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149 results on '"A, Bonura"'

1. Evaluation of the diagnostic performances of two commercially available assays for the detection of enteric adenovirus antigens

Author

Chiara Filizzolo, Donatella Ferraro, Francesca Di Bernardo, Floriana Bonura, Antonella Collura, Vito Martella, Simona De Grazia, Giovanni M. Giammanco, Chiara Mascarella, Celestino Bonura, Bonura F., Mascarella C., Filizzolo C., Bonura C., Ferraro D., Di Bernardo F., Collura A., Martella V., Giammanco G.M., and De Grazia S.

Subjects
Microbiology (medical), medicine.medical_specialty, Settore MED/07 - Microbiologia E Microbiologia Clinica, Adolescent, Adenoviridae Infections, Concordance, Sensitivity and Specificity, Gastroenterology, Adenoviridae, Feces, Antigen, Chemiluminescent immunoassay, Internal medicine, Fecal antigens detection, medicine, Humans, Child, Antigens, Viral, Immuno chromatography, Acute gastroenteriti, business.industry, Significant difference, Infant, Newborn, Enteric adenoviruse, Infant, General Medicine, Acute gastroenteritis, Gastroenteritis, Hospitalization, Infectious Diseases, Italy, Child, Preschool, Luminescent Measurements, Reagent Kits, Diagnostic, Diagnostic performance, business, Viral load
Abstract

The performance of 2 antigenic commercial assays for enteric adenovirus (AdV) infection, bioNexia Rota-Adeno ImmunoChromatographic Tests (ICT) and LIAISON® Adenovirus ChemiLuminescence Immuno Assays (CLIA), was evaluated on 321 stools from children hospitalized for acute gastroenteritis in Palermo, Italy, using a Real time-PCR (Rt-PCR) as reference method. The CLIA showed higher sensitivity (77% vs 60%), accuracy (94.4 vs 90.9) and concordance (k: 0.81 vs 0.67) with respect to ICT, despite equivalent specificity (98.8%). Using the Ct values of the Rt-PCR as a proxy of the fecal viral load, similar Ct values (mean 9.32 vs 9.89) were observed among the true positive samples, whilst a significant difference (P < 0.05) was observed in false negative samples of CLIA (mean Ct 25.68) and ICT (mean Ct 19.87). Cross-reactivity with other enteric viruses was not observed. These results indicate that both the assays tested are suitable for diagnosis of AdV gastroenteritis.

Published
2021

2. An emergent infectious disease: Clostridioides difficile infection hospitalizations, 10-year trend in Sicily

Author

Sergio Buffa, Raffaella Rubino, Chiara Iaria, Silvia Bonura, Alice Annalisa Medaglia, Claudia Colomba, Claudia Gioè, Antonio Cascio, Medaglia A.A., Buffa S., Gioe C., Bonura S., Rubino R., Iaria C., Colomba C., and Cascio A.

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Pediatrics, Health care-associated diarrhoea, Disease, Communicable Diseases, Clostridioides, Epidemiology, Case fatality rate, medicine, Humans, media_common.cataloged_instance, European union, Sicily, Aged, media_common, Cross Infection, Original Paper, Clostridioides difficile, business.industry, Incidence (epidemiology), Correction, General Medicine, medicine.disease, Hospitalization, Pneumonia, Surveillance of C. difficile, Infectious Diseases, Clostridioides difficile infection, Infectious disease (medical specialty), Clostridium Infections, Emerging infectious disease, Female, business
Abstract

Background Clostridioides difficile is the most common cause of healthcare-associated diarrhoea worldwide and C. difficile infection is an emerging infectious disease. In the US, its rates are monitored trough an active surveillance system, but many European Union member states still lack this, and in Italy no epidemiological data on C. difficile infection are available except for a few single-centre data. Aim To provide data on the C. difficile infection incidence in Sicily (the biggest and 5th most populous region of Italy) during a 10-year period. Methods We revised all the regional standardized discharge forms between 2009 and June 2019 using the code ICD-9 00845 of the International Classification of Diseases, Ninth Revision Clinical Modification, which refers to C. difficile infection with or without complications. Results 1139 cases of CDI were identified. 97% were adults with a median age of 73.2 years and a male-to-female ratio of 1:1.4. Female patients were older than males and patients who died were older than patients who did not. The main comorbidities were renal disease, diabetes, pneumonia and hypertension. There were 65 reporting hospitals and 86% of cases were provided by level III and II hospitals. Between 2009 and 2019, the incidence increased 40-fold. 81.5% of cases were reported in Medicine Units, Infectious Diseases Units and long-term care facilities. The mean length of stay was 20 days. Mean case fatality rate was 8.3% over the 10-year period. Conclusion Clostridioides difficile infection is a dramatically increasing condition in Sicily. A high-quality surveillance system and shared diagnostic protocols are needed.

Published
2021
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3. A severe case of Israeli spotted fever with pleural effusion in Italy

Author

Cristoforo Guccione, Celestino Bonura, Giovanni M. Giammanco, Valentina Caputo, Raffaella Rubino, Antonio Anastasia, Antonio Cascio, Stefano Agrenzano, Claudia Colomba, Guccione C., Colomba C., Rubino R., Bonura C., Anastasia A., Agrenzano S., Caputo V., Giammanco G.M., and Cascio A.

Subjects
Microbiology (medical), Male, medicine.medical_specialty, Settore MED/07 - Microbiologia E Microbiologia Clinica, Italy, Mediterranean spotted fever, Pleural effusion, Rickettsia, Rickettsiales, Rickettsiosis, Settore MED/17 - Malattie Infettive, Pleural effusion, medicine.medical_treatment, Rickettsiales, Thoracentesis, Case Report, Eschar, Rickettsiosis, Boutonneuse Fever, Medicine, Humans, Rickettsia, Aged, business.industry, Mediterranean spotted fever, Rickettsia Infections, General Medicine, Petechial rash, Spotted Fever Group Rickettsiosis, medicine.disease, Rash, Dermatology, Spotted fever, Pneumonia, Infectious Diseases, Italy, medicine.symptom, business
Abstract

Background The most common Italian rickettsiosis is Mediterranean Spotted Fever (MSF). MSF is commonly associated with a symptom triad consisting of fever, cutaneous rash, and inoculation eschar. The rash is usually maculopapular but, especially in severe presentations, may be petechial. Other typical findings are arthromyalgia and headache. Herein, we describe for the first time an unusual case of Israeli spotted fever (ISF) associated with interstitial pneumonia and pleural effusion in which R. conorii subsp. israelensis was identified by molecular methods in the blood, as well as in the pleural fluid. Case presentation A 72-year-old male presented with a 10-day history of remittent fever. On admission, the patient’s general condition appeared poor with confusion and drowsiness; the first assessment revealed a temperature of 38.7°, blood pressure of 110/70 mmHg, a blood oxygen saturation level of 80% with rapid, frequent, and superficial breathing using accessory muscles (28 breaths per minute), and an arrhythmia with a heart rate of 90 beats per minute. qSOFA score was 3/3. Chest CT revealed ground-glass pneumonia with massive pleural effusion. Petechial exanthema was present diffusely, including on the palms and soles, and a very little eschar surrounded by a violaceous halo was noted on the dorsum of the right foot. Awaiting the results of blood cultures, broad-spectrum antibiotic therapy with meropenem 1 g q8h, ciprofloxacin 400 mg q12h, and doxycycline 100 mg q12h was initiated. Doxycycline was included in the therapy because of the presence of petechial rash and fever, making us consider a diagnosis of rickettsiosis. This suspicion was confirmed by the positivity of polymerase chain reaction on whole blood for R. conorii subsp. israelensis. Thoracentesis was performed to improve alveolar ventilation. R. conorii subsp. israelensis was again identified in the pleural fluid by PCR technique. On day 4 the clinical condition worsened. Blood exams showed values suggestive of secondary hemophagocytic lymphohistiocytosis; 4 out of 8 diagnostic criteria were present and empirical treatment with prednisone was started resulting in a gradual improvement in general condition. Conclusions Israeli spotted fever may be a severe disease. A high index of suspicion is required to promptly start life-saving therapy. Pleural effusion and interstitial pneumonia may be part of the clinical picture of severe rickettsial disease and should not lead the physician away from this diagnosis.

Published
2021

4. Assessing the burden of viral co-infections in acute gastroenteritis in children: An eleven-year-long investigation

Author

Floriana Bonura, Leonardo Mangiaracina, Celestino Bonura, Vito Martella, Chiara Filizzolo, Giovanni M. Giammanco, Simona De Grazia, De Grazia S., Bonura F., Bonura C., Mangiaracina L., Filizzolo C., Martella V., and Giammanco G.M.

Subjects
0301 basic medicine, Rotavirus, Settore MED/07 - Microbiologia E Microbiologia Clinica, medicine.medical_specialty, viruses, 030106 microbiology, medicine.disease_cause, Virus, Astrovirus, 03 medical and health sciences, Feces, fluids and secretions, 0302 clinical medicine, Virology, Epidemiology, Genotype, Medicine, Humans, 030212 general & internal medicine, Child, biology, business.industry, Coinfection, Norovirus, virus diseases, Infant, biology.organism_classification, Gastroenteritis, Co-infection, Ct values, Enteric viruses, Genotypes, Real-time PCR, Infectious Diseases, Italy, business, Viral load
Abstract

Background Acute gastroenteritis is an important cause of childhood morbidity and mortality worldwide. A number of pathogens are responsible for human acute gastroenteritis. The recent introduction of syndromic assays for the diagnosis of enteric infections, including a wide panel of enteric pathogens, has unveiled the frequency of mixed infections. This study was carried out to assess the burden of viral co-infections and the genetic diversity of the viruses detected in children hospitalized with acute gastroenteritis in Italy. Methods A total of 4161 stool samples collected from diarrheic children over 11 years, from January 2008 to December 2018, were investigated for the presence of four enteric viruses, i.e. group A rotavirus, norovirus, astrovirus and adenovirus. The samples were initially screened by either molecular or immunochromatographic assays and subsequently confirmed by Real-time PCR and sequence analyses. Results At least one viral agent was detected in 48.6 %of specimens. Rotavirus was the most prevalent virus (24.7 %) followed by norovirus (19.6 %), adenovirus (5.3 %) and astrovirus (3%). Co-infections were detected in 8.3 % of virus-positive patients, with common viral combination being rotavirus with norovirus (70.6 % of co-infections) or with astrovirus (9.6 %). A variety of viral genotypes was detected in co-infections and in single infections. Using Real-time PCR cycle thresholds as a proxy measure of fecal viral load, rotavirus was generally detected at higher levels in co-infected patients. Conclusions Combining and deciphering measurable indicators of viral load and epidemiological information could be useful for an accurate interpretation of viral co-infections.

Published
2020

5. Preclinical Assessment Performance as a Predictor of USMLE Step 1 Scores or Passing Status

Author

Leslie A. Haedinger, Case Keltner, Erin M. Bonura, and Patricia A. Carney

Subjects
medicine.medical_specialty, 020205 medical informatics, business.industry, Medicine (miscellaneous), Retrospective cohort study, 02 engineering and technology, Odds ratio, Logistic regression, United States Medical Licensing Examination, Education, 03 medical and health sciences, 0302 clinical medicine, 0202 electrical engineering, electronic engineering, information engineering, Physical therapy, Medicine, Observational study, Medical school curriculum, 030212 general & internal medicine, business, Original Research
Abstract

PURPOSE: To determine the association between student performance on preclinical pass/fail assessments in an allopathic medical school curriculum and Step 1 scores or passing status. MATERIALS AND METHODS: This observational retrospective study involved preclinical assessments, including National Board of Medical Examiners Customized Assessment Services (NBME CAS) exams, faculty developed exams, and the United States Medical Licensing Examination (USMLE) Step 1 from 582 medical students in four cohorts (2018–2021). Analyses included descriptive statistics, Pearson’s correlation coefficient (ρ) and logistic regression, presented as odds ratios (ORs) and associated p values. RESULTS: Mean scores on Component 4 end-of-block NBME CAS examinations positively correlated with Step 1 scores (ρ = 0.83, p

Published
2021
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6. How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post-MI Study

Author

De Luca L., Colivicchi F., Meessen J., Uguccioni M., Piscione F., Bernabo P., Lardieri G., Granatelli A., Gabrielli D., Gulizia M. M., Silverio A., Benvenga R. M., Mascia F., Fusco A., Cicala S., Oltrona Visconti L., Marinoni B., Canosi U., Cirillo P., Trimarco B., Ziviello F., Grosseto D., Menozzi M., Mezzena D., Mauro C., Sasso A., Bellis A., Calabro P., Gragnano F., Cesaro A., Venturelli V., Porretta V., Borrelli N., Indolfi C., De Rosa S., Torella D., Morici N., Molfese M., Della Rovere F., Caiffa T., Moretto G., Grippo G., Di Vincenzo E., Lucisano L., Pennacchi M., Geraci G., Sanfilippo N., Ledda A., Di Lenarda A., Cherubini A., Russo G., Piemonte F., Di Donato A., Carraturo A., Villari B., Ciampi Q., Contaldi C., Pacher V., Corrada E., Cattani D., Nassiacos D., Meloni S., Barco B., Bonmassari R., Bertoldi A., Tedoldi F., Cannone M., Valenti G., Musci R. L., Caldarola P., Locuratolo N., Sublimi Saponetti L., Gentili L., Maiandi C., Caputo M., Capparuccia C. A., Tonella T., Massari F. M., Lupi A., Tessitori M., Montano M., Scaglione A., Torri A., Tortorella G., Navazio A., Cemin R., Latina L., Briguglia D., Marino R., Scalvini S., Zanelli E., Paganini V., Riboni G., Leiballi E., Della Mattia A., Imperadore F., Tespili M., Santangelo G., Parravicini U., Dellavesa P., Testa R., Venturini E., Feola M., Testa M., Crisci V., Tramontana M., Robiglio L., Varbella F., Meynet I., Galati A., Maddaluna A., Bilato C., Loddo I., Licciardello G., Cassaniti L., Scherillo M., Formigli D., Marullo L., Chianese L., Paolillo C., De Santis A. P. A., Brunetti N. D., Bottigliero D., Della Bona R., Giannico M. B., Tramarin R., Lucibello S., Perna G. P., Marini M., Colavita A. R., Raziliop A., Francese G. M., Mariani M., Collauto F., D'Urbano M., Naio R., Ando G., Saporito F., Assanelli E. M., Cabiati A., Crivaro A., Alberti S., Marchese I., Nejat T., Refice S., Raino R., Aiello A., Cristinziani G. R., Barilla F., Iorio R., Mascelli G., Tartaglione S. N., Di Chiara G., D'Andrea D., Antonicelli R., Malatesta G., Di Mario C., Mattesini A., Tramontana L., Conti S., Sommariva L., Celestini A., Amico F., Giubilato S., Amico A. F., De Filippis M., Pasini G. F., Triggiani M., Ferrara V., Cappetti S., Carugo S., Lucreziotti S., Persico M., Gizzi G., Cipolla T., Caronia A., Buia E., Pastori P., Scarpignato M., Biscottini E., Poletti F., Vimercati C., Pirola R., Barbieri E., Dugo C., De Cesare N., De Benedictis M. L., Ruggeri A., Campana C., Bonura S., Vigna C., Marchese N., Partesana N. G., Bandini P., Farinola G., Santoro D., Cassadonte F., Calabro F., Sansoni M., Abrignani M. G., Bonura F., Benvenuto M., Liso A., Passero T., Mori I., Pozzoni B., Prati F., Finocchiaro M. L., Tufano N., Miserrafiti B., Lacquaniti V., Del Piccolo F., Mohamad B., Spinnler M. T., Bovolo V., Rebulla E., Pieri M., Paloscia L., Di Clemente D., Mazzucco G., Micanti A., Peci P., Ornago O., Proietti F., Michisanti M., Reverzani A., Donatini A., Costa P., Russo S., Franceschini Grisolia E., Mario L., Di Palma F., Dell'Aquila F., Maestroni A., Caico S. I., De Caro G., Attianese L., Perotti S., Cotti Cometti V., Astengo D., Guerri E., Cianflone D., Maranta F., Esposito N., Malvezzi Caracciolo D'Aquino M., Caliendo L., Ricci C., Ceruso C. P., Lanteri S., Serdoz R., Bruno E., De Matteis C., Campagnuolo C., Ammirati M. A., Corrado V. M., Amado Eleas M. A., Fattore L., Ippoliti C., Turiano G., Piergentili C., Chiarella F., Capogrosso P., Perotti M., Di Marco S., Sibilio G., Di Lorenzo L., Aurelio A., Ramondo A. B., Zanna D., Cernetti C., Napolitano G., Negroni S., Alessandri N., Rigo F., Giusti F., Casu G., Vicentini A., Calculli G., Fera M. S., Lettica G. V., Vagheggini G., Piti A., Porfidia A., Di Leo A., Ravera A., Ciotta E., Sacca S., Silvestri O., Isidori S., Natali P., Anselmi M., Testa L., Antonelli A., Tavasci E., Furgi G., Lavorgna A., Gasparetto N., Bisceglia T., De Luca, L., Colivicchi, F., Meessen, J., Uguccioni, M., Piscione, F., Bernabo, P., Lardieri, G., Granatelli, A., Gabrielli, D., Gulizia, M. M., Silverio, A., Benvenga, R. M., Mascia, F., Fusco, A., Cicala, S., Oltrona Visconti, L., Marinoni, B., Canosi, U., Cirillo, P., Trimarco, B., Ziviello, F., Grosseto, D., Menozzi, M., Mezzena, D., Mauro, C., Sasso, A., Bellis, A., Calabro, P., Gragnano, F., Cesaro, A., Venturelli, V., Porretta, V., Borrelli, N., Indolfi, C., De Rosa, S., Torella, D., Morici, N., Molfese, M., Della Rovere, F., Caiffa, T., Moretto, G., Grippo, G., Di Vincenzo, E., Lucisano, L., Pennacchi, M., Geraci, G., Sanfilippo, N., Ledda, A., Di Lenarda, A., Cherubini, A., Russo, G., Piemonte, F., Di Donato, A., Carraturo, A., Villari, B., Ciampi, Q., Contaldi, C., Pacher, V., Corrada, E., Cattani, D., Nassiacos, D., Meloni, S., Barco, B., Bonmassari, R., Bertoldi, A., Tedoldi, F., Cannone, M., Valenti, G., Musci, R. L., Caldarola, P., Locuratolo, N., Sublimi Saponetti, L., Gentili, L., Maiandi, C., Caputo, M., Capparuccia, C. A., Tonella, T., Massari, F. M., Lupi, A., Tessitori, M., Montano, M., Scaglione, A., Torri, A., Tortorella, G., Navazio, A., Cemin, R., Latina, L., Briguglia, D., Marino, R., Scalvini, S., Zanelli, E., Paganini, V., Riboni, G., Leiballi, E., Della Mattia, A., Imperadore, F., Tespili, M., Santangelo, G., Parravicini, U., Dellavesa, P., Testa, R., Venturini, E., Feola, M., Testa, M., Crisci, V., Tramontana, M., Robiglio, L., Varbella, F., Meynet, I., Galati, A., Maddaluna, A., Bilato, C., Loddo, I., Licciardello, G., Cassaniti, L., Scherillo, M., Formigli, D., Marullo, L., Chianese, L., Paolillo, C., De Santis, A. P. A., Brunetti, N. D., Bottigliero, D., Della Bona, R., Giannico, M. B., Tramarin, R., Lucibello, S., Perna, G. P., Marini, M., Colavita, A. R., Francese, G. M., Mariani, M., Collauto, F., D'Urbano, M., Naio, R., Ando, G., Saporito, F., Assanelli, E. M., Cabiati, A., Crivaro, A., Alberti, S., Marchese, I., Nejat, T., Refice, S., Aiello, A., Cristinziani, G. R., Barilla, F., Iorio, R., Mascelli, G., Tartaglione, S. N., Di Chiara, G., D'Andrea, D., Antonicelli, R., Malatesta, G., Di Mario, C., Mattesini, A., Tramontana, L., Conti, S., Sommariva, L., Celestini, A., Amico, F., Giubilato, S., Amico, A. F., De Filippis, M., Pasini, G. F., Triggiani, M., Ferrara, V., Cappetti, S., Carugo, S., Lucreziotti, S., Persico, M., Gizzi, G., Cipolla, T., Caronia, A., Buia, E., Pastori, P., Scarpignato, M., Biscottini, E., Poletti, F., Vimercati, C., Pirola, R., Barbieri, E., Dugo, C., De Cesare, N., De Benedictis, M. L., Ruggeri, A., Campana, C., Bonura, S., Vigna, C., Marchese, N., Partesana, N. G., Bandini, P., Farinola, G., Santoro, D., Cassadonte, F., Calabro, F., Sansoni, M., Abrignani, M. G., Bonura, F., Benvenuto, M., Liso, A., Passero, T., Mori, I., Pozzoni, B., Prati, F., Finocchiaro, M. L., Tufano, N., Miserrafiti, B., Lacquaniti, V., Del Piccolo, F., Mohamad, B., Spinnler, M. T., Bovolo, V., Rebulla, E., Pieri, M., Paloscia, L., Di Clemente, D., Mazzucco, G., Micanti, A., Peci, P., Ornago, O., Proietti, F., Michisanti, M., Reverzani, A., Donatini, A., Costa, P., Russo, S., Franceschini Grisolia, E., Mario, L., Di Palma, F., Dell'Aquila, F., Maestroni, A., Caico, S. I., De Caro, G., Attianese, L., Perotti, S., Cotti Cometti, V., Astengo, D., Guerri, E., Cianflone, D., Maranta, F., Esposito, N., Malvezzi Caracciolo D'Aquino, M., Caliendo, L., Ricci, C., Ceruso, C. P., Lanteri, S., Serdoz, R., Bruno, E., De Matteis, C., Campagnuolo, C., Ammirati, M. A., Corrado, V. M., Amado Eleas, M. A., Fattore, L., Ippoliti, C., Turiano, G., Piergentili, C., Chiarella, F., Capogrosso, P., Perotti, M., Di Marco, S., Sibilio, G., Di Lorenzo, L., Aurelio, A., Ramondo, A. B., Zanna, D., Cernetti, C., Napolitano, G., Negroni, S., Alessandri, N., Rigo, F., Giusti, F., Casu, G., Vicentini, A., Calculli, G., Fera, M. S., Lettica, G. V., Vagheggini, G., Piti, A., Porfidia, A., Di Leo, A., Ravera, A., Ciotta, E., Sacca, S., Silvestri, O., Isidori, S., Natali, P., Anselmi, M., Testa, L., Antonelli, A., Tavasci, E., Furgi, G., Lavorgna, A., Gasparetto, N., Bisceglia, T., Raziliop, A., and Raino, R.

Subjects
Male, Multivariate analysis, Time Factors, medicine.medical_treatment, Myocardial Infarction, 030204 cardiovascular system & hematology, 0302 clinical medicine, Cardiologists, post‐MI, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Registries, intervention, risk, Dual Anti-Platelet Therapy, focused update, ticagrelor keywords plus:coronary-artery-disease, Atrial fibrillation, General Medicine, clopidogrel, dual antiplatelet therapy, percutaneous coronary intervention, post-mi, secondary prevention, dapt score, duration, management, Middle Aged, Clopidogrel, Treatment Outcome, Female, Cardiology and Cardiovascular Medicine, Ticagrelor, Human, medicine.drug, medicine.medical_specialty, animal structures, Time Factor, Clinical Investigations, Cardiologist, Drug Administration Schedule, Follow-Up Studie, ticagrelor, 03 medical and health sciences, Internal medicine, medicine, Humans, cardiovascular diseases, Aged, Aspirin, post-MI, Follow-Up Studies, Platelet Aggregation Inhibitors, Patient Selection, business.industry, Platelet Aggregation Inhibitor, Percutaneous coronary intervention, medicine.disease, Prospective Studie, Conventional PCI, Observational study, business
Abstract

Background Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1%) were on DAPT at the time of enrolment, and 450 (27.6%) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI.

Published
2019

7. Cardiac Magnetic Resonance Imaging Features in Hypertrophic Cardiomyopathy Diagnosed at <21 Years of Age

Author

Steve R. Ommen, Philip A. Araoz, Jeffrey B. Geske, Mahmoud A. Abdelsalam, Michael J. Ackerman, Erica D. Bonura, and J. Martijn Bos

Subjects
Gadolinium DTPA, Male, medicine.medical_specialty, Adolescent, Heart Ventricles, medicine.medical_treatment, Cardiomyopathy, Contrast Media, Magnetic Resonance Imaging, Cine, Ventricular Septum, 030204 cardiovascular system & hematology, Risk Assessment, Sudden cardiac death, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Cardiac magnetic resonance imaging, Internal medicine, Cardiomyopathy, Hypertrophic, Familial, Humans, Medicine, cardiovascular diseases, 030212 general & internal medicine, Risk factor, Child, Proportional Hazards Models, Heart transplantation, Framingham Risk Score, medicine.diagnostic_test, business.industry, Age Factors, Hypertrophic cardiomyopathy, Magnetic resonance imaging, Organ Size, Cardiomyopathy, Hypertrophic, medicine.disease, Magnetic Resonance Imaging, Death, Sudden, Cardiac, Echocardiography, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Hypertrophic cardiomyopathy (HC) is the most common inherited cardiomyopathy, with varied timing of phenotypic and clinical presentation. Literature describing cardiac magnetic resonance (CMR) imaging and late gadolinium enhancement (LGE) in young patients with HC is limited. This study included patients diagnosed with HC at young age (21 years) between January 1990 and January 2015 who underwent transthoracic echocardiography and CMR with assessment of LGE at a single tertiary referral center. LGE was quantified via a method of 6 standard deviations and patients were grouped based upon presence or absence of LGE (≤1% and1% LGE, respectively). Sudden cardiac death (SCD) risk was assessed in patients16 years of age using the European SCD risk score. A composite outcome of New York Heart Association class III-IV symptoms, aborted SCD, heart transplantation, and all-cause mortality was assessed via Kaplan-Meier curves with log-rank analysis. Overall, 126 patients were included (78 male; 62%). Median age of diagnosis was 15 (12 to 18) years. LGE was present in 81 (64%) patients, although only 4 (3%) patients had LGE15%. Median age at CMR imaging was 19 (15 to 23) years. Patients with LGE had greater wall thickness (25 ± 8 mm vs 22 ± 7 mm, p = 0.01). Median European SCD risk score was 4.7 (2.9 to 6.5). Median follow-up was 6.5 (2.5 to 13) years with 26 patients (21%) meeting the composite outcome. There were no significant differences in composite outcome since age of diagnosis when stratified by presence/absence of LGE (p = 1.0). The presence of LGE in young HC patients was not an independent risk factor for cardiovascular morbidity and mortality. Wall thickness was greater in patients with LGE. There remains a need for further evaluation of this unique HC cohort.

Published
2020
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8. Worldwide Survey of COVID-19-Associated Arrhythmias

Author

Pietro Enea Lazzerini, Alberto Cipriani, Fatima Rodriguez, Mauricio Scanavacca, Connor O'Brien, Lia Crotti, Paul J. Wang, Wee Kooi Cheah, Serena Bricoli, Angelo Auricchio, Yi Li, Nicolas Schaerli, Federico Franchi, Angelo B. Biviano, Saud Ahmed Khawaja, Shashank Jain, Filippo Donato, Anna Rosenblatt, Milton E Guevara-Valdivia, Michela Casella, Stephanie M. Kochav, Chia Siang Kow, Seongwook Han, Paola Ferrari, Cynthia M. Tracy, Daniele Fabbri, Raphael Twerenbold, Stefan Osswald, Julio Echarte-Morales, Aditi Naniwadekar, Carlos Minguito-Carazo, Joseph G. Akar, Federico Migliore, Vahideh Laleh Far, Gianfranco Parati, Masoud Eslami, Elaine Wan, Rosario Bonura, Luciana Sacilotto, Ilhwan Yeo, Melissa Y.Y. Moey, Pier Leopoldo Capecchi, Prapa Kanagaratnam, Carlos A. Rivera-Santiago, Keith Sai Kit Leung, Ludhmila Abrahão Hajjar, Jongmin Hwang, Reza Mollazadeh, Mauricio Pimentel, Amato Santoro, Gary Tse, Giuseppe Boriani, Avinainder Singh, Seth Goldbarg, Isaac L Goldenthal, Anna Vittoria Mattioli, Jose A. Joglar, James Coromilas, Tomás Benito-González, Paolo De Filippo, Joon Hyuk Kim, Felipe Fernández-Vázquez, Brenno Rizerio, Ellie J. Coromilas, Hasan Garan, Marco Zardini, Eduardo Zatarain, Shant Ayanian, Paolo Compagnucci, Kyoko Soejima, Antonio Dello Russo, Giovanni Malanchini, Giulio Conte, Ghada W. Mikhail, Leandro Ioschpe Zimerman, Felipe Atienza, Andrew Aboyme, Clinical sciences, Coromilas, E, Kochav, S, Goldenthal, I, Biviano, A, Garan, H, Goldbarg, S, Kim, J, Yeo, I, Tracy, C, Ayanian, S, Akar, J, Singh, A, Jain, S, Zimerman, L, Pimentel, M, Osswald, S, Twerenbold, R, Schaerli, N, Crotti, L, Fabbri, D, Parati, G, Li, Y, Atienza, F, Zatarain, E, Tse, G, Leung, K, Guevara-Valdivia, M, Rivera-Santiago, C, Soejima, K, De Filippo, P, Ferrari, P, Malanchini, G, Kanagaratnam, P, Khawaja, S, Mikhail, G, Scanavacca, M, Abrahao Hajjar, L, Rizerio, B, Sacilotto, L, Mollazadeh, R, Eslami, M, Laleh Far, V, Mattioli, A, Boriani, G, Migliore, F, Cipriani, A, Donato, F, Compagnucci, P, Casella, M, Dello Russo, A, Coromilas, J, Aboyme, A, O'Brien, C, Rodriguez, F, Wang, P, Naniwadekar, A, Moey, M, Kow, C, Cheah, W, Auricchio, A, Conte, G, Hwang, J, Han, S, Lazzerini, P, Franchi, F, Santoro, A, Capecchi, P, Joglar, J, Rosenblatt, A, Zardini, M, Bricoli, S, Bonura, R, Echarte-Morales, J, Benito-Gonzalez, T, Minguito-Carazo, C, Fernandez-Vazquez, F, and Wan, E

Subjects
Tachycardia, Male, Time Factors, Medical Physiology, Comorbidity, Practice Patterns, 030204 cardiovascular system & hematology, Arrhythmias, Cardiac/epidemiology, Arrhythmias, Cardiorespiratory Medicine and Haematology, Global Health, tachycardia, Electrophysiologic Techniques, Cardiac/trends, 0302 clinical medicine, Prevalence, atrial fibrillation, 030212 general & internal medicine, Practice Patterns, Physicians', COVID-19/epidemiology, Incidence (epidemiology), Incidence, Atrial fibrillation, Middle Aged, Prognosis, atrial flutter, cardiovascular system, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Female, Electrophysiologic Techniques, medicine.symptom, Risk assessment, Cardiology and Cardiovascular Medicine, Electrophysiologic Techniques, Cardiac, Cardiac, Bradycardia, medicine.medical_specialty, Clinical Sciences, torsade de pointe, arrhythmia, Risk Assessment, bradycardia, 03 medical and health sciences, Cardiac Electrophysiology/trends, Physiology (medical), Internal medicine, medicine, Humans, cardiovascular diseases, Healthcare Disparities, Retrospective Studies, Aged, Global Health/trends, Physicians', SARS-CoV-2, business.industry, COVID-19, Retrospective cohort study, Arrhythmias, Cardiac, Original Articles, medicine.disease, Practice Patterns, Physicians'/trends, Cardiovascular System & Hematology, Health Care Surveys, torsade de pointes, Cardiac Electrophysiology, business, Atrial flutter
Abstract

Supplemental Digital Content is available in the text., Background: Coronavirus disease 2019 (COVID-19) has led to over 1 million deaths worldwide and has been associated with cardiac complications including cardiac arrhythmias. The incidence and pathophysiology of these manifestations remain elusive. In this worldwide survey of patients hospitalized with COVID-19 who developed cardiac arrhythmias, we describe clinical characteristics associated with various arrhythmias, as well as global differences in modulations of routine electrophysiology practice during the pandemic. Methods: We conducted a retrospective analysis of patients hospitalized with COVID-19 infection worldwide with and without incident cardiac arrhythmias. Patients with documented atrial fibrillation, atrial flutter, supraventricular tachycardia, nonsustained or sustained ventricular tachycardia, ventricular fibrillation, atrioventricular block, or marked sinus bradycardia (heart rate

Published
2021

9. Efficacy of a coordinated strategy for containment of multidrug-resistant Gram-negative bacteria carriage in a Neonatal Intensive Care Unit in the context of an active surveillance program

Author

Carmelo Massimo Maida, Francesco Vitale, Aurora Aleo, Vincenzo Insinga, Grazia Rinaudo, Mario Giuffrè, Celestino Bonura, Emanuele Amodio, Vitaliti M, Giovanni Corsello, Giorgio Graziano, Federica Mescolo, Laura Saporito, Saporito L., Graziano G., Mescolo F., Amodio E., Insinga V., Rinaudo G., Aleo A., Bonura C., Vitaliti M., Corsello G., Vitale F., Maida C.M., and Giuffre M.

Subjects
0301 basic medicine, Microbiology (medical), Male, medicine.medical_specialty, Neonatal intensive care unit, 030106 microbiology, Extended spectrum β lactamases producing klebsiella pneumoniae, Context (language use), Drug resistance, Microbial Sensitivity Tests, Antimicrobial resistance, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Medical microbiology, Internal medicine, Drug Resistance, Multiple, Bacterial, Intensive Care Units, Neonatal, Gram-Negative Bacteria, medicine, Humans, Pharmacology (medical), lcsh:RC109-216, 030212 general & internal medicine, Cross Infection, Infection Control, Active surveillance program, business.industry, Research, Public Health, Environmental and Occupational Health, Infant, Newborn, Antimicrobial, Multi-drug resistant gram-negative bacteria, Electrophoresis, Gel, Pulsed-Field, Infectious Diseases, Carriage, Italy, Intervention strategy, Carrier State, Female, Sample collection, business, Gram-Negative Bacterial Infections
Abstract

BackgroundAntimicrobial resistance in neonatal intensive care unit (NICU) patients is a threat, due to the frequent use of antimicrobial treatment and invasive devices in fragile babies. Since 2014 an active surveillance program of multidrug-resistant Gram-negative bacteria (MDR-GNB) carriage has been in place in the five NICUs of Palermo, Italy. In 2017 an increase in the prevalence of MDR-GNB, and in particular of extended-spectrum β-lactamases-producingKlebsiella pneumoniae(ESBL-KP), was observed in “Civico” hospital NICU.AimTo assess the impact of a coordinated intervention strategy in achieving long-lasting reduction of MDR-GNB prevalence in the NICU.MethodsRectal swabs were obtained monthly and processed to detect MDR-GNB using standard methods. MDR-GNB were characterized by pulsed-field gel electrophoresis (PFGE). Since November 2017 the following intervention measures were applied: (a) two-months intensification of sample collection; (b) stakeholders meetings; (c) improvement of prevention measures and antimicrobial policies.FindingsDuring the intensified microbiological surveillance MDR-GNB and ESBL-KP were detected in rectal swabs (34.8%; 23.2%), nasal swabs (24.6%; 14.5%), oral swabs (14.5%; 5.4%), milk samples (32.1%; 17.9%), pacifiers swabs (30.8%; 17.9%) and from sub-intensive room surfaces. Thirteen ESBL-KP strains isolated from clinical and environmental samples showed identical PFGE patterns. The prevalence of MDR-GNB and ESBL-KP carriage significantly decreased in the year after intervention compared to the previous year (20.6% vs 62.2%;p p p ConclusionsMDR-GNB broadly circulate in NICU setting, they can colonize different body sites and spread through various vehicles. A coordinated strategy of multiple interventions with active cooperation between epidemiologists and clinicians in the NICU can effectively reduce their circulation and in particular the carriage of the most dangerous ESBL-KP strains.

Published
2021

10. The Impact of Coronavirus Disease 2019 on Medical Trainee Career Decisions

Author

Heather C. Yun, Erin M. Bonura, David A Lindholm, Alice E Barsoumian, Jennifer L Hsu, and Dana M Blyth

Subjects
2019-20 coronavirus outbreak, medicine.medical_specialty, Infectious Diseases, Oncology, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Family medicine, Medicine, business, Letter to the Editor
Published
2021

12. Extramural extension of a buried over-the-scope clip in the stomach: an unusual adverse event

Author

Mauro Manno, Giuliano Francesco Bonura, Paolo Biancheri, T Gabbani, and Paola Soriani

Subjects
medicine.medical_specialty, Extramural, business.industry, Stomach, General surgery, Gastroenterology, Over the scope clip, Surgical Instruments, Upper Gastrointestinal Tract, medicine.anatomical_structure, Abdomen, Medicine, Humans, Adverse effect, business
Published
2021

13. Risk factors and clinical characteristics of early-onset colorectal cancer vs. late-onset colorectal cancer: a case-case study

Author

Giulia Martina Cavestro, Pier Alberto Testoni, Marta Puzzono, Lorella Fanti, Annalisa Russo Raucci, Raffaella Alessia Zuppardo, Giuliano Francesco Bonura, Andrea Marco Tamburini, Graziana Antoci, Milena Di Leo, Riccardo Rosati, Francesco Azzolini, Maria Grazia Patricelli, Ugo Elmore, Chiara Notaristefano, Alessandro Mannucci, Luca Albarello, Edi Viale, José Perea, Dario Esposito, Ilaria Ditonno, Di Leo, Milena, Zuppardo, Raffaella A, Puzzono, Marta, Ditonno, Ilaria, Mannucci, Alessandro, Antoci, Graziana, Russo Raucci, Annalisa, Patricelli, Maria G, Elmore, Ugo, Tamburini, Andrea M, Albarello, Luca, Azzolini, Francesco, Bonura, Giuliano F, Esposito, Dario, Fanti, Lorella, Notaristefano, Chiara, Viale, Edi, Perea, Josè, Testoni, Pier A, Rosati, Riccardo, and Cavestro, Giulia M

Subjects
medicine.medical_specialty, Hepatology, business.industry, Colorectal cancer, Incidence (epidemiology), Incidence, Gastroenterology, Rectum, Late onset, Odds ratio, medicine.disease, Young Adult, Risk Factors, Diabetes mellitus, Internal medicine, medicine, Humans, Young adult, Family history, Age of Onset, business, Colorectal Neoplasms, Early onset, Retrospective Studies
Abstract

BACKGROUND AND OBJECTIVES Early-onset colorectal cancer (eoCRC), defined as colorectal cancer (CRC) before the age of 50 is increasing in incidence. We evaluated exogenous and endogenous risk factors, and clinical features of eoCRC, compared to late-onset CRC (loCRC). METHODS In this retrospective case-case study, patients were prospectively enrolled from 2015 to 2018. We collected clinical features (age, sex, time from symptom onset to diagnosis, symptoms, family history, smoking and alcohol habits, diabetes, BMI, and genetic analysis) and tumor characteristics. Independent risk factors for eoCRC and odds ratios (ORs) were identified. RESULTS Fifty-four eoCRCs and 494 loCRCs were enrolled. Patients with eoCRC experienced longer delay time from symptom onset to diagnosis: 40.7% were diagnosed within 6 months from symptoms onset, compared to 85.6% of patients with loCRC (P < 0.0001). They differed for sex, presence of symptoms, family history, smoking habit, alcohol intake, and BMI. Rectal localization was more closely associated with eoCRC (64.8%) than loCRC (34.5%, P < 0.0001). Family history of CRC was associated with eoCRC (OR = 8.8). When family history occurred with hereditary cancer syndromes, the OR for eoCRC increased to 21. CONCLUSION In young adults with alarming symptoms, CRC must be suspected to avoid delay time from symptom onset to diagnosis and genetic risk assessment has to be evaluated. Smoking habits, alcohol intake, and BMI are not associated with eoCRC.

Published
2020

14. A large anastomotic leakage after esophageal surgery treated with endoluminal vacuum-assisted closure: a case report

Author

Francesco Vito Mandarino, Paolo Parise, Dario Esposito, Riccardo Rosati, Lorella Fanti, Giuliano Francesco Bonura, Mandarino, Francesco Vito, Bonura, Giuliano Francesco, Esposito, Dario, Rosati, Riccardo, Parise, Paolo, and Fanti, Lorella

Subjects
medicine.medical_specialty, Leak, business.industry, Vacuum assisted closure, medicine.medical_treatment, Fistula, Case Report, Esosponge, Anastomosis, medicine.disease, esophageal leak, Surgery, 03 medical and health sciences, 0302 clinical medicine, vacuum therapy, Esophagectomy, Anastomotic leakage, 030220 oncology & carcinogenesis, Negative-pressure wound therapy, medicine, Esophageal surgery, esophagectomy, 030211 gastroenterology & hepatology, business
Abstract

The treatment of anastomotic post-esophagectomy leaks and fistula is challenging. Endoluminal vacuum-assisted closure (EVAC) is an emerging technique that employs negative pressure wound therapy to treat anastomotic leaks endoscopically. Esosponge is specifically designed for esophageal EVAC therapy. We report on a 49-year-old woman who underwent a totally mini-invasive Ivor–Lewis esophagectomy and developed a giant postoperative leak with a complex pleural collection, but she was not fit for surgical re-intervention. The patient healed almost completely after 14 exchange sessions of Esosponge over 35 days.

Published
2020

15. Waterborne Norovirus outbreak at a seaside resort likely originating from municipal water distribution system failure

Author

S. De Grazia, Floriana Bonura, C. Saglimbene, Giuseppa Purpari, S. Li Muli, Vincenzo Cappa, A. Pepe, I. Di Bartolo, Annalisa Guercio, M. Cuccia, Angelo Marino, Giovanni M. Giammanco, Noemi Urone, G. Mandolfo, Giammanco, G.M., Bonura, F., Urone, N., Purpari, G., Cuccia, M., Pepe, A., Li Muli, S., Cappa, V., Saglimbene, C., Mandolfo, G., Marino, A., Guercio, A., Di Bartolo, I., and De Grazia, S.

Subjects
Male, 0301 basic medicine, Settore MED/07 - Microbiologia E Microbiologia Clinica, Veterinary medicine, medicine.medical_specialty, waterborne, Adolescent, Epidemiology, 030106 microbiology, Sewage, medicine.disease_cause, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, Tap water, Waterborne Diseases, Genotype, medicine, Humans, 030212 general & internal medicine, Sicily, Feces, Caliciviridae Infections, Noroviru, Original Paper, business.industry, Drinking Water, Norovirus, Outbreak, Waterborne diseases, medicine.disease, Gastroenteritis, Infectious Diseases, Geography, Female, genotype GII.P2/GII.2, business, gastroenteritis outbreak
Abstract

In May 2016 a Norovirus (NoV) gastroenteritis outbreak involved a high school class visiting a seaside resort near Taormina (Mascali, Sicily). Twenty-four students and a teacher were affected and 17 of them showed symptoms on the second day of the journey, while the others got ill within the following 2 days. Symptoms included vomiting, diarrhoea and fever, and 12 students required hospitalisation. Stool samples tested positive for NoV genome by Real-Time polymerase chain reaction assay in all 25 symptomatic subjects. The GII.P2/GII.2 NoV genotype was linked to the outbreak by ORF1/ORF2 sequence analysis. The epidemiological features of the outbreak were consistent with food/waterborne followed by person-to-person and/or vomit transmission. Food consumed at a shared lunch on the first day of the trip was associated to illness and drinking un-bottled tap water was also considered as a risk factor. The analysis of water samples revealed the presence of bacterial indicators of faecal contamination in the water used in the resort as well as in other areas of the municipal water network, linking the NoV gastroenteritis outbreak to tap water pollution from sewage leakage. From a single water sample, an amplicon whose sequence corresponded to the capsid genotype recovered from patients could be obtained.

Published
2018
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16. Linear EUS Accuracy in Gastric Cancer Preoperative Staging: A Retrospective Multicentric Study

Author

Lorenzo Fuccio, Laura Ottaviani, Leonardo Frazzoni, Paola Soriani, G.F. Bonura, Sara Vavassori, S Deiana, Maurizio Vecchi, G Impellizzeri, Gianpiero Manes, A. Curatolo, J. Rainer, Mauro Manno, T Gabbani, and G. De Nucci

Subjects
medicine.medical_specialty, Preoperative staging, business.industry, Medicine, Cancer, Radiology, business, medicine.disease
Published
2021
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17. Differences between Transient Neonatal Diabetes Mellitus Subtypes can Guide Diagnosis and Therapy

Author

Riccardo Bonfanti, Dario Iafusco, Ivana Rabbone, Giacomo Diedenhofen, Carla Bizzarri, Patrizia Ippolita Patera, Petra Reinstadler, Francesco Costantino, Valeria Calcaterra, Lorenzo Iughetti, Silvia Savastio, Anna Favia, Francesca Cardella, Donatella Lo Presti, Ylenia Girtler, Sarah Rabbiosi, Giuseppe D’Annunzio, Angela Zanfardino, Alessia Piscopo, Francesca Casaburo, Letizia Pintomalli, Lucia Russo, Valeria Grasso, Nicola Minuto, Mafalda Mucciolo, Antonio Novelli, Antonella Marucci, Barbara Piccini, Sonia Toni, Francesca Silvestri, Paola Carrera, Andrea Rigamonti, Giulio Frontino, Michela Trada, Davide Tinti, Maurizio Delvecchio, Novella Rapini, Riccardo Schiaffini, Corrado Mammì, Fabrizio Barbetti, Monica Aloe, Simona Amadeo, Claudia Arnaldi, Marta Bassi, Luciano Beccaria, Marzia Benelli, Giulia Maria Berioloi, Enrica Bertelli, Martina Biagioni, Adriana Bobbio, Stefano Boccato, Oriana Bologna, Franco Bontempi, Clara Bonura, Giulia Bracciolini, Claudia Brufani, Patrizia Bruzzi, Pietro Buono, Roberta Cardani, Giuliana Cardinale, Alberto Casertano, Maria Cristina Castiglione, Vittoria Cauvin, Valentino Cherubini, Franco Chiarelli, Giovanni Chiari, Stefano Cianfarani, Dante Cirillo, Felice Citriniti, Susanna Coccioli, Anna Cogliardi, Santino Confetto, Giovanna Contreas, Anna Corò, Elisa Corsini, Nicoletta Cresta, Fiorella De Berardinis, Valeria De Donno, Giampaolo De Filippo, Rosaria De Marco, Annalisa Deodati, Elena Faleschini, Valentina Fattorusso, Valeria Favalli, Barbara Felappi, Lucia Ferrito, Graziella Fichera, Franco Fontana, Elena Fornari, Roberto Franceschi, Francesca Franco, Adriana Franzese, Anna Paola Frongia, Alberto Gaiero, Francesco Gallo, Luigi Gargantini, Elisa Giani, Chiara Giorgetti, Giulia Bianchi, Vanna Graziani, Antonella Gualtieri, Monica Guasti, Gennaro Iannicelli, Antonio Iannilli, Ignaccolo Giovanna, Dario Ingletto, Stefania Innaurato, Elena Inzaghi, Brunella Iovane, Peter Kaufmann, Alfonso La Loggia, Rosa Lapolla, Anna Lasagni, Nicola Lazzaro, Lorenzo Lenzi, Riccardo Lera, Gabriella Levantini, Fortunato Lombardo, Antonella Lonero, Silvia Longhi, Sonia Lucchesi, Lucia Paola Guerraggio, Sergio Lucieri, Patrizia Macellaro, Claudio Maffeis, Bendetta Mainetti, Giulio Maltoni, Chiara Mameli, Francesco Mammì, Maria Luisa Manca-Bitti, Melania Manco, Monica Marino, Matteo Mariano, Marco Marigliano, Alberto Marsciani, Costanzo Mastrangelo, Maria Cristina Matteoli, Elena Mazzali, Franco Meschi, Antonella MIgliaccio, Anita Morandi, Gianfranco Morganti, Enza Mozzillo, Gianluca Musolino, Rosa Nugnes, Federica Ortolani, Daniela Pardi, Filomena Pascarella, Stefano Passanisi, Annalisa Pedini, Cristina Pennati, Angelo Perrotta, Sonia Peruzzi, Paola Peverelli, Giulia Pezzino, Anita Claudia Piona, Gavina Piredda, Carmelo Pistone, Elena Prandi, Barbara Pedieri, Procolo Di Bonito, Anna Pulcina, Maria Quinci, Emioli Randazzo, Rossella Ricciardi, Carlo Ripoli, Rosanna Roppolo, Irene Rutigliano, Alberto Sabbio, Silvana salardi, Alessandro Salvatoni, Anna Saporiti, Rita Sardi, Mariapiera Scanu, Andrea Scaramuzza, Eleonardo Schiven, Andrea Secco, Linda Sessa, Paola Sogno Valin, Silvia Sordelli, Luisa Spallino, Stefano Stagi, Filomena Stamati, Tosca Suprani, Valentina Talarico, Tiziana Timapanaro, Antonella Tirendi, Letizia Tomaselli, Gianluca Tornese, Adolfo Andrea Trettene, Stefano Tumini, Giuliana Valerio, Claudia Ventrici, Matteo Viscardi, Silvana Zaffani, Maria Zampolli, Giorgio Zanette, Clara Zecchino, Maria Antonietta Zedda, Silvia Zonca, Stefano Zucchini, Bonfanti, R., Iafusco, D., Rabbone, I., Diedenhofen, G., Bizzarri, C., Patera, P. I., Reinstadler, P., Costantino, F., Calcaterra, V., Iughetti, L., Savastio, S., Favia, A., Cardella, F., Presti, D. L., Girtler, Y., Rabbiosi, S., D'Annunzio, G., Zanfardino, A., Piscopo, A., Casaburo, F., Pintomalli, L., Russo, L., Grasso, V., Minuto, N., Mucciolo, M., Novelli, A., Marucci, A., Piccini, B., Toni, S., Silvestri, F., Carrera, P., Rigamonti, A., Frontino, G., Trada, M., Tinti, D., Delvecchio, M., Rapini, N., Schiaffini, R., Mammi, C., and Barbetti, F.

Subjects
Proband, Male, Pediatrics, Potassium Channels, Endocrinology, Diabetes and Metabolism, Datasets as Topic, Diagnosis, Differential, Diagnostic Techniques, Endocrine, Female, Humans, Infant, Infant, Newborn, Italy, Mutation, Potassium Channels, Inwardly Rectifying, Remission Induction, Retrospective Studies, Sulfonylurea Receptors, Diabetes Mellitus, Infant, Newborn, Diseases, Diseases, Gastroenterology, Diabetes mellitus genetics, Endocrinology, Settore MED/13, Retrospective Studie, Diagnosis, Medicine, Endocrine pancreas, Transient Neonatal Diabetes Mellitus, 6q24 TNDM, KATP TNDM, Sulfonylureas, Sulfonylureas, Sulfonylurea Receptor, biology, Diabetes Mellitu, General Medicine, Metformin, Inwardly Rectifying, Settore MED/03, 6q24 TNDM, medicine.symptom, Endocrine, hormones, hormone substitutes, and hormone antagonists, medicine.drug, Human, endocrine system, medicine.medical_specialty, KATP TNDM, ABCC8, Transient Neonatal Diabetes Mellitus, Internal medicine, Diabetes mellitus, Macroglossia, Endocrine pancreas, business.industry, medicine.disease, Newborn, Diagnostic Techniques, Transient neonatal diabetes mellitus, Differential, biology.protein, Sulfonylurea receptor, business
Abstract

Objective Transient neonatal diabetes mellitus (TNDM) is caused by activating mutations in ABCC8 and KCNJ11 genes (KATP/TNDM) or by chromosome 6q24 abnormalities (6q24/TNDM). We wanted to assess whether these different genetic aetiologies result in distinct clinical features. Design Retrospective analysis of the Italian data set of patients with TNDM. Methods Clinical features and treatment of 22 KATP/TNDM patients and 12 6q24/TNDM patients were compared. Results Fourteen KATP/TNDM probands had a carrier parent with abnormal glucose values, four patients with 6q24 showed macroglossia and/or umbilical hernia. Median age at diabetes onset and birth weight were lower in patients with 6q24 (1 week; −2.27 SD) than those with KATP mutations (4.0 weeks; −1.04 SD) (P = 0.009 and P = 0.007, respectively). Median time to remission was longer in KATP/TNDM than 6q24/TNDM (21.5 weeks vs 12 weeks) (P = 0.002). Two KATP/TNDM patients entered diabetes remission without pharmacological therapy. A proband with the ABCC8/L225P variant previously associated with permanent neonatal diabetes entered 7-year long remission after 1 year of sulfonylurea therapy. Seven diabetic individuals with KATP mutations were successfully treated with sulfonylurea monotherapy; four cases with relapsing 6q24/TNDM were treated with insulin, metformin or combination therapy. Conclusions If TNDM is suspected, KATP genes should be analyzed first with the exception of patients with macroglossia and/or umbilical hernia. Remission of diabetes without pharmacological therapy should not preclude genetic analysis. Early treatment with sulfonylurea may induce long-lasting remission of diabetes in patients with KATP mutations associated with PNDM. Adult patients carrying KATP/TNDM mutations respond favourably to sulfonylurea monotherapy.

Published
2021

18. Metabolic control and complications in Italian people with diabetes treated with continuous subcutaneous insulin infusion

Author

Giuseppe Lepore, Riccardo Bonfanti, Lutgarda Bozzetto, Vincenzo Di Blasi, Angela Girelli, Giorgio Grassi, Dario Iafusco, Luigi Laviola, Ivana Rabbone, Riccardo Schiaffini, Daniela Bruttomesso, F. Mammì, M. Bruzzese, M. Schettino, M.G. Nuzzo, V. Di Blasi, R. Fresa, C. Lambiase, D. Iafusco, A. Zanfardino, S. Confetto, L. Bozzetto, G. Annuzzi, A. Alderisio, G. Riccardi, S. Gentile, G. Marino, G. Guarino, S. Zucchini, G. Maltoni, T. Suprani, V. Graziani, M. Nizzoli, S. Acquati, R. Cavani, S. Romano, M. Michelini, E. Manicardi, R. Bonadonna, A. Dei Cas, E. Dall'aglio, M. Papi, S. Riboni, V. Manicardi, V. Pugni, A. Lasagni, M.E. Street, U. Pagliani, C. Rossi, R. Assaloni, B. Brunato, C. Tortul, G. Zanette, P. Li Volsi, M. Zanatta, L. Tonutti, S. Agus, M.A. Pellegrini, P. Ceccano, G. Pozzilli, Beretta Anguissola, R. Buzzetti, C. Moretti C, G. Leto, P. Pozzilli, S. Manfrini, A.R. Maurizi, S. Leotta, M. Altomare, S. Abbruzzese, S. Carletti, C. Suraci, S. Filetti, M.L. Manca Bitti, S. Arcano, M.G. Cavallo, M. De Bernardinis, D. Pitocco, S. Caputo, A. Rizzi, A. Manto, R. Schiaffini, M. Cappa, D. Benevento, S. Frontoni, I. Malandrucco, S. Morano, T. Filardi, D. Lauro, M.A. Marini, E. Castaldo, D. Sabato, F. Tuccinardi, E. Forte, P. Viterbori, C. Arnaldi, N. Minuto, G. d'Annunzio, A. Corsi, R. Rota, C. Scaranna, R. Trevisan, U. Valentini, A. Girelli, S. Bonfadini, E. Zarra, A. Plebani, E. Prandi, B. Felappi, A. Rocca, E. Meneghini, P. Galli, P. Ruggeri, E. Carrai, L. Fugazza, V. Baggi, D. Conti, E. Bosi, A. Laurenzi, A. Caretto, C. Molinari, E. Orsi, V. Grancini, V. Resi, R. Bonfanti, V. Favalli, C. Bonura, A. Rigamonti, M. Bonomo, F. Bertuzzi, B. Pintaudi, O. Disoteo, G. Perseghin, S. Perra, L. Chiovato, P. De Cata, F. Zerbini, E. Lovati, M. Laneri, L. Guerraggio, A.C. Bossi, V. De Mori, M. Galetta, I. Meloncelli, A. Aiello A, S. Di Vincenzo, A. Nuzzi, E. Fraticelli, E. Ansaldi, M. Battezzati, M. Lombardi, M. Balbo, R. Lera, A. Secco, V. De Donno, F. Cadario, S. Savastio, C. Ponzani, G. Aimaretti, I. Rabbone, G. Ignaccolo, D. Tinti, F. Cerutti, F. Bari, F. Giorgino, E. Piccinno, O. Zecchino, M. Cignarelli, O. Lamacchia, G. Picca, S. De Cosmo, A. Rauseo, L. Tomaselli, A. Tumminia, C. Egiziano, A.M. Scarpitta, F. Maggio, F. Cardella, R. Roppolo, V. Provenzano, M. Fleres, A. Scorsone, A. Scatena, G. Gregori, S. Lucchesi, F. Gadducci, S. Di Cianni, S. Pancani, S. Del Prato, M. Aragona, I. Crisci, A. Calianno, B. Fattor, D. Crazzolara, P. Reinstadler, S. Longhi, G. Incelli, S. Rauch, T. Romanelli, M. Orrasch, V. Cauvin, R. Franceschi, C. Lalli, A. Pianta, A. Marangoni, C.N. Aricò, N. Marin, N. Nogara, N. Simioni, A. Filippi, G.L. Gidoni Guarneri, M.L. Contin M.L, A.P. Decata, L. Bondesan, L. Confortin, A. Coracina, S. Lombardi, S. Costa Padova, E. Cipponeri, R. Scotton, S. Galasso, F. Boscari, M.S. Zanon, C. Vinci, G. Lisato, L. Gottardo, E. Bonora, M. Trombetta, C. Negri, C. Brangani, C. Maffeis, A. Sabbion, M. Marigliano, Lepore, Giuseppe, Bonfanti, Riccardo, Bozzetto, Lutgarda, Di Blasi, Vincenzo, Girelli, Angela, Grassi, Giorgio, Iafusco, Dario, Laviola, Luigi, Rabbone, Ivana, Schiaffini, Riccardo, Bruttomesso, Daniela, Lepore, G., Bonfanti, R., Bozzetto, L., Di Blasi, V., Girelli, A., Grassi, G., Iafusco, D., Laviola, L., Rabbone, I., Schiaffini, R., Bruttomesso, D., Mammi, F., Bruzzese, M., Schettino, M., Nuzzo, M. G., Fresa, R., Lambiase, C., Zanfardino, A., Confetto, S., Annuzzi, G., Alderisio, A., Riccardi, G., Gentile, S., Marino, G., Guarino, G., Zucchini, S., Maltoni, G., Suprani, T., Graziani, V., Nizzoli, M., Acquati, S., Cavani, R., Romano, S., Michelini, M., Manicardi, E., Bonadonna, R., Dei Cas, A., Dall'Aglio, E., Papi, M., Riboni, S., Manicardi, V., Pugni, V., Lasagni, A., Street, M. E., Pagliani, U., Rossi, C., Assaloni, R., Brunato, B., Tortul, C., Zanette, G., Li Volsi, P., Zanatta, M., Tonutti, L., Agus, S., Pellegrini, M. A., Ceccano, P., Pozzilli, G., Anguissola, B., Buzzetti, R., Moretti C, C., Leto, G., Pozzilli, P., Manfrini, S., Maurizi, A. R., Leotta, S., Altomare, M., Abbruzzese, S., Carletti, S., Suraci, C., Filetti, S., Manca Bitti, M. L., Arcano, S., Cavallo, M. G., De Bernardinis, M., Pitocco, D., Caputo, S., Rizzi, A., Manto, A., Cappa, M., Benevento, D., Frontoni, S., Malandrucco, I., Morano, S., Filardi, T., Lauro, D., Marini, M. A., Castaldo, E., Sabato, D., Tuccinardi, F., Forte, E., Viterbori, P., Arnaldi, C., Minuto, N., D'Annunzio, G., Corsi, A., Rota, R., Scaranna, C., Trevisan, R., Valentini, U., Bonfadini, S., Zarra, E., Plebani, A., Prandi, E., Felappi, B., Rocca, A., Meneghini, E., Galli, P., Ruggeri, P., Carrai, E., Fugazza, L., Baggi, V., Conti, D., Bosi, E., Laurenzi, A., Caretto, A., Molinari, C., Orsi, E., Grancini, V., Resi, V., Favalli, V., Bonura, C., Rigamonti, A., Bonomo, M., Bertuzzi, F., Pintaudi, B., Disoteo, O., Perseghin, G., Perra, S., Chiovato, L., De Cata, P., Zerbini, F., Lovati, E., Laneri, M., Guerraggio, L., Bossi, A. C., De Mori, V., Galetta, M., Meloncelli, I., Aiello A, A., Di Vincenzo, S., Nuzzi, A., Fraticelli, E., Ansaldi, E., Battezzati, M., Lombardi, M., Balbo, M., Lera, R., Secco, A., De Donno, V., Cadario, F., Savastio, S., Ponzani, C., Aimaretti, G., Ignaccolo, G., Tinti, D., Cerutti, F., Bari, F., Giorgino, F., Piccinno, E., Zecchino, O., Cignarelli, M., Lamacchia, O., Picca, G., De Cosmo, S., Rauseo, A., Tomaselli, L., Tumminia, A., Egiziano, C., Scarpitta, A. M., Maggio, F., Cardella, F., Roppolo, R., Provenzano, V., Fleres, M., Scorsone, A., Scatena, A., Gregori, G., Lucchesi, S., Gadducci, F., Di Cianni, S., Pancani, S., Del Prato, S., Aragona, M., Crisci, I., Calianno, A., Fattor, B., Crazzolara, D., Reinstadler, P., Longhi, S., Incelli, G., Rauch, S., Romanelli, T., Orrasch, M., Cauvin, V., Franceschi, R., Lalli, C., Pianta, A., Marangoni, A., Arico, C. N., Marin, N., Nogara, N., Simioni, N., Filippi, A., Gidoni Guarneri, G. L., Contin, M. L M. L., Decata, A. P., Bondesan, L., Confortin, L., Coracina, A., Lombardi, S., Costa Padova, S., Cipponeri, E., Scotton, R., Galasso, S., Boscari, F., Zanon, M. S., Vinci, C., Lisato, G., Gottardo, L., Bonora, E., Trombetta, M., Negri, C., Brangani, C., Maffeis, C., Sabbion, A., Marigliano, M., Lepore, G, Bonfanti, R, Bozzetto, L, Di Blasi, V, Girelli, A, Grassi, G, Iafusco, D, Laviola, L, Rabbone, I, Schiaffini, R, Bruttomesso, D, Mammi, F, Bruzzese, M, Schettino, M, Nuzzo, M, Fresa, R, Lambiase, C, Zanfardino, A, Confetto, S, Annuzzi, G, Alderisio, A, Riccardi, G, Gentile, S, Marino, G, Guarino, G, Zucchini, S, Maltoni, G, Suprani, T, Graziani, V, Nizzoli, M, Acquati, S, Cavani, R, Romano, S, Michelini, M, Manicardi, E, Bonadonna, R, Dei Cas, A, Dall'Aglio, E, Papi, M, Riboni, S, Manicardi, V, Pugni, V, Lasagni, A, Street, M, Pagliani, U, Rossi, C, Assaloni, R, Brunato, B, Tortul, C, Zanette, G, Li Volsi, P, Zanatta, M, Tonutti, L, Agus, S, Pellegrini, M, Ceccano, P, Pozzilli, G, Anguissola, B, Buzzetti, R, Moretti C, C, Leto, G, Pozzilli, P, Manfrini, S, Maurizi, A, Leotta, S, Altomare, M, Abbruzzese, S, Carletti, S, Suraci, C, Filetti, S, Manca Bitti, M, Arcano, S, Cavallo, M, De Bernardinis, M, Pitocco, D, Caputo, S, Rizzi, A, Manto, A, Cappa, M, Benevento, D, Frontoni, S, Malandrucco, I, Morano, S, Filardi, T, Lauro, D, Marini, M, Castaldo, E, Sabato, D, Tuccinardi, F, Forte, E, Viterbori, P, Arnaldi, C, Minuto, N, D'Annunzio, G, Corsi, A, Rota, R, Scaranna, C, Trevisan, R, Valentini, U, Bonfadini, S, Zarra, E, Plebani, A, Prandi, E, Felappi, B, Rocca, A, Meneghini, E, Galli, P, Ruggeri, P, Carrai, E, Fugazza, L, Baggi, V, Conti, D, Bosi, E, Laurenzi, A, Caretto, A, Molinari, C, Orsi, E, Grancini, V, Resi, V, Favalli, V, Bonura, C, Rigamonti, A, Bonomo, M, Bertuzzi, F, Pintaudi, B, Disoteo, O, Perseghin, G, Perra, S, Chiovato, L, De Cata, P, Zerbini, F, Lovati, E, Laneri, M, Guerraggio, L, Bossi, A, De Mori, V, Galetta, M, Meloncelli, I, Aiello A, A, Di Vincenzo, S, Nuzzi, A, Fraticelli, E, Ansaldi, E, Battezzati, M, Lombardi, M, Balbo, M, Lera, R, Secco, A, De Donno, V, Cadario, F, Savastio, S, Ponzani, C, Aimaretti, G, Ignaccolo, G, Tinti, D, Cerutti, F, Bari, F, Giorgino, F, Piccinno, E, Zecchino, O, Cignarelli, M, Lamacchia, O, Picca, G, De Cosmo, S, Rauseo, A, Tomaselli, L, Tumminia, A, Egiziano, C, Scarpitta, A, Maggio, F, Cardella, F, Roppolo, R, Provenzano, V, Fleres, M, Scorsone, A, Scatena, A, Gregori, G, Lucchesi, S, Gadducci, F, Di Cianni, S, Pancani, S, Del Prato, S, Aragona, M, Crisci, I, Calianno, A, Fattor, B, Crazzolara, D, Reinstadler, P, Longhi, S, Incelli, G, Rauch, S, Romanelli, T, Orrasch, M, Cauvin, V, Franceschi, R, Lalli, C, Pianta, A, Marangoni, A, Arico, C, Marin, N, Nogara, N, Simioni, N, Filippi, A, Gidoni Guarneri, G, Contin, M, Decata, A, Bondesan, L, Confortin, L, Coracina, A, Lombardi, S, Costa Padova, S, Cipponeri, E, Scotton, R, Galasso, S, Boscari, F, Zanon, M, Vinci, C, Lisato, G, Gottardo, L, Bonora, E, Trombetta, M, Negri, C, Brangani, C, Maffeis, C, Sabbion, A, and Marigliano, M

Subjects
Blood Glucose, Male, Pediatrics, Acute and chronic complication, Glycated Hemoglobin A, Time Factors, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Medicine (miscellaneous), Ketosi, Infusions, Subcutaneous, Settore MED/13 - Endocrinologia, Acute and chronic complications, Continuous subcutaneous insulin infusion (CSII), Diabetes mellitus, Metabolic control, Nutrition and Dietetics, Cardiology and Cardiovascular Medicine, 0302 clinical medicine, Endocrinology, Adolescent, Adult, Albuminuria, Biomarkers, Child, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Diabetic Retinopathy, Female, Health Care Surveys, Humans, Hypertension, Hypoglycemia, Hypoglycemic Agents, Insulin, Italy, Ketosis, Middle Aged, Risk Factors, Treatment Outcome, Young Adult, Insulin Infusion Systems, 030212 general & internal medicine, Subcutaneous, Diabetic retinopathy, Diabetes and Metabolism, medicine.symptom, Type 2, Human, Type 1, Insulin pump, Infusions, medicine.medical_specialty, Diabetes mellitu, Time Factor, 030209 endocrinology & metabolism, 03 medical and health sciences, medicine, Cross-Sectional Studie, Glycated Hemoglobin, Type 1 diabetes, Hypoglycemic Agent, business.industry, Risk Factor, Biomarker, medicine.disease, Ketoacidosis, Infusions, Subcutaneou, Health Care Survey, Diabetic Nephropathie, business
Abstract

Background and aim: The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII). Methods and results: Questionnaires investigating the organisation of diabetes care centres, individuals’ clinical and metabolic features and pump technology and its management were sent to adult and paediatric diabetes centres that use CSII for treatment in Italy. Information on standard clinical variables, demographic data and acute and chronic diabetic complications was derived from local clinical management systems. The sample consisted of 6623 people with diabetes, which was obtained from 93 centres. Of them, 98.8% had type 1 diabetes mellitus, 57.2% were female, 64% used a conventional insulin pump and 36% used a sensor-augmented insulin pump. The median glycated haemoglobin (HbA1c) level was 60 mmol/mol (7.6%). The HbA1c target (i.e. 18 years) was achieved in 43.4% of paediatric and 23% of adult participants. Factors such as advanced pump functions, higher rate of sensor use, pregnancy in the year before the study and longer duration of diabetes were associated with lower HbA1c levels. The most common chronic complications occurring in diabetes were retinopathy, microalbuminuria and hypertension. In the year before the study, 5% of participants reported ≥1 episode of severe hypoglycaemic (SH) episodes (SH) and 2.6% reported ≥1 episode of ketoacidosis. Conclusions: Advanced personal skills and use of sensor-based pump are associated with better metabolic control outcomes in Italian people with diabetes who were treated with CSII. The reduction in SH episodes confirms the positive effect of CSII on hypoglycaemia. Clinical trial registration number: NCT 02620917 (ClinicalTrials.gov).

Published
2018

20. AF.145 LINEAR EUS ACCURACY IN GASTRIC CANCER PREOPERATIVE STAGING: A RETROSPECTIVE MULTICENTRIC STUDY

Author

G. De Nucci, Paola Soriani, Paolo Biancheri, Giovanna Impellizzeri, Sara Vavassori, Lorenzo Fuccio, J. Rainer, Maurizio Vecchi, G.F. Bonura, S Deiana, T Gabbani, A. Curatolo, Laura Ottaviani, Mauro Manno, Gianpiero Manes, and Leonardo Frazzoni

Subjects
medicine.medical_specialty, Preoperative staging, Hepatology, business.industry, Gastroenterology, medicine, Cancer, Radiology, medicine.disease, business
Published
2021
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21. A New Genetic Risk Score to Predict the Outcome of Locally Advanced or Metastatic Breast Cancer Patients Treated With First-Line Exemestane: Results From a Prospective Study

Author

Andrea Rocca, Mario D'Andrea, Vito Amoroso, Anna Maria Baldelli, Elisabetta Cretella, Chiara Saggia, Ilaria Spagnoletti, Marcella Montico, Stefania Russo, Rosa Meo, Elena Collovà, Emanuela Vattemi, M. Bari, Eva Dreussi, Ferdinando Riccardi, Umberto Basso, Marika Cinausero, Chiara Zanusso, Michele Medici, Maria Agnese Fabbri, Fabio Puglisi, Donatella Iacono, Lorenzo Gianni, Patrizia Serra, Sara Gagno, Mauro Mansutti, Donata Sartori, Giampietro Gasparini, Laura Foghini, Silvana Saracchini, Erika Cecchin, Paola Biason, Salvatore Bonura, Mario Clerico, Arianna Pellegrino, Ghassan Merkabaoui, Giovanni Benedetti, Giuseppe Toffoli, Paolo Sandri, Federico Innocenti, Gagno, Sara, D'Andrea, Mario Rosario, Mansutti, Mauro, Zanusso, Chiara, Puglisi, Fabio, Dreussi, Eva, Montico, Marcella, Biason, Paola, Cecchin, Erika, Iacono, Donatella, Russo, Stefania, Cinausero, Marika, Saracchini, Silvana, Gasparini, Giampietro, Sartori, Donata, Bari, Mario, Collovà, Elena, Meo, Rosa, Merkabaoui, Ghassan, Spagnoletti, Ilaria, Pellegrino, Arianna, Gianni, Lorenzo, Sandri, Paolo, Cretella, Elisabetta, Vattemi, Emanuela, Rocca, Andrea, Serra, Patrizia, Fabbri, Maria Agnese, Benedetti, Giovanni, Foghini, Laura, Medici, Michele, Basso, Umberto, Amoroso, Vito, Riccardi, Ferdinando, Baldelli, Anna Maria, Clerico, Mario, Bonura, Salvatore, Saggia, Chiara, Innocenti, Federico, and Toffoli, Giuseppe

Subjects
Male, 0301 basic medicine, Oncology, Cancer Research, DNA Repair, Survival, medicine.medical_treatment, chemistry.chemical_compound, 0302 clinical medicine, Exemestane, Medicine, Prospective Studies, Prospective cohort study, Aged, 80 and over, Framingham Risk Score, Aromatase Inhibitors, Hazard ratio, Middle Aged, Metastatic breast cancer, Receptors, Estrogen, 030220 oncology & carcinogenesis, Female, Advanced breast cancer, Signal Transduction, Adult, Risk, medicine.medical_specialty, Antineoplastic Agents, Hormonal, Breast Neoplasms, 03 medical and health sciences, Breast cancer, Aromatase inhibitor, Hormone therapy, Polymorphisms, Internal medicine, Biomarkers, Tumor, Humans, Polymorphism, Aged, Polymorphism, Genetic, business.industry, Proportional hazards model, Reproducibility of Results, medicine.disease, Survival Analysis, Androstadienes, 030104 developmental biology, chemistry, business
Abstract

Currently there are no reliable biomarkers to predict outcome of exemestane treatment. We designed a prospective study to investigate whether constitutive genetic background might affect response to therapy. In a population of 302 advanced breast cancer patients treated with exemestane we showed that a 5-polymorphism-based genetic score could be used to identify patients with different risks of progression and death.Introduction: Approximately 50% of locally advanced or metastatic breast cancer (MBC) patients treated with first-line exemestane do not show objective response and currently there are no reliable biomarkers to predict the outcome of patients using this therapy. The constitutive genetic background might be responsible for differences in the outcome of exemestane-treated patients. We designed a prospective study to investigate the role of germ line polymorphisms as biomarkers of survival. Patients and Methods: Three hundred two locally advanced or MBC patients treated with first-line exemestane were genotyped for 74 germ line polymorphisms in 39 candidate genes involved in drug activity, hormone balance, DNA replication and repair, and cell signaling pathways. Associations with progression-free survival (PFS) and overall survival (OS) were tested with multivariate Cox regression. Bootstrap resampling was used as an internal assessment of results reproducibility. Results: Cytochrome P450 19A1-rs10046TC/CC, solute carrier organic anion transporter 1B1-rs4149056TT, adenosine triphosphate binding cassette subfamily G member 2-rs2046134GG, fibroblast growth factor receptor-4-rs351855TT, and X-ray repair cross complementing 3-rs861539TT were significantly associated with PFS and then combined into a risk score (0-1, 2, 3, or 4-6 risk points). Patients with the highest risk score (4-6 risk points) compared with ones with the lowest score (0-1 risk points) had a median PFS of 10 months versus 26.3 months (adjusted hazard ratio [AdjHR], 3.12 [95% confidence interval (CI), 2.18-4.48]; P < .001) and a median OS of 38.9 months versus 63.0 months (AdjHR, 2.41 [95% CI, 1.22-4.79], P = .012), respectively. Conclusion: In this study we defined a score including 5 polymorphisms to stratify patients for PFS and OS. This score, if validated, might be translated to personalize locally advanced or MBC patient treatment and management.

Published
2019

22. An Unusual Case of Acute Pancreatitis After Endoscopic Full-Thickness Resection of a Recurrent Nonampullary Duodenal Adenoma

Author

Giuliano Francesco Bonura, Francesco Azzolini, Maria Napolitano, Ruggero Ponz de Leon Pisani, Dario Esposito, Giuseppe Dell’Anna, and Francesco Vito Mandarino

Subjects
Adenoma, Male, medicine.medical_specialty, Unusual case, Hepatology, business.industry, Gastroenterology, medicine.disease, Endoscopy, Gastrointestinal, Duodenal Adenoma, Text mining, Postoperative Complications, Pancreatitis, Duodenal Neoplasms, medicine, Acute pancreatitis, Humans, Full thickness resection, Radiology, Neoplasm Recurrence, Local, business, Tomography, X-Ray Computed, Aged
Published
2020

23. Gastric peroral endoscopic myotomy (G-POEM) for refractory gastroparesis: 3-month follow-up results

Author

Giuliano Francesco Bonura, Francesco Azzolini, Pier Alberto Testoni, Gino Pepe, Sabrina Gloria Giulia Testoni, and Dario Esposito

Subjects
Myotomy, Male, medicine.medical_specialty, Gastroparesis, Hepatology, business.industry, medicine.medical_treatment, Gastroenterology, MEDLINE, Middle Aged, medicine.disease, Surgery, Treatment Outcome, Refractory, Gastric Emptying, Pyloromyotomy, Medicine, Humans, Female, Prospective Studies, business, Month follow up, Aged, Follow-Up Studies
Published
2020

24. Sex-based differences in long-term outcomes after early-onset myocardial infarction

Author

Piera Angelica Merlini, Maddalena Ardissino, Rosario Bonura, Giulia Magnani, Stefano Duga, Serena Bricoli, Adam J. Nelson, Caterina Disisto, Andrea Botti, Raffaella Fetiveau, Andrea Biagi, Giuseppe Maglietta, Carlo Cernetti, Carlo Berzuini, Emilia Solinas, Guidantonio Malagoli Tagliazucchi, Federico Barocelli, Silvia Buratti, Giorgia Paoli, Umberto Canosi, Diego Ardissino, Antonio Crocamo, Elvezia Maria Paraboschi, Elisabetta Ponte, and Domenico Tuttolomondo

Subjects
medicine.medical_specialty, Estrogen, medicine.drug_class, business.industry, Internal medicine, medicine, Long term outcomes, Cardiology, Myocardial infarction, Cardiology and Cardiovascular Medicine, medicine.disease, business, Early onset
Abstract

BackgroundThere is growing appreciation for sex-based differences in cardiovascular risk, but little is known about whether these extend to pre-menopausal females experiencing early-onset myocardial infarction (MI) who might benefit from the protective effects of estrogen exposure.MethodsThe Italian Genetic Study of Early-Onset Myocardial Infarction was a nationwide prospective cohort study involving 125 centres which, between 1998 and 2002, enrolled 2,000 consecutive patients who experienced a first MI before the age of 45 years and underwent coronary angiography at the time of the index event, and followed them up for a median of 19.9 years. The primary composite endpoint was cardiovascular death, non-fatal MI and non-fatal stroke.ResultsFollow-up was completed by 1,984 patients (98.2%) with a median age of 41 years (IQR 37-43): 1,778 men (88.9%) men and 222 women (11.1%). Smoking (46.5% vs 42.8%), dyslipidemia (62.9% vs 50.7%) and diabetes (7.8% vs 5.4%) were more frequent among the men (all pConclusionSignificant sex-based differences in baseline risk factors and outcomes were observed in patients with early-onset MI: women presented with a lower atherosclerotic disease burden and, despite having lower rates of secondary prevention measures, experienced better long-term outcomes.

Published
2020
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25. Factors Influencing Selection of Infectious Diseases Training for Military Internal Medicine Residents

Author

Timothy J. Whitman, Heather C. Yun, Alice E Barsoumian, Erin M. Bonura, Joshua D. Hartzell, and Roseanne A. Ressner

Subjects
Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, Graduate medical education, Context (language use), Global Health, Military medicine, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Internal medicine, Internal Medicine, Humans, Medicine, 030212 general & internal medicine, Salary, Fellowships and Scholarships, Military Medicine, Response rate (survey), Infectious Disease Medicine, Career Choice, Salaries and Fringe Benefits, business.industry, Internship and Residency, Military personnel, Military Personnel, Infectious Diseases, Cohort, Female, business, Cohort study
Abstract

Background Applications to infectious diseases fellowships have declined nationally; however, the military has not experienced this trend. In the past 6 years, 3 US military programs had 58 applicants for 52 positions. This study examines military resident perceptions to identify potential differences in factors influencing career choice, compared with published data from a nationwide cohort. Methods An existing survey tool was adapted to include questions unique to the training and practice of military medicine. Program directors from 11 military internal medicine residencies were asked to distribute survey links to their graduating residents from December 2016 to January 2017. Data were categorized by ID interest. Result The response rate was 51% (n = 68). Of respondents, 7% were ID applicants, 40% considered ID but reconsidered, and 53% were uninterested. Of those who considered ID, 73% changed their mind in their second and third postgraduate years and cited salary (22%), lack of procedures (18%), and training length (18%) as primary deterrents to choosing ID. Active learning styles were used more frequently by ID applicants to learn ID concepts than by those who considered or were uninterested in ID (P = .02). Conclusions Despite differences in the context of training and practice among military trainees compared with civilian colleagues, residents cited similar factors affecting career choice. Interest in global health was higher in this cohort. Salary continues to be identified as a deterrent to choosing ID. Differences between military and civilian residents' desire to pursue ID fellowship are likely explained by additional unmeasured factors deserving further study.

Published
2018
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26. Left cardiac sympathetic denervation for recurrent ventricular tachyarrhythmias in children with congenital heart disease

Author

Philip L. Wackel, Erica D. Bonura, Michael J. Ackerman, and Christopher R. Moir

Subjects
medicine.medical_specialty, Heart disease, Ventricular Tachyarrhythmias, Long QT syndrome, Case Report, 030204 cardiovascular system & hematology, Ventricular tachycardia, Sympathetic Denervation, 03 medical and health sciences, Sympathetic denervation, 0302 clinical medicine, Refractory, Internal medicine, Medicine, Ventricular fibrillation, cardiovascular diseases, 030212 general & internal medicine, Congenital heart disease, Pediatric, Denervation, business.industry, medicine.disease, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

The first sympathetic denervation was described in 1961 as a treatment for ventricular tachycardia (VT).1 Following this, left cardiac sympathetic denervation (LCSD) was first applied as a treatment for long QT syndrome (LQTS) in humans in 1971.2 Currently, LCSD is recognized as an effective treatment for LQTS and catecholaminergic polymorphic VT (CPVT).3, 4 However, there are increasing data that bilateral denervation surgery or LCSD may be useful in non-channelopathy-related ventricular arrhythmias.5, 6 Although denervation therapy in adult congenital heart disease (CHD) has been reported previously, there are no reports on utilizing LCSD in pediatric patients with CHD and refractory ventricular tachyarrhythmias after surgical repair.7 We present a series of 2 patients with surgically corrected CHD and refractory arrhythmias who experienced resolution of their arrhythmias following videoscopic LCSD.

Published
2019
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27. Norovirus GII.17 as Major Epidemic Strain in Italy, Winter 2015–16

Author

Krisztián Bányai, P. Dones, Anna Morea, Maria Cristina Medici, Daniela Loconsole, Adriana Calderaro, Valentina Terio, Floriana Bonura, Vincenzo Cappa, Fabio Tummolo, Sara Li Muli, Giovanni M. Giammanco, Simona De Grazia, Maria Chironna, Vito Martella, A. Pepe, Cristiana Catella, Francesca Di Bernardo, Giammanco, G., De Grazia, S., Bonura, F., Cappa, V., Li Muli, S., Pepe, A., Medici, M., Tummolo, F., Calderaro, A., Di Bernardo, F., Dones, P., Morea, A., Loconsole, D., Catella, C., Terio, V., Bã nyai, K., Chironna, M., and Martella, V.

Subjects
0301 basic medicine, Settore MED/07 - Microbiologia E Microbiologia Clinica, Epidemiology, viruses, lcsh:Medicine, medicine.disease_cause, Disease Outbreaks, fluids and secretions, Child, Epidemic strain, Caliciviridae Infections, Norovirus GII, virus diseases, Infectious Diseases, Italy, Child, Preschool, Population Surveillance, Seasons, gastroenteriti, gastroenteritis, Norovirus GII.17 as Major Epidemic Strain in Italy, Winter 2015–16, Microbiology (medical), medicine.medical_specialty, Adolescent, Genotype, 030106 microbiology, enteric infection, History, 21st Century, lcsh:Infectious and parasitic diseases, Open Reading Frames, 03 medical and health sciences, Patient age, Research Letter, medicine, Humans, lcsh:RC109-216, Noroviru, viruse, business.industry, enteric infections, Norovirus, lcsh:R, Infant, Newborn, Infant, GII.17 Kawasaki 2014, Virology, 030104 developmental biology, business
Abstract

In winter 2015-16, norovirus GII.17 Kawasaki 2014 emerged as a cause of sporadic gastroenteritis in children in Italy. Median patient age was higher for those with GII.17 than GII.4 infection (55 vs. 24 months), suggesting limited cross-protection for older children.

Published
2017

28. Postpartum listeria meningitis

Author

Raffaella Rubino, Antonio Anastasia, Davide Lo Porto, Michelle Abbott, Antonio Cascio, Claudia Colomba, Silvia Bonura, Gabriele Palermo, Colomba, Claudia, Rubino, Raffaella, Anastasia, Antonio, Palermo, Gabriele, Lo Porto, Davide, Abbott, Michelle, Bonura, Silvia, and Cascio, Antonio

Subjects
0301 basic medicine, Pediatrics, medicine.medical_specialty, 030106 microbiology, Infectious and parasitic diseases, RC109-216, Disease, Abortion, medicine.disease_cause, Asymptomatic, Article, 03 medical and health sciences, 0302 clinical medicine, Immune system, Listeria monocytogenes, medicine, Meningitis, 030212 general & internal medicine, reproductive and urinary physiology, Listeria monocytogene, Pregnancy, business.industry, Puerperium, medicine.disease, Antimicrobial, female genital diseases and pregnancy complications, Meningiti, Infectious Diseases, medicine.symptom, business
Abstract

Highlights • Listeria monocytogenes is a rare cause of meningitis in immunocompetent patient. • Pregnancy and puerperium are accompanied by a decrease in cellular immunity. • Pregnancy and puerperium should be considered as risk factors for invasive listeriosis., Listeria monocytogenes is a small Gram positive, intracellular bacillus known to cause a foodborne disease in immunocompromised patients and other high-risk groups. The infection that usually is asymptomatic or resembles a mild influenza like disease, in some risk groups can cause meningitis and brain abscesses. In pregnant women, L. monocytogenes may lead to abortion or delivery of an acutely ill infant. We describe a case of L. monocytogenes meningitis occurred in a young puerpera without immunological disorders or other risk factors. We think that because the puerperium is accompanied by the same physiological changes in immune response that features pregnancy, a higher infectious risk should be considered during this period of woman’s life. Therefore, an empiric antimicrobial therapy also for listeriosis should be promptly started in meningitis that arises in post-partum period so to achieve the best outcome of the infection.

Published
2020
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29. AF.67 1L-PEG-ASC SOLUTION FOR BOWEL PREPARATION IN AN 'OPEN ACCESS' COLONOSCOPY BOOKING SYSTEM: EVALUATION OF ADVERSE EVENTS

Author

T Gabbani, Laura Ottaviani, Paolo Biancheri, S Deiana, Giovanna Impellizzeri, D. Corbascio, J. Rainer, Paola Soriani, S. Scarpelli, A. Curatolo, Mauro Manno, and G.F. Bonura

Subjects
medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, PEG ratio, Gastroenterology, Bowel preparation, Medicine, System evaluation, Colonoscopy, business, Adverse effect, Surgery
Published
2021
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30. AF.68 EVALUATION OF THE EFFICACY OF 1L-PEG-ASC SOLUTION FOR BOWEL PREPARATION IN AN 'OPEN ACCESS' COLONOSCOPY BOOKING SYSTEM

Author

S. Scarpelli, A. Curatolo, Paola Soriani, G.F. Bonura, Paolo Biancheri, L Miglioli, D. Corbascio, J. Rainer, S Deiana, T Gabbani, Giovanna Impellizzeri, Laura Ottaviani, and Mauro Manno

Subjects
medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, PEG ratio, Gastroenterology, medicine, Bowel preparation, Colonoscopy, business, Surgery
Published
2021
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31. Sentinel hospital-based surveillance for norovirus infection in children with gastroenteritis between 2015 and 2016 in Italy

Author

Flora De Conto, Fabio Tummolo, Noemi Urone, Daniela Loconsole, Gianvito Lanave, Vito Martella, Anna Morea, Mariarosaria Marinaro, Simona De Grazia, Maria Cristina Medici, Cristiana Catella, Maria Chironna, Antonio Parisi, Adriana Calderaro, Giovanni M. Giammanco, Floriana Bonura, De Grazia, Simona, Lanave, Gianvito, Giammanco, Giovanni Maurizio, Medici, Maria Cristina, De Conto, Flora, Tummolo, Fabio, Calderaro, Adriana, Bonura, Floriana, Urone, Noemi, Morea, Anna, Loconsole, Daniela, Catella, Cristiana, Marinaro, Mariarosaria, Parisi, Antonio, Martella, Vito, and Chironna, Maria

Subjects
0301 basic medicine, RNA viruses, European People, Settore MED/07 - Microbiologia E Microbiologia Clinica, viruses, medicine.disease_cause, Pathology and Laboratory Medicine, Pediatrics, Geographical locations, fluids and secretions, Epidemiology, Genotype, Prevalence, Medicine and Health Sciences, Ethnicities, Child, Caliciviridae Infections, Multidisciplinary, Incidence (epidemiology), Database and informatics methods, Sequence analysis, virus diseases, Gastroenteritis, Italian People, Europe, Capsid, Italy, Medical Microbiology, Child, Preschool, Viral Pathogens, Viruses, Medicine, RNA, Viral, Pathogens, Pediatric Infections, Research Article, medicine.medical_specialty, Genotyping, Bioinformatics, Science, 030106 microbiology, Sequence Databases, Microbiology, Caliciviruses, 03 medical and health sciences, Age groups, medicine, Humans, European Union, Molecular Biology Techniques, Microbial Pathogens, Molecular Biology, Biochemistry, Genetics and Molecular Biology (all), RNA sequence analysis, Biology and life sciences, business.industry, Sequence Analysis, RNA, Norovirus, Organisms, Genetic Variation, RNA-Dependent RNA Polymerase, Virology, digestive system diseases, Research and analysis methods, 030104 developmental biology, Biological Databases, Agricultural and Biological Sciences (all), Capsid Proteins, Population Groupings, People and places, business, Sentinel Surveillance
Abstract

Noroviruses are one of the leading causes of gastro-enteric diseases worldwide in all age groups. Novel epidemic noroviruses with GII.P16 polymerase and GII.2 or GII.4 capsid type have emerged worldwide in late 2015 and in 2016. We performed a molecular epidemiological study of the noroviruses circulating in Italy to investigate the emergence of new norovirus strains. Sentinel hospital-based surveillance, in three different Italian regions, revealed increased prevalence of norovirus infection in children (

Published
2018

32. Outbreak of ST395 KPC-Producing Klebsiella pneumoniae in a Neonatal Intensive Care Unit in Palermo, Italy

Author

Carmelo Massimo Maida, Angelo Rizzo, Maria Valeria Torregrossa, Davide Vecchio, Daniela Maria Geraci, Celestino Bonura, Mario Giuffrè, Giorgio Graziano, Alessandra Carattoli, Maida Carmelo Massimo, Bonura Celestino, Geraci Daniela Maria, Graziano Giorgio, Carattoli Alessandra, Rizzo Angelo, Torregrossa Maria Valeria, Vecchio Davide, and Giuffrè Mario

Subjects
0301 basic medicine, Microbiology (medical), Klebsiella pneumoniae, Neonatal Intensive Care Unit, Carbapenem resistance, KPC, Outbreak, medicine.medical_specialty, Neonatal intensive care unit, Epidemiology, Klebsiella pneumoniae, 030106 microbiology, Settore MED/42 - Igiene Generale E Applicata, beta-Lactam Resistance, Disease Outbreaks, 03 medical and health sciences, Intensive Care Units, Neonatal, medicine, Humans, Bacteriological Techniques, Infection Control, biology, Outbreak, biology.organism_classification, Klebsiella Infections, 030104 developmental biology, Infectious Diseases, Carbapenems, Italy, Emergency medicine, Beta lactam antibiotics
Published
2018

33. Traumatic intracranial nail-gun injury of the right internal carotid artery causing pseudoaneurysm and caroticocavernous fistula

Author

James Van Gelder, Ashraf Dower, Andrew Bonura, Nathan Manning, and Christopher Alan Brooks

Subjects
Surgical repair, medicine.medical_specialty, medicine.diagnostic_test, business.industry, General Medicine, medicine.disease, Cerebral Angiography, Surgery, Catheter, Pseudoaneurysm, Carotid-Cavernous Sinus Fistula, medicine.anatomical_structure, medicine, Nail (anatomy), Craniocerebral Trauma, Humans, Nail gun, Female, cardiovascular diseases, Neurosurgery, business, Aneurysm, False, Carotid Artery, Internal, Penetrating trauma, Cerebral angiography
Abstract

Penetrating trauma due to nail gun is an uncommon yet important clinical entity. There are numerous case reports describing these injuries, yet few describe those resulting in cerebrovascular injury. Laceration of cerebral blood vessels may result in significant intracranial haemorrhage and cerebral ischaemia, with catastrophic consequences. In the present study, we report a female patient who was shot in the face with a nail gun in a domestic assault. The nail entered her right cavernous sinus and lacerated her right internal carotid artery causing a pseudoaneurysm and a caroticocavernous fistula. This report details the approach to, and pitfalls of, managing a cerebrovascular injury due to penetrating intracranial nail. Catheter cerebral angiography is essential in the diagnosis and treatment of these injuries. Best treatment and outcomes require clinicians with expertise in endovascular and surgical repair strategies.

Published
2021
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34. Multi-valvular infective endocarditis from Gemella morbillorum

Author

Erin M. Bonura and Anish K. Desai

Subjects
medicine.medical_specialty, biology, business.industry, General Medicine, Bacteriological Cure, Disease, 030204 cardiovascular system & hematology, Gemella morbillorum, medicine.disease, biology.organism_classification, 03 medical and health sciences, 0302 clinical medicine, Infective endocarditis, Heart failure, Gemella, medicine, Endocarditis, 030212 general & internal medicine, Intensive care medicine, business, Normal heart
Abstract

Gemella morbillorum is increasingly implicated in infectious endocarditis. Our patient presented with anaemia and renal failure with evidence of infarcts and embolic disease. He was found to have endocarditis with an organism that could not speciate with standard culture methods requiring matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF) for identification and susceptibilities. While involvement of mitral and aortic valves can be expected with Gemella, he had rare involvement of the pulmonic valve in a structurally normal heart. Although bacteriological cure was achieved, due to the locally destructive nature of Gemella, he ultimately required valve replacements for heart failure resolution. Workup for commonly implicated pathologies associated with G. morbillorum led to suspicion of gastrointestinal malignancy with findings of occult bleeding prompting an ongoing evaluation. With improved access to advanced diagnostics, G. morbillorum has been increasingly identified in infectious endocarditis. Given its destructive nature, it is important for clinicians to consider this organism is difficult to identify isolates.

Published
2021
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36. Hemorrhagic stroke complicated by cerebral venous sinus thrombosis with idarucizumab

Author

Andrew Bonura, Ho Choong, and Chun Seng Phua

Subjects
medicine.medical_specialty, business.industry, fungi, Case, food and beverages, Idarucizumab, medicine.disease, Internal medicine, medicine, Cardiology, Neurology (clinical), Acute thrombosis, Cerebral venous sinus thrombosis, business, Stroke
Abstract

Idarucizumab can lead to acute thrombosis in a patient with an underlying procoagulant state.

Published
2018
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37. SCAR-ENGAGED COLORECTAL LESIONS: ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD) VERSUS A HYBRID RESECTION TECHNIQUE (ENDOSCOPIC UNSCARRING MUCOSAL RESECTION – EUMR)

Author

Paolo Cecinato, Romano Sassatelli, A Ianniello, P.A. Testoni, F Calabrese, G Francesco Bonura, M. Cavina, Giuliana Sereni, Veronica Iori, Dario Esposito, Lorella Fanti, Edi Viale, Giuseppe Dell’Anna, Francesco Azzolini, S Grillo, and Ramona Zecchini

Subjects
medicine.medical_specialty, business.industry, Medicine, Endoscopic mucosal resection, Endoscopic submucosal dissection, business, Resection, Surgery
Published
2019
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38. A NOVEL EX VIVO PORCINE SIMULATOR FOR PERORAL ENDOSCOPIC MYOTOMY TRAINING (POMOD)

Author

Veronica Iori, Francesco Azzolini, Edi Viale, Giuliana Sereni, Giuliano Francesco Bonura, M Cavina, F Calabrese, Paolo Cecinato, R Tomba, Giuseppe Dell’Anna, P.A. Testoni, Dario Esposito, Lorella Fanti, and Romano Sassatelli

Subjects
Myotomy, medicine.medical_specialty, business.industry, medicine.medical_treatment, medicine, business, Ex vivo, Surgery
Published
2019
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39. The Brief Case

Author

Zoe L Lyski, Lauren Fontana, Erin M. Bonura, and William B. Messer

Subjects
0301 basic medicine, Microbiology (medical), Male, Abdominal pain, Klebsiella, medicine.medical_specialty, Colorectal cancer, The Brief Case, medicine.medical_treatment, 030106 microbiology, Klebsiella variicola, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Peritoneum, Japan, Internal medicine, Drug Resistance, Multiple, Bacterial, medicine, Humans, 030212 general & internal medicine, Diagnostic Errors, Phylogeny, Aged, Chemotherapy, biology, Asian, business.industry, Emergency department, medicine.disease, biology.organism_classification, humanities, Anti-Bacterial Agents, Bacterial Typing Techniques, Klebsiella Infections, medicine.anatomical_structure, Bacteremia, medicine.symptom, business, Colorectal Neoplasms
Abstract

A 72-year-old Japanese male with a history of colorectal cancer with metastases to the liver and peritoneum presented to the emergency department with fever and abdominal pain and was subsequently found to have Gram-negative bacteremia. The patient had undergone numerous chemotherapy treatment

Published
2019

40. Antithrombotic strategies in the catheterization laboratory for patients with acute coronary syndromes undergoing percutaneous coronary interventions: insights from the EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units Registry

Author

De Luca, L., Musumeci, G., Leonardi, S., Gonzini, L., Cavallini, C., Calabro, P., Mauro, C., Cacciavillani, L., Savonitto, S., De Servi, S., Caporale, R., Ceravolo, R., Formigli, D., Lupi, A., Rakar, S., Smecca, I. M., Maggioni, A. P., Lucci, D., Lorimer, A., Orsini, G., Fabbri, G., Bianchini, E., Abrignani, M. G., Bonura, F., Trimarco, B., Galasso, G., Misuraca, G., Manes, M. T., Tuccillo, B., Irace, L., Olivari, Z., Totis, O., Ledda, A., Boccalatte, M., Iliceto, S., Tortorella, G., Esposito, L., De Rosa, P., Bianchi, R., Napoletano, C., Piccioni, L. L., Pavesi, P. C., Bovenzi, F. M., Boni, A., Merenda, R., Wolff, S., De Ferrari, G. M., Camporotondo, R., Gambino, P., Cutaia, A., Picariello, C., Cemin, R., Chiarella, F., Gauthier, L. G., Mircoli, L., Del Pinto, M., Finocchiaro, M. L., Scioli, R., Farina, R., Naddeo, C., Scherillo, M., Santopietro, S., Metra, M., Costa, F., Calculli, G., Troito, G., Pennisi, V., Adornato, E. M. F., Pirelli, S., Fadin, B. M., DI Biase, M., Ieva, R., Zuin, G., Sanfilippo, N., Mancuso, L., Pani, A., Serra, E., Marenzi, G., Assanelli, E. M., Ansalone, G., Cacciotti, L., Morocutti, G., Fresco, C., Berti, S., Paradossi, U., Bozzano, A., Mauro, A., Noussan, P., Zanini, P., Bolognese, L., Falsini, G., Costa, P., Manca, G., Caldarola, P., Locuratolo, N., Cipolla, T., Becchina, M., Cocco, G., Scalera, G., Stefanelli, S., Giunta, N., Sinagra, G., Meloni, L., Lai, O., Chiaranda, G., Luca, G., Helou, J. S., Biscottini, E., Magliari, F., Callerame, M., Uguccioni, M., Pugliese, M., Sanchez, F., Tartaglione, S., Ignone, G., Mavilio, G., Mantovan, R., Bini, R., Caico, S. I., Demolli, V., Proietti, F., Michisanti, M., Musmeci, G., Cantamessa, P., Sicuso, G., Micalef, S. S., Accogli, M., Zaccaria, M., Caputo, M., DI Paolo, G., Piatti, L., Farina, A., Vicinelli, P., Paloscia, L., DI Clemente, D., Felis, S., Castini, D., Rota, C., Casu, G., Bonano, S., Margheri, M., Lucchi, G. R., Serdoz, R., Proietti, P., Autore, C., Conti, E., Russo, V., Orlando, P., Ramondo, A. B., Bontorin, M., Marcolongo, M., Santagostino, M., Maestroni, A., Vitti, P., Rodella, P., Bonetti, P., Elia, M., Lumare, R., Politi, A., Gritti, S., Poletti, F., Mafrici, A., Fusco, R., Bongo, A. S., Bacchini, S., Gasparetto, V., Ferraiuolo, G., De Luca, M., Campana, C., Bonatti, R., Gaita, F., Bergerone, S., Bonmassari, R., Zeni, P., Langialonga, T., Scarcia, A., Caravita, L., Musacchio, E., Augello, G., Usmiani, T., Stomaci, B., Cirino, D., Pierini, S., Bottiglieri, G., Liso, A., Mussardo, M., Tosi, P., Sala, R., Belloni, A., Blengino, S., Lisi, E., Delfino, P., Auguadro, C., Brunazzi, M. C., Pacchioni, E., Fattore, L., Bosco, B., Blandizzi, S., Pajes, G., Patruno, N., Perna, G. P., Francioni, M., Favale, S., Vestito, D., Lombardi, A., Capecchi, A., Ferrero, P., De Vincenzo, C., Magri, G., Indolfi, C., De Rosa, S., Rossi, M., Collarini, L., Agnelli, D., Conti, G., Tonelli, C., Spadaro, C., Negroni, S., DI Noto, G., Lanari, A., Casolo, G., Del Meglio, J., Negrini, M., Celentano, A., Sifola, C., Rellini, G., Mattia, A. D., Molero, U., Piovaccari, G., Grosseto, D., Callegarin, L., Fiasconaro, G., Crivello, R., Thiebat, B., Leone, G., Tamburino, C., Caruso, G., Cassadonte, F., Sassone, B., Fuca, G., Sormani, L., Percoco, G. F., Mazzucco, R., Cazzani, E., Gianni, M., Limido, A., Luvini, M., Guglielmi, R., Mannarini, A., Moruzzi, P., Pastori, P., Golia, B., Marzano, A., Orazi, S., Marchese, I., Anselmi, M., Girardi, P., Nassiacos, D., Meloni, S., Busacca, P., Generali, C. A., Corda, S., Costanza, G., Montalto, S., Argenziano, L., Tommasini, P., Emdin, M., Pasanisi, E. M., Colivicchi, F., Tubaro, M., Azzolini, P., Luciani, C., Doronzo, B., Coppolino, A., Dellavesa, P., Zenone, F., DI Marco, A., De Conti, F., Piccinni, G. C., Gualtieri, M. R., Bisignani, G., Leone, A., Arcuri, G. M., Marinacci, L., Rossi, P., Perotti, S., Cometti, V. C., Arcidiacono, S., Tramontana, M., Bazzucchi, M., Mezzetti, P., Romano, M., Villani, R., DI Giovambattista, R., Volpe, B., Tedesco, L., Carini, M., Vinci, S., Paolini, E. A., Busoni, F., Piergentili, C., Navazio, A., Manca, F., Cocco, F., Pennetta, C. A., Maggiolini, S., Galbiati, R., Bruna, C., Ferrero, L., Brigido, S., Barducci, E., Musacchio, D., Manduca, B., Marchese, D., Patrassi, L. A., Pattarino, F. A., Rocchi, M., Briglia, S., Fanelli, R., Villella, M., Gronda, E., Massa, D., Lenti, V., DI Gregorio, L., Bottero, M., Bazzanini, F., Braggion, G., Antoniceli, R., Caraceni, D., Guzzo, V., DI Giovanni, P., Scarpini, S., Severgnini, B., Musolino, M. F., Casa, S. D., Gobbi, M., Arena, G., Bonizzato, S., Agnoletto, V., Sansoni, S., Pes, R. A. M., Denti, S., Polizzi, G. M., Pino, R., Commisso, B., Merlino, A., DI Lorenzo, L., Porchetta, I., Del Furia, F., Colombi, E., Covini, D., Cavalieri, F., Antonaci, S., Rubino, G., Ciulla, A., Bui, F., Casorelli, E., Caliendo, L., Laezza, A., Americo, L., Schillaci, A. M., Cordoni, M., Barsotti, L., Gaudio, C., Barilla, F., Cannone, M., Memeo, R., Truncellito, L., Andriani, A., Salituri, S., Verrina, F., Pafi, M., Sebastiani, M. L., Amico, A. F., Scolozzi, D., Lupi, G., D'Alea, A., Catanzariti, D., Angheben, C., Ottaviano, A., Levantesi, G., de Luca, Leonardo, Musumeci, Giuseppe, Leonardi, Sergio, Gonzini, Lucio, Cavallini, Claudio, Calabrò, Paolo, Mauro, Ciro, Cacciavillani, Luisa, Savonitto, Stefano, de Servi, Stefano, Caporale, Roberto, Ceravolo, Roberto, Formigli, Dario, Lupi, Alessandro, Rakar, Sadir, Smecca, Ivan, Maggioni, Aldo Pietro, Lucci, Donata, Lorimer, Andrea, Orsini, Giampietro, Fabbri, Gianna, Bianchini, Elisa, Abrignani, Maurizio Giuseppe, Bonura, Francesc, Trimarco, Bruno, Galasso, Gennaro, Misuraca, Gianfranco, Manes, Maria Teresa, Tuccillo, Bernardino, and Irace, Luigi.

Subjects
Male, Prasugrel, medicine.medical_treatment, Myocardial Infarction, antithrombotic therapy, 030204 cardiovascular system & hematology, acute coronary syndromes, bivalirudin, heparins, percutaneous coronary intervention, prasugrel, ticagrelor, 0302 clinical medicine, Antithrombotic, 80 and over, Bivalirudin, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Registries, Aged, 80 and over, General Medicine, Hirudins, Middle Aged, Recombinant Proteins, Italy, Female, Cardiology and Cardiovascular Medicine, Ticagrelor, medicine.drug, medicine.medical_specialty, Platelet Glycoprotein GPIIb-IIIa Complex, NO, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, Acute Coronary Syndrome, Aged, Aspirin, business.industry, Heparin, Percutaneous coronary intervention, Anticoagulants, medicine.disease, Peptide Fragments, Clinical trial, Cross-Sectional Studies, Logistic Models, Conventional PCI, Multivariate Analysis, business
Abstract

Aims In the last decades, several new therapies have emerged for the treatment of acute coronary syndromes (ACS). We sought to describe real-world patterns of use of antithrombotic treatments in the catheterization laboratory for ACS patients undergoing percutaneous coronary interventions (PCI). Methods EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in ACS patients in Italy. Results Over a 3-week period, a total of 2585 consecutive ACS patients have been enrolled in 203 cardiac care units across Italy. Among these patients, 1755 underwent PCI (923 with ST-elevation myocardial infarction and 832 with non-ST-elevation ACS). In the catheterization laboratory, unfractioned heparin was the most used antithrombotic drug in both ST-elevation myocardial infarction (64.7%) and non-ST-elevation ACS (77.5%) undergoing PCI and, as aspirin, bivalirudin and glycoprotein IIb/IIIa inhibitors (GPIs) more frequently employed before or during PCI compared with the postprocedural period. Any crossover of heparin therapy occurred in 36.0% of cases, whereas switching from one P2Y12 inhibitor to another occurred in 3.7% of patients. Multivariable analysis yielded several independent predictors of GPIs and of bivalirudin use in the catheterization laboratory, mainly related to clinical presentation, PCI complexity and presence of complications during the procedure. Conclusion In our contemporary, nationwide, all-comers cohort of ACS patients undergoing PCI, antithrombotic therapies were commonly initiated before the catheterization laboratory. In the periprocedural period, the most frequently employed drugs were unfractioned heparin, leading to a high rate of crossover, followed by GPIs and bivalirudin, mainly used during complex PCI. Clinical trial registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02015624.

Published
2017

41. Insulin pump failures in Italian children with Type 1 diabetes: retrospective 1-year cohort study

Author

Rabbone, I., Minuto, N., Bonfanti, R., Marigliano, M., Cerutti, F., Cherubini, V., d(')Annunzio, G., Frongia, A. P., Iafusco, D., Ignaccolo, G., Lombardo, F., Schiaffini, R., Toni, S., Tumini, S., Zucchini, S., Pistorio, A., Scaramuzza, A. E., Scaramuuzza, A. E., Lera, R., Secco, A., Bobbio, A., Bechaz, M., Piccinno, E., Natale, M. P., Ortolani, F., Zecchino, C., Lonero, A., Maltoni, G., Pasquino, B., Gallo, F., Frongia, P., Ripoli, C., Lo Presti, D., Timpanaro, T., Citriniti, F., Suprani, T., Carinci, S., Cipriano, P., Lazzaro, N., De Donno, V., Gallarotti, F., Lenzi, L., Piccini, B., Vittorio, L., Russo, C., Borea, R., Mamm(`i), F., Bruzzese, M., Ventrici, C., Salzano, G., Frontino, G., Bonura, C., Favalli, V., Scaramuzza, A., Zuccotti, G. V., Ferrari, M., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, E., Buono, P., Confetto, S., Zanfardino, A., Cadario, F., Savastio, S., Fiorito, C., Barbieri, P., Piredda, G., Cardella, F., Ropolo, R., Federico, G., Marchi, B., Benevento, D., Carducci, C., Mancabitti, M. L., Delvecchio, M., Lapolla, R., Gaiero, A., Fichera, G., Ignaccolo, M. G., Tinti, D., Cauvin, V., Franceschi, R., Biagioni, M., Salvatoni, A., Scolari, A., Maffeis, C., Sabbion, A., Arnaldi, C., Tosini, D., Rabbone, I, Minuto, N., Bonfanti, R., Marigliano, M., Cerutti, F., Cherubini, V., D'Annunzio, G., Frongia, A. P., Iafusco, Dario, Ignaccolo, G., Lombardo, F., Schiaffini, R., Toni, S., Tumini, S., Zucchini, S., Pistorio, A., Scaramuzza, A. E., Rabbone, I., Iafusco, D., Lera, R., Secco, A., Bobbio, A., Bechaz, M., Piccinno, E., Natale, M. P., Ortolani, F., Zecchino, C., Lonero, A., Maltoni, G., Pasquino, B., Gallo, F., Frongia, P., Ripoli, C., Lo Presti, D., Timpanaro, T., Citriniti, F., Suprani, T., Carinci, S., Cipriano, P., Lazzaro, N., De Donno, V., Gallarotti, F., Lenzi, L., Piccini, B., Vittorio, L., Russo, C., Borea, R., Mammi, F., Bruzzese, M., Ventrici, C., Salzano, G., Frontino, G., Bonura, C., Favalli, V., Scaramuzza, A., Zuccotti, G. V., Ferrari, M., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, E., Buono, P., Confetto, S., Zanfardino, A., Cadario, F., Savastio, S., Fiorito, C., Barbieri, P., Piredda, G., Cardella, F., Ropolo, R., Federico, G., Marchi, B., Benevento, D., Carducci, C., Mancabitti, M. L., Del Vecchio, M., Lapolla, R., Gaiero, A., Fichera, G., Ignaccolo, M. G., Tinti, D., Cauvin, V., Franceschi, R., Biagioni, M., Salvatoni, A., Scolari, A., Maffeis, C., Sabbion, A., Arnaldi, C., Tosini, D., Rabbone, Minuto, Mammì, F., and Mozzillo, Enza.

Subjects
Blood Glucose, Male, Pediatrics, Adolescent, Blood Glucose Self-Monitoring, Child, Child, Preschool, Diabetes Mellitus, Type 1, Equipment Failure, Female, Humans, Infant, Insulin, Italy, Retrospective Studies, Insulin Infusion Systems, type 1 diabetes, medicine.medical_treatment, Endocrinology, Diabetes and Metabolism, Internal Medicine, Endocrinology, 0302 clinical medicine, Retrospective Studie, Medicine, 030212 general & internal medicine, Diabetes, Diabetology, failure, Diabetes and Metabolism, children and adolescents, insulin pump, Cohort study, Type 1, Human, Insulin pump, medicine.medical_specialty, Disease duration, 030209 endocrinology & metabolism, 03 medical and health sciences, Diabetes mellitus, Diabetes Mellitus, Preschool, Type 1 diabetes, business.industry, Diabetes, Type1, Pump, Insulin, Type1, Retrospective cohort study, Pump, medicine.disease, Surgery, Insulin Infusion System, business
Abstract

Aims Insulin pump failure and/or malfunction requiring replacement have not been thoroughly investigated. This study evaluated pump replacement in children and adolescents with Type 1 diabetes using insulin pump therapy. Methods Data were collected for all participants younger than 19 years, starting insulin pump therapy before 31 December 2013. For each child, age, disease duration, date of insulin pump therapy initiation, insulin pump model, failure/malfunction/replacement yes/no and reason were considered for the year 2013. Results Data were returned by 40 of 43 paediatric centres belonging to the Diabetes Study Group of the Italian Society of Paediatric Endocrinology and Diabetology. In total, 1574 of 11 311 (13.9%) children and adolescents with Type 1 diabetes were using an insulin pump: 29.2% Animas VIBE™, 9.4% Medtronic MiniMed 715/515™, 34.3% Medtronic MiniMed VEO™, 24.3% Accu-Check Spirit Combo™ and 2.8% other models. In 2013, 0.165 insulin pump replacements per patient-year (11.8% due to pump failure/malfunction and 4.7% due to accidental damage) were recorded. Animas VIBE™ (22.1%) and Medtronic MiniMed VEO™ (17.7%) were the most replaced. Conclusions In a large cohort of Italian children and adolescents with Type 1 diabetes, insulin pump failure/malfunction and consequent replacement are aligned with rates previously reported and higher in more sophisticated pump models. This article is protected by copyright. All rights reserved.

Published
2017

42. Is the hip capsule thicker in diseased hips?

Author

A. A. Bonura, R. Nairn, N. M. Kolanko, K. S. Rakhra, Paul E. Beaulé, and Mark E. Schweitzer

Subjects
musculoskeletal diseases, medicine.medical_specialty, Alpha angle, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Femoroacetabular Impingement, Hip Capsule, medicine, Orthopedics and Sports Medicine, In patient, Femoroacetabular impingement, Hip disease, 030222 orthopedics, Hip, CAM, business.industry, Alpha Angle, Capsule, Mean age, 030229 sport sciences, medicine.disease, Surgery, Etiology, Hip Joint, medicine.symptom, business
Abstract

Objectives The purpose of this study was to compare the thickness of the hip capsule in patients with surgical hip disease, either with cam-femoroacetabular impingement (FAI) or non-FAI hip pathology, with that of asymptomatic control hips. Methods A total of 56 hips in 55 patients underwent a 3Tesla MRI of the hip. These included 40 patients with 41 hips with arthroscopically proven hip disease (16 with cam-FAI; nine men, seven women; mean age 39 years, 22 to 58) and 25 with non-FAI chondrolabral pathology (four men, 21 women; mean age 40 years, 18 to 63) as well as 15 asymptomatic volunteers, whose hips served as controls (ten men, five women; mean age 62 years, 33 to 77). The maximal capsule thickness was measured anteriorly and superiorly, and compared within and between the three groups with a gender subanalysis using student’s t-test. The correlation between alpha angle and capsule thickness was determined using Pearson’s correlation coefficient. Results Superiorly, the hip capsule was significantly greater in cam- (p = 0.028) and non-FAI (p = 0.048) surgical groups compared with the asymptomatic group. Within groups, the superior capsule thickness was significantly greater than the anterior in cam- (p < 0.001) and non-FAI (p < 0.001) surgical groups, but not in the control group. There was no significant correlation between the alpha angle and capsule thickness. There were no gender differences identified in the thickness of the hip capsule. Conclusion The thickness of the capsule does not differ between cam- and non-FAI diseased hips, and thus may not be specific for a particular aetiology of hip disease. The capsule is, however, thicker in diseased surgical hips compared with asymptomatic control hips. Cite this article: K. S. Rakhra, A. A. Bonura, R. Nairn, M. E. Schweitzer, N. M. Kolanko, P. E. Beaule. Is the hip capsule thicker in diseased hips? Bone Joint Res 2016;5:586–593. DOI: 10.1302/2046-3758.511.2000495.

Published
2016
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43. Factors Influencing Internal Medicine Resident Choice of Infectious Diseases or Other Specialties: A National Cross-sectional Study

Author

Erin M. Bonura, Wendy S. Armstrong, Eun Sul Lee, and Katrina Ramsey

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Cross-sectional study, education, 030106 microbiology, Communicable Diseases, 03 medical and health sciences, 0302 clinical medicine, Mentorship, Physicians, Intervention (counseling), Internal medicine, medicine, Humans, 030212 general & internal medicine, Salary, Fellowships and Scholarships, Articles and Commentaries, Medical education, ComputingMilieux_THECOMPUTINGPROFESSION, business.industry, Infectious Diseases, Family medicine, Medical training, Survey data collection, business, Career choice, Specialization, Cohort study
Abstract

Background. Only 49% of infectious diseases (ID) fellowship programs were filled in 2015 through the national match, but little is known about internal medicine (IM) resident perceptions of ID and factors related to IM resident career choice. Methods. We conducted 25 interviews and disseminated a Web-based survey to graduating IM residents in the United States utilizing a 2-stage sampling strategy. Participants were categorized into 3 groups based on interest in ID: (1) applied/intended to apply to ID; (2) interested in ID but did not apply; (3) never interested in ID. We conducted all analysis using poststratification adjustment weights with survey data analysis procedures. Results. Of the 590 participants, 42 (7%) selected category 1, 188 (32%) category 2, and 360 (61%) category 3. Most (65%) developed an interest in their ultimate career before residency. Of those interested in ID, >52% rated their ID medical school curriculum as very good and influential on their interest in ID. Ninety-one percent of category 2 participants felt mentorship was influential on career choice, although 43% identified an ID mentor. Category 2 chose salary as the most dissuading factor and the most likely intervention to increase ID interest. Conclusions. In this nationally representative sample of graduating IM residents, most develop an interest in their ultimate career before residency. Factors influencing this decision reside in both medical school and residency, which is consistent with career decision-making constructs. By identifying career determining factors and understanding how they fit into medical training frameworks, we can develop targeted initiatives to reinvigorate interest in ID.

Published
2016
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44. Impact on Survival of Timing and Duration of Adjuvant Chemotherapy in Radically Resected Gastric Cancer

Author

Maria Di Bartolomeo, Filippo Pietrantonio, Eliana Rulli, Davide Poli, Rosa Berenato, Marta Caporale, Emilio Bajetta, Irene Floriani, E. Bajetta, M. Di Bartolomeo, L. Catena, M. Schiavo, G. Pinotti, I. Proserpio, G. Rosati, R. Bordonaro, S. Cordio, G. Burrafato, A.M. Bochicchio, M. Aieta, N. Fazio, F. Spada, V. Amoroso, G. Marini, H. Soto Parra, G. Novello, B. Massidda, M.T. Ionta, M. Comandè, R. Venezia, A. Bertolini, E. Menatti, L. Zanlorenzi, A. Colombo, A. Iop, S. Bonura, E. Mazza, M. Viganò, A. Ardizzoia, S. Dell'Oro, G. Lo Re, D. Santeufemia, A. Buonadonna, D. Luisi, G. Ucci, G. Di Lucca, A. Bonetti, F. Bergamo, M. Alù, F. Vastola, P. Marchetti, D.C. Corsi, E. Massa, G. Di Pinto, M. Duro, C. Oliani, M. Franchini, A. Inzoli, N. Gebbia, L. Repetto, S. Rota, L. Frontini, R. Labianca, S. Mosconi, A. Quadri, S. De Grossi, P. Bidoli, M.E. Cazzaniga, F. Villa, P. Foa, D. Ferrari, E. Aitini, C. Rabbi, S. Barni, F. Petrelli, M. Giordano, G. Luchena, M. Pirovano, A. Nasisi, V. Catalano, P. Giordani, A. Zaniboni, F. Leone, S. Ferrario, G.D. Beretta, E.T. Menichetti, D. Conte, D. Mari, R. Giannicola, C. Pierantoni, A.G. Luporini, A. Ragazzini, A. Ravaioli, D. Tassinari, M. Nicolini, D. Amadori, G.L. Frassineti, D. Turci, F. Zumaglini, S. Tamberi, A. Piancastelli, G. Cruciani, E. Bejtja, A. Falcone, L. Landi, G. Minuti, M. Cantore, M. Orlandi, A. Mambrini, A. Ciarlo, D. Cavaciocchi, F. Del Monte, S. Ricci, I.M. Brunetti, M. Lencioni, M. Sisani, P. Sozzi, C. Granetto, S. Chiara, A.S. Galetto, A.S. Ribecco, A. DeCensi, L. Ciuffreda, E.E. Baldini, R. Camisa, R. Todeschini, A. Santoro, L. Rimassa, C. Carnaghi, T. Pressiani, C. Boni, E. Rondini, R. Gnoni, F. Di Costanzo, S. Gasperoni, L. Cavanna, M.A. Palladino, R. Mattioli, G. Laici, F. Pucci, M.D. Alessio, I. Bernardini, G. Tomasello, G. Baldino, R. Rossetti, S. Giaquinta, C. Pinto, F. Di Fabio, F.L. Rijas Llimpe, A.A. Brandes, M. Marzola, A.O.G. Rummo Benevento, S. Competiello, V. Montesarchio, A. Rea, B. Daniele, G. Genua, M. Licenziato, R. Casaretti, L. Silvestro, M. Montano, M.G. Sarobba, G. Sanna, G. Filippelli, G. Dima, E. Greco, M. Roselli, D. Natale, G. Condemi, G. Fumi, S. Tafuto, P. Masullo, D. Nitti, A. Marchet, G. Tiberio, G. de Manzoni, S. Nobili, G. Fiorentini, R. Mazzanti, E. Perrotta, C. Carlomagno, A. De Stefano, G. Cartenì, and M. Otero

Subjects
Male, Oncology, Cancer Research, medicine.medical_specialty, Adjuvant chemotherapy, medicine.medical_treatment, Time-to-Treatment, 03 medical and health sciences, 0302 clinical medicine, Stomach Neoplasms, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Combined Modality Therapy, Aged, Neoplasm Staging, Proportional Hazards Models, Postoperative Care, Chemotherapy, Proportional hazards model, business.industry, Stomach, Cancer, General Medicine, Middle Aged, medicine.disease, medicine.anatomical_structure, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Adenocarcinoma, Female, 030211 gastroenterology & hepatology, business, Adjuvant
Abstract

Purpose Adjuvant chemotherapy improves survival of patients with gastric cancer. Intergroup Trial of Adjuvant Chemotherapy in Adenocarcinoma of the Stomach (ITACA-S) was a phase III study comparing sequential FOLFIRI followed by docetaxel/cisplatin versus 5-fluorouracil monotherapy. The intensive regimen was not superior in terms of disease-free survival (DFS) and overall survival (OS). Methods The treatment was to be started within 8 weeks from surgery. This analysis evaluates the impact of time from surgery to chemotherapy start (TSC) on outcomes. Results Out of 1,106 randomized, 1,072 patients without major violations of eligibility criteria and receiving at least one treatment cycle were analyzed. Median TSC was 50 days. Chemotherapy was interrupted in 201 (18.8%) cases, whereas it was completed without or with modifications in 277 (25.8%) and 594 (55.4%), respectively. At a median follow-up of 56.9 months, 513 progressions and 472 deaths occurred. A longer TSC was significantly associated with longer DFS (hazard ratio [HR] 0.95; 95% confidence interval [CI] 0.89-1.00; p = 0.05) and OS (HR 0.91; 95% CI 0.86-0.97; p = 0.004), after adjustment for treatment arm, age, sex, primary tumor site, number of resected nodes, and tumor stage. Better treatment compliance was associated with improved survival. Conclusions Our findings suggest that longer TSC had at least no detrimental effect on DFS and OS, whereas treatment completion had a protective effect. Our findings need to be confirmed prospectively.

Published
2016
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45. A case report of basic calcium phosphate deposition disease mimicking septic arthritis

Author

Siroos Nasibi, Queenie Luu, Praneal Sharma, Andrew Bonura, and David Massasso

Subjects
Calcium Phosphates, Male, medicine.medical_specialty, Conservative management, Diagnostic dilemma, Disease, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Predictive Value of Tests, Calcinosis, Humans, Medicine, Disease process, 030212 general & internal medicine, Arthrography, 030203 arthritis & rheumatology, Arthritis, Infectious, medicine.diagnostic_test, business.industry, Anti-Inflammatory Agents, Non-Steroidal, Magnetic resonance imaging, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Treatment Outcome, Hip Joint, Periarthritis, Septic arthritis, Radiology, Differential diagnosis, Crystallization, business, human activities
Abstract

We report a case of a 53-year-old man who presented with a diagnostic dilemma mimicking septic arthritis. It is important to consider the diagnosis of calcific peri-arthritis clinically and recognize the hallmarks on radiograph and magnetic resonance imaging as this disease process resolves completely with conservative management like in our patient, and does not require operative intervention.

Published
2017
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46. T05.02.10 PRELIMINARY DATA ON ORAL AND FECAL MICROBIOTA IN PATIENTS AFFECTED BY LYNCH SYNDROME

Author

Marta Puzzono, Chiara Notaristefano, Giuliano Francesco Bonura, Nicasio Mancini, Alessandro Mannucci, Raffaella Alessia Zuppardo, Giulia Martina Cavestro, Maria Grazia Patricelli, Roberto Ferrarese, Ilaria Ditonno, P.A. Testoni, and A. Russo Raucci

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Gastroenterology, medicine, In patient, Fecal microbiota, medicine.disease, business, Lynch syndrome
Published
2020
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47. Adjusting insulin doses in patients with type 1 diabetes who use insulin pump and continuous glucose monitoring: Variations among countries and physicians

Author

Jasna Suput Omladic, Olga Kordonouri, Caroline Passone, Silvana Caiulo, Moshe Phillip, Natasa Bratina, Caroline Steele, Avivit Brener, Clara Bonura, Eyal Dassau, Barbara Piccini, Eran Atlas, Tomer Segall, Irene Rutigliano, Davide Tinti, Ido Muller, Dinesh Giri, Tadej Battelino, Thomas Danne, Patrizia Bruzzi, Anna Ruszała, Ariel Tenenbaum, Michal Nevo Shenker, Rachel Bello, Ronnie Stein, Ivana Rabbone, Guglielmo Beccuti, Marko Simunovic, Torben Biester, Revital Nimri, Michal Yackobovitch-Gavan, Klemen Dovc, and Sophia Sakka

Subjects
Blood Glucose, Male, decision support system, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 0302 clinical medicine, Endocrinology, Clinical endpoint, Insulin, Longitudinal Studies, 030212 general & internal medicine, Israel, Practice Patterns, Physicians', Child, Advisor Pro, insulin pump settings, non-interventional survey, treatment adjustments, Geography, Continuous glucose monitoring, Diabetes and Metabolism, Europe, Calibration, Female, Adult, Insulin pump, medicine.medical_specialty, Adolescent, 030209 endocrinology & metabolism, Internal Medicine, Young Adult, 03 medical and health sciences, Insulin Infusion Systems, Diabetes mellitus, Internal medicine, medicine, Humans, In patient, Type 1 diabetes, Dose-Response Relationship, Drug, business.industry, Blood Glucose Self-Monitoring, South America, medicine.disease, Diabetes Mellitus, Type 1, Basal (medicine), business
Abstract

Aims To evaluate physicians' adjustments of insulin pump settings based on continuous glucose monitoring (CGM) for patients with type 1 diabetes and to compare these to automated insulin dose adjustments. Methods A total of 26 physicians from 16 centres in Europe, Israel and South America participated in the study. All were asked to adjust insulin dosing based on insulin pump, CGM and glucometer downloads of 15 patients (mean age 16.2 ± 4.3 years, six female, mean glycated haemoglobin 8.3 ± 0.9% [66.8 ± 7.3 mmol/mol]) gathered over a 3-week period. Recommendations were compared for the relative changes in the basal, carbohydrate to insulin ratio (CR) and correction factor (CF) plans among physicians and among centres and also between the physicians and an automated algorithm, the Advisor Pro (DreaMed Diabetes Ltd, Petah Tikva, Israel). Study endpoints were the percentage of comparison points for which there was full agreement on the trend of insulin dose adjustments (same trend), partial agreement (increase/decrease vs no change) and full disagreement (opposite trend). Results The percentages for full agreement between physicians on the trend of insulin adjustments of the basal, CR and CF plans were 41 ± 9%, 45 ± 11% and 45.5 ± 13%, and for complete disagreement they were 12 ± 7%, 9.5 ± 7% and 10 ± 8%, respectively. Significantly similar results were found between the physicians and the automated algorithm. The algorithm magnitude of insulin dose change was at least equal to or less than that proposed by the physicians. Conclusions Physicians provide different insulin dose recommendations based on the same datasets. The automated advice of the Advisor Pro did not differ significantly from the advice given by the physicians in the direction or magnitude of the insulin dosing.

Published
2018

48. Successful control of an outbreak of colonization by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae sequence type 258 in a neonatal intensive care unit, Italy

Author

F. Nociforo, Laura Saporito, Giovanni Corsello, Daniela Maria Geraci, Caterina Mammina, R. Catalano, Celestino Bonura, S Di Noto, Mario Giuffrè, Giuffrè, M, Bonura, C, Geraci, DM, Saporito, L, Catalano, R, Di Noto, S, Nociforo, F, Corsello, G, and Mammina, C

Subjects
Colonization, Male, Microbiology (medical), Settore MED/07 - Microbiologia E Microbiologia Clinica, Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, Klebsiella pneumoniae, Multidrug resistance, Settore MED/42 - Igiene Generale E Applicata, ST258, beta-Lactamases, Disease Outbreaks, Settore MED/38 - Pediatria Generale E Specialistica, Bacterial Proteins, Drug Resistance, Multiple, Bacterial, Intensive Care Units, Neonatal, Ampicillin, polycyclic compounds, medicine, Humans, Infection control, Infection Control, KPC-Klebsiella pneumoniae, biology, business.industry, Infant, Newborn, Outbreak, General Medicine, Sulbactam, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, Klebsiella Infections, Infectious Diseases, Italy, Female, Gentamicin, business, Multilocus Sequence Typing, medicine.drug
Abstract

This article reports an outbreak of colonization by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) sequence type (ST) 258 in a neonatal intensive care unit (NICU) in Palermo, Italy. KPC-Kp ST258 was detected by an active surveillance culture programme. Between 18th September and 14th November 2012, KPC-Kp was isolated from 10 out of 54 neonates admitted in the outbreak period. No cases of infection were recorded. Male sex was associated with colonization, whereas administration of ampicilline-sulbactam plus gentamicin was protective. Infection control interventions interrupted the spread of KPC-Kp without the need to close the NICU to new admissions. (C) 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Published
2013
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49. Co-colonization with carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii in intensive care unit patients

Author

Anna Rita Vivoli, Laura Saporito, Maria Antonietta Saporito, Pier Giorgio Fabbri, Daniela Maria Palma, Francesca Di Bernardo, Romano Tetamo, Concetta Sodano, Andrea Neville Cracchiolo, Celestino Bonura, Caterina Mammina, Maria Stella Verde, Mammina, C, Bonura, C, Vivoli, AR, Di Bernardo, F, Sodano, C, Saporito, MA, Verde, MS, Saporito, L, Cracchiolo, AN, Fabbri, PG, Tetamo, R, and Palma, DM

Subjects
Acinetobacter baumannii, Adult, Male, Microbiology (medical), medicine.medical_specialty, Pediatrics, Younger age, Genotype, Carbapenem resistant Klebsiella pneumoniae, Klebsiella pneumoniae, Critical Illness, Settore MED/42 - Igiene Generale E Applicata, Hospitals, General, beta-Lactamases, law.invention, Bacterial Proteins, Risk Factors, law, Internal medicine, Drug Resistance, Bacterial, medicine, Humans, General hospital, Sicily, Aged, Aged, 80 and over, General Immunology and Microbiology, biology, Coinfection, business.industry, Major trauma, General Medicine, Middle Aged, biology.organism_classification, medicine.disease, Intensive care unit, Carbapenem resistance, co-colonization, intensive care unit, risk factors, Klebsiella Infections, Molecular Typing, Intensive Care Units, Infectious Diseases, Female, Co colonization, business, Acinetobacter Infections
Abstract

Objectives: This investigation was conducted to study co-colonization by carbapenem-resistant Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) and Acinetobacter baumannii (CRAB) in intensive care unit (ICU) patients in Palermo, Sicily, a geographic area where both organisms are endemic in the healthcare setting. Risk factors at admission and during ICU stay and outcomes were also evaluated. Methods: All patients colonized by KPC-Kp, or CRAB, or both in 2 ICUs of a large general hospital during the period October 2011 – March 2012 were enrolled. Demographics and clinical data were collected. Resistance determinants and clonality of the 2 organisms were characterized by molecular methods. Results: Seventy-fi ve of 391 patients (19.2%) proved to be colonized by KPC-Kp, CRAB, or both: 30 (40%) were co-colonized and 44 (58.7%) were mono-colonized by CRAB and 1 by KPC-Kp. Younger age, major trauma, and length of stay were positively associated with co-colonization. However, no signifi cant differences were detected between co-colonized and non co-colonized patients in infection and ICU mortality rates and length of stay after the fi rst isolation. Both organisms proved to be circulating in a clonal way. Conclusions: In our setting, co-colonization by KPC-Kp and CRAB disproportionately affected young trauma patients with those with a prolonged ICU stay.

Published
2013
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50. Contemporary antithrombotic strategies in patients with acute coronary syndromes managed without revascularization: insights from the EYESHOT study

Author

De Luca, Leonardo, Leonardi, Sergio, Smecca, Ignazio Maria, Formigli, Dario, Lucci, Donata, Gonzini, Lucio, Tuccillo, Bernardino, Olivari, Zoran, Gulizia, Michele Massimo, Bovenzi, Francesco Maria, De Servi, Stefano, Caporale, R., Cavallini, C., Ceravolo, R., Lupi, A., Musumeci, G., Rakar, S., Maggioni, A. P., Lorimer, A., Orsini, G., Fabbri, Giorgio, Bianchini, E., Abrignani, M. G., Bonura, F., Trimarco, B., Galasso, Giorgia, Misuraca, G., Manes, M. T., Irace, Lorenzo, Totis, O., Ledda, A., Mauro, C., Boccalatte, M., Iliceto, S., Cacciavillani, L., Savonitto, S., Tortorella, G., Esposito, L., DE ROSA, Paolo, Calabrò, P., Bianchi, R., Napoletano, C., Lalla Piccioni, L., Pavesi, P. C., Boni, Allegra, Merenda, R., Wolff, S., De Ferrari, G. M., Camporotondo, R., Gambino, Paolo, Cutaia, A., Picariello, C., Cemin, R., Chiarella, F., Grazioli Gauthier, L., Mircoli, L., Del Pinto, M., Finocchiaro, M. L., Scioli, R., Farina, R., Naddeo, C., Scherillo, M., Santopietro, S., Metra, M., Costa, F., Calculli, G., Troito, G., Pennisi, V., Adornato, E. M. F., Pirelli, S., Fadin, B. M., Di Biase, M., Ieva, R., Zuin, G., Sanfilippo, N., Mancuso, LAURA CATERINA, Pani, Luisa Anna, Serra, Eleonora, Marenzi, G., Assanelli, E. M., Ansalone, G., Cacciotti, L., Morocutti, G., Fresco, C., Berti, S., Paradossi, U., Bozzano, A., Mauro, A., Noussan, P., Zanini, P., Bolognese, L., Falsini, G., Costa, P., Manca, G., Caldarola, P., Locuratolo, N., Cipolla, T., Becchina, M., Cocco, Gabriele, Scalera, G., Stefanelli, S., Giunta, N., Sinagra, G., Meloni, L., Lai, O., Chiaranda, G., Luca, G., Sleiman Helou, J., Biscottini, E., Magliari, F., Callerame, M., Uguccioni, M., Pugliese, M., Sanchez, F., Tartaglione, S., Ignone, G., Mavilio, G., Mantovan, R., Bini, R., Caico, S. I., Demolli, V., Proietti, F., Michisanti, M., Musmeci, G., Cantamessa, P., Sicuso, G., Micalef, S. S., Accogli, M., Zaccaria, MICHELA MARIA, Caputo, M., Di Paolo, G., Piatti, L., Farina, A., Vicinelli, P., Paloscia, L., Di Clemente, D., Felis, S., Castini, D., Rota, C., Casu, Gabriella, Bonano, S., Margheri, M., Ricci Lucchi, G., Serdoz, R., Proietti, P., Autore, C., Conti, E., Russo, V., Orlando, P., Ramondo, A. B., Bontorin, M., Marcolongo, M., Marrara, F., Maestroni, A., Vitti, P., Rodella, P., Bonetti, P., Elia, M., Lumare, R., Politi, A., Gritti, S., Poletti, F., Mafrici, A., Fusco, R., Bongo, A. S., Bacchini, S., Gasparetto, V., Ferraiuolo, G., Campana, C., Bonatti, R., Gaita, F., Bergerone, S., Bonmassari, R., Zeni, P., Langialonga, T., Scarcia, A., Caravita, L., Musacchio, E., Augello, G., Usmiani, T., Stomaci, B., Cirino, D., Pierini, S., Bottiglieri, G., Liso, A., Mussardo, M., Tosi, P., Sala, R., Belloni, A., Blengino, S., Lisi, E., Delfino, P., Auguadro, C., Brunazzi, M. C., Pacchioni, E., Fattore, L., Bosco, B., Blandizzi, S., Pajes, G., Patruno, N., Perna, G. P., Francioni, M., Favale, S., Vestito, D., Lombardi, A., Capecchi, A., Ferrero, P., De Vincenzo, C., Magri, G., Indolfi, C., De Rosa, S., Rossi, M., Collarini, L., Agnelli, D., Conti, G., Tonelli, C., Spadaro, C., Negroni, S., Di Noto, G., Lanari, A., Casolo, G., Del Meglio, J., Negrini, M., Celentano, A., Sifola, C., Rellini, G., Della Mattia, A., Molero, U., Piovaccari, G., Grosseto, D., Callegarin, L., Fiasconaro, G., Crivello, R., Thiebat, B., Leone, G., Tamburino, C., Caruso, G., Cassadonte, F., Sassone, B., Fuca, G., Sormani, L., Percoco, G. F., Mazzucco, R., Cazzani, E., Gianni, M., Limido, A., Luvini, M., Guglielmi, R., Mannarini, A., Moruzzi, P., Pastori, P., Golia, B., Marzano, A., Orazi, S., Marchese, I., Anselmi, M., Girardi, P., Nassiacos, D., Meloni, S., Busacca, P., Generali, C. A., Corda, S., Costanza, G., Montalto, S., Argenziano, L., Tommasini, P., Emdin, M., Pasanisi, E. M., Colivicchi, F., Tubaro, M., Azzolini, P., Luciani, C., Doronzo, B., Coppolino, A., Dellavesa, P., Zenone, F., Di Marco, A., De Conti, F., Piccinni, G. C., Gualtieri, M. R., Bisignani, G., Leone, A., Arcuri, G. M., Marinacci, L., Rossi, P., Perotti, S., Cotti Cometti, V., Arcidiacono, S., Tramontana, M., Bazzucchi, M., Mezzetti, P., Romano, M., Villani, R., Di Giovambattista, R., Volpe, B., Tedesco, L., Carini, M., Vinci, S., Paolini, E. A., Busoni, F., Piergentili, C., Navazio, A., Manca, F., Cocco, F., Pennetta, C. A., Maggiolini, S., Galbiati, R., Bruna, C., Ferrero, L., Brigido, S., Barducci, E., Musacchio, D., Manduca, B., Marchese, D., Patrassi, L. A., Pattarino, F. A., Rocchi, M., Briglia, S., Fanelli, R., Villella, M., Gronda, E., Massa, D., Lenti, V., Di Gregorio, L., Bottero, M., Bazzanini, F., Braggion, G., Antoniceli, R., Caraceni, D., Guzzo, V., Di Giovanni, P., Scarpini, S., Severgnini, B., Musolino, M. F., Della Casa, S., Gobbi, M., Arena, G., Bonizzato, S., Agnoletto, V., Sansoni, S., Pes, R. A. M., Denti, S., Polizzi, G. M., Pino, R., Commisso, B., Merlino, A., Di Lorenzo, L., Porchetta, I., Del Furia, F., Colombi, E., Covini, D., Cavalieri, F., Antonaci, S., Rubino, G., Ciulla, A., Bui, F., Casorelli, E., Caliendo, L., Laezza, A., Americo, L., Schillaci, A. M., Cordoni, M., Barsotti, L., Gaudio, C., Barilla, F., Cannone, M., Memeo, R., Truncellito, L., Andriani, A., Salituri, S., Verrina, F., Pafi, M., Sebastiani, M. L., Amico, A. F., Scolozzi, D., D'Alea, A., Catanzariti, D., Angheben, C., Ottaviano, A., and Levantesi, G.

Subjects
Male, Ticagrelor, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Conservative strategy, Population, Acute coronary syndromes, Revascularization, acute coronary syndromes, anticoagulant, antithrombotic therapy, conservative strategy, prasugrel, ticagrelor, aged, coronary care units, female, fibrinolytic agents, follow-up studies, hospital mortality, humans, iItaly, length of stay, male, myocardial revascularization, retrospective studies, survival rate, thrombolytic therapy, practice guidelines as topic, Fibrinolytic Agents, Anticoagulant, Antithrombotic therapy, Prasugrel, Acute Coronary Syndrome, Aged, Coronary Care Units, Female, Follow-Up Studies, Hospital Mortality, Humans, Italy, Length of Stay, Myocardial Revascularization, Retrospective Studies, Survival Rate, Thrombolytic Therapy, Practice Guidelines as Topic, Cardiology and Cardiovascular Medicine, Pharmacology (medical), Internal medicine, Antithrombotic, medicine, education, Survival rate, education.field_of_study, business.industry, Clopidogrel, medicine.disease, Cardiology, business, Fibrinolytic agent, medicine.drug
Abstract

Aims Patients with acute coronary syndromes (ACSs) who are managed without coronary revascularization represent a mixed and understudied population that seems to receive suboptimal pharmacological treatment. Methods and results We assessed patterns of antithrombotic therapies employed during the hospitalization and in-hospital clinical events of medically managed patients with ACS enrolled in the prospective, multicentre, nationwide EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units) registry. Among the 2585 consecutive ACS patients enrolled in EYESHOT, 783 (30.3%) did not receive any revascularization during hospital admission. Of these, 478 (61.0%) underwent coronary angiography (CA), whereas 305 (39.0%) did not. The median GRACE and CRUSADE risk scores were significantly higher among patients who did not undergo CA compared with those who did (180 vs. 145, P < 0.0001 and 50 vs. 33, P < 0.0001, respectively). Antithrombotic therapies employed during hospitalization significantly differ between patients who received CA and those who did not with unfractioned heparin and novel P2Y12 inhibitors more frequently used in the first group, and low-molecular-weight heparins and clopidogrel in the latter group. During the index hospitalization, patients who did not receive CA presented a higher incidence of ischaemic cerebrovascular events and of mortality compared with those who underwent CA (1.6 vs. 0.2%, P = 0.04 and 7.9 vs. 2.7%, P = 0.0009, respectively). Conclusion Almost one-third of ACS patients are managed without revascularization during the index hospitalization. In this population, a lower use of recommended antiplatelet therapy and worse clinical outcome were observed in those who did not undergo CA when compared with those who did. Clinical Trial Registration Unique identifier: [NCT02015624][1], . [10.1093/ehjcvp/pvv017][2] [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02015624&atom=%2Fehjcardpharm%2F1%2F3%2F168.atom [2]: /lookup/doi/10.1093/ehjcvp/pvv017

Published
2015
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