Author: "Mario Pirisi" / Topic: medicine.medical_specialty - Searchworks@Jio Institute Digital Library Search Results

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278 results on '"Mario Pirisi"'

1. Long-term sequelae are highly prevalent one year after hospitalization for severe COVID-19

Author: Gian Carlo Avanzi, Michela Barini, Piero Emilio Balbo, Simone Bor, Carla Gramaglia, Pier Paolo Sainaghi, Alberto Loro, Giuseppe Patti, Alessio Baricich, Alessandro Carriero, Mario Pirisi, Mattia Bellan, Davide Raineri, Francesco Murano, Filippo Patrucco, Patrizia Zeppegno, Marco Battaglia, Umberto Morosini, Annalisa Chiocchetti, Federico Ceruti, Stefano Tricca, Daria Cuneo, E. Gattoni, Roberta Rolla, Chiara Santa Amico, Elena Paracchini, Eleonora Gambaro, Mara Giordano, Giuseppe Cappellano, Elisa Clivati, David J. Pinato, Vincenzo Cantaluppi, and Marcello Manfredi
Subjects: Male, Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Science, Walk Test, Motor Activity, Microbiology, Article, Pulmonary function testing, Stress Disorders, Post-Traumatic, Post-Acute COVID-19 Syndrome, DLCO, Virology, medicine, Prevalence, Humans, Respiratory function, Lung volumes, Prospective Studies, Survivors, Prospective cohort study, Aged, Carbon Monoxide, Multidisciplinary, Lung, business.industry, Patient Acuity, COVID-19, Middle Aged, medicine.disease, Patient Discharge, Respiratory Function Tests, Hospitalization, Pneumonia, medicine.anatomical_structure, Logistic Models, Mental Health, Italy, Pulmonary Diffusing Capacity, Medicine, Female, business, Tomography, X-Ray Computed
Abstract: Many coronavirus disease 2019 (Covid-19) survivors show symptoms months after acute illness. The aim of this work is to describe the clinical evolution of Covid-19, one year after discharge. We performed a prospective cohort study on 238 patients previously hospitalized for Covid-19 pneumonia in 2020 who already underwent clinical follow-up 4 months post-Covid-19. 200 consented to participate to a 12-months clinical assessment, including: pulmonary function tests with diffusing lung capacity for carbon monoxide (DLCO); post-traumatic stress (PTS) symptoms evaluation by the Impact of Event Scale (IES); motor function evaluation (by Short Physical Performance Battery and 2 min walking test); chest Computed Tomography (CT). After 366 [363–369] days, 79 patients (39.5%) reported at least one symptom. A DLCO
Published: 2021

2. Red cell distribution width is a potential predictor of early relapse in polymyalgia rheumatica

Author: P.P. Sainaghi, A R Pedrinelli, M G Cittone, Veronica Vassia, E Matino, Erika Zecca, Daniele Sola, Raffaella Landi, S Tonello, E Rizzi, E Boin, Roberta Pedrazzoli, Mario Pirisi, Daniele Soddu, and Mattia Bellan
Subjects: Erythrocyte Indices, Male, musculoskeletal diseases, 030213 general clinical medicine, medicine.medical_specialty, Red cell distribution width, Giant Cell Arteritis, Early Relapse, Disease, Gastroenterology, Polymyalgia rheumatica, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Recurrence, Prednisone, Internal medicine, medicine, Humans, Retrospective Studies, relapse, Aged, 80 and over, 030203 arthritis & rheumatology, Predictive marker, business.industry, biomarker, Red blood cell distribution width, Stepwise regression, medicine.disease, RC31-1245, Polymyalgia Rheumatica, Medicine, Biomarker (medicine), Female, business, medicine.drug
Abstract: Red blood cell distribution width (RDW) has been studied as a prognostic biomarker for different chronic inflammatory diseases. In this paper we aim to evaluate its potential role in the prediction of early relapse in patients affected by polymyalgia rheumatica (PMR). We revised retrospectively clinical records of patients who received a diagnosis of PMR, according to 2012 ACR/EULAR classification criteria, for whom baseline clinical and laboratory data were available. The baseline RDW variation coefficient was correlated to the risk of relapse, in the first 6 months of the disease. We identified 44 patients [females 15 (34.0%)/males 29 (66.0%); median age 80 (72-83)], 9 of whom had an early relapse. These patients showed a larger median RDW than patients who did not relapse [13.7 (13.5-14.9)% vs 13.5 (12.7-14.2)%; p=0.04). The two groups were comparable for all the other clinical and laboratory parameters considered. Interestingly, patients in the higher half of the RDW distribution showed a shorter relapse-free survival (p
Published: 2021

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

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

4. Radiotherapy in COVID-19 patient affected by multiple myeloma: a case report

Author: Gianluca Gaidano, Marco Krengli, Debora Beldì, Lorenzo De Paoli, Federico Mastroleo, Eleonora Ferrara, Micol Zannetti, Mario Pirisi, Mariangela Greco, and Erica Matino
Subjects: Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Autologous stem-cell transplantation, medicine, case report, Radiology, Nuclear Medicine and imaging, radiotherapy, Multiple myeloma, Case report, COVID-19, Palliative treatment, Radiotherapy, business.industry, palliative treatment, Cancer, Hydroxychloroquine, medicine.disease, Dysphagia, Surgery, multiple myeloma, Radiation therapy, Oncology, Respiratory failure, Concomitant, medicine.symptom, business, medicine.drug
Abstract: In COVID-19 pandemic, cancer patients may be vulnerable for their immunological status and need of immunosuppressive anti-neoplastic treatments Choosing the best treatment option in COVID-19 positive cancer patients is still a challenging issue We report the case of a 62-year-old woman diagnosed with multiple myeloma and affected by COVID-19 After the diagnosis of multiple myeloma in January 2019, the patient underwent first line therapy followed by bone marrow autologous stem cell transplantation, achieving a complete response in September 2019 In March 2020, the patient showed intrathoracic progression of the disease, resulting in a severe dysphagia and concomitant positivity to SARS-CoV-2 swab test, cough, fever, and dyspnea related to the involvement of the lung parenchyma as shown by CT-scan After her admittance to a COVID-19 dedicated inward, she was administered oral hydroxychloroquine and darunavir-cobicistat for 7 days with stabilization of her general clinical conditions For the worsening of dysphagia, after multidisciplinary discussion, it was decided to deliver radiotherapy to the mediastinal and paravertebral mass with 8 Gy single fraction After 5 days, her clinical conditions improved, with reduction of dysphagia The CT confirmed a partial response with reduction of the mass of about 50% Viral clearance was confirmed by triple negative search for SARS-CoV-2 on nasopharyngeal swabs, one month after first documentation of positivity Unfortunately, the patient died three months later due to a pulmonary mycotic infection causing respiratory failure To our knowledge, this case report describes the first experience of mediastinal radiotherapy in a COVID-19 patient affected by myeloma reported in the literature In case of clinical indication, even in presence of SARS-CoV-2 infection, radiotherapy can be safely delivered and might be considered a treatment option as shown by our experience in this challenging case of intrathoracic myeloma © Translational Cancer Research All rights reserved
Published: 2020

5. Long-lasting consequences of coronavirus disease 19 pneumonia: a systematic review

Author: Mattia Bellan, Mario Pirisi, Filippo Patrucco, Patrizia Zeppegno, Alessandro Carriero, Alessio Baricich, Zeno Falaschi, Carla Gramaglia, Daria Cuneo, and Piero Emilio Balbo
Subjects: medicine.medical_specialty, SARS-CoV-2, business.industry, Public health, COVID-19, General Medicine, Disease, Anxiety, medicine.disease_cause, medicine.disease, Pneumonia, Infectious disease (medical specialty), medicine, Humans, Female, Respiratory function, medicine.symptom, Intensive care medicine, business, Pandemics, Fatigue, Depression (differential diagnoses), Coronavirus
Abstract: INTRODUCTION Coronavirus Disease 19 (Covid-19) is an infectious disease caused by the newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We have plenty of data about the clinical features of the disease's acute phase, while little is known about the long-term consequences on survivors. EVIDENCE ACQUISITION We aimed to review systematically emerging evidence about clinical and functional consequences of Covid-19 pneumonia months after hospital discharge. EVIDENCE SYNTHESIS Current evidence supports the idea that a high proportion of Covid-19 survivors complain of symptoms months after the acute illness phase, being fatigue and reduced tolerance to physical effort the most frequently reported symptom. The strongest association for these symptoms is with the female gender, while disease severity seems less relevant. Respiratory symptoms are associated with a decline in respiratory function and, conversely, seem to be more frequent in those who experienced a more severe acute pneumonia. Current evidence highlighted a persistent motor impairment which is, again, more prevalent among those survivors who experienced a more severe acute phase of the disease. Additionally, the persistence of symptoms is a primary determinant of mental health outcome, with anxiety, depression, sleep disturbances, and post-traumatic stress symptoms being commonly reported in Covid-19 survivors. CONCLUSIONS Current literature highlights the importance of a multidisciplinary approach to Coronavirus Disease 19 since the sequelae appear to involve different organs and systems. Given the pandemic outbreak's size, this is a critical public health issue: a better insight on this topic should inform clinical decisions about the modalities of follow-up for Covid-19 survivors.
Published: 2022

6. Direct antivirals and cognitive impairment in hepatitis C: a clinical-neurophysiologic study

Author: Claudia Varrasi, Benedetta Gori, Matteo Nazzareno Barbaglia, Elena Brigatti, Michela Emma Burlone, Gionata Strigaro, Rosalba Minisini, Gloria Vaghi, Mario Pirisi, and Roberto Cantello
Subjects: Male, medicine.medical_specialty, Sustained Virologic Response, Hepacivirus, Neuropsychological Tests, Direct antiviral agents, Antiviral Agents, Article, Executive Function, 03 medical and health sciences, Cellular and Molecular Neuroscience, Cognition, 0302 clinical medicine, Non-alcoholic Fatty Liver Disease, Neuropsychology, Virology, Internal medicine, medicine, Humans, Attention, Cognitive Dysfunction, Hepatic encephalopathy, Aged, business.industry, Working memory, Fatty liver, Brain, Hepatitis C, Hepatitis C, Chronic, Middle Aged, medicine.disease, Executive functions, Event-Related Potentials, P300, P300 wave, Memory, Short-Term, Cognitive impairment, Liver, Neurology, Case-Control Studies, Female, 030211 gastroenterology & hepatology, Neurology (clinical), Liver function, business, 030217 neurology & neurosurgery
Abstract: Cognition was assessed in hepatitis C virus (HCV) patients, who did not meet the criteria for a minimal hepatic encephalopathy. Their liver function was compensated. We then disentangled potential cognitive changes associated with a sustained virologic response at 12 weeks (SVR-12), following treatment with direct antiviral agents (DAAs). We studied 23 selected HCV patients with a battery of standard neuropsychological tests, and with recordings of the P300 wave, a cerebral potential of “cognitive” significance. There was a baseline evaluation (T0) and a second one 6 months later (T1). We had 2 control groups of comparable age and sex, i.e., 15 patients suffering from non-alcoholic fatty liver disease (NAFLD) and 15 healthy subjects. At T0, we detected a significant (p p p p
Published: 2020

7. Novel Calculators for Risk Stratification in Hepatocellular Carcinoma

Author: Raffaele Romito, Monica Leutner, Silvia Gaia, and Mario Pirisi
Subjects: medicine.medical_specialty, Carcinoma, Hepatocellular, business.industry, Liver Neoplasms, Gastroenterology, Scientific literature, Risk Assessment, law.invention, 03 medical and health sciences, 0302 clinical medicine, Calculator, law, 030220 oncology & carcinogenesis, Risk stratification, Humans, Medicine, 030211 gastroenterology & hepatology, Medical physics, business
Abstract: Among clinicians, the users of medical calculators have expanded in recent years to an unprecedented number. The usefulness of some of these calculators is sometimes debatable, and experienced professionals may at times be right in avoiding their use; however, many may simply be unaware of the very existence of medical calculators applicable to their field of interest. The authors felt that this latter scenario might possibly apply to hepatocellular carcinoma (HCC). Hence, the authors concisely reviewed 10 free online medical calculators proposed in the last 8 years, categorizing them on the basis of the purpose for which they were developed (risk of harboring or developing HCC, N=4; prognostication in established HCC, N=6). In addition, the authors tried to establish the success each calculator has had so far in the medical community, by 2 criteria: having been included in the more popular app of medical calculators and being highly cited in the scientific literature.
Published: 2020

8. The association between education level and chronic liver disease of any etiology

Author: Evangelista Sagnelli, Filomena Morisco, Maurizio Russello, Sergio Babudieri, Caterina Sagnelli, Caterina Furlan, Mariantonietta Pisaturo, Mario Pirisi, Piero Luigi Almasio, Antonina Smedile, Tommaso Stroffolini, Stroffolini, T., Sagnelli, E., Sagnelli, C., Morisco, F., Babudieri, S., Furlan, C., Pirisi, M., Russello, M., Smedile, A., Pisaturo, M., Almasio, P. L., Stroffolini T., Sagnelli E., Sagnelli C., Morisco F., Babudieri S., Furlan C., Pirisi M., Russello M., Smedile A., Pisaturo M., and Almasio P.L.
Subjects: Liver Cirrhosis, medicine.medical_specialty, Cirrhosis, Alcohol Drinking, Liver Cirrhosi, Disease, 030204 cardiovascular system & hematology, Educational setting, Chronic liver disease, Logistic regression, Chronic disease, 03 medical and health sciences, 0302 clinical medicine, Non-alcoholic Fatty Liver Disease, Internal medicine, HBV, Internal Medicine, medicine, Humans, 030212 general & internal medicine, Stage (cooking), Association (psychology), business.industry, Liver Diseases, Liver Disease, Fatty liver, Middle Aged, medicine.disease, Italy, HCV, Etiology, Liver disorder, Alcohol, business, Human, Liver disorders
Abstract: Background The potential link between educational level and chronic liver diseases (CLD) were explored using the mortality records of liver cirrhosis, which lack accuracy and are unable to identify the different etiological factors of liver cirrhosis. Information on the association of low educational level with the severity of CLD is lacking. Aim To evaluate the potential association linking education level to etiology and clinical stage of CLD cases. Methods Consecutive enrolment of 11,107 subjects with CLD aged≥18 years prospectively recruited in two national surveys in 2001 and 2014 at one of the participating Italian liver units throughout the country. Subjects were pooled in two groups: low education level (less than high school) and high education level (completed high school or beyond). The association of demographic, etiological, and clinical stage of subjects with educational level was assessed using logistic regression analysis. In the analysis low educational level was the outcome variable. Results A total of 11,107 subjects born in Italy (mean age 55.5 years, sex ratio 1.5) were evaluated. Multiple logistic regression analysis shows that chronic HCV infection (O.R.1,38:95%,C.I.1.23-1.55), risky alcohol intake (O.R.1.96;95%,C.I.1.73-2.21) and liver cirrhosis (O.R.1.65;95%,C.I.1.46-1.85) all resulted independently associated with less than a completed high school education. HBV infection resulted independently associated with high education level (O.R.0.74;95%,C.I.0.64-0.86), reflecting changes in HBV modes of transmission in recent decades. No association was found with CLD related to non-alcoholic fatty liver disease (O.R.1.03;95%, C.I.0.81-1.30). Conclusions These findings show an independent association linking education level with viruses and alcohol-related CLD. Low educational level is associated with the severity of CLD.
Published: 2020

9. Eosinophilic gastroenteritis in pregnancy: A review of the literature

Author: Rachele Rapetti, Daniela Surico, Roberta Amadori, Viviana Stampini, Mario Pirisi, and A. Vigone
Subjects: Adult, Pediatrics, medicine.medical_specialty, Preterm labor, Prednisolone, Anti-Inflammatory Agents, Disease, Ultrasonography, Prenatal, Young Adult, Obstetric Labor, Premature, Eosinophilic infiltration, Pregnancy, Eosinophilia, Eosinophilic gastroenteritis, medicine, Late preterm, Humans, Young female, business.industry, Obstetrics and Gynecology, medicine.disease, Enteritis, Pregnancy Complications, Reproductive Medicine, Gastritis, Gestation, Female, business
Abstract: Eosinophilic gastroenteritis (EGE) is an uncommon and heterogeneous disease characterized by eosinophilic infiltration of the gastrointestinal tract. There are very few reports in literature describing pregnancies in EGE patients, and no review has ever been published. We found a total of 12 cases including one that occurred in our clinic. In 5 out of 12 cases, EGE was diagnosed after delivery and pregnancies are described as uneventful. Of the 5 patients who already had a diagnosis of EGE before pregnancy, only one registered an improvement of symptoms during gestation, while the rest had no significant changes, and their pregnancies needed to be monitored as high risk. Regarding pregnancy complications, only two patients had a pre-term delivery. Both patients had not only EGE, but a remarkable obstetrical history, that could slightly complicate the interpretation of the events that occurred in their pregnancies. More studies are necessary to demonstrate if EGE is connected with pre-term onset of labor. It's not easy to define the reasons of some patient's pre term labor, and we could suppose that a combination of different mechanisms leads to this condition of breakdown of maternal-fetal tolerance. Nevertheless, we know that spontaneous preterm labor is a syndrome attributable to multiple pathologic processes and most of them are yet to be understood. However, we cannot exclude that EGE is related to late preterm delivery. We hope that this review will provide some measures of guidance to those clinicians who must satisfy the questions of young female patients diagnosed with EGE and wishing for a pregnancy.
Published: 2020

10. Association between red cell distribution width and response to methotrexate in rheumatoid arthritis

Author: Mario Pirisi, Roberta Pedrazzoli, R. Bonometti, Alessandro Croce, Cristina Rigamonti, Luigi Mario Castello, Daniele Sola, G.C. Avanzi, P.P. Sainaghi, Erika Zecca, Mattia Bellan, and Daniele Soddu
Subjects: Erythrocyte Indices, Male, rheumatoid arthritis, lcsh:Internal medicine, Treatment response, medicine.medical_specialty, Time Factors, Red cell distribution width, lcsh:Medicine, Arthritis, Gastroenterology, methotrexate, Arthritis, Rheumatoid, Rheumatology, Interquartile range, Internal medicine, medicine, Humans, lcsh:RC31-1245, Aged, Retrospective Studies, business.industry, lcsh:R, biomarker, Red blood cell distribution width, Retrospective cohort study, Middle Aged, medicine.disease, Treatment Outcome, ROC Curve, Antirheumatic Agents, Rheumatoid arthritis, Biomarker (medicine), Female, Methotrexate, business, Biomarkers, medicine.drug
Abstract: Red cell distribution width (RDW) is an unconventional biomarker of inflammation. We aimed to explore its role as a predictor of treatment response in rheumatoid arthritis (RA). Eighty-two RA patients (55 females), median age [interquartile range] 63 years [52-69], were selected by scanning the medical records of a rheumatology clinic, to analyze the associations between baseline RDW, disease activity scores and inflammatory markers, as well as the relationship between RDW changes following methotrexate (MTX) and treatment response. The lower the median baseline RDW, the greater were the chances of a positive EULAR response at three months, 13.5% [13.0-14.4] being among those with good response, vs 14.0% [13.2-14.7] and 14.2% [13.5- 16.0] (p=0.009) among those with moderate and poor response, respectively. MTX treatment was followed by a significant RDW increase (p
Published: 2020

11. Pattern of Emergency Department referral during the COVID-19 outbreak in Italy

Author: Mirta Menegatti, Francesco Gavelli, Eleonora Rizzi, Mattia Bellan, Michela Beltrame, Eyal Hayden, Mario Pirisi, Anita R. Pedrinelli, Daniele Soddu, Pier Paolo Sainaghi, Raffaella Landi, Filippo Patrucco, Luigi Mario Castello, Gian Carlo Avanzi, Veronica Vassia, Emanuela Labella, Maria Luisa Gastaldello, Micol Giulia Cittone, Stelvio Tonello, and Giuseppe Francesco Casciaro
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Coronavirus disease 2019 (COVID-19), Referral, Disease, 030204 cardiovascular system & hematology, Health Services Accessibility, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, Pandemic, medicine, Humans, Pandemics, Referral and Consultation, Aged, Retrospective Studies, Aged, 80 and over, National health, 030219 obstetrics & reproductive medicine, SARS-CoV-2, business.industry, COVID-19, Outbreak, General Medicine, Emergency department, Middle Aged, University hospital, Italy, Emergency medicine, Female, Emergency Service, Hospital, business
Abstract: BACKGROUND: The coronavirus disease (COVID-19) outbreak is putting the European National Health Systems under pressure. Interestingly, Emergency Department (ED) referrals for reasons other than Covid-19 seem to have declined steeply. In the present paper, we aimed to verify how the Covid-19 outbreak changed ED referral pattern. METHODS: We retrospectively reviewed the clinical records of patients referred to the ED of a University Hospital in Northern Italy from 1st March to 13th April 2020. We compared the following data with those belonging to the same period in 2019: number of EDs accesses, rate of hospital admission, frequencies of the most common causes of ED referral, priority codes of access. RESULTS: The number of ED referrals during the Covid-19 outbreak was markedly reduced when compared to the same period in 2019 (3059 vs. 5691;-46.3%). Conversely, the rate of hospital admission raised from 16.9% to 35.4% (p
Published: 2021

12. Stiffer Spleen Predicts Higher Bone Marrow Fibrosis and Higher JAK2 Allele Burden in Patients With Myeloproliferative Neoplasms

Author: Mattia Bellan, Cristina Rigamonti, Pier Paolo Sainaghi, Chiara Favini, Abdurraouf Mokhtar Mahmoud, Mario Pirisi, Giulia Francesca Manfredi, Riccardo Moia, Anita R. Pedrinelli, Maura Nicolosi, Micol Giulia Cittone, Andrea Patriarca, Paola Boggione, Bassel Awikeh, and Gianluca Gaidano
Subjects: JAK2 mutations, medicine.medical_specialty, Cancer Research, business.industry, Essential thrombocythemia, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Spleen, medicine.disease, Gastroenterology, myeloproliferative neoplasms, medicine.anatomical_structure, Polycythemia vera, vibration-controlled transient elastography (VCTE), Oncology, Fibrosis, Internal medicine, NGS, medicine, Hemoglobin, Bone marrow, Transient elastography, business, Myelofibrosis, spleen stiffness, RC254-282
Abstract: A total of 63 myeloproliferative neoplasms [MPN; 9 polycythemia vera (PV), 32 essential thrombocythemia (ET), and 22 myelofibrosis (MF)] underwent spleen stiffness (SS) measurement by vibration-controlled transient elastography equipped with a novel spleen-dedicated module. Higher SS values significantly correlated with grade 2-3 bone marrow (BM) fibrosis (p=0.035), with hemoglobin level p=0.014) and with white blood cells ≥10,000/μl (p=0.008). Median SS was significantly higher in MF patients compared to ET and PV (p=0.015). SS also correlated with higher JAK2 variant allele frequency (p=0.02). This study identifies SS as a potential noninvasive tool that reflects BM fibrosis and the mutational burden in MPN.
Published: 2021
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13. Kidney Disease Management in the Hospital Setting: A Focus on Inappropriate Drug Prescriptions in Older Patients

Author: Vincenzo, Arcoraci, Maria Antonietta Barbieri, Michelangelo, Rottura, Alessandro, Nobili, Giuseppe, Natoli, Christiano, Argano, Giovanni, Squadrito, Francesco, Squadrito, Salvatore, Corrao, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Irene, Mattioli, Gianni, Biolo, Michela, Zanetti, Giacomo, Bartelloni, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Graziana, Lupattelli, Vanessa, Bianconi, Riccardo, Alcidi, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Vincenza, Beneduce, Federica, Cacioppo, Massimo, Raspanti, Marco, Zoli, Maria Laura Matacena, Giuseppe, Orio, Eleonora, Magnolfi, Giovanni, Serafini, Angelo, Simili, Giuseppe, Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Giovanna, Fabio, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Matteo, Cesari, Paolo Dionigi Rossi, Sarah, Damanti, Marta, Clerici, Simona, Leoni, Alessandra Danuta Di Mauro, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Giovanna, Leoncini, Luigi, Anastasio, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Antonella, Giorgi, Christian, Gracin, Giuseppe, Zuccalà, Gabriella, D’Aurizio, Giuseppe, Romanelli, Alessandra, Marengoni, Andrea, Volpini, Daniela, Lucente, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giuseppe, Bellelli, Maurizio, Corsi, Cesare, Antonucci, Chiara, Sidoli, Giulia, Principato, Franco, Arturi, Elena, Succurro, Bruno, Tassone, Federica, Giofrè, Maria Grazia Serra, Maria Antonietta Bleve, Antonio, Brucato, Teresa De Falco, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Tancredi, Prandini, Manfredini, Roberto, Fabbian, Fabio, Benedetta, Boari, DE GIORGI, Alfredo, Ruana, Tiseo, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudia, Catalano, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Silvia, Schiavone, Alessio, Bragagni, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Carlo, Custodero, Luigi, Fenoglio, Andrea, Falcetta, Fracanzani, Anna L., Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Raffaella, Rossio, Giulia, Colombo, Pasquale, Agosti, Valter, Monzani, Valeria, Savojardo, Giuliana, Ceriani, Francesco, Salerno, Giada, Pallini, Fabrizio, Montecucco, Luciano, Ottonello, Lara, Caserza, Giulia, Vischi, Nicola Lucio Liberato, Tiziana, Tognin, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Maria Stella Pisciotta, Francesco Baffa Bellucci, Stefano, Buffelli, Giuseppe, Montrucchio, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Carl, Margaria, Maura, Sanino, Francesco, Violi, Ludovica, Perri, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Roberto Davide Diprizio, Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Matteo, Galassi, Yasmine, Grassi, Alessio, Greco, Angela, Sciacqua, Maria, Perticone, Rosa, Battaglia, Raffaele, Maio, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara del Vecchio, Andrea, Salvi, Roberto, Leonardi, Giampaolo, Damiani, William, Capeci, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Riccardo, Ghio, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Alfio, Gennaro, Agostino, Gaudio, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Francesca, Mete, Miriam, Gino, Carlo, Vigorito, Antonio, Cittadini, Guido, Moreo, Silvia, Prolo, Gloria, Pina, Alberto, Ballestrero, Fabio, Ferrando, Roberta, Gonella, Domenico, Cerminara, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella, Gruden, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Leonardo, Sechi, Cristiana, Catena, Gianluca, Colussi, Alessandro, Cavarape, Andea Da Porto, Nicola, Passariello, Luca, Rinaldi, Franco, Berti, Giuseppe, Famularo, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta, Morganti, Andrea, Artoni, Margherita, Grossi, Stefano Del Giacco, Davide, Firinu, Giulia, Costanzo, Giacomo, Argiolas, Giuseppe, Montalto, Anna, Licata, Filippo Alessandro Montalto, Francesco, Corica, Giorgio, Basile, Antonino, Catalano, Federica, Bellone, Concetto, Principato, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Giandomenico Nigro Imperiale, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Mattia, Bellan, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, Giorgio, Scanzi, Caterina, Mengoli, Stella, Provini, Laura, Ricevuti, Emilio, Simeone, Rosa, Scurti, Fabio, Tolloso, Roberto, Tarquini, Alice, Valoriani, Silvia, Dolenti, Giulia, Vannini, Riccardo, Volpi, Pietro, Bocchi, Alessandro, Vignali, Sergio, Harari, Chiara, Lonati, Federico, Napoli, Italia, Aiello, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Silvia, Ghidoni, Teresa, Salvatore, Lucio, Monaco, Carmen, Ricozzi, Alberto, Pilotto, Ilaria, Indiano, Federica, Gandolfo., Arcoraci V., Barbieri M.A., Rottura M., Nobili A., Natoli G., Argano C., Squadrito G., Squadrito F., and Corrao S.
Subjects: medicine.medical_specialty, appropriateness of prescription, prescribing patterns, Renal function, Context (language use), RM1-950, Logistic regression, NO, chemistry.chemical_compound, older patient, Internal medicine, hospital setting, medicine, Pharmacology (medical), LS4_4, Medical prescription, prescribing pattern, appropriateness of prescriptions, chronic kidney disease, hospital setting, older patients, prescribing patterns, real-world data, Original Research, Pharmacology, Creatinine, real-world data, business.industry, Retrospective cohort study, medicine.disease, older patients, appropriateness of prescriptions, chronic kidney disease, chemistry, Observational study, Therapeutics. Pharmacology, business, Kidney disease
Abstract: Aging with multimorbidity and polytherapy are the most significant factors that could led to inappropriate prescribing of contraindicated medications in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the prescriptions of contraindicated drugs in older adults in CKD and to identify their associated factors in a hospital context. An observational retrospective study was carried out considering all patients ≥65 years with at least one serum creatinine value recorded into the REPOSI register into 2010–2016 period. The estimated glomerular filtration rate (eGFR) was applied to identify CKD. A descriptive analysis was performed to compare demographic and clinical characteristics; logistic regression models were used to estimate factors of inappropriate and percentage changes of drug use during hospitalization. A total of 4,713 hospitalized patients were recorded, of which 49.8% had an eGFR 2; the 21.9% were in treatment with at least one inappropriate drug at the time of hospital admission with a decrease of 3.0% at discharge (p = 0.010). The probability of using at least one contraindicated drug was significantly higher in patients treated with more several drugs (OR 1.21, 95% CI 1.16–1.25, p p < 0.001; G5: 19.38, 11.51–32.64, p < 0.001). Low-dose acetylsalicylic acid was the contraindicated drug mainly used at the time of admission, reducing 1.2% at discharge. An overall increase in therapeutic appropriateness in hospitalized older patients with CKD was observed, despite a small percentage of therapeutic inappropriateness at discharge that underlines the need for a closer collaboration with the pharmacologist to improve the drug management.
Published: 2021

14. Sofosbuvir‐based therapies in genotype 2 hepatitis C virus cirrhosis: A real‐life experience with focus on ribavirin dose

Author: Mattia Bellan, Antonio D'Avolio, Carlo Smirne, Mario Pirisi, Alessandro Gualerzi, and Maria Grazia Stella Crobu
Subjects: Liver Cirrhosis, Male, Pyrrolidines, Sofosbuvir, Hepacivirus, medicine.disease_cause, 030226 pharmacology & pharmacy, Gastroenterology, chemistry.chemical_compound, 0302 clinical medicine, Medicine, General Pharmacology, Toxicology and Pharmaceutics, Aged, 80 and over, Imidazoles, virus diseases, Valine, Hepatitis C, Middle Aged, anemia, Treatment Outcome, Neurology, Tolerability, 030220 oncology & carcinogenesis, RNA, Viral, Drug Therapy, Combination, Female, Original Article, medicine.drug, Adult, medicine.medical_specialty, Daclatasvir, Genotype, Anemia, ribavirin, Hepatitis C virus, cirrhosis, hepatitis C, sofosbuvir, RM1-950, Antiviral Agents, 03 medical and health sciences, Internal medicine, parasitic diseases, Humans, Adverse effect, Aged, Retrospective Studies, business.industry, Ribavirin, Original Articles, Hepatitis C, Chronic, medicine.disease, digestive system diseases, chemistry, Carbamates, Therapeutics. Pharmacology, business
Abstract: This study aimed to investigate the efficacy and safety of sofosbuvir‐based therapies for the treatment of cirrhosis from hepatitis C virus (HCV) genotype 2 infection. Data of all consecutive HCV genotype 2 cirrhotic patients who started sofosbuvir‐based treatments between January 2015 and March 2017 in eight Italian tertiary hospitals were collected retrospectively. Overall, 273 patients (Child A: 94.5%) were enrolled. In the 194 subjects treated with sofosbuvir/ribavirin, median initial ribavirin dosage was 13.9 mg/kg/day, and therapy duration was 16 weeks. Sustained virological response (SVR) rates were 93.8% in intention‐to‐treat (ITT) and 95.3% in per‐protocol (PP) analyses for the 129 treatment‐naïve patients, and 96.9% (ITT) and 98.4% (PP) for the 65 treatment‐experienced subjects. Adverse events were reported in 142 patients (73.2%), but only 1.5% discontinued treatment. Eighty‐eight subjects with treatment‐induced anemia (mild: 34.5%, moderate: 7.7%, severe: 3.1%) had to reduce ribavirin dosage, but SVR rates were comparable to the weight‐based dose group, both in ITT (95.4% and 94.3%) and PP (97.7% and 95.2%) analyses, respectively. Moreover, ITT and PP SVR rates were similar between shorter (
Published: 2021

15. Exposure to Plasma From Non-alcoholic Fatty Liver Disease Patients Affects Hepatocyte Viability, Generates Mitochondrial Dysfunction, and Modulates Pathways Involved in Fat Accumulation and Inflammation

Author: Elena Grossini, Divya Praveen Garhwal, Giuseppe Calamita, Raffaele Romito, Cristina Rigamonti, Rosalba Minisini, Carlo Smirne, Daniela Surico, Mattia Bellan, and Mario Pirisi
Subjects: 0301 basic medicine, Mitochondrial ROS, Medicine (General), medicine.medical_specialty, Inflammation, Mitochondrion, medicine.disease_cause, 03 medical and health sciences, R5-920, 0302 clinical medicine, inflammasome, NAFLD, Internal medicine, medicine, oxidative stress, Viability assay, NADPH oxidase, biology, Chemistry, Fatty liver, Inflammasome, General Medicine, Brief Research Report, medicine.disease, mitochondria, 030104 developmental biology, Endocrinology, 030220 oncology & carcinogenesis, biology.protein, Medicine, biomarker, medicine.symptom, Oxidative stress, medicine.drug
Abstract: Changes of lipidic storage, oxidative stress and mitochondrial dysfunction may be involved in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Although the knowledge of intracellular pathways has vastly expanded in recent years, the role and mechanisms of circulating triggering factor(s) are debated. Thus, we tested the hypothesis that factors circulating in the blood of NAFLD patients may influence processes underlying the disease. Huh7.5 cells/primary human hepatocytes were exposed to plasma from 12 NAFLD patients and 12 healthy subjects and specific assays were performed to examine viability, H2O2 and mitochondrial reactive oxygen species (ROS) release, mitochondrial membrane potential and triglycerides content. The involvement of NLRP3 inflammasome and of signaling related to peroxisome-proliferator-activating-ligand-receptor-γ (PPARγ), sterol-regulatory-element-binding-protein-1c (SREBP-1c), nuclear-factor-kappa-light-chain-enhancer of activated B cells (NF-kB), and NADPH oxidase 2 (NOX2) was evaluated by repeating the experiments in the presence of NLRP3 inflammasome blocker, MCC950, and through Western blot. The results obtained shown that plasma of NAFLD patients was able to reduce cell viability and mitochondrial membrane potential by about 48 and 24% (p < 0.05), and to increase H2O2, mitochondrial ROS, and triglycerides content by about 42, 19, and 16% (p < 0.05), respectively. An increased expression of SREBP-1c, PPARγ, NF-kB and NOX2 of about 51, 121, 63, and 46%, respectively, was observed (p < 0.05), as well. Those effects were reduced by the use of MCC950. Thus, in hepatocytes, exposure to plasma from NAFLD patients induces a NAFLD-like phenotype by interference with NLRP3-inflammasome pathways and the activation of intracellular signaling related to SREBP-1c, PPARγ, NF-kB and NOX2.
Published: 2021

16. Mid-term Psychiatric Outcomes of Patients Recovered From COVID-19 From an Italian Cohort of Hospitalized Patients

Author: Carla Gramaglia, Eleonora Gambaro, Mattia Bellan, Piero Emilio Balbo, Alessio Baricich, Pier Paolo Sainaghi, Mario Pirisi, Giulia Baldon, Sofia Battistini, Valeria Binda, Alessandro Feggi, Martina Gai, Eleonora Gattoni, Amalia Jona, Luca Lorenzini, Debora Marangon, Maria Martelli, Pierluigi Prosperini, Patrizia Zeppegno, The NO-MORE COVID Group, Gian Carlo Avanzi, Marco Battaglia, Emanuela Cadario, Vincenzo Cantaluppi, Luigi Mario Castello, Elisa Clivati, Martina Costanzo, Alessandro Croce, Carla De Benedittis, Simona De Vecchi, Francesco Gavelli, Leonardo Grisafi, Eyal Hayden, Marco Invernizzi, Paolo Marzullo, Erica Matino, Antonio Panero, Elena Parachini, Filippo Patrucco, Giuseppe Patti, Alice Pirovano, Cristina Rigamonti, Daniele Soddu, and Erika Zecca
Subjects: Psychiatry, medicine.medical_specialty, business.industry, Psychiatric assessment, Beck Anxiety Inventory, RC435-571, COVID-19, Context (language use), anxiety, Mental health, patients, Psychiatry and Mental health, Quality of life, depression, medicine, follow-up, Anxiety, Psychiatric interview, medicine.symptom, business, Depression (differential diagnoses), mid-term sequelae, Original Research
Abstract: Background: Although the usual primary clinical manifestation of Coronavirus disease (COVID-19) is respiratory, several non-respiratory symptoms have been described, including neuropsychiatric ones. The aim of this study was to investigate the mid-term mental health outcomes in patients recovered from COVID-19, 3–4 months after discharge from the University Hospital Maggiore della Carità, Novara, Italy. Furthermore, we investigated the possible association of the mid-term mental health consequences of the COVID-19 infection with patients' clinical current status, persistent physical impairment and severity of acute phase of the disease.Methods: Prospective study involving 238 individuals recovered from COVID-19. In the context of a multi-disciplinary approach, patients' assessment included both a clinical interview performed by an experienced psychiatrist, trained in the use of the Mini-International Neuropsychiatric Interview to assess the presence of anxiety and depressive symptoms and self-administered questionnaires: Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Resilience Scale for Adults (RSA), Impact of Event Scale (IES).Results: At the psychiatric assessment 32.9 and 29.5% of participants showed anxiety and depressive symptoms, respectively. Changes in appetite and sleep patterns emerged for 15.6 and 31.2% of patients. According to the self-administered questionnaires, 7.1% of participants had moderate-severe anxiety levels (BAI), while 10.5% had mild to severe depression (BDI-II). Twenty-six (11%) participants were referred to further psychiatric consultation. Psychiatric symptoms showed no correlation with acute COVID-19 severity; in our sample patients with depressive symptoms at the clinical interview, as well as those with mild to severe levels of depression according to BDI-II scores, had lower forced expiratory volume in the 1st second (FEV1) values than those without and greater odds for persistent, poor tolerance for physical efforts.Conclusions: As could be expected, an approach including both a psychiatric interview and the use of self-administered questionnaires is likely to capture the psychiatric outcome of patients recovered from COVID-19 better than questionnaires alone. Anxiety and depressive symptoms at follow-up had no correlation with the severity of COVID acute manifestations, but rather with ongoing and persistent physical symptoms. Further studies and longer follow-up duration will allow a better understanding of the complex relationship between residual physical symptoms, quality of life and psychological health.
Published: 2021
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17. Interaction between thrombin potential and age on early clinical outcome in patients hospitalized for COVID-19

Author: Mattia Bellan, Umberto Dianzani, Giuseppe Patti, Gian Carlo Avanzi, Veronica Lio, Enrico Guido Spinoni, Daniela Ferrante, Roberta Rolla, Pier Paolo Sainaghi, Mario Pirisi, Luigi Mario Castello, Andrea Rognoni, Leonardo Grisafi, Marco G. Mennuni, Marco Krengli, and Gianluca Aimaretti
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, 030204 cardiovascular system & hematology, Risk Assessment, Article, law.invention, Thrombin potential, 03 medical and health sciences, 0302 clinical medicine, law, Risk Factors, Internal medicine, Medicine, Humans, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Risk factor, Adverse effect, Stroke, Aged, Mechanical ventilation, Aged, 80 and over, Hemostasis, Thrombotic complications, business.industry, Bleeding, COVID-19, Age Factors, Thrombin, Thrombosis, Hematology, Middle Aged, medicine.disease, Prognosis, Intensive care unit, Hospitalization, Case-Control Studies, Cohort, Female, Cardiology and Cardiovascular Medicine, business, Mace, Biomarkers
Abstract: Patients with Coronavirus Disease-2019 (COVID‐19) have haemostatic dysfunction and are at higher risk of thrombotic complications. Although age is a major risk factor for outcome impairment in COVID-19, its impact on coagulative patterns here is still unclear. We investigated the association of Endogenous Thrombin Potential (ETP) with thrombotic and haemorrhagic events according to different ages in patients admitted for COVID-19. A total of 27 patients with COVID‐19-related pneumonia, without need for intensive care unit admission or mechanical ventilation at hospital presentation, and 24 controls with non-COVID-19 pneumonia were prospectively included. ETP levels were measured on admission. Patients were evaluated for major adverse cardiovascular events (MACE: cardiovascular death, myocardial infarction, stroke, transient ischemic attack, venous thromboembolism) and bleeding complications [according to Bleeding Academic Research Consortium (BARC) definition] during in-hospital stay. COVID-19 patients had similar ETP levels compared to controls (AUC 93 ± 24% vs 99 ± 21%, p = 0.339). In the COVID-19 cohort, patients with in-hospital MACE showed lower ETP levels on admission vs those without (AUC 86 ± 14% vs 95 ± 27%, p = 0.041), whereas ETP values were comparable in patients with or without bleeding (AUC 82 ± 16% vs 95 ± 26%, p = 0.337). An interaction between age and ETP levels for both MACE and bleeding complications was observed, where a younger age was associated with an inverse relationship between ETP values and adverse event risk (pint 0.018 for MACE and 0.050 for bleeding). Patients with COVID-19 have similar thrombin potential on admission compared to those with non-COVID-19 pneumonia. In younger COVID-19 patients, lower ETP levels were associated with a higher risk of both MACE and bleeding. Supplementary Information The online version contains supplementary material available at 10.1007/s11239-021-02497-1.
Published: 2021

18. Role of positron emission tomography in the assessment of disease burden and risk of relapse in patients affected by giant cell arteritis

Author: Mattia Bellan, Roberta Pedrazzoli, Gian Mauro Sacchetti, Alessandro Croce, Gian Carlo Avanzi, Erika Zecca, Mario Pirisi, Daniele Sola, Francesco Gavelli, Daniele Soddu, Pier Paolo Sainaghi, Federica Orsini, Luigi Mario Castello, and Erinda Puta
Subjects: Male, medicine.medical_specialty, Giant Cell Arteritis, Disease, 03 medical and health sciences, 0302 clinical medicine, Cost of Illness, Rheumatology, Fluorodeoxyglucose F18, Recurrence, immune system diseases, Positron Emission Tomography Computed Tomography, Internal medicine, Humans, Medicine, cardiovascular diseases, 030212 general & internal medicine, Risk factor, skin and connective tissue diseases, Aortitis, Aged, Retrospective Studies, 030203 arthritis & rheumatology, medicine.diagnostic_test, business.industry, General Medicine, Middle Aged, Prognosis, medicine.disease, Giant cell arteritis, Logistic Models, Positron emission tomography, Multivariate Analysis, cardiovascular system, Population study, Female, Radiology, Radiopharmaceuticals, business, Vasculitis
Abstract: Giant cell arteritis (GCA) is characterized by two subsets: cranial GCA and large-vessel GCA (LV-GCA); positron emission tomography (PET) is an essential tool in the diagnosis of LV-GCA. In this study, we aimed to investigate its potential prognostic value in the stratification of relapse risk. We retrospectively revised all the clinical records of patients who received a diagnosis of GCA at an immuno-rheumatology clinic of a University Hospital along 6 years and who underwent to a PET-CT examination at diagnosis. Clinical, laboratory, and imaging data were collected. Relapses were recorded. The study population included 19 patients (10 females, 52.6%; median age 74.0 [65.5-76.0] years), 12 with typical cranial GCA (63%) and 7 (37%) with LV-GCA. Based on PET findings, a diagnosis of aortitis was made in 15/19 patients, including 8/12 patients with a classical cranial GCA (58%). Along a median follow-up of 15 months [4.5-26.5], 4 relapses were observed. All relapsers were male; indeed, the difference in gender distribution was the only variable reaching statistical difference between relapsers and non-relapsers. Specifically, aortitis was not more frequent among relapsers. Our study confirms PET as a valid tool in the identification of LV-GCA with no cranial involvement. We failed to demonstrate a role for PET in the prognostic stratification of GCA, while male gender is suggested as a potential risk factor for GCA relapse.Key Points• A significant proportion of patients with GCA presents with non-cranial disease, the identification of which requires imaging studies, among which PET is particularly useful.• Aortitis might be detected also in patients with the classical, cranial GCA type but does not seem to have prognostic implications, at least in terms of relapse risk.• Male gender is suggested as a risk factor for relapse in GCA.
Published: 2019

19. Age related structural and functional changes in left ventricular performance in healthy subjects: a 2D echocardiographic study

Author: Mario Pirisi, Francesco Antonini-Canterin, Domenico Galzerano, Eduardo Bossone, Olga Vriz, Eiad Habib, Bahaa M. Fadel, Gruschen Veldtman, Vriz, O, Pirisi, M, Habib, E, Galzerano, D, Fadel, B, Antonini-Canterin, F, Veldtman, G, and Bossone, E
Subjects: Adult, Male, Aging, medicine.medical_specialty, Adolescent, Heart Ventricles, Diastole, 030204 cardiovascular system & hematology, Ventricular Function, Left, Contractility, Young Adult, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Predictive Value of Tests, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, 030212 general & internal medicine, Aged, Aged, 80 and over, Body surface area, Ejection fraction, Ventricular Remodeling, business.industry, Age Factors, Hemodynamics, Stroke volume, Middle Aged, Adaptation, Physiological, Myocardial Contraction, Echocardiography, Doppler, Healthy Volunteers, Blood pressure, Cardiology, Female, Transthoracic echocardiogram, Cardiology and Cardiovascular Medicine, business, Body mass index
Abstract: Left ventricular (LV) adaptation to aging is currently poorly understood. We aimed to characterize age related changes in LV structure and function by studying a large group of healthy subjects across a wide age range. Prospectively enrolled healthy volunteers (n = 778, 327 females; age 18 to 100 years, mean age 49.8 ± 18.1 years), were divided into 4 age groups: 18 to 34 years (n = 165); 35 to 49 years (n = 242), 50 to 79 years (n = 334) and ≥ 80 years (n = 40). All subjects underwent clinical examination, as well as comprehensive transthoracic echocardiogram [TTE]. Body mass index, systolic blood pressure (BP), and left atrial volume (p < 0.0001) increased with age while diastolic BP (p < 0.0001) decreased over time. LV mass/body surface area (BSA) and relative wall thickness increased with age (p < 0.0001) coincident with worsening parameters of diastolic function (E/A and E/Em, p < 0.0001). The ejection fraction and Sm did not change significantly. Stroke volume, ejection time index, flow rate and stroke work significantly increased with age (p < 0.01). The arterial elastance (Ea), a measure of ventricular afterload, and ventricular elastance (Ees), an index of LV systolic stiffness did not change with age nor did their ratio (Ees/Ea) the latter being an expression of ventricular-arterial coupling. Age, gender and LVM were the main independent variables associated with LV systolic function. In conclusion, LV adaptation to aging in a healthy cohort is characterized by concentric LV remodeling, increased contractility and preserved ventricular-arterial coupling.
Published: 2019

20. Lusutrombopag for the Treatment of Thrombocytopenia in Patients With Chronic Liver Disease Undergoing Invasive Procedures (L‐PLUS 2)

Author: Toshimitsu Ochiai, Markus Peck-Radosavljevic, Tomoko Motomiya, Mihaly Makara, Marius Braun, Sheng-Shun Yang, Nezam H. Afdhal, Zeid Kayali, Ziv Ben Ari, Ajay Duggal, Tsutae Nagata, Paul Mitrut, Meral Akdogan, A. Iacobellis, Albert Tran, Krzysztof Simon, Takeshi Kano, Tarek Hassanein, and Mario Pirisi
Subjects: Adult, Male, 0301 basic medicine, medicine.medical_specialty, Blood Loss, Surgical, Administration, Oral, Postoperative Hemorrhage, Placebo, Chronic liver disease, Risk Assessment, Gastroenterology, Drug Administration Schedule, law.invention, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Randomized controlled trial, Reference Values, law, Internal medicine, Confidence Intervals, Clinical endpoint, Humans, Medicine, Adverse effect, Dose-Response Relationship, Drug, Hepatology, business.industry, Liver Diseases, Original Articles, Liver Failure/Cirrhosis/Portal Hypertension, Middle Aged, Prognosis, medicine.disease, Thrombocytopenia, Confidence interval, Clinical trial, Thiazoles, Treatment Outcome, 030104 developmental biology, Platelet transfusion, Cinnamates, Surgical Procedures, Operative, Chronic Disease, Original Article, Female, 030211 gastroenterology & hepatology, business, Receptors, Thrombopoietin
Abstract: Thrombocytopenia may be associated with increased bleeding risk impacting timing and outcome of invasive procedures in patients with chronic liver disease (CLD). Lusutrombopag, a small-molecule, thrombopoietin (TPO) receptor agonist, was evaluated as a treatment to raise platelet counts (PCs) in patients with thrombocytopenia and CLD undergoing invasive procedures. L-PLUS 2 was a global, phase 3, randomized, double-blind, placebo-controlled study. Adults with CLD and baseline PCs < 50 × 109 /L were randomized to receive once-daily lusutrombopag 3 mg or placebo ≤ 7 days before an invasive procedure scheduled 2-7 days after the last dose. The primary endpoint was avoidance of preprocedure platelet transfusion and avoidance of rescue therapy for bleeding. A key secondary endpoint was number of days PCs were ≥ 50 × 109 /L throughout the study. Safety analysis was performed on patients who received at least one dose of study drug. This study occurred between June 15, 2015, and April 19, 2017, with a total of 215 randomized patients (lusutrombopag, 108; placebo, 107); 64.8% (70/108) of patients in the lusutrombopag group versus 29.0% (31/107) in the placebo group met the primary endpoint (P < 0.0001; difference of proportion 95% confidence interval [CI], 36.7 [24.9, 48.5]). The median duration of PCs ≥ 50 × 109 /L was 19.2 days with lusutrombopag (without platelet transfusion) compared with 0.0 in the placebo group (with platelet transfusion) (P = 0.0001). Most adverse events were mild or moderate in severity, and rates were similar in the lusutrombopag and placebo groups (47.7% and 48.6%, respectively). Conclusion: Lusutrombopag was superior to placebo for reducing the need for platelet transfusions and achieved durable PC response in patients with thrombocytopenia and CLD undergoing invasive procedures, with a safety profile similar to placebo.
Published: 2019

21. Detrimental Impact of Interferon-Based Regimens for Chronic Hepatitis C on Vitamin D/Parathyroid Hormone Homeostasis

Author: G. Guaschino, Maria Grazia Stella Crobu, Carlo Smirne, Mario Pirisi, Matteo Nazzareno Barbaglia, Livia Salmi, Rosalba Minisini, and Sara Bianco
Subjects: medicine.medical_specialty, Vitamin d supplementation, business.industry, Parathyroid hormone, Hcv therapy, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Rheumatology, Chronic hepatitis, Interferon, Internal medicine, medicine, Vitamin D and neurology, 030211 gastroenterology & hepatology, Secondary hyperparathyroidism, 030212 general & internal medicine, business, Homeostasis, medicine.drug
Abstract: Background: Both the anti-infective and anti-inflammatory properties of vitamin D, an essential hormone of calcium homeostasis, have ample support in the literature. The high rates of vitamin D deficiency among patients with chronic hepatitis C are also well known. That supplementation with vitamin D may boost sustained viral response rates in vitamin D deficient, hepatitis C virus (HCV) infected patients undergoing Interferon-alpha (IFN) treatment, on the other hand, is controversial. Surprisingly, studies considering in this latter setting what are the effects of IFN treatment (with or without vitamin D supplementation) on the other major regulator of mineral metabolism, i.e. the Parathyroid hormone (PTH), are lacking. Aim: Evaluate the impact of interferon-based treatment against HCV (±cholecalciferol supplementation) on vitamin D and PTH homeostasis. Methods: A series of 40 consecutive patients received pegylated IFN plus ribavirin to treat chronic hepatitis C. At the discretion of their physician, some of them (N. = 27) received vitamin D supplementation while others did not (N. = 13). All had measured plasma 25-hydroxycholecalciferol and PTH concentrations at baseline, at completion of the 4th (TW4) and 12th treatment week (TW12) and at 24 weeks after the end of therapy (SVR24). Results: Plasma PTH concentration increased significantly from baseline during treatment, raising to 44.8 [30.7-57.2] pg/mL at TW4 (p=0.01), 47.0 [37.1-63.2] pg/mL at TW12 (p=0.006) to return to baseline levels in the follow-up (34.5 [27.6-43.0]; p=0.16). The proportion of patients who satisfied criteria for hyperparathyroidism was higher at TW12 (N=10, 25%) than at TW4 (N=6, 15%). There was no statistical correlation between vitamin D and PTH blood levels (ρ=-0.07; p=0.65). Conclusion: An increase in plasma PTH occurs systematically during IFN treatment of HCV patients and cannot be prevented by vitamin D supplementation.
Published: 2018

22. Inflammatory markers predict insulin sensitivity in active rheumatoid arthritis but not in psoriatic arthritis

Author: R. Bonometti, G P Carnevale Schianca, A. Rossini, A. Gibbin, Alessandro Gualerzi, Serena Favretto, Daniele Sola, S Bor, P.P. Sainaghi, Mattia Bellan, Mario Pirisi, Roberta Pedrazzoli, and G. Guaschino
Subjects: Male, lcsh:Internal medicine, medicine.medical_specialty, medicine.medical_treatment, Inflammatory arthritis, lcsh:Medicine, Arthritis, Arthritis, Rheumatoid, 03 medical and health sciences, Psoriatic arthritis, 0302 clinical medicine, Insulin resistance, Rheumatology, Predictive Value of Tests, Internal medicine, medicine, Humans, 030212 general & internal medicine, Rheumatoid arthritis, lcsh:RC31-1245, Aged, Inflammation, 030203 arthritis & rheumatology, medicine.diagnostic_test, business.industry, Insulin, Arthritis, Psoriatic, lcsh:R, Middle Aged, Insulin sensitivity, medicine.disease, Endocrinology, Case-Control Studies, Erythrocyte sedimentation rate, Oral glucose tolerance test, Female, business, Body mass index, Biomarkers
Abstract: Whether the insulin resistance commonly observed in patients with inflammatory arthritis is a disease-specific feature and/or is limited to a disease phase (i.e., it occurs only during phases of high disease activity) is unknown. Fifty-three rheumatoid arthritis (RA) and 44 psoriatic arthritis (PsA) patients were recruited consecutively along with 194 controls matched for age, sex and body mass index for a case-control study. All underwent an oral glucose tolerance test, the results of which were analysed to derive the following indexes: homeostatic model of insulin resistance (HOMA-IR), insulin sensitivity index (ISI) and early insulin sensitivity index (EISI). These data were related to anthropometric, clinical and laboratory findings. Metabolic parameters of patients and controls were similar. Neither inflammatory markers nor disease activity scores were related to glucose metabolism for the generality of RA and PsA patients; however, by restricting the analysis to the subset of RA patients with residual disease activity, an association emerged between erythrocyte sedimentation rate, on the one hand, and fasting insulin (β=0.46, p=0.047) and HOMA-IR (β=0.44, p=0.02), on the other. Moreover, C-reactive protein (CRP) levels were associated with plasma glucose and insulin levels measured 120 min after the glucose load (β=0.91, p=0.0003 and β=0.77, p=0.0006, respectively); ISI and EISI were predicted by CRP (β=-0.79, p=0.0006; β=-0.80, p=0.0001, respectively). The same did not hold true for PsA patients. The association between systemic inflammation and insulin resistance indexes is a feature of RA with residual disease activity, not a universal feature of inflammatory arthritides.
Published: 2018

23. Midterm functional sequelae and implications in rehabilitation after COVID-19: a cross-sectional study

Author: Alessio, Baricich, Margherita B, Borg, Daria, Cuneo, Emanuela, Cadario, Danila, Azzolina, Piero E, Balbo, Mattia, Bellan, Patrizia, Zeppegno, Mario, Pirisi, Carlo, Cisari, and Erika, Zecca
Subjects: Adult, Male, 030506 rehabilitation, medicine.medical_specialty, Adolescent, Cross-sectional study, medicine.medical_treatment, Population, Walk Test, Physical Therapy, Sports Therapy and Rehabilitation, NO, law.invention, Disability Evaluation, Young Adult, 03 medical and health sciences, 0302 clinical medicine, law, Outpatients, Epidemiology, medicine, Humans, Disabled Persons, Patient outcome assessment, Young adult, education, Pandemics, Aged, Mechanical ventilation, education.field_of_study, Rehabilitation, SARS-CoV-2, business.industry, COVID-19, Cardiorespiratory fitness, Middle Aged, Physical Functional Performance, Intensive care unit, Coronavirus, Cross-Sectional Studies, Italy, Coronavirus, Rehabilitation, Patient outcome assessment, COVID-19, Disability evaluation, Outpatients, Physical therapy, Female, 0305 other medical science, business, human activities, 030217 neurology & neurosurgery
Abstract: BACKGROUND: COVID-19 has been mainly investigated concerning the acute and subacute phase implications and management. Meanwhile, few studies focused on the midterm sequelae, which still remain largely unknown. AIM: To assess the physical performance of COVID-19 survivors at 3 to 6 months from Hospital discharge. DESIGN: A cross-sectional study focused on mid-term functional outcomes evaluation in COVID-19 survivors. SETTING: Outpatients who had been previously hospitalized due to COVID-19 from March to May 2020 at the University Hospital of Novara, Italy. POPULATION: We enrolled 204 patients, of which 60% were men, with the mean age of 57.9 years. METHODS: Patients firstly underwent the short physical performance battery test (SPPB), which is composed of a series of physical tests assessing the lower limb function and the functional status of the subjects. Subsequently, based on SPPB results, patients' cardiorespiratory fitness performance was further investigated. Patients with normal SPPB score (SPPB>10) underwent the 2-minute walking test (2MWT) whereas, in order to safely test the cardiorespiratory function, in patients with abnormal SPPB score (SPPB≤10) the 1-minute sit-to-stand test (1MSTST) was performed. It should be noted that the 1MSTST can be safely performed even by subjects with compromised walking ability. RESULTS: Overall, 66 patients (32% of our sample) showed an impaired physical performance at 3 to 6 months after hospital discharge. In particular, 29 patients presented an SPPB score ≤10, and the 1MSTST confirmed this status in the whole group (100%) compared to the reference values for age and sex. Besides, among patients with a normal SPPB score, 37 showed a lower sex- and age-matched 2MWT score. Finally, a significant association between Intensive Care Unit hospitalization or mechanical ventilation and physical impairment was observed together with a significant association between the walking ability (measured with SPPB and 2MWT) and the number of comorbidities. CONCLUSIONS: A residual physical and functional impairment was observed in COVID-19 survivors at mid-term evaluation after hospitalization. CLINICAL REHABILITATION IMPACT: Considering the current COVID-19 epidemiology, we might expect a tremendous burden of disability in the next future. Thus, an appropriate clinical rehabilitation pathway must be implemented.
Published: 2021

24. Finding the seed of recurrence: Hepatocellular carcinoma circulating tumor cells and their potential to drive the surgical treatment

Author: Matteo Donadon, Simone Famularo, Matteo Nazzareno Barbaglia, Venkata Ramana Mallela, Fabrizio Romano, Cristina Ciulli, Francesca Carissimi, Guido Torzilli, Mario Pirisi, Livia Salmi, Rosalba Minisini, Linda Roccamatisi, Giuseppe Cordaro, Biagio Eugenio Leone, Carissimi, F, Barbaglia, M, Salmi, L, Ciulli, C, Roccamatisi, L, Cordaro, G, Mallela, V, Minisini, R, Leone, B, Donadon, M, Torzilli, G, Pirisi, M, Romano, F, and Famularo, S
Subjects: Liver surgery, medicine.medical_specialty, Pathology, Liquid biopsy, business.industry, Hepatocellular carcinoma, Circulating tumor cell, Circulating tumor cells, food and beverages, Minireviews, Hepatocellular carcinoma recurrence, medicine.disease, digestive system diseases, Surgery, medicine, Surgical treatment, business, Microvascular invasion
Abstract: The treatment for hepatocellular carcinoma (HCC) relies on liver resection, which is, however, burdened by a high rate of recurrence after surgery, up to 60% at 5 years. No pre-operative tools are currently available to assess the recurrence risk tailored to every single patient. Recently liquid biopsy has shown interesting results in diagnosis, prognosis and treatment allocation strategies in other types of cancers, since its ability to identify circulating tumor cells (CTCs) derived from the primary tumor. Those cells were advocated to be responsible for the majority of cases of recurrence and cancer-related deaths for HCC. In fact, after being modified by the epithelial-mesenchymal transition, CTCs circulate as "seeds " in peripheral blood, then reach the target organ as dormant cells which could be subsequently "awakened " and activated, and then initiate metastasis. Their presence may justify the disagreement registered in terms of efficacy of anatomic vs non-anatomic resections, particularly in the case of microvascular invasion, which has been recently pointed as a histological sign of the spread of those cells. Thus, their presence, also in the early stages, may justify the recurrence event also in the contest of liver transplant. Understanding the mechanism behind the tumor progression may allow improving the treatment selection according to the biological patient-based characteristics. Moreover, it may drive the development of novel biological tailored tests which could address a specific patient to neoadjuvant or adjuvant strategies, and in perspective, it could also become a new method to allocate organs for transplantation, according to the risk of relapse after liver transplant. The present paper will describe the most recent evidence on the role of CTCs in determining the relapse of HCC, highlighting their potential clinical implication as novel tumor behavior biomarkers able to influence the surgical choice.
Published: 2021

25. Contribution of Atrial Fibrillation to In-Hospital Mortality in Patients With COVID-19

Author: Enrico Guido Spinoni, Marco, Mennuni, Andrea, Rognoni, Leonardo, Grisafi, Crizia, Colombo, Veronica, Lio, Giulia, Renda, Melissa, Foglietta, Ivan, Petrilli, Damiano, D’Ardes, Pier Paolo Sainaghi, Gianluca, Aimaretti, Mattia, Bellan, Luigi, Castello, Gian Carlo Avanzi, Francesco Della Corte, Krengli, Marco, Mario, Pirisi, Mario, Malerba, Andrea, Capponi, Sabina, Gallina, Sante Donato Pierdomenico, Francesco, Cipollone, Giuseppe, Patti, the COVID-UPO Clinical Team, Emanuele, Albano, Umberto, Dianzani, Gianluca, Gaidano, Alessandra, Gennari, Carla, Gramaglia, Martina, Solli, Ailia, Giubertoni, Alessia, Veia, Carlo, Cisari, Paolo Amedeo Tillio, Paolo Aluffi Valletti, BARONE ADESI, Francesco, Michela, Barini, Ferrante, Daniela, Simona De Vecchi, Matteo, Santagostino, Antonio, Acquaviva, Elisa, Calzaducca, Francesco Giuseppe Casciaro, Federico, Ceruti, Micol Giulia Cittone, Davide Di Benedetto, Ileana, Gagliardi, Greta Maria Giacomini, Irene Cecilia Landi, Raffaella, Landi, Giulia Francesca Manfredi, Anita Rebecca Pedrinelli, Cristina, Rigamonti, Eleonora, Rizzi, Carlo, Smirne, Veronica, Vassia, Roberto, Arioli, Pietro, Danna, Zeno, Falaschi, Alessio, Paschè, Ilaria, Percivale, Domenico, Zagaria, Michela, Beltrame, Matteo, Bertoli, Alessandra, Galbiati, Clara Ada Gardino, Maria Luisa Gastaldello, Valentina Giai Via, Francesca, Giolitti, Ilaria, Inserra, Emanuela, Labella, Ilaria, Nerici, Laura Cristina Gironi, Edoardo, Cammarata, Elia, Esposto, Vanessa, Tarantino, Elisa, Zavattaro, Francesca, Zottarelli, Tommaso, Daffara, Alice, Ferrero, Ilaria, Leone, Alessandro, Nuzzo, Giulia, Baldon, Sofia, Battistini, Emilio, Chirico, Luca, Lorenzini, Maria, Martelli, Emanuela, Barbero, Paolo, Boffano, Matteo, Brucoli, Massimiliano, Garzaro, Alberto, Pau, Stephanie, Bertolin, Letizia, Marzari, Gianluca, Avino, Massimo, Saraceno, Umberto, Morosini, Alessio, Baricich, Marco, Invernizzi, Silvia, Gallo, Claudia, Montabone, Samuel Alberto Padelli, Lucio, Boglione, Filippo, Patrucco, Luigia, Salamina, Francesca, Baorda, Eleonora, Croce, and Irene, Giacone.
Subjects: Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Risk Assessment, Risk Factors, Physiology (medical), Atrial Fibrillation, Research Letter, medicine, Humans, In patient, Hospital Mortality, hospital, Risk factor, Retrospective Studies, In hospital mortality, business.industry, COVID-19, Atrial fibrillation, Retrospective cohort study, Prognosis, medicine.disease, atrial fibrillation, mortality, risk factor, Female, Hospitalization, Italy, Emergency medicine, Cardiology and Cardiovascular Medicine, Risk assessment, business
Published: 2021

26. Drug–drug interactions in italian patients with chronic hepatitis C treated with pangenotypic direct acting agents: Insights from a real-world study

Author: Nicola Coppola, Gema Alvarez Nieto, Giovanni Di Perri, Candido Hernandez, Stefano Fagiuoli, Luca Degli Esposti, Valentina Perrone, Pierluigi Toniutto, Alessandra Mangia, Stefano Calabrese, Francesco Scaglione, Mario Pirisi, Mangia, A, Scaglione, F, Toniutto, P, Pirisi, M, Coppola, N, Di Perri, G, Nieto, G, Calabrese, S, Hernandez, C, Perrone, V, Esposti, L, Fagiuoli, S, Mangia, A., Scaglione, F., Toniutto, P., Pirisi, M., Coppola, N., Di Perri, G., Nieto, G. A., Calabrese, S., Hernandez, C., Perrone, V., Esposti, L. D., and Fagiuoli, S.
Subjects: Drug, medicine.medical_specialty, Genotype, Sofosbuvir, Health, Toxicology and Mutagenesis, media_common.quotation_subject, Hepacivirus, Antiviral Agents, 030226 pharmacology & pharmacy, Sofosbuvir/velpatasvir, Article, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Drug–drug interaction, medicine, Humans, Drug Interactions, Chronic, Aged, media_common, Antiviral Agent, Hepaciviru, business.industry, Glecaprevir/pibrentasvir, Public Health, Environmental and Occupational Health, Glecaprevir, Hepatitis C, Chronic, Middle Aged, Hepatitis C, Pibrentasvir, Drug Interaction, Italy, Concomitant, Cohort, HCV, Drug–drug interactions, Medicine, drug–drug interactions, 030211 gastroenterology & hepatology, business, Direct acting, Human, medicine.drug
Abstract: This Italian observational real-world study aims to assess in chronic hepatitis C virus (HCV) patients treated with pangenotypic direct acting agents (pDAAs) glecaprevir/pibrentasvir (GLE/PIB) or sofosbuvir/velpatasvir (SOF/VEL) the potential drug–drug interactions (DDIs) with concomitant medications prescribed, with a focus on cardiovascular and system nervous (CNS) co-medications. Data were collected from administrative databases covering 6.9 million health-assisted individuals. All patients prescribed SOF/VEL or GLE/PIB between 11/2017 and 12/2018 were included. Patients were analyzed while on DAA. DDIs were identified according to the Liverpool University tool. Overall, 3,181 HCV patients were included: 1619 in the GLE/PIB cohort and 1,562 in the SOF/VEL cohort. SOF/VEL patients were generally older than GLE/PIB ones (mean age 58.4 vs. 53.1, p &lt, 0.001) and had more cardiovascular and CNS comorbidities (58% vs. 42%, p &lt, 0.001 and 33% vs. 28%, p = 0.002, respectively). Contraindications due to DDIs in the GLE/PIB cohort affected 9.3% and 3.2% of patients before and on DAA, respectively, while the percentages in the SOF/VEL cohort were 3.2% before and 0.4% after pDAAs initiation. Among GLE/PIB patients, 2.7% had cardiovascular drugs (all statins) contraindicated while on DAA. The potential DDIs between cardiovascular drugs and SOF/VEL were mainly with statins (5%). SOF/VEL was prescribed in patients with older age and with more cardiovascular and CNS comorbidities. Despite this, a proportion of contraindicated drugs lower than that of GLE/PIB was registered.
Published: 2021

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

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

28. Radioembolization vs sorafenib in locally advanced hepatocellular carcinoma with portal vein tumor thrombosis: A propensity score and Bayesian analysis

Author: Patrizia Carucci, Marco Tabone, Mario Pirisi, Michela Emma Burlone, Marcantonio Gesualdo, Alberto Mattalia, Emanuela Rolle, Stefano Okolicsanyi, Paola Berchialla, Carolina Martelletti, Andrea Ricotti, and Silvia Gaia
Subjects: Sorafenib, medicine.medical_specialty, Carcinoma, Hepatocellular, Tare weight, medicine.medical_treatment, Gastroenterology, Internal medicine, medicine, Humans, Chemoembolization, Therapeutic, Propensity Score, neoplasms, Retrospective Studies, Venous Thrombosis, business.industry, Portal Vein, hepatocellular carcinoma, portal vein tumor thrombosis, sorafenib, transarterial radioembolization, yttrium-90 microsphere, Bayes Theorem, Treatment Outcome, Liver Neoplasms, Carcinoma, Retrospective cohort study, Hepatocellular, medicine.disease, Thrombosis, digestive system diseases, Venous thrombosis, Hepatocellular carcinoma, Propensity score matching, Chemoembolization, Hepatectomy, Therapeutic, business, medicine.drug
Abstract: OBJECTIVE In this study we aimed to compare patient outcomes between the use of transarterial radioembolization (TARE) and sorafenib in patients with hepatocellular carcinoma (HCC) and intrahepatic portal vein tumor thrombosis (PVTT). METHODS A total of 65 patients with HCC and intrahepatic PVTT treated in five Italian hospitals between 2012 and 2018 were included in the analysis. Those with any previous treatment, extension of PVTT to the main portal tract and extrahepatic involvement were excluded. Propensity score matching analysis and Bayesian model averaging analysis were performed. RESULTS Of the 41 patients treated with TARE and 24 with sorafenib, 11 patients were downstaged to curative-intent surgery (liver transplant in three and hepatectomy in eight), including 10 treated with TARE and one with sorafenib. TARE was more effective than sorafenib in downstaging patients to surgery, achieving a mean survival of 54 months. In the 54 patients without downstaging after treatment, of whom 31 were treated with TARE and 23 with sorafenib, median survival was 20.3 and 9.1 months, respectively (P = 0.001), with different 1-, 2- and 3-year OS rates (64.5%, 42.6% and 37.3% vs 39.1%, 13.0% and 0%). Both propensity score and Bayesian model averaging confirmed an improvement in overall survival in the TARE group compared with sorafenib treatment. CONCLUSIONS TARE was more effective than sorafenib in downstaging patients with HCC to surgery, providing a significant improvement in survival. Even in patients who were not downstaged to surgery, survival appeared to be superior with TARE over sorafenib.
Published: 2021

29. Initiation of Psycholeptic Medication During Hospitalization With Recommendation for Discontinuation After Discharge

Author: Federica, Conti, Dario, Consonni, Sarah, Damanti, Alessandro, Nobili, Luca, Pasina, Pier Mannuccio Mannucci, Matteo, Cesari, Paolo Dionigi Rossi, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Irene, Mattioli, Gianni, Biolo, Michela, Zanetti, Giacomo, Bartelloni, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Graziana, Lupattelli, Vanessa, Bianconi, Riccardo, Alcidi, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Vincenza, Beneduce, Federica, Cacioppo, Salvatore, Corrao, Giuseppe, Natoli, Salvatore, Mularo, Massimo, Raspanti, Marco, Zoli, Maria Laura Matacena, Giuseppe, Orio, Eleonora, Magnolfi, Giovanni, Serafini, Angelo, Simili, Giuseppe, Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Giovanna, Fabio, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Marta, Clerici, Simona, Leoni, Alessandra Danuta Di Mauro, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Giovanna, Leoncini, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Antonella, Giorgi, Christian, Gracin, Giuseppe, Zuccalà, Gabriella, D'Aurizio, Giuseppe, Romanelli, Alessandra, Marengoni, Andrea, Volpini, Daniela, Lucente, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giuseppe, Bellelli, Maurizio, Corsi, Cesare, Antonucci, Chiara, Sidoli, Giulia, Principato, Franco, Arturi, Elena, Succurro, Bruno, Tassone, Federica, Giofrè, Maria Grazia Serra, Maria Antonietta Bleve, Antonio, Brucato, Teresa De Falco, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Tancredi, Prandini, Manfredini, Roberto, Fabbian, Fabio, Benedetta, Boari, DE GIORGI, Alfredo, Ruana, Tiseo, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudia, Catalano, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Silvia, Schiavone, Alessio, Bragagni, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Carlo, Custodero, Luigi, Fenoglio, Andrea, Falcetta, Fracanzani, Anna L., Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Raffaella, Rossio, Giulia, Colombo, Pasquale, Agosti, Valter, Monzani, Valeria, Savojardo, Giuliana, Ceriani, Francesco, Salerno, Giada, Pallini, Fabrizio, Montecucco, Luciano, Ottonello, Lara, Caserza, Giulia, Vischi, Nicola Lucio Liberato, Tiziana, Tognin, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Maria Stella Pisciotta, Francesco Baffa Bellucci, Stefano, Buffelli, Giuseppe, Montrucchio, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Carl, Margaria, Maura, Sanino, Francesco, Violi, Ludovica, Perri, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Roberto Davide Diprizio, Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Matteo, Galassi, Yasmine, Grassi, Alessio, Greco, Angela, Sciacqua, Maria, Perticone, Rosa, Battaglia, Raffaele, Maio, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara del Vecchio, Andrea, Salvi, Roberto, Leonardi, Giampaolo, Damiani, William, Capeci, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Riccardo, Ghio, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Alfio, Gennaro, Agostino, Gaudio, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Francesca, Mete, Miriam, Gino, Carlo, Vigorito, Antonio, Cittadini, Guido, Moreo, Silvia, Prolo, Gloria, Pina, Alberto, Ballestrero, Fabio, Ferrando, Roberta, Gonella, Domenico, Cerminara, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella, Gruden, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Leonardo, Sechi, Cristiana, Catena, Gianluca, Colussi, Alessandro, Cavarape, Andea Da Porto, Nicola, Passariello, Luca, Rinaldi, Franco, Berti, Giuseppe, Famularo, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta, Morganti, Andrea, Artoni, Margherita, Grossi, Stefano Del Giacco, Davide, Firinu, Giulia, Costanzo, Giacomo, Argiolas, Giuseppe, Montalto, Anna, Licata, Filippo Alessandro Montalto, Francesco, Corica, Giorgio, Basile, Antonino, Catalano, Federica, Bellone, Concetto, Principato, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Giandomenico Nigro Imperiale, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Mattia, Bellan, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, Giorgio, Scanzi, Caterina, Mengoli, Stella, Provini, Laura, Ricevuti, Emilio, Simeone, Rosa, Scurti, Fabio, Tolloso, Roberto, Tarquini, Alice, Valoriani, Silvia, Dolenti, Giulia, Vannini, Riccardo, Volpi, Pietro, Bocchi, Alessandro, Vignali, Sergio, Harari, Chiara, Lonati, Federico, Napoli, Italia, Aiello, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Maria Angela Iseni, Silvia, Ghidoni, Teresa, Salvatore, Lucio, Monaco, Carmen, Ricozzi, Alberto, Pilotto, Ilaria, Indiano, and Federica, Gandolfo.
Subjects: medicine.medical_specialty, Socio-culturale, Psycholeptic, 03 medical and health sciences, 0302 clinical medicine, delirium, deprescribing, medicine, Psycholeptics, Humans, 030212 general & internal medicine, LS4_4, Medical prescription, Cognitive decline, Risk factor, General Nursing, Aged, Retrospective Studies, business.industry, Health Policy, Retrospective cohort study, General Medicine, Length of Stay, Psycholeptics, delirium, dementia, deprescribing, hospitalization, older patients, older patients, Patient Discharge, Discontinuation, Hospitalization, Italy, Emergency medicine, Delirium, Geriatrics and Gerontology, medicine.symptom, Deprescribing, business, 030217 neurology & neurosurgery, dementia
Abstract: Objectives Psycholeptic drugs have been used in the older population for years, especially to control delirium and neuropsychiatric symptoms (NPS) of dementia. However, data from the literature confirm that the prolonged use of psycholeptics may be responsible for adverse reactions in older patients. The aim of this study was (1) to identify how many patients receive the first prescription of a psycholeptic drug during the hospital stay; (2) to evaluate the main sociodemographic and clinical characteristics of these patients; and (3) to verify if the prescribed psycholeptic drugs are continued after 3 months from the hospital discharge. Design Our retrospective study was based on data from the REPOSI (REgistro POliterapie SIMI) registry, a cohort of older patients hospitalized in internal medicine and geriatric wards throughout Italy from 2010 to 2018. Setting and Participants Patients aged 65 years or older who were not on home therapy with psycholeptic drugs were considered in the analyses. Methods We did both univariate and multivariate analyses in order to find the variables associated independently to an increased risk for first psycholeptic prescription at hospital discharge. Results At hospital discharge, 193 patients (5.8%) out of a total sample of 3322 patients were prescribed at least 1 psycholeptic drug. Cognitive impairment was the main risk factor for the introduction of psycholeptic drugs at discharge. Among them, 89.1% were still on therapy with a psycholeptic drug after 3 months from the hospital discharge. Conclusions and Implications Cognitive impairment represents the main risk factor for psycholeptic initiation in hospitalized older patients. The vast majority of these treatments are chronically continued after the discharge. Therefore, special attention is needed in prescribing psycholeptics at discharge, because their prolonged use may lead to cognitive decline. Moreover, their continued use should be questioned by physicians providing post-acute care, and deprescribing should be considered.
Published: 2021

30. Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge

Author: Paolo Marzullo, Vincenzo Cantaluppi, P. Prosperini, Marco Battaglia, Filippo Patrucco, Valeria Binda, Alessandro Croce, Elisa Clivati, Luca Lorenzini, Maria Martelli, Alice Pirovano, Erica Matino, Mario Pirisi, Pier Paolo Sainaghi, Mattia Bellan, Marco Invernizzi, A. Feggi, Antonio Panero, Martina Costanzo, Cristina Rigamonti, Simona De Vecchi, Margherita Borg, Daria Cuneo, Giuseppe Bartolomei, Sofia Battistini, Carlo Cisari, Alessio Baricich, Elena Parachini, Amalia Jona, Carla Gramaglia, Martina Gai, Giuseppe Patti, Luigi Mario Castello, Carla De Benedittis, Riccardo Quaglino, Lucia Loreti, Erika Zecca, Camilla Vecchi, Daniele Soddu, Patrizia Zeppegno, Gian Carlo Avanzi, Giulia Baldon, E. Gattoni, Eleonora Gambaro, Leonardo Grisafi, Chiara Guerriero, Piero Emilio Balbo, and Eyal Hayden
Subjects: Male, medicine.medical_specialty, Time Factors, Pulmonary function testing, Stress Disorders, Post-Traumatic, Post-Acute COVID-19 Syndrome, DLCO, Interquartile range, Internal medicine, Case fatality rate, Medicine, Humans, Lung volumes, Respiratory system, Prospective cohort study, Original Investigation, Aged, Lung, business.industry, SARS-CoV-2, Research, COVID-19, General Medicine, Middle Aged, Physical Functional Performance, Respiration Disorders, Patient Discharge, Respiratory Function Tests, Online Only, medicine.anatomical_structure, Infectious Diseases, Italy, Female, business
Abstract: Key Points Question What respiratory, functional, and psychological sequalae are associated with recovery from coronavirus disease 2019 (COVID-19)? Findings In this cohort study of 238 patients with COVID-19 hospitalized in an academic hospital in Northern Italy, more than half of participants had a significant reduction of diffusing lung capacity for carbon monoxide or measurable functional impairment and approximately one-fifth of patients had symptoms of posttraumatic stress 4 months after discharge. Meaning These findings suggest that despite virological recovery, a sizable proportion of patients with COVID-19 experienced respiratory, functional, or psychological sequelae months after hospital discharge., This cohort study examines prevalence and risk factors associated with lung function or physical impairment or posttraumatic stress symptoms among survivors of severe coronavirus disease 2019 (COVID-19)., Importance Although plenty of data exist regarding clinical manifestations, course, case fatality rate, and risk factors associated with mortality in severe coronavirus disease 2019 (COVID-19), long-term respiratory and functional sequelae in survivors of COVID-19 are unknown. Objective To evaluate the prevalence of lung function anomalies, exercise function impairment, and psychological sequelae among patients hospitalized for COVID-19, 4 months after discharge. Design, Setting, and Participants This prospective cohort study at an academic hospital in Northern Italy was conducted among a consecutive series of patients aged 18 years and older (or their caregivers) who had received a confirmed diagnosis of severe acute respiratory coronavirus 2 (SARS-CoV-2) infection severe enough to require hospital admission from March 1 to June 29, 2020. SARS-CoV-2 infection was confirmed via reverse transcription–polymerase chain reaction testing, bronchial swab, serological testing, or suggestive computed tomography results. Exposure Severe COVID-19 requiring hospitalization. Main Outcomes and Measures The primary outcome of the study was to describe the proportion of patients with a diffusing lung capacity for carbon monoxide (Dlco) less than 80% of expected value. Secondary outcomes included proportion of patients with severe lung function impairment (defined as Dlco
Published: 2021

31. Impact of age on sorafenib outcomes in hepatocellular carcinoma: an international cohort study

Author: Elias Allara, Leila Motedayеn Aval, Ramya Ramaswami, Rohini Sharma, Lorenza Rimassa, David E. Kaplan, David J. Pinato, Dominik Bettinger, Joong-Won Park, Tiziana Pressiani, Robert Thimme, Tadaaki Arizumi, Saur Hajiev, Tamar H. Taddei, Nicola Personeni, Masatoshi Kudo, Mario Pirisi, Laura Giordano, Sharma, Rohini [0000-0003-2441-549X], and Apollo - University of Cambridge Repository
Subjects: Sorafenib, Adult, Male, Cancer Research, medicine.medical_specialty, Carcinoma, Hepatocellular, Hepatocellular carcinoma, Antineoplastic Agents, Article, Cohort Studies, 03 medical and health sciences, Targeted therapies, 0302 clinical medicine, Internal medicine, medicine, Humans, Clinical efficacy, Dosing, Aged, Aged, 80 and over, Dose-Response Relationship, Drug, business.industry, Incidence (epidemiology), Liver Neoplasms, Age Factors, Correction, Middle Aged, medicine.disease, Prognosis, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Toxicity, Female, Liver function, business, Cohort study, medicine.drug
Abstract: Background There is no consensus on the effect of sorafenib dosing on efficacy and toxicity in elderly patients with hepatocellular carcinoma (HCC). Older patients are often empirically started on low-dose therapy with the aim to avoid toxicities while maximising clinical efficacy. We aimed to verify whether age impacts on overall survival (OS) and whether a reduced starting dose impacts on OS or toxicity experienced by the elderly. Methods In an international, multicentre cohort study, outcomes for those aged Results Five thousand five hundred and ninety-eight patients were recruited; 792 (14.1%) were aged ≥75 years. The elderly were more likely to have larger tumours (>7 cm) (39 vs 33%, p p p = 0.97). There was no relationship between starting dose of sorafenib 800 mg vs 400 mg/200 mg and OS between those p = 0.11). However, the elderly were more likely to discontinue sorafenib due to toxicity (27.0 vs 21.6%, p Conclusions Clinical outcomes in the elderly is equivalent to patients aged
Published: 2021

32. Clinical outcome with different doses of low-molecular-weight heparin in patients hospitalized for COVID-19

Author: Leonardo Grisafi, Vincenzo Cantaluppi, Patrizia Zeppegno, Damiano D'Ardes, Marco G. Mennuni, Andrea Capponi, Francesco Cipollone, Eyal Hayden, Enrico Guido Spinoni, Marco Krengli, Mattia Bellan, Paola Savoia, Ivan Petrilli, Crizia Colombo, Sabina Gallina, Melissa Foglietta, Sante D. Pierdomenico, Andrea Rognoni, Danila Azzolina, Luigi Mario Castello, Pier Paolo Sainaghi, Giuseppe Patti, Veronica Lio, Gian Carlo Avanzi, Giulia Renda, Francesco Della Corte, Mario Malerba, Mario Pirisi, and Gianluca Aimaretti
Subjects: Male, COVID-19, Thromboprophylaxis, Mortality, Enoxaparin doses, medicine.medical_specialty, ARDS, Time Factors, medicine.drug_class, medicine.medical_treatment, Low molecular weight heparin, 030204 cardiovascular system & hematology, Risk Assessment, Article, NO, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Thromboembolism, Internal medicine, medicine, Humans, Hospital Mortality, 030212 general & internal medicine, Enoxaparin, Mortality, Adverse effect, Thromboprophylaxis, Enoxaparin doses, Aged, Retrospective Studies, Aged, 80 and over, Mechanical ventilation, business.industry, Incidence (epidemiology), Anticoagulant, Anticoagulants, COVID-19, Hematology, Middle Aged, Protective Factors, medicine.disease, Respiration, Artificial, Hospitalization, Regimen, Treatment Outcome, Italy, Propensity score matching, Female, Cardiology and Cardiovascular Medicine, business
Abstract: A pro-thrombotic milieu and a higher risk of thrombotic events were observed in patients with CoronaVirus disease-19 (COVID-19). Accordingly, recent data suggested a beneficial role of low molecular weight heparin (LMWH), but the optimal dosage of this treatment is unknown. We evaluated the association between prophylactic vs. intermediate-to-fully anticoagulant doses of enoxaparin and in-hospital adverse events in patients with COVID-19. We retrospectively included 436 consecutive patients admitted in three Italian hospitals. Outcome according to the use of prophylactic (4000 IU) vs. higher (> 4000 IU) daily dosage of enoxaparin was evaluated. The primary end-point was in-hospital death. Secondary outcome measures were in-hospital cardiovascular death, venous thromboembolism, new-onset acute respiratory distress syndrome (ARDS) and mechanical ventilation. A total of 287 patients (65.8%) were treated with the prophylactic enoxaparin regimen and 149 (34.2%) with a higher dosing regimen. The use of prophylactic enoxaparin dose was associated with a similar incidence of all-cause mortality (25.4% vs. 26.9% with the higher dose; OR at multivariable analysis, including the propensity score: 0.847, 95% CI 0.400–0.1.792; p = 0.664). In the prophylactic dose group, a significantly lower incidence of cardiovascular death (OR 0.165), venous thromboembolism (OR 0.067), new-onset ARDS (OR 0.454) and mechanical intubation (OR 0.150) was observed. In patients hospitalized for COVID-19, the use of a prophylactic dosage of enoxaparin appears to be associated with similar in-hospital overall mortality compared to higher doses. These findings require confirmation in a randomized, controlled study. Supplementary Information The online version contains supplementary material available at 10.1007/s11239-021-02401-x.
Published: 2021

33. Comparison between drug therapy-based comorbidity indices and the Charlson Comorbidity Index for the detection of severe multimorbidity in older subjects

Author: Alessio, Novella, Chiara, Elli, Mauro, Tettamanti, Alessandro, Nobili, Aladar, Ianes, Pier Mannuccio Mannucci, Luca, Pasina, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Irene, Mattioli, Gianni, Biolo, Michela, Zanetti, Giacomo, Bartelloni, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Graziana, Lupattelli, Vanessa, Bianconi, Riccardo, Alcidi, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Vincenza, Beneduce, Federica, Cacioppo, Salvatore, Corrao, Giuseppe, Natoli, Salvatore, Mularo, Massimo, Raspanti, Marco, Zoli, Maria Laura Matacena, Giuseppe, Orio, Eleonora, Magnolfi, Giovanni, Serafini, Angelo, Simili, Giuseppe, Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Giovanna, Fabio, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Matteo, Cesari, Paolo Dionigi Rossi, Sarah, Damanti, Marta, Clerici, Simona, Leoni, Alessandra Danuta Di Mauro, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Giovanna, Leoncini, Luigi, Anastasio, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Antonella, Giorgi, Christian, Gracian, Giuseppe, Zuccalà, Gabriella, D’Aurizio, Giuseppe, Romanelli, Alessandra, Marengoni, Andrea, Volpini, Daniela, Lucente, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giuseppe, Bellelli, Maurizio, Corsi, Cesare, Antonucci, Chiara, Sidoli, Giulia, Principato, Franco, Arturi, Elena, Succurro, Bruno, Tassone, Federica, Giofrè, Maria Grazia Serra, Maria Antonietta Bleve, Antonio, Brucato, Teresa De Falco, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Tancredi, Prandini, Manfredini, Roberto, Fabbian, Fabio, Benedetta, Boari, DE GIORGI, Alfredo, Ruana, Tiseo, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudia, Catalano, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Silvia, Schiavone, Alessio, Bragagni, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Carlo, Custodero, Luigi, Fenoglio, Andrea, Falcetta, Fracanzani, Anna L., Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Raffaella, Rossio, Giulia, Colombo, Pasquale, Agosti, Valter, Monzani, Valeria, Savojardo, Giuliana, Ceriani, Francesco, Salerno, Giada, Pallini, Fabrizio, Montecucco, Luciano, Ottonello, Lara, Caserza, Giulia, Vischi, Nicola Lucio Liberato, Tiziana, Tognin, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Maria Stella Pisciotta, Francesco Baffa Bellucci, Stefano, Buffelli, Giuseppe, Montrucchio, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Carl, Margaria, Maura, Sanino, Francesco, Violi, Ludovica, Perri, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Roberto Davide Diprizio, Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Matteo, Galassi, Yasmine, Grassi, Alessio, Greco, Angela, Sciacqua, Maria, Perticone, Rosa, Battaglia, Raffaele, Maio, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara del Vecchio, Andrea, Salvi, Roberto, Leonardi, Giampaolo, Damiani, William, Capeci, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Riccardo, Ghio, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Alfio, Gennaro, Agostino, Gaudio, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Francesca, Mete, Miriam, Gino, Carlo, Vigorito, Antonio, Cittadini, Guido, Moreo, Silvia, Prolo, Gloria, Pina, Alberto, Ballestrero, Fabio, Ferrando, Roberta, Gonella, Domenico, Cerminara, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella, Gruden, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Leonardo, Sechi, Cristiana, Catena, Gianluca, Colussi, Alessandro, Cavarape, Andea Da Porto, Nicola, Passariello, Luca, Rinaldi, Franco, Berti, Giuseppe, Famularo, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta, Morganti, Andrea, Artoni, Margherita, Grossi, Stefano Del Giacco, Davide, Firinu, Giulia, Costanzo, Giacomo, Argiolas, Giuseppe, Montalto, Anna, Licata, Filippo Alessandro Montalto, Francesco, Corica, Giorgio, Basile, Antonino, Catalano, Federica, Bellone, Concetto, Principato, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Giandomenico Nigro Imperiale, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Mattia, Bellan, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, Giorgio, Scanzi, Caterina, Mengoli, Stella, Provini, Laura, Ricevuti, Emilio, Simeone, Rosa, Scurti, Fabio, Tolloso, Roberto, Tarquini, Alice, Valoriani, Silvia, Dolenti, Giulia, Vannini, Riccardo, Volpi, Pietro, Bocchi, Alessandro, Vignali, Sergio, Harari, Chiara, Lonati, Federico, Napoli, Italia, Aiello, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Silvia, Ghidoni, Teresa, Salvatore, Lucio, Monaco, Carmen, Ricozzi, Alberto, Pilotto, Ilaria, Indiano, Federica, Gandolfo., Novella, A, Elli, C, Tettamanti, M, Nobili, A, Ianes, A, Mannucci, P, Pasina, L, and Bellelli, G
Subjects: Aging, medicine.medical_specialty, Comorbidity indices, Socio-culturale, Comorbidity, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Internal medicine, Medicine, Humans, LS4_4, 030212 general & internal medicine, Medical prescription, Medical diagnosis, Older adult, Operating characteristic, Disease burden, Aged, Receiver operating characteristic, business.industry, Chronic diseae, Area under the curve, Multimorbidity, medicine.disease, Comorbidity indice, Hospitalization, Italy, Multimorbidiy, Older adults, Chronic Disease, Chronic disease, Comorbidity indices, Multimorbidiy, Older adults, Operating characteristic, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery
Abstract: Background: To know burden disease of a patient is a key point for clinical practice and research, especially in the elderly. Charlson’s Comorbidity Index (CCI) is the most widely used rating system, but when diagnoses are not available therapy-based comorbidity indices (TBCI) are an alternative. However, their performance is debated. This study compares the relations between Drug Derived Complexity Index (DDCI), Medicines Comorbidity Index (MCI), Chronic Disease Score (CDS), and severe multimorbidity, according to the CCI classification, in the elderly. Methods: Logistic regression and Receiver Operating Characteristic (ROC) analysis were conducted on two samples from Italy: 2579 nursing home residents (Korian sample) and 7505 older adults admitted acutely to geriatric or internal medicine wards (REPOSI sample). Results: The proportion of subjects with severe comorbidity rose with TBCI score increment, but the Area Under the Curve (AUC) for the CDS (Korian: 0.70, REPOSI: 0.79) and MCI (Korian: 0.69, REPOSI: 0.81) were definitely better than the DDCI (Korian: 0.66, REPOSI: 0.74). All TBCIs showed low Positive Predictive Values (maximum: 0.066 in REPOSI and 0.317 in Korian) for the detection of severe multimorbidity. Conclusion: CDS and MCI were better predictors of severe multimorbidity in older adults than DDCI, according to the CCI classification. A high CCI score was related to a high TBCI. However, the opposite is not necessarily true probably because of non-evidence-based prescriptions or physicians’ prescribing attitudes. TBCIs did not appear selective for detecting of severe multimorbidity, though they could be used as a measure of disease burden, in the absence of other solutions.
Published: 2021

34. Cardiovascular adaptation after liver transplantation. Ventricular changes detect by 2d echocardiography and by speckle tracking

Author: Domenico Galzerano, R Troisi, SM Alharbi, Afrah Alsomali, A Alfehaid, A Eltayeb, Mario Pirisi, Olga Vriz, and Bandar Alamro
Subjects: Cardiac output, medicine.medical_specialty, Ejection fraction, business.industry, medicine.medical_treatment, Diastole, Cardiomyopathy, General Medicine, Liver transplantation, medicine.disease, Speckle pattern, 2d echocardiography, Internal medicine, Cardiology, Medicine, Radiology, Nuclear Medicine and imaging, Systole, Cardiology and Cardiovascular Medicine, business
Abstract: Funding Acknowledgements Type of funding sources: None. Background. Patients who underwent liver transplantation (LT) may suffer from heart disease that can be related to the liver disease itself or to other associated pathologies. It has been suggested that there is a specific heart disease associated with cirrhosis, termed cirrhotic cardiomyopathy which is characterized by the presence of increased baseline cardiac output, systolic and diastolic left ventricular (LV) dysfunction and increased in pulmonary artery systolic pressure (PASP). The aim of the study was to evaluate the cardiac structural and functional changes after LT and eventually to determine the improvement in PASP. Method. 51 patients were considered for the analysis who had a good quality pre and post LT echocardiograms. The echo-study was done preLT and repeated within 4 months and 3 years after LT. All studies were red of-line, global longitudinal stains (GLS) of the LV and right ventricle (RV) were analyzed using TOMTEC application. A Paired T-test was used to compare the echocardiographic parameters. The group was also divided according to tertiles of pre LT PASP for the evaluation of pulmonary pressure. Results . Patients` mean age was 58.1 ± 7.8 years, 32 (62.6%) men, mean time between the 2 echocardiographic studies was 529.2 ± 471 days. After LT all the patients were on immunosuppressant therapy (calcineurin inhibitors, ciclosporin and/or tacrolimus). After LT blood pressure (BP) (83.4 ± 16 vs 91.5 ± 14 mmHg, p = 0.009 for mean BP ), heart rate (72.5 ± 15.2 vs 80.6 ± 15.3 bpm, p = 0.004), increased as LV mass index (78.6 ± 21.1 to 91.4 ± 29, p= 0.003) and relative wall thickness (0.34 ± 0.06 to 0.39 ± 0.08, p = 0.001). LV ejection fraction did not change while there was a significant decrease in LV GLS (-20.9 ± 4.4% vs -17.4 ± 3.9%, p Conclusion. Increased in BP has been found in patients after LT , likely related to immensuppressive therapy. LV remodeling, impaired diastolic function were likely a conseguence of increase in BP and the increased in PASP and worst RV- pulmonary circulation coupling was secondary to impaired diastolic function and increased filling pressure. After LT, patients require particular clinical attention and echocardiographic monitoring included GLS for target organ damage and prompt adequate therapy at least in terms of BP control to avoid later cardiovascular complications.
Published: 2021

35. Periostin Circulating Levels and Genetic Variants in Patients with Non-Alcoholic Fatty Liver Disease

Author: Nadia Barizzone, Rosalba Minisini, Venkata Ramana Mallela, Mario Pirisi, Matteo Nazzareno Barbaglia, Michela Emma Burlone, Violante Mulas, Elena Grossini, and Carlo Smirne
Subjects: 0301 basic medicine, medicine.medical_specialty, extracellular matrix, Clinical Biochemistry, Periostin, Gastroenterology, digestive system, Article, metabolic syndrome, liver steatosis, 03 medical and health sciences, Liver disease, 0302 clinical medicine, single nucleotide polymorphism, Internal medicine, medicine, liver fibrosis, periostin, lcsh:R5-920, business.industry, Fatty liver, nutritional and metabolic diseases, non-alcoholic fatty liver disease, Hepatitis C, hepatocellular carcinoma, medicine.disease, digestive system diseases, 030104 developmental biology, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Biomarker (medicine), biomarker, non-alcoholic steatohepatitis, Steatosis, Metabolic syndrome, lcsh:Medicine (General), business
Abstract: Circulating periostin has been suggested as a possible biomarker in non-alcoholic fatty liver disease (NAFLD) in Asian studies. In the present study, we aimed to test its still controversial relevance in a Caucasian population. In patients with histologically-proven NAFLD (N. = 74, 10 with hepatocellular carcinoma, HCC) plasma periostin concentrations were analyzed. POSTN haplotype analysis was based on rs9603226, rs3829365, and rs1029728. Hepatitis C patients (N. = 81, 7 HCC) and healthy subjects (N. = 27) were used as controls. The median plasma periostin concentration was 11.6 ng/mL without differences amongst groups, it was not influenced by age, liver fibrosis or steatosis. However, possession of haplotype two (rs9603226 = G, rs3829365 = C, rs1028728 = A) was associated with lower circulating periostin compared to other haplotypes. Moreover, periostin was higher in HCC patients. At multivariate analysis, HCC remained the only predictor of high periostin. In conclusion, plasma periostin concentrations in Caucasians NAFLD patients are not influenced by the degree of liver disease, but are significantly higher in HCC. Genetically-determined differences may account for some of the variability. These data suggest extreme caution in predicting a possible future role of periostin antagonists as a rational therapeutic alternative for NAFLD, but show a potential periostin role in the management of NAFLD-associated HCC.
Published: 2020

36. Outcomes of COVID-19 patients treated with continuous positive airway pressure outside ICU

Author: Raffaella Perucca, Carlo Maestrone, Gianluca Airoldi, Erminio Santangelo, Paolo Navalesi, Sara Baino, Piero Emilio Balbo, Claudio Pissaia, Francesco Della Corte, Valentina Rondi, Carlo Olivieri, Luca Grillenzoni, Federico Crimaldi, Nello De Vita, Francesco Mojoli, Letizia Vanni, Maria Adele Moschella, Marta Baggiani, Daniela Rosalba, Tiziana Cena, Matteo Maestrone, Davide Colombo, Simona Bazzano, Gianmaria Cammarota, Sara Carbonati, Francesco Barone-Adesi, Silvio Borrè, Valeria Bonato, Martina Taverna, Luca De Col, Mario Malerba, Rosanna Vaschetto, Mario Pirisi, Fabrizio Racca, Lorenza Scotti, Veronica Daffara, Francesca Vigone, Federica Moroni, and Luigi Mario Castello
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, medicine.medical_treatment, Hazard ratio, lcsh:R, lcsh:Medicine, Intensive care unit, law.invention, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Interquartile range, law, Internal medicine, medicine, Risk of mortality, Intubation, Original Article, 030212 general & internal medicine, Continuous positive airway pressure, Risk factor, business, Cohort study
Abstract: AimWe aimed to characterise a large population of coronavirus disease 2019 (COVID-19) patients with moderate-to-severe hypoxaemic acute respiratory failure (ARF) receiving continuous positive airway pressure (CPAP) outside the intensive care unit (ICU), and to ascertain whether the duration of CPAP application increased the risk of mortality for patients requiring intubation.MethodsIn this retrospective, multicentre cohort study, we included adult COVID-19 patients, treated with CPAP outside ICU for hypoxaemic ARF from 1 March to 15 April, 2020. We collected demographic and clinical data, including CPAP therapeutic goal, hospital length of stay and 60-day in-hospital mortality.ResultsThe study included 537 patients with a median (interquartile range (IQR) age of 69 (60–76) years. 391 (73%) were male. According to the pre-defined CPAP therapeutic goal, 397 (74%) patients were included in the full treatment subgroup, and 140 (26%) in the do not intubate (DNI) subgroup. Median (IQR) CPAP duration was 4 (1–8) days, while hospital length of stay was 16 (9–27) days. 60-day in-hospital mortality was 34% (95% CI 0.304–0.384%) overall, and 21% (95% CI 0.169–0.249%) and 73% (95% CI 0.648–0.787%) for full treatment and DNI subgroups, respectively. In the full treatment subgroup, in-hospital mortality was 42% (95% CI 0.345–0.488%) for 180 (45%) CPAP failures requiring intubation, and 2% (95% CI 0.008–0.035%) for the remaining 217 (55%) patients who succeeded. Delaying intubation was associated with increased mortality (hazard ratio 1.093, 95% CI 1.010–1.184).ConclusionsWe described a large population of COVID-19 patients treated with CPAP outside ICU. Intubation delay represents a risk factor for mortality. Further investigation is needed for early identification of CPAP failures.
Published: 2020

37. Cerebral nervous system vasculitis in a Covid-19 patient with pneumonia

Author: Simona Bazzano, Francesco Della Corte, Mario Pirisi, Michela Barini, Tiziana Cena, Grazia Meneghetti, Gianmaria Cammarota, Diego Brustia, Rosanna Vaschetto, Domizia Vecchio, Luigi Mario Castello, and Pier Paolo Sainaghi
Subjects: Nervous system, Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), SARS-Cov-2, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Cerebral vasculitis, Clinical Neurology, Acute respiratory distress, Article, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Pandemic, medicine, business.industry, COVID-19, General Medicine, medicine.disease, Pneumonia, medicine.anatomical_structure, Neurology, 030220 oncology & carcinogenesis, Surgery, Neurology (clinical), business, Vasculitis, 030217 neurology & neurosurgery
Abstract: Highlights • Novel coronavirus (COVID-19) directly or indirectly may affect cerebral nervous system. • We described the first case of cerebral nervous system vasculitis triggered by COVID-19. • Medical treatment with both immunoglobulins and steroids ameliorated both MRI and clinical symptoms., We describe a patient affected by Covid-19 acute respiratory distress syndrome with a cerebral nervous system vasculitis triggered by SARS-Cov-2, managed at the University hospital, in Novara, Italy in the area most impacted by the pandemic and where 749 Covid-19 positive patients were admitted from March 1st until April 25th, 2020.
Published: 2020
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38. Presenting Features and Early Mortality from SARS-CoV-2 Infection in Cancer Patients during the Initial Stage of the COVID-19 Pandemic in Europe

Author: Rachel Sharkey, Roxana Reyes, Josep Tabernero, Joanne Evans, Daniela Ferrante, Joan Brunet, Andrea Patriarca, Mattia Bellan, Gianluca Gaidano, Isabel Garcia-Fructuoso, Anna Carbó, Christopher C T Sng, Alessandra Gennari, Mark Bower, Sarah Benafif, Alessia Dalla Pria, Lorenza Scotti, Elia Seguí, Riccardo Bruna, Francesca D'Avanzo, Aleix Prat, Claudia Andrea Cruz, Diego Ottaviani, Gianpiero Rizzo, Yien Ning Sophia Wong, Meritxell Mollà, Mario Pirisi, Pier Paolo Sainaghi, Thomas Newsom-Davis, Isabel Ruiz-Camps, Gian Carlo Avanzi, Myria Galazi, Javier Marco-Hernández, David J. Pinato, Federica Biello, Alvin J.X. Lee, Neha Chopra, Juan Aguilar-Company, Carme Carmona, Luigi Mario Castello, Wellcome Trust, Pinato, D, Lee, A, Biello, F, Segui, E, Aguilar-Company, J, Carbo, A, Bruna, R, Bower, M, Rizzo, G, Benafif, S, Carmona, C, Chopra, N, Cruz, C, D'Avanzo, F, Evans, J, Galazi, M, Garcia-Fructuoso, I, Pria, A, Newsom-Davis, T, Ottaviani, D, Patriarca, A, Reyes, R, Sharkey, R, Sng, C, Wong, Y, Ferrante, D, Scotti, L, Avanzi, G, Bellan, M, Castello, L, Marco-Hernandez, J, Molla, M, Pirisi, M, Ruiz-Camps, I, Sainaghi, P, Gaidano, G, Brunet, J, Tabernero, J, Prat, A, Gennari, A, Institut Català de la Salut, [Pinato DJ] Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK. [Lee AJX] Department of Oncology, University College London Hospitals, London, UK. [Biello F] Department of Translational Medicine, Division of Oncology, University of Piemonte Orientale and Maggiore della Carita’ Hospital, Novara, Italy. [Seguí E] Department of Medical Oncology, Hospital Clinic, Barcelona, Spain. [Aguilar-Company J] Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Carbó A] Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain. [Ruiz-Camps I] Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Tabernero J] Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
Subjects: 0301 basic medicine, Cancer Research, medicine.medical_specialty, Coronaviru, coronavirus, Disease, Malignancy, outcomes, lcsh:RC254-282, survival, Article, neoplasias [ENFERMEDADES], 03 medical and health sciences, Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores], 0302 clinical medicine, Internal medicine, Intensive care, Other subheadings::Other subheadings::Other subheadings::/mortality [Other subheadings], Pandemic, Càncer - Mortalitat, medicine, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], cancer, 1112 Oncology and Carcinogenesis, Stage (cooking), COVID-19 (Malaltia) - Complicacions, Outcome, Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad [Otros calificadores], business.industry, SARS-CoV-2, Outbreak, Cancer, COVID-19, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, mortality, Neoplasms [DISEASES], 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, business, Complication, Other subheadings::Other subheadings::/complications [Other subheadings]
Abstract: We describe the outcomes in cancer patients during the initial outbreak of the COVID-19 in Europe from the retrospective, multi-center observational OnCovid study. We identified 204 cancer patients from eight centers in the United Kingdom, Italy, and Spain aged &gt, 18 (mean = 69) and diagnosed with COVID-19 between February 26th and April 1st, 2020. A total of 127 (62%) were male, 184 (91%) had a diagnosis of solid malignancy, and 103 (51%) had non-metastatic disease. A total of 161 (79%) had &gt, 1 co-morbidity. A total of 141 (69%) patients had &gt, 1 COVID-19 complication. A total of 36 (19%) were escalated to high-dependency or intensive care. A total of 59 (29%) died, 53 (26%) were discharged, and 92 (45%) were in-hospital survivors. Mortality was higher in patients aged &gt, 65 (36% versus 16%), in those with &gt, 2 co-morbidities (40% versus 18%) and developing &gt, 1 complication from COVID-19 (38% versus 4%, p = 0.004). Multi-variable analyses confirmed age &gt, 65 and &gt, 2 co-morbidities to predict for patient mortality independent of tumor stage, active malignancy, or anticancer therapy. During the early outbreak of SARS-CoV-2 infection in Europe co-morbid burden and advancing age predicted for adverse disease course in cancer patients. The ongoing OnCovid study will allow us to compare risks and outcomes in cancer patients between the initial and later stages of the COVID-19 pandemic.
Published: 2020
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39. Reduced activity of B lymphocytes, recognised by Sysmex XN-2000™ haematology analyser, predicts mortality in patients with coronavirus disease 2019

Author: Chiara Puricelli, Anita R. Pedrinelli, Cristina Rigamonti, Umberto Dianzani, Roberta Rolla, Anna Maria Scotta, Mario Pirisi, Patrizia Pergolini, and Matteo Vidali
Subjects: Male, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Clinical Biochemistry, chemistry.chemical_compound, Patient Admission, Internal medicine, Medicine, Humans, In patient, Hospital Mortality, Epidemics, Aged, Biochemistry, medical, Aged, 80 and over, Automation, Laboratory, Creatinine, B-Lymphocytes, Hematology, business.industry, SARS-CoV-2, Biochemistry (medical), COVID-19, General Medicine, Middle Aged, Prognosis, Blood Cell Count, chemistry, Female, Creatinine blood, business, Sysmex xn
Published: 2020

40. Right ventricular-pulmonary arterial uncoupling in mild-to-moderate systemic hypertension

Author: Olga Vriz, Paolo Palatini, Fadl ElMula Mohammed Fadl ElMula, Eduardo Bossone, Mario Pirisi, Robert Naeije, Cardiology, Vriz, O., Pirisi, M., Bossone, E., Fadl Elmula, F. E. M., Palatini, P., and Naeije, R.
Subjects: Adult, Male, medicine.medical_specialty, Physiology, Heart Ventricles, Ventricular Dysfunction, Right, right ventricle, 030204 cardiovascular system & hematology, Doppler echocardiography, Pulmonary Artery, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Internal medicine, medicine.artery, pulmonary hypertension, Internal Medicine, echocardiography, Medicine, Ventricular outflow tract, Humans, Arterial Pressure, 030212 general & internal medicine, Aged, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, Pulmonary hypertension, Echocardiography, Doppler, Mean blood pressure, Blood pressure, medicine.anatomical_structure, Heart failure, pulmonary vascular resistance, Pulmonary artery, Hypertension, Cardiology, Vascular resistance, Female, Vascular Resistance, Cardiology and Cardiovascular Medicine, business
Abstract: Background: Mild-to-moderate hypertension with preserved left ventricular (LV) function may be associated with right ventricular (RV) dysfunction and increased pulmonary vascular resistance (PVR). Methods: The present study explored the adequacy of RV–pulmonary arterial (PA) coupling in 211 never-treated hypertensive patients (mean blood pressure, BP 112 12 mmHg) and 246 controls (BP 93 12 mmHg). They underwent a comprehensive transthoracic Doppler echocardiography, and RV–PA coupling was estimated by the tricuspid annular plane systolic excursion (TAPSE) to systolic pulmonary artery pressure (PASP) ratio (TAPSE/ PASP). Results: Compared with the controls, hypertensive patients had increased LV wall thickness and decreased trans-mitral E/A with only slight but significant increase in transmitral Doppler E wave to tissue Doppler mitral annulus e0 wave ratio (6.3 1.9 vs. 5.8 1. 5, P < 0.05). RV dimensions and indices of either systolic or diastolic function were not different. PASP was increased in the hypertensive patients (25 7 vs. 21 7 mmHg, P < 0.001), as was PVR estimated from the tricuspid regurgitation velocity to right ventricular outflow tract velocity ratio (1.7 0.4 vs. 1.5 0.5 Wood units, P < 0.001). The TAPSE/ PASP ratio was decreased (1.08 0.35 vs. 1.43 0.67 mm/ mmHg, P < 0.001). This difference was mainly driven by male hypertensive patients. At multivariable analysis, the only independent predictors of decreased TAPSE/PASP were age and blood pressure. Conclusion: The TAPSE/PASP is markedly decreased in hypertension without heart failure, chiefly in men, with only slight increases in estimates of LV filling pressure or PVR, suggesting RV–PA uncoupling.
Published: 2020

41. Role of Gas6 and TAM Receptors in the Identification of Cardiopulmonary Involvement in Systemic Sclerosis and Scleroderma Spectrum Disorders

Author: Michela Emma Burlone, Matteo Nazzareno Barbaglia, Cristina Rigamonti, Federico Grimoldi, Ailia Giubertoni, Rosalba Minisini, Alessandro Carriero, Carlo Smirne, Gian Carlo Avanzi, Maurizio Sguazzotti, Michela Barini, Paolo Marino, Mario Pirisi, Arnaldo Dimagli, Mattia Bellan, Alessandra Nerviani, Cristina Piccinino, Daniele Sola, Aurora Ianniello, Luigi Mario Castello, Pier Paolo Sainaghi, and Livia Salmi
Subjects: Male, 0301 basic medicine, Medicine (General), medicine.medical_specialty, Tam receptors, Article Subject, Hypertension, Pulmonary, Clinical Biochemistry, Sensitivity and Specificity, Severity of Illness Index, Gastroenterology, Scleroderma, 03 medical and health sciences, R5-920, 0302 clinical medicine, Proto-Oncogene Proteins, Internal medicine, Genetics, Humans, Medicine, Outpatient clinic, Molecular Biology, Aged, 030203 arthritis & rheumatology, Scleroderma, Systemic, c-Mer Tyrosine Kinase, business.industry, GAS6, Biochemistry (medical), Interstitial lung disease, Receptor Protein-Tyrosine Kinases, General Medicine, Middle Aged, medicine.disease, Axl Receptor Tyrosine Kinase, Pulmonary hypertension, Cross-Sectional Studies, 030104 developmental biology, Gene Expression Regulation, Intercellular Signaling Peptides and Proteins, Female, Lung Diseases, Interstitial, business, Area under the roc curve, Biomarkers, Research Article
Abstract: Background. Few biomarkers are available for early identification of pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD) in systemic sclerosis (SS) and scleroderma spectrum disorders (SSD). Aims. To evaluate Gas6, sAxl, and sMer as biomarkers for cardiopulmonary complications of SS and SSD. Methods. In a cross-sectional observational study, we recruited 125 consecutive patients, affected by SS and SSD and referred to a tertiary-level pulmonary hypertension outpatient clinic. All patients underwent a comprehensive evaluation for identification of PAH and ILD. Gas6, sMer, and sAxl concentrations were measured with ELISA protocols, and concentrations were compared according to PAH or ILD. Results. Nineteen subjects had pulmonary hypertension (PH) (14 PAH), and 39 had ILD (6 severe). Plasma sMer was increased in PAH (18.6 ng/ml IQR [11.7-20.3]) with respect to the absence (12.4 [8.0-15.8]) or other form of pulmonary hypertension (9.6 [7.4-12.5]; K–W variance p<0.04). Conversely, Gas6 and sAxl levels were slightly increased in mild ILD (25.8 ng/ml [19.5-32.1] and 24.6 [20.1-32.5]) and reduced in severe ILD (16.6 [15.0-22.1] and 15.5 [14.9-22.4]) in comparison to no evidence of ILD (23.4 [18.8-28.1] and 21.6 [18.1-28.4]; K–W, p≤0.05). Plasma sMer≥19 ng/ml has 50% sensitivity and 92% specificity in PAH identification (area under the ROC curve (AUC) 0.697, p<0.03). Values of Gas6≤24.5 ng/ml and of sAxl≤15.5 ng/ml have 100% and 67% sensitivity and 47% and 86% specificity, respectively, in identifying severe ILD (Gas6 AUC 0.787, p<0.001; sAxl AUC 0.705, p<0.05). Conclusions. The assay of Gas6 sAxl and sMer may be useful to help in the identification of PAH and ILD in SS and SSD patients. The Gas6/TAM system seems to be relevant in cardiopulmonary complications of SS and SSD and merits further investigations.
Published: 2020
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42. Pain and Frailty in Hospitalized Older Adults

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

43. Clinical portrait of the SARS-CoV-2 epidemic in european patients with cancer

Author: David J. Pinato, Alberto Zambelli, Juan Aguilar-Company, Mark Bower, Christopher C.T. Sng, Ramon Salazar, Alexia Bertuzzi, Joan Brunet, Ricard Mesia, Elia Seguí, Federica Biello, Daniele Generali, Salvatore Grisanti, Gianpiero Rizzo, Michela Libertini, Antonio Maconi, Nadia Harbeck, Bruno Vincenzi, Rossella Bertulli, Diego Ottaviani, Anna Carbó, Riccardo Bruna, Sarah Benafif, Andrea Marrari, Rachel Wuerstlein, M. Carmen Carmona-Garcia, Neha Chopra, Carlo Tondini, Oriol Mirallas, Valeria Tovazzi, Marta Betti, Salvatore Provenzano, Vittoria Fotia, Claudia Andrea Cruz, Alessia Dalla Pria, Francesca D'Avanzo, Joanne S. Evans, Nadia Saoudi-Gonzalez, Eudald Felip, Myria Galazi, Isabel Garcia-Fructuoso, Alvin J.X. Lee, Thomas Newsom-Davis, Andrea Patriarca, David García-Illescas, Roxana Reyes, Palma Dileo, Rachel Sharkey, Yien Ning Sophia Wong, Daniela Ferrante, Javier Marco-Hernández, Anna Sureda, Clara Maluquer, Isabel Ruiz-Camps, Gianluca Gaidano, Lorenza Rimassa, Lorenzo Chiudinelli, Macarena Izuzquiza, Alba Cabirta, Michela Franchi, Armando Santoro, Aleix Prat, Josep Tabernero, Alessandra Gennari, Gian Carlo Avanzi, Mattia Bellan, Luigi Mario Castello, Maria Martinez, Meritxell Mollà, Mario Pirisi, Lorenza Scotti, Judith Swallow, Pinato, D. J., Zambelli, A., Aguilar-Company, J., Bower, M., Sng, C. C. T., Salazar, R., Bertuzzi, A., Brunet, J., Mesia, R., Segui, E., Biello, F., Generali, D., Grisanti, S., Rizzo, G., Libertini, M., Maconi, A., Harbeck, N., Vincenzi, B., Bertulli, R., Ottaviani, D., Carbo, A., Bruna, R., Benafif, S., Marrari, A., Wuerstlein, R., Carmona-Garcia, M. C., Chopra, N., Tondini, C., Mirallas, O., Tovazzi, V., Betti, M., Provenzano, S., Fotia, V., Cruz, C. A., Pria, A. D., D'Avanzo, F., Evans, J. S., Saoudi-Gonzalez, N., Felip, E., Galazi, M., Garcia-Fructuoso, I., Lee, A. J. X., Newsom-Davis, T., Patriarca, A., Garcia-Illescas, D., Reyes, R., Dileo, P., Sharkey, R., Wong, Y. N. S., Ferrante, D., Marco-Hernandez, J., Sureda, A., Maluquer, C., Ruiz-Camps, I., Gaidano, G., Rimassa, L., Chiudinelli, L., Izuzquiza, M., Cabirta, A., Franchi, M., Santoro, A., Prat, A., Tabernero, J., and Gennari, A.
Subjects: 0301 basic medicine, medicine.medical_specialty, medicine.medical_treatment, Population, MEDLINE, risk stratification, Targeted therapy, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, SARS-CoV-2 pandemic, oncology practice, Internal medicine, Pandemic, medicine, education, education.field_of_study, Chemotherapy, Research Briefs, business.industry, Mortality rate, Cancer, medicine.disease, 3. Good health, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, business
Abstract: Higher risk of death from COVID-19 among patients with cancer was correlated with male sex, greater age, presence of multiple comorbidities, advanced-stage disease, and active disease; there was no association between risk and anticancer treatment., The SARS-CoV-2 pandemic significantly affected oncology practice across the globe. There is uncertainty as to the contribution of patients' demographics and oncologic features to severity and mortality from COVID-19 and little guidance as to the role of anticancer and anti–COVID-19 therapy in this population. In a multicenter study of 890 patients with cancer with confirmed COVID-19, we demonstrated a worsening gradient of mortality from breast cancer to hematologic malignancies and showed that male gender, older age, and number of comorbidities identify a subset of patients with significantly worse mortality rates from COVID-19. Provision of chemotherapy, targeted therapy, or immunotherapy did not worsen mortality. Exposure to antimalarials was associated with improved mortality rates independent of baseline prognostic factors. This study highlights the clinical utility of demographic factors for individualized risk stratification of patients and supports further research into emerging anti–COVID-19 therapeutics in SARS-CoV-2–infected patients with cancer. Significance: In this observational study of 890 patients with cancer diagnosed with SARS-CoV-2, mortality was 33.6% and predicted by male gender, age ≥65, and comorbidity burden. Delivery of cancer therapy was not detrimental to severity or mortality from COVID-19. These patients should be the focus of shielding efforts during the SARS-CoV-2 pandemic. This article is highlighted in the In This Issue feature, p. 1426
Published: 2020

44. Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients

Author: Lucio Boglione, Irene Cecilia Landi, Marinella Bertolotti, Alessandra Galbiati, Luca Lorenzini, Carlo Cisari, Luigia Salamina, Matteo Brucoli, Irene Giacone, Carlo Olivieri, Flavio Bobbio, Marta Betti, Maria Martelli, Paolo Amedeo Tillio, Vanessa Tarantino, Anita R. Pedrinelli, Mario Pirisi, Pietro Luigi Garavelli, Eleonora Croce, Alessandra Gennari, Francesca Zottarelli, Pietro Danna, Marco Invernizzi, Antonio Maconi, Francesca Giolitti, Sofia Battistini, Paolo Marzullo, Roberta Re, Domenico Zagaria, Francesco Gavelli, Federico Ceruti, Ilaria Leone, Greta Maria Giacomini, Leonardo Grisafi, Andrea Parisini, Stephanie Bertolin, Elia Esposto, Vincenzo Cantaluppi, Mattia Bellan, Giuseppe Patti, Emilio Chirico, Matteo Bertoli, Paolo Boffano, Paolo Aluffi Valletti, Alessandro Carriero, Cristoforo Comi, Umberto Dianzani, Eleonora Rizzi, Massimiliano Panella, Marco Sciarra, Edoardo Cammarata, Letizia Marzari, Elisa Zavattaro, Claudia Montabone, Gian Carlo Avanzi, Samuel Alberto Padelli, Massimiliano Garzaro, Pier Paolo Sainaghi, Francesco Barone-Adesi, Carlo Smirne, Gianluca Gaidano, Michela Barini, Francesco Giuseppe Casciaro, Ilaria Inserra, Laura Cristina Gironi, Ilaria Nerici, Clara Ada Gardino, Maria Luisa Gastaldello, Micol Giulia Cittone, Marco Mussa, Umberto Morosini, Andrea Capponi, Davide Di Benedetto, Fabrizio Faggiano, Crizia Colombo, Andrea Rognoni, Elisa Calzaducca, Alessio Paschè, Annalisa Roveta, Gianluca Aimaretti, Roberto Arioli, Giulia Baldon, Roberto Cantello, Ilaria Percivale, Piero Emilio Balbo, Emanuela Barbero, Silvio Borrè, Luigi Mario Castello, Patrizia Zeppegno, Ileana Gagliardi, Emanuela Labella, Alice Ferrero, Marco Krengli, Silvia Gallo, Andrea Schimmenti, Tommaso Daffara, Raffaella Landi, Paola Savoia, Giulia Francesca Manfredi, Valentina Giai Via, Michela Beltrame, Eyal Hayden, Enrico Guido Spinoni, Francesca Baorda, Cristina Rigamonti, Alessandro Nuzzo, Mario Malerba, Carla Gramaglia, Rosanna Vaschetto, Massimo Saraceno, Gianluca Avino, Marco G. Mennuni, Daniela Ferrante, Guido Chichino, Danila Azzolina, Alessio Baricich, Veronica Lio, Veronica Vassia, Alberto Pau, Roberto Angilletta, Simona De Vecchi, Antonio Acquaviva, Lorenza Scotti, Francesco Della Corte, Matteo Santagostino, Zeno Falaschi, Bellan, M, Patti, G, Hayden, E, Azzolina, D, Pirisi, M, Acquaviva, A, Aimaretti, G, Aluffi Valletti, P, Angilletta, R, Arioli, R, Avanzi, G, Avino, G, Balbo, P, Baldon, G, Baorda, F, Barbero, E, Baricich, A, Barini, M, Barone-Adesi, F, Battistini, S, Beltrame, M, Bertoli, M, Bertolin, S, Bertolotti, M, Betti, M, Bobbio, F, Boffano, P, Boglione, L, Borre, S, Brucoli, M, Calzaducca, E, Cammarata, E, Cantaluppi, V, Cantello, R, Capponi, A, Carriero, A, Casciaro, F, Castello, L, Ceruti, F, Chichino, G, Chirico, E, Cisari, C, Cittone, M, Colombo, C, Comi, C, Croce, E, Daffara, T, Danna, P, Della Corte, F, De Vecchi, S, Dianzani, U, Di Benedetto, D, Esposto, E, Faggiano, F, Falaschi, Z, Ferrante, D, Ferrero, A, Gagliardi, I, Gaidano, G, Galbiati, A, Gallo, S, Garavelli, P, Gardino, C, Garzaro, M, Gastaldello, M, Gavelli, F, Gennari, A, Giacomini, G, Giacone, I, Giai Via, V, Giolitti, F, Gironi, L, Gramaglia, C, Grisafi, L, Inserra, I, Invernizzi, M, Krengli, M, Labella, E, Landi, I, Landi, R, Leone, I, Lio, V, Lorenzini, L, Maconi, A, Malerba, M, Manfredi, G, Martelli, M, Marzari, L, Marzullo, P, Mennuni, M, Montabone, C, Morosini, U, Mussa, M, Nerici, I, Nuzzo, A, Olivieri, C, Padelli, S, Panella, M, Parisini, A, Pasche, A, Pau, A, Pedrinelli, A, Percivale, I, Re, R, Rigamonti, C, Rizzi, E, Rognoni, A, Roveta, A, Salamina, L, Santagostino, M, Saraceno, M, Savoia, P, Sciarra, M, Schimmenti, A, Scotti, L, Spinoni, E, Smirne, C, Tarantino, V, Tillio, P, Vaschetto, R, Vassia, V, Zagaria, D, Zavattaro, E, Zeppegno, P, Zottarelli, F, and Sainaghi, P
Subjects: Male, COVID-19, Viral infection, Risk factors, lcsh:Medicine, Comorbidity, Sex Factor, 030204 cardiovascular system & hematology, 0302 clinical medicine, Retrospective Studie, Case fatality rate, Pandemic, Age Factor, 030212 general & internal medicine, lcsh:Science, clinical characteristics, Aged, 80 and over, Multidisciplinary, Reverse Transcriptase Polymerase Chain Reaction, Smoking, Age Factors, Middle Aged, Coronavirus disease, Natural history, Survival Rate, Italy, Cohort, Female, Human, medicine.medical_specialty, Article, NO, 03 medical and health sciences, Sex Factors, Internal medicine, medicine, Humans, Pandemics, Survival rate, Retrospective Studies, Aged, business.industry, SARS-CoV-2, Risk Factor, lcsh:R, Retrospective cohort study, Length of Stay, medicine.disease, Obesity, lcsh:Q, Coronavirus disease, clinical characteristics, business
Abstract: Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk.
Published: 2020

45. Preliminary qualification of a novel, hypoxic-based radiologic signature for trans-arterial chemoembolization in hepatocellular carcinoma

Author: Madhava Pai, Paul Tait, Alexandros Giakoustidis, Isabella Reccia, Alberto Oldani, Georgios Karamanakos, Markand Patel, David J. Pinato, Rohini Sharma, G. Grossi, Azelea Rushd, Mario Pirisi, and Shiraz Jamshaid
Subjects: Male, Oncology, Cancer Research, Survival, Hepatocellular carcinoma, Kaplan-Meier Estimate, 0302 clinical medicine, Surgical oncology, Hypoxia, Aged, 80 and over, Univariate analysis, Liver Neoplasms, Middle Aged, Prognosis, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Tumor Burden, Treatment Outcome, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Trans arterial chemoembolization, Research Article, Adult, medicine.medical_specialty, Poor prognosis, Carcinoma, Hepatocellular, Prognostic index, lcsh:RC254-282, 03 medical and health sciences, Transarterial chemoembolisation, Internal medicine, Genetics, medicine, Humans, In patient, Oncology & Carcinogenesis, Chemoembolization, Therapeutic, Aged, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, Proportional hazards model, business.industry, Retrospective cohort study, medicine.disease, Tomography, X-Ray Computed, business, 1112 Oncology And Carcinogenesis, Biomarkers
Abstract: Background Survival advantage following trans-arterial chemoembolization (TACE) is variable in patients with hepatocellular carcinoma (HCC). We combined pre-TACE radiologic features to derive a novel prognostic signature in HCC. Methods A multi-institutional dataset of 98 patients was generated from two retrospective cohorts from United Kingdom (65%) and Italy (36%). The prognostic impact of a number baseline imaging parameters was assessed and factors significant on univariate analysis were combined to create a novel radiologic signature on multivariable analyses predictive of overall survival (OS) following TACE. Results Median OS was 15.4 months. Tumour size > 7 cm (p 7 cm, ITN and AEN identified patients with poor prognosis (p
Published: 2018

46. Gas6 as a predictor of esophageal varices in patients affected by hepatitis C virus related-chronic liver disease

Author: Matteo Nazzareno Barbaglia, Rosalba Minisini, Gian Carlo Avanzi, Paolo Ravanini, Luca Molinari, Mattia Bellan, Pier Paolo Sainaghi, Luigi Mario Castello, Mario Pirisi, Livia Salmi, Margherita Tran Minh, and Marco Baldrighi
Subjects: Male, medicine.medical_specialty, Cirrhosis, Hepatitis C virus, Clinical Biochemistry, Hepacivirus, Esophageal and Gastric Varices, Chronic liver disease, medicine.disease_cause, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Esophageal varices, Internal medicine, Drug Discovery, medicine, Humans, In patient, Aged, business.industry, Liver Diseases, Biochemistry (medical), Upper endoscopy, Middle Aged, medicine.disease, Liver, 030220 oncology & carcinogenesis, Intercellular Signaling Peptides and Proteins, Female, 030211 gastroenterology & hepatology, Varices, Transient elastography, business
Abstract: Aim: Plasma Gas6 was tested as an alternative to Baveno VI criteria (liver stiffness 150 × 109/l) in an endoscopy-sparing strategy. Methods: A total of 160 patients with chronic hepatitis C and advanced fibrosis/cirrhosis underwent, on the same occasion, liver elastography, upper endoscopy, a platelet count and serum Gas6 measurement. Results: A total of 74/160 (46%) patients had esophageal varices, that were small (diameter
Published: 2018

47. Epidemiological and clinical profile of 302 patients with primary biliary cholangitis in Piedmont and Liguria

Author: D. Azzolina, Sara Labanca, A. Morgando, C. De Benedittis, E. Vanni, Micol Giulia Cittone, Mario Pirisi, Antonio Picciotto, and Cristina Rigamonti
Subjects: medicine.medical_specialty, Primary (chemistry), Hepatology, business.industry, Internal medicine, Epidemiology, Gastroenterology, Medicine, business
Published: 2021

48. Integration of the cancer-related inflammatory response as a stratifying biomarker of survival in hepatocellular carcinoma treated with sorafenib

Author: Antonello Gibbin, Jessica Howell, C. Ferrari, James R M Black, Tadaaki Arizumi, Michela Emma Burlone, Masatoshi Kudo, David J. Pinato, Pierluigi Toniutto, Laura Sellers, G. Guaschino, Mario Pirisi, Ramya Ramaswami, and Rohini Sharma
Subjects: Male, CLIP score, IMPACT, Neutrophils, PREDICT, 0302 clinical medicine, BCLC, Inflammation, Liver cancer, VEGF inhibitor, Lymphocytes, CIRRHOSIS, OUTCOMES, Liver Neoplasms, Middle Aged, Sorafenib, Prognosis, C-REACTIVE PROTEIN, SINGLE-CENTER EXPERIENCE, Oncology, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Female, 030211 gastroenterology & hepatology, LYMPHOCYTE RATIO, Life Sciences & Biomedicine, Research Paper, medicine.drug, Niacinamide, Risk, medicine.medical_specialty, Carcinoma, Hepatocellular, Antineoplastic Agents, CELL DISTRIBUTION WIDTH, liver cancer, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, SCORE, medicine, Humans, SKIN TOXICITY, Neutrophil to lymphocyte ratio, Aged, Neoplasm Staging, Retrospective Studies, Science & Technology, business.industry, Phenylurea Compounds, Cancer, Red blood cell distribution width, Cell Biology, Hepatology, medicine.disease, Survival Analysis, BCLC Stage, Surgery, business, Biomarkers, Follow-Up Studies
Abstract: // Jessica A. Howell 1, 2, 3, * , David J. Pinato 1, * , Ramya Ramaswami 1 , Tadaaki Arizumi 4 , Carlotta Ferrari 5 , Antonello Gibbin 5 , Michela E. Burlone 5 , Giulia Guaschino 5 , Pierluigi Toniutto 6 , James Black 1 , Laura Sellers 1 , Masatoshi Kudo 4 , Mario Pirisi 5 and Rohini Sharma 1 1 Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK 2 Centre for Population Health, Burnet Institute, Melbourne, Australia 3 Department of Medicine, University of Melbourne, Melbourne, Australia 4 Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan 5 Department of Translational Medicine, Universita degli Studi del Piemonte Orientale “A. Avogadro”, Novara, Italy 6 Department of Experimental and Clinical Medicine, University of Udine, Udine, Italy * These authors have contributed equally to the work Correspondence to: Jessica A. Howell, email: jessica.howell@svha.org.au Keywords: liver cancer, VEGF inhibitor, CLIP score, BCLC, inflammation Received: March 30, 2016 Accepted: October 13, 2016 Published: February 14, 2017 ABSTRACT Background and Aims: Response to sorafenib is highly variable in hepatocellular carcinoma (HCC). Baseline inflammatory parameters and treatment toxicities may improve survival prediction in patients on sorafenib therapy. Results: 442 patients with advanced stage HCC on sorafenib were recruited (follow-up 5096 person-months at risk). 88% had BCLC stage B or greater HCC and 72.3% had Child-Pugh A cirrhosis. On Cox multivariate regression, previously-treated HCC (HR 0.579, 95% CI 0.385-0.872, p=0.009), Cancer of Liver Italian Program (CLIP) score (HR 1.723, 95% CI 1.462-2.047, p
Published: 2017

49. The albumin-bilirubin grade improves hepatic reserve estimation post-sorafenib failure: implications for drug development

Author: C. Yen, Robert Thimme, Caroline Ward, Ramya Ramaswami, Mario Pirisi, Rohini Sharma, David J. Pinato, Tadaaki Arizumi, Dominik Bettinger, Masatoshi Kudo, and Michela Emma Burlone
Subjects: Male, ALBI GRADE, PROGNOSIS, Databases, Factual, IMPACT, 0302 clinical medicine, Pharmacology (medical), Pharmacology & Pharmacy, Prospective Studies, Stage (cooking), Prospective cohort study, TARGETED THERAPIES, Aged, 80 and over, Liver Neoplasms, Gastroenterology, Middle Aged, Sorafenib, 3. Good health, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, SURVIVAL, Disease Progression, Female, 030211 gastroenterology & hepatology, Liver cancer, Life Sciences & Biomedicine, medicine.drug, Adult, Niacinamide, medicine.medical_specialty, Carcinoma, Hepatocellular, Antineoplastic Agents, CHILD-PUGH, 03 medical and health sciences, ADVANCED HEPATOCELLULAR-CARCINOMA, Albumins, Internal medicine, medicine, Carcinoma, Humans, neoplasms, Aged, Science & Technology, Gastroenterology & Hepatology, Hepatology, business.industry, Patient Selection, Phenylurea Compounds, BRIVANIB, LIVER-CIRRHOSIS, 1103 Clinical Sciences, Bilirubin, EFFICACY, medicine.disease, digestive system diseases, Surgery, Discontinuation, 1115 Pharmacology And Pharmaceutical Sciences, Liver function, business
Abstract: SummaryBackground Drug development in hepatocellular carcinoma (HCC) is limited by disease heterogeneity, with hepatic reserve being a major source of variation in survival outcomes. The albumin–bilirubin (ALBI) grade is a validated index of liver function in patients with HCC. Aim To test the accuracy of the ALBI grade in predicting post-sorafenib overall survival (PSOS) in patients who permanently discontinued treatment. Methods From a prospectively maintained international database of 447 consecutive referrals, we derived 386 eligible patients treated with sorafenib within Barcelona Clinic Liver Cancer C stage (62%), 75% of whom were of Child class A at initiation. Clinical variables at sorafenib discontinuation were analysed for their impact on post-sorafenib overall survival using uni- and multivariable analyses. Results Median post-sorafenib overall survival of the 386 eligible patients was 3.4 months and median sorafenib duration was 2.9 months, with commonest causes of cessation being disease progression (68%) and toxicity (24%). At discontinuation, 92 patients (24%) progressed to terminal stage, due to worsening Child class to C in 40 (10%). Median post-sorafenib overall survival in patients eligible for second-line therapies (n = 294) was 17.5, 7.5 and 1.9 months according respectively to ALBI grade 1, 2 and 3 (P < 0.001). Conclusions The ALBI grade at sorafenib discontinuation identifies a subset of patients with prolonged stability of hepatic reserve and superior survival. This may allow improved patient selection for second-line therapies in advanced HCC.
Published: 2017

50. Modulation of Oxidative Stress by 17 β-Estradiol and Genistein in Human Hepatic Cell Lines In Vitro

Author: Giulia Raina, Nicola Surico, Daniela Surico, David A.S.G. Mary, Mario Pirisi, Serena Farruggio, Rosalba Minisini, Alfredo Ercoli, Elena Grossini, and Davide Filippini
Subjects: 0301 basic medicine, MAPK/ERK pathway, Cell viability, medicine.medical_specialty, Peroxidation, Cell Survival, Physiology, Estrogen receptor, Genistein, Phytoestrogens, Pharmacology, Biology, medicine.disease_cause, p38 Mitogen-Activated Protein Kinases, lcsh:Physiology, Antioxidants, Cell Line, lcsh:Biochemistry, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, Humans, lcsh:QD415-436, Protein kinase B, Estrogenic receptors, lcsh:QP1-981, Estradiol, Mitochondria, Oxidative Stress, 030104 developmental biology, Endocrinology, chemistry, 030220 oncology & carcinogenesis, Hepatocytes, Hepatic stellate cell, Proto-Oncogene Proteins c-akt, GPER, Oxidative stress, Signal Transduction
Abstract: Background/Aims: estrogens and phytoestrogens exert hepatoprotection through mechanisms not clearly examined yet. Here, we investigated the protective effects exerted by 17β-estradiol and genistein against oxidative stress in hepatocytes and hepatic stellate cells (HSCs) and the involvement of specific receptors and the intracellular signalling. Methods: Huh7.5 and LX-2, alone or in co-culture with Huh7.5, were treated with 17β-estradiol and genistein alone or in the presence of menadione and of estrogen receptors (ERs) and G protein-coupled-estrogenic-receptors (GPER) blockers. Cell viability, mitochondrial membrane potential and oxidant/antioxidant system were measured by specific kits. Western Blot was used for the analysis of Akt and p38-mitogen-activated-protein kinases (MAPK) activation and α-smooth-muscle actin expression. Results: In Huh7.5, 17β-estradiol and genistein prevented the effects of peroxidation by modulating Akt and p38MAPK activation. Similar antioxidant and protective findings were obtained in LX-2 of co-culture experiments, only. ERs and GPER blockers were able to prevent the effects of 17β-estradiol and genistein. Conclusion: In Huh7.5 and LX-2, 17β-estradiol and genistein counteract the effects of peroxidation through the involvement of ERs and GPER and by an intracellular signalling related to Akt and p38MAPK. As concerning LX-2, paracrine factors released by Huh7.5 play a key role in protection against oxidative stress.
Published: 2017

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