519 results on '"Clini E."'
Search Results
2. Influence of frailty on cardiovascular events and mortality in patients with Chronic Obstructive Pulmonary Disease (COPD): Study Protocol for a multicentre European observational study
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Verduri, A, primary, Clini, E, additional, Carter, B, additional, and Hewitt, J, additional
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- 2024
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3. Prevalence and development of chronic critical illness in acute patients admitted to a respiratory intensive care setting
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Marchioni, A., Tonelli, R., Sdanganelli, A., Gozzi, F., Musarò, L., Fantini, R., Tabbì, L., Andreani, A., Cappiello, G., Costi, S., Castaniere, I., and Clini, E.
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- 2020
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4. Baseline Exercise Tolerance and Perceived Dyspnea to Identify the Ideal Candidate to Pulmonary Rehabilitation: A Risk Chart in COPD Patients
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Costi S, Crisafulli E, Trianni L, Beghè B, Faverzani S, Scopelliti G, Chetta A, and Clini E
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chronic obstructive pulmonary disease ,pulmonary rehabilitation ,patient selection ,minimal clinically important difference ,exercise tolerance ,dyspnea ,disease management ,treatment outcome. ,Diseases of the respiratory system ,RC705-779 - Abstract
Stefania Costi,1 Ernesto Crisafulli,2 Ludovico Trianni,3 Bianca Beghè,4 Silvia Faverzani,5 Giuseppe Scopelliti,5 Alfredo Chetta,5 Enrico Clini4 1Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplants Oncology and Regenerative Medicine-University of Modena and Reggio Emilia and Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy; 2Department of Medicine, Respiratory Medicine Unit and Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy; 3Rehabilitation Unit-Hospital Villa Pineta, Pavullo Nel Frignano, Modena, Italy; 4Department of Medical and Surgical Sciences-University of Modena and Reggio Emilia and University Hospital of Modena Policlinico, Modena, Italy; 5Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, ItalyCorrespondence: Ernesto CrisafulliDepartment of Medicine, Respiratory Medicine Unit and Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, ItalyEmail ernesto.crisafulli@univr.itBackground: The appropriate criteria for patient selection are still a key issue in the clinical management of patients referred to pulmonary rehabilitation (PR).Methods: We retrospectively analyzed the records of a wide population of 1470 outpatient or inpatients with chronic obstructive pulmonary disease (COPD) referred to standard PR at two specialized Italian centers. Two models of multivariate logistic regression were developed to test the predictive powers of baseline exercise tolerance, namely the distance walked in 6 mins (6MWD), and of baseline dyspnea on exertion, measured by the modified Medical Research Council scale (mMRC), versus the minimal clinically important difference (MCID) for the same outcomes.Results: Compared to the category of individuals with 6MWD >350 meters, those patients with 201–350 meters and ≤200 meters showed a higher probability (p
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- 2019
5. Bronchiectasis as long-term complication of acute fire smoke inhalation?
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Rizzato, S., Tacconi, M., Andrisani, D., Luppi, F., Clini, E., and Cerri, S.
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- 2024
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6. Bronchiectasis as long-term complication of acute fire smoke inhalation?
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Rizzato, S., primary, Tacconi, M., additional, Andrisani, D., additional, Luppi, F., additional, Clini, E., additional, and Cerri, S., additional
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- 2023
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7. Respiratory Mechanics and Diaphragmatic Dysfunction in COPD Patients Who Failed Non-Invasive Mechanical Ventilation
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Marchioni A, Tonelli R, Fantini R, Tabbì L, Castaniere I, Livrieri F, Bedogni S, Ruggieri V, Pisani L, Nava S, and Clini E
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acute exacerbation of copd ,non-invasive mechanical ventilation ,respiratory failure ,transdiaphragmatic pressure. ,Diseases of the respiratory system ,RC705-779 - Abstract
Alessandro Marchioni,1 Roberto Tonelli,1,2 Riccardo Fantini,1 Luca Tabbì,1 Ivana Castaniere,1,2 Francesco Livrieri,1,3 Sabrina Bedogni,4 Valentina Ruggieri,1 Lara Pisani,5 Stefano Nava,5 Enrico Clini1 1University Hospital of Modena, Pneumology Unit and Center for Rare Lung Diseases, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy; 2PhD Course in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy; 3Respiratory Disease Unit, Hospital Carlo Poma, Mantova, Italy; 4School of Medicine, University of Modena and Reggio Emilia, Modena, Italy; 5Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), University of Bologna, Bologna, ItalyCorrespondence: Roberto TonelliUniversity Hospital of Modena, Pneumology Unit and Center for Rare Lung Diseases, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Via del Pozzo, 71 – 41125, Modena, ItalyTel +39-342-7241672Email roberto.tonelli@me.com Skype roberto.tonelli150288Background: Although non-invasive mechanical ventilation (NIV) is the gold standard treatment for patients with acute exacerbation of COPD (AECOPD) developing respiratory acidosis, failure rates still range from 5% to 40%. Recent studies have shown that the onset of severe diaphragmatic dysfunction (DD) during AECOPD increases risk of NIV failure and mortality in this subset of patients. Although the imbalance between the load and the contractile capacity of inspiratory muscles seems the main cause of AECOPD-induced hypercapnic respiratory failure, data regarding the influence of mechanical derangement on DD in this acute phase are lacking. With this study, we investigate the impact of respiratory mechanics on diaphragm function in AECOPD patients experiencing NIV failure.Methods: Twelve AECOPD patients with respiratory acidosis admitted to the Respiratory ICU of the University Hospital of Modena from 2017 to 2018 undergoing mechanical ventilation (MV) due to NIV failure were enrolled. Static respiratory mechanics and end-expiratory lung volume (EELV) were measured after 30 mins of volume control mode MV. Subsequently, transdiaphragmatic pressure (Pdi) was calculated by means of a sniff maneuver (Pdisniff) after 30 mins of spontaneous breathing trial. Linear regression analysis and Pearson’s correlation coefficient served to assess associations.Results: Average Pdisniff was 23.3 cmH2O (standard deviation 29 cmH2O) with 3 patients presenting bilateral diaphragm palsy. Pdisniff was directly correlated with static lung elastance (r=0.69, p=0.001) while inverse correlation was found with dynamic intrinsic PEEP (r=−0.73, p=0.007). No significant correlation was found with static intrinsic PEEP (r=−0.55, p=0.06), EELV (r=−0.4, p=0.3), airway resistance (r=−0.2, p=0.54), chest wall, and total elastance (r=−0-01, p=0.96 and r=0.3, p=0.36, respectively). Significant linear inverse correlation was found between Pdisniff and the ratio between Pdi assessed at tidal volume and Pdi sniff (r=−0.82, p=0.02).Conclusion: The causes of extreme DD in AECOPD patients who experienced NIV failure might be predominantly mechanical, driven by a severe dynamic hyperinflation that overlaps on an elastic lung substrate favoring volume overload.Keywords: acute exacerbation of COPD, non-invasive mechanical ventilation, respiratory failure, transdiaphragmatic pressure
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- 2019
8. Association between respiratory distress time and invasive mechanical ventilation in COVID-19 patients: A multicentre regional cohort study
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Busani, S., Coloretti, I., Baciarello, M., Bellini, V., Sarti, M., Biagioni, E., Tonelli, R., Marchioni, A., Clini, E., Guaraldi, G., Mussini, C., Meschiari, M., Tonetti, T., Pisani, L., Nava, S., Bignami, E., Ranieri, M.V., and Girardis, M.
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- 2024
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9. LABA/LAMA fixed-dose combinations in patients with COPD: a systematic review
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Rogliani P, Calzetta L, Braido F, Cazzola M, Clini E, Pelaia G, Rossi A, Scichilone N, and Di Marco F
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LABA ,LAMA ,fixed-dose combination ,COPD ,systematic review. ,Diseases of the respiratory system ,RC705-779 - Abstract
Paola Rogliani,1 Luigino Calzetta,1 Fulvio Braido,2 Mario Cazzola,1 Enrico Clini,3 Girolamo Pelaia,4 Andrea Rossi,5 Nicola Scichilone,6 Fabiano Di Marco7 1Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy; 2Department of Internal Medicine, IRCCS San Martino Genoa University Hospital, Genoa, Italy; 3Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy; 4Department of Medical and Surgical Sciences, Section of Respiratory Diseases, Magna Græcia University, Catanzaro, Italy; 5Pulmonary Unit, University of Verona, Verona, Italy; 6Department of Internal Medicine, University of Palermo, Palermo, Italy; 7Department of Health Sciences, Università degli Studi di Milano, Respiratory Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy Objectives: The aim of this study was to assess the current evidence for long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA) fixed-dose combinations (FDCs) in the treatment of COPD.Materials and methods: A systematic literature search of randomized controlled trials published in English up to September 2017 of LABA/LAMA FDCs vs LABA or LAMA or LABA/inhaled corticosteroid (ICS) FDCs in COPD patients was performed using PubMed, Embase, Scopus, and Google Scholar. Outcomes including forced expiratory volume in 1 second (FEV1), Transition Dyspnea Index (TDI) scores, St George’s Respiratory Questionnaire (SGRQ) scores, exacerbations, exercise tolerance (endurance time [ET]), inspiratory capacity (IC), and rescue medication use were evaluated.Results: In total, 27 studies were included in the review. LABA/LAMA FDCs significantly improved lung function (FEV1) at 12 weeks compared with LABA or LAMA or LABA/ICS. These effects were maintained over time. Significant improvements with LABA/LAMA FDCs vs each evaluated comparator were also observed in TDI and SGRQ scores, even if significant differences between different LABA/LAMA FDCs were detected. Only the LABA/LAMA FDC indacaterol/glycopyrronium has shown superiority vs LAMA and LABA/ICS for reducing exacerbation rates, while olodaterol/tiotropium and indacaterol/glycopyrronium have been shown to improve ET and IC vs the active comparators. Rescue medication use was significantly reduced by LABA/LAMA FDCs vs the evaluated comparators. LABA/LAMA FDCs were safe, with no increase in the risk of adverse events with LABA/LAMA FDCs vs the monocomponents.Conclusion: Evidence supporting the efficacy of LABA/LAMA FDCs for COPD is heterogeneous, particularly for TDI and SGRQ scores, exacerbation rates, ET, and IC. So far, indacaterol/glycopyrronium is the LABA/LAMA FDC that has the strongest evidence for superiority vs LABA, LAMA, and LABA/ICS FDCs across the evaluated outcomes. LABA/LAMA FDCs were safe; however, more data should be collected in a real-world setting to confirm their safety. Keywords: LABA, LAMA, fixed-dose combination, COPD, systematic review
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- 2018
10. Prevalence of asthma and COPD in a cohort of patients at the follow up after COVID-19 pneumonia
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Verduri, A., primary, Hewitt, J., additional, Carter, B., additional, Tonelli, R., additional, Clini, E., additional, and Beghè, B., additional
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- 2023
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11. Accuracy of Nasal Pressure Swing to Predict Failure of High Flow Nasal Oxygen in Patients With Acute Hypoxemic Respiratory Failure
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Bruzzi, G., primary, Tonelli, R., additional, Cortegiani, A., additional, Fantini, R., additional, Tabbì, L., additional, Castaniere, I., additional, Manicardi, L., additional, Moretti, A., additional, Cerbone, C., additional, Gozzi, F., additional, Andrisani, D., additional, Baroncini, S., additional, Busani, S., additional, Ball, L., additional, Clini, E., additional, and Marchioni, A., additional
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- 2023
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12. Bronchiectasis as long-term complication of acute fire smoke inhalation?
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Rizzato, S, Tacconi, M, Andrisani, D, Luppi, F, Clini, E, Cerri, S, Rizzato, S, Tacconi, M, Andrisani, D, Luppi, F, Clini, E, and Cerri, S
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- 2023
13. Differences between acute exacerbations of idiopathic pulmonary fibrosis and other interstitial lung diseases
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Faverio, P, Stainer, A, Conti, S, Madotto, F, De Giacomi, F, Zoppa, M, Vancheri, A, Pellegrino, M, Tonelli, R, Cerri, S, Clini, E, Mantovani, L, Pesci, A, Luppi, F, Faverio P., Stainer A., Conti S., Madotto F., De Giacomi F., Zoppa M. D., Vancheri A., Pellegrino M. R., Tonelli R., Cerri S., Clini E. M., Mantovani L. G., Pesci A., Luppi F., Faverio, P, Stainer, A, Conti, S, Madotto, F, De Giacomi, F, Zoppa, M, Vancheri, A, Pellegrino, M, Tonelli, R, Cerri, S, Clini, E, Mantovani, L, Pesci, A, Luppi, F, Faverio P., Stainer A., Conti S., Madotto F., De Giacomi F., Zoppa M. D., Vancheri A., Pellegrino M. R., Tonelli R., Cerri S., Clini E. M., Mantovani L. G., Pesci A., and Luppi F.
- Abstract
Interstitial lung diseases (ILDs) comprise a wide group of pulmonary parenchymal disorders. These patients may experience acute respiratory deteriorations of their respiratory condition, termed “acute exacerbation” (AE). The incidence of AE-ILD seems to be lower than idiopathic pulmonary fibrosis (IPF), but prognosis and prognostic factors are largely unrecognized. We retrospectively analyzed a cohort of 158 consecutive adult patients hospitalized for AE-ILD in two Italian university hospitals from 2009 to 2016. Patients included in the analysis were divided into two groups: non-IPF (62%) and IPF (38%). Among ILDs included in the non-IPF group, the most frequent diagnoses were non-specific interstitial pneumonia (NSIP) (42%) and connective tissue disease (CTD)-ILD (20%). Mortality during hospitalization was significantly different between the two groups: 19% in the non-IPF group and 43% in the IPF group. AEs of ILDs are difficult-to-predict events and are burdened by relevant mortality. Increased inflammatory markers, such as neutrophilia on the differential blood cell count (HR 1.02 (CI 1.01–1.04)), the presence of pulmonary hypertension (HR 1.85 (CI 1.17–2.92)), and the diagnosis of IPF (HR 2.31 (CI 1.55–3.46)), resulted in negative prognostic factors in our analysis. Otherwise, lymphocytosis on the differential count seemed to act as a protective prognostic factor (OR 0.938 (CI 0.884–0.995)). Further prospective, large-scale, real-world data are needed to support and confirm the impact of our findings.
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- 2021
14. Comments on “Preventive home therapy for symptomatic patients affected by COVID-19 and followed by teleconsultations” by D'Amato et al
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Adiletta, G, Baglioni, S, Bettoncelli, G, Bracciale, P, Cazzola, M, Clini, E, Cutrera, R, D'Adduzio, F, de Blasio, F, Ferraro, F, Fumagalli, R, Lequaglie, C, Matera, M, Numis, F, Palange, P, Picciolo, S, Potena, A, Romano, F, Sabato, E, Sacchetta, A, Spatafora, M, Stefanelli, F, Zottola, C, Adiletta G., Baglioni S., Bettoncelli G., Bracciale P., Cazzola M., Clini E. M., Cutrera R., D'Adduzio F., de Blasio F., Ferraro F., Fumagalli R., Lequaglie C., Matera M. G., Numis F., Palange P., Picciolo S., Potena A., Romano F., Sabato E., Sacchetta A., Spatafora M., Stefanelli F., Zottola C., Adiletta, G, Baglioni, S, Bettoncelli, G, Bracciale, P, Cazzola, M, Clini, E, Cutrera, R, D'Adduzio, F, de Blasio, F, Ferraro, F, Fumagalli, R, Lequaglie, C, Matera, M, Numis, F, Palange, P, Picciolo, S, Potena, A, Romano, F, Sabato, E, Sacchetta, A, Spatafora, M, Stefanelli, F, Zottola, C, Adiletta G., Baglioni S., Bettoncelli G., Bracciale P., Cazzola M., Clini E. M., Cutrera R., D'Adduzio F., de Blasio F., Ferraro F., Fumagalli R., Lequaglie C., Matera M. G., Numis F., Palange P., Picciolo S., Potena A., Romano F., Sabato E., Sacchetta A., Spatafora M., Stefanelli F., and Zottola C.
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- 2021
15. Metabolic associated fatty liver disease is highly prevalent in the post-acute COVID syndrome
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Raggi, P., primary, Barbieri, S., additional, Milic, J., additional, Gozzi, L., additional, Brigo, A., additional, Beghe', B., additional, Verduri, A., additional, Clini, E., additional, Mussini, C., additional, Sebastiani, G., additional, and Guaraldi, G., additional
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- 2022
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16. Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial
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Perrone, F, Piccirillo, M, Ascierto, P, Salvarani, C, Parrella, R, Marata, A, Popoli, P, Ferraris, L, Marrocco-trischitta, M, Ripamonti, D, Binda, F, Bonfanti, P, Squillace, N, Castelli, F, Muiesan, M, Lichtner, M, Calzetti, C, Salerno, N, Atripaldi, L, Cascella, M, Costantini, M, Dolci, G, Facciolongo, N, Fraganza, F, Massari, M, Montesarchio, V, Mussini, C, Negri, E, Botti, G, Cardone, C, Gargiulo, P, Gravina, A, Schettino, C, Arenare, L, Chiodini, P, Gallo, C, Vitale, M, Trojaniello, C, Palla, M, Bianchi, A, De Feo, G, Miscio, L, Froldi, M, Menicanti, L, Cuppone, M, Gobbo, G, Baldessari, C, Valenti, V, Castelvecchio, S, Poli, F, Giacomazzi, F, Piccinni, R, Annnunziata, M, Biondi, A, Bussolari, C, Mazzoleni, M, Giachi, A, Filtz, A, Manini, A, Poletti, E, Masserini, F, Conforti, F, Gaudiano, G, Favero, V, Moroni, A, Viva, T, Fancoli, F, Ferrari, D, Niro, D, Resta, M, Ballotta, A, Poli, M, Ranucci, M, Tebaldi, A, Gritti, G, Pasulo, L, Gaglio, L, Del Fabbro, R, Alborghetti, L, Giustinetti, G, Columpsi, P, Cazzaniga, M, Capici, S, Sala, L, Di Sciacca, R, Mosca, G, Pirozzi, M, Franceschini, F, Roccaro, A, Salvetti, M, Paini, A, Corda, L, Ricci, C, Tomasoni, L, Nasta, P, Lorenzotti, S, Odolini, S, Foca, E, Roldan, E, Metra, M, Magrini, S, Borghetti, P, Latronico, N, Piva, S, Filippini, M, Tomasoni, G, Zuccala, F, Cattaneo, S, Scolari, F, Bossini, N, Gaggiotti, M, Properzi, M, Del Giudice, E, Marocco, R, Carraro, A, Del Borgo, C, Belvisi, V, Tieghi, T, De Masi, M, Zuccala, P, Fabietti, P, Vetica, A, Mercurio, V, Fondaco, L, Kertusha, B, Curtolo, A, Lubrano, R, Zotti, M, Puorto, A, Ciuffreda, M, Sarni, A, Monteforte, G, Romeo, D, Viola, E, Damiani, C, Barone, A, Mantovani, B, Di Sanzo, D, Gentili, V, Carletti, M, Aiuti, M, Gallo, A, Meliante, P, Martellucci, S, Riggio, O, Cardinale, V, Ridola, L, Bragazzi, M, Gioia, S, Valenzi, E, Graziosi, C, Bina, N, Fasolo, M, Ricci, S, Gioacchini, M, Lucci, A, Corso, L, Tornese, D, Nijhawan, P, Equitani, F, Cosentino, C, Palladino, M, Leonetti, F, Leto, G, Gnessi, C, Campagna, G, Cesareo, R, Marrocco, F, Straface, G, Mecozzi, A, Cerbo, L, Isgro, V, Parrocchia, S, Visconti, G, Casati, G, Ariani, A, Donghi, L, Tacconelli, E, Bertoldi, M, Cattaneo, P, Lambertenghi, L, Motta, L, Omega, L, Albano, G, Scarano, F, De Rosa, A, Buglione, A, Lavoretano, S, Gaglione, G, De Marco, M, Sangiovanni, V, Fusco, F, Viglietti, R, Manzillo, E, Rescigno, C, Pisapia, R, Plamieri, G, Maraolo, A, Calabria, G, Catalano, M, Fiorentino, G, Annunziata, A, Polistina, G, Imitazione, P, Mollica, M, Esposito, V, D'Abraccio, M, Punzi, R, Bianco, V, Sbreglia, C, Del Vecchio, R, Bordonali, A, Franco, A, Salsi, P, Fontana, M, Virzi, G, Ornella, C, Molteni, A, Gennarini, S, Gnudi, U, Ricci, M, Titolo, G, Mensi, G, Vuotto, P, Gasperini, B, Mancini, M, Pasquini, Z, Spanu, P, Clementi, S, Pierini, S, Bokor, D, Gori, D, Ciofetti, M, Caimi, M, Bettazzi, L, Allevi, E, Furiani, S, Capitanio, C, Mastropasqua, B, Fara, C, Pulitano, G, Matsuno, J, Porta, F, Dolfini, V, Beyene, N, Bezzi, M, Novali, M, Viale, P, Tedeschi, S, Pascale, R, Bruno, R, Di Filippo, A, Sachs, M, Oggionni, T, Di Stefano, M, Mengoli, C, Facchini, C, Daniele, D, Frausini, G, Mucci, L, Tedesco, S, Girolimetti, R, Manfredini, E, Di Carlo, A, Espinosa, E, Dennetta, D, Ticinesi, A, Meschi, T, Nouvenne, A, Claudio, N, Vitale, F, Saracco, M, Codeluppi, M, Fronti, E, Ferrante, P, Nespola, G, Francisci, D, Tosti, A, Carbonelli, C, Greco, A, Tinti, M, Stellini, R, Appiani, C, Reghenzi, P, Poletti, V, Ravaglia, C, Tacconi, D, Malcontenti, C, Sainaghi, P, Landi, R, Vassia, V, Rizzi, E, Bellan, M, Rossati, A, Castello, L, Mastroianni, C, Russo, G, Fabio, T, Serino, F, Brollo, L, Momesso, E, Turati, M, Monforte, A, Marchetti, G, Boni, F, Teopompi, E, Trenti, C, Boracchia, L, Minelli, E, Ghidoni, G, Matei, A, Caruso, A, Arcoleo, G, Camarda, G, Catalano, F, Spatafora, M, Bettega, D, Andreoni, M, Teti, E, Sarmati, L, Di Lorenzo, A, Celeste, M, Baratto, F, Monticelli, J, Criveller, P, Andrea, A, Anselmo, R, Castellano, M, Cappelli, C, Corvini, F, Zanini, B, Crippa, M, Ronconi, M, Costa, R, Casella, S, Brentana, L, Bernardi, L, Frascati, A, Panese, S, Presotto, F, Michieletto, L, Bernardi, C, Fusar, M, Agnoletti, V, Farina, M, Russo, Lavorini, F, Ginanni, R, Palmieri, F, Mosti, S, Amaglio, A, Cattaneo, A, Cirri, S, Montisci, A, Gallazzi, C, Cosseta, D, Baronio, B, Rampa, L, Maggi, P, Messina, V, Berlendis, M, Sabatti, M, Palumbo, M, Mazzone, A, Faggioli, P, Bussini, L, Fornaro, G, Volpato, F, Imperiale, D, Manno, E, Ferreri, E, Martelli, D, Verhovez, A, Giorgis, S, Faccio, L, Quadri, R, Negro, C, Converso, M, Bosco, F, Amadasi, S, Prandini, P, Cocchi, S, Manfrin, V, Del Punta, V, Mazzola, G, Sportato, G, Romagnoli, M, Cristini, F, Facondini, F, Perin, T, Boschi, A, Meschiari, M, Guaraldi, G, Modica, S, Moneta, S, Boccalatte, D, Marchetti, V, Ebbreo, G, Dale, M, Tura, P, Rizzoni, D, Boari, G, Bonetti, S, Marini, E, Daniele, I, Grossi, P, Delfrate, N, Bernhart, O, Spizzo, G, Mahlknecht, K, Volkl, T, Di Pietro, M, Trezzi, M, Monacci, C, Peris, A, Bonizzoli, M, Cavanna, L, Moroni, C, Stroppa, E, Savio, M, Gatti, F, Bartolaminelli, C, Petrosillo, N, Donno, D, Taglietti, F, Topino, S, Chinello, P, Galati, V, D'Offizi, G, Taibi, C, Cimolato, B, Moroni, F, Palagano, N, Pelagatti, L, Cristiana, S, Landini, G, Amitrano, M, Raimondo, M, Mangiacapra, S, Romano, A, Atteno, M, Blanc, P, Suardi, L, Pallotto, C, Casinelli, K, Uccella, I, Harari, S, Caminati, A, Lipani, F, Di Perri, G, Calcagno, A, Calleri, G, Montrucchio, C, Caputo, A, Cozzio, S, Donne, L, Bassetti, M, Malgorzata, M, Nicolini, L, Russo, C, Sepulcri, C, Beltramini, S, Mina, F, Puoti, M, Gandino, A, Langer, T, D'Amico, F, Rocchetti, C, Cettolo, F, Gabriele, F, Bocchi, P, Cioni, G, Cappi, C, Corcione, S, De Rosa, F, Scabini, S, Canta, F, Pinna, S, Pensa, A, Rocco, M, Cirasa, M, Spinicci, M, Mencarini, J, Zammarchi, L, Giovanni, C, Sciole, K, Bassi, F, Bianchi, M, Frigerio, S, Spaziani, S, Nucera, A, Rizzardini, G, Cossu, M, Antivalle, M, Carpinteri, G, Macheda, S, Labate, D, Bottiroli, M, Erne, E, Cristina, Z, Di Biase, V, Malberti, F, Montani, G, Poisa, P, Bettini, D, Cauda, R, Ciccullo, A, Riccardi, N, Angheben, A, Turrini, M, Clerici, R, Gardellini, A, Liparulo, L, Rossini, T, Ucciferri, C, Cipollone, F, Vecchiet, J, Nico, A, Marra, L, Leone, A, Sdanganelli, A, Palmiotti, G, D'Alagni, G, Santantonio, T, Caputo, S, Bottalico, I, Ponticiello, A, Di Perna, F, Bernardi, E, Beltrame, A, Bravi, S, David, M, Bernardi, P, Galante, D, Uccelli, M, Prestini, K, Drera, M, Zini, E, Peregrinelli, A, Blanzuoli, L, Benedetti, V, Calvi, R, Scaglione, N, Nallino, G, Bonazzi, M, Crespi, T, Masolin, T, Regazzetti, A, Cerri, M, Maffezzini, E, Piazza, M, Papetti, C, Filippi, C, Roveda, E, Cipolla, G, Scozzafava, M, Crepaldi, M, Henchi, S, Vanoni, N, Repossi, A, Vezzoli, M, Scorletti, E, Perugini, O, Pasini, S, Pacetti, V, Ferrari, L, de Paduanis, G, Del Duca, S, Dell'Ara, F, 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L., Bottalico I., Ponticiello A., Di Perna F., Bernardi E., Beltrame A., Bravi S., David M., Bernardi P., Galante D., Uccelli M. C., Prestini K., Drera M., Zini E., Peregrinelli A., Blanzuoli L., Benedetti V., Calvi R., Scaglione N., Nallino G., Bonazzi M., Crespi T., Masolin T., Regazzetti A., Cerri M. C., Maffezzini E., Piazza M., Papetti C., Filippi C. D., Roveda E., Cipolla G., Scozzafava M., Crepaldi M., Henchi S., Vanoni N., Repossi A., Vezzoli M., Scorletti E., Perugini O., Pasini S. M., Pacetti V., Ferrari L., de Paduanis G. A., Del Duca S., Dell'ara F., Brocchieri A., Minoja G., Storti E., Pitagora L., Costa I., Delfanti F., Orlandi M., Ruggeri R., Ruggieri L., Livigni S., Silengo D., Ageno W., Pedrini L., Artiol S., Morbidoni L., De Donno G., Ravagnani V., Inglese F., Scotton P. G., Costantini P., Delucchi M., Clini E., Ansuini A., Marco B., Giuseppe L., Vincenzo B., Rastelli G., Doria A., Vianello A., Cattelan A. M., Bindoli S., Felicietti M., Canetta C., Scartabellati A., Accordino S., Ferrara M., Cocco L., Cirillo F., Pace E., De Caro M., Alberico M., Benigni G., Damiano T., Fusco P., Iuorio A., Torretta G., Racagni M., Muttini S., Sala G., Ghiringhelli P., Chiumiento F., Baccari L., Luca B., Bocchi F., Benatti F., Catellani J., Coppola M., Papi A., Bosco E., Lazzeri C., Cesira N., Puttini C., Carli T., Croci L., Corridi M., Arlotti M., Guerrini G., Cola L., Romanelli M., Bonifazi M., Gasparini S., Mei F., Cerutti E., Lacedonia D., Santoro A., Guidelli G. M., Greco S., Castellan A., Infantino G., Camici L., Frigieri F. C., Pavoni V., Migliori L., Rossetti B., Montagnini F., Mauro I., Genovese E., Capuozzo A., Vitiello L., Sirignano E., Gnesin P., Servillo G., Marinelli A., Pasero D., Casadio L., Babudieri S., Madeddu G., De Vito A., Ranghitta M., Passalacqua R., Antonio F., Gentile I., Buonomo A. R., Scotto R., Zappulo E., Dell'aquila G., Bianchetti A., Guerini F., Vallone A., Oppedisano P., Pusterla L., Giglio O., Sartori E., Zanardini C., Gatti P., Vincenzo V., Piconi S., Molteni C., Dognini G., Cosimo F., Guarneri L., Pulvirenti F., Mondino V., Traballi G., Iemoli E., Grisolia A., Giorgi R., Nucera G., Raffaelli V., Marino P., Negro E., Serati L., Silvia T., Iacobello C., Strano G., Boglione L., Catania A., Gipponi P., Di Cato L., Panaccione A., Vitale G., Crippa I. A., Giacomini M., Basile A., Andrea B., Tundo P., Buzzigoli S., Palmiero G., Magnaca A., Silva M., Ricci M., Crespi S., Pasquino B., Consales G., Bragantini D., Mastroianni F., Righetti G., Scarafino A., Bitetto M., Franzetti F., Piga S., Delmonte V., Carbonara S., Losappio R., Dejaco C., Mastroianni C., Del Bono V., Gilioli F., Barzan D., De Struppi S., Carlotto A., Guadagnin M. L., Girardis M., Bertellini E., Dentali F., Foresta G., Baratta A., Viviani R., Agrati A. M., Perego G. B., Montineri A., Manuele R., Bonfante S., Aquilini D., Prozzo A., Santopuoli D., Di Rosa Z., Alborghetti A., Peci P., Bakhtadze N., Pandini C. S., Ashofarir N., Casella G., Spagnolli W., Urru S., Marchesoni I., Caminiti G., Argilloni E., Danieli E., Ghirardi G., Antonioli C. M., Lipari A., Zavarise P., Kokaly F., Polati E., Gottin L., Lucernoni P., De Conti F., Marcon E., Pontali E., Vacca E. B., Saffioti C., Zunino A., Pognuz E. R., Berlot G., Saltori M., Tedesco A., Agostini C., Di Rosolini M. A., Marino F., Bellinzona G., Grassi W., Di Carlo M., Scimonello G., Nonini S., Mondino M., Mantovani L. F., Tenti E., Tropea C. M. G., Di Stefano D. E., Guelfi P., Dagna L., Morgana G., Montemurro L., Girelli D., Crisafulli E., Maroccia A., Cemuschi A. M., Bernasconi M., Zummo U., Barbato V., Bevilacqua S., Buonfanti G., Canzanella G., De Matteis G., Florio M., Martino M., Ribecco M. T., Romano F., Savio A., Sparavigna L., Curvietto M., Citarella M., Nava V., Maggioni P., Magni M., Iommelli C., Bianco A., Corsini R., Valli L., Ruggieri M. P., Mancini A., Melica T., Ferrari A., Cicognini D., Delliponti M., Zuccarini A., Ciani S., Raffaeli D., Donati L., Cannizzo S., Lui S., Santini L., Roncaglia E., Mighali P., Eisendle F., Cerino G., Citterio C., Di Nunzio C., Lamonica S., Resimini S., Sarteschi G., Pavei C., Battistini N., Gazzola E., Miceli M., Pontiggia S., Lonati V., Giannandrea G., Sortino C., Ravani S., Uggeri C., Jocolle G., Bare C., Baroni I., De Candia D., Fiorini B., Chierico K., Romeo F., Bottega R., Boccasile L., Corsaro A., Spadoni C., Ria E., Chiari S., Ercolino G., Dell'uomo V., Viri S., Minato M., Gazzola L., Dorina B., Gianelli D., Maspero S., Farinazzo M., Zanini P., Sangiovanni A., Del Giudice A., Dragonetti M. M., Bordignon S., Machiavelli A. M., Chiodelli G., Spatarella M., Zenoni D., Beretta F. N., Santilli G., Badagliacca R., Angileri M., Giannelli L., Campomori A., Maimone P., Fadda A., Faoro S., Pisterna A., Cacopardo B., Marino A., Pampaloni A., Celesia B. M., Cinnella G., Labella D., Caporusso R. R., Danzi M., Fiscon M., Malena M., Fendt D., Nardi S., Stobbione P., Savi M. L., De Monte A., Scala A., Liberato N. L., Luchi S., Vincenti A., Cabrini L., Pinelli G., Brugioni L., Potenza D., Numis F. G., Porta G., D'amico M., Iengo B., Angarano G., Saracino A., Blasi L., De Negri P., Angelici S., Farina A., Martino G. P., Bitti G., Tedeschi A., De Ponti S., Agostinone A., Parruti G., Consorte A., Frattari A., Filippelli A., Pagliano P., Masullo A., Sellitto C., Reta M., Rossi N., Raumer L., Andreassi S., Brancaleoni P., Carai A., Salerno A. M., Marinangeli F., Mariani R., Ciccone A., Meschini C., Santoboni G., Angrisani C., Micarelli D., Tarquini G., Fregoni V., Volta C. A., Cherubini A., Del Prete M. S., Ciarrochi E., Tasca F., Ballarin A., Bianchin A., Flocco R., Cuzzone V., Carpinteri M., Gallotti P., Torre F., Zannetti P., Crapis M., Venturini S., Barattini M., Gori G., Mastroianni A., De Stefano G., Gilio M., Rapisarda G., Gulisano L., Granata M. L., Saglimbene S., Montalto M. T., Grasso I., De Luca S., Magro G., Messina F., Scapino B., Abrate P., Francisco C., Pesce L., Navarra M., Agosti M., Pagani S., Piluso M., Ricioppo A., Tognella S., Rovere P., Vincenzi M., Ghirardi L., Generali D., Ingrosso M., Desiderio E., Molaro R., Vitiello S., Lancione L., Paone T. C., Meli A., Mainardi S., Rastellino V., Ursillo A., Grigoli P. D., Bovetto E., Stefanetto I. M., Mazzola F., Daniele A., Bisio C., Delnero P., Morando G., Nava A., Francesco L., Fiammengo F., Regis M., Roccatello D., Sabato E., Liccardi M. M., Bretto C., Lutri L., Castenetto E., Roberti G., Guidi M. F., Bini F., Zappa M. C., Trequattrini T., Rivitti R., Vigliarolo R., Succu A., Lilli M., Serao M., Giogre G., Ruggieri A., Flores K., Vairo G., Satira R., Lingua A., Spina R., Nicastri E., Maffongelli G., Barreca F., Scollet S., Franchi F., Fabbri C., Minuz P., Dalbeni A., Zanatta P., Gelormini D., Mandelli A., Galderisi F., Zoia E., Marchi M. R., Neves N. D. A., Carbone G., Di Caterino E., Petrone A., Usai C. A., Bandiera F., Monti R., Hofer A., Castiglione G., Angeletti C., Tarsia P., Veronese L., Artoni P. D., Larussa D., Fumagalli R., Brioschi P., Cerutti A., Pasquino P., Gilberto F., Cantadori L., Tomasoni L. R., Coppola N., Spolveri S., Pollastri C., Fico L., Principi T., Pierantozzi S., Fontana C. C., Lubrano G., Martinelli L., Navalesi P., Serra E., Cogi E., Manzi A., Furino E., Dasseni N., Gentilini C., Benatti E., Pignatti A., Aiello G., Milia M., Covesnon M. G., Brianti A., Francesco C., Ilaria B., Pagnozzi F., Mietta S., Rossi A., Maroni L., Borroni V., Bellintani C., Sgarabotto C., Bizzotto G., Bucci L., Spagnuolo G., Agostini M., Caria F. C., Testa F., De Palma R., Murdaca G., Zanolini G., Sala N., Righini E., Pontremoli R., Aondio G., Riccardi F., De Cristoforo M. G., De Michele F., Storti A., Perra R., Deidda S., Enrica C., Valastro F., Pierfranceschi M. G., De Gennaro F., Nardecchia A. L., Castellini M., Buetto G., Ippoliti G., Sicheri D., Bottoli M. G., De Arroyabe B. M. L., Versaci A., Pallotti G., Civita M., Grio M., Liuzzi N., Molino P., Pastorelli M., Ricchiardi A., Varbella F., Zeme A. D., Sighieri C., Portale G., Olivetti A., Pagnoni C., Moschini G., Boni S., Guerra A., Scudellari R., Vella S., Inchiostro S., Piazza O., Guarino S., Aldegheri G., Napoli G., Morettini A., Caldini E., Menicacci L., Pieralli F., Torrini M., Poggesi L., Visetti E. M., Mangano C., Visconti S., Maietta P., Banfi E., Cartella S., Venturi B., Nuceri A., Chiesa E., Pacentra E., Panzolato G., Giannotti M., Bianchi C., Pietrangelo A., Para O., Rutili M. S., Russo R., Lanfranco M., Scalabrino E., Tafuri A., Chiarello T., Perfetti E., Cancanelli L., Otero M., Pannella G., Bellucci F., Ferrero G., Vico C., Stillante M. S., D'andrea G., Amoroso F., Arcidiacono A., Bella A. M., Belsito A., Berte Y., Carubia G., Caruso M. G., Casella O., Chiereleson F., Costa C., De Franco D., Germana G., Messina A., Musumeci D., Noto C., Valenti M., Sorrentino C., Panico R., Schettino G., Piccoli J., Pepe A., De Rosa F., Ottaviano M., Marrazzo G., Raponi G., Diberardino S., Bausi S., Marini S. F., Giubellino E., Innocenti G., Gugliemi G., Maccari D., Baciu I., Perrone, F, Piccirillo, M, Ascierto, P, Salvarani, C, Parrella, R, Marata, A, Popoli, P, Ferraris, L, Marrocco-trischitta, M, Ripamonti, D, Binda, F, Bonfanti, P, Squillace, N, Castelli, F, Muiesan, M, Lichtner, M, Calzetti, C, Salerno, N, Atripaldi, L, Cascella, M, Costantini, M, Dolci, G, Facciolongo, N, Fraganza, F, Massari, M, Montesarchio, V, Mussini, C, Negri, E, Botti, G, Cardone, C, Gargiulo, P, Gravina, A, Schettino, C, Arenare, L, Chiodini, P, Gallo, C, Vitale, M, Trojaniello, C, Palla, M, Bianchi, A, De Feo, G, Miscio, L, Froldi, M, Menicanti, L, Cuppone, M, Gobbo, G, Baldessari, C, Valenti, V, Castelvecchio, S, Poli, F, Giacomazzi, F, Piccinni, R, Annnunziata, M, Biondi, A, Bussolari, C, Mazzoleni, M, Giachi, A, Filtz, A, Manini, A, Poletti, E, Masserini, F, Conforti, F, Gaudiano, G, Favero, V, Moroni, A, Viva, T, Fancoli, F, Ferrari, D, Niro, D, Resta, M, Ballotta, A, Poli, M, Ranucci, M, Tebaldi, A, 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Corso, L, Tornese, D, Nijhawan, P, Equitani, F, Cosentino, C, Palladino, M, Leonetti, F, Leto, G, Gnessi, C, Campagna, G, Cesareo, R, Marrocco, F, Straface, G, Mecozzi, A, Cerbo, L, Isgro, V, Parrocchia, S, Visconti, G, Casati, G, Ariani, A, Donghi, L, Tacconelli, E, Bertoldi, M, Cattaneo, P, Lambertenghi, L, Motta, L, Omega, L, Albano, G, Scarano, F, De Rosa, A, Buglione, A, Lavoretano, S, Gaglione, G, De Marco, M, Sangiovanni, V, Fusco, F, Viglietti, R, Manzillo, E, Rescigno, C, Pisapia, R, Plamieri, G, Maraolo, A, Calabria, G, Catalano, M, Fiorentino, G, Annunziata, A, Polistina, G, Imitazione, P, Mollica, M, Esposito, V, D'Abraccio, M, Punzi, R, Bianco, V, Sbreglia, C, Del Vecchio, R, Bordonali, A, Franco, A, Salsi, P, Fontana, M, Virzi, G, Ornella, C, Molteni, A, Gennarini, S, Gnudi, U, Ricci, M, Titolo, G, Mensi, G, Vuotto, P, Gasperini, B, Mancini, M, Pasquini, Z, Spanu, P, Clementi, S, Pierini, S, Bokor, D, Gori, D, Ciofetti, M, Caimi, M, Bettazzi, L, Allevi, E, Furiani, S, Capitanio, C, Mastropasqua, B, Fara, C, Pulitano, G, Matsuno, J, Porta, F, Dolfini, V, Beyene, N, Bezzi, M, Novali, M, Viale, P, Tedeschi, S, Pascale, R, Bruno, R, Di Filippo, A, Sachs, M, Oggionni, T, Di Stefano, M, Mengoli, C, Facchini, C, Daniele, D, Frausini, G, Mucci, L, Tedesco, S, Girolimetti, R, Manfredini, E, Di Carlo, A, Espinosa, E, Dennetta, D, Ticinesi, A, Meschi, T, Nouvenne, A, Claudio, N, Vitale, F, Saracco, M, Codeluppi, M, Fronti, E, Ferrante, P, Nespola, G, Francisci, D, Tosti, A, Carbonelli, C, Greco, A, Tinti, M, Stellini, R, Appiani, C, Reghenzi, P, Poletti, V, Ravaglia, C, Tacconi, D, Malcontenti, C, Sainaghi, P, Landi, R, Vassia, V, Rizzi, E, Bellan, M, Rossati, A, Castello, L, Mastroianni, C, Russo, G, Fabio, T, Serino, F, Brollo, L, Momesso, E, Turati, M, Monforte, A, Marchetti, G, Boni, F, Teopompi, E, Trenti, C, Boracchia, L, Minelli, E, Ghidoni, G, Matei, A, Caruso, A, Arcoleo, G, Camarda, G, Catalano, F, Spatafora, M, Bettega, D, Andreoni, M, Teti, E, Sarmati, L, Di Lorenzo, A, Celeste, M, Baratto, F, Monticelli, J, Criveller, P, Andrea, A, Anselmo, R, Castellano, M, Cappelli, C, Corvini, F, Zanini, B, Crippa, M, Ronconi, M, Costa, R, Casella, S, Brentana, L, Bernardi, L, Frascati, A, Panese, S, Presotto, F, Michieletto, L, Bernardi, C, Fusar, M, Agnoletti, V, Farina, M, Russo, Lavorini, F, Ginanni, R, Palmieri, F, Mosti, S, Amaglio, A, Cattaneo, A, Cirri, S, Montisci, A, Gallazzi, C, Cosseta, D, Baronio, B, Rampa, L, Maggi, P, Messina, V, Berlendis, M, Sabatti, M, Palumbo, M, Mazzone, A, Faggioli, P, Bussini, L, Fornaro, G, Volpato, F, Imperiale, D, Manno, E, Ferreri, E, Martelli, D, Verhovez, A, Giorgis, S, Faccio, L, Quadri, R, Negro, C, Converso, M, Bosco, F, Amadasi, S, Prandini, P, Cocchi, S, Manfrin, V, Del Punta, V, Mazzola, G, Sportato, G, Romagnoli, M, Cristini, F, Facondini, F, Perin, T, Boschi, A, Meschiari, M, Guaraldi, G, Modica, S, Moneta, S, Boccalatte, D, Marchetti, V, Ebbreo, G, Dale, M, Tura, P, Rizzoni, D, Boari, G, Bonetti, S, Marini, E, Daniele, I, Grossi, P, Delfrate, N, Bernhart, O, Spizzo, G, Mahlknecht, K, Volkl, T, Di Pietro, M, Trezzi, M, Monacci, C, Peris, A, Bonizzoli, M, Cavanna, L, Moroni, C, Stroppa, E, Savio, M, Gatti, F, Bartolaminelli, C, Petrosillo, N, Donno, D, Taglietti, F, Topino, S, Chinello, P, Galati, V, D'Offizi, G, Taibi, C, Cimolato, B, Moroni, F, Palagano, N, Pelagatti, L, Cristiana, S, Landini, G, Amitrano, M, Raimondo, M, Mangiacapra, S, Romano, A, Atteno, M, Blanc, P, Suardi, L, Pallotto, C, Casinelli, K, Uccella, I, Harari, S, Caminati, A, Lipani, F, Di Perri, G, Calcagno, A, Calleri, G, Montrucchio, C, Caputo, A, Cozzio, S, Donne, L, Bassetti, M, Malgorzata, M, Nicolini, L, Russo, C, Sepulcri, C, Beltramini, S, Mina, F, Puoti, M, Gandino, A, Langer, T, D'Amico, F, Rocchetti, C, Cettolo, F, Gabriele, F, Bocchi, P, Cioni, G, Cappi, C, Corcione, S, De Rosa, F, Scabini, S, Canta, F, Pinna, S, Pensa, A, Rocco, M, Cirasa, M, Spinicci, M, Mencarini, J, Zammarchi, L, 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D., Ranucci M., Tebaldi A., Gritti G., Pasulo L., Gaglio L., Del Fabbro R., Alborghetti L., Giustinetti G., Columpsi P., Cazzaniga M., Capici S., Sala L., Di Sciacca R., Mosca G., Pirozzi M. R., Franceschini F., Roccaro A., Salvetti M., Paini A., Corda L., Ricci C., Tomasoni L., Nasta P., Lorenzotti S., Odolini S., Foca E., Roldan E. Q., Metra M., Magrini S., Borghetti P., Latronico N., Piva S., Filippini M., Tomasoni G., Zuccala F., Cattaneo S., Scolari F., Bossini N., Gaggiotti M., Properzi M., Del Giudice E., Marocco R., Carraro A., Del Borgo C., Belvisi V., Tieghi T., De Masi M., Zuccala P., Fabietti P., Vetica A., Mercurio V. S., Fondaco L., Kertusha B., Curtolo A., Lubrano R., Zotti M. G., Puorto A., Ciuffreda M., Sarni A., Monteforte G., Romeo D., Viola E., Damiani C., Barone A., Mantovani B., Di Sanzo D., Gentili V., Carletti M., Aiuti M., Gallo A., Meliante P. G., Martellucci S., Riggio O., Cardinale V., Ridola L., Bragazzi M. C., Gioia S., Valenzi E., Graziosi C., Bina N., Fasolo M., Ricci S., Gioacchini M. T., Lucci A., Corso L., Tornese D., Nijhawan P., Equitani F., Cosentino C., Palladino M., Leonetti F., Leto G., Gnessi C., Campagna G., Cesareo R., Marrocco F., Straface G., Mecozzi A., Cerbo L., Isgro V., Parrocchia S., Visconti G., Casati G., Ariani A., Donghi L., Tacconelli E., Bertoldi M., Cattaneo P., Lambertenghi L., Motta L., Omega L., Albano G., Scarano F., De Rosa A., Buglione A., Lavoretano S., Gaglione G., De Marco M., Sangiovanni V., Fusco F. M., Viglietti R., Manzillo E., Rescigno C., Pisapia R., Plamieri G., Maraolo A., Calabria G., Catalano M., Fiorentino G., Annunziata A., Polistina G., Imitazione P., Mollica M., Esposito V., D'abraccio M., Punzi R., Bianco V., Sbreglia C., Del Vecchio R. F., Bordonali A., Franco A., Salsi P., Fontana M., Virzi G., Ornella C., Molteni A., Gennarini S., Gnudi U., Ricci M. A., Titolo G., Mensi G., Vuotto P., Gasperini B., Mancini M., Pasquini Z., Spanu P., Clementi S., Pierini S., Bokor D., Gori D., Ciofetti M., Caimi M., Bettazzi L., Allevi E., Furiani S., Capitanio C., Mastropasqua B., Fara C., Pulitano G., Matsuno J. S., Porta F. D., Dolfini V., Beyene N. B., Bezzi M., Novali M., Viale P., Tedeschi S., Pascale R., Bruno R., Di Filippo A., Sachs M., Oggionni T., Di Stefano M., Mengoli C., Facchini C., Daniele D. N., Frausini G., Mucci L., Tedesco S., Girolimetti R., Manfredini E., Di Carlo A. M., Espinosa E., Dennetta D., Ticinesi A., Meschi T., Nouvenne A., Claudio N., Vitale F., Saracco M., Codeluppi M., Fronti E., Ferrante P., Nespola G. A., Francisci D., Tosti A., Carbonelli C. M., Greco A., Tinti M. G., Stellini R., Appiani C., Reghenzi P., Poletti V., Ravaglia C., Tacconi D., Malcontenti C., Sainaghi P. P., Landi R., Vassia V., Rizzi E., Bellan M., Rossati A., Castello L., Mastroianni C. M., Russo G., Fabio T., Serino F. S., Brollo L., Momesso E., Turati M. L., Monforte A. D., Marchetti G., Boni F., Teopompi E., Trenti C., Boracchia L., Minelli E., Ghidoni G., Matei A., Caruso A., Arcoleo G., Camarda G., Catalano F., Spatafora M., Bettega D., Andreoni M., Teti E., Sarmati L., Di Lorenzo A., Celeste M., Baratto F., Monticelli J., Criveller P., Andrea A., Anselmo Riccio, Castellano M., Cappelli C., Corvini F., Zanini B., Crippa M., Ronconi M., Costa R., Casella S., Brentana L., Bernardi L., Frascati A., Panese S., Presotto F., Michieletto L., Bernardi C., Fusar M., Agnoletti V., Farina M., Lavorini F., Ginanni R., Palmieri F., Mosti S., Amaglio A., Cattaneo A., Cirri S., Montisci A., Gallazzi C., Cosseta D., Baronio B., Rampa L., Maggi P., Messina V., Berlendis M., Sabatti M. C., Palumbo M., Mazzone A., Faggioli P., Bussini L., Fornaro G., Volpato F., Imperiale D., Manno E., Ferreri E., Martelli D., Verhovez A., Giorgis S., Faccio L., Quadri R. D., Negro C., Converso M., Bosco F., Amadasi S., Prandini P., Cocchi S., Manfrin V., Del Punta V., Mazzola G., Sportato G., Romagnoli M., Cristini F., Facondini F., Perin T., Boschi A., Meschiari M., Guaraldi G., Modica S., Moneta S., Boccalatte D., Marchetti V., Ebbreo G., Dale M., Tura P., Rizzoni D., Boari G. E. M., Bonetti S., Marini E., Daniele I., Grossi P. A., Delfrate N. W., Bernhart O., Spizzo G., Mahlknecht K., Volkl T., Di Pietro M. A., Trezzi M., Monacci C., Peris A., Bonizzoli M., Cavanna L., Moroni C., Stroppa E. M., Savio M. C., Gatti F., Bartolaminelli C., Petrosillo N., Donno D. R., Taglietti F., Topino S., Chinello P., Galati V., D'offizi G., Taibi C., Cimolato B., Moroni F., Palagano N., Pelagatti L., Cristiana S., Landini G., Amitrano M., Raimondo M., Mangiacapra S., Romano A., Atteno M., Blanc P., Suardi L. R., Pallotto C., Casinelli K., Uccella I., Harari S., Caminati A., Lipani F., Di Perri G., Calcagno A., Calleri G., Montrucchio C., Caputo A. 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R., Scotto R., Zappulo E., Dell'aquila G., Bianchetti A., Guerini F., Vallone A., Oppedisano P., Pusterla L., Giglio O., Sartori E., Zanardini C., Gatti P., Vincenzo V., Piconi S., Molteni C., Dognini G., Cosimo F., Guarneri L., Pulvirenti F., Mondino V., Traballi G., Iemoli E., Grisolia A., Giorgi R., Nucera G., Raffaelli V., Marino P., Negro E., Serati L., Silvia T., Iacobello C., Strano G., Boglione L., Catania A., Gipponi P., Di Cato L., Panaccione A., Vitale G., Crippa I. A., Giacomini M., Basile A., Andrea B., Tundo P., Buzzigoli S., Palmiero G., Magnaca A., Silva M., Ricci M., Crespi S., Pasquino B., Consales G., Bragantini D., Mastroianni F., Righetti G., Scarafino A., Bitetto M., Franzetti F., Piga S., Delmonte V., Carbonara S., Losappio R., Dejaco C., Mastroianni C., Del Bono V., Gilioli F., Barzan D., De Struppi S., Carlotto A., Guadagnin M. L., Girardis M., Bertellini E., Dentali F., Foresta G., Baratta A., Viviani R., Agrati A. M., Perego G. 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T., Romano F., Savio A., Sparavigna L., Curvietto M., Citarella M., Nava V., Maggioni P., Magni M., Iommelli C., Bianco A., Corsini R., Valli L., Ruggieri M. P., Mancini A., Melica T., Ferrari A., Cicognini D., Delliponti M., Zuccarini A., Ciani S., Raffaeli D., Donati L., Cannizzo S., Lui S., Santini L., Roncaglia E., Mighali P., Eisendle F., Cerino G., Citterio C., Di Nunzio C., Lamonica S., Resimini S., Sarteschi G., Pavei C., Battistini N., Gazzola E., Miceli M., Pontiggia S., Lonati V., Giannandrea G., Sortino C., Ravani S., Uggeri C., Jocolle G., Bare C., Baroni I., De Candia D., Fiorini B., Chierico K., Romeo F., Bottega R., Boccasile L., Corsaro A., Spadoni C., Ria E., Chiari S., Ercolino G., Dell'uomo V., Viri S., Minato M., Gazzola L., Dorina B., Gianelli D., Maspero S., Farinazzo M., Zanini P., Sangiovanni A., Del Giudice A., Dragonetti M. M., Bordignon S., Machiavelli A. M., Chiodelli G., Spatarella M., Zenoni D., Beretta F. N., Santilli G., Badagliacca R., Angileri M., Giannelli L., Campomori A., Maimone P., Fadda A., Faoro S., Pisterna A., Cacopardo B., Marino A., Pampaloni A., Celesia B. M., Cinnella G., Labella D., Caporusso R. R., Danzi M., Fiscon M., Malena M., Fendt D., Nardi S., Stobbione P., Savi M. L., De Monte A., Scala A., Liberato N. L., Luchi S., Vincenti A., Cabrini L., Pinelli G., Brugioni L., Potenza D., Numis F. G., Porta G., D'amico M., Iengo B., Angarano G., Saracino A., Blasi L., De Negri P., Angelici S., Farina A., Martino G. P., Bitti G., Tedeschi A., De Ponti S., Agostinone A., Parruti G., Consorte A., Frattari A., Filippelli A., Pagliano P., Masullo A., Sellitto C., Reta M., Rossi N., Raumer L., Andreassi S., Brancaleoni P., Carai A., Salerno A. M., Marinangeli F., Mariani R., Ciccone A., Meschini C., Santoboni G., Angrisani C., Micarelli D., Tarquini G., Fregoni V., Volta C. A., Cherubini A., Del Prete M. S., Ciarrochi E., Tasca F., Ballarin A., Bianchin A., Flocco R., Cuzzone V., Carpinteri M., Gallotti P., Torre F., Zannetti P., Crapis M., Venturini S., Barattini M., Gori G., Mastroianni A., De Stefano G., Gilio M., Rapisarda G., Gulisano L., Granata M. L., Saglimbene S., Montalto M. T., Grasso I., De Luca S., Magro G., Messina F., Scapino B., Abrate P., Francisco C., Pesce L., Navarra M., Agosti M., Pagani S., Piluso M., Ricioppo A., Tognella S., Rovere P., Vincenzi M., Ghirardi L., Generali D., Ingrosso M., Desiderio E., Molaro R., Vitiello S., Lancione L., Paone T. C., Meli A., Mainardi S., Rastellino V., Ursillo A., Grigoli P. D., Bovetto E., Stefanetto I. M., Mazzola F., Daniele A., Bisio C., Delnero P., Morando G., Nava A., Francesco L., Fiammengo F., Regis M., Roccatello D., Sabato E., Liccardi M. M., Bretto C., Lutri L., Castenetto E., Roberti G., Guidi M. F., Bini F., Zappa M. C., Trequattrini T., Rivitti R., Vigliarolo R., Succu A., Lilli M., Serao M., Giogre G., Ruggieri A., Flores K., Vairo G., Satira R., Lingua A., Spina R., Nicastri E., Maffongelli G., Barreca F., Scollet S., Franchi F., Fabbri C., Minuz P., Dalbeni A., Zanatta P., Gelormini D., Mandelli A., Galderisi F., Zoia E., Marchi M. R., Neves N. D. A., Carbone G., Di Caterino E., Petrone A., Usai C. A., Bandiera F., Monti R., Hofer A., Castiglione G., Angeletti C., Tarsia P., Veronese L., Artoni P. D., Larussa D., Fumagalli R., Brioschi P., Cerutti A., Pasquino P., Gilberto F., Cantadori L., Tomasoni L. R., Coppola N., Spolveri S., Pollastri C., Fico L., Principi T., Pierantozzi S., Fontana C. C., Lubrano G., Martinelli L., Navalesi P., Serra E., Cogi E., Manzi A., Furino E., Dasseni N., Gentilini C., Benatti E., Pignatti A., Aiello G., Milia M., Covesnon M. G., Brianti A., Francesco C., Ilaria B., Pagnozzi F., Mietta S., Rossi A., Maroni L., Borroni V., Bellintani C., Sgarabotto C., Bizzotto G., Bucci L., Spagnuolo G., Agostini M., Caria F. C., Testa F., De Palma R., Murdaca G., Zanolini G., Sala N., Righini E., Pontremoli R., Aondio G., Riccardi F., De Cristoforo M. G., De Michele F., Storti A., Perra R., Deidda S., Enrica C., Valastro F., Pierfranceschi M. G., De Gennaro F., Nardecchia A. L., Castellini M., Buetto G., Ippoliti G., Sicheri D., Bottoli M. G., De Arroyabe B. M. L., Versaci A., Pallotti G., Civita M., Grio M., Liuzzi N., Molino P., Pastorelli M., Ricchiardi A., Varbella F., Zeme A. D., Sighieri C., Portale G., Olivetti A., Pagnoni C., Moschini G., Boni S., Guerra A., Scudellari R., Vella S., Inchiostro S., Piazza O., Guarino S., Aldegheri G., Napoli G., Morettini A., Caldini E., Menicacci L., Pieralli F., Torrini M., Poggesi L., Visetti E. M., Mangano C., Visconti S., Maietta P., Banfi E., Cartella S., Venturi B., Nuceri A., Chiesa E., Pacentra E., Panzolato G., Giannotti M., Bianchi C., Pietrangelo A., Para O., Rutili M. S., Russo R., Lanfranco M., Scalabrino E., Tafuri A., Chiarello T., Perfetti E., Cancanelli L., Otero M., Pannella G., Bellucci F., Ferrero G., Vico C., Stillante M. S., D'andrea G., Amoroso F., Arcidiacono A., Bella A. M., Belsito A., Berte Y., Carubia G., Caruso M. G., Casella O., Chiereleson F., Costa C., De Franco D., Germana G., Messina A., Musumeci D., Noto C., Valenti M., Sorrentino C., Panico R., Schettino G., Piccoli J., Pepe A., De Rosa F., Ottaviano M., Marrazzo G., Raponi G., Diberardino S., Bausi S., Marini S. F., Giubellino E., Innocenti G., Gugliemi G., Maccari D., and Baciu I.
- Abstract
Background: Tocilizumab blocks pro-inflammatory activity of interleukin-6 (IL-6), involved in pathogenesis of pneumonia the most frequent cause of death in COVID-19 patients. Methods: A multicenter, single-arm, hypothesis-driven trial was planned, according to a phase 2 design, to study the effect of tocilizumab on lethality rates at 14 and 30 days (co-primary endpoints, a priori expected rates being 20 and 35%, respectively). A further prospective cohort of patients, consecutively enrolled after the first cohort was accomplished, was used as a secondary validation dataset. The two cohorts were evaluated jointly in an exploratory multivariable logistic regression model to assess prognostic variables on survival. Results: In the primary intention-to-treat (ITT) phase 2 population, 180/301 (59.8%) subjects received tocilizumab, and 67 deaths were observed overall. Lethality rates were equal to 18.4% (97.5% CI: 13.6-24.0, P = 0.52) and 22.4% (97.5% CI: 17.2-28.3, P < 0.001) at 14 and 30 days, respectively. Lethality rates were lower in the validation dataset, that included 920 patients. No signal of specific drug toxicity was reported. In the exploratory multivariable logistic regression analysis, older age and lower PaO2/FiO2 ratio negatively affected survival, while the concurrent use of steroids was associated with greater survival. A statistically significant interaction was found between tocilizumab and respiratory support, suggesting that tocilizumab might be more effective in patients not requiring mechanical respiratory support at baseline. Conclusions: Tocilizumab reduced lethality rate at 30 days compared with null hypothesis, without significant toxicity. Possibly, this effect could be limited to patients not requiring mechanical respiratory support at baseline. Registration EudraCT (2020-001110-38); clinicaltrials.gov (NCT04317092).
- Published
- 2020
17. Ventilatory support and mechanical properties of the fibrotic lung acting as a “squishy ball”
- Author
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Marchioni, A, Tonelli, R, Rossi, G, Spagnolo, P, Luppi, F, Cerri, S, Cocconcelli, E, Pellegrino, M, Fantini, R, Tabbi, L, Castaniere, I, Ball, L, Malbrain, M, Pelosi, P, Clini, E, Marchioni A., Tonelli R., Rossi G., Spagnolo P., Luppi F., Cerri S., Cocconcelli E., Pellegrino M. R., Fantini R., Tabbi L., Castaniere I., Ball L., Malbrain M. L. N. G., Pelosi P., Clini E., Marchioni, A, Tonelli, R, Rossi, G, Spagnolo, P, Luppi, F, Cerri, S, Cocconcelli, E, Pellegrino, M, Fantini, R, Tabbi, L, Castaniere, I, Ball, L, Malbrain, M, Pelosi, P, Clini, E, Marchioni A., Tonelli R., Rossi G., Spagnolo P., Luppi F., Cerri S., Cocconcelli E., Pellegrino M. R., Fantini R., Tabbi L., Castaniere I., Ball L., Malbrain M. L. N. G., Pelosi P., and Clini E.
- Abstract
Protective ventilation is the cornerstone of treatment of patients with the acute respiratory distress syndrome (ARDS); however, no studies have yet established the best ventilatory strategy to adopt when patients with acute exacerbation of interstitial lung disease (AE-ILD) are admitted to the intensive care unit. Due to the severe impairment of the respiratory mechanics, the fibrotic lung is at high risk of developing ventilator-induced lung injury, regardless of the lung fibrosis etiology. The purpose of this review is to analyze the effects of mechanical ventilation in AE-ILD and to increase the knowledge on the characteristics of fibrotic lung during artificial ventilation, introducing the concept of “squishy ball lung”. The role of positive end-expiratory pressure is discussed, proposing a “lung resting strategy” as opposed to the “open lung approach”. The review also discusses the practical management of AE-ILD patients discussing illustrative clinical cases.
- Published
- 2020
18. Nasal Pressure Swings as the Measure of Inspiratory Effort in Spontaneously Breathing Patients with De Novo Acute Respiratory Failure
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Tonelli, R., primary, Ball, L., additional, Cortegiani, A., additional, Marchioni, A., additional, Fantini, R., additional, Tabbì, L., additional, Castaniere, I., additional, Manicardi, L., additional, Bruzzi, G., additional, Andrisani, D., additional, Gozzi, F., additional, Busani, S., additional, Girardis, M., additional, Gregoretti, C., additional, Pelosi, P., additional, and Clini, E., additional
- Published
- 2022
- Full Text
- View/download PDF
19. Correction: Endobronchial valve positioning for alveolar-pleural fistula following ICU management complicating COVID-19 pneumonia (BMC Pulmonary Medicine, (2021), 21, 1, (307), 10.1186/s12890-021-01653-w)
- Author
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Donatelli, P., Trentacosti, F., Pellegrino, M. R., Tonelli, R., Bruzzi, G., Andreani, A., Cappiello, G. F., Andrisani, D., Gozzi, F., Mussini, C., Busani, S., Cavaliere, G. V., Girardis, M., Bertellini, E., Clini, E., and Marchioni, A.
- Published
- 2022
20. First and second wave among hospitalized COVID-19 patients with severe pneumonia: a comparison of 28-day mortality over 1-year pandemic in a tertiary university hospital in Italy
- Author
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Meschiari, M, Cozzi-Lepri, A, Tonelli, R, Bacca, E, Menozzi, M, Franceschini, E, Cuomo, G, Bedini, A, Volpi, S, Milic, J, Brugioni, L, Romagnoli, E, Pietrangelo, A, Corradini, E, Coloretti, I, Biagioni, E, Busani, S, Girardis, M, Cossarizza, A, Clini, E, Guaraldi, G, and Mussini, C.
- Subjects
Thoracic medicine ,Epidemiology Infectitious diseases ,COVID-19 ,Respiratory infections ,COVID-19, Epidemiology Infectitious diseases, Respiratory infections, Thoracic medicine - Published
- 2022
21. Effects of beclomethasone/formoterol fixed combination on lung hyperinflation and dyspnea in COPD patients
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Tzani P, Crisafulli E, Nicolini G, Aiello M, Chetta A, Clini E, and Olivieri D
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Diseases of the respiratory system ,RC705-779 - Abstract
Panagiota Tzani1, Ernesto Crisafulli2, Gabriele Nicolini3, Marina Aiello1, Alfredo Chetta1, Enrico Maria Clini2, Dario Olivieri1 1Department of Clinical Sciences, University of Parma, Parma, Italy; 2Department of Oncology Haematology and Pulmonary Diseases, University of Modena and Ospedale Villa Pineta, Pavullo, Modena, Italy; 3Medical Affairs Department, Chiesi Farmaceutici SpA, Parma, Italy Background: Chronic obstructive pulmonary disease (COPD) is a common disease characterized by airflow obstruction and lung hyperinflation leading to dyspnea and exercise capacity limitation. Objectives: The present study was designed to evaluate whether an extra-fine combination of beclomethasone and formoterol (BDP/F) was effective in reducing air trapping in COPD patients with hyperinflation. Fluticasone salmeterol (FP/S) combination treatment was the active control. Methods: COPD patients with forced expiratory volume in one second
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- 2011
22. Molecular mechanisms and cellular contribution from lung fibrosis to lung cancer development
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Samarelli AV, Masciale V, Aramini B, Coló GP, Tonelli R, Marchioni A, Bruzzi G, Gozzi F, Andrisani D, Castaniere I, Manicardi L, Moretti A, Tabbì L, Guaitoli G, Cerri S, Dominici M, Clini E., and Samarelli AV, Masciale V, Aramini B, Coló GP, Tonelli R, Marchioni A, Bruzzi G, Gozzi F, Andrisani D, Castaniere I, Manicardi L, Moretti A, Tabbì L, Guaitoli G, Cerri S, Dominici M, Clini E.
- Subjects
Molecular mechanisms, lung fibrosis, lung cancer ,respiratory system ,respiratory tract diseases - Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial lung disease (ILD) of unknown aetiology, with a median survival of 2–4 years from the time of diagnosis. Although IPF has unknown aetiology by definition, there have been identified several risks factors increasing the probability of the onset and progression of the disease in IPF patients such as cigarette smoking and environmental risk factors associated with domestic and occupational exposure. Among them, cigarette smoking together with concomitant emphysema might predispose IPF patients to lung cancer (LC), mostly to non-small cell lung cancer (NSCLC), increasing the risk of lung cancer development. To this purpose, IPF and LC share several cellular and molecular processes driving the progression of both pathologies such as fibroblast transition proliferation and activation, endoplasmic reticulum stress, oxidative stress, and many genetic and epigenetic markers that predispose IPF patients to LC development. Nintedanib, a tyrosine–kinase inhibitor, was firstly developed as an anticancer drug and then recognized as an anti-fibrotic agent based on the common target molecular pathway. In this review our aim is to describe the updated studies on common cellular and molecular mechanisms between IPF and lung cancer, knowledge of which might help to find novel therapeutic targets for this disease combination.
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- 2021
23. Real-life comparison of pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis: A 24-month assessment
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Cerri, S, Monari, M, Guerrieri, A, Donatelli, P, Bassi, I, Garuti, M, Luppi, F, Betti, S, Bandelli, G, Carpano, M, Bacchi Reggiani, M, Tonelli, R, Clini, E, Nava, S, Cerri S., Monari M., Guerrieri A., Donatelli P., Bassi I., Garuti M., Luppi F., Betti S., Bandelli G., Carpano M., Bacchi Reggiani M. L., Tonelli R., Clini E., Nava S., Cerri, S, Monari, M, Guerrieri, A, Donatelli, P, Bassi, I, Garuti, M, Luppi, F, Betti, S, Bandelli, G, Carpano, M, Bacchi Reggiani, M, Tonelli, R, Clini, E, Nava, S, Cerri S., Monari M., Guerrieri A., Donatelli P., Bassi I., Garuti M., Luppi F., Betti S., Bandelli G., Carpano M., Bacchi Reggiani M. L., Tonelli R., Clini E., and Nava S.
- Abstract
Background: Real-life data on the use of pirfenidone and nintedanib to treat patients with idiopathic pulmonary fibrosis (IPF) are still scarce. Methods: We compared the efficacy of either pirfenidone (n = 78) or nintedanib (n = 28) delivered over a 24-month period in patients with IPF, followed at two regional clinic centers in Italy, with a group of patients who refused the treatment (n = 36), and who were considered to be controls. All patients completed regular visits at 1- to 3-month intervals, where primary [forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO)] and secondary outcomes (side effects, treatment compliance, and mortality) were recorded. Results: Over time, the decline in FVC and DLCO was significantly higher (p = 0.0053 and p = 0.037, respectively) in controls when compared with the combined treated group, with no significant difference between the two treated groups. Compared to patients with less advanced disease (GAP (Gender, Age, Physiology) stage I), those in GAP stages II and III showed a significantly higher decline in both FVC and DLCO irrespective of the drug taken. Side effects were similarly reported in patients receiving pirfenidone and nintedanib (5% and 7%, respectively), whereas mortality did not differ among the three groups. Conclusion: This real-life study demonstrated that both pirfenidone and nintedanib were equally effective in reducing the decline of FVC and DLCO versus non-treated patients after 24 months of treatment; however, patients with more advanced disease were likely to show a more rapid decline in respiratory function
- Published
- 2019
24. Dissecting the Role of Mesenchymal Stem Cells in Idiopathic Pulmonary Fibrosis: Cause or Solution
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Samarelli, Av, Tonelli, R, Heijink, I, Martin Medina, A, Marchioni, A, Bruzzi, G, Castaniere, I, Andrisani, D, Gozzi, F, Manicardi, L, Moretti, A, Cerri, S, Fantini, R, Tabbì, L, Nani, C, Mastrolia, I, Weiss, Dj, Dominici, M, and Clini, E.
- Subjects
Pharmacology ,mesenchymal stem cells ,cell-based therapy ,extracellular matrix ,Idiopathic pulmonary fibrosis, mesenchymal stromal/stem cells, lung diseases, cell-based therapy, extracellular vesicles ,Idiopathic pulmonary fibrosis ,Review ,exosomes ,respiratory system ,idiopathic pulmonary fibrosis ,respiratory tract diseases ,mesenchymal stromal/stem cells ,extracellular vesicles ,cell based therapy ,lung diseases - Abstract
Idiopathic pulmonary fibrosis (IPF) is one of the most aggressive forms of idiopathic interstitial pneumonias, characterized by chronic and progressive fibrosis subverting the lung's architecture, pulmonary functional decline, progressive respiratory failure, and high mortality (median survival 3 years after diagnosis). Among the mechanisms associated with disease onset and progression, it has been hypothesized that IPF lungs might be affected either by a regenerative deficit of the alveolar epithelium or by a dysregulation of repair mechanisms in response to alveolar and vascular damage. This latter might be related to the progressive dysfunction and exhaustion of the resident stem cells together with a process of cellular and tissue senescence. The role of endogenous mesenchymal stromal/stem cells (MSCs) resident in the lung in the homeostasis of these mechanisms is still a matter of debate. Although endogenous MSCs may play a critical role in lung repair, they are also involved in cellular senescence and tissue ageing processes with loss of lung regenerative potential. In addition, MSCs have immunomodulatory properties and can secrete anti-fibrotic factors. Thus, MSCs obtained from other sources administered systemically or directly into the lung have been investigated for lung epithelial repair and have been explored as a potential therapy for the treatment of lung diseases including IPF. Given these multiple potential roles of MSCs, this review aims both at elucidating the role of resident lung MSCs in IPF pathogenesis and the role of administered MSCs from other sources for potential IPF therapies.
- Published
- 2021
25. In memoriam Claudio F. Donner
- Author
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Clini, E., primary
- Published
- 2021
- Full Text
- View/download PDF
26. Never Give Up: Lesson learned from a severe COVID-19 patient
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Tonelli, R., Iattoni, A., Girardis, M., De Pietri, L., Clini, E., and Mussini, C.
- Published
- 2021
- Full Text
- View/download PDF
27. Spontaneous breathing and evolving phenotypes of lung damage in patients with COVID-19
- Author
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Tonelli, R, Marchioni, A, Tabbì, L, Fantini, R, Busani, S, Castaniere, I, Andrisani, D, Gozzi, F, Bruzzi, G, Manicardi, L, Demurtas, J, Andreani, A, Cappiello, G, Samarelli, A, and Clini, E.
- Subjects
acute respiratory failure ,SARS-CoV-2 ,spontaneous breathing ,COVID-19 ,SARS-CoV-2, COVID-19, mechanical ventilation, spontaneous breathing, acute respiratory distress syndrome, acute respiratory failure ,mechanical ventilation ,acute respiratory distress syndrome - Published
- 2021
28. Subclinical Atherosclerosis at Peripheral Arteries in Obese Individuals
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Farinetti, A, Castaniere, I, Clini, E, Migaldi, M, Gelmini, R, Scaringi Raspagliesi, F, Ara, N, Serra, F, Spatafora, F, Genazzani, A, and Mattioli, Av.
- Subjects
obesity ,peripheral arterial disease ,intima/media thickness - Published
- 2021
29. COVIDGuide una app per il triage e l'autovalutazione della COVID-19
- Author
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Demurtas, J, Tonelli, R, Celotto, S, Veronese, N, Lagolio, E, Rossi, F, Clini, E, Righi, E, and Meer, A.
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SSDC ,COVID-19 ,e-health ,SSDC, triage, sicurezza, e-health, telemedicina ,triage ,telemedicina ,sicurezza - Published
- 2021
30. Insufficienza respiratoria acuta e cronica (cap.21)
- Author
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Bonsignore, Mr, Clini, E, Confalonieri, M, Costi, S, Crimi, C, Crisafulli, E, Longhini, F, Marchioni, A, Nava, S, Navalesi, P, Pisani, L, Spanevello, A, and Tonelli, R.
- Subjects
riabilitazione respiratoria ,insufficienza respiratoria ,sindrome delle apnee del sonno ,ARDS ,ossigenoterapia domiciliare ,insufficienza respiratoria, sindrome delle apnee del sonno, riabilitazione respiratoria, ARDS, ossigenoterapia domiciliare - Published
- 2021
31. Rugarli. Medicina interna sistematica
- Author
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Bonsignore, Mr, Clini, E, Confalonieri, M, Costi, S, Crimi, C, Crisafulli, E, Longhini, F, Marchioni, A, Nava, S, Navalesi, P, Pisani, L, Spanevello, A, and Tonelli, R.
- Published
- 2021
32. Effects of cytokine blocking agents on hospital mortality in patients admitted to ICU with acute respiratory distress syndrome by SARS-CoV2 infection: retrospective cohort study
- Author
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Coloretti, I, Busani, S, Biagioni, E, Venturelli, S, Munari, E, Marco, S, Dall’Ara, L, Tosi, M, Clini, E, Tonelli, R, Fantini, R, Mussini, C, Meschiari, M, Guaraldi, G, Cossarizza, A, Alfano, G, Girardis, M, and Gibellini, Lara
- Subjects
Anakinra ,COVID19 ,Mechanical Ventilation ,Intensive Care Unit ,COVID19, Acute Respiratory Distress Syndrome, Tocilizumab, Anakinra, Intensive Care Unit, Mechanical Ventilation ,Tocilizumab ,Acute Respiratory Distress Syndrome - Published
- 2021
33. Correction to: Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial (Journal of Translational Medicine, (2020), 18, 1, (405), 10.1186/s12967-020-02573-9)
- Author
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Perrone, F., Piccirillo, M. C., Ascierto, P. A., Salvarani, C., Parrella, R., Marata, A. M., Popoli, P., Ferraris, L., Marrocco-Trischitta, M. M., Ripamonti, D., Binda, F., Bonfanti, P., Squillace, N., Castelli, F., Muiesan, M. L., Lichtner, M., Calzetti, C., Salerno, N. D., Atripaldi, L., Cascella, M., Costantini, M., Dolci, G., Facciolongo, N. C., Fraganza, F., Massari, M., Montesarchio, V., Mussini, C., Negri, E. A., Botti, G., Cardone, C., Gargiulo, P., Gravina, A., Schettino, C., Arenare, L., Chiodini, P., Gallo, C., Vitale, M. G., Trojaniello, C., Palla, M., Bianchi, A. A. M., De Feo, G., Miscio, L., Chiodiniy, P., Froldi, M., Menicanti, L., Cuppone, M. T., Gobbo, G., Baldessari, C., Valenti, V., Castelvecchio, S., Poli, F., Giacomazzi, F., Piccinni, R., Annnunziata, M. L., Biondi, A., Bussolari, C., Mazzoleni, M., Giachi, A., Filtz, A., Manini, A., Poletti, E., Masserini, F., Conforti, F., Gaudiano, G., Favero, V., Moroni, A., Viva, T., Fancoli, F., Ferrari, D., Niro, D., Resta, M., Ballotta, A., Poli, M. D., Ranucci, M., Tebaldi, A., Gritti, G., Pasulo, L., Gaglio, L., Del Fabbro, R., Alborghetti, L., Giustinetti, G., Columpsi, P., Cazzaniga, M., Capici, S., Sala, L., Di Sciacca, R., Mosca, G., Pirozzi, M. R., Franceschini, F., Roccaro, A., Salvetti, M., Paini, A., Corda, L., Ricci, C., Tomasoni, L., Nasta, P., Lorenzotti, S., Odolini, S., Foca, E., Roldan, E. Q., Metra, M., Magrini, S., Borghetti, P., Latronico, N., Piva, S., Filippini, M., Tomasi, G., Zuccala, F., Cattaneo, S., Scolari, F., Bossini, N., Gaggiotti, M., Properzi, M., Del Borgo, C., Marocco, R., Belvisi, V., Tieghi, T., De Masi, M., Zuccala, P., Fabietti, P., Vetica, A., Mercurio, V. S., Carraro, A., Fondaco, L., Kertusha, B., Curtolo, A., Del Giudice, E., Lubrano, R., Zotti, M. G., Puorto, A., Ciuffreda, M., Sarni, A., Monteforte, G., Romeo, D., Viola, E., Damiani, C., Barone, A., Mantovani, B., Di Sanzo, D., Gentili, V., Carletti, M., Aiuti, M., Gallo, A., Meliante, P. G., Martellucci, S., Riggio, O., Cardinale, V., Ridola, L., Bragazzi, M. C., Gioia, S., Valenzi, E., Graziosi, C., Bina, N., Fasolo, M., Ricci, S., Gioacchini, M. T., Lucci, A., Corso, L., Tornese, D., Nijhawan, P., Equitani, F., Cosentino, C., Palladino, M., Leonetti, F., Leto, G., Gnessi, C., Campagna, G., Cesareo, R., Marrocco, F., Straface, G., Mecozzi, A., Cerbo, L., Isgro, V., Parrocchia, S., Visconti, G., Casati, G., Ariani, A., Donghi, L., Tacconelli, E., Bertoldi, M., Cattaneo, P., Lambertenghi, L., Motta, L., Omega, L., Albano, G., Scarano, F., De Rosa, A., Buglione, A., Lavoretano, S., Gaglione, G., De Marco, M., Sangiovanni, V., Fusco, F. 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L., Girardis, M., Bertellini, E., Dentali, F., Foresta, G., Baratta, A., Viviani, R., Agrati, A. M., Perego, G. B., Montineri, A., Manuele, R., Bonfante, S., Aquilini, D., Prozzo, A., Santopuoli, D., Di Rosa, Z., Alborghetti, A., Peci, P., Bakhtadze, N., Pandini, C. S., Ashofarir, N., Casella, G., Spagnolli, W., Urru, S., Marchesoni, I., Caminiti, G., Argilloni, E., Danieli, E., Ghirardi, G., Antonioli, C. M., Lipari, A., Zavarise, P., Kokaly, F., Polati, E., Gottin, L., Lucernoni, P., De Conti, F., Marcon, E., Pontali, E., Vacca, E. B., Saffioti, C., Zunino, A., Pognuz, E. R., Berlot, G., Saltori, M., Tedesco, A., Agostini, C., Di Rosolini, M. A., Marino, F., Bellinzona, G., Grassi, W., Di Carlo, M., Scimonello, G., Nonini, S., Mondino, M., Mantovani, L. F., Tenti, E., Tropea, C. M. G., Di Stefano, D. E., Guelfi, P., Dagna, L., Morgana, G., Montemurro, L., Girelli, D., Crisafulli, E., Maroccia, A., Cemuschi, A. M., Bernasconi, M., Zummo, U., Barbato, V., Bevilacqua, S., Buonfanti, G., Canzanella, G., De Matteis, G., Florio, M., Martino, M., Ribecco, M. T., Romano, F., Savio, A., Sparavigna, L., Curvietto, M., Citarella, M., Nava, V., Maggioni, P., Magni, M., Iommelli, C., Bianco, A., Corsini, R., Valli, L., Ruggieri, M. P., Melica, T., Ferrari, A., Cicognini, D., Delliponti, M., Zuccarini, A., Ciani, S., Raffaeli, D., Donati, L., Cannizzo, S., Lui, S., Santini, L., Roncaglia, E., Mighali, P., Eisendle, F., Cerino, G., Citterio, C., Di Nunzio, C., Mancini, A., Lamonica, S., Resimini, S., Sarteschi, G., Pavei, C., Battistini, N., Gazzola, O. 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- Subjects
tocilizumab ,covid 19 ,pneumonia - Published
- 2021
34. Interstitial Lung Disease and Anti-Myeloperoxidase Antibodies: Not a Simple Association
- Author
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Sebastiani, M, Luppi, F, Sambataro, G, Castillo Villegas, D, Cerri, S, Tomietto, P, Cassone, G, Bocchino, M, Atienza-Mateo, B, Cameli, P, Moya Alvarado, P, Faverio, P, Bargagli, E, Vancheri, C, Gonzalez-Gay, M, Clini, E, Salvarani, C, Manfredi, A, Sebastiani, Marco, Luppi, Fabrizio, Sambataro, Gianluca, Castillo Villegas, Diego, Cerri, Stefania, Tomietto, Paola, Cassone, Giulia, Bocchino, Marialuisa, Atienza-Mateo, Belen, Cameli, Paolo, Moya Alvarado, Patricia, Faverio, Paola, Bargagli, Elena, Vancheri, Carlo, Gonzalez-Gay, Miguel A, Clini, Enrico, Salvarani, Carlo, Manfredi, Andreina, Sebastiani, M, Luppi, F, Sambataro, G, Castillo Villegas, D, Cerri, S, Tomietto, P, Cassone, G, Bocchino, M, Atienza-Mateo, B, Cameli, P, Moya Alvarado, P, Faverio, P, Bargagli, E, Vancheri, C, Gonzalez-Gay, M, Clini, E, Salvarani, C, Manfredi, A, Sebastiani, Marco, Luppi, Fabrizio, Sambataro, Gianluca, Castillo Villegas, Diego, Cerri, Stefania, Tomietto, Paola, Cassone, Giulia, Bocchino, Marialuisa, Atienza-Mateo, Belen, Cameli, Paolo, Moya Alvarado, Patricia, Faverio, Paola, Bargagli, Elena, Vancheri, Carlo, Gonzalez-Gay, Miguel A, Clini, Enrico, Salvarani, Carlo, and Manfredi, Andreina
- Abstract
Anti-neutrophil cytoplasmic antibodies (ANCA), mainly anti-myeloperoxidase (MPO) antibodies, have been frequently identified in patients with idiopathic pulmonary fibrosis (IPF). However, their role remains unclear, and only 7-23% of these patients develops clinically overt vasculitis. We aimed to investigate the clinical, serological, and radiological features and prognosis of anti-MPO-positive interstitial lung disease (ILD) patients. Fifty-eight consecutive patients firstly referred for idiopathic interstitial pneumonia and showing serological positivity of anti-MPO antibodies were retrospectively enrolled. For each patient, clinical data, lung function testing, chest high-resolution computed tomography (HRCT) pattern, and survival were recorded. Thirteen patients developed a rheumatic disease during a median follow-up of 39 months. Usual interstitial pneumonia (UIP) was the most frequent ILD pattern, significantly influencing the patients' survival. In fact, while the 52-week survival of the overall population was 71.4 ± 7.5%, significantly higher than IPF, survivals of anti-MPO patients with UIP pattern and IPF were similar. Forced vital capacity and diffusion lung capacity for CO significantly declined in 37.7 and 41.5% of cases, respectively, while disease progression at chest HRCT was observed in 45.2%. A careful clinical history and evaluation should always be performed in ILD patients with anti-MPO antibodies to quickly identify patients who are developing a systemic rheumatic disease.
- Published
- 2021
35. Subclinical liver fibrosis in patients with idiopathic pulmonary fibrosis
- Author
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Cocconcelli, E, Tonelli, R, Abbati, G, Marchioni, A, Castaniere, I, Pelizzaro, F, Russo, F, Vegetti, A, Balestro, E, Pietrangelo, A, Richeldi, L, Luppi, F, Spagnolo, P, Clini, E, Cerri, S, Cocconcelli, Elisabetta, Tonelli, Roberto, Abbati, Gianluca, Marchioni, Alessandro, Castaniere, Ivana, Pelizzaro, Filippo, Russo, Francesco Paolo, Vegetti, Alberto, Balestro, Elisabetta, Pietrangelo, Antonello, Richeldi, Luca, Luppi, Fabrizio, Spagnolo, Paolo, Clini, Enrico, Cerri, Stefania, Cocconcelli, E, Tonelli, R, Abbati, G, Marchioni, A, Castaniere, I, Pelizzaro, F, Russo, F, Vegetti, A, Balestro, E, Pietrangelo, A, Richeldi, L, Luppi, F, Spagnolo, P, Clini, E, Cerri, S, Cocconcelli, Elisabetta, Tonelli, Roberto, Abbati, Gianluca, Marchioni, Alessandro, Castaniere, Ivana, Pelizzaro, Filippo, Russo, Francesco Paolo, Vegetti, Alberto, Balestro, Elisabetta, Pietrangelo, Antonello, Richeldi, Luca, Luppi, Fabrizio, Spagnolo, Paolo, Clini, Enrico, and Cerri, Stefania
- Abstract
Data on the presence of subclinical fibrosis across multiple organs in patients with idiopathic lung fibrosis (IPF) are lacking. Our study aimed at investigating through hepatic transient elastography (HTE) the prevalence and clinical impact of subclinical liver fibrosis in a cohort of patients with IPF. Patients referred to the Centre for Rare Lung Disease of the University Hospital of Modena (Italy) from March 2012 to February 2013 with established diagnosis of IPF and without a documented history of liver diseases were consecutively enrolled and underwent HTE. Based on hepatic stiffness status as assessed through METAVIR score patients were categorized as "with liver fibrosis" (corresponding to a METAVIR score of F1-F4) and "without liver fibrosis" (METAVIR F0). Potential predictors of liver fibrosis were investigated through logistic regression model among clinical and serological variables. The overall survival (OS) was assessed according to liver fibrosis and multivariate Cox regression analysis was used to identify independent predictors. In 13 out of 37 patients (35%) with IPF, a certain degree of liver fibrosis was documented. No correlation was found between liver stiffness and clinical-functional parameters. OS was lower in patients 'with liver fibrosis' than in patients 'without liver fibrosis' (median months 33 [23-55] vs. 63 [26-94], p = 0.038). Patients 'with liver fibrosis' presented a higher risk of death at seven years as compared to patients 'without liver fibrosis' (HR = 2.6, 95% CI [1.003-6.7], p = 0.049). Higher level of AST to platelet ratio index (APRI) was an independent predictor of survival (HR = 4.52 95% CI [1.3-15.6], p = 0.02). In our cohort, more than one-third of IPF patients had concomitant subclinical liver fibrosis that negatively affected OS. These preliminary claims further investigation aimed at clarifying the mechanisms beyond multiorgan fibrosis and its clinical implication in patients with IPF.
- Published
- 2021
36. Unusual effectiveness of systemic steroids in Whipple disease
- Author
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Fontana, M., Cerri, S., Bernardelli, G., Brugioni, L., Clini, E., and Tonelli, R.
- Published
- 2020
- Full Text
- View/download PDF
37. Janus-faced amiodarone-induced pneumopathy
- Author
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Cerri, S., Tonelli, R., Faverio, P., Sverzellati, N., Clini, E., and Luppi, F.
- Published
- 2020
- Full Text
- View/download PDF
38. Increased care at discharge from COVID-19: The association between pre-admission frailty and increased care needs after hospital discharge; a multicentre European observational cohort study
- Author
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Vilches-Moraga, A., Price, A., Braude, P., Pearce, L., Short, R., Verduri, A., Stechman, M., Collins, J. T., Mitchell, E., Einarsson, A. G., Moug, S. J., Quinn, T. J., Stubbs, B., Mccarthy, K., Myint, P. K., Hewitt, J., Carter, B., Davey, C., Jones, S., Lunstone, K., Cavenagh, A., Evans, L., Silver, C., Telford, T., Simmons, R., Mutasem, T. E. J., Singh, S., Paxton, D., Harris, W., Galbraith, N., Bhatti, E., Edwards, J., Duffy, S., Kelly, J., Murphy, C., Bisset, C., Alexander, R., Garcia, M., Sangani, S., Kneen, T., Lee, T., Kyriakopoulos, G., Thomas, M., Tan, D., Clini, E., Bruce, E., Rickard, F., Balow-Pay, F., Hesford, J., and Holloway, M.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Increased care need ,medicine.medical_treatment ,lcsh:Medicine ,Aftercare ,Disease ,Comorbidity ,Logistic regression ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,medicine ,Humans ,030212 general & internal medicine ,Care need ,Clinical frailty scale ,COVID-19 ,Discharge destination ,Frailty ,Older people ,Aged ,Aged, 80 and over ,Rehabilitation ,business.industry ,SARS-CoV-2 ,lcsh:R ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Patient Discharge ,Emergency medicine ,Quality of Life ,Female ,business ,030217 neurology & neurosurgery ,Cohort study ,Research Article - Abstract
BackgroundThe COVID-19 pandemic has placed significant pressure on health and social care. Survivors of COVID-19 may be left with substantial functional deficits requiring ongoing care. We aimed to determine whether pre-admission frailty was associated with increased care needs at discharge for patients admitted to hospital with COVID-19.MethodsPatients were included if aged over 18 years old and admitted to hospital with COVID-19 between 27 February and 10 June 2020. The Clinical Frailty Scale (CFS) was used to assess pre-admission frailty status. Admission and discharge care levels were recorded. Data were analysed using a mixed-effects logistic regression adjusted for age, sex, smoking status, comorbidities, and admission CRP as a marker of severity of disease.ResultsThirteen hospitals included patients: 1671 patients were screened, and 840 were excluded including, 521 patients who died before discharge (31.1%). Of the 831 patients who were discharged, the median age was 71 years (IQR, 58–81 years) and 369 (44.4%) were women. The median length of hospital stay was 12 days (IQR 6–24). Using the CFS, 438 (47.0%) were living with frailty (≥ CFS 5), and 193 (23.2%) required an increase in the level of care provided. Multivariable analysis showed that frailty was associated with an increase in care needs compared to patients without frailty (CFS 1–3). The adjusted odds ratios (aOR) were as follows: CFS 4, 1.99 (0.97–4.11); CFS 5, 3.77 (1.94–7.32); CFS 6, 4.04 (2.09–7.82); CFS 7, 2.16 (1.12–4.20); and CFS 8, 3.19 (1.06–9.56).ConclusionsAround a quarter of patients admitted with COVID-19 had increased care needs at discharge. Pre-admission frailty was strongly associated with the need for an increased level of care at discharge. Our results have implications for service planning and public health policy as well as a person's functional outcome, suggesting that frailty screening should be utilised for predictive modelling and early individualised discharge planning.
- Published
- 2020
39. Randomised controlled trial comparing efficacy and safety of high versus low Low-Molecular Weight Heparin dosages in hospitalized patients with severe COVID-19 pneumonia and coagulopathy not requiring invasive mechanical ventilation (COVID-19 HD): a structured summary of a study protocol
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Marietta, M, Vandelli, P, Mighali, P, Vicini, R, Coluccio, V, D'Amico, R, Aschieri, D, Brugioni, L, Clini, E, Codeluppi, M, Imberti, D, Magnacavallo, A, Meschiari, M, Mussini, C, Orlando, S, Pinelli, G, Pietrangelo, A, Sarti, L, and Silva, M.
- Subjects
medicine.medical_specialty ,Letter ,Randomization ,Blinding ,Dose ,medicine.drug_class ,Low-molecular weight heparin ,medicine.medical_treatment ,Medicine (miscellaneous) ,Low molecular weight heparin ,law.invention ,03 medical and health sciences ,COVID-19, Randomised controlled trial, Protocol, Low-molecular weight heparin, Enoxaparin, Pneumonia, Coagulopathy ,0302 clinical medicine ,Randomized controlled trial ,Coagulopathy ,law ,Internal medicine ,Protocol ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Enoxaparin ,COVID-19 ,Randomised controlled trial ,Pneumonia ,Mechanical ventilation ,lcsh:R5-920 ,business.industry ,medicine.disease ,Sample size determination ,lcsh:Medicine (General) ,business ,030217 neurology & neurosurgery - Abstract
Objectives To assess whether high doses of Low Molecular Weight Heparin (LMWH) (i.e. Enoxaparin 70 IU/kg twice daily) compared to standard prophylactic dose (i.e., Enoxaparin 4000 IU once day), in hospitalized patients with COVID19 not requiring Invasive Mechanical Ventilation [IMV], are: more effective in preventing clinical worsening, defined as the occurrence of at least one of the following events, whichever comes first: DeathAcute Myocardial Infarction [AMI]Objectively confirmed, symptomatic arterial or venous thromboembolism [TE]Need of either: Continuous Positive Airway Pressure (Cpap) or Non-Invasive Ventilation (NIV) orIMV in patients who at randomisation were receiving standard oxygen therapyIMV in patients who at randomisation were receiving non-invasive mechanical ventilationSimilar in terms of major bleeding risk Trial design Multicentre, randomised controlled, superiority, open label, parallel group, two arms (1:1 ratio), in-hospital study. Participants Inpatients will be recruited from 7 Italian Academic and non-Academic Internal Medicine Units, 2 Infectious Disease Units and 1 Respiratory Disease Unit. Inclusion Criteria (all required) Age > 18 and < 80 years Positive SARS-CoV-2 diagnostic (on pharyngeal swab of deep airways material) Severe pneumonia defined by the presence of at least one of the following criteria: Respiratory Rate ≥25 breaths /minArterial oxygen saturation≤93% at rest on ambient airPaO2/FiO2 ≤300 mmHg Coagulopathy, defined by the presence of at least one of the following criteria: D-dimer >4 times the upper level of normal reference rangeSepsis-Induced Coagulopathy (SIC) score >4 No need of IMV Exclusion Criteria Age 80 years IMV Thrombocytopenia (platelet count < 80.000 mm3) Coagulopathy: INR >1.5, aPTT ratio > 1.4 Impaired renal function (eGFR calculated by CKD-EPI Creatinine equation < 30 ml/min) Known hypersensitivity to enoxaparin History of heparin induced thrombocytopenia Presence of an active bleeding or a pathology susceptible of bleeding in presence of anticoagulation (e.g. recent haemorrhagic stroke, peptic ulcer, malignant cancer at high risk of haemorrhage, recent neurosurgery or ophthalmic surgery, vascular aneurysms, arteriovenous malformations) Concomitant anticoagulant treatment for other indications (e.g. atrial fibrillation, venous thromboembolism, prosthetic heart valves) Concomitant double antiplatelet therapy Administration of therapeutic doses of LMWH, fondaparinux, or unfractionated heparin (UFH) for more than 72 hours before randomization; prophylactic doses are allowed Pregnancy or breastfeeding or positive pregnancy test Presence of other severe diseases impairing life expectancy (e.g. patients are not expected to survive 28 days given their pre-existing medical condition) Lack or withdrawal of informed consent Intervention and comparator Control Group (Low-Dose LMWH): patients in this group will be administered Enoxaparin (Inhixa®) at standard prophylactic dose (i.e., 4000 UI subcutaneously once day). Intervention Group (High-Dose LMWH): patients in this group will be administered Enoxaparin (Inhixa®) at dose of 70 IU/kg every 12 hours, as reported in the following table. This dose is commonly used in Italy when a bridging strategy is required for the management of surgery or invasive procedures in patients taking anti-vitamin K oral anticoagulants Body Weight (kg)Enoxaparin dose every 12 hours (IU)200050-69400070-89600090-1108000>11010000 The treatment with Enoxaparin will be initiated soon after randomization (maximum allowed starting time 12h after randomization). The treatment will be administered every 12 hours in the intervention group and every 24 hours in the control group. Treatments will be administered in the two arms until hospital discharge or the primary outcomes detailed below occur. Main outcomes Primary Efficacy Endpoint: Clinical worsening, defined as the occurrence of at least one of the following events, whichever comes first: DeathAcute Myocardial Infarction [AMI]Objectively confirmed, symptomatic arterial or venous thromboembolism [TE]Need of either: Continuous Positive Airway Pressure (Cpap) or Non-Invasive Ventilation (NIV) orIMV in patients who at randomisation were in standard oxygen therapy by delivery interfacesNeed for IMV, in patients who at randomisation were in Cpap or NIV Time to the occurrence of each of these events will be recorded. Clinical worsening will be analysed as a binary outcome as well as a time-to-event one. Secondary Efficacy Endpoints: Any of the following events occurring within the hospital stay DeathAcute Myocardial Infarction [AMI]Objectively confirmed, symptomatic arterial or venous thromboembolism [TE]Need of either: Continuous Positive Airway Pressure (Cpap) or Non-Invasive Ventilation (NIV) orIMV in patients who at randomisation were in standard oxygen therapy by delivery interfacesNeed for IMV in patients who at randomisation were in Cpap or NIVImprovement of laboratory parameters of disease severity, including: o D-dimer levelo Plasma fibrinogen levelso Mean Platelet Volumeo Lymphocyte/Neutrophil ratioo IL-6 plasma levels Mortality at 30 days Information about patients’ status will be sought in those who are discharged before 30 days on Day 30 from randomisation. Time to the occurrence of each of these events will be recorded. Each of these events will be analysed as a binary outcome and as a time-to-event one. Primary safety endpoint: Major bleeding, defined as an acute clinically overt bleeding associated with one or more of the following: Decrease in haemoglobin of 2 g/dl or more;Transfusion of 2 or more units of packed red blood cells;Bleeding that occurs in at least one of the following critical sites [intracranial, intraspinal, intraocular (within the corpus of the eye; thus, a conjunctival bleed is not an intraocular bleed), pericardial, intra-articular, intramuscular with compartment syndrome, or retroperitoneal];Bleeding that is fatal (defined as a bleeding event that was the primary cause of death or contributed directly to death);Bleeding that necessitates surgical intervention Time to the occurrence of each of these events will be recorded. Each of these events will be analysed as a binary outcome and as a time-to-event one. Secondary safety endpoint: Clinically Relevant non-major bleeding, defined as an acute clinically overt bleeding that does not meet the criteria for major and consists of: Any bleeding compromising hemodynamicSpontaneous hematoma larger than 25 cm2, or 100 cm2 if there was a traumatic causeIntramuscular hematoma documented by ultrasonographyEpistaxis or gingival bleeding requiring tamponade or other medical interventionBleeding from venipuncture for >5 minutesHaematuria that was macroscopic and was spontaneous or lasted for more than 24 hours after invasive proceduresHaemoptysis, hematemesis or spontaneous rectal bleeding requiring endoscopy or other medical interventionAny other bleeding requiring temporary cessation of a study drug. Time to the occurrence of each of these events will be recorded. Each of these events will be analysed as a binary outcome and as a time-to-event one. Randomisation Randomisation (with a 1:1 randomisation ratio) will be centrally performed by using a secure, web-based system, which will be developed by the Methodological and Statistical Unit at the Azienda Ospedaliero-Universitaria of Modena. Randomisation stratified by 4 factors: 1) Gender (M/F); 2) Age (2) with random variable block sizes will be generated by STATA software. The web-based system will guarantee the allocation concealment. Blinding (masking) The study is conceived as open-label: patients and all health-care personnel involved in the study will be aware of the assigned group. Numbers to be randomised (sample size) The target sample size is based on the hypothesis that LMWH administered at high doses versus low doses will significantly reduce the risk of clinical worsening. The overall sample size in this study is expected to be 300 with 150 in the Low-Dose LMWH control group and 150 in the High-Dose LMWH intervention group, recruited over 10-11 months. Assuming an alpha of 5% (two tailed) and a percentage of patients who experience clinical worsening in the control group being between 25% and 30%, the study will have 80% power to detect at least 50% relative reduction in the risk of death between low and high doses of heparin. Trial Status Protocol version 1.2 of 11/05/2020. Recruitment start (expected): 08/06/2020 Recruitment finish (expected): 30/04/2021 Trial registration EudraCT 2020-001972-13, registered on April 17th, 2020 Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
- Published
- 2020
40. Response Letter to Tuffet S, et al. and to Michard F, et al
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Tonelli, R, Tabbì, L, Fantini, R, Castaniere, I, Gozzi, F, Busani, S, Nava, S, Clini, E, and Marchioni, A
- Subjects
acute respiratory distress syndrome, respiratory failure, non-invasive mechanical ventilation, transpulmonary pressure, esophageal pressure - Published
- 2020
41. Response letter to Spinelli E, et al. and Jha
- Author
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Tonelli, R, Castaniere, I, Fantini, R, Tabbì, L, Busani, S, Pisani, L, Nava, S, Clini, E, and Marchioni, A.
- Subjects
transpulmonary pressure ,non-invasive mechanical ventilation ,esophageal pressure swings ,respiratory failure ,acute respiratory distress syndrome ,acute respiratory distress syndrome, respiratory failure, non-invasive mechanical ventilation, transpulmonary pressure, esophageal pressure swings - Published
- 2020
42. Early inspiratory effort assessment by esophageal manometry predicts noninvasive ventilation outcome in de novo respiratory failure: A pilot study
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Tonelli R., Fantini R., Tabbi L., Castaniere I., Pisani L., Pellegrino M. R., Casa G. D., D'Amico R., Girardis M., Nava S., Clini E. M., Marchioni A., Tonelli R., Fantini R., Tabbi L., Castaniere I., Pisani L., Pellegrino M.R., Casa G.D., D'Amico R., Girardis M., Nava S., Clini E.M., and Marchioni A.
- Subjects
Acute respiratory distress syndrome ,Esophageal pressure swing ,Noninvasive mechanical ventilation ,Respiratory failure ,Transpulmonary pressure - Abstract
Rationale: The role of inspiratory effort still has to be determined as a potential predictor of noninvasive mechanical ventilation (NIV) failure in acute hypoxic de novo respiratory failure. Objectives: To explore the hypothesis that inspiratory effort might be a major determinant of NIV failure in these patients. Methods: Thirty consecutive patients with acute hypoxic de novo respiratory failure admitted to a single center and candidates for a 24-hour NIV trial were enrolled. Clinical features, tidal change in esophageal pressure (ΔPes), tidal change in dynamic transpulmonary pressure (ΔPL), expiratory VT, and respiratory rate were recorded on admission and 2-4 to 12-24 hours after NIV start and were tested for correlation with outcomes. Measurements and Main Results: ΔPes and ΔPes/ΔPL ratio were significantly lower 2 hours after NIV start in patients who successfully completed the NIV trial (n = 18) compared with those who needed endotracheal intubation (n = 12) (median [interquartile range], 11 [8-15] cmH2O vs. 31.5 [30-36] cm H2O; P
- Published
- 2020
43. Ventilazione meccanica domiciliare (cap.26)
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Vitacca, M, Marchioni, A, Tonelli, R, and Clini, E.
- Subjects
insufficienza respiratoria ,BPCO ,ventilazione meccanica domiciliare ,insufficienza respiratoria, ventilazione meccanica domiciliare, BPCO, malattie neuromuscolari, cifoscoliosi ,malattie neuromuscolari ,cifoscoliosi - Published
- 2020
44. Janus-faced amiodarone-induced pneumopathy
- Author
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Cerri, S, Tonelli, R, Faverio, P, Sverzellati, N, Clini, E, Luppi, F, Cerri, S, Tonelli, R, Faverio, P, Sverzellati, N, Clini, E, and Luppi, F
- Published
- 2020
45. Subclinical liver fibrosis in patients with idiopathic pulmonary fibrosis
- Author
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Cocconcelli, E., Tonelli, R., Abbati, G., Marchioni, A., Castaniere, I., Pelizzaro, F., Russo, F. P., Vegetti, A., Balestro, E., Pietrangelo, A., Richeldi, Luca, Luppi, F., Spagnolo, P., Clini, E., Cerri, S., Richeldi L. (ORCID:0000-0001-8594-1448), Cocconcelli, E., Tonelli, R., Abbati, G., Marchioni, A., Castaniere, I., Pelizzaro, F., Russo, F. P., Vegetti, A., Balestro, E., Pietrangelo, A., Richeldi, Luca, Luppi, F., Spagnolo, P., Clini, E., Cerri, S., and Richeldi L. (ORCID:0000-0001-8594-1448)
- Abstract
Data on the presence of subclinical fibrosis across multiple organs in patients with idiopathic lung fibrosis (IPF) are lacking. Our study aimed at investigating through hepatic transient elastography (HTE) the prevalence and clinical impact of subclinical liver fibrosis in a cohort of patients with IPF. Patients referred to the Centre for Rare Lung Disease of the University Hospital of Modena (Italy) from March 2012 to February 2013 with established diagnosis of IPF and without a documented history of liver diseases were consecutively enrolled and underwent HTE. Based on hepatic stiffness status as assessed through METAVIR score patients were categorized as “with liver fibrosis” (corresponding to a METAVIR score of F1–F4) and “without liver fibrosis” (METAVIR F0). Potential predictors of liver fibrosis were investigated through logistic regression model among clinical and serological variables. The overall survival (OS) was assessed according to liver fibrosis and multivariate Cox regression analysis was used to identify independent predictors. In 13 out of 37 patients (35%) with IPF, a certain degree of liver fibrosis was documented. No correlation was found between liver stiffness and clinical–functional parameters. OS was lower in patients ‘with liver fibrosis’ than in patients ‘without liver fibrosis’ (median months 33 [23–55] vs. 63 [26–94], p = 0.038). Patients ‘with liver fibrosis’ presented a higher risk of death at seven years as compared to patients ‘without liver fibrosis’ (HR = 2.6, 95% CI [1.003–6.7], p = 0.049). Higher level of AST to platelet ratio index (APRI) was an independent predictor of survival (HR = 4.52 95% CI [1.3–15.6], p = 0.02). In our cohort, more than one-third of IPF patients had concomitant subclinical liver fibrosis that negatively affected OS. These preliminary claims further investigation aimed at clarifying the mechanisms beyond multiorgan fibrosis and its clinical implication in patients with IPF.
- Published
- 2020
46. Preliminary results on nursing workload in a dedicated weaning center
- Author
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Vitacca, M., Clini, E., Porta, R., and Ambrosino, N.
- Published
- 2000
- Full Text
- View/download PDF
47. Nosocomial COVID-19 infection: examining the risk of mortality. The COPE-Nosocomial Study (COVID in Older PEople)
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Carter, B., primary, Collins, J.T., additional, Barlow-Pay, F., additional, Rickard, F., additional, Bruce, E., additional, Verduri, A., additional, Quinn, T.J., additional, Mitchell, E., additional, Price, A., additional, Vilches-Moraga, A., additional, Stechman, M.J., additional, Short, R., additional, Einarsson, A., additional, Braude, P., additional, Moug, S., additional, Myint, P.K., additional, Hewitt, J., additional, Pearce, L., additional, McCarthy, K., additional, Davey, C., additional, Jones, S., additional, Lunstone, K., additional, Cavenagh, A., additional, Silver, C., additional, Telford, T., additional, Simmons, R., additional, Holloway, M., additional, Hesford, J., additional, El Jichi Mutasem, T., additional, Singh, S., additional, Paxton, D., additional, Harris, W., additional, Galbraith, N., additional, Bhatti, E., additional, Edwards, J., additional, Duffy, S., additional, Kelly, J., additional, Murphy, C., additional, Bisset, C., additional, Alexander, R., additional, Garcia, M., additional, Sangani, S., additional, Kneen, T., additional, Lee, T., additional, McGovern, A., additional, Guaraldi, G., additional, and Clini, E., additional
- Published
- 2020
- Full Text
- View/download PDF
48. INCIDENCE AND PREDICTORS OF DELIRIUM IN PATIENTS WITH ACUTE RESPIRATORY FAILURE UNDERGOING NON-INVASIVE MECHANICAL VENTILATION
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Tabbì, L., primary, Tonelli, R., additional, Fantini, R., additional, Castaniere, I., additional, Bruzzi, G., additional, Nani, C., additional, Caffarri, L., additional, Sacchi, M., additional, Spacone, A., additional, Dongilli, R., additional, Boni, E., additional, Falsini, L., additional, Ribuffo, V., additional, Marchioni, A., additional, and Clini, E., additional
- Published
- 2020
- Full Text
- View/download PDF
49. Prognostication by concomitant organ failure in mechanically ventilated patients in ICU: Important issue to face with
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Beghè, Bianca, primary and Clini, E., additional
- Published
- 2019
- Full Text
- View/download PDF
50. Role of hyperinflation vs. deflation on dyspnoea in severely to extremely obese subjects
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Romagnoli, I., Laveneziana, P., Clini, E. M., Palange, P., Valli, G., de Blasio, F., Gigliotti, F., and Scano, G.
- Published
- 2008
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