Search

Your search keyword '"Zappa MC"' showing total 14 results
Start Over Author "Zappa MC"
14 results on '"Zappa MC"'

1. COVID-19 in Severe Asthma Network in Italy (SANI) patients: Clinical features, impact of comorbidities and treatments

Author

Heffler, Enrico, Detoraki, Aikaterini, Contoli, Marco, Papi, Alberto, Paoletti, Giovanni, Malipiero, Giacomo, Brussino, Luisa, Crimi, Claudia, Morrone, Daniela, Padovani, Marianna, Guida, Giuseppe, Gerli, Alberto Giovanni, Centanni, Stefano, Senna, Gianenrico, Paggiaro, Pierluigi, Blasi, Francesco, Canonica, Giorgio Walter, SANI Working Group, Bonavia, M, Bucca, C, Caiaffa, Mf, Calabrese, C, Camiciottoli, G, Caruso, C, Conte, Me, Corsico, Ag, Cosmi, L, Costantino, Mt, Crimi, N, D’Alò, S, D’Amato, M, Del Giacco, S, Farsi, A, Favero, E, Foschino, Bmp, Guarnieri, G, Lo Cicero, S, Lombardi, C, Macchia, L, Mazza, F, Menzella, F, Milanese, M, Montuschi, P, Montagni, M, Nucera, E, Parente, R, Passalacqua, G, Patella, V, Pelaia, G, Pini, L, Puggioni, F, Ricciardi, L, Ricciardolo, Flm, Richeldi, L, Ridolo, E, Rolla, G, Santus, P, Scichilone, N, Solidoro, P, Spadaro, G, Vianello, A, Viviano, V, Yacoub, Mr, Zappa, Mc, Heffler E., Detoraki A., Contoli M., Papi A., Paoletti G., Malipiero G., Brussino L., Crimi C., Morrone D., Padovani M., Guida G., Gerli A.G., Centanni S., Senna G., Paggiaro P., Blasi F., Canonica G.W., Bonavia M., Bucca C., Caiaffa M.F., Calabrese C., Camiciottoli G., Caruso C., Conte M.E., Corsico A.G., Cosmi L., Costantino M.T., Crimi N., D'Alo S., D'Amato M., Del Giacco S., Farsi A., Favero E., Foschino B.M.P., Guarnieri G., Cicero S.L., Lombardi C., Macchia L., Mazza F., Menzella F., Milanese M., Montuschi P., Montagni M., Nucera E., Parente R., Passalacqua G., Patella V., Pelaia G., Pini L., Puggioni F., Ricciardi L., Ricciardolo F.L.M., Richeldi L., Ridolo E., Rolla G., Santus P., Scichilone N., Solidoro P., Spadaro G., Vianello A., Viviano V., Yacoub M.R., and Zappa M.C.

Subjects
severe asthma, medicine.medical_specialty, 2019-20 coronavirus outbreak, COVID-19, Severe Asthma Network in Italy, inflammation, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Severe asthma, Population, Immunology, MEDLINE, Omalizumab, Settore MED/10 - Malattie Dell'Apparato Respiratorio, NO, Internal medicine, Diabetes mellitus, Severity of illness, medicine, Immunology and Allergy, Risk factor, Letters to the Editor, education, Letter to the Editor, Asthma, education.field_of_study, business.industry, Incidence (epidemiology), Mortality rate, COVID-19, medicine.disease, Comorbidity, Severe Asthma Network in Italy, inflammation, Cohort, business, Mepolizumab, medicine.drug
Abstract

To the Editor Since the end of February 2020 Italy, first non- Asian Country, has reported an ever increasing number of COronaVIrus Disease 19 (COVID-19) patients, which has reached over 200,000 confirmed Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infected subjects and resulted in more than 34000 deaths (data updated to June 19th, 20201).Patients with asthma are potentially more severely affected by by SARS-CoV-2 infection 2 and it is well established that respiratory viral infections are associated with severe adverse outcomes in patients with asthma, including increased risk of asthma exacerbation episodes 3. Nonetheless, according to the epidemiological studies published so far, chronic pulmonary diseases are not amongst the most common clinical conditions in COVID-19 patients4About 5-10% of entire asthma population, are severe asthmatics5 and one would expect increased vulnerability to SARS-CoV-2 infection, but no data is so fare available ti confirm this hypothesis.We investigated the incidence of COVID-19, describing its clinical course, in the population of the Severe Asthma Network in Italy (SANI), one of the largest registry for severe asthma worldwide6, and in an additional Center (Azienda Ospedaliero Univeristaria di Ferrara, Ferrara, Italy). All centers, have been contacted and inquired to report confirmed (i.e. patients with positive test result for the virus SARS-CoV-2 from analysis of nasopharyngeal or oropharyngeal swab specimens) or highly suspect cases of COVID-19 (i.e. patients with symptoms, laboratory findings and lung imaging typical of COVID-19 but without access to nasopharyngeal or oropharyngeal swab specimens because of clinical contingencies/emergency) among their cohorts of severe asthma. Demographic and clinical data of the entire cohort of severe asthmatics enrolled in the study and all reported cases of confirmed or suspect cases of COVID-19, have been obtained from the registry platform and collected from the additional Center. Additional data about COVID-19 symptoms, treatment and clinical course have been collected for all cases reported.Ethical issues and statistical analysis are reported in the online supplementary material.Twenty-six (1.73%) out of 1504 severe asthmatics had confirmed (11 out of 26) or highly suspect COVID-19 (15 out 26); eighteen (69.2%) were females and mean age was 56.2 ± 10 years. The geographical distribution of COVID-19 cases is presented in Figure 1.Nine (34.6%) infected patients experienced worsening of asthma during the COVID-19 symptomatic period; four of them needed a short course of oral corticosteroids for controlling asthma exacerbation symptoms.The most frequent COVID-19 symptoms reported were fever (100% of patients), malaise (84.6%), cough (80.8%), dyspnea (80.8%), headache (42.3%) and loss of smell (42.3%). Four patients (15.3%) have been hospitalized, one of which in intensive care unit; among hospitalized patients, two (7.7%) died for COVID-19 interstitial pneumonia. No deaths have been reported among the non-hospitalized patients.Severe asthmatics affected by COVID-19, had a significantly higher prevalence of non-insulin-dependent diabetes mellitus (NIDDM) compared to non-infected severe asthma patients (15.4% vs 3.8%, p=0.002; odds ratio: 4.7). No difference was found in other comorbidities (including rhinitis, chronic rhinosinusitis with or without nasal polyps, bronchiectasis, obesity, gastroesophageal reflux, arterial hypertension, cardiovascular diseases).Twenty-one patients with COVID-19 were on biological treatments: 15 (71%) were on anti-IL-5 or anti-IL5R agents (Mepolizumab n= 13; Benralizumab n=2 - counting for the 2.9% of all severe asthmatics treated with anti-IL5 in our study population) and 6 (29%) were on anti IgE (Omalizumab - 1.3% of all severe asthmatics treated with omalizumab in our study population).Table I summarizes demographic and clinical characteristics of the 26 COVID-19 patients.In conclusion, in our large cohort of severe asthmatics, COVID-19 was infrequent, not supporting the concept of asthma as a particularly susceptible condition to SARS-COV2 infection 2. This is in line with the first published large epidemiological data on COVID-19 patients, in which asthma is under-reported as comorbidity4. The COVID-19 related mortality rate in our cohort of patients was 7.7%, lower than the COVID-19 mortality rate in the general population (14.5% in Italy 1). These findings suggest that severe asthmatics are not at high risk of the SARS-CoV-2 infection and of severe forms of COVID-19. There are potentially different reasons for this. Self-containment is the first, because of the awareness of virus infections acting as a trigger for exacerbations, and therefore they could have acted with greater caution, scrupulously respecting social distancing, lockdown and hygiene rules of prevention, and being more careful in regularly taking asthma medications.Another possible explanation stands in the intrinsic features of type-2 inflammation, that characterizes a great proportion of severe asthmatics. Respiratory allergies and controlled allergen exposures are associated with significant reduction in angiotensin-converting enzyme 2 (ACE2) expression 7, the cellular receptor for SARS-CoV-2. Interestingly, ACE2 and Transmembrane Serine Protease 2 (TMPRSS2) (another protein mediating SARS-CoV-2 cell entry) have been found highly expressed in asthmatics with concomitant NIDDM8, the only comorbidity that was more frequent reported in our COVID-19 severe asthmatics.The third possible explanation refers to the possibility that inhaled corticosteroids (ICS) might prevent or mitigate the development of Coronaviruses infections. By definition, patients with severe asthma are treated with high doses of ICS 5 and this may have had a protective effect for SARS-CoV-2 infection.Noteworthy, among the patients of our case-series of severe asthmatics with COVID-19, the proportion of those treated anti-IL5 biologics was higher (71%) compared to the number of patients treated with anti-IgE (29%). Although the number of cases is too small to draw any conclusion, it is tempting to speculate that different biological treatments can have specific and different impact on antiviral immune response. In addition we may speculate of the consequence of blood eosinophils reduction: eosinopenia has been reported in 52-90% of COVID-19 patients worldwide and it has been suggested as a risk factor for more severe COVID-19 9.In conclusion, in our large cohort of severe asthmatics only a small minority experienced symptoms consistent with COVID-19, and these patients had peculiar clinical features including high prevalence of NIDDM as comorbidity. Further real-life registry-based studies are needed to confirm our findings and to extend the evidence that severe asthmatics are at low risk of developing COVID-19.

Published
2021

2. Circadian rhythm of COPD symptoms in clinically based phenotypes. Results from the STORICO Italian observational study

Author

Scichilone, Nicola, Antonelli Incalzi, Raffaele, Blasi, Francesco, Schino, Pietro, Cuttitta, Giuseppina, Zullo, Alessandro, Ori, Alessandra, Canonica, Giorgio Walter, Schino P, Cuttitta G, Foschino MP, Prediletto R, Tranfa C, Zappa MC, Patriciello P, Labate L, Mariotta S, Nava S, Vatrella A, Mastroberardino M, Sarzani R, Iuliano A, Maggi L, Zedda A, Pesci A, Sera G, Nicolini A, Salvatore Walter DD, Forte S, Mario DD, Rivolta F, Ferliga M, Raco AF, Luigi DR, Cabibbo G, Maselli R, Gulotta C, Nardini S, Guffanti EE, Castellani W, Triolo L, Passalacqua G, Beghè B, Salvatore LC, Faccini E, Atzeni E, Tazza R, Giamesio P., Scichilone N., Antonelli Incalzi R., Blasi F., Schino P., Cuttitta G., Zullo A., Ori A., Canonica G., Foschino M.P., Prediletto R., Tranfa C.M.E., Zappa M.C., Patriciello P., Labate L., Mariotta S., Nava S., Vatrella A., Mastroberardino M., Sarzani R., Iuliano A., Maggi L., Zedda A., Pesci A., Sera G., Nicolini A., Salvatore Walter D.D., Forte S., Mario D.D., Rivolta F., Ferliga M., Raco A.F., Luigi D.R., Cabibbo G., Maselli R., Gulotta C., Nardini S., Guffanti E.E., Castellani W., Triolo L., Passalacqua G., Beghe B., Salvatore L.C., Faccini E., Atzeni E., Tazza R., Giamesio P., Scichilone, N, Antonelli Incalzi, R, Blasi, F, Schino, P, Cuttitta, G, Zullo, A, Ori, A, Canonica, G, Foschino, M, Prediletto, R, Tranfa, C, Zappa, M, Patriciello, P, Labate, L, Mariotta, S, Nava, S, Vatrella, A, Mastroberardino, M, Sarzani, R, Iuliano, A, Maggi, L, Zedda, A, Pesci, A, Sera, G, Nicolini, A, Salvatore Walter, D, Forte, S, Mario, D, Rivolta, F, Ferliga, M, Raco, A, Luigi, D, Cabibbo, G, Maselli, R, Gulotta, C, Nardini, S, Guffanti, E, Castellani, W, Triolo, L, Passalacqua, G, Beghe, B, Salvatore, L, Faccini, E, Atzeni, E, Tazza, R, Giamesio, P, Scichilone, Nicola, Antonelli Incalzi, Raffaele, Blasi, Francesco, Schino, Pietro, Cuttitta, Giuseppina, Zullo, Alessandro, Ori, Alessandra, Canonica, Giorgio, Walter, Foschino, Mp, Zappa, Mc, Salvatore Walter, Dd, Mario, Dd, Raco, Af, Luigi, Dr, Guffanti, Ee, Beghè, B, Salvatore, Lc, and Giamesio, P.

Subjects
Male, Chronic bronchitis, Time Factors, Health Status, Anxiety, Hospital Anxiety and Depression Scale, Severity of Illness Index, Health Statu, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Surveys and Questionnaires, Forced Expiratory Volume, Clinical phenotype, Medicine, Surveys and Questionnaire, Respiratory function, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Lung, Depression (differential diagnoses), COPD, Depression, Middle Aged, Circadian Rhythm, Phenotype, Italy, Female, medicine.symptom, 24-hour symptoms, Clinical phenotype, Real-world, Respiratory function, Research Article, Human, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Chronic Obstructive, Time Factor, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Pulmonary Disease, 03 medical and health sciences, Internal medicine, Humans, Asthma, 24-hour symptoms, Real-world, Aged, Sleep, Quality of Life, lcsh:RC705-779, business.industry, Correction, lcsh:Diseases of the respiratory system, medicine.disease, 24-hour symptom, Prospective Studie, 030228 respiratory system, business
Abstract

Background Chronic Obstructive Pulmonary Disease (COPD) encompasses various phenotypes that severely limit the applicability of precision respiratory medicine. The present investigation is aimed to assess the circadian rhythm of symptoms in pre-defined clinical COPD phenotypes and its association with health-related quality of life (HR-QoL), the quality of sleep and the level of depression/anxiety in each clinical phenotype. Methods The STORICO (NCT03105999) Italian observational prospective cohort study enrolled COPD subjects. A clinical diagnosis of either chronic bronchitis (CB), emphysema (EM) or mixed COPD-asthma (MCA) phenotype was made by clinicians at enrollment. Baseline early-morning, day-time and nocturnal symptoms (gathered via the Night-time, Morning and Day-time Symptoms of COPD questionnaire), HR-QoL (via the St. George’s Respiratory Questionnaire), anxiety and depression levels (via the Hospital Anxiety and Depression Scale), quality of sleep (via COPD and Asthma Sleep Impact Scale), physical activity (via the International Physical Activity Questionnaire) as well as lung function were recorded. Results 606 COPD subjects (age 71.4 ± 8.2 years, male 75.1%) were studied. 57.9, 35.5 5.3 and 1.3% of the sample belonged to the CB, EM, MCA and EM + CB phenotypes respectively. The vast majority of subjects reported early-morning and day-time symptoms (79.5 and 79.2% in the CB and 75.8 and 77.7% in the EM groups); the proportion suffering from night-time symptoms was higher in the CB than in the EM group (53.6% vs. 39.5%, p = 0.0016). In both CB and EM, indiscriminately, the presence of symptoms during the 24-h day was associated with poorer HR-QoL, worse quality of sleep and higher levels of anxiety/depression. Conclusions The findings highlight the primary classificatory role of nocturnal symptoms in COPD. Trial registration Trial registration number: NCT03105999, date of registration: 10th April 2017.

Published
2019

3. Frequency of tiotropium bromide use and clinical features of patients with severe asthma in a real-life setting: Data from the severe asthma network in Italy (sani) registry

Author

Puggioni, F., Brussino, L., Canonica, G. W., Blasi, F., Paggiaro, P., Caminati, M., Latorre, M., Heffler, E., Senna, G., Sani, Group, Bonavia, M., Caiaffa, Mf., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, Me., Corsico, Ag., Cosmi, L., Costantino, Mt., Crimi, N., D’Alo, S., D’Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino, Bmp., Guarnieri, G., Guida, G., Yacoub, Mr., Lombardi, C., Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montuschi, P., Nucera, E., Paoletti, G., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardi, L., Ricciardolo, Flm., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Zappa, Mc., Concetta, Sirena., Daniela, Morrone, and Silvia, Rabotti

Subjects
lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, severe asthma, registry, long-acting muscarinic antagonists, real-ligfe, medicine.medical_specialty, Registry, Severe asthma, Respimat, real-life, Exacerbation, Long-acting muscarinic antagonists, Real-life, Umeclidinium bromide, Internal medicine, Journal of Asthma and Allergy, Immunology and Allergy, Medicine, Glycopyrronium bromide, Original Research, Asthma, Bronchiectasis, biology, business.industry, Tiotropium bromide, Lama, medicine.disease, biology.organism_classification, respiratory tract diseases, real-ligfe, lcsh:RC581-607, business, medicine.drug
Abstract

Francesca Puggioni,1,2 Luisa Brussino,3 Giorgio Walter Canonica,1,2 Francesco Blasi,4,5 Pierluigi Paggiaro,6 Marco Caminati,7,8 Manuela Latorre,6 Enrico Heffler,1,2 Gianenrico Senna7,8 On behalf of the Severe Asthma Network in Italy (SANI) group1Personalized Medicine, Asthma and Allergy – Humanitas Clinical and Research Center, IRCCS – Rozzano (MI), Milan, Italy; 2Department of Biomedical Sciences, Humanitas University – Pieve Emanuele (MI), Milan, Italy; 3Dipartimento di Scienze Mediche, SSDDU Allergologia e Immunologia Clinica, Università degli Studi di Torino, AO Ordine Mauriziano Umberto I – Torino, Torino, Italy; 4Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; 5Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy; 6Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy; 7Department of Medicine, University of Verona, Verona, Italy; 8Allergy Unit and Asthma Center, Verona University Hospital, Verona, Verona, ItalyCorrespondence: Enrico HefflerPersonalized Medicine, Asthma and Allergy, Istituto Clinico Humanitas, Milan, ItalyTel +39 0288247013Fax + 39 0282246484Email enrico.heffler@hunimed.euPurpose: Patients with uncontrolled asthma despite high doses of inhaled corticosteroid therapy plus another controller are defined as severe asthmatics. Tiotropium bromide respimat (TBR) is the only long-acting muscarinic antagonists (LAMA) approved for severe asthma. The aim of this study was to explore the frequency of severe asthmatics treated with TBR and characterize their clinical features in a real-life, registry-based setting.Materials and Methods: Baseline data from the Severe Asthma Network in Italy (SANI) registry have been analyzed to determine the use of TBR and other LAMA, and to compare clinical, functional and inflammatory features associated with the use of LAMA.Results: Among a total of 698 enrolled patients, 35.9% were treated with LAMA (23.3% TBR, 4.5% tiotropium bromide handihaler, 4.5% aclidinium, 3.4% glycopyrronium bromide 0.3% umeclidinium bromide). Age of asthma onset was higher in patients taking LAMA, whom, compared to others were more frequently former smokers. They also had a higher annual exacerbation rate, experienced worst asthma control, worst disease-related quality of life and poorer lung function. Bronchiectasis was more frequently found in LAMA users (25.9% vs 13.1%).Conclusion: TBR is still underused in severe asthma in a real-life setting, while a relevant proportion of patients are treated with other LAMA that are not approved for severe asthma treatment. Patients taking LAMA have features characteristic of even more severe asthma.Keywords: severe asthma, registry, long-acting muscarinic antagonists, real-ligfe

Published
2020

4. Gender differences in asthma perception and its impact on quality of life: a post hoc analysis of the PROXIMA (Patient Reported Outcomes and Xolair® In the Management of Asthma) study

Author

Colombo, D, Zagni, E, Ferri, F, Canonica, Gw, Astarita, C, Balbo, P, Berlendis, M, Bruni, G, Bucca, C, Corsico, Ag, Foresi, A, Macciocchi, B, Michetti, G, Montera, M, Palange, P, Pareo, C, Polla, B, Polosa, R, Puddu, E, Rogliani, P, Romano, A, Rottoli, P, Sabato, E, Santus, P, Schiavino, D, Spanevello, A, Trovato, A, and Zappa, Mc

Subjects
lcsh:Immunologic diseases. Allergy, Quality of life, medicine.medical_specialty, Severe allergic asthma, Settore MED/10 - Malattie dell'Apparato Respiratorio, Disease perception, Omalizumab, 03 medical and health sciences, 0302 clinical medicine, Statistical significance, Internal medicine, Asthma control, Post-hoc analysis, medicine, Gender differences, 030212 general & internal medicine, Asthma, business.industry, Research, Repeated measures design, General Medicine, medicine.disease, 030228 respiratory system, Asthma Control Questionnaire, Cohort, Observational study, business, lcsh:RC581-607
Abstract

Background Gender differences in asthma perception and control have been reported. The PROXIMA observational study assessed these outcomes in a cohort of Italian severe allergic asthma (SAA) patients. This post hoc analysis of the PROXIMA results was aimed at assessing gender differences in SAA in a real-world setting, focusing on disease perception and impact on quality of life (QoL). Methods The PROXIMA study was an observational, multicenter study, consisting of a cross-sectional and a prospective longitudinal phase, including adult outpatients diagnosed with SAA at step 4 requiring a therapeutic step-up. Patients on omalizumab treatment at baseline were included in the 12-month longitudinal phase. Disease control was assessed by the Asthma Control Questionnaire (ACQ) score, patients’ disease perception by the Brief Illness Perception Questionnaire (BIPQ), and QoL by the EuroQoL five-dimensional three-level questionnaire (EQ-5D-3 L) at baseline and after 6 and 12 months. Two regression models were used to evaluate the association between gender and BIPQ total score and EQ-5D-3L score, respectively. Results 357 patients (65% females) were analyzed for the cross-sectional phase and 99 (62.6% females) for the longitudinal phase. The prevalence of perennial and seasonal aeroallergens was similar between genders. ACQ score decreased similarly during omalizumab treatment at 6 and 12 months in both genders; no gender differences were observed in control rates. Asthma perception was worse among females at all study visits reaching statistical significance at 12 months (mean (SD) B-IPQ total score 41.8 (9.4) vs 35.6 (12.0); T test p-value (males vs females) Conclusions In this real-world setting, females confirmed to have a worse perception of asthma, feel it as more symptomatic and suffer a greater impact on their QoL, even though having similar baseline severity and obtaining similar level of control.

Published
2019

5. Sex Differences in Severe Asthma: Results From Severe Asthma Network in Italy-SANI

Author

Senna, Gianenrico, Latorre, Manuela, Bugiani, Massimo, Caminati, Marco, Heffler, Enrico, Morrone, Daniela, Paoletti, Giovanni, Parronchi, Paola, Puggioni, Francesca, Blasi, Francesco, Canonica, Giorgio Walter, Paggiaro, Pierluigi, Sani, Network, Bacci, E., Bonavia, M., Caiaffa, P., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S, Conte, Me., Corsico, Ag., Cosmi, L., Costantino, Mt., Crimi, N., D'Alò, S., D'Amato, M., Del Giacco, S., Favero, E., Farsi, A., Foschino, Bpm., Guarnieri, G., Guida, G., Lombardi, C., Macchia, L., Menzella, F., Milanese, M., Montuschi, P., Nucera, E., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardolo, Flm., Ricciardi, L., L. Richeldi, E, Ridolo, Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Yacoub, Mr., and Zappa, Mc.

Subjects
Pulmonary and Respiratory Medicine, Severe asthma, obesity, medicine.medical_specialty, Multivariate analysis, Immunology, Disease, Immunoglobulin E, smoking, 03 medical and health sciences, 0302 clinical medicine, male, Internal medicine, Female patient, sex, Immunology and Allergy, Medicine, 030223 otorhinolaryngology, Asthma, biology, business.industry, biomarkers, female, type 2, medicine.disease, Obesity, 030228 respiratory system, Exhaled nitric oxide, biology.protein, Original Article, business
Abstract

Purpose After adolescence, asthma is more frequent in females than in males due to different hormonal, immunologic, and occupational/environmental factors. The higher prevalence and severity of the disease in females have already been reported in international registries. The aim of this study was to explore the difference in terms of clinical, functional, and biological characteristics between male and female patients with severe asthma in a real-life, registry-based setting. Methods Baseline data from the Severe Asthma Network in Italy registry were analyzed in 1,123 patients with severe asthma, according to sex. Results Almost 2/3 of severe asthmatics were female. Late-onset asthma, obesity and gastro-esophageal reflux were more frequent in females than in males, while previous smoking habits and nasal polyposis were more frequent in males. Females had poor asthma control and a higher number of severe exacerbations leading to hospitalization, in comparison to males. Biomarkers of type 2 inflammation (blood eosinophil, exhaled nitric oxide, and serum immunoglobulin E levels) were significantly higher in males than in females. The type 2 profile (defined by a combination of these 3 biomarkers) was significantly more frequent in males than in females. In multivariate analysis, late-onset asthma and a normal body mass index were only independent variables associated with the type 2 profile, while male sex and age showed only a trend toward the association with the type 2 profile. Conclusions Significant differences may be observed between male and female patients with severe asthma, influencing the asthma pheno-endotyping in both sexes.

Published
2021

7. Oleothorax: An Ultrasound Sign of an Old Practice.

Author

Flores KR, Piamonti D, Vigliarolo R, Impellizzeri P, Serao M, Lilli M, Trequattrini T, Rivitti R, Succu AMP, Gioffrè G, Condoluci C, Maggi B, Lamarra S, Villani A, Marchetti GP, Zappa MC, and Palange P

Subjects
Humans, Male, Ultrasonography, Pneumothorax chemically induced, Pneumothorax diagnostic imaging
Abstract

Introduction: The high morbidity and mortality of tuberculosis has led to the development of numerous therapeutic interventions during the pre-antibiotic era. In 1894, Forlanini proposed the technique of collapse therapy, using spontaneous pneumothorax. In 1926, Bernou developed the oleothorax technique to induce an iatrogenic collapse of the lung through the instillation of oil into the pleural cavity, which was subsequently removed. Nowadays, there are few patients that still represent a living testimony of this historic technique and have been described through traditional radiology., Case Presentation: We report the case of a patient with evidence of a right oleothorax that was investigated not only with traditional radiology but also with the use of chest ultrasonography. Ultrasounds were able to show peculiar characteristics of the oleothorax, including its particular echogenicity, the rigidity and static nature of the collection, the presence of peripheral calcifications, and the negative impact of the collection on diaphragmatic mobility and excursion., Conclusion: To our knowledge, this is the first report of an ultrasound description of oleothorax. We have observed that ultrasound examination, in cases of basal oleothorax, is able to add information regarding its radiological appearance and physiopathological implications on ventilatory mechanics and diaphragmatic distress., (© 2024 S. Karger AG, Basel.)

Published
2024
Full Text
View/download PDF

8. The impact of long-acting muscarinic antagonists on mucus hypersecretion and cough in chronic obstructive pulmonary disease: a systematic review.

Author

Calzetta L, Ritondo BL, Zappa MC, Manzetti GM, Perduno A, Shute J, and Rogliani P

Subjects
Cough diagnosis, Cough drug therapy, Humans, Mucus, Tiotropium Bromide, Muscarinic Antagonists adverse effects, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive drug therapy
Abstract

Patients suffering from chronic obstructive pulmonary disease (COPD) clinically manifest airway mucus hypersecretion as sputum expectoration and cough. Evidence accumulated in the past decade has shown that the cholinergic system not only regulates airway smooth muscle contraction but also the activity of inflammatory and airway epithelial cells, including goblet cells, and submucosal gland activity. Long-acting muscarinic antagonists (LAMAs) with the most favourable M 3 /M 2 muscarinic acetylcholine (ACh) receptors residency properties are not only excellent bronchodilators but potentially also mucus-modifying agents, able to positively impact on mucus hypersecretion and cough. The aim of this systematic review was to investigate the impact of LAMAs on mucus hypersecretion and cough in COPD patients. The evidence confirmed that LAMAs, mainly tiotropium and aclidinium, improved sputum production and cough in moderate to severe COPD. Thus, LAMAs not only antagonise the ACh-induced bronchoconstriction of the airways but also appear to limit the production of mucus secreted in response to ACh by airway goblet cells and/or submucosal glands. Further clinical studies are necessary to evaluate the impact of LAMAs exclusively on sputum symptoms and cough as primary end-points and to investigate whether LAMAs have a modulatory action on the rheological properties of mucus., Competing Interests: Conflict of interest: L. Calzetta reports grants and personal fees from Boehringer Ingelheim, grants and personal fees from Novartis, non-financial support from AstraZeneca, grants from Chiesi Farmaceutici, grants from Almirall, personal fees from ABC Farmaceutici, personal fees from Edmond Pharma, grants and personal fees from Zambon, personal fees from Verona Pharma, and personal fees from Ockham Biotech. Conflict of interest: B.L. Ritondo declares no conflict of interest. Conflict of interest: M.C. Zappa declares no conflict of interest. Conflict of interest: G.M. Manzetti. declares no conflict of interest. Conflict of interest: A. Perduno declares no conflict of interest. Conflict of interest: J. Shute is the Scientific Director of Ockham Biotech Ltd. Conflict of interest: P. Rogliani reports grants and personal fees from Boehringer Ingelheim, grants and personal fees from Novartis, personal fees from AstraZeneca, grants and personal fees from Chiesi Farmaceutici, grants and personal fees from Almirall, grants from Zambon, personal fees from Biofutura, personal fees from GlaxoSmithKline, personal fees from Menarini, and personal fees from Mundipharma., (Copyright ©The authors 2022.)

Published
2022
Full Text
View/download PDF

9. Oral CorticoSteroid sparing with biologics in severe asthma: A remark of the Severe Asthma Network in Italy ( SANI ).

Author

Canonica GW, Blasi F, Paggiaro P, Senna G, Passalacqua G, Spanevello A, Aliberti S, Bagnasco D, Bonavia M, Bonini M, Brussino L, Bucca C, Caiaffa MF, Calabrese C, Camiciottoli G, Caminati M, Carpagnano GE, Caruso C, Centanni S, Conte ME, Corsico AG, Cosmi L, Costantino MT, Crimi N, D'Alò S, D'Amato M, Del Giacco S, Farsi A, Favero E, Foschino Barbaro MP, Guarnieri G, Guida G, Latorre M, Lo Cicero S, Lombardi C, Macchia L, Mazza F, Menzella F, Milanese M, Montagni M, Montuschi P, Nucera E, Parente R, Patella V, Pelaia G, Pini L, Puggioni F, Ricciardi L, Ricciardolo FLM, Richeldi L, Ridolo E, Rolla G, Santus P, Scichilone N, Spadaro G, Vianello A, Viviano V, Yacoub MR, Zappa MC, and Heffler E

Abstract

According to the data derived from several national and international registries, including SANI (Severe Asthma Network Italy), and considering the strong impact that frequent or regular use of oral corticosteroid has on quality of life (QoL) of severe asthmatics, as well as on the costs for managing corticosteroid-related diseases, oral corticosteroid sparing up to withdrawal should be considered a primary outcome in the management of severe asthma. New biologics have clearly demonstrated that this effect is possible, with concomitant reduction in the rate of exacerbations and in symptom control. Then, there is no reason for using so frequently oral corticosteroid before having explored all alternatives currently available for a large part of severe asthmatics., Competing Interests: GW Canonica received in the last three years research grants as well as lecture or advisory board fees from: A. Menarini, Alk-Abello, Allergy Therapeutics, AstraZeneca, Boehringer-Ingelheim, Chiesi Farmaceutici, Genentech, Guidotti-Malesci, Glaxo Smith Kline, Hal Allergy, Mylan, Merck, Mundipharma, Novartis, Regeneron, Sanofi-Aventis, Sanofi-Genzyme, StallergenesGreer, UCB pharma, Uriach Pharma, Valeas, ViborPharma. F Blasi received grants and/or personal fees from: AstraZeneca, Bayer, Chiesi, Guidotti, Glaxo Smith Kline, Grifols, Insmed, Menarini, Mundifarma, Novartis, Pfizer, Zambon. PL Paggiaro received grants and/or personal fees from AstraZeneca, Chiesi, GlaxoSmithKline, Guidotti, Mundipharma, Novartis, Sanofi. S Aliberti received grants and/or personal fees from Actavis UK Ltd, Aradigm Corporation, AstraZeneca, Basilea, Bayer Healthcare, Chiesi, Grifols, Horizon, INSMED, Novartis, Raptor, Zambon. L Cosmi received personal fees from Glaxo Smith Kline and Novartis. S Centanni received grants and/or personal fees from AstraZeneca, Boheringer Ingelheim, Chiesi, Glaxo Smith Kline, Guidotti, Menarini, Novartis, Valeas. ME Conte received personal fees from Glaxo Smith Kline. S D’Alò received fees for clinical trials from Glaxo Smith Kline. S Del Giacco received grants and/or personal fees from AstraZeneca, Chiesi, Glaxo Smith Kline, Menarini. Novartis. F Puggioni received personal fees from Allergy therapeutics, Almirall, AstraZeneca, Chiesi, Glaxo Smith Kline, Guidotti, Menarini, Mundipharma, Novartis, Sanofi, Valeas. FLM Ricciardolo received grants, personal fees and/or other supports from AstraZeneca, Boehringer Ingelheim, Chiesi, Glaxo Smith Kline, Guidotti, Lusofarmaco, Menarini, Neopharmed, Novartis, Sanofi, Teva. L Richeldi received personal fees from Bayer, Boehringer Ingelheim, Celgene, FibroGen, Promedior, RespiVant, Roche, Sanofi-Aventis. P Santus received grants and/or personal fees from ALK Abellò, AstraZeneca, Berlin Chemie, Boheringer Ingheleim, Menarini International, Novartis, Sanofi, Valeas, Zambon. E Heffler received personal fees from AstraZeneca, Boheringer Ingheleim, Circassia, Glaxo Smith Kline, Nestlè Purina, Novartis, Sanofi, Teva, Valeas. GE Senna, G Passalacqua, A Spanevello, D Bagnasco, M Bonavia, M Bonini, L Brussino, C Bucca, MF Caiaffa, C Calabresi, G Camiciottoli, M Caminati, GE Carpagnano, C Caruso, AG Corsico, MT Costantino, N Crimi, M D'Amato, A Farsi, E Favero, MP Foschino Barbato, G Guarneri, G Guida, M Latorre, S Lo Cicero, C Lombardi, L Macchia, F Mazza, F Menzella, M Milanese, M Montagni, P Montuschi, E Nucera, R Parente, V Patella, G Pelaia, L Pini, L Ricciardi, E Ridolo, G Rolla, N Scichilone, G Spadaro, A Vianello, V Viviano, MR Yacoub, MC Zappa have nothing to disclose., (© 2020 The Authors.)

Published
2020
Full Text
View/download PDF

10. Improvement of patient-reported outcomes in severe allergic asthma by omalizumab treatment: the real life observational PROXIMA study.

Author

Canonica GW, Rottoli P, Bucca C, Zappa MC, Michetti G, Macciocchi B, Caruso C, Santus P, Bartezaghi M, and Rigoni L

Abstract

Background: Data on the prevalence of perennial versus seasonal allergic asthma in Italy are lacking; moreover, there is limited evidence on the effect of omalizumab on patient-reported outcomes in Italian patients with severe allergic asthma. PROXIMA, an observational, multicenter study, was designed to assess the prevalence of perennial versus seasonal allergic asthma (cross-sectional phase) and the effect of omalizumab on improving illness perception, quality of life (QoL) and asthma control of Italian patients with severe allergic asthma (longitudinal phase)., Methods: The study included a cross-sectional phase ( n  = 357) and a longitudinal phase ( n  = 123): during the longitudinal phase, patients received omalizumab (75-600 mg subcutaneously every month) and were followed-up for 12 months. The primary parameter of cross-sectional phase was prevalence of perennial allergic asthma and that of longitudinal phase was proportion of patients with asthma control (assessed using asthma control questionnaire [ACQ]). Secondary parameters assessed were patients' disease perception, level of asthma control, exacerbation rate during both cross-sectional and longitudinal phases, and patients' compliance to and persistence with omalizumab, and patients' QoL during the longitudinal phase., Results: Most patients (95.8%) had perennial allergies; 81% had polysensitization. Of 99 patients in the per-protocol set, 95 (95.96% [95% CI: 89.98-98.89%]) achieved asthma control (ACQ < 4) at both 6 and 12 months of omalizumab treatment; ACQ score decreased after 6 and 12 months ( P  < 0.0001). Omalizumab treatment resulted in a significant improvement in QoL and patients' illness perception and 87% decrease in exacerbation rate. The compliance rate with omalizumab was high (73.2%). No new safety signals were identified during treatment., Conclusion: This study demonstrated that in severe allergic asthma, omalizumab improves patient-reported outcomes such as patients' illness perception and QoL, while confirming improvement of asthma control and exacerbation rate reduction in Italian patients., Competing Interests: The study was conducted in accordance with the ethical principles laid down in the Declaration of Helsinki and the AIFA Guideline for classification and management of observational studies on drugs. All patients provided informed consent before participating in the study.Not applicable.Giorgio Walter Canonica reports having received research grants as well as lecture or advisory board fees from A. Menarini, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Genentech, Guidotti-Malesci, Glaxo Smith Kline, Mundipharma, Novartis, Sanofi-Aventis, Teva. Paola Rottoli reports receiving personal fees and other from Roche, personal fees from Boehringer Ingelheim, grants and personal fees from Novartis, personal fees from TEVA, other from Menarini, from null, outside the submitted work. Bruno Macciocchi reports receiving grants from Boehringer Ingelheim. Pierachille Santus reports receiving personal fees from Astra Zeneca, grants and personal fees from Boehringer ingelheim, grants from Almirall, grants and personal fees from Chiesi Farmaceutici, personal fees from Guidotti, personal fees from GSK, personal fees from Zambon Italia, outside the submitted work. Marta Bartezaghi and Laura Rigoni are the employees of Novartis.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Published
2018
Full Text
View/download PDF

11. Local Control and Toxicity of Adaptive Radiotherapy Using Weekly CT Imaging: Results from the LARTIA Trial in Stage III NSCLC.

Author

Ramella S, Fiore M, Silipigni S, Zappa MC, Jaus M, Alberti AM, Matteucci P, Molfese E, Cornacchione P, Greco C, Trodella L, Ippolito E, and D'Angelillo RM

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Prospective Studies, Lung Neoplasms radiotherapy, Tomography, X-Ray Computed methods
Abstract

Introduction: Anatomical change of tumor during radiotherapy contributes to target missing. However, in the case of tumor shrinkage, adaptation of volume could result in an increased incidence of recurrence in the area of target reduction. This study aims to investigate the incidence of failure of the adaptive approach and, in particular, the risk for local recurrence in the area excluded after replanning., Methods: In this prospective study, patients with locally advanced NSCLC treated with concomitant chemoradiation underwent weekly chest computed tomography simulation during treatment. In the case of tumor shrinkage, a new tumor volume was delineated and a new treatment plan outlined (replanning). Toxicity was evaluated with the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scale. Patterns of failures were classified as in field (dimensional and/or metabolic progression within the replanning planning target volume [PTV]), marginal (recurrence in initial the PTV excluded from the replanning PTV), and out of field (recurrence outside the initial PTV)., Results: Replanning was outlined in 50 patients selected from a total of 217 patients subjected to weekly simulation computed tomography in our center from 2012 to 2014. With a median follow-up of 20.5 months, acute grade 3 or higher pulmonary and esophageal toxicity were reported in 2% and 4% of cases and late toxicity in 4% and 2%, respectively. Marginal relapse was recorded in 6% of patients, and 20% and 4% of patients experienced in-field and out-of-field local failure, respectively., Conclusions: The reduced toxicity and the documented low rate of marginal failures make the adaptive approach a modern option for future randomized studies. The best scenario to confirm its application is probably in neoadjuvant chemoradiation trials., (Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)

Published
2017
Full Text
View/download PDF

12. Idiopathic Pulmonary Fibrosis (IPF) incidence and prevalence in Italy.

Author

Agabiti N, Porretta MA, Bauleo L, Coppola A, Sergiacomi G, Fusco A, Cavalli F, Zappa MC, Vignarola R, Carlone S, Facchini G, Mariotta S, Palange P, Valente S, Pasciuto G, Pezzuto G, Orlandi A, Fusco D, Davoli M, Saltini C, and Puxeddu E

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Databases, Factual, Female, Health Surveys, Humans, Idiopathic Pulmonary Fibrosis diagnosis, Idiopathic Pulmonary Fibrosis mortality, Incidence, Italy epidemiology, Male, Middle Aged, Patient Admission, Prevalence, Retrospective Studies, Time Factors, Young Adult, Idiopathic Pulmonary Fibrosis epidemiology
Abstract

Background: Studies of Idiopathic Pulmonary Fibrosis (IPF) epidemiology show regional variations of incidence and prevalence; no epidemiological studies have been carried out in Italy., Objective: To determine incidence and prevalence rates of IPF in the population of a large Italian region., Methods: in this cross-sectional study study data were collected on all patients of 18 years of age and older admitted as primary or secondary idiopathic fibrosing alveolitis (ICD9-CM 516.3) to Lazio hospitals, from 1/1/2005 to 31/12/2009, using regional hospital discharge, population and cause of death databases. Reporting accuracy was assessed on a random sample of hospital charts carrying the ICD9-CM 516.3, 516.8, 516.9 and 515 codes, by reviewing radiology and pathology findings to define cases as IPF "confident", "possible" or "inconsistent"., Results: Annual prevalence and incidence of IPF were estimated at 25.6 per 100,000 and 7.5 per 100,000 using the ICD9-CM code 516.3 without chart audit while they were estimated at 31.6 per 100,000 and at 9,3 per 100,000 for the IPF "confident" definition after hospital chart audit., Conclusion: The data provide a first estimate of IPF incidence in Italy and indicate that incidence and prevalence in southern European regions may be similar to those observed in northern Europe and North America.

Published
2014

13. Rituximab treatment in a case of antisynthetase syndrome with severe interstitial lung disease and acute respiratory failure.

Author

Zappa MC, Trequattrini T, Mattioli F, Rivitti R, Vigliarolo R, Marcoccia A, and D'Arcangelo G

Abstract

We present a case of severe interstitial pneumonitis, mild polyarthritis and polymyositis, and Raynaud's syndrome with the presence of anti-Jo-1 antibodies, which had been diagnosed as anti-synthetase syndrome. The presence, however, of anti-Ro/SSA antibodies led us to understand that we were dealing here with a more severe form of interstitial lung disease. The patient was treated for acute respiratory failure but he showed resistance to glucocorticoids and cyclosporine. Thus, he was treated with infusions of anti-CD20 therapy (rituximab): his clinical conditions improved very rapidly and a significant decrease in the activity of pulmonary disease was detected using high-resolution computerized tomography (HRCT) of the thorax and pulmonary function tests.

Published
2011
Full Text
View/download PDF

14. Tilt test results in young and elderly patients with syncope of unknown origin.

Author

Marangoni E, Zucchi A, Lissoni F, Oddone A, Ferraris P, Galloni G, Zappa MC, and Orlandi M

Subjects
Adult, Aged, Blood Pressure, Female, Heart Rate, Humans, Incidence, Male, Middle Aged, Syncope etiology, Syncope physiopathology, Aging physiology, Syncope diagnosis, Tilt-Table Test
Abstract

The effects of aging on the results of prolonged drug-free tilt testing were studied in 175 consecutive patients with unexplained syncope divided into 3 groups: 59 patients < 40 years old; 57 patients between 40 and 60 years; and 59 patients > 60 years old. Tilt-induced vaso-vagal syncope occurred respectively in 17 (29%), 20 (35%), and 18 patients (31%) in the 3 age groups. Vasodepressor, mixed, and cardioinhibitory vaso-vagal syncope occurred similarly in the 3 groups; organic heart disease and systemic hypertension were more frequent in elderly patients without affecting the incidence of tilt-induced syncope. Blood pressure and heart rate variations during syncope were similar in the 3 age groups; in the first 20 minutes of tilt testing, before the appearance of the vaso-vagal reflex, elderly patients showed greater reduction in blood pressure and smaller increase in heart rate than younger patients. Our data indicate that increasing age determines a different blood pressure and heart rate behavior during tilt testing, but apparently does not influence the incidence of vaso-vagal syncope in patients with syncope of undetermined etiology. As the proportion of patients with a positive isoproterenol tilt test was reported to decline with age, our results suggest that the reduced incidence of syncope during isoproterenol tilt testing could be the expression of impaired autonomic response among elderly syncope patients.

Published
1996
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results