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1. Recurrence Risk after First Symptomatic Distal versus Proximal Deep Vein Thrombosis According to Baseline Risk Factors

Author

Valerio, Luca, Ambaglio, Chiara, Barone, Marisa, Ciola, Mariella, Konstantinides, Stavros V., Mahmoudpour, Seyed H., Picchi, Chiara, Pieresca, Carla, Trinchero, Alice, and Barco, Stefano

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, pulmonary embolism, lcsh:RC666-701, 610 Medical sciences, venous thromboembolism, 610 Medizin, Original Article, epidemiology, cardiovascular diseases, prognosis
Abstract

Background It remains unclear whether the distal location of deep vein thrombosis (DVT) is independently associated with a lower risk of recurrence in all patients, or represents a marker of the presence and severity of provoking factors for venous thromboembolism (VTE). Methods We investigated the impact of distal (vs. proximal) DVT location on the risk of developing symptomatic, objectively confirmed recurrent VTE in 831 patients with a first acute symptomatic DVT not associated with pulmonary embolism (PE), who were stratified by the presence of transient or persistent risk factors at baseline. The primary outcome was symptomatic, objectively diagnosed recurrent VTE, including proximal DVT and PE. Results A total of 205 (24.7%) patients presented with a transient risk factor, 189 (22.7%) with a minor persistent risk factor, 202 (24.3%) with unprovoked DVT, and 235 (28.3%) with cancer-associated DVT. One-hundred twenty-five patients (15.0%) experienced recurrent DVT or PE. The largest relative difference between patients with distal (vs. proximal) DVT was observed in the absence of identifiable risk factors (adjusted hazard ratio [aHR]: 0.11; 95% CI [confidence interval]: 0.03–0.45). In patients with cancer, distal and proximal DVT had a comparable risk of recurrence (aHR: 0.70; 95% CI: 0.28–1.78]). Conclusions The distal (vs. proximal) location of first acute symptomatic DVT represented, in the absence of any identifiable transient or persistent risk factors, a favorable prognostic factor for recurrence. In contrast, the prognostic impact of DVT location was weaker if persistent provoking risk factors for VTE were present, notably cancer.

Published
2019

2. High versus standard dose methylprednisolone in the acute phase of idiopathic thrombotic thrombocytopenic purpura: a randomized study

Author

Balduini, Carlo L., Gugliotta, Luigi, Luppi, Mario, Laurenti, Luca, Klersy, Catherine, Pieresca, Carla, Quintini, Gerlando, Iuliano, Francesco, Re, Rossana, Spedini, Pierangelo, Vianelli, Nicola, Zaccaria, Alfonso, Pogliani, Enrico Maria, Musso, Roberto, Bobbio Pallavicini, Enrico, Quarta, Giovanni, Galieni, Piero, Fragasso, Alberto, Casella, Gianluca, Noris, Patrizia, Ascari, Edoardo, and The Italian TTP Study Group

Published
2010
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3. Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy

Author

Melazzini, Federica, Colaneri, Marta, Fumoso, Federica, Freddi, Giulia, Lenti, Marco Vincenzo, Pieri, Teresa Chiara, Piloni, Davide, Noris, Patrizia, Pieresca, Carla, Preti, Paola Stefania, Russo, Mariaconcetta, Corsico, Angelo, Tavazzi, Guido, Baldanti, Fausto, Triarico, Antonio, Mojoli, Francesco, Bruno, Raffaele, Di Sabatino, Antonio, Aronico, Nicola, Bergamaschi, Gaetano, Bertolino, Giampiera, Codega, Silvia, Costanzo, Filippo, Cresci, Roberto, Delliponti, Angela, Derosa, Giuseppe, Di Stefano, Michele, Falaschi, Francesco, Iadarola, Carmine, Lovati, Elisabetta, Lucotti, Pietro Carlo, Martignoni, Alessandra, Mengoli, Caterina, Miceli, Emanuela, Mugellini, Amedeo, Muggia, Chiara, Pagani, Elisabetta, Palumbo, Ilaria, Pecci, Alessandro, Perrone, Tiziano, Sgarlata, Carmelo, Siciliani, Luisa, Staniscia, Andrea, Vjera, Francesca Torello, Achilli, Giovanna, Agostinelli, Andrea, Antoci, Valentina, Ballesio, Alessia, Banfi, Francesco, Barteselli, Chiara, Benedetti, Irene, de Andreis, Federica Borrelli, Brattoli, Michele, Calabretta, Francesca, Cambiè, Ginevra, Canta, Roberta, Conca, Federico, Coppola, Luigi, Cremonte, Elisa Maria, Croce, Gabriele, Del Rio, Virginia, Di Terlizzi, Francesco, Ferrari, Maria Giovanna, Ferrari, Sara, Fiengo, Anna, Forni, Tommaso, Frigerio, Chiara, Fusco, Alessandra, Gabba, Margherita, Garolfi, Matteo, Gentile, Antonella, Gori, Giulia, Grandi, Giacomo, Grimaldi, Paolo, Lampugnani, Alice, Lapia, Francesco, Lepore, Federica, Lettieri, Gianluca, Mambella, Jacopo, Mercanti, Chiara, Merli, Stefania, Mordà, Francesco, Nardone, Alba, Pace, Luca, Padovini, Lucia, Parodi, Alessandro, Pellegrino, Ivan, Pitotti, Lavinia, Reduzzi, Margherita, Rigano, Giovanni, Romito, Giovanni, Rotola, Giorgio, Sabatini, Umberto, Salvi, Lucia, Santacroce, Giovanni, Savioli, Jessica, Soriano, Simone, Spataro, Carmine, Stefani, Debora, Aliberti, Anna Rita, Amatu, Alessandro, Anfossi, Laura, Arisi, Eric, Baldi, Chiara, Belliato, Mirko, Bellini, Lorenzo, Benzi, Alberto, Bichisao, Germana, Bolongaro, Antonia, Bottazzi, Andrea, Broglia, Federica, Bruschi, Giacomo, Caneva, Luca, Capaccio, Emanuele, Carboni, Valeria, Cavalloro, Fabrizio, Ciceri, Maria, Civardi, Luca, Delmonte, Maria Paola, Domenegati, Elisa Lucia, Ferrari, Federica, Ferrari, Fiorenza, Ferrari, Marta, Fuardo, Marinella, Gerletti, Maddalena Margherita, Gualdana, Simonetta, Ilardi, Marcella, Lo Coco, Claudia, Maggio, Giuseppe, Mascia, Maria Benedetta, Mencherini, Simonetta, Merati, Paola Maria, Mongodi, Silvia, Mori, Anna Maria, Morgante, Federica, Niebel, Thekla Larissa, Noli, Silvano, Orlando, Anita, Pagani, Michele, Passador, Debora, Pellicori, Simona, Perotti, Luciano, Picchioni, Raffaella, Poma, Silvia, Pozzi, Marco, Preti, Emanuela, Puce, Roberta, Radolovich, Danila Katia, Ragni, Gianluca, Repossi, Filippo, Riccardi, Francesca, Rizzardi, Roberto, Rodi, Giuseppe, Roldi, Emanuela, Rossi, Cristina, Sala Gallini, Giuseppe, Sciutti, Fabio, Sportiello, Debora, Ticozzelli, Giulia, Visconti, Federico, Zizzi, Silvia, Bagliani, Alessandro, Belotti, Corrado, Bossi, Chiara, Colombo, Andrea, Colombo, Costanza Natalia Julia, Cremascoli, Luca, Dammassa, Valentino, Discepoli, Roberto, Garlando, Maria Adelaide, Grandini, Filippo, Pellegrini, Andrea, Quaranta, Cecilia, Stella, Andrea, Torresani, Francesco, Mondelli, Mario, Brunetti, Enrico, Di Matteo, Angela, Seminari, Elena, Maiocchi, Laura, Zuccaro, Valentina, Pagnucco, Layla, Mariani, Bianca, Ludovisi, Serena, Lissandrin, Raffaella, Parisi, Aldo, Sacchi, Paolo, Patruno, Savino F. A., Michelone, Giuseppe, Gulminetti, Roberto, Zanaboni, Domenico, Novati, Stefano, Maserati, Renato, Orsolini, Paolo, Vecchia, Marco, Asperges, Erika, Di Filippo, Alessandro, Sambo, Margherita, Biscarini, Simona, Lupi, Matteo, Roda, Silvia, Gallazzi, Ilaria, Sachs, Michele, Valsecchi, Pietro, Ferrari, Alessandra, Bosio, Matteo, Cascina, Alessandro, Conio, Valentina, Di Domenica, Rita, Donnetta, Anna, Fraolini, Elia, Gualtieri, Giuseppe, Mangiarotti, Patrizia, Mariani, Francesca, Meloni, Federica, Oggionni, Tiberio, Pasturenzi, Lidia, Ronzoni, Vanessa, Saracino, Laura, Stella, Giulia, Tomaselli, Stefano, Abbate, Tommaso, Accordino, Giulia, Bertuccio, Francesco, Burattini, Cecilia, Cacciatore, Elisa, Cattaneo, Elena, Chino, Vittorio, Coretti, Manuela, Della Zoppa, Matteo, Infusino, Cristina, Lettieri, Sara, Maccabruni, Valeria, Mancinelli, Silvia, Tirelli, Claudio, and Vertui, Valentina

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), 030204 cardiovascular system & hematology, Single Center, Tertiary referral hospital, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Internal Medicine, Medicine, cardiovascular diseases, Mean platelet volume, biology, SARS-CoV-2, business.industry, Pulmonary embolism, C-reactive protein, Anticoagulants, Thrombosis, equipment and supplies, medicine.disease, Im - Original, 030220 oncology & carcinogenesis, biology.protein, Emergency Medicine, Observational study, business
Abstract

Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p p p = 0.002 and p = 0.005, respectively). No significant difference was found in d-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.

Published
2020
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4. Anemia in patients with Covid-19: pathogenesis and clinical significance

Author

Bergamaschi, Gaetano, Borrelli de Andreis, Federica, Aronico, Nicola, Lenti, Marco Vincenzo, Barteselli, Chiara, Merli, Stefania, Pellegrino, Ivan, Coppola, Luigi, Cremonte, Elisa Maria, Croce, Gabriele, Mordà, Francesco, Lapia, Francesco, Ferrari, Sara, Ballesio, Alessia, Parodi, Alessandro, Calabretta, Francesca, Ferrari, Maria Giovanna, Fumoso, Federica, Gentile, Antonella, Melazzini, Federica, Di Sabatino, Antonio, Bertolino, Giampiera, Codega, Silvia, Costanzo, Filippo, Cresci, Roberto, Derosa, Giuseppe, Stefano, Michele Di, Falaschi, Francesco, Iadarola, Carmine, Lovati, Elisabetta, Lucotti, Pietro Carlo, Martignoni, Alessandra, Mengoli, Caterina, Miceli, Emanuela, Mugellini, Amedeo, Muggia, Chiara, Noris, Patrizia, Pagani, Elisabetta, Palumbo, Ilaria, Pecci, Alessandro, Perrone, Tiziano, Pieresca, Carla, Preti, Paola Stefania, Russo, Maria Concetta, Sgarlata, Carmelo, Siciliani, Luisa, Staniscia, Andrea, Vjera, Francesca Torello, Achilli, Giovanna, Agostinelli, Andrea, Antoci, Valentina, Banfi, Francesco, Benedetti, Irene, Brattoli, Michele, Cambiè, Ginevra, Canta, Roberta, Cococcia, Sara, Conca, Federico, Delliponti, Mariangela, Rio, Virginia Del, Terlizzi, Francesco Di, Fiengo, Anna, Forni, Tommaso, Freddi, Giulia, Frigerio, Chiara, Fusco, Alessandra, Gabba, Margherita, Garolfi, Matteo, Gori, Giulia, Grandi, Giacomo, Grimaldi, Paolo, Lampugnani, Alice, Lepore, Federica, Lettieri, Gianluca, Mambella, Jacopo, Mercanti, Chiara, Nardone, Alba, Pace, Luca, Padovini, Lucia, Pitotti, Lavinia, Reduzzi, Margherita, Rigano, Giovanni, Rotola, Giorgio, Sabatini, Umberto, Salvi, Lucia, Santacroce, Giovanni, Savioli, Jessica, Soriano, Simone, Spataro, Carmine, and Stefani, Debora

Subjects
0301 basic medicine, Male, Comorbidity, Gastroenterology, Hemoglobins, 0302 clinical medicine, Medicine, Cholinesterases, Hematology, biology, medicine.diagnostic_test, Anemia, Iron-Deficiency, Oxygen partial pressure/oxygen concentration, Anemia, General Medicine, Middle Aged, C-Reactive Protein, 030220 oncology & carcinogenesis, Erythrocyte sedimentation rate, Original Article, Female, Adult, medicine.medical_specialty, Blood Sedimentation, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Red blood cell distribution width, Internal medicine, Humans, Clinical significance, Aged, L-Lactate Dehydrogenase, business.industry, SARS-CoV-2, C-reactive protein, COVID-19, Correction, medicine.disease, Ferritin, Oxygen, 030104 developmental biology, Ferritins, biology.protein, Erythrocyte Count, Hemoglobin, business, Anemia of inflammation, Blood Gas Monitoring, Transcutaneous
Abstract

COVID-19 patients typically present with lower airway disease, although involvement of other organ systems is usually the rule. Hematological manifestations such as thrombocytopenia and reduced lymphocyte and eosinophil numbers are highly prevalent in COVID-19 and have prognostic significance. Few data, however, are available about the prevalence and significance of anemia in COVID-19. In an observational study, we investigated the prevalence, pathogenesis and clinical significance of anemia among 206 patients with COVID-19 at the time of their hospitalization in an Internal Medicine unit. The prevalence of anemia was 61% in COVID-19, compared with 45% in a control group of 71 patients with clinical and laboratory findings suggestive of COVID-19, but nasopharyngeal swab tests negative for SARS-CoV-2 RNA (p = 0.022). Mortality was higher in SARS-CoV-2 positive patients. In COVID-19, females had lower hemoglobin concentration than males and a higher prevalence of moderate/severe anemia (25% versus 13%, p = 0.032). In most cases, anemia was mild and due to inflammation, sometimes associated with iron and/or vitamin deficiencies. Determinants of hemoglobin concentration included: erythrocyte sedimentation rate, serum cholinesterase, ferritin and protein concentrations and number of chronic diseases affecting each patient. Hemoglobin concentration was not related to overall survival that was, on the contrary, influenced by red blood cell distribution width, age, lactate dehydrogenase and the ratio of arterial partial oxygen pressure to inspired oxygen fraction. In conclusion, our results highlight anemia as a common manifestation in COVID-19. Although anemia does not directly influence mortality, it usually affects elderly, frail patients and can negatively influence their quality of life.

Published
2020

5. Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy

Author

Lenti, Marco Vincenzo, Borrelli de Andreis, Federica, Pellegrino, Ivan, Klersy, Catherine, Merli, Stefania, Miceli, Emanuela, Aronico, Nicola, Mengoli, Caterina, Di Stefano, Michele, Cococcia, Sara, Santacroce, Giovanni, Soriano, Simone, Melazzini, Federica, Delliponti, Mariangela, Baldanti, Fausto, Triarico, Antonio, Corazza, Gino Roberto, Pinzani, Massimo, Di Sabatino, Antonio, Bergamaschi, Gaetano, Bertolino, Giampiera, Codega, Silvia, Costanzo, Filippo, Cresci, Roberto, Derosa, Giuseppe, Falaschi, Francesco, Iadarola, Carmine, Lovati, Elisabetta, Lucotti, Pietro Carlo, Martignoni, Alessandra, Mugellini, Amedeo, Muggia, Chiara, Noris, Patrizia, Pagani, Elisabetta, Palumbo, Ilaria, Pecci, Alessandro, Perrone, Tiziano, Pieresca, Carla, Preti, Paola Stefania, Russo, Mariaconcetta, Sgarlata, Carmelo, Siciliani, Luisa, Staniscia, Andrea, Torello Vjera, Francesca, Achilli, Giovanna, Agostinelli, Andrea, Antoci, Valentina, Ballesio, Alessia, Banfi, Francesco, Barteselli, Chiara, Benedetti, Irene, Brattoli, Michele, Calabretta, Francesca, Cambiè, Ginevra, Canta, Roberta, Conca, Federico, Coppola, Luigi, Cremonte, Elisa Maria, Croce, Gabriele, Del Rio, Virginia, Di Terlizzi, Francesco, Ferrari, Maria Giovanna, Ferrari, Sara, Fiengo, Anna, Forni, Tommaso, Freddi, Giulia, Frigerio, Chiara, Fumoso, Federica, Fusco, Alessandra, Gabba, Margherita, Garolfi, Matteo, Gentile, Antonella, Gori, Giulia, Grandi, Giacomo, Grimaldi, Paolo, Lampugnani, Alice, Lapia, Francesco, Lepore, Federica, Lettieri, Gianluca, Mambella, Jacopo, Mercanti, Chiara, Mordà, Francesco, Nardone, Alba, Pace, Luca, Padovini, Lucia, Parodi, Alessandro, Pitotti, Lavinia, Reduzzi, Margherita, Rigano, Giovanni, Rotola, Giorgio, Sabatini, Umberto, Salvi, Lucia, Savioli, Jessica, Spataro, Carmine, and Stefani, Debora

Subjects
Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, 030204 cardiovascular system & hematology, Acute respiratory failure, Chronic liver disease, Hepatitis, 03 medical and health sciences, 0302 clinical medicine, Intensive care, Internal medicine, Patients' Rooms, medicine, Internal Medicine, Humans, 030212 general & internal medicine, Pandemics, Aged, Retrospective Studies, Aged, 80 and over, Liver injury, medicine.diagnostic_test, business.industry, COVID-19, Retrospective cohort study, Middle Aged, medicine.disease, Im - Original, Coronavirus, Hospitalization, Severe acute respiratory syndrome, Italy, Liver, Emergency Medicine, Female, Liver function, Coronavirus Infections, business, Liver function tests, Liver Failure
Abstract

Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25–97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2

Published
2020
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6. Correction to: Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy

Author

Melazzini, Federica, Colaneri, Marta, Fumoso, Federica, Freddi, Giulia, Lenti, Marco Vincenzo, Pieri, Teresa Chiara, Piloni, Davide, Noris, Patrizia, Pieresca, Carla, Preti, Paola Stefania, Russo, Mariaconcetta, Corsico, Angelo, Tavazzi, Guido, Baldanti, Fausto, Triarico, Antonio, Mojoli, Francesco, Bruno, Raffaele, Di Sabatino, Antonio, Aronico, Nicola, Bergamaschi, Gaetano, Bertolino, Giampiera, Codega, Silvia, Costanzo, Filippo, Cresci, Roberto, Delliponti, Angela, Derosa, Giuseppe, Di Stefano, Michele, Falaschi, Francesco, Iadarola, Carmine, Lovati, Elisabetta, Lucotti, Pietro Carlo, Martignoni, Alessandra, Mengoli, Caterina, Miceli, Emanuela, Mugellini, Amedeo, Muggia, Chiara, Pagani, Elisabetta, Palumbo, Ilaria, Pecci, Alessandro, Perrone, Tiziano, Sgarlata, Carmelo, Siciliani, Luisa, Staniscia, Andrea, Vjera, Francesca Torello, Achilli, Giovanna, Agostinelli, Andrea, Antoci, Valentina, Ballesio, Alessia, Banfi, Francesco, Barteselli, Chiara, Benedetti, Irene, Borrelli de Andreis, Federica, Brattoli, Michele, Calabretta, Francesca, Cambiè, Ginevra, Canta, Roberta, Conca, Federico, Coppola, Luigi, Cremonte, Elisa Maria, Croce, Gabriele, Del Rio, Virginia, Di Terlizzi, Francesco, Ferrari, Maria Giovanna, Ferrari, Sara, Fiengo, Anna, Forni, Tommaso, Frigerio, Chiara, Fusco, Alessandra, Gabba, Margherita, Garolfi, Matteo, Gentile, Antonella, Gori, Giulia, Grandi, Giacomo, Grimaldi, Paolo, Lampugnani, Alice, Lapia, Francesco, Lepore, Federica, Lettieri, Gianluca, Mambella, Jacopo, Mercanti, Chiara, Merli, Stefania, Mordà, Francesco, Nardone, Alba, Pace, Luca, Padovini, Lucia, Parodi, Alessandro, Pellegrino, Ivan, Pitotti, Lavinia, Reduzzi, Margherita, Rigano, Giovanni, Romito, Giovanni, Rotola, Giorgio, Sabatini, Umberto, Salvi, Lucia, Santacroce, Giovanni, Savioli, Jessica, Soriano, Simone, Spataro, Carmine, Stefani, Debora, Aliberti, Anna Rita, Amatu, Alessandro, Anfossi, Laura, Arisi, Eric, Baldi, Chiara, Belliato, Mirko, Bellini, Lorenzo, Benzi, Alberto, Bichisao, Germana, Bolongaro, Antonia, Bottazzi, Andrea, Broglia, Federica, Bruschi, Giacomo, Caneva, Luca, Capaccio, Emanuele, Carboni, Valeria, Cavalloro, Fabrizio, Ciceri, Maria, Civardi, Luca, Delmonte, Maria Paola, Domenegati, Elisa Lucia, Ferrari, Federica, Ferrari, Fiorenza, Ferrari, Marta, Fuardo, Marinella, Gerletti, Maddalena Margherita, Gualdana, Simonetta, Ilardi, Marcella, Lo Coco, Claudia, Maggio, Giuseppe, Mascia, Maria Benedetta, Mencherini, Simonetta, Merati, Paola Maria, Mongodi, Silvia, Mori, Anna Maria, Morgante, Federica, Niebel, Thekla Larissa, Noli, Silvano, Orlando, Anita, Pagani, Michele, Passador, Debora, Pellicori, Simona, Perotti, Luciano, Picchioni, Raffaella, Poma, Silvia, Pozzi, Marco, Preti, Emanuela, Puce, Roberta, Radolovich, Danila Katia, Ragni, Gianluca, Repossi, Filippo, Riccardi, Francesca, Rizzardi, Roberto, Rodi, Giuseppe, Roldi, Emanuela, Rossi, Cristina, Sala Gallini, Giuseppe, Sciutti, Fabio, Sportiello, Debora, Ticozzelli, Giulia, Visconti, Federico, Zizzi, Silvia, Bagliani, Alessandro, Belotti, Corrado, Bossi, Chiara, Colombo, Andrea, Colombo, Costanza Natalia Julia, Cremascoli, Luca, Dammassa, Valentino, Discepoli, Roberto, Garlando, Maria Adelaide, Grandini, Filippo, Pellegrini, Andrea, Quaranta, Cecilia, Stella, Andrea, Torresani, Francesco, Mondelli, Mario, Brunetti, Enrico, Di Matteo, Angela, Seminari, Elena, Maiocchi, Laura, Zuccaro, Valentina, Pagnucco, Layla, Mariani, Bianca, Ludovisi, Serena, Lissandrin, Raffaella, Parisi, Aldo, Sacchi, Paolo, Patruno, Savino F. A., Michelone, Giuseppe, Gulminetti, Roberto, Zanaboni, Domenico, Novati, Stefano, Maserati, Renato, Orsolini, Paolo, Vecchia, Marco, Asperges, Erika, Di Filippo, Alessandro, Sambo, Margherita, Biscarini, Simona, Lupi, Matteo, Roda, Silvia, Gallazzi, Ilaria, Sachs, Michele, Valsecchi, Pietro, Ferrari, Alessandra, Bosio, Matteo, Cascina, Alessandro, Conio, Valentina, Di Domenica, Rita, Donnetta, Anna, Fraolini, Elia, Gualtieri, Giuseppe, Mangiarotti, Patrizia, Mariani, Francesca, Meloni, Federica, Oggionni, Tiberio, Pasturenzi, Lidia, Ronzoni, Vanessa, Saracino, Laura, Stella, Giulia, Tomaselli, Stefano, Abbate, Tommaso, Accordino, Giulia, Bertuccio, Francesco, Burattini, Cecilia, Cacciatore, Elisa, Cattaneo, Elena, Chino, Vittorio, Coretti, Manuela, Della Zoppa, Matteo, Infusino, Cristina, Lettieri, Sara, Maccabruni, Valeria, Mancinelli, Silvia, Tirelli, Claudio, and Vertui, Valentina

Subjects
Adult, Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), MEDLINE, Tertiary referral hospital, Single Center, Statistics, Nonparametric, Tertiary Care Centers, Prevalence, Internal Medicine, medicine, Humans, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Aged, Retrospective Studies, Aged, 80 and over, Academic Medical Centers, Task force, business.industry, Correction, COVID-19, Venous Thromboembolism, Middle Aged, Northern italy, Italy, Emergency medicine, Emergency Medicine, Female, business, Venous thromboembolism
Abstract

Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in D-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.

Published
2021
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7. Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy.

Author

Melazzini, Federica, Colaneri, Marta, Fumoso, Federica, Freddi, Giulia, Lenti, Marco Vincenzo, Pieri, Teresa Chiara, Piloni, Davide, Noris, Patrizia, Pieresca, Carla, Preti, Paola Stefania, Russo, Mariaconcetta, Corsico, Angelo, Tavazzi, Guido, Baldanti, Fausto, Triarico, Antonio, Mojoli, Francesco, Bruno, Raffaele, Di Sabatino, Antonio, on behalf of the San Matteo Pavia COVID-19 Task Force, and Aronico, Nicola

Abstract

Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p < 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p < 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p < 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in d-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE. [ABSTRACT FROM AUTHOR]

Published
2021
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9. The role of surgery in the multimodal treatment of primary gastric non-Hodgkin's lymphomas: a report of 76 cases and review of the literature

Author

Gobbi, Paolo G., Dionigi, Paolo, Barbieri, Fausto, Corbella, Franco, Bertoloni, Daniele, Grignani, Giovani, Jemos, Vassili, Pieresca, Carla, and Ascari, Edoardo

Subjects
Stomach cancer, Non-Hodgkin's lymphomas -- Care and treatment, Gastrectomy -- Complications, Health
Abstract

Diagnostic capability has improved dramatically in recent years, and endoscopic biopsy has made preoperative diagnosis possible for primary gastric non-Hodgkin's lymphoma (PGL). Nevertheless, much of the insight into the treatment of this tumor was obtained in earlier years, and the optimal treatment for PGL has not yet been agreed upon. Since endoscopic biopsies raise the possibility of curative surgery with preservation of the stomach, a retrospective review of 76 patients was undertaken to determine which factors determine the best treatment of this cancer. Overall, a 43 percent survival was seen at 10 years for patients with Stage I or II cancer; for Stage IV the 10-year survival fell to 20 percent. All combinations of surgery, radiotherapy, and chemotherapy were included in the patient population, with the exception that no patient was treated with radiotherapy alone. No significant differences were found in relation to the different treatments, but five postoperative deaths were recorded from 45 surgically treated patients. This indicates that the benefits of surgery may well have been overestimated relative to the surgical risk. Although in some cases, surgical resection of the stomach may be unavoidable, it should not be regarded as mandatory in the treatment of primary gastric lymphoma. Many of the complications of gastrectomy may be avoided, while maintaining optimal chances for survival of the patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

10. Granulocitopenia in paziente in trattamento profilattico con trimetoprim/sulfametossazolo

Author

Guerrini, Chiara, Scavariello, Concetta, Picchi, Chiara, Pieresca, Carla, Invernizzi, Rosangela, and Balduini, Carlo Luigi

Abstract

L’agranulocitosi secondaria a trattamento antibiotico è un effetto collaterale alquanto raro, ma grave. Gli anti-biotici che più frequentemente la determinano sono beta lattamici, citrimossazolo, cloramfenicolo, ceftazidime, imipenem, vancomicina. Quale sia il meccanismo implicato non è totalmente chiaro, ma potrebbe essere coinvolta la produzione di anticorpi contro il farmaco che cross-reagiscono con le cellule ematiche. L’età media di presentazione del fenomeno è 68 anni ed i soggetti anziani manifestano le reazioni più gravi; la somministrazione di fattore di crescita granulocitario (G-CSF) ne determina un decorso favorevole. In questa sede descriviamo il caso di una donna, affetta da linfoma, che ha sviluppato leucopenia a seguito di una terapia profilattica con cotrimossazolo. Le nostre indagini cliniche hanno escluso che questa reazione avesse altre cause, soprattutto un’infiltrazione midollare da parte del linfoma o un’infezione virale. La sola causa possibile di questa leucopenia sembra essere una reazione farmaco-indotta., Bollettino della Società Medico Chirurgica di Pavia, Vol 123, N° 1 (2010)

Published
2010
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11. Lesioni nodulari epatiche come inusuale manifestazione di mieloma multiplo in progressione: descrizione di un caso clinico

Author

Scavariello, Concetta, Carnevale Maffè, Gabriella, Travaglino, Erica, Pagani, Elisabetta, Bertolino, Giampiera, Pieresca, Carla, Gobbi, Paolo, Invernizzi, Rosangela, and Balduini, Carlo Luigi

Abstract

Localizzazioni extramidollari in corso di mieloma multiplo (MM) sono rare. Possono interessare qualsiasi tessuto ed il loro riscontro si associa ad una malattia più aggressiva. Particolarmente atipico sembrerebbe l’interessamento epatico in pazienti in vita. Nell’articolo descriviamo un caso di lesione epatica diagnosticato mediante agobiopsia come localizzazione extramidollare di malattia in corso di mieloma multiplo in fase avanzata. Da studi post mortem il riscontro di coinvolgimento epatico in MM ha una prevalenza maggiore rispetto ai dati su pazienti in vita; appare pertanto necessaria una valutazione critica e clinica per confermare se davvero tale evento sia così insolito come precedentemente riportato., Bollettino della Società Medico Chirurgica di Pavia, Vol 122, N° 2 (2009)

Published
2010
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13. ProMECE-CytaBOM vs MACOP-B in Advanced Aggressive Non-Hodgkin's Lymphoma: Long Term Results of a Multicenter Study of the Italian Lymphoma Study Group (GISL)

Author

Silingardi, Vittorio, primary, Federico, Massimo, additional, Cavanna, Luigi, additional, Avanzini, Paolo, additional, Gobbi, Paolo G., additional, Lombardo, Marco, additional, Carotenuto, Mario, additional, Frassoldati, Antonio, additional, Pieresca, Carla, additional, Vallisa, Daniele, additional, Merli, Francesco, additional, Ascari, Edoardo, additional, and Mauri, Carlo, additional

Published
1995
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14. A pilot study on the use of the ProMACE-CytaBOM regimen as a first-line treatment of advanced follicular non-Hodgkin's lymphoma. Gruppo Italiano per lo Studio dei Linfomi.

Author

Baldini, Luca, Guffanti, Andrea, Gobbi, Paolo, Colombi, Mariangela, Federico, Massimo, Avanzini, Paolo, Cavanna, Luigi, Pieresca, Carla, Silingardi, Vittorio, Maiolo, Anna T., Baldini, L, Guffanti, A, Gobbi, P, Colombi, M, Federico, M, Avanzini, P, Cavanna, L, Pieresca, C, Silingardi, V, and Maiolo, A T

Published
1997
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17. A pilot study on the use of the proMACE-cytaBOM regimen as a first-line treatment of advanced follicular non-Hodgkin's lymphoma<FNR HREF="fn1"></FNR><FN ID="fn1"> Presented in part, in poster form, at the 35th Congresso Nazionale Società Italiana di Ematolgia, Pavia-Cernobbio, Italy, September 10-13, 1995. </FN>

Author

Baldini, Luca, Guffanti, Andrea, Gobbi, Paolo, Colombi, Mariangela, Federico, Massimo, Avanzini, Paolo, Cavanna, Luigi, Pieresca, Carla, Silingardi, Vittorio, and Maiolo, Anna T.

Abstract

The role of intensive conventional dose chemotherapy in advanced low grade non-Hodgkin's lymphomas is a matter of debate. The Gruppo Italiano per lo Studio dei Linfomi conducted a study to evaluate the efficacy and toxicity of a third-generation polychemotherapeutic regimen, ProMACE-CytaBOM, as a first-line therapy in a selected group of patients with advanced follicular non-Hodgkin's lymphoma (Fo-NHL) who were younger than 60 years. Thirty-nine patients were included in the study (14 males, 25 females; median age, 44 years; age range, 22-60 years). Their WF histotypes were B (9 patients), C (23 patients), and D (7 patients). All of the patients had disease in an advanced clinical stage (Stage III, 15 patients; Stage IV, 24 patients), and 9 patients had B symptoms. According to the age-adjusted International Prognostic Index (IPI), 20 patients exhibited low-intermediate risk, 14 high-intermediate risk, and 5 high risk. Three of the patients were not considered evaluable because they withdrew their consent after three (one patient) and four (two patients) cycles of therapy (one of these patients was in complete remission [CR], and two were in partial remission [PR]). Of the 36 evaluable patients, 4 received IF-RT after the 6 planned cycles of therapy. CR was achieved in 20 patients (55.5%) and PR in 14 (38.8%). One patient (2.7%) experienced disease progression during the treatment program. Eight of the 20 patients with CR (40%) relapsed. Eight patients (22.2%) died: 6 died of disease progression, 1 died of therapy consequences, and 1 died of an unrelated cause. With a median follow-up of 49 months (range, 28-79 months), the disease free survival rate was 60%. The overall survival rate was 80% after a median follow-up of 44 months (range, 3-79 months). The IPI stratification of patients showed a borderline statistical difference in terms of time to treatment failure and overall survival. The main hematologic toxicity was neutropenia (Grade 3 in approximately 10% of patients). One patient died of sepsis. Cotrimoxazole prophylaxis was always given. Cardiac toxicity (Grade 3) was observed in 1 patient at the end of the planned therapy. The average relative dose intensity of the drugs was 89% of the projected dose, without the regular use of growth factors. This study indicates that ProMACE-CytaBOM could be a suitable regimen for adult patients with advanced Fo-NHL, allowing a good CR rate and very good disease free survival rate. However, the occurrence of severe, albeit limited, adverse effects suggests that this regimen should first be used in controlled therapeutic protocols to verify its efficacy with respect to less intensive approaches. Cancer 1997; 79:1234-40.© 1997 American Cancer Society.

Published
1997
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18. Long-Term Results From MOPPEBVCAD Chemotherapy With Optional Limited Radiotherapy in Advanced Hodgkin's Disease

Author

Gobbi, Paolo G., Pieresca, Carla, Ghirardelli, Maria L., DiRenzo, Nicola, Federico, Massimo, Merli, Francesco, Iannitto, Emilio, Pitini, Vincenzo, Grignani, Giovanni, Donelli, Amedea, Carotenuto, Mario, Silingardi, Vittorio, Ascari, Edoardo, and Gruppo Italiano per lo Studio dei Linfomi, the

Abstract

The purpose was to verify the 5-year results of the MOPPEBVCAD chemotherapy regimen with limited radiotherapy in relation to the promising preliminary data. Mechlorethamine, vincristine, procarbazine, prednisone, epidoxorubicin, bleomycin, vinblastine, lomustine, melphalan, and vindesine were delivered according to a schedule derived through hybridization, intensification, and shortening of the corresponding alternating CAD/MOPP/ABV regimen. Radiotherapy was restricted to sites of bulky involvement or to areas that responded incompletely to chemotherapy. This multicenter, controlled, nonrandomized trial involved 145 eligible patients. Radiotherapy was administered to 47 patients, 46 of whom were in complete remission after chemotherapy. Remissions were complete in 137 patients (94%), partial in 4 (3%), and null in the remaining 4. Tumor-specific, overall, relapse-free, and failure-free survival at 5 years were 0.89, 0.86, 0.82, and 0.78, respectively. Hematologic toxicity was considerable, whereas nonhematologic side effects were fully acceptable. Most of the unfavorable prognostic factors lost their clinical weight. Only age and lymphocyte depletion histologic type were statistically correlated with major follow-up endpoints; performance status and bone marrow involvement were subordinate to age. Seven patients developed a second cancer (including 3 myelodysplasias). MOPPEBVCAD with selected radiotherapy is a highly effective regimen in advanced Hodgkin's disease. Early and late toxicity are no more severe than what would be expected with other alternating or hybrid regimens. A comparison with ABVD, which is currently considered the standard regimen for advanced Hodgkin's disease, is needed.

Published
1998
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20. Recurrence Risk after First Symptomatic Distal versus Proximal Deep Vein Thrombosis According to Baseline Risk Factors.

Author

Valerio L, Ambaglio C, Barone M, Ciola M, Konstantinides SV, Mahmoudpour SH, Picchi C, Pieresca C, Trinchero A, and Barco S

Abstract

Background  It remains unclear whether the distal location of deep vein thrombosis (DVT) is independently associated with a lower risk of recurrence in all patients, or represents a marker of the presence and severity of provoking factors for venous thromboembolism (VTE). Methods  We investigated the impact of distal (vs. proximal) DVT location on the risk of developing symptomatic, objectively confirmed recurrent VTE in 831 patients with a first acute symptomatic DVT not associated with pulmonary embolism (PE), who were stratified by the presence of transient or persistent risk factors at baseline. The primary outcome was symptomatic, objectively diagnosed recurrent VTE, including proximal DVT and PE. Results  A total of 205 (24.7%) patients presented with a transient risk factor, 189 (22.7%) with a minor persistent risk factor, 202 (24.3%) with unprovoked DVT, and 235 (28.3%) with cancer-associated DVT. One-hundred twenty-five patients (15.0%) experienced recurrent DVT or PE. The largest relative difference between patients with distal (vs. proximal) DVT was observed in the absence of identifiable risk factors (adjusted hazard ratio [aHR]: 0.11; 95% CI [confidence interval]: 0.03-0.45). In patients with cancer, distal and proximal DVT had a comparable risk of recurrence (aHR: 0.70; 95% CI: 0.28-1.78]). Conclusions  The distal (vs. proximal) location of first acute symptomatic DVT represented, in the absence of any identifiable transient or persistent risk factors, a favorable prognostic factor for recurrence. In contrast, the prognostic impact of DVT location was weaker if persistent provoking risk factors for VTE were present, notably cancer.

Published
2019
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