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1. Inhaled recombinant GM-CSF reduces the need for whole lung lavage and improves gas exchange in autoimmune pulmonary alveolar proteinosis patients

Author

Campo, Ilaria, primary, Carey, Brenna C., additional, Paracchini, Elena, additional, Kadija, Zamir, additional, De Silvestri, Annalisa, additional, Rodi, Giuseppe, additional, De Amici, Mara, additional, Torre, Cristina, additional, Zorzetto, Michele, additional, Griese, Matthias, additional, Meloni, Federica, additional, Corsico, Angelo Guido, additional, Trapnell, Bruce C., additional, and Mariani, Francesca, additional

Published
2023
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2. Long-term sequelae are highly prevalent one year after hospitalization for severe COVID-19

Author

Bellan, Mattia, Baricich, Alessio, Patrucco, Filippo, Zeppegno, Patrizia, Gramaglia, Carla, Balbo, Piero Emilio, Carriero, Alessandro, Amico, Chiara Santa, Avanzi, Gian Carlo, Barini, Michela, Battaglia, Marco, Bor, Simone, Cantaluppi, Vincenzo, Cappellano, Giuseppe, Ceruti, Federico, Chiocchetti, Annalisa, Clivati, Elisa, Giordano, Mara, Cuneo, Daria, Gambaro, Eleonora, Gattoni, Eleonora, Loro, Alberto, Manfredi, Marcello, Morosini, Umberto, Murano, Francesco, Paracchini, Elena, Patti, Giuseppe, Pinato, David James, Raineri, Davide, Rolla, Roberta, Sainaghi, Pier Paolo, Tricca, Stefano, and Pirisi, Mario

Published
2021
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3. Treatment and clinical outcomes in pleural infection: preliminary results from a multi-centre study

Author

Fattori, Chiara, primary, Piergentili, Luca, additional, Bonifazi, Martina, additional, Barbisan, Francesca, additional, Goteri, Gaia, additional, Zuccatosta, Lina, additional, Di Marco Berardino, Alessandro, additional, Sediari, Michele, additional, Gonnelli, Francesca, additional, Cirilli, Laura, additional, Porcarelli, Francesco Maria, additional, Balbo, Piero Emilio, additional, Paracchini, Elena, additional, Carpagnano, Giovanna Elisiana, additional, Gasparini, Stefano, additional, Marchetti, Giampietro, additional, and Mei, Federico, additional

Published
2023
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4. High-Flow Oxygen Therapy During Exercise Training in Patients With Chronic Obstructive Pulmonary Disease and Chronic Hypoxemia: A Multicenter Randomized Controlled Trial

Author

Vitacca, Michele, Paneroni, Mara, Zampogna, Elisabetta, Visca, Dina, Carlucci, Annalisa, Cirio, Serena, Banf, Paolo, Pappacoda, Gabriele, Trianni, Ludovico, Brogneri, Antonio, Belli, Stefano, Paracchini, Elena, Aliani, Maria, Spinelli, Vito, Gigliotti, Francesco, Lanini, Barbara, Lazzeri, Marta, Clini, Enrico M., Malovini, Alberto, and Ambrosino, Nicolino

Subjects
Anoxemia -- Analysis, Chronic obstructive lung disease -- Analysis, Patient satisfaction -- Analysis, Health
Abstract

Objective. The study aimed to evaluate whether high-flow oxygen therapy (HFOT) during training was more effective than oxygen in improving exercise capacity in hypoxemic chronic obstructive pulmonary disease (COPD). Methods. A total of 171 patients with COPD and chronic hypoxemia were consecutively recruited in 8 rehabilitation hospitals in a randomized controlled trial. Cycle-ergometer exercise training was used in 20 supervised sessions at iso inspiratory oxygen fraction in both groups. Pre- and post-training endurance time (Tlim), 6-minute walking distance (6MWD), respiratory and limb muscle strength, arterial blood gases, Barthel Index, Barthel Dyspnea Index, COPD Assessment Test, Maugeri Respiratory Failure questionnaire, and patient satisfaction were evaluated. Results. Due to 15.4% and 24.1% dropout rates, 71 and 66 patients were analyzed in HFOT and Venturi mask (V-mask) groups, respectively. Exercise capacity significantly improved after training in both groups with similar patient satisfaction. Between-group difference in post-training improvement in 6MWD (mean: 17.14 m; 95% CI = 0.87 to 33.43 m) but not in Tlim (mean: 141.85 seconds; 95% CI = -18.72 to 302.42 seconds) was significantly higher in HFOT. The minimal clinically important difference of Tlim was reached by 47% of patients in the V-mask group and 56% of patients in the HFOT group, whereas the minimal clinically important difference of 6MWD was reached by 51% of patients in the V-mask group and 69% of patients in the HFOT group, respectively. Conclusion. In patients with hypoxemic COPD, exercise training is effective in improving exercise capacity. Impact Statement. The addition of HFOT during exercise training is not more effective than oxygen through V-mask in improving endurance time, the primary outcome, whereas it is more effective in improving walking distance., Pulmonary rehabilitation, including aerobic exercise training, has stronger evidence of effectiveness to improve exercise capacity, dyspnea, and health-related quality of life (HRQL) than almost all other therapies in patients with [...]

Published
2020
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9. Pulmonary alveolar proteinosis: diagnostic and therapeutic challenges

Author

Campo Ilaria, Kadija Zamir, Mariani Francesca, Paracchini Elena, Rodi Giuseppe, Mojoli Francesco, Braschi Antonio, and Luisetti Maurizio

Subjects
GM-CSF, Pulmonary alveolar proteinosis, WLL, Diseases of the respiratory system, RC705-779
Abstract

Abstract Pulmonary Alveolar Proteinosis (PAP) is a rare syndrome characterized by pulmonary surfactant accumulation within the alveolar spaces. It occurs with a reported prevalence of 0.1 per 100,000 individuals and in distinct clinical forms: autoimmune (previously referred to as the idiopathic form, represents the vast majority of PAP cases, and is associated with Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) auto-antibodies; GMAbs), secondary (is a consequence of underlying disorders), congenital (caused by mutations in the genes encoding for the GM-CSF receptor), and PAP-like syndromes (disorders associated with surfactant gene mutations). The clinical course of PAP is variable, ranging from spontaneous remission to respiratory failure. Whole lung lavage (WLL) is the current standard treatment for PAP patients and although it is effective in the majority of cases, disease persistence is not an unusual outcome, even if disease is well controlled by WLL. In this paper we review the therapeutic strategies which have been proposed for the treatment of PAP patients and the progress which has been made in the understanding of the disease pathogenesis.

Published
2012
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10. High-Flow Oxygen Therapy (HFOT) during training in COPD with chronic respiratory failure (CRF): a multicentre randomized controlled trial

Author

Vitacca, Michele, primary, Paneroni, Mara, additional, Zampogna, Elisabetta, additional, Spanevello, Antonio, additional, Ceriana, Piero, additional, Carlucci, Annalisa, additional, Banfi, Paolo, additional, Pappacoda, Gabriele, additional, Trianni, Ludovico, additional, Brogneri, Antonio, additional, Belli, Stefano, additional, Paracchini, Elena, additional, Aliani, Maria, additional, Spinelli, Vito, additional, Gigliotti, Francesco, additional, Lanini, Barbara, additional, Lazzeri, Marta, additional, Clini, Enrico, additional, and Ambrosino, Nicolino, additional

Published
2019
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11. Patients with Alpha-1 antitrypsin Deficiency due to Null mutations have clinical peculiarities and should require personalized pulmonary management

Author

Ferrarotti, Ilaria, primary, Ottaviani, Stefania, additional, Paracchini, Elena, additional, Piloni, Davide, additional, Mariani, Francesca, additional, Paone, Gregorino, additional, Balderacchi, Alice M., additional, Barzon, Valentina, additional, Bosio, Matteo, additional, Kadija, Zamir, additional, Balbi, Bruno, additional, and Corsico, Angelo G., additional

Published
2019
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13. Bacterial load and inflammatory response in sputum of alpha-1 antitrypsin deficiency patients with COPD

Author

Balbi, Bruno, primary, Sangiorgi, Claudia, additional, Gnemmi, Isabella, additional, Ferrarotti, Ilaria, additional, Vallese, Davide, additional, Paracchini, Elena, additional, Delle Donne, Lorena, additional, Corda, Luciano, additional, Baderna, Paolo, additional, Corsico, Angelo, additional, Carone, Mauro, additional, Brun, Paola, additional, Cappello, Francesco, additional, Ricciardolo, Fabio LM, additional, Ruggeri, Paolo, additional, Mumby, Sharon, additional, Adcock, Ian M, additional, Caramori, Gaetano, additional, and Di Stefano, Antonino, additional

Published
2019
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15. Late Breaking Abstract - Bacterial Load and Inflammation in Sputum from patients with Alpha-1-Antitrypsin Deficiency as compared with COPD Patients

Author

Di Stefano, Antonino, primary, Sangiorgi, Claudia, additional, Gnemmi, Isabella, additional, Ferrarotti, Ilaria, additional, Anchisi, Federica, additional, Paracchini, Elena, additional, Corda, Lucio, additional, Baderna, Paolo, additional, Corsico, Angelo, additional, and Balbi, Bruno, additional

Published
2017
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19. Inhaled sargramostim and whole lung lavage (WLL) as therapy of autoimmune pulmonary alveolar proteinosis (aPAP)

Author

Campo, Ilaria, primary, Mariani, Francesca, additional, Paracchini, Elena, additional, Kadija, Zamir, additional, Zorzetto, Michele, additional, Tinelli, Carmine, additional, Rodi, Giuseppe, additional, Meloni, Federica, additional, Griese, Matthias, additional, Trapnell, Bruce, additional, Scheuch, Gerhard, additional, Muellinger, Bernhard, additional, and Luisetti, Maurizio, additional

Published
2016
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21. Proteinosi alveolare polmonare: caratteristiche cliniche della casistica raccolta da un centro nazionale di riferimento

Author

Nobili, Isabella, Paracchini, Elena, and Luisetti, Maurizio

Abstract

La proteinosi alveolare polmonare (PAP) è una patologia caratterizzata dall’accumulo a livello degli spazi alveolari di materiale lipoproteinaceo, eosinofilico, PAS positivo. La PAP è un disordine estremamente raro; dal punto di vista eziopatologico se ne possono distinguere tre diverse forme: autoimmune, secondaria e congenita. La sua evoluzione clinica è variabile, spaziando dalla risoluzione spontanea all’insufficienza respiratoria grave. Al momento attuale il lavaggio polmonare massivo (WLL) viene considerato il trattamento standard. I risultati post-WLL possono variare dalla completa risoluzione alla persistenza della malattia, comunque controllabile con ulteriori WLL. Scopo di questo lavoro è stato analizzare i dati relativi agli 81 pazienti che afferiscono al nostro Centro, che è Istituto di riferimento nazionale, valutando gli aspetti clinici, laboratoristici, funzionali e radiologici e fornendo in questo modo una visione globale di questa rara patologia respiratoria., Bollettino della Società Medico Chirurgica di Pavia, Vol 126, N° 2 (2013)

Published
2013
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22. L’epidemiologia dell’asma bronchiale

Author

Viscardi, Arianna, Mennitti, Maria Chiara, Surbone, Sara, Paracchini, Elena, Di Vincenzo, Eti Maria Giulia, Ronzoni, Vanessa, and Cerveri, Isa

Abstract

L’asma è una delle patologie più diffuse al mondo, si stima che ne siano affetti circa 300 milioni di persone. La sua prevalenza varia notevolmente da nazione a nazione e all’interno della stessa nazione, in conseguenza a varianti genetiche con una sovrapposizione di fattori socio-economici e ambientali. La prevalenza di asma nel mondo è aumentata dalla metà del secolo scorso fino agli anni ‘90, ma da quel momento non è chiara la sua evoluzione temporale. La prevalenza di asma nella popolazione infantile sta aumentando nei paesi in cui era minore mentre nei paesi occidentali nei quali era già elevata, è stabile o in diminuzione. Il cambiamento del trend della prevalenza negli adulti è ancora controverso. In parecchie aree italiane tra il 1991 e il 2010 sono state condotte ripetute indagini cross-sectional con un identico disegno dello studio ed identici metodi di valutazione. In Italia si sta verificando ancora un incremento della prevalenza dell’asma bronchiale che sembra inserirsi nell’ambito dei cambiamenti generali all’interno delle varie nazioni che portano ad un livellamento delle differenze nei tassi di prevalenza. Appare necessario quindi focalizzare l’attenzione sulla prevenzione e sul trattamento precoce ed adeguato di tutti i casi di asma., Bollettino della Società Medico Chirurgica di Pavia, Vol 126, N° 1 (2013)

Published
2013
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27. Assessment and management of pulmonary alveolar proteinosis in a reference center

Author

Campo, Ilaria, primary, Mariani, Francesca, additional, Rodi, Giuseppe, additional, Paracchini, Elena, additional, Tsana, Eric, additional, Piloni, Davide, additional, Nobili, Isabella, additional, Kadija, Zamir, additional, Corsico, Angelo, additional, Cerveri, Isa, additional, Chalk, Claudia, additional, Trapnell, Bruce C, additional, Braschi, Antonio, additional, Tinelli, Carmine, additional, and Luisetti, Maurizio, additional

Published
2013
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28. Ventilator Settings to Avoid Nuisance Alarms During Mouthpiece Ventilation.

Author

Carlucci, Annalisa, Mattei, Alessio, Rossi, Veronica, Paracchini, Elena, Rained, Santi Maurizio, and Gregoretti, Cesare

Subjects
RESPIRATORY therapy equipment, APNEA, ARTIFICIAL respiration, LIFE support systems in critical care, MONITOR alarms (Medicine), PATIENT monitoring, RESPIRATORY measurements
Abstract

BACKGROUND: A recent study found that activation of disconnection and low-pressure alarms is common during mouthpiece ventilation and may represent a major limitation to its use. The aim of this bench study was: (1) to investigate the technical aspects that can influence the setting of the ventilator during mouthpiece ventilation and (2) to provide a practical setting strategy to avoid the alarm activation. METHODS: Eight life-support ventilators able to deliver volume controlled ventilation were tested in a bench study using a single-limb non-vented circuit configuration connected to a standard mouthpiece. Disconnection and apnea alarm were turned off or set at the least sensitive setting. The backup frequency was set at the lowest available level. Different tidal volumes (VT) (from 500 to 1,200 mL) were tested with the rectangular and descending flow shape. For each VT, we reported the maximum set inspiratory time (TI) that allowed preventing activation of the low-pressure alarm. The presence of auto-triggering was also surveyed. RESULTS: We found that a correct combination of VT and TI avoided the activation of disconnection and low-pressure alarms in all but 3 ventilators. One ventilator did not allow mouthpiece ventilation independently from the settings used. The inability to turn off the apnea alarm in two other ventilators led to the alarm going off in any tested conditions after 120 s without triggered breaths. Auto-triggering was seldom found and easily worked out, except for in one ventilator. CONCLUSIONS: An appropriate alarm setting and combination of VT and TI would allow the majority of the tested ventilators to be used for mouthpiece ventilation without alarm activation. [ABSTRACT FROM AUTHOR]

Published
2016
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31. Association Of CR2/CD21 Polymorphisms With Systemic Sclerosis

Author

Zorzetto, Michele, primary, Ottaviani, Stefania, additional, Bonino, Claudia, additional, Montecucco, Carlomaurizio, additional, Cavagna, Lorenzo, additional, Paracchini, Elena, additional, Pozzi, Ernesto, additional, De Silvestri, Annalisa, additional, and Luisetti, Maurizio, additional

Published
2010
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34. Inhaled recombinant GM-CSF reduces the need for whole lung lavage and improves gas exchange in autoimmune pulmonary alveolar proteinosis patients.

Author

Campo I, Carey BC, Paracchini E, Kadija Z, De Silvestri A, Rodi G, De Amici M, Torre C, Zorzetto M, Griese M, Meloni F, Corsico AG, Trapnell BC, and Mariani F

Subjects
Humans, Granulocyte-Macrophage Colony-Stimulating Factor, Prospective Studies, Administration, Inhalation, Treatment Outcome, Bronchoalveolar Lavage, Oxygen therapeutic use, Surface-Active Agents therapeutic use, Biomarkers, Pulmonary Alveolar Proteinosis drug therapy, Pulmonary Alveolar Proteinosis pathology, Autoimmune Diseases drug therapy, Pulmonary Surfactants therapeutic use
Abstract

Rationale: Whole lung lavage (WLL) is a widely accepted palliative treatment for autoimmune pulmonary alveolar proteinosis (aPAP) but does not correct myeloid cell dysfunction or reverse the pathological accumulation of surfactant. In contrast, inhaled recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF) is a promising pharmacological approach that restores alveolar macrophage functions including surfactant clearance. Here, we evaluate WLL followed by inhaled rGM-CSF (sargramostim) as therapy of aPAP., Methods: 18 patients with moderate-to-severe aPAP were enrolled, received baseline WLL, were randomised into either the rGM-CSF group (receiving inhaled sargramostim) or control group (no scheduled therapy) and followed for 30 months after the baseline WLL. Outcome measures included additional unscheduled "rescue" WLL for disease progression, assessment of arterial blood gases, pulmonary function, computed tomography, health status, biomarkers and adverse events. Patients requiring rescue WLL were considered to have failed their assigned intervention group., Results: The primary end-point of time to first rescue WLL was longer in rGM-CSF-treated patients than controls (30 versus 18 months, n=9 per group, p=0.0078). Seven control patients (78%) and only one rGM-CSF-treated patient (11%) required rescue WLL, demonstrating a 7-fold increase in relative risk (p=0.015). Compared to controls, rGM-CSF-treated patients also had greater improvement in peripheral arterial oxygen tension, alveolar-arterial oxygen tension difference, diffusing capacity of the lungs for carbon monoxide and aPAP biomarkers. One patient from each group withdrew for personal reasons. No serious adverse events were reported., Conclusions: This long-term, prospective, randomised trial demonstrated inhaled sargramostim following WLL reduced the requirement for WLL, improved lung function and was safe in aPAP patients. WLL plus inhaled sargramostim may be useful as combined therapy for aPAP., Competing Interests: Conflict of interest: I. Campo, B.C. Trapnell and B.C. Carey serve as investigators on another clinical trial of inhaled rGM-CSF therapy of autoimmune PAP. B.C. Trapnell and B.C. Carey have served as consultants regarding the development of inhaled rGM-CSF as therapy of aPAP. No other authors have no financial or other conflicts of interest to declare related to this work., (Copyright ©The authors 2024.)

Published
2024
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35. Something is changing in adherence to CPAP therapy: real world data after 1 year of treatment in patients with obstructive sleep apnoea.

Author

Morrone E, Giordano A, Carli S, Visca D, Rossato F, Godio M, Paracchini E, Rossi S, Balbi B, Sacco C, and Braghiroli A

Subjects
Continuous Positive Airway Pressure, Humans, Patient Compliance, Sleep Apnea, Obstructive therapy
Abstract

Competing Interests: Conflict of interest: E. Morrone has nothing to disclose. Conflict of interest: A. Giordano has nothing to disclose. Conflict of interest: S. Carli has nothing to disclose. Conflict of interest: D. Visca has nothing to disclose. Conflict of interest: F. Rossato has nothing to disclose. Conflict of interest: M. Godio has nothing to disclose. Conflict of interest: E. Paracchini has nothing to disclose. Conflict of interest: S. Rossi has nothing to disclose. Conflict of interest: B. Balbi has nothing to disclose. Conflict of interest: C. Sacco has nothing to disclose. Conflict of interest: A. Braghiroli has nothing to disclose.

Published
2020
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