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725 results on '"Milani, Gregorio P."'

23. Kidney tubular injury induced by valproic acid: systematic literature review

Author

Anguissola, Giulia, Leu, Dennis, Simonetti, Giacomo D., Simonetti, Barbara Goeggel, Lava, Sebastiano A. G., Milani, Gregorio P., and Bianchetti, Mario G.

Subjects
Valproic acid -- Health aspects, Divalproex -- Health aspects, Kidney diseases -- Risk factors -- Diagnosis, Health
Abstract

Background Valproic acid is prescribed for epilepsy and as prophylaxis for bipolar disorder and migraine headaches. It has also been implicated as a cause of a kidney tubular injury. Methods We undertook a review of the literature to characterize the biochemical and histopathological features of the overt kidney tubular injury and to evaluate the possible existence of a pauci-symptomatic injury. The pre-registered review (CRD42022360357) was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Searches were conducted in Excerpta Medica, the National Library of Medicine, and Web of Science. The gray literature was also considered. Results For the final analysis, we retained 36 articles: 28 case reports documented 48 individuals with epilepsy on valproic acid for 7 months or more and presenting with features consistent with an overt kidney tubular injury. The following disturbances were noted: hypophosphatemia (N = 46), normoglycemic glycosuria (N = 46), total proteinuria (N = 45), metabolic acidosis (N = 36), hypouricemia (N = 27), tubular proteinuria (N = 27), hypokalemia (N = 23), and hypocalcemia (N = 8). A biopsy, obtained in six cases, disclosed altered proximal tubular cells with giant and dysmorphic mitochondria. Eight case series addressed the existence of a pauci- or even asymptomatic kidney injury. In the reported 285 subjects on valproic acid for 7 months or more, an isolated tubular proteinuria, mostly N-acetyl-[beta]-glucosaminidase, was often noted. Conclusions Valproic acid may induce an overt kidney tubular injury, which is associated with a proximal tubular mitochondrial toxicity. Treatment for 7 months or more is often associated with a pauci- or oligosymptomatic kidney tubular injury. Graphical abstract, Author(s): Giulia Anguissola [sup.1] , Dennis Leu [sup.2] , Giacomo D. Simonetti [sup.1] [sup.2] , Barbara Goeggel Simonetti [sup.1] [sup.2] [sup.3] , Sebastiano A. G. Lava [sup.4] [sup.5] , Gregorio [...]

Published
2023
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34. Posterior reversible leukoencephalopathy syndrome associated with acute postinfectious glomerulonephritis: systematic review

Author

Orlando, Corinne, Milani, Gregorio P., Simonetti, Giacomo D., Goeggel Simonetti, Barbara, Lava, Sebastiano A. G., Wyttenbach, Rolf, and Bianchetti, Mario G.

Subjects
Leukoencephalopathy -- Risk factors -- Complications and side effects, Glomerulonephritis -- Complications and side effects, Anticonvulsants -- Dosage and administration, Antihypertensive drugs -- Dosage and administration, Hypertension -- Risk factors -- Drug therapy, Health
Abstract

Background Kidney diseases are a recognized cause of posterior reversible leukoencephalopathy syndrome, usually abbreviated as PRES. The purpose of this review was to systematically address the association between acute postinfectious glomerulonephritis and PRES. Methods We performed a systematic review of the literature on acute postinfectious glomerulonephritis associated with PRES. The principles recommended by the Economic and Social Research Council guidance on the conduct of narrative synthesis and on the Preferred Reporting Items for Systematic Reviews and Meta-analyses were used. Databases searched included Excerpta Medica, US National Library of Medicine, and Web of Science. Results For the final analysis, we evaluated 47 reports describing 52 cases (32 males and 20 females). Fifty patients were [less than or equal to] 18 years of age. Blood pressure was classified as follows: normal-elevated (n = 3), stage 1 hypertension (n = 3), stage 2 hypertension (n = 5), and severe hypertension (n = 41). Acute kidney injury was classified as stage 1 in 32, stage 2 in 16, and stage 3 in four cases. Neuroimaging studies disclosed a classic posterior PRES pattern in 28 cases, a diffuse PRES pattern in 23 cases, and a brainstem-cerebellum PRES pattern in the remaining case. Antihypertensive drugs were prescribed in all cases and antiepileptic drugs in cases presenting with seizures. A resolution of clinical findings and neuroimaging lesions was documented in all cases with information about follow-up. Conclusions The main factor associated with PRES in acute postinfectious glomerulonephritis is severe hypertension. Prompt clinical suspicion, rapid evaluation, and management of hypertension are crucial. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information, Author(s): Corinne Orlando [sup.1] , Gregorio P. Milani [sup.2] [sup.3] , Giacomo D. Simonetti [sup.4] [sup.5] , Barbara Goeggel Simonetti [sup.4] [sup.5] [sup.6] , Sebastiano A. G. Lava [sup.7] , [...]

Published
2022
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35. BLOOD PRESSURE SCREENING IN MATA SECTOR, A RURAL AREA OF RWANDA

Author

Hunjan, Isabella, primary, Parati, Gianfranco, additional, Bianchetti, Mario G, additional, Milani, Gregorio P, additional, Stroppa, Clara, additional, Muvunyi, Bienvenu, additional, Ntaganda, Evariste, additional, Radovanovic, Dragana, additional, Suter, Paolo, additional, Umulisa, Alice, additional, and Muggli, Franco, additional

Published
2024
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40. A systematic review and meta‐analysis on nutritional and dietary interventions for the treatment of acute respiratory infection in pediatric patients: An EAACI taskforce.

Author

Milani, Gregorio P., Alberti, Ilaria, Abodi, Martina, Lakoumentas, John, Konstantinou, George N., Papadopoulos, Nikolaos G., Pop, Raluca M., Bocsan, Ioana C., Cassimos, Dimitrios, Kull, Inger, Bettocchi, Silvia, Corsello, Antonio, Cugliari, Marco, Ciliberti, Letizia, Spolidoro, Giulia C. I., Agostoni, Carlo, Vlieg Boerstra, Berber, Venter, Carina, O'Mahony, Liam, and Vassilopoulou, Emilia

Subjects
*RESPIRATORY infections, *PEDIATRIC respiratory diseases, *RESPIRATORY infections in children, *CHILD patients, *VITAMIN A
Abstract

Acute respiratory infections are a major cause of morbidity and mortality in children worldwide. Dietary and nutritional interventions, including minerals and vitamin supplementation, have been explored as potential treatments for these infections. However, the evidence on their efficacy is limited and inconclusive. This systematic review and meta‐analysis aim to provide a comprehensive summary of the available evidence on the effectiveness of dietary and nutritional interventions for treating acute respiratory tract infections in children. A systematic review was conducted according to the PRISMA 2020 guidelines in April 2022 and updated in April 2023. Clinical trials focusing on dietary or nutritional interventions, including supplementations, in children with acute respiratory tract infections were included. The selection of interventions and outcomes was based on biological plausibility. Data were extracted using a standardized form, and the risk of bias was assessed using the Cochrane Risk of Bias Tool. Meta‐analysis was performed using random‐effect models. A total of 50 studies were included in the review. Four trials were conducted in low, 32 in lower‐middle, 12 in upper‐middle, and only two in high‐income countries. The studies evaluated various dietary interventions, including zinc, vitamin A, vitamin E, vitamin D, and probiotics. The results of individual studies on the efficacy of these interventions were mixed, with some showing positive effects on clinical outcomes such as duration of symptoms, while others showed no significant impact. Meta‐analysis was conducted for zinc supplementation in children with pneumonia, and the pooled results suggested a potential limited benefit in terms of reduced hospital length of stay but not time to recovery. Meta‐analyses on vitamin D did not show any effect in children with pneumonia. This systematic review fills a critical gap in the literature by synthesizing the available evidence on the efficacy and safety of nutritional or dietary interventions for acute respiratory tract infections in children. The findings indicate no dietary or nutritional intervention can currently be recommended for the routine treatment of respiratory tract infections in children based on single supplement studies. The metanalysis suggests that zinc supplementation might have a beneficial effect on length of hospitalization in children with pneumonia. New studies are needed to establish more conclusive evidence for pediatric acute respiratory diseases especially for children living in a context of high‐income countries. [ABSTRACT FROM AUTHOR]

Published
2024
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