation in Male Mice

Author: Maria Merkulova, Jodie L. Babitt, Amanda B. Core, Chia-Yu Wang, Antonello Pietrangelo, Kimberly B. Zumbrennen-Bullough, Alan L. Schneyer, and Susanna Canali
Subjects: 0301 basic medicine, Male, Smad5 Protein, medicine.medical_specialty, endocrine system, animal structures, Immunoblotting, Type I, ACVR1, Real-Time Polymerase Chain Reaction, Cell Line, Smad1 Protein, 03 medical and health sciences, Mice, Endocrinology, Hepcidins, Hepcidin, Internal medicine, Cell Line, Tumor, TGF beta signaling pathway, medicine, Animals, Humans, Activin type 2 receptors, Bone Morphogenetic Protein Receptors, Type I, Hemojuvelin, Original Research, Inflammation, Tumor, biology, Reverse Transcriptase Polymerase Chain Reaction, Bone Morphogenetic Protein Receptors, Surface Plasmon Resonance, Activins, Hepatocytes, Signal Transduction, Smad8 Protein, 030104 developmental biology, embryonic structures, biology.protein, Signal transduction, ACVR2B, hormones, hormone substitutes, and hormone antagonists, ACVR2A
Abstract: Induction of the iron regulatory hormone hepcidin contributes to the anemia of inflammation. Bone morphogenetic protein 6 (BMP6) signaling is a central regulator of hepcidin expression in the liver. Recently, the TGF-β/BMP superfamily member activin B was implicated in hepcidin induction by inflammation via noncanonical SMAD1/5/8 signaling, but its mechanism of action and functional significance in vivo remain uncertain. Here, we show that low concentrations of activin B, but not activin A, stimulate prolonged SMAD1/5/8 signaling and hepcidin expression in liver cells to a similar degree as canonical SMAD2/3 signaling, and with similar or modestly reduced potency compared with BMP6. Activin B stimulates hepcidin via classical activin type II receptors ACVR2A and ACVR2B, noncanonical BMP type I receptors activin receptor-like kinase 2 and activin receptor-like kinase 3, and SMAD5. The coreceptor hemojuvelin binds to activin B and facilitates activin B-SMAD1/5/8 signaling. Activin B-SMAD1/5/8 signaling has some selectivity for hepatocyte-derived cells and is not enabled by hemojuvelin in other cell types. Liver activin B mRNA expression is up-regulated in multiple mouse models of inflammation associated with increased hepcidin and hypoferremia, including lipopolysaccharide, turpentine, and heat-killed Brucella abortus models. Finally, the activin inhibitor follistatin-315 blunts hepcidin induction by lipopolysaccharide or B. abortus in mice. Our data elucidate a novel mechanism for noncanonical SMAD activation and support a likely functional role for activin B in hepcidin stimulation during inflammation in vivo.
Published: 2017

26. An unfortunate case of post-ERCP complications

Author: Alberto Vegetti, Massimo Fiorini, and Antonello Pietrangelo
Subjects: medicine.medical_specialty, MEDLINE, Emergency Medicine, Internal Medicine, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, X ray computed, medicine, Combined Modality Therapy, Humans, Cholangiopancreatography, Endoscopic Retrograde, Hematoma, business.industry, Liver Diseases, Middle Aged, Anti-Bacterial Agents, Pancreatitis, Emergency medicine, Acute Disease, Drainage, 030211 gastroenterology & hepatology, Female, Radiology, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery
Published: 2017

27. Rare ceruloplasmin variants are associated with hyperferritinemia and increased hepatic iron in NAFLD patients: results from a NGS study

Author: Paola Dongiovanni, Antonello Pietrangelo, Silvia Fargion, A.L. Fracanzani, Elena Corradini, Lucia Artuso, Angela Caleffi, Elena Tenedini, R. Rametta, Serena Pelusi, Elena Buzzetti, Enrico Tagliafico, Luca Valenti, and Isabella Bernardis
Subjects: medicine.medical_specialty, Hepatology, biology, business.industry, 02 engineering and technology, 021001 nanoscience & nanotechnology, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, biology.protein, Medicine, 030211 gastroenterology & hepatology, Hepatic iron, 0210 nano-technology, business, Ceruloplasmin
Published: 2018

28. Mixed hepatic iron deposition but not serum ferritin is associated with the presence of nonalcoholic steatohepatitis (NASH)

Author: Antonello Pietrangelo, S. Petta, Emmanuel Tsochatzis, Roberta Manuguerra, Elena Corradini, Massimo Pinzani, Elena Buzzetti, Daniela Cabibi, Antonio Craxì, and Tu Vinh Luong
Subjects: Nonalcoholic steatohepatitis, medicine.medical_specialty, Endocrinology, Hepatology, Chemistry, Internal medicine, medicine, Hepatic iron, Serum ferritin, Deposition (chemistry)
Published: 2018

29. LBP-32-The Natural History of Ferroportin Disease-First Results of the International, Multicenter EASL non-HFE Registry

Author: Graça Porto, Sebastian Schoenherr, Günter Weiss, Dorine W. Swinkels, André Viveiros, Lukas Forer, Heinz Zoller, Stefania Scarlini, Olivier Loréal, Martina U. Muckenthaler, Sara Pelucchi, Igor Theurl, Alberto Piperno, Massimo Fiorini, Hansi Weissensteiner, Nathan Subramaniam, Edouard Bardou-Jacquet, Raffaela Rametta, Alexander Drakesmith, Mayka Sanchez, Benedikt Schaefer, John Ryan, Fabiana Busti, Antonello Pietrangelo, Elena Corradini, Florian Kronenberg, Domenico Girelli, Herbert Tilg, and Luca Valenti
Subjects: Natural history, medicine.medical_specialty, Hepatology, business.industry, Internal medicine, medicine, Ferroportin disease, business
Published: 2019

30. Sudden Onset of Lower Abdominal Pain Without Peritonitis or Ileus

Author: Stefania Scarlini, Marco Gandolfo, and Antonello Pietrangelo
Subjects: 0301 basic medicine, medicine.medical_specialty, Ileus, medicine.medical_treatment, Peritonitis, lcsh:Medicine, 03 medical and health sciences, 0302 clinical medicine, Lower abdominal pain, Diabetes mellitus, Clostridium septicum, Internal Medicine, medicine, 030222 orthopedics, Debridement, business.industry, lcsh:R, Immunosuppression, Articles, medicine.disease, Gas-gangrene, Clostridium septicum, acute abdominal pain, acute abdominal pain, Surgery, Radiation therapy, 030104 developmental biology, Gas gangrene, business
Abstract: A patient presented with sudden, unexplained lower abdominal pain without peritonism or signs of infection or inflammatory reaction, but with recent bloody stools and a history of radiation therapy, diabetes and immunosuppression. Plain abdominal x-ray showed only air-fluid levels and air distention of the colon, but a later abdominal CT scan revealed extensive gas gangrene of the colon. The patient’s clinical status rapidly worsened. Elective surgical rectosigmoid debridement did not prevent the patient’s death. In conclusion, the diagnosis of ‘spontaneous’ life-threatening gas gangrene requires a high degree of clinical suspicion and allows life-saving surgical intervention. LEARNING POINTS Sudden and rapidly worsening lower abdominal pain without peritonitis or ileus can indicate gas gangrene from distal bowel perforation. Bloody stools or other symptoms and/or procedures reported previously and apparently resolved could indicate hidden perforation. Diagnostic gas detection, clinically or radiologically, occurs too late to prevent fatal consequences, so early signs of infection and inflammation should be sought for and evaluated as early surgery is life saving.
Published: 2016

31. Mechanisms of iron hepatotoxicity

Author: Antonello Pietrangelo
Subjects: 0301 basic medicine, Liver Cirrhosis, medicine.medical_specialty, Liver fibrosis, Iron, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Hemochromatosis, Reactive oxygen species, Hepatology, Internal medicine, medicine, Humans, Hemochromatosis Protein, chemistry.chemical_classification, business.industry, medicine.disease, 030104 developmental biology, chemistry, Liver, 030220 oncology & carcinogenesis, Chemical and Drug Induced Liver Injury, business
Published: 2016

32. The SMAD pathway is required for hepcidin response during endoplasmic reticulum stress

Author: Antonello Pietrangelo, Giuliana Montosi, Chiara Vecchi, Susanna Canali, Jodie L. Babitt, and Cinzia Garuti
Subjects: Male, inorganic chemicals, 0301 basic medicine, CAMP Responsive Element Binding Protein, congenital, hereditary, and neonatal diseases and abnormalities, Small interfering RNA, medicine.medical_specialty, SMAD, Bone morphogenetic protein, digestive system, 03 medical and health sciences, Endocrinology, Hepcidins, Hepcidin, hemic and lymphatic diseases, Internal medicine, medicine, Animals, Humans, Original Research, biology, Chemistry, Endoplasmic reticulum, nutritional and metabolic diseases, Hep G2 Cells, Endoplasmic Reticulum Stress, Smad Proteins, Receptor-Regulated, Mice, Inbred C57BL, 030104 developmental biology, biology.protein, Unfolded protein response, Signal transduction, Signal Transduction
Abstract: Hepcidin, the iron hormone, is regulated by a number of stimulatory and inhibitory signals. The cAMP responsive element binding protein 3-like 3 (CREB3L3) mediates hepcidin response to endoplasmic reticulum (ER) stress. In this study we asked whether hepcidin response to ER stress also requires the small mother against decapentaplegic (SMAD)-1/5/8 pathway, which has a major role in hepcidin regulation in response to iron and other stimuli. We analyzed hepcidin mRNA expression and promoter activity in response to ER stressors in HepG2 cells in the presence of the bone morphogenetic protein (BMP) type I receptor inhibitor LDN-193189, mutated hepcidin promoter or small interfering RNA against different SMAD proteins. We then used a similar approach in vivo in wild-type, Smad1/5, or Creb3l3−/− animals undergoing ER stress. In vitro, LDN-193189 prevented hepcidin mRNA induction by different ER stressors. Seemingly, mutation of a BMP-responsive element in the hepcidin promoter prevented ER stress-mediated up-regulation. Moreover, in vitro silencing of SMAD proteins by small interfering RNA, in particular SMAD5, blunted hepcidin response to ER stress. On the contrary, hepcidin induction by ER stress was maintained when using antibodies against canonical BMP receptor ligands. In vivo, hepcidin was induced by ER stress and prevented by LDN-193189. In addition, in Smad1/5 knockout mice, ER stress was unable to induce hepcidin expression. Finally, in Creb3l3 knockout mice, in response to ER stress, SMAD1/5 were correctly phosphorylated and hepcidin induction was still appreciable, although to a lesser extent as compared with the control mice. In conclusion, our study indicates that hepcidin induction by ER stress involves the central regulatory SMAD1/5 pathway.
Published: 2016

33. Iron and steatohepatitis

Author: Elena Corradini and Antonello Pietrangelo
Subjects: medicine.medical_specialty, Alcoholic liver disease, Hepatology, biology, business.industry, Fatty liver, Gastroenterology, medicine.disease, Liver disease, Endocrinology, Hepcidin, Internal medicine, medicine, Genetic predisposition, biology.protein, Steatohepatitis, business, Homeostasis, Hormone
Abstract: As the main iron storage site in the body and the main source of the iron-regulatory hormone, hepcidin, the liver plays a pivotal role in iron homeostasis. A variable degree of hepatic iron accumulation has long been recognized in a number of chronic liver diseases. Both alcoholic and non-alcoholic steatohepatitis display increased iron deposits in the liver, with an hepatocellular, mesenchymal, or mixed pattern, and recent reports have documented a concomitant aberrant hepcidin expression that could be linked to different coincidental pathogenic events (e.g. the etiological agent itself, necroinflammation, metabolic derangements, genetic predisposition). The present study reviews the pathogenic mechanisms of iron accumulation in steatohepatitis during alcoholic and non-alcoholic liver disease and the role of excess iron in chronic disease progression.
Published: 2012

34. Altered hepatic BMP signaling pathway in human HFE hemochromatosis

Author: Cinzia Garuti, Elena Corradini, Giuliano Bolondi, Heinz Zoller, Herbert Y. Lin, Jodie L. Babitt, Wolfgang Vogel, Armin Finkenstedt, and Antonello Pietrangelo
Subjects: Inhibitor of Differentiation Protein 1, congenital, hereditary, and neonatal diseases and abnormalities, Liver Iron Concentration, medicine.medical_specialty, Iron Overload, SMAD, Biology, Bone morphogenetic protein, Article, Smad7 Protein, Hepcidins, Hepcidin, Internal medicine, medicine, Humans, RNA, Messenger, Hemochromatosis Protein, BMP signaling pathway, Molecular Biology, Hemochromatosis, Histocompatibility Antigens Class I, Iron overload, Bone morphogenetic proteins, Membrane Proteins, nutritional and metabolic diseases, Cell Biology, Hematology, medicine.disease, Endocrinology, Gene Expression Regulation, Liver, Bone Morphogenetic Proteins, biology.protein, Molecular Medicine, HAMP, Signal transduction, Antimicrobial Cationic Peptides, Signal Transduction
Abstract: Human hemochromatosis (HC) has been associated with the common C282Y polymorphism of HFE or rare pathogenic mutations of TfR2, HJV, FPN and HAMP. All forms of human HC seem to be caused by low or inadequate levels of hepcidin, the iron hormone. We and others have recently shown that Hfe(-/-) mice exhibit an impairment in the bone morphogenetic protein (BMP) signaling pathway controlling hepcidin. However, all data indicating the central role of BMPs in hepcidin regulation and an impaired BMP/SMAD signaling in HC have been collected in mice. In this study we investigated whether also in humans the expression of BMP signaling targets, SMAD7 and Id1, are associated with liver iron concentration (LIC) and whether such regulation is disrupted in HFE-HC. We correlated the mRNA expression, assessed by RT-PCR, of HAMP, SMAD7 and Id1 with LIC in liver biopsies from patients with normal iron status, HFE-HC or non-HC hepatic iron overload. We found that in human liver, not only HAMP, but also SMAD7 and Id1 mRNA significantly correlate with the extent of hepatic iron burden. However, this correlation is lost in patients with HFE-HC, but maintained in subjects with non-hemochromatotic iron overload. These data indicate that in human HFE-HC a disrupted BMP/SMAD signaling in the liver is key in the pathogenesis of the disease.
Published: 2010

35. Hemochromatosis: An endocrine liver disease

Author: Antonello Pietrangelo
Subjects: EXPRESSION, medicine.medical_specialty, Iron, FERROPORTIN DISEASE, Ferroportin, Endocrine System Diseases, PHENOTYPE, Bioinformatics, NONINVASIVE PREDICTION, HEPCIDIN, Hepcidins, Hepcidin, Internal medicine, MAGNETIC-RESONANCE, IRON OVERLOAD, medicine, Homeostasis, Humans, Hemochromatosis Protein, Hemochromatosis, Hemojuvelin, HEREDITARY HEMOCHROMATOSIS, Endocrine disease, Hepatology, biology, MUTATIONS, business.industry, Histocompatibility Antigens Class I, JUVENILE HEMOCHROMATOSIS, Membrane Proteins, medicine.disease, Juvenile hemochromatosis, Endocrinology, Hereditary hemochromatosis, Mutation, biology.protein, HAMP, business, Antimicrobial Cationic Peptides
Abstract: This review acknowledges the recent and dramatic advancement in the field of hemochromatosis and highlights the surprising analogies with a prototypic endocrine disease, diabetes. The term hemochromatosis should refer to a unique clinicopathologic subset of iron-overload syndromes that currently includes the disorder related to the C282Y homozygote mutation of the hemochromatosis protein HFE (by far the most common form of hemochromatosis) and the rare disorders more recently attributed to the loss of transferrin receptor 2, HAMP (hepcidin antimicrobial peptide), or hemojuvelin or to certain ferroportin mutations. The defining characteristic of this subset is failure to prevent unneeded iron from entering the circulatory pool as a result of genetic changes compromising the synthesis or activity of hepcidin, the iron hormone. Like diabetes, hemochromatosis results from the complex, nonlinear interaction between genetic and acquired factors. Depending on the underlying mutation, the coinheritance of modifier genes, the presence of nongenetic hepcidin inhibitors, and other host-related factors, the clinical manifestation may vary from simple biochemical abnormalities to severe multiorgan disease. The recognition of the endocrine nature of hemochromatosis suggests intriguing possibilities for new and more effective approaches to diagnosis and treatment.
Published: 2007

36. Reducing the risk of hospital admission: a call to action from the Italian Society of Internal Medicine

Author: Francesco Violi, Francesco Perticone, Antonello Pietrangelo, Rodolfo Sbrojavacca, Gino Roberto Corazza, and Luigi Fenoglio
Subjects: Cross infection, Frail Elderly, Health outcomes, Patient Admission, Risk Factors, Health care, Internal Medicine, Medicine, Humans, Frail elderly, Societies, Medical, Aged, Aged, 80 and over, Cross Infection, business.industry, Stressor, Length of Stay, medicine.disease, humanities, Call to action, Italy, Frail patient, Hospital admission, Iatrogenic damages, Stressors, Medicine (all), Medical emergency, business, Hospital stay
Abstract: The belief that hospital stays may constitute per se a risk for patients is not widespread among patients and health care professionals. In the balance between advantages and disadvantages of admission, we rarely take into account the impact of the hospital stay itself on the well-being of the patient. In a society that is getting older the hospital may become a hostile environment for the complex and frail patient. Reducing the risks associated with hospital admission implies a radical cultural change accepted and shared by all health care professionals. The critical reconsideration of admission is a way of reasoning not only on hospitalisation but also on what the correct health outcome paradigms should be.
Published: 2015

37. Primary hypoparathyroidism is common in adult patients with [beta]-thalassemia and protect patients from osteoporosis

Author: Antonello Pietrangelo, Francesca Ferrara, Anna Ansaloni, Chiara Diazzi, Vincenzo Rochira, and Manuela Simoni
Subjects: medicine.medical_specialty, Pediatrics, Adult patients, business.industry, Thalassemia, Osteoporosis, Beta thalassemia, medicine.disease, Endocrinology, medicine.anatomical_structure, Hypoparathyroidism, Internal medicine, medicine, Parathyroid gland, business, Primary Hypoparathyroidism
Published: 2015

38. Hepcidin and iron

Author: Antonello Pietrangelo and Chiara Vecchi
Subjects: Bone morphogenetic proteins (BMPs), medicine.medical_specialty, CREB3L3 (CREBH), biology, business.industry, Cyclic adenosine monophosphate (cAMP) response element binding protein 3-like 3, Small mother against decapentaplegic (SMAD), Ferroportin, medicine.disease, Anemia of chronic disease, Hepcidin gene (HAMP), Endocrinology, Hepcidin, Hemochromatosis, Hemojuvelin, Signal transducer and activator of transcription 3 (STAT3), Internal medicine, medicine, biology.protein, business
Published: 2015

39. Kupffer cells and macrophages are not required for hepatic hepcidin activation during iron overload

Author: Francesca Ferrara, Elena Corradini, Linda Valli, Giuliana Montosi, Stefania Recalcati, Antonello Pietrangelo, S. Barelli, Elisa Pignatti, Gaetano Cairo, Cinzia Garuti, and Chiara Vecchi
Subjects: Lipopolysaccharides, Male, LIVER, Lipopolysaccharide, medicine.medical_treatment, PROTEIN, Gadolinium, Mice, chemistry.chemical_compound, hemic and lymphatic diseases, Macrophage, Cells, Cultured, Mice, Inbred BALB C, HEREDITARY HEMOCHROMATOSIS, biology, Kupffer cell, Middle Aged, Cytokine, medicine.anatomical_structure, Liver, Hereditary hemochromatosis, Female, medicine.symptom, REGULATOR, EXPRESSION, Adult, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Iron Overload, Kupffer Cells, Inflammation, digestive system, INFLAMMATION, Hepcidins, Downregulation and upregulation, Hepcidin, Internal medicine, GADOLINIUM CHLORIDE, ANTIMICROBIAL PEPTIDE, HFE, ANEMIA, medicine, Animals, Humans, RNA, Messenger, Hemochromatosis Protein, Hepatology, Macrophages, Histocompatibility Antigens Class I, Membrane Proteins, nutritional and metabolic diseases, Endocrinology, chemistry, biology.protein, Antimicrobial Cationic Peptides
Abstract: Hepcidin, the iron hormone, is produced by the liver in response to iron and inflammation. Its synthesis during inflammation is triggered by cytokines, but the details of iron activation are obscure. We tested the role of Kupffer cells and macrophages by studying iron-loaded or inflamed mice with selective inactivation of Kupffer cells or the in vitro effect of conditioned human macrophages on hepcidin expression. Hepcidin messenger RNA (mRNA) expression was studied by Northern blot and reverse transcriptase polymerase chain reaction analysis in mice that were treated with 40 mg/kg gadolinium (III) chloride (GdCl(3)) as a Kupffer cell inactivating agent and subjected to inflammatory challenges with either lipopolysaccharide (LPS) and turpentine or iron overload by iron-dextran administration. Similar analyses were performed in human hepatoma cells (HepG2) cultured with medium from LPS- or iron-conditioned macrophages from blood donors or patients with HFE-linked hereditary hemochromatosis (HH). In vivo, LPS and particularly turpentine stimulated hepcidin mRNA expression, and this effect was prevented by the inactivation of Kupffer cells. Also, iron overload markedly upregulated hepatic hepcidin mRNA, but this activity persisted in spite of Kupffer cell blockade. In vitro, the medium of LPS-treated normal or hemocromatotic macrophages turned on hepcidin expression. On the contrary, medium of iron-manipulated macrophages, regardless of their HFE status, did not affect hepcidin mRNA steady-state levels. In conclusion, Kupffer cells are required for the activation of hepcidin synthesis during inflammation, and HH inflamed macrophages are capable of mounting a normal response, eventually leading to hepcidin stimulation. However, both Kupffer cells and human macrophages are dispensable for the regulatory activity exerted by iron on hepatic hepcidin.
Published: 2005

40. [Untitled]

Author: Alberto Masini, Giuliana Montosi, Cinzia Garuti, Fabiola Giovannini, Miranda Contri, Antonello Pietrangelo, and Daniela Ceccarelli
Subjects: Membrane potential, medicine.medical_specialty, Physiology, Cell Biology, Biology, Mitochondrion, Gerbil, medicine.disease_cause, medicine.disease, Endocrinology, Biochemistry, In vivo, Fibrosis, Internal medicine, medicine, Hepatic stellate cell, Hepatic fibrosis, Oxidative stress
Abstract: Hepatic fibrosis due to iron overload is mediated by oxidant stress. The basic mechanisms underlying this process in vivo are still little understood. Acutely iron-dosed gerbils were assayed for lobular accumulation of hepatic lipid peroxidation by-products, oxidant-stress gene response, mitochondrial energy-dependent functions, and fibrogenesis. Iron overload in nonparenchymal cells caused an activation of hepatic stellate cells and fibrogenesis. Oxidant-stress gene response and accumulation of malondialdehyde-protein adducts were restricted to iron-filled nonparenchymal cells, sparing nearby hepatocytes. Concomitantly, a significant rise in the mitochondrial desferrioxamine-chelatable iron pool associated with the impairment of mitochondrial oxidative metabolism and the hepatic ATP decrease, was detected. Ultrastructural mitochondrial alterations were observed only in nonparenchymal cells. All biochemical and functional derangements were hindered by in vivo silybin administration which blocked completely fibrogenesis. Iron-induced oxidant stress in nonparenchymal cells appeared to bring about irreversible mitochondrial derangement associated with the onset of hepatic fibrosis.
Published: 2002

41. POPDC1(S201F) causes muscular dystrophy and arrhythmia by affecting protein trafficking

Author: Hui Jiang, Francesca Romana Di Raimo, Subreena Simrick, Giorgio Tasca, Jianguo Zhang, Fabiana Fattori, C. Scotton, Claudio Rapezzi, Thomas Brand, Bruno Dallapiccola, Rita Selvatici, Niels Decher, Alexander Froese, Viacheslav O. Nikolaev, Antonello Pietrangelo, Roland F.R. Schindler, Jun Wang, Fabrizio Drago, Enrico Bertini, Susanne Rinné, Marcella Neri, Alessandra Ferlini, Thorsten Schwerte, Kar Lai Poon, Thomas Müller, Christiane Grunert, Wenyan Li, Eloisa Arbustini, Mingyan Fang, Xun Xu, Chiara Passarelli, Beatriz Ortiz-Bonnin, Padmini Sarathchandra, Francesca Gualandi, Schindler, Roland F. R., Scotton, Chiara, Zhang, Jianguo, Passarelli, Chiara, Ortiz-Bonnin, Beatriz, Simrick, Subreena, Schwerte, Thorsten, Poon, Kar-Lai, Fang, Mingyan, Rinné, Susanne, Froese, Alexander, Nikolaev, Viacheslav O., Grunert, Christiane, Müller, Thoma, Tasca, Giorgio, Sarathchandra, Padmini, Drago, Fabrizio, Dallapiccola, Bruno, Rapezzi, Claudio, Arbustini, Eloisa, Romana Di Raimo, Francesca, Neri, Marcella, Selvatici, Rita, Gualandi, Francesca, Fattori, Fabiana, Pietrangelo, Antonello, Li, Wenyan, Jiang, Hui, Xu, Xun, Bertini, Enrico, Decher, Niel, Wang, Jun, Brand, Thoma, Ferlini, Alessandra, Medical Research Council (MRC), British Heart Foundation, and The Magdi Yacoub Institute
Subjects: 0301 basic medicine, Male, Pathology, Muscle Proteins, Research & Experimental Medicine, DOMAIN-CONTAINING PROTEINS, domain containing proteins, Membrane Potentials, Cyclic AMP, Missense mutation, Muscular dystrophy, Child, Zebrafish, Membrane Protein, Cardiac muscle cell, Aged, 80 and over, biology, Medicine (all), Aged, Animals, Arrhythmias, Cardiac, Humans, Membrane Proteins, Middle Aged, Muscular Dystrophies, Limb-Girdle, Mutation, Potassium Channels, Tandem Pore Domain, Protein Transport, STRESS-MEDIATED MODULATION, General Medicine, 11 Medical And Health Sciences, medicine.anatomical_structure, Medicine, Research & Experimental, SKELETAL-MUSCLE, HEART, POTASSIUM CHANNEL, muscular dystrophy, arrhythmia, ITGA7, Life Sciences & Biomedicine, Human, Research Article, medicine.medical_specialty, HL-1 CELLS, Immunology, cardiac pacemakin, Membrane Potential, NO, HL1 cell, 03 medical and health sciences, Internal medicine, medicine, KINASE, Allele, skeletal muscle, Science & Technology, COMPLEX, Animal, Cardiac arrhythmia, Skeletal muscle, stress mediated modulation, domain containing proteins, skeletal muscle, cardiac pacemakin, potassium channel, HL1 cell, zebrafish, heart, kinase, biology.organism_classification, medicine.disease, 030104 developmental biology, Endocrinology, stress mediated modulation, CARDIAC PACEMAKING, Cell Adhesion Molecules
Abstract: The Popeye domain-containing 1 (POPDC1) gene encodes a plasma membrane-localized cAMP-binding protein that is abundantly expressed in striated muscle. In animal models, POPDC1 is an essential regulator of structure and function of cardiac and skeletal muscle; however, POPDC1 mutations have not been associated with human cardiac and muscular diseases. Here, we have described a homozygous missense variant (c.602C>T, p.S201F) in POPDC1, identified by whole-exome sequencing, in a family of 4 with cardiac arrhythmia and limb-girdle muscular dystrophy (LGMD). This allele was absent in known databases and segregated with the pathological phenotype in this family. We did not find the allele in a further screen of 104 patients with a similar phenotype, suggesting this mutation to be family specific. Compared with WT protein, POPDC1(S201F) displayed a 50% reduction in cAMP affinity, and in skeletal muscle from patients, both POPDC1(S201F) and WT POPDC2 displayed impaired membrane trafficking. Forced expression of POPDC1(S201F) in a murine cardiac muscle cell line (HL-1) increased hyperpolarization and upstroke velocity of the action potential. In zebrafish, expression of the homologous mutation (popdc1(S191F)) caused heart and skeletal muscle phenotypes that resembled those observed in patients. Our study therefore identifies POPDC1 as a disease gene causing a very rare autosomal recessive cardiac arrhythmia and LGMD, expanding the genetic causes of this heterogeneous group of inherited rare diseases. peerReviewed
Published: 2014

42. Hypoxia induced downregulation of hepcidin is mediated by platelet derived growth factor BB

Author: Martin Burtscher, Susanne Trübsbach, David Nachbaur, Günter Weiss, Martina U. Muckenthaler, Axel Kleinsasser, Egon Demetz, Derrick R. Witcher, Thomas Sonnweber, Anthony T. Murphy, Igor Theurl, Andrea Schroll, Katarzyna Mleczko-Sanecka, Markus Seifert, Manfred Nairz, Victor J. Wroblewski, Antonello Pietrangelo, Anna-Maria Mitterstiller, David Haschka, and Chiara Vecchi
Subjects: Adult, Male, medicine.medical_specialty, Platelet-derived growth factor, Iron, Becaplermin, PROTEIN, Down-Regulation, CREB, C/EBP-ALPHA, chemistry.chemical_compound, Mice, Downregulation and upregulation, Hepcidins, Hepcidin, Internal medicine, Hematologic Agents, medicine, Animals, Humans, Erythropoiesis, TRANSCRIPTION, ANEMIA, Hypoxia, Transcription factor, ANTIMICROBIAL PEPTIDE, IN-VIVO, GENE-EXPRESSION, Platelet-Derived Growth Factor, biology, medicine.diagnostic_test, Gastroenterology, IRON-METABOLISM, Hep G2 Cells, Proto-Oncogene Proteins c-sis, Hypoxia (medical), CHRONIC DISEASE, ERYTHROPOIETIN, Healthy Volunteers, Mice, Inbred C57BL, Disease Models, Animal, Endocrinology, chemistry, biology.protein, Serum iron, Female, medicine.symptom
Abstract: Objective Hypoxia affects body iron homeostasis; however, the underlying mechanisms are incompletely understood. Design Using a standardised hypoxia chamber, 23 healthy volunteers were subjected to hypoxic conditions, equivalent to an altitude of 5600 m, for 6 h. Subsequent experiments were performed in C57BL/6 mice, CREB-H knockout mice, primary hepatocytes and HepG2 cells. Results Exposure of subjects to hypoxia resulted in a significant decrease of serum levels of the master regulator of iron homeostasis hepcidin and elevated concentrations of platelet derived growth factor (PDGF)-BB. Using correlation analysis, we identified PDGF-BB to be associated with hypoxia mediated hepcidin repression in humans. We then exposed mice to hypoxia using a standardised chamber and observed downregulation of hepatic hepcidin mRNA expression that was paralleled by elevated serum PDGF-BB protein concentrations and higher serum iron levels as compared with mice housed under normoxic conditions. PDGF-BB treatment in vitro and in vivo resulted in suppression of both steady state and BMP6 inducible hepcidin expression. Mechanistically, PDGF-BB inhibits hepcidin transcription by downregulating the protein expression of the transcription factors CREB and CREB-H, and pharmacological blockade or genetic ablation of these pathways abrogated the effects of PDGF-BB toward hepcidin expression. Conclusions Hypoxia decreases hepatic hepcidin expression by a novel regulatory pathway exerted via PDGF-BB, leading to increased availability of circulating iron that can be used for erythropoiesis.
Published: 2014

43. Thyroid volume in adult beta-thalassemic patients is smaller than in controls

Author: Vincenzo Rochira, Francesca Ferrara, Giulia Brigante, Antonello Pietrangelo, Chiara Diazzi, Anna Ansaloni, and Daniele Santi
Subjects: medicine.medical_specialty, thyroid gland, business.industry, Thyroid, Beta thalassemia, thyroid volume, Thyroid ultrasound, beta-thalassemia, medicine.disease, medicine.anatomical_structure, Endocrinology, Internal medicine, medicine, Beta (finance), business
Published: 2014

44. Luspatercept Increases Hemoglobin, Decreases Transfusion Burden and Improves Iron Overload in Adults with Beta-Thalassemia

Author: Ashley Leneus, Antonio Piga, Rita Gamberini, Abderrahmane Laadem, Dawn Wilson, Matthew L. Sherman, Ersi Voskaridou, Angela Melpignano, Vincenzo Caruso, Immacolata Tartaglione, Kenneth M. Attie, Paolo Ricchi, Xiaosha Zhang, and Antonello Pietrangelo
Subjects: myalgia, Ineffective erythropoiesis, medicine.medical_specialty, Anemia, medicine.medical_treatment, Immunology, Splenectomy, 030204 cardiovascular system & hematology, medicine.disease_cause, Biochemistry, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Bone pain, business.industry, Surrogate endpoint, Beta thalassemia, Cell Biology, Hematology, medicine.disease, Surgery, 030220 oncology & carcinogenesis, Hemoglobin, medicine.symptom, business
Abstract: Background.Luspatercept (ACE-536) is a modified activin receptor type IIB fusion protein that promotes late-stage erythroid differentiation. In beta-thalassemia, imbalanced production of alpha and beta globin chains in erythroid precursors causes ineffective erythropoiesis (IE) leading to anemia and dysregulated iron homeostasis. In a mouse model of beta-thalassemia, luspatercept corrected the effects of ineffective erythropoiesis and in a phase 1 clinical study with healthy volunteers, was well tolerated and increased hemoglobin (Suragani R, Nat Med, 2014; Suragani R, Blood, 2014; Attie K, Am J Hematol, 2014). Aims.This is an ongoing, phase 2, multicenter, open-label, dose-finding study followed by a long-term extension study to evaluate the effects of luspatercept in patients (pts) with either transfusion-dependent (TD) or non-transfusion dependent (NTD) beta-thalassemia with the following key endpoints: erythroid response (including Hgb increase) and patient-reported quality-of-life (QoL) measures in NTD patients, and reductions in RBC transfusion burden in TD patients. Methods.Inclusion criteria included age ≥ 18 yr and either TD (defined as ≥ 4 RBC units transfused in the 8 weeks prior to first dose, confirmed over 6 months) or NTD (defined as < 4 RBC units transfused in the 8 weeks prior to first dose with baseline Hgb < 10.0 g/dL). Luspatercept was administered subcutaneously every 3 weeks for up to 5 doses over 12 weeks with an 8 week follow-up (20 weeks total). Six cohorts (n=35) were treated at dose levels from 0.2-1.25 mg/kg. Pts in the expansion cohort (n=29) and all pts who rolled over to the extension study (n=51) were treated at ≥ 0.8 mg/kg with escalation up to 1.25 mg/kg. Results. A total of 30 TD pts enrolled in the base study and, of those, 24 enrolled in the extension study (data as of 11 March 2016). Data summarized are for the long-term extension study. Median age was 38 yr (range 22-55 yr), 67% had prior splenectomy. At baseline, median transfusion burden was 8 units/12 weeks (range 4-15 units) and mean (SD) liver iron concentration (LIC) was 5.1 (5.3) mg/g dw. A total of 20/24 (83%) and 16/24 (67%) TD pts achieved a ≥ 33% and ≥ 50% decrease in transfusion burden over any 12-week period compared to baseline, respectively. Duration of response ranged from 12 to 48+ weeks. A total of 34 NTD pts enrolled in the base study and, of those, 27 enrolled in the extension study (data as of 11 March 2016). Data summarized are for the long-term extension study. Median age was 37 yr (range 23-62 yr); 67% had prior splenectomy. At baseline, median Hgb was 8.7 g/dL (range 7.6-9.8 g/dL) and mean (SD) LIC was 4.9 (3.4) mg/g dw. A total of 21/27 (78%) and 15/27 (56%) NTD pts achieved ≥ 1.0 g/dL and ≥ 1.5 g/dL increases, respectively, in mean Hgb over any 12-week period compared to baseline. Duration of response ranged from 16 to 72+ weeks, with no trend for lower Hgb response over time. Increases in mean hemoglobin over a 12-week period correlated with increases in a pt-reported QoL questionnaire, FACIT-F (r=0.67, p=0.001). 3/5 (60%) pts with baseline LIC ≥ 5 mg/g dw had a decrease in LIC ≥ 2 mg/g dw after at least 6 months of treatment; 8/9 (89%) patients with baseline LIC < 5 mg/g dw maintained LIC < 5 mg/g dw. Luspatercept was generally well tolerated, with no related SAEs. AEs were mostly mild-moderate. The most frequent related AEs (≥ 10% in base + extension studies) in TD pts were bone pain, myalgia, arthralgia, headache, asthenia, and musculoskeletal pain. The most frequent related AEs (≥ 10% in base + extension studies) in NTD pts were bone pain, headache, musculoskeletal pain, and arthralgia. Conclusions: Luspatercept treatment in pts with beta-thalassemia had a favorable safety profile. Efficacy was clinically relevant in both NTD pts (increased Hgb levels, decreased LIC, and improved quality of life) and TD pts (decreased RBC transfusions). A Phase 3, double-blind, placebo-controlled study of luspatercept in regularly transfused adults with beta-thalassemia is ongoing (NCT02604433). Disclosures Zhang: Acceleron Pharma: Employment. Wilson:Acceleron Pharma: Employment, Equity Ownership. Leneus:Acceleron Pharma: Employment. Laadem:Celgene Corporation: Employment, Equity Ownership. Sherman:Acceleron Pharma: Employment, Equity Ownership, Patents & Royalties. Attie:Acceleron Pharma: Employment, Equity Ownership.
Published: 2016

45. A challenging diagnosis for potential fatal diseases: recommendations for diagnosing acute porphyrias

Author: Antonello Pietrangelo, Filippo Aucella, Sergio Marchini, Elena Di Pierro, Francesca Granata, Valentina Brancaleoni, Giovanna Graziadei, Paolo Ventura, and MARIA DOMENICA CAPPELLINI
Subjects: medicine.medical_specialty, Exacerbation, Vomiting, Alcohol abuse, Acute porphyrias Acute porphyric attack Lead intoxication Diagnosis Differential diagnosis Biochemical, Internal Medicine, medicine, Effective treatment, Humans, Intensive care medicine, Pathological, Psychomotor Agitation, Heterogeneous group, business.industry, Nausea, Porphobilinogen Synthase, Coproporphyria, Hereditary, medicine.disease, Abdominal Pain, Acute porphyrias, Lead Poisoning, Porphyria, Psychotic Disorders, Porphyria, Acute Intermittent, Practice Guidelines as Topic, Porphyria, Variegate, Medical emergency, Differential diagnosis, business
Abstract: Acute porphyrias are a heterogeneous group of metabolic disorders resulting from a variable catalytic defect of four enzymes out of the eight involved in the haem biosynthesis pathway; they are rare and mostly inherited diseases, but in some circumstances, the metabolic disturbance may be acquired. Many different environmental factors or pathological conditions (such as drugs, calorie restriction, hormones, infections, or alcohol abuse) often play a key role in triggering the clinical exacerbation (acute porphyric attack) of these diseases that may often mimic many other more common acute medical and neuropsychiatric conditions and whose delayed diagnosis and treatment may be fatal. In order to obtain an accurate diagnosis of acute porphyria, the knowledge and the use of appropriate diagnostic tools are mandatory, even in order to provide as soon as possible the more effective treatment and to prevent the use of potentially unsafe drugs, which can severely precipitate these diseases, especially in the presence of life-threatening symptoms. In this paper, we provide some recommendations for the diagnostic steps of acute porphyrias by reviewing literature and referring to clinical experience of the board members of the Gruppo Italiano Porfiria (GrIP).
Published: 2013

46. [Untitled]

Author: Fabiola Giovannini, Daniela Ceccarelli, Cinzia Garuti, Alberto Masini, Giuliana Montosi, and Antonello Pietrangelo
Subjects: medicine.medical_specialty, Antioxidant, Physiology, medicine.medical_treatment, Respiratory chain, Cell Biology, Oxidative phosphorylation, medicine.disease_cause, medicine.disease, Lipid peroxidation, chemistry.chemical_compound, Endocrinology, chemistry, Biochemistry, In vivo, Fibrosis, Internal medicine, Toxicity, medicine, Oxidative stress
Abstract: Hepatic iron toxicity because of iron overload seems to be mediated by lipid peroxidation ofbiological membranes and the associated organelle dysfunctions. However, the basicmechanisms underlying this process in vivo are still little understood. Gerbils were dosed with weeklyinjections of iron—dextran alone or in combination with sylibin, a well—known antioxidant,by gavage for 8 weeks. A strict correlation was found between lipid peroxidation and the levelof desferrioxamine chelatable iron pool. A consequent derangement in the mitochondrialenergy-transducing capability, resulting from a reduction in the respiratory chain enzymeactivities, occurred. These irreversible oxidative anomalies brought about a dramatic drop intissue ATP level. The mitochondrial oxidative derangement was associated with thedevelopment of fibrosis in the hepatic tissue. Silybin administration significantly reduced bothfunctional anomalies and the fibrotic process by chelating desferrioxamine chelatable iron.
Published: 2000

47. Hereditary Hemochromatosis in Adults without Pathogenic Mutations in the Hemochromatosis Gene

Author: Giuliana Montosi, Francesco Vasta, Mirella Fraquelli, Paolo Gasparini, A. Totaro, C. Sardini, Antonello Pietrangelo, Stefano Cassanelli, Dario Conte, Cinzia Garuti, Pietrangelo, A, Montosi, G, Totaro, A, Garuti, C, Conte, D, Cassanelli, S, Fraquelli, M, Sardini, C, Vasta, F, and Gasparini, Paolo
Subjects: medicine.medical_specialty, Pathology, Mutation, medicine.diagnostic_test, Transferrin saturation, business.industry, Chromosome, General Medicine, medicine.disease, medicine.disease_cause, Gastroenterology, Genetic linkage, Liver biopsy, Internal medicine, Hereditary hemochromatosis, IRON OVERLOAD, medicine, business, Gene, Hemochromatosis
Abstract: Background and Methods Hereditary hemochromatosis in adults is usually characterized by mutations in the hemochromatosis (HFE) gene on the short arm of chromosome 6. Most patients have a substitution of tyrosine for cysteine at position 282 (C282Y). We studied a large family from Italy that includes persons who have a hereditary iron-overload condition indistinguishable from hemochromatosis but without apparent pathogenic mutations in the HFE gene. We performed biochemical, histologic, and genetic studies of 53 living members of the family, including microsatellite analysis of chromosome 6 and direct sequencing of the HFE gene. Results Of the 53 family members, 15 had abnormal serum ferritin levels, values for transferrin saturation that were higher than 50 percent, or both. Thirteen of the 15 had elevated body iron levels, diagnosed on the basis of the clinical evaluation and liver biopsy, and underwent iron-removal therapy. The other two, both children, did not undergo liver biopsy or iron-removal thera...
Published: 1999

48. Iron, oxidative stress and liver fibrogenesis

Author: Antonello Pietrangelo
Subjects: Liver Cirrhosis, medicine.medical_specialty, Iron Overload, Cirrhosis, Hepatology, business.industry, Hepatotoxin, Phlebotomy, medicine.disease, medicine.disease_cause, Oxidative Stress, Endocrinology, Liver, Fibrosis, Internal medicine, Toxicity, Humans, Medicine, business, Viral hepatitis, Oxidative stress, Hemochromatosis
Abstract: T” LIVER is a major recipient of excess iron in overload conditions, and elevated hepatic concentrations of this metal can result in hepatocellular injury, fibrosis and cirrhosis. As keloids and hypertrophic dermal scarring can result in disfigurement and disability, scarring in the liver leads to disruption of normal lobular architecture, nodular regeneration and loss of function. Liver cirrhosis, in fact, is a major cause of morbidity and mortality. Main causes of iron overload in humans are genetically determined, increased iron absorption (as occurs in hemochromatosis, HC), parenteral administration (e.g., transfusions as a source of iron in patients with refractory anemias) (l), but also conditions such as chronic alcohol abuse or viral hepatitis in which iron may represent a potent cofactorial hepatotoxin. The hepatic concentration of iron in these settings is an important factor in determining toxicity, since removal of excess iron by phlebotomy or chelation results in clinical improvement.
Published: 1998

49. Haptoglobin modifies the hemochromatosis phenotype in mice

Author: Sharmila Fagoonee, Fiorella Altruda, Nancy C. Andrews, Cinzia Garuti, Emanuela Tolosano, Antonello Pietrangelo, and Linda Valli
Subjects: medicine.medical_specialty, Iron, Immunology, Mutant, Penetrance, Biology, Biochemistry, Mice, Internal medicine, polycyclic compounds, medicine, Animals, HEREDITARY HEMOCHROMATOSIS, DUODENAL EXPRESSION, IRON ACCUMULATION, MURINE MODEL, GENE, POLYMORPHISM, GENOTYPE, MUTATION, Hemochromatosis Protein, skin and connective tissue diseases, Hemochromatosis, Haptoglobins, Histocompatibility Antigens Class I, Haptoglobin, Genetic disorder, Membrane Proteins, food and beverages, Cell Biology, Hematology, medicine.disease, Blood proteins, Mice, Mutant Strains, Mice, Inbred C57BL, Phenotype, Endocrinology, Liver, Hereditary hemochromatosis, haptoglobin, hemochromatosis, HFE, biology.protein, Hemoglobin
Abstract: Classic hereditary hemochromatosis (HH) is a common genetic disorder of iron metabolism caused by a mutation in the HFE gene. Whereas the prevalence of the mutation is very high, the clinical penetrance of the disease is low, suggesting that the HFE mutation is a necessary but not sufficient cause of clinical HH. Several candidate modifier genes have been proposed in mice and humans, including haptoglobin. Haptoglobin is the plasma protein with the highest binding affinity for hemoglobin. It delivers free plasma hemoglobin to the reticuloendothelial system, thus reducing loss of hemoglobin through the glomeruli and allowing heme-iron recycling. To gain insight into the role of haptoglobin as a modifier gene in HH, we used Hfe and haptoglobin double-null mice. Here, we show that Hfe and haptoglobin compound mutant mice accumulate significantly less hepatic iron than Hfe-null mice, thus demonstrating that haptoglobin-mediated heme-iron recovery may contribute significantly to iron loading in HH. (Blood. 2005;105:3353-3355)
Published: 2005

50. Gene expression of urea cycle enzymes following two-thirds partial hepatectomy in the rat

Author: Niels Tygstrup, David A. Shafritz, Antonello Pietrangelo, Søren Bak, and Bjørg Krog
Subjects: medicine.medical_specialty, Transcription, Genetic, Biology, Gene Expression Regulation, Enzymologic, chemistry.chemical_compound, Albumins, Internal medicine, medicine, Animals, Hepatectomy, Urea, RNA, Messenger, Rats, Wistar, chemistry.chemical_classification, Hepatology, Albumin, GENE EXPRESSION, LIVER FUNCTION, PARTIAL HEPATECTOMY, UREA CYCLE, Carbamoyl phosphate synthetase, Rats, Arginase, medicine.anatomical_structure, Endocrinology, Enzyme, Liver, Biochemistry, chemistry, Hepatocyte, Urea cycle, Autoradiography, Female, Liver function, Densitometry
Abstract: The effect of reduction of functional liver mass on the expression of enzyme systems for hepatic urea synthesis was assessed in rats following two-thirds partial hepatectomy. Results were related to normal, fed rats and to sham-operated rats, with identical timing for surgery and feeding. Among the five urea cycle enzymes the mRNA steady-state level was higher in hepatectomized than in sham-operated rats for carbamoyl phosphate synthetase and arginino-succinate lyase. The level for albumin mRNA remained close to that of the controls. Relative transcription rates were found to be increased for carbamoyl phosphate synthetase, arginino-succinate synthase and arginase. For albumin the transcription rate was drastically reduced initially, but recovered gradually during the experimental period. The data indicate that the expression of urea cycle enzymes, in particular that of carbamoyl phosphate synthetase which is the rate-limiting step, is up-regulated by partial hepatectomy. This helps to maintain urea synthesis rate at a normal or near normal level during the period of reduced liver mass, confirming metabolic studies. In contrast, the transcription for albumin was reduced. The immediate increase in urea cycle enzyme expression during the period of acute hepatocyte loss is consistent with the view that it is vitally important that urea synthesis, in contrast to e.g. albumin synthesis, remains intact when the metabolic capacity of the liver is reduced.
Published: 1995

Catalog

Books, media, physical & digital resources

See catalog results

Searchworks

Select search scope, currently: Articles Catalog books, media & more in Jio Institute collections Articles journal articles & other e-resources

Search

Search Constraints

Refine your results

Search Limiters

Topic

Publication Year Range

Language

Publication Type

Journal

Database

Publisher

109 results on '"Antonello Pietrangelo"'

Search Results

Catalog

Select search scope, currently: Articles

Catalog

books, media & more in Jio Institute collections

Articles

journal articles & other e-resources