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141 results on '"Caturegli, Giorgio"'

4. Transcranial Doppler microemboli and acute brain injury in extracorporeal membrane oxygenation: A prospective observational study

Author

Zhang, Lucy Q., Mayasi, Yunis, Gusdon, Aaron, Ergin, Bahattin, Keller, Steven, Acton, Matthew, Rando, Hannah, Alejo, Diane, Calligy, Kate, Anderson, Scott, Shou, Benjamin, Mendez-Tellez, Pedro A., Chang, Henry, Sussman, Marc, Wilcox, Christopher, Brown, Patricia, Peeler, Anna, Caturegli, Giorgio, Kapoor, Shrey, Ponomarev, Vladimir, Kim, Bo Soo, Whitman, Glenn J.R., Ziai, Wendy, and Cho, Sung-Min

Published
2022
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9. Changing characteristics among in-hospital HIV deaths: An 11-year retrospective review of a regional hospital in South Africa

Author

Lombardo, Alexandra R, primary, Materi, Joshua, additional, Caturegli, Giorgio, additional, Milovanovic, Minja, additional, Martinson, Neil, additional, Calver, Alistair, additional, Nonyane, Bareng A. S., additional, Golub, Jonathan, additional, Hoffmann, Christopher J, additional, and Variava DTM&H, Ebrahim, additional

Published
2023
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10. Risk Factors of Ischemic and Hemorrhagic Strokes During Venovenous Extracorporeal Membrane Oxygenation: Analysis of Data From the Extracorporeal Life Support Organization Registry

Author

Cho, Sung-Min, Canner, Joe, Caturegli, Giorgio, Choi, Chun Woo, Etchill, Eric, Giuliano, Katherine, Chiarini, Giovanni, Calligy, Kate, Rycus, Peter, Lorusso, Roberto, Kim, Bo Soo, Sussman, Marc, Suarez, Jose I., Geocadin, Romergryko, Bush, Errol L., Ziai, Wendy, and Whitman, Glenn

Published
2021
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11. Modifiable Risk Factors and Mortality From Ischemic and Hemorrhagic Strokes in Patients Receiving Venoarterial Extracorporeal Membrane Oxygenation: Results From the Extracorporeal Life Support Organization Registry

Author

Cho, Sung-Min, Canner, Joe, Chiarini, Giovanni, Calligy, Kate, Caturegli, Giorgio, Rycus, Peter, Barbaro, Ryan P., Tonna, Joseph, Lorusso, Roberto, Kilic, Ahmet, Choi, Chun Woo, Ziai, Wendy, Geocadin, Romergryko, and Whitman, Glenn

Published
2020
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16. Supplemental Material - Challenges in determining death by neurologic criteria in extracorporeal membrane oxygenation – A single center experience

Author

Zhao, David X, Caturegli, Giorgio, Wilcox, Christopher, Stephens, R Scott, Kim, Bo Soo, Keller, Steven, Geocadin, Romergryko G, Suarez, Jose I, Whitman, Glenn JR, and Cho, Sung-Min

Subjects
Cardiology, Surgery
Abstract

Supplemental Material for Challenges in determining death by neurologic criteria in extracorporeal membrane oxygenation – A single center experience by David X Zhao, Giorgio Caturegli, Christopher Wilcox, R Scott Stephens, Bo Soo Kim, Steven Keller, Romergryko G Geocadin, Jose I Suarez, Glenn JR Whitman, and Sung-Min Cho in Perfusion.

Published
2023
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18. Transcranial Doppler microemboli and acute brain injury in extracorporeal membrane oxygenation: A prospective observational study

Author

Caturegli, Giorgio, primary, Kapoor, Shrey, additional, Ponomarev, Vladimir, additional, Kim, Bo Soo, additional, Whitman, Glenn J.R., additional, Ziai, Wendy, additional, Cho, Sung-Min, additional, Zhang, Lucy Q., additional, Mayasi, Yunis, additional, Gusdon, Aaron, additional, Ergin, Bahattin, additional, Keller, Steven, additional, Acton, Matthew, additional, Rando, Hannah, additional, Alejo, Diane, additional, Calligy, Kate, additional, Anderson, Scott, additional, Shou, Benjamin, additional, Mendez-Tellez, Pedro A., additional, Chang, Henry, additional, Sussman, Marc, additional, Wilcox, Christopher, additional, Brown, Patricia, additional, and Peeler, Anna, additional

Published
2022
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22. Early Low Pulse Pressure in VA-ECMO Is Associated with Acute Brain Injury.

Author

Shou, Benjamin L., Wilcox, Christopher, Florissi, Isabella, Kalra, Andrew, Caturegli, Giorgio, Zhang, Lucy Q., Bush, Errol, Kim, Bo, Keller, Steven P., Whitman, Glenn J. R., Cho, Sung-Min, Calligy, Kate, Brown, Patricia, Alejo, Diane, Anderson, Scott, Acton, Matthew, Rando, Hannah, Chang, Henry, and Kerr, Hannah

Subjects
BRAIN injuries, PULSATILE flow, CEREBRAL edema, EXTRACORPOREAL membrane oxygenation, ARTIFICIAL blood circulation
Abstract

Background: Pulse pressure is a dynamic marker of cardiovascular function and is often impaired in patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO). Pulsatile blood flow also serves as a regulator of vascular endothelium, and continuous-flow mechanical circulatory support can lead to endothelial dysfunction. We explored the impact of early low pulse pressure on occurrence of acute brain injury (ABI) in VA-ECMO. Methods: We conducted a retrospective analysis of adults with VA-ECMO at a tertiary care center between July 2016 and January 2021. Patients underwent standardized multimodal neuromonitoring throughout ECMO support. ABI included intracranial hemorrhage, ischemic stroke, hypoxic ischemic brain injury, cerebral edema, seizure, and brain death. Blood pressures were recorded every 15 min. Low pulse pressure was defined as a median pulse pressure < 20 mm Hg in the first 12 h of ECMO. Multivariable logistic regression was performed to investigate the association between pulse pressure and ABI. Results: We analyzed 5138 blood pressure measurements from 123 (median age 63; 63% male) VA-ECMO patients (54% peripheral; 46% central cannulation), of whom 41 (33%) experienced ABI. Individual ABIs were as follows: ischemic stroke (n = 18, 15%), hypoxic ischemic brain injury (n = 14, 11%), seizure (n = 8, 7%), intracranial hemorrhage (n = 7, 6%), cerebral edema (n = 7, 6%), and brain death (n = 2, 2%). Fifty-eight (47%) patients had low pulse pressure. In a multivariable model adjusting for preselected covariates, including cannulation strategy (central vs. peripheral), lactate on ECMO day 1, and left ventricle venting strategy, low pulse pressure was independently associated with ABI (adjusted odds ratio 2.57, 95% confidence interval 1.05–6.24). In a model with the same covariates, every 10-mm Hg decrease in pulse pressure was associated with 31% increased odds of ABI (95% confidence interval 1.01–1.68). In a sensitivity analysis model adjusting for systolic pressure, pulse pressure remained significantly associated with ABI. Conclusions: Early low pulse pressure (< 20 mm Hg) was associated with ABI in VA-ECMO patients. Low pulse pressure may serve as a marker of ABI risk, which necessitates close neuromonitoring for early detection. [ABSTRACT FROM AUTHOR]

Published
2023
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32. Clinical Validity of Serum Antibodies to SARS-CoV-2

Author

Caturegli, Giorgio, Materi, Joshua, Howard, Brittney M., and Caturegli, Patrizio

Subjects
Adult, Male, SARS-CoV-2, viruses, fungi, Pneumonia, Viral, COVID-19, Enzyme-Linked Immunosorbent Assay, Middle Aged, Antibodies, Viral, respiratory tract diseases, body regions, Betacoronavirus, Case-Control Studies, Humans, Female, skin and connective tissue diseases, Coronavirus Infections, Pandemics, Original Research, Retrospective Studies
Abstract

Serum antibodies develop upon infection with SARS-CoV-2 and are currently used to stratify donors of convalescent plasma and assess the prevalence of COVID-19. This study examines the use of serum antibodies to SARS-CoV-2 spike protein in the diagnosis of COVID-19., Background: The clinical utility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies remains undefined. Objective: To determine the clinical validity and utility of SARS-CoV-2 antibodies. Design: Case–control study. Setting: First month of testing for coronavirus disease 2019 (COVID-19) by using a nucleic acid amplification test (NAAT) on nasopharyngeal swabs at the Johns Hopkins Hospital, Baltimore, Maryland (11 066 persons). Participants: Of the 11 066 tested persons, 115 (1%) were hospitalized adults investigated for COVID-19. Clinical record review was performed to classify them into a COVID-19 case group (n = 60) or a non–COVID-19 control group (n = 55). The laboratory control groups comprised 513 persons not tested by NAAT: 160 healthy laboratory employees, 101 persons positive for IgG antibodies against Epstein-Barr virus capsid antigen, 215 positive for thyroperoxidase antibody, and 37 positive for rheumatoid factor. Measurements: Serum IgG and IgA antibodies against SARS-CoV-2 spike protein were detected by using enzyme-linked immunosorbent assay. Results: Sensitivity and specificity of the SARS-CoV-2 IgG assay were 0.976 (95% CI, 0.928 to 0.995) and 0.988 (CI, 0.974 to 0.995), respectively, when performed 14 days or later after symptom onset, but sensitivity decreased at earlier time points. Immunoglobulin G developed rapidly and was sustained at high levels throughout follow-up (up to 58 days). Antibodies to SARS-CoV-2 predicted the odds of developing acute respiratory distress syndrome, which increased by 62% (CI, 48% to 81%; P < 0.001) for every 2-fold increase in IgG. Of 11 066 NAAT-tested patients, 457 were repeatedly NAAT-negative, and serum samples were obtained for 18 such patients: 6 COVID-19 case patients and 12 non–COVID-19 control patients. Antibodies were present in 5 of 6 case patients and none of the 12 control patients (P = 0.001). Limitations: The study was retrospective and performed at a single-center; the sample was small; follow-up was limited; and selection bias may have occurred. Conclusion: Antibodies to SARS-CoV-2 demonstrate infection when measured at least 14 days after symptom onset, associate with clinical severity, and provide valuable diagnostic support in patients who test negative by NAAT but remain clinically suspicious for COVID-19. Primary Funding Source: Clinical Immunology Laboratory, Department of Pathology, Johns Hopkins Hospital.

Published
2020

34. Risk Factors of Ischemic and Hemorrhagic Strokes During Venovenous Extracorporeal Membrane Oxygenation: Analysis of Data From the Extracorporeal Life Support Organization Registry

Author

Cho, Sung-Min, primary, Canner, Joe, additional, Caturegli, Giorgio, additional, Choi, Chun Woo, additional, Etchill, Eric, additional, Giuliano, Katherine, additional, Chiarini, Giovanni, additional, Calligy, Kate, additional, Rycus, Peter, additional, Lorusso, Roberto, additional, Kim, Bo Soo, additional, Sussman, Marc, additional, Suarez, Jose I., additional, Geocadin, Romergryko, additional, Bush, Errol L., additional, Ziai, Wendy, additional, and Whitman, Glenn, additional

Published
2020
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41. Microwave Thermal Ablation in an Unusual Case of Malignant and Locally Advanced Rare Tumor of Pancreas in ASA IV Old Male Patient and Literature Review

Author

D’Amico, Francesco, Finotti, Michele, Di Renzo, Chiara, Pasquale, Alessio, Bertacco, Alessandra, Caturegli, Giorgio, Gondolesi, Gabriel E., and Cillo, Umberto

Subjects
Article Subject
Abstract

Pancreatic intraductal papillary-mucinous neoplasm is a rare primary neoplasm of unknown pathogenesis. This kind of tumor represents 0.2–2.7% of all pancreatic cancers and they may proceed to malignant lesions. In this study, we describe a case of pancreatic intraductal papillary-mucinous tumor (4.3 cm) with normal tumoral markers and nuclear atypia. We perform also a systematic review of the literature on MEDLINE and find only one relevant study that used microwave ablation for the palliative treatment of pancreatic tumor. We describe the case of a 70-year-old Caucasian male who was diagnosed with a pancreatic tumor with biliary tree dilatation. The patient underwent computed tomography (CT), percutaneous biopsy, and an endoscopic positioning of prosthesis in the biliary tree. Due to the worsening of jaundice and cholestasis, and considering the severe systemic disease status, palliative surgery with microwave thermoablation in the head of pancreas was performed. No complications were observed. The hospitalization lasted for 11 days after surgery, with normal liver and pancreatic lab tests at discharge. The patient followed a line of chemotherapy for 6 months with a complete response for 8 months. One month after the treatment, a staging CT scan was performed showing the size of the cephalopancreatic lesion had decreased from 43 to 35 mm with signs of complete ablation. The patient had a total response at the imaging of 10 months. One year later, a CT scan follow-up showed progression of the pancreatic disease. The disease remained stable for 18 months. The patient died due to cardiovascular complications with an overall survival of 30 months. Microwave ablation in our case report has been demonstrated to be feasible and safe without complications. It can be used as a phase of multimodality treatment in patients with severe systemic disease status and advanced intraductal papillary-mucinous neoplasm.

Published
2018
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50. Challenges in determining death by neurologic criteria in extracorporeal membrane oxygenation – A single center experience.

Author

Zhao, David X, Caturegli, Giorgio, Wilcox, Christopher, Stephens, R Scott, Kim, Bo Soo, Keller, Steven, Geocadin, Romergryko G, Suarez, Jose I, Whitman, Glenn JR, and Cho, Sung-Min

Abstract

Apnea test (AT) in patients on extracorporeal membrane oxygenation (ECMO) support is challenging, leading to variation in determining death by neurologic criteria (DNC). We aim to describe the diagnostic criteria and barriers for DNC in adults on ECMO in a tertiary care center.A retrospective review of a prospective observational standardized neuromonitoring study was conducted in adult VA- and VV-ECMO patients at a tertiary center from June 2016 to March 2022. Brain death was defined according to the 2010 American Academy of Neurology guidelines and following the 2020 World Brain Death Project recommendations for performing AT in ECMO patients.Eight (2.7%) ECMO patients (median age = 44 years, 75% male, 50% VA-ECMO) met criteria for DNC, six (75%) of whom were determined with AT. In the other two patients who did not undergo AT due to safety concerns, ancillary tests (transcranial doppler and electroencephalography) were consistent with DNC. An additional seven (2.3%) patients (median age = 55 years, 71% male, 86% VA-ECMO) were noted to have absent brainstem reflexes but failed to complete determination of DNC as they underwent withdrawal of life-sustaining treatment (WLST) before a full evaluation was completed. In these patients, AT was never performed, and ancillary tests were inconsistent with either neurological exam findings and/or neuroimaging supporting DNC, or with each other.AT was used safely and successfully in 6 of the 8 ECMO patients diagnosed with DNC and was always consistent with the neurological exam and imaging findings, as opposed to ancillary tests alone. [ABSTRACT FROM AUTHOR]

Published
2023
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