73 results on '"Lorini S"'
Search Results
2. Multimessenger Characterization of Markarian 501 during Historically Low X-Ray and $γ$-Ray Activity
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Abe, Abe, H., Acciari, S., Agudo, V. A., Aniello, I., Ansoldi, T., Antonelli, S., Arbet-Engels, L. A., Arcaro, A., Artero, C., Asano, M., Baack, K., Babić, D., Baquero, A., de Almeida, A., Barres, Barrio, U., Batković, J. A., Baxter, I., Becerra González, J., Bednarek, J., Bernardini, W., Bernardos, E., Berti, M., Besenrieder, A., Bhattacharyya, J., Bigongiari, W., Biland, C., Blanch, A., Bonnoli, O., Bošnjak, G., Burelli, Ž., Busetto, I., Carosi, G., Carretero-Castrillo, R., Castro-Tirado, M., Ceribella, A. J., Chai, G., Chilingarian, Y., Cikota, A., Colombo, S., Contreras, E., Cortina, J. L., Covino, J., D’Amico, S., D’Elia, G., Da Vela, V., Dazzi, P., De Angelis, F., De Lotto, A., Del Popolo, B., Delfino, A., Delgado, M., Delgado Mendez, J., Depaoli, C., Di Pierro, D., Di Venere, F., Souto Espiñeira, L., Dominis Prester, E., Donini, D., Dorner, A., Doro, D., Elsaesser, M., Emery, D., Escudero, G., Fallah Ramazani, J., Fariña, V., Fattorini, L., Foffano, A., Font, L., Fruck, L., Fukami, C., Fukazawa, S., García López, Y., Garczarczyk, R. J., Gasparyan, M., Gaug, S., Giesbrecht Paiva, M., Giglietto, J. G., Giordano, N., Gliwny, F., Godinović, P., Grau, N., Green, R., Green, D., Hadasch, J. G., Hahn, D., Hassan, A., Heckmann, T., Herrera, L., Hrupec, J., Hütten, D., Imazawa, M., Inada, R., Iotov, T., Ishio, R., Jiménez Martínez, K., Jormanainen, I., Kerszberg, J., Kobayashi, D., Kubo, Y., Kushida, H., Lamastra, J., Lelas, A., Leone, D., Lindfors, F., Linhoff, E., Lombardi, L., Longo, S., López-Coto, F., López-Moya, R., López-Oramas, M., Loporchio, A., Lorini, S., Lyard, A., Machado de Oliveira Fraga, E., Majumdar, B., Makariev, P., Maneva, M., Mang, G., Manganaro, N., Mangano, M., Mannheim, S., Mariotti, K., Martínez, M., Mas-Aguilar, M., Mazin, A., Menchiari, D., Mender, S., Mićanović, S., Miceli, S., Miener, D., Miranda, T., Mirzoyan, J. M., Molina, R., Mondal, E., Moralejo, H. A., Morcuende, A., Moreno, D., Nakamori, V., Nanci, T., Nava, C., Neustroev, L., Nievas Rosillo, V., Nigro, M., Nilsson, C., Nishijima, K., Njoh Ekoume, K., Noda, T., Nozaki, K., Ohtani, S., Oka, Y., Okumura, T., Otero-Santos, A., Paiano, J., Palatiello, S., Paneque, M., Paoletti, D., Paredes, R., Pavletić, J. M., Persic, L., Pihet, M., Pirola, M., Podobnik, G., Moroni, F., Prada, Prandini, P. G., Principe, E., Priyadarshi, G., Rhode, C., Ribó, W., Rico, M., Righi, J., Rugliancich, C., Sahakyan, A., Saito, N., Sakurai, T., Satalecka, S., Saturni, K., Schleicher, F. G., Schmidt, B., Schmuckermaier, K., Schubert, F., Schweizer, J. L., Sitarek, T., Sliusar, J., Sobczynska, V., Spolon, D., Stamerra, A., Strišković, A., Strom, J., Strzys, D., Suda, M., Surić, Y., Tajima, T., Takahashi, H., Takeishi, M., Tavecchio, R., Temnikov, F., Terauchi, P., Terzić, K., Teshima, T., Tosti, M., Truzzi, L., Tutone, S., Ubach, A., van Scherpenberg, S., Acosta, J., Vazquez, Ventura, M., Verguilov, S., Viale, V., Vigorito, I., Vitale, C. F., Vovk, V., Walter, I., Will, R., Wunderlich, M., Yamamoto, C., Zarić, T., Cerruti, D., Acosta-Pulido, M., Apolonio, J. A., Bachev, G., Baloković, R., Benítez, M., Björklund, E., Bozhilov, I., Brown, V., Bugg, L. F., Carbonell, A., Carnerero, W., Carosati, M. I., Casadio, D., Chamani, C., Chen, W., Chigladze, W. P., Damljanovic, R. A., Epps, G., Erkenov, K., Feige, A., Finke, M., Fuentes, J., Gazeas, A., Giroletti, K., Grishina, M., Gupta, T. S., Heidemann, A. C., Gurwell, M. A., Hiriart, E., Hou, D., Hovatta, W. J., Ibryamov, T., Joner, S., Jorstad, M. D., Kania, S. G., Kiehlmann, J., Kimeridze, S., Kopatskaya, G. N., Kopp, E. N., Korte, M., Kotas, M., Koyama, B., Kramer, S., Kunkel, J. A., Kurtanidze, L., Kurtanidze, S. O., Lähteenmäki, O. M., López, A., Larionov, J. M., Larionova, V. M., Larionova, E. G., Leto, L. V., Lorey, C., Mújica, C., Madejski, R., Marchili, G. M., Marscher, N., Minev, A. P., Modaressi, M., Morozova, A., Mufakharov, D. A., Myserlis, T., Nikiforova, I., Nikolashvili, A. A., Ovcharov, M. G., Perri, E., Raiteri, M., Readhead, C. M., Reimer, A. C. S., Reinhart, A., Righini, D., Rosenlehner, S., Sadun, K., Savchenko, A. C., Scherbantin, S. S., Schneider, A., Schoch, L., Seifert, K., Semkov, D., Sigua, E., Singh, L. A., Sola, C., Sotnikova, P., Spencer, Y., Steineke, M., Stojanovic, R., Strigachev, M., Tornikoski, A., Traianou, M., Tramacere, E., Troitskaya, A., Troitskiy, Yu. V., Trump, I. S., Tsai, J. B., Valcheva, A., Vasilyev, A., Verrecchia, A. A., Villata, F., Vince, M., Vrontaki, O., Weaver, K., Zaharieva, Z. R., and Zottmann, E.
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ddc:520 - Abstract
The astrophysical journal / Supplement series 266(2), 37 (2023). doi:10.3847/1538-4365/acc181, We study the broadband emission of Mrk 501 using multiwavelength observations from 2017 to 2020 performed with a multitude of instruments, involving, among others, MAGIC, Fermi's Large Area Telescope (LAT), NuSTAR, Swift, GASP-WEBT, and the Owens Valley Radio Observatory. Mrk 501 showed an extremely low broadband activity, which may help to unravel its baseline emission. Nonetheless, significant flux variations are detected at all wave bands, with the highest occurring at X-rays and very-high-energy (VHE) $γ$-rays. A significant correlation (>3σ) between X-rays and VHE $γ$-rays is measured, supporting leptonic scenarios to explain the variable parts of the emission, also during low activity. This is further supported when we extend our data from 2008 to 2020, and identify, for the first time, significant correlations between the Swift X-Ray Telescope and Fermi-LAT. We additionally find correlations between high-energy γ-rays and radio, with the radio lagging by more than 100 days, placing the γ-ray emission zone upstream of the radio-bright regions in the jet. Furthermore, Mrk 501 showed a historically low activity in X-rays and VHE $γ$-rays from mid-2017 to mid-2019 with a stable VHE flux (>0.2 TeV) of 5% the emission of the Crab Nebula. The broadband spectral energy distribution (SED) of this 2 $γ$r long low state, the potential baseline emission of Mrk 501, can be characterized with one-zone leptonic models, and with (lepto)-hadronic models fulfilling neutrino flux constraints from IceCube. We explore the time evolution of the SED toward the low state, revealing that the stable baseline emission may be ascribed to a standing shock, and the variable emission to an additional expanding or traveling shock., Published by Institute of Physics Publ., London
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- 2023
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3. POS1267 LONG-TERM SURVEY STUDY OF THE IMPACT OF COVID-19 ON SYSTEMIC AUTOIMMUNE DISEASES. LOW DEATH RATE DESPITE THE INCREASED PREVALENCE OF SYMPTOMATIC INFECTION. ROLE OF PRE-EXISTING INTERSTITIAL LUNG DISEASE AND ONGOING TREATMENTS.
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Ferri, C., primary, Raimondo, V., additional, Gragnani, L., additional, Giuggioli, D., additional, Dagna, L., additional, Tavoni, A., additional, Ursini, F., additional, L’andolina, M., additional, Caso, F., additional, Ruscitti, P., additional, Caminiti, M., additional, Foti, R., additional, Riccieri, V., additional, Guiducci, S., additional, Pellegrini, R., additional, Zanatta, E., additional, Varcasia, G., additional, Olivo, D., additional, Gigliotti, P., additional, Cuomo, G., additional, Murdaca, G., additional, Cecchetti, R., additional, De Angelis, R., additional, Romeo, N., additional, Ingegnoli, F., additional, Cozzi, F., additional, Codullo, V., additional, Cavazzana, I., additional, Colaci, M., additional, Abignano, G., additional, De Santis, M., additional, Lubrano, E., additional, Fusaro, E., additional, Spinella, A., additional, Lumetti, F., additional, De Luca, G., additional, Bellando Randone, S., additional, Visalli, E., additional, Dal Bosco, Y., additional, Amato, G., additional, Giannini, D., additional, Bilia, S., additional, Masini, F., additional, Pellegrino, G., additional, Pigatto, E., additional, Generali, E., additional, Pagano Mariano, G., additional, Pettiti, G., additional, Zanframundo, G., additional, Brittelli, R., additional, Aiello, V., additional, Caminiti, R., additional, Scorpiniti, D., additional, Ferrari, T., additional, Campochiaro, C., additional, Brusi, V., additional, Fredi, M., additional, Moschetti, L., additional, Cacciapaglia, F., additional, Ferrari, S. M., additional, DI Cola, I., additional, Vadacca, M., additional, Lorusso, S., additional, Monti, M., additional, Lorini, S., additional, Paparo, S. R., additional, Ragusa, F., additional, Elia, G., additional, Mazzi, V., additional, Aprile, M. L., additional, Tasso, M., additional, Miccoli, M., additional, Bosello, S. L., additional, D’angelo, S., additional, Doria, A., additional, Franceschini, F., additional, Meliconi, R., additional, Matucci-Cerinic, M., additional, Iannone, F., additional, Giacomelli, R., additional, Salvarani, C., additional, Zignego, A. L., additional, Fallahi, P., additional, and Antonelli, A., additional
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- 2022
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4. SARS-CoV-2 was already circulating in Italy, in early December 2019
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Gragnani, L, Monti, M, A Santini, S, Marri, S, Madia, F, Lorini, S, Petraccia, L, Stasi, C, Basile, U, Luti, V, Pagliai, F, Saccardi, R, and L Zignego, A
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Immunoassay ,Male ,Time Factors ,SARS-CoV-2 ,SARS-CoV-2 infection ,Liver Diseases ,Rapid tests ,COVID-19 ,Anti-SARS-CoV-2 antibodies ,Blood Donors ,Chemoluminescence ,Middle Aged ,Antibodies, Viral ,COVID-19 Serological Testing ,Immunoglobulin M ,Italy ,Immunoglobulin G ,Luminescent Measurements ,Humans ,RNA, Viral ,Female ,Serologic Tests ,Settore BIO/10 - BIOCHIMICA ,Aged ,Retrospective Studies - Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) identified in China, in December 2019 determines COronaVIrus Disease 19 (COVID-19). Whether or not the virus was present in Italy earlier the first autochthonous COVID-19 case was diagnosed is still uncertain. We aimed to identify anti-SARS-CoV-2 antibodies in sera collected from 4th November 2019 to 9th March 2020, in order to assess the possible spread of the virus in Italy earlier than the first official national diagnosis.Anti-SARS-CoV-2 antibodies were evaluated in retrospective serum samples from 234 patients with liver diseases (Hep-patients) and from 56 blood donors (BDs). We used two rapid serologic tests which were confirmed by a validated chemoluminescence assay.Via rapid tests, we found 10/234 (4.3%) IgG-positive and 1/234 (0.4%) IgM-positive cases in the Hep-patient group. Two/56 (3.6%) IgG-positive and 2/56 (3.6%) IgM-positive cases were detected in BD group. Chemoluminescence confirmed IgG-positivity in 3 Hep-patients and 1 BD and IgM-positivity in 1 Hep-patient. RNAemia was not detected in any of the subjects, rendering the risk of transfusion transmission negligible.Our results suggest an early circulation of SARS-CoV-2 in Italy, before the first COVID-19 cases were described in China. Rapid tests have multiple benefits; however, a confirmation assay is required to avoid false positive results.
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- 2021
5. Pilot screening of HBV and HCV prevalence in at risk po-pulations due to geographical origin and conditions of socio-economic distress
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Lorini, S., primary, Gragnani, L., additional, Marri, S., additional, Madia, F., additional, Monti, M., additional, Stasi, C., additional, Petraccia, L., additional, Bamoshmoosh, M., additional, and Zignego, AL., additional
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- 2021
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6. Genetic and B-cell clonality markers in HCV-related cryoglobulinemic vasculitis persisting after DAA therapy
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Marri, S., primary, Gragnani, L., additional, Lorini, S., additional, Santarlasci, V., additional, Basile, U., additional, Monti, M., additional, Petraccia, L., additional, Stasi, C., additional, Martini, L., additional, Madia, F., additional, Mudalal, M., additional, Caini, P., additional, Marello, N., additional, Cosmi, L., additional, Annunziato, F., additional, and Zignego, A.L., additional
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- 2020
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7. Influence of Depression on Self-Care Behaviors in Older Adults With Multiple Chronic Conditions: A Multivariate Analysis
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Iovino, P, Vellone, E, De Maria, M, Lorini, S, Ausili, D, Matarese, M, and Riegel, B
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Settore MED/45 - Scienze Infermieristiche Generali, Cliniche e Pediatriche - Published
- 2019
8. L’influenza della depressione sui comportamenti di self-care nei pazienti anziani con malattie cardiovascolari e malattie croniche multiple. Giornale Italiano di Cardiologia. 2019; 20 (Supp. 1): 260S
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Iovino, P, Riegel, B, De Maria, M, Lorini, S, Ausili, D, Matarese, M, Alvaro, R, and Vellone, E
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Settore MED/45 - Scienze Infermieristiche Generali, Cliniche e Pediatriche - Published
- 2019
9. Determinanti sociodemografici e clinici del selfcare e del contributo del caregiver al self-care nei pazienti anziani con malattie cardiovascolari e malattie croniche multiple. Giornale Italiano di Cardiologia. 2019; 20 (Supp. 1): 259S
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Iovino, P, Vellone, E, Ausili, D, De Maria, M, Lyons, K, Lee, C, Lorini, S, Riegel, B, and Matarese, M
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Settore MED/11 - Malattie dell'Apparato Cardiovascolare ,Settore MED/45 - Scienze Infermieristiche Generali, Cliniche e Pediatriche - Published
- 2019
10. Non-Invasive B-Cell Clonality Markers May Help in the Rational Approach to HCV Svr Cryoglobulinemic Patients with Persisting Manifestations
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Lorini, S, Gragnani, L, Santarlasci, V, Monti, M, Basile, U, Petraccia, L, Madia, F, Marri, S, Martini, L, Carradori, E, Xheka, A, Caini, P, Pellicelli, Am, Cosmi, L, Annunziato, F, and Zignego, Al
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- 2018
11. Editorial: interferon-free DAAs are a great boon for patients with hepatitis C and cryoglobulinaemia—Authors’ reply
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Zignego, A. L., Lorini, S., and Gragnani, L.
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Interferon free DAAs ,hepatitis C - Published
- 2018
12. IGG subclasses, free light chains and vascular endothelial growth factor in HCV-related mixed cryoglobulinemic syndrome
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Napodano, C., primary, Basile, U., additional, Pocino, K., additional, Marino, M., additional, Gragnani, L., additional, Gulli, F., additional, Lorini, S., additional, Stefanile, A., additional, Santini, S.A., additional, Rapaccini, G.L., additional, and Zignego, A.L., additional
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- 2019
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13. Mixed cryoglobulinemia patients with persisting symptoms after SVR are characterized by B-cell clonality markers
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Lorini, S., primary, Gragnani, L., additional, Santarlasci, V., additional, Monti, M., additional, Basile, U., additional, Petraccia, L., additional, Madia, F., additional, Marri, S., additional, Martini, L., additional, Carradori, E., additional, Xheka, A., additional, Caini, P., additional, Pellicelli, A.M., additional, Cosmi, L., additional, Annunziato, F., additional, and Zignego, A.L., additional
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- 2019
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14. Extracellular vesicles derived from CHK2 mRNA as a possible predictive marker of HCC in HCV-infected patients
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Cavallini, L., primary, Caini, P., additional, Lorini, S., additional, Marri, S., additional, Carloni, V., additional, Gragnani, L., additional, and Zignego, A.L., additional
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- 2019
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15. Female athletes and menstrual disorders: a pilot study
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Stefani, L., primary, Galanti, G., additional, Lorini, S., additional, Beni, G., additional, Dei, M., additional, and Maffulli, N., additional
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- 2019
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16. Non-invasive B-cell clonality markers may help in the rational approach to HCV SVR cryoglobulinemic patients with persisting manifestations
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Lorini, S., primary, Gragnani, L., additional, Santarlasci, V., additional, Monti, M., additional, Basile, U., additional, Petraccia, L., additional, Madia, F., additional, Marri, S., additional, Martini, L., additional, Carradori, E., additional, Xheka, A., additional, Caini, P., additional, Pellicelli, A.M., additional, Cosmi, L., additional, Annunziato, F., additional, and Zignego, A.L., additional
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- 2018
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17. Interferon-free therapy in hepatitis C virus mixed cryoglobulinaemia: a prospective, controlled, clinical and quality of life analysis
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Gragnani, L., primary, Cerretelli, G., additional, Lorini, S., additional, Steidl, C., additional, Giovannelli, A., additional, Monti, M., additional, Petraccia, L., additional, Sadalla, S., additional, Urraro, T., additional, Caini, P., additional, Xheka, A., additional, Simone, A., additional, Arena, U., additional, Matucci-Cerinic, M., additional, Vergani, D., additional, Laffi, G., additional, and Zignego, A. L., additional
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- 2018
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18. COVID-19 AND CRYOGLOBULINEMIC VASCULITIS. LONG-TERM SURVEY STUDY ON THE IMPACT OF PANDEMIC AND VACCINATION ON A LARGE PATIENT'S POPULATION.
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Gragnani, L., Visentini, M., Lorini, S., Santini, S., Lauletta, G., Mazzaro, C., Urraro, T., Luca, Q., Cacciapaglia, F., Ruscitti, P., Tavoni, A., Marri, S., Cusano, G., Petraccia, L., Naclerio, C., Treppo, E., Del Frate, G., Di Cola, I., Raimondo, V., and Scorpiniti, D.
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- 2023
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19. Cardiovascular Performance And Prevalence Of Menstrual Disorders
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Lorini, S., Stefani, L., Beni, G., Dei, M., Bruni, V., and Galanti, G.
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- 2012
20. Displaced comminuted midshaft clavicle fractures: use of mennen fixation system.
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Russo R, Visconti V, Lorini S, and Lombardi LV
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- 2007
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21. The kaon identification system at the NA62 experiment at CERN
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Massri, K., Rinella, G. A., Aliberti, R., Ambrosino, F., Ammendola, R., Angelucci, B., Antonelli, A., Anzivino, G., Arcidiacono, R., Azhinenko, I., Balev, S., Barbanera, M., Bendotti, J., Biagioni, A., Bician, L., Biino, C., Bizzeti, A., Blazek, T., Blik, A., Bloch-Devaux, B., Bolotov, V., Bonaiuto, V., Boretto, M., Bragadireanu, M., Britton, D., Britvich, G., Brunetti, M. B., Bryman, D., Bucci, F., Butin, F., Calvo, J., Capitolo, E., Capoccia, C., Capussela, T., Cassese, A., Catinaccio, A., Cecchetti, A., Ceccucci, A., Cenci, P., Cerny, V., Cerri, C., Checcucci, B., Chikilev, O., Chiozzi, S., Ciaranfi, R., Collazuol, G., Conovaloff, A., Cooke, P., Cooper, P., Corradi, G., Gil, E. C., Costantini, F., Cotorobai, F., Ramusino, A. C., Coward, D., D Agostini, G., Dainton, J., Dalpiaz, P., Danielsson, H., Degrange, J., Simone, N., Di Filippo, D., Di Lella, L., Di Lorenzo, S., Dixon, N., Doble, N., Dobrich, B., Duk, V., Elsha, V., Engelfried, J., Enik, T., Estrada, N., Falaleev, V., Fantechi, R., Fascianelli, V., Federici, L., Fedotov, S., Fiorini, M., Fry, J., Fu, J., Fucci, A., Fulton, L., Gal-Lorini, S., Galeotti, S., Gamberini, E., Gatignon, L., Georgiev, G., Gianoli, A., Giorgi, M., Giudici, S., Glonti, L., Martins, A. G., Gonnella, F., Goudzovski, E., Guida, R., Gushchin, E., Hahn, F., Hallgren, B., Heath, H., Herman, F., Husek, T., Hutanu, O., Hutchcroft, D., Iacobuzio, L., Iacopini, E., Imbergamo, E., Jamet, O., Jarron, P., Jones, E., Jones, T., Kampf, K., Kaplon, J., Kekelidze, V., Kholodenko, S., Khoriauli, G., Khotyantsev, A., Khudyakov, A., Kiryushin, Y. U., Kleimenova, A., Kleinknecht, K., Kluge, A., Koval, M., Kozhuharov, V., Krivda, M., Kucerova, Z., Kudenko, Y. U., Kunze, J., Lamanna, G., Latino, G., Lazzeroni, C., Lehmann-Miotto, G., Lenci, R., Lenti, M., Leonardi, E., Lichard, P., Lietava, R., Likhacheva, V., Litov, L., Lollini, R., Lomidze, D., Lonardo, A., Lupi, M., Lurkin, N., Mccormick, K., Madigozhin, D., Maire, G., Man-Deiro, C., Mannelli, I., Mannocchi, G., Mapelli, A., Marchetto, F., Marchevski, R., Martellotti, S., Massarotti, P., Matak, P., Maurice, E., Medvedeva, M., Mefodev, A., Menichetti, E., Minucci, E., Mirra, M., Misheva, M., Molokanova, N., Morant, J., Morel, M., Moulson, M., Movchan, S., Munday, D., Napolitano, M., Neri, I., Newson, F., Norton, A., Noy, M., Nuessle, G., Numao, T., Obraztsov, V., Ostankov, A., Padolski, S., Page, R., Palladino, V., Paoluzzi, G., Parkinson, C., Pe-Dreschi, E., Pepe, M., Gomez, F. P., Perrin-Terrin, M., Peruzzo, L., Petrov, P., Petrucci, F., Piandani, R., Piccini, M., Pietre-Anu, D., Pinzino, J., Polenkevich, I., Pontisso, L., Potrebenikov, Yu, Protopopescu, D., Raffaelli, F., Raggi, M., Riedler, P., Romano, A., Rubin, P., Ruggiero, G., Russo, V., Ryjov, V., Salamon, A., Salina, G., Samsonov, V., Santoni, C., Saracino, G., Sar-Geni, F., Semenov, V., Sergi, A., Serra, M., Shaikhiev, A., Shkarovskiy, S., Skillicorn, I., Soldi, D., Sotnikov, A., Sugonyaev, V., Sozzi, M., Spadaro, T., Spinella, F., Staley, R., Sturgess, A., Sutcliffe, P., Szilasi, N., Tagnani, D., Trilov, S., Valdata-Nappi, M., Valente, P., Vasile, M., Vassilieva, T., Velghe, B., Veltri, M., Venditti, S., Vicini, P., Volpe, R., Vormstein, M., Wahl, H., Wanke, R., Wertelaers, P., Winhart, A., Winston, R., Wrona, B., Yushchenko, O., Michal Zamkovsky, and Zinchenko, A.
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Physics ,Particle physics ,Physics - Instrumentation and Detectors ,Large Hadron Collider ,hep-ex ,Branching fraction ,Hadron ,Nuclear Theory ,FOS: Physical sciences ,Instrumentation and Detectors (physics.ins-det) ,NA62 experiment ,Measure (mathematics) ,Settore FIS/04 - Fisica Nucleare e Subnucleare ,High Energy Physics - Experiment ,Identification system ,High Energy Physics - Experiment (hep-ex) ,High Energy Physics::Experiment ,Detectors and Experimental Techniques ,Nuclear Experiment ,Beam (structure) ,Bar (unit) - Abstract
The NA62 experiment at CERN SPS aims to measure the branching ratio of the ultra-rare kaon decay $K^+\to\pi^+\nu\bar{\nu}$ with 10\% precision, collecting $\sim 100$ events, assuming the Standard Model~(SM) branching ratio of $8.4 \times 10^{-11}$, starting in 2016. The NA62 experiment uses a kaon decay-in-flight technique and is exposed to a 750~MHz high-energy unseparated charged hadron beam, in which kaons are a minor component (6\%). Kaon identification is therefore mandatory to reduce the interference of the dominant non-kaon component with the experimental measurements. The NA62 kaon identification system and its performances are presented., Comment: 6 pages. To be published in ICHEP 2016 conference proceedings
22. Patient self-care and caregiver contribution to patient self-care of chronic conditions : What is dyadic and what it is not
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Maddalena, De Maria, Davide, Ausili, Silvia, Lorini, Ercole, Vellone, Barbara, Riegel, Maria, Matarese, De Maria, M, Ausili, D, Lorini, S, Vellone, E, Riegel, B, and Matarese, M
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Heart Failure ,dyad ,Health Policy ,Public Health, Environmental and Occupational Health ,chronic condition ,chronic conditions ,Self Care ,Settore MED/45 ,Cross-Sectional Studies ,Caregivers ,Chronic Disease ,caregiver contribution ,self-care ,Humans - Abstract
Objectives: Self-care of chronic conditions involves both patients and their informal caregivers and therefore might be considered as a dyadic phenomenon. Nevertheless, empirical evidence supporting a dyadic construct is unavailable. This study aimed to explore the existence of a dyadic construct in self-care maintenance, monitoring, and management in patients affected by chronic conditions and their informal caregivers. Methods: This study used a cross-sectional design. We used the Self-Care of Chronic Illness Inventory and the Caregiver Contribution to Self-Care of Chronic Illness Inventory, which measure patient self-care and informal caregivers’ contribution to self-care maintenance, monitoring and management. Exploratory Structural Equation Modeling was performed to verify the existence of dyadic latent constructs in each scale in patients and informal caregivers. Results: A convenience sample of 493 patients and informal caregivers, with a mean age of 76.47 and 52.76 years, respectively, was studied. In the self-care maintenance scales, 2 correlated factors (r = 0.34, P < .001) were identified, indicating the presence of a dyadic second-order construct. In addition, 2 factors that were not correlated (r = 0.11, P = .064) were identified in the self-care monitoring scales, indicating the absence of a dyadic construct. Finally, we found a 3-factor model in the self-care management scales composed of both patient and caregiver items, indicating a dyadic first-order construct. Conclusions: Knowing which care behaviors are dyadic in chronic conditions is important for tailoring interventions to improve self-care. Self-care maintenance and management would benefit from dyadic interventions, while self-care monitoring would not. The results of this study may illuminate future theoretical and scientific developments in dyadic care of chronic illness.
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- 2022
23. Absent or suboptimal response to booster dose of COVID-19 vaccine in patients with autoimmune systemic diseases
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Clodoveo Ferri, Laura Gragnani, Vincenzo Raimondo, Marcella Visentini, Dilia Giuggioli, Serena Lorini, Rosario Foti, Fabio Cacciapaglia, Maurizio Caminiti, Domenico Olivo, Giovanna Cuomo, Roberta Pellegrini, Erika Pigatto, Teresa Urraro, Caterina Naclerio, Antonio Tavoni, Lorenzo Puccetti, Ilaria Cavazzana, Piero Ruscitti, Marta Vadacca, Francesca La Gualana, Franco Cozzi, Amelia Spinella, Elisa Visalli, Ylenia Dal Bosco, Giorgio Amato, Francesco Masini, Giuseppa Pagano Mariano, Raffaele Brittelli, Vincenzo Aiello, Daniela Scorpiniti, Giovanni Rechichi, Giuseppe Varcasia, Monica Monti, Giusy Elia, Franco Franceschini, Milvia Casato, Francesco Ursini, Roberto Giacomelli, Poupak Fallahi, Stefano Angelo Santini, Florenzo Iannone, Carlo Salvarani, Anna Linda Zignego, Alessandro Antonelli, Ferri, C., Gragnani, L., Raimondo, V., Visentini, M., Giuggioli, D., Lorini, S., Foti, R., Cacciapaglia, F., Caminiti, M., Olivo, D., Cuomo, G., Pellegrini, R., Pigatto, E., Urraro, T., Naclerio, C., Tavoni, A., Puccetti, L., Cavazzana, I., Ruscitti, P., Vadacca, M., La Gualana, F., Cozzi, F., Spinella, A., Visalli, E., Bosco, Y. D., Amato, G., Masini, F., Mariano, G. P., Brittelli, R., Aiello, V., Scorpiniti, D., Rechichi, G., Varcasia, G., Monti, M., Elia, G., Franceschini, F., Casato, M., Ursini, F., Giacomelli, R., Fallahi, P., Santini, S. A., Iannone, F., Salvarani, C., Zignego, A. L., and Antonelli, A.
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Autoimmune systemic diseases ,Booster vaccine ,COVID-19 vaccine ,Cryoglobulinemic vasculitis ,Neutralizing antibodies ,Rheumatoid arthritis ,Systemic lupus ,Systemic sclerosis ,Systemic vasculitis ,Antibodies, Viral ,BNT162 Vaccine ,Humans ,Immunization, Secondary ,Vaccination ,COVID-19 ,COVID-19 Vaccines ,Secondary ,Immunology ,Autoimmune systemic disease ,Antibodies ,Systemic sclerosi ,Systemic lupu ,Neutralizing antibodie ,Immunology and Allergy ,Viral ,Settore BIO/10 - BIOCHIMICA ,Rheumatoid arthriti ,Cryoglobulinemic vasculiti ,Systemic vasculiti ,Immunization ,Human - Abstract
Autoimmune systemic diseases (ASD) show impaired immunogenicity to COVID-19 vaccines. Our prospective observational multicenter study aimed at evaluating the seroconversion elicited by COVID-19 vaccine over the entire vaccination cycle including the booster dose. Among 478 unselected ASD patients originally evaluated at the end of the first vaccination cycle (time 1), 344 individuals were re-evaluated after a 6-month period (time 2), and 244 after the booster vaccine dose (time 3). The immunogenicity of mRNA COVID-19 vaccines (BNT162b2 and mRNA-1273) was assessed by measuring serum IgG-neutralizing antibody (NAb) on samples obtained at the three time points in both patients and 502 age-matched controls. In the 244 ASD group that received booster vaccine and monitored over the entire follow-up, the mean serum NAb levels (time 1, 2, and 3: 696.8±52.68, 370.8±41.92, and 1527±74.16SD BAU/mL, respectively; p 
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- 2022
24. Psychometric characteristics of the caregiver contribution to self‐care of chronic illness inventory
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Silvia Lorini, Ercole Vellone, Maria Grazia De Marinis, Stefania Di Mauro, Maria Matarese, Davide Ausili, Rosaria Alvaro, Maddalena De Maria, Vellone, E, Lorini, S, Ausili, D, Alvaro, R, Di Mauro, S, De Marinis, M, Matarese, M, and De Maria, M
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validity ,multimorbidity ,Psychometrics ,instrument development ,psychometric ,Concurrent validity ,MED/45 - SCIENZE INFERMIERISTICHE GENERALI, CLINICHE E PEDIATRICHE ,03 medical and health sciences ,0302 clinical medicine ,nursing ,Cronbach's alpha ,Surveys and Questionnaires ,self-care ,Humans ,030212 general & internal medicine ,caregiver ,General Nursing ,Reliability (statistics) ,reliability ,030504 nursing ,Reproducibility of Results ,Confirmatory factor analysis ,Test (assessment) ,Self Care ,Settore MED/45 ,Cross-Sectional Studies ,Caregivers ,Scale (social sciences) ,caregiver contribution ,Chronic Disease ,Self care ,Factor Analysis, Statistical ,0305 other medical science ,Psychology ,Clinical psychology - Abstract
The purpose of the this study was to test the factorial structure, internal consistency reliability and concurrent validity of the Caregiver Contribution to Self-Care Chronic Illness Inventory.Existing measures of caregiver contribution to self-care are disease-specific or behaviour-specific; no generic measures exist.A cross-sectional study.Between April 2017 - December 2018, we enrolled a convenience sample of 358 patients with chronic illnesses and their caregivers. Patients completed the Self-Care of Chronic Illness Inventory while caregivers completed the Caregiver Contribution to Self-Care of Chronic Illness Inventory, a modification of the Self-Care of Chronic Illness Inventory, which includes three scales as follows: the Caregiver Contribution to Self-Care Maintenance, the Caregiver Contribution to Self-Care Monitoring and the Caregiver Contribution to Self-Care Management. Of each scale, we tested the factorial structure with confirmatory factor analysis and reliability with the factor score determinacy coefficient, the global reliability index for multidimensional scale and Cronbach's alpha. Also, we used Pearson's correlations for concurrent validity purposes.Confirmatory factor analysis supported the two-factor structure of the Caregiver Contribution to Self-Care Maintenance and Management scales and the one-factor structure of the Caregiver Contribution to Self-Care Monitoring scale. A simultaneous confirmatory factor analysis on the combined set of items supported the more general model (Comparative Fit Index = 0.933). Reliability estimates ranged between 0.701 and 0.961 across the three scales. Concurrent validity of Caregiver Contribution to Self-Care of Chronic Illness Inventory with the Self-Care of Chronic Illness Inventory was not sufficiently supported since weak correlations were found.The Caregiver Contribution to Self-Care of Chronic Illness Inventory is valid and reliable and can be used in clinical practice and research.The Caregiver Contribution to Self-Care of Chronic Illness Inventory is an useful instrument to evaluate the extent to which caregivers contribute to patient self-care in chronic illnesses.目的: 本研究旨在检验慢性疾病护理人员自我照顾贡献量表的因子结构、内部一致信度及并发效度。 背景: 现有护理人员对自我照顾的贡献衡量标准均是以疾病或行为为基础;无通用衡量标准。 设计: 横断面研究。 方法: 2017年4月至2018年12月间,我们对358名慢性病患者及其护理人员进行随机抽样调查。患者已填写慢性疾病自我照顾量表,且护理人员已填写其对慢性病自我照顾贡献量表,此量表是在慢性疾病自我照顾量表的基础上修订,包括三个量表:护理人员对自我照顾的贡献,护理人员对自我照顾监控的贡献以及护理人员对自我照顾管理的贡献。各量表中,我们通过验证性因子分析对因子结构进行检验,并用因子得分确定系数、多维量表整体信度指标和克隆巴赫系数,以进行信度检验。同时,我们利用皮尔逊相关系数进行并发效度分析。 结果: 验证性因子分析可在护理人员自我照顾共享维持与管理量表中所列双因素结构和护理人员自我照顾监测量表中所列单因素结构中适用。一般模型可在组合项目的同时验证性因素分析中适用(比较拟合指数=0.933)。经预计,上述三个量表的信度介于0.701到0.961之间。慢性疾病护理人员自我照顾量表与慢性疾病患者自我照顾量表的并发效度呈弱相关,因此,慢性疾病患者自我照顾量表未充分使用。 结论: 慢性疾病护理人员自我照顾贡献量表有效、可靠,可在临床实践和研究中使用。 影响: 慢性疾病护理人员自我照顾贡献量表是评估护理人员对慢性疾病患者自我照顾的贡献程度的有效工具。.
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- 2020
25. Development and Psychometric Testing of the Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale
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Paolo Iovino, Ercole Vellone, Maria Matarese, Maddalena De Maria, Silvia Lorini, Davide Ausili, De Maria, M, Iovino, P, Lorini, S, Ausili, D, Matarese, M, and Vellone, E
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Male ,validity ,Psychometrics ,psychometric ,Cost of Illness ,self care ,Medicine ,Humans ,survey ,Psychometric testing ,Reliability (statistics) ,Self-efficacy ,reliability ,business.industry ,Health Policy ,questionnaire ,Public Health, Environmental and Occupational Health ,Construct validity ,Reproducibility of Results ,Middle Aged ,Caregiver ,Confirmatory factor analysis ,self efficacy ,Settore MED/45 ,Cross-Sectional Studies ,Caregivers ,Scale (social sciences) ,Self care ,Female ,Multiple Chronic Conditions ,business ,Clinical psychology - Abstract
Objectives Caregiver self-efficacy—a caregiver’s belief in his/her ability to contribute to patient self-care—is associated with better patient and caregiver outcomes in single chronic conditions. It is, however, unknown if caregiver self-efficacy improves patient and caregiver outcomes in multiple chronic conditions (MCCs) because there is no instrument to measure this variable. We developed the 10-item Caregiver Self-Efficacy in Contributing to patient Self-Care (CSE-CSC) scale for that purpose, and we tested its psychometric characteristics in caregivers of patients with MCCs. Methods In this cross-sectional multisite study, we tested the structural validity of the CSE-CSC scale with exploratory and confirmatory factor analysis, and we tested construct validity by correlating CSE-CSC scores with those of the Caregiver Contributions to Self-Care of Chronic Illness Inventory. We also tested reliability, and precision of the CSE-CSC scale. Results The 358 enrolled caregivers (mean age 54.6 years; 71.5% female) cared for patients with an average of 3.2 chronic conditions. Structural validity was good, and it showed 2 factors within the scale. Construct validity showed significant correlations between scores of the CSE-CSC scale and the Caregiver Contributions to Self-Care of Chronic Illness Inventory. Reliability coefficients were between 0.90 and 0.97. Measurement error yielded satisfactory results. Conclusions The CSE-CSC scale is valid, reliable, and precise in measuring caregiver self-efficacy in contributing to patient self-care in MCCs. Because caregiver self-efficacy is a modifiable variable, the CSE-CSC scale can be used in clinical practice and research to improve patient and caregiver outcomes.
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- 2021
26. Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments
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M. L. Aprile, Rosario Foti, Ruscitti Piero, Giuseppe Varcasia, Ilaria Cavazzana, Nicoletta Romeo, Riccardo Meliconi, Serena Lorini, Serena Guiducci, Amelia Spinella, Roberto Giacomelli, Vincenzo Aiello, Alessandra Della Rossa, Giorgio Amato, Daiana Giannini, Vincenzo Raimondo, Francesco Caso, Ennio Lubrano, Silvia Bosello, Maurizio Caminiti, Monica Monti, Tasso Marco, Francesca Ingegnoli, Giorgio Pettiti, Massimo L'Andolina, Salvatore D'Angelo, Francesca Ragusa, Elisabetta Zanatta, Giacomo De Luca, Riccardo Cecchetti, Franco Franceschini, Greta Pellegrino, Silvia Bellando-Randone, Silvia Martina Ferrari, Micaela Fredi, Veronica Brusi, Lorenzo Dagna, Giusy Elia, Fabio Cacciapaglia, Francesco Ursini, Giuseppina Abignano, Sebastiano Lorusso, Clodoveo Ferri, Anna Linda Zignego, Rodolfo Caminiti, Sabrina Rosaria Paparo, Raffaele Brittelli, Liala Moschetti, Elena Generali, Marco Matucci-Cerinic, Roberta Pellegrini, Ylenia Dal Bosco, Giovanni Zanframundo, Domenico Olivo, Tommaso Ferrari, Alessandro Antonelli, M. Vadacca, Andrea Doria, Pietro Gigliotti, Poupak Varcasia, Enrico Fusaro, Elisa Visalli, Simone Barsotti, Giuseppa Pagano Mariano, Giovanna Cuomo, Florenzo Iannone, Maria De Santis, Valeria Mazzi, Giuseppe Murdaca, Michele Colaci, Silvia Bilia, Franco Cozzi, Dilia Giuggioli, Corrado Campochiaro, Valeria Riccieri, Erika Pigatto, Laura Gragnani, Ilenia Di Cola, Daniela Scorpiniti, Mario Miccoli, Francesco Masini, Veronica Codullo, Rossella De Angelis, Federica Lumetti, Antonio Tavoni, Ferri, Clodoveo, Giuggioli, Dilia, Raimondo, Vincenzo, L’Andolina, Massimo, Dagna, Lorenzo, Tavoni, Antonio, Caso, Francesco, Ursini, Francesco, Piero, Ruscitti, Caminiti, Maurizio, Foti, Rosario, Riccieri, Valeria, Guiducci, Serena, Pellegrini, Roberta, Zanatta, Elisabetta, Varcasia, Giuseppe, Olivo, Domenico, Gigliotti, Pietro, Cuomo, Giovanna, Murdaca, Giuseppe, Cecchetti, Riccardo, De Angelis, Rossella, Romeo, Nicoletta, Ingegnoli, Francesca, Cozzi, Franco, Codullo, Veronica, Cavazzana, Ilaria, Colaci, Michele, Abignano, Giuseppina, De Santis, Maria, Lubrano, Ennio, Fusaro, Enrico, Rossa, Alessandra Della, Spinella, Amelia, Lumetti, Federica, De Luca, Giacomo, Bellando-Randone, Silvia, Visalli, Elisa, Dal Bosco, Ylenia, Amato, Giorgio, Giannini, Daiana, Bilia, Silvia, Masini, Francesco, Pellegrino, Greta, Pigatto, Erika, Generali, Elena, Mariano, Giuseppa Pagano, Pettiti, Giorgio, Zanframundo, Giovanni, Brittelli, Raffaele, Aiello, Vincenzo, Caminiti, Rodolfo, Scorpiniti, Daniela, Ferrari, Tommaso, Campochiaro, Corrado, Brusi, Veronica, Fredi, Micaela, Moschetti, Liala, Cacciapaglia, Fabio, Gragnani, Laura, Monti, Monica, Lorini, Serena, Paparo, Sabrina Rosaria, Ragusa, Francesca, Mazzi, Valeria, Elia, Giusy, Ferrari, Silvia Martina, Di Cola, Ilenia, Vadacca, Marta, Lorusso, Sebastiano, Barsotti, Simone, Aprile, Maria Letizia, Marco, Tasso, Miccoli, Mario, Bosello, Silvia, Matucci-Cerinic, Marco, D'Angelo, Salvatore, Doria, Andrea, Franceschini, Franco, Meliconi, Riccardo, Iannone, Florenzo, Giacomelli, Roberto, Zignego, Anna Linda, Varcasia, Poupak, Antonelli, Alessandro, L'Andolina, Massimo, Della Rossa, Alessandra, Pagano Mariano, Giuseppa, Rosaria Paparo, Sabrina, Martina Ferrari, Silvia, Letizia Aprile, Maria, Linda Zignego, Anna, Ferri C., Giuggioli D., Raimondo V., L'andolina M., Dagna L., Tavoni A., Caso F., Ursini F., Ruscitti P., Caminiti M., Foti R., Riccieri V., Guiducci S., Pellegrini R., Zanatta E., Varcasia G., Olivo D., Gigliotti P., Cuomo G., Murdaca G., Cecchetti R., De Angelis R., Romeo N., Ingegnoli F., Cozzi F., Codullo V., Cavazzana I., Colaci M., Abignano G., De Santis M., Lubrano E., Fusaro E., Della Rossa A., Spinella A., Lumetti F., De Luca G., Bellando-Randone S., Visalli E., Dal Bosco Y., Amato G., Giannini D., Bilia S., Masini F., Pellegrino G., Pigatto E., Generali E., Mariano G.P., Pettiti G., Zanframundo G., Brittelli R., Aiello V., Caminiti R., Scorpiniti D., Ferrari T., Campochiaro C., Brusi V., Fredi M., Moschetti L., Cacciapaglia F., Gragnani L., Monti M., Lorini S., Paparo S.R., Ragusa F., Mazzi V., Elia G., Ferrari S.M., Di Cola I., Vadacca M., Lorusso S., Barsotti S., Aprile M.L., Marco T., Miccoli M., Bosello S., Matucci-Cerinic M., D'angelo S., Doria A., Franceschini F., Meliconi R., Iannone F., Giacomelli R., Zignego A.L., Fallahi P., and Antonelli A.
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medicine.medical_specialty ,Settore MED/16 - REUMATOLOGIA ,Referral ,Coronavirus disease 2019 (COVID-19) ,autoimmune systemic disease ,systemic sclerosis ,Population ,COVID-19 ,SARS-CoV-2 ,arthritis ,autoimmune systemic diseases ,connective tissue diseases ,interstitial lung disease ,rheumatic diseases ,Arthritis ,Keywords: COVID-19 ,Scleroderma ,Autoimmune Diseases ,Covid-19 ,Autoimmune systemic diseases ,Connective tissue diseases ,Interstitial lung disease ,Rheumatic diseases ,Systemic sclerosis ,Internal medicine ,Rheumatic Diseases ,Drug Discovery ,Pandemic ,medicine ,Humans ,education ,rheumatic disease ,Lung ,Pandemics ,Pharmacology ,education.field_of_study ,Aspirin ,business.industry ,covid 19 ,medicine.disease ,arthriti ,connective tissue disease ,business ,medicine.drug - Abstract
Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations. Objective: This study aims to investigate the prevalence of symptomatic Covid-19 and its correlations with both organ involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic. Methods: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral centers of northern, central, and southern Italian macro-areas with different diffusion of the pandemic. Symptomatic SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal swabs) or highly suspected Covid-19 (highly suggestive symptoms, in the absence of a swab testing). Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to the Italian general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas (p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000). Patients treated with either conventional disease-modifying anti-rheumatic drugs (DMARDs) and/or biological DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing low-dose aspirin showed a significantly lower rate of Covid-19 compared to those without (p=0.003). Conclusion: The higher prevalence of Covid-19 in ASD patients, along with the significant correlations with important clinical features and therapeutic regimens, suggests the need to develop targeted prevention/management strategies during the current pandemic wave.
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- 2021
27. Impact of COVID-19 and vaccination campaign on 1,755 systemic sclerosis patients during first three years of pandemic. Possible risks for individuals with impaired immunoreactivity to vaccine, ongoing immunomodulating treatments, and disease-related lung involvement during the next pandemic phase.
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Ferri C, Raimondo V, Giuggioli D, Gragnani L, Lorini S, Dagna L, Bosello SL, Foti R, Riccieri V, Guiducci S, Cuomo G, Tavoni A, De Angelis R, Cacciapaglia F, Zanatta E, Cozzi F, Murdaca G, Cavazzana I, Romeo N, Codullo V, Pellegrini R, Varcasia G, De Santis M, Selmi C, Abignano G, Caminiti M, L'Andolina M, Olivo D, Lubrano E, Spinella A, Lumetti F, De Luca G, Ruscitti P, Urraro T, Visentini M, Bellando-Randone S, Visalli E, Testa D, Sciascia G, Masini F, Pellegrino G, Saccon F, Balestri E, Elia G, Ferrari SM, Tonutti A, Dall'Ara F, Pagano Mariano G, Pettiti G, Zanframundo G, Brittelli R, Aiello V, Dal Bosco Y, Foti R, Di Cola I, Scorpiniti D, Fusaro E, Ferrari T, Gigliotti P, Campochiaro C, Francioso F, Iandoli C, Caira V, Zignego AL, D'Angelo S, Franceschini F, Matucci-Cerinic M, Giacomelli R, Doria A, Santini SA, Fallahi P, Iannone F, and Antonelli A
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Introduction: The impact of COVID-19 pandemic represents a serious challenge for 'frail' patients' populations with inflammatory autoimmune systemic diseases such as systemic sclerosis (SSc). We investigated the prevalence and severity of COVID-19, as well the effects of COVID-19 vaccination campaign in a large series of SSc patients followed for the entire period (first 38 months) of pandemic., Patients and Method: This prospective survey study included 1755 unselected SSc patients (186 M, 1,569F; mean age 58.7 ± 13.4SD years, mean disease duration 8.8 ± 7.3SD years) recruited in part by telephone survey at 37 referral centers from February 2020 to April 2023. The following parameters were carefully evaluated: i. demographic, clinical, serological, and therapeutical features; ii. prevalence and severity of COVID-19; and iii. safety, immunogenicity, and efficacy of COVID-19 vaccines., Results: The prevalence of COVID-19 recorded during the whole pandemic was significantly higher compared to Italian general population (47.3 % vs 43.3 %, p < 0.000), as well the COVID-19-related mortality (1.91 % vs 0.72 %, p < 0.001). As regards the putative prognostic factors of worse outcome, COVID-19 positive patients with SSc-related interstitial lung involvement showed significantly higher percentage of COVID-19-related hospitalization compared to those without (5.85 % vs 1.73 %; p < 0.0001), as well as of mortality rate (2.01 % vs 0.4 %; p = 0.002). Over half of patients (56.3 %) received the first two plus one booster dose of vaccine; while a fourth dose was administered to 35.6 %, and only few of them (1.99 %) had five or more doses of vaccine. Of note, an impaired seroconversion was recorded in 25.6 % of individuals after the first 2 doses of vaccine, and in 8.4 % of patients also after the booster dose. Furthermore, the absence of T-cell immunoreactivity was observed in 3/7 patients tested by QuantiFERON® SARSCoV-2 Starter Set (Qiagen). The efficacy of vaccines, evaluated by comparing the COVID-19-related death rate recorded during pre- and post-vaccination pandemic periods, revealed a quite stable outcome in SSc patients ( death rate from 2.54 % to 1.76 %; p = ns), despite the significant drop of mortality observed in the Italian general population (from 2.95 % to 0.29 %; p < 0.0001)., Conclusions: An increased COVID-19 prevalence and mortality rate was recorded in SSc patients; moreover, the efficacy of vaccines in term of improved outcomes was less evident in SSc compared to Italian general population. This discrepancy might be explained by concomitant adverse prognostic factors: increased rate of non-responders to vaccine in SSc series, low percentage of individuals with four or more doses of vaccine, ongoing immunomodulating treatments, disease-related interstitial lung disease, and/or reduced preventive measures in the second half of pandemic. A careful monitoring of response to COVID-19 vaccines together with adequate preventive/therapeutical strategies are highly recommendable in the near course of pandemic in this frail patients' population., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Alessandro Antonelli reports financial support was provided by Italian 10.13039/100009647Ministry of Health, Ricerca Finalizzata (RF-2021-12374986) Destinatario istituzionale: Regione Toscana. Unità Operative:U.O.1: Azienda Ospedaliero-Universitaria Pisana; U.O.2: Azienda Ospedaliero-Universitaria Aldo Moro Bari; U.O.3: Azienda Ospedaliero-Universitaria Modena, CUP Master: D55E22000670001., (© 2023 Published by Elsevier B.V.)
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- 2023
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28. Dyadic Archetypes of Patient Self-Care and Caregiver Contribution to Self-Care in Dyads With Multiple Chronic Conditions: An Observational Study.
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De Maria M, Lee CS, Matarese M, Vellone E, Lorini S, and Ausili D
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- Humans, Female, Aged, Male, Cross-Sectional Studies, Patient Care, Quality of Life, Self Care, Caregivers
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Self-care of multiple chronic conditions (MCCs) and caregiver contribution to self-care have been theorized as dyadic. However, the different dyadic archetypes are still unknown. This cross-sectional study aimed to identify dyadic archetypes related to how in patient-caregiver dyads manage the patient's MCCs and to describe other ways in which the dyadic archetypes differ. A sample of 340 MCCs patient-caregiver dyads was enrolled in outpatient and community settings. Patients had a mean age of 76.7 (±7.3) years and were mostly female (54.5%). Caregivers had a mean age of 54.6 (±15.1) years and were mostly female (71.5%). Four dyadic archetypes were observed: "autonomous," "compensatory," "balanced," and "complementary" care. Clinical programs should consider the different characteristics of dyads to support self-care.
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- 2023
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29. Evaluation of Plasma miR-17-5p, miR-24-3p and miRNA-223-3p Profile of Hepatitis C Virus-Infected Patients after Treatment with Direct-Acting Antivirals.
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Öksüz Z, Gragnani L, Lorini S, Temel GÖ, Serin MS, and Zignego AL
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The expression of miR-223-3p, miR-17-5p, and miR-24-3p was evaluated in hepatitis C virus (HCV) patient serum samples, collected before DAA treatment and after a sustained virological response (SVR). Fifty HCV patients were stratified based on their liver damage stages into three different subgroups (21 with chronic hepatitis-CH, 15 with cirrhosis, and 14 with hepatocellular carcinoma-HCC). Considering the entire HCV population, the miRNA expression levels were significantly downregulated after the SVR compared to pre-treatment ones ( p < 0.05). Stratifying the patients based on liver damage, the post-SVR values of the three miRNAs were significantly downregulated compared to the pre-treatment levels for both cirrhosis and HCC patients. No significant differences emerged from the analysis of the CH group. To our knowledge, this is the first study to detail the behavior of miR-223-3p, miR-17-5p, and miR-24-3p levels in patients with HCV-related CH, cirrhosis, and HCC after DAA therapy. Our findings show that HCV-infected patients have different miRNA profiles before and after treatment with DAAs, strongly suggesting that miRNAs may be involved in the pathogenesis of HCV-related damage. In this respect, the correlation observed among the three studied miRNAs could imply that they share common pathways by which they contribute the progression of HCV-induced chronic liver damage.
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- 2023
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30. Serological and Molecular Characterization of Hepatitis C Virus-Related Cryoglobulinemic Vasculitis in Patients without Cryoprecipitate.
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Napodano C, Ciasca G, Chiusolo P, Pocino K, Gragnani L, Stefanile A, Gulli F, Lorini S, Minnella G, Fosso F, Di Santo R, Romanò S, Basile V, De Stefano V, Rapaccini GL, Zignego AL, Di Stasio E, Marino M, and Basile U
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- Humans, Male, Female, Rheumatoid Factor blood, Immunoglobulins blood, Vasculitis diagnosis, Vasculitis immunology, Vasculitis virology, Cryoglobulinemia diagnosis, Cryoglobulinemia virology, Cryoglobulins analysis, Hepatitis C, Chronic blood, Hepatitis C, Chronic complications
- Abstract
Prolonged B cells stimulation due to the Hepatitis C virus (HCV) can result in autoimmunity, stigmatized by rising levels of cryoglobulins (CGs), the rheumatoid factor (RF), and free light chains (FLC) of immunoglobulins (Ig) associated with a range of symptoms, from their absence to severe cryoglobulinemic vasculitis and lymphoma. Here, we aimed to identify an immunological signature for the earliest stages of vasculitis when cryoprecipitate is still not detectable. We firstly analyzed the IgG subclasses, FLC, and RF in 120 HCV-RNA-positive patients divided into four groups according to the type of cryoprecipitate and symptoms: 30 asymptomatic without cryoprecipitate (No Cryo), 30 with vasculitis symptoms but without CGs that we supposed were circulating but still not detectable (Circulating), 30 type II and 30 type III mixed cryoglobulinemia (Cryo II and Cryo III, respectively). Our results revealed that patients with supposed circulating CGs displayed a pattern of serological parameters that closely resembled Cryo II and Cryo III, with a stronger similarity to Cryo II. Accordingly, we analyzed the groups of Circulating and Cryo II for their immunoglobulin heavy chain (IgH) and T-cell receptor (TCR) gene rearrangements, finding a similar mixed distribution of monoclonal, oligoclonal, and polyclonal responses compared to a control group of ten HCV-RNA-negative patients recovered from infection, who displayed a 100% polyclonal response. Our results strengthened the hypothesis that circulating CGs are the origin of symptoms in HCV-RNA-positive patients without cryoprecipitate and demonstrated that an analysis of clonal IGH and TCR rearrangements is the best option for the early diagnosis of extrahepatic complications.
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- 2023
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31. COVID-19 and Mixed Cryoglobulinemia Syndrome: Long-Term Survey Study on the Prevalence and Outcome, Vaccine Safety, and Immunogenicity.
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Gragnani L, Visentini M, Lorini S, Santini SA, Lauletta G, Mazzaro C, Urraro T, Quartuccio L, Cacciapaglia F, Ruscitti P, Tavoni A, Marri S, Cusano G, Petraccia L, Naclerio C, Treppo E, Del Frate G, Di Cola I, Raimondo V, Scorpiniti D, Monti M, Puccetti L, Elia G, Fallahi P, Basili S, Scarpato S, Iannone F, Casato M, Antonelli A, Zignego AL, and Ferri C
- Subjects
- Aged, Aged, 80 and over, Humans, Middle Aged, Antibodies, Viral, Immunologic Factors, Prevalence, Vaccination adverse effects, Vaccines, COVID-19 complications, COVID-19 epidemiology, COVID-19 Vaccines adverse effects, Cryoglobulinemia diagnosis, Cryoglobulinemia epidemiology
- Abstract
Purpose: Mixed cryoglobulinemia syndrome (MCs) is a rare immunoproliferative systemic disorder with cutaneous and multiple organ involvement. Our multicenter survey study aimed to investigate the prevalence and outcome of COVID-19 and the safety and immunogenicity of COVID-19 vaccines in a large MCs series., Methods: The survey included 430 unselected MCs patients (130 M, 300 F; mean age 70 ± 10.96 years) consecutively collected at 11 Italian referral centers. Disease classification, clinico-serological assessment, COVID-19 tests, and vaccination immunogenicity were carried out according to current methodologies., Results: A significantly higher prevalence of COVID-19 was found in MCs patients compared to Italian general population (11.9% vs 8.0%, p < 0.005), and the use of immunomodulators was associated to a higher risk to get infected (p = 0.0166). Moreover, higher mortality rate was recorded in MCs with COVID-19 compared to those without (p < 0.01). Patients' older age (≥ 60 years) correlated with worse COVID-19 outcomes. The 87% of patients underwent vaccination and 50% a booster dose. Of note, vaccine-related disease flares/worsening were significantly less frequent than those associated to COVID-19 (p = 0.0012). Impaired vaccination immunogenicity was observed in MCs patients compared to controls either after the first vaccination (p = 0.0039) and also after the booster dose (p = 0.05). Finally, some immunomodulators, namely, rituximab and glucocorticoids, hampered the vaccine-induced immunogenicity (p = 0.029)., Conclusions: The present survey revealed an increased prevalence and morbidity of COVID-19 in MCs patients, as well an impaired immunogenicity even after booster vaccination with high rate of no response. Therefore, MCs can be included among frail populations at high risk of infection and severe COVID-19 manifestations, suggesting the need of a close monitoring and specific preventive/therapeutical measures during the ongoing pandemic., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2023
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32. B-cell activating factor (BAFF), BAFF promoter and BAFF receptor allelic variants in hepatitis C virus related Cryoglobulinemic Vasculitis and Non-Hodgkin's Lymphoma.
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Gragnani L, Lorini S, Marri S, Rattotti S, Madia F, Zibellini S, Monti M, Basile U, Di Stasio E, Libra M, Arcaini L, and Zignego AL
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- Alleles, Hepacivirus, Humans, Interleukin-4, B-Cell Activating Factor genetics, B-Cell Activation Factor Receptor genetics, Cryoglobulinemia genetics, Hepatitis C complications, Hepatitis C genetics, Lymphoma, Non-Hodgkin complications, Lymphoma, Non-Hodgkin genetics, Vasculitis complications, Vasculitis genetics
- Abstract
Cryoglobulinemic Vasculitis (CV) is an autoimmune/lymphoproliferative disorder associated with HCV infection that in 5%-10% of cases evolves into a B cell Non-Hodgkin's Lymphoma (NHL). B-cell activating factor (BAFF) is a key regulator in B-cell development and survival. Particular genetic variants are responsible for BAFF signaling impairment in autoimmune and neoplastic diseases. We evaluated BAFF and BAFF-receptor (BAFF-R) polymorphisms in order to determine if they predispose to HCV-related CV and NHL. The analysis was performed on 416 HCV-chronically infected patients: 136 HCV without signs/symptoms of lymphoproliferations/autoimmunity (HCV), 166 HCV with CV (HCV-CV) and 114 HCV with NHL (HCV-NHL). Rs9514828 SNP on BAFF promoter, rs61756766 on BAFF-R and rs12428930 on the BAFF gene were evaluated by Real-Time PCR. Concerning rs9514828, the frequency of C/T genotype was significantly higher in HCV-CV than in HCV. The difference in the distribution of the T/T mutant genotype in HCV-CV compared to HCV was significant as well as the distribution of C/T and T/T genotype in HCV-NHL versus HCV. T minor allele was more frequent in HCV-NHL and HCV-CV than in HCV. The distribution of C/T + T/T (for the dominant model of penetrance C/T + T/T vs. C/C) was significantly higher in HCV-CV and HCV-NHL than in HCV. Genotyping of rs61756766 on BAFF-R coding gene, revealed C/T heterozygosis at a frequency of 11% in HCV-NHL versus 3% in HCV. The T minor allele frequency was higher in HCV-NHL than in HCV. No differences emerged by genotyping rs12428930 SNP on BAFF coding gene. Our results reinforce the hypothesis that BAFF/BAFF-R genetic pattern has a role in the pathogenesis of HCV-related lymphoproliferations. BAFF/BAFF-R variants could identify a risk haplotype for HCV related CV and NHL and a BAFF/BAFF-R genetic profile assessment could potentially contribute to tailoring anti-BAFF therapy by identifying patients with BAFF alterations in which the treatment could be more beneficial., (© 2022 The Authors. Hematological Oncology published by John Wiley & Sons Ltd.)
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- 2022
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33. Patient Self-Care and Caregiver Contribution to Patient Self-Care of Chronic Conditions: What Is Dyadic and What It Is Not.
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De Maria M, Ausili D, Lorini S, Vellone E, Riegel B, and Matarese M
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- Chronic Disease, Cross-Sectional Studies, Humans, Self Care, Caregivers, Heart Failure
- Abstract
Objectives: Self-care of chronic conditions involves both patients and their informal caregivers and therefore might be considered as a dyadic phenomenon. Nevertheless, empirical evidence supporting a dyadic construct is unavailable. This study aimed to explore the existence of a dyadic construct in self-care maintenance, monitoring, and management in patients affected by chronic conditions and their informal caregivers., Methods: This study used a cross-sectional design. We used the Self-Care of Chronic Illness Inventory and the Caregiver Contribution to Self-Care of Chronic Illness Inventory, which measure patient self-care and informal caregivers' contribution to self-care maintenance, monitoring and management. Exploratory Structural Equation Modeling was performed to verify the existence of dyadic latent constructs in each scale in patients and informal caregivers., Results: A convenience sample of 493 patients and informal caregivers, with a mean age of 76.47 and 52.76 years, respectively, was studied. In the self-care maintenance scales, 2 correlated factors (r = 0.34, P < .001) were identified, indicating the presence of a dyadic second-order construct. In addition, 2 factors that were not correlated (r = 0.11, P = .064) were identified in the self-care monitoring scales, indicating the absence of a dyadic construct. Finally, we found a 3-factor model in the self-care management scales composed of both patient and caregiver items, indicating a dyadic first-order construct., Conclusions: Knowing which care behaviors are dyadic in chronic conditions is important for tailoring interventions to improve self-care. Self-care maintenance and management would benefit from dyadic interventions, while self-care monitoring would not. The results of this study may illuminate future theoretical and scientific developments in dyadic care of chronic illness., (Copyright © 2022. Published by Elsevier Inc.)
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- 2022
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34. Absent or suboptimal response to booster dose of COVID-19 vaccine in patients with autoimmune systemic diseases.
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Ferri C, Gragnani L, Raimondo V, Visentini M, Giuggioli D, Lorini S, Foti R, Cacciapaglia F, Caminiti M, Olivo D, Cuomo G, Pellegrini R, Pigatto E, Urraro T, Naclerio C, Tavoni A, Puccetti L, Cavazzana I, Ruscitti P, Vadacca M, La Gualana F, Cozzi F, Spinella A, Visalli E, Bosco YD, Amato G, Masini F, Mariano GP, Brittelli R, Aiello V, Scorpiniti D, Rechichi G, Varcasia G, Monti M, Elia G, Franceschini F, Casato M, Ursini F, Giacomelli R, Fallahi P, Santini SA, Iannone F, Salvarani C, Zignego AL, and Antonelli A
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- Antibodies, Viral, BNT162 Vaccine, Humans, Immunization, Secondary, Vaccination, COVID-19 prevention & control, COVID-19 Vaccines
- Abstract
Autoimmune systemic diseases (ASD) show impaired immunogenicity to COVID-19 vaccines. Our prospective observational multicenter study aimed at evaluating the seroconversion elicited by COVID-19 vaccine over the entire vaccination cycle including the booster dose. Among 478 unselected ASD patients originally evaluated at the end of the first vaccination cycle (time 1), 344 individuals were re-evaluated after a 6-month period (time 2), and 244 after the booster vaccine dose (time 3). The immunogenicity of mRNA COVID-19 vaccines (BNT162b2 and mRNA-1273) was assessed by measuring serum IgG-neutralizing antibody (NAb) on samples obtained at the three time points in both patients and 502 age-matched controls. In the 244 ASD group that received booster vaccine and monitored over the entire follow-up, the mean serum NAb levels (time 1, 2, and 3: 696.8 ± 52.68, 370.8 ± 41.92, and 1527 ± 74.16SD BAU/mL, respectively; p < 0.0001) were constantly lower compared to controls (p < 0.0001), but they significantly increased after the booster dose compared to the first two measurements (p < 0.0001). The percentage of patients with absent/suboptimal response to vaccine significantly decreased after the booster dose compared to the first and second evaluations (time 1, 2, and 3: from 28.2% to 46.3%, and to 7.8%, respectively; p < 0.0001). Of note, the percentage of patients with absent/suboptimal response after the booster dose was significantly higher compared to controls (19/244, 7.8% vs 1/502, 0.2%; p < 0.0001). Similarly, treatment with immune-modifiers increased the percentage of patients exhibiting absent/suboptimal response (16/122, 13.1% vs 3/122, 2.46%; p = 0.0031). Overall, the above findings indicate the usefulness of booster vaccine administration in ASD patients. Moreover, the persistence of a significantly higher percentage of individuals without effective seroconversion (7.8%), even after the booster dose, warrants for careful monitoring of NAb levels in all ASD patients to identify those with increased risk of infection. In this particularly frail patients' setting, tailored vaccination and/or therapeutic strategy are highly advisable., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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35. Flares of mixed cryoglobulinaemia vasculitis after vaccination against SARS-CoV-2.
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Visentini M, Gragnani L, Santini SA, Urraro T, Villa A, Monti M, Palladino A, Petraccia L, La Gualana F, Lorini S, Marri S, Madia F, Stefanini L, Basili S, Fiorilli M, Ferri C, Zignego AL, and Casato M
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Symptom Flare Up, COVID-19 prevention & control, COVID-19 Vaccines adverse effects, Cryoglobulinemia immunology, SARS-CoV-2 immunology, Vasculitis chemically induced
- Abstract
Competing Interests: Competing interests: None declared.
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- 2022
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36. Predictors of long-term cryoglobulinemic vasculitis outcomes after HCV eradication with direct-acting antivirals in the real-life.
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Gragnani L, Lorini S, Marri S, Vacchi C, Madia F, Monti M, Ferri C, and Zignego AL
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- Antiviral Agents therapeutic use, Hepacivirus, Humans, Persistent Infection, Cryoglobulinemia complications, Cryoglobulinemia drug therapy, Hepatitis C, Hepatitis C, Chronic complications, Hepatitis C, Chronic drug therapy, Vasculitis complications, Vasculitis drug therapy
- Abstract
Cryoglobulinemic vasculitis (CV) is the most frequent extrahepatic manifestation during HCV-chronic infection. An effective Direct Acting Antiviral-treatment leads to CV clinical response in the majority of CV-patients although symptoms may persist/recur despite a sustained virological response. At present, no standardized clinical predictive factors for disease maintenance/recurrence were proposed, as emerged from a complete literature review we performed and reported. Here we provided a detailed descriptive analysis of a wide population of CV patients treated with DAA-based regimes and followed-up after therapy completion for longer than 72 weeks, in order to identify clinical or laboratory predictors of disease outcome and to optimize the patient management. Together with some baseline symptoms (neuropathy, weakness and sicca syndrome), two newly created scores, CV- and Global Severity Index, emerged as reliable and standardized tools to predict CV clinical response before initiating an antiviral therapy. In addition to predictive parameters previously proposed in the world literature, these novel Indexes could fill an unmet gap in the clinical management of the complex HCV-related CV., (Copyright © 2021 Elsevier B.V. All rights reserved.)
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- 2022
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37. Rapid improvement of psychiatric stigmata after IFN-free treatment in HCV patients with and without cryoglobulinemic vasculitis.
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Gragnani L, Lorini S, Martini L, Stasi C, Visentini M, Petraccia L, Marello N, Monti M, Marri S, Madia F, Ricca V, and Zignego AL
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- Antiviral Agents therapeutic use, Hepacivirus, Humans, Quality of Life, Cryoglobulinemia complications, Cryoglobulinemia drug therapy, Hepatitis C complications, Hepatitis C drug therapy, Hepatitis C, Chronic complications, Hepatitis C, Chronic drug therapy, Vasculitis drug therapy
- Abstract
Objective: Hepatitis C virus (HCV) causes neuropsychiatric disorders and quality of life impairment, especially in patients with cryoglobulinemic vasculitis (CV). Direct acting antivirals (DAAs) are effective in most extrahepatic HCV diseases, but limited information exists regarding the outcome of psychiatric disorders in patients with and without CV, after therapy. We aimed to evaluate psychiatric outcomes, in HCV-patients with and without CV, before and after successful DAA therapy., Methods: We prospectively studied DAA-treated HCV-patients, stratified into presence (CV) or absence of CV (NON-CV). Four psychometric scales were administered to assess depression (HAM-D and MADRS), anxiety (HAM-A), and mania (MRS). Short-Form-36 questionnaires evaluated quality of life., Results: Seventy-six patients were recruited, and 47 CV and 29 NON-CV were treated with antivirals. At baseline, depression and anxiety, from mild to severe, were frequently shown, with the most advanced cases in thee CV group; no patients achieved the scores for mania. A significant improvement emerged for all the psychometric scales in the entire population and in the subgroups, after viral eradication even in the short-term outcome. The Short-Form-36 summary components showed benefits., Conclusions: After HCV eradication, the depression and anxiety scores significantly improved and severity grade generally lowered. DAA-positive effects on mental disorders should be considered part of the therapy outcome, being beneficial especially in CV patients who usually have worse baseline mental scores. Key Points • HCV frequently causes psychiatric disorders and an often-invalidating autoimmune/lymphoproliferative disease called cryoglobulinemic vasculitis. • The new direct acting antivirals (DAAs) are very effective and well tolerated by HCV-patients. • This study shows DAA-induced benefits on depression and anxiety in HCV-patients that are especially evident in CV patients who usually have worse baseline mental scores. • DAA-induced benefits are observed in the short-term post-therapy follow-up, in contrast with data previously obtained in HCV patients treated with IFN-based anti-HCV therapy., (© 2021. The Author(s).)
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- 2022
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38. Prevalence and Death Rate of COVID-19 in Autoimmune Systemic Diseases in the First Three Pandemic Waves. Relationship with Disease Subgroups and Ongoing Therapies.
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Ferri C, Raimondo V, Gragnani L, Giuggioli D, Dagna L, Tavoni A, Ursini F, L'Andolina M, Caso F, Ruscitti P, Caminiti M, Foti R, Riccieri V, Guiducci S, Pellegrini R, Zanatta E, Varcasia G, Olivo D, Gigliotti P, Cuomo G, Murdaca G, Cecchetti R, De Angelis R, Romeo N, Ingegnoli F, Cozzi F, Codullo V, Cavazzana I, Colaci M, Abignano G, De Santis M, Lubrano E, Fusaro E, Spinella A, Lumetti F, De Luca G, Bellando-Randone S, Visalli E, Bosco YD, Amato G, Giannini D, Bilia S, Masini F, Pellegrino G, Pigatto E, Generali E, Mariano GP, Pettiti G, Zanframundo G, Brittelli R, Aiello V, Caminiti R, Scorpiniti D, Ferrari T, Campochiaro C, Brusi V, Fredi M, Moschetti L, Cacciapaglia F, Paparo SR, Ragusa F, Mazzi V, Elia G, Ferrari SM, Di Cola I, Vadacca M, Lorusso S, Monti M, Lorini S, Aprile ML, Tasso M, Miccoli M, Bosello S, D'Angelo S, Doria A, Franceschini F, Meliconi R, Matucci-Cerinic M, Iannone F, Giacomelli R, Salvarani C, Zignego AL, Fallahi P, and Antonelli A
- Subjects
- Aged, Humans, Male, Middle Aged, Pandemics, Prevalence, Prospective Studies, Antirheumatic Agents therapeutic use, Autoimmune Diseases drug therapy, Autoimmune Diseases epidemiology, COVID-19 epidemiology, Lung Diseases, Interstitial drug therapy, Lung Diseases, Interstitial epidemiology, Scleroderma, Systemic, COVID-19 Drug Treatment
- Abstract
Objective: Autoimmune systemic diseases (ASD) represent a predisposing condition to COVID-19. Our prospective, observational multicenter telephone survey study aimed to investigate the prevalence, prognostic factors, and outcomes of COVID-19 in Italian ASD patients., Methods: The study included 3,918 ASD pts (815 M, 3103 F; mean age 59±12SD years) consecutively recruited between March 2020 and May 2021 at the 36 referral centers of COVID-19 and ASD Italian Study Group. The possible development of COVID-19 was recorded by means of a telephone survey using a standardized symptom assessment questionnaire., Results: ASD patients showed a significantly higher prevalence of COVID-19 (8.37% vs. 6.49%; p<0.0001) but a death rate statistically comparable to the Italian general population (3.65% vs. 2.95%). Among the 328 ASD patients developing COVID-19, 17% needed hospitalization, while mild-moderate manifestations were observed in 83% of cases. Moreover, 12/57 hospitalized patients died due to severe interstitial pneumonia and/or cardiovascular events; systemic sclerosis (SSc) patients showed a significantly higher COVID-19-related death rate compared to the general population (6.29% vs. 2.95%; p=0.018). Major adverse prognostic factors to develop COVID-19 were: older age, male gender, SSc, pre-existing ASD-related interstitial lung involvement, and long-term steroid treatment. Of note, patients treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) showed a significantly lower prevalence of COVID-19 compared to those without (3.58% vs. 46.99%; p=0.000), as well as the SSc patients treated with low dose aspirin (with 5.57% vs. without 27.84%; p=0.000)., Conclusion: During the first three pandemic waves, ASD patients showed a death rate comparable to the general population despite the significantly higher prevalence of COVID-19. A significantly increased COVID-19- related mortality was recorded in only SSc patients' subgroup, possibly favored by preexisting lung fibrosis. Moreover, ongoing long-term treatment with csDMARDs in ASD might usefully contribute to the generally positive outcomes of this frail patients' population., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2022
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39. COVID-19 vaccine immunogenicity in 16 patients with autoimmune systemic diseases. Lack of both humoral and cellular response to booster dose and ongoing disease modifying therapies.
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Gragnani L, Visentini M, Lorini S, La Gualana F, Santini SA, Cacciapaglia F, Tavoni A, Cuomo G, Fallahi P, Iannone F, Antonelli A, Casato M, Zignego AL, and Ferri C
- Abstract
Background: Patients with autoimmune systemic diseases (ASDs) represent a frail population during the ongoing COVID-19 pandemic. The vaccination is the major preventive measure; however, a significant number of ASD patients show an impaired production of anti-COVID-19 neutralizing antibodies (NAb), possibly counterbalanced by adequate T-cell response. The present study aimed at evaluating both humoral and cellular response to COVID-19 vaccine booster dose in this particular setting., Patients and Methods: Serum NAb titer and T-cell response (measuring interferon gamma -IFN-γ- release) were evaluated 3 weeks after the COVID-19 vaccine booster dose, in 17 patients (12 F, mean age 68.8 ± 15.3 SD yrs) with different ASDs, compared to 17 healthy controls (HCs)., Results: The analysis excluded one patient reporting symptoms of COVID-19 only after the immunogenicity tests had been performed.The NAb levels were significantly lower in ASD compared to HCs (p < 0.0001); moreover, patients showed a higher percentage of negative/sub-optimal humoral response (31% vs 0% of HCs; p = 0.0184).The study of cellular response showed lower levels of IFN-γ for both Ag1 ( p = 0.0032) and Ag2 (p = 0.0136) in ASD patients compared to HCs, as well lower rate of adequate T-cell response compared to HCs (50% vs 94%; p = 0.0066).Disease modifying therapies (DMT) were administered in all patients with deficient NAb production (5/5, 100%), but in only 3/11 (27%) of responders ( p = 0.025).Worthy to note, 3/16 (19%) ASD patients developed neither humoral nor cellular responses, all treated with DMT., Conclusions: The impaired immunogenicity to COVID-19 vaccine booster and even more the concomitant lack of both humoral and cellular response might represent a high risk for severe COVID-19, particularly in ASD patients undergoing DMT.These frail subjects should be tightly monitored for their immune protection and prioritized for the fourth dose of COVID-19 vaccine. Moreover, in the occurrence of SARS-CoV2 infection, treatments with specific monoclonal antibodies and/or antivirals may be highly recommendable., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)
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- 2022
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40. REPLY.
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Gragnani L, Lorini S, and Zignego AL
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- 2021
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41. Development and Psychometric Testing of the Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale.
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De Maria M, Iovino P, Lorini S, Ausili D, Matarese M, and Vellone E
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- Cost of Illness, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Psychometrics instrumentation, Psychometrics methods, Reproducibility of Results, Self Care methods, Self Care psychology, Caregivers psychology, Psychometrics standards, Self Efficacy
- Abstract
Objectives: Caregiver self-efficacy-a caregiver's belief in his/her ability to contribute to patient self-care-is associated with better patient and caregiver outcomes in single chronic conditions. It is, however, unknown if caregiver self-efficacy improves patient and caregiver outcomes in multiple chronic conditions (MCCs) because there is no instrument to measure this variable. We developed the 10-item Caregiver Self-Efficacy in Contributing to patient Self-Care (CSE-CSC) scale for that purpose, and we tested its psychometric characteristics in caregivers of patients with MCCs., Methods: In this cross-sectional multisite study, we tested the structural validity of the CSE-CSC scale with exploratory and confirmatory factor analysis, and we tested construct validity by correlating CSE-CSC scores with those of the Caregiver Contributions to Self-Care of Chronic Illness Inventory. We also tested reliability, and precision of the CSE-CSC scale., Results: The 358 enrolled caregivers (mean age 54.6 years; 71.5% female) cared for patients with an average of 3.2 chronic conditions. Structural validity was good, and it showed 2 factors within the scale. Construct validity showed significant correlations between scores of the CSE-CSC scale and the Caregiver Contributions to Self-Care of Chronic Illness Inventory. Reliability coefficients were between 0.90 and 0.97. Measurement error yielded satisfactory results., Conclusions: The CSE-CSC scale is valid, reliable, and precise in measuring caregiver self-efficacy in contributing to patient self-care in MCCs. Because caregiver self-efficacy is a modifiable variable, the CSE-CSC scale can be used in clinical practice and research to improve patient and caregiver outcomes., (Copyright © 2021 ISPOR–The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)
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- 2021
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42. Hematological and Genetic Markers in the Rational Approach to Patients With HCV Sustained Virological Response With or Without Persisting Cryoglobulinemic Vasculitis.
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Gragnani L, Lorini S, Marri S, Basile U, Santarlasci V, Monti M, Madia F, Petraccia L, Stasi C, Marello N, Napodano C, Annunziato F, and Zignego AL
- Subjects
- Aged, Chromosomes, Human, Pair 14 genetics, Chromosomes, Human, Pair 18 genetics, Cryoglobulinemia genetics, Female, Hepatitis C, Chronic blood, Hepatitis C, Chronic genetics, Humans, Immunoglobulin kappa-Chains blood, Immunoglobulin lambda-Chains blood, Male, Middle Aged, Polymorphism, Single Nucleotide, Prognosis, Receptor, Notch4 genetics, Recurrence, Sustained Virologic Response, Translocation, Genetic, Vasculitis genetics, Antiviral Agents therapeutic use, Cryoglobulinemia blood, Hepatitis C, Chronic drug therapy, Vasculitis blood
- Abstract
Background and Aims: Direct-acting antivirals (DAAs) usually lead to improvement/remission of cryoglobulinemic vasculitis (CV), although symptoms may persist/recur after a sustained virological response (SVR). We evaluated hematological and genetic markers in patients with HCV-SVR vasculitis with and without persisting/recurring symptoms to early predict the CV outcome., Approach and Results: Ninety-eight patients with HCV-CV were prospectively enrolled after a DAA-induced SVR: Group A: 52 with complete clinical response; Group B: 46 with symptom maintenance/recurrence. Monoclonal B-cell lymphocytosis, t(14;18) translocation, and abnormal free light chains κ/λ ratios were detected by flow cytometry or nested-PCR or nephelometry in 4% Group A versus 17% Group B (P = 0.04) patients, 17% Group A versus 40% Group B patients (P = 0.02), and 17% Group A versus 47% Group B (P = 0.003) patients, respectively. At least 1 out of 3 clonality markers was altered/positive in 29% of Group A versus 70% of Group B patients (P < 0.0001). When available, pretherapy samples were also tested for t(14;18) translocation (detected in 12/37 [32%] Group A and 21/38 [55%] Group B) and κ/λ ratios (abnormal in 5/35 [14%] Group A and 20/38 [53%] Group B) (P = 0.0006), whereas at least one clonality marker was detected/altered in 16/37 (43%) Group A and 30/38 (79%) Group B (P = 0.002). CV-associated single-nucleotide polymorphisms were tested by real-time PCR. Among them, notch4 rs2071286 T minor allele and TT genotype showed a higher frequency in Group B versus Group A (46% vs. 29%, P = 0.01, and 17% vs. 2%, P = 0.006, respectively)., Conclusions: Hematological or genetic analyses could be used to foresee the CV clinical response after DAA therapy and could be valuable to assess a rational flowchart to manage CV during follow-up., (© 2021 The Authors. Hepatology published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases.)
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- 2021
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43. Solving the mystery of HBV-related mixed cryoglobulinemia: potential biomarkers of disease progression.
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Pocino K, Napodano C, Gragnani L, Ciasca G, Colantuono S, Marri S, Vantaggio L, Gulli F, Lorini S, Barini A, Stefanile A, Miele L, Casato M, Zignego AL, Rapaccini GL, Marino M, Visentini M, and Basile U
- Subjects
- Adult, Aged, Aged, 80 and over, Disease Progression, Female, Humans, Male, Middle Aged, Pandemics, Retrospective Studies, SARS-CoV-2, Biomarkers blood, COVID-19 immunology, Cryoglobulinemia immunology, Cryoglobulinemia virology, Hepatitis B virus immunology
- Abstract
Objectives: The biomarkers of an immunological dysregulation due to a chronic HBV infection are indeed understudied. If untreated, this condition may evolve into liver impairment co-occurring with extrahepatic involvements. Here, we aim to identify a new panel of biomarkers [including immunoglobulin G (IgG) subclasses, RF, and Free Light Chains (FLCs)] that may be useful and reliable for clinical evaluation of HBV-related cryoglobulinemia., Methods: We retrospectively analysed clinical data from 44 HBV-positive patients. The patients were stratified (according to the presence/absence of mixed cryoglobulinemia) into two groups: 22 with cryoglobulins (CGs) and 22 without CGs. Samples from 20 healthy blood donors (HDs) were used as negative controls. Serum samples were tested for IgG subclasses, RF (-IgM, -IgG, and -IgA type), and FLCs., Results: We detected a strikingly different distribution of serum IgG subclasses between HDs and HBV-positive patients, together with different RF isotypes; in addition, FLCs were significantly increased in HBV-positive patients compared with HDs, while no significant difference was shown between HBV-positive patients with/without mixed cryoglobulinemia., Conclusion: The immune-inflammatory response triggered by HBV may be monitored by a peculiar profile of biomarkers. Our results open a new perspective in the precision medicine era; in these challenging times, they could also be employed to monitor the clinical course of those COVID-19 patients who are at high risk of HBV reactivation due to liver impairment and/or immunosuppressive therapies., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2021
- Full Text
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44. Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments.
- Author
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Ferri C, Giuggioli D, Raimondo V, L'Andolina M, Dagna L, Tavoni A, Caso F, Ursini F, Ruscitti P, Caminiti M, Foti R, Riccieri V, Guiducci S, Pellegrini R, Zanatta E, Varcasia G, Olivo D, Gigliotti P, Cuomo G, Murdaca G, Cecchetti R, De Angelis R, Romeo N, Ingegnoli F, Cozzi F, Codullo V, Cavazzana I, Colaci M, Abignano G, De Santis M, Lubrano E, Fusaro E, Rossa AD, Spinella A, Lumetti F, De Luca G, Bellando-Randone S, Visalli E, Dal Bosco Y, Amato G, Giannini D, Bilia S, Masini F, Pellegrino G, Pigatto E, Generali E, Mariano GP, Pettiti G, Zanframundo G, Brittelli R, Aiello V, Caminiti R, Scorpiniti D, Ferrari T, Campochiaro C, Brusi V, Fredi M, Moschetti L, Cacciapaglia F, Gragnani L, Monti M, Lorini S, Paparo SR, Ragusa F, Mazzi V, Elia G, Ferrari SM, Di Cola I, Vadacca M, Lorusso S, Barsotti S, Aprile ML, Marco T, Miccoli M, Bosello S, Matucci-Cerinic M, D'Angelo S, Doria A, Franceschini F, Meliconi R, Iannone F, Giacomelli R, Zignego AL, Fallahi P, and Antonelli A
- Subjects
- Humans, Lung, Pandemics, SARS-CoV-2, Autoimmune Diseases drug therapy, Autoimmune Diseases epidemiology, COVID-19, Rheumatic Diseases drug therapy, Rheumatic Diseases epidemiology
- Abstract
Background: The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations., Objective: This study aims to investigate the prevalence of symptomatic Covid-19 and its correlations with both organ involvement and ongoing treatments in a large series of Italian ASD patients during the first wave of pandemic., Methods: Our multicenter telephone 6-week survey included 3,029 unselected ASD patients enrolled at 36 tertiary referral centers of northern, central, and southern Italian macro-areas with different diffusion of the pandemic. Symptomatic SARS-CoV-2 infection was classified as definite Covid-19 (presence of symptoms plus positive oral/nasopharyngeal swabs) or highly suspected Covid-19 (highly suggestive symptoms, in the absence of a swab testing)., Results: A significantly higher prevalence of definite plus highly suspected Covid-19 compared to the Italian general population was detected in the whole ASD series (p=.000), as well as in patients from the three macro-areas (p=.000 in all). Statistically higher prevalence of Covid-19 was also found in connective tissue diseases compared to chronic arthritis subgroup (p=.000) and in ASD patients with pre-existing interstitial lung involvement (p=.000). Patients treated with either conventional disease-modifying anti-rheumatic drugs (DMARDs) and/or biological DMARDs showed a significantly lower prevalence of Covid-19 (p=.000 in both). Finally, scleroderma patients undergoing low-dose aspirin showed a significantly lower rate of Covid-19 compared to those without (p=0.003)., Conclusion: The higher prevalence of Covid-19 in ASD patients, along with the significant correlations with important clinical features and therapeutic regimens, suggests the need to develop targeted prevention/management strategies during the current pandemic wave., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
- Published
- 2021
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45. Role of Notch Receptors in Hematologic Malignancies.
- Author
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Gragnani L, Lorini S, Marri S, and Zignego AL
- Subjects
- Animals, Humans, Mice, Signal Transduction, B-Lymphocytes cytology, B-Lymphocytes metabolism, B-Lymphocytes pathology, Hematologic Neoplasms metabolism, Receptors, Notch physiology, T-Lymphocytes cytology, T-Lymphocytes metabolism, T-Lymphocytes pathology
- Abstract
Notch receptors are single-pass transmembrane proteins that play a critical role in cell fate decisions and have been implicated in the regulation of many developmental processes. The human Notch family comprises of four receptors (Notch 1 to 4) and five ligands. Their signaling can regulate extremely basic cellular processes such as differentiation, proliferation and death. Notch is also involved in hematopoiesis and angiogenesis, and increasing evidence suggests that these genes are involved and frequently deregulated in several human malignancies, contributing to cell autonomous activities that may be either oncogenic or tumor suppressive. It was recently proposed that Notch signaling could play an active role in promoting and sustaining a broad spectrum of lymphoid malignancies as well as mutations in Notch family members that are present in several disorders of T- and B-cells, which could be responsible for altering the related signaling. Therefore, different Notch pathway molecules could be considered as potential therapeutic targets for hematological cancers. In this review, we will summarize and discuss compelling evidence pointing to Notch receptors as pleiotropic regulators of hematologic malignancies biology, first describing the physiological role of their signaling in T- and B-cell development and homeostasis, in order to fully understand the pathological alterations reported.
- Published
- 2020
- Full Text
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46. The Relevance of MicroRNAs in the Pathogenesis and Prognosis of HCV-Disease: The Emergent Role of miR-17-92 in Cryoglobulinemic Vasculitis.
- Author
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Lorini S, Gragnani L, and Zignego AL
- Subjects
- Aged, Biomarkers, Carcinoma, Hepatocellular etiology, Cell Transformation, Neoplastic genetics, Cell Transformation, Neoplastic metabolism, Cryoglobulinemia etiology, Female, Genotype, Hepatitis C complications, Hepatitis C diagnosis, Humans, Liver Neoplasms etiology, Lymphoma etiology, Lymphoproliferative Disorders etiology, Male, Middle Aged, Prognosis, RNA, Long Noncoding, Vasculitis etiology, Disease Susceptibility, Hepacivirus physiology, Hepatitis C etiology, Host-Pathogen Interactions genetics, MicroRNAs genetics
- Abstract
Hepatitis C virus (HCV) is a major public health problem. HCV is a hepatotropic and lymphotropic virus that leads to hepatocellular carcinoma (HCC) and lymphoproliferative disorders such as cryoglobulinemic vasculitis (CV) and non-Hodgkin's lymphoma (NHL). The molecular mechanisms by which HCV induces these diseases are not fully understood. MicroRNAs (miRNAs) are small non-coding molecules that negatively regulate post-transcriptional gene expression by decreasing their target gene expression. We will attempt to summarize the current knowledge on the role of miRNAs in the HCV life cycle, HCV-related HCC, and lymphoproliferative disorders, focusing on both the functional effects of their deregulation as well as on their putative role as biomarkers, based on association analyses. We will also provide original new data regarding the miR 17-92 cluster in chronically infected HCV patients with and without lymphoproliferative disorders who underwent antiviral therapy. All of the cluster members were significantly upregulated in CV patients compared to patients without CV and significantly decreased in those who achieved vasculitis clinical remission after viral eradication. To conclude, miRNAs play an important role in HCV infection and related oncogenic processes, but their molecular pathways are not completely clear. In some cases, they may be potential therapeutic targets or non-invasive biomarkers of tumor progression.
- Published
- 2020
- Full Text
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47. Psychometric characteristics of the caregiver contribution to self-care of chronic illness inventory.
- Author
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Vellone E, Lorini S, Ausili D, Alvaro R, Di Mauro S, De Marinis MG, Matarese M, and De Maria M
- Subjects
- Chronic Disease, Cross-Sectional Studies, Factor Analysis, Statistical, Humans, Psychometrics, Reproducibility of Results, Surveys and Questionnaires, Caregivers, Self Care
- Abstract
Aim: The purpose of the this study was to test the factorial structure, internal consistency reliability and concurrent validity of the Caregiver Contribution to Self-Care Chronic Illness Inventory., Background: Existing measures of caregiver contribution to self-care are disease-specific or behaviour-specific; no generic measures exist., Design: A cross-sectional study., Method: Between April 2017 - December 2018, we enrolled a convenience sample of 358 patients with chronic illnesses and their caregivers. Patients completed the Self-Care of Chronic Illness Inventory while caregivers completed the Caregiver Contribution to Self-Care of Chronic Illness Inventory, a modification of the Self-Care of Chronic Illness Inventory, which includes three scales as follows: the Caregiver Contribution to Self-Care Maintenance, the Caregiver Contribution to Self-Care Monitoring and the Caregiver Contribution to Self-Care Management. Of each scale, we tested the factorial structure with confirmatory factor analysis and reliability with the factor score determinacy coefficient, the global reliability index for multidimensional scale and Cronbach's alpha. Also, we used Pearson's correlations for concurrent validity purposes., Results: Confirmatory factor analysis supported the two-factor structure of the Caregiver Contribution to Self-Care Maintenance and Management scales and the one-factor structure of the Caregiver Contribution to Self-Care Monitoring scale. A simultaneous confirmatory factor analysis on the combined set of items supported the more general model (Comparative Fit Index = 0.933). Reliability estimates ranged between 0.701 and 0.961 across the three scales. Concurrent validity of Caregiver Contribution to Self-Care of Chronic Illness Inventory with the Self-Care of Chronic Illness Inventory was not sufficiently supported since weak correlations were found., Conclusion: The Caregiver Contribution to Self-Care of Chronic Illness Inventory is valid and reliable and can be used in clinical practice and research., Impact: The Caregiver Contribution to Self-Care of Chronic Illness Inventory is an useful instrument to evaluate the extent to which caregivers contribute to patient self-care in chronic illnesses., (© 2020 John Wiley & Sons Ltd.)
- Published
- 2020
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48. Sentinel biomarkers in HCV positive patients with mixed cryoglobulinemia.
- Author
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Basile U, Marino M, Gragnani L, Napodano C, Gulli F, Pocino K, Lorini S, Santini SA, Basile V, Miele L, Zignego AL, and Rapaccini GL
- Subjects
- Aged, Biomarkers blood, Cryoglobulinemia complications, Female, Hepatitis C complications, Humans, Immunoglobulin G blood, Immunoglobulin G classification, Immunoglobulin Isotypes blood, Immunoglobulin Light Chains, Male, Middle Aged, Retrospective Studies, Rheumatic Fever blood, Vascular Endothelial Growth Factors blood, Cryoglobulinemia blood, Cryoglobulinemia virology, Hepacivirus, Hepatitis C blood
- Abstract
Background: Infections, autoimmunity and cancer play a role as determinants of etiology in Hepatitis C virus (HCV) related mixed cryoglobulinemia (MC). Several factors of risk have been suggested as markers of pathogenesis and progression of HCV-related MC into B cell Non-Hodgkin's Lymphoma (B-NHL). Here, we evaluated IgG subclass distribution, free light chains (FLCs) and vascular endothelial growth factor (VEGF) as a new combination of biomarkers., Methods: We measured IgG1-4 subclasses, FLCs and VEGF levels in sera 53 from HCV-related MC, in comparison with 40 sera from HCV negative patients with rheumatoid arthritis (RA) and 30 from healthy blood donors (HBD)., Results: IgG3 levels were significantly higher in HCV-MC patients with a decrement of IgG2 and IgG4; FLC levels significantly increased in both MC and RA patients' groups; serological VEGF was higher in HCV-MC patients than in HBD in correlation with k and λ levels., Conclusion: Our results suggest that a specific IgG subclasses pattern together with raised levels of FLCs and VEGF could represent the biomarker "signature" of an inflammation multistage of acquired immune system., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2020
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49. The metabolic fingerprints of HCV and HBV infections studied by Nuclear Magnetic Resonance Spectroscopy.
- Author
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Meoni G, Lorini S, Monti M, Madia F, Corti G, Luchinat C, Zignego AL, Tenori L, and Gragnani L
- Subjects
- Clinical Chemistry Tests methods, Female, Glycolysis, Hepatitis B diagnostic imaging, Hepatitis C diagnosis, Humans, Ketoglutaric Acids blood, Magnetic Resonance Spectroscopy methods, Male, Middle Aged, Oxidative Phosphorylation, Hepatitis B blood, Hepatitis C blood, Metabolome
- Abstract
Few studies are available on metabolic changes in liver injuries and this is the first metabolomic study evaluating a group of HCV-positive patients, before and after viral eradication via DAA IFN-free regimens, using
1 H-NMR to characterize and compare their serum fingerprints to naïve HBV-patients and healthy donors. The investigation clearly shows differences in the metabolomic profile of HCV patients before and after effective DAA treatment. Significant changes in metabolites levels in patients undergoing therapy suggest alterations in several metabolic pathways. It has been shown that1 H-NMR fingerprinting approach is an optimal technique in predicting the specific infection and the healthy status of studied subjects (Monte-Carlo cross validated accuracies: 86% in the HCV vs HBV model, 98.7% in the HCV vs HC model). Metabolite data collected support the hypothesis that the HCV virus induces glycolysis over oxidative phosphorylation in a similar manner to the Warburg effect in cancer, moreover our results have demonstrated a different action of the two viruses on cellular metabolism, corroborating the hypothesis that the metabolic perturbation on patients could be attributed to a direct role in viral infection. This metabolomic study has revealed some alteration in metabolites for the first time (2-oxoglutarate and 3-hydroxybutrate) concerning the HCV-infection model that could explain several extrahepatic manifestations associated with such an infection.- Published
- 2019
- Full Text
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50. Editorial: interferon-free DAAs are a great boon for patients with hepatitis C and cryoglobulinaemia-Authors' reply.
- Author
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Zignego AL, Lorini S, and Gragnani L
- Subjects
- Hepacivirus, Humans, Interferons, Prospective Studies, Quality of Life, Antiviral Agents, Cryoglobulinemia, Hepatitis C
- Published
- 2018
- Full Text
- View/download PDF
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