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1. Hypoalbuminemia and Risk of Portal Vein Thrombosis in Cirrhosis

Author

Roberto Cangemi, Valeria Raparelli, Giovanni Talerico, Stefania Basili, Francesco Violi, Palasciano Giuseppe, D’Alitto Felicia, Palmieri Vincenzo Ostilio, Santovito Daniela, Di Michele Dario, Croce Giuseppe, Sacerdoti David, Brocco Silvia, Fasolato Silvano, Cecchetto Lara, Bombonato Giancarlo, Bertoni Michele, Restuccia Tea, Andreozzi Paola, Liguori Maria Livia, Perticone Francesco, Caroleo Benedetto, Perticone Maria, Staltari Orietta, Manfredini Roberto, De Giorgi Alfredo, Averna Maurizio, Giammanco Antonina, Granito Alessandro, Pettinari Irene, Marinelli Sara, Bolondi Luigi, Falsetti Lorenzo, Salvi Aldo, Durante-Mangoni Emanuele, Cesaro Flavio, Farinaro Vincenza, Ragone Enrico, Morana Ignazio, Andriulli Angelo, Ippolito Antonio, Iacobellis Angelo, Niro Grazia, Merla Antonio, Raimondo Giovanni, Maimone Sergio, Cacciola Irene, Varvara Doriana, Drenaggi Davide, Staffolani Silvia, Picardi Antonio, Vespasiani-Gentilucci Umberto, Galati Giovanni, Gallo Paolo, Davì Giovanni, Schiavone Cosima, Santilli Francesca, Tana Claudio, Licata Anna, Soresi Maurizio, Bianchi Giovanni Battista, Carderi Isabella, Pinto Antonio, Tuttolomondo Antonino, Ferrari Giovanni, Gresele Paolo, Fierro Tiziana, Morelli Olivia, Laffi Giacomo, Romanelli Roberto Giulio, Arena Umberto, Stasi Cristina, Gasbarrini Antonio, Gargovich Matteo, Zocco Maria Assunta, Riccardi Laura, Ainora Maria Elena, Capeci William, Martino Giuseppe Pio, Nobili Lorenzo, Cavallo Maurizio, Frugiuele Pierluigi, Greco Antonio, Pietrangelo Antonello, Ventura Paolo, Cuoghi Chiara, Marcacci Matteo, Serviddio Gaetano, Vendemiale Gianluigi, Villani Rosanna, Gargano Ruggiero, Vidili Gianpaolo, Di Cesare Valentina, Masala Maristella, Delitala Giuseppe, Invernizzi Pietro, Di Minno Giovanni, Tufano Antonella, Purrello Francesco, Privitera Graziella, Forgione Alessandra, Curigliano Valentina, Senzolo Marco, Rodríguez-Castro Kryssia Isabel, Giannelli Gianluigi, Serra Carla, Neri Sergio, Pignataro Pietro, Rizzetto Mario, Debernardi Venon Wilma, Svegliati Baroni Gianluca, Bergamaschi Gaetano, Masotti Michela, Costanzo Filippo, Corazza Gino Roberto, Caldwell Stephen Hugh, Angelico Francesco, Del Ben Maria, Napoleone Laura, Polimeni Licia, Proietti Marco, Raparelli Valeria, Romiti Giulio Francesco, Ruscio Eleonora, Severoni Andrea, Talerico Giovanni, Toriello Filippo, and Vestri Annarita

Subjects
Albumin, Cirrhosis, Portal Vein Thrombosis, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background and Aims: Hypoalbuminemia, as defined by serum albumin (SA) levels ≤35 g/L, is associated to venous and arterial thrombosis in general population and in patients at risk of cardiovascular disease. It is unknown if SA ≤35 g/L is also associated to portal vein thrombosis (PVT) in cirrhosis. Methods: Cirrhotic patients enrolled in the Portal vein thrombosis Relevance On Liver cirrhosis: Italian Venous thrombotic Events Registry (PRO-LIVER) study (n = 753), were followed-up for 2 years to assess the risk of PVT, that was diagnosed by Doppler ultrasonography. Child-Pugh classes, Model for End-Stage Liver Disease score, presence of hepatocellular carcinoma and laboratory variables including SA, D-dimer, and high-sensitivity C-reactive protein (hs-CRP) were measured at baseline. Results: SA ≤35 g/L was detected in 52% of patients. A logistic multivariate regression analysis showed that higher Child-Pugh class, hepatocellular carcinoma and thrombocytopenia were significantly associated to SA ≤35 g/L. In a subgroup of patients where data regarding hs-CRP and D-dimer were available, SA ≤35 g/L was inversely associated with hs-CRP and D-dimer. During the follow-up, a total of 61 patients experienced PVT. A Kaplan Meier survival analysis showed SA ≤35 g/L was associated to increased risk of PVT compared to SA >35 g/L (P = .005). A multivariate Cox proportional hazards regression analysis showed that male sex, lower platelet count, and SA ≤35 g/L remained associated to PVT after adjusting for confounding factors. Conclusion: Cirrhotic patients with SA ≤35 g/L are at higher risk of experiencing PVT compared to those with SA >35 g/L and could be considered as potential candidates to anticoagulant prophylaxis for PVT prevention.

Published
2024
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10. Disease-modifying therapies in managing disability worsening in paediatric-onset multiple sclerosis: a longitudinal analysis of global and national registries

Author

Horakova, Dana, Prat, Alexandre, Girard, Marc, Duquette, Pierre, Boz, Cavit, Pozzilli, Carlo, Cocco, Eleonora, Gallo, Paolo, Yamout, Bassem, Khoury, Samia J., Lugaresi, Alessandra, Onofrj, Marco, Lus, Giacomo, Clerici, Valentina Torri, Maniscalco, Giorgia Teresa, Romano, Silvia, Tortorella, Carla, Valentino, Paola, Rovaris, Marco, Shaygannejad, Vahid, Ferraro, Diana, Vianello, Marika, Grammond, Pierre, Bergamaschi, Roberto, Gallo, Antonio, Cavalla, Paola, Sa, Maria Jose, Lechner-Scott, Jeannette, Pesci, Ilaria, Buzzard, Katherine, Gouider, Riadh, Mrabet, Saloua, Aguglia, Umberto, Conte, Antonella, Avolio, Carlo, Bellantonio, Paolo, John, Nevin, Cartechini, Elisabetta, De Robertis, Francesca, Ferraro, Elisabetta, Weinstock-Guttman, Bianca, Barcella, Valeria, Van der Walt, Anneke, Butzkueven, Helmut, Coniglio, Maria Gabriella, Granella, Franco, Kuhle, Jens, Marfia, Girolama Alessandra, Laureys, Guy, Van Hijfte, Liesbeth, Maimone, Davide, Gazzola, Paola, Blanco, Yolanda, Turkoglu, Recai, Montepietra, Sara, Spitaleri, Daniele, van Pesch, Vincent, Gerlach, Oliver, Prevost, Julie, Ampapa, Radek, Soysal, Aysun, Altintas, Ayse, Rini, Augusto, Solaro, Claudio, Protti, Alessandra, Foschi, Matteo, Surcinelli, Andrea, Gatto, Maurizia, Mascoli, Nerina, De Riz, Milena, Realmuto, Sabrina, Rossi, Patrizia, Totaro, Rocco, Barnett, Michael, Oh, Jiwon, Nasuelli, Davide, Ramo-Tello, Cristina, Sanchez-Menoyo, Jose Luis, Al-Harbi, Talal, Fioretti, Cristina, Bucello, Sebastiano, Cargnelutti, Daniela, Vukusic, Sandra, Sharmin, Sifat, Roos, Izanne, Malpas, Charles B, Iaffaldano, Pietro, Simone, Marta, Filippi, Massimo, Kubala Havrdova, Eva, Ozakbas, Serkan, Brescia Morra, Vincenzo, Alroughani, Raed, Zaffaroni, Mauro, Patti, Francesco, Eichau, Sara, Salemi, Giuseppe, Di Sapio, Alessia, Inglese, Matilde, Portaccio, Emilio, Trojano, Maria, Amato, Maria Pia, and Kalincik, Tomas

Published
2024
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11. Development and Validation of a Scoring System to Predict Response to Obeticholic Acid in Primary Biliary Cholangitis

Author

Scaravaglio, Miki, Nofit, Eugenia, Gallo, Paolo, Galati, Giovanni, Pezzato, Francesco, Rollo, Paolo, D’Ovidio, Erica, Coco, Barbara, Tortora, Annalisa, Fiorini, Cecilia, Venere, Rosanna, Scifo, Gaetano, Cannavò, Mariarita, Feletti, Valentina, Pizzolante, Fabrizio, Giannini, Edoardo Giovanni, Cotugno, Rosa, Fanella, Silvia, Losito, Francesco, Grassi, Giuseppe, Manfredi, Giulia Francesca, Buzzanca, Valerio, Omazzi, Barbara, Casella, Silvia, Zani, Francesca, Ricci, Chiara, Bellia, Valentina, Abenavoli, Ludovico, Morelli, Olivia, Crocè, Lory Saveria, Scivetti, Paolo, Panero, Antonio, Boano, Valentina, Poggi, Guido, Gimignani, Giancarlo, Conforti, Alessandro, Frazzetto, Evelise, Rapisarda, Laura, Demma, Shrin, De Vincentis, Antonio, Ampuero, Javier, Terracciani, Francesca, D’Amato, Daphne, Gerussi, Alessio, Cristoferi, Laura, Cazzagon, Nora, Bonaiuto, Emanuela, Floreani, Annarosa, Calvaruso, Vincenza, Cadamuro, Luca, Degasperi, Elisabetta, Morgando, Anna, Vanni, Ester, Lleo, Ana, Colapietro, Francesca, Alvaro, Domenico, Castellaneta, Antonino, Labanca, Sara, Viganò, Mauro, Distefano, Marco, Pace Palitti, Valeria, De Matthaeis, Nicoletta, Marzioni, Marco, Gómez-Dominguez, Elena, Montero, Jose-Luis, Molina, Esther, Garcia-Buey, Luisa, Casado, Marta, Berenguer, Marina, Conde, Isabel, Simon, Miguel-Angel, Fuentes, Javier, Costa-Moreira, Pedro, Macedo, Guilherme, Jorquera, Francisco, Morillas, Rosa-Maria, Presa, Jose, Sousa, Jose-Manuel, Gomes, Dario, Santos, Luis, Olveira, Antonio, Hernandez-Guerra, Manuel, Aburruza, Leire, Santos, Arsenio, Carvalho, Armando, Uriz, Juan, Gutierrez, Maria-Luisa, Perez, Elia, Chessa, Luchino, Pellicelli, Adriano, Marignani, Massimo, Muratori, Luigi, Niro, Grazia Anna, Brunetto, Maurizia, Ponziani, Francesca Romana, Pompili, Maurizio, Marra, Fabio, Galli, Andrea, Mussetto, Alessandro, Alagna, Giuliano, Simone, Loredana, Bertino, Gaetano, Rosina, Floriano, Cozzolongo, Raffaele, Russello, Maurizio, Baiocchi, Leonardo, Saitta, Carlo, Terreni, Natalia, Zolfino, Teresa, Rigamonti, Cristina, Vigano, Raffaella, Cuccorese, Giuseppe, Pozzoni, Pietro, Pedone, Claudio, Grasso, Simone, Picardi, Antonio, Invernizzi, Pietro, Sacco, Rodolfo, Izzi, Antonio, Fernandez-Rodriguez, Conrado, Vespasiani-Gentilucci, Umberto, and Carbone, Marco

Published
2024
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13. Long-term follow-up (up to 11 years) of an Italian pediatric MS cohort treated with Natalizumab: a multicenter, observational study

Author

Baroncini, Damiano, Ghezzi, Angelo, Guaschino, Clara, Moiola, Lucia, Filippi, Massimo, Ianniello, Antonio, Pozzilli, Carlo, Lanzillo, Roberta, Brescia-Morra, Vincenzo, Margoni, Monica, Gallo, Paolo, Callari, Graziella, Grimaldi, Luigi, Lus, Giacomo, Calabrese, Massimiliano, Simone, Marta, Marfia, Girolama Alessandra, Rasia, Sarah, Cargnelutti, Daniela, Comi, Giancarlo, and Zaffaroni, Mauro

Published
2022
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17. Clinical relevance of thymic and bone marrow outputs in multiple sclerosis patients treated with alemtuzumab

Author

Sottini, Alessandra, Quaresima, Virginia, Barbaro, Mosè, Moiola, Lucia, Filippi, Massimo, Malentacchi, Maria, Capobianco, Marco, Puthenparampil, Marco, Gallo, Paolo, Cocco, Eleonora, Frau, Jessica, Zaffaroni, Mauro, Guaschino, Clara, Stampatori, Chiara, Mancinelli, Chiara, Brambilla, Laura, Clerici, Valentina Torri, Vianello, Marika, Vitetta, Francesca, Ferraro, Diana, Rosettani, Pamela, Danni, Maura Chiara, Conti, Marta, Grimoldi, Maria, Capra, Ruggero, and Imberti, Luisa

Published
2023
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20. A comparison of natalizumab's effects on SDMT between pediatric-onset and adult-onset multiple sclerosis patients.

Author

Puthenparampil, Marco, Scialpi, Graziana, Gaggiola, Marta, Zanotelli, Giovanni, Miscioscia, Alessandro, Berardi, Angela, Riccardi, Alice, Nosadini, Margherita, Sartori, Stefano, Perini, Paola, Rinaldi, Francesca, and Gallo, Paolo

Abstract

Background: Pediatric-onset multiple sclerosis (POMS) patients often exhibit a wide range of cognitive deficits. Therefore, therapeutic approaches should aim not only to prevent cognitive decline but also to promote cognitive improvement. Objective: This study aimed to explore the effects of natalizumab (NTZ) on cognitive function, as measured by the Symbol Digit Modalities Test (SDMT), in both POMS and adult-onset multiple sclerosis (AOMS) patients. Method: A total of 63 patients (34 AOMS and 29 POMS) were enrolled in this retrospective, single-center study. Patients were clinically and radiologically assessed every 6 months, and they completed the SDMT at baseline and after at least 24 months of follow-up. SDMT values were reported as corrected values (cSDMT) and z-scores (zSDMT). Annualized cSDMT and zSDMT scores were calculated by dividing the change in scores by the length of the follow-up period (expressed in years). Results: Both POMS and AOMS groups showed improvement in annualized cSDMT and zSDMT scores, but the improvement was significantly greater in the POMS group compared to the AOMS group (+3.85 ± 4.32 vs. +1.76 ± 2.80, p = 0.010 for cSDMT; 0.41 ± 0.40 vs. 0.25 ± 0.34, p = 0.026 for zSDMT). After re-baselining at 6 months, 93% of POMS patients (27 patients) and 85.3% of AOMS patients (29 patients, p = 0.84) achieved NEDA-3 (no evidence of disease activity). The NEDA-3 status, along with clinical and demographic parameters at baseline, did not account for the observed SDMT improvement. Conclusion: The favorable clinical, radiological, and neuropsychological outcomes observed in this study support the use of natalizumab as a viable treatment option in POMS. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Telehealth Feasibility, Interest, and Satisfaction of Patients with Multiple Sclerosis Living in the Veneto Region, Italy, During the COVID-19 Pandemic.

Author

Puthenparampil, Marco, Stivanello, Celeste, Bano, Maria Chiara, Tessarin, Michele, Martello, Tiziano, Rinaldi, Francesca, Perini, Paola, and Gallo, Paolo

Subjects
COVID-19 pandemic, PATIENT satisfaction, MEDICAL care, IDENTIFICATION cards, TELEMEDICINE, NEUROLOGISTS
Abstract

Introduction: Synchronous telehealth (ST) consists of the remote real-time delivery of health services. COVID-19 pandemic has pressed the use of ST and forced neurologists to deliver telehealth services. The aim of this study was to obtain the actual picture of ST accessibility/interest and to evaluate the user satisfaction in patients with multiple sclerosis (MS) during the COVID-19 pandemic. Methods: The study consisted of two phases. First, a hard-copy questionnaire ("Telehealth Identity Card" [TIC]), including only yes/no questions, filled in the presence of a neurologist, and investigating the technical/practical access and the willingness/interest of MS patients to the telehealth services, was obtained from 600 consecutive outpatients, with no time limit for answering. Second, a fully filled "Televisit Satisfaction Questionnaire" (TSQ) was obtained from 100 consecutive patients that underwent a televisit. Statistical analysis applied the t test for normally distributed variables and the Mann–Whitney U test for ordinal. Logistic univariate and multivariate regressions were applied to predict televisit availability on the base of demographic variables. Results: Statistical analysis was performed on 552/600 consecutive TIC (92%). Of them, 464/552 (84%) of the MS patients declared to possess the tools and to be interested in telehealth services. Compared with noninterested patients, they were younger (mean age: 44.0 vs. 49.8, p < 0.001) and with lower disability (mean Expanded Disability Status Scale: 2.5 vs. 3.3, p < 0.01). From TSQ, it emerged that 95% agree or strongly agree that televisit respected timelines, saved time and money, was conducted with respect to privacy, can be a useful tool for monitoring disease and therapy, and expressed their availability for further televisits. Discussion: A great majority of MS patients living in Padua Province were interested in telehealth. High satisfaction and the willingness for further televist were expressed. Telehealth services can help neurologists to manage the increasing number of MS patients and their complex therapeutic monitoring. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Safety of Sofosbuvir-Based Direct-Acting Antivirals for Hepatitis C Virus Infection and Direct Oral Anticoagulant Co-Administration.

Author

Rosato, Valerio, Nevola, Riccardo, Dallio, Marcello, Di Micco, Pierpaolo, Spinetti, Angiola, Zeneli, Laert, Ciancio, Alessia, Milella, Michele, Colombatto, Piero, D'Adamo, Giuseppe, Rosselli Del Turco, Elena, Gallo, Paolo, Falcomatà, Andrea, De Nicola, Stella, Pugliese, Nicola, D'Ambrosio, Roberta, Soria, Alessandro, Colella, Elisa, Federico, Alessandro, and Brunetto, Maurizia

Subjects
ANTICOAGULANTS, ORAL medication, HEPATITIS C virus, ANTIVIRAL agents, CYTOCHROME P-450
Abstract

Background: Direct oral anticoagulants (DOACs) are recommended for the management of thrombosis prophylaxis, especially in patients with atrial fibrillation. As substrates of cytochrome P450 (CYP) 3A4 and/or P-glycoprotein, they are implicated in potential drug–drug interactions. NS5A/NS5B inhibitors are direct-acting agents (DAAs) against the Hepatitis C Virus (HCV) infection that exert a mild inhibition of P-glycoprotein without effects on CYP3A4. A DOAC and NS5A/NS5B inhibitor co-administration may lead to an increased risk of bleeding. Real-world data on the concomitant use of DOACs and DAAs are scarce. On this purpose, we perform a retrospective analysis on the risk of vascular adverse events (bleeding and thrombosis) among HCV patients under DOAC/DAA therapy, even in advanced liver disease. Methods: Between May 2015 and April 2023, patients treated with sofosbuvir-based DAA regimens and DOACs were consecutively included in this study from 12 Italian medical centers. Baseline characteristics, especially concerning bleeding risk and liver function, were collected. The occurrence of bleeding events, classified as major and minor, was the primary endpoint. Secondary endpoints were the rate of any thrombotic events and/or the need for discontinuation of one or both treatments. Moreover, a cohort of patients, matched by demographic characteristics (age and sex), that switched to vitamin K antagonists (VKAs) during the antiviral treatment was compared with the DOAC/DAA group. Results: A total of 104 patients were included. Thirty-eight of them (36.5%) were cirrhotic. Atrial fibrillation was an indication for anticoagulation in almost all cases (76%). Rivaroxaban (35.6%) was the most used DOAC, followed by apixaban (26.9%), dabigatran (19.2%) and edoxaban (18.3%). Sofosbuvir/velpatasvir (78.8%) was the most prescribed DAA, and all patients were already on anticoagulant therapy before the start of DAAs. During concomitant DOAC/DAA treatment, no major bleeding events were recorded, while four minor bleeding events occurred, but none resulted in DAA or DOAC discontinuation. At univariate analysis, the only additional risk factor statistically related to bleeding events was the anticoagulant therapy (hazard ratio [HR]: 13.2, 95% confidence interval 1,6-109). Performing an evaluation by a LOGIT binomial analysis with demographic characteristics, the antiplatelet therapy remained statistically associated to bleeding events. No significant differences were found in the rate of clinically relevant bleeding when the main population was compared with the VKA-switched cohort. A single major bleeding event leading to anticoagulation and DAA discontinuation was reported in VKA-switched matched cohort. Conclusions: In our study, the concomitant use of NS5A/NS5B inhibitors with DOAC showed good safety, and the only risk factor associated with bleeding events was the concomitant antiplatelet therapy. These findings support the use of DOACs during sofosbuvir-based HCV treatment, even in advanced liver disease. Replacing DOACs with VKAs does not appear to be of clinical benefit. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Feasibility of a Cardiac Magnetic Resonance Protocol for "off‐on" Cardiac Resynchronization Therapy Evaluation.

Author

Basile, Christian, Scatteia, Alessandra, Giacopelli, Daniele, Gallo, Paolo, Pezzullo, Salvatore, Mancusi, Costantino, Pascale, Carmine E., Gargiulo, Paola, Marzano, Federica, Perrone‐Filardi, Pasquale, Paolillo, Stefania, and Dellegrottaglie, Santo

Subjects
LEFT heart ventricle, DIAGNOSTIC imaging, VENTRICULAR ejection fraction, MAGNETIC resonance imaging, DESCRIPTIVE statistics, STRUCTURED treatment interruption, PRE-tests & post-tests, IMPLANTABLE cardioverter-defibrillators, CARDIAC pacing, COOPERATIVENESS
Abstract

Background: Cardiac resynchronization therapy (CRT) is a standard treatment for patients with heart failure and electrical dyssynchrony. Cardiac magnetic resonance (CMR) is the gold standard for assessing left ventricular (LV) function. However, the feasibility of using CMR with active CRT is still uncertain. Purpose: To assess the feasibility of a CRT "off‐on" protocol during CMR and measure the acute effects of CRT interruption on LV function. Methods: Patients underwent CMR before (pre‐CRT) and 6 months after (post‐CRT) an MR‐conditional CRT defibrillator implantation. The post‐CRT scan included two complete sets of cine images, one with inactive (post‐CRTOFF) and one with active CRT (post‐CRTON), maintaining a continuous connection between device and programmer. Results: Out of 29 enrolled patients, 8 (28%) had complete and analyzable post‐CRT data. Unsuccessful procedures were attributed to connection problems between the CRT device and the programmer (n = 10), poor image quality (n = 7), and lack of patient cooperation (n = 4). LV ejection fraction significantly increased between pre‐CRT scan (28.1%) and both post‐CRTOFF (37.9%; p = 0.046) and post‐CRTON CMR (35.0%; p = 0.037), with a nonstatistically significant trend toward decreased LV volumes. No adverse events or significant changes in device electrical parameters (including battery level) were detected during the post‐CMR scan period. Conclusion: A CRT "off‐on" protocol during CMR studies can be safely executed in patients with an MR‐conditional CRT defibrillator. However, technical improvements are needed to facilitate high‐quality scans during active CRT. Favorable changes in LV function induced by CRT remodeling were not acutely reversed with the interruption of electrical therapy. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Case report: Breaking CNS immuno-privilege: TNFα-inhibitor triggers aseptic meningitis in a patient with rheumatoid arthritis.

Author

Kassabian, Benedetta, Facco, Monica, Miscioscia, Alessandro, Carraro, Samuela, Rinaldi, Francesca, Gallo, Paolo, and Puthenparampil, Marco

Subjects
CENTRAL nervous system, MAGNETIC resonance imaging, POSITRON emission tomography, BLOOD-brain barrier, NEUROLOGICAL disorders
Abstract

Blood-brain barrier dysfunction might be driven by peripheral inflammation. TNFa inhibitors (TNF-αi) are occasionally associated with a wide spectrum of neurological immuno-mediated disorders. However, patients with systemic autoimmune disorders, including rheumatoid arthritis (RA), might be prone to develop further organ-specific, including central nervous system (CNS), autoimmunity. Here we report the case of a patient, affected by RA and treated with etanercept, who suddenly developed focal neurological symptoms. Cerebrospinal fluid, magnetic resonance imaging (MRI), and positron emission tomography (PET)/MRI findings are reported and support the diagnosis of TNF-αi-associated aseptic meningitis. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Proteomic profile of extracellular vesicles from plasma and CSF of multiple sclerosis patients reveals disease activity-associated EAAT2.

Author

D'Ambrosio, Antonella, Zamboni, Silvia, Camerini, Serena, Casella, Marialuisa, Sanchez, Massimo, Pietraforte, Donatella, Vanacore, Nicola, Diociauti, Marco, Altieri, Marta, Di Piero, Vittorio, Francia, Ada, Pontecorvo, Simona, Puthenparampil, Marco, Gallo, Paolo, and Margutti, Paola

Subjects
GLUTAMATE transporters, EXTRACELLULAR vesicles, NEURAL transmission, DISEASE relapse, COMPLEX fluids
Abstract

Background and objectives: There is an urgent need to discover blood-based biomarkers of multiple sclerosis (MS) to better define the underlying biology of relapses and monitor disease progression. The main goal of this study is to search for candidate biomarkers of MS relapses associated with circulating extracellular vesicles (EVs), an emerging tool for biomarker discovery. Methods: EVs, purified from unpaired plasma and CSF samples of RRMS patients by size-exclusion chromatography (SEC), underwent proteomic analysis to discover novel biomarkers associated with MS relapses. The candidate biomarkers of disease activity were detected by comparison approach between plasma- and CSF-EV proteomes associated with relapses. Among them, a selected potential biomarker was evaluated in a cohort of MS patients, using a novel and highly reproducible flow cytometry-based approach in order to detect low abundant EV subsets in a complex body fluid such as plasma. Results: The proteomic profiles of both SEC-purified plasma EVs (from 6 patients in relapse and 5 patients in remission) and SEC-purified CSF EVs (from 4 patients in relapse and 3 patients in remission) revealed a set of proteins associated with MS relapses significant enriched in the synaptic transmission pathway. Among common proteins, excitatory amino-acid transporter 2, EAAT2, responsible for the majority of the glutamate uptake in CNS, was worthy of further investigation. By screening plasma samples from 110 MS patients, we found a significant association of plasma EV-carried EAAT2 protein (EV-EAAT2) with MS relapses, regardless of disease-modifying therapies. This finding was confirmed by investigating the presence of EV-EAAT2 in plasma samples collected longitudinally from 10 RRMS patients, during relapse and remission. Moreover, plasma EV-EAAT2 levels correlated positively with Expanded Disability Status Scale (EDSS) score in remitting MS patients but showed a negative correlation with age in patients with secondary progressive (SPMS). Conclusion: Our results emphaticize the usefulness of plasma EVs as a source of accessible biomarkers to remotely analyse the CNS status. Plasma EV-EAAT2 showed to be a promising biomarker for MS relapses. Further studies are required to assess the clinical relevance of this biomarker also for disability progression independent of relapse activity and transition from RRMS towards SPMS. [ABSTRACT FROM AUTHOR]

Published
2024
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26. The Role of Artificial Intelligence on Tumor Boards: Perspectives from Surgeons, Medical Oncologists and Radiation Oncologists.

Author

Nardone, Valerio, Marmorino, Federica, Germani, Marco Maria, Cichowska-Cwalińska, Natalia, Menditti, Vittorio Salvatore, Gallo, Paolo, Studiale, Vittorio, Taravella, Ada, Landi, Matteo, Reginelli, Alfonso, Cappabianca, Salvatore, Girnyi, Sergii, Cwalinski, Tomasz, Boccardi, Virginia, Goyal, Aman, Skokowski, Jaroslaw, Oviedo, Rodolfo J., Abou-Mrad, Adel, and Marano, Luigi

Subjects
CLINICAL decision support systems, INDIVIDUALIZED medicine, ARTIFICIAL intelligence, CANCER treatment, MEDICAL personnel
Abstract

The integration of multidisciplinary tumor boards (MTBs) is fundamental in delivering state-of-the-art cancer treatment, facilitating collaborative diagnosis and management by a diverse team of specialists. Despite the clear benefits in personalized patient care and improved outcomes, the increasing burden on MTBs due to rising cancer incidence and financial constraints necessitates innovative solutions. The advent of artificial intelligence (AI) in the medical field offers a promising avenue to support clinical decision-making. This review explores the perspectives of clinicians dedicated to the care of cancer patients—surgeons, medical oncologists, and radiation oncologists—on the application of AI within MTBs. Additionally, it examines the role of AI across various clinical specialties involved in cancer diagnosis and treatment. By analyzing both the potential and the challenges, this study underscores how AI can enhance multidisciplinary discussions and optimize treatment plans. The findings highlight the transformative role that AI may play in refining oncology care and sustaining the efficacy of MTBs amidst growing clinical demands. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Usefulness of Adding Pre-procedural Glycemia to the Mehran Score to Enhance Its Ability to Predict Contrast-induced Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention Development and Validation of a Predictive Model

Author

Nusca, Annunziata, Mangiacapra, Fabio, Sticchi, Alessandro, Polizzi, Giovanni, D'Acunto, Giulia, Ricottini, Elisabetta, Melfi, Rosetta, Gallo, Paolo, Miglionico, Marco, Giannone, Sara, Ussia, Gian Paolo, and Grigioni, Francesco

Published
2021
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31. Early Immunotherapy and Longer Corticosteroid Treatment Are Associated With Lower Risk of Relapsing Disease Course in Pediatric MOGAD

Author

Nosadini, Margherita, Eyre, Michael, Giacomini, Thea, Valeriani, Massimiliano, Della Corte, Marida, Praticò, Andrea D., Annovazzi, Pietro, Cordani, Ramona, Cordelli, Duccio Maria, Crichiutti, Giovanni, Di Rosa, Gabriella, Dolcemascolo, Valentina, Fetta, Anna, Freri, Elena, Gallo, Paolo, Gastaldi, Matteo, Granata, Tiziana, Grazian, Luisa, Iorio, Raffaele, Lombardini, Martina, Margoni, Monica, Mariotto, Sara, Matricardi, Sara, Melani, Federico, Nardocci, Nardo, Papetti, Laura, Passarini, Alice, Pisani, Francesco, Poʼ, Chiara, Puthenparampil, Marco, Ragona, Francesca, Savasta, Salvatore, Siliquini, Sabrina, Toldo, Irene, Tozzo, Alessandra, Turco, Emanuela Claudia, Varone, Antonio, Vogrig, Alberto, Zuliani, Luigi, Bugin, Samuela, Rossato, Sara, Orsini, Alessandro, Cantalupo, Gaetano, Mancardi, Maria Margherita, Ferilli, Michela Ada Noris, Foiadelli, Thomas, and Sartori, Stefano

Published
2023
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32. Genetic profiling in radiotherapy: a comprehensive review.

Author

Rubini, Dino, Gagliardi, Federico, Menditti, Vittorio Salvatore, D'Ambrosio, Luca, Gallo, Paolo, D'Onofrio, Ida, Pisani, Antonio Rosario, Sardaro, Angela, Rubini, Giuseppe, Cappabianca, Salvatore, Nardone, Valerio, and Reginelli, Alfonso

Subjects
GENETIC markers, CANCER radiotherapy, INDIVIDUALIZED medicine, CANCER treatment, PROGNOSIS
Abstract

This comprehensive review explores the pivotal role of radiotherapy in cancer treatment, emphasizing the diverse applications of genetic profiling. The review highlights genetic markers for predicting radiation toxicity, enabling personalized treatment planning. It delves into the impact of genetic profiling on radiotherapy strategies across various cancer types, discussing research findings related to treatment response, prognosis, and therapeutic resistance. The integration of genetic profiling is shown to transform cancer treatment paradigms, offering insights into personalized radiotherapy regimens and guiding decisions in cases where standard protocols may fall short. Ultimately, the review underscores the potential of genetic profiling to enhance patient outcomes and advance precision medicine in oncology. [ABSTRACT FROM AUTHOR]

Published
2024
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33. A comparison of natalizumab and ocrelizumab on disease progression in multiple sclerosis.

Author

Iaffaldano, Pietro, Lucisano, Giuseppe, Guerra, Tommaso, Paolicelli, Damiano, Portaccio, Emilio, Inglese, Matilde, Foschi, Matteo, Patti, Francesco, Granella, Franco, Romano, Silvia, Cavalla, Paola, De Luca, Giovanna, Gallo, Paolo, Bellantonio, Paolo, Gallo, Antonio, Montepietra, Sara, Di Sapio, Alessia, Vianello, Marika, Quatrale, Rocco, and Spitaleri, Daniele

Subjects
PROPORTIONAL hazards models, NATALIZUMAB, MULTIPLE sclerosis, DISEASE progression
Abstract

Objective: No direct comparisons of the effect of natalizumab and ocrelizumab on progression independent of relapse activity (PIRA) and relapse‐associated worsening (RAW) events are currently available. We aimed to compare the risk of achieving first 6 months confirmed PIRA and RAW events and irreversible Expanded Disability Status Scale (EDSS) 4.0 and 6.0 in a cohort of naïve patients treated with natalizumab or ocrelizumab from the Italian Multiple Sclerosis Register. Methods: Patients with a first visit within 1 year from onset, treated with natalizumab or ocrelizumab, and ≥3 visits were extracted. Pairwise propensity score‐matched analyses were performed. Risk of reaching the first PIRA, RAW, and EDSS 4.0 and 6.0 events were estimated using multivariable Cox proportional hazards models. Kaplan–Meier curves were used to show cumulative probabilities of reaching outcomes. Results: In total, 770 subjects were included (natalizumab = 568; ocrelizumab = 212) and the propensity score‐matching retrieved 195 pairs. No RAW events were found in natalizumab group and only 1 was reported in ocrelizumab group. A first PIRA event was reached by 23 natalizumab and 25 ocrelizumab exposed patients; 7 natalizumab‐ and 10 ocrelizumab‐treated patients obtained an irreversible EDSS 4.0, while 13 natalizumab‐ and 15 ocrelizumab‐treated patients reached an irreversible EDSS 6.0. No differences between the two groups were found in the risk (HR, 95%CI) of reaching a first PIRA (1.04, 0.59–1.84; p = 0.88) event, an irreversible EDSS 4.0 (1.23, 0.57–2.66; p = 0.60) and 6.0 (0.93, 0.32–2.68; p = 0.89). Interpretation: Both medications strongly suppress RAW events and, in the short term, the risk of achieving PIRA events, EDSS 4.0 and 6.0 milestones is not significantly different. [ABSTRACT FROM AUTHOR]

Published
2024
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34. Hyper-reflective foci changes in RRMS under natalizumab therapy.

Author

Puthenparampil, Marco, Basili, Elisa, Ponzano, Marta, Mauceri, Valentina Annamaria, Miscioscia, Alessandro, Pilotto, Elisabetta, Perini, Paola, Rinaldi, Francesca, Bovis, Francesca, and Gallo, Paolo

Subjects
OPTICAL coherence tomography, DISEASE relapse, MULTIPLE sclerosis, NATALIZUMAB, IMMUNOPATHOLOGY
Abstract

Introduction: Microglia (MG) is suggested to play an immunopathological role of in Multiple Sclerosis (MS). Since hyper-reflective foci (HRF) might mark MG activation, in vivo analysis by Optic Coherence Tomography (OCT) in MS patients under disease modifying therapies may help to clarify MS immunopathology as well as drug's mechanism of intrathecal action. Objective: To analyze HRF in patients treated with Natalizumab (NTZ), a high efficacy therapy for MS. Materials and methods: The effect of NTZ on the retina of 36 Relapsing-Remitting MS patients was investigated in a prospective, single-center study. OCT was performed immediately before the first infusion and then between infusion 3 and 4, infusion 6 and 7, infusion 11 and 13. Peripapillary and macular scans were acquired, evaluating peripapillary RNFL thickness, macular volumes (vertical scans), and HRF count (horizontal scan) in Ganglion Cell Layer (GCL), Inner Plexiform Layer (IPL) and Inner Nuclear Layer (INL). Clinical examination was performed every six months. Results: HRF count significantly increased under NTZ therapy (p<0.001) in both GCL (18.85 ± 6.93 at baseline, 28.24 ± 9.55 after 12 months) and IPL (25.73 ± 7.03 at baseline, 33.21 ± 8.50 after 12 months) but remained stable in INL (33.65 ± 7.76 at baseline, 36.06 ± 6.86 after 12 months, p=0.87), while no relevant modification of pRNFL and macular volumes were observed during the study. EDSS remained stable and no clinical relapse was observed between month 6 and 12. Conclusion: In RRMS NTZ affects HRF count in GCL and IPL, but not in INL, suggesting that NTZ does not impact on some aspects of MS immunopathology. [ABSTRACT FROM AUTHOR]

Published
2024
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37. Long-term Cognitive Outcomes and Socioprofessional Attainment in People With Multiple Sclerosis With Childhood Onset

Author

Portaccio, Emilio, Bellinvia, Angelo, Razzolini, Lorenzo, Pastò, Luisa, Goretti, Benedetta, Niccolai, Claudia, Fonderico, Mattia, Zaffaroni, Mauro, Pippolo, Lorena, Moiola, Lucia, Falautano, Monica, Celico, Claudia, Viterbo, Rossella, Patti, Francesco, Chisari, Clara, Gallo, Paolo, Riccardi, Alice, Borghi, Martina, Bertolotto, Antonio, Simone, Marta, Pozzilli, Carlo, Bianchi, Valentina, Roscio, Marco, Martinelli, Vittorio, Comi, Giancarlo, Filippi, Massimo, Trojano, Maria, Ghezzi, Angelo, and Amato, Maria Pia

Published
2022
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43. Hospital Care of Older Patients With COPD: Adherence to International Guidelines for Use of Inhaled Bronchodilators and Corticosteroids

Author

Mannucci, Pier Mannuccio, Nobili, Alessandro, Tettamanti, Mauro, Pasina, Luca, Franchi, Carlotta, Corrao, Salvatore, Marengoni, Alessandra, Salerno, Francesco, Cesari, Matteo, Perticone, Francesco, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Cortesi, Laura, Ardoino, Ilaria, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Emmi, Giacomo, Biolo, Gianni, Zanetti, Michela, Guadagni, Martina, Zaccari, Michele, Vanoli, Massimo, Grignani, Giulia, Pulixi, Edoardo Alessandro, Bernardi, Mauro, Bassi, Silvia Li, Santi, Luca, Zaccherini, Giacomo, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Palazzuoli, Alberto, Olivieri, Oliviero, Girelli, Domenico, Matteazzi, Thomas, Barbagallo, Mario, Dominguez, Ligia, Cocita, Floriana, Beneduce, Vincenza, Plances, Lidia, Zoli, Marco, Lazzari, Ilaria, Brunori, Mattia, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Palasciano, Giuseppe, Modeo, Maria Ester, Di Gennaro, Carla, Cappellini, Maria Domenica, Maira, Diletta, Di Stefano, Valeria, Fabio, Giovanna, Seghezzi, Sonia, Mancarella, Marta, Rossi, Paolo Dionigi, Damanti, Sarah, Clerici, Marta, Conti, Federica, Miceli, Emanuela, Lenti, Marco Vincenzo, Pisati, Martina, Dominioni, Costanza Caccia, Murialdo, Giovanni, Marra, Alessio, Cattaneo, Federico, Pontremoli, Roberto, Secchi, Maria Beatrice, Ghelfi, Davide, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Cipollone, Francesco, Guagnano, Maria Teresa, Angelucci, Ermanno, Valeriani, Emanuele, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Delitala, Giuseppe, Berria, Maria, Muscaritoli, Maurizio, Molfino, Alessio, Petrillo, Enrico, Zuccalà, Giuseppe, D’Aurizio, Gabriella, Romanelli, Giuseppe, Zucchelli, Alberto, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Gallo, Paolo, Dell’Unto, Chiara, Annoni, Giorgio, Corsi, Maurizio, Bellelli, Giuseppe, Zazzetta, Sara, Mazzola, Paolo, Szabo, Hajnalka, Bonfanti, Alessandra, Arturi, Franco, Succurro, Elena, Rubino, Mariangela, Serra, Maria Grazia, Bleve, Maria Antonietta, Gasbarrone, Laura, Sajeva, Maria Rosaria, Brucato, Antonio, Ghidoni, Silvia, Fabris, Fabrizio, Bertozzi, Irene, Bogoni, Giulia, Rabuini, Maria Victoria, Cosi, Elisabetta, Manfredini, Roberto, Fabbian, Fabio, Boari, Benedetta, De Giorgi, Alfredo, Tiseo, Ruana, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Borghi, Claudio, Strocchi, Enrico, De Sando, Valeria, Pareo, Ilenia, Sabbà, Carlo, Vella, Francesco Saverio, Suppressa, Patrizia, Agosti, Pasquale, Schilardi, Andrea, Loparco, Francesca, Fenoglio, Luigi, Bracco, Christian, Giraudo, Alessia Valentina, Fargion, Silvia, Periti, Giulia, Porzio, Marianna, Tiraboschi, Slivia, Peyvandi, Flora, Rossio, Raffaella, Ferrari, Barbara, Colombo, Giulia, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Ceriani, Giuliana, Pallini, Giada, Dallegri, Franco, Ottonello, Luciano, Liberale, Luca, Caserza, Lara, Salam, Kassem, Liberato, Nicola Lucio, Tognin, Tiziana, Bianchi, Giovanni Battista, Giaquinto, Sabrina, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Rozzini, Renzo, Falanga, Lina, Spazzini, Elena, Ferrandina, Camillo, Montrucchio, Giuseppe, Petitti, Paolo, Salmi, Raffaella, Gaudenzi, Piergiorgio, Perri, Ludovica, Landolfi, Raffaele, Montalto, Massimo, Mirijello, Antonio, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Molaro, Marta, Grossi, Alessandra, Bertolotti, Marco, Mussi, Chiara, Libbra, Maria Vittoria, Dondi, Giulia, Pellegrini, Elisa, Carulli, Lucia, Colangelo, Lidia, Falbo, Tania, Stanghellini, Vincenzo, De Giorgio, Roberto, Ruggeri, Eugenio, Vecchio, Sara del, Salvi, Andrea, Leonardi, Roberto, Damiani, Giampaolo, Gabrielli, Armando, Capeci, William, Mattioli, Massimo, Martino, Giuseppe Pio, Biondi, Lorenzo, Pettinari, Pietro, Ghio, Riccardo, Col, Anna Dal, Minisola, Salvatore, Colangelo, Luciano, Afeltra, Antonella, Marigliano, Benedetta, Pipita, Maria Elena, Castellino, Pietro, Blanco, Julien, Zanoli, Luca, Pignataro, Samuele, Saracco, Valter, Fogliati, Marisa, Bussolino, Carlo, Mete, Francesca, Gino, Miriam, Cittadini, Antonio, Vigorito, Carlo, Arcopinto, Michele, Salzano, Andrea, Bobbio, Emanuele, Marra, Alberto Maria, Sirico, Domenico, Moreo, Guido, Gasparini, Francesca, Prolo, Silvia, Pina, Gloria, Ballestrero, Alberto, Ferrando, Fabio, Berra, Sergio, Dassi, Simonetta, Nava, Maria Cristina, Graziella, Bruno, Baldassarre, Stefano, Fragapani, Salvatore, Gruden, Gabriella, Galanti, Giorgio, Mascherini, Gabriele, Petri, Cristian, Stefani, Laura, Girino, Margherita, Piccinelli, Valeria, Nasso, Francesco, Gioffrè, Vincenza, Pasquale, Maria, Scattolin, Giuseppe, Martinelli, Sergio, Turrin, Mauro, Sechi, Leonardo, Catena, Cristina, Colussi, Gianluca, Passariello, Nicola, Rinaldi, Luca, Berti, Franco, Famularo, Giuseppe, Patrizia, Tarsitani, Castello, Roberto, Pasino, Michela, Ceda, Gian Paolo, Maggio, Marcello Giuseppe, Morganti, Simonetta, Artoni, Andrea, Del Giacco, Stefano, Firinu, Davide, Losa, Francesca, Paoletti, Giovanni, Montalto, Giuseppe, Licata, Anna, Malerba, Valentina, Antonino, Lasco, Basile, Giorgio, Antonino, Catalano, Malatino, Lorenzo, Stancanelli, Benedetta, Terranova, Valentina, Di Marca, Salvatore, Mecocci, Patrizia, Ruggiero, Carmelinda, Boccardi, Virginia, Meschi, Tiziana, Lauretani, Fulvio, Ticinesi, Andrea, Minuz, Pietro, Fondrieschi, Luigi, Pirisi, Mario, Fra, Gian Paolo, Sola, Daniele, Porta, Massimo, Riva, Piero, Quadri, Roberto, Scanzi, Giorgio, Mengoli, Caterina, Provini, Stella, Ricevuti, Laura, Simeone, Emilio, Scurti, Rosa, Tolloso, Fabio, Tarquini, Roberto, Valoriani, Alice, Dolenti, Silvia, Vannini, Giulia, Tedeschi, Alberto, Trotta, Lucia, Volpi, Riccardo, Bocchi, Pietro, Vignali, Alessandro, Harari, Sergio, Lonati, Chiara, Cattaneo, Mara, and Proietti, Marco

Published
2019
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46. COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Author

Sormani, Maria Pia, Schiavetti, Irene, Carmisciano, Luca, Cordioli, Cinzia, Filippi, Massimo, Radaelli, Marta, Immovilli, Paolo, Capobianco, Marco, De Rossi, Nicola, Brichetto, Giampaolo, Cocco, Eleonora, Scandellari, Cinzia, Cavalla, Paola, Pesci, Ilaria, Zito, Antonio, Confalonieri, Paolo, Marfia, Girolama Alessandra, Perini, Paola, Inglese, Matilde, Trojano, Maria, Brescia Morra, Vincenzo, Tedeschi, Gioacchino, Comi, Giancarlo, Battaglia, Mario Alberto, Patti, Francesco, Salvetti, Marco, Abbadessa, Gianmarco, Aguglia, Umberto, Allegorico, Lia, Allegri Rossi, Beatrice Maria, Amato, Maria Pia, Annovazzi, Pietro, Antozzi, Carlo, Appendino, Lucia, Arena, Sebastiano, Baione, Viola, Balgera, Roberto, Barcella, Valeria, Baroncini, Damiano, Barrilà, Caterina, Bellacosa, Alessandra, Bellucci, Gianmarco, Bergamaschi, Roberto, Bergamaschi, Valeria, Bezzini, Daiana, Biolzi, Beatrice, Bisecco, Alvino, Bonavita, Simona, Borriello, Giovanna, Bosa, Chiara, Bosco, Antonio, Bovis, Francesca, Bozzali, Marco, Brambilla, Laura, Buccafusca, Maria, Bucciantini, Elisabetta, Bucello, Sebastiano, Buscarinu, Maria Chiara, Cabboi, Maria Paola, Calabrese, Massimiliano, Calabria, Francesca, Caleri, Francesca, Camilli, Federico, Caniatti, Luisa Maria, Cantello, Roberto, Capra, Ruggero, Capuano, Rocco, Carta, Patrizia, Celani, Maria Grazia, Cellerino, Maria, Cerqua, Raffaella, Chisari, Clara, Clerici, Raffaella, Clerico, Marinella, Cola, Gaia, Conte, Antonella, Conti, Marta Zaffira, Cordano, Christian, Cordera, Susanna, Corea, Francesco, Correale, Claudio, Cottone, Salvatore, Crescenzo, Francesco, Curti, Erica, dʼAmbrosio, Alessandro, DʼAmico, Emanuele, Danni, Maura Chiara, dʼArma, Alessia, Dattola, Vincenzo, de Biase, Stefano, Luca, Giovanna De, Mercanti, Stefania Federica De, De Mitri, Paolo, De Stefano, Nicola, Cava, Marco Della, Napoli, Mario di, Sapio, Alessia Di, Docimo, Renato, Dutto, Anna, Evangelista, Luana, Fanara, Salvatore, Diana, Ferraro, Ferrò, Maria Teresa, Fioretti, Cristina, Fratta, Mario, Frau, Jessica, Fronza, Marzia, Furlan, Roberto, Gajofatto, Alberto, Gallo, Antonio, Gallo, Paolo, Gasperini, Claudio, Ghazaryan, Anna, Giometto, Bruno, Gobbin, Francesca, Govone, Flora, Granella, Franco, Grange, Erica, Grasso, Maria Grazia, Guareschi, Angelica, Guaschino, Clara, Guerrieri, Simone, Guidetti, Donata, Iaffaldano, Pietro, Ianniello, Antonio, Iasevoli, Luigi, Imperiale, Daniele, Infante, Maria Teresa, Iodice, Rosa, Iovino, Aniello, Konrad, Giovanna, Landi, Doriana, Lanzillo, Roberta, Lapucci, Caterina, Lavorgna, Luigi, LʼEpiscopo, Maria Rita, Leva, Serena, Liberatore, Giuseppe, Lo Re, Marianna, Longoni, Marco, Lopiano, Leonardo, Lorefice, Lorena, Lucchini, Matteo, Lus, Giacomo, Maimone, Davide, Malentacchi, Maria, Mallucci, Giulia, Malucchi, Simona, Mancinelli, Chiara Rosa, Mancinelli, Luca, Manganotti, Paolo, Maniscalco, Giorgia Teresa, Mantero, Vittorio, Marangoni, Sabrina, Marastoni, Damiano, Marinelli, Fabiana, Marti, Alessandro, Boneschi, Filippo Martinelli, Masserano Zoli, Federco, Matta, Francesca, Mendozzi, Laura, Meucci, Giuseppe, Miante, Silvia, Miele, Giuseppina, Milano, Eva, Mirabella, Massimiliano, Missione, Rosanna, Moccia, Marcello, Moiola, Lucia, Montepietra, Sara, MontiBragadin, Margherita, Montini, Federico, Motta, Roberta, Nardone, Raffaele, Nicoletti, Carolina Gabri, Nobile-Orazio, Eduardo, Nozzolillo, Agostino, Onofrj, Marco, Orlandi, Riccardo, Palmieri, Anna, Paolicelli, Damiano, Pasquali, Livia, Pastò, Luisa, Pedrazzoli, Elisabetta, Petracca, Maria, Petrone, Alfredo, Piantadosi, Carlo, Pietroboni, Anna M, Pinardi, Federica, Ponzano, Marta, Portaccio, Emilio, Pozzato, Mattia, Pozzilli, Carlo, Prosperini, Luca, Protti, Alessandra, Ragonese, Paolo, Rasia, Sarah, Realmuto, Sabrina, Repice, Anna, Rigoni, Eleonora, Rilla, Maria Teresa, Rinaldi, Francesca, Romano, Calogero Marcello, Ronzoni, Marco, Rovaris, Marco, Ruscica, Francesca, Sabattini, Loredana, Salemi, Giuseppe, Saraceno, Lorenzo, Sartori, Alessia, Sartori, Arianna, Sbragia, Elvira, Scarano, Giuditta Ilaria, Scarano, Valentina, Schillaci, Valentina, Sessa, Maria, Sgarito, Caterina, Sibilia, Grazia, Siciliano, Gabriele, Signori, Alessio, Signoriello, Elisabetta, Sinisi, Leonardo, Sireci, Francesca, Sola, Patrizia, Solaro, Claudio, Sotgiu, Stefano, Sparaco, Maddalena, Stromillo, Maria Laura, Strumia, Silvia, Susani, Emanuela Laura, Tabiadon, Giulietta, Teatini, Francesco, Tomassini, Valentina, Tonietti, Simone, Torri, Clerici Valentina, Tortorella, Carla, Toscano, Simona, Totaro, Rocco, Trotta, Maria, Turano, Gabriella, Ulivelli, Monica, Valentino, Manzo, Vaula, Giovanna, Vecchio, Domizia, Vercellino, Marco, Verrengia, Elena Pinuccia, Vianello, Marika, Virgilio, Eleonora, Vitetta, Francesca, Vollaro, Stefano, Zaffaroni, Mauro, Zampolini, Mauro, Zarbo, Ignazio Roberto, and Zuliani, Luigi

Published
2022
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47. Coronary Chronic Total Occlusion Revascularization: When, Who and How?

Author

Ricottini, Elisabetta, Coletti, Federica, Nusca, Annunziata, Cocco, Nino, Corlianò, Andrea, Appetecchia, Alessandro, Melfi, Rosetta, Mangiacapra, Fabio, Gallo, Paolo, Rinaldi, Raffaele, Grigioni, Francesco, and Ussia, Gian Paolo

Subjects
CHRONIC total occlusion, PERCUTANEOUS coronary intervention, CORONARY artery disease
Abstract

Coronary chronic total occlusions (CTO) are an increasingly frequent entity in clinical practice and represent a challenging percutaneous coronary intervention (PCI) scenario. Despite data from randomized trials that have not yet demonstrated a clear benefit of CTO recanalization, the widespread of CTO-PCI has substantially increased. The improvement in operators' techniques, equipment, and training programs has led to an improvement in the success rate and safety of these procedures, which will represent an important field of future development of PCI. The present review will summarize clinical outcomes and technical and safety issues of CTO revascularization with the aim to guide clinical daily cath-lab practice. [ABSTRACT FROM AUTHOR]

Published
2024
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48. Time is myelin: early cortical myelin repair prevents atrophy and clinical progression in multiple sclerosis.

Author

Lazzarotto, Andrea, Hamzaoui, Mariem, Tonietto, Matteo, Dubessy, Anne-Laure, Khalil, Michael, Pirpamer, Lukas, Ropele, Stefan, Enzinger, Christian, Battaglini, Marco, Stromillo, Maria Laura, Stefano, Nicola De, Filippi, Massimo, Rocca, Maria Assunta, Gallo, Paolo, Gasperini, Claudio, Stankoff, Bruno, Bodini, Benedetta, and Group, the MAGNIMS Study

Subjects
DISEASE progression, MYELIN, MULTIPLE sclerosis, MAGNETIZATION transfer, CEREBRAL atrophy
Abstract

Cortical myelin loss and repair in multiple sclerosis (MS) have been explored in neuropathological studies, but the impact of these processes on neurodegeneration and the irreversible clinical progression of the disease remains unknown. Here, we evaluated in vivo cortical demyelination and remyelination in a large cohort of people with all clinical phenotypes of MS followed up for 5 years using magnetization transfer imaging (MTI), a technique that has been shown to be sensitive to myelin content changes in the cortex. We investigated 140 people with MS (37 clinically isolated syndrome, 71 relapsing-MS, 32 progressive-MS), who were clinically assessed at baseline and after 5 years and, along with 84 healthy controls, underwent a 3 T-MRI protocol including MTI at baseline and after 1 year. Changes in cortical volume over the radiological follow-up were computed with a Jacobian integration method. Magnetization transfer ratio was employed to calculate for each patient an index of cortical demyelination at baseline and of dynamic cortical demyelination and remyelination over the follow-up period. The three indices of cortical myelin content change were heterogeneous across patients but did not significantly differ across clinical phenotypes or treatment groups. Cortical remyelination, which tended to fail in the regions closer to CSF (−11%, P < 0.001), was extensive in half of the cohort and occurred independently of age, disease duration and clinical phenotype. Higher indices of cortical dynamic demyelination (β = 0.23, P = 0.024) and lower indices of cortical remyelination (β = −0.18, P = 0.03) were significantly associated with greater cortical atrophy after 1 year, independently of age and MS phenotype. While the extent of cortical demyelination predicted a higher probability of clinical progression after 5 years in the entire cohort [odds ratio (OR) = 1.2; P = 0.043], the impact of cortical remyelination in reducing the risk of accumulating clinical disability after 5 years was significant only in the subgroup of patients with shorter disease duration and limited extent of demyelination in cortical regions (OR = 0.86, P = 0.015, area under the curve = 0.93). In this subgroup, a 30% increase in cortical remyelination nearly halved the risk of clinical progression at 5 years, independently of clinical relapses. Overall, our results highlight the critical role of cortical myelin dynamics in the cascade of events leading to neurodegeneration and to the subsequent accumulation of irreversible disability in MS. Our findings suggest that early-stage myelin repair compensating for cortical myelin loss has the potential to prevent neuro-axonal loss and its long-term irreversible clinical consequences in people with MS. [ABSTRACT FROM AUTHOR]

Published
2024
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49. Acoustic Radiation Forced Impulse of the Liver and the Spleen, Combined with Spleen Dimension and Platelet Count in New Ratio Scores, Identifies High-Risk Esophageal Varices in Well-Compensated Cirrhotic Patients.

Author

Vainieri, Antonio F. M., Brando, Elisa, De Vincentis, Antonio, Di Pasquale, Giulia, Flagiello, Valentina, Gallo, Paolo, Barone, Francesca, Massaro Cenere, Teresa, Di Matteo, Evelyn, Picardi, Antonio, and Galati, Giovanni

Subjects
ACOUSTIC radiation force, ESOPHAGEAL varices, PLATELET count, SPLEEN, LIVER
Abstract

Acoustic radiation forced impulse (ARFI) is an integrated ultrasound method, measuring stiffness by point shear wave elastography. To evaluate the diagnostic performance of the ARFI of the liver and the spleen, combined with spleen dimension and platelet count, in predicting high-risk esophageal varices (HRVs) in cirrhotic patients, a prospective and cross-sectional study was conducted between February 2017 and February 2021. The following ratio scores were calculated based on ARFI measurements: ALSDP (ARFI Liver–Spleen Diameter-to-Platelet Ratio Score), ASSDP (ARFI Spleen–Spleen Diameter-to-Platelet Ratio Score), ASSAP (ARFI Spleen–Spleen Area-to-Platelet Ratio Score), and ALSAP (ARFI Liver–Spleen Area-to-Platelet Ratio Score). In 100 enrolled subjects, spleen ARFI, ASSDP, and ASSAP were significantly associated with HRVs in the prospective short- and long-term follow-ups and in the cross-sectional study (p < 0.05), while ALSDP and ALSAP were associated with HRVs only in the prospective long-term follow-up and cross-sectional study (p< 0.05). ASSAP was the best ARFI ratio score for HRVs at the long-term follow-up [value of area under curve (AUC) = 0.88], although all the ARFI ratio scores performed better than individual liver and spleen ARFI (AUC > 0.7). In our study, ARFI ratio scores can predict, in well-compensated cirrhotic patients, the risk of developing HVRs in short- and long-term periods. [ABSTRACT FROM AUTHOR]

Published
2024
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50. Non‐invasive assessment of hepatic steatosis by ultrasound‐derived fat fraction in individuals at high‐risk for metabolic dysfunction‐associated steatotic liver disease.

Author

Tavaglione, Federica, Flagiello, Valentina, Terracciani, Francesca, Gallo, Paolo, Capparelli, Emma, Spiezia, Chiara, De Vincentis, Antonio, Palermo, Andrea, Scriccia, Sara, Galati, Giovanni, Napoli, Nicola, Daniels, Samuel J., Blau, Jenny E., Carlsson, Björn, Khazrai, Yeganeh M., Incalzi, Raffaele Antonelli, Picardi, Antonio, and Vespasiani‐Gentilucci, Umberto

Subjects
FATTY liver, LIVER diseases, RECEIVER operating characteristic curves, TYPE 2 diabetes, DISEASE progression
Abstract

Aims: Given the increasing number of individuals developing metabolic dysfunction‐associated steatotic liver disease (MASLD) and the low rate of those with progressive liver disease, there is a pressing need to conceive affordable biomarkers to assess MASLD in general population settings. Herein, we aimed to investigate the performance of the ultrasound‐derived fat fraction (UDFF) for hepatic steatosis in high‐risk individuals. Methods: A total of 302 Europeans with obesity, type 2 diabetes, or a clinical history of hepatic steatosis were included in the analyses. Clinical, laboratory, and imaging data were collected using standardized procedures during a single screening visit in Rome, Italy. Hepatic steatosis was defined by controlled attenuation parameter (CAP) or ultrasound‐based Hamaguchi's score. UDFF performance for hepatic steatosis was estimated by the area under the receiver operating characteristic curve (AUC). Results: Overall, median (IQR) UDFF was 12% (7–20). UDFF was positively correlated with CAP (ρ = 0.73, p < 0.0001) and Hamaguchi's score (ρ = 0.79, p < 0.0001). Independent predictors of UDFF were circulating triglycerides, alanine aminotransferase (ALT), and ultrasound‐measured visceral adipose tissue (VAT). UDFF AUC was 0.89 (0.85–0.93) and 0.92 (0.88–0.95) for CAP‐ and ultrasound‐diagnosed hepatic steatosis, respectively. UDFF AUC for hepatic steatosis was higher than those of fatty liver index (FLI), hepatic steatosis index (HSI), CAP‐score (CAPS), and ALT (p < 0.0001). Lower age, ALT, and VAT were associated with discordance between UDFF and ultrasound. Conclusions: UDFF may be a simple and accurate imaging biomarker to assess hepatic steatosis and monitor changes in hepatic fat content over time or in response to therapeutic interventions beyond clinical trials. [ABSTRACT FROM AUTHOR]

Published
2024
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