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3. AI-SCoRE (artificial intelligence-SARS CoV2 risk evaluation): a fast, objective and fully automated platform to predict the outcome in COVID-19 patients

Author

Palmisano, A, Vignale, D, Boccia, E, Nonis, A, Gnasso, C, Leone, R, Montagna, M, Nicoletti, V, Bianchi, A, Brusamolino, S, Dorizza, A, Moraschini, M, Veettil, R, Cereda, A, Toselli, M, Giannini, F, Loffi, M, Patelli, G, Monello, A, Iannopollo, G, Ippolito, D, Mancini, E, Pontone, G, Vignali, L, Scarnecchia, E, Iannacone, M, Baffoni, L, Sperandio, M, de Carlini, C, Sironi, S, Rapezzi, C, Antiga, L, Jagher, V, Di Serio, C, Furlanello, C, Tacchetti, C, Esposito, A, Palmisano A., Vignale D., Boccia E., Nonis A., Gnasso C., Leone R., Montagna M., Nicoletti V., Bianchi A. G., Brusamolino S., Dorizza A., Moraschini M., Veettil R., Cereda A., Toselli M., Giannini F., Loffi M., Patelli G., Monello A., Iannopollo G., Ippolito D., Mancini E. M., Pontone G., Vignali L., Scarnecchia E., Iannacone M., Baffoni L., Sperandio M., de Carlini C. C., Sironi S., Rapezzi C., Antiga L., Jagher V., Di Serio C., Furlanello C., Tacchetti C., Esposito A., Palmisano, A, Vignale, D, Boccia, E, Nonis, A, Gnasso, C, Leone, R, Montagna, M, Nicoletti, V, Bianchi, A, Brusamolino, S, Dorizza, A, Moraschini, M, Veettil, R, Cereda, A, Toselli, M, Giannini, F, Loffi, M, Patelli, G, Monello, A, Iannopollo, G, Ippolito, D, Mancini, E, Pontone, G, Vignali, L, Scarnecchia, E, Iannacone, M, Baffoni, L, Sperandio, M, de Carlini, C, Sironi, S, Rapezzi, C, Antiga, L, Jagher, V, Di Serio, C, Furlanello, C, Tacchetti, C, Esposito, A, Palmisano A., Vignale D., Boccia E., Nonis A., Gnasso C., Leone R., Montagna M., Nicoletti V., Bianchi A. G., Brusamolino S., Dorizza A., Moraschini M., Veettil R., Cereda A., Toselli M., Giannini F., Loffi M., Patelli G., Monello A., Iannopollo G., Ippolito D., Mancini E. M., Pontone G., Vignali L., Scarnecchia E., Iannacone M., Baffoni L., Sperandio M., de Carlini C. C., Sironi S., Rapezzi C., Antiga L., Jagher V., Di Serio C., Furlanello C., Tacchetti C., and Esposito A.

Abstract

Purpose: To develop and validate an effective and user-friendly AI platform based on a few unbiased clinical variables integrated with advanced CT automatic analysis for COVID-19 patients’ risk stratification. Material and Methods: In total, 1575 consecutive COVID-19 adults admitted to 16 hospitals during wave 1 (February 16-April 29, 2020), submitted to chest CT within 72 h from admission, were retrospectively enrolled. In total, 107 variables were initially collected; 64 extracted from CT. The outcome was survival. A rigorous AI model selection framework was adopted for models selection and automatic CT data extraction. Model performances were compared in terms of AUC. A web–mobile interface was developed using Microsoft PowerApps environment. The platform was externally validated on 213 COVID-19 adults prospectively enrolled during wave 2 (October 14-December 31, 2020). Results: The final cohort included 1125 patients (292 non-survivors, 26%) and 24 variables. Logistic showed the best performance on the complete set of variables (AUC = 0.839 ± 0.009) as in models including a limited set of 13 and 5 variables (AUC = 0.840 ± 0.0093 and AUC = 0.834 ± 0.007). For non-inferior performance, the 5 variables model (age, sex, saturation, well-aerated lung parenchyma and cardiothoracic vascular calcium) was selected as the final model and the extraction of CT-derived parameters was fully automatized. The fully automatic model showed AUC = 0.842 (95% CI: 0.816–0.867) on wave 1 and was used to build a 0–100 scale risk score (AI-SCoRE). The predictive performance was confirmed on wave 2 (AUC 0.808; 95% CI: 0.7402–0.8766). Conclusions: AI-SCoRE is an effective and reliable platform for automatic risk stratification of COVID-19 patients based on a few unbiased clinical data and CT automatic analysis.

Published
2022

4. Dental Health and Mortality in People With End-Stage Kidney Disease Treated With Hemodialysis: A Multinational Cohort Study

Author

Raña, S., Serrano, M., Claros, S., Arias, M., Petracci, L., Arana, M., De Rosa, P., Gutierrez, A., Simon, M., Vergara, V., Tosi, M., Cernadas, M., Vilamajó, I., Gravac, D., Paulón, M., Penayo, L., Carrizo, G., Ghiani, M., Perez, G., Da Cruz, O., Galarce, D., Gravielle, M., Vescovo, E., Paparone, R., Mato Mira, C., Mojico, E., Hermida, O., Florio, D., Yucoswky, M., Labonia, W., Rubio, D., Di Napoli, G., Fernandez, A., Altman, H., Rodriguez, J., Serrano, S., Valle, G., Lobos, M., Acosta, V., Corpacci, G., Jofre, M., Gianoni, L., Chiesura, G., Capdevila, M., Montenegro, J., Bequi, J., Dayer, J., Gómez, A., Calderón, C., Abrego, E., Cechín, C., García, J., Corral, J., Natiello, M., Coronel, A., Muñiz, M., Muñiz, V., Bonelli, A., Sanchez, F., Maestre, S., Olivera, S., Camargo, M., Avalos, V., Geandet, E., Canteli, M., Escobar, A., Sena, E., Tirado, S., Peñalba, A., Neme, G., Cisneros, M., Oliszewski, R., Nascar, V., Daud, M., Mansilla, S., Paredes Álvarez, A., Gamín, L., Arijón, M., Coombes, M., Zapata, M., Boriceanu, C., Frantzen-Trendel, S., Albert, K., Csaszar, I., Kiss, E., Kosa, D., Orosz, A., Redl, J., Kovacs, L., Varga, E., Szabo, M., Magyar, K., Kriza, G., Zajko, E., Bereczki, A., Csikos, J., Kuti, A., Mike, A., Steiner, K., Nemeth, E., Tolnai, K., Toth, A., Vinczene, J., Szummer, Sz., Tanyi, E., Toth, R., Szilvia, M., Dambrosio, N., Paparella, G., Sambati, M., Donatelli, C., Pedone, F., Cagnazzo, V.A., Antinoro, R., Torsello, F., Saturno, C., Giannoccaro, G., Maldera, S., Boccia, E., Mantuano, M., Di Toro Mammarella, R., Meconizzi, M., Steri, P.F., Riccardi, C., Flammini, A., Moscardelli, L., Murgo, M., San Filippo, N., Pagano, S., Marino, G., Montalto, G., Cantarella, S., Salamone, B., Randazzo, G., Rallo, D., Maniscalco, A., Fici, M., Lupo, A., Pellegrino, P., Fichera, R., D’Angelo, A., Falsitta, N., Bochenska-Nowacka, E., Jaroszynski, A., Drabik, J., Birecka, M., Daniewska, D., Drobisz, M., Doskocz, K., Wyrwicz, G., Inchaustegui, L., Outerelo, C., Sousa Mendes, D., Mendes, A., Lopes, J., Barbas, J., Madeira, C., Fortes, A., Vizinho, R., Cortesão, A., Almeida, E., Bernat, A., De la Torre, B., Lopez, A., Martín, J., Cuesta, G., Rodriguez, R.M., Ros, F., Garcia, M., Orero, E., Ros, E., Caetano, A., MacGregor, K., Santos, M., Silva Pinheiro, S., Martins, L., Leitão, D., Izidoro, C., Bava, G., Bora, A., Gorena, H., Calderón, T., Dupuy, R., Alonso, N., Siciliano, V., Nagy, K., Bajusz, Ö., Pinke, I., Decsi, G., Gyergyoi, L., Jobba, Zs., Zalai, Zs., Zsedenyi, Á., Kiss, G., Pinter, M., Kereszturi, M., Petruzzi, M., De Benedittis, M., Szkutnik, J., Sieczkarek, J., Capelo, A., Garcia Gallart, M., Mendieta, C., Palmer, Suetonia C., Ruospo, Marinella, Wong, Germaine, Craig, Jonathan C., Petruzzi, Massimo, De Benedittis, Michele, Ford, Pauline, Johnson, David W., Tonelli, Marcello, Natale, Patrizia, Saglimbene, Valeria, Pellegrini, Fabio, Celia, Eduardo, Gelfman, Ruben, Leal, Miguel R., Torok, Marietta, Stroumza, Paul, Bednarek-Skublewska, Anna, Dulawa, Jan, Frantzen, Luc, Ferrari, Juan Nin, del Castillo, Domingo, Bernat, Amparo G., Hegbrant, Jorgen, Wollheim, Charlotta, Gargano, Letizia, Bots, Casper P., and Strippoli, Giovanni F.M.

Published
2015
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6. Risk factors and action thresholds for the novel coronavirus pandemic. Insights from the Italian Society of Nephrology COVID-19 Survey

Author

Nordio, M., Reboldi, G., Di Napoli, A., Quintaliani, G., Alberici, F., Postorino, M., Aucella, F., Messa, P., Brunori, G., Bosco, M., Malberti, F., Mandreoli, M., Mazzaferro, S., Movilli, E., Ravera, M., Salomone, M., Santoro, D., Postorinolimido, M. A., Bonomini, M., Stingone, A., Maccarone, M., Di Loreto, E., Stacchiotti, L., Malandra, R., Chiarella, S., D'Agostino, F., Fuiano, G., Nicodemo, L., Bonofiglio, R., Greco, S., Mallamaci, F., Barreca, E., Caserta, C., Bruzzese, V., Galati, D., Tramontana, D., Viscione, M., Chiuchiolo, L., Tuccillo, S., Sepe, M., Vitale, F., Ciriana, E., Martignetti, V., Caserta, D., Stizzo, A., Romano, A., Iulianiello, G., Cascone, E., Minicone, P., Chiricone, D., Delgado, G., Barbato, A., Celentano, S., Molfino, I., Coppola, S., Raiola, I., Abategiovanni, M., Borrelli, S., Margherita, C., Bruno, F., Ida, M., Aliperti, E., Potito, D., Cuomo, G., De Luca, M., Merola, M., Botta, C., Garofalo, G., Alinei, P., Paglionico, C., Roano, M., Vitale, S., Ierardi, R., Fimiani, V., Conte, G., Di Natale, G., Romano, M., Di Marino, V., Scafarto, A., Meccariello, S., Pecoraro, C., Di Stazio, E., Di Meglio, E., Cuomo, A., Maresca, B., Rotaia, E., Capasso, G., Auricchio, M., Pluvio, C., Maddalena, L., De Maio, A., Palladino, G., Buono, F., Gigliotti, G., Mancini, E., La Manna, G., Storari, A., Mosconi, G., Cappelli, G., Scarpioni, R., Gregorini, M., Rigotti, A., Mancini, W., Bianco, F., Boscutti, G., Amici, G., Tosto, M., Fini, R., Pace, G., Cioffi, A., Boccia, E., Di Lullo, L., Di Zazzo, G., Simonelli, R., Bondatti, F., Miglio, L., Rifici, N., Treglia, A., Muci, M., Baldinelli, G., Rizzi, E., Lonzi, M., De Cicco, C., Forte, F., De Paolis, P., Grandaliano, Giuseppe, Cuzziol, C., Torre, V. M., Sfregola, P., Rossi, V., Fabio, G., Flammini, A., Filippini, A., Onorato, L., Vendola, F., Di Daniela, N., Alfarone, C., Scabbia, L., Ferrazzano, M., Grotta, B. D., Gamberini, M., Fazzari, L., Mene, P., Morgia, A., Catucci, A., Palumbo, R., Puliti, M., Marinelli, R., Polito, P., Marrocco, F., Morabito, S., Rocca, R., Nazzaro, L., Lavini, R., Iamundo, V., Chiappini, M., Casarci, M., Morosetti, M., Hassan, S., Firmi, G., Galliani, M., Serraiocco, M., Feriozzi, S., Valentini, W., Sacco, P., Garibotto, G., Cappelli, V., Saffioti, C., Repetto, M., Rolla, D., Lorenz, M., Pedrini, L., Polonioli, D., Galli, E., Ruggenenti, P., Scolari, F., Bove, S., Costantino, E., Bracchi, M., Mangano, S., Depetri, G., La Milia, V., Farina, M., Zecchini, S., Savino, R., Melandri, M., Guastoni, C., Paparella, M., Gallieni, M., Minetti, E., Bisegna, S., Righetti, M., Badalamenti, S., Alberghini, E., Bertoli, S., Fabbrini, P., Albrizio, P., Rampino, T., Colturi, C., Rombola, G., Lucatello, A., Guerrini, E., Ranghino, A., Lenci, F., Fanciulli, E., Santarelli, S., Damiani, C., Garofalo, D., Sopranzi, F., Santoferrara, A., Di Luca, M., Galiotta, P., Brigante, M., Manganaro, M., Maffei, S., Berto, I., Besso, L., Viglino, G., Cusinato, S., Chiarinottichiappero, D. F., Tognarelli, G., Gianoglio, B., Forneris, G., Biancone, L., Savoldi, S., Vitale, C., Boero, R., Filiberti, O., Borzumati, M., Gesualdo, L., Lomonte, C., Gernone, G., Pallotta, G., Di Paolo, S., Vernaglione, L., Specchio, A., Stallone, G., Dell'Aquila, R., Sandri, G., Russo, F., Napoli, M., Marangi, A., Morrone, L., Di Stratis, C., Fresu, A., Cicu, F., Murtas, S., Manca, O., Pani, A., Pilloni, M., Pistis, R., Cadoni, M., Contu, B., Logias, F., Ivaldi, R., Fancello, S., Cossu, M., Lepori, G., Vittoria, S., Battiati, E., Arnone, M., Rome, M., Barbera, A., Granata, A., Collura, G., Dico, C. L., Pugliese, G., Di Natale, E., Rizzari, G., Cottone, L., Longo, N., Battaglia, G., Marcantoni, C., Giannetto, G., Tumino, G., Randazzo, F., Bellissimo, L., Faro, F. L., Grippaldi, F., Urso, S., Quattrone, G., Todaro, I., Vincenzo, D., Murgo, A., Masuzzo, M., Pisacane, A., Monardo, P., Pontorierro, M., Quari, C., Bauro, A., Chimenz, R. R., Alfio, D., Girasole, F., Cascio, A. L., Caviglia, A., Tornese, F., Sirna, F., Altieri, C., Cusumano, R., Saveriano, V., La Corte, A., Locascio, G., Rotolo, U., Musso, S., Risuglia, L., Blanco, G., Minardo, G., Castellino, S., Zappulla, Z., Randone, S., Di Francesca, M., Cassetti, C. C., Oddo, G., Buscaino, G., Mucaria, F., Barraco, V. I., Di Martino, A., Rallo, D., Dani, L., Campolo, G., Manescalchi, F., Biagini, M., Agate, M., Panichi, V., Casani, A., Traversari, L., Garosi, G., Tabbi, M., Selvi, A., Cencioni, L., Fagugli, R., Timio, F., Leveque, A., Manes, M., Mennella, G., Calo, L., Fiorini, F., Abaterusso, C., Calzavara, P., Meneghel, G., Bonesso, C., Gambaro, G., Gammaro, L., Rugiu, C., Ronco, C., Nordio M., Reboldi G., Di Napoli A., Quintaliani G., Alberici F., Postorino M., Aucella F., Messa P., Brunori G., Bosco M., Malberti F., Mandreoli M., Mazzaferro S., Movilli E., Ravera M., Salomone M., Santoro D., PostorinoLimido M.A., Bonomini M., Stingone A., Maccarone M., Di Loreto E., Stacchiotti L., Malandra R., Chiarella S., D'Agostino F., Fuiano G., Nicodemo L., Bonofiglio R., Greco S., Mallamaci F., Barreca E., Caserta C., Bruzzese V., Galati D., Tramontana D., Viscione M., Chiuchiolo L., Tuccillo S., Sepe M., Vitale F., Ciriana E., Martignetti V., Caserta D., Stizzo A., Romano A., Iulianiello G., Cascone E., Minicone P., Chiricone D., Delgado G., Barbato A., Celentano S., Molfino I., Coppola S., Raiola I., Abategiovanni M., Borrelli S., Margherita C., Bruno F., Ida M., Aliperti E., Potito D., Cuomo G., De Luca M., Merola M., Botta C., Garofalo G., Alinei P., Paglionico C., Roano M., Vitale S., Ierardi R., Fimiani V., Conte G., Di Natale G., Romano M., Di Marino V., Scafarto A., Meccariello S., Pecoraro C., Di Stazio E., Di Meglio E., Cuomo A., Maresca B., Rotaia E., Capasso G., Auricchio M., Pluvio C., Maddalena L., De Maio A., Palladino G., Buono F., Gigliotti G., Mancini E., La Manna G., Storari A., Mosconi G., Cappelli G., Scarpioni R., Gregorini M., Rigotti A., Mancini W., Bianco F., Boscutti G., Amici G., Tosto M., Fini R., Pace G., Cioffi A., Boccia E., Di Lullo L., Di Zazzo G., Simonelli R., Bondatti F., Miglio L., Rifici N., Treglia A., Muci M., Baldinelli G., Rizzi E., Lonzi M., De Cicco C., Forte F., De Paolis P., Grandaliano G., Cuzziol C., Torre V.M., Sfregola P., Rossi V., Fabio G., Flammini A., Filippini A., Onorato L., Vendola F., Di Daniela N., Alfarone C., Scabbia L., Ferrazzano M., Grotta B.D., Gamberini M., Fazzari L., Mene P., Morgia A., Catucci A., Palumbo R., Puliti M., Marinelli R., Polito P., Marrocco F., Morabito S., Rocca R., Nazzaro L., Lavini R., Iamundo V., Chiappini M., Casarci M., Morosetti M., Hassan S., Firmi G., Galliani M., Serraiocco M., Feriozzi S., Valentini W., Sacco P., Garibotto G., Cappelli V., Saffioti C., Repetto M., Rolla D., Lorenz M., Pedrini L., Polonioli D., Galli E., Ruggenenti P., Scolari F., Bove S., Costantino E., Bracchi M., Mangano S., Depetri G., La Milia V., Farina M., Zecchini S., Savino R., Melandri M., Guastoni C., Paparella M., Gallieni M., Minetti E., Bisegna S., Righetti M., Badalamenti S., Alberghini E., Bertoli S., Fabbrini P., Albrizio P., Rampino T., Colturi C., Rombola G., Lucatello A., Guerrini E., Ranghino A., Lenci F., Fanciulli E., Santarelli S., Damiani C., Garofalo D., Sopranzi F., Santoferrara A., Di Luca M., Galiotta P., Brigante M., Manganaro M., Maffei S., Berto I., Besso L., Viglino G., Cusinato S., ChiarinottiChiappero D.F., Tognarelli G., Gianoglio B., Forneris G., Biancone L., Savoldi S., Vitale C., Boero R., Filiberti O., Borzumati M., Gesualdo L., Lomonte C., Gernone G., Pallotta G., Di Paolo S., Vernaglione L., Specchio A., Stallone G., Dell'Aquila R., Sandri G., Russo F., Napoli M., Marangi A., Morrone L., Di Stratis C., Fresu A., Cicu F., Murtas S., Manca O., Pani A., Pilloni M., Pistis R., Cadoni M., Contu B., Logias F., Ivaldi R., Fancello S., Cossu M., Lepori G., Vittoria S., Battiati E., Arnone M., Rome M., Barbera A., Granata A., Collura G., Dico C.L., Pugliese G., Di Natale E., Rizzari G., Cottone L., Longo N., Battaglia G., Marcantoni C., Giannetto G., Tumino G., Randazzo F., Bellissimo L., Faro F.L., Grippaldi F., Urso S., Quattrone G., Todaro I., Vincenzo D., Murgo A., Masuzzo M., Pisacane A., Monardo P., Pontorierro M., Quari C., Bauro A., Chimenz R.R., Alfio D., Girasole F., Cascio A.L., Caviglia A., Tornese F., Sirna F., Altieri C., Cusumano R., Saveriano V., La Corte A., Locascio G., Rotolo U., Musso S., Risuglia L., Blanco G., Minardo G., Castellino S., Zappulla Z., Randone S., Di Francesca M., Cassetti C.C., Oddo G., Buscaino G., Mucaria F., Barraco V.I., Di Martino A., Rallo D., Dani L., Campolo G., Manescalchi F., Biagini M., Agate M., Panichi V., Casani A., Traversari L., Garosi G., Tabbi M., Selvi A., Cencioni L., Fagugli R., Timio F., Leveque A., Manes M., Mennella G., Calo L., Fiorini F., Abaterusso C., Calzavara P., Meneghel G., Bonesso C., Gambaro G., Gammaro L., Rugiu C., and Ronco C.

Subjects
Male, Contextual analysis, medicine.medical_treatment, Population, 030232 urology & nephrology, Recursive partitioning, 030204 cardiovascular system & hematology, Rate ratio, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Classification tree, COVID-19, Renal replacement therapy, Risk Factors, Medical, Surveys and Questionnaires, Health care, medicine, Settore MED/14 - NEFROLOGIA, Humans, education, Pandemics, Societies, Medical, Female, Italy, Nephrology, education.field_of_study, business.industry, Multilevel model, Decision rule, Confidence interval, Original Article, Hemodialysis, business, Contextual analysi, Societies, Demography
Abstract

Background and aim: Over 80% (365/454) of the nation’s centers participated in the Italian Society of Nephrology COVID-19 Survey. Out of 60,441 surveyed patients, 1368 were infected as of April 23rd, 2020. However, center-specific proportions showed substantial heterogeneity. We therefore undertook new analyses to identify explanatory factors, contextual effects, and decision rules for infection containment. Methods: We investigated fixed factors and contextual effects by multilevel modeling. Classification and Regression Tree (CART) analysis was used to develop decision rules. Results: Increased positivity among hemodialysis patients was predicted by center location [incidence rate ratio (IRR) 1.34, 95% confidence interval (CI) 1.20–1.51], positive healthcare workers (IRR 1.09, 95% CI 1.02–1.17), test-all policy (IRR 5.94, 95% CI 3.36–10.45), and infected proportion in the general population (IRR 1.002, 95% CI 1.001–1.003) (all p < 0.01). Conversely, lockdown duration exerted a protective effect (IRR 0.95, 95% CI 0.94–0.98) (p < 0.01). The province-contextual effects accounted for 10% of the total variability. Predictive factors for peritoneal dialysis and transplant cases were center location and infected proportion in the general population. Using recursive partitioning, we identified decision thresholds at general population incidence ≥ 229 per 100,000 and at ≥ 3 positive healthcare workers. Conclusions: Beyond fixed risk factors, shared with the general population, the increased and heterogeneous proportion of positive patients is related to the center’s testing policy, the number of positive patients and healthcare workers, and to contextual effects at the province level. Nephrology centers may adopt simple decision rules to strengthen containment measures timely.

Published
2021

7. Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients

Author

Giannini, F, Toselli, M, Palmisano, A, Cereda, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Manfrini, M, Khokhar, A, Sticchi, A, Biagi, A, Turchio, P, Tacchetti, C, Landoni, G, Boccia, E, Campo, G, Scoccia, A, Ponticelli, F, Danzi, G, Loffi, M, Muri, M, Pontone, G, Andreini, D, Mancini, E, Casella, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Franzesi, C, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Sverzellati, N, Scarnecchia, E, Lombardo, F, Anastasio, F, Iannaccone, M, Vaudano, P, Pacielli, A, Baffoni, L, Gardi, I, Cesini, E, Sperandio, M, Micossi, C, De Carlini, C, Spreafico, C, Maggiolini, S, Bonaffini, P, Iacovoni, A, Sironi, S, Senni, M, Fominskiy, E, De Cobelli, F, Maggioni, A, Rapezzi, C, Ferrari, R, Colombo, A, Esposito, A, Giannini, Francesco, Toselli, Marco, Palmisano, Anna, Cereda, Alberto, Vignale, Davide, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Manfrini, Marco, Khokhar, Arif, Sticchi, Alessandro, Biagi, Andrea, Turchio, Piergiorgio, Tacchetti, Carlo, Landoni, Giovanni, Boccia, Edda, Campo, Gianluca, Scoccia, Alessandra, Ponticelli, Francesco, Danzi, Gian Battista, Loffi, Marco, Muri, Margherita, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Ippolito, Davide, Bellani, Giacomo, Franzesi, Camillo Talei, Patelli, Gianluigi, Besana, Francesca, Costa, Claudia, Vignali, Luigi, Benatti, Giorgio, Sverzellati, Nicola, Scarnecchia, Elisa, Lombardo, Francesco Paolo, Anastasio, Fabio, Iannaccone, Mario, Vaudano, Paolo Giacomo, Pacielli, Alberto, Baffoni, Lucio, Gardi, Iljia, Cesini, Elisabetta, Sperandio, Massimiliano, Micossi, Chiara, De Carlini, Caterina Chiara, Spreafico, Cristiano, Maggiolini, Stefano, Bonaffini, Pietro Andrea, Iacovoni, Attilio, Sironi, Sandro, Senni, Michele, Fominskiy, Evgeny, De Cobelli, Francesco, Maggioni, Aldo Pietro, Rapezzi, Claudio, Ferrari, Roberto, Colombo, Antonio, Esposito, Antonio, Giannini, F, Toselli, M, Palmisano, A, Cereda, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Manfrini, M, Khokhar, A, Sticchi, A, Biagi, A, Turchio, P, Tacchetti, C, Landoni, G, Boccia, E, Campo, G, Scoccia, A, Ponticelli, F, Danzi, G, Loffi, M, Muri, M, Pontone, G, Andreini, D, Mancini, E, Casella, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Franzesi, C, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Sverzellati, N, Scarnecchia, E, Lombardo, F, Anastasio, F, Iannaccone, M, Vaudano, P, Pacielli, A, Baffoni, L, Gardi, I, Cesini, E, Sperandio, M, Micossi, C, De Carlini, C, Spreafico, C, Maggiolini, S, Bonaffini, P, Iacovoni, A, Sironi, S, Senni, M, Fominskiy, E, De Cobelli, F, Maggioni, A, Rapezzi, C, Ferrari, R, Colombo, A, Esposito, A, Giannini, Francesco, Toselli, Marco, Palmisano, Anna, Cereda, Alberto, Vignale, Davide, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Manfrini, Marco, Khokhar, Arif, Sticchi, Alessandro, Biagi, Andrea, Turchio, Piergiorgio, Tacchetti, Carlo, Landoni, Giovanni, Boccia, Edda, Campo, Gianluca, Scoccia, Alessandra, Ponticelli, Francesco, Danzi, Gian Battista, Loffi, Marco, Muri, Margherita, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Ippolito, Davide, Bellani, Giacomo, Franzesi, Camillo Talei, Patelli, Gianluigi, Besana, Francesca, Costa, Claudia, Vignali, Luigi, Benatti, Giorgio, Sverzellati, Nicola, Scarnecchia, Elisa, Lombardo, Francesco Paolo, Anastasio, Fabio, Iannaccone, Mario, Vaudano, Paolo Giacomo, Pacielli, Alberto, Baffoni, Lucio, Gardi, Iljia, Cesini, Elisabetta, Sperandio, Massimiliano, Micossi, Chiara, De Carlini, Caterina Chiara, Spreafico, Cristiano, Maggiolini, Stefano, Bonaffini, Pietro Andrea, Iacovoni, Attilio, Sironi, Sandro, Senni, Michele, Fominskiy, Evgeny, De Cobelli, Francesco, Maggioni, Aldo Pietro, Rapezzi, Claudio, Ferrari, Roberto, Colombo, Antonio, and Esposito, Antonio

Abstract

Background: Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated. Objectives: The aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients. Methods: 1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients’ outcomes. Results: Non-survivors compared to survivors had higher coronary artery [Agatston (467.76 ​± ​570.92 vs 206.80 ​± ​424.13 ​mm2, p ​< ​0.001); Volume (487.79 ​± ​565.34 vs 207.77 ​± ​406.81, p ​< ​0.001)], aortic valve [Volume (322.45 ​± ​390.90 vs 98.27 ​± ​250.74 mm2, p ​< ​0.001; Agatston 337.38 ​± ​414.97 vs 111.70 ​± ​282.15, p ​< ​0.001)] and thoracic aorta [Volume (3786.71 ​± ​4225.57 vs 1487.63 ​± ​2973.19 mm2, p ​< ​0.001); Agatston (4688.82 ​± ​5363.72 vs 1834.90 ​± ​3761.25, p ​< ​0.001)] calcium values. Coronary artery calcium (HR 1.308; 95% CI, 1.046–1.637, p ​= ​0.019) and total thoracic calcium (HR 1.975; 95% CI, 1.200–3.251, p ​= ​0.007) resulted to be independent predictors of in-hospital mortality. Conclusion: Coronary, aortic valve and thoracic aortic calcium assessment on admission non-gated CT permits to stratify the COVID-19 patients in-hospital mortality risk.

Published
2021

8. Waves of infection and waves of communication: the importance of sharing in the era of Covid-19

Author

Mazzaferro, S., Rocca, A. R., Bagordo, D., Alfarone, C., Baldinelli, G., Boccia, E., Bondatti, F., Casarci, M., Catucci, A. E., Chiappini, M. G., Cioffi, A., Cuzziol, C., De Paolis, P., Della Grotta, B., Daniele, N. D., Di Lullo, L., Di Pietro, G., Di Zazzo, G., Fazzari, L., Feriozzi, S., Ferrazzano, M., Filippini, A., Fini, R., Firmi, G., Flammini, A., Forte, F., Galliani, M., Gamberini, M., Gangeri, F., Grandaliano, Giuseppe, Iamundo, V., Lavini, R., Lonzi, M., Marinelli, R., Marrocco, F., Mene, P., Miglio, L., Morabito, S., Morgia, A., Morosetti, M., Muci, M. L., Nazzaro, L., Nusca, C., Onorato, L., Pace, G., Palumbo, R., Pantano, L., Polito, P., Puliti, M., Rifici, N., Rizzi, E., Rossi, V., Sabry, H., Scabbia, L., Serraiocco, M., Sfregola, P., Simonelli, R., Treglia, A., Umbro, I., Valentini, W., Grandaliano G. (ORCID:0000-0003-1213-2177), Mazzaferro, S., Rocca, A. R., Bagordo, D., Alfarone, C., Baldinelli, G., Boccia, E., Bondatti, F., Casarci, M., Catucci, A. E., Chiappini, M. G., Cioffi, A., Cuzziol, C., De Paolis, P., Della Grotta, B., Daniele, N. D., Di Lullo, L., Di Pietro, G., Di Zazzo, G., Fazzari, L., Feriozzi, S., Ferrazzano, M., Filippini, A., Fini, R., Firmi, G., Flammini, A., Forte, F., Galliani, M., Gamberini, M., Gangeri, F., Grandaliano, Giuseppe, Iamundo, V., Lavini, R., Lonzi, M., Marinelli, R., Marrocco, F., Mene, P., Miglio, L., Morabito, S., Morgia, A., Morosetti, M., Muci, M. L., Nazzaro, L., Nusca, C., Onorato, L., Pace, G., Palumbo, R., Pantano, L., Polito, P., Puliti, M., Rifici, N., Rizzi, E., Rossi, V., Sabry, H., Scabbia, L., Serraiocco, M., Sfregola, P., Simonelli, R., Treglia, A., Umbro, I., Valentini, W., and Grandaliano G. (ORCID:0000-0003-1213-2177)

Abstract

No abstract available

Published
2021

9. Dietary Patterns and Mortality in a Multinational Cohort of Adults Receiving Hemodialysis

Author

Saglimbene, Valeria M., primary, Wong, Germaine, additional, Teixeira-Pinto, Armando, additional, Ruospo, Marinella, additional, Garcia-Larsen, Vanessa, additional, Palmer, Suetonia C., additional, Natale, Patrizia, additional, Campbell, Katrina, additional, Carrero, Juan-Jesus, additional, Stenvinkel, Peter, additional, Gargano, Letizia, additional, Murgo, Angelo M., additional, Johnson, David W., additional, Tonelli, Marcello, additional, Gelfman, Rubén, additional, Celia, Eduardo, additional, Ecder, Tevfik, additional, Bernat, Amparo G., additional, Del Castillo, Domingo, additional, Timofte, Delia, additional, Török, Marietta, additional, Bednarek-Skublewska, Anna, additional, Duława, Jan, additional, Stroumza, Paul, additional, Hansis, Martin, additional, Fabricius, Elisabeth, additional, Felaco, Paolo, additional, Wollheim, Charlotta, additional, Hegbrant, Jörgen, additional, Craig, Jonathan C., additional, Strippoli, Giovanni F.M., additional, Badino, A., additional, Petracci, L., additional, Villareal, C., additional, Soto, M., additional, Arias, M., additional, Vera, F., additional, Quispe, V., additional, Morales, S., additional, Bueno, D., additional, Bargna, R., additional, Peñaloza, G., additional, Alcalde, L., additional, Dayer, J., additional, Milán, A., additional, Centurión, N., additional, Ramos, A., additional, De Orta, E., additional, Menardi, S., additional, Austa Bel, N., additional, Marileo, E., additional, Junqueras, N., additional, Favalli, C., additional, Trioni, R., additional, Valle, G., additional, López, M., additional, Marinaro, C., additional, Fernandez, A., additional, Corral, J., additional, Nattiello, E., additional, Marone, S., additional, García, J., additional, Carrizo, G., additional, González, P., additional, Delicia, O., additional, Maza, M., additional, Chauque, M., additional, Mora, J., additional, Grbavac, D., additional, López, L., additional, Alonso, M., additional, Villalba, C., additional, Simon, M., additional, Cernadas, M., additional, Moscatelli, C., additional, Vilamajó, I., additional, Tursky, C., additional, Martínez, M., additional, Villalba, F., additional, Pereira, D., additional, Araujo, S., additional, López, H., additional, Alonso, V., additional, Vázquez, B., additional, Rapetti, M., additional, Raña, S., additional, Capdevila, M., additional, Ljubich, C., additional, Acosta, M., additional, Coombes, M., additional, Doria, V., additional, Ávila, M., additional, Cáceres, D., additional, Geandet, E., additional, Romero, C., additional, Morales, E., additional, Recalde, C., additional, Casanú, M., additional, Lococo, B., additional, Da Cruz, O., additional, Focsaner, C., additional, Galarce, D., additional, Albarracín, L., additional, Vescovo, E., additional, Gravielle, M., additional, Florio, D., additional, Baumgart, L., additional, Corbalán, M., additional, Aguilera, V., additional, Hermida, O., additional, Galli, C., additional, Ziombra, L., additional, Gutierrez, A., additional, Frydelund, S., additional, Hardaman, A., additional, Maciel, A., additional, Arrigo, M., additional, Mato Mira, C., additional, Leibovich, J., additional, Paparone, R., additional, Muller, E., additional, Malimar, A., additional, Leocadio, I., additional, Cruz, W., additional, Tirado, S., additional, Peñalba, A., additional, Cejas, R., additional, Mansilla, S., additional, Campos, C., additional, Abrego, E., additional, Chávez, P., additional, Corpacci, G., additional, Echavarría, A., additional, Engler, C., additional, Vergara, P., additional, Hubeli, M., additional, Redondo, G., additional, Noroña, B., additional, Boriceanu, C., additional, Lankester, M., additional, Poignet, J.L., additional, Saingra, Y., additional, Indreies, M., additional, Santini, J., additional, Mahi, A., additional, Robert, A., additional, Bouvier, P., additional, Merzouk, T., additional, Villemain, F., additional, Pajot, A., additional, Tollis, F., additional, Brahim-Bounab, M., additional, Benmoussa, A., additional, Albitar, S., additional, Guimont, M.C., additional, Ciobotaru, P., additional, Guerin, A., additional, Diaconita, M., additional, Hoischen, S.H., additional, Saupe, J., additional, Ullmann, I., additional, Grosser, S., additional, Kunow, J., additional, Grueger, S., additional, Bischoff, D., additional, Benders, J., additional, Worch, P., additional, Pfab, T., additional, Kamin, N., additional, Roesch, M., additional, May, M., additional, Albert, K., additional, Csaszar, I., additional, Kiss, E., additional, Kosa, D., additional, Orosz, A., additional, Redl, J., additional, Kovacs, L., additional, Varga, E., additional, Szabo, M., additional, Magyar, K., additional, Zajko, E., additional, Bereczki, A., additional, Csikos, J., additional, Kerekes, E., additional, Mike, A., additional, Steiner, K., additional, Nemeth, E., additional, Tolnai, K., additional, Toth, A., additional, Vinczene, J., additional, Szummer, S.z., additional, Tanyi, E., additional, Szilvia, M., additional, Murgo, A.M., additional, Sanfilippo, N., additional, Dambrosio, N., additional, Saturno, C., additional, Matera, G., additional, Benevento, M., additional, Greco, V., additional, di Leo, G., additional, Papagni, S., additional, Alicino, F., additional, Marangelli, A., additional, Pedone, F., additional, Cagnazzo, A.V., additional, Antinoro, R., additional, Sambati, M.L., additional, Donatelli, C., additional, Ranieri, F., additional, Torsello, F., additional, Steri, P., additional, Riccardi, C., additional, Flammini, A., additional, Moscardelli, L., additional, Boccia, E., additional, Mantuano, M., additional, Di Toro Mammarella, R., additional, Meconizzi, M., additional, Fichera, R., additional, D’Angelo, A., additional, Latassa, G., additional, Molino, A., additional, Fici, M., additional, Lupo, A., additional, Montalto, G., additional, Messina, S., additional, Capostagno, C., additional, Randazzo, G., additional, Pagano, S., additional, Marino, G., additional, Rallo, D., additional, Maniscalco, A., additional, Trovato, O.M., additional, Strano, C., additional, Failla, A., additional, Bua, A., additional, Campo, S., additional, Nasisi, P., additional, Salerno, A., additional, Laudani, S., additional, Grippaldi, F., additional, Bertino, D., additional, Di Benedetto, D.V., additional, Puglisi, A., additional, Chiarenza, S., additional, Lentini Deuscit, M., additional, Incardona, C.M., additional, Scuto, G., additional, Todaro, C., additional, Dino, A., additional, Novello, D., additional, Coco, A., additional, Bocheńska-Nowacka, E., additional, Jaroszyński, A., additional, Drabik, J., additional, Wypych-Birecka, M., additional, Daniewska, D., additional, Drobisz, M., additional, Doskocz, K., additional, Wyrwicz-Zielińska, G., additional, Kosicki, A., additional, Ślizień, W., additional, Rutkowski, P., additional, Arentowicz, S., additional, Dzimira, S., additional, Grabowska, M., additional, Ostrowski, J., additional, Całka, A., additional, Grzegorczyk, T., additional, Dżugan, W., additional, Mazur, M., additional, Myślicki, M., additional, Piechowska, M., additional, Kozicka, D., additional, de Sá Martins, V., additional, Aguiar, L., additional, Mira, A.R., additional, Velez, B., additional, Pinheiro, T., additional, Agapi, E., additional, Ardelean, C.L., additional, Baidog, A., additional, Bako, G., additional, Barb, M., additional, Blaga, A., additional, Bodurian, E., additional, Bumbea, V., additional, Dragan, E., additional, Dumitrache, D., additional, Florescu, L., additional, Havasi, N., additional, Hint, S., additional, Ilies, R., additional, Mandita, A.G.M., additional, Marian, R.I., additional, Medrihan, S.L., additional, Mitea, L., additional, Mitea, S., additional, Mocanu, R., additional, Moro, D.C., additional, Nitu, M., additional, Popa, M.L., additional, Popa, M., additional, Railean, E., additional, Scuturdean, A.R., additional, Szentendrey, K., additional, Teodoru, C.L., additional, Varga, A., additional, García, M., additional, Olaya, M., additional, Abujder, V., additional, Carreras, J., additional, López, A., additional, Ros, F., additional, Cuesta, G., additional, García, A., additional, Orero, E., additional, Ros, E., additional, Bea, S., additional, Pizarro, J.L., additional, Luengo, S., additional, Romero, A., additional, Navarro, M., additional, Cermeño, L., additional, Rodriguez, A., additional, Lopez, D., additional, Barrera, A., additional, Montoya, F., additional, Tajahuerce, J., additional, Carro, M., additional, Cunill, M.Q., additional, Narci, S., additional, Ballester, T., additional, Soler, M.J., additional, Traver, S., additional, Buta, P.P., additional, Cucuiat, L., additional, Rosu, L., additional, Garcia, I., additional, Gavra, C.M., additional, Gonzalez, R., additional, Filimon, S., additional, Peñalver, M., additional, Benages, V., additional, Cardo, M.I., additional, García, E., additional, Soler, P., additional, Fernnandez, E., additional, Popescu, F., additional, Munteanu, R., additional, Tanase, E., additional, Sagau, F., additional, Prades, D., additional, Esteller, S., additional, Gonzalez, E., additional, Martinez, R., additional, Diago, A., additional, Torres, J., additional, Perez, E., additional, Garcia, C., additional, Lluch, I., additional, Forcano, J., additional, Fóns, M., additional, Rodríguez, A., additional, Millán, N.A., additional, Fernández, J., additional, Ferreiro, B., additional, Otero, M., additional, Pesqueira, V., additional, Abal, S., additional, Álvarez, R., additional, Jorge, C., additional, Rico, I., additional, de Dios Ramiro, J., additional, Duzy, L., additional, Soto, A., additional, Lopez, J.L., additional, Diaz, Y., additional, Herrero, I., additional, Farré, M., additional, Blasco, C., additional, Ferrás, S., additional, Agost, M.J., additional, Miracle, C., additional, Farto, J., additional, Goch, J., additional, Katzarski, K.S., additional, Wulcan, A., additional, Akbiber, H., additional, Arslan, H., additional, Bicen, L., additional, Buyukkiraz, A., additional, Celik, R., additional, Dogan, I.S., additional, Erkalkan, S., additional, Ertas, A., additional, Hark, U., additional, Iravul, E., additional, Karakaya, M., additional, Mengu, K., additional, Ongun, S., additional, Ozkan, Z., additional, Ozlu, A., additional, Ozveren, N., additional, Sifil, H.M., additional, Sonmez Turksoz, N., additional, and Yilmaz, Z., additional

Published
2020
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10. Associations of Cognitive Function and Education Level With All-Cause Mortality in Adults on Hemodialysis: Findings From the COGNITIVE-HD Study

Author

van Zwieten, Anita, primary, Wong, Germaine, additional, Ruospo, Marinella, additional, Palmer, Suetonia C., additional, Teixeira-Pinto, Armando, additional, Barulli, Maria Rosaria, additional, Iurillo, Annalisa, additional, Saglimbene, Valeria, additional, Natale, Patrizia, additional, Gargano, Letizia, additional, Murgo, Marco, additional, Loy, Clement T., additional, Tortelli, Rosanna, additional, Craig, Jonathan C., additional, Johnson, David W., additional, Tonelli, Marcello, additional, Hegbrant, Jörgen, additional, Wollheim, Charlotta, additional, Logroscino, Giancarlo, additional, Strippoli, Giovanni F.M., additional, Cagnazzo, A.V., additional, Antinoro, R., additional, Sambati, M.L., additional, Donatelli, C., additional, Dambrosio, N., additional, Saturno, C., additional, Marangelli, A., additional, Pedone, F., additional, Matera, G., additional, Benevento, M., additional, Papagni, S., additional, Alicino, F., additional, Latassa, G., additional, Molino, A., additional, Grippaldi, F., additional, Bertino, D., additional, Montalto, G., additional, Messina, S., additional, Campo, S., additional, Nasisi, P., additional, Failla, A., additional, Bua, A., additional, Pagano, S., additional, Marino, G., additional, Sanfilippo, N., additional, Rallo, D., additional, Maniscalco, A., additional, Capostagno, C., additional, Randazzo, G., additional, Fici, M., additional, Lupo, A., additional, Fichera, R., additional, D'angelo, A., additional, Di Toro Mammarella, R., additional, Meconizzi, M., additional, Boccia, E., additional, Mantuano, M., additional, Flammini, A., additional, and Moscardelli, L., additional

Published
2019
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13. Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study

Author

Palmer, Sc, Ruospo, M, Campbell, Kl, Garcia Larsen, V, Saglimbene, V, Natale, P, Gargano, L, Craig, Jc, Johnson, Dw, Tonelli, M, Knight, J, Bednarek Skublewska, A, Celia, E, Del Castillo, D, Dulawa, J, Ecder, T, Fabricius, E, Frazão, Jm, Gelfman, R, Hoischen, Sh, Schön, S, Stroumza, P, Timofte, D, Török, M, Hegbrant, J, Wollheim, C, Frantzen, L, Strippoli, Gf, Raña, S, Serrano, M, Claros, S, Arias, M, Petracci, L, Arana, M, De Rosa, P, Gutierrez, A, Simon, M, Vergara, V, Tosi, M, Cernadas, M, Vilamajó, I, Gravac, D, Paulón, M, Penayo, L, Carrizo, G, Ghiani, M, Perez, G, Da Cruz, O, Galarce, D, Gravielle, M, Vescovo, E, Paparone, R, Mato Mira, C, Mojico, E, Hermida, O, Florio, D, Yucoswky, M, Labonia, W, Rubio, D, Di Napoli, G, Fernandez, A, Altman, H, Rodriguez, J, Serrano, S, Valle, G, Lobos, M, Acosta, V, Corpacci, G, Jofre, M, Gianoni, L, Chiesura, G, Capdevila, M, Montenegro, J, Bequi, J, Dayer, J, Gómez, A, Calderón, C, Abrego, E, Cechín, C, García, J, Corral, J, Natiello, M, Coronel, A, Muñiz, M, Muñiz, V, Bonelli, A, Sanchez, F, Maestre, S, Olivera, S, Camargo, M, Avalos, V, Geandet, E, Canteli, M, Escobar, A, Sena, E, Tirado, S, Peñalba, A, Neme, G, Cisneros, M, Oliszewski, R, Nascar, V, Daud, M, Mansilla, S, Paredes Álvarez, A, Gamín, L, Arijón, M, Coombes, M, Zapata, M, Boriceanu, C, Lankester, M, Poignet, Jl, Saingra, Y, Indreies, M, Santini, J, Amar, M, Robert, A, Bouvier, P, Merzouk, T, Villemain, F, Pajot, A, Tollis, F, Brahim Bounab, M, Benmoussa, A, Albitar, S, Guimont, Mc, Ciobotaru, P, Guerin, A, Diaconita, M, Shh, Saupe, J, Ullmann, I, Grosser, S, Kunow, J, Grueger, S, Bischoff, D, Benders, J, Worch, P, Pfab, T, Kamin, N, Roesch, M, Albert, K, Csaszar, I, Kiss, E, Kosa, D, Orosz, A, Redl, J, Kovacs, L, Varga, E, Szabo, M, Magyar, K, Zajko, E, Bereczki, A, Csikos, J, Kerekes, E, Mike, A, Steiner, K, Nemeth, E, Tolnai, K, Toth, A, Vinczene, J, Szummer, S, Tanyi, E, Szilvia, M, Murgo, Am, Sanfilippo, N, Dambrosio, N, Saturno, C, Matera, G, Benevento, M, Greco, V, di Leo, G, Papagni, S, Alicino, F, Marangelli, A, Pedone, F, Cagnazzo, Av, Antinoro, R, Sambati, Ml, Donatelli, C, Ranieri, F, Torsello, F, Steri, P, Riccardi, C, Flammini, A, Moscardelli, L, Boccia, E, Mantuano, M, Di Toro Mammarella, R, Meconizzi, M, Fichera, R, D'Angelo, A, Latassa, G, Molino, A, Fici, M, Lupo, Antonio, Montalto, G, Messina, S, Capostagno, C, Randazzo, G, Pagano, S, Marino, G, Rallo, D, Maniscalco, A, Trovato, Om, Strano, C, Failla, A, Bua, A, Campo, S, Nasisi, P, Salerno, A, Laudani, S, Grippaldi, F, Bertino, D, Di Benedetto, Dv, Puglisi, A, Chiarenza, S, Lentini Deuscit, M, Incardona, Cm, Scuto, G, Todaro, C, Dino, A, Novello, D, Coco, A, Bocheńska Nowacka, E, Jaroszyński, A, Drabik, J, Wypych Birecka, M, Daniewska, D, Drobisz, M, Doskocz, K, Wyrwicz Zielińska, G, Kosicki, A, Ślizień, Ws, Rutkowski, P, Arentowicz, S, Dzimira, S, Grabowska, M, Ostrowski, J, Całka, A, Grzegorczyk, T, Dżugan, W, Mazur, M, Myślicki, M, Piechowska, M, Kozicka, D, Mira, Ar, Martins, V, Velez, B, Pinheiro, T, Agapi, E, Ardelean, Cl, Baidog, A, Bako, G, Barb, M, Blaga, A, Bodurian, E, Bumbea, V, Dragan, E, Dumitrache, D, Florescu, L, Havasi, N, Hint, S, Ilies, R, Mandita, Ag, Marian, Ri, Medrihan, Sl, Mitea, L, Mitea, S, Mocanu, R, Moro, Dc, Nitu, M, Popa, Ml, Popa, M, Railean, E, Scuturdean, Ar, Szentendrey, K, Teodoru, Cl, Varga, A, Bernat, A, De la Torre, B, Lopez, A, Martin, J, Cuesta, G, Rodriguez, Rm, Ros, F, Garcia, M, Orero, E, Ros, E, Goch, J, Katzarski, Ks, Wulcan, A, Akbiber, H, Arslan, H, Bicen, L, Buyukkiraz, A, Celik, R, Dogan, Is, Erkalkan, S, Ertas, A, Hark, U, Iravul, E, Karakaya, M, Mengu, K, Ongun, S, Ozkan, Z, Ozlu, A, Ozveren, N, Sifil, Hm, Sonmez Turksoz, N, and Yilmaz, Z.

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Adolescent, Turkey, medicine.medical_treatment, Argentina, NUTRITION & DIETETICS, Nutritional Status, Infections, Young Adult, Informed consent, Renal Dialysis, Cause of Death, Fatty Acids, Omega-6, Epidemiology, Fatty Acids, Omega-3, medicine, Protocol, Humans, EPIDEMIOLOGY, Social determinants of health, hemodialysis, Prospective Studies, Prospective cohort study, Dialysis, Renal Medicine, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], General Medicine, medicine.disease, Europe, Hospitalization, Cardiovascular Diseases, Food, Research Design, Emergency medicine, Kidney Failure, Chronic, Female, Hemodialysis, business, Energy Intake, Kidney disease, Cohort study
Abstract

Contains fulltext : 153534.pdf (Publisher’s version ) (Open Access) INTRODUCTION: Adults with end-stage kidney disease (ESKD) treated with haemodialysis experience mortality of between 15% and 20% each year. Effective interventions that improve health outcomes for long-term dialysis patients remain unproven. Novel and testable determinants of health in dialysis are needed. Nutrition and dietary patterns are potential factors influencing health in other health settings that warrant exploration in multinational studies in men and women treated with dialysis. We report the protocol of the "DIETary intake, death and hospitalisation in adults with end-stage kidney disease treated with HaemoDialysis (DIET-HD) study," a multinational prospective cohort study. DIET-HD will describe associations of nutrition and dietary patterns with major health outcomes for adults treated with dialysis in several countries. METHODS AND ANALYSIS: DIET-HD will recruit approximately 10,000 adults who have ESKD treated by clinics administered by a single dialysis provider in Argentina, France, Germany, Hungary, Italy, Poland, Portugal, Romania, Spain, Sweden and Turkey. Recruitment will take place between March 2014 and June 2015. The study has currently recruited 8000 participants who have completed baseline data. Nutritional intake and dietary patterns will be measured using the Global Allergy and Asthma European Network (GA(2)LEN) food frequency questionnaire. The primary dietary exposures will be n-3 and n-6 polyunsaturated fatty acid consumption. The primary outcome will be cardiovascular mortality and secondary outcomes will be all-cause mortality, infection-related mortality and hospitalisation. ETHICS AND DISSEMINATION: The study is approved by the relevant Ethics Committees in participating countries. All participants will provide written informed consent and be free to withdraw their data at any time. The findings of the study will be disseminated through peer-reviewed journals, conference presentations and to participants via regular newsletters. We expect that the DIET-HD study will inform large pragmatic trials of nutrition or dietary interventions in the setting of advanced kidney disease.

Published
2015

14. COGNITIVE-HD study: protocol of an observational study of neurocognitive functioning and association with clinical outcomes in adults with end-stage kidney disease treated with haemodialysis

Author

Palmer, Sc, Ruospo, M, Barulli, Mr, Iurillo, A, Saglimbene, V, Natale, P, Gargano, L, Murgo, Am, Loy, C, van Zwieten, A, Wong, G, Tortelli, R, Craig, Jc, Johnson, Dw, Tonelli, M, Hegbrant, J, Wollheim, C, Logroscino, G, Strippoli, Gf, Cagnazzo, A, Antinoro, R, Sambati, M, Donatelli, C, Dambrosio, N, Saturno, C, Marangelli, A, Pedone, F, Matera, G, Benevento, M, Papagni, S, Alicino, F, Latassa, G, Molino, A, Grippaldi, F, Bertino, D, Montalto, G, Messina, S, Campo, S, Nasisi, P, Failla, A, Bua, A, Pagano, S, Marino, G, Sanfilippo, N, Rallo, D, Maniscalco, A, Capostagno, C, Randazzo, G, Fici, M, Lupo, Antonio, Fichera, R, D'Angelo, A, Region, L, Mammarella, Rd, Meconizzi, M, Boccia, E, Mantuano, M, Flammini, A, and Moscardelli, L.

Subjects
Adult, Pediatrics, medicine.medical_specialty, Patient Dropouts, Adolescent, Epidemiology, medicine.medical_treatment, Population, Neuropsychological Tests, Executive Function, Cognition, Clinical Protocols, Memory, Renal Dialysis, Informed consent, Cause of Death, Activities of Daily Living, Protocol, medicine, Humans, Learning, Longitudinal Studies, Prospective Studies, Prospective cohort study, education, Dialysis, cognitive impairment, education.field_of_study, hemodialysis, business.industry, General Medicine, medicine.disease, Treatment Outcome, Italy, Motor Skills, Research Design, cognitive impairment, chronic kidney disease, hemodialysis, Kidney Failure, Chronic, Cognition Disorders, business, Neurocognitive, chronic kidney disease, Kidney disease, Cohort study
Abstract

Introduction The prevalence of cognitive impairment may be increased in adults with end-stage kidney disease compared with the general population. However, the specific patterns of cognitive impairment and association of cognitive dysfunction with activities of daily living and clinical outcomes (including withdrawal from treatment) among haemodialysis patients remain incompletely understood. The COGNITIVE impairment in adults with end-stage kidney disease treated with HemoDialysis (COGNITIVE-HD) study aims to characterise the age-adjusted and education-adjusted patterns of cognitive impairment (using comprehensive testing for executive function, perceptual-motor function, language, learning and memory, and complex attention) in patients on haemodialysis and association with clinical outcomes. Methods and analysis A prospective, longitudinal, cohort study of 750 adults with end-stage kidney disease treated with long-term haemodialysis has been recruited within haemodialysis centres in Italy (July 2013 to April 2014). Testing for neurocognitive function was carried out by a trained psychologist at baseline to assess cognitive functioning. The primary study factor is cognitive impairment and secondary study factors will be specific domains of cognitive function. The primary outcome will be total mortality. Secondary outcomes will be cause-specific mortality, major cardiovascular events, fatal and non-fatal myocardial infarction and stroke, institutionalisation, and withdrawal from treatment at 12 months. Ethics and dissemination This protocol was approved before study conduct by the following responsible ethics committees: Catania (approval reference 186/BE; 26/09/2013), Agrigento (protocol numbers 61–62; 28/6/2013), USL Roma C (CE 39217; 24/6/2013), USL Roma F (protocol number 0041708; 23/7/2013), USL Latina (protocol number 20090/A001/2011; 12/7/2013), Trapani (protocol number 3413; 16/7/2013) and Brindisi (protocol number 40259; 6/6/2013). All participants have provided written and informed consent and can withdraw from the study at any time. The findings of the study will be disseminated through peer-reviewed journals and national and international conference presentations and to the participants through communication within the dialysis network in which this study is conducted.

Published
2015

15. Lazio dialysis registry: natives vs foreigners

Author

Di Napoli, A, Lapucci, E, Baglio, G, Di Giulio, S, Addessi, M, Alfarone, C, Amoroso, F, Apollinari, E, Baldinelli, G, Baldinelli, M, Barbera, G, Barone, P, Bartolomucci, M, Basili, A, Battista, M, Beraldi, M, Boccia, E, Bruno, F, Buono, A, Canulla, C, Capobianco, L, Caschera, M, Castellano, F, Chamoun, G, Cherubini, C, Chiappini, M, Ciano, G, Costantini, S, Cuzziol, C, Darida, S, Dascal, M, De Bella, E, De Caro, M, De Cicco, C, De Fazio, S, de Virgiliis, G, Della Grotta, F, Della Rovere, F, Di Daniele, N, Di Legge, R, Di Toro Mammarella, R, Dominijanni, S, Esposto, G, Fabozzi, G, Falcone, C, Faraglia, F, Felice, C, Felicioni, R, Feriozzi, S, Ferrari, I, Filippini, A, Fini, R, Firmi, G, Flammini, A, Floccari, F, Forte, F, Galli, D, Galliani, M, Gamberoni, M, Gargiulo, A, Giordano, N, Giustini, A, Grimaldi, R, Hassan, S, Iacono, R, Iamundo, V, Kristuli, L, Laino, M, Leoni, M, Lonzi, M, Lucchetta, F, Maggesano, V, Malaguti, M, Mangeri, M, Marinelli, A, Marinelli, R, Marsili, F, Mauro, L, Mazzaferro, S, Meconizzi, M, Melillo, F, Merigliano, V, Messia, A, Morabito, S, Morosetti, M, Murrone, P, Muzi, L, Nacca, R, Nardone, P, Naticchia, A, Nazzaro, L, Nigro, A, Noce, A, Ordonez, D, Pace, G, Palombo, R, Pantano, L, Panzieri, G, Paone, A, Paparella, M, Pasquarelli, C, Pelosi, M, Petroni, S, Picca, S, Polidori, L, Polito, P, Principe, F, Pulcinelli, G, Puliti, M, Punzo, G, Retico, E, Rifici, N, Riveruzzi, P, Rodriguez, I, Rossi, V, Rossini, B, Santoboni, A, Sfregola, P, Simeoni, P, Simonelli, R, Solazzo, A, Spagnolini, A, Spaziani, M, Splendiani, G, Staffolani, E, Startari, S, Steri, P, Sturniolo, A, Tazza, L, Torre, M, Treglia, A, Triolo, L, Tuderti, F, Tulli, U, Turchetta, L, Valentini, W, Vancini, C, Vastano, S, Vega, A, Ventola, F, Veronese, P, Villani, A, Violi, F, Vitaliano, E, Zanfoni, C, Zazzaro, D, and Zugaro, A

Subjects
Male, Survival Rate, Settore MED/14 - Nefrologia, Italy, Renal Dialysis, Emigrants and Immigrants, Humans, Female, Registries, Middle Aged, Aged
Abstract

An increasing number of foreigners was observed in Italy even among chronic dialysis patients. We compared demographic, clinical, treatment characteristics and survival probability between groups of Italian and foreign patients with chronic dialysis in Lazio.We analysed data from the Lazio Dialysis and Transplantation Registry from 2004 to 2012 (4,076 prevalent chronic dialysis patients in 31-12-2012). Among 7,970 incident patients, we evaluated, by country of birth, survival probability by using Kaplan-Meier method and mortality risk, through multiple Cox regression.We observed an increase of foreigners among chronic dialysis patients in Lazio from 2004 (4.4%) up to 2012 (7.6%, test for trend: p0,001). Compared with Italians, foreign patients were younger (53.816.3 vs. 68.713.6) and more frequently: women (42.7% vs. 37.7%), HbsAg-positive (18.1% vs. 13.9%), not vaccinated if HBV susceptible (26.8% vs. 20.9%), late referral (21.6% vs. 12.9%) and suitable for kidney transplantation (21.7% vs. 9.9%). Foreigners compared with Italians had higher survival probability at 1 year (91.9% vs. 84.7%) and 5 years (74,6% vs. 51,5%) after chronic dialysis has been started. We observed a lower mortality risk (HR=0.71;IC95%:0.58-0.87) among foreign patients even after adjustment for many potential confounding factors. Our findings suggest that health status and treatment of end stage renal disease, including access to kidney transplantation, were similar between groups of Italian and foreign patients in Lazio. Observed differences in patients' characteristics were probably attributable to younger age of foreigners. However, further analyses are needed to fully explain higher survival probability in chronic dialysis among foreigners compared with Italians.

Published
2015

17. Viscoelastic computational modeling of the human head-neck system: Eigenfrequencies and time-dependent analysis.

Author

Boccia, E., Gizzi, A., Cherubini, C., Nestola, M. G. C., and Filippi, S.

Subjects
*FINITE element method, *BIOMECHANICS, *SIMULATION methods & models, *NEUROSCIENCES, *YOUNG'S modulus
Abstract

A subject-specific 3-dimensional viscoelastic finite element model of the human head-neck system is presented and investigated based on computed tomography and magnetic resonance biomedical images. Ad hoc imaging processing tools are developed for the reconstruction of the simulation domain geometry and the internal distribution of bone and soft tissues. Material viscoelastic properties are characterized point-wise through an image-based interpolating function used then for assigning the constitutive prescriptions of a heterogenous viscoelastic continuum model. The numerical study is conducted both for modal and time-dependent analyses, compared with similar studies and validated against experimental evidences. Spatiotemporal analyses are performed upon different exponential swept-sine wave–localized stimulations. The modeling approach proposes a generalized, patient-specific investigation of sound wave transmission and attenuation within the human head-neck system comprising skull and brain tissues. Model extensions and applications are finally discussed. [ABSTRACT FROM AUTHOR]

Published
2018
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18. Dental Health and Mortality in People With End-Stage Kidney Disease Treated With Hemodialysis: A Multinational Cohort Study

Author

Palmer, Suetonia C., primary, Ruospo, Marinella, additional, Wong, Germaine, additional, Craig, Jonathan C., additional, Petruzzi, Massimo, additional, De Benedittis, Michele, additional, Ford, Pauline, additional, Johnson, David W., additional, Tonelli, Marcello, additional, Natale, Patrizia, additional, Saglimbene, Valeria, additional, Pellegrini, Fabio, additional, Celia, Eduardo, additional, Gelfman, Ruben, additional, Leal, Miguel R., additional, Torok, Marietta, additional, Stroumza, Paul, additional, Bednarek-Skublewska, Anna, additional, Dulawa, Jan, additional, Frantzen, Luc, additional, Ferrari, Juan Nin, additional, del Castillo, Domingo, additional, Bernat, Amparo G., additional, Hegbrant, Jorgen, additional, Wollheim, Charlotta, additional, Gargano, Letizia, additional, Bots, Casper P., additional, Strippoli, Giovanni F.M., additional, Raña, S., additional, Serrano, M., additional, Claros, S., additional, Arias, M., additional, Petracci, L., additional, Arana, M., additional, De Rosa, P., additional, Gutierrez, A., additional, Simon, M., additional, Vergara, V., additional, Tosi, M., additional, Cernadas, M., additional, Vilamajó, I., additional, Gravac, D., additional, Paulón, M., additional, Penayo, L., additional, Carrizo, G., additional, Ghiani, M., additional, Perez, G., additional, Da Cruz, O., additional, Galarce, D., additional, Gravielle, M., additional, Vescovo, E., additional, Paparone, R., additional, Mato Mira, C., additional, Mojico, E., additional, Hermida, O., additional, Florio, D., additional, Yucoswky, M., additional, Labonia, W., additional, Rubio, D., additional, Di Napoli, G., additional, Fernandez, A., additional, Altman, H., additional, Rodriguez, J., additional, Serrano, S., additional, Valle, G., additional, Lobos, M., additional, Acosta, V., additional, Corpacci, G., additional, Jofre, M., additional, Gianoni, L., additional, Chiesura, G., additional, Capdevila, M., additional, Montenegro, J., additional, Bequi, J., additional, Dayer, J., additional, Gómez, A., additional, Calderón, C., additional, Abrego, E., additional, Cechín, C., additional, García, J., additional, Corral, J., additional, Natiello, M., additional, Coronel, A., additional, Muñiz, M., additional, Muñiz, V., additional, Bonelli, A., additional, Sanchez, F., additional, Maestre, S., additional, Olivera, S., additional, Camargo, M., additional, Avalos, V., additional, Geandet, E., additional, Canteli, M., additional, Escobar, A., additional, Sena, E., additional, Tirado, S., additional, Peñalba, A., additional, Neme, G., additional, Cisneros, M., additional, Oliszewski, R., additional, Nascar, V., additional, Daud, M., additional, Mansilla, S., additional, Paredes Álvarez, A., additional, Gamín, L., additional, Arijón, M., additional, Coombes, M., additional, Zapata, M., additional, Boriceanu, C., additional, Frantzen-Trendel, S., additional, Albert, K., additional, Csaszar, I., additional, Kiss, E., additional, Kosa, D., additional, Orosz, A., additional, Redl, J., additional, Kovacs, L., additional, Varga, E., additional, Szabo, M., additional, Magyar, K., additional, Kriza, G., additional, Zajko, E., additional, Bereczki, A., additional, Csikos, J., additional, Kuti, A., additional, Mike, A., additional, Steiner, K., additional, Nemeth, E., additional, Tolnai, K., additional, Toth, A., additional, Vinczene, J., additional, Szummer, Sz., additional, Tanyi, E., additional, Toth, R., additional, Szilvia, M., additional, Dambrosio, N., additional, Paparella, G., additional, Sambati, M., additional, Donatelli, C., additional, Pedone, F., additional, Cagnazzo, V.A., additional, Antinoro, R., additional, Torsello, F., additional, Saturno, C., additional, Giannoccaro, G., additional, Maldera, S., additional, Boccia, E., additional, Mantuano, M., additional, Di Toro Mammarella, R., additional, Meconizzi, M., additional, Steri, P.F., additional, Riccardi, C., additional, Flammini, A., additional, Moscardelli, L., additional, Murgo, M., additional, San Filippo, N., additional, Pagano, S., additional, Marino, G., additional, Montalto, G., additional, Cantarella, S., additional, Salamone, B., additional, Randazzo, G., additional, Rallo, D., additional, Maniscalco, A., additional, Fici, M., additional, Lupo, A., additional, Pellegrino, P., additional, Fichera, R., additional, D’Angelo, A., additional, Falsitta, N., additional, Bochenska-Nowacka, E., additional, Jaroszynski, A., additional, Drabik, J., additional, Birecka, M., additional, Daniewska, D., additional, Drobisz, M., additional, Doskocz, K., additional, Wyrwicz, G., additional, Inchaustegui, L., additional, Outerelo, C., additional, Sousa Mendes, D., additional, Mendes, A., additional, Lopes, J., additional, Barbas, J., additional, Madeira, C., additional, Fortes, A., additional, Vizinho, R., additional, Cortesão, A., additional, Almeida, E., additional, Bernat, A., additional, De la Torre, B., additional, Lopez, A., additional, Martín, J., additional, Cuesta, G., additional, Rodriguez, R.M., additional, Ros, F., additional, Garcia, M., additional, Orero, E., additional, Ros, E., additional, Caetano, A., additional, MacGregor, K., additional, Santos, M., additional, Silva Pinheiro, S., additional, Martins, L., additional, Leitão, D., additional, Izidoro, C., additional, Bava, G., additional, Bora, A., additional, Gorena, H., additional, Calderón, T., additional, Dupuy, R., additional, Alonso, N., additional, Siciliano, V., additional, Nagy, K., additional, Bajusz, Ö., additional, Pinke, I., additional, Decsi, G., additional, Gyergyoi, L., additional, Jobba, Zs., additional, Zalai, Zs., additional, Zsedenyi, Á., additional, Kiss, G., additional, Pinter, M., additional, Kereszturi, M., additional, Petruzzi, M., additional, De Benedittis, M., additional, Szkutnik, J., additional, Sieczkarek, J., additional, Capelo, A., additional, Garcia Gallart, M., additional, and Mendieta, C., additional

Published
2015
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22. [Effects of Dose of Erythropoiesis Stimulating Agents on Cardiovascular Outcomes, Quality of Life and Costs of Haemodialysis. The Clinical Evaluation of the DOSe of Erythropoietins (C.E. DOSE) Trial]

Author

Saglimbene V, D'Alonzo D, Ruospo M, Vecchio M, Natale P, Gargano L, Nicolucci A, Pellegrini F, Jc, Craig, Triolo G, Da, Procaccini, Santoro A, Giulio S, Rosa S, Murgo A, Mammarella R, Sambati M, D'Ambrosio N, Greco V, Giannoccaro G, Flammini A, Boccia E, Montalto G, Pagano S, Amarù S, Fici M, Lumaga G, Mancini E, Veronesi M, Patregnani L, Querques M, Schiavone P, Chimienti S, Palumbo R, Franco D, Volpe M, Gori E, Salomone M, Iacono A, Moscoloni M, Treglia A, Casu D, Am, Piras, Silva A, Mandreoli M, Lopez A, Quarello F, Catizone L, Russo G, Forcellini S, Maccarone M, Catucci G, Paolo B, Stingone A, D'Angelo B, Guastoni C, Pasquali S, Minoretti C, Bellasi A, Boscutti G, Martone M, David S, Schito F, Urban L, Iorio B, Caruso F, Mazzoni A, Musacchio R, Andreoli D, Cossu M, Cavoli G, Cornacchiari M, Granata A, Clementi A, Giordano R, Barzaghi W, Miriam Valentini, Hegbrant J, Tognoni G, and Gf, Strippoli

Subjects
Risk, Dose-Response Relationship, Drug, Disease Management, Anemia, Middle Aged, Hemoglobins, Observational Studies as Topic, Double-Blind Method, Meta-Analysis as Topic, Renal Dialysis, Research Design, Outcome Assessment, Health Care, Hematinics, Quality of Life, Humans, Kidney Failure, Chronic, Diabetic Nephropathies, Female
Abstract

Anaemia is a risk factor for death, adverse cardiovascular outcomes and poor quality of life in patients with chronic kidney disease (CKD). Erythropoietin Stimulating Agents (ESA) are the most used treatment option. In observational studies, higher haemoglobin (Hb) levels (around 11-13 g/dL) are associated with improved survival and quality of life compared to Hb levels around 9-10 g/dL. Randomized studies found that targeting higher Hb levels with ESA causes an increased risk of death, mainly due to adverse cardiovascular outcomes. It is possible that this is mediated by ESA dose rather than haemoglobin concentration, although this hypothesis has never been formally tested.We present the protocol of the Clinical Evaluation of the Dose of Erythropoietins (C.E. DOSE) trial, which will assess the benefits and harms of a high versus a low ESA dose therapeutic strategy for the management of anaemia of end stage kidney disease (ESKD). This is a randomized, prospective open label blinded end-point (PROBE) design trial due to enroll 900 haemodialysis patients. Patients will be randomized 1:1 to 4000 UI/week i. v. versus 18000 UI/week i. v. of epoetin alfa, beta or any other epoetin in equivalent doses. The primary outcome of the trial is a composite of cardiovascular events. In addition, quality of life and costs of these two strategies will be assessed. The study has been approved and funded by the Italian Agency of Drugs (Agenzia Italiana del Farmaco (AIFA)) within the 2006 funding plan for independent research on drugs (registered at www.clinicaltrials.gov (NCT00827021)).

23. Effects of dose of erythropoiesis stimulating agents on cardiovascular outcomes, quality of life and costs of haemodialysis. the clinical evaluation of the DOSe of erythropoietins (C.E. DOSE) Trial | Effetti della dose degli agenti stimolanti l'eritropoiesi su esiti cardio-cerebrovascolari, qualità di vita e costi in emodialisi

Author

Saglimbene, V., D Alonzo, D., Ruospo, M., Vecchio, M., Natale, P., Gargano, L., Nicolucci, A., Pellegrini, F., Craig, J. C., Triolo, G., Procaccini, D. A., Santoro, A., Di Giulio, S., La Rosa, S., Murgo, A., Di Toro Mammarella, R., Sambati, M., D Ambrosio, N., Greco, V., Giannoccaro, G., Flammini, A., Boccia, E., Giuseppe MONTALTO, Pagano, S., Amarù, S., Fici, M., Lumaga, G. B., Mancini, E., Veronesi, M., Patregnani, L., Querques, M., Schiavone, P., Chimienti, S., Palumbo, R., Di Franco, D., Della Volpe, M., Gori, E., Salomone, M., Iacono, A., Moscoloni, M., Treglia, A., Casu, D., Piras, A. M., Di Silva, A., Mandreoli, M., Lopez, A., Quarello, F., Catizone, L., Russo, G., Forcellini, S., Maccarone, M., Catucci, G., Di Paolo, B., Stingone, A., D Angelo, B., Guastoni, C., Pasquali, S., Minoretti, C., Bellasi, A., Boscutti, G., Martone, M., David, S., Schito, F., Urban, L., Di Iorio, B., Caruso, F., Mazzoni, A., Musacchio, R., Andreoli, D., Cossu, M., Li Cavoli, G., Cornacchiari, M., Granata, A., Clementi, A., Giordano, R., Barzaghi, W., Valentini, M., Hegbrant, J., Tognoni, G., and Strippoli, G. F.

24. Determinants of hospitalization in a cohort of chronic dialysis patients in central Italy

Author

Anteo Di Napoli, Pezzotti, P., Di Lallo, D., Tancioni, V., Papini, P., Guasticchi, G., Addessi, M. A., Ajam, M. F., Alfarone, C., Ancarani, E., Baldinelli, G., Balducci, A., Barbera, V., Barone, P., Battista, M. L., Beraldi, M. P., Biagini, M., Boccia, E., Bravi, M., Brunetti, G., Bucciolini, S., Buono, A., Canulla, F., Caschera, M., Casciani, C. U., Castellano, F., Cavarretta, L., Cerulli, N., Cherubini, C., Chiappini, M. G., Colonnelli, R., Costantini, S., Cuzziol, C., D Adamo, G., Bella, E., Cicco, C., Virgiliis, G., Della Grotta, F., Di Giandomenico, W., Di Giulio, S., Di Legge, R., Di Lullo, L., Di Toro, M. R., Esposto, C., Falcone, C., Felicioni, R., Feliziani, C., Ferrazzoli, F., Filippini, A., Fini, R., Firmi, G., Flammini, A., Forte, F., Franceschelli, L., Galiardi, M. S., Gentile, M., Germani, A., Giordano, F., Giustini, A., Hassan, S., Iamundo, V., Iannacci, R., Iorio, L., Jankovic, L., Luciani, G., Manca, S., Mantella, D., Mangieri, M., Mariano, V., Marin, M., Marinelli, A., Marinelli, R., Massa, P., Mauro, L. M., Mauro, M. M., Meschini, L., Mignozzi, M., Militello, A., Misiti, L., Morabito, S., Morosetti, M., Morricone, A., Moscoloni, M., Murrone, P., Nacca, R., Nazzaro, L., Onorato, L., Pace, G., Palumbo, R., Panzieri, G., Paolozzi, G., Paone, A., Parravano, M., Pasquarelli, C., Pelosi, M., Petroni, S., Poggi, A., Polito, P., and Ponzio, R.

25. Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients

Author

Giovanni Landoni, Andrea Biagi, Nicola Sverzellati, Roberto Ferrari, Fabio Anastasio, Gianluigi Patelli, Claudia Costa, Piergiorgio Turchio, Arif A. Khokhar, Alessandra Scoccia, Pietro Andrea Bonaffini, Cristiano Spreafico, Camillo Talei Franzesi, Gianni Casella, Edda Boccia, Antonio Esposito, Marco Toselli, Aldo P. Maggioni, Elisabetta Mancini, Chiara Gnasso, Luigi Vignali, Alessandro Sticchi, Elisa Scarnecchia, Antonio Colombo, Giacomo Bellani, Gianluca Pontone, Alberto Cereda, Caterina Chiara De Carlini, Marco Manfrini, Francesco Ponticelli, Stefano Maggiolini, Anna Palmisano, Claudio Rapezzi, Marco Loffi, Alberto Pacielli, Francesca Besana, Michele Senni, Lucio Baffoni, Sandro Sironi, Evgeny Fominskiy, Gianmarco Iannopollo, Francesco De Cobelli, Daniele Andreini, Giorgio Benatti, Paolo Giacomo Vaudano, Francesco Giannini, Gian Battista Danzi, Chiara Micossi, Alberto Monello, Tommaso Nannini, Massimiliano Sperandio, Carlo Tacchetti, Mario Iannaccone, Davide Vignale, Attilio Iacovoni, Riccardo Leone, Davide Ippolito, Gianluca Campo, Francesco Paolo Lombardo, Elisabetta Cesini, Valeria Nicoletti, Margherita Muri, Iljia Gardi, Giannini, F., Toselli, M., Palmisano, A., Cereda, A., Vignale, D., Leone, R., Nicoletti, V., Gnasso, C., Monello, A., Manfrini, M., Khokhar, A., Sticchi, A., Biagi, A., Turchio, P., Tacchetti, C., Landoni, G., Boccia, E., Campo, G., Scoccia, A., Ponticelli, F., Danzi, G. B., Loffi, M., Muri, M., Pontone, G., Andreini, D., Mancini, E. M., Casella, G., Iannopollo, G., Nannini, T., Ippolito, D., Bellani, G., Franzesi, C. T., Patelli, G., Besana, F., Costa, C., Vignali, L., Benatti, G., Sverzellati, N., Scarnecchia, E., Lombardo, F. P., Anastasio, F., Iannaccone, M., Vaudano, P. G., Pacielli, A., Baffoni, L., Gardi, I., Cesini, E., Sperandio, M., Micossi, C., De Carlini, C. C., Spreafico, C., Maggiolini, S., Bonaffini, P. A., Iacovoni, A., Sironi, S., Senni, M., Fominskiy, E., De Cobelli, F., Maggioni, A. P., Rapezzi, C., Ferrari, R., Colombo, A., Esposito, A., Giannini, F, Toselli, M, Palmisano, A, Cereda, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Manfrini, M, Khokhar, A, Sticchi, A, Biagi, A, Turchio, P, Tacchetti, C, Landoni, G, Boccia, E, Campo, G, Scoccia, A, Ponticelli, F, Danzi, G, Loffi, M, Muri, M, Pontone, G, Andreini, D, Mancini, E, Casella, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Franzesi, C, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Sverzellati, N, Scarnecchia, E, Lombardo, F, Anastasio, F, Iannaccone, M, Vaudano, P, Pacielli, A, Baffoni, L, Gardi, I, Cesini, E, Sperandio, M, Micossi, C, De Carlini, C, Spreafico, C, Maggiolini, S, Bonaffini, P, Iacovoni, A, Sironi, S, Senni, M, Fominskiy, E, De Cobelli, F, Maggioni, A, Rapezzi, C, Ferrari, R, Colombo, A, and Esposito, A

Subjects
Aortic valve, Male, Computed Tomography Angiography, Aorta, Thoracic, 030204 cardiovascular system & hematology, Severity of Illness Index, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Thoracic aorta, Aged, 80 and over, Middle Aged, Coronary Vessels, Pathophysiology, Calcium score, In-hospital mortality, medicine.anatomical_structure, Italy, Aortic Valve, Cardiology, Aortic valve, Calcification, Calcium score, Coronary artery, COVID-19, Thoracic aorta, In-hospital mortality, Female, Cardiology and Cardiovascular Medicine, Artery, Research Paper, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Aortic Diseases, chemistry.chemical_element, Calcium, Coronary artery, NO, Calcification, 03 medical and health sciences, Predictive Value of Tests, medicine.artery, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Vascular Calcification, Aged, Retrospective Studies, business.industry, SARS-CoV-2, COVID-19, medicine.disease, Pneumonia, chemistry, business
Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated. OBJECTIVES: The aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients. METHODS: 1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients' outcomes. RESULTS: Non-survivors compared to survivors had higher coronary artery [Agatston (467.76 ​± ​570.92 vs 206.80 ​± ​424.13 ​mm2, p ​

Published
2021

26. Quantitative assessment of lung involvement on chest CT at admission: Impact on hypoxia and outcome in COVID-19 patients

Author

Giovanni Landoni, Marzia Spessot, Diego Palumbo, Alberto Zangrillo, Anna Palmisano, Michele Cosenza, Daniele Grippaldi, Roberta Cao, Antonio Esposito, Paolo Scarpellini, Antonio Messina, Fabio Ciceri, Clelia Di Serio, Edda Boccia, Moreno Tresoldi, Salvatore La Marca, Paola M.V. Rancoita, Francesco De Cobelli, Esposito, A., Palmisano, A., Cao, R., Rancoita, P., Landoni, G., Grippaldi, D., Boccia, E., Cosenza, M., Messina, A., La Marca, S., Palumbo, D., Di Serio, C., Spessot, M., Tresoldi, M., Scarpellini, P., Ciceri, F., Zangrillo, A., and De Cobelli, F.

Subjects
Male, medicine.medical_specialty, Artificial intelligence, AUC, area under curve, 030218 nuclear medicine & medical imaging, Hypoxemia, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Cardiothoracic Imaging, Hypoxia, Lung, COVID-19, coronavirus disease 2019, Retrospective Studies, Outcome, Receiver operating characteristic, business.industry, Proportional hazards model, SARS-CoV-2, Quantitative CT, COVID-19, Retrospective cohort study, Emergency department, HU, Hounsfield Unit, Pneumonia, Hypoxia (medical), Middle Aged, medicine.disease, GGO, ground glass opacity, Hospitalization, medicine.anatomical_structure, 030220 oncology & carcinogenesis, ED, emergency department, Female, medicine.symptom, business, Tomography, X-Ray Computed, Covid-19, ROC, receiver operating characteristics curve
Abstract

Background: The aim of this study was to quantify COVID-19 pneumonia features using CT performed at time of admission to emergency department in order to predict patients' hypoxia during the hospitalization and outcome. Methods: Consecutive chest CT performed in the emergency department between March 1st and April 7th 2020 for COVID-19 pneumonia were analyzed. The three features of pneumonia (GGO, semi-consolidation and consolidation) and the percentage of well-aerated lung were quantified using a HU threshold based software. ROC curves identified the optimal cut-off values of CT parameters to predict hypoxia worsening and hospital discharge. Multiple Cox proportional hazards regression was used to analyze the capability of CT quantitative features, demographic and clinical variables to predict the time to hospital discharge. Results: Seventy-seven patients (median age 56-years-old, 51 men) with COVID-19 pneumonia at CT were enrolled. The quantitative features of COVID-19 pneumonia were not associated to age, sex and time-from-symptoms onset, whereas higher number of comorbidities was correlated to lower well-aerated parenchyma ratio (rho = −0.234, p = 0.04) and increased semi-consolidation ratio (rho = −0.303, p = 0.008). Well-aerated lung (≤57%), semi-consolidation (≥17%) and consolidation (≥9%) predicted worst hypoxemia during hospitalization, with moderate areas under curves (AUC 0.76, 0.75, 0.77, respectively). Multiple Cox regression identified younger age (p < 0.01), female sex (p < 0.001), longer time-from-symptoms onset (p = 0.049), semi-consolidation ≤17% (p < 0.01) and consolidation ≤13% (p = 0.03) as independent predictors of shorter time to hospital discharge. Conclusion: Quantification of pneumonia features on admitting chest CT predicted hypoxia worsening during hospitalization and time to hospital discharge in COVID-19 patients.

Published
2021

27. Long-term zinc and iron supplementation in children of short stature: effect of growth and on trace element content in tissues

Author

E. Boccia, S.L. Feng, R. Di Toro, Laura Perrone, G. Gialanella, R. Moro, R. Di Lascio, M. Salerno, Perrone, L, Salerno, Mariacarolina, Gialanella, G, Feng, Sl, Moro, R, Di Lascio, R, Boccia, E, Di Toro, R., Perrone, Laura, Salerno, M, DI LASCIO, R, and DI TORO, R.

Subjects
Male, medicine.medical_specialty, Erythrocytes, Iron, chemistry.chemical_element, Zinc, Biochemistry, Short stature, Inorganic Chemistry, Selenium, Internal medicine, Age Determination by Skeleton, medicine, Humans, Child, chemistry.chemical_classification, Glutathione Peroxidase, biology, Anthropometry, Chemistry, Metallurgy, Trace element, Copper, Body Height, Long-term, zinc and iron supplementation, children, short stature, effect , growth, trace element, Trace Elements, Ferritin, Endocrinology, Transferrin, Child, Preschool, Dietary Supplements, Ferritins, biology.protein, Iron supplementation, Molecular Medicine, Female, medicine.symptom, Hair
Abstract

We evaluated the effect of one year of supplementation with iron plus zinc (12 mg/day of Fe+++ and 12.5 mg/day of Zn++), zinc alone (12.5 mg/day of Zn++) and placebo on growth and on the iron, zinc, copper and selenium tissue contents in 30 well-selected children of short stature (16 M and 14 F; 4-11 years old). Before and after supplementation, we measured the concentrations of iron, transferrin, ferritin, zinc and copper in serum, of zinc in erythrocytes and leukocytes, and of zinc, copper and selenium in hair, as well as glutathione peroxidase activity in erythrocytes. Before supplementation, ferritin and serum, erythrocyte and hair zinc contents were significantly lower than in age-matched controls, while the other measured indices were in the normal range. Iron plus zinc supplementation caused an improvement in growth rate in all subjects, i.e., the median Z-score increased from -2.22 +/- 0.45 to -0.64 +/- 0.55; (p < 0.01). In the zinc-supplemented group, only the subjects whose ferritin levels were higher than 20 ng/L before supplementation showed a similar improvement of growth rate. Iron plus zinc supplementation could be a reasonable treatment in short, prepubertal children affected by marginal zinc and iron deficiency.

Published
1999

28. Coping with modesty during radiotherapy for breast cancer: a multicentric study.

Author

Boldrini L, Dinapoli L, Boccia E, Caliandro M, Colangione SP, Elia C, Pollutri V, Sartori G, Gregucci F, Marconi E, Manfrida S, Masiello V, Chieffo DPR, Marazzi F, Fiorentino A, and Gambacorta MA

Subjects
Humans, Female, Middle Aged, Aged, Adult, Surveys and Questionnaires, Adaptation, Psychological, Italy, Aged, 80 and over, Radiotherapy, Adjuvant adverse effects, Breast Neoplasms radiotherapy, Breast Neoplasms psychology
Abstract

Purpose: Breast cancer is the most frequently diagnosed tumour, representing nearly 30% of all new cases in women. Radiotherapy (RT) plays a crucial role in the management of breast cancer. The objective of this study is to assess modesty in patients undergoing RT for breast cancer and take their suggestions and ideas into consideration to enhance the quality of treatment in this regard., Methods: The study enrolled 555 breast cancer patients undergoing adjuvant RT in three Italian centres. Patients completed a self-test questionnaire assessing their comfort level concerning modesty during therapy and their relationship with strangers and healthcare professionals. The impact of religious views and potential changes in sexuality were also examined., Results: Results showed that modesty was a common concern across the overall cohort of patients, with discomfort in being undressed during RT correlating with discomfort experienced in other daily life situations. Most patients felt more at ease with same sex healthcare workers. Age was also a major factor with younger patients generally feeling more comfortable with healthcare workers of the same age group. Interestingly, the surgical technique used (mastectomy vs. quadrantectomy) did not significantly influence modesty perceptions. Patients provided valuable suggestions to improve privacy and modesty during RT., Conclusion: This study demonstrates that modesty is an important issue for women undergoing RT, which can be influenced by personal characteristics and hospital-related factors. A reflection about the need to address modesty concerns and to incorporate dedicated interventions for protecting patients' physical and emotional well-being is warranted. Initiatives to improve communication, involvement, and body image support should also be integrated into the care path of patients to better their overall therapeutic experience. This study paves the way for broader research and interventions in daily cancer care., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Published
2024
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29. Identification of Novel Bromodomain-Containing Protein 4 (BRD4) Binders through 3D Pharmacophore-Based Repositioning Screening Campaign.

Author

Colarusso E, Gazzillo E, Boccia E, Terracciano S, Bruno I, Bifulco G, Chini MG, and Lauro G

Subjects
Humans, Protein Binding, Ligands, Drug Repositioning, Binding Sites, Nuclear Proteins antagonists & inhibitors, Nuclear Proteins metabolism, Nuclear Proteins chemistry, Triazoles chemistry, Triazoles pharmacology, Azepines chemistry, Azepines pharmacology, Molecular Docking Simulation, Models, Molecular, Structure-Activity Relationship, Drug Evaluation, Preclinical, Pharmacophore, Bromodomain Containing Proteins, Transcription Factors antagonists & inhibitors, Transcription Factors metabolism, Transcription Factors chemistry, Cell Cycle Proteins antagonists & inhibitors, Cell Cycle Proteins metabolism, Cell Cycle Proteins chemistry
Abstract

A 3D structure-based pharmacophore model built for bromodomain-containing protein 4 (BRD4) is reported here, specifically developed for investigating and identifying the key structural features of the (+)-JQ1 known inhibitor within the BRD4 binding site. Using this pharmacophore model, 273 synthesized and purchased compounds previously considered for other targets but yielding poor results were screened in a drug repositioning campaign. Subsequently, only six compounds showed potential as BRD4 binders and were subjected to further biophysical and biochemical assays. Compounds 2 , 5 , and 6 showed high affinity for BRD4, with IC 50 values of 0.60 ± 0.25 µM, 3.46 ± 1.22 µM, and 4.66 ± 0.52 µM, respectively. Additionally, these compounds were tested against two other bromodomains, BRD3 and BRD9, and two of them showed high selectivity for BRD4. The reported 3D structure-based pharmacophore model proves to be a straightforward and useful tool for selecting novel BRD4 ligands.

Published
2024
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30. AI-SCoRE (artificial intelligence-SARS CoV2 risk evaluation): a fast, objective and fully automated platform to predict the outcome in COVID-19 patients.

Author

Palmisano A, Vignale D, Boccia E, Nonis A, Gnasso C, Leone R, Montagna M, Nicoletti V, Bianchi AG, Brusamolino S, Dorizza A, Moraschini M, Veettil R, Cereda A, Toselli M, Giannini F, Loffi M, Patelli G, Monello A, Iannopollo G, Ippolito D, Mancini EM, Pontone G, Vignali L, Scarnecchia E, Iannacone M, Baffoni L, Sperandio M, de Carlini CC, Sironi S, Rapezzi C, Antiga L, Jagher V, Di Serio C, Furlanello C, Tacchetti C, and Esposito A

Subjects
Adult, Artificial Intelligence, Calcium, Humans, Retrospective Studies, SARS-CoV-2, COVID-19
Abstract

Purpose: To develop and validate an effective and user-friendly AI platform based on a few unbiased clinical variables integrated with advanced CT automatic analysis for COVID-19 patients' risk stratification., Material and Methods: In total, 1575 consecutive COVID-19 adults admitted to 16 hospitals during wave 1 (February 16-April 29, 2020), submitted to chest CT within 72 h from admission, were retrospectively enrolled. In total, 107 variables were initially collected; 64 extracted from CT. The outcome was survival. A rigorous AI model selection framework was adopted for models selection and automatic CT data extraction. Model performances were compared in terms of AUC. A web-mobile interface was developed using Microsoft PowerApps environment. The platform was externally validated on 213 COVID-19 adults prospectively enrolled during wave 2 (October 14-December 31, 2020)., Results: The final cohort included 1125 patients (292 non-survivors, 26%) and 24 variables. Logistic showed the best performance on the complete set of variables (AUC = 0.839 ± 0.009) as in models including a limited set of 13 and 5 variables (AUC = 0.840 ± 0.0093 and AUC = 0.834 ± 0.007). For non-inferior performance, the 5 variables model (age, sex, saturation, well-aerated lung parenchyma and cardiothoracic vascular calcium) was selected as the final model and the extraction of CT-derived parameters was fully automatized. The fully automatic model showed AUC = 0.842 (95% CI: 0.816-0.867) on wave 1 and was used to build a 0-100 scale risk score (AI-SCoRE). The predictive performance was confirmed on wave 2 (AUC 0.808; 95% CI: 0.7402-0.8766)., Conclusions: AI-SCoRE is an effective and reliable platform for automatic risk stratification of COVID-19 patients based on a few unbiased clinical data and CT automatic analysis., (© 2022. The Author(s).)

Published
2022
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31. Plant hairy roots for the production of extracellular vesicles with antitumor bioactivity.

Author

Boccia E, Alfieri M, Belvedere R, Santoro V, Colella M, Del Gaudio P, Moros M, Dal Piaz F, Petrella A, Leone A, and Ambrosone A

Subjects
Antineoplastic Agents administration & dosage, Biotechnology, Cell Communication, Humans, Membrane Proteins metabolism, Plants, Drug Delivery Systems methods, Extracellular Vesicles metabolism
Abstract

Plant extracellular vesicles (EVs) concentrate and deliver different types of bioactive molecules in human cells and are excellent candidates for a next-generation drug delivery system. However, the lack of standard protocols for plant EV production and the natural variations of their biomolecular cargo pose serious limitation to their use as therapeutics. To overcome these issues, we set up a versatile and standardized procedure to purify plant EVs from hairy root (HR) cultures, a versatile biotechnological system, already successfully employed as source of bioactive molecules with pharmaceutical and nutraceutical relevance. Herewith, we report that HR of Salvia dominica represent an excellent platform for the production of plant EVs. In particular, EVs derived from S. dominica HRs are small round-shaped vesicles carrying typical EV-associated proteins such as cytoskeletal components, chaperon proteins and integral membrane proteins including the tetraspanin TET-7. Interestingly, the HR-derived EVs showed selective and strong pro-apoptotic activity in pancreatic and mammary cancer cells. These results reveal that plant hairy roots may be considered a new promising tool in plant biotechnology for the production of extracellular vesicles for human health., (© 2022. The Author(s).)

Published
2022
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32. Myocardial Late Contrast Enhancement CT in Troponin-Positive Acute Chest Pain Syndrome.

Author

Palmisano A, Vignale D, Tadic M, Moroni F, De Stefano D, Gatti M, Boccia E, Faletti R, Oppizzi M, Peretto G, Slavich M, Sala S, Montorfano M, Agricola E, Margonato A, De Cobelli F, Gentile F, Robella M, Cortese G, and Esposito A

Subjects
Acute Disease, Aged, Biomarkers blood, Contrast Media, Coronary Angiography, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Prospective Studies, Syndrome, Chest Pain diagnostic imaging, Chest Pain etiology, Tomography, X-Ray Computed methods, Troponin blood
Abstract

Background Acute chest pain with mild troponin rise and inconclusive diagnosis after clinical evaluation represents a diagnostic challenge. Triple-rule-out (TRO) CT may exclude coronary artery disease (CAD), as well as acute aortic syndrome and pulmonary embolism, but cannot help identify other causes of myocardial injury. Purpose To investigate the diagnostic value of a comprehensive CT protocol including both an angiographic and a late contrast enhancement (LCE) scan in participants with troponin-positive acute chest pain. Materials and Methods In this prospective study, consecutive patients with troponin-positive acute chest pain or anginal equivalent and inconclusive diagnosis after clinical evaluation (symptoms, markers, electrocardiography, and echocardiography) who underwent TRO CT between June 2018 and September 2020 were enrolled. TRO CT was performed to evaluate the presence of obstructive CAD (stenosis ≥50%), acute aortic syndrome, and pulmonary embolism. If the findings on the TRO CT scan were negative, an LCE CT scan was acquired after 10 minutes to assess the presence and pattern of scar and quantify the myocardial extracellular volume fraction. CT-based diagnoses were compared with diagnoses obtained with reference standard methods, including invasive coronary angiography, cardiac MRI, and endomyocardial biopsy. Results Eighty-four patients (median age, 69 years [interquartile range, 50-77 years]; 45 men) were enrolled. TRO CT helped identify obstructive CAD in 35 participants (42%), acute aortic syndrome in one (1.2%), and pulmonary embolism in six (7.1%). LCE CT scans were acquired in the remaining 42 participants. The following diagnoses were reached with use of LCE CT: myocarditis (22 of 42 participants [52%]), takotsubo cardiomyopathy (four of 42 [10%]), amyloidosis (three of 42 [7.1%]), myocardial infarction with nonobstructed coronary arteries (three of 42 [7.1%]), dilated cardiomyopathy (two of 42 [4.8%]), and negative or inconclusive findings (eight of 42 [19%]). The addition of LCE CT improved the diagnostic rate of TRO CT from 42 of 84 participants (50% [95% CI: 38.9, 61.1]) to 76 of 84 (90% [95% CI: 82.1, 95.8]) ( P < .001). Conclusion A CT protocol including triple-rule-out and late contrast enhancement CT scans improved diagnostic rate in participants presenting with acute chest pain syndrome. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Nagpal and Bluemke in this issue.

Published
2022
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33. Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients.

Author

Giannini F, Toselli M, Palmisano A, Cereda A, Vignale D, Leone R, Nicoletti V, Gnasso C, Monello A, Manfrini M, Khokhar A, Sticchi A, Biagi A, Turchio P, Tacchetti C, Landoni G, Boccia E, Campo G, Scoccia A, Ponticelli F, Danzi GB, Loffi M, Muri M, Pontone G, Andreini D, Mancini EM, Casella G, Iannopollo G, Nannini T, Ippolito D, Bellani G, Franzesi CT, Patelli G, Besana F, Costa C, Vignali L, Benatti G, Sverzellati N, Scarnecchia E, Lombardo FP, Anastasio F, Iannaccone M, Vaudano PG, Pacielli A, Baffoni L, Gardi I, Cesini E, Sperandio M, Micossi C, De Carlini CC, Spreafico C, Maggiolini S, Bonaffini PA, Iacovoni A, Sironi S, Senni M, Fominskiy E, De Cobelli F, Maggioni AP, Rapezzi C, Ferrari R, Colombo A, and Esposito A

Subjects
Aged, Aged, 80 and over, Aorta, Thoracic diagnostic imaging, Aortic Diseases diagnostic imaging, Aortic Diseases mortality, Aortic Diseases physiopathology, Aortic Valve diagnostic imaging, COVID-19 diagnostic imaging, Coronary Vessels diagnostic imaging, Female, Humans, Italy epidemiology, Male, Middle Aged, Pneumonia, Viral diagnostic imaging, Pneumonia, Viral mortality, Pneumonia, Viral physiopathology, Pneumonia, Viral virology, Predictive Value of Tests, Retrospective Studies, SARS-CoV-2, Severity of Illness Index, Vascular Calcification diagnostic imaging, COVID-19 mortality, COVID-19 physiopathology, Computed Tomography Angiography, Vascular Calcification mortality, Vascular Calcification physiopathology
Abstract

Background: Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated., Objectives: The aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients., Methods: 1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients' outcomes., Results: Non-survivors compared to survivors had higher coronary artery [Agatston (467.76 ​± ​570.92 vs 206.80 ​± ​424.13 ​mm 2 , p ​< ​0.001); Volume (487.79 ​± ​565.34 vs 207.77 ​± ​406.81, p ​< ​0.001)], aortic valve [Volume (322.45 ​± ​390.90 vs 98.27 ​± ​250.74 mm 2 , p ​< ​0.001; Agatston 337.38 ​± ​414.97 vs 111.70 ​± ​282.15, p ​< ​0.001)] and thoracic aorta [Volume (3786.71 ​± ​4225.57 vs 1487.63 ​± ​2973.19 mm 2 , p ​< ​0.001); Agatston (4688.82 ​± ​5363.72 vs 1834.90 ​± ​3761.25, p ​< ​0.001)] calcium values. Coronary artery calcium (HR 1.308; 95% CI, 1.046-1.637, p ​= ​0.019) and total thoracic calcium (HR 1.975; 95% CI, 1.200-3.251, p ​= ​0.007) resulted to be independent predictors of in-hospital mortality., Conclusion: Coronary, aortic valve and thoracic aortic calcium assessment on admission non-gated CT permits to stratify the COVID-19 patients in-hospital mortality risk., (Copyright © 2021 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)

Published
2021
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34. Quantitative assessment of lung involvement on chest CT at admission: Impact on hypoxia and outcome in COVID-19 patients.

Author

Esposito A, Palmisano A, Cao R, Rancoita P, Landoni G, Grippaldi D, Boccia E, Cosenza M, Messina A, La Marca S, Palumbo D, Di Serio C, Spessot M, Tresoldi M, Scarpellini P, Ciceri F, Zangrillo A, and De Cobelli F

Subjects
Female, Hospitalization, Humans, Hypoxia diagnostic imaging, Lung diagnostic imaging, Male, Middle Aged, Retrospective Studies, SARS-CoV-2, Tomography, X-Ray Computed, COVID-19
Abstract

Background: The aim of this study was to quantify COVID-19 pneumonia features using CT performed at time of admission to emergency department in order to predict patients' hypoxia during the hospitalization and outcome., Methods: Consecutive chest CT performed in the emergency department between March 1st and April 7th 2020 for COVID-19 pneumonia were analyzed. The three features of pneumonia (GGO, semi-consolidation and consolidation) and the percentage of well-aerated lung were quantified using a HU threshold based software. ROC curves identified the optimal cut-off values of CT parameters to predict hypoxia worsening and hospital discharge. Multiple Cox proportional hazards regression was used to analyze the capability of CT quantitative features, demographic and clinical variables to predict the time to hospital discharge., Results: Seventy-seven patients (median age 56-years-old, 51 men) with COVID-19 pneumonia at CT were enrolled. The quantitative features of COVID-19 pneumonia were not associated to age, sex and time-from-symptoms onset, whereas higher number of comorbidities was correlated to lower well-aerated parenchyma ratio (rho = -0.234, p = 0.04) and increased semi-consolidation ratio (rho = -0.303, p = 0.008). Well-aerated lung (≤57%), semi-consolidation (≥17%) and consolidation (≥9%) predicted worst hypoxemia during hospitalization, with moderate areas under curves (AUC 0.76, 0.75, 0.77, respectively). Multiple Cox regression identified younger age (p < 0.01), female sex (p < 0.001), longer time-from-symptoms onset (p = 0.049), semi-consolidation ≤17% (p < 0.01) and consolidation ≤13% (p = 0.03) as independent predictors of shorter time to hospital discharge., Conclusion: Quantification of pneumonia features on admitting chest CT predicted hypoxia worsening during hospitalization and time to hospital discharge in COVID-19 patients., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Published
2021
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35. Early T1 Myocardial MRI Mapping: Value in Detecting Myocardial Hyperemia in Acute Myocarditis.

Author

Palmisano A, Benedetti G, Faletti R, Rancoita PMV, Gatti M, Peretto G, Sala S, Boccia E, Francone M, Galea N, Basso C, Del Maschio A, De Cobelli F, and Esposito A

Subjects
Acute Disease, Adult, Biopsy, Case-Control Studies, Computed Tomography Angiography, Contrast Media administration & dosage, Coronary Angiography, Echocardiography, Electrocardiography, Female, Humans, Male, Middle Aged, Organometallic Compounds administration & dosage, Proof of Concept Study, Sensitivity and Specificity, Hyperemia diagnostic imaging, Magnetic Resonance Imaging methods, Myocarditis diagnostic imaging
Abstract

Background Hyperemia is a key component of acute myocarditis (AM). Early gadolinium uptake because of myocardial hyperemia may be quantified by using T1 mapping. Purpose To evaluate the value of early enhanced T1 shortening for the diagnosis of acute myocarditis. Materials and Methods Study participants suspected of having AM and healthy control (HC) participants were prospectively enrolled from September 2016 to May 2019. Participants underwent 1.5-T cardiac MRI including Lake Louise criteria, T2 mapping, native T1, and extracellular volume, with the addition of early enhanced T1 mapping (2 minutes after intravenous administration of 0.15 mmol/kg gadobutrol). Color-coded maps of the percentage of T1 shortening from precontrast to early postcontrast were generated. Optimal early T1 shortening cut-off value and its diagnostic performance in the identification of acute myocarditis were calculated. Results Forty-five study participants with AM (median age, 40 years; interquartile range [IQR], 20-46 years; 22 women) diagnosed according to multidisciplinary clinical evaluation, electrocardiography, laboratory test, echocardiography, cardiac MRI, and coronary CT and/or invasive angiography. Findings were confirmed by endomyocardial biopsy in 64% (29 of 45) of participants. MRI parameters were compared with 19 HC participants (median age, 39 years; IQR, 28-46 years; seven women). Median early T1 shortening was 75% (IQR, 72%-78%) in participants with AM versus 65% (IQR, 61%-66%) in HC participants ( P < .001). Early T1 shortening showed high diagnostic performance (area under the receiver operating characteristic curve [AUC], 0.97; 95% confidence interval [CI]: 0.94, 1.00) and excellent interobserver reproducibility (intraclass correlation coefficient: 0.98; 95% CI: 0.96, 1.00). Early T1 shortening of 70% or greater identified acute myocarditis with 93% sensitivity, 100% specificity, and 95% diagnostic accuracy. Early T1 shortening had better diagnostic performance than late percentage T1 shortening (AUC, 0.97 vs 0.90, respectively; P = .03) and extracellular volume (AUC, 0.97 vs 0.88, respectively; P = .046), and similar to native T1 (AUC, 0.97 vs 0.93, respectively; P = .63) and T2 mapping (AUC, 0.97 vs 0.97, respectively; P > .99). Conclusion In this proof-of-concept study, percentage of T1 shortening at early enhanced T1 mapping showed high accuracy for the diagnosis of acute myocarditis. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by De Cecco and Monti in this issue.

Published
2020
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36. Modelling far field pacing for terminating spiral waves pinned to ischaemic heterogeneities in cardiac tissue.

Author

Boccia E, Luther S, and Parlitz U

Subjects
Action Potentials, Animals, Anisotropy, Arrhythmias, Cardiac etiology, Computer Simulation, Humans, Myocardial Ischemia complications, Myocardial Ischemia prevention & control, Therapy, Computer-Assisted methods, Arrhythmias, Cardiac physiopathology, Arrhythmias, Cardiac prevention & control, Cardiac Pacing, Artificial methods, Heart Conduction System physiopathology, Models, Cardiovascular, Myocardial Ischemia physiopathology
Abstract

In cardiac tissue, electrical spiral waves pinned to a heterogeneity can be unpinned (and eventually terminated) using electric far field pulses and recruiting the heterogeneity as a virtual electrode. While for isotropic media the process of unpinning is much better understood, the case of an anisotropic substrate with different conductivities in different directions still needs intensive investigation. To study the impact of anisotropy on the unpinning process, we present numerical simulations based on the bidomain formulation of the phase I of the Luo and Rudy action potential model modified due to the occurrence of acute myocardial ischaemia. Simulating a rotating spiral wave pinned to an ischaemic heterogeneity, we compare the success of sequences of far field pulses in the isotropic and the anisotropic case for spirals still in transient or in steady rotation states. Our results clearly indicate that the range of pacing parameters resulting in successful termination of pinned spiral waves is larger in anisotropic tissue than in an isotropic medium.This article is part of the themed issue 'Mathematical methods in medicine: neuroscience, cardiology and pathology'., (© 2017 The Authors.)

Published
2017
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37. [Effects of dose of erythropoiesis stimulating agents on cardiovascular outcomes, quality of life and costs of haemodialysis. the clinical evaluation of the DOSe of erythropoietins (C.E. DOSE) Trial].

Author

Saglimbene V, D'Alonzo D, Ruospo M, Vecchio M, Natale P, Gargano L, Nicolucci A, Pellegrini F, Craig JC, Triolo G, Procaccini DA, Santoro A, Di Giulio S, La Rosa S, Murgo A, Di Toro Mammarella R, Sambati M, D'Ambrosio N, Greco V, Giannoccaro G, Flammini A, Boccia E, Montalto G, Pagano S, Amarù S, Fici M, Lumaga GB, Mancini E, Veronesi M, Patregnani L, Querques M, Schiavone P, Chimienti S, Palumbo R, Di Franco D, Della Volpe M, Gori E, Salomone M, Iacono A, Moscoloni M, Treglia A, Casu D, Piras AM, Di Silva A, Mandreoli M, Lopez A, Quarello F, Catizone L, Russo G, Forcellini S, Maccarone M, Catucci G, Di Paolo B, Stingone A, D'Angelo B, Guastoni C, Pasquali S, Minoretti C, Bellasi A, Boscutti G, Martone M, David S, Schito F, Urban L, Di Iorio B, Caruso F, Mazzoni A, Musacchio R, Andreoli D, Cossu M, Li Cavoli G, Cornacchiari M, Granata A, Clementi A, Giordano R, Guastoni C, Barzaghi W, Valentini M, Hegbrant J, Tognoni G, and Strippoli GF

Subjects
Anemia economics, Anemia etiology, Diabetic Nephropathies complications, Disease Management, Dose-Response Relationship, Drug, Double-Blind Method, Female, Hematinics adverse effects, Hematinics economics, Hematinics pharmacology, Hematinics therapeutic use, Hemoglobins analysis, Humans, Kidney Failure, Chronic blood, Kidney Failure, Chronic complications, Kidney Failure, Chronic therapy, Meta-Analysis as Topic, Middle Aged, Observational Studies as Topic, Outcome Assessment, Health Care, Quality of Life, Research Design, Risk, Anemia drug therapy, Hematinics administration & dosage, Renal Dialysis adverse effects, Renal Dialysis economics
Abstract

Background: Anaemia is a risk factor for death, adverse cardiovascular outcomes and poor quality of life in patients with chronic kidney disease (CKD). Erythropoietin Stimulating Agents (ESA) are the most used treatment option. In observational studies, higher haemoglobin (Hb) levels (around 11-13 g/dL) are associated with improved survival and quality of life compared to Hb levels around 9-10 g/dL. Randomized studies found that targeting higher Hb levels with ESA causes an increased risk of death, mainly due to adverse cardiovascular outcomes. It is possible that this is mediated by ESA dose rather than haemoglobin concentration, although this hypothesis has never been formally tested., Methods: We present the protocol of the Clinical Evaluation of the Dose of Erythropoietins (C.E. DOSE) trial, which will assess the benefits and harms of a high versus a low ESA dose therapeutic strategy for the management of anaemia of end stage kidney disease (ESKD). This is a randomized, prospective open label blinded end-point (PROBE) design trial due to enroll 900 haemodialysis patients. Patients will be randomized 1:1 to 4000 UI/week i. v. versus 18000 UI/week i. v. of epoetin alfa, beta or any other epoetin in equivalent doses. The primary outcome of the trial is a composite of cardiovascular events. In addition, quality of life and costs of these two strategies will be assessed. The study has been approved and funded by the Italian Agency of Drugs (Agenzia Italiana del Farmaco (AIFA)) within the 2006 funding plan for independent research on drugs (registered at www.clinicaltrials.gov (NCT00827021)).

Published
2013

38. [Patient satisfaction in hemodialysis: a pilot cross-sectional analysis and a review].

Author

Pansini F, Gargano L, Sambati M, Dambrosio N, D'Altri C, Giannoccaro G, Boccia E, Cecilia A, Di Toro Mammarella R, Flammini A, La Rosa S, Fici M, Sabella V, Falco M, Montalto G, Rindone F, Murgo AM, Greco V, Giannetto M, D'Agostino F, Pellegrini F, Invernizzi C, Strippoli GF, and Manno C

Subjects
Aged, Cross-Sectional Studies, Female, Humans, Male, Pilot Projects, Surveys and Questionnaires, Patient Satisfaction, Renal Dialysis
Abstract

Background: Assessment of patient satisfaction is not performed routinely in many healthcare institutions. In this review, we discuss methodological aspects of assessment of patient satisfaction in hemodialysis. We also present a pilot study conducted in the Gambro Healthcare Italy dialysis clinics network., Methods: Patient satisfaction was assessed in a network of hemodialysis units by using an internally validated Italian translation of the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) questionnaire. A cross-sectional analytic study design was used and data analysed with univariate and multivariate hierarchical logistic regression to explore correlates of the risk of being unsatisfied with dialysis treatment. Covariates which were considered include a series of over 20 clinical, demographic, organizational and structural aspects. In addition, unexplained inter-centre residual variability due to 'case-mix' was explored and plotted., Results: Seventeen dialysis units participated in this cross-sectional analysis and 758/1001 (75.7%) provided answers to the questionnaires. There was a statistically significant association on multivariate hierarchical analysis between the risk of being unsatisfied with dialysis treatment and interdialysis body weight gain (unit of increase: 1 kg, p=0.004). On the contrary, the risk of unsatisfaction with dialysis treatment was significantly lower in patients with higher dry weight (unit of increase: 1 kg, p=0.002). Our multivariate hierarchical analysis identified some residual variability between dialysis units (n=6 outliers) which may not be explained by any of over 20 potential confounding covariates which were explored., Conclusions: Assessment of ''customer satisfaction'' is standard practice in private for profit product companies in general but needs to be increasingly recognized as a standard in both public and private providers of healthcare services. Social research methods, which are used for this type of analysis, need to be fine tuned and actively implemented in order to better understand how we may influence the quality of service we provide to our patients and the level at which they rate it.

Published
2007

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