39 results on '"Antonio Mazza"'
Search Results
2. Iron Deficiency Anemia in Celiac Disease
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Valentina Talarico, Laura Giancotti, Marco Bertini, Roberto Miniero, and Giuseppe Antonio Mazza
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medicine.medical_specialty ,Duodenum ,Iron ,Iron absorption ,Review ,Disease ,Gastroenterology ,Ferrous ,Diet, Gluten-Free ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Celiac disease ,In patient ,TX341-641 ,030212 general & internal medicine ,Nutrition and Dietetics ,Anemia, Iron-Deficiency ,business.industry ,Nutrition. Foods and food supply ,iron absorption ,Inflammatory Bowel Diseases ,Iron Deficiencies ,medicine.disease ,Iron deficiency Anemia ,Intestinal Absorption ,Tolerability ,Iron-deficiency anemia ,030211 gastroenterology & hepatology ,business ,Food Science ,Proximal duodenum - Abstract
The iron absorption process developsmainly in the proximal duodenum. This portion of the intestine is typically destroyed in celiac disease (CD), resulting in a reduction in absorption of iron and subsequent iron deficiency anemia (IDA). In fact, the most frequent extra-intestinal manifestation (EIM) of CD is IDA, with a prevalence between 12 and 82% (in relation with the various reports) in patients with new CD diagnosis. The primary treatment of CD is the gluten-free diet (GFD), which is associated with adequate management of IDA, if present. Iron replacement treatment historically has been based on oral products containing ferrous sulphate (FS). However, the absorption of FS is limited in patients with active CD and unpredictable in patients on a GFD. Furthermore, a poor tolerability of this kind of ferrous is particularly frequent in patients with CD or with other inflammatory bowel diseases. Normalization from anemic state typically occurs after at least 6 months of GFD, but the process can take up to 2 years for iron stores to replenish.
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- 2021
3. Serological screening for hepatitis C during pregnancy: Seroprevalence and maternal and neonatal outcomes in 45,000 pregnant women
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Laura Dell’Anna, Antonio Mazza, and Silvano Piffer
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medicine.medical_specialty ,Asia ,Hepacivirus ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Seroepidemiologic Studies ,Childbirth ,Medicine ,Seroprevalence ,Humans ,030212 general & internal medicine ,Pregnancy Complications, Infectious ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Absolute risk reduction ,Infant, Newborn ,Obstetrics and Gynecology ,Retrospective cohort study ,Hepatitis C ,medicine.disease ,Gestational diabetes ,Low birth weight ,Reproductive Medicine ,Italy ,Female ,Pregnant Women ,medicine.symptom ,business - Abstract
Objectives The study evaluates the trend over time and the results of serological screening for hepatitis C infection in pregnancy and obstetric and neonatal outcomes. Study design It is a retrospective observational study of all pregnant women delivered in maternity units in Trento province, North East Italy, between 2009-2018. Serological screening data for hepatitis C virus were collected through the birth attendance certificate that is the mandatory tool in Italy for the birth report and the monitoring of the pregnancy, childbirth and health of the newborn. We also used the informations collected in the Hospital information system in order to get, for confirmed positive cases, the data of the entire serological profile. On this basis, we calculated the coverage of serological screening, the seroprevalence of the infection and the obstetric and neonatal outcomes. Results A total of 45,493 pregnant women were analysed, 75.5% Italians and 24.5% foreigners. The mean coverage for serological HCV screening in pregnancy was 99.4%. 177 women tested positive for HCV antibodies (107 Italian and 70 foreign women). Mean overall seroprevalence in pregnant women was 3.9‰ (95% CI: 3.8-4.0); amongst Italians it was 3.2‰ (95% CI: 3.0-3.4) and amongst foreigners it was 6.1‰ (95% CI: 5.9-6.2). The highest seroprevalence was recorded in mothers coming from Asian countries. HCV positive mothers present an excess risk for intrahepatic cholestasis and gestational diabetes compared to HCV negative mothers. The neonatal outcomes considered bring to light a statistically significant increase in preterm births, low birth weight, elective Caesarean births, hospitalisation at birth and bottle- or mixed-feeding vs breast-only feeding. There are differences in obstetric and neonatal outcomes in relation to the HCV positive subgroup of the mother defined in particular by exposure to smoke and/or opioids. Conclusions The availability and integration of current information sources allows you to verify compliance with national recommendations on the serological screening of hepatitis C virus infection, to determine infection seroprevalence, the characteristics of the cases and the obstetric and neonatal outcomes. Only part of the maternal and neonatal outcomes studied can be attributed to the presence of HCV.
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- 2020
4. Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era
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Thomas Berger, Evangelia Kouidi, Ana Abreu, C H Davos, Marie Christine Iliou, Wolfram Doehner, Véronique Cornelissen, Carlo Vigorito, Alain Cohen-Solal, Heinz Völler, Josef Niebauer, Maria Simonenko, Marco Ambrosetti, Elio Venturini, Dominique Hansen, Dan Gaita, Carlos Peña Gil, Hareld M. C. Kemps, Bernhard H. Rauch, Paul Dendale, Nicolle Kraenkel, Chiara Giuseppina Beccaluva, Roberto F E Pedretti, Daniel Neunhaeuserer, Mathias Wilhelm, Marinella Sommaruga, Miguel Mendes, Massimo F Piepoli, Andreas B. Gevaert, Jari A. Laukkanen, Paul Beckers, Ines Frederix, Bruno Pavy, Simona Sarzi Braga, Antonio Mazza, Francesco Maranta, Repositório da Universidade de Lisboa, Ambrosetti, M, Abreu, A, Cornelissen, V, HANSEN, Dominique, Iliou, MC, Kemps, H, Pedretti, RFE, Voller, H, Wilhelm, M, Piepoli, MF, Beccaluva, CG, Beckers, P, Berger, T, Davos, CH, DENDALE, Paul, Doehner, W, FREDERIX, Ines, Gaita, D, Gevaert, A, Kouidi, E, Kraenkel, N, Laukkanen, J, Maranta, F, Mazza, A, Mendes, M, Neunhaeuserer, D, Niebauer, J, Pavy, B, Gil, CP, Rauch, B, Braga, SS, Simonenko, M, Cohen-Solal, A, Sommaruga, M, Venturini, E, Vigorito, C, Future Everyday, and Eindhoven MedTech Innovation Center
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medicine.medical_specialty ,Consensus ,Referral ,Coronavirus disease 2019 (COVID-19) ,Delphi Technique ,Epidemiology ,medicine.medical_treatment ,Comorbidity ,030204 cardiovascular system & hematology ,SDG 3 – Goede gezondheid en welzijn ,Likert scale ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,COVID-19 ,Cardiovascular disease ,Coronavirus ,Prevention ,Rehabilitation ,Intervention (counseling) ,medicine ,Humans ,030212 general & internal medicine ,610 Medicine & health ,Consensus Document ,Pandemics ,computer.programming_language ,COVID-19/epidemiology ,Cardiac Rehabilitation ,business.industry ,SARS-CoV-2 ,Cardiovascular Diseases/epidemiology ,medicine.disease ,Cardiovascular Diseases ,Family medicine ,Human medicine ,Cardiology and Cardiovascular Medicine ,business ,computer ,Delphi ,Cardiac Rehabilitation/methods ,Cardiovascular rehabilitation - Abstract
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com., This Delphi consensus by 28 experts from the European Association of Preventive Cardiology (EAPC) provides initial recommendations on how cardiovascular rehabilitation (CR) facilities should modulate their activities in view of the ongoing coronavirus disease 2019 (COVID-19) pandemic. A total number of 150 statements were selected and graded by Likert scale [from -5 (strongly disagree) to +5 (strongly agree)], starting from six open-ended questions on (i) referral criteria, (ii) optimal timing and setting, (iii) core components, (iv) structure-based metrics, (v) process-based metrics, and (vi) quality indicators. Consensus was reached on 58 (39%) statements, 48 'for' and 10 'against' respectively, mainly in the field of referral, core components, and structure of CR activities, in a comprehensive way suitable for managing cardiac COVID-19 patients. Panelists oriented consensus towards maintaining usual activities on traditional patient groups referred to CR, without significant downgrading of intervention in case of COVID-19 as a comorbidity. Moreover, it has been suggested to consider COVID-19 patients as a referral group to CR per se when the viral disease is complicated by acute cardiovascular (CV) events; in these patients, the potential development of COVID-related CV sequelae, as well as of pulmonary arterial hypertension, needs to be focused. This framework might be used to orient organization and operational of CR programmes during the COVID-19 crisis.
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- 2020
5. Strategies for Prevention of Mother-to-Child Transmission Adopted in the 'Real-World' Setting: Data From the Italian Register for HIV-1 Infection in Children
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Giacomo Faldella, Wilma Buffolano, Vania Giacomet, Elena Chiappini, Carlo Giaquinto, Marco Rabusin, Fabio Natale, Raffaele Badolato, C. Gotta, Maurizio de Martino, Mara Merighi, Luisa Galli, Stefania Bernardi, Michele Quercia, Susanna Esposito, Catiuscia Lisi, Monica Cellini, P. Osimani, Orazio Genovese, Antonio Mazza, Anna Maccabruni, Filippo Salvini, Osvalda Rampon, Clara Gabiano, Icilio Dodi, and Pier-Angelo Tovo
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Adult ,Male ,Register (sociolinguistics) ,medicine.medical_specialty ,Human immunodeficiency virus (HIV) ,HIV Infections ,030204 cardiovascular system & hematology ,medicine.disease_cause ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,children ,Pregnancy ,immune system diseases ,law ,mother-to-child transmission rate ,medicine ,HIV ,antiretroviral drugs ,prophylaxis ,Humans ,Pharmacology (medical) ,Registries ,030212 general & internal medicine ,Child ,reproductive and urinary physiology ,business.industry ,Infant ,virus diseases ,Prevention of mother to child transmission ,Infectious Disease Transmission, Vertical ,female genital diseases and pregnancy complications ,Infectious Diseases ,Transmission (mechanics) ,Italy ,Family medicine ,HIV-1 ,Female ,business - Abstract
Strategies for prevention of HIV-1 mother-to-child transmission (PMTCT) have been continuously optimized. However, cases of vertical transmission continue to occur in high-income countries.To investigate changes in PMTCT strategies adopted by Italian clinicians over time and to evaluate risk factors for transmission.Data from mother-child pairs prospectively collected by the Italian Register, born in Italy in 1996-2016, were analyzed. Risk factors for MTCT were explored by logistic regression analyses.Six thousand five hundred three children (348 infections) were included. In our cohort, the proportion of children born to foreign mothers increased from 18.3% (563/3078) in 1996%-2003% to 66.2% (559/857) in 2011-2016 (P0.0001). Combination neonatal prophylaxis use significantly (P0.0001) increased over time, reaching 6.3% (56/857) after 2010, and it was largely (4.2%) adopted in early preterm infants. The proportion of vaginal deliveries in women with undetectable viral load (VL) increased over time and was 9.9% (85/857) in 2011-2016; no infection occurred among them. In children followed up since birth MTCT, rate was 3.5% (96/2783) in 1996-2003; 1.4% (36/2480) in 2004-2010; and 1.1% (9/835) in 2011-2016. At a multivariate analysis, factors associated with MTCT were vaginal delivery with detectable or missing VL or nonelective caesarean delivery, prematurity, breastfeeding, lack of maternal or neonatal antiretroviral therapy, detectable maternal VL, and age at first observation. Previously described increased risk of offspring of immigrant women was not confirmed.Risk of MTCT in Italy is ongoing, even in recent years, underling the need for implementation of the current screening program in pregnancy. Large combination neonatal prophylaxis use in preterm infants was observed, even if data on safety and efficacy in prematures are poor.
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- 2018
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6. ECG in Noonan syndrome: Beyond the 'normal abnormalities'
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Giuseppe Antonio Mazza, Giuseppina Baldassarre, Giovanni Battista Ferrero, Elena Banaudi, and Gabriella Agnoletti
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Male ,medicine.medical_specialty ,medicine.diagnostic_test ,Adolescent ,business.industry ,Noonan Syndrome ,MEDLINE ,Arrhythmias, Cardiac ,Arrhythmias ,medicine.disease ,Electrocardiography ,Child ,Echocardiography ,Female ,Humans ,CARDIAC THERAPY ,Internal medicine ,Cardiology ,Medicine ,Noonan syndrome ,Cardiology and Cardiovascular Medicine ,business ,Cardiac - Published
- 2019
7. Comparison between IEGM-based approach and echocardiography in AV/PV and VV delay optimization in CRT-D recipients (Quicksept study)
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G. Quirino, Mario Bocchiardo, Eraldo Occhetta, Cristina Piccinino, Andrea Motto, Andrea Magnani, Elisa Favro, Michele Raineri, Claudia Amellone, Roberto Mureddu, Fabrizio Orlando, Marco Giuggia, Aldo Pinnavia, Roberto Orsi, E. Gostoli, Anna Ferraro, Daniele Barone, Massimo Imazio, Filippo Rabajoli, Lucio Capulzini, Catia Checchinato, Massimo Giammaria, Enrico Cecchi, Maria Teresa Lucciola, Valentina Conti, Marica Di Tria, Davide Forno, Antonello Perrucca, Monica Anselmino, Antonio Mazza, Cosimo Tolardo, Alberto De Salvia, Mohamed Moballeghi, Gaetano Senatore, Giuseppe Trapani, Giuditta Corgnati, Paolo Pistelli, Paolo Diotallevi, S. Badolati, Rosa Coppoletta, Giuliana Ronzani, Marco Piana, Mauro Bensoni, and Valeria Sebastiani
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medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_treatment ,Cardiac resynchronization therapy ,Optimization algorythm ,Review Article ,030204 cardiovascular system & hematology ,Lead location ,Random order ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,Cardiac resinchronization therapy ,Mid-septum stimulation ,medicine ,030212 general & internal medicine ,Echocardiographyc optimization ,Lead (electronics) ,Intracardiac Electrogram ,Ventricular function ,business.industry ,IEGM based algorythm ,lcsh:RC666-701 ,Cardiology ,Velocity time integral ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background AtrioVentricular (AV) and InterVentricular (VV) delay optimization can improve ventricular function in Cardiac Resynchronization Therapy (CRT) and is usually performed by means of echocardiography. St Jude Medical has developed an automated algorhythm which calculates the optimal AV and VV delays (QuickOpt™) based on Intracardiac ElectroGrams, (IEGM), within 2 min. So far, the efficacy of the algorhythm has been tested acutely with standard lead position at right ventricular (RV) apex. Aim of this project is to evaluate the algorhythm performance in the mid- and long-term with RV lead located in mid-septum. Methods AV and VV delays optimization data were collected in 13 centers using both echocardiographic and QuickOpt™ guidance in CRTD implanted patients provided with this algorhythm. Measurements of the aortic Velocity Time Integral (aVTI) were performed with both methods in a random order at pre-discharge, 6-month and 12-month follow-up. Results Fifty-three patients were studied (46 males; age 68 ± 10y; EF 28 ± 7%). Maximum aVTI obtained by echocardiography at different AV delays, were compared with aVTI acquired at AV delays suggested by QuickOpt. The AV Pearson correlations were 0.96 at pre-discharge, 0.95 and 0,98 at 6- and 12- month follow-up respectively. After programming optimal AV, the same approach was used to compare echocardiographic aVTI with aVTI corresponding to the VV values provided by QuickOpt. The VV Pearson Correlation were 0,92 at pre-discharge, 0,88 and 0.90 at 6-month and 12- month follow-up respectively. Conclusions IEGM-based optimization provides comparable results with echocardiographic method (maximum aVTI) used as reference with mid-septum RV lead location.
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- 2016
8. Cardiac Prevention and Rehabilitation '3.0': From acute to chronic phase. Position Paper of the ltalian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR)
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Cesare Greco, Gian Francesco Mureddu, Oreste Febo, Maria Teresa La Rovere, Francesco Giallauria, Marco Ambrosetti, Carmine Riccio, Manuela Iannucci, Pompilio Faggiano, Silvia Brazzo, Nicolò Dasseni, Simonetta Scalvini, Antonio Mazza, Raffaele Griffo, Ugo Corrà, Elisabetta Angelino, Giuseppe Favretto, Roberto F.E. Pedretti, Mario Mallardo, Pier Luigi Temporelli, Marina Ferrari, Massimo Piepoli, Luigi Tavazzi, Francesco Fattirolli, Pedretti, RFE(1), Fattirolli, F, Griffo, R, Ambrosetti, M, Angelino, E, Brazzo, S, Corrà, U, Dasseni, N, Faggiano, P, Favretto, G, Febo, O, Ferrari, M, Giallauria, F, Greco, C, Iannucci, M, La Rovere, Mt, Mallardo, M, Mazza, A, Piepoli, M, Riccio, C, Scalvini, S, Tavazzi, L, Temporelli, Pl, and Mureddu, Gf.
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Heart Diseases ,medicine.medical_treatment ,Psychological intervention ,Cardiac rehabilitation ,lcsh:Medicine ,Subspecialty ,Phase (combat) ,Quality of life (healthcare) ,Health care ,Humans ,Medicine ,Intensive care medicine ,Societies, Medical ,Secondary prevention ,Rehabilitation ,business.industry ,lcsh:R ,Prognosis ,Italy ,Cardiovascular Diseases ,Acute Disease ,Chronic Disease ,Quality of Life ,Position paper ,Cardiology and Cardiovascular Medicine ,business ,secondary prevention - Abstract
Cardiac rehabilitation (CR) is the subspecialty of clinical cardiology dedicated to the treatment of cardiac patients, early and in the long term after an acute event. The aim of CR is to improve both quality of life and prognosis through prognostic stratification, clinical stabilization and optimization of therapy (pharmacological and non), management of comorbidities, treatment of disability, as well as through the provision and reinforcement of secondary prevention interventions and maintenaince of adherence to treatment. The mission of CR has changed over time. Once centered on the acute phase, aimed primarily at short-term survival, the healthcare of cardiac patients now increasingly involves the chronic phase where the challenge is to guarantee continuity and quality of care in the medium and long-term. The aim of the present position paper is to provide the state-of-the-art of CR in Italy, discussing its trengths and weaknesses as well as future perspectives.
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- 2018
9. What constitutes the 'Minimal Care' interventions of the nurse, physiotherapist, dietician and psychologist in Cardiovascular Rehabilitation and secondary prevention: A position paper from the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology
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Francesco Fattirolli, Barbara Maffezzoni, Manuela Iannucci, Marco Ambrosetti, Silvana Borghi, Letizia da Vico, Barbara Biffi, Antonio Mazza, Daniele Temporelli, Raffaele Griffo, Marinella Sommaruga, Antonia Pierobon, Elisabetta Angelino, Massimo F Piepoli, Maria Luisa Masini, Silvia Brazzo, Sabrina Barro, Roberto F E Pedretti, Ornella Bettinardi, Marina Ferrari, Susanna Agostini, and Pompilio Faggiano
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medicine.medical_specialty ,Consensus ,Epidemiology ,medicine.medical_treatment ,Psychological intervention ,030204 cardiovascular system & hematology ,Nurse's Role ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Cardiovascular prevention ,medicine ,Secondary Prevention ,Humans ,Psychology ,030212 general & internal medicine ,Nutritionists ,Competence (human resources) ,Secondary prevention ,Patient Care Team ,Rehabilitation ,Cardiac Rehabilitation ,business.industry ,Physical Therapists ,Treatment Outcome ,Cardiovascular Diseases ,Position paper ,Cardiology and Cardiovascular Medicine ,business ,Cardiovascular rehabilitation - Abstract
Background In cardiovascular prevention and rehabilitation, care activities are carried out by different professionals in coordination, each with their own specific competence. This GICR–IACPR position paper has analysed the interventions performed by the nurse, physiotherapist, dietician and psychologist in order to identify what constitutes minimal care, and it lists the activities that are fundamental and indispensable for each team member to perform in clinical practice. Results In analysing each type of intervention, the following dimensions were considered: the level of clinical care complexity, determined both by the disease and by environmental factors; the ‘area’ complexity, i.e. the specific level of competence required of the professional in each professional section; organisational factors, i.e. whether the care is performed in an inpatient or outpatient setting; duration of the rehabilitation intervention. The specific contents of minimal care have been identified for each professional area together with the specific goals, the assessment tools and the main essential interventions. For the assessments, only a few validated tools have been indicated, leaving the choice of which instrument to use to the individual professional based on experience and usual practice. Conclusion For the interventions, attention has been focused on conditions of major complexity requiring special care, taking into account the different care settings, the clinical conditions secondary to the disease event, and the distinct tasks of each area according to the operator's specific role. The final report performed by each professional has also been included.
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- 2018
10. A Double Lane for a Better Circulation: Percutaneous Duplication of the Thoracic Aorta in a Child
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Giuseppe Antonio Mazza, Gaetana Ferraro, and Gabriella Agnoletti
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Aortic arch ,Male ,medicine.medical_specialty ,Percutaneous ,Aortic arch atresia ,Aortic Diseases ,Aorta, Thoracic ,030204 cardiovascular system & hematology ,Doppler echocardiography ,Aortic disease ,030218 nuclear medicine & medical imaging ,Aortic arch interruption ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,medicine ,Thoracic aorta ,Humans ,Radiology, Nuclear Medicine and imaging ,Child ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,medicine.disease ,Magnetic Resonance Imaging ,Echocardiography, Doppler ,Surgery ,Treatment Outcome ,Atresia ,cardiovascular system ,Stents ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aortic arch interruption or atresia consists in a complete loss of anatomical and luminal continuity between the ascending and descending thoracic aorta. It is usually diagnosed in newborn babies but may also be present in young children, adolescents, adults and elderly patients. In these cases, it can be congenital or more frequently acquired. This latter type of aortic arch atresia is a challenge, and surgery is usually the treatment of choice. Percutaneous approaches are also possible today. We describe a case of percutaneous aortic arch reconstruction in a 9-year-old boy.
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- 2017
11. Calcified pericarditis associated with ventricular septal defect: should we close the hole or open our eyes?
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Francesca Ferroni, Roberto Bordese, Giuseppe Antonio Mazza, and Gabriella Agnoletti
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Heart Septal Defects, Ventricular ,medicine.medical_specialty ,business.industry ,Calcinosis ,Middle Aged ,medicine.disease ,Pericarditis ,Text mining ,Echocardiography ,Internal medicine ,Cardiology ,Medicine ,Humans ,Female ,Cardiac Surgical Procedures ,Cardiology and Cardiovascular Medicine ,business - Published
- 2017
12. Predictors of Treatment Failure in HIV-Positive Children Receiving Combination Antiretroviral Therapy: Cohort Data From Mozambique and Uganda
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Deven Patel, Davide Bilardi, Carlo Giaquinto, Andrea Atzori, Antonio Mazza, Maria Nannyonga, William Massavon, Maria L. Mastrogiacomo, Martina Penazzato, Erika Morelli, Giovanni Putoto, Genny Franceschetto, Sandra Nabachwa, Giuliana Rossi, Paola Costenaro, and Rebecca Lundin
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Male ,Cart ,Pediatrics ,medicine.medical_specialty ,Tuberculosis ,Population ,HIV Infections ,Drug Substitution ,Humans ,Medicine ,Uganda ,Treatment Failure ,Child ,education ,Mozambique ,Proportional Hazards Models ,Retrospective Studies ,education.field_of_study ,business.industry ,Incidence ,Infant ,Lamivudine ,General Medicine ,Prognosis ,medicine.disease ,Infectious Diseases ,Anti-Retroviral Agents ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Cohort ,Coinfection ,Female ,business ,Follow-Up Studies ,Cohort study ,medicine.drug - Abstract
Background. Delays detecting treatment failure and switching to second-line combination antiretroviral therapy (cART) are often observed in human immunodeficiency virus (HIV)–infected children of low-middleincome countries (LMIC). Methods. An observational study included HIV-infected children attending the Beira Central Hospital (Mozambique) and the Nsambya Hospital, Home Care Department (Uganda) evaluated clinical and immunological failure according to World Health Organization (WHO) 2006 guidelines. Baseline predictors for cART failure and for drug substitution were explored in unadjusted and adjusted Cox proportional hazard models. Results. Two hundred eighteen of 740 children with at least 24 weeks follow-up experienced treatment failure (29%; 95% confidence interval [CI] 26–33), with crude incidence of 20.0 events per 100 person-years (95% CI 17.5–22.9). Having tuberculosis co-infection or WHO stage 4, or starting a nontriple cART significantly increased risk of failure. Two hundred two of 769 (26.3%) children receiving cART substituted drug(s), with crude incidence of 15.4 events per 100 person-years (95% CI 13.4–17.7). Drug toxicity (18.3%), drug availability (17.3%), and tuberculosis drugs interaction (52, 25.7%) were main reported reasons, while only 9 (4%) patients switched cART for clinical or immunological failure. Children starting lamivudine-zidovudine-nevirapine or lamivudine-stavudineefavirenz or lamivudine-zidovudine-efavirenz were more likely to have substitute drugs. Increased substitution was found in children with mild immunosuppression and tuberculosis co-infection at cART initiation as well as poor adherence before drug substitution. Conclusions. Considerable delay in switching to second-line cART may occur despite an observed high rate of failure. Factors including WHO clinical stage and tuberculosis co-infection should be evaluated before starting cART. Toxicity and drug adherence should be monitored to minimize drug substitution in LMIC.
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- 2014
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13. Nsambya Community Home-Based Care Complements National HIV and TB Management Efforts and Contributes to Health Systems Strengthening in Uganda: An Observational Study
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Carlo Giaquinto, Levi Mugenyi, Davide Bilardi, Maria Nannyonga, Antonio Mazza, Bart Criel, Rebecca Lundin, Janet Seeley, Martin Nsubuga, William Massavon, Martina Penazzato, Susan Kironde, Charles Namisi, Daniel Kalibbala, James K Tumwine, Resty Ingabire, and Paola Costenaro
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medicine.medical_specialty ,Pediatrics ,Tuberculosis ,Article Subject ,business.industry ,Human immunodeficiency virus (HIV) ,Retrospective cohort study ,medicine.disease_cause ,medicine.disease ,Home based ,Unmet needs ,Acquired immunodeficiency syndrome (AIDS) ,Family medicine ,Medicine ,Health systems strengthening ,Observational study ,business - Abstract
Community Home-Based Care (CHBC) has evolved in resource-limited settings to fill the unmet needs of people living with HIV/AIDS (PLHA). We compare HIV and tuberculosis (TB) outcomes from the Nsambya CHBC with national averages in Kampala, Uganda. This retrospective observational study compared HIV and TB outcomes from adults and children in the Nsambya CHBC to national averages from 2007 to 2011. Outcomes included numbers of HIV and TB patients enrolled into care, retention, loss to follow-up (LTFU), and mortality among patients on antiretroviral therapy (ART) at 12 months from initiation; new smear-positive TB cure and defaulter rates; and proportion of TB patients tested for HIV. Chi-square test and trends analyses were used to compare outcomes from Nsambya CHBC with national averages. By 2011, approximately 14,000 PLHA had been enrolled in the Nsambya CHBC, and about 4,000 new cases of TB were detected and managed over the study period. Overall, retention and LTFU of ART patients 12 months after initiation, proportion of TB patients tested for HIV, and cure rates for new smear-positive TB scored higher in the Nsambya CHBC compared to national averages. The findings show that Nsambya CHBC complements national HIV and TB management and results in more positive outcomes.
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- 2014
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14. Feralgine™ a New Approach for Iron Deficiency Anemia in Celiac Patients
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Santina Marrazzo, Pietro Gangemi, Marco Bertini, Valentina Talarico, Giuseppe Antonio Mazza, Roberto Miniero, and Laura Giancotti
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Alginates ,Iron ,Glycine ,Administration, Oral ,Biological Availability ,lcsh:TX341-641 ,Absorption (skin) ,Gastroenterology ,Ferrous ,03 medical and health sciences ,0302 clinical medicine ,Atrophy ,ferrous bisglycinate chelate alginate ,Internal medicine ,medicine ,Humans ,Ingestion ,Ferrous Compounds ,030212 general & internal medicine ,High absorption ,iron deficiency anemia ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Anemia, Iron-Deficiency ,medicine.diagnostic_test ,business.industry ,Brief Report ,Iron Deficiencies ,medicine.disease ,oral iron absorption test ,Bioavailability ,Intestinal Absorption ,Iron-deficiency anemia ,Serum iron ,Female ,business ,lcsh:Nutrition. Foods and food supply ,celiac disease ,Food Science - Abstract
Background: Celiac disease (CD) is an immunologically-mediated disorder characterized by duodenal mucosa villi atrophy. Iron absorption is usually reduced in celiac patients making every kind of oral iron treatment unhelpful because of malasorption. Feralgine™ is a new product that has been demonstrated to be more bioavailable. As such, the aim of our study was to evaluate the absorption of Feralgine™ in adult patients with CD. Methods: Twenty-six adults affected by Iron Deficiency Anemia (IDA), of which 14 were also affected by CD and 12 were not affected by CD, were enrolled. An oral iron absorption test (OIAT) was performed in each patient by administrating Feralgine™, and serum iron was evaluated at baseline (T0) and after 2 h (T1) from the oral iron ingestion. Results: The OIAT was well tolerated in all patients, and, surprisingly, an equivalent statistically significant improvement in serum iron occurred in the two groups of patients (IDA plus CD: T0 = 28.21 µg/dL vs. T1 = 94.14 µg/dL p = 0.004 and IDA without CD: T0 = 34.91 µg/dL vs. T1 = 118.83 µg/dL, p = 0.0003). Conclusions: These results demonstrated the high absorption of Feralgine™ in celiac patients, confirming our previous data obtained with Ferrous Bysglicinate in children with CD.
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- 2019
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15. Oral iron absorption test with ferrous bisglycinate chelate in children with celiac disease
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Laura Giancotti, Giuseppe Antonio Mazza, Roberto Miniero, Santina Marrazzo, Elisabetta Battaglia, and Pietro Gangemi
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Male ,medicine.medical_specialty ,Adolescent ,Anemia ,Glycine ,Administration, Oral ,Gastroenterology ,03 medical and health sciences ,Diet, Gluten-Free ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,medicine ,Ingestion ,Humans ,Enteropathy ,Ferrous Compounds ,Villous atrophy ,Child ,chemistry.chemical_classification ,medicine.diagnostic_test ,Anemia, Iron-Deficiency ,business.industry ,medicine.disease ,Gluten ,Celiac Disease ,030228 respiratory system ,chemistry ,Iron-deficiency anemia ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Serum iron ,Gluten free ,Female ,business - Abstract
BACKGROUND Celiac disease (CD) is an immunologically-mediated enteropathy resulting in small-bowel mucosal villous atrophy with crypt hyperplasia. Iron malabsorption is usually observed in CD. Only few studies investigated oral iron absorption in subjects with gastrointestinal diseases and Iron Deficiency Anemia (IDA), using the oral iron absorption test (OIAT). We considered useful to investigate the OIAT, using ferrous bisglycinate chelate (FBC), in patients with CD at diagnosis or on gluten free diet (GFD) from at least 1 year. METHODS A total of 25 patients with CD (3-18 years old) and iron depletion, at diagnosis of CD (N.=12) or on GFD from at least 12 months (N.=13), were considered. Serum iron was evaluated at baseline (T0) and after 3 hours (T1) from the oral iron ingestion. Statistical analyses were conducted using SPSS 21.0 software for Mac. RESULTS OIAT was well tolerated by all patients. An important increase of the serum iron at T1, of at least twice the baseline values, occurred in all patients except in one (P value
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- 2016
16. Elderly patient-centered rehabilitation after cardiac surgery
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Federica Camera, Antonio Mazza, Alessandra Gualco, Antonella Maestri, Anna Patrignani, Franco Cobelli, Cristina Opasich, and Francesco Longoni
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Male ,Pulmonary and Respiratory Medicine ,Program evaluation ,medicine.medical_specialty ,Time Factors ,Activities of daily living ,Heart Diseases ,Frail Elderly ,medicine.medical_treatment ,MEDLINE ,lcsh:Medicine ,elderly ,Patient-Centered Care ,Activities of Daily Living ,Task Performance and Analysis ,medicine ,Humans ,Postoperative Period ,Cardiac Surgical Procedures ,Elderly patient ,Aged ,Analysis of Variance ,Rehabilitation ,business.industry ,lcsh:R ,Exercise Therapy ,Cardiac surgery ,cardiac rehabilitation ,Treatment Outcome ,Needs assessment ,Physical therapy ,Female ,Functional status ,Cardiology and Cardiovascular Medicine ,business ,cardiac surgery ,Needs Assessment ,Follow-Up Studies ,Program Evaluation - Abstract
The rate of over-70 year post-surgery patients referred to the Cardiac Rehabilitation Units is increasing. Strategies designed to encourage and facilitate participation in rehabilitation programs in the elderly should be developed. Aim of this paper is to present our elderly-centered program, specifically designed on patient’s needs and frailty, and its short- and medium-term results in 160 consecutive over-70 year patients, admitted in our Cardiac Rehabilitation Unit soon after cardiac surgery. The program was safe, well accepted by the patients, and effective in improving objective and subjective functional status.
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- 2016
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17. Implementation and Operational Research: Implementation of the WHO 2011 Recommendations for Isoniazid Preventive Therapy (IPT) in Children Living With HIV/AIDS: A Ugandan Experience
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Carlo Giaquinto, Rebecca Lundin, Sandra Nabachwa, Paola Costenaro, Charles Namisi, Davide Bilardi, William Massavon, Susan Kizito, Martina Penazzato, Mark F. Cotton, Agnes Alowo, Federica Fregonese, Maria Nannyonga Musoke, Erika Morelli, and Antonio Mazza
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Male ,Pediatrics ,medicine.medical_specialty ,Tuberculosis ,Adolescent ,Population ,Antitubercular Agents ,HIV Infections ,World Health Organization ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,030225 pediatrics ,parasitic diseases ,Health care ,medicine ,Isoniazid ,Humans ,Pharmacology (medical) ,Uganda ,030212 general & internal medicine ,Prospective Studies ,education ,Prospective cohort study ,Child ,Proportional Hazards Models ,education.field_of_study ,AIDS-Related Opportunistic Infections ,Proportional hazards model ,business.industry ,Hazard ratio ,Infant ,medicine.disease ,Infectious Diseases ,Child, Preschool ,Female ,Liver function ,business - Abstract
Background Intensified tuberculosis (TB) case finding and isoniazid preventive therapy (IPT) are strongly recommended for children who are HIV infected. Data are needed to assess the feasibility of the WHO 2011 intensified tuberculosis case finding/IPT clinical algorithm. Methods Children who are HIV infected and attending Nsambya Home Care at Nsambya Hospital, Uganda, were screened for TB following WHO recommendations. IPT was given for 6 months after excluding TB. Factors associated with time to IPT initiation were investigated by multivariate Cox proportional hazard regression. Health care workers were interviewed on reasons for delay in IPT initiation. Results Among the 899 (49% male) children with HIV, 529 (58.8%) were screened for TB from January 2011 to February 2013. Children with active TB were 36/529 (6.8%), 24 (4.5%) were lost to follow-ups and 280 (52.9%) started IPT, 86/280 (30.7%) within 3 months of TB screening and 194/280 (69.3%) thereafter. Among the 529 children screened for TB, longer time to IPT initiation was independently associated with cough at TB screening (hazard ratio 0.62, P = 0.02, 95% confidence interval: 0.41 to 0.94). Four children (1% of those starting treatments) interrupted IPT because of a 5-fold increase in liver function measurements. In the survey, Health care workers reported poor adherence to antiretroviral therapy, poor attendance to periodic HIV follow-ups, and pill burden as the 3 main reasons to delay IPT. Conclusion In resource-constrained settings, considerable delays in IPT initiation may occur, particularly in children with HIV who are presenting with cough at TB screening. The good safety profile of isoniazid in antiretroviral-therapy-experienced children provides further support to IPT implementation in this population.
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- 2016
18. First-line antiretroviral therapy with a protease inhibitor versus non-nucleoside reverse transcriptase inhibitor and switch at higher versus low viral load in HIV-infected children: an open-label, randomised phase 2/3 trial
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J. Fanning, M. Keuth, E. Cagwin, E. Lachassinne, S. Campbell, K. Jeffries, J. Tutko, L. Vladau, Raffaele Badolato, Paolo Palma, J. Orendi, I. Colombo, A. Buckton, J. Neubert, Y. Rodriguez Lozano, V. Novelli, E. Belfrage, M. della Negra, N. Boudjoudi, R. Nickel, F. Schumacher, A. Furcas, J. Navarra, C. B. S. de Souza, B. Zöhrer, M. Neely, G. Pontrelli, D. Duiculescu, M. Clapson, K. A. Contello, G. Kudesia, R. Santos, Catherine Dollfus, Raffaella Rosso, G. Lewis, A. Sarah Walker, James Homans, Pier-Angelo Tovo, T. Chen, K. Fidler, V. Reliquet, A. Aali, J. Cottalorda, D. Michalik, Barbra Murante, Marisa Zanchetta, Jaime G. Deville, P. McNeil, Z. Shah, K. O’connor, H. Haley, M. I. Gonzalez Tomé, M. C. Cervi, Rosa Bologna, Abdel Babiker, D. Hamadache, A. Pala, Merlin L. Robb, E. Voicu, Cristina Bertulli, A. Smyth, G. Hadjou, L. Lugo, M. Burke, E. Hayes, Janice Hodge, Marco Tabone, Ram Yogev, A. Jurgrau, Lucia de Araujo Evangelista, K. Nguyen, P. Kamara, N. Le Gueyades, D. Picard, A. Dehée, J. Leleu, D. M. Ferraro, F. Damond, Iraina Fernandes, S. Bradford, K. Swaby, Laura Schneider, Albert Faye, T. Dunaway, Carlo Giaquinto, D. Otelea, C. Jennings, D. Gibb, J. Horton, G. Alexandre-Castor, D. Muir, A. Mazzei, J. Nelson, M. Snelling, M.J. Mellado Peña, S. Welch, C. Belmega, B. V.M. Negrini, L. Garrovillo, S. Walters, C. Müller, Andrew Collinson, Lynda Harper, T. Fleming, C. Concato, Polly Clayden, K. Elkins, A. Schnuriger, I. Farias, Caroline Foster, M. C. Sapia, L. Alecsandru, A. Alvarez, A. Waters, N. O’sullivan, S. Buskirk, Yacine Saidi, R. Pineiro Perez, Elaine J. Abrams, Y. C. Lian, L. Buck, H. Tchidjou, M. Gonzalez, S. Blanche, M. E. Paul, Leonard B. Weiner, K. Moshal, S. Marino, S. Wong, Angela Berzi, D. P. Pacola, A. Rodallec, C. Frillici, C. Rodriguez, Cristiana Oprea, L. Dehache, Anthony C. Gordon, Christine Rouzioux, P. Valentin, Jay A. Levy, Sharon Nachman, Andrea Kovacs, J. Batra, R. Croteau, I. L. Febo, Yvonne J. Bryson, P. Archer, Z. Benabadji, M. Stevanovic, E. Hutchison, G. Boddy, M. Ilie, K. Kabat, C. Monrose, Vania Giacomet, Marianne C. Jacobsen, Antonio Mazza, N. Patel, C. Farmer, A. Krivine, I. Fineanganofo, M. García López, C. Graisbery, CS Peckham, F. Monpoux, William Borkowsky, M. Denon, A. Doyle, T. Schmitz, Ann J. Melvin, Gareth Tudor-Williams, Osvalda Rampon, L. Marty, M. Sellier, M. Fernandez, Marc Foca, C. Hayes, C. Peiser, T. C. Matsubara, A. Finn, P. Martín Fontelos, W. A. Holz, A. Zoccano, Mike Sharland, R. Dersimonian, S. Champion, M. Kline, D. Collins, J.T. Ramos Amador, Angela Di Martino, Hermione Lyall, Christine A. Powell, Stephen A. Spector, J. Swan, S. Eloby-Childress, S. Yeadon, C. McMullen-Jackson, A. L. Chang, Diana M. Gibb, Henriette J. Scherpbier, G. Ball, Hannah Castro, Elena Spinelli, M. Jervis, G. Delommois, S. Scott, I. Garcia Mellado, S. Discenza, P. Lepage, S. Hawkins, F. Méchinaud, Alexandra Compagnucci, T. Ilmet, A. Mangano, H. Carreira, Andrew J. Pollard, G. Silva, L. Cerracchio, R. Sellers, Edward Handelsman, C. Floch, M. Lajeunesse, Stefano Vella, Thalita F. Abreu, N. Martinez-Allier, C. Florea, C. Newbould, I. Grosch-Wörner, M. F. Courcoux, Gert Warncke, I. Whyms, J. C. Gabaldi, T. Piening, F. Hoffman, V. Shah, B. Bucholz, S. Costa, G. Firtion, E. R. Stiehm, J. Palm, S. Deygoo, L. Rosado, V. Tournier, Y. Saïdi, M. Wigger, G. Vaudre, V. Lobato, E. Yeagley, A. B. Bohlin, Delane Shingadia, L. S. Spencer, M. Depala, G. Tardei, S. Akleh, S. Marks, S. Vasquez Bonilla, Stefania Bernardi, D. Costello, S. Segal, S. Gudowius, Saniyyah Mahmoudi, M. Debré, C. Borne, D. Melvin, S. Kaye, S. Johnson, Ellen G. Chadwick, Marie-Laure Chaix, H. Loeffler, G. Stringari, J. L. Jimenez, Arry Dieudonne, G. Notheis, J. Dodge, C. Nesel, D. Mecikovsky, Meredith G. Warshaw, Shunmay Yeung, C. De Bortoli, J. Shenton, R. de Groot, S. Forcat, M. A. Kelly, J. Usher, I. Falconi, M. Rein, D. Nayagam, R. Delgado Garcia, P. McMaster, J. Flynn, S. Rugina, Susan A. Fiscus, S. Liebeschuetz, A. Sorlini, G. Tatum, Magdalena Marczyńska, H. J. Laws, Paul Palumbo, Nigel Klein, E. Daghofer, D. Painter, D. Poalelungi, Anne A. Gershon, L. Martins, N. Pineda, Patricia M. Flynn, J. H. Darbyshire, Michael Hughes, Pim Brouwers, Guido Castelli-Gattinara, M. Byrne, J. Stroobant, G. Talero, C. Reed, D. Patel, F. Nganzali, J. F. Méritet, M. Elizabeth Smith, M. A. Muñoz Fernandez, K. Huck, G. Castelli Gattinara, M. L. Issac, S. Gaur, M. Johnson, K. Mohan, B. Ward, A. Cheng, M. Dunn, M. Frere, T. Alford, K. Doerholt, S. Storey, J. Smith, S. Cleto, A. Ferreira, J. Darbyshire, J. Johnson, A. Marion, P. Butler, K. M. Kim, H. Hichou, D. Casey, L. Farrelly, R. Draghicenoiu, Alessandra Viganò, M. F. Melo, S. Bellert, Jintanat Ananworanich, F. Ferreira, K. Sloper, Deenan Pillay, E. Ferguson, Karina Butler, D. Rivaux, A. D. Fernandez, M. Penin, V. Bennato, M. Filisetti, W. Tomosada, Daria Trabattoni, J. P. Aboulker, A. Diniz, Patricia Emmanuel, C. Rodier, Jorge Pinto, S. McDonagy, M. Goode, K. Swaminathan, H. Sprenger, L. Deveikis, L. Ball, E. André, Susan Laverty, John S. Lambert, F. Abaab, C. Hill, A. Menon, A. García Torre, T. Belger, Christoph Rudin, R. Neubauer, Cornelia Feiterna-Sperling, U. Wintergerst, B. Brody, Silvia Netescu, Ross E. McKinney, Yoann Riault, J. Galimand, G. Deluchi, J. Hobbs, K. Buckberry, C. Mazhude, S. Doshi, Maripat Toye, C. Ball, David M. Burger, A. Werthmann, R. Matusa, J. Wong, Joseph A. Church, M. Pourrat, K. Pfurtscheller, S. Seyboldt, R. Lawrence, M. Butler, D. Scott, T. Niehues, Katherine Luzuriaga, B. Pabst, R. Lakshman, M. Donohoe, A. Ortwin, M. Brusati, M. O’connell, W. Queiroz, M. P. Gomez, J. C. Roa, P. Rojo Conejo, A. De Rossi, C. Norgeux, A. Rochford, Linda Harrison, Tao Dong, W. Zenz, S. Donaghy, S. Mellul, L. M. Lira, Paula Britto, J. Romeiro, C. Taylor, J. Jackson Alvarez, Judith A. Guzman-Cottrill, J. Arias, Lynne M. Mofenson, D. Calo, I. Le Moal, J. Lujan-Zimmerman, T. Alchediak, C. Guérin, Ricardo H. Oliveira, Jonathan Cohen, D. Kwolfe, Ana Puga, L. Navarante, William T. Shearer, L. Angeli, Marc Lallemant, J. Bane, Niels Henrik Valerius, Ayesha Mirza, John F. Modlin, G. Rossetti, David Nadal, M. Acevedo-Flores, F. Shackley, S. Léonardo, E. Smidt, I. Jimenez Nacher, Margarita Silio, Geoffrey A. Weinberg, C. Galvez, F. Kakehasi, L. Fabregas, S. Moore, M. M. Mussi-Pinhata, M. O’connor, M. Diniz, M. Mardarescu, J. King, Sohail Rana, D. Johnson, J. M. Ferrari, Lisa M. Frenkel, T. Hastings, C. Wells, R. B. Van Dyke, G. Bowen, Claire Thorne, L. Sen, E. Hyland, L. Barrett, E Jungmann, Mobeen H. Rathore, D. Beniken, B. Sodiende, C. Ryan, A. Malheiro, Y. Peng, R. O’connell, A. Walsh, John L. Sullivan, A. Deveikis, P. Rice, A. Le Pelletier, and A. Poziak
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Male ,medicine.medical_specialty ,Nevirapine ,Pediatric AIDS ,Adolescent ,Anti-HIV Agents ,antiretroviral therapy ,pediatric HIV/AIDS, antiretroviral therapy ,HIV Infections ,Article ,Nucleoside Reverse Transcriptase Inhibitor ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antiretroviral Therapy, Highly Active ,medicine ,Humans ,pediatric HIV/AIDS ,Protease inhibitor (pharmacology) ,030212 general & internal medicine ,Child ,0303 health sciences ,Intention-to-treat analysis ,Reverse-transcriptase inhibitor ,030306 microbiology ,business.industry ,Infant ,South America ,Viral Load ,Virology ,Settore MED/38 ,3. Good health ,Europe ,Infectious Diseases ,Nelfinavir ,Treatment Outcome ,Child, Preschool ,North America ,Female ,Drug Monitoring ,business ,Viral load ,medicine.drug - Abstract
Background Children with HIV will be on antiretroviral therapy (ART) longer than adults, and therefore the durability of first-line ART and timing of switch to second-line are key questions. We assess the long-term outcome of protease inhibitor and non-nucleoside reverse transcriptase inhibitor (NNRTI) first-line ART and viral load switch criteria in children. Methods In a randomised open-label factorial trial, we compared effectiveness of two nucleoside reverse transcriptase inhibitors (NRTIs) plus a protease inhibitor versus two NRTIs plus an NNRTI and of switch to second-line ART at a viral load of 1000 copies per mL versus 30,000 copies per mL in previously untreated children infected with HIV from Europe and North and South America. Random assignment was by computer-generated sequentially numbered lists stratified by age, region, and by exposure to perinatal ART. Primary outcome was change in viral load between baseline and 4 years. Analysis was by intention to treat, which we defined as all patients that started treatment. This study is registered with ISRCTN, number ISRCTN73318385. Findings Between Sept 25, 2002, and Sept 7, 2005, 266 children (median age 6.5 years; IQR 2.8-12.9) were randomly assigned treatment regimens: 66 to receive protease inhibitor and switch to second-line at 1000 copies per mL (PI-low), 65 protease inhibitor and switch at 30,000 copies per mL (PI-higher), 68 NNRTI and switch at 1000 copies per mL (NNRTI-low), and 67 NNRTI and switch at 30,000 copies per mL (NNRTI-higher). Median follow-up was 5.0 years (IQR 4.2-6.0) and 188 (71%) children were on first-line ART at trial end. At 4 years, mean reductions in viral load were -3.16 log(10) copies per mL for protease inhibitors versus -3.31 log(10) copies per mL for NNRTIs (difference -0.15 log(10) copies per mL, 95% CI -0.41 to 0.11; p=0.26), and -3.26 log(10) copies per mL for switching at the low versus -3.20 log(10) copies per mL for switching at the higher threshold (difference 0.06 log(10) copies per mL, 95% CI -0.20 to 0.32; p=0.56). Protease inhibitor resistance was uncommon and there was no increase in NRTI resistance in the PI-higher compared with the PI-low group. NNRTI resistance was selected early, and about 10% more children accumulated NRTI mutations in the NNRTI-higher than the NNRTI-low group. Nine children had new CDC stage-C events and 60 had grade 3/4 adverse events; both were balanced across randomised groups. Interpretation Good long-term outcomes were achieved with all treatments strategies. Delayed switching of protease-inhibitor-based ART might be reasonable where future drug options are limited, because the risk of selecting for NRTI and protease-inhibitor resistance is low. Funding Paediatric European Network for Treatment of AIDS (PENTA) and Pediatric AIDS Clinical Trials Group (PACTG/IMPAACT).
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- 2011
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19. Viral Load Detection Using Dried Blood Spots in a Cohort of HIV-1-Infected Children in Uganda: Correlations with Clinical and Immunological Criteria for Treatment Failure
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Rebecca Lundin, William Massavon, Carlo Giaquinto, Anita De Rossi, Martina Penazzato, Antonio Mazza, Susan Kizito, Marisa Zanchetta, Erika Morelli, Maria Nannyonga Musoke, Charles Namisi, Maria Raffaella Petrara, Sandra Nabachwa, Paola Costenaro, and Davide Bilardi
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Male ,Microbiology (medical) ,Cart ,medicine.medical_specialty ,stavudine ,nevirapine ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,Sensitivity and Specificity ,Treatment failure ,Specimen Handling ,Cohort Studies ,virus RNA ,Antiretroviral Therapy, Highly Active ,Virology ,Internal medicine ,medicine ,Humans ,Uganda ,Treatment Failure ,Desiccation ,Child ,Dried blood ,antiretrovirus agent ,business.industry ,antiretrovirus agent, efavirenz, lamivudine, lopinavir, nevirapine, ritonavir, stavudine, virus RNA, zidovudine ,efavirenz ,Viral Load ,zidovudine ,Dried blood spot ,lopinavir ,ritonavir ,Blood ,Anti-Retroviral Agents ,Child, Preschool ,Cohort ,Immunology ,HIV-1 ,Female ,lamivudine ,business ,Viral load ,Cohort study - Abstract
Correlations between clinical/immunological treatment failure and viral load (VL) detected by dried blood spot (DBS) sampling were explored in HIV-1-infected children in Uganda. Of 104 children on combined antiretroviral treatment (cART), 12.5% experienced clinical and/or immunological failure, while 28.8%, 44.2%, and 26.9% had VLs of 5,000 copies/ml, respectively. Clinical/immunological failure poorly predicted virological failure.
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- 2014
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20. An elderly-centered, personalized, physiotherapy program early after cardiac surgery
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Franco Cobelli, Cristina Opasich, Anna Patrignani, Gian Domenico Pinna, Antonio Mazza, and Alessandra Gualco
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Male ,medicine.medical_specialty ,Time Factors ,Activities of daily living ,Health Services for the Aged ,Epidemiology ,Functional autonomy ,Frail Elderly ,medicine.medical_treatment ,MEDLINE ,Walking ,Physical function ,Disability Evaluation ,Physical functioning ,Activities of Daily Living ,Humans ,Medicine ,Muscle Strength ,Cardiac Surgical Procedures ,Physical Therapy Modalities ,Aged ,Aged, 80 and over ,Chi-Square Distribution ,Rehabilitation ,business.industry ,Patient Selection ,Age Factors ,Recovery of Function ,Length of Stay ,Cardiac surgery ,Treatment Outcome ,Italy ,Linear Models ,Physical therapy ,Female ,Cardiology and Cardiovascular Medicine ,business ,Chi-squared distribution - Abstract
Early post-surgery in-hospital rehabilitation in elderly patients should be aimed at accelerating the recovery of the highest level of functional autonomy and reducing the hospital stay.We designed a personalized physiotherapy program tailored to the frailty level of over-70-year-old patients soon after cardiac surgery. The aims of this study were (a) to validate our frailty-based approach for functional stratification of the patients, and (b) to assess the effect of the individualized program on independence and mobility, and compare it with our usual program.We followed 224 consecutive patients aged 70-87 years, who followed either the personalized (n= 150) or usual (n= 74) program. All patients underwent a comprehensive physical functioning evaluation at the baseline and at the end of hospitalization.The frailty-based stratification was successful in identifying those patients at higher risk of falls, with heavy nursing needs, greater dependency, and poorer heath status perception. On discharge, both groups had significantly improved on all measures of independence and mobility, but most of these changes (nursing needs, mobility, balance, and muscle strength) were significantly greater (P0.05) in the intervention group. These patients also had a significantly shorter length of stay (17.5 ± 8 vs. 21 ± 4 days, P = 0.0002), and 91% of them could be discharged in a state of substantial independence.An elderly-centered stratification based on functional frailty is useful to identify patients with more dependency and greater needs. A consequent personalized physiotherapy program designed to enhance independent mobility soon after cardiac surgery is safe and well accepted, and is more effective then usual physiotherapy.
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- 2010
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21. P1549The adherence to 2016 ESC guidelines for CRT is associated with an improved outcome, when compared with 2013 guidelines
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A De Simone, Patrizia Pepi, Giuseppe Stabile, V. Magnano, Antonio Mazza, Paolo Pieragnoli, Anna Ferraro, A. Mazzuero, T. Giovannini, M. Menichelli, Domenico Pecora, Si. Caico, Maurizio Malacrida, Antonio D'Onofrio, and G.L. Botto
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medicine.medical_specialty ,business.industry ,Physiology (medical) ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Intensive care medicine ,Outcome (game theory) - Published
- 2017
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22. Chronic Idiopathic Neutrophilia in Two Twins
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Federica Altomare, Giuseppe Antonio Mazza, Carla Fusaro, and Roberto Miniero
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medicine.medical_specialty ,Pediatrics ,Hematology ,business.industry ,lcsh:RC633-647.5 ,Blood neutrophils ,First year of life ,Case Report ,General Medicine ,lcsh:Diseases of the blood and blood-forming organs ,Neutrophilia ,Internal medicine ,Long period ,medicine ,Absolute neutrophil count ,Abnormality ,medicine.symptom ,business - Abstract
Neutrophilia in adults refers to an alteration in the total number of blood neutrophils that is in excess of about 7500 cells/μL. This definition is restrictive in childhood as neutrophil count is age-dependent. Chronic Idiopathic Neutrophilia (CIN) refers to a condition that persists for many years in individuals who appear otherwise healthy. CIN is rarely mentioned in scientific literature and in academic books of hematology; only few words are dedicated to this topic. We report a case study of two twins with CIN followed from the first year of life to 24 years of age. To the best of our knowledge this is the first case report of two twins with CIN followed through a long period of time. We believe that our observation may contribute to better understand and characterize this hematologic abnormality.
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- 2014
23. Six-minute walking performance in patients with moderate-to-severe heart failure; is it a useful indicator in clinical practice?
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Gian Domenico Pinna, Riccardi Pg, Roberto Riccardi, Franco Cobelli, Giovanni Forni, Oreste Febo, Antonio Mazza, Luigi Tavazzi, Soccorso Capomolla, and Cristina Opasich
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Adult ,Male ,Cardiac function curve ,medicine.medical_specialty ,Heart disease ,Hemodynamics ,Sensitivity and Specificity ,Oxygen Consumption ,Predictive Value of Tests ,medicine ,Humans ,Survival analysis ,Proportional Hazards Models ,Heart Failure ,Proportional hazards model ,business.industry ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,ROC Curve ,Predictive value of tests ,Heart failure ,Exercise Test ,Physical therapy ,Female ,Cardiology and Cardiovascular Medicine ,business ,Anaerobic exercise - Abstract
The 6-min walk test has been incorporated into studies on the efficacy of new therapies and into prognostic stratification for chronic heart failure patients. Firm conclusions on the usefulness of the test in clinical practice are still lacking. The aim of this study was to investigate (1) the correlation between walk test performance and standard indices of cardiac function and exercise capacity, and (2) the prognostic value of the walk test with respect to peak VO2 and NYHA class.Three hundred and fifteen chronic heart failure patients (age: 53+/-9 years, NYHA class: II (182), III (133)) underwent a functional evaluation and a 6-min walk test. Of these, 270 were followed-up for a minimum of 6 months (mean 387+/-177 days). Walked distance was 396+/-92 m. There was no significant correlation between distance walked and central haemodynamic data. Functional capacity, as measured by ergometry, correlated moderately with distance walked (duration: r=0.48, peak VO2: r=0.59, anaerobic threshold: r=0.54; all P0.001). During follow-up, 46 patients died from cardiovascular causes and 12 were urgently transplanted. Either of these events were considered end points of the study. Survival analysis was performed from a continuous walk test and peak VO2 measurements or after categorization of (a) quartile segmentation, (b) cut-off points from the literature and (c) thresholds from receiver operating characteristic curves. At univariate survival analysis (Cox regression), the association of the walk test with survival was of significance (P=0.03, continuous variable), or borderline significance (0.05or =Por =0.1, after categorization). Peak VO2 was always significant, independent of the scale used (0.005or =Por =0.03). The strongest association was found for NYHA class (P0.001), which showed the highest sensitivity and specificity for the prediction of the event (0.64 and 0.65, respectively). When walk test performance, continuous or categorized, was entered into a multivariate model with NYHA class or peak VO2, it lost any significant association with survival (P0.76 in all models with NYHA class and P0.27 in all models with peak VO2).In moderate-to-severe chronic heart failure patients, the 6-min walk test is not related to cardiac function and only moderately related to exercise capacity. Walking performance does not provide prognostic information which can complement or substitute for that provided by peak VO2 or NYHA class. Hence the test is of limited usefulness as a decisional indicator in clinical practice.
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- 2001
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24. Rapid disease progression in HIV-1 perinatally infected children born to mothers receiving zidovudine monotherapy during pregnancy
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M. G. Marazzi, G. Sabatino, G. Ferraris, Rita Consolini, M. Ruggeri, C. Salvatore, Alberto Vierucci, D. De Mattia, R. Pinzani, R. Lipreri, S. Catania, S. Riva, S. Boni, C. Gotta, C. Cancrini, C. Fundarò, A. Antonellini, E. Massironi, R. Tornaghi, Orazio Genovese, L. Anastasio, Anna Maccabruni, G. L. Forni, P. Crispino, Gianfranco Anzidei, P. Zizzadoro, G. Castelli Gattinara, M. De Martino, C. Giaquinto, S. Bernardi, G. Gambaretto, Luisa Galli, P. Osimani, L Tarallo, C. Dessì, Massimo Masi, Antonio Mazza, M. Sticca, S. Farina, A. De Maria, A. Meo, Clara Gabiano, P. G. Chiriacò, Alfredo Guarino, A. Romano, C. Scolfaro, Monica Cellini, Claudio Pignata, A. Miniaci, Marcello Lanari, M. De Luca, G. Dell'Erba, E. Pontali, Marzia Duse, S. de Carlis, S. Dalla Vecchia, F. Salvini, G. Benaglia, R. Berrino, M. Dedoni, C. Pintor, Gian Vincenzo Zuccotti, Francesca Fioredda, C. Magnani, Paola Marchisio, C. Rendeli, L. Tasso, M. Zappa, A. Lodato, L. Battisti, M. Stegagno, T. Cecchi, C. Riva, E. Uberti, C. Timpano, Osvalda Rampon, Désirée Caselli, D. Loriano, E. Palomba, G. Palla, Anna Plebani, A. Pellegatta, Pier-Angelo Tovo, A. Bucceri, E. Ruga, E. Bresciani, and F. Baldi
- Subjects
Pregnancy ,Pediatrics ,medicine.medical_specialty ,business.industry ,Immunology ,Disease progression ,Human immunodeficiency virus (HIV) ,medicine.disease ,medicine.disease_cause ,Rapid disease progression ,Zidovudine ,Infectious Diseases ,Perinatal infection ,medicine ,Immunology and Allergy ,business ,medicine.drug - Published
- 1999
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25. Reproducibility of the Six-Minute Walking Test in Patients With Chronic Congestive Heart Failure: Practical Implications
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Luigi Tavazzi, Antonio Mazza, Oreste Febo, Franco Cobelli, P.Giorgio Riccardi, Gian Domenico Pinna, Soccorso Capomolla, and Cristina Opasich
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Adult ,Male ,medicine.medical_specialty ,Heart disease ,MEDLINE ,Walking ,Severity of Illness Index ,Internal medicine ,Severity of illness ,medicine ,Humans ,In patient ,Practical implications ,Aged ,Heart Failure ,Reproducibility ,Walking test ,business.industry ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Heart failure ,Exercise Test ,Physical therapy ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
This study assesses the reproducibility of the 6-minute walking test in patients with chronic heart failure using 2 different measurement protocols. Practical suggestions for the clinical setting are given.
- Published
- 1998
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26. Does the presence of ANCA in patients with ulcerative colitis necessarily imply renal involvement?
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Alfredo Caglioti, M. Rosa, Nicolino Comi, Giuseppe Antonio Mazza, Giorgio Fuiano, G. Monteleone, R. A. Sinico, Ciro Esposito, Maria Capria, Rosa, M, Esposito, C, Caglioti, A, Mazza, G, Capria, M, Comi, N, Monteleone, G, Sinico, R, and Fuiano, G
- Subjects
Adult ,Male ,Vasculitis ,Pathology ,medicine.medical_specialty ,Adolescent ,Renal function ,Kidney ,urologic and male genital diseases ,Follow-Up Studie ,Antibodies, Antineutrophil Cytoplasmic ,chemistry.chemical_compound ,immune system diseases ,medicine ,Humans ,cardiovascular diseases ,skin and connective tissue diseases ,Anti-neutrophil cytoplasmic antibody ,Transplantation ,Creatinine ,business.industry ,Middle Aged ,medicine.disease ,Ulcerative colitis ,respiratory tract diseases ,medicine.anatomical_structure ,chemistry ,Renal pathology ,Nephrology ,Colitis, Ulcerative ,Female ,business ,Human ,Follow-Up Studies ,Kidney disease - Abstract
Background. ANCA are thought to play a pathogenic role in renal vasculitis. ANCA may also be detected in patients with diseases not usually associated with renal pathology, such as ulcerative colitis. Our study was conducted to determine if the presence of ANCA in patients with ulcerative colitis is associated with renal pathology. Methods. Eight ANCA-positive and five ANCA-negative patients with a histological and endoscopic diagnosis of active ulcerative colitis were investigated. Repeated complete urinalyses and determination of microalbuminuria and creatinine clearance were performed. Serum IgG and IgA ANCA were evaluated in all patients by indirect immunofluorescence and ELISA, and when detected the antibodies were further characterized by alpha granules preparation, myeloperoxidase, lactoferrin, and cathepsin G. Results. In both ANCA-positive and ANCA-negative patients renal function was normal or near normal and urinalyses (including microalbuminuria) failed to disclose any abnormalities. ANCA exhibited a perinuclear pattern in all ANCA-positive patients. Interestingly, none of the ANCA-positive patients had antibodies to myeloperoxidase or to alpha granules which are usually found in the sera of patients with ANCA-associated vasculitis, and only one had antibodies to lactoferrin. The ANCA specificity remained undetermined in the remaining seven patients. At the end of the 1-year observation period, all ANCA-positive patients remained ANCA-positive without developing symptoms, signs or laboratory abnormalities consistent with renal involvement. Conclusions. Renal damage was not observed in ANCA-positive patients with ulcerative colitis even after 1 year of follow-up, suggesting that the ANCA found in these patients do not share the antigenic targets with the ANCA commonly found in renal vasculitis. Therefore the potential of ANCA of induCorrespondence and offprint requests to: Prof. G. Fuiano, Cattedra di Nefrologia, Facolta di Medicina, Via T. Campanella, 88100, Catanzaro, Italy. cing renal lesions (if any) is dependent on their own antigenic specificity.
- Published
- 1996
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27. 136-68: Response to cardiac resynchronization therapy with quadripolar lead - preliminary results of ResQ-CRT prospective study
- Author
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Antonio Mazza, Gaetano Senatore, Valerio Zacà, Antonello Vado, E. Menardi, Francesco Rametta, Massimo Giammaria, Fabrizio Pizzetti, Pasquale Notarstefano, Marco Giuggia, and T. Giovannini
- Subjects
medicine.medical_specialty ,Ejection fraction ,business.industry ,medicine.medical_treatment ,Cardiac resynchronization therapy ,Repeat Surgery ,medicine.disease ,New York Heart Association Classification ,Physiology (medical) ,Heart failure ,Internal medicine ,Cardiology ,medicine ,Cardiology and Cardiovascular Medicine ,Prospective cohort study ,business ,Lead (electronics) ,RESQ - Published
- 2016
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28. Programmatic impact of the evolution of WHO pediatric antiretroviral treatment guidelines for resource-limited countries (Tukula Fenna Project, Uganda)
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Genny Franceschetto, Carlo Giaquinto, Martina Penazzato, Siobhan Crowley, Lynne M. Mofenson, Antonio Mazza, and Maria-Musoke Nannyonga
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Program evaluation ,Male ,Pediatrics ,medicine.medical_specialty ,Population ,Developing country ,Guidelines as Topic ,HIV Infections ,World Health Organization ,Cohort Studies ,Antiretroviral treatment ,Medicine ,Humans ,Pharmacology (medical) ,Uganda ,education ,Child ,Developing Countries ,education.field_of_study ,business.industry ,Infant ,Odds ratio ,Antiretroviral therapy ,Drug Utilization ,Infectious Diseases ,Anti-Retroviral Agents ,Child, Preschool ,Cohort ,Female ,business ,Cohort study ,Follow-Up Studies - Abstract
BACKGROUND: World Health Organization (WHO) recommendations for the initiation of antiretroviral therapy (ART) in children were revised in 2010 but the programmatic impact has had limited study. METHODS: We used a cohort of 985 Ugandan children followed since 2003 by the Tukula Fenna project to model the differential impact of the 2006 2008 and 2010 WHO pediatric ART inititation criteria on the proportion of children eligible for ART at enrollment and over time. RESULTS: Using the WHO 2006 2008 and 2010 ART criteria 40% 57% and 66% of children respectively would have been eligible for ART at enrollment and 76% 84% and 88% 2 years later. Evaluating the entire cohort followed for 6 years using the 2006 2008 and 2010 guidelines the proportion in need of ART was found to be 70% 82% and 87% respectively. Between 2006 and 2008 the proportions of eligible children starting ART within 6 and 12 months were 39% and 50% respectively; after this the proportions starting within 6 and 12 months were 50% and 52%. Before 2008 the most common criterion met in children who did not start ART was WHO clinical stage (odds ratio = 2.0 CI 95% = 1.2 to 3.2); after the 2008 recommendations the most common eligibility criterion in children who did not start ART was age
- Published
- 2012
29. Features of children perinatally infected with HIV-1 surviving longer than 5 years
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A. Loy, M. De Martino, P. Falconieri, P. Osimani, V. Portelli, Fabrizio Veglia, G. Gambaretto, F. Chiappe, T. Bezzi, Alberto Vierucci, Alfredo Guarino, P L Mazzoni, M. T. Cecchi, S. Tulisso, G. L. Forni, Gian Vincenzo Zuccotti, P. Cocchi, M. Ruggeri, Désirée Caselli, Antonio Mazza, I. Ragazzini, S. Risso, F. Bassanetti, Guido Castelli Gattinara, Rita Consolini, Pier-Angelo Tovo, D. Demattia, M. Sticca, G. Ferraris, Laura Galli, Clara Gabiano, C. Giaquinto, G. Benaglia, C. Fundarò, E. Micheletti, P. Dallacasa, Paola Marchisio, M. Stegagno, A. Soresina, Gianfranco Anzidei, F. Ciccimarra, A. Corrias, L Tarallo, and M.C. Schoeller
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Pediatrics ,medicine.medical_specialty ,Register (music) ,business.industry ,Human immunodeficiency virus (HIV) ,Medicine ,General Medicine ,business ,medicine.disease_cause - Published
- 1994
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30. Diagnosis of paroxysmal atrial fibrillation in patients with implanted pacemakers: relationship to symptoms and other variables
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Elena Turri, Catia Checchinato, S. Serge Barold, Antonio Mazza, Antonello Perucca, Gianluca Quirino, Maurizio Dalmasso, Paolo Pistelli, Massimo Giammaria, and Giorgio Corbucci
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Male ,medicine.medical_specialty ,Pacemaker, Artificial ,Heart disease ,Paroxysmal atrial fibrillation ,Asymptomatic ,Risk Assessment ,Sick sinus syndrome ,Electrocardiography ,Pharmacotherapy ,Risk Factors ,Internal medicine ,Atrial Fibrillation ,Medicine ,Humans ,In patient ,Aged ,business.industry ,Incidence (epidemiology) ,Incidence ,Atrial fibrillation ,General Medicine ,medicine.disease ,Italy ,Cardiology ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: Atrial fibrillation (AF) is not always accompanied by clear-cut symptoms and symptoms suggestive of AF may not correspond to a genuine AF episode. The study prospectively evaluated the burden of asymptomatic AF episodes in pacemaker patients (for sick sinus syndrome) with a history of documented paroxysmal AF. Methods: Consecutive patients were enrolled and implanted with dual-chamber pacemakers equipped with diagnostic features for AF monitoring. Each patient was instructed about typical AF symptoms and was asked to keep a detailed log of symptoms. Stored pacemaker data were analyzed using only AF episodes >30 s. Results: The mean follow-up was 16 ± 6 months and 102 patients were enrolled (73 ± 7 years, 59 M). Thirteen patients (13%) dropped out with the development of permanent AF and their data were discarded. Twenty-three patients (26%) without device-stored AF episodes all reported at least one annotated AF episode. There were 1,245 device-stored AF episodes in 66 (74%) out of 89 patients. Patients reported 1,141 episodes of AF-related symptoms. Only 240 (21%) corresponded to a genuine device-stored AF event. The sensitivity and positive predictive value of symptoms to detect AF were respectively 19% and 21%. Episode duration, rate increase at the onset of the arrhythmia, heart disease, or antiarrhythmic drug therapy showed no statistically significant differences comparing symptomatic and asymptomatic episodes. Conclusions: Many pacemaker patients with paroxysmal AF can develop AF-like symptoms in the absence of device-stored AF. AF-related symptoms have low sensitivity and low positive predictive value in patients with permanent pacemakers.
- Published
- 2009
31. Relation between Spontaneous Atrial Fibrillation and Atrial Vulnerability in Patients with Wolff-Parkinson-White Pattern
- Author
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Carla Giustetto, Fiorenzo Gaita, Antonio Brusca, Riccardo Riccardi, Mangiardi L, Antonio Mazza, and Rosettani E
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Adult ,Male ,medicine.medical_specialty ,macromolecular substances ,Asymptomatic ,Heart Conduction System ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,In patient ,Longitudinal Studies ,Prospective Studies ,cardiovascular diseases ,Fibrillation ,Atrial pacing ,Atrial vulnerability ,business.industry ,P wave ,Cardiac Pacing, Artificial ,Atrial fibrillation ,General Medicine ,Atrial Function ,Wolff-Parkinson-White pattern ,medicine.disease ,Electrophysiology ,Anesthesia ,cardiovascular system ,Cardiology ,Female ,Wolff-Parkinson-White Syndrome ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
An intracavitary electrophysiological study was carried out on 103 patients with Wolff-Parkinson-White (WPW), 23 symptomatic patients had documented episodes of atrial fibrillation, 54 symptomatic patients had atrioventricular reentrant tachycardias, and 26 asymptomatic. Patients were examined for the relation between spontaneous atrial fibrillation and atrial vulnerability, defined as the possibility to induce sustained (greater than 1 minute) episodes of atrial fibrillation with a stimulation protocol excluding atrial bursts. Atrail fibrillation induction was attempted by single and double atrial extrastimuli during pacing at two different cycle lengths and incremental atrial pacing. Sustained atrail fibrillation was induced in 65% of the patients with spontaneous atrial fibrillation, and in 13% of the symptomatic patients with documented episodes of atrioventricular reentrant tachycardias and in 15% of the asymptomatic patients (P less than 0.0005). Atrial vulnerability was higher in patients with spontaneous atrial fibrillation than in patients without this arrhythmia. No significant difference was observed between symptomatic without atrial fibrillation and asymptomatic patients.
- Published
- 1990
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32. Camel milk in children with cow milk allergy: Is it time for more investigations and less skepticism?
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Mario Rubino, G Monti, Roberto Miniero, A. Bua, Giuseppe Antonio Mazza, and A.M. Mahdi
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chemistry.chemical_classification ,medicine.medical_specialty ,Chemotherapy ,Hepatology ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Lymphoproliferative disorders ,medicine.disease ,Rash ,Coeliac disease ,Liver disease ,chemistry ,Transferrin ,Internal medicine ,medicine ,Serum iron ,Gluten free ,medicine.symptom ,business - Abstract
s / Digestive and Liver Disease 47S (2015) e237–e276 e265 neous rash, night sweating and systemic lymphadenitis. Hodgkin lymphomawas diagnosed at pediatric hematology and chemotherapy and radiotherapy were administered. She was admitted to our GI surgery practice because of refractory to iron therapy anaemia (haemoglobin 11.4 g/dl nv.12.1–15.2; serum iron 7.8 mol/L nv.9–21.5; ferritin1107 g/L nv.15–150; transferrin 2.28g/L nv.2.5–3.8). Workup: • EmA-IgA positive (nv.negative); Ab-anti-tTg-IgA>100UA/ml (nv. 100UA/ml (nv.
- Published
- 2015
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33. A new test (VITTORIO Test) for functional fitness assessment in rehabilitation after cardiac surgery
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Franco Cobelli, Roberto Tramarin, Federica Camera, Antonio Mazza, G. Calsamiglia, Francesca Gigli Berzolari, and Paola Villa
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Male ,Pulmonary and Respiratory Medicine ,Functional training ,medicine.medical_specialty ,Activities of daily living ,medicine.medical_treatment ,Statistics as Topic ,lcsh:Medicine ,Coronary artery bypass surgery ,Physical medicine and rehabilitation ,Myocardial Revascularization ,Humans ,Medicine ,Aerobic exercise ,Coronary Artery Bypass ,Aerobic capacity ,Aged ,Retrospective Studies ,Rehabilitation ,business.industry ,lcsh:R ,physical function assessment ,Middle Aged ,Test (assessment) ,Cardiac surgery ,cardiac rehabilitation ,Physical Fitness ,Exercise Test ,Physical therapy ,Female ,Cardiology and Cardiovascular Medicine ,business ,cardiac surgery - Abstract
An adequate assessment of physical function (PF) in Cardiac Rehabilitation (CR) plays a central role in early detection of physical limitations. Traditionally exercise tolerance has been used as an indicator of overall PF. However exercise tolerance has been shown to poorly predict patients' ability to perform daily-life activities. The goal of the present study is to evaluate a new test, named VITTORIO TEST, for assessing various component of daily activities among patients in CR after cardiac surgery. VITTORIO test consists in 8 items that assess lower and upper extremity strength and flexibility, agility, dynamic balance, aerobic capacity. 500 patients (359 males; 141 females) admitted to CR programs following cardiac surgery (349 coronary artery bypass surgery; 151 valvular surgery) were enrolled in the study. They were evaluated with an initial test (T1) (10.7 +/- 6.3 days after cardiac surgery) and a final test (T2) after an in-hospital intensive training program (mean length 16.8 +/- 6.6 days) consisting in stretching, large muscle group and aerobic activity, resistance exercises. Statistical analysis showed a significant improvement of all items at the end of the rehabilitation program. Old patients (70 years) and particularly females demonstrate exercise improvement comparable to that of younger subjects especially regards lower extremity strength and aerobic capacity. VITTORIO test is inexpensive, simple and easy to perform by the patient. Through the identification and the measurement of different aspects of physical disability, it allows a personalized rehabilitation exercise program. It could be used as an outcome measure of CR programs.
- Published
- 2005
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34. A significant sex - but not elective cesarean section - effect on mother - to- child transmission of hepatitis C virus infection
- Author
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M. R. Sartorelli, Anna Maria Casadei, L. Lazier, C. Fabris, G. Lindh, G. Cilla, F. Asensi-Botet, A. Corrias, C. Riva, Vania Giacomet, S. Lindgren, Karina Butler, Raffaele Iorio, Charles A. Boucher, J. Ruiz Contreras, Angela Vegnente, Elisabetta Tanzi, Antonio Amoroso, H. O. Fjaerli, Filippo Salvini, M. Viñolas, A. Hatzakis, Alessandra Viganò, C. Inchley, V. Balossini, J. Echeverria, A. De Maria, C. Figini, S. Hannam, A.R. Zanetti, M. Merlo, P. Grella, J. Y.Q. Mok, D. M. Paternoster, A. Pereda, G. Claret Teruel, Marie-Louise Newell, I. Grosch-Wörner, Valentina Venturi, C. Servera Ginard, M. Zaffaroni, T. Schmitz, Dante Bassetti, A. Coscia, P. Martin Fontelos, S. Garetto, G. Bossi, Antonio Mazza, S. Ferrando, A. Mur, G. Norkrans, C. Fortuny, Susanne Polywka, J. M. Bertran Sanges, B. Salati, A. Manzanares, A. Berg, Pier-Angelo Tovo, R. Rosso, Wilma Buffolano, T. Piening, Paola Erba, S. Floris, Marcello Lanari, Gian Vincenzo Zuccotti, L. Cabero Roura, A. B. Bohlin, S. Aime, Oriol Coll, A. Maccabruni, A. Bandelloni, A Alfarano, C. Belloni, M. Marcellini, E. Tridapalli, A. Versace, Giacomo Faldella, S. Bressio, Isabella Quinti, Lucy Pembrey, A. Rojahn, P. Cigna, B. Fischler, C. Feiterna Sperling, A. Ruiz Extremera, L. M. Ciria, G. Mieli-Vergani, R. Wejstal, R. Ledda, Gianni Bona, Tovo, P. A., Pembrey, L., Newell, M. L., Iorio, Raffaele, European, Paediatric Hepatitis C Virus Network, and Lanari, M.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Mother to child transmission ,Hepatitis C virus ,Sex Factor ,medicine.disease_cause ,Pregnancy ,Odds Ratio ,medicine ,Immunology and Allergy ,HIV Infection ,Prospective cohort study ,Hepaciviru ,Elective Surgical Procedure ,Elective cesarean section ,biology ,Cesarean Section ,Transmission (medicine) ,business.industry ,Obstetrics ,Risk Factor ,Infant, Newborn ,Infant ,Infant, Premature, Disease ,Odds ratio ,Delivery, Obstetric ,Hepatitis C ,Virology ,Infectious Disease Transmission, Vertical ,Confidence interval ,Europe ,Prospective Studie ,Infectious Diseases ,Pregnancy Complications, Infectiou ,biology.protein ,Female ,Antibody ,business ,Confidence Interval ,Infant, Premature ,Human - Abstract
BACKGROUND: Risk factors for mother-to-child transmission of hepatitis C virus (HCV) are poorly quantified. METHODS: We conducted a European multicenter prospective study of HCV-infected pregnant women and their infants. Children with > or =2 positive HCV RNA polymerase chain reaction test results and/or anti-HCV antibodies after 18 months of age were considered to be infected. RESULTS: The overall HCV vertical transmission rate was 6.2% (95% confidence interval [CI], 5.0%-7.5%; 91/1479). Girls were twice as likely to be infected as boys (adjusted odds ratio [OR], 2.07 [95% CI, 1.23-3.48]; P=.006). There was no protective effect of elective cesarean section (CS) delivery on HCV vertical transmission (adjusted OR, 1.46 [95% CI, 0.86-2.48]; P=.16). HCV/human immunodeficiency virus-coinfected women more frequently transmitted HCV than did women with HCV infection only, although the difference was not statistically significant (adjusted OR, 1.82 [95% CI, 0.94-3.52]; P=.08). Maternal history of injection drug use, prematurity, and breast-feeding were not significantly associated with transmission. Transmission occurred more frequently from viremic women, but it also occurred from a few nonviremic women. CONCLUSIONS: Our results strongly suggest that women should neither be offered an elective CS nor be discouraged from breast-feeding on the basis of HCV infection alone. The sex association is an intriguing finding that probably reflects biological differences in susceptibility or response to infection.
- Published
- 2005
35. Double nucleotidic mutation of the MYH9 gene in a young patient with end-stage renal disease
- Author
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Michele Andreucci, Domenico Mancuso, Laura Fuiano, Giorgio Fuiano, Maria Capria, Alfredo Caglioti, Giuseppe Antonio Mazza, Paola Cianfrone, and Nicola Comi
- Subjects
Adult ,medicine.medical_specialty ,Myh9 gene ,medicine.medical_treatment ,Nephritis, Hereditary ,Bioinformatics ,End stage renal disease ,Internal medicine ,medicine ,Humans ,Alport syndrome ,Transplantation ,Myosin Heavy Chains ,business.industry ,Molecular Motor Proteins ,Glomerulonephritis ,medicine.disease ,Endocrinology ,Nephrology ,Mutation (genetic algorithm) ,Mutation ,Kidney Failure, Chronic ,Female ,Hemodialysis ,business ,Nephritis ,Kidney disease - Published
- 2003
36. Celiac disease and inflammatory bowel disease: Which association?
- Author
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Laura Giancotti, Giuseppe Antonio Mazza, Pasquale Minchella, Anna Maria Lavecchia, Roberto Miniero, and Giulia Paolella
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Gastroenterology ,medicine ,Disease ,business ,medicine.disease ,Inflammatory bowel disease - Published
- 2014
- Full Text
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37. Oral iron absorption test in children with celiac disease and iron deficiency anemia: New insight for a forgotten test
- Author
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Giulia Paolella, Luisa Pedrelli, Elisabetta Battaglia, Giuseppe Antonio Mazza, Roberto Miniero, and Laura Giancotti
- Subjects
chemistry.chemical_classification ,medicine.medical_specialty ,Abdominal pain ,Constipation ,Hepatology ,business.industry ,Gastroenterology ,nutritional and metabolic diseases ,Gluten intolerance ,Disease ,medicine.disease ,Gluten ,digestive system diseases ,Surgery ,Liver disease ,chemistry ,Iron-deficiency anemia ,Internal medicine ,Medicine ,medicine.symptom ,business ,Wheat allergy - Abstract
s / Digestive and Liver Disease 46 (2014) e85–e127 e115 ance of symptoms (constipation, abdominal pain, aphtae) whereas the restatement caused the reappearance. Diagnosis was therefore an adverse reaction to gluten (NCGS). Results: Gluten-free diet has resulted in a stable condition of well-being. An year after the diagnosis, the boy does not denounce any symptoms. Being it not celiac disease, no strict recommendations have bee provided in relation to food contamination. At present transglutaminase antibodies remain negative. Conclusions: NCGS is rare in childhood. Diagnosis requires a high index of trace, the exclusion of other forms of gluten intolerance (celiac disease, wheat allergy), intestinal biopsy and gluten challenge. Up to now the follow-up and the prognosis are difficult to be scheduled as clinical records and knowledge on the matter are insufficient. http://dx.doi.org/10.1016/j.dld.2014.07.131 CELIAC DISEASE: OUR RESULTS ACCORDING TO THE NEW ESPGHAN DIAGNOSTIC CRITERIA
- Published
- 2014
- Full Text
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38. Reproducibility of the six-minute walking test in chronic heart failure patients
- Author
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Cristina Opasich, Antonio Tangenti, Antonio Mazza, Gian Domenico Pinna, Maurizio Sanarico, and Roberto Maestri
- Subjects
Statistics and Probability ,Mixed model ,Adult ,Male ,medicine.medical_specialty ,Heart disease ,Epidemiology ,Physical exercise ,Walking ,Internal medicine ,medicine ,Humans ,Clinical significance ,Aged ,Heart Failure ,Reproducibility ,Models, Statistical ,business.industry ,Walking test ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Random effects model ,Surgery ,Heart failure ,Chronic Disease ,Cardiology ,Exercise Test ,Female ,business - Abstract
The six-minute walking test (WT) is used in trials and clinical practice as an easy tool to evaluate the functional capacity of chronic heart failure (CHF) patients. As WT measurements are highly variable both between and within individuals, this study aims at assessing the contribution of the different sources of variation and estimating the reproducibility of the test. A statistical model describing WT measurements as a function of fixed and random effects is proposed and its parameters estimated. We considered 202 stable CHF patients who performed two baseline WTs separated by a 30 minute rest; 49 of them repeated the two tests 3 months later (follow-up control). They had no changes in therapy or major clinical events. Another 31 subjects performed two baseline tests separated by 24 hours. Collected data were analysed using a mixed model methodology. There was no significant difference between measurements taken 30 minutes and 24 hours apart (p = 0.99). A trend effect of 17 (1.4) m (mean (SE)) was consistently found between duplicate tests (p0.001). REML estimates of variance components were: 5189 (674) for subject differences in the error-free value; 1280 (304) for subject differences in spontaneous clinical evolution between baseline and follow-up control, and 266 (23) for the within-subject error. Hence, the standard error of measurement was 16.3 m, namely 4 per cent of the average WT performance (403 m) in this sample. The intraclass correlation coefficient was 0.96. We conclude that WT measurements are characterized by good intrasubject reproducibility and excellent reliability. When follow-up studiesor = 3 months are performed, unpredictable changes in individual walking performance due to spontaneous clinical evolution are to be expected. Their clinical significance, however, is not known.
- Published
- 2000
39. Congenital Plasmodium ovale malaria in an infant born to HIV positive mother
- Author
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Carlo Giaquinto, Anita De Rossi, Martina Penazzato, Osvalda Rampon, Ettore De Canale, R. D'Elia, and Antonio Mazza
- Subjects
Pediatrics ,medicine.medical_specialty ,Pregnancy ,biology ,business.industry ,Anemia ,Viral culture ,medicine.disease ,Plasmodium ovale ,biology.organism_classification ,Virology ,Congenital malaria ,Zidovudine ,Infectious Diseases ,Pediatrics, Perinatology and Child Health ,Medicine ,Hemoglobin ,medicine.symptom ,business ,Malaria ,medicine.drug - Abstract
We report a case of congenital Plasmodium ovale malaria in an infant born to an human immunodeficiency virus ositive Nigerian woman living in Italy throughout pregnancy. In the fifth week of life, while on prophylactic treatment with zidovudine (ZDV), 2 mg/kg/day, the baby developed marked anemia (Hemoglobin: 6.2 g/dL) without any other symptoms. Although ZDV was immediately stopped, the anemia worsened during a second determination (Hemoglobin: 5.4 g/dL), five days later when the mother could be contacted. Blood smear showed the presence of P. ovale, also confirmed by real-time polymerase chain reaction amplification and sequencing. The baby was hemotransfused and successfully treated with oral quinine sulphate (20 mg/kg/day) for five days and repeated blood smear became negative for malaria. Polymerase chain reaction and viral culture for human immunodeficiency virus at 4 months of age were negative. This report suggests that symptomatic congenital malaria may be present even in European countries and should be considered in the differential diagnosis of anemia in infants, born to human immunodeficiency virus positive immigrant mothers, receiving ZDV prophylaxis.
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