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351. Personalized Approach to Severe Asthma

Author

Heffler, Enrico, Canonica, Giorgio Walter, Diamant, Zuzana, Fonseca, Joao, Malinovschi, Andrei, Heffler, Enrico, Canonica, Giorgio Walter, Diamant, Zuzana, Fonseca, Joao, and Malinovschi, Andrei

Published
2018
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352. Utility of ultrasound assessment of diaphragmatic function before and after pulmonary rehabilitation in COPD patients

Author

Crimi,Claudia, Heffler,Enrico, Augelletti,Teresa, Campisi,Raffaele, Noto,Alberto, Vancheri,Carlo, Crimi,Nunzio, Crimi,Claudia, Heffler,Enrico, Augelletti,Teresa, Campisi,Raffaele, Noto,Alberto, Vancheri,Carlo, and Crimi,Nunzio

Abstract

Claudia Crimi,1 Enrico Heffler,2 Teresa Augelletti,2 Raffaele Campisi,1 Alberto Noto,3 Carlo Vancheri,4 Nunzio Crimi2 1Respiratory Medicine Unit, AOU “Policlinico-Vittorio Emanuele”, Catania, Italy; 2Respiratory Medicine Unit, Department of Clinical and Experimental Medicine, AOU “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy; 3Anesthesia and Intensive Care Unit, AOU Policinico “G. Martino”, Messina, Italy; 4Regional Referral Centre for Rare Lung Diseases, A.O.U. “Policlinico-Vittorio Emanuele”, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy Background: Pulmonary rehabilitation (PR) may improve respiratory symptoms and skeletal muscle strength in patients with COPD. We aimed to evaluate changes in ultrasound (US) measurements of diaphragmatic mobility and thickness after PR in COPD patients and to test its correlation with PR outcomes.Methods: Twenty-five COPD patients were enrolled and underwent a diaphragm US assessment before and after a 12-week PR program.Results: We found a correlation between the intraindividual percentage of change in the diaphragmatic length of zone of apposition at functional residual capacity (ΔLzapp%) and the change in 6-minute walking distance (6MWD) after PR (rho=0.49, P=0.02). ΔLzapp% was significantly higher in patients with improved 6MWD and COPD Assessment Test (CAT) score (mean rank=12.03±2.57 vs 6.88±4.37; P=0.02). A ΔLzapp% of ≥10% was able to discriminate among patients with improved 6MWD, with a sensitivity of 83% and a specificity of 74%. The area under the receiver operating characteristic curve for ΔLzapp% was 0.83. A cutoff value of ≥9% of ΔLzapp% had a positive predictive value in discriminating a reduction in ≥2 points of CAT score after PR, with a sensitivity and a specificity of 80% and

Published
2018

353. Pigeon tick bite: A neglected cause of idiopathic nocturnal anaphylaxis

Author

Rolla, G., Heffler, Enrico, Boita, Monica, Doyen, Virginie, Mairesse, Michel, Cvackova, Milada, Debarbieux, Sébastien, Kleine-Tebbe, Jörg, Ollert, Markus, Raulf, Monika, Bircher, Andreaas A.J., Hilger, Christiane, Rolla, G., Heffler, Enrico, Boita, Monica, Doyen, Virginie, Mairesse, Michel, Cvackova, Milada, Debarbieux, Sébastien, Kleine-Tebbe, Jörg, Ollert, Markus, Raulf, Monika, Bircher, Andreaas A.J., and Hilger, Christiane

Abstract

Anaphylaxis is a serious systemic allergic reaction with rapid onset and potentially life-threatening. We report in detail a case of severe nocturnal anaphylaxis due to pigeon tick bite showing the diagnostic value of the extract and the recombinant allergen in the diagnostic procedures (basophil activation test, IgE immunoblot, and experimental ImmunoCAP). Apart from the presented case, we describe that during the last 10 years, we have collected 28 cases of allergy to Argas reflexus from several European countries. We suspect that this allergy is underdiagnosed because of the lack of diagnostic reagents. Because of the growing number of pigeons in Middle and Southern Europe cities, some cases of idiopathic anaphylaxis could potentially be caused by A. reflexus in those countries. The identification of pigeon ticks as a trigger of anaphylaxis would greatly improve medical care and advice for these patients as the parasite can be exterminated by eradication measures to avoid further incidents., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2018

358. Effectiveness of pulmonary rehabilitation in severe asthma: a retrospective data analysis.

Author

Zampogna, Elisabetta, Centis, Rosella, Negri, Stefano, Fiore, Elisabetta, Cherubino, Francesca, Pignatti, Patrizia, Heffler, Enrico, Canonica, Giorgio Walter, Sotgiu, Giovanni, Saderi, Laura, Migliori, Giovanni Battista, Spanevello, Antonio, and Visca, Dina

Subjects
BRONCHIECTASIS, SYMPTOMS, ASTHMA, MUSCLE fatigue, DATA analysis, REHABILITATION
Abstract

Background: Pulmonary Rehabilitation (PR) is a multimodal treatment that is still poorly investigated in severe asthma where respiratory symptoms remain "uncontrolled" despite intensive pharmacological therapy. Bronchiectasis and obstructive sleep apnea (OSAS) are common comorbidities which may worsen asthma control. Aim: Aim of the present study is to investigate the effectiveness of PR on functional exercise, dyspnea, and muscle fatigue in patients with severe asthma. Methods: A total of 317 patients affected from severe asthma according to GINA guidelines who underwent a multidisciplinary 3 weeks rehabilitation program with an adherence of >80% to PR and able to complete a Six Minute Walking Test (6MWT) were retrospectively included in the analysis. Pulmonary rehabilitation included endurance training, educational meetings, chest physiotherapy, breathing exercises, and psychological support. Six-minute walking distance and Borg scale for dyspnea and muscle fatigue were recorded before and after the rehabilitation. Results: A total of 371 patients were analyzed, 39 had bronchiectasis (10.5%), 163 (43.9%) OSAS and 17 had both (4.6%). PR significantly improved 6MWT distance, Borg dyspnea and muscle fatigue (p value < 0.0001 for all outcomes) and mean SpO2 recorded during 6MWT (p value < 0.0001). Median (IQR) delta 6 minute walking distance was 33 (14–60) m. 6MWT distance (p < 0.0001) and the oxygen saturation (p < 0.01) significantly improved in severe asthma with bronchiectasis and/or OSAS. Conclusions: Our study provides evidence for the first time on a large sample of patients with severe asthma that a multidisciplinary PR program is effective in terms of exercise capacity and symptoms. In addition, exercise capacity improved in the presence of bronchiectasis and/or OSAS. [ABSTRACT FROM AUTHOR]

Published
2020
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361. Impact of pre-biologic impairment on meeting domain-specific biologic responder definitions in patients with severe asthma

Author

Perez-de-Llano, Luis, Scelo, Ghislaine, Canonica, G. Walter, Chen, Wenjia, Henley, William, Larenas-Linnemann, Désirée, Peters, Matthew J., Pfeffer, Paul E., Tran, Trung N., Ulrik, Charlotte Suppli, Popov, Todor A., Sadatsafavi, Mohsen, Hew, Mark, Máspero, Jorge, Gibson, Peter G., Christoff, George C., Fitzgerald, J. Mark, Torres-Duque, Carlos A., Porsbjerg, Celeste M., Papadopoulos, Nikolaos G., Papaioannou, Andriana I., Heffler, Enrico, Iwanaga, Takashi, Al-Ahmad, Mona, Kuna, Piotr, Fonseca, João A., Al-Lehebi, Riyad, Rhee, Chin Kook, Koh, Mariko Siyue, Cosio, Borja G., Perng (Steve), Diahn-Warng, Mahboub, Bassam, Menzies-Gow, Andrew N., Jackson, David J., Busby, John, Heaney, Liam G., Patel, Pujan H., Wang, Eileen, Wechsler, Michael E., Altraja, Alan, Lehtimäki, Lauri, Bourdin, Arnaud, Bjermer, Leif, Bulathsinhala, Lakmini, Carter, Victoria, Murray, Ruth, Beastall, Aaron, Denton, Eve, and Price, David B.

Abstract

There is little agreement on clinically useful criteria for identifying real-world responders to biologic treatments for asthma.

Published
2024
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362. Is air pollution affecting the disease activity in patients with systemic lupus erythematosus? State of the art and a systematic literature review.

Author

Gilcrease, Gregory Winston, Padovan, Dario, Heffler, Enrico, Peano, Cristiana, Massaglia, Stefano, Roccatello, Dario, Radin, Massimo, Josè Cuadrado, Maria, and Sciascia, Savino

Subjects
AIR pollution, MEDICAL personnel, SYSTEMIC lupus erythematosus, POLYCYCLIC aromatic hydrocarbons
Abstract

Objective: It has been documented that several major components of air pollution, including trace elements and polycyclic aromatic hydrocarbons, are associated with the prevalence of systemic lupus erythematosus (SLE). However, the impact of air pollution on the SLE disease activity is still elusive. In this paper, we review the current evidence investigating the link between air pollution, especially when measured as PM2.5, and SLE severity and activity. Methods: A detailed literature search was applied a priori to the Ovid MEDLINE In-Process and Other Non-Indexed Citation 1986 to present. Presented abstracts from the European League Against Rheumatism and American College of Rheumatology (ACR)/Association for Rheumatology Health Professionals (ARHP) Annual Meetings (2011-2018) were also screened. Results: Out of a total of 1354 papers retrieved from search and references list for detailed evaluation, data from 652 patients with SLE from three studies were analyzed. Two studies had an observational longitudinal design, counting for 348 patients with a follow-up of 24 months and 79 months. Retrieved studies differed for disease activity assessment and air pollution quantifications. Conclusion: Current evidence suggests that variations in air pollution may influence the disease activity in patients with SLE. However, the sample size, methodological biases, and differences across the studies make further research mandatory. Understanding the increased burden of SLE and its complications, not only from a medical, but also from a socio-demographic perspective, including an exposure to pollutants, should have implications for resource allocation and access to subspecialty care. [ABSTRACT FROM AUTHOR]

Published
2020
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363. Diagnosis and management of NSAID ‐Exacerbated Respiratory Disease (N‐ ERD )—a EAACI position paper

Author

Kowalski, Marek L., primary, Agache, Ioana, additional, Bavbek, Sevim, additional, Bakirtas, Arzu, additional, Blanca, Miguel, additional, Bochenek, Grażyna, additional, Bonini, Matteo, additional, Heffler, Enrico, additional, Klimek, Ludger, additional, Laidlaw, Tanya M., additional, Mullol, Joaquim, additional, Niżankowska‐Mogilnicka, Ewa, additional, Park, Hae‐Sim, additional, Sanak, Marek, additional, Sanchez‐Borges, Mario, additional, Sanchez‐Garcia, Silvia, additional, Scadding, Glenis, additional, Taniguchi, Masami, additional, Torres, Maria J., additional, White, Andrew A., additional, and Wardzyńska, Aleksandra, additional

Published
2018
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365. Impact of bronchiectasis on severe asthma: data from the “Severe Asthma Network Italy” (SANI) registry

Author

Heffler, Enrico Marco, primary, Aliberti, Stefano, additional, Sirena, Concetta, additional, D’Adda, Alice, additional, Ferri, Sebastian, additional, Crimi, Nunzio, additional, Latorre, Manuela, additional, Senna, Gianenrico, additional, Paggiaro, Pierluigi, additional, Blasi, Francesco, additional, and Canonica, Giorgio Walter, additional

Published
2018
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370. Anxiety and Depression Effects During Drug Provocation Test

Author

Losappio, Laura Michelina, primary, Cappai, Alessandra, additional, Arcolaci, Alessandra, additional, Badiu, Iuliana, additional, Bonadonna, Patrizia, additional, Boni, Elisa, additional, Bussolino, Claudia, additional, Caminati, Marco, additional, Galati, Pietro, additional, Heffler, Enrico, additional, Intravaia, Rossella, additional, Mauro, Marina, additional, Massaro, Ilaria, additional, Romano, Antonino, additional, Rumi, Gabriele, additional, Parolo, Anna, additional, Pizzimenti, Stefano, additional, Nichelatti, Michele, additional, and Pastorello, Elide Anna, additional

Published
2018
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372. Personalizing the approach to asthma treatment

Author

Ferrando, Matteo, primary, Bagnasco, Diego, additional, Heffler, Enrico, additional, Paoletti, Giovanni, additional, Passalacqua, Giovanni, additional, Puggioni, Francesca, additional, and Canonica, Giorgio Walter, additional

Published
2018
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373. Immunological mechanisms underlying chronic rhinosinusitis with nasal polyps

Author

Heffler, Enrico, primary, Malvezzi, Luca, additional, Boita, Monica, additional, Brussino, Luisa, additional, De Virgilio, Armando, additional, Ferrando, Matteo, additional, Puggioni, Francesca, additional, Racca, Francesca, additional, Stomeo, Niccolò, additional, Spriano, Giuseppe, additional, and Canonica, Giorgio Walter, additional

Published
2018
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377. Basophil Membrane Expression of Epithelial Cytokine Receptors in Patients with Severe Asthma

Author

Boita, Monica, primary, Heffler, Enrico, additional, Omedè, Paola, additional, Bellocchia, Michela, additional, Bussolino, Claudia, additional, Solidoro, Paolo, additional, Giorgis, Veronica, additional, Guerrera, Francesco, additional, Riva, Giuseppe, additional, Brussino, Luisa, additional, Bucca, Caterina, additional, and Rolla, Giovanni, additional

Published
2018
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384. Appropriateness in allergic respiratory diseases health care in Italy: definitions and organizational aspects

Author

Lombardi, C, Savi, E, Costantino, Mt, Heffler, ENRICO MARCO, Milanese, M, Passalacqua, G, Canonica, Gw, and Italian Allergic Respiratory Diseases Task Force

Subjects
Decree, medicine.medical_specialty, Pediatrics, Population, Immunology, Alternative medicine, National Health System, Choosing wisely, 03 medical and health sciences, 0302 clinical medicine, Health care, Medicine, Immunology and Allergy, National level, Appropriateness, 030212 general & internal medicine, education, Molecular Biology, education.field_of_study, business.industry, Slow medicine, Health resources, National health service, 030228 respiratory system, Allergology, Italy, Family medicine, Sustainability, Commentary, Christian ministry, business
Abstract

In a historical period in which sustainability of the National Health Service is mandatory because of the international economical situation, the limited available resources at national level and the tendency of passing from a “population medicine” model towards the concept of “individualized medicine”, the debate on appropriateness of medical and surgical procedures is of central importance. The choosing wisely campaign, started in United States in 2012 and then spread all over the world, tries to summarize which are the most inappropriate procedures for each medical and surgical speciality; as far as allergic respiratory diseases, the most relevant Italian societies and the American Academy defined the allergological procedures with the highest probability of inappropriateness. In Italy, a recent decree of the Ministry of Health defined a list of more than 200 procedures that will be considered as inappropriate in certain conditions; many of these procedures concern allergology, including allergic respiratory diseases. In this commentary we discuss the above mentioned decree and the concept of appropriateness in the field of allergic respiratory diseases, trying to figure out some practical considerations based on the current health resources available in the field of allergology in Italy.

Published
2016

391. Bronchiectasis: understanding the phenotype

Author

Ferri, Sebastian, primary, Sorrentino, Ramona, additional, Chessari, Carlo, additional, Terranova, Giovanni, additional, Augelletti, Teresa, additional, Campisi, Raffaele, additional, Heffler, Enrico, additional, Crimi, Nunzio, additional, and Genco, Sabrina, additional

Published
2017
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398. List of Contributors

Author

Agache, Ioana, Akdis, Cezmi A., Alvarez-Perea, Alberto, Amaral, Rita, Antolín-Amérigo, Darío, Bachert, Claus, Baiardini, Ilaria, Berkouk, Karim, Bewick, Mike, Bousquet, Jean, Canonica, Giorgio Walter, Cojanu, Catalina, Crisafulli, Aldo, Desrosiers, Martin, Dörr, Tamara, Endam, Leandra Mfuna, Ferrando, Matteo, Fokkens, Wytske, Fonseca, João A, Gajdanowicz, Paweł, Haahtela, Tari, Hanrahan, Finnian, Heffler, Enrico, Hellings, Peter W., Hofmaier, Stephanie, Hofman, Ingrid van, Hogan, Stéphane, Hopkins, Claire, Huang, Xinyuan, Jacinto, Tiago, Jácome, Cristina, Jones, Christina, Jutel, Marek, Kogan, Grigorij, Laang, Hannu, Lund, Valerie J., Lunjani, Nonhlanhla, Mäkelä, Mika J., Mariën, Gert, Matricardi, Paolo Maria, Matthiessen, Line, Nowak, Elisabeth, O’Mahony, Liam, Paoletti, Giovanni, Pereira, Ana Margarida, Popescu, Florin-Dan, Pugin, Benoit, Rogozea, Liliana, Ryan, Dermot, Saarinen, Kimmo, Schaub, Bianca, Schmidt-Weber, Carsten B., Sedillot, Eve, Seys, Sven F., Smith, Helen E., Sokolowska, Milena, Steelant, Brecht, Sugita, Kazunari, Tomassen, Peter, Tommila, Erja, Trzaska, Dominika, Valovirta, Erkka, Vasankari, Tuula, Vidal-Ragout, María, Wong, Gary W.K., Yorgancıoğlu, Arzu, and Zuberbier, Torsten

Published
2019
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