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

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1,087 results on '"Morena A."'

1. Molecular and clinical characterization of transient antithrombin deficiency: A new concept in congenital thrombophilia

Author: José Padilla, Carlos Bravo-Pérez, Vicente Vicente, Rosa Cifuentes, María Eugenia de la Morena-Barrio, Belén de la Morena-Barrio, Pedro Garrido, Antonia Miñano, and Javier Corral
Subjects: Adult, Male, medicine.medical_specialty, Antithrombin III, Thrombophilia, Gastroenterology, Internal medicine, Functional methods, medicine, Humans, Family history, Antithrombin III Deficiency, Molecular screening, business.industry, Antithrombin, Genetic Variation, Antithrombin Activity, Hematology, Middle Aged, medicine.disease, Antithrombin deficiency, Female, business, Thrombotic complication, medicine.drug
Abstract: Antithrombin deficiency, the most severe thrombophilia, might be underestimated, since it is only investigated in cases with consistent functional deficiency or family history. We have analyzed 444 consecutive, unrelated cases, from 1998 to 2021, with functional results supporting antithrombin deficiency in at least one sample. Plasma antithrombin was evaluated by functional and biochemical methods in at least two samples. SERPINC1 gene was analyzed by sequencing and MPLA. Hypoglycosylation was studied by electrophoresis and high-performance liquid chromatography (HPLC). In 260 of 305 cases (85.2%) with constitutive deficiency (activity < 80% in all samples), a SERPINC1 (N = 250), or N-glycosylation defect (N = 10) was observed, while 45 remained undetermined. The other 139 cases had normal antithrombin activity (≥ 80%) in at least one sample, what we called transient deficiency. Sixty-one of these cases (43.9%) had molecular defects: 48 had SERPINC1 variants, with two recurrent mutations (p.Ala416Ser[Cambridge II], N = 15; p.Val30Glu[Dublin], N = 12), and 13 hypoglycosylation. Thrombotic complications occurred in transient deficiency, but were less frequent, latter-onset, and had a higher proportion of arterial events than in constitutive deficiency. Two mechanisms explained transient deficiency: The limitation of functional methods to detect some variants and the influence of external factors on the pathogenic consequences of these mutations. Our study reveals a molecular defect in a significant proportion of cases with transient antithrombin deficiency, and changes the paradigm of thrombophilia, as the pathogenic effect of some mutations might depend on external factors and be present only at certain timepoints. Antithrombin deficiency is underestimated, and molecular screening might be appropriate in cases with fluctuating laboratory findings.
Published: 2021
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2. Change in levothyroxine requirements after bariatric surgery in patients with hypothyroidism

Author: Miriam Zapatero Larrauri, Ana Isabel Cos Blanco, Rosa María García-Moreno, Lucrecia Herranz de la Morena, and Isabel Calvo Viñuela
Subjects: Pediatrics, medicine.medical_specialty, business.industry, Endocrinology, Diabetes and Metabolism, Levothyroxine, Bariatric Surgery, Thyroxine, Text mining, Endocrinology, Hypothyroidism, Weight Loss, medicine, Humans, In patient, business, medicine.drug, Retrospective Studies
Abstract: Objectives. This study aims to evaluate the need to modify the total and weight-adjusted doses of levothyroxine after bariatric surgery, identify predictors, and assess the influence of the weight loss on the levothyroxine requirements. Methods. A retrospective study in patients with treated hypothyroidism that underwent bariatric surgery. The modification of the levothyroxine dose and its association with the weight loss and other potential predictors were evaluated at 6, 12, and 24 months post-surgery. Results. Among the 63 patients included, 82.54% needed an adjustment of levothyroxine dose during the follow-up. The total weekly dose of levothyroxine (µg) decreased post-surgery at 6 months (β= −49.1; 95%CI-93.7 to −4.5; p=0.031) and 12 months (β=−54.9; 95%CI-102 to −7.8; p=0.022), but did not significantly change at 24 months (p=0.114). The weekly weight-adjusted dose (µg/k) increased at 6 months (β=1.37; 95%CI 0.91 to 1.83; p Conclusions. This study shows a significant decrease in the total dose of levothyroxine requirements change after bariatric surgery during the first year of the follow-up and an increase in the weight-adjusted dose over the first two years. No predictors of modification of the total dose of levothyroxine were identified.
Published: 2022
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3. High penetrance of inferior vena cava system atresia in severe thrombophilia caused by homozygous antithrombin Budapest 3 variant: Description of a new syndrome

Author: Maria S Infante, Réka Gindele, Zsolt Oláh, Marianna Speker, Isabel Zuazu, Carlos Bravo-Pérez, Péter Ilonczai, Laura Entrena, José María Navarro García, Asunción Mora-Casado, María Eugenia de la Morena-Barrio, Antonia Miñano, José Padilla, Ágota Schlammadinger, Vicente Vicente, Belén de la Morena-Barrio, Zsuzsanna Bereczky, Javier Corral, Juan J Rodríguez-Sevilla, and Rosa Cifuentes-Riquelme
Subjects: Adult, Male, medicine.medical_specialty, Antithrombin III, Vena Cava, Inferior, Thrombophilia, Polymorphism, Single Nucleotide, Inferior vena cava, Young Adult, Internal medicine, medicine, Humans, Vascular Diseases, Aged, Fetus, business.industry, Homozygote, Antithrombin, Hematology, Middle Aged, medicine.disease, Thrombosis, Venous thrombosis, Cross-Sectional Studies, medicine.vein, Atresia, cardiovascular system, Etiology, Cardiology, Female, business, medicine.drug
Abstract: Atresia of inferior vena cava (IVC) is a rare congenital malformation associated with high risk of venous thrombosis that still has unknown etiology, although intrauterine IVC thrombosis has been suggested to be involved. The identification of IVC atresia in a case with early idiopathic venous thrombosis and antithrombin deficiency caused by the homozygous SERPINC1 c.391C > T variant (p.Leu131Phe; antithrombin Budapest 3) encouraged us to evaluate the role of this severe thrombophilia in this vascular abnormality. We have done a cross-sectional study in previously identified cohorts of patients homozygous for the Budapest 3 variant (N = 61) selected from 1118 patients with congenital antithrombin deficiency identified in two different populations: Spain (N = 692) and Hungary (N = 426). Image analysis included computed tomography and phlebography. Atresia of the IVC system was observed in 17/24 cases (70.8%, 95% confidence interval [CI]: 48.9%-87.3%) homozygous for antithrombin Budapest 3 with available computed tomography (5/8 and 12/16 in the Spanish and Hungarian cohorts, respectively), 16 had an absence of infrarenal IVC and one had atresia of the left common iliac vein. All cases with vascular defects had compensatory mechanisms, azygos-hemiazygos continuation or double IVC, and seven also had other congenital anomalies. Short tandem repeat analysis supported the specific association of the IVC system atresia with SERPINC1. We show the first evidence of the association of a severe thrombophilia with IVC system atresia, supporting the possibility that a thrombosis in the developing fetal vessels is the reason for this anomaly. Our hypothesis-generating results encourage further studies to investigate severe thrombophilic states in patients with atresia of IVC.
Published: 2021
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4. Phenotypes of Patients with COVID-19 Who Have a Positive Clinical Response to Helmet Noninvasive Ventilation

Author: Domenico Luca Grieco, Luca S. Menga, Melania Cesarano, Savino Spadaro, Maria Maddalena Bitondo, Cecilia Berardi, Tommaso Rosà, Filippo Bongiovanni, Salvatore Maurizio Maggiore, Massimo Antonelli, Jonathan Montomoli, Giulia Falò, Tommaso Tonetti, Salvatore L. Cutuli, Gabriele Pintaudi, Eloisa S. Tanzarella, Edoardo Piervincenzi, Antonio M. Dell’Anna, Luca Delle Cese, Simone Carelli, Maria Grazia Bocci, Luca Montini, Giuseppe Bello, Daniele Natalini, Gennaro De Pascale, Matteo Velardo, Carlo Alberto Volta, V. Marco Ranieri, Giorgio Conti, Riccardo Maviglia, Giovanna Mercurio, Paolo De Santis, Mariano Alberto Pennisi, Gian Marco Anzellotti, Flavia Torrini, Carlotta Rubino, Tony C. Morena, Veronica Gennenzi, Stefania Postorino, Joel Vargas, Nicoletta Filetici, Donatella Settanni, Miriana Durante, Laura Cascarano, Mariangela Di Muro, Roberta Scarascia, Martina Murdolo, Alessandro Mele, Serena Silva, Carmelina Zaccone, Francesca Pozzana, Alessio Maccaglia, Martina Savino, Antonella Potalivo, Francesca Ceccaroni, Angela Scavone, Gianmarco Lombardi, and Teresa Michi
Subjects: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MEDLINE, Critical Care and Intensive Care Medicine, Respiratory Rate, Internal medicine, Settore MED/41 - ANESTESIOLOGIA, Intubation, Intratracheal, Humans, Medicine, Aged, Noninvasive Ventilation, business.industry, Oxygen Inhalation Therapy, COVID-19, Middle Aged, Phenotype, Respiratory Function Tests, Treatment Outcome, Italy, Female, Noninvasive ventilation, business, Phenotypes of Patients with COVID-19
Published: 2022
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5. Uniportal Video-Assisted Thoracoscopic Right Upper Lobectomy

Author: Diego Gonzalez-Rivas, Anna Minasyan, Marina Paradela de la Morena, and Alejandro García-Pérez
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Standard of care, business.industry, General surgery, Sagittal plane, medicine.anatomical_structure, Daily practice, Invasive surgery, Adjuvant therapy, Medicine, Surgery, Video assisted, Instrumentation (computer programming), Cardiology and Cardiovascular Medicine, business, Surgical treatment
Abstract: Minimally invasive surgery (MIS) is gradually becoming the standard of care for the surgical treatment of nonsmall cell lung cancer (NSCLC). Compared with the multiple incision approach, including conventional multiportal video-assisted thoracoscopic surgery (mVATS) and multiportal robotic-assisted thoracoscopic surgery (mRATS), uniportal video-assisted thoracoscopic surgery (uVATS) offers a range of potential benefits such as straight target view from a sagittal plane, better lung exposure, ergonomic instrumentation, reduced postoperative pain, faster recovery, shorter length of hospital stay, and earlier administration of adjuvant therapy when necessary. However, uVATS remains a challenging procedure since all instrumentation shares the same access incision along the videothoracoscope. The learning curve demands a profound knowledge of specific technical details and comfort with specialized equipment to avoid intraoperative complications, essentially vascular accidents. This article provides a step-by-step description of uVATS right upper lobectomy, reviewing practical tips and tricks about operating room set-up, incision strategy, instrumentation management and operative sequence applied to the fissureless technique. This surgical technique is based on the author's preference and experience and therefore should not be taken as the only valid option. Our purpose is to make uVATS surgery accessible for most surgeons in their daily practice.
Published: 2022
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6. Chronic exertional compartment syndrome of the forearm: a systematic review

Author: Mario Cherubino, Federico Tamborini, Andrea Minini, Morena A Basso, Francesco Smeraglia, Leonardo Garutti, Smeraglia, Francesco, Tamborini, Federico, Garutti, Leonardo, Minini, Andrea, Basso, Morena A, and Cherubino, Mario
Subjects: medicine.medical_specialty, Diagnostic methods, medicine.medical_treatment, Pain relief, MEDLINE, Hand & Wrist, Fasciotomy, Return to sport, 03 medical and health sciences, 0302 clinical medicine, Forearm, Survivorship curve, medicine, chronic, compartment, exertional, forearm, Orthopedics and Sports Medicine, Chronic exertional compartment syndrome, 030222 orthopedics, business.industry, 030229 sport sciences, medicine.disease, medicine.anatomical_structure, Physical therapy, Surgery, business
Abstract: The aim of this systematic review is to understand which surgical procedure provides better results in terms of pain relief and function in the treatment of chronic exertional compartment syndrome (CECS) of the forearm. We searched Medline (PubMed), Web of Science, Embase and Scopus databases on 8 July 2020. Twelve studies were included in this review. We assessed the quality of the studies using the Coleman Methodological Score. Data on demographic features, operative readings, diagnostic methods, follow-up periods, type and rates of complications, survivorship of the procedure, return to sport activity, and outcome measures were recorded. In conclusion, compared to the other techniques, endoscopic fasciotomy delivers similar success rates and lower incidence of complications. Cite this article: EFORT Open Rev 2021;6:101-106. DOI: 10.1302/2058-5241.6.200107
Published: 2021
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7. Cerebellar Ischemia Presenting as Transient Global Amnesia

Author: Hera A. Kamdar, Jonathan Morena, and Amir Adeli
Subjects: congenital, hereditary, and neonatal diseases and abnormalities, Cerebellum, medicine.medical_specialty, Anterograde amnesia, Cognitive Neuroscience, Ischemia, Hippocampus, Limbic system, Amnesia, Transient Global, Spect imaging, Internal medicine, medicine, Humans, Aged, business.industry, General Medicine, Amnesia, Anterograde, medicine.disease, Psychiatry and Mental health, Diffusion Magnetic Resonance Imaging, Neuropsychology and Physiological Psychology, medicine.anatomical_structure, nervous system, Cardiology, Cerebellar vermis, Transient global amnesia, Female, Amnesia, medicine.symptom, business
Abstract: Transient global amnesia (TGA) consists of acute-onset anterograde amnesia and typically resolves within 24 hours. Reported etiologies of TGA include transient ischemia to the hippocampus or thalamus, migraine, venous flow abnormalities, and epilepsy. There are no reports of cerebellar ischemia as an etiology of TGA. A 78-year-old woman with a medical history of diabetes presented to the Ohio State University ER after a period of anterograde amnesia lasting 3 hours. She was alert during the event, but asked the same questions repeatedly. Upon arrival to the ER, she was hypertensive but clinically back to baseline, with no recall of the 3-hour time period. An MRI of her brain revealed an isolated hyperintense signal on diffusion-weighted imaging (DWI) at the junction of the superior cerebellum and vermis, with apparent diffusion coefficient correlation. Vascular imaging of the brain and neck and a routine EEG were unremarkable. We diagnosed her with cerebellar ischemia presenting as TGA. She had no head injury, migraine, or history of epilepsy to suggest alternative etiologies of TGA. An increasing amount of literature has reported that the cerebellum is linked to the limbic system. A case series of SPECT imaging on individuals with TGA revealed transient cerebellar vermis hypoperfusion in addition to hippocampal DWI changes. We present what may be a novel report of isolated cerebellar ischemia presenting as TGA, and we add to the literature for clinicians to consider the possibility that damage to the cerebellum or its circuit to the cerebrum or thalamus can present as TGA.
Published: 2021
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8. Skeletal Muscle Phenotype in Patients Undergoing Long-Term Hemodialysis Awaiting Kidney Transplantation

Author: Fabrice Raynaud, Marion Morena, Fares Gouzi, Maurice Hayot, Bronia Ayoub, Valérie Garrigue, Eric Badia, Moglie Le Quintrec, Jean-Sébastien Souweine, Pascal Pomiès, Jacques Mercier, Jean-Paul Cristol, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and MORNET, Dominique
Subjects: medicine.medical_specialty, Epidemiology, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Population, 030232 urology & nephrology, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Mitophagy, medicine, Humans, Renal Insufficiency, Muscle, Skeletal, education, 2. Zero hunger, Transplantation, education.field_of_study, Muscle biopsy, medicine.diagnostic_test, business.industry, Skeletal muscle, Original Articles, medicine.disease, Uremia, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, Endocrinology, Nephrology, Sarcopenia, Hemodialysis, Energy Metabolism, business
Abstract: International audience; Background and objectives Age and comorbidity-related sarcopenia represent a main cause of muscle dysfunction in patients on long-term hemodialysis. However, recent findings suggest muscle abnormalities that are not associated with sarcopenia. The aim of this study was to isolate functional and cellular muscle abnormalities independently of other major confounding factors, including malnutrition, age, comorbidity, or sedentary lifestyle, which are common in patients on maintenance hemodialysis. To overcome these confounding factors, alterations in skeletal muscle were analyzed in highly selected patients on long-term hemodialysis undergoing kidney transplantation. Design, setting, participants, & measurements In total, 22 patients on long-term hemodialysis scheduled for kidney transplantation with few comorbidities, but with a long-term uremic milieu exposure, and 22 age, sex, and physical activity level frequency-matched control participants were recruited. We compared biochemical, functional, and molecular characteristics of the skeletal muscle using maximal voluntary force and endurance of the quadriceps, 6-minute walking test, and muscle biopsy of vastus lateralis . For statistical analysis, mean comparison and multiple regression tests were used. Results In patients on long-term hemodialysis, muscle endurance was lower, whereas maximal voluntary force was not significantly different. We observed a transition from type I (oxidative) to type II (glycolytic) muscle fibers, and an alteration of mitochondrial structure (swelling) without changes in DNA content, genome replication (peroxisome proliferator activator receptor γ coactivator-1 α and mitochondrial transcription factor A), regulation of fusion (mitofusin and optic atrophy 1), or fission (dynamin-related protein 1). Notably, there were autophagosome structures containing glycogen along with mitochondrial debris, with a higher expression of light chain 3 (LC3) protein, indicating phagophore formation. This was associated with a greater conversion of LC3-I to LC3-II and the expression of Gabaralp1 and Bnip3l genes involved in mitophagy. Conclusions In this highly selected long-term hemodialysis population, a low oxidative phenotype could be defined by a poor endurance, a fiber-type switch, and an alteration of mitochondria structure, without evidence of sarcopenia. This phenotype could be related to uremia through the activation of autophagy/mitophagy. Clinical Trial registration numbers: NCT02794142 and NCT02040363 .
Published: 2021
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9. Initial experience with a homemade 'hybrid-tome' for needle-knife precut in patients with difficult biliary cannulation

Author: Emilio Jesús de la Morena Madrigal, Ana Belén Galera Ródenas, Isabel Rodríguez García, and Elena Pérez Arellano
Subjects: Original article, medicine.medical_specialty, business.industry, Technical success, Objective data, RC799-869, Diseases of the digestive system. Gastroenterology, Clinical success, Surgery, Major duodenal papilla, Medicine, Pharmacology (medical), Observational study, In patient, Needle knife, business
Abstract: Background and study aims Current clinical guidelines recommend needle-knife precut (NKP) as the primary and best method for performing a biliary cannulation (BC) when simple techniques fail and the criteria are met for difficult BC (DBC). However, many endoscopists avoid or defer early NKP in favor of alternative, simpler techniques that have not been shown to be either safer or more effective. Our goal is to test a device that provides the needle-knife papillotome (NKPT) with traction capability and which can facilitate the learning and execution of NKP. Patients and methods This was a descriptive bicentric observational study of a personal cohort of patients undergoing early NKP to analyse the efficacy and safety of the technique with a “hybrid-tome” (HT) built using the isolated core of a NKPT and a conventional canulotome. Results Over a 4-year period, we performed 43 NKPs with the HT, achieving BC in one or two steps in all cases. The 100 % technical success was matched by a 95 % clinical success rate. We recorded 11 adverse events (23 %): five hemorrhages, four pancreatitis, and two cholangitis. In addition to the objective data, we confirmed that HT facilitates alignment with the duodenal papilla and the execution of pre-cutting, especially if the papilla is intradiverticular or hidden by folds. Conclusions The HT tested seems to help trained endoscopists to perform NKP, especially in some anatomic situations, which can improve compliance with the guidelines recommended for early NKP in patients with DBC.
Published: 2021
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10. Choroid Plexus Enlargement in Inflammatory Multiple Sclerosis: 3.0-T MRI and Translocator Protein PET Evaluation

Author: Matteo Tonietto, Vito A. G. Ricigliano, Benedetta Bodini, Emilie Poirion, Annalisa Colombi, Bruno Stankoff, Michel Bottlaender, Mariem Hamzaoui, Emanuele Morena, Céline Louapre, and Philippe Gervais
Subjects: Adult, Male, Pathology, medicine.medical_specialty, Multiple Sclerosis, Receptors, GABA, medicine, Translocator protein, Humans, Radiology, Nuclear Medicine and imaging, In patient, Prospective Studies, Inflammation, biology, business.industry, Multiple sclerosis, Organ Size, Middle Aged, medicine.disease, Magnetic Resonance Imaging, medicine.anatomical_structure, Positron-Emission Tomography, Choroid Plexus, biology.protein, Female, Choroid plexus, Choroid, business
Abstract: Background Choroid plexuses (CPs) have been suggested as a key gateway for inflammation in experimental autoimmune encephalitis, but in vivo evidence of their involvement in multiple sclerosis (MS) is lacking. Purpose To assess CP volumetric and inflammatory changes in patients with MS versus healthy control participants. Materials and Methods This was a secondary analysis of 97 patients (61 with relapsing-remitting MS [RRMS] and 36 with progressive MS) and 44 healthy control participants who participated in three prospective 3.0-T brain MRI studies between May 2009 and September 2017. A subgroup of 37 patients and 19 healthy control participants also underwent translocator protein fluorine 18 (
Published: 2021
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11. Botulinum toxin for the management of spasticity in multiple sclerosis: the Italian botulinum toxin network study

Author: Anna Castagna, Calogera Butera, Ubaldo Del Carro, M. Frontoni, S. Lori, Jessica Frau, Giancarlo Coghe, Francesco Bono, Vincenzo Brescia Morra, Antonio Carotenuto, Marcello Moccia, Pamela Latino, Stefania Lanfranchi, Morena Giovannelli, Marcello Romano, Caterina Nascimbene, Laura Rapisarda, P. Barbero, Loredana Maggi, Elisabetta Groppo, Vitalma Liotti, Roberto Eleopra, Cristina Inglese, Marcello Esposito, Maria Concetta Altavista, Emma Frasson, Maria Buccafusca, Salvatore Lo Fermo, Martina Petracca, Moccia, Marcello, Frau, Jessica, Carotenuto, Antonio, Butera, Calogera, Coghe, Giancarlo, Barbero, Pierangelo, Frontoni, Marco, Groppo, Elisabetta, Giovannelli, Morena, Del Carro, Ubaldo, Inglese, Cristina, Frasson, Emma, Castagna, Anna, Buccafusca, Maria, Latino, Pamela, Nascimbene, Caterina, Romano, Marcello, Liotti, Vitalma, Lanfranchi, Stefania, Rapisarda, Laura, Lori, Silvia, Esposito, Marcello, Maggi, Loredana, Petracca, Martina, Lo Fermo, Salvatore, Altavista, Maria Concetta, Bono, Francesco, Eleopra, Roberto, and Brescia Morra, Vincenzo
Subjects: Adult, medicine.medical_specialty, Multiple Sclerosis, Botulinum, Modified Ashworth scale, Hypophonia, Dermatology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Activities of Daily Living, Humans, Medicine, Multiple sclerosi, Symptomatic treatment, 030212 general & internal medicine, Spasticity, Botulinum Toxins, Type A, Multiple sclerosis, Adverse effect, Expanded Disability Status Scale, business.industry, General Medicine, Middle Aged, Botulinum toxin, Clinical trial, Psychiatry and Mental health, Cross-Sectional Studies, Treatment Outcome, Italy, Neuromuscular Agents, Muscle Spasticity, Concomitant, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, medicine.drug
Abstract: Botulinum toxin (BT) is an effective and safe treatment for spasticity, with limited evidence in multiple sclerosis (MS). We aim to describe the use of BT for the management of MS spasticity in the clinical practice, its combination with other anti-spastic treatments in MS and possible MS clinical correlates. This is a multicentre cross-sectional observational study including 386 MS patients, receiving BT for spasticity in 19 Italian centres (age 53.6 ± 10.9 years; female 228 (59.1%); disease duration 18.7 ± 9.2 years; baseline Expanded Disability Status Scale (EDSS) 6.5 (2.0–9.0)). BT was used for improving mobility (n = 170), functioning in activities of daily living (n = 56), pain (n = 56), posturing-hygiene (n = 63) and daily assistance (n = 41). BT formulations were AbobotulinumtoxinA (n = 138), OnabotulinumtoxinA (n = 133) and IncobotulinumtoxinA (n = 115). After conversion to unified dose units, higher BT dose was associated with higher EDSS (Coeff = 0.591; p
Published: 2020
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12. Initial Invasive or Conservative Strategy for Stable Coronary Disease

Author: Maron D. J., Hochman J. S., Reynolds H. R., Bangalore S., O'Brien S. M., Boden W. E., Chaitman B. R., Senior R., Lopez-Sendon J., Alexander K. P., Lopes R. D., Shaw L. J., Berger J. S., Newman J. D., Sidhu M. S., Goodman S. G., Ruzyllo W., Gosselin G., Maggioni A. P., White H. D., Bhargava B., Min J. K., John Mancini G. B., Berman D. S., Picard M. H., Kwong R. Y., Ali Z. A., Mark D. B., Spertus J. A., Krishnan M. N., Elghamaz A., Moorthy N., Hueb W. A., Demkow M., Mavromatis K., Bockeria O., Peteiro J., Miller T. D., Szwed H., Doerr R., Keltai M., Selvanayagam J. B., Gabriel Steg P., Held C., Kohsaka S., Mavromichalis S., Kirby R., Jeffries N. O., Harrell F. E., Rockhold F. W., Broderick S., Bruce Ferguson T., Williams D. O., Harrington R. A., Stone G. W., Rosenberg Y, ISCHEMIA Research Group: Joseph Ricci, A Tello Montoliu, A I Robero Aniorte, Abbey Mulder, Abhay A Laddu, Abhinav Goyal, Abhishek Dubey, Abhishek Goyal, Abigail Knighton, Abraham Oomman, Adam J Jaskowiak, Adam Kolodziej, Adam Witkowski, Adnan Hameed, Adriana Anesini, Afshan Hussain, Agne Juceviciene, Agne Urboniene, Agnes Jakal, Agnieszka Szramowska, Ahmad Khairuddin, Ahmed Abdel-Latif, Ahmed Adel, Ahmed Aljzeeri, Ahmed Kamal, Ahmed Talaat, Aimee Mann, Aira Contreras, Ajit Kumar, V K Kumar, Akemi Furukawa, Akshay Bagai, Akvile Smigelskaite, Alain Furber, Alain Rheault, Alaine Melanie Loehr, Alan Rosen, Albert Varga, Albertina Qelaj, Alberto Barioli, Aldo Russo, Alec Moorman, Alejandro Gisbert, Aleksandra Fratczak, Aleksandras Laucevicius, Alena Kuleshova, Alessandro Sionis, Alexander A Sirker, Alexander M Chernyavskiy, Alexandra Craft, Alexandra Vazquez, Alexandre Ciappina Hueb, Alexandre S Colafranseschi, Alexandre Schaan de Quadros, Alexandre Tognon, Ali Alghamdi, Alice Manica Muller, Aline Nogueira Rabaça, Aline Peixoto Deiro, Alison Hallam, Allegra Stone, Allison Schley, Almudena Castro, Alvaro Rabelo Ales, Amanda Germann, Amanda O'Malley, Amar Uxa, Amarachi Ojajuni, Amarino C Oliveira Jr, Amber B Hull, Ambuj Roy, Amer Zarka, Amir Janmohamed, Ammani Brown, Ammy Malinay, Amparo Martinez Monzonis, Amy J Richards, Amy Iskandrian, Amy Ollinger, Ana D Djordjevic-Dikic, Ana Fernández Martínez, Ana Gomes Almeida, Ana Paula Batista, Ana Rita Francisco, Ana S Mladenovic, Ana Santana, Anam Siddiqui, Anastasia M Kuzmina-Krutetskaya, Andras Vertes, Andre S Sousa, Andre Gabriel, André Schmidt, Andrea M Lundeen, Andrea Bartykowszki, Andrea Lorimer, Andrea Mortara, Andrea Pascual, Andreia Coelho, Andreia Rocha, Andrés García-Rincón, Andrew G Howarth, Andrew J Moriarty, Andrew Docherty, Andrew Starovoytov, Andrew Zurick, Andrzej Łabyk, Andrzej Swiatkowski, Andy Lam, Anelise Kawakami, Angela Hoye, Angela Kim, Angelique Smit, Angelo Nobre, Anil V Shah, Anja Ljubez, Anjali Anand, Ankush Sachdeva, Ann Greenberg, Ann Luyten, Ann Ostrander, Anna Di Donato, Anna Cichocka-Radwan, Anna Fojt, Anna Plachcinska, Anna Proietti, Anna Teresinska, Anne Marie Webb, Anne Cartwright, Anne Heath, Anne Mackin, Anong Amaritakomol, Anong Chaiyasri, Anoop Chauhan, Anoop Mathew, Anthony Gemignani, Anto Luigi Andres, Antonia Vega, Antonietta Hansen, Antonino Ginel Iglesias, Antonio Carlos Carvalho, Antonio Di Chiara, Antonio Serra Peñaranda, Antonio Carvalho, Antonio Colombo, Antonio Fiarresga, Anupama Rao, Aquiles Valdespino-Estrada, Araceli Boan, Areef Ishani, Ariel Diaz, Arijit Ghosh, Arintaya Prommintikul, Arline Roberts, Arnold H Seto, Arnold P Good, Arshed Quyyumi, Arthur J Labovitz, Arthur Kerner, Arturo S Campos-Santaolalla, Arunima Misra, Ashok Mukherjee, Ashok Seth, Ashraf Seedhom, Asim N Cheema, Asker Ahmed, Atul Mathur, Atul Verma, Audrey W Leong, Axel Åkerblom, Axelle Fuentes, Aynun Naher, Badhma Valaiyapathi, Baljeet Kaur, Bandula Guruge, Barbara 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Wu, Yu Kunwu, Yu Zhao, Yudong Peng, Yueh-Hung Lin, Yulan Zhao, Yumei Dong, Yunhai Zhao, Yutthaphan Wannasopha, Yvonne Taul, Zakir Sahul, Zalina Kudzoeva, Zbigniew Kalarus, Zeljko Z Markovic, Zhen Huang, Zheng Ji, Zhenyu Liu, Zhou Yue, Zhulin Zhang, Zhuxi Li, Zile Singh Meharwal, Ziliang Bai, Zixiang Yu, Zohra Huda, Zoltan Davidovits
Subjects: Male, Cardiac Catheterization, Computed Tomography Angiography, medicine.medical_treatment, Myocardial Ischemia, Coronary Disease, Coronary Artery Disease, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Coronary Angiography, ISCHEMIA Research Group, law.invention, Angina, Coronary artery disease, 0302 clinical medicine, Randomized controlled trial, law, Cardiovascular Disease, Myocardial Revascularization, 030212 general & internal medicine, Coronary Artery Bypass, 11 Medical and Health Sciences, Cardiac catheterization, General Medicine, Middle Aged, humanities, Cardiovascular Diseases, Cardiology, Female, Human, medicine.medical_specialty, Ischemia, Article, 03 medical and health sciences, Geriatric cardiology, Percutaneous Coronary Intervention, General & Internal Medicine, Internal medicine, medicine, Humans, Angina, Unstable, Aged, business.industry, Coronary Artery Bypa, Percutaneous coronary intervention, Bayes Theorem, medicine.disease, Heart failure, Quality of Life, business
Abstract: BACKGROUND: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS: We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS: Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, -1.8 percentage points; 95% CI, -4.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS: Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA ClinicalTrials.gov number, NCT01471522.).
Published: 2020
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13. Risk factors for COVID-19-related in-hospital mortality in a high HIV and tuberculosis prevalence setting in South Africa: a cohort study

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Babalwa, Johan Badenhorst, Miranda Badenhorst, Bianca Badripersad, Lalihla Badul, M Bagananeng, Mncedisi Bahle, Liezl Balfour, T C Baloyi, S Baloyi, Tinyiko Baloyi, Tshepo Mpho Baloyi, Thokozani Banda, Shimon Barit, Nicole Bartsch, Junaid Bayat, Siyabulela Bazana, Marlene Beetge, Nosindiso Bekapezulu, Rammala Belebele, Phala Bella, Zanenkululeko Belot, Lindi Gladys Bembe, Sonja Bensch, Gishma Beukes, Karla Bezuidenhout, Themba Bhembe, N A Bikisha, Ben Bilenge, Leesa Bishop, Baphamandla Biyela, Cyntheola Blaauw, Mark Blaylock, Nicola Bodley, Power Bogale, Sibongile Bokolo, Stefan Bolon, Mary Booysen, Eldereze Booysen, Lia Boretti, Paula Borges, Millicent Boshoga, Natasha Bosman, Lucinda Bosvark, Nicky Botes, Adele Botha, Chantall Botha, Jana Botha, Chantall botha, Mandlakayise Irvin Botha, Alet Botha, Janet Bradbury, Zandisile Breakfast, Maria Breed, Molele Brenda, Moshito Brice, Jolene Britz, Amanda Brown, T Buchanan, Thozama Bucwa, Crystelle Burger, Ziyanda Busakwe, Nosiviwe Bushula, 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Alfred Daumas, Madelein Dauth, Mongalo David, Wayne Davids, Nozuko Daweti, Wandisa Dayile, B De Bruin, Karin De Klerk, Tanya De la Rosa, Marice de Nysschen, Marie De vos, Darien De Wet, Mohith Debising, Darshan Deenadayalu, Babalwa Dekeda, Mofokeng Desiree, Annelise Deysel, Abram Dhlamini, Makgethwa Dhlala Diala, Mathapelo Diale, Bella Diketane, Nosisa Dingani, Siyabonga Diniso, Lesego Diphatse, Anele Diya, Zihloniphile Dladla, Nompumelelo Dladla, Mlungisi Dladla, Patience Dladla, Baphilie Dlamini, Nonhlanhla Dlamini, Linda Dlamini, Nonzwakazi Dlamini, Wendy Dlamini, Ncomeka Dlamini, Siyabonga Dlamini, Nicodemus Dlamini, Lebohang Dlamini, Motshedise Dlamini, Babalwa Christine Dlava, Phikiwe Dlova, Lindiwe Dlozi, Maenetja Doreen, Vumile Doyi, Athini Doyi, Belinda Du Plessis, Johanna Aletta du Plessis, Eddie du Plessis, Nicolette du Plessis, Karin du Plessis, Briette du Toit, Narissa du Toit, Jabulile Dube, Athayanda Dubula, Msomi Duduzile, Sechaba Duiker, Unati Bongile Duma, Kholiwe Duma, Kella Dunne, Kholeka Dyantyi, Avile Dyantyi, Simphiwe Dyasi, Chauke Dyondzo, Phelisa Dyubhele, B J Dywili, Letitia Edwards, Madie Eksteen, Tersia Ellis, Tia Ellis, Glenda Emmerson, Theusia Enslin, Odimula Epule, Lana Erasmus, Mathonsi Erick, Lerato Etsane, Shimange Eunice, Zanele Fani, Mariette Ferreira, K L Finger-Motsepe, Fabion Floris, Tseko Fobo, Keresemetse Fokotsane, Duduzile Emmelda Fokwana, Genevieve Marion Fords, Juanita Fortein, Christine Fouche, Rulandi Fourie, Andrew Frean, Ludwig Fredericks, Wandile Funda, kabelo funjwa, Martha Futhane, Amanda Futuse, Dora Gabaediwe, Nonhlanhla Gabuza, Janycke Galant, Zanele Gama, Thobile Gano, Emma Cora Gardiner, Henri Gastrow, Kelly Gate, Ben Gaunt, Rikhotso Gavaza, Thapelo Gayi, Nkosinathi Gcakasi, Nomusa Gcobo, Leon Geffen, S Geldenhuys, Jenny George, Martha Gerber, Zolisa Getyengana, Nkululo Gigi, Radha Gihwala, Mitchell Gilliland, Zandile Gloria, Elitia Glover, Ellen Gokailemang, Suseth Goosen, Maria Gopane, Thandazile Gosa-Lufuta, Bernadett Gosnell, Sharleen Gouws, Christina Govender, Raksha Govender, Pearl Govender, Sally Govender, Roxanne Govender, K Govender, Savie Govender, Rashika Govinden, Luphumlo Gqabuza, Nomthandazo Gqaji, Maneo Gqetywa, Caroline Green, Nathan Green, Neera Green, Hendrik Grobler, Pamela Groenwald, Daniel Grootboom, Beatrice Gumede, Nomonde Gumede, Simphiwe Gumede, Slindile Gumede, Ntombikayise Gumede, Zenande Gumede, Thandiswa Gxotiwe, Makhubela H L, Nonhlanhla Hadebe, Skhumbuzo Hadebe, Christos Halkas, Ansie Hamer, Ebrahim Hamida, Juan Hammond, Sumayia Haniff, Annelise Hare, lorinda Hattingh, Thenjiwe Hendricks, Philip-George Henecke, Brends Henly-Smith, Glynis Herselman, Ansie Heymans, Chantel Heyns, Golekane Hlabahlaba, Lucky Hlabangwane, Simango Hlamarisa, Ntokozo Hlanzi, Hlengiwe Hlela, Katlego Hlokwe, Thembinkosi Hlongwa, Anele Hlongwana, Themba Hlubi, Tozama Hobo, Nare Nathaniel Hopane, Mariska House, Catharina Hudson, Marinda Huysamen, Jezreen Indheren, Samantha Ingle, Gavin Isaacs, T S Thekiso Isaacs, Maringa Itumeleng, Karien J van Rensburg, Saloshni Jackson, Neziswa Jacob, Burton Jacobs, Tshireletso Jacobs, Gugulethu Jacobs, Mesadi Jaftha, Zimkhitha Jaji, Sibusiso Jali, Gcobisa James, Gillian January, Andiswa Jeke, Laurent Jeremiah, L S Jeremiah, Mubeen Jhetam, Maureen John, Chuene John, Thandiwe Jola, Yolande Jonas, Anovick Jonas, Amilcar Juggernath, Eileen Kaba, Venetia Kabo, Disebo Kadi, Karabo Kaizer, Moshaya Peter Kambule, Lorraine Kapp, Tshepo Kau, Nchabeleng Keneth, O Kgabi, Tebogo Audrey Kgafela, Vincent Kgakgadi, Isabella Kgaswe, Tsholofelo Kgathlane, Vuyelwa Julia Kgetha, Mmaselloane Kgomojoo, B Kgoro, Christinah Kgosiemang, Gloria Kgosiencho, Stephen Khambula, Ariffa Khan, Refemetswe Khanare, Ncamsile Khanyase, Nokwethemba Khanyile, Fillip Kharatsi, Simangele Khawula, Themba Khohlakala, Letitia Khomo, Isabel Khoza, Sinethemba Khoza, Nombulelo Khukule, Busisiwe Khumalo, Tracy Khumalo, Zinhle khumalo, Vuyelwa Khumalo, Delisile Khumalo, Lebohang Khumalo, Boitumelo Khumalo, Thuli Khumalo, Gugu Khumalo, Bongiwe Khuzwayo, Thembhelihle Khuzwayo, Hennie Kidson, Jesne Kistan, Gugu Klaas, Marilyn Klassen, Josehine Koeberg, Marizel Koen, Simphiwe Koena, Ina Kok, Imraan Kola, Karabo Kolokoto, Ramachandra Konar, Dr Kotsedi, Jaline Kotze, Martins Koupis, Helen Kritzinger, Marlize Kruger, Henk Kruger, Tlangelani Kubayi, Thabisile Kubeka, Nonjabulo Kubheka, Melusi Kubheka, Sibusiso Clifford Kubheka, Erol Kubheka, Monica Kumalo, Thulani Kunene, Siphilile Candy Kunene, Yvette Kunneke, R P Kupa, Rachel Kutama, Nompumelelo Kwakwazi, Lwanele Kweyama, Maureen Labuschagne, Marina Labuschagne, Prabha Lakshman, Lungelo Lamani, Thembela Lamani, Naomi Langa, Khangelani Langeni, Aphelele Langeni, Nwabisa Hazel Langeni, Gena Langeveldt, Anchen Laubscher, Laetitia Le Roux, Magagane Leah, Collen Lebea, Sello Lebea, Viyella Phumla Cynthia Lebenya, Lorraine Lebogang, P K Leboho, Chantel Lee, Kelebogile Rejoice Lefakane, Zandile Legoabe, Patrick Lekala, Motsitsi Lekhoaba, Tanki Shadrack Lekunutu, Galaletsang Lerefolo, N Letebele, Tsepo Patric Lethoba, Emission Letlalo, Ofentse Letlhage, D S V Letshufi, Dineo Fiona Letsoalo, Seleka Jones Letsoalo, Pennelope Letsoalo, Getrude Letwaba, Sobekwa Linda, Katleho Lipholo, Sabata Litabe, Harsha Lochan, Linda Lomax, Francina Lombaard, Elmarie Loots, Ariana Lourens, Celeste Louw, Rianna Louw, Zikhona Lubambo, Msebenzi Moises Lubambo, Gregory Ludada, Michael Lukas, Thembela Lungu, Nomvume Lupindo, Emmah Lusenga, Happiness Luthuli, Zoleka Sylvia Luvuno, Gwangwa M H, Mustafa Maarman, Buyisiwe Mabaso, Cynthia Mabaso, Morena Mabitle, Grace Mabogoane, Kgakgamatso Mabone, Rueben Mabuza, Velaphi Mabuza, Mogantla Madiseng, Thobile Madlala, Mashooase Madolo, Thabiso Madonsela, Lesetsa Madubanya, Amukelani Maepa, Namhla Mafumana, Caroline Mafumo, Pumeza Magadla, Viscah Magale, Nompumelelo Magaqa, Oberholzer Magda, Rakgoale Magdeline, Tswai Maggie, Bongeka Maginxa, Cathrine Maite Magoba, Caroline Magongwa, Agretia Magubane, Agretia Ntombizodwa Magubane, R Magwai, D I Mahabane, Padmini Mahabeer, Elsie Mahadulula, Lungiswa Mahanjana, Amy Maharaj, Qedusiza Mahlambi, Yvonne Mahlangu, Lerato Mahlangu, Ntombifikile Mahlangu, Makhosazana Mahlangu, Mahlatsi Mahlangu, Penelope Mahlasela, Thosago Mahlatse, Regina Mahlobo, Dikhing Mahole, Adam Mahomed, Mapeu Debora Mahubane, Peter Mahume, Lehlogonolo Maifo, Vincent Maimane, Petunia Maimele, Phakoe Maine, Patricia Senyanyathi Mainongwane, Nomalungisa Majamani, Amahle Majozini, Noluthando Makalima, Nomfundo Makam, Khanyisa Makamba, R Makan, Mashiane Makarapa, Malesela Makgahlela, Mogoiwa David Makgisa, Makgoba Makgomo, M A Makgopa, Mabone Makhalema, Lindokuhle Lizo Makhanya, Philile Valentia Makhanya, Tolerance Makharaedzha, Nathi Makhathini, Elizabeth Makhesi, Cinile Makhubela, Nkululeko Freedom Makhunga, Nomalinge Makhupula, R R Makhura, Rangwato Makola, Zingisa Makuba, Asanda Makubalo, Lonwabo Makumsha, George Makuya, Levy Mmachuene Malaka, Themba Malangeni, M L Malatji, Pelonomi Malebana-Metsing, Malek Malek, Luthando Malevu, Juanita Malgas, Dimakatso Malgas, Paul Makgasane Malope, Monyeki Malose, Katekani Maluleke, Kato Mambane, Nthabiseng Mamorobela, Kukami Manamela, Tshepo Manana, Sathiel Maneto, Aron Kabelo Manganye, Pheto Mangena, Anna Mangoale, Tinotenda Florence Mangozho, Pariva Manickchund, Zandisile Mankayi, Arthur Manning, Kelebogile Manyaapelo Manyaapelo, Tabea Manyane, Zoliswa Manzana, Milton Manzini, Busisiwe Mapasa-Dube, Siboniso Maphumulo, Ntombifuthi Maphumulo, Sindy Maponya, Khomotso Mumsy Maponya, Napjadi Maponya, Lami Maqubela, Lizeka Maqubela, Vuyo Maqungo, Marisa Marais, Chantal Marais, Nondumiso Maramba, Annelize Mare, Madumetsa Maredi, Afikile Martins, Johanna Marule, Refilwe Marumo, N N Masakona, Kedibone Vincentia Masehla, Eric Maseko, Tshilidzi Maselesele, Mojalefa Maselo, M Maseloa, M E Masemola, Thembi Masemola, Bella Mashaba, James Mashangwane, Mantebele Mashao, Shalom Mashego, Lerato Mashele, Ester Mashiane, Joyce Mashibini, J Mashilo, Tumi Mashiloane, Charity Mashishi, Ngazibini Mashiyi, Khomola Mashudu, Aluwani Masindi, Caroline Maslo, Nduduzo Masondo, Dumisile Masuku, Cry Matamela, Mirriam Matandela, Nontokozo Mathabela, T Mathabi, Keitumetse Mathe, Mathabo Mathebula, Catherine Mathebula, Mdungazi Andres Mathebula, Nqobizwe Mathenjwa, Jane Mathibe, Lebohang Mathibela, Makwela Mathilda, Khakhu Mathiva, Mokgadi Alinah Mathobela, Fikile Pearl Mathonsi, K P Mathonsi, Katlego Mathosa, Noluvo Matiwane, Emma Matjeke, Bella Matjiane, Thabang Matjila, Chidi Matlala, Petlo Matome, Nolusindiso Matoti, C Matseliso, Dineo Matsemela, Phumeza Matsha, Gaalebale Prudence Matshediso, Motsumi Matshediso, Esther Matshela, Bongeka Mavuma, Pearl Mavundla, Nomthandazo Mavuso, Lovender Mawasha, Rebecca Mawelela, Nelisiwe Mazibuko, Phumlani Mazibuko, Lindiwe Mazubane, Bavumile Mbanjwa, Ayanda Mbasa, Nosimilo Mbatha, Zanele Mbatha, Rudolph Zenzele Mbatha, Gift Mbedzi, Tatenda Trevor Mbizi, Khumbulani Mbonambi, Nondumiso Mboniswa, Nomfanelo Mbonisweni, Jody Mbuilu, Siyabonga Mbulawa, Zama Mbutho, Natasha Mbuzi, Nonkululeko Mchunu, Cyprian Mchunu, Nokuzola Mchunu, Masesi Thandeka Mchunu, Vuyokazi Mciteka, Solly Mdaka, Neho Mdakane, Siyabonga Mdediswa, Melusi Mdima, Nozipho Mdima Masondo, Siviwe Mdindana, Ntombizikhona Mdleleni, Sibusiso Mdletshe, Gcobisa Precious Mdoda, Ntombi Mdolo, Anele Mdontsane, Ruchikas Mehta, Philile Rittah Memela, Masande Methuse, Keatlaretse Metshile, Pheliswa Metuse, Anton Meyer, Gavin Meyer, Cameron Meyer, Sisonke Mfazwe, Andiswa Mfecane, Bongeka Mfecane, Nelisiwe Mfeka, Busisiwe Mgaga, Thandiwe Portia Mgauli, Thembekile Mgedezi, Vuyokazi Mgedezi, Kalipile Mgevane, Bongni Mgiba, Babalwa Mgoduka, Patrick Mhlaba, Zeldah Mhlaba, Ntombizodwa Mhlanga, Vangile Mhlinza, Nokuthula Mhlongo, sibongiseni Mhlongo, Unamandla Mhlotshana, Mabaso Mikateko, Helena Minnie, Karen Mintoor, Bongi Miyeni, Mabelane M J, Rosy Mjethu, Gloria Mkhize, Mvuselelo Mkhize, Ntokozo Siyabonga Mkhize, Victoria Mkhize, Nomkhosi Mkhize, Nokuthula Mkhize, Mathini Mkhwanazi, Nolwandle Mkile, Kholofelo Mkise, Nokwandiso Mkiya, Pearl Mkongi, Mnonopheli Mkungeka, Hlomile Mlahleki, Nolukholo Mlibali, Sakhumzi Mlungwana, Jonas Mmachele, Mashatole Mmateka, Molebatsi Mmokwa, Thembisa Mmutlane, Zanele Olive Mndebele, Nonhlanhla Mngomezulu, Noluthando Millicent Mnguni, Pumza Mngunyana, Nomxolisi Mngunyana, Ntombebongo Mngxekeza, Zenzele Mnisi, Hlengiwe Precious Mnqayi, Phumzile Mnqayi, Thabiso Mntungwa, Siya Mnyaka, Ntombikayise Mnyakeni, Vuyani Mnyamana, Nomzingisi Mnyipika, Koena Moabelo, Mmakgoshi Alseria Moatshe, Jennifer Mochaki-Senoge, Sharon Moche, Tebello Mocwagae, Koeikantse Modibane, Tebogo godfrey Modimoeng, Obakeng Modisa, Itumeleng Modisane, Olebogeng Modise, Makaepeaa Flovia Modjadji, Sharon Modupe, Maja Moeketsi, Ntswaki Moeketsi, Kereditse Kingsley Moeng, Naledi Nthabiseng Mofamere, Samuel Mofokeng, Thabo Mofokeng, Jonas 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Sharita Rameshwarnath, Yeishna Ramkillawan, null Ramotlou, Faith Rampedi, Vijayluxmi Rampersad, Avhashoni Ramuima, Noluthando Ranone, Mabohlale Portia Rapasa, Mpharoane rapelang, Nika Raphaely, Lesiba Rashokeng, Caroline Rashopola, Tebogo Ratau, M Ratau, Mpfariseni David Ratshili, Elmari Rautenbach, Rofhiwa Ravele, Johannes Reachable, Peta Mmalahla Rebecca, Kessendri Reddy, Andrew Redfern, Robertha Reed, Mumsy Rees, Dr Reji, Gary Reubenson, Veena Rewthinarain, Nkonayani Rhulani, Mufamadi Richard, J S Rikhotso, Shatimone Beverley Rikhotso, Lavhelani Ndivhaleni Robert, Noncedo Roto, Gideon Ruder, Kapil Rugnath, Lizette Ruiters, Mina Ruiters, Sue Russell, Lynn Ruwiza, Molokoane R Y, Mandy Saaiman, Emmanuel Sabela, Lerato Sadiq, Litha Saki, Hyppolite Salambwa, Menitha Samjowan, Nazlee Samodien, Rakgolele Samuel, Fakudze Sandile, Cekuse Sanelisiwe, Mandlankosi Sani, Simangele Sawuka, Lelani Schoeman, Magriet Scholts, Ronel Schroder, Mamotetekoane Sebalabala, Selwalenkwe Collet Sebati, Jacoline Seboko, Wilheminah Sebuthoma, Annah Segami, Ruth Segokotlo, MR Sehloho, Khutjo Seisa, Antony Sekgobela, Monica Sekhosana, John Sekonyela, Mpho Sekoto, Naledi Sekulisa, Mokgadi Vanessa Sekwadi, Lebogo Selaelo, Johannes Selatlha, Kgomotso Selekolo, William Selfridge, Lucy Semenya, Ivy Sengakane, Masabata Sengata, Petronella Sentle, Malebo Seoketsa, Pratheesha Seonandan, Thomas Mambushi Serumula, Nkululeko Setheni, Refiloe Setlale, Tumediso Setlhodi, Barbara Setlhodi, Robert Setloghele, Aarthi Sewpersad, Ryan Sewpersadh, Phumlile Shabalala, Owen Shabangu, Kungesihe Shabangu, Harriet Sbonangaye Shabangu, Thokozani Shabangu, Clifford Shadi, Hasifa Shaik, Tseliso Shale, Qedani Shandu, Nomvelo Shandu, Ntswaki Marcia Shange, Abongile Shenxane, A Sherriff, Sebenzile Shezi, Thenjiwe Shezi, Scally Shihangule, Cheyeza Shikwambana, Lungisani Shoba, Kamogelo shokane, Nora Sibande, Lydia Sibeko, Xolani Sibeko, Zanele Sibiya, Mncedisi Sibiya, Sphamandla Sibuta, Thembakazi Sifumba, Sipho Sigcau, Lutho Sigila, Kayakazi Sihentshe, Bongani Sihlangu, Daisy Sikhakhane, Shaun Nhlanhla Sikhakhane, Mbali Siko, Sipho Sikonje, Khumbulekile Simanga, Nomsa Simango, Thulisile Simela, Ntombikayise Simelane, Sashah Singh, Marjorie Singh, Ragani Singh, Shash Singh, Anita Singh, Hitekani Sithole, Senzekile Sithole, Ntokozo Danielle Sithole, Koketso Maxwell Sithole, Jonnie Situma, Annie Sivraman, Katekani Siwela, Nonqubela Siyewuyewu, Maweya Sizeka, Nonceba Siziba, Andrew Skhosana, Khanyisile Skhosana, Rorisang Skhosana, Tandiwe Skoko, Sunet Slabbert, Ntombela Smangaliso, Christine Smedley, Lydia Smit, Natassia Smit, Lizelle Smit, Michelle Smit, Fasie Smith, Lizzie Smith, Sunell Smith, Cassius Smith, Stefan Smuts, Ayanda Sofe, Khobane Solomon, L J Solomon, chauke Sombani, Richard Songca, Anga Sontamo, Supriya Soorju, Zubenathi Sopazi, Brian Soqasha, Bongiwe Sosibo, Ntsika Sotsaka, Mandy Soula, Simon Spoor, Sarah Stacey, Asanda Stali, Mutele Mmboniseni Stephina, Myra Steup, Sinoxolo Steven, AW Stevens, Vincent Stevens, Dewald Steyn, Bianca Steyn, Pat Stocks, Henk Stolk, Alida Stoltz, Renate Strehlau, Anneke Stroebel, Loraine Strydom, Jean-Marie Strydom, Anton Strydom, Ursula Strydom, Midhu Sunnyraj, Nwabisa Swana, Winnie Swanepoel, Suzan Swanepoel, Elsie Swartbooi, Estley Swartz Swartz, Casandra Syce, Shihambi T E, Joyce Tabane, N E Tabane, Mrs Tawana, Ntene Tebello, Siphosetu Wiseman Tembe, Samantha Terblanche, Ntombifuthi Thabede, Nkhumeleni Thabelo, Sibusiso Thabethe, Lekhanya Thabo George, Keorapetse Thare, Makofane Thebogo, Lerato Thekiso, Lloyd Theko, Celimphilo Zandi Themba, Danie Theron, Henda Theron, Ilze Theron, Thandiwe Thingathinga, M M Thlabadira, Dikeledi Thoka, Zanele Thokwana, Gustav Thom, Mamphot Joel Thubakgale, Theodora Thwala, P Thys, Monethi Tieho, Matodzi Timothy, Ndlovu Tintswalo, Babalwa Tivana, Molefi Tladi, Bongiwe Tokota, Simthandile Toni, Ariel Torres, Mande Toubkin, Marinda Tsatsi, Khanyisile Tshabalala, Nozibele Tshamase, Gontse Tshefu, Makgoga Tshegofatjo, Given Tshikomba, Thapelo Tshilo, Lerato Tshira, S T Tshirado, Maipfi Tshisikule, G Tsoke, N TSOKE, Alatha Tsoko, Mosele Tsotetsi, Sandeva Tsubella, Noxolo Tuswa, Maipato Tutse, Nomayenzeke Tutu, Sphephelo Twala, Nhlanhla Twala, Simphiwe Twala, John Ubisi, Tefo Unathi, A Van Aswegen, Marietjie van der Merwe, Trudie van der Merwe, Patience van der Plank, Elmarie van der Spuy, Linda Van Der Westhuizen, Adele Van Der Westhuizen, Talana van der Westhuizen, Mene van der Westhuyzen, Thea Van Dyk, Ingrid van Heerden, Ryno van Jaarsveld, M Van Lill, Heidi van Niekerk, Ben van Niekerk, Amanda van Rensburg, Judy van Schallwyk, Zeitschke Yarnrich Van Sensie, Magda van Vuuren, Cloete van Vuuren, Olga Funiswa Vandu, Mandisa Vane, Lucia VanZyl, Ebrahim Variava, Mariam Veerus, Nokhwezi Velapi, Sebina Veleko, Z Velezantsi, Retha Venter, Corlia Vergottini, Inga Vermeulen, Liabara Lufuluvhi Vidah, Bongani Vilakazi, Treasure N Vilakazi, Mbalenhle Precious Vilakazi, Karen Viljoen, Werner Viljoen, Zuretha Volschenk, Angelo Vos, Matlala V V, Jacques Walters, Kate Webb, John Welsh, D Wessels, Judy Wheller, Fundile White, Priscilla White, Carmen Whyte, Ansie Willemse, Sape William, Daniel Williams, Kamielah Williams, Mercia Williams, Anne Williamson, Cherade Wilson, Boipelo Wolff, Michelle Wray, Ntombizonke B Xaba, Thabang Jabulani Xaba, Thanks Xiniwe, Mtshali Xoliswa, Funokwakhe Xulu, Gibson Xulu, Sandlakazi Yam, NM Zakhura, Mashela Zareloa, Sive Zinto, Dyibeni Zinziswa, Lulamile Ziselo, Zakhele Zitha, Emmanuel Zitha, Anele Zokufa, Innocent Zondi, Sikhumbuzo Bernard Zondi, Sbuyi Zondi, Thulani Zondi, Wandiswa Zongola, Liesl Zühlke, Zandile Zulu, Lungelo Zulu, Thandeka Zulu, Slindili Zulu, Nkosinathi Zulu, Angel Zuma, Precious Zungu, Pamela Zungu, Melusi Zungu, Priscilla Zungu, Bongo Lihle Zwakala, Antonia Zwane, Promise Zwane, Muziwendoda Zwane, Hlengiwe Priscila Zwane, and Nomgcobo Zwane
Subjects: Male, Pediatrics, medicine.medical_specialty, Tuberculosis, Epidemiology, Immunology, HIV Infections, Comorbidity, Disease, Cohort Studies, South Africa, Risk Factors, Virology, Diabetes mellitus, Prevalence, Humans, Medicine, Hospital Mortality, Asthma, SARS-CoV-2, business.industry, Public health, COVID-19, Articles, Odds ratio, medicine.disease, Infectious Diseases, Anti-Retroviral Agents, Female, business, Cohort study
Abstract: Summary Background The interaction between COVID-19, non-communicable diseases, and chronic infectious diseases such as HIV and tuberculosis is unclear, particularly in low-income and middle-income countries in Africa. South Africa has a national HIV prevalence of 19% among people aged 15–49 years and a tuberculosis prevalence of 0·7% in people of all ages. Using a nationally representative hospital surveillance system in South Africa, we aimed to investigate the factors associated with in-hospital mortality among patients with COVID-19. Methods In this cohort study, we used data submitted to DATCOV, a national active hospital surveillance system for COVID-19 hospital admissions, for patients admitted to hospital with laboratory-confirmed SARS-CoV-2 infection between March 5, 2020, and March 27, 2021. Age, sex, race or ethnicity, and comorbidities (hypertension, diabetes, chronic cardiac disease, chronic pulmonary disease and asthma, chronic renal disease, malignancy in the past 5 years, HIV, and past and current tuberculosis) were considered as risk factors for COVID-19-related in-hospital mortality. COVID-19 in-hospital mortality, the main outcome, was defined as a death related to COVID-19 that occurred during the hospital stay and excluded deaths that occurred because of other causes or after discharge from hospital; therefore, only patients with a known in-hospital outcome (died or discharged alive) were included. Chained equation multiple imputation was used to account for missing data and random-effects multivariable logistic regression models were used to assess the role of HIV status and underlying comorbidities on COVID-19 in-hospital mortality. Findings Among the 219 265 individuals admitted to hospital with laboratory-confirmed SARS-CoV-2 infection and known in-hospital outcome data, 51 037 (23·3%) died. Most commonly observed comorbidities among individuals with available data were hypertension in 61 098 (37·4%) of 163 350, diabetes in 43 885 (27·4%) of 159 932, and HIV in 13 793 (9·1%) of 151 779. Tuberculosis was reported in 5282 (3·6%) of 146 381 individuals. Increasing age was the strongest predictor of COVID-19 in-hospital mortality. Other factors associated were HIV infection (adjusted odds ratio 1·34, 95% CI 1·27–1·43), past tuberculosis (1·26, 1·15–1·38), current tuberculosis (1·42, 1·22–1·64), and both past and current tuberculosis (1·48, 1·32–1·67) compared with never tuberculosis, as well as other described risk factors for COVID-19, such as male sex; non-White race; underlying hypertension, diabetes, chronic cardiac disease, chronic renal disease, and malignancy in the past 5 years; and treatment in the public health sector. After adjusting for other factors, people with HIV not on antiretroviral therapy (ART; adjusted odds ratio 1·45, 95% CI 1·22–1·72) were more likely to die in hospital than were people with HIV on ART. Among people with HIV, the prevalence of other comorbidities was 29·2% compared with 30·8% among HIV-uninfected individuals. Increasing number of comorbidities was associated with increased COVID-19 in-hospital mortality risk in both people with HIV and HIV-uninfected individuals. Interpretation Individuals identified as being at high risk of COVID-19 in-hospital mortality (older individuals and those with chronic comorbidities and people with HIV, particularly those not on ART) would benefit from COVID-19 prevention programmes such as vaccine prioritisation as well as early referral and treatment. Funding South African National Government.
Published: 2021
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14. Intracranial calcifications in pseudohypoparathyroidism type 1b: Report of four cases

Author: Beatriz de León Fuentes, Beatriz Santamaría, Cristina Álvarez Escolá, Jorge Gabriel Ruiz Sánchez, and Lucrecia Herranz de la Morena
Subjects: medicine.medical_specialty, Nutrition and Dietetics, Endocrinology, Text mining, business.industry, Endocrinology, Diabetes and Metabolism, Medicine, Pseudohypoparathyroidism Type 1b, Radiology, business, Intracranial calcification
Published: 2022
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15. New SERPINC1 gene mutations in patients with antithrombin deficiency: antithrombin Lodz I, II, III, and IV

Author: Jacek Treliński, Javier Corral, Anetta Undas, Ewa Wypasek, Belén de la Morena-Barrio, María Eugenia de la Morena-Barrio, and Weronika Nowak
Subjects: Fibrin, medicine.medical_specialty, Antithrombin III Deficiency, business.industry, Antithrombin III, Antithrombin, Antithrombin deficiency, Endocrinology, SERPINC1 Gene, Internal medicine, Mutation, Internal Medicine, medicine, Humans, In patient, business, medicine.drug
Published: 2021
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16. Serum IgG Profiling of Toddlers Reveals a Subgroup with Elevated Seropositive Antibodies to Viruses Correlating with Increased Vaccine and Autoantigen Responses

Author: Nicolai S. C. van Oers, Igor Dozmorov, Rebecca S. Gruchalla, Quan Zhen Li, Patricia Pichilingue-Reto, M. Teresa de la Morena, Prithvi Raj, Edward K. Wakeland, Morgan Nelson, and David R. Karp
Subjects: Male, 0301 basic medicine, medicine.medical_specialty, toddler immune responses, Genotype, Immunology, Coxsackievirus, Antibodies, Viral, Autoantigens, Virus, 03 medical and health sciences, 0302 clinical medicine, Medical microbiology, Immune system, Antigen, Humans, RNA Viruses, Immunology and Allergy, Medicine, Vaccines, Attenuated vaccine, Bacteria, biology, business.industry, Parvovirus, IgGs, DNA Viruses, Infant, Microfluidic Analytical Techniques, biology.organism_classification, 030104 developmental biology, Immunoglobulin M, Child, Preschool, Immunoglobulin G, biology.protein, Cytokines, Original Article, Female, Antibody, serum antibody responses, business, antigen arrays, 030215 immunology
Abstract: Purpose The human antibody repertoire forms in response to infections, the microbiome, vaccinations, and environmental exposures. The specificity of such antibody responses was compared among a cohort of toddlers to identify differences between seropositive versus seronegative responses. Methods An assessment of the serum IgM and IgG antibody reactivities in 197 toddlers of 1- and 2-years of age was performed with a microfluidic array containing 110 distinct antigens. Longitudinal profiling was done from years 1 to 2. Seropositivity to RNA and DNA viruses; bacteria; live attenuated, inactive, and subunit vaccines; and autoantigens was compared. A stratification was developed based on quantitative variations in the IgG responses. Clinical presentations and previously known genetic risk alleles for various immune system conditions were investigated in relation to IgG responses. Results IgG reactivities stratified toddlers into low, moderate, and high responder groups. The high group (17%) had elevated IgG responses to multiple RNA and DNA viruses (e.g., respiratory syncytial virus, Epstein-Barr virus, adenovirus, Coxsackievirus) and this correlated with increased responses to live attenuated viral vaccines and certain autoantigens. This high group was more likely to be associated with gestational diabetes and an older age. Genetic analyses identified polymorphisms in the IL2RB, TNFSF4, and INS genes in two high responder individuals that were associated with their elevated cytokine levels and clinical history of eczema and asthma. Conclusion Serum IgG profiling of toddlers reveals correlations between the magnitude of the antibody responses towards viruses, live attenuated vaccines, and certain autoantigens. A low responder group had much weaker responses overall, including against vaccines. The serum antibody screen also identifies individuals with IgG responses to less common infections (West Nile virus, parvovirus, tuberculosis). The characterization of the antibody responses in combination with the identification of genetic risk alleles provides an opportunity to identify children with increased risk of clinical disease. Supplementary Information The online version contains supplementary material available at 10.1007/s10875-021-00993-w.
Published: 2021
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17. Drug–Drug Interactions and Prescription Appropriateness at Hospital Discharge: Experience with COVID-19 Patients

Author: Letizia Oreni, Annalisa Ridolfo, Laura Pezzati, Dario Cattaneo, Cristina Gervasoni, Spinello Antinori, Luca Pasina, Cecilia Bonazzetti, Giacomo Casalini, Valentina Morena, Aldo P. Maggioni, and Federico Conti
Subjects: Drug, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Potentially Inappropriate Medication List, media_common.quotation_subject, Drug Prescriptions, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, medicine, Hospital discharge, Humans, Pharmacology (medical), Drug Interactions, 030212 general & internal medicine, Original Research Article, Medical prescription, media_common, Aged, Polypharmacy, Aged, 80 and over, business.industry, SARS-CoV-2, Heparin, Patient Discharge, COVID-19 Drug Treatment, Emergency medicine, Female, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, medicine.drug
Abstract: Background Patients with coronavirus disease 2019 (COVID-19) are often elderly, with comorbidities, and receiving polypharmacy, all of which are known factors for potentially severe drug–drug interactions (DDIs) and the prescription of potentially inappropriate medications (PIMs). Objective The aim of this study was to assess the risk of DDIs and PIMs in COVID-19 patients at hospital discharge. Method Patients with a proven diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were hospitalized between 21 February and 30 April 2020, treated with at least two drugs, and with available information regarding pharmacological treatments upon admission and at discharge were considered. The appropriateness of drug prescriptions was assessed using INTERcheck®. Results A significant increase in the prescription of proton pump inhibitors and heparins was found when comparing admission with hospital discharge (from 24 to 33% [p 65 years had at least one PIM upon admission, with an insignificant increment at discharge (58%). Conclusion An increased number of prescribed drugs was observed in COVID-19 patients discharged from our hospital. The addition of heparins is appropriate according to the current literature, while the use of proton pump inhibitors is more controversial. Particular attention should be paid to the risk of bleeding complications linked to heparin-based DDIs.
Published: 2021

18. Abstract PS6-45: Prognostic significance of tumor-infiltrating lymphocytes and neutrophil-to-lymphocyte ratio in patients with breast cancer receivingneoadjuvant chemotherapy

Author: Elena Garcia Martinez, Alberto Carmona-Bayonas, Beatriz Alvarez-Abril, Francisco Ayala de la Peña, Alejandra Ivars Rubio, Gema Marin Zafra, Esmeralda García-Torralba, Pilar de la Morena Barrio, and Elisa García Garre
Subjects: Oncology, Cancer Research, medicine.medical_specialty, Univariate analysis, business.industry, Tumor-infiltrating lymphocytes, medicine.medical_treatment, Cancer, medicine.disease, Breast cancer, Internal medicine, Medicine, Clinical significance, Neutrophil to lymphocyte ratio, business, Neoadjuvant therapy, Survival analysis
Abstract: Introduction and objectives: Tumor infiltrating lymphocytes (TILs) and neutrophil-to-lymphocyte ratio (NLR) play a prognostic role in early stage breast cancer (BC). There is no evidence about the combined effect of both factors. Our objective was to evaluate the integrated clinical significance of TILs and NLR in patients with early BC treated with neoadjuvant therapy. Materials and methods: Retrospective, single-center analysis of a cohort of patients with early BC treated with neoadjuvant chemotherapy between 2001-2010. Pre-treatment TILs (CD3+-TIL count) was evaluated using a tumor tissue microarray. NLR was calculated within one month of cancer diagnosis. TILs (logarithmic transformed) and NLR were analyzed as continuous variables. Survival analysis was performed using multivariable Cox regression models. Results:A total of 121 patients were included. Median age: 56 years. Cancer stage at diagnosis: 16% IIA, 28% IIB, 33% IIIA, 7% IIIB and 16% IIIC. Molecular subtype: 64% hormone receptor(HR)-positive (12% HER2-positive), 11% HER2-positive HR-negative and 22% triple-negative. Pathological complete response (pCR): 16.5%. Median follow-up: 12 years. Pre-treatment TIL analysis was available in 71 patients (59%) and NLR in 101 (83%). There was no correlation between both variables (Spearman's Rho: 0.03, p = 0.98). In the univariate analysis, the NLR showed a negative prognostic value for overall survival (OS) (HR 1.23, 95%CI 1.11-1.36; p Citation Format: Esmeralda García-Torralba, Francisco Ayala de la Peña, Beatriz Alvarez-Abril, Pilar de la Morena Barrio, Alejandra Ivars Rubio, Elisa Garcia Garre, Gema Marin Zafra, Alberto Carmona-Bayonas, Elena Garcia Martinez. Prognostic significance of tumor-infiltrating lymphocytes and neutrophil-to-lymphocyte ratio in patients with breast cancer receivingneoadjuvant chemotherapy [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-45.
Published: 2021
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19. Abstract PS6-54: Prognostic significance of residual micrometastatic axillary involvement with complete pathologic breast response after neoadjuvant chemotherapy for early breast cancer

Author: Maria Esperanza Guirao Garcia, Esmeralda García-Torralba, Beatriz Alvarez Abril, Francisco Ayala de la Peña, Alejandra Ivars Rubio, Pilar de la Morena Barrio, Elena Garcia Martinez, Esther Navarro Manzano, Elisa García Garre, and Gema Marin Zafra
Subjects: Oncology, Cancer Research, medicine.medical_specialty, business.industry, medicine.medical_treatment, Sentinel lymph node, Cancer, Context (language use), medicine.disease, medicine.anatomical_structure, Breast cancer, Internal medicine, medicine, Adjuvant therapy, Lymphadenectomy, business, Survival rate, Lymph node
Abstract: Introduction and objectives Pathologic complete response (pCR, ypT0/Tis ypN0) after neoadjuvant chemotherapy (nCT) in early breast cancer (BC) is associated with higher survival rate. Controversy about the prognostic significance of low-volume or micrometastatic axillary residual disease (ypN1mi-RD) exists. Essentially, it is considered equivalent to high-volume nodal disease (ypN1/ypN2-RD) for the indication of lymphadenectomy after nCT. Clarifying ypN1mi-RD prognostic value would be useful for planning adjuvant therapy. Thus, our objective was to assess the prognostic significance of ypN1mi-RD in the context of primary breast tumor pCR. Material and methodsRetrospective, single-center analysis of a cohort of early BC patients treated with nCT between 2010 and 2018 who achieved breast pCR (ypT0/Tis) combined with axillary pCR (ypN0) or ypN1mi-RD or ypN1/ypN2-RD. Cases with pre-nCT sentinel lymph node biopsy were excluded. 5-year disease-free survival (DFS) and overall survival (OS) were analyzed using Cox regression models.ResultsAmong 470 early BC patients treated with nCT, 134 (28.5%) had in-breast pCR, of whom: 97 (20.6%) were ypN0; 7 (1.5%) were ypN1mic; 10 (2.1%) were ypN1 and 5 (1.1%) were ypN2. Clinicopathological characteristics of the groups are shown in the Table. Median follow-up: 33 months. Eight patients relapsed, 4 of 97 with nodal pCR and 4 of 22 with axillary residual disease: 2/7 ypN1mic; 1/10 ypN1 and 1/5 ypN2. Patients who relapsed predominantly presented pre-nCT clinical lymph node involvement, hormone receptor negativity, ki67 Table. Clinicopathologic characteristics of the cohort of early BC patients treated with nCT betweenypT0/TisypT0/TisypN1mic-RDypN1/N2-RDpCR(N=7)(N=15)(N=97)Age (median, range)49 (25-83)47 (40-77)47 (25-80)Menstrual statusPostmenopausal3 (42,8%)4 (26,7%)42 (43,3%)Premenopausal4 (57,1%)11 (73,3%)55 (56,7%)ECOGECOG 05 (71,4%)13 (86,7%)78 (80,4%)ECOG 12 (28,5%)2 (13,3%)19 (19,6%)Histologic subtypeInvasive ductal carcinoma7(100,0%)14 (93,3%)95 (97,9%)Other subtypes0 (0,0%)1 (6,7%)2 (2,0%)Histologic gradeGrade 10 (0,0%)0 (0,0%)1 (1,0%)Grade 23 (42,9%)5 (33,3%)17 (17,5%)Grade 34 (57,1%)8 (53,3%)67 (69,1%)Unknown0 (0,0%)2 (13,3%)0 (0,0%)cTcT11 (14,2%)4 (26,7%)8 (8,2%)cT24 (57,1%)5 (33,3%)63 (64,9%)cT32 (28,6%)6 (40,0%)24 (24,7%)cT4a-d0 (0,0%)0 (0,0%)2 (2,1%)cNcN01 (14,3%)0 (0,0%)27 (27,8%)cN13 (42,9%)5 (33,3%)34 (35,1%)cN21 (14,3%)6 (40,0%)24 (24,7%)cN32 (28,6%)4 (26,7%)11 (11,3%)Molecular subtypeHR+ HER2-1 (14,3%)8 (53,3%)11 (11,3%)HR+ HER2+3 (42,9%)1 (6,7%)30 (30,9%)HR- HER2+2 (28,6%)3 (20,0%)21 (21,6%)TNBC1 (14,3%)3 (20,0%)35 (36,1%)Breast surgeryConservative7 (100%)10 (66,7%)67 (69,1%)Mastectomy0 (0,0%)5 (33,3%)30 (30,9%)Nodal surgerySLN biopsy0 (0,0%)0 (0,0%)22 (22,7%)ALND7 (100,0%)15 (100,0%)75 (77,3%)ypTypT05 (71,4%)7 (46,7%)80 (82,5%)ypTis2 (28,6%)8 (53,3%)17 (17,5%)Relapse typeMetastatic2 (28,6%)2 (28,6%)2 (2,1%)Local/contralateral0 (0,0%)0 (0,0%)2 (2,1%)Deaths0 (0,0%)1 (6,7%)1 (1,0%)BC: breast cancer. HR: hormone receptor. nCT: neoadjuvant chemotherapy. pCR: pathologic complete response. SLN: sentinel lymph node. TN: triple negative. ypN1mic-RD: micrometastatic axillary residual disease. ypN1/N2-RD: high-volume axillary residual disease. Citation Format: Esmeralda García-Torralba, Maria Esperanza Guirao Garcia, Pilar de la Morena Barrio, Alejandra Ivars Rubio, Elena Garcia Martinez, Elisa Garcia Garre, Gema Marin Zafra, Beatriz Alvarez Abril, Esther Navarro Manzano, Francisco Ayala de la Peña. Prognostic significance of residual micrometastatic axillary involvement with complete pathologic breast response after neoadjuvant chemotherapy for early breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-54.
Published: 2021
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20. Clinical Management of COPD in a Real-World Setting. A Big Data Analysis

Author: Matilde Gutiérrez, Diego Morena, Yolanda González, José Luis Izquierdo, Desirée Graziani, José Manuel Paredero, Bernardino Pérez, and José Miguel Rodríguez
Subjects: Adult, Big Data, Data Analysis, Male, Spirometry, medicine.medical_specialty, medicine.drug_class, Population, Muscarinic Antagonists, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Administration, Inhalation, Anticholinergic, Humans, Medicine, education, Adrenergic beta-2 Receptor Agonists, Geriatrics, COPD, education.field_of_study, medicine.diagnostic_test, biology, business.industry, Mortality rate, General Medicine, Lama, medicine.disease, biology.organism_classification, Pulmonology, 030228 respiratory system, Drug Therapy, Combination, business
Abstract: Objective The aim of this study was to evaluate the quality of diagnosis and treatment of COPD using Big Data methodology on the Savana Manager 2.1 clinical platform. Materials and methods A total of 59,369 patients with a diagnosis of COPD were included from a population of 1,219,749 adults over 40 years of age. Results In total, 78% were men. Spirometry data were available for only 26,453 (43.5%) subjects. Disease severity was classified in 18,172 patients: 4396 mild, 7100 moderate, and 6676 severe, although only 27%, 34%, and 28%, respectively, presented obstructive spirometry. The clinical management of COPD is mainly the responsibility of the primary care and pulmonology departments, while internal medicine and, to a lesser extent, geriatrics also participate. Drug treatment was based on bronchodilators and inhaled corticosteroids (ICS). A marked decline in the use of long-acting beta-2 agonists (LABA) in monotherapy and a slight reduction in ICS/LABA combinations, associated with a long-acting anticholinergic (LAMA) in 74% of cases, were observed. All-cause in-hospital mortality among the overall population was 5.6% compared to 1% of the general population older than 40 years. In total, 35% were admitted to hospital, with an average stay of 6.6 days and an in-hospital mortality rate in this group of 10.74%. Discussion This study identifies the main features of an unselected COPD population and the main errors made in the management of the disease.
Published: 2021
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21. The probability of receiving a kidney transplantation in end-stage kidney disease patients who are treated with haemodiafiltration or haemodialysis: a pooled individual participant data from four randomised controlled trials

Author: Mark Woodward, Way Law, Bernard Canaud, Michiel L. Bots, Marion Morena, Francisco Maduell, Francesco Locatelli, Muriel P.C. Grooteman, Peter J. Blankestijn, Sanne A.E. Peters, Ercan Ok, Andrew Davenport, Ferran Torres, Robin W.M. Vernooij, Menso J. Nubé, Fatih Kircelli, MORNET, Dominique, University Medical Center [Utrecht], Université de Montpellier (UM), Royal Free Hospital [London, UK], VU University Medical Center [Amsterdam], Ege University - EGE (Izmir, Turkey), Alessandro Manzoni Hospital, Hospital Clinic [Barcelona, Spain], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Vrije Universiteit Amsterdam [Amsterdam] (VU), Universitat Autònoma de Barcelona (UAB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Imperial College London, University of New South Wales [Sydney] (UNSW), Nephrology, ACS - Diabetes & metabolism, Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Ege Üniversitesi
Subjects: Male, Nephrology, medicine.medical_specialty, medicine.medical_treatment, 030232 urology & nephrology, Hemodiafiltration, lcsh:RC870-923, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Renal Dialysis, Internal medicine, Diabetes mellitus, Humans, Medicine, 030212 general & internal medicine, Kidney transplantation, Dialysis, Aged, Randomized Controlled Trials as Topic, Aged, 80 and over, Body surface area, Creatinine, business.industry, Proportional hazards model, Hazard ratio, Middle Aged, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Kidney Transplantation, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 3. Good health, chemistry, [No Keyword], [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Kidney Failure, Chronic, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Research Article
Abstract: BackgroundDue to a critical shortage of available kidney grafts, most patients with Stage 5 Chronic Kidney Disease (CKD5) require bridging dialysis support. It remains unclear whether treatment by different dialysis modalities changes the selection and/or preparation of a potential transplant candidate. Therefore, we assessed whether the likelihood of receiving kidney transplant (both living or deceased kidney donors) differs between haemodialysis (HD) and online haemodiafiltration (HDF) in patients with CKD5D.MethodsIndividual participant data from four randomised controlled trials comparing online HDF with HD were used. Information on kidney transplant was obtained during follow-up. The likelihood of receiving a kidney transplant was compared between HD and HDF, and evaluated across different subgroups: age, sex, diabetes, history of cardiovascular disease, albumin, dialysis vintage, fistula, and level of convection volume standardized to body surface area. Hazard ratios (HRs), with corresponding 95% confidence intervals (95% CI), comparing the effect of online HDF versus HD on the likelihood of receiving a kidney transplant, were estimated using Cox proportional hazards models with a random effect for study.ResultsAfter a median follow-up of 2.5years (Q1 to Q3: 1.9-3.0), 331 of the 1620 (20.4%) patients with CKD5D received a kidney transplant. This concerned 22% (n=179) of patients who were treated with online HDF compared with 19% (n=152) of patients who were treated with HD. No differences in the likelihood of undergoing a kidney transplant were found between the two dialysis modalities in both the crude analyse (HR: 1.07, 95% CI: 0.86-1.33) and adjusted analysis for age, sex, diabetes, cardiovascular history, albumin, and creatinine (HR: 1.15, 95%-CI: 0.92-1.44). There was no evidence for a differential effect across subgroups based on patient- and disease-characteristics nor in different categories of convection volumes.ConclusionsTreatment with HD and HDF does not affect the selection and/or preparation of CKD5D patients for kidney transplant given that the likelihood of receiving a kidney transplant does not differ between the dialysis modalities. These finding persisted across a variety of subgroups differing in patient and disease characteristics and is not affected by the level of convection volume delivered during HDF treatment sessions., CONVINCE study (European Union's Horizon 2020 research and innovation programme) [754803], Funding details are listed in Appendix 4. RWMV, PJB, and MLB are funded by the CONVINCE study (European Union's Horizon 2020 research and innovation programme under grant agreement No 754803).
Published: 2021
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22. Noninvasive Ventilation in a Pediatric Trauma Center: A Cohort Study

Author: Orazio Genovese, Andrea De Bellis, Aldo Mancino, Tony C Morena, Alessandro Pizza, Lucilla Pezza, Daniele De Luca, Marco Piastra, Giorgio Conti, and Enzo Picconi
Subjects: pediatric trauma, medicine.medical_specialty, medicine.medical_treatment, Pilot Projects, Critical Care and Intensive Care Medicine, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Trauma Centers, Intensive care, medicine, Humans, Child, intensive care, Noninvasive Ventilation, Acute hypoxemic respiratory failure, business.industry, non-invasive ventilation, acute hypoxemic respiratory failure, Tracheal intubation, 030208 emergency & critical care medicine, medicine.disease, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, 030228 respiratory system, Emergency medicine, Breathing, Noninvasive ventilation, business, Pediatric trauma, Cohort study
Abstract: Objective: To determine whether non-invasive ventilation (NIV) can avoid the need for tracheal intubation and/or reduce the duration of invasive ventilation (IMV) in previously intubated patients admitted to the pediatric intensive care unit (PICU) and developing acute hypoxemic respiratory failure (AHRF) after major traumatic injury. Study Design: A single center observational cohort study. Setting: Pediatric ICU in a University Hospital (tertiary referral Pediatric Trauma Centre) Population: During the 48-month study period, 276 patients (median age 6.4 years) with trauma were admitted to PICU; among 86 of them, who suffered from AHRF and received ventilation (IMV and/or NIV) for more than 12 hrs, 32 patients (median age 8.5 years) were treated with NIV. Inclusion/Exclusion Criteria: Inclusion criteria: at least 12 hours of NIV; exclusion criteria: patients with facial trauma or congenital malformations; patients receiving IMV Measurements and Results: Among NIV patients, 27 (84,3%) were previously on IMV, while 5 (15,6%) could be managed exclusively with NIV. In patients with post-extubation respiratory distress, NIV was successful in 88.4% of cases. Before starting NIV, P/F ratio was 242.7 ± 71. After 8 hours of NIV treatment, a significant oxygenation improvement (PaO2/FiO2 = 354.3 ± 81; p = 0.0002) was found, with no significant changes in carbon dioxide levels. A trend toward increasing ventilation-free time has been evidenced; NIV resulted feasible and generally well tolerated. Conclusions: AHRF in trauma patients is multifactorial and may be due to many reasons, such as lung contusion, aspiration of blood or gastric contents. Systemic inflammatory response and transfusions may also contribute to hypoxia. Our pilot study strongly suggests that NIV can be applied in post-traumatic AHRF: it may successfully reduce the time of both invasive ventilation and deep sedation. Further data from controlled studies are needed to assess the advantage of NIV in pediatric trauma.
Published: 2021
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23. Comorbid anxiety-like behavior in a rat model of colitis is mediated by an upregulation of corticolimbic fatty acid amide hydrolase

Author: Catherine M. Keenan, Matthew N. Hill, Vincent Chiang, Haley A. Vecchiarelli, Quentin J. Pittman, Kira D. Leitl, Kaitlyn Tan, Alessia Santori, Min Qiao, Keith A. Sharkey, and Maria Morena
Subjects: Male, medicine.medical_specialty, Polyunsaturated Alkamides, anxiety, endocannabinoids, anandamid, colitis, Inflammation, Anxiety, Article, Amidohydrolases, Behavioural methods, Rats, Sprague-Dawley, 03 medical and health sciences, chemistry.chemical_compound, Limbic system, 0302 clinical medicine, Fatty acid amide hydrolase, Corticosterone, Internal medicine, medicine, Animals, Colitis, Pharmacology, business.industry, Anandamide, medicine.disease, Endocannabinoid system, Rats, Up-Regulation, 3. Good health, Psychiatry and Mental health, Endocrinology, chemistry, Quality of Life, 030211 gastroenterology & hepatology, Experimental organisms, medicine.symptom, business, Stress and resilience, 030217 neurology & neurosurgery, Endocannabinoids, Hormone
Abstract: Peripheral inflammatory conditions, including those localized to the gastrointestinal tract, are highly comorbid with psychiatric disorders such as anxiety and depression. These behavioral symptoms are poorly managed by conventional treatments for inflammatory diseases and contribute to quality of life impairments. Peripheral inflammation is associated with sustained elevations in circulating glucocorticoid hormones, which can modulate central processes, including those involved in the regulation of emotional behavior. The endocannabinoid (eCB) system is exquisitely sensitive to these hormonal changes and is a significant regulator of emotional behavior. The impact of peripheral inflammation on central eCB function, and whether this is related to the development of these behavioral comorbidities remains to be determined. To examine this, we employed the trinitrobenzene sulfonic acid-induced model of colonic inflammation (colitis) in adult, male, Sprague Dawley rats to produce sustained peripheral inflammation. Colitis produced increases in behavioral measures of anxiety and elevations in circulating corticosterone. These alterations were accompanied by elevated hydrolytic activity of the enzyme fatty acid amide hydrolase (FAAH), which hydrolyzes the eCB anandamide (AEA), throughout multiple corticolimbic brain regions. This elevation of FAAH activity was associated with broad reductions in the content of AEA, whose decline was driven by central corticotropin releasing factor type 1 receptor signaling. Colitis-induced anxiety was reversed following acute central inhibition of FAAH, suggesting that the reductions in AEA produced by colitis contributed to the generation of anxiety. These data provide a novel perspective for the pharmacological management of psychiatric comorbidities of chronic inflammatory conditions through modulation of eCB signaling.
Published: 2021
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24. FIB-4 and APRI scores for predicting severe liver fibrosis in chronic hepatitis HCV patients: a monocentric retrospective study

Author: Morena Sciuto, Roberto Catanzaro, Luca Zanoli, Baskar Balakrishnan, Alice Aleo, and Francesco Marotta
Subjects: hepatitis C virus, Original Paper, medicine.medical_specialty, Cirrhosis, Liver infection, Hepatology, medicine.diagnostic_test, business.industry, Area under the curve, biomarkers, Complete blood count, Context (language use), medicine.disease, Gastroenterology, Fibrosis, Internal medicine, Hepatocellular carcinoma, FIB-4, Medicine, business, Transient elastography, liver fibrosis, APRI
Abstract: Aim of the study Hepatitis C virus (HCV) can cause a chronic liver infection which could then develop into fibrosis, cirrhosis, and hepatocellular carcinoma. Today the diagnosis of liver fibrosis also includes the use of biomarkers. The purpose of our study was to determine the ability of the fibrosis index based on four factors (FIB-4) and aspartate aminotransferase-to-platelet ratio (APRI) to predict the severity of liver fibrosis or cirrhosis. Material and methods Medical records of 106 patients with HCV-related liver fibrosis were analyzed. All patients underwent clinical examination, blood tests (complete blood count, total bilirubin, etc.) and transient elastography. FIB-4 and APRI were calculated for each patient. Results Twenty-six patients (24.52%) had F4 fibrosis, 80 patients (75.48%) had non-F4 fibrosis (F0-F3). There was a statistically significant difference (p < 0.05) between non-F4 fibrosis patients and F4 fibrosis patients in many parameters, including APRI (F4 fibrosis patients had higher values: 2.06 ±3.22 compared to 0.68 ±0.76 of the non-F4 group; p = 0.044) and FIB-4 (F4 fibrosis patients had higher values: 4.84 ±4.14 compared to 2.29 ±2.90 of the non-F4 group; p = 0.006). Receiver operating characteristic (ROC) curve analysis for APRI and FIB-4 revealed that the area under the curve (AUC) of FIB-4 was 0.855 (CI: 0.813-0.936), while the APRI score had an AUC of 0.767 (CI: 0.79-0.932). Conclusions In this study, patients with severe fibrosis or cirrhosis were found to have a higher FIB-4 value than APRI in the context of chronic hepatitis C.
Published: 2021
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25. Correlation between non-invasive myocardial work indices and main parameters of systolic and diastolic function

Author: Arnaud Ancion, Ciro Santoro, Roberto M. Lang, Krasimira Hristova, Dragos Vinereanu, Patrizio Lancellotti, Marie Moonen, Maurizio Galderisi, George Kacharava, José Luis Zamorano, Daniele Barone, Andreas Hagendorff, Julien Magne, Christophe Martinez, Bernard Cosyns, Nico Van de Veire, Monica Baroni, Tolga Ozyigit, Toshimitsu Tsugu, Nuno Cardim, Raluca Elena Dulgheru, Ralph Stephan von Bardeleben, Gonzalo de la Morena, Concetta Zito, Scipione Carerj, Luigi P. Badano, Elena Galli, Martin Penicka, George Athanassopoulos, Bogdan A. Popescu, Erwan Donal, Jose David Rodrigo Carbonero, Adriana Postolache, Federica Ilardi, Monica Rosca, Teresa López, Andreea Calin, Marianna Cicenia, Tadafumi Sugimoto, Roberta Manganaro, Stella Marchetta, Clinical sciences, Cardio-vascular diseases, Cardiology, Manganaro, Roberta, Marchetta, Stella, Dulgheru, Raluca, Sugimoto, Tadafumi, Tsugu, Toshimitsu, Ilardi, Federica, Cicenia, Marianna, Ancion, Arnaud, Postolache, Adriana, Martinez, Christophe, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andrea, Hristova, Krasimira, Lopez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan A, Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Drago, Zamorano, Jose Lui, Rosca, Monica, Calin, Andreea, Moonen, Marie, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Carerj, Scipione, Zito, Concetta, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi P, Lang, Roberto M, Lancellotti, Patrizio, Centre Hospitalier Universitaire de Liège (CHU-Liège), Service de cardiologie [Liège], CHU de Liège-Domaine Universitaire du Sart Tilman, Universität Leipzig [Leipzig], Hospital Univeristario Virgen de la Arrixaca, Johannes Gutenberg - Universität Mainz (JGU), University and Emergency Hospital, Universidad de Alcalá - University of Alcalá (UAH), Service de cardiologie [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Academisch Ziekenhuis Vrije Universiteit Brussel, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Messina, Università degli studi di Napoli Federico II, GE Healthcare and Philips Healthcare, Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de cardiologie et maladies vasculaires [CHU de Rennes], Manganaro, R, Marchetta, S, Dulgheru, R, Sugimoto, T, Tsugu, T, Ilardi, F, Cicenia, M, Ancion, A, Postolache, A, Martinez, C, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, de la Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, van de Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Rosca, M, Calin, A, Moonen, M, Magne, J, Cosyns, B, Galli, E, Donal, E, Carerj, S, Zito, C, Santoro, C, Galderisi, M, Badano, L, Lang, R, and Lancellotti, P
Subjects: Adult, Male, medicine.medical_specialty, Systole, adult echocardiography, Diastole, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, myocardial strain, myocardial work, speckle tracking echocardiography, Ventricular Function, Left, Correlation, Ventricular Dysfunction, Left, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Ejection fraction, business.industry, Work (physics), Stroke Volume, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, General Medicine, Middle Aged, medicine.anatomical_structure, Blood pressure, Echocardiography, Ventricle, Cardiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cardiology and Cardiovascular Medicine, business
Abstract: Aims The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and diastolic function by 2D echocardiography (2DE). Methods and results A total of 226 (85 men, mean age: 45 ± 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from LV pressure-strain loops using custom software. Peak LV pressure was estimated non-invasively from brachial artery cuff pressure. LV size, parameters of systolic and diastolic function and ventricular-arterial coupling were measured by echocardiography. As advanced indices of myocardial performance, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained. On multivariable analysis, GWI was significantly correlated with GLS (standardized beta-coefficient = −0.23, P Conclusion The non-invasive MW indices show a good correlation with traditional 2DE parameters of myocardial systolic function and myocardial strain.
Published: 2020
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26. Burden of Disease in PWH Harboring a Multidrug-Resistant Virus: Data from the PRESTIGIO Registry

Author: Galli, L., Parisi, M. R., Poli, A., Menozzi, M., Fiscon, M., Garlassi, E., Francisci, D., DI Biagio, A., Sterrantino, G., Fornabaio, C., Degli Antoni, A., Angarano, G., Fusco, F. M., D'Arminio Monforte, A., Corbelli, G. M., Santoro, M. M., Zazzi, M., Castagna, A., Gianotti, N., Maggiolo, F., Calza, L., Foca, E., Cenderello, G., Rusconi, S., Mussini, C., Antinori, A., Gagliardini, R., Bonora, S., Ferrara, M., Santoro, M., Galli, A., Carini, E., Bigoloni, A., Tavio, M., Butini, L., Giacometti, A., Vaccher, E., Martellotta, F., Da Ros, V., Saracino, A., Balena, F., Comi, L., DI Filippo, E., Valenti, D., Suardi, C., Mazzola, B., Viale, P., Del Turco, E. R., Ramirez, M. V., Castelli, F., Celotti, A., Brognoli, F., Bonoldi, G., Menzaghi, B., Abeli, C., Farinazzo, M., Ortu, F., Campus, M., Cacopardo, B., Celesia, M., Pan, A., Bartoloni, A., Rinaldi, F., Giache, S., Pierluigi, B., Vichi, F., Santantonio, T., Ferrara, S., Bruno, S. R., Cassola, G., Marcello, F., Calautti, F., Bassetti, M., Bruzzone, B., Artioli, S., Lazzarin, A., Canetti, D., Galli, M., Formenti, T., Morena, V., Gabrieli, A., Gazzola, L., Merlini, E., Minieri, V., Gori, A., Bandera, A., Pastore, V., Ferroni, V., Puoti, M., Moioli, C., Vassalli, S., Enrica, R., Giulia, N., Beghetto, B., Manzillo, E., Franco, A., Cattelan, A. M., Marinello, S., Cavinato, S., Macario, A., Cascio, A., Mazzola, G., Antoni, A. M. D., Ferrari, C., Laccabue, D., Filice, G., Gulminetti, R., Pagnucco, L., Asti, A., Schiaroli, E., Papalini, C., Italiani, F., DI Pietro, M., Magnani, G., Elisa, G., Barchi, E., Corsini, R., Vergori, A., Cicalini, S., Onnelli, G., Giannetti, A., Cauda, R., Ciccullo, A., La Monica, S., Vullo, V., Dettorre, G., Cavallari, E. N., Andreoni, M., Malagnino, V., Ceccarelli, L., Viviani, F., Sasset, L., Dentone, C., Rossetti, B., Modica, S., Borgo, V., DI Perri, G., Carcieri, C., Malena, M., Padovani, B., Luzzati, R., Centonze, S., Valentinotti, R., Galli L., Parisi M.R., Poli A., Menozzi M., Fiscon M., Garlassi E., Francisci D., DI Biagio A., Sterrantino G., Fornabaio C., Degli Antoni A., Angarano G., Fusco F.M., D'Arminio Monforte A., Corbelli G.M., Santoro M.M., Zazzi M., Castagna A., Gianotti N., Maggiolo F., Calza L., Foca E., Cenderello G., Rusconi S., Mussini C., Antinori A., Gagliardini R., Bonora S., Ferrara M., Santoro M., Galli A., Carini E., Bigoloni A., Tavio M., Butini L., Giacometti A., Vaccher E., Martellotta F., Da Ros V., Saracino A., Balena F., Comi L., DI Filippo E., Valenti D., Suardi C., Mazzola B., Viale P., Del Turco E.R., Ramirez M.V., Castelli F., Celotti A., Brognoli F., Bonoldi G., Menzaghi B., Abeli C., Farinazzo M., Ortu F., Campus M., Cacopardo B., Celesia M., Pan A., Bartoloni A., Rinaldi F., Giache S., Pierluigi B., Vichi F., Santantonio T., Ferrara S., Bruno S.R., Cassola G., Marcello F., Calautti F., Bassetti M., Bruzzone B., Artioli S., Lazzarin A., Canetti D., Galli M., Formenti T., Morena V., Gabrieli A., Gazzola L., Merlini E., Minieri V., Gori A., Bandera A., Pastore V., Ferroni V., Puoti M., Moioli C., Vassalli S., Enrica R., Giulia N., Beghetto B., Manzillo E., Franco A., Cattelan A.M., Marinello S., Cavinato S., MacArio A., Cascio A., Mazzola G., Antoni A.M.D., Ferrari C., Laccabue D., Filice G., Gulminetti R., Pagnucco L., Asti A., Frsdi E., Schiaroli E., Papalini C., Italiani F., DI Pietro M., Magnani G., Elisa G., Barchi E., Corsini R., Vergori A., Cicalini S., Onnelli G., Giannetti A., Cauda R., Ciccullo A., La Monica S., Vullo V., Dettorre G., Cavallari E.N., Andreoni M., Malagnino V., Ceccarelli L., Viviani F., Sasset L., Dentone C., Rossetti B., Modica S., Borgo V., DI Perri G., Carcieri C., Malena M., Padovani B., Luzzati R., Centonze S., Valentinotti R., Galli, L, Parisi, M, Poli, A, Menozzi, M, Fiscon, M, Garlassi, E, Francisci, D, DI Biagio, A, Sterrantino, G, Fornabaio, C, Degli Antoni, A, Angarano, G, Fusco, F, D'Arminio Monforte, A, Corbelli, G, Santoro, M, Zazzi, M, Castagna, A, Gianotti, N, Maggiolo, F, Calza, L, Foca, E, Cenderello, G, Rusconi, S, Mussini, C, Antinori, A, Gagliardini, R, Bonora, S, Ferrara, M, Galli, A, Carini, E, Bigoloni, A, Tavio, M, Butini, L, Giacometti, A, Vaccher, E, Martellotta, F, Da Ros, V, Saracino, A, Balena, F, Comi, L, DI Filippo, E, Valenti, D, Suardi, C, Mazzola, B, Viale, P, Del Turco, E, Ramirez, M, Castelli, F, Celotti, A, Brognoli, F, Bonoldi, G, Menzaghi, B, Abeli, C, Farinazzo, M, Ortu, F, Campus, M, Cacopardo, B, Celesia, M, Pan, A, Bartoloni, A, Rinaldi, F, Giache, S, Pierluigi, B, Vichi, F, Santantonio, T, Ferrara, S, Bruno, S, Cassola, G, Marcello, F, Calautti, F, Bassetti, M, Bruzzone, B, Artioli, S, Lazzarin, A, Canetti, D, Galli, M, Formenti, T, Morena, V, Gabrieli, A, Gazzola, L, Merlini, E, Minieri, V, Gori, A, Bandera, A, Pastore, V, Ferroni, V, Puoti, M, Moioli, C, Vassalli, S, Enrica, R, Giulia, N, Beghetto, B, Manzillo, E, Franco, A, Cattelan, A, Marinello, S, Cavinato, S, Macario, A, Cascio, A, Mazzola, G, Antoni, A, Ferrari, C, Laccabue, D, Filice, G, Gulminetti, R, Pagnucco, L, Asti, A, Schiaroli, E, Papalini, C, Italiani, F, DI Pietro, M, Magnani, G, Elisa, G, Barchi, E, Corsini, R, Vergori, A, Cicalini, S, Onnelli, G, Giannetti, A, Cauda, R, Ciccullo, A, La Monica, S, Vullo, V, Dettorre, G, Cavallari, E, Andreoni, M, Malagnino, V, Ceccarelli, L, Viviani, F, Sasset, L, Dentone, C, Rossetti, B, Modica, S, Borgo, V, DI Perri, G, Carcieri, C, Malena, M, Padovani, B, Luzzati, R, Centonze, S, Valentinotti, R, Galli, Laura, Parisi, Maria Rita, Poli, Andrea, Menozzi, Marianna, Fiscon, Marta, Garlassi, Elisa, Francisci, Daniela, Di Biagio, Antonio, Sterrantino, Gaetana, Fornabaio, Chiara, Degli Antoni, Anna, Angarano, Gioacchino, Fusco, Francesco Maria, D'Arminio Monforte, Antonella, Corbelli, Giulio Maria, Santoro, Maria Mercede, Zazzi, Maurizio, and Castagna, Antonella
Subjects: 0301 basic medicine, medicine.medical_specialty, 4-class drug resistance, AIDS-defining event, cancer, death, non-AIDS-defining event, Population, Major Articles, Settore MED/07, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Internal medicine, medicine, Cumulative incidence, 030212 general & internal medicine, education, Disease burden, education.field_of_study, Proportional hazards model, business.industry, Incidence (epidemiology), Hazard ratio, 030112 virology, AcademicSubjects/MED00290, Infectious Diseases, Oncology, business, Cohort study
Abstract: BackgroundCurrently, no data are available on the burden of morbidity and mortality in people with HIV-1 (PWH) harboring a 4-class drug-resistant (4DR) virus (nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, integrase strand transfer inhibitors). The study aimed to assess the incidence of clinical events and death in this population.MethodsThis was a cohort study on PWH from the PRESTIGIO Registry with a documented 4DR virus. Burden of disease was defined as the occurrence of any new event including an AIDS-defining event (ADE) or non-AIDS-defining event (NADE) or death from any cause after 4DR evidence (baseline). Cox regression models evaluated factors associated with the risk of new clinical events/death.ResultsAmong 148 PWH followed for a median (interquartile range) of 47 (32–84) months after 4DR evidence, 38 PWH had 62 new events or died from any cause (incidence rate, 9.12/100 person-years of follow-up; 95% CI = 6.85–11.39): 12 deaths (6 AIDS-related and 6 non-AIDS-related), 18 ADEs, 32 NADEs; 20 of the 38 NADEs (45%) of the incident clinical events were malignancies. The 4-year cumulative incidence of death was 6% (95% CI, 3%–13%), and that of ≥1 event or death was 22% (95% CI, 16%–31%). A higher risk of new clinical events/death was more likely in PWH with previous clinical events (adjusted hazard ratio [aHR], 2.67; 95% CI, 1.07–6.67) and marginally associated with lower baseline CD4+/CD8+ ratio (aHR, 0.82; 95% CI, 0.65–1.02).ConclusionsPWH harboring 4DR have a high burden of disease with a worrying incidence of malignancies, strongly advising for close prevention and monitoring interventions as well as access to innovative therapeutic strategies, especially in people with a history of clinical events and low CD4+/CD8+ ratio.
Published: 2020

27. Echocardiographic reference ranges for normal left ventricular layer-specific strain: results from the EACVI NORRE study

Author: Erwan Donal, Ralph Stephan von Bardeleben, Jose David Rodrigo Carbonero, Maurizio Galderisi, Simona Sperlongano, Monica Rosca, Caroline Piette, Roberta Manganaro, Daniele Barone, Adriana Postolache, Gonzalo de la Morena, Ciro Santoro, Federica Ilardi, Teresa López, George Kacharava, Bogdan A. Popescu, Monica Baroni, Elena Galli, Patrizio Lancellotti, Toshimitsu Tsugu, Julien Magne, Yun Yun Go, Dragos Vinereanu, Nuno Cardim, Marie Moonen, Julien Tridetti, Andreea Calin, José Luis Zamorano, Tolga Ozyigit, Krasimira Hristova, Martin Penicka, Mai-Linh Nguyen Trung, Bernard Cosyns, Raluca Elena Dulgheru, Alexandra Maria Chitroceanu, Tadafumi Sugimoto, George Athanassopoulos, Luigi P. Badano, Nico Van de Veire, Roberto M. Lang, Andreas Hagendorff, Tsugu, Toshimitsu, Postolache, Adriana, Dulgheru, Raluca, Sugimoto, Tadafumi, Tridetti, Julien, Nguyen Trung, Mai-Linh, Piette, Caroline, Moonen, Marie, Manganaro, Roberta, Ilardi, Federica, Chitroceanu, Alexandra Maria, Sperlongano, Simona, Go, Yun Yun, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andrea, Hristova, Krasimira, Lopez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan A, Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Drago, Zamorano, Jose Lui, Rosca, Monica, Calin, Andreea, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi P, Lang, Roberto M, Lancellotti, Patrizio, Tsugu, T., Postolache, A., Dulgheru, R., Sugimoto, T., Tridetti, J., Trung, M. -L. N., Piette, C., Moonen, M., Manganaro, R., Ilardi, F., Chitroceanu, A. M., Sperlongano, S., Go, Y. Y., Kacharava, G., Athanassopoulos, G. D., Barone, D., Baroni, M., Cardim, N., Hagendorff, A., Hristova, K., Lopez, T., de la Morena, G., Popescu, B. A., Penicka, M., Ozyigit, T., Carbonero, J. D. R., van de Veire, N., von Bardeleben, R. S., Vinereanu, D., Zamorano, J. L., Rosca, M., Calin, A., Magne, J., Cosyns, B., Galli, E., Donal, E., Santoro, C., Galderisi, M., Badano, L. P., Lang, R. M., Lancellotti, P., Clinical sciences, Cardio-vascular diseases, Cardiology, GIGA [Université Liège], Université de Liège, CHU Limoges, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), GE Healthcare and Philips Healthcare, Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Tsugu, T, Postolache, A, Dulgheru, R, Sugimoto, T, Tridetti, J, Nguyen Trung, M, Piette, C, Moonen, M, Manganaro, R, Ilardi, F, Chitroceanu, A, Sperlongano, S, Go, Y, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, de la Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, van de Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Rosca, M, Calin, A, Magne, J, Cosyns, B, Galli, E, Donal, E, Santoro, C, Galderisi, M, Badano, L, Lang, R, and Lancellotti, P
Subjects: Adult, Male, medicine.medical_specialty, adult echocardiography, deformation imaging, Heart Ventricles, 030204 cardiovascular system & hematology, Ventricular Function, Left, Reference values, 2D echocardiography, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, reference values, Healthy volunteers, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Endocardium, Normal range, Strain (chemistry), business.industry, Myocardium, Healthy subjects, reference value, Mean age, General Medicine, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Middle Aged, Apex (geometry), Echocardiography, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, business, Large group, Cardiology and Cardiovascular Medicine, Human
Abstract: Aims To obtain the normal range for 2D echocardiographic (2DE) measurements of left ventricular (LV) layer-specific strain from a large group of healthy volunteers of both genders over a wide range of ages. Methods and results A total of 287 (109 men, mean age: 46 ± 14 years) healthy subjects were enrolled at 22 collaborating institutions of the EACVI Normal Reference Ranges for Echocardiography (NORRE) study. Layer-specific strain was analysed from the apical two-, three-, and four-chamber views using 2DE software. The lowest values of layer-specific strain calculated as ±1.96 standard deviations from the mean were −15.0% in men and −15.6% in women for epicardial strain, −16.8% and −17.7% for mid-myocardial strain, and −18.7% and −19.9% for endocardial strain, respectively. Basal-epicardial and mid-myocardial strain decreased with age in women (epicardial; P = 0.008, mid-myocardial; P = 0.003) and correlated with age (epicardial; r = −0.20, P = 0.007, mid-myocardial; r = −0.21, P = 0.006, endocardial; r = −0.23, P = 0.002), whereas apical-epicardial, mid-myocardial strain increased with the age in women (epicardial; P = 0.006, mid-myocardial; P = 0.03) and correlated with age (epicardial; r = 0.16, P = 0.04). End/Epi ratio at the apex was higher than at the middle and basal levels of LV in men (apex; 1.6 ± 0.2, middle; 1.2 ± 0.1, base 1.1 ± 0.1) and women (apex; 1.6 ± 0.1, middle; 1.1 ± 0.1, base 1.2 ± 0.1). Conclusion The NORRE study provides useful 2DE reference ranges for novel indices of layer-specific strain.
Published: 2020
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28. Gynaecological and obstetrical bleeding in Caucasian women with congenital factor XI deficiency: Results from a twenty-year, retrospective, observational study

Author: Carlos Bravo-Pérez, Vicente Vicente, Javier Corral, María Eugenia de la Morena-Barrio, Belén de la Morena-Barrio, Salam Salloum-Asfar, Teresa Ródenas, Julio Esteban, and Antonia Miñano
Subjects: Adult, medicine.medical_specialty, Metrorrhagia, Adolescent, Factor XI Deficiency, Postoperative Hemorrhage, Hemostatics, White People, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Congenital factor XI deficiency, medicine, Humans, 030212 general & internal medicine, Aged, Retrospective Studies, Aged, 80 and over, Obstetrics, business.industry, Postsurgical bleeding, Postpartum Hemorrhage, Obstetrical bleeding, Uterine bleeding, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Spain, Female, Observational study, Fresh frozen plasma, business
Abstract: Introduction Factor XI (FXI) deficiency is a mild bleeding disorder, common among Ashkenazis, that may be underestimated in Caucasians. Management of FXI deficiency in women is a challenge, due to its unpredictable bleeding tendency and the little evidence available on this issue. Objective To describe gynaecological/obstetrical bleeding complications and to analyze the effectiveness and safety of the antihaemorrhagic treatment among women with FXI deficiency. Material and methods A retrospective, observational study of 214 Caucasian subjects with FXI deficiency collected during 20 years (1994–2014) without clinical selection. Results We identified 95 women with FXI deficiency. Any haemorrhagic event was communicated by 26/95 (27.4%), being abnormal uterine bleeding the most frequently found (12/95, 12.6%). Nine postpartum haemorrhages were recorded from 136 deliveries (6.6%) in 57 women. Four postsurgical bleeding complications were registered among 25 gynaecological surgeries (16%) in 20 women. Abnormal uterine bleeding, postpartum and postsurgical haemorrhages were related to both a positive bleeding history and FXI:C values ≤43.5%. Prophylaxis with fresh frozen plasma, used in 12/25 (48%) gynaecological surgeries, did not prevent from postoperative bleeding in three cases, but two developed severe adverse reactions. Conclusion Women with FXI deficiency, especially those with a positive history of bleeding or FXI:C ≤43.5%, are at risk of developing gynaecological/obstetrical haemorrhages, most of them mild/moderate. Systematic prophylaxis has questionable effectiveness, but might cause severe side effects.
Published: 2019
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29. Asymptomatic azygos vein overflow in a young patient with primary mediastinal seminoma

Author: Andrea Ronchi, Morena Fasano, Giuseppe Viscardi, Maria Lucia Iacovino, Francesca Sparano, Rosa Laura Sabetta, Floriana Morgillo, Giovanni Vicidomini, Alfonso Reginelli, Fortunato Ciardiello, Carminia Maria Della Corte, Raimondo Di Liello, Di Liello, Raimondo, Sparano, Francesca, Iacovino, Maria Lucia, Viscardi, Giuseppe, Della Corte, Carminia Maria, Ronchi, Andrea, Sabetta, Rosa Laura, Fasano, Morena, Vicidomini, Giovanni, Reginelli, Alfonso, Ciardiello, Fortunato, and Morgillo, Floriana
Subjects: 0301 basic medicine, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Mediastinal germ cell tumor, Case Report, Case Reports, lcsh:RC254-282, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Superior vena cava, medicine, cardiovascular diseases, Primary mediastinal seminoma, Lung, Superior vena cava syndrome, Mediastinal Seminoma, business.industry, superior vena cava syndrome, General Medicine, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, radiology, 030104 developmental biology, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, cardiovascular system, Radiology, Germ cell tumors, medicine.symptom, Azygos vein, business
Abstract: The azygos system is the most important pathway for decompression of the superior vena cava (SVC) when a blood flow obstruction to the right atrium is present. Thoracic and mediastinal malignancies, mainly lung cancers, are responsible for 60%-85% of superior vena cava syndrome (SVCS) cases. An uncommon origin of SVCS is primary malignant mediastinal germ cell tumor (PMMGCT) which represent 1%-4% of all mediastinal tumors and can be divided into two broad groups: seminomas and nonseminomatous germ cell tumors (NSGCTs). Primary mediastinal seminomas clinical presentation is often nonspecific, even if the majority of patients present with superior vena cava involvement. Here, we present the radiologic features of asymptomatic azygos system overflow in a patient with primary mediastinal seminoma.
Published: 2019

30. Incidence and features of thrombosis in children with inherited antithrombin deficiency

Author: María Eugenia de la Morena-Barrio, Kristin Jochmans, Vicente Vicente, Javier Corral, Christelle Orlando, Belén de la Morena-Barrio, Basic (bio-) Medical Sciences, Clinical Biology, Faculty of Medicine and Pharmacy, Clinical sciences, Reproductive immunology and implantation, and Hematology
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Adolescent, Population, Thrombophilia, Article, Protein S, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Belgium, Pregnancy, Risk Factors, medicine, Humans, Genetic Predisposition to Disease, Thrombus, Child, education, Retrospective Studies, education.field_of_study, Antithrombin III Deficiency, biology, business.industry, Incidence, Infant, Newborn, Coagulation & its Disorders, Case-control study, Infant, Thrombosis, Hematology, Prognosis, medicine.disease, Pulmonary embolism, Venous thrombosis, Spain, Case-Control Studies, Child, Preschool, biology.protein, Female, business, Follow-Up Studies, 030215 immunology
Abstract: Pediatric thromboembolism (≤18 years) is very rare (0.07-0.14/10,000/year) but may be more prevalent in children with severe thrombophilia (protein C, protein S or antithrombin deficiency). The aim of this study was to define the prevalence and clinical characteristics of pediatric thrombosis in subjects with inherited antithrombin deficiency. Our observational retrospective multicentric study from two countries recruited 968 patients of any age from 441 unrelated families with genetically, biochemically and functionally characterized antithrombin deficiency. Seventy-three subjects (7.5%) developed thrombosis before 19 years of age. Two high-risk periods for thrombosis were identified: adolescence (12-18 years, n=49) with thrombus localization (lower limb deep venous thrombosis or pulmonary embolism) and triggering factors common to adults (oral contraceptives, surgery or pregnancy); and the neonatal period (
Published: 2019
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31. Gentamicin plasma concentrations in hospitalized horses and retrospective minimal inhibitory concentrations of gram‐negative equine pathogens

Author: Angelika Schoster, Morena Laura Amsler, Sarah Schmitt, Colin C Schwarzwald, Lanja Saleh, Constanze Kirchgaessner, University of Zurich, and Schoster, Angelika
Subjects: medicine.medical_specialty, Aerobic bacteria, 3400 General Veterinary, Microbial Sensitivity Tests, Gastroenterology, Nephrotoxicity, Minimum inhibitory concentration, Internal medicine, Drug Resistance, Bacterial, Gram-Negative Bacteria, medicine, Animals, Horses, Prospective Studies, 10082 Institute of Food Safety and Hygiene, 10038 Institute of Clinical Chemistry, Retrospective Studies, 630 Agriculture, General Veterinary, business.industry, Aminoglycoside, medicine.disease, Antimicrobial, Anti-Bacterial Agents, Systemic inflammatory response syndrome, 570 Life sciences, biology, Gentamicin, 10090 Equine Department, Azotemia, Gentamicins, business, medicine.drug
Abstract: Objectives The optimal dosage regimen of gentamicin in horses is still under investigation. The objectives of this study were to determine gentamicin plasma concentrations in hospitalized horses treated with 10 mg/kg gentamicin (IV, q 24 h) and to determine whether a plasma concentration to minimum inhibitory concentration (MIC) ratio of 10:1 is reached for equine pathogens using this dose. Design Prospective clinical observational study; retrospective study on MICs of 131 gram-negative bacteria isolated from horses (2012-2015). Setting University teaching hospital. Animals Ninety-eight horses >6 months old, treated with gentamicin for their primary disease, consecutive samples. Measurements and main results Plasma concentrations were measured 1 hour (C1h ) and 20 hours (C20h ) after gentamicin administration using fluorescence polarization. Presence of systemic inflammatory response syndrome (SIRS) and azotemia was recorded, as well as the reason for antimicrobial administration (primary disease) and whether administration was prophylactic or therapeutic. The target C1h of ≥20 µg/mL gentamicin was reached in 90% of horses and was sufficient to reach a plasma concentration:MIC of 10:1 in 32 of 131 (24%) of gram-negative aerobic bacteria. A C20h ≤ 2 µg/mL was reached in 97% horses. Therapeutic versus prophylactic administration, primary disease, azotemia, and systemic inflammatory response syndrome were not associated with a failure to reach a desired peak or trough. Conclusions The gentamicin dose of 10 mg/kg every 24 hours should be further investigated and safety assessed because a target gentamicin plasma concentration of ≥20 µg/mL was achieved in the majority of cases. Nephrotoxic side effects were not assessed. Individual drug monitoring should be performed because clinical factors are unreliable predictors of plasma concentrations. A gentamicin target concentration of ≥40 µg/mL does not offer additional benefits compared to ≥20 µg/mL, due to the bimodal distribution of resistance in bacterial isolates.
Published: 2020
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32. Disease-specific plasma levels of mitokines FGF21, GDF15, and Humanin in type II diabetes and Alzheimer’s disease in comparison with healthy aging

Author: Morena Martucci, Daniela Monti, Aurelia Santoro, Marina Arcaro, Elio Scarpini, Fabiola Olivieri, Claudio Franceschi, Stefano Salvioli, Jacopo Sabbatinelli, Maria Conte, Anna Rita Bonfigli, Daniela Galimberti, Angelica Giuliani, Antonio Chiariello, and Conte M, Sabbatinelli J, Chiariello A, Martucci M, Santoro A, Monti D, Arcaro M, Galimberti D, Scarpini E, Bonfigli AR, Giuliani A, Olivieri F, Franceschi C, Salvioli S
Subjects: 0301 basic medicine, Aging, medicine.medical_specialty, Growth Differentiation Factor 15, FGF21, Disease, Type 2 diabetes, Healthy Aging, 03 medical and health sciences, 0302 clinical medicine, Alzheimer Disease, Internal medicine, medicine, Humans, T2D, Humanin, Aged, 80 and over, Successful aging, business.industry, Intracellular Signaling Peptides and Proteins, AD, medicine.disease, Fibroblast Growth Factors, GDF15, 030104 developmental biology, Endocrinology, Diabetes Mellitus, Type 2, GDF15, FGF21, Humanin, Aging, AD, T2D, Original Article, Geriatrics and Gerontology, Alzheimer's disease, Centenarian, business, 030217 neurology & neurosurgery
Abstract: Fibroblast Growth Factor 21 (FGF21), Growth Differentiation Factor 15 (GDF15), and Humanin (HN) are mitochondrial stress-related mitokines, whose role in health and disease is still debated. In this study, we confirmed that their plasma levels are positively correlated with age in healthy subjects. However, when looking at patients with type 2 diabetes (T2D) or Alzheimer’s disease (AD), two age-related diseases sharing a mitochondrial impairment, we found that GDF15 is elevated in T2D but not in AD and represents a risk factor for T2D complications, while FGF21 and HN are lower in AD but not in T2D. Moreover, FGF21 reaches the highest levels in centenarian’ offspring, a model of successful aging. As a whole, these data indicate that (i) the adaptive mitokine response observed in healthy aging is lost in age-related diseases, (ii) a common expression pattern of mitokines does not emerge in T2D and AD, suggesting an unpredicted complexity and disease-specificity, and (iii) FGF21 emerges as a candidate marker of healthy aging. Supplementary Information The online version of this article (10.1007/s11357-020-00287-w) contains supplementary material, which is available to authorized users.
Published: 2020
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33. Actualización urgente: alternativa temporal para el diagnóstico de hiper-glucemia gestacional y el seguimiento de estas mujeres y aquellas con diabetes pregestacional durante la pandemia COVID-19. Consenso del Grupo Español de Diabetes y Embarazo (GEDE) de la Sociedad Española de Diabetes (SED) y la Sociedad Española de Ginecología y Obstetricia (SEGO)

Author: Mercè Codina, Rosa Corcoy, María M. Goya, Domingo Acosta Delgado, Mónica Ballesteros Pérez, María Orosia Bandres Nivela, José Luis Bartha Rasero, Jordi Bellart Alfonso, José Eliseo Blanco, Manuel Botana López, Fernando Bugatto González, Mercedes Codina Marcet, Rosa Corcoy Pla, Alicia Cortázar Galarzar, Sergio Donnay Candil, Alejandra Durán Rodríguez-Hervada, María del Carmen Gómez García, Nieves Luisa González González, María Goya Canino, Lucrecia Herranz de la Morena, Cristina López Tinoco, Patricia Martín García, Ana Megía Colet, María Dolores Montañes Quero, Eduardo Moreno Reina, Juan Mozas Moreno, Marta Ontañón Nasarre, Verónica Perea Castilla, María José Picón César, José Antonio Rubio García, Berta Soldevila Madorell, Begoña Vega Guedes, Irene Vinagre Torres, and Ana María Wägner Falhin
Subjects: Pregnancy, Pediatrics, medicine.medical_specialty, Nutrition and Dietetics, Coronavirus disease 2019 (COVID-19), business.industry, Endocrinology, Diabetes and Metabolism, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine.disease, Endocrinology, Diabetes mellitus, Pandemic, Medicine, Gestation, business
Published: 2020
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34. Unexpectedly High Frequency of Enterococcal Bloodstream Infections in Coronavirus Disease 2019 Patients Admitted to an Italian ICU: An Observational Study

Author: Spinello Antinori, Letizia Oreni, Matteo Rimoldi, Andrea Giacomelli, Laura Galimberti, Elisabetta Ballone, Giacomo Casalini, Cecilia Bonazzetti, Matteo Bolis, Valentina Morena, Riccardo Colombo, and Anna Lisa Ridolfo
Subjects: Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), bloodstream infections, medicine.medical_treatment, Critical Illness, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Internal medicine, Sepsis, severe acute respiratory syndrome-coronavirus-2, medicine, Enterococcus species, Humans, Gram-Positive Bacterial Infections, Aged, Retrospective Studies, Mechanical ventilation, biology, Transmission (medicine), business.industry, Online Clinical Investigations, COVID-19, 030208 emergency & critical care medicine, Retrospective cohort study, Length of Stay, Middle Aged, biology.organism_classification, infection control, Icu admission, Intensive Care Units, Treatment Outcome, 030228 respiratory system, Enterococcus, Italy, frequency, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Observational study, Female, business
Abstract: Supplemental Digital Content is available in the text., OBJECTIVES: We aimed to assess the frequency of ICU-acquired bloodstream infections in coronavirus disease 2019 patients. DESIGN: Retrospective observational study. SETTING: The emergency expansion of an ICU from eight general beds to 30 coronavirus disease 2019 beds. PARTICIPANTS: Patients with coronavirus disease 2019 admitted to the ICU of Luigi Sacco Hospital (Milan, Italy) for greater than or equal to 48 hours between February 21, 2020, and April 30, 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The frequency of bloodstream infections per 1,000 days of ICU stay was calculated in 89 coronavirus disease 2019 patients, and the cumulative probability of bloodstream infection was estimated using death and ICU discharge as competing events. Sixty patients (67.4%) experienced at least one of the 93 recorded episodes of bloodstream infection, a frequency of 87 per 1,000 days of ICU stay (95% CI, 67–112).The patients who experienced a bloodstream infection had a higher Sequential Organ Failure Assessment score upon ICU admission (9.5; interquartile range, 8–12 vs 8, interquartile range, 5–10; p = 0.042), a longer median ICU stay (15 d; interquartile range, 11–23 vs 8, interquartile range, 5–12; p < 0.001), and more frequently required invasive mechanical ventilation (98.3% vs 82.8%; p = 0.013) than those who did not. The median time from ICU admission to the first bloodstream infection episode was 10 days. Gram-positive bacteria accounted for 74 episodes (79.6%), with Enterococcus species being the most prevalent (53 episodes, 55.8%). Thirty-two isolates (27.3%) showed multidrug resistance. CONCLUSIONS: Coronavirus disease 2019 seemed to increase the frequency of bloodstream infections (particularly Enterococcus-related bloodstream infection) after ICU admission. This may have been due to enteric involvement in patients with severe coronavirus disease 2019 and/or limitations in controlling the patient-to-patient transmission of infectious agents in extremely challenging circumstances.
Published: 2020

35. Epileptic seizures of suspected autoimmune origin: a multicentre retrospective study

Author: Silvia Bozzetti, Gaetano Cantalupo, Giampietro Zanette, Giuseppina Vitale, Marco Turatti, Romana Hoeftberger, Francesca Rossi, Carmela Zuco, Giorgia Teresa Maniscalco, Fabio Marchioretto, Eugen Trinka, Luca Di Tizio, Salvatore Monaco, Sergio Ferrari, Tiziano Zanoni, Sara Mariotto, Fabio Soldani, Morena Cadaldini, Fabio Rossini, and Rachele Delogu
Subjects: Male, Neurology, Hippocampus, Epilepsy, Status Epilepticus, 0302 clinical medicine, Cerebellum, Neoplasms, Child, Aged, 80 and over, 0303 health sciences, Movement Disorders, biology, Mental Disorders, Middle Aged, Psychiatry and Mental health, Treatment Outcome, Child, Preschool, Cohort, Anticonvulsants, Female, Immunotherapy, medicine.symptom, Antibody, Adult, medicine.medical_specialty, Adolescent, Primary Dysautonomias, Status epilepticus, neuroimmunology, Young Adult, 03 medical and health sciences, Autoimmune Diseases of the Nervous System, Internal medicine, medicine, Animals, Humans, Cognitive Dysfunction, Aged, Autoantibodies, Retrospective Studies, 030304 developmental biology, Autoimmune encephalitis, Dyskinesias, business.industry, Autoantibody, Infant, Reproducibility of Results, Retrospective cohort study, medicine.disease, autoimmune encephalitis, Rats, biology.protein, Surgery, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: ObjectiveTo analyse autoantibody status in a well-defined European multicentre cohort of patients with epilepsy of unknown aetiology and to validate the recently proposed Antibody Prevalence in Epilepsy (APE2) and Response to ImmunoTherapy in Epilepsy (RITE2) scores.MethodsWe retrospectively collected clinical and paraclinical data of 92 patients referred to the Neurology Units of Verona and Salzburg between January 2014 and July 2019 with new-onset epilepsy, status epilepticus or chronic epilepsy of unknown aetiology. Fixed and live cell-based assays, tissue-based assays, immunoblot, and live rat hippocampal cell cultures were performed in paired serum/cerebrospinal fluid (CSF) to detect antineuronal and antiglial antibodies. The APE2 and RITE2 scores were then calculated and compared with clinical and laboratory data.ResultsAutoantibodies were detected in 29/92 patients (31.5%), with multiple positivity observed in 6/29 cases. The APE2 score (median 5, range 1–15) significantly correlated with antibody positivity (p=0.014), especially for the presence of neuropsychiatric symptoms (pConclusionsThis is the first study that independently validates the APE2 and RITE2 scores and includes the largest cohort of patients whose paired serum and CSF samples have been tested for autoantibodies possibly associated with autoimmune epilepsy.
Published: 2020
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36. Comprehensive Molecular Screening in a Cohort of Young Men Who Have Sex With Men and Transgender Women: Effect of Additive Rectal Specimen Source Collection and Analyte Testing

Author: Ethan Morgan, Antonia Clifford, Kathleen Buehler, Brian Mustanski, Daniel T. Ryan, Morena Pass, Erik Munson, and Alyssa Reynoso
Subjects: Male, Microbiology (medical), medicine.medical_specialty, Analyte, Sexually Transmitted Diseases, Trichomonas Infections, Chlamydia trachomatis, Mycoplasma genitalium, Dermatology, Urine, urologic and male genital diseases, medicine.disease_cause, Transgender Persons, Article, Men who have sex with men, Gonorrhea, 03 medical and health sciences, 0302 clinical medicine, Prevalence, Trichomonas vaginalis, medicine, Humans, Mass Screening, Mycoplasma Infections, 030212 general & internal medicine, Homosexuality, Male, 030505 public health, biology, Obstetrics, business.industry, Rectum, Public Health, Environmental and Occupational Health, Chlamydia Infections, biology.organism_classification, Neisseria gonorrhoeae, female genital diseases and pregnancy complications, Infectious Diseases, Cohort, Female, 0305 other medical science, business, Nucleic Acid Amplification Techniques
Abstract: BACKGROUND This study's purposes were to characterize detection rates of several sexually transmitted infection (STI) agents and describe the effect additional specimen source and analyte screening has on STI detection within a cohort of young men who have sex with men and transgender women. METHODS Within a 16-month interval, 1966 encounters involved dual urine and rectal swab submissions assessed by commercial transcription-mediated amplification-based assays for Chlamydia trachomatis and Neisseria gonorrhoeae and by off-label transcription-mediated amplification-based Trichomonas vaginalis and Mycoplasma genitalium testing. Identification of STI carriers used algorithms involving Food and Drug Administration-cleared screening methods, laboratory-modified testing for extraurogenital C. trachomatis and N. gonorrhoeae, and laboratory-developed tests for T. vaginalis and M. genitalium. RESULTS Food and Drug Administration-indicated urine C. trachomatis and N. gonorrhoeae screening revealed 39 encounters (2.0%) yielding one or both agents. Via C. trachomatis and N. gonorrhoeae screening that included rectal swab analysis, 264 encounters (13.4%) yielded evidence of either (140 C. trachomatis, 88 N. gonorrhoeae) or both (36 participants) infections. Detection rates for C. trachomatis and N. gonorrhoeae were 1.4% and 0.6% for urine screening and 8.2% and 6.2% for rectal screening, respectively. Off-label screening identified 413 additional encounters with STI (5 T. vaginalis, 396 M. genitalium, 12 with both). Of these identifications, 82.1% were generated from analysis of rectal swabs (4 participants with T. vaginalis, 323 participants with M. genitalium, 12 with both). Overall detection rates of T. vaginalis (0.2% urine, 1.3% rectal) and M. genitalium (9.1% urine, 21.5% rectal) were variable. CONCLUSIONS Additive analyte testing, including extraurogenital collections, contributes to comprehensive STI screening within a high-risk demographic.
Published: 2020
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37. Determination of saliva epigenetic age in infancy, and its association with parental socio-economic characteristics and pregnancy outcomes

Author: Laura De Marco, Chiara Moccia, Lorenzo Richiardi, Costanza Pizzi, Silvia Polidoro, Elena Isaevska, Morena Trevisan, Franco Merletti, Franca Rusconi, Valentina Fiano, and Maja Popovic
Subjects: Adult, Male, Parents, epigenetic age acceleration, 0301 basic medicine, medicine.medical_specialty, Saliva, Epigenetic age, medicine.medical_treatment, Medicine (miscellaneous), Gestational Age, Epigenesis, Genetic, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Birth Weight, Humans, Medicine, Caesarean section, Epigenetics, Child, Pregnancy outcomes, Association (psychology), saliva, DNA methylation, birth cohort, Cesarean Section, business.industry, Obstetrics, Pregnancy Outcome, Infant, Gestational age, Confidence interval, 030104 developmental biology, Socioeconomic Factors, Case-Control Studies, Child, Preschool, Female, business, 030217 neurology & neurosurgery
Abstract: Epigenetic age acceleration (AA) has been associated with adverse environmental exposures and many chronic conditions. We estimated, in the NINFEA birth cohort, infant saliva epigenetic age, and investigated whether parental socio-economic position (SEP) and pregnancy outcomes are associated with infant epigenetic AA. A total of 139 saliva samples collected at on average 10.8 (range 7–17) months were used to estimate Horvath’s DNA methylation age. Epigenetic AA was defined as the residual from a linear regression of epigenetic age on chronological age. Linear regression models were used to test the associations of parental SEP and pregnancy outcomes with saliva epigenetic AA. A moderate positive association was found between DNA methylation age and chronological age, with the median absolute difference of 6.8 months (standard deviation [SD] 3.9). The evidence of the association between the indicators of low SEP and epigenetic AA was weak; infants born to unemployed mothers or with low education had on average 1 month higher epigenetic age than infants of mothers with high education and employment (coefficient 0.78 months, 95% confidence intervals [CIs]: −0.79 to 2.34 for low/medium education; 0.96, 95% CI: −1.81 to 3.73 for unemployment). There was no evidence for association of gestational age, birthweight or caesarean section with infant epigenetic AA. Using the Horvath’s method, DNA methylation age can be fairly accurately predicted from saliva samples already in the first months of life. This study did not reveal clear associations between either pregnancy outcomes or parental socio-economic characteristics and infant saliva epigenetic AA.
Published: 2020
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38. Standardized surgical technique for uniportal video-assisted thoracoscopic lobectomy

Author: Diego Gonzalez-Rivas, Alejandro García-Pérez, Ricardo Fernández Prado, Marina Paradela de la Morena, Anna Minasyan, Luis Fernandez-Vago, and Mercedes de la Torre Bravos
Subjects: Pulmonary and Respiratory Medicine, Reconstructive surgery, medicine.medical_specialty, Lung Neoplasms, medicine.diagnostic_test, Thoracic Surgery, Video-Assisted, business.industry, General surgery, General Medicine, Standard technique, medicine, Thoracoscopy, Humans, Surgery, Video assisted, Pneumonectomy, Cardiology and Cardiovascular Medicine, business
Abstract: Summary Uniportal video-assisted thoracoscopic surgery may be the approach for any thoracic procedure, from minor resections to complex reconstructive surgery. However, anatomical lobectomy represents its most common and clinically proven usage. A wide variety of information about uniportal video-assisted thoracoscopic lobectomies can be found in the literature and multimedia sources. This article focuses on updating the surgical technique and includes important aspects such as the geometric approach, anaesthesia considerations, operating room set-up, tips about the incision, instrumentation management and the operative technique to perform the 5 lobectomies. The following issues are explained for each lobectomy: anatomical considerations, surgical steps and technical advice. Medical illustrations and videos are included to clarify the text with the goal of describing a standard surgical practice.
Published: 2020
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39. Involvement of the Hsp70/TLR4/IL‐6 and TNF‐α pathways in delayed‐onset muscle soreness

Author: Morena Brazil Sant'Anna, Flávio P. Veras, Thiago M. Cunha, Giovane Galdino, Rafaela Silva dos Santos, Pablo Christiano Barboza Lollo, and David Wilson Ferreira
Subjects: Male, 0301 basic medicine, medicine.medical_specialty, Biochemistry, Proinflammatory cytokine, Mice, 03 medical and health sciences, Cellular and Molecular Neuroscience, 0302 clinical medicine, Physical Conditioning, Animal, Internal medicine, Delayed onset muscle soreness, medicine, Animals, Aerobic exercise, HSP70 Heat-Shock Proteins, Muscle, Skeletal, Receptor, Pain Measurement, Mice, Knockout, Microglia, Interleukin-6, Tumor Necrosis Factor-alpha, business.industry, Myalgia, Aerobiosis, Mice, Inbred C57BL, Toll-Like Receptor 4, 030104 developmental biology, medicine.anatomical_structure, Endocrinology, Nociception, Spinal Cord, Myeloid Differentiation Factor 88, TLR4, MEDULA ESPINHAL, Tumor necrosis factor alpha, medicine.symptom, business, 030217 neurology & neurosurgery, Signal Transduction
Abstract: Delayed-onset muscle soreness (DOMS) is a very common condition in athletes and individuals not accustomed to physical activity that occurs after moderate/high-intensity exercise sessions. The activation of microglial Toll-like receptor 4 (TLR4) in the spinal cord has been described to be important for the induction and maintenance of persistent pain. Based on that, we hypothesize that 70 kilodalton heat-shock protein (Hsp70), a mediator released by exercise, could activate microglial TLR4 in the spinal cord, releasing proinflammatory cytokines and contributing to the start of DOMS. In fact, we found that the knockout of TLR4, myeloid differentiation primary response 88 (MyD88), interleukin-6 (IL-6), or both tumor necrosis factor-α (TNF-α) receptor 1 and TNF-α receptor 2 in mice prevented the development of DOMS following acute aerobic exercise in contrast to the findings in male C57BL/6 wild-type mice. Furthermore, DOMS in exercised wild-type mice was also prevented after pre-treatment with microglia inhibitor, TLR4 antagonist, and anti-Hsp70 antibody. During exercise-induced DOMS, Hsp70 mRNA, TLR4 mRNA, and protein levels, as well as Iba-1 (a microglial marker), IL-6, and TNF-α protein levels, were increased in the muscle and/or spinal cord. Together, these findings suggest that Hsp70 released during exercise-induced DOMS activates the microglial TLR4/IL-6/TNF-α pathway in the spinal cord. Thus, the blockade of TLR4 activation may be a new strategy to prevent the development of DOMS before intense exercise.
Published: 2020
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40. Holistic approach of the care of the infant with hypoxic-ischaemic encephalopathy in Spain

Author: Juan Arnaez, Nuria Herranz-Rubia, Alfredo Garcia-Alix, J. Diez-Delgado, I. Benavente-Fernández, I. Tofé, A.E. Jerez, J.A. Hurtado, J.M. Ceballos, M.L. Millán, M.D. Esquivel, C. Ruiz, M. Baca, E. Tapia, M. Losada, E. Torres, A. Pavón, P.J. Jiménez, F. Jiménez, M.P. Ventura, S. Rite, T. González, R.P. Arias, P.R. Balliu, J.M. Lloreda-García, J.L. Alcaráz, C. Tapia, A. de la Morena, I. Centelles, I. Güemes, J. Estañ, A. Alberola, S. Aparici, R. López, J. Beceiro, B. García, L. Martínez, E. González, L. Arruza, M.D. Blanco, M.T. Moral, B. Arias, F. Mar, J. Jiménez, G. Romera, A. Cuñarro, C. Muñóz, F. Cabañas, E. Valverde, R. Montero, J.C. Tejedor, C. Santana, B. Reyes, S. Romero, A. Orizaola, M. Baquero, D. Hernández, A. Pantoja, C. Vega-del-Val, L. Castañón, E.P. Gutiérrez, M. Benito, S. Caserío, G. Arca, M.J. García, M.A. López-Vílchez, L. Castells, M. Domingo, W. Coroleu, H. Boix, R. Porta, A. García-Alix, S. Martínez-Nadal, E. Jiménez, E. Sole, M. Albújar, E.M. Fernández, A.R. Barrio, E. Piñán, A. Avila-Alvarez, M.E. Vázquez, N. Balado, P.A. Crespo, M.L. Couce, A. Concheiro-Guisán, I. Esteban, A. Lavilla, V. Alzina, A. Aguirre, B. Loureiro, I. Echániz, M.D. Elorza, and A. Euba
Subjects: medicine.medical_specialty, Sedation, media_common.quotation_subject, Encephalopathy, Hipoxia-isquemia, Pediatrics, Enteral administration, RJ1-570, Hypoxic ischaemic encephalopathy, 03 medical and health sciences, 0302 clinical medicine, Hipotermia terapéutica, 030225 pediatrics, Management of Technology and Innovation, Cooling methods, medicine, Neonato, media_common, Asphyxia, Asfixia, Teamwork, business.industry, Pronóstico, medicine.disease, Biomarcadores, Emergency medicine, medicine.symptom, business
Abstract: Introduction: There is not much information about the care of infants with hypoxic-ischaemic encephalopathy (HIE) treated with therapeutic hypothermia (TH) in Spain. This includes whether protocols are routinely used, the type of neuro-monitoring performed, and how information on the neurological prognosis is presented to families. The answers to these would allow to detect and implement areas of improvement. Method: A cross-sectional analysis was performed on the responses to structured questionnaires sent to all the Spanish neonatal units that were performing TH in June 2015. Questions were divided into 5 sections: (1) the availability of protocols and technological resources, (2) the use of neuro-monitoring tools, (3) the knowledge and training of the professionals; (4) the prognostic information given to the parents; and (5) the discharge report and the follow-up plan. Results: Most centres (95%) use servo controlled whole-body cooling methods and have specific management protocols. Sedation is used in 70% of centres, and in 68% of them the onset of enteral feeding is delayed until the end of the cooling period. Amplitude-integrated electroencephalography monitoring is used in more than 80% of the centres, although only in 50% are nurses able to interpret it. Cerebral oxygen saturation is not often monitored (16%). As regards diagnostic-prognostic studies, neuroimaging is universal, but brain damage biomarkers are hardly used (29%). Prognostic information is offered within the first 72 posnatal hours in 21% of the centres, and is given without the presence of the nurse in 70% of the centres. Follow-up is performed by a neuro-paediatrician (84%), with an uneven duration between centres. Conclusions: The care of infants with HIE treated with TH in Spain is generally adequate, although there are areas for improvement in neuromonitoring, sedation, prognostic information, teamwork, and duration of follow-up. Resumen: Introducción: Apenas conocemos cómo es la asistencia de los recién nacidos (RN) con encefalopatía hipóxico-isquémica (EHI) en hipotermia terapéutica (HT), especialmente si existen protocolos asistenciales, la neuromonitorización que se realiza o cómo es la aproximación al pronóstico neurológico. Este conocimiento permite detectar e implementar áreas de mejora asistencial. Método: Estudio transversal de los 57 hospitales españoles que realizaban HT en 2015, mediante cuestionario sobre: 1) la disponibilidad de protocolos y de recursos tecnológicos; 2) el uso de herramientas de neuromonitorización; 3) los conocimientos de los profesionales; 4) la información pronóstica que se da los padres, y 5) el informe al alta y del plan de seguimiento. Resultados: El 95% utiliza enfriamiento corporal-total servocontrolado y dispone de protocolos específicos de actuación. El 70% utiliza sedación y el 68% deja al paciente a dieta absoluta. La monitorización con electroencefalografía integrada por amplitud se utiliza en más del 80% de los centros, aunque solo en el 50% la enfermera es capaz de interpretarlo. La saturación de oxígeno cerebral es escasamente monitorizada (16%). Entre los estudios diagnóstico-pronósticos, la neuroimagen es universal, pero los neurobiomarcadores apenas se utilizan (29%). Solo el 21% ofrece información pronóstica antes de las 72 h de vida; sin presencia de la enfermera en el 70%. El seguimiento lo realiza el neuropediatra (84%), con una duración desigual entre centros. Conclusiones: La asistencia del RN con EHI en España es adecuada, con áreas de mejora en: neuromonitorización, sedación, marco temporal de la información pronóstica, trabajo en equipo y estandarización de la duración del seguimiento.
Published: 2020
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41. Motivationale Einflüsse auf exekutive Funktionen bei Aufmerksamkeitsdefizit-/ Hyperaktivitätsstörungen (ADHS)

Author: Gerhard W. Lauth and Morena Lauth-Lebens
Subjects: Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Aufmerksamkeitsdefizit hyperaktivitatsstorung, 05 social sciences, medicine, Attention deficit hyperactivity disorder, 0501 psychology and cognitive sciences, medicine.disease, Psychology, 030217 neurology & neurosurgery, 050104 developmental & child psychology
Abstract: Zusammenfassung. Problemstellung: Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen (ADHS) werden als Defizit der Selbststeuerung verstanden und vielfach mit exekutiven Dysfunktionen assoziiert. Es mehren sich die empirischen Hinweise auf einen Rückgang der symptomatischen und funktionalen Handlungsbeeinträchtigungen unter extrinsisch motivierenden Bedingungen. Sie stammen aus experimentellen Untersuchungen zu dem Einfluss von Motivation auf verschiedene Zielbereiche. Ausgehend von einem lerntheoretischen Verständnis der Motivation erfolgt die experimentelle Bedingungsvariation meist über Verstärkerdarbietung. Entsprechend ihres hypothesengenerierenden Erkenntnisinteresses beinhalten die Arbeiten noch wenig Informationen über die bereichsabhängige Wirkspezifität. Hieraus ergibt sich das Forschungsrationale für ein systematisches Review zu bereichsspezifischen Verstärkereffekten bei ADHS. Zur Systematisierung und Synthese der Befunde bedient es sich neuropsychologischer Modellvorstellungen. Methode: Ausgehend von einer nach PRISMA Standards durchgeführten Recherche wurden 19 experimentelle Vergleichsstudien mit insgesamt 2.692 Kindern eingeschlossen und ausgewertet. Sie untersuchen „kalte“ exekutive Funktionen als abhängige Variablen und schließen aus verstärkerabhängigen Testleistungen auf motivationale Einflüsse. In der hier vorliegenden Studie wurden diese nach der Richtung (förderlich vs. abträglich) und Reichweite (optimierend sowie kompensatorisch und normalisierend) der erzielten Veränderung ausgewertet. Ergebnis: Insgesamt 19 Studien haben die Verstärkerwirkung an 32 abhängigen Variablen überprüft und bei 24 von ihnen leistungsförderliche Effekte festgestellt. Hierbei reichen die Veränderungen von einer Optimierung bis zu einer Normalisierung exekutiver Funktionen. Bei 8 abhängigen Variablen werden keine oder abträgliche Verstärkerwirkungen festgestellt. Schlussfolgerung: Zusammenfassend belegt die Forschung eine Verstärkerabhängigkeit exekutiver Dysfunktionen bei ADHS. Künftig scheint ein weniger deterministisches Verständnis der störungsspezifischen Dysfunktionen als nützlich und angebracht für Theoriebildung und Therapiepraxis.
Published: 2020
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42. Estimation of residual renal function using beta‐trace protein: Impact of dialysis procedures

Author: Marion Morena, Jean-Paul Cristol, Olivia Gilbert, Moglie Le Quintrec, Maria-Eugenia Noguera-Gonzalez, Anne-Sophie Bargnoux, Delphine Buthiau, Nils Kuster, Annie Rodriguez, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département d'hématologie biologique[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), MORNET, Dominique, and Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi
Subjects: Male, medicine.medical_treatment, Medicine (miscellaneous), 02 engineering and technology, 030204 cardiovascular system & hematology, Kidney, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, chemistry.chemical_compound, 0302 clinical medicine, Dialysis Solutions, Aged, 80 and over, biology, General Medicine, residual renal function, Middle Aged, Lipocalins, 3. Good health, Intramolecular Oxidoreductases, peritoneal dialysis, Female, Peritoneum, Glomerular Filtration Rate, Adult, medicine.medical_specialty, Urinary system, beta-2 microglobulin, 0206 medical engineering, Biomedical Engineering, Urology, Renal function, Bioengineering, Peritoneal dialysis, Biomaterials, 03 medical and health sciences, Renal Dialysis, medicine, Humans, Beta-Trace Protein, Cystatin C, Renal Insufficiency, Chronic, Dialysis, Aged, hemodiafiltration, Creatinine, Beta-2 microglobulin, business.industry, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 020601 biomedical engineering, Renal Elimination, Cross-Sectional Studies, chemistry, biology.protein, business, conventional hemodialysis, Biomarkers, Kidney disease
Abstract: International audience; AbstractBeta‐trace protein (BTP), a low molecular weight protein of 23‐29 kDa, has been proposed as a promising biomarker to estimate residual renal function (RRF) in patients on maintenance hemodialysis (HD). Indeed, BTP is cleared by native kidney but not during conventional HD session. By contrast, the removal rate of BTP using convective processes (mainly hemodiafiltration [HDF]) and peritoneal dialysis (PD) has been little or not investigated. Therefore, an aim of this study was to evaluate the impact of dialysis procedures (high‐flux HD, on‐line post‐dilution HDF and PD) on BTP removal in comparison with beta‐2 microglobulin (B2M) and cystatin C (CYSC) removals after a single session. In addition, the ability of BTP to predict RRF in PD was assessed. This observational cross‐sectional study included a total of 82 stable chronic kidney disease patients, 53 patients were on maintenance dialysis (with n = 26 in HD and n = 27 in HDF) and 29 were on PD. Serum concentrations of BTP, B2M, and CYSC were measured (a) before and after a single dialysis session in HD and HDF anuric patients to calculate reduction percentages, (b) in serum, 24‐hour‐dialysate and 24‐hour‐urine in PD patients to compute total, peritoneal, and urinary clearance. RRF was estimated using four equations developed for dialysis patients without urine collection and compared to the mean of the urea and creatinine clearances in PD. The concentrations of the three studied molecules were significantly reduced (P < .001) after dialysis session with significantly higher reduction ratio using HDF compared to HD modality (P < .001): BTP 49.3% vs 17.5%; B2M 82.3% vs 69.7%; CYSC 77.4% vs 66% in HDF and HD, respectively. In non‐anuric PD patients, B2M and CYSC were partly removed by peritoneal clearance (72.3% and 57.6% for B2M and CYSC, respectively). By contrast, BTP removal by the peritoneum was negligible and a low bias for the BTP‐based equation to estimate RRF (−1.4 mL/min/1.73 m2) was calculated. BTP is significantly removed by high‐flux HD or HDF, thereby compromising its use to estimate RRF. By contrast, BTP appears as a promising biomarker to estimate RRF in PD patients since it is not affected by peritoneal clearance, unlike B2M and CYSC, and it is well correlated to RRF.
Published: 2020
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43. Congenital antithrombin deficiency in patients with splanchnic vein thrombosis

Author: María Eugenia de la Morena-Barrio, José Ferrusquia, Marta Magaz, Juan Carlos Reverter, Anna Baiges, Vicente Vicente, Juan Carlos García-Pagán, Fanny Turon, Javier Corral, Virginia Hernández-Gea, and Antonia Miñano
Subjects: medicine.medical_specialty, Thrombophilia, Gastroenterology, Antithrombins, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Splanchnic Circulation, Trombosi, Vein, Venous Thrombosis, Antithrombin III Deficiency, Hepatology, business.industry, Mutació (Biologia), Antithrombin, Thrombosis, Mutation (Biology), medicine.disease, Venous thrombosis, medicine.anatomical_structure, Splanchnic vein thrombosis, 030220 oncology & carcinogenesis, Etiology, 030211 gastroenterology & hepatology, business, Splanchnic, medicine.drug
Abstract: Splanchnic vein thromboses (SVT) are a rare condition that can be life-threatening. The most severe thrombophilia associated to SVT is antithrombin (AT) deficiency, usually caused by SERPINC1 mutations. Although transitory AT deficiencies and congenital disorders of the N-glycosylation pathways (CDG) have been recently reported as causes of AT deficiency, the current AT clinical screening still only includes anti-FXa activity. This study aims to 1) improve the detection of antithrombin deficiency in SVT and 2) characterize the features of antithrombin deficiency associated with SVT.The study was performed in 2 cohorts: 1) 89 SVT patients with different underlying etiologies but in whom AT deficiency had been ruled out by classical diagnostic methods; and 2) 271 unrelated patients with confirmed AT deficiency and venous thrombosis. Antithrombin was evaluated by functional (anti-FXa and anti-FIIa) and immunological methods (ELISA, crossed immunoelectrophoresis, western blot), and SERPINC1 sequencing was performed.In 4/89 patients (4.5%) additional alterations in AT were found (two had SERPINC1 mutations, one had a specific variant causing transient AT deficiency and one patient had CDG). In 11 of the 271 patients (4.1%) with AT deficiency and thrombosis, thrombosis was located at the splanchnic venous territory.AT deficiency may be underdiagnosed by current clinical screening techniques. Therefore, a comprehensive AT evaluation should be considered in cases of rethrombosis or doubtful interpretation of anti-FXa activity levels. SVT is a relatively common localization of the thrombotic event in patients with congenital AT deficiency.© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Published: 2020
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44. Management practices for postdural puncture headache in obstetrics: a prospective, international, cohort study

Author: Gupta, A., von Heymann, C., Magnuson, A., Alahuhta, S., Fernando, R., Van de Velde, M., Mercier, F. J., Schyns-van den Berg, A. M. J. V., Isabelle, C., Bart, B., Filiep, S., Pierre-Yves, D., Geraldine, L., Jan, C., Roel, S., Patrick, V. H., Alain, K., Henk, V., Monique, B., Eva, R., Ana, J., Aleksandra, J., Damjan, M., Ivan, S., Slobodan, M., Martina, K., Petr, S., Milan, A., Christian, K., Ivana, V., Blazena, Z., Christina, F. -F., Bjoern, M., Charlotte, K. A., Tomi, K., Seppo, A., Anne, M., Susanna, M., Kati, R., Tuula, H., Vesa, K., Kirsti, L., Sara, T., Emmanuel, B., Pierre-Edouard, G., Olivier, M., Aurelie, C., Jean, L., Therese, S., Marie, B., Tarik, H., Fleur, M. D., Christine, Q., Karim, B., Agnes, L., Mickael, S., Marie-Pierre, B., Mathieu, C., Catherine, F., Paola-Carla, P., Martine, B., Brigitte, S., Anne-Sophie, B., Thomas, D., Minh, N. T., Hawa, K., Sophie, N., Lauranne, O., Anne, D., Florence, V., Lutz, K., Christoph, H., Stefan, M., Karin, B., Manfred, B., Heidrun, L., Josef, S. S., Ellis, M., Birgit, B., Claudia, N., Stefan, W., Matthias, G., Henning, O., Antonia, H., Yvonne, J., Peter, K., Christian, V. H., Sabine, W., Chryssoula, S., Antonia, S., Athanasia, T., Konstantina, K., Anastasia, L., Dimitrios, V., Paraskevi, M., Adalbjorn, T., Riad, T., Eidelman Leonid, A., Atara, D., Sharon, O. -Z., Alexander, I., Iacob, R., Luigi, D. S., Barbara, P., Luca, B., Alessandro, Z., Michela, C., Giorgio, D. R., Marco, A., Grazia, F. M., Cristina, T., Qamile, M., Andrius, M., Grazina, K., Kestutis, R., Francis, B., Carl, T., Agnes Geertje, K. -V., Alexandra, S. -V. D. B., Markus, H. W., Tijs, V. D. B., Eric, K., Ilse, D., Anouk, V. D. K., Caroline, V. D. M., Nele, R., Michal, P., Christine, P., Marjolein, V. D. N., Seppe, K., Aart-Jan, T., Dick, C., van Nick, D., Bastiaan, V., Ingrid, B., Vegard, D., Robert, H., Francesco, V., Reidar, E. J., Radovan, W., Naz, A. T., Else-Marie, R., Radoslaw, C., Tomasz, S., Bartlomiej, W., Aida, F. M., Amelia, F., Catarina, S. A., Irene, F., Bernardo, M., Joana, T., Rita, A., Herminia, C., Rosario, F., Paulo, L., Carolina, C., Fernando, M., Cristiana, P., Sandra, P., Francisca, T., Pedro, V., Filipa, L., Paulo, M., Lucindo, O., Isabel, G. -A., Vitor, P. -O., Paulo, P., Carla, B., Francisco, G., Ana, M., Claudia, C., Miriam, N., Vania, P., Mara, C., Raquel, T., Gloria, T., Ines, F., Estela, P., Luisa, M., Manue, S., Aleksandra, B., Mirjana, K., Lidija, J., Borislava, P., Marija, K., Monika, G., Jana, S., Gordana, P., Ales, R., Iva, B., Dragan, G., Tatjana, S. P., Teresa, C., Pablo, M., De Joaquin, C. -E., Roque, G. -C., Leonor, V. -G., Morena, B., Carolina, G. B., Cristian, H., Laura, R., De Maroto Pinar, S., Gracia Solsona, J. A., Manuel, L. -B., Marta, M. M., Ana Maria, P. M., Lourdes, T., Anibal Ricardo, P. G., Clara, A. S., Enric, M., Jose Luis, A. S., Maria, S. P., Maria Inmaculada, V. H., Gorka, A., Estibaliz, B., Julia, H., Fernando, I., Alberto, M., Fernando, G., Emilia, G. A., Fabrizio, I., Julieta, L., Cristina, R. R., Osvaldo Ceferino, P. P., Natalia, S. B., Ceferina, S. C., Lourdes, H. G., Caridad, R. G., Raquel, S. N., Diego, A., Belena, J. M., Carmen, G. -C., Irene, G., Susana, M., Elena, S., Anette, H., Elisabet, A., Helena, H., Monika, T., Ruaa, A. -T., Susanne, L. -E., Anja, L. -S., Ola, R., Evija, A., Lars, G., Bijan, D., Anil, G., Nordstom Johan, L., Jan, P., Jan, R., Lars, B., Johan, F., Malin, U. E., Hakan, R., Anna, H., Katarina, L., Sofus, R., Karin, T., Peter, B., Moira, R. B., Ulrike, S., Stanislas, M., Georges, S., Pia, A. D. M., Miodrag, F., Alexander, D., Maya, B., Thierry, G., Claudia, V., Sule, O., Berrin, G. D., Pelin, C. D., Ayca, T. T., Sarah, D., Marc, V. D. V., Manuel, A., Marina, V., Leire, M., Rosa, S., Brazzi, L, Anesthesiology, ACS - Heart failure & arrhythmias, and ACS - Microcirculation
Subjects: Adult, Pediatrics, medicine.medical_specialty, Adolescent, accidental dural puncture, Analgesic, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, 030202 anesthesiology, Pregnancy, epidural blood patch, Medicine, Humans, Prospective Studies, Management practices, Accidental dural puncture, Pain Measurement, Epidural blood patch, obstetrics, business.industry, Disease Management, epidural analgesia, Odds ratio, postdural puncture headache, Analgesia, Epidural, Blood Patch, Epidural, Female, Follow-Up Studies, Intracranial Hemorrhages, Middle Aged, Obstetrics, Post-Dural Puncture Headache, Confidence interval, 3. Good health, Blood Patch, Anesthesiology and Pain Medicine, Epidural, Analgesia, business, Complication, Cohort study
Abstract: © 2020 British Journal of AnaesthesiaBackground: Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache (PDPH). We aimed to describe management practices and outcomes after PDPH treated by epidural blood patch (EBP) or no EBP. Methods: Following ethics committee approval, patients who developed PDPH after accidental dural puncture were recruited from participating countries and divided into two groups, those receiving EBP or no EBP. Data registered included patient and procedure characteristics, headache symptoms and intensity, management practices, and complications. Follow-up was at 3 months. Results: A total of 1001 patients from 24 countries were included, of which 647 (64.6%) received an EBP and 354 (35.4%) did not receive an EBP (no-EBP). Higher initial headache intensity was associated with greater use of EBP, odds ratio 1.29 (95% confidence interval 1.19–1.41) per pain intensity unit increase. Headache intensity declined sharply at 4 h after EBP and 127 (19.3%) patients received a second EBP. On average, no or mild headache (numeric rating score≤3) was observed 7 days after diagnosis. Intracranial bleeding was diagnosed in three patients (0.46%), and backache, headache, and analgesic use were more common at 3 months in the EBP group. Conclusions: Management practices vary between countries, but EBP was more often used in patients with greater initial headache intensity. EBP reduced headache intensity quickly, but about 20% of patients needed a second EBP. After 7 days, most patients had no or mild headache. Backache, headache, and analgesic use were more common at 3 months in patients receiving an EBP.
Published: 2020
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45. Non-alcoholic fatty liver disease: correlation with hyperuricemia in a European Mediterranean population

Author: Morena Sciuto, Francesco Marotta, Roberto Catanzaro, Birbal Singh, and Fang He
Subjects: Male, medicine.medical_specialty, animal structures, Population, Disease, hyperuricemia, digestive system, Gastroenterology, 03 medical and health sciences, chemistry.chemical_compound, Liver disease, 0302 clinical medicine, uric acid, Non-alcoholic Fatty Liver Disease, Risk Factors, Internal medicine, NAFLD, MetS, medicine, Humans, 030212 general & internal medicine, Hyperuricemia, education, Retrospective Studies, Metabolic Syndrome, education.field_of_study, business.industry, Fatty liver, nutritional and metabolic diseases, Non alcoholic, General Medicine, medicine.disease, digestive system diseases, liver disease, Cross-Sectional Studies, chemistry, 030220 oncology & carcinogenesis, Uric acid, Female, Metabolic syndrome, business
Abstract: Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) are two pathologies that intersect each other. It was found that there is an association between MetS/NAFLD and hyperuricemia. The aim of our study was to demonstrate this association in a European Mediterranean population.We compared 236 patients with NAFLD to 218 patients without NAFLD. We assessed laboratory metabolic parameters (serum uric acid - SUA, fasting glucose, triglycerides, total cholesterol, etc.) and the presence or absence of MetS in a retrospective, cross-sectional, case-control manner.Analysis of the two main variables in study showed a moderate direct correlation (We have found a significant correlation between NAFLD and hyperuricemia. The higher SUA levels accompanied the risk of NAFLD.
Published: 2022

46. Triglycerides to high-density lipoprotein cholesterol ratio for diagnosing nonalcoholic fatty liver disease

Author: Fang He, Luca Zanoli, Azam Yazdani, Roberto Catanzaro, Federica Selvaggio, Francesco Marotta, and Morena Sciuto
Subjects: medicine.medical_specialty, Cirrhosis, Endocrinology, Diabetes and Metabolism, Population, Gastroenterology, Body Mass Index, chemistry.chemical_compound, High-density lipoprotein, Non-alcoholic Fatty Liver Disease, Internal medicine, Fatty liver, Nonalcoholic fatty liver disease, Internal Medicine, medicine, Humans, education, Triglycerides, education.field_of_study, Cholesterol, business.industry, Cholesterol, HDL, Area under the curve, nutritional and metabolic diseases, medicine.disease, Metabolic syndrome, digestive system diseases, chemistry, business, Body mass index, Biomarkers
Abstract: BACKGROUND Nonalcoholic Fatty Liver Disease (NAFLD) is a widespread disease in the western world. It can develop into more serious pathological conditions (i.e. liver cirrhosis). Therefore it is important to diagnose it in order to prevent this evolution. For diagnosis it is possible to use both imaging methods and biomarkers, such as the Triglycerides To High-Density Lipoprotein Cholesterol Ratio (TG/HDL-C). Aim of our study is to determine whether TG/HDL-C ratio is significantly associated with NAFLD and Metabolic Syndrome (MetS). METHODS We recruited 231 patients, 131 with and 100 without NAFLD. The Body Mass Index had been calculated and different laboratory parameters had been obtained. TG/HDL-C ratio was calculated for each. RESULTS In our sample HDL-C was not significantly reduced in NAFLD group (p = 0.49), but higher TG and TG/HDL-C ratio were significantly associated with NAFLD: in both p < 0.001. According to receiver operating characteristic curve, the best cut-off of TG/HDL-C in NAFLD population was 1.64 [area under the curve (AUC) 0.675 (95% CI 0.604-0.746), p < 0.001]. TG/HDL-C higher ratio was significantly associated with MetS (p < 0.001). The best cut-off of TG/HDL-C in patients with MetS was 2.48 [AUC 0.871 (95% CI 0.808-0.935), p < 0.001]. CONCLUSIONS We demonstrated that higher TG/HDL-C ratio is associated with NAFLD and MetS. Though nowadays TG/HDL-C ratio is not a criteria for NAFLD diagnosis, we believe that in the future it could be used as a reliable non-invasive marker in routine diagnostics of NAFLD.
Published: 2022

47. The Role of Immunotherapy in a Tolerogenic Environment: Current and Future Perspectives for Hepatocellular Carcinoma

Author: Maria D’Antò, Liliana Montella, Lucia Altucci, Ermelinda Quarata, Massimiliano Berretta, Raffaele Angelo Nicola Ranucci, Federica Sarno, Maria Maddalena Laterza, Morena Fasano, Sergio Facchini, Annamaria Ambrosino, Gaetano Facchini, Montella, Liliana, Sarno, Federica, Ambrosino, Annamaria, Facchini, Sergio, D'Antò, Maria, Laterza, Maria Maddalena, Fasano, Morena, Quarata, Ermelinda, Ranucci, Raffaele Angelo Nicola, Altucci, Lucia, Berretta, Massimiliano, and Facchini, Gaetano
Subjects: 0301 basic medicine, Sorafenib, Oncology, medicine.medical_specialty, Carcinoma, Hepatocellular, Cabozantinib, QH301-705.5, medicine.medical_treatment, immune checkpoint inhibitor, Review, Ramucirumab, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Immune system, Antineoplastic Agents, Immunological, Hepatocellular carcinoma, Immune checkpoint inhibitor, Immunotherapy, Pathogenesis, Internal medicine, Regorafenib, medicine, Immune Tolerance, Tumor Microenvironment, Animals, Humans, Biology (General), Immune Checkpoint Inhibitors, business.industry, pathogenesis, Liver Neoplasms, General Medicine, hepatocellular carcinoma, medicine.disease, digestive system diseases, 030104 developmental biology, Treatment Outcome, chemistry, 030220 oncology & carcinogenesis, Tumor Escape, immunotherapy, business, Lenvatinib, medicine.drug
Abstract: Simple Summary The liver can be considered an immune organ, given its role as a hub for gut-derived antigens and liver-resident immune cells and the tolerance status of its environment. However, chronic inflammation represents a disruption to this balance and, pathogenetically, represents the beginning of a multistep process leading to cancer. The present study aimed to describe the key points of liver cancer pathogenesis, which may help in understanding the limits and perspectives of investigations concerning immunotherapy. Abstract In contrast to several tumors whose prognoses are radically affected by novel immunotherapeutic approaches and/or targeted therapies, the outcomes of advanced hepatocellular carcinoma (HCC) remain poor. The underlying cirrhosis that is frequently associated with it complicates medical treatment and often determines survival. The landscape of HCC treatment had included sorafenib as the only drug available for ten years, until 2018, when lenvatinib was approved for treatment. The second-line systemic treatments available for hepatocellular carcinoma include regorafenib, cabozantinib, ramucirumab, and, more recently, immune checkpoint inhibitors. However, the median survival remains below 15 months. The results obtained in clinics should be interpreted whilst considering the peculiar role of the liver as an immune organ. A healthy liver microenvironment ordinarily experiences stimulation by gut-derived antigens. This setup elucidates the response to chronic inflammation and the altered balance between tolerance and immune response in HCC development. This paper provides an overview of the mechanisms involved in HCC pathogenesis, with a special focus on the immune implications, along with current and future clinical perspectives.
Published: 2021

48. Which treatment after first line therapy in NSCLC patients without genetic alterations in the era of immunotherapy?

Author: Paloma Martín-Martorell, Carminia Maria Della Corte, Renato Franco, Morena Fasano, Salvatore Cappabianca, Giulia Martini, Amelia Insa, Giovanni Vicidomini, Stefania Napolitano, Raimondo Di Liello, Floriana Morgillo, Insa, Amelia, Martín-Martorell, Paloma, Di Liello, Raimondo, Fasano, Morena, Martini, Giulia, Napolitano, Stefania, Vicidomini, Giovanni, Cappabianca, Salvatore, Franco, Renato, Morgillo, Floriana, and Della Corte, Carminia Maria
Subjects: Oncology, medicine.medical_specialty, Lung Neoplasms, medicine.medical_treatment, Second line therapy, NSCLC, Retrospective data, Second line, First line therapy, Cancer immunotherapy, Retrospective Studie, Internal medicine, Carcinoma, Non-Small-Cell Lung, Antineoplastic Combined Chemotherapy Protocols, Medicine, Chemotherapy, Humans, Retrospective Studies, Response rate (survey), ICI resistance, Antineoplastic Combined Chemotherapy Protocol, business.industry, Hematology, Immunotherapy, Non small cell, Neoplasm Recurrence, Local, business, Human
Abstract: Cancer immunotherapy has produced an unprecedented durable response rate, thus shifting from traditional doublet chemotherapy to immunotherapy-based treatments with and without chemotherapy as the first line strategies for advanced non-small cell lung cancer patients without a molecular driver. However, the majority of patients do not benefit from the treatment or may relapse after a period of response. As few treatment options are available after failure of cancer immunotherapy, including the combination of chemotherapy and anti-angiogenic drugs, a better understanding of the mechanisms limiting cancer immunotherapy may be of help in the definition of the best second line. Whereas only retrospective data support an immunotherapy rechallenge approach, new combination strategies including immunotherapy and cell-signaling inhibitors or double immunotherapy represent the newest and most promising strategy to overcome primary or acquired resistance to first line immunotherapy.
Published: 2021

49. Prognostic value of thrombin generation parameters in hospitalized COVID-19 patients

Author: Vicente Vicente, Antonia Miñano, Enrique Bernal, Javier Corral, María Piedad Fernández-Pérez, Maria Luisa Lozano, Belén de la Morena-Barrio, María Teresa Herranz, María Eugenia de la Morena-Barrio, Carlos Bravo-Pérez, and Jose Miguel Gómez-Verdú
Subjects: Adult, Male, medicine.medical_specialty, Science, Inflammation, 030204 cardiovascular system & hematology, Gastroenterology, Article, Fibrin Fibrinogen Degradation Products, 03 medical and health sciences, Tissue factor, 0302 clinical medicine, Internal medicine, Humans, Medicine, Adverse effect, Aged, Blood coagulation test, Respiratory tract diseases, Multidisciplinary, SARS-CoV-2, business.industry, Thrombin, COVID-19, Thrombosis, Heparin, Disseminated Intravascular Coagulation, Middle Aged, Prognosis, medicine.disease, Hospitalization, Cardiovascular diseases, Coagulation, 030220 oncology & carcinogenesis, Hemostasis, Infectious diseases, Female, Blood Coagulation Tests, medicine.symptom, business, Haematological diseases, medicine.drug
Abstract: SARS-CoV-2 infection increases the risk of thrombosis by different mechanisms not fully characterized. Although still debated, an increase in D-dimer has been proposed as a first-line hemostasis test associated with thromboembolic risk and unfavorable prognosis. We aim to systematically and comprehensively evaluate the association between thrombin generation parameters and the inflammatory and hypercoagulable state, as well as their prognostic value in COVID-19 patients. A total of 127 hospitalized patients with confirmed COVID-19, 24 hospitalized patients with SARS-CoV-2-negative pneumonia and 12 healthy subjects were included. Clinical characteristics, thrombin generation triggered by tissue factor with and without soluble thrombomodulin, and also by silica, as well as other biochemical parameters were assessed. Despite the frequent use of heparin, COVID-19 patients had similar thrombin generation to healthy controls. In COVID-19 patients, the thrombin generation lag-time positively correlated with markers of cell lysis (LDH), inflammation (CRP, IL-6) and coagulation (D-dimer), while the endogenous thrombin potential (ETP) inversely correlated with D-dimer and LDH, and positively correlated with fibrinogen levels. Patients with more prolonged lag-time and decreased ETP had higher peak ISTH-DIC scores, and had more severe disease (vascular events and death). The ROC curve and Kaplan Meier estimate indicated that the D-dimer/ETP ratio was associated with in-hospital mortality (HR 2.5; p = 0.006), and with the occurrence of major adverse events (composite end-point of vascular events and death) (HR 2.38; p = 0.004). The thrombin generation ETP and lag-time variables correlate with thromboinflammatory markers, and the D-dimer/ETP ratio can predict major adverse events in COVID-19.
Published: 2021
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50. The effect of COVID-19 outbreak on endourological activities: a multicentric retrospective study

Author: Emanuele Serafin, Andrea Antonelli, Maria Angela Cerruto, G. De Marco, G. Mazzon, S. Nazzani, M. Creta, Gregorio Costa, A. Peroni, U. Maestrani, Davide Campobasso, Tonino Morena, Antonio Celia, L. F. Carmignani, G. Celentano, Stefania Ferretti, S. Micali, C. Trombetta, F. Germinale, N. Pavan, P. Acquati, C. Vaccaro, B. Filippi, Bernardo Rocco, A. Vismara Fugini, Mazzon, G., Ferretti, S., Acquati, P., Nazzani, S., Campobasso, D., Germinale, F., Filippi, B., Micali, S., Pavan, N., De Marco, G., Vismara Fugini, A., Morena, T., Peroni, A., Celentano, G., Creta, M., Serafin, E., Costa, G., Maestrani, U., Rocco, B., Vaccaro, C., Carmignani, L. F., Trombetta, C., Cerruto, M. A., Antonelli, A., and Celia, A.
Subjects: 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Urology, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Emergency medicine, Medicine, Outbreak, Retrospective cohort study, business, Smart communication (SC173–SC181) Urinary stones: timing and assessment
Abstract: Author of the Study: The COVID-19 outbreak has brought challenges to the global healthcare community. The management of upper urinary tract stones has been affected even further, with potential severe sequelae for patient’s health. Materials and Methods: We report a multicentric retrospective study involving 9 Centers regularly delivering treatment for upper tract urinary stones across the country. All Centers suffered significant limitations during the pandemic period due to government limitations. We compared the 12 months-period prior to COVID-19 (from march 1st 2019 to February 28th 2020, named as period A) with postCOVID-19 period (from march 1st, 2020 to February 28th, 2021 named as period B). Aim of the study was to compare endourological procedures for upper urinary stones during period A and the period B. This study investigated all types of surgeries delivered in both elective and emergency setting. Results: A total of 4018 procedures were collected, including 2176 procedures in period A. In period B, 1842 procedures were carried out, corresponding to a loss of 15.35% of cases (p < 0.001). Looking into elective cases, 1622 procedures were delivered in period A, compared to 1280 in period B, resulting in a loss of 342 cases corresponding to 21.81% (p = 0.001). All types of stone treatments resulted affected, including ESWL (from 487 cases in period A to 344 in period B, − 29.37%, p = 0.001), PCNLs (from 170 to 125 cases, corresponding to − 26.47%, p:0.008), retrograde surgery for renal stones (from 433 to 387 cases, − 10.63%, p = 0.008) and for ureteric stones (from 614 cases to 484, − 21.18%, p.008). Additionally, waiting lists resulted affected, with significant delays in period B. In particular, for ureteric stones, mean waiting time in period A was 61.5 days compared to 87.5 days in period B (p = 0.008). Regarding renal stones, waiting list increased from 64.74 days in period A to 85.66 days in period B for RIRS. The waiting list for percutaneous surgeries increased from 79 days to 103 days (p = 0.001). We did not find any patient which acquired COVID-19 during hospitalization for elective or urgent surgery. We also found a longer waiting list for pre-stented patients, resulting to be 86.5 days in period B compared to 64 days in period A (p < 0.005). Conclusions: Our study showed how COVID-19 caused a significant disruption in endourological services across the country. Our data underlined how less patients received treatment in a longer time. This can potentially lead to an increased risk of stone- related complications, including sepsis and kidney loss.
Published: 2021

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