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1. Clinical risk scores for the early prediction of severe outocomes in patients hospitalized for COVID-19: comment

Author

Rossio R., Tettamanti M., Nobili A., Harari S., Mannucci P. M., Bandera A., Peyvandi F., Bosari S., Scudeller L., Fusetti G., Rusconi L., Dell'Orto S., Prati D., Valenti L., Giovannelli S., Manunta M., Lamorte G., Ferrari F., Gori A., Muscatello A., Mangioni D., Alagna L., Bozzi G., Lombardi A., Ungaro R., Ancona G., Zuglian G., Bolis M., Iannotti N., Ludovisi S., Comelli A., Renisi G., Biscarini S., Castelli V., Palomba E., Fava M., Fortina V., Peri C. A., Saltini P., Viero G., Itri T., Ferroni V., Pastore V., Massafra R., Liparoti A., Muheberimana T., Giommi A., Bianco R., De Azevedo R. M., Chitani G. E., Gualtierotti R., Ferrari B., Boasi N., Pagliaro E., Massimo C., De Caro M., Giachi A., Montano N., Vigone B., Bellocchi C., Carandina A., Fiorelli E., Melli V., Tobaldini E., Blasi F., Aliberti S., Spotti M., Terranova L., Misuraca S., D'Adda A., Fiore S. D., Di Pasquale M., Mantero M., Contarini M., Ori M., Morlacchi L., Rossetti V., Gramegna A., Pappalettera M., Cavallini M., Buscemi A., Vicenzi M., Rota I., Costantino G., Solbiati M., Furlan L., Mancarella M., Colombo G., Fanin A., Passarella M., Monzani V., Canetta C., Rovellini A., Barbetta L., Billi F., Folli C., Accordino S., Maira D., Hu C. M., Motta I., Scaramellini N., Fracanzani A. L., Lombardi R., Cespiati A., Cesari M., Lucchi T., Proietti M., Calcaterra L., Mandelli C., Coppola C., Cerizza A., Pesenti A. M., Grasselli G., Galazzi A., Monti I., Galbussera A. A., Crisafulli E., Girelli D., Maroccia A., Gabbiani D., Busti F., Vianello A., Biondan M., Sartori F., Faverio P., Pesci A., Zucchetti S., Bonfanti P., Rossi M., Beretta I., Spolti A., Elia D., Cassandro R., Caminati A., Cipollone F., Guagnano M. T., D'Ardes D., Rossi I., Vezzani F., Spanevello A., Cherubino F., Visca D., Contoli M., Papi A., Morandi L., Battistini N., Moreo G. L., Iannuzzi P., Fumagalli D., Leone S., Rossio, R, Tettamanti, M, Nobili, A, Harari, S, Mannucci, P, Bandera, A, Peyvandi, F, Bosari, S, Scudeller, L, Fusetti, G, Rusconi, L, Dell'Orto, S, Prati, D, Valenti, L, Giovannelli, S, Manunta, M, Lamorte, G, Ferrari, F, Gori, A, Muscatello, A, Mangioni, D, Alagna, L, Bozzi, G, Lombardi, A, Ungaro, R, Ancona, G, Zuglian, G, Bolis, M, Iannotti, N, Ludovisi, S, Comelli, A, Renisi, G, Biscarini, S, Castelli, V, Palomba, E, Fava, M, Fortina, V, Peri, C, Saltini, P, Viero, G, Itri, T, Ferroni, V, Pastore, V, Massafra, R, Liparoti, A, Muheberimana, T, Giommi, A, Bianco, R, De Azevedo, R, Chitani, G, Gualtierotti, R, Ferrari, B, Boasi, N, Pagliaro, E, Massimo, C, De Caro, M, Giachi, A, Montano, N, Vigone, B, Bellocchi, C, Carandina, A, Fiorelli, E, Melli, V, Tobaldini, E, Blasi, F, Aliberti, S, Spotti, M, Terranova, L, Misuraca, S, D'Adda, A, Fiore, S, Di Pasquale, M, Mantero, M, Contarini, M, Ori, M, Morlacchi, L, Rossetti, V, Gramegna, A, Pappalettera, M, Cavallini, M, Buscemi, A, Vicenzi, M, Rota, I, Costantino, G, Solbiati, M, Furlan, L, Mancarella, M, Colombo, G, Fanin, A, Passarella, M, Monzani, V, Canetta, C, Rovellini, A, Barbetta, L, Billi, F, Folli, C, Accordino, S, Maira, D, Hu, C, Motta, I, Scaramellini, N, Fracanzani, A, Lombardi, R, Cespiati, A, Cesari, M, Lucchi, T, Proietti, M, Calcaterra, L, Mandelli, C, Coppola, C, Cerizza, A, Pesenti, A, Grasselli, G, Galazzi, A, Monti, I, Galbussera, A, Crisafulli, E, Girelli, D, Maroccia, A, Gabbiani, D, Busti, F, Vianello, A, Biondan, M, Sartori, F, Faverio, P, Pesci, A, Zucchetti, S, Bonfanti, P, Rossi, M, Beretta, I, Spolti, A, Elia, D, Cassandro, R, Caminati, A, Cipollone, F, Guagnano, M, D'Ardes, D, Rossi, I, Vezzani, F, Spanevello, A, Cherubino, F, Visca, D, Contoli, M, Papi, A, Morandi, L, Battistini, N, Moreo, G, Iannuzzi, P, Fumagalli, D, and Leone, S

Subjects
Male, Outcome Assessment, Disease, 030204 cardiovascular system & hematology, Respiratory failure, 0302 clinical medicine, Risk Factors, Epidemiology, Early prediction, Outcome Assessment, Health Care, 030212 general & internal medicine, Framingham Risk Score, Respiration, Area under the curve, Middle Aged, Hospitalization, Survival Rate, Italy, Artificial, Emergency Medicine, Female, Clinical risk factor, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Ce - Letter to the Editor, MEDLINE, Risk Assessment, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, Internal Medicine, medicine, Intubation, Intratracheal, Humans, In patient, Derivation, COVID-19, Risk prediction model, SARS-CoV 2, Selection (genetic algorithm), Aged, Retrospective Studies, SARS-CoV-2, business.industry, Retrospective cohort study, Respiration, Artificial, Im - Original, Health Care, Intratracheal, ROC Curve, Intubation, business
Abstract

Coronavirus disease of 2019 (COVID-19) is associated with severe acute respiratory failure. Early identification of high-risk COVID-19 patients is crucial. We aimed to derive and validate a simple score for the prediction of severe outcomes. A retrospective cohort study of patients hospitalized for COVID-19 was carried out by the Italian Society of Internal Medicine. Epidemiological, clinical, laboratory, and treatment variables were collected at hospital admission at five hospitals. Three algorithm selection models were used to construct a predictive risk score: backward Selection, Least Absolute Shrinkage and Selection Operator (LASSO), and Random Forest. Severe outcome was defined as the composite of need for non-invasive ventilation, need for orotracheal intubation, or death. A total of 610 patients were included in the analysis, 313 had a severe outcome. The subset for the derivation analysis included 335 patients, the subset for the validation analysis 275 patients. The LASSO selection identified 6 variables (age, history of coronary heart disease, CRP, AST, D-dimer, and neutrophil/lymphocyte ratio) and resulted in the best performing score with an area under the curve of 0.79 in the derivation cohort and 0.80 in the validation cohort. Using a cut-off of 7 out of 13 points, sensitivity was 0.93, specificity 0.34, positive predictive value 0.59, and negative predictive value 0.82. The proposed score can identify patients at low risk for severe outcome who can be safely managed in a low-intensity setting after hospital admission for COVID-19.

Published
2021

2. The effects of oral supplements with sambucus nigra, Zinc, Tyndallized Lactobacillus acidophilus (H122), Arabinogalactans, Vitamin D, vitamin E and Vitamin C in otitis media with effusion in children: a randomized controlled trial

Author

della Volpe, A., Ricci, G., Ralli, M., Gambacorta, V., Lucia, A. D. E., Minni, A., Pirozzi, C., Paccone, M., Pastore, V., and Di Stadio, A.

Subjects
Male, Administration, Oral, Otoscopy, Ascorbic Acid, Galactans, Rhinophar-ynx, Sambucus nigra, Humans, Vitamin E, Treatment supplementation, Vitamin D, Child, Otitis media, Pure tone auditory test, Otitis Media with Effusion, Infant, Vitamins, Combined Modality Therapy, Lactobacillus acidophilus, Zinc, Treatment Outcome, Acoustic Impedance Tests, Child, Preschool, Audiometry, Pure-Tone, Female
Abstract

To evaluate the ability of oral supplements with immune-stimulating molecules (Sambucus nigra, Zinc, Tyndallized Lactobacillus acidophilus (HA122), Arabinogalactans, vitamin D, vitamin E and vitamin C) to reduce the inflammation of the upper airway tract and improve the outcome of otitis media with effusion (OME) in children.Randomized controlled trial. One-hundred ninety-eight children (CI 95%: 12-96 months) were divided into four groups. Group 1 (48 subjects) received 10 ml of oral supplements (OS) with immune-stimulating molecules for three months (20 days consecutively, then 10 days of suspension - the therapeutic scheme was repeated three times); Group 2 (54 children) underwent treatment with 10 ml of OS for 90 consecutive days; Group 3 (48 subjects) received 15 ml of OS for 45 consecutive days; a control group (48 children) underwent the standard treatment for rhinitis and OME. Outcome measures included otoscopy, tympanometry, fibroendoscopy, and the pure tone audiometry (PTA) at T0 (before treatment), T1 (45 days after treatment), and T2 (90 days after treatment).All children treated with OS showed a reduction of Upper Airway Infection (UAI) episodes and OME compared to the control group independent of the administration method and posology. The three groups treated with OS showed statistically significant differences between T0 and T2 for otoscopy, tympanometry, fibroendoscopy, and PTA. In Group 2, the otoscopy and the tympanometry scores improved at T1. Group 2 and 3 had better PTA results than Group 1.OS with immune-stimulating molecules should be considered as a supporting therapy in children affected by recurrent episodes of UAI associated with OME due to their capacity to improve the immune response and reduce the inflammatory phenomena. OS can improve the fibroendoscopic findings by restoring middle ear ventilation, in addition to their ability to reduce inflammation in the middle ear.

Published
2019

3. Immune activation and microbial translocation in liver disease progression in HIV/hepatitis co-infected patients: results from the Icona Foundation study

Author

Marchetti, Giulia, Cozzi Lepri, Alessandro, Tincati, Camilla, Calcagno, Andrea, Ceccherini Silberstein, Francesca, De Luca, Andrea, Antinori, Andrea, Castagna, Antonella, Puoti, Massimo, Monforte, Antonella d'Arminio, for the Icona Foundation Study Group […, Moroni M, Angarano G, Antinori A, Carosi G, Cauda R, Monforte A, Di Perri G, Galli M, Iardino R, Ippolito G, Lazzarin A, Perno CF, Viale PL, Von Schlosser F, Monforte Ad, Ammassari A, Andreoni M, Balotta C, Bonfanti P, Bonora S, Borderi M, Capobianchi MR, Castagna A, Ceccherini Silberstein F, Cozzi Lepri A, De Luca A, Gargiulo M, Gervasoni C, Girardi E, Lichtner M, Lo Caputo S, Madeddu G, Maggiolo F, Marcotullio S, Monno L, Murri R, Mussini C, Puoti M, Torti C, Fanti I, Formenti T, Montroni M, Giacometti A, Costantini A, Riva A, Tirelli U, Martellotta F, Ladisa N, Suter F, Piergentili B, Cristini G, Minardi C, Bertelli D, Quirino T, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Carnevale G, Lorenzotti S, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Cassola G, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Mastroianni C, Belvisi V, Molteni C, Chiodera A, Castelli P, Rizzardini G, Ridolfo AL, Foschi A, Salpietro S, Merli S, Carenzi L, Moioli MC, Cicconi P, Esposito R, Gori A, Pastore V, Abrescia N, Chirianni A, De Marco M, Ferrari C, Borghi R, Baldelli F, Belfiori B, Parruti G, Sozio F, Magnani G, Ursitti MA, Arlotti M, Ortolani P, Antonucci G, Narciso P, Tozzi V, Vullo V, Zaccarelli M, Gallo L, Acinapura R, De Longis P, Ceccarelli L, Libertone R, Trotta MP, Miccoli A, Cattelan AM, Mura MS, Caramello P, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D, VERUCCHI, GABRIELLA, Marchetti, G, Cozzi Lepri, A, Tincati, C, Calcagno, A, Ceccherini Silberstein, F, DE LUCA, A, Antinori, A, Castagna, A, Puoti, M, Monforte, A, Marchetti, Giulia, Cozzi Lepri, Alessandro, Tincati, Camilla, Calcagno, Andrea, Ceccherini Silberstein, Francesca, De Luca, Andrea, Antinori, Andrea, Castagna, Antonella, Puoti, Massimo, Monforte Antonella, D'Arminio, Cozzi-Lepri, Alessandro, Ceccherini-Silberstein, Francesca, Monforte, Antonella d'Arminio, and for the Icona Foundation Study Group […, Moroni M, Angarano G, Antinori A, Carosi G, Cauda R, Monforte A, Di Perri G, Galli M, Iardino R, Ippolito G, Lazzarin A, Perno CF, Viale PL, Von Schlosser F, Monforte Ad, Ammassari A, Andreoni M, Balotta C, Bonfanti P, Bonora S, Borderi M, Capobianchi MR, Castagna A, Ceccherini-Silberstein F, Cozzi-Lepri A, De Luca A, Gargiulo M, Gervasoni C, Girardi E, Lichtner M, Lo Caputo S, Madeddu G, Maggiolo F, Marcotullio S, Monno L, Murri R, Mussini C, Puoti M, Torti C, Fanti I, Formenti T, Montroni M, Giacometti A, Costantini A, Riva A, Tirelli U, Martellotta F, Ladisa N, Suter F, Verucchi G, Piergentili B, Cristini G, Minardi C, Bertelli D, Quirino T, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Carnevale G, Lorenzotti S, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Cassola G, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Mastroianni C, Belvisi V, Molteni C, Chiodera A, Castelli P, Rizzardini G, Ridolfo AL, Foschi A, Salpietro S, Merli S, Carenzi L, Moioli MC, Cicconi P, Esposito R, Gori A, Pastore V, Abrescia N, Chirianni A, De Marco M, Ferrari C, Borghi R, Baldelli F, Belfiori B, Parruti G, Sozio F, Magnani G, Ursitti MA, Arlotti M, Ortolani P, Antonucci G, Narciso P, Tozzi V, Vullo V, Zaccarelli M, Gallo L, Acinapura R, De Longis P, Ceccarelli L, Libertone R, Trotta MP, Miccoli A, Cattelan AM, Mura MS, Caramello P, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D, …], DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, and AREA MIN. 06 - Scienze mediche

Subjects
microbial, Male, Fibrosi, Lipopolysaccharide Receptors, HIV Infections, Kaplan-Meier Estimate, Liver disease, Medical microbiology, Risk Factors, HIV Infection, Fib-4, Coinfection, Liver Disease, Medicine (all), Liver Diseases, virus diseases, Hepatitis A, Hepatitis C, Hepatitis B, Middle Aged, sCD14, Settore MED/07 - Microbiologia e Microbiologia Clinica, Infectious Diseases, Treatment Outcome, HIV/hepatitis co-infection, traslocation, HCV, HIV, liver, Disease Progression, Biological Markers, Female, medicine.symptom, Adult, Antigens, CD14, CD4 Lymphocyte Count, Enzyme-Linked Immunosorbent Assay, Fibrosis, Humans, Inflammation, CD14, Microbial translocation, Research Article, Human, medicine.medical_specialty, Infectious Disease, Settore MED/17 - MALATTIE INFETTIVE, Biomarkers, medicine, Antigens, Hepatitis, business.industry, Risk Factor, Biomarker, medicine.disease, Virology, digestive system diseases, Immunology, business
Abstract

none 157 no Abstract BACKGROUND: We evaluated whether immune activation (IA) and microbial translocation (MT) might play a role in accelerating liver disease progression in HIV-HBV/HCV co-infected patients. METHODS: ART-naïve HIV/viral hepatitis co-infected patients from Icona with a CD4 cell count >200/μl and with a known date of prior HIV neg/pos tests and ≥1 plasma sample stored were included in the study. Plasma MT (LPS, sCD14) and IA (IL-6,TNFα) were measured using ELISA while activated CD8 + CD38 + HLA-DR + were measured by flow cytometry, with one measurement being performed for all patients and two measurements for a smaller group of subjects. The association between these biomarkers and the time to i) a single ALT >200 IU/l and ii) a Fib-4 >1.45 was also investigated. A standard survival analysis with robust standard errors was used for all evaluations. Follow-up was censored at patients' last clinical follow-up. RESULTS: We studied 127 HIV-infected hepatitis viruses co-infected patients (118 HCV, 9 HBV). Overall median (IQR) CD4, VL, age were 596/μl (208-1303), 3.8 log10cp/mL (3-4.3), 34 years (22-56). While heightened TNF-α was associated with a 13-fold increased risk of Fib-4 > 1.45 (RH 13.05, 95% CI 2.43-70; p = 0.003), markers of MT did not show an association with liver illness. Interestingly, higher sCD14 was associated with a decreased risk of Fib-4 > 1.45, independently of other biomarkers considered (RH 0.20, 95% CI 0.04-0,9; p = 0.04). CONCLUSIONS: In HIV/hepatitis virus co-infected ART-naive patients, higher TNF-α plasma levels were associated with a 13-fold increase in the risk of progression to a Fib-4 >1.45, suggesting that the pro-inflammatory status in HIV infection might hasten the course of HCV. In view of the fact that sCD14 may hinder the interaction between LPS and the phagocyte membrane CD14, we herewith propose a model which aims to demonstrate that high sCD14 levels might contribute to shelter liver function through the down-regulation of the inflammatory cascade. Marchetti, Giulia; Cozzi-Lepri, Alessandro; Tincati, Camilla; Calcagno, Andrea; Ceccherini-Silberstein, Francesca; De Luca, Andrea; Antinori, Andrea; Castagna, Antonella; Puoti, Massimo; Monforte, Antonella d'Arminio; and for the Icona Foundation Study Group […; Moroni M; Angarano G; Antinori A; Carosi G; Cauda R; Monforte A; Di Perri G; Galli M; Iardino R; Ippolito G; Lazzarin A; Perno CF; Viale PL; Von Schlosser F; Monforte Ad; Ammassari A; Andreoni M; Antinori A; Balotta C; Bonfanti P; Bonora S; Borderi M; Capobianchi MR; Castagna A; Ceccherini-Silberstein F; Cozzi-Lepri A; Monforte A; De Luca A; Gargiulo M; Gervasoni C; Girardi E; Lichtner M; Lo Caputo S; Madeddu G; Maggiolo F; Marcotullio S; Monno L; Murri R; Mussini C; Puoti M; Torti C; Cozzi-Lepri A; Fanti I; Formenti T; Montroni M; Giacometti A; Costantini A; Riva A; Tirelli U; Martellotta F; Angarano G; Monno L; Ladisa N; Suter F; Maggiolo F; Viale PL; Verucchi G; Piergentili B; Carosi G; Cristini G; Torti C; Minardi C; Bertelli D; Quirino T; Abeli C; Manconi PE; Piano P; Vecchiet J; Falasca K; Carnevale G; Lorenzotti S; Sighinolfi L; Leoncini F; Mazzotta F; Pozzi M; Lo Caputo S; Cassola G; Viscoli G; Alessandrini A; Piscopo R; Mazzarello G; Mastroianni C; Belvisi V; Bonfanti P; Molteni C; Chiodera A; Castelli P; Galli M; Lazzarin A; Rizzardini G; Puoti M; Monforte A; Ridolfo AL; Foschi A; Castagna A; Salpietro S; Merli S; Carenzi L; Moioli MC; Cicconi P; Formenti T; Esposito R; Mussini C; Gori A; Pastore V; Abrescia N; Chirianni A; De Marco M; Ferrari C; Borghi R; Baldelli F; Belfiori B; Parruti G; Sozio F; Magnani G; Ursitti MA; Arlotti M; Ortolani P; Cauda R; Andreoni M; Antinori A; Antonucci G; Narciso P; Tozzi V; Vullo V; De Luca A; Zaccarelli M; Gallo L; Acinapura R; De Longis P; Ceccarelli L; Libertone R; Trotta MP; Miccoli A; Cattelan AM; Mura MS; Madeddu G; Caramello P; Di Perri G; Orofino GC; Sciandra M; Raise E; Ebo F; Pellizzer G; Buonfrate D; …] Marchetti, Giulia; Cozzi-Lepri, Alessandro; Tincati, Camilla; Calcagno, Andrea; Ceccherini-Silberstein, Francesca; De Luca, Andrea; Antinori, Andrea; Castagna, Antonella; Puoti, Massimo; Monforte, Antonella d'Arminio; and for the Icona Foundation Study Group […; Moroni M; Angarano G; Antinori A; Carosi G; Cauda R; Monforte A; Di Perri G; Galli M; Iardino R; Ippolito G; Lazzarin A; Perno CF; Viale PL; Von Schlosser F; Monforte Ad; Ammassari A; Andreoni M; Antinori A; Balotta C; Bonfanti P; Bonora S; Borderi M; Capobianchi MR; Castagna A; Ceccherini-Silberstein F; Cozzi-Lepri A; Monforte A; De Luca A; Gargiulo M; Gervasoni C; Girardi E; Lichtner M; Lo Caputo S; Madeddu G; Maggiolo F; Marcotullio S; Monno L; Murri R; Mussini C; Puoti M; Torti C; Cozzi-Lepri A; Fanti I; Formenti T; Montroni M; Giacometti A; Costantini A; Riva A; Tirelli U; Martellotta F; Angarano G; Monno L; Ladisa N; Suter F; Maggiolo F; Viale PL; Verucchi G; Piergentili B; Carosi G; Cristini G; Torti C; Minardi C; Bertelli D; Quirino T; Abeli C; Manconi PE; Piano P; Vecchiet J; Falasca K; Carnevale G; Lorenzotti S; Sighinolfi L; Leoncini F; Mazzotta F; Pozzi M; Lo Caputo S; Cassola G; Viscoli G; Alessandrini A; Piscopo R; Mazzarello G; Mastroianni C; Belvisi V; Bonfanti P; Molteni C; Chiodera A; Castelli P; Galli M; Lazzarin A; Rizzardini G; Puoti M; Monforte A; Ridolfo AL; Foschi A; Castagna A; Salpietro S; Merli S; Carenzi L; Moioli MC; Cicconi P; Formenti T; Esposito R; Mussini C; Gori A; Pastore V; Abrescia N; Chirianni A; De Marco M; Ferrari C; Borghi R; Baldelli F; Belfiori B; Parruti G; Sozio F; Magnani G; Ursitti MA; Arlotti M; Ortolani P; Cauda R; Andreoni M; Antinori A; Antonucci G; Narciso P; Tozzi V; Vullo V; De Luca A; Zaccarelli M; Gallo L; Acinapura R; De Longis P; Ceccarelli L; Libertone R; Trotta MP; Miccoli A; Cattelan AM; Mura MS; Madeddu G; Caramello P; Di Perri G; Orofino GC; Sciandra M; Raise E; Ebo F; Pellizzer G; Buonfrate D; …]

Published
2014

4. Prevalence of hypovitaminosis D and factors associated with vitamin D deficiency and morbidity among HIV-infected patients enrolled in a large Italian cohort

Author

Vescini F, Cozzi Lepri A, Maggiolo F, De Luca A, Cassola G, Vullo V, Carosi G, Antinori A, Tozzi V, Monforte AD, Icona Foundation Study G.r.o.u.p. Moroni M, Angarano G, Cauda R, Di Perri G, Galli M, Iardino R, Ippolito G, Lazzarin A, Perno CF, Von Schlosser F, Ammassari A, Andreoni M, Balotta C, Bonfanti P, Bonora S, Capobianchi MR, Castagna A, Ceccherini Silberstein F, Gargiulo M, Gervasoni C, Girardi E, Lichtner M, Lo Caputo S, Madeddu G, Marcotullio S, Monno L, Murri R, Mussini C, Puoti M, Torti C, Fanti I, Formenti T, Montroni M, Giacometti A, Costantini A, Riva A, Tirelli U, Martellotta F, Ladisa N, Suter F, Cristini G, Minardi C, Bertelli D, Quirino T, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Carnevale G, Lorenzotti S, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Mastroianni C, Belvisi V, Molteni C, Chiodera A, Castelli P, Rizzardini G, Ridolfo AL, Foschi A, Salpietro S, Merli S, Carenzi L, Moioli MC, Cicconi P, Esposito R, Gori A, Pastore V, Abrescia N, Chirianni A, De Marco M, Ferrari C, Borghi R, Baldelli F, Belfiori B, Parruti G, Sozio F, Magnani G, Ursitti MA, Emilia R, Arlotti M, Ortolani P, Antonucci G, Narciso P, Zaccarelli M, Gallo L, Acinapura R, De Longis P, Ceccarelli L, Libertone R, Trotta MP, Miccoli A, Cattelan AM, Mura MS, Caramello P, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D., BORDERI, MARCO, RE, MARIA CARLA, VIALE, PIERLUIGI, VERUCCHI, GABRIELLA, PIERGENTILI, BENEDETTA, Vescini F, Cozzi-Lepri A, Borderi M, Re MC, Maggiolo F, De Luca A, Cassola G, Vullo V, Carosi G, Antinori A, Tozzi V, Monforte AD, Icona Foundation Study Group.Moroni M, Angarano G, Cauda R, Di Perri G, Galli M, Iardino R, Ippolito G, Lazzarin A, Perno CF, Viale PL, Von Schlosser F, Ammassari A, Andreoni M, Balotta C, Bonfanti P, Bonora S, Capobianchi MR, Castagna A, Ceccherini-Silberstein F, Gargiulo M, Gervasoni C, Girardi E, Lichtner M, Lo Caputo S, Madeddu G, Marcotullio S, Monno L, Murri R, Mussini C, Puoti M, Torti C, Fanti I, Formenti T, Montroni M, Giacometti A, Costantini A, Riva A, Tirelli U, Martellotta F, Ladisa N, Suter F, Verucchi G, Piergentili B, Cristini G, Minardi C, Bertelli D, Quirino T, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Carnevale G, Lorenzotti S, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Mastroianni C, Belvisi V, Molteni C, Chiodera A, Castelli P, Rizzardini G, Ridolfo AL, Foschi A, Salpietro S, Merli S, Carenzi L, Moioli MC, Cicconi P, Esposito R, Gori A, Pastore V, Abrescia N, Chirianni A, De Marco M, Ferrari C, Borghi R, Baldelli F, Belfiori B, Parruti G, Sozio F, Magnani G, Ursitti MA, Emilia R, Arlotti M, Ortolani P, Antonucci G, Narciso P, Zaccarelli M, Gallo L, Acinapura R, De Longis P, Ceccarelli L, Libertone R, Trotta MP, Miccoli A, Cattelan AM, Mura MS, Caramello P, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D., Vescini, F, Cozzi Lepri, A, Borderi, M, Re, M, Maggiolo, F, De Luca, A, Cassola, G, Vullo, V, Carosi, G, Antinori, A, Tozzi, V, Monforte, A, Gori, A, Vescini, Fabio, Cozzi lepri, Alessandro, Borderi, Marco, Re, Maria Carla, Maggiolo, Franco, De Luca, Andrea, Cassola, Giovanni, Vullo, Vincenzo, Carosi, Giampiero, Antinori, Andrea, Tozzi, Valerio, Monforte, Antonella D'arminio, Icona Foundation Study, Group, and Castagna, Antonella

Subjects
Male, HIV Infections, vitamin D, Logistic regression, Risk Factors, Cardiovascular Disease, Prevalence, HIV Infection, Pharmacology (medical), Renal Insufficiency, Chronic, Vitamin D, Young adult, education.field_of_study, hiv infection, prognosis, vitamin d deficiency and insufficiency, Diabetes Mellitu, Middle Aged, Prognosis, Infectious Diseases, Anti-Retroviral Agents, Italy, Cardiovascular Diseases, Combination, Cohort, Linear Model, Drug Therapy, Combination, Female, Seasons, prognosi, Adult, Africa, Aged, Central America, Diabetes Mellitus, Drug Therapy, Humans, Linear Models, South America, Vitamin D Deficiency, Young Adult, Human, medicine.medical_specialty, Population, Infectious Disease, Settore MED/17 - MALATTIE INFETTIVE, vitamin D deficiency, Internal medicine, medicine, Vitamin D and neurology, Renal Insufficiency, Chronic, education, Survival analysis, business.industry, Risk Factor, Hypovitaminosis D, HIV, Odds ratio, medicine.disease, vitamin D deficiency and insufficiency, Immunology, Anti-Retroviral Agent, Season, business
Abstract

Background: A high prevalence of hypovitaminosis D (hypD) in HIV-infected patients has been reported, but reasons are unclear. Methods: The 25 hydroxy vitamin D (vitD) concentration was measured in a sample of HIV-positive patients from Italy enrolled in the Icona Foundation Study. The change in absolute levels of vitD pre/post combination antiretroviral treatment was modelled by linear regression controlling for confounders and seasonality. Factors associated with hypD were identified using logistic regression analysis, and survival analysis was employed to evaluate the prognostic value of vitD concentration to predict severe diseases (diabetes, cardiovascular, renal), AIDS, and death. RESULTS:: We studied 810 patients contributing 1408 vitD measures. Median age was 36 years (range: 20-69). VitD insufficiency (30-75 nmol/L) and deficiency (

Published
2011

5. E-ABR in Patients with Cochlear Implant: A Comparison between Patients with Malformed Cochlea and Normal Cochlea

Author

Franco Trabalzini, Arianna Di Stadio, Giampietro Ricci, Vincenzo Pastore, Laura Dipietro, Antonio Della Volpe, Francesco Martines, Antonietta De Lucia, Di Stadio A., Dipietro L., de Lucia A., Trabalzini F., Ricci G., Martines F., Pastore V., and Volpe A.D.

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Otoacoustic Emissions, Spontaneous, EABR, Cochlear nerve conduction, Deafness, Audiology, ABR, Postoperative Complications, Cochlear malformation, Cochlear implant, Evoked Potentials, Auditory, Brain Stem, Reaction Time, otorhinolaryngologic diseases, Humans, Medicine, In patient, Cochlear Nerve, Cochlea, medicine.diagnostic_test, business.industry, Significant difference, Infant, Magnetic resonance imaging, General Medicine, lcsh:Otorhinolaryngology, Magnetic Resonance Imaging, lcsh:RF1-547, Settore MED/32 - Audiologia, Cochlear Implants, Settore MED/31 - Otorinolaringoiatria, Auditory brainstem response, Otorhinolaryngology, Case-Control Studies, Child, Preschool, Surgery outcome, Female, Original Article, Tomography, X-Ray Computed, business
Abstract

Objectives This study aims to compare the electrical auditory brainstem response (EABR) following cochlear implant (CI) surgery in pediatric subjects with cochlear malformation and a normal cochlea, in order to assess the sensitivity of EABR and to evaluate the surgery outcome. Materials and methods A total of 26 pediatric subjects who were deaf and scheduled for CI surgery were enrolled into this case control study. Group A (n=20) included subjects with a normo-conformed cochlea. Group B (n=6) included subjects with cochlear malformation. Subjects were evaluated with EABR immediately (T0) and 6 months (T1) post-CI surgery. The EABR Waves III and V average amplitude and latency were compared across time, separately for each group, and across groups, separately for each time. Results Auditory brainstem response (ABR) could only be recorded in Group A. We were able to record EABR from all subjects at T0 and T1, and waves III and V were present in all the recorded signals. There were no statistically significant differences between T0 and T1 in EABR Waves III and V in terms of average amplitude and latency in neither group. When comparing Groups A and B, the only statistically significant difference was the average amplitude of wave V, both at T0 and T1. Conclusion EABR is a valid tool to measure the auditory nerve integrity after CI surgery in patients with a normal and malformed cochlea, as shown by its ability to measure waves III and V when ABR is absent. The EABR testing should be performed before and after CI surgery, and EABR should be used as a measure of outcome, especially in patients with a malformed cochlea.

Published
2019

6. A diffusion tensor magnetic resonance imaging study of paediatric patients with severe non-traumatic brain injury

Author

Massimiliano Copetti, Filippo Arrigoni, Massimo Filippi, Katia Colombo, Valentina Pastore, Erika Molteni, Sandra Strazzer, Giacomo Boffa, Maria A. Rocca, Elisabetta Pagani, Molteni, E, Rocca, Ma, Strazzer, S, Pagani, E, Colombo, K, Arrigoni, F, Boffa, G, Copetti, M, Pastore, V, and Filippi, Massimo

Subjects
Male, Pathology, medicine.medical_specialty, Adolescent, Statistics as Topic, Corpus callosum, Severity of Illness Index, 030218 nuclear medicine & medical imaging, White matter, 03 medical and health sciences, 0302 clinical medicine, Developmental Neuroscience, Neural Pathways, Fractional anisotropy, Severity of illness, Image Processing, Computer-Assisted, medicine, Humans, Child, Analysis of Variance, medicine.diagnostic_test, business.industry, Glasgow Outcome Scale, Minimally conscious state, Magnetic resonance imaging, medicine.disease, White Matter, Diffusion Magnetic Resonance Imaging, medicine.anatomical_structure, Brain Injuries, Case-Control Studies, Child, Preschool, Pediatrics, Perinatology and Child Health, Anisotropy, Female, Neurology (clinical), Psychology, Nuclear medicine, business, 030217 neurology & neurosurgery, Diffusion MRI
Abstract

AimIn this observational study using 3T magnetic resonance imaging (MRI) and diffusion tensor, we investigated the differential effects of pathology, stage of disease, state of consciousness, and aetiology on the modifications of supra‐ and infra‐tentorial white matter tracts and their correlations with clinical scales in paediatric patients with severe non‐traumatic brain injury.MethodDiffusion tensor magnetic resonance imaging (DT‐MRI) was obtained from seven children with unresponsive wakefulness syndrome (UWS; five males, two females; age at event 5y; standard deviation [SD] 2y 1mo), six children in a minimally conscious state (MCS; three males, three females; age at event 5y 10mo; SD 5y), and 10 healthy children as controls(two males, eight females; age at study 10y 10mo; SD 2y 10mo). Fractional anisotropy, mean, axial, and radial diffusivities were calculated for the corpus callosum, inferior, middle (MCP), and superior cerebellar peduncles (SCP).ResultsDT‐MRI parameters from corpus callosum and SCP differed between patients and controls. MCP abnormalities were detected in patients presenting non‐traumatic composite aetiology (n=4) versus those suffering from pure anoxia (n=9). The supra‐tentorial compartment was more damaged (i.e. decreased fractional anisotropy and increased diffusivities) than the infra‐tentorial one. Correlations were found between DT‐MRI abnormalities and Glasgow Outcome Scale scores.InterpretationIn paediatric UWS/MCS, the severity of clinical disability correlates with white matter tract abnormalities.

Published
2017

7. Use of an electrothermal bipolar tissue sealing system in lung surgery☆

Author

Maria Marino, Alfonso Baldi, Luigi Busiello, V. Pastore, Paolo Laperuta, Giuseppe Gallo, Giovanni Vicidomini, Mario Santini, Santini, Mario, Vicidomini, Giovanni, Baldi, Alfonso, Gallo, G., Laperuta, P., Busiello, L., DI MARINO, M., and Pastore, V.

Subjects
Adult, Lung Diseases, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Swine, medicine.medical_treatment, Hydrostatic pressure, Pulmonary Surgical Procedures, Suture (anatomy), Diathermy, Tissue sealing, Electrocoagulation, Animals, Humans, Medicine, Thoracotomy, Lung surgery, Aged, Wound Healing, Lung, Hemostasis technique, Thoracic Surgery, Video-Assisted, business.industry, Suture Techniques, General Medicine, Middle Aged, Hemostasis, Surgical, Biomechanical Phenomena, Surgery, Treatment Outcome, medicine.anatomical_structure, Models, Animal, Circulatory system, Female, Cardiology and Cardiovascular Medicine, business, Wedge resection (lung)
Abstract

Objective: We evaluated the validity of an electrothermal bipolar tissue sealing system (LigaSure, Valleylab Inc., USA) in lung surgery. Methods: Our study was divided into two phases. Experimental: We performed sutures of pulmonary vessels and bronchi and lung wedge resections by LigaSure in 28 lungs of adult pigs; subsequently, we quantitated the sealing capacity of the system detecting the burst pressure for each anatomical structure. Clinical: LigaSure was used in 36 patients undergoing lung surgery. We performed 23 thoracotomic procedures in 16 patients (19 wedge resections, 2 segmentectomies, and 2 fissure separations), and 20 thoracoscopic procedures (13 wedge resections, 5 bullectomies, and 2 adherence dissections). Results: Experimental: Bronchi and vessels were divided into seven groups (diameter: 1-7 mm); 10 burst pressure measurements for each group were performed. A total of 84 wedge resections were performed; lung specimens were divided into seven groups (weight: 0.2-1.4 g). The percentage of bronchial sutures resistant to the pneumatic critical pressure (60 mmHg) was 100% in the 1-mm and 2-mm groups. No bronchi with 6-mm or 7-mm diameter reached the critical pressure. All pulmonary vessel sutures were resistant to the critical hydrostatic pressure (150 mmHg). The average burst pressure of wedge resection margins was higher than the critical pressure, and the percentage of suture margins resistant to the critical pressure decreased from 95% (0.2-g group) to 68% (1.4-g group). Histology confirmed the sealing of vessels, with a mean depth of thermal injury limited to 1.1 mm. Clinical: In all patients, hemostasis obtained by LigaSure was effective, with minimal perioperative bleeding. The mean operating time was 77.2 min (range: 60-97) for thoracotomies and 60.3 min (range: 46-80) for thoracoscopies. The mean drainage duration was 3.1 days (range: 1-8). Two patients had prolonged air leaks (>7 days). The mean postoperative stay was 7.3 days (range: 5-13) for thoracotomies and 4.6 days (range: 1-6) for thoracoscopies. Conclusions: Use of LigaSure in lung surgery appears feasible and easy. It provides satisfactory hemostasis and air-leak prevention; results are comparable to those of stapling devices, but this system seems to have a better benefit/cost ratio. Larger series are needed to confirm these data. © 2005 Elsevier B.V. All rights reserved.

Published
2006

8. Intraoperative Pleural Lavage: Is It a Valid Prognostic Factor in Lung Cancer?

Author

Giovanni Vicidomini, Alfonso Fiorello, Barbara Calabrò, Vincenzo Parascandolo, V. Pastore, Mario Santini, Vicidomini, Giovanni, Santini, Mario, Fiorelli, Alfonso, Parascandolo, V., Calabrò, B., and Pastore, V.

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, Pleural effusion, medicine.medical_treatment, Therapeutic irrigation, Adenocarcinoma, Metastasis, Pneumonectomy, Predictive Value of Tests, Carcinoma, Non-Small-Cell Lung, medicine, Carcinoma, Humans, Life Tables, Neoplasm Invasiveness, Stage (cooking), Therapeutic Irrigation, Lung cancer, Aged, Neoplasm Staging, Aged, 80 and over, NSCLC, Pleural Cavity, Intraoperative Care, business.industry, Respiratory disease, pleural lavage, Middle Aged, Prognosis, medicine.disease, Survival Analysis, Pleural Effusion, Malignant, respiratory tract diseases, lung cancer, Carcinoma, Squamous Cell, Female, Surgery, Radiology, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Background In patients undergoing lung resection for non-small cell lung cancer (NSCLC), the primary TNM (tumor–regional lymph node–distant metastasis) staging system is the best prognostic factor. However, it is necessary to investigate other factors that could more accurately predict a patient's prognosis. In this study we evaluated the significance of positive intraoperative pre-resectional lavage in patients with NSCLC. Methods We enrolled 84 patients (79 men, 5 women) aged between 36 and 81 years (mean age, 64.8 years) undergoing a major lung resection for NSCLC, with no preoperative evidence of pleural effusions. Intraoperatively, the patients were given a pre-resectional pleural lavage with physiologic saline solution. The fluid was aspirated and sent to cytology. Results Pre-resectional pleural lavage was positive in 19 patients (22.6%). The lavage was positive in 7.3% in patients with early stage I disease (3/41) and 37.2% in patients with stage II/III disease. In the group of 16 patients with chest wall neoplastic involvement (T3), 9 had a positive lavage (56.2%; p = 0.05). No significant correlation was found between positive lavage and nodal status, visceral pleural involvement, or histologic findings. Patients with malignant cells in the pre-resectional lavage had a significantly shorter survival than patients with a negative lavage ( p = 0.025). Conclusions A positive cytology finding of intraoperative pre-resectional pleural lavage could be an important prognostic factor in patients undergoing major lung resection for NSCLC. Patients with a positive lavage should be upstaged. However, larger series are needed to define accurately the role of this technique in early stage lung cancer.

Published
2005

9. Further empirical data on the psychoeducational profile-revised (PEP-R): reliability and validation with the Vineland adaptive behavior scales

Author

Valentina Pastore, Massimo Molteni, Laura Villa, Enrico Micheli, S. Villa, Alessandro Crippa, Villa, S, Micheli, E, Villa, L, Pastore, V, Crippa, A, and Molteni, M

Subjects
Male, Psychometrics, medicine.medical_treatment, Autism, Developmental Disabilities, Test validity, Assessment, Neuropsychological Tests, Developmental psychology, Cognition, Cronbach's alpha, Adaptation, Psychological, Developmental and Educational Psychology, medicine, Psychoeducation, Early Intervention, Educational, Humans, Autistic Disorder, Child, Vineland Adaptive Behavior Scale, Reproducibility of Results, medicine.disease, Psychometrics propertie, Developmental disorder, Inter-rater reliability, Aptitude Tests, Motor Skills, Psychoeducational profile- revised (PEP-R), Child, Preschool, Female, Psychology, Clinical psychology
Abstract

The PEP-R (psychoeducational profile revised) is an instrument that has been used in many countries to assess abilities and formulate treatment programs for children with autism and related developmental disorders. To the end to provide further information on the PEP-R's psychometric properties, a large sample (N = 137) of children presenting Autistic Disorder symptoms under the age of 12 years, including low-functioning individuals, was examined. Results yielded data of interest especially in terms of: Cronbach's alpha, interrater reliability, and validation with the Vineland Adaptive Behavior Scales. These findings help complete the instrument's statistical description and augment its usefulness, not only in designing treatment programs for these individuals, but also as an instrument for verifying the efficacy of intervention. © 2009 Springer Science+Business Media, LLC.

Published
2009

10. Prevalence and correlates of mental disorders among adolescents in Italy: the PrISMA study

Author

Laura Villa, Annarita Milone, Filippo Muratori, Alessandra Frigerio, Robert Goodman, Ombretta Carlet, Alessandro Zuddas, Franco Nardocci, Paola Rucci, Massimo Molteni, Andrea Martinuzzi, Elisa Mani, P. Cavolina, G Polidori, Nadia Micali, C. Lenti, Pierluigi Morosini, Giovanni de Girolamo, Loredana Lucarelli, Andrea Tullini, Mauro Walder, Valentina Pastore, Laura Vanzin, Massimo Ammaniti, Scientific Institute ‘E. Medea', DPNFB, University of Pisa - Università di Pisa, Western Psychiatric Institute and Clinic, University of Pittsburgh (PITT), Pennsylvania Commonwealth System of Higher Education (PCSHE)-Pennsylvania Commonwealth System of Higher Education (PCSHE), Institute of Psychiatry, King's College, Dipartimentio di Psicologia Dinamica e Clinica, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Department of Neuroscience, University of Cagliari, Department of Mental Health, Azienda USL, University of Milan, Scientific Institute ‘Stella Maris', National Institute of Health, Azienda ASL, Frigerio A., Rucci P., Goodman R., Ammaniti M., Carlet O., Cavolina P., De Girolamo G., Lenti C., Lucarelli L., Mani E., Martinuzzi A., Micali N., Milone A., Morosini P., Muratori F., Nardocci F., Pastore V., Polidori G., Tullini A., Vanzin L., Villa L., Walder M., Zuddas A., and Molteni M.

Subjects
Male, mental disorder, psychische Störung, CBCL, Mental disorders, Severity of Illness Index, sozioökonomische Faktoren, ddc:616.89, 0302 clinical medicine, ddc:150, Surveys and Questionnaires, Developmental and Educational Psychology, Child and adolescent psychiatry, Prevalence, Psychology, Medicine, Child Behavior Checklist, Child, ComputingMilieux_MISCELLANEOUS, Psychological Disorders, Mental Health Treatment and Prevention, empirisch, Mental Disorders, 05 social sciences, Jugendlicher, General Medicine, 3. Good health, Diagnostic and Statistical Manual of Mental Disorders, Psychiatry and Mental health, Italy, psychische Störungen, Behandlung und Prävention, Female, 050104 developmental & child psychology, Psychopathology, Clinical psychology, medicine.medical_specialty, Adolescent, prevalence, Italien, Adoleszenz, socioeconomic factors, 03 medical and health sciences, Prevalence of mental disorders, Humans, 0501 psychology and cognitive sciences, Psychiatry, Socioeconomic status, business.industry, Single parent, mental disorders, adolescence, Mental health, 030227 psychiatry, Psychologie, adolescent, Pediatrics, Perinatology and Child Health, empirical, business
Abstract

BACKGROUND: While in the last 5 years several studies have been conducted in Italy on the prevalence of mental disorders in adults, to date no epidemiological study has been targeted on mental disorders in adolescents. METHOD: A two-phase study was conducted on 3,418 participants using the child behavior checklist/6-18 (CBCL) and the development and well-being assessment (DAWBA), a structured interview with verbatim reports reviewed by clinicians. RESULTS: The prevalence of CBCL caseness and DSM-IV disorders was 9.8% (CI 8.8-10.8%) and 8.2% (CI 4.2-12.3%), respectively. DSM-IV Emotional disorders were more frequently observed (6.5% CI 2.2-10.8%) than externalizing disorders (1.2% CI 0.2-2.3%). In girls, prevalence estimates increased significantly with age; furthermore, living with a single parent, low level of maternal education, and low family income were associated with a higher likelihood of suffering from emotional or behavioral problems. CONCLUSIONS: Approximately one in ten adolescents has psychological problems. Teachers and clinicians should focus on boys and girls living with a single parent and/or in disadvantaged socioeconomic conditions.

Published
2007

11. An enormous asymptomatic solitary fibrous tumour of the pleura

Author

Alfonso Fiorello, V. Pastore, Giovanni Vicidomini, Mario Santini, Fiorelli, Alfonso, Vicidomini, Giovanni, Pastore, V, and Santini, Mario

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Pathology, Heart disease, business.industry, Neoplasms, Fibrous Tissue, Pleural Neoplasms, Solitary fibrous tumour, General Medicine, medicine.disease, Asymptomatic, Magnetic Resonance Imaging, medicine, Humans, Surgery, Radiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Aged
Published
2006

12. Use of a modified endobronchial tube for mechanical ventilation of patients with bronchopleural fistula

Author

V. Pastore, Mario Santini, Giovanni Vicidomini, Giovanni La Monica, Santini, Mario, Vicidomini, Giovanni, LA MONICA, G, and Pastore, V.

Subjects
Pulmonary and Respiratory Medicine, Artificial ventilation, Male, medicine.medical_specialty, Fistula, medicine.medical_treatment, Bronchopleural fistula, Lumen (anatomy), medicine, Intubation, Intratracheal, Humans, Respiratory function, Aged, Mechanical ventilation, business.industry, General Medicine, Equipment Design, respiratory system, Pleural Diseases, medicine.disease, Double-lumen endobronchial tube, Respiration, Artificial, Surgery, Radiography, Catheter, Bronchial Fistula, Cardiology and Cardiovascular Medicine, business
Abstract

Mechanical ventilation in patients with bronchopleural fistula after lung resection is a major problem, as it causes increase of the air-leak, complicates the healing process and makes residual lung tissue ventilation difficult. We present two cases in which the use of a modified double lumen endobronchial tube improved ventilation and eliminated the fistula air-leak. We used a right-sided double lumen sher-i-bronch tube (Sheridan Catheter Corp., USA). This method, by blocking the airflow through the fistula, may facilitate the expansion of the residual lung parenchyma. In both the patients treated with this technique, we obtained a good expansion of the residual parenchyma. Despite the procedure, the first patient died of septic shock; in the second patient, we achieved improvement of the respiratory function, the weaning from the mechanical ventilation, and thereafter, the healing of the fistula. The use of a modified double lumen sher-i-bronch tube in mechanically ventilated patients with post-resection bronchopleural fistula allows the anaesthesiologist to suction separately the two lungs and to ventilate adequately the remaining lung tissue, thus obtaining the lung reexpansion and the consequent reduction of the residual pleural space, and facilitating the healing of the fistula.

Published
2005

13. [Role of radio-guided surgery with 111In-octreotide in the treatment of thoracic neoplasms]

Author

M, Santini, P F, Rambaldi, E, Di Lieto, V, Cuccurullo, G, Vicidomini, V G, Di Crescenzo, L, Mansi, V, Pastore, Santini, Mario, Rambaldi, Pf, Di Lieto, E, Cuccurullo, Vincenzo, Vicidomini, Giovanni, Di Crescenzo, Vg, Mansi, Luigi, and Pastore, V.

Subjects
Adult, Aged, 80 and over, Male, Lung Neoplasms, Humans, Female, Middle Aged, Radiopharmaceuticals, Thoracic Neoplasms, Octreotide, Radionuclide Imaging, Aged, Neoplasm Staging
Abstract

The study evaluates the role of radio-guided surgery (RGS) with 111In-octreotide in the treatment of lung neoplasms. RGS with octreotide appears to be useful in surgery, above all during the intraoperative staging of the tumour; it can define with greater precision the extent of the resections extended towards the lung wall and ensure a radical approach in minimal lung resections.

Published
2001

14. Diagnosis and radioguided surgery with 111In-pentetreotide in a patient with paraneoplastic Cushing's syndrome due to a bronchial carcinoid

Author

N. Panza, Dario Esposito, Luigi Mansi, Vincenzo Esposito, V. Pastore, Pier Francesco Rambaldi, Mansi, Luigi, Rambaldi, Pier Francesco, Panza, N, Esposito, D, Esposito, V, and Pastore, V.

Subjects
Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Octreotide, Carcinoid Tumor, Malignancy, Scintigraphy, Cushing syndrome, Endocrinology, Pituitary adenoma, Internal medicine, medicine, Humans, Radionuclide Imaging, Lymph node, Cushing Syndrome, Lung, medicine.diagnostic_test, business.industry, Bronchial Neoplasms, General Medicine, medicine.disease, medicine.anatomical_structure, Differential diagnosis, business, Somatostatin, medicine.drug
Abstract

In a 28-year-old man with Cushing's syndrome, studies investigating a hypophyseal and/or adrenal origin of the disease, including computed tomography and magnetic resonance imaging, were negative. In agreement with reports showing somatostatin receptors on the cell membrane of ectopically secreting ACTH tumours, scintigraphy was performed after intravenous injection of 111 MBq 111In-pentetreotide (OCT). The radiolabelled OCT scan showed a small focal area of intense uptake at the inferior lobe of the right lung. Subsequent radioguided surgery located and defined a small mass (1.8 x 1.4 x 1.6 cm). The probe pinpointed the mass to the right inferior chest lobe, with a tumour/normal tissue count ratio of 6:1 and tumour/hilar normal lymph node ratio of 12:1, thus permitting the complete excision of the tumour to exclude lymph node and/or parietal involvement. A lung carcinoid was diagnosed at histology. The patient is still alive and disease-free 24 months after surgery. 111In-OCT was found to be useful for localizing the ACTH-secreting tumour and also permitted rapid non-invasive differential diagnosis between an ACTH-secreting pituitary adenoma and malignancy causing ectopic ACTH syndrome. This study also showed the clinical usefulness of radioguided surgery in the treatment of bronchial carcinoid.

Published
1998

15. Intraoperative detection of lung cancer by octreotide labeled to Indium-111

Author

Pier Francesco Rambaldi, Luigi Mansi, V. Pastore, Rosario Mancusi, Eugenio Di Lieto, Mario Santini, Pastore, V, DI LIETO, Eugenio, Mansi, Luigi, Rambaldi, Pf, Santini, Mario, and Mancusi, R.

Subjects
Adult, Male, medicine.medical_specialty, Lung Neoplasms, Octreotide, Resection, Histological staining, Intraoperative Period, Carcinoembryonic antigen, medicine, Humans, Lung cancer, Aged, Neoplasm Staging, biology, business.industry, Indium Radioisotopes, fungi, Middle Aged, medicine.disease, Hormones, Surgery, Dissection, Radioimmunodetection, Oncology, Mediastinal lymph node, biology.protein, Female, Radiology, Pulmonary resection, business, medicine.drug
Abstract

The contribution of radio surgery (RGS) using octreotide labeled with Indium-111 (In111) has been studied for surgical treatment of lung cancer. Thirteen patients were administered 111 Mbq of In111 octreotide intravenously. Scintigraphic images were preoperatively taken at 4, 24, and 48 hours after the tracer injection. Pulmonary resection and intraoperative evaluation by RGS technique were then performed to set the section limits. Histological staining of all the resected specimens and resection margins were assessed and their results were used as a confirmation of the RGS intraoperative findings. RGS is a simple method that can help the surgeon in the intraoperative assessment of bronchial, parenchymal, and parietal resection margins. Further research is needed to verify whether this method also may be useful in the intraoperative definition of the extent of mediastinal lymph node dissection.

Published
1998

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