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8. Management Strategies of Juvenile Idiopathic Arthritis-Associated Chronic Anterior Uveitis: Current Perspectives

Author

Paroli MP, Del Giudice E, Giovannetti F, Caccavale R, and Paroli M

Subjects
juvenile idiopathic arthritis, uveitis, biologics, jak inhibitors, Ophthalmology, RE1-994
Abstract

Maria Pia Paroli,1 Emanuela Del Giudice,2 Francesca Giovannetti,1 Rosalba Caccavale,3 Marino Paroli3 1Uveitis Service, Ophthalmologic Unit, Department of Sense Organs, Sapienza University of Rome, Rome, Italy; 2Pediatric Rheumatology Unit, Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy; 3Clinical Immunology Unit, Department of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, ItalyCorrespondence: Maria Pia Paroli, Uveitis Service, Ophthalmologic Unit, Department of Sense Organs, Sapienza University of Rome, Rome, Italy, Tel/Fax +39-06-519-3220, Email mariapia.paroli@uniroma1.itAbstract: Juvenile idiopathic arthritis (JIA) is the most common extraocular disease associated with pediatric uveitis. Despite the growing knowledge about the pathogenetic and clinical characteristics of the disease, it still remains a challenge for both the pediatric rheumatologist and ophthalmologist. Since uveitis is asymptomatic in most cases, it is generally detected by parents in a late phase of the disease when complications have occurred with consequent severe vision loss. Improvement in attentive screening and early treatment initiation to suppress inflammation has considerably reduced the sight-threatening outcomes of JIA-associated chronic anterior uveitis (JIA-CAU). Initial treatment with topical steroids is effective in most cases. However, more severe cases require the use of periocular or systemic corticosteroids, possibly leading to long-term complications. These include growth retardation, cataract and glaucoma. Systemic immunosuppressive agents are then employed in patients resistant to first-line therapy or to reduce steroid-associated complications. In this review, we will discuss the immunosuppressant agents currently employed for the treatment of the disease, including anti-tumor necrosis factor (TNF)α biologics approved or not by the regulatory agencies. We will also highlight how new therapeutic options like biologic targeting cytotoxic T-lymphocyte antigen-4 (CTLA-4) co-stimulatory molecule, interleukin-6 receptor (IL-6R) or B lymphocytes might represent exciting new options for patients resistant to conventional therapy. Finally, the potential use of janus kinase (JAK) inhibitors recently approved for the treatment of several inflammatory rheumatic diseases in adults will be also discussed.Keywords: juvenile idiopathic arthritis, uveitis, biologics, JAK inhibitors

Published
2022

10. Worldwide Diagnostic Reference Levels for Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging: Findings From INCAPS

Author

Einstein, A.J., Pascual, T.N.B., Paez, D., Dondi, M., Better, N., Bouyoucef, S.E., Karthikeyan, G., Kashyap, R., Lele, V., Magboo, V.P.C., Mahmarian, J.J., Meeks, J.B., Mercuri, M., Mut, F., Rehani, M.M., Vitola, J.V., Alexanderson, E., Allam, A., Al-Mallah, M.H., Bom, H., Flotats, A., Jerome, S., Kaufmann, P.A., Luxenburg, O., Mahmarian, J., Shaw, L.J., Underwood, S.R., Vitola, J., Amouri, W., Essabbah, H., Gassama, S.S., Makhdomi, K.B., El Mustapha, G.I.E., El Ouchdi, N., Qaïs, N., Soni, N., Vangu, W., Abazid, R.M., Adams, B., Agarwal, V., Alfeeli, M.A., Alnafisi, N., Bernabe, L., Bural, G.G., Chaiwatanarat, T., Chandraguptha, J.M., Cheon, G.J., Cho, I., Dogan, A.S., Eftekhari, M., Frenkel, A., Garty, I., George, S., Geramifar, P., Golan, H., Habib, S., Hussain, R., Im, H., Jeon, H.-J., Kalawat, T., Kang, W.J., Keng, F., Klaipetch, A., Kumar, P.G., Lee, J., Lee, W.W., Lim, I., Macaisa, C.M.M., Malhotra, G., Mittal, B.R., Mohammad, M.H., Mohan, P., Mulyanto, I.D., Nariman, D., Nayak, U.N., Niaz, K., Nikolov, G., Obaldo, J.M., Ozturk, E., Park, J.M., Park, S., Patel, C.D., Phuong, H.K., Quinon, A.P., Rajini, T.R., Saengsuda, Y., Santiago, J., Sayman, H.B., Shinto, A.S., Sivasubramaniyan, V., Son, M.H., Sudhakar, P., Syed, G.M.S., Tamaki, N., Thamnirat, K., Thientunyakit, T., Thongmak, S., Velasco, D.N., Verma, A., Vutrapongwatana, U., Wang, Y., Won, K.S., Yao, Z., Yingsa-nga, T., Yudistiro, R., Yue, K.T., Zafrir, N., Adrian, S.C., Agostini, D., Aguadé, S., Armitage, G., Backlund, M., Backman, M., Baker, M., Balducci, M.T., Bavelaar, C., Berovic, M., Bertagna, F., Beuchel, R., Biggi, A., Bisi, G., Bonini, R., Bradley, A., Brudin, L., Bruno, I., Busnardo, E., Casoni, R., Choudhri, A., Cittanti, C., Clauss, R., Costa, D.C., Costa, M., Dixon, K., Dziuk, M., Egelic, N., Eriksson, I., Fagioli, G., de Faria, D.B., Florimonte, L., Francini, A., French, M., Gallagher, E., Garai, I., Geatti, O., Genovesi, D., Gianolli, L., Gimelli, A., del Giudice, E., Halliwell, S., Hansson, M.J., Harrison, C., Homans, F., Horton, F., Jędrzejuk, D., Jogi, J., Johansen, A., Johansson, H., Kalnina, M., Kaminek, M., Kiss, A., Kobylecka, M., Kostkiewicz, M., Kropp, J., Kullenberg, R., Lahoutte, T., Lang, O., Larsson, Y.H., Lázár, M., Leccisotti, L., Leners, N., Lindner, O., Lipp, R.W., Maenhout, A., Maffioli, L., Marcassa, C., Martins, B., Marzullo, P., Medolago, G., Mendiguchía, C.G., Mirzaei, S., Mori, M., Nardi, B., Nazarenko, S., Nikoletic, K., Oleksa, R., Parviainen, T., Patrina, J., Peace, R., Pirich, C., Piwowarska-Bilska, H., Popa, S., Prakash, V., Pubul, V., Puklavec, L., Rac, S., Ratniece, M., Rogan, S.A., Romeo, A., Rossi, M., Ruiz, D., Sabharwal, N., Salobir, B.G., Santos, A.I., Saranovic, S., Sarkozi, A., Schneider, R.P., Sciagra, R., Scotti, S., Servini, Z., Setti, L.R., Starck, S.-Å., Vajauskas, D., Veselý, J., Vieni, A., Vignati, A., Vito, I.M., Weiss, K., Wild, D., Zdraveska-Kochovska, M., Agüro, R.N., Alvarado, N., Barral, C.M., Beretta, M., Berrocal, I., Cuellar, J.F. Batista, Chang, T-M. Cabral, Rodríguez, L.O. Cabrera, Canessa, J., Mora, G. Castro, Claudia, A.C., Clavelo, G.F., Júnior, A.F. Cruz, Faccio, F.F., Fernández, K.M., Garibo, J.R. Gomez, Gonzalez, U., González E, P., Guzzo, M.A., Jofre, J., Kapitán, M., Kempfer, G., Lopez, J.L., Massardo V, T., Colaco, I. Medeiros, Mesquita, C.T., Montecinos, M., Neubauer, S., Pabon, L.M., Puente, A., Vazquez, L.M. Rochela, Macias, J.A. Serna, Pino, A.G. Silva, Huber, F.Z. Tártari, Tovar, A.P., Vargas, L., Wiefels, C., Aljizeeri, A., Alvarez, R.J., Barger, D., Beardwood, W., Behrens, J., Brann, L., Brown, D., Carr, H., Churchwell, K., Comingore, G.A., Corbett, J., Costello, M., Cruz, F., Depinet, T., Dorbala, S., Earles, M., Esteves, F.P., Etherton, E., Fanning, R.J., Jr., Fornace, J., Franks, L., Gewirtz, H., Gulanchyn, K., Hannah, C.-L., Hays, J., Hendrickson, J., Hester, J., Holmes, K., Johnson, A., Jopek, C., Lewin, H., Lyons, J., Manley, C., Meden, J., Moore, S., Moore, W.H., Murthy, V., Nace, R., Neely, D., Nelson, L., Niedermaier, O., Rice, D., Rigs, R., Schiffer, K., Schockling, E., Schultz, T., Schumacker, T., Sheesley, B., Sheikh, A., Siegel, B., Slim, A.M., Smith, J., Szulc, M., Tanskersley, N., Tilkemeier, P., Valdez, G.D., Vrooman, R., Wawrowicz, D., Winchester, D.E., Alcheikh, A., Allen, B., Atkins, E., Bevan, J., Bonomini, C., Christiansen, J., Clack, L., Craig, E., Dixson, H., Duncan, I., Fredericks, S., Gales, S., Hampson, R., Hanley, T., Hartcher, K., Hassall, J., Kelley, B., Kelly, S., Kidd, T., de Kort, T., Larcos, G., Macdonald, W., McGrath, C., Murdoch, E., O'Malley, S., O'Rourke, M., Pack, M., Pearce, R., Praehofer, R., Ramsay, S., Scarlett, L., Smidt, K., Souvannavong, F., Taubman, K., Taylor, G., Tse, K., Unger, S., Weale, J., Hirschfeld, Cole B., Dondi, Maurizio, Pascual, Thomas N.B., Mercuri, Mathew, Vitola, Joao, Karthikeyan, Ganesan, Better, Nathan, Mahmarian, John J., Bouyoucef, Salah E., Hee-Seung Bom, Henry, Lele, Vikram, Magboo, Vincent Peter C., Alexánderson, Erick, Allam, Adel H., Al-Mallah, Mouaz H., Flotats, Albert, Jerome, Scott, Kaufmann, Philipp A., Luxenburg, Osnat, Underwood, S. Richard, Rehani, Madan M., Vassileva, Jenia, Paez, Diana, and Einstein, Andrew J.

Published
2021
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11. Early anakinra treatment improves cardiac outcome of multisystem inflammatory syndrome in children, regardless of disease severity

Author

Taddio, A, Della Paolera, S, Abbagnato, L, Agrusti, A, Badolato, R, Biscaro, F, Caorsi, R, Consolaro, A, Dellepiane, Rm, Fabi, M, Floretta, I, Gattorno, M, Giangreco, M, La Torre, F, Maggio, Mc, Mambelli, L, Mauro, A, Mastrolia, Mv, Meneghel, A, Montin, D, Ricci, F, Simonini, G, Smarrazzo, A, Sottile, R, Stucchi, S, Tardi, M, Verdoni, L, Zuccotti, G, Zunica, F, Ravelli, A, Cattalini, M, Adamoli, P, Alberelli, Mc, Alessio, M, Alizzi, C, Barone, P, Baselli, La, Bennato, V, Boscarol, G, Bossi, G, Campana, A, Campus, S, Carone, M, Civino, A, Conti, G, Dei Rossi, E, Del Giudice, E, Dell’Anna, A, De Luca, M, Felici, E, Filocamo, G, Foschini, Ml, Gallizzi, R, Giordano, S, Lanciotti, S, Lattanzi, B, Lazzerotti, A, Licciardi, F, Manerba, A, Mannarino, S, Marino, A, Marolda, A, Martelli, L, Martini, G, Mazza, A, Minasi, D, Miniaci, A, Minoia, F, Olivieri, A, Pennoni, G, Pignataro, R, Rigante, Donato, Rossi, M, Santagati, C, Moliani, M, Sonego, S, Sperlì, D, Teruzzi, Bl, Tierno, E, Utytatnikova, T, Valentini, Piero, Vergine, G &amp, Italian Society of Pediatric Rheumatology, (ReumaPed), Rigante D (ORCID:0000-0001-7032-7779), Valentini P (ORCID:0000-0001-6095-9510), Taddio, A, Della Paolera, S, Abbagnato, L, Agrusti, A, Badolato, R, Biscaro, F, Caorsi, R, Consolaro, A, Dellepiane, Rm, Fabi, M, Floretta, I, Gattorno, M, Giangreco, M, La Torre, F, Maggio, Mc, Mambelli, L, Mauro, A, Mastrolia, Mv, Meneghel, A, Montin, D, Ricci, F, Simonini, G, Smarrazzo, A, Sottile, R, Stucchi, S, Tardi, M, Verdoni, L, Zuccotti, G, Zunica, F, Ravelli, A, Cattalini, M, Adamoli, P, Alberelli, Mc, Alessio, M, Alizzi, C, Barone, P, Baselli, La, Bennato, V, Boscarol, G, Bossi, G, Campana, A, Campus, S, Carone, M, Civino, A, Conti, G, Dei Rossi, E, Del Giudice, E, Dell’Anna, A, De Luca, M, Felici, E, Filocamo, G, Foschini, Ml, Gallizzi, R, Giordano, S, Lanciotti, S, Lattanzi, B, Lazzerotti, A, Licciardi, F, Manerba, A, Mannarino, S, Marino, A, Marolda, A, Martelli, L, Martini, G, Mazza, A, Minasi, D, Miniaci, A, Minoia, F, Olivieri, A, Pennoni, G, Pignataro, R, Rigante, Donato, Rossi, M, Santagati, C, Moliani, M, Sonego, S, Sperlì, D, Teruzzi, Bl, Tierno, E, Utytatnikova, T, Valentini, Piero, Vergine, G &amp, Italian Society of Pediatric Rheumatology, (ReumaPed), Rigante D (ORCID:0000-0001-7032-7779), and Valentini P (ORCID:0000-0001-6095-9510)

Abstract

Objective: The main aim of this study was to define the best treatment option for multisystem inflammatory syndrome in children (MIS-C) and to analyse the role of anakinra. Methods: This is a multicentre retrospective cohort study. Patients were treated according to the attending physician's decision. The patients were divided into four groups on the basis of the first treatment at time of admittance: (i) IVIG, (ii) IVIG and methylprednisolone (≤2 mg/kg/day), (iii) IVIG with high-dose methylprednisolone (>2 mg/kg/day) and (iv) anakinra with or without IVIG and/or methylprednisolone. Primary outcomes were defined as the presence of at least one of the following features: death, the failure of initial treatment, meaning the need for additional treatment for clinical worsening and cardiac involvement at the end of follow-up. Results: Two hundred thirty-nine patients were recruited. At univariate analysis, persistent heart involvement at discharge was more frequent in those not receiving anakinra as initial treatment (3/21 vs 66/189; P = 0.047). After comparisons between the four treatment regimens, adjusting for the propensity score, we observed that early treatment with anakinra was associated with a lower probability of developing persistent heart disease at the end of follow-up (odds ratio: 0.6; 95% CI: 0.4-1.0). Conclusion: We report that early treatment with anakinra is safe and very effective in patients with severe MIS-C. In addition, our study suggests that early treatment with anakinra is the most favourable option for patients with a higher risk of developing a severe disease outcome.

Published
2024

12. Adolescent gender dysphoria management: position paper from the Italian Academy of Pediatrics, the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, the Italian Society of Adolescent Medicine and the Italian Society of Child and Adolescent Neuropsychiatry

Author

Calcaterra, V, Tornese, G, Zuccotti, G, Staiano, A, Cherubini, V, Gaudino, R, Fazzi, E, Barbi, E, Chiarelli, F, Corsello, G, Esposito, S, Ferrara, P, Iughetti, L, Laforgia, N, Maghnie, M, Marseglia, G, Perilongo, G, Pettoello-Mantovani, M, Ruggieri, M, Russo, G, Salerno, M, Striano, P, Valerio, G, Wasniewska, M, Agosti, M, Agostoni, C, Aiuti, A, Azzari, C, Badolato, R, Balduzzi, A, Baraldi, E, Canani, R, Biffi, A, Biondi, A, Bisogno, G, Pierri, N, Carnielli, V, Cianfarani, S, Cogo, P, Corvaglia, L, Dani, C, Di Salvo, G, Fagioli, F, Fanos, V, Ferrero, G, Francavilla, R, Galli, L, Gazzolo, D, Giaquinto, C, Giordano, P, Gitto, E, Grosso, S, Guarino, A, Indrio, F, Lanari, M, Lionetti, P, Locatelli, F, Lombardo, F, Maffeis, C, Marino, B, Midulla, F, Del Giudice, E, Del Giudice, M, Montini, G, Parenti, G, Parisi, P, Peroni, D, Perrotta, S, Piacentini, G, Pietrobelli, A, Raimondi, F, Ramenghi, U, Ravelli, A, Romano, C, Rossi, F, Rossi, P, Damiano, V, Spalice, A, Suppiej, A, Troncone, R, Verrotti, A, Null, N, Calcaterra, Valeria, Tornese, Gianluca, Zuccotti, Gianvincenzo, Staiano, Annamaria, Cherubini, Valentino, Gaudino, Rossella, Fazzi, Elisa Maria, Barbi, Egidio, Chiarelli, Francesco, Corsello, Giovanni, Esposito, Susanna Maria Roberta, Ferrara, Pietro, Iughetti, Lorenzo, Laforgia, Nicola, Maghnie, Mohamad, Marseglia, Gianluigi, Perilongo, Giorgio, Pettoello-Mantovani, Massimo, Ruggieri, Martino, Russo, Giovanna, Salerno, Mariacarolina, Striano, Pasquale, Valerio, Giuliana, Wasniewska, Malgorzata, Agosti, Massimo, Agostoni, Carlo Virginio, Aiuti, Alessandro, Azzari, Chiara, Badolato, Raffaele, Balduzzi, Adriana, Baraldi, Eugenio, Canani, Roberto Berni, Biffi, Alessandra, Biondi, Andrea, Bisogno, Gianni, Pierri, Nicola Brunetti, Carnielli, Virginio, Cianfarani, Stefano, Cogo, Paola, Corvaglia, Luigi, Dani, Carlo, Di Salvo, Giovanni, Fagioli, Franca, Fanos, Vassilios, Ferrero, Giovanni Battista, Francavilla, Ruggiero, Galli, Luisa, Gazzolo, Diego, Giaquinto, Carlo, Giordano, Paola, Gitto, Eloisa, Grosso, Salvatore, Guarino, Alfredo, Indrio, Flavia, Lanari, Marcello, Lionetti, Paolo, Locatelli, Franco, Lombardo, Fortunato, Maffeis, Claudio, Marino, Bruno, Midulla, Fabio, Del Giudice, Emanuele Miraglia, Del Giudice, Michele Miraglia, Montini, Giovanni, Parenti, Giancarlo, Parisi, Pasquale, Peroni, Diego, Perrotta, Silverio, Piacentini, Giorgio, Pietrobelli, Angelo, Raimondi, Francesco, Ramenghi, Ugo, Ravelli, Angelo, Romano, Claudio, Rossi, Francesca, Rossi, Paolo, Damiano, Vincenzo Salpietro, Spalice, Alberto, Suppiej, Agnese, Troncone, Riccardo, Verrotti, Alberto, null, null, Calcaterra, V, Tornese, G, Zuccotti, G, Staiano, A, Cherubini, V, Gaudino, R, Fazzi, E, Barbi, E, Chiarelli, F, Corsello, G, Esposito, S, Ferrara, P, Iughetti, L, Laforgia, N, Maghnie, M, Marseglia, G, Perilongo, G, Pettoello-Mantovani, M, Ruggieri, M, Russo, G, Salerno, M, Striano, P, Valerio, G, Wasniewska, M, Agosti, M, Agostoni, C, Aiuti, A, Azzari, C, Badolato, R, Balduzzi, A, Baraldi, E, Canani, R, Biffi, A, Biondi, A, Bisogno, G, Pierri, N, Carnielli, V, Cianfarani, S, Cogo, P, Corvaglia, L, Dani, C, Di Salvo, G, Fagioli, F, Fanos, V, Ferrero, G, Francavilla, R, Galli, L, Gazzolo, D, Giaquinto, C, Giordano, P, Gitto, E, Grosso, S, Guarino, A, Indrio, F, Lanari, M, Lionetti, P, Locatelli, F, Lombardo, F, Maffeis, C, Marino, B, Midulla, F, Del Giudice, E, Del Giudice, M, Montini, G, Parenti, G, Parisi, P, Peroni, D, Perrotta, S, Piacentini, G, Pietrobelli, A, Raimondi, F, Ramenghi, U, Ravelli, A, Romano, C, Rossi, F, Rossi, P, Damiano, V, Spalice, A, Suppiej, A, Troncone, R, Verrotti, A, Null, N, Calcaterra, Valeria, Tornese, Gianluca, Zuccotti, Gianvincenzo, Staiano, Annamaria, Cherubini, Valentino, Gaudino, Rossella, Fazzi, Elisa Maria, Barbi, Egidio, Chiarelli, Francesco, Corsello, Giovanni, Esposito, Susanna Maria Roberta, Ferrara, Pietro, Iughetti, Lorenzo, Laforgia, Nicola, Maghnie, Mohamad, Marseglia, Gianluigi, Perilongo, Giorgio, Pettoello-Mantovani, Massimo, Ruggieri, Martino, Russo, Giovanna, Salerno, Mariacarolina, Striano, Pasquale, Valerio, Giuliana, Wasniewska, Malgorzata, Agosti, Massimo, Agostoni, Carlo Virginio, Aiuti, Alessandro, Azzari, Chiara, Badolato, Raffaele, Balduzzi, Adriana, Baraldi, Eugenio, Canani, Roberto Berni, Biffi, Alessandra, Biondi, Andrea, Bisogno, Gianni, Pierri, Nicola Brunetti, Carnielli, Virginio, Cianfarani, Stefano, Cogo, Paola, Corvaglia, Luigi, Dani, Carlo, Di Salvo, Giovanni, Fagioli, Franca, Fanos, Vassilios, Ferrero, Giovanni Battista, Francavilla, Ruggiero, Galli, Luisa, Gazzolo, Diego, Giaquinto, Carlo, Giordano, Paola, Gitto, Eloisa, Grosso, Salvatore, Guarino, Alfredo, Indrio, Flavia, Lanari, Marcello, Lionetti, Paolo, Locatelli, Franco, Lombardo, Fortunato, Maffeis, Claudio, Marino, Bruno, Midulla, Fabio, Del Giudice, Emanuele Miraglia, Del Giudice, Michele Miraglia, Montini, Giovanni, Parenti, Giancarlo, Parisi, Pasquale, Peroni, Diego, Perrotta, Silverio, Piacentini, Giorgio, Pietrobelli, Angelo, Raimondi, Francesco, Ramenghi, Ugo, Ravelli, Angelo, Romano, Claudio, Rossi, Francesca, Rossi, Paolo, Damiano, Vincenzo Salpietro, Spalice, Alberto, Suppiej, Agnese, Troncone, Riccardo, Verrotti, Alberto, and null, null

Abstract

Background In response to the imperative need for standardized support for adolescent Gender Dysphoria (GD), the Italian Academy of Pediatrics, in collaboration with the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, Italian Society of Adolescent Medicine and Italian Society of Child and Adolescent Neuropsychiatry is drafting a position paper. The purpose of this paper is to convey the author's opinion on the topic, offering foundational information on potential aspects of gender-affirming care and emphasizing the care and protection of children and adolescents with GD.Main body Recognizing that adolescents may choose interventions based on their unique needs and goals and understanding that every individual within this group has a distinct trajectory, it is crucial to ensure that each one is welcomed and supported. The approach to managing individuals with GD is a multi-stage process involving a multidisciplinary team throughout all phases. Decisions regarding treatment should be reached collaboratively by healthcare professionals and the family, while considering the unique needs and circumstances of the individual and be guided by scientific evidence rather than biases or ideologies. Politicians and high court judges should address discrimination based on gender identity in legislation and support service development that aligns with the needs of young people. It is essential to establish accredited multidisciplinary centers equipped with the requisite skills and experience to effectively manage adolescents with GD, thereby ensuring the delivery of high-quality care.Conclusion Maintaining an evidence-based approach is essential to safeguard the well-being of transgender and gender diverse adolescents.

Published
2024

13. Risk for cancer development in familial Mediterranean fever and associated predisposing factors: an ambidirectional cohort study from the international AIDA Network registries

Author

Vitale, A, Caggiano, V, Tufan, A, Ragab, G, Batu, Ed, Portincasa, P, Aragona, E, Sota, J, Conti, G, De Paulis, A, Rigante, Donato, Olivieri, An, S ̧ahin, A, La Torre, F, Lopalco, G, Cattalini, M, Maggio, Mc, Insalaco, A, Sfikakis, Pp, Verrecchia, Elena, Yildirim, D, Kucuk, H, Kardas, Rc, Laymouna, Ah, Ghanema, M, Saad, Ma, Sener, S, Ercan Emreol, H, Ozen, S, Jaber, N, Khalil, M, Di Ciaula, A, Gaggiano, C, Malizia, G, Affronti, A, Patroniti, S, Romeo, M, Sbalchiero, J, Della Casa, F, Mormile, I, Silvaroli, Sara, Gicchino, Mf, Çelik, Nç, Tarsia, M, Karamanakos, A, Hernández-Rodríguez, J, Parronchi, P, Opris-Belinski, D, Barone, P, Recke, A, Costi, S, Sfriso, P, Giardini, Ham, Gentileschi, S, Wiesik-Szewczyk, E, Vasi, I, Loconte, R, Jahnz-Różyk, K, Martín-Nares, E, Torres-Ruiz, J, Cauli, A, Conforti, A, Emmi, G, Li Gobbi, F, Biasi, Gr, Terribili, R, Ruscitti, P, Del Giudice, E, Tharwat, S, Brucato, Al, Ogunjimi, B, Hinojosa-Azaola, A, Balistreri, A, Fabiani, C, Frediani, B, Cantarini, L, Rigante D (ORCID:0000-0001-7032-7779), Verrecchia E, Silvaroli S, Vitale, A, Caggiano, V, Tufan, A, Ragab, G, Batu, Ed, Portincasa, P, Aragona, E, Sota, J, Conti, G, De Paulis, A, Rigante, Donato, Olivieri, An, S ̧ahin, A, La Torre, F, Lopalco, G, Cattalini, M, Maggio, Mc, Insalaco, A, Sfikakis, Pp, Verrecchia, Elena, Yildirim, D, Kucuk, H, Kardas, Rc, Laymouna, Ah, Ghanema, M, Saad, Ma, Sener, S, Ercan Emreol, H, Ozen, S, Jaber, N, Khalil, M, Di Ciaula, A, Gaggiano, C, Malizia, G, Affronti, A, Patroniti, S, Romeo, M, Sbalchiero, J, Della Casa, F, Mormile, I, Silvaroli, Sara, Gicchino, Mf, Çelik, Nç, Tarsia, M, Karamanakos, A, Hernández-Rodríguez, J, Parronchi, P, Opris-Belinski, D, Barone, P, Recke, A, Costi, S, Sfriso, P, Giardini, Ham, Gentileschi, S, Wiesik-Szewczyk, E, Vasi, I, Loconte, R, Jahnz-Różyk, K, Martín-Nares, E, Torres-Ruiz, J, Cauli, A, Conforti, A, Emmi, G, Li Gobbi, F, Biasi, Gr, Terribili, R, Ruscitti, P, Del Giudice, E, Tharwat, S, Brucato, Al, Ogunjimi, B, Hinojosa-Azaola, A, Balistreri, A, Fabiani, C, Frediani, B, Cantarini, L, Rigante D (ORCID:0000-0001-7032-7779), Verrecchia E, and Silvaroli S

Abstract

Objective: Inflammation has been associated with an increased risk for cancer development, while innate immune system activation could counteract the risk for malignancies. Familial Mediterranean fever (FMF) is a severe systemic inflammatory condition and also represents the archetype of innate immunity deregulation. Therefore, the aim of this study is to investigate the risk for cancer development in FMF. Methods: The risk ratio (RR) for malignancies was separately compared between FMF patients and fibromyalgia subjects, Still’s disease patients and Behçet’s disease patients. Clinical variables associated with cancer development in FMF patients were searched through binary logistic regression. Results: 580 FMF patients and 102 fibromyalgia subjects, 1012 Behçet’s disease patients and 497 Still’s disease patients were enrolled. The RR for the occurrence of malignant neoplasms was 0.26 (95% Confidence Interval [CI.] 0.10-0.73, p=0.006) in patients with FMF compared to fibromyalgia subjects; the RR for the occurrence of malignant cancer was 0.51 (95% CI. 0.23-1.16, p=0.10) in FMF compared to Still’s disease and 0.60 (95% CI. 0.29-1.28, p=0.18) in FMF compared to Behçet’s disease. At logistic regression, the risk of occurrence of malignant neoplasms in FMF patients was associated with the age at disease onset (b1 = 0.039, 95% CI. 0.001-0.071, p=0.02), the age at the diagnosis (b1 = 0.048, 95% CI. 0.039-0.085, p=0.006), the age at the enrolment (b1 = 0.05, 95% CI. 0.007-0.068, p=0.01), the number of attacks per year (b1 = 0.011, 95% CI. 0.001- 0.019, p=0.008), the use of biotechnological agents (b1 = 1.77, 95% CI. 0.43-3.19, p=0.009), the use of anti-IL-1 agents (b1 = 2.089, 95% CI. 0.7- 3.5, p=0.002). Conclusions: The risk for cancer is reduced in Caucasic FMF patients; however, when malignant neoplasms occur, this is more frequent in FMF cases suffering from a severe disease phenotype and presenting a colchicine-resistant disease.

Published
2024

15. Self-similarity properties of nafionized and filtered water and deformed coherent states

Author

Capolupo, A., Del Giudice, E., Elia, V., Germano, R., Napoli, E., Niccoli, M., Tedeschi, A., and Vitiello, G.

Subjects
Physics - General Physics
Abstract

By resorting to measurements of physically characterizing observables of water samples perturbed by the presence of Nafion and by iterative filtration processes, we discuss their scale free, self-similar fractal properties. By use of algebraic methods the isomorphism is proved between such self-similarity features and the deformed coherent state formalism., Comment: 20 pages, 3 figures. International Journal of Modern Physics B, to appear

Published
2013
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16. The Structure of Liquid Water Emerging from the Vibrational Spectroscopy: Interpretation with QED Theory

Author

De Ninno, A., Del Giudice, E., Gamberale, L., and Castellano, A. Congiu

Subjects
Condensed Matter - Soft Condensed Matter, Physics - Chemical Physics
Abstract

We report an analysis of the stretching peak appearing in the IR experimental spectra of liquid water. In the literature, ATR-IR spectroscopic measurements were repeatedly performed in a wide range of temperature and gave rise to a lively debate among scientists. In particular a two components model related to H-bond complexes of different strength have been proposed in order to justify the existence of two types of molecules as it appears from the spectroscopic data. At the opposite, Molecular Dynamics simulations support a multistate (continuum) system of H bond having different strength giving rise to a (locally) tetrahedral description of liquid water. We will show that liquid water is a quantum two-level system according to the predictions of Quantum Electrodynamics (QED) and that several features (the asymmetric band profile, the existence of an isosbestic point and the modifications of the vibrational stretching band with the temperature) cannot be fully justified in the realm of a classical picture. In particular the differences of energy and entropy between the two phases are estimated from the experimental data and compared with the prediction of QED showing a remarkable agreement. The behavior of water near hydrophilic surfaces is also discussed and several feature of the so called Exclusion Zone observed by several authors are evaluated according to the two level system model., Comment: 14 pages, 5 figures

Published
2013

17. DNA waves and water

Author

Montagnier, L., Aissa, J., Del Giudice, E., Lavallee, C., Tedeschi, A., and Vitiello, G.

Subjects
Quantitative Biology - Other Quantitative Biology, Quantum Physics
Abstract

Some bacterial and viral DNA sequences have been found to induce low frequency electromagnetic waves in high aqueous dilutions. This phenomenon appears to be triggered by the ambient electromagnetic background of very low frequency. We discuss this phenomenon in the framework of quantum field theory. A scheme able to account for the observations is proposed. The reported phenomenon could allow to develop highly sensitive detection systems for chronic bacterial and viral infections., Comment: Invited talk at the DICE2010 Conference, Castiglioncello, Italy September 2010

Published
2010
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19. Pediatric non-alcoholic fatty liver disease: current perspectives on diagnosis and management

Author

Di Sessa A, Cirillo G, Guarino S, Marzuillo P, and Miraglia del Giudice E

Subjects
fatty, liver, pediatric, diagnosis, management, Pediatrics, RJ1-570
Abstract

Anna Di Sessa, Grazia Cirillo, Stefano Guarino, Pierluigi Marzuillo, Emanuele Miraglia del GiudiceDepartment of Woman, Child and General and Specialized Surgery, University of Studies of Campania “Luigi Vanvitelli”, Napoli 80138, ItalyCorrespondence: Pierluigi MarzuilloDepartment of Woman, Child and General and Specialized Surgery, University of Studies of Campania “Luigi Vanvitelli”, 80138 Napoli, ItalyTel +39 081 566 5465Email pierluigi.marzuillo@gmail.comAbstract: Non-alcoholic fatty liver disease (NAFLD) represents the most common cause of chronic liver disease in childhood. To date, the “multiple-hit” hypothesis is largely recognized as an explanation of NAFLD pathogenesis and progression. Obesity and features of the metabolic syndrome have been closely linked to NAFLD development. Due to the increased prevalence of obesity worldwide, NAFLD has reached epidemic proportions over time. Given its unfavorable cardiometabolic burden (such as cardiovascular and metabolic consequences), it represents a worrying phenomenon needing a more comprehensive and successful management. Laboratory tests and classical imaging techniques play a pivotal role in NAFLD diagnosis, but novel noninvasive alternative methods to diagnose and monitor NAFLD have been investigated. Currently, lifestyle modifications remain the mainstay treatment, although its efficacy is poor because of the lack of compliance. Pediatric research is focusing on multiple alternative treatments targeting the main pathogenic factors such as insulin-resistance, dyslipidemia, gut-liver axis and microbiota, oxidative stress, and proinflammatory pathways. Results from these studies are promising but larger validation is needed. Innovative therapeutic approaches might add an important piece in the complex knowledge of pediatric NAFLD. We aimed to summarize recent insights into NAFLD diagnosis and treatment in children, with a focus on possible future perspectives in pediatric research.Keywords: fatty, liver, pediatric, diagnosis, management

Published
2019

22. Glasses: a new view from QED coherence

Author

Del Giudice, E., Preparata, G., and Buzzacchi, M.

Subjects
Condensed Matter
Abstract

Faced with the Kauzmann paradox, glasses have always been a puzzle for condensed matter theorists. We show that in a new picture of condensed matter, which takes into account the coherent interaction mechanisms of QED, glasses are nothing but liquids, whose non coherent fraction is highly depleted, very close to zero near T$_g$, the temperature of glass formation. Using the recently developed QED theory of liquid water, we are also able to give a successful account of the surprising finding of two low-temperature water amorphs and of their phase-transition.

Published
1999

23. Bose-Einstein vs. electrodynamic condensates: the question of order and coherence

Author

Del Giudice, E. and Preparata, G.

Subjects
Condensed Matter - Statistical Mechanics
Abstract

The remarkable recent experiments on ensembles of magnetically trapped ultracold alkali atoms have demonstrated the transition to a highly ordered phase, that has been attributed to the process of quantum-mechanical condensation, predicted long ago (1924) by Bose and Einstein. After having presented our argument against the above attribution, we show that the known phenomenology, including a discrepancy of about one order of magnitude with the predictions of Bose- Einstein condensation, is in good agreement with the electromagnetic coherence induced on the alkali atoms by the long range electrodynamic interactions. We also predict that for temperatures lower than a well defined $T_{BEC}$, the state predicted by Bose and Einstein coexists with the new coherent electrodynamic state., Comment: 6 pages

Published
1998

24. A tale of two condensates: the odd 'Bose - Einstein' condensation of atomic Hydrogen

Author

Del Giudice, E. and Preparata, G.

Subjects
Condensed Matter - Statistical Mechanics
Abstract

The recent report of the observation of Bose-Einstein condensation in atomic Hydrogen, characterized by an "anomalous" density spectrum, is shown to be in agreement with the prediction of the existence of two condensates for temperatures lower than a well defined temperature (which for Hydrogen is $ 105~ \mu K $), based on the QED coherent interaction in a gas of ultracold atoms at a density $n > n_0 (n_0=(1/\lambda)^3, \lambda$ being the wave-length of the e.m. modes resonantly coupled to the Hydrogen atoms), Comment: 5 pages, 1 table, 1 figure in preparation (sorry for the trouble)

Published
1998

25. Sonoluminescence Unveiled ?

Author

Buzzacchi, M., Del Giudice, E., and Preparata, G.

Subjects
Quantum Physics
Abstract

The widening phenomenology of Single Bubble Sonoluminescence (SBSL) is shown to be in good agreement with a new approach to condensed matter, based on the QED coherent interactions. Some remarkable properties of SBSL are shown to emerge from the electromagnetic release of part of the latent heat of the water's vapour-liquid phase transition occurring at the bubble surface after it becomes supersonic., Comment: LaTeX, 3 postscript figures

Published
1998

26. Anomalies in H2O-D2O mixtures: Evidence for the Two-Fluid Structure of Water

Author

Buzzacchi, M., Del Giudice, E., and Preparata, G.

Subjects
Condensed Matter - Statistical Mechanics, Condensed Matter - Materials Science, Quantum Physics
Abstract

Recent probing of H2O-D2O mixtures by various means (neutron deep-inelastic scattering, Raman absorption, electrical H+/D+ conductivity) revealed an unexpected dependence of the relevant physical quantities on the isotopic composition of the mixture. We show that these observation can find their physical rationale in the context of an approach to the physics of liquid water which takes into account the non-negligible interaction of the molecules with the electromagnetic field, from which a two-fluid micro- scopical picture of water naturally emerges., Comment: 13 pages Latex, 5 PostScript figures

Published
1998

27. Coherent Electrodynamic Processes in Solid Molecular Hydrogen

Author

Buzzacchi, M., Del Giudice, E., Preparata, G., and Xue, S. S.

Subjects
Condensed Matter - Materials Science, Condensed Matter - Statistical Mechanics, High Energy Physics - Phenomenology, Quantum Physics
Abstract

The many experimental puzzles of solid hydrogen, that seem to defy the generally accepted view of condensed matter, are shown to be a rather straightforward consequence of a new approach to condensed matter physics, that takes into account the coherent electrodynamic processes, predicted by Quantum ElectroDynamics (QED) that have been so far overlooked. As a consequence, a revision of the present view, based on electrostatic forces only, is called for., Comment: 5 pages, 4 figures

Published
1998

29. On the Dielectric Instability of High-Pressure Hydrogen

Author

Buzzacchi, M., Del Giudice, E., Preparata, G., and Xue, S. - S.

Subjects
Condensed Matter - Statistical Mechanics, Condensed Matter - Materials Science, Quantum Physics
Abstract

We present a comment on a recent letter by B. Edwards, N.W. Ashcroft, Nature 388 (1997) 652, in which the dielectric instabilty of the phase III of the solid molecular hydrogen system is suggested on the basis of electrostatics., Comment: 3 pages LaTex, a letter to the Scientific Correspondence section of Nature

Published
1997

31. Gender Differences in Radiation Dose From Nuclear Cardiology Studies Across the World: Findings From the INCAPS Registry

Author

Einstein, A.J., Pascual, T.N.B., Paez, D., Dondi, M., Better, N., Bouyoucef, S.E., Karthikeyan, G., Kashyap, R., Lele, V., Magboo, V.P.C., Mahmarian, J.J., Meeks, J.B., Mercuri, M., Mut, F., Rehani, M.M., Vitola, J.V., Alexanderson, E., Allam, A., Al-Mallah, M.H., Bom, H., Flotats, A., Jerome, S., Kaufmann, P.A., Luxenburg, O., Mahmarian, J., Shaw, L.J., Underwood, S.R., Vitola, J., Amouri, W., Essabbah, H., Gassama, S.S., Makhdomi, K.B., El Mustapha, G.I.E., El Ouchdi, N., Qaïs, N., Soni, N., Vangu, W., Abazid, R.M., Adams, B., Agarwal, V., Alfeeli, M.A., Alnafisi, N., Bernabe, L., Bural, G.G., Chaiwatanarat, T., Chandraguptha, J.M., Cheon, G.J., Cho, I., Dogan, A.S., Eftekhari, M., Frenkel, A., Garty, I., George, S., Geramifar, P., Golan, H., Habib, S., Hussain, R., Im, H., Jeon, H.-J., Kalawat, T., Kang, W.J., Keng, F., Klaipetch, A., Kumar, P.G., Lee, J., Lee, W.W., Lim, I., Macaisa, C.M.M., Malhotra, G., Mittal, B.R., Mohammad, M.H., Mohan, P., Mulyanto, I.D., Nariman, D., Nayak, U.N., Niaz, K., Nikolov, G., Obaldo, J.M., Ozturk, E., Park, J.M., Park, S., Patel, C.D., Phuong, H.K., Quinon, A.P., Rajini, T.R., Saengsuda, Y., Santiago, J., Sayman, H.B., Shinto, A.S., Sivasubramaniyan, V., Son, M.H., Sudhakar, P., Syed, G.M.S., Tamaki, N., Thamnirat, K., Thientunyakit, T., Thongmak, S., Velasco, D.N., Verma, A., Vutrapongwatana, U., Wang, Y., Won, K.S., Yao, Z., Yingsa-nga, T., Yudistiro, R., Yue, K.T., Zafrir, N., Adrian, S.C., Agostini, D., Aguadé, S., Armitage, G., Backlund, M., Backman, M., Baker, M., Balducci, M.T., Bavelaar, C., Berovic, M., Bertagna, F., Beuchel, R., Biggi, A., Bisi, G., Bonini, R., Bradley, A., Brudin, L., Bruno, I., Busnardo, E., Casoni, R., Choudhri, A., Cittanti, C., Clauss, R., Costa, D.C., Costa, M., Dixon, K., Dziuk, M., Egelic, N., Eriksson, I., Fagioli, G., de Faria, D.B., Florimonte, L., Francini, A., French, M., Gallagher, E., Garai, I., Geatti, O., Genovesi, D., Gianolli, L., Gimelli, A., del Giudice, E., Halliwell, S., Hansson, M.J., Harrison, C., Homans, F., Horton, F., Jędrzejuk, D., Jogi, J., Johansen, A., Johansson, H., Kalnina, M., Kaminek, M., Kiss, A., Kobylecka, M., Kostkiewicz, M., Kropp, J., Kullenberg, R., Lahoutte, T., Lang, O., Larsson, Y.H., Lázár, M., Leccisotti, L., Leners, N., Lindner, O., Lipp, R.W., Maenhout, A., Maffioli, L., Marcassa, C., Martins, B., Marzullo, P., Medolago, G., Mendiguchía, C.G., Mirzaei, S., Mori, M., Nardi, B., Nazarenko, S., Nikoletic, K., Oleksa, R., Parviainen, T., Patrina, J., Peace, R., Pirich, C., Piwowarska-Bilska, H., Popa, S., Prakash, V., Pubul, V., Puklavec, L., Rac, S., Ratniece, M., Rogan, S.A., Romeo, A., Rossi, M., Ruiz, D., Sabharwal, N., Salobir, B.G., Santos, A.I., Saranovic, S., Sarkozi, A., Schneider, R.P., Sciagra, R., Scotti, S., Servini, Z., Setti, L.R., Starck, S.-Å., Vajauskas, D., Veselý, J., Vieni, A., Vignati, A., Vito, I.M., Weiss, K., Wild, D., Zdraveska-Kochovska, M., Agüro, R.N., Alvarado, N., Barral, C.M., Beretta, M., Berrocal, I., Batista Cuellar, J.F., Cabral Chang, T.-M., Cabrera Rodríguez, L.O., Canessa, J., Castro Mora, G., Claudia, A.C., Clavelo, G.F., Cruz Júnior, A.F., Faccio, F.F., Fernández, K.M., Gomez Garibo, J.R., Gonzalez, U., González E., P., Guzzo, M.A., Jofre, J., Kapitán, M., Kempfer, G., Lopez, J.L., Massardo V., T., Medeiros Colaco, I., Mesquita, C.T., Montecinos, M., Neubauer, S., Pabon, L.M., Puente, A., Rochela Vazquez, L.M., Serna Macias, J.A., Silva Pino, A.G., Tártari Huber, F.Z., Tovar, A.P., Vargas, L., Wiefels, C., Aljizeeri, A., Alvarez, R.J., Barger, D., Beardwood, W., Behrens, J., Brann, L., Brown, D., Carr, H., Churchwell, K., Comingore, G.A., Corbett, J., Costello, M., Cruz, F., Depinet, T., Dorbala, S., Earles, M., Esteves, F.P., Etherton, E., Fanning, R.J., Jr., Fornace, J., Franks, L., Gewirtz, H., Gulanchyn, K., Hannah, C.-L., Hays, J., Hendrickson, J., Hester, J., Holmes, K., Johnson, A., Jopek, C., Lewin, H., Lyons, J., Manley, C., Meden, J., Moore, S., Moore, W.H., Murthy, V., Nace, R., Neely, D., Nelson, L., Niedermaier, O., Rice, D., Rigs, R., Schiffer, K., Schockling, E., Schultz, T., Schumacker, T., Sheesley, B., Sheikh, A., Siegel, B., Slim, A.M., Smith, J., Szulc, M., Tanskersley, N., Tilkemeier, P., Valdez, G.D., Vrooman, R., Wawrowicz, D., Winchester, D.E., Alcheikh, A., Allen, B., Atkins, E., Bevan, J., Bonomini, C., Christiansen, J., Clack, L., Craig, E., Dixson, H., Duncan, I., Fredericks, S., Gales, S., Hampson, R., Hanley, T., Hartcher, K., Hassall, J., Kelley, B., Kelly, S., Kidd, T., de Kort, T., Larcos, G., Macdonald, W., McGrath, C., Murdoch, E., O'Malley, S., O'Rourke, M., Pack, M., Pearce, R., Praehofer, R., Ramsay, S., Scarlett, L., Smidt, K., Souvannavong, F., Taubman, K., Taylor, G., Tse, K., Unger, S., Weale, J., Shi, Lynn, Dorbala, Sharmila, Paez, Diana, Shaw, Leslee J., Zukotynski, Katherine A., Pascual, Thomas N.B., Karthikeyan, Ganesan, Vitola, João V., Better, Nathan, Bokhari, Nadia, Rehani, Madan M., Kashyap, Ravi, Dondi, Maurizio, Mercuri, Mathew, and Einstein, Andrew J.

Published
2016
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33. Hypoglycaemia and hyperglycaemia in neonatal encephalopathy: a systematic review and meta-analysis

Author

Puzone, S, Diplomatico, M, Caredda, E, Maietta, A, Miraglia Del Giudice, E, and Montaldo, P

Abstract

Importance Although hypoglycaemia and hyperglycaemia represent the most common metabolic problem in neonates, there is still uncertainty regarding the effects of glucose homeostasis on the neurological outcomes of infants with neonatal encephalopathy (NE). Objective To systematically investigate the association between neonatal hypo and hyperglycaemia with adverse outcome in children who suffered from NE. Study selection We searched Pubmed, Embase, and Web of Science databases to identify studies which reported prespecified outcomes and compared infants with NE who had been exposed to neonatal hypoglycaemia or hyperglycaemia with infants not exposed. Data analysis We assessed the risk of bias (ROBINS-I), quality of evidence (GRADE) for each of the studies. REVMAN was used for meta-analysis (inverse variance, fixed effects). Main outcome Death or neurodevelopmental outcomes at 18 months of age or later. Results Eighty-two studies were screened, 28 reviewed in full, and 12 included. Children who were exposed to neonatal hypoglycaemia had higher odds of neurodevelopmental impairment or death (6 studies, 685 infants; 40.6 vs. 25.4%; OR= 2.17, 95%CI=1.46– 3.25; p=0.0001). Neonatal exposure to hyperglycaemia was associated with death or neurodisability at 18 months or later (7 studies, 807 infants; 46.1 vs. 28.0%; OR=3.07, 95%CI=2.17– 4.35; p

Published
2023

34. Recommendations on Complementary Feeding as a Tool for Prevention of Non-Communicable Diseases (NCDs)—Paper Co-Drafted by the SIPPS, FIMP, SIDOHaD, and SINUPE Joint Working Group

Author

Caroli, M, Vania, A, Verga, M, Di Mauro, G, Bergamini, M, Cuomo, B, D'Anna, R, D'Antonio, G, Iacono, I, Dessi, A, Doria, M, Fanos, V, Fiore, M, Francavilla, R, Genovesi, S, Giussani, M, Gritti, A, Iafusco, D, Leonardi, L, Miniello, V, Del Giudice, E, Palma, F, Pastore, F, Scotese, I, Simeone, G, Squicciarini, M, Tezza, G, Troiano, E, Umano, G, Caroli M., Vania A., Verga M. C., Di Mauro G., Bergamini M., Cuomo B., D'anna R., D'antonio G., Iacono I. D., Dessi A., Doria M., Fanos V., Fiore M., Francavilla R., Genovesi S., Giussani M., Gritti A., Iafusco D., Leonardi L., Miniello V. L., Del Giudice E. M., Palma F., Pastore F., Scotese I., Simeone G., Squicciarini M., Tezza G., Troiano E., Umano G. R., Caroli, M, Vania, A, Verga, M, Di Mauro, G, Bergamini, M, Cuomo, B, D'Anna, R, D'Antonio, G, Iacono, I, Dessi, A, Doria, M, Fanos, V, Fiore, M, Francavilla, R, Genovesi, S, Giussani, M, Gritti, A, Iafusco, D, Leonardi, L, Miniello, V, Del Giudice, E, Palma, F, Pastore, F, Scotese, I, Simeone, G, Squicciarini, M, Tezza, G, Troiano, E, Umano, G, Caroli M., Vania A., Verga M. C., Di Mauro G., Bergamini M., Cuomo B., D'anna R., D'antonio G., Iacono I. D., Dessi A., Doria M., Fanos V., Fiore M., Francavilla R., Genovesi S., Giussani M., Gritti A., Iafusco D., Leonardi L., Miniello V. L., Del Giudice E. M., Palma F., Pastore F., Scotese I., Simeone G., Squicciarini M., Tezza G., Troiano E., and Umano G. R.

Abstract

Adequate and balanced nutrition is essential to promote optimal child growth and a long and healthy life. After breastfeeding, the second step is the introduction of complementary feeding (CF), a process that typically covers the period from 6 to 24 months of age. This process is, however, still highly controversial, as it is heavily influenced by socio-cultural choices, as well as by the availability of specific local foods, by family traditions, and pediatrician beliefs. The Società Italiana di Pediatria Preventiva e Sociale (SIPPS) together with the Federazione Italiana Medici Pediatri (FIMP), the Società Italiana per lo Sviluppo e le Origine della Salute e delle Malattie (SIDOHaD), and the Società Italiana di Nutrizione Pediatrica (SINUPE) have developed evidence-based recommendations for CF, given the importance of nutrition in the first 1000 days of life in influencing even long-term health outcomes. This paper includes 38 recommendations, all of them strictly evidence-based and overall addressed to developed countries. The recommendations in question cover several top-ics such as the appropriate age for the introduction of CF, the most appropriate quantitative and qualitative modalities to be chosen, and the relationship between CF and the development of Non-Communicable Diseases (NCDs) later in life.

Published
2022

35. Musculoskeletal manifestations in children with Behçet’s syndrome: data from the AIDA Network Behçet’s Syndrome Registry

Author

Gaggiano, C. Maselli, A. Sfikakis, P.P. Laskari, K. Ragab, G. Hegazy, M.T. Laymouna, A.H. Lopalco, G. Almaghlouth, I.A. Asfina, K.N. Alahmed, O. Giardini Mayrink, H.A. Parente de Brito Antonelli, I. Cattalini, M. Piga, M. Sota, J. Gentileschi, S. Maggio, M.C. Opris-Belinski, D. Hatemi, G. Insalaco, A. Olivieri, A.N. Tufan, A. Karadeniz, H. Kardaş, R.C. La Torre, F. Cardinale, F. Marino, A. Guerriero, S. Ruscitti, P. Tarsia, M. Vitale, A. Caggiano, V. Telesca, S. Iannone, F. Parretti, V. Frassi, M. Aragona, E. Ciccia, F. Wiesik-Szewczyk, E. Ionescu, R. Şahin, A. Akkoç, N. Hinojosa-Azaola, A. Tharwat, S. Hernández-Rodríguez, J. Espinosa, G. Conti, G. Del Giudice, E. Govoni, M. Emmi, G. Fabiani, C. Balistreri, A. Frediani, B. Rigante, D. Cantarini, L. the AIDA Network and Gaggiano, C. Maselli, A. Sfikakis, P.P. Laskari, K. Ragab, G. Hegazy, M.T. Laymouna, A.H. Lopalco, G. Almaghlouth, I.A. Asfina, K.N. Alahmed, O. Giardini Mayrink, H.A. Parente de Brito Antonelli, I. Cattalini, M. Piga, M. Sota, J. Gentileschi, S. Maggio, M.C. Opris-Belinski, D. Hatemi, G. Insalaco, A. Olivieri, A.N. Tufan, A. Karadeniz, H. Kardaş, R.C. La Torre, F. Cardinale, F. Marino, A. Guerriero, S. Ruscitti, P. Tarsia, M. Vitale, A. Caggiano, V. Telesca, S. Iannone, F. Parretti, V. Frassi, M. Aragona, E. Ciccia, F. Wiesik-Szewczyk, E. Ionescu, R. Şahin, A. Akkoç, N. Hinojosa-Azaola, A. Tharwat, S. Hernández-Rodríguez, J. Espinosa, G. Conti, G. Del Giudice, E. Govoni, M. Emmi, G. Fabiani, C. Balistreri, A. Frediani, B. Rigante, D. Cantarini, L. the AIDA Network

Abstract

This study aims to describe musculoskeletal manifestations (MSM) in children with Behçet’s syndrome (BS), their association with other disease manifestations, response to therapy, and long-term prognosis. Data were retrieved from the AIDA Network Behçet’s Syndrome Registry. Out of a total of 141 patients with juvenile BS, 37 had MSM at disease onset (26.2%). The median age at onset was 10.0 years (IQR 7.7). The median follow-up duration was 21.8 years (IQR 23.3). Recurrent oral (100%) and genital ulcers (67.6%) and pseudofolliculitis (56.8%) were the most common symptoms associated with MSM. At disease onset, 31 subjects had arthritis (83.8%), 33 arthralgia (89.2%), and 14 myalgia (37.8%). Arthritis was monoarticular in 9/31 cases (29%), oligoarticular in 10 (32.3%), polyarticular in 5 (16.1%), axial in 7 (22.6%). Over time, arthritis became chronic-recurrent in 67.7% of cases and 7/31 patients had joint erosions (22.6%). The median Behçet's Syndrome Overall Damage Index was 0 (range 0–4). Colchicine was inefficacious for MSM in 4/14 cases (28.6%), independently from the type of MSM (p = 0.46) or the concomitant therapy (p = 0.30 for cDMARDs, p = 1.00 for glucocorticoids); cDMARDs and bDMARDs were inefficacious for MSM in 6/19 (31.4%) and 5/12 (41.7%) cases. The presence of myalgia was associated with bDMARDs inefficacy (p = 0.014). To conclude, MSM in children with BS are frequently associated with recurrent ulcers and pseudofolliculitis. Arthritis is mostly mono- or oligoarticular, but sacroiliitis is not unusual. Prognosis of this subset of BS is overall favorable, though the presence of myalgia negatively affects response to biologic therapies. ClinicalTrials.gov Identifier: NCT05200715 (registered on December 18, 2021). © 2023, The Author(s).

Published
2023

36. Preliminary data revealing efficacy of Streptococcus salivarius K12 (SSK12) in Periodic Fever, Aphthous stomatitis, Pharyngitis, and cervical Adenitis (PFAPA) syndrome: A multicenter study from the AIDA Network PFAPA syndrome registry

Author

La Torre, F. Sota, J. Insalaco, A. Conti, G. Del Giudice, E. Lubrano, R. Breda, L. Maggio, M.C. Civino, A. Mastrorilli, V. Loconte, R. Natale, M.F. Celani, C. Romeo, M. Patroniti, S. Gentile, C. Vitale, A. Caggiano, V. Gaggiano, C. Diomeda, F. Cattalini, M. Lopalco, G. Emmi, G. Parronchi, P. Gentileschi, S. Cardinale, F. Aragona, E. Shahram, F. Marino, A. Barone, P. Moscheo, C. Ozkiziltas, B. Carubbi, F. Alahmed, O. Iezzi, L. Ogunjimi, B. Mauro, A. Tarsia, M. Mahmoud, A.A.-M.A. Giardini, H.A.M. Sfikakis, P.P. Laskari, K. Więsik-Szewczyk, E. Hernández-Rodríguez, J. Frediani, B. Gómez-Caverzaschi, V. Tufan, A. Almaghlouth, I.A. Balistreri, A. Ragab, G. Fabiani, C. Cantarini, L. Rigante, D. for the AIDA Network and La Torre, F. Sota, J. Insalaco, A. Conti, G. Del Giudice, E. Lubrano, R. Breda, L. Maggio, M.C. Civino, A. Mastrorilli, V. Loconte, R. Natale, M.F. Celani, C. Romeo, M. Patroniti, S. Gentile, C. Vitale, A. Caggiano, V. Gaggiano, C. Diomeda, F. Cattalini, M. Lopalco, G. Emmi, G. Parronchi, P. Gentileschi, S. Cardinale, F. Aragona, E. Shahram, F. Marino, A. Barone, P. Moscheo, C. Ozkiziltas, B. Carubbi, F. Alahmed, O. Iezzi, L. Ogunjimi, B. Mauro, A. Tarsia, M. Mahmoud, A.A.-M.A. Giardini, H.A.M. Sfikakis, P.P. Laskari, K. Więsik-Szewczyk, E. Hernández-Rodríguez, J. Frediani, B. Gómez-Caverzaschi, V. Tufan, A. Almaghlouth, I.A. Balistreri, A. Ragab, G. Fabiani, C. Cantarini, L. Rigante, D. for the AIDA Network

Abstract

Objective: To evaluate the potential role of Streptococcus salivarius K12 (SSK12) in controlling febrile flares in patients with Periodic Fever, Aphthous stomatitis, Pharyngitis, and cervical Adenitis (PFAPA) syndrome. Further aims were to assess the impact of SSK12 on (i) flare duration, (ii) variation in the degree of the highest body temperature during flares, (iii) steroid-sparing effect, and (iv) change of PFAPA accompanying symptoms before and after SSK12 introduction. Patients and methods: The medical charts from 85 pediatric patients with PFAPA syndrome (49 males and 36 females) enrolled in the AIDA registry and treated with SSK12 for a median period of 6.00 ± 7.00 months in the period between September 2017 and May 2022 were examined. Children recruited had a median time of disease duration of 19.00 ± 28.00 months. Results: The number of febrile flares significantly decreased comparing the 12 months before [median (IQR), 13.00 (6.00)] and after SSK12 initiation [median (IQR), 5.50 (8.00), p < 0.001]. The duration of fever was significantly reduced from 4.00 (2.00) days to 2.00 (2.00) days [p < 0.001]. Similarly, the highest temperature in°C was found significantly lower in the last follow-up assessment [median (IQR), 39.00 (1.00)] compared to the period prior to SSK12 start [median (IQR), 40.00 (1.00), p < 0.001]. Steroid load (mg/year) of betamethasone (or any equivalent steroid) significantly decreased between 12 months before treatment with SSK12 [median (IQR), 5.00 (8.00) mg/year] and the last follow-up visit [median (IQR), 2.00 (4.00) mg/year, p < 0.001]. The number of patients experiencing symptoms including pharyngitis/tonsillitis (p < 0.001), oral aphthae (p < 0.001) and cervical lymphadenopathy (p < 0.001) significantly decreased following SSK12. Conclusion: SSK12 prophylaxis given for at least 6.00 months was found to reduce febrile flares of PFAPA syndrome: in particular, it halved the total number per year of fever flares, s

Published
2023

37. Preliminary data revealing efficacy of Streptococcus salivarius K12 (SSK12) in Periodic Fever, Aphthous stomatitis, Pharyngitis, and cervical Adenitis (PFAPA) syndrome: a multicenter study from the AIDA Network PFAPA syndrome registry

Author

La Torre, F, Sota, J, Insalaco, A, Conti, G, Del Giudice, E, Lubrano, R, Breda, L, Maggio, Mc, Civino, A, Mastrorilli, V, Loconte, R, Natale, Mf, Celani, C, Romeo, M, Patroniti, S, Gentile, C, Vitale, A, Caggiano, V, Gaggiano, C, Diomeda, F, Cattalini, M, Lopalco, G, Emmi, G, Parronchi, P, Gentileschi, S, Cardinale, F, Aragona, E, Shahram, F, Marino, A, Barone, P, Moscheo, C, Ozkiziltas, B, Carubbi, F, Alahmed, O, Iezzi, Ludovica, Ogunjimi, B, Mauro, A, Tarsia, M, Mahmoud, Aaa, Mayrink Giardini, Ham, Sfikakis, Pp, Laskari, K, Więsik-Szewczyk, E, Hernàndez-Rodriguez, J, Frediani, B, Gòmez-Caverzaschi, V, Tufan, A, Almaghlouth, Ia, Balistreri, A, Ragab, G, Fabiani, C, Cantarini, L, Rigante, Donato, Iezzi L, Rigante D (ORCID:0000-0001-7032-7779), La Torre, F, Sota, J, Insalaco, A, Conti, G, Del Giudice, E, Lubrano, R, Breda, L, Maggio, Mc, Civino, A, Mastrorilli, V, Loconte, R, Natale, Mf, Celani, C, Romeo, M, Patroniti, S, Gentile, C, Vitale, A, Caggiano, V, Gaggiano, C, Diomeda, F, Cattalini, M, Lopalco, G, Emmi, G, Parronchi, P, Gentileschi, S, Cardinale, F, Aragona, E, Shahram, F, Marino, A, Barone, P, Moscheo, C, Ozkiziltas, B, Carubbi, F, Alahmed, O, Iezzi, Ludovica, Ogunjimi, B, Mauro, A, Tarsia, M, Mahmoud, Aaa, Mayrink Giardini, Ham, Sfikakis, Pp, Laskari, K, Więsik-Szewczyk, E, Hernàndez-Rodriguez, J, Frediani, B, Gòmez-Caverzaschi, V, Tufan, A, Almaghlouth, Ia, Balistreri, A, Ragab, G, Fabiani, C, Cantarini, L, Rigante, Donato, Iezzi L, and Rigante D (ORCID:0000-0001-7032-7779)

Abstract

Objective: To evaluate the potential role of Streptococcus salivarius K12 (SSK12) in controlling febrile flares in patients with Periodic Fever, Aphthous stomatitis, Pharyngitis, and cervical Adenitis (PFAPA) syndrome. Further aims were to assess the impact of SSK12 on (i) flare duration, (ii) variation in the degree of the highest body temperature during flares, (iii) steroid-sparing effect, and (iv) change of PFAPA accompanying symptoms before and after SSK12 introduction. Patients and methods: The medical charts from 85 pediatric patients with PFAPA syndrome (49 males and 36 females) enrolled in the AIDA registry and treated with SSK12 for a median period of 6.00±7.00 months in the period between September 2017 and May 2022 were examined. Children recruited had a median time of disease duration of 19.00±28.00 months. Results: The number of febrile flares significantly decreased comparing the 12 months before [median (IQR), 13.00 (6.00)] and after SSK12 initiation [median (IQR), 5.50 (8.00), p<0.001]. The duration of fever was significantly reduced from 4.00 (2.00) days to 2.00 (2.00) days [p<0.001]. Similarly, the highest temperature in °C was found significantly lower in the last follow-up assessment [median (IQR), 39.00 (1.00)] compared to the period prior to SSK12 start [median (IQR), 40.00 (1.00), p<0.001]. Steroid load (mg/year) of betamethasone (or any equivalent steroid) significantly decreased between 12 months before treatment with SSK12 [median (IQR), 5.00 (8.00) mg/year] and the last follow-up visit [median (IQR), 2.00 (4.00) mg/year, p<0.001]. The number of patients experiencing symptoms including pharyngitis/tonsillitis (p<0.001), oral aphthae (p<0.001) and cervical lymphadenopathy (p<0.001) significantly decreased following SSK12. Conclusion: SSK12 prophylaxis given for at least 6.00±7.00 months was found to reduce febrile flares of PFAPA syndrome: in particular, it halved the total number per year of fever flares, shortened the

Published
2023

38. The administration of methotrexate in patients with Still’s disease, “real-life” findings from AIDA Network Still Disease Registry

Author

362., Ruscitti P, Sota, J, Vitale, A, Lopalco, G, Iannone, F, Morrone, M, Giardini, Ham, D'Agostin, Ma, Antonelli, Ipb, Almaghlouth, I, Asfina, Kn, Khalil, N, Sfikakis, Pp, Laskari, K, Tektonidou, M, Ciccia, F, Iacono, D, Riccio, F, Ragab, G, Hussein, Ma, Govoni, M, Ruffilli, F, Direskeneli, H, Alibaz-Oner, F, Giacomelli, R, Navarini, L, Bartoloni, E, Riccucci, I, Martín-Nares, E, Torres-Ruiz, J, Cipriani, P, Di Cola, I, Hernández-Rodríguez, J, Gómez-Caverzaschi, V, Dagna, L, Tomelleri, A, Makowska, J, Brzezinska, O, Iagnocco, A, Bellis, E, Caggiano, V, Gaggiano, C, Tarsia, M, Mormile, I, Emmi, G, Sfriso, P, Monti, S, Erten, Ş, Del Giudice, E, Lubrano, R, Conti, G, Olivieri, An, Lo Gullo, A, Tharwat, S, Karamanakos, A, Gidaro, A, Maggio, Mc, La Torre, F, Cardinale, F, Ogunjimi, B, Maier, A, Sebastiani, Gd, Opris-Belinski, D, Frassi, M, Viapiana, O, Bizzi, E, Carubbi, F, Fotis, L, Tufan, A, Kardas, Rc, Więsik-Szewczyk, E, Jahnz-Różyk, K, Fabiani, C, Frediani, B, Balistreri, A, Rigante, Donato, Cantarini, L, Rigante D (ORCID:0000-0001-7032-7779), 362., Ruscitti P, Sota, J, Vitale, A, Lopalco, G, Iannone, F, Morrone, M, Giardini, Ham, D'Agostin, Ma, Antonelli, Ipb, Almaghlouth, I, Asfina, Kn, Khalil, N, Sfikakis, Pp, Laskari, K, Tektonidou, M, Ciccia, F, Iacono, D, Riccio, F, Ragab, G, Hussein, Ma, Govoni, M, Ruffilli, F, Direskeneli, H, Alibaz-Oner, F, Giacomelli, R, Navarini, L, Bartoloni, E, Riccucci, I, Martín-Nares, E, Torres-Ruiz, J, Cipriani, P, Di Cola, I, Hernández-Rodríguez, J, Gómez-Caverzaschi, V, Dagna, L, Tomelleri, A, Makowska, J, Brzezinska, O, Iagnocco, A, Bellis, E, Caggiano, V, Gaggiano, C, Tarsia, M, Mormile, I, Emmi, G, Sfriso, P, Monti, S, Erten, Ş, Del Giudice, E, Lubrano, R, Conti, G, Olivieri, An, Lo Gullo, A, Tharwat, S, Karamanakos, A, Gidaro, A, Maggio, Mc, La Torre, F, Cardinale, F, Ogunjimi, B, Maier, A, Sebastiani, Gd, Opris-Belinski, D, Frassi, M, Viapiana, O, Bizzi, E, Carubbi, F, Fotis, L, Tufan, A, Kardas, Rc, Więsik-Szewczyk, E, Jahnz-Różyk, K, Fabiani, C, Frediani, B, Balistreri, A, Rigante, Donato, Cantarini, L, and Rigante D (ORCID:0000-0001-7032-7779)

Abstract

Objectives: To describe clinical characteristics of patients with Still's disease treated with methotrexate (MTX) and to assess drug effectiveness evaluating change in disease activity, reduction of inflammatory markers, and glucocorticoid (GC)-sparing effect. Methods: Patients with Still's disease treated with MTX were assessed among those included in AIDA Network Still Disease Registry. Results: In this registry, 171 patients with Still's disease were treated with MTX (males 43.3%, age 37.1 ± 16.0 years). They were mainly characterised by joint features and fever without a prominent multiorgan involvement. MTX was administered with GCs in 68.4% of patients, with other conventional synthetic DMARDs in 6.4%, and with biologic DMARDs in 25.1%. A significant reduction of the modified systemic score was observed, and 38.6% patients were codified as being in clinical remission at the end of follow-up. The concomitant administration of a biologic DMARD resulted a predictor of the clinical remission. Furthermore, a reduction of inflammatory markers and ferritin levels was observed following the administration of MTX. Additionally, a marked reduction of the dosage of concomitant GCs was identified, while 36.7% discontinued such drugs. Male gender appeared as a predictor of GC discontinuation. MTX was discontinued in 12.3% of patients because of adverse effects, and in 12.3% for lack of efficacy. Conclusions: Clinical characteristics of patients with Still's disease treated with MTX were described, mainly joint features and fever without a prominent multiorgan involvement. The clinical usefulness of MTX was reported in reducing the disease activity, decreasing the inflammatory markers, and as GC-sparing agent.

Published
2023

39. A patient-driven registry on Behçet's disease: the AIDA for patients pilot project

Author

Gaggiano, C, Del Bianco, A, Sota, J, Gentileschi, S, Ruscitti, P, Giacomelli, R, Piga, M, Crisafulli, F, Monti, S, Emmi, G, De Paulis, A, Vitale, A, Tarsia, M, Caggiano, V, Nuzzolese, R, Parretti, V, Fabiani, C, Lopalco, G, Maier, A, Cattalini, M, Rigante, Donato, Govoni, M, Li Gobbi, F, Guiducci, S, Parronchi, P, Marino, A, Ciccia, F, Maggio, Mc, Aragona, E, Bartoloni, E, Iagnocco, A, Viapiana, O, Sebastiani, Gd, Guerriero, S, Insalaco, A, Del Giudice, E, Conti, G, Barone, P, Olivieri, An, Brucato, A, Carubbi, F, Triggianese, P, Mauro, A, Tosi, Gm, Fonollosa, A, Giardini, Ham, Ragab, G, Tharwat, S, Hernández-Rodríguez, J, Sfikakis, Pp, Laskari, K, Karamanakos, A, Espinosa, G, Shahram, F, Direskeneli, H, Hinojosa-Azaola, A, Opris-Belinski, D, Almaghlouth, Ia, Hatemi, G, Eksin, Ma, Önen, F, Więsik-Szewczyk, E, Akkoç, N, Tufan, A, Şahin, A, Erten, Ş, Ozen, S, Batu, Ed, Frediani, B, Balistreri, A, Cantarini, L, Rigante D (ORCID:0000-0001-7032-7779), Gaggiano, C, Del Bianco, A, Sota, J, Gentileschi, S, Ruscitti, P, Giacomelli, R, Piga, M, Crisafulli, F, Monti, S, Emmi, G, De Paulis, A, Vitale, A, Tarsia, M, Caggiano, V, Nuzzolese, R, Parretti, V, Fabiani, C, Lopalco, G, Maier, A, Cattalini, M, Rigante, Donato, Govoni, M, Li Gobbi, F, Guiducci, S, Parronchi, P, Marino, A, Ciccia, F, Maggio, Mc, Aragona, E, Bartoloni, E, Iagnocco, A, Viapiana, O, Sebastiani, Gd, Guerriero, S, Insalaco, A, Del Giudice, E, Conti, G, Barone, P, Olivieri, An, Brucato, A, Carubbi, F, Triggianese, P, Mauro, A, Tosi, Gm, Fonollosa, A, Giardini, Ham, Ragab, G, Tharwat, S, Hernández-Rodríguez, J, Sfikakis, Pp, Laskari, K, Karamanakos, A, Espinosa, G, Shahram, F, Direskeneli, H, Hinojosa-Azaola, A, Opris-Belinski, D, Almaghlouth, Ia, Hatemi, G, Eksin, Ma, Önen, F, Więsik-Szewczyk, E, Akkoç, N, Tufan, A, Şahin, A, Erten, Ş, Ozen, S, Batu, Ed, Frediani, B, Balistreri, A, Cantarini, L, and Rigante D (ORCID:0000-0001-7032-7779)

Abstract

Introduction: This paper describes the creation and preliminary results of a patient-driven registry for the collection of patient-reported outcomes (PROs) and patient-reported experiences (PREs) in Behçet’s disease (BD). Methods: The project was coordinated by the University of Siena and the Italian patient advocacy organization SIMBA (Associazione Italiana Sindrome e Malattia di Behçet), in the context of the AIDA (AutoInflammatory Diseases Alliance) Network programme. Quality of life, fatigue, socioeconomic impact of the disease and therapeutic adherence were selected as core domains to include in the registry. Results: Respondents were reached via SIMBA communication channels in 167 cases (83.5%) and the AIDA Network affiliated clinical centers in 33 cases (16.5%). The median value of the Behçet’s Disease Quality of Life (BDQoL) score was 14 (IQR 11, range 0–30), indicating a medium quality of life, and the median Global Fatigue Index (GFI) was 38.7 (IQR 10.9, range 1–50), expressing a significant level of fatigue. The mean Beliefs about Medicines Questionnaire (BMQ) necessity-concern differential was 0.9 ± 1.1 (range – 1.8–4), showing that the registry participants prioritized necessity belief over concerns to a limited extent. As for the socioeconomic impact of BD, in 104 out of 187 cases (55.6%), patients had to pay from their own pocket for medical exams required to reach the diagnosis. The low family socioeconomic status (p < 0.001), the presence of any major organ involvement (p < 0.031), the presence of gastro-intestinal (p < 0.001), neurological (p = 0.012) and musculoskeletal (p = 0.022) symptoms, recurrent fever (p = 0.002), and headache (p < 0.001) were associated to a higher number of accesses to the healthcare system. Multiple linear regression showed that the BDQoL score could significantly predict the global socioeconomic impact of BD (F = 14.519, OR 1.162 [CI 0.557–1.766], p < 0.001). Discussion: Preliminary results from the AID

Published
2023

40. Musculoskeletal manifestations in children with Behçet's syndrome: data from the AIDA Network Behçet's Syndrome Registry

Author

Gaggiano, C, Maselli, A, Sfikakis, Pp, Laskari, K, Ragab, G, Hegazy, Mt, Laymouna, Ah, Lopalco, G, Almaghlouth, Ia, Asfina, Kn, Alahmed, O, Giardini Mayrink, Ha, Parente de Brito Antonelli, I, Cattalini, M, Piga, M, Sota, J, Gentileschi, S, Maggio, Mc, Opris-Belinski, D, Hatemi, G, Insalaco, A, Olivieri, An, Tufan, A, Karadeniz, H, Kardaş, Rc, La Torre, F, Cardinale, F, Marino, A, Guerriero, S, Ruscitti, P, Tarsia, M, Vitale, A, Caggiano, V, Telesca, S, Iannone, F, Parretti, V, Frassi, M, Aragona, E, Ciccia, F, Wiesik-Szewczyk, E, Ionescu, R, Şahin, A, Akkoç, N, Hinojosa-Azaola, A, Tharwat, S, Hernández-Rodríguez, J, Espinosa, G, Conti, G, Del Giudice, E, Govoni, M, Emmi, G, Fabiani, C, Balistreri, A, Frediani, B, Rigante, Donato, Cantarini, L, Rigante D (ORCID:0000-0001-7032-7779), Gaggiano, C, Maselli, A, Sfikakis, Pp, Laskari, K, Ragab, G, Hegazy, Mt, Laymouna, Ah, Lopalco, G, Almaghlouth, Ia, Asfina, Kn, Alahmed, O, Giardini Mayrink, Ha, Parente de Brito Antonelli, I, Cattalini, M, Piga, M, Sota, J, Gentileschi, S, Maggio, Mc, Opris-Belinski, D, Hatemi, G, Insalaco, A, Olivieri, An, Tufan, A, Karadeniz, H, Kardaş, Rc, La Torre, F, Cardinale, F, Marino, A, Guerriero, S, Ruscitti, P, Tarsia, M, Vitale, A, Caggiano, V, Telesca, S, Iannone, F, Parretti, V, Frassi, M, Aragona, E, Ciccia, F, Wiesik-Szewczyk, E, Ionescu, R, Şahin, A, Akkoç, N, Hinojosa-Azaola, A, Tharwat, S, Hernández-Rodríguez, J, Espinosa, G, Conti, G, Del Giudice, E, Govoni, M, Emmi, G, Fabiani, C, Balistreri, A, Frediani, B, Rigante, Donato, Cantarini, L, and Rigante D (ORCID:0000-0001-7032-7779)

Abstract

This study aims to describe musculoskeletal manifestations (MSM) in children with Behçet’s syndrome (BS), their association with other disease manifestations, response to therapy, and long-term prognosis. Data were retrieved from the AIDA Network Behçet’s Syndrome Registry. Out of a total of 141 patients with juvenile BS, 37 had MSM at disease onset (26.2%). The median age at onset was 10.0 years (IQR 7.7). The median follow-up duration was 21.8 years (IQR 23.3). Recurrent oral (100%) and genital ulcers (67.6%) and pseudofolliculitis (56.8%) were the most common symptoms associated with MSM. At disease onset, 31 subjects had arthritis (83.8%), 33 arthralgia (89.2%), and 14 myalgia (37.8%). Arthritis was monoarticular in 9/31 cases (29%), oligoarticular in 10 (32.3%), polyarticular in 5 (16.1%), axial in 7 (22.6%). Over time, arthritis became chronic-recurrent in 67.7% of cases and 7/31 patients had joint erosions (22.6%). The median Behçet's Syndrome Overall Damage Index was 0 (range 0–4). Colchicine was inefcacious for MSM in 4/14 cases (28.6%), independently from the type of MSM (p=0.46) or the concomitant therapy (p=0.30 for cDMARDs, p=1.00 for glucocorticoids); cDMARDs and bDMARDs were inefcacious for MSM in 6/19 (31.4%) and 5/12 (41.7%) cases. The presence of myalgia was associated with bDMARDs inefcacy (p=0.014). To conclude, MSM in children with BS are frequently associated with recurrent ulcers and pseudofolliculitis. Arthritis is mostly mono- or oligoarticular, but sacroiliitis is not unusual. Prognosis of this subset of BS is overall favorable, though the presence of myalgia negatively afects response to biologic therapies.

Published
2023

41. Efficacy and Safety of Adalimumab in Pediatric Non-infectious Non-anterior Uveitis: Real-life Experience From the International AIDA Network Uveitis Registry

Author

Vitale, A., Casa, F. D., Guerriero, S., Ragab, G., Mauro, A., Caggiano, V., Cattalini, M., Del Giudice, E., Favale, R., Gaggiano, C., Bellicini, I., Paroli, M. P., Hegazy, M. T., Sota, J., Tufan, A., Balistreri, A., Almaghlouth, I., La Torre, F., Więsik-Szewczyk, E., Tarsia, M., Hinojosa-Azaola, A., Martín-Nares, E., Frediani, B., Tosi, G. M., Fonollosa, A., Hernández-Rodríguez, J., Amin, R. H., Lopalco, G., Rigante, Donato, Cantarini, L., Fabiani, C., Rigante D. (ORCID:0000-0001-7032-7779), Vitale, A., Casa, F. D., Guerriero, S., Ragab, G., Mauro, A., Caggiano, V., Cattalini, M., Del Giudice, E., Favale, R., Gaggiano, C., Bellicini, I., Paroli, M. P., Hegazy, M. T., Sota, J., Tufan, A., Balistreri, A., Almaghlouth, I., La Torre, F., Więsik-Szewczyk, E., Tarsia, M., Hinojosa-Azaola, A., Martín-Nares, E., Frediani, B., Tosi, G. M., Fonollosa, A., Hernández-Rodríguez, J., Amin, R. H., Lopalco, G., Rigante, Donato, Cantarini, L., Fabiani, C., and Rigante D. (ORCID:0000-0001-7032-7779)

Abstract

Introduction: Scientific evidence of the effectiveness of the tumor necrosis factor inhibitor adalimumab (ADA) in pediatric patients with non-infectious non-anterior uveitis is still limited. The aim of this study is to investigate the therapeutic role of ADA in a cohort of pediatric patients with non-anterior uveitis. MethodsThis is an international multicenter study analyzing real-life data referred to pediatric patients treated with ADA for intermediate uveitis/pars planitis, posterior uveitis and panuveitis. Data were drawn from the AutoInflammatory Disease Alliance (AIDA) registry for patients with uveitis. ResultsTwenty-one patients (36 affected eyes) were enrolled, and all patients benefited from ADA administration. In detail, 11 patients (19 affected eyes) did not experience further ocular inflammation after ADA introduction; 10 cases (17 affected eyes) showed a significant clinical improvement consisting of a decrease in severity and/or frequency of ocular relapses. The number of ocular flares dropped from 3.91 to 1.1 events/patient/year after ADA introduction (p = 0.0009); macular edema and retinal vasculitis were respectively observed in 18 eyes and 20 eyes at the start of ADA and in 4 eyes and 2 eyes at the last assessment. The mean daily glucocorticoid dosage significantly decreased from 26.8 +/- 16.8 mg/day at the start of ADA to 6.25 +/- 6.35 mg/day at the last assessment (p = 0.002). Intermediate uveitis/pars planitis (p = 0.01) and posterior uveitis (p = 0.03) were more frequently observed in patients with full response to ADA; panuveitis (p = 0.001) was significantly more frequent among patients continuing to experience uveitic flares. This could be related to a higher use of systemic glucocorticoids (p = 0.002) and conventional immunosuppressants (p = 0.007) at the start of ADA when treating intermediate uveitis/pars planitis. Regarding the safety profile, only one adverse event was reported during ADA treatment, consisting of the development of g

Published
2023

42. POS0756 EFFICACY AND SAFETY OF ADALIMUMAB IN PEDIATRIC NON-INFECTIOUS NON-ANTERIOR UVEITIS: REAL-LIFE EXPERIENCE FROM AIDA INTERNATIONAL REGISTRY

Author

Fabiani, C., primary, Vitale, A., additional, Della Casa, F., additional, Guerriero, S., additional, Ragab, G., additional, Brucato, A., additional, Cattalini, M., additional, Del Giudice, E., additional, Marino, A., additional, Paroli, M. P., additional, Gaggiano, C., additional, Sota, J., additional, Caggiano, V., additional, Tarsia, M., additional, Frediani, B., additional, and Cantarini, L., additional

Published
2023
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44. Impaired fasting glucose and impaired glucose tolerance in children and adolescents with overweight/obesity

Author

Di Bonito, P., Pacifico, L., Chiesa, C., Valerio, G., Miraglia del Giudice, E., Maffeis, C., Morandi, A., Invitti, C., Licenziati, M. R., Loche, S., Tornese, G., Franco, F., Manco, M., Baroni, M. G., Driul, D., Grandone, A., Incani, M., Pani, M. G., Tomat, Michela, Sanguigno, E., Gilardini, L., Pellegrin, M. C., and for the “CARdiometabolic risk factors in overweight and obese children in ITALY” (CARITALY) Study Group

Published
2017
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45. Diagnostic issues faced by a rare disease healthcare network during Covid-19 outbreak: data from the Campania Rare Disease Registry

Author

Limongelli G, Iucolano S, Monda E, Elefante P, De Stasio C, Lubrano I, Caiazza M, Mazzella M, Fimiani F, Galdo M, De Marchi G, Esposito M, Rubino M, Cirillo A, Fusco A, Esposito A, Trama U, Esposito S, Scarano G, Sepe J, Andria G, Orlando V, Menditto E, Chiodini P, Campania Rare Disease, Iolascon A, Franzese A, Sanduzzi Zamparelli A, Tessitore A, Romano A, Venosa A, Nunzia Olivieri A, Bianco A, La Manna A, Cerbone AM, Spasiano A, Agnese Stanziola A, Colao A, De Bellis A, Gambale A, Toriello A, Tufano A, Ciampa A, Maria Risitano A, Pisani A, Russo A, Volpe A, De Martino B, Amato B, De Fusco C, Piscopo C, Selleri C, Tucci C, Pignata C, Cioffi D, Melis D, Pasquali D, De Brasi D, Spitaleri D, Russo D, Martellotta D, De Michele E, Varricchio E, Miraglia Del Giudice E, Coscioni E, Cimino E, Pane F, Tranfa F, Pollio F, Lonardo F, Nuzzi F, Simonelli F, Trojsi F, Habetswallner F, Valentini G, Cerbone G, Parenti G, Tedeschi G, Capasso G, Battista Rossi G, Gaglione G, Sarnelli G, Argenziano G, Bellastella G, De Michele G, Fiorentino G, Spadaro G, Scala I, Santoro L, Zeppa L, Auricchio L, Elio Adinolfi L, Alessio M, Amitrano M, Savanelli MC, Russo MG, Ferrucci MG, Carbone MT, Pellecchia MT, Salerno M, Melone M, Del Donno M, Vitale M, Triggiani M, Della Monica M, Lo Presti M, Tenuta M, Mignogna MD, Schiavulli M, Zacchia M, Brunetti-Pierri N, Iovino P, Moscato P, Iandoli R, Scarpa R, Russo R, Troisi S, Sbordone S, Perrotta S, Fecarotta S, Sampaolo S, Cicalese V., Limongelli, Giuseppe, Iucolano, Stefano, Monda, Emanuele, Elefante, Pasquale, De Stasio, Chiara, Lubrano, Imma, Caiazza, Martina, Mazzella, Marialuisa, Fimiani, Fabio, Galdo, Maria, De Marchi, Giulia, Esposito, Martina, Rubino, Marta, Cirillo, Annapaola, Fusco, Adelaide, Esposito, Augusto, Trama, Ugo, Esposito, Salvatore, Scarano, Gioacchino, Sepe, Joseph, Andria, Generoso, Orlando, Valentina, Menditto, Enrica, Chiodini, Paolo, Iolascon, Achille, Franzese, Adriana, Sanduzzi Zamparelli, Alessandro, Tessitore, Alessandro, Romano, Alfonso, Venosa, Alfredo, Nunzia Olivieri, Alma, Bianco, Andrea, La Manna, Angela, Cerbone, Anna Maria, Spasiano, Anna, Agnese Stanziola, Anna, Colao, Annamaria, De Bellis, Annamaria, Gambale, Antonella, Toriello, Antonella, Tufano, Antonella, Ciampa, Antonio, Maria Risitano, Antonio, Pisani, Antonio, Russo, Antonio, Volpe, Antonio, De Martino, Bernardo, Amato, Bruno, De Fusco, Carmela, Piscopo, Carmelo, Selleri, Carmine, Tucci, Celeste, Pignata, Claudio, Cioffi, Daniela, Melis, Daniela, Pasquali, Daniela, De Brasi, Daniele, Spitaleri, Daniele, De Brasi, Davide, Russo, Domenico, Martellotta, Donata, De Michele, Elisa, Varricchio, Elziario, Miraglia Del Giudice, Emanuele, Coscioni, Enrico, Cimino, Ernesto, Pane, Fabrizio, Tranfa, Fausto, Pollio, Filiberto, Lonardo, Fortunato, Nuzzi, Francesca, Simonelli, Francesca, Trojsi, Francesca, Habetswallner, Francesco, Valentini, Gabriele, Cerbone, Gaetana, Parenti, Giancarlo, Tedeschi, Gioacchino, Capasso, Giovambattista, Battista Rossi, Giovanni, Gaglione, Giovanni, Sarnelli, Giovanni, Argenziano, Giuseppe, Bellastella, Giuseppe, De Michele, Giuseppe, Fiorentino, Giuseppe, Spadaro, Giuseppe, Scala, Iri, Santoro, Lucio, Zeppa, Lucio, Auricchio, Luigi, Elio Adinolfi, Luigi, Alessio, Maria, Amitrano, Maria, Savanelli, Maria Cristina, Russo, Maria Giovanna, Ferrucci, Maria Grazia, Carbone, Maria Teresa, Pellecchia, Maria Teresa, Salerno, Mariacarolina, Melone, Marina, Del Donno, Mario, Vitale, Mario, Triggiani, Massimo, Della Monica, Matteo, Lo Presti, Maurizio, Tenuta, Maurizio, Mignogna, Michele Davide, Schiavulli, Michele, Zacchia, Miriam, Brunetti-Pierri, Nicola, Iovino, Paola, Moscato, Paolo, Iandoli, Raffaele, Scarpa, Raffaele, Russo, Romualdo, Troisi, Salvatore, Sbordone, Sandro, Perrotta, Silverio, Fecarotta, Simona, Sampaolo, Simone, Cicalese, Virgilio, Limongelli, G, Iucolano, S, Monda, E, Elefante, P, De Stasio, C, Lubrano, I, Caiazza, M, Mazzella, M, Fimiani, F, Galdo, M, De Marchi, G, Esposito, M, Rubino, M, Cirillo, A, Fusco, A, Esposito, A, Trama, U, Esposito, S, Scarano, G, Sepe, J, Andria, G, Orlando, V, Menditto, E, Chiodini, P, Campania Rare, Disease, Iolascon, A, Franzese, A, Sanduzzi Zamparelli, A, Tessitore, A, Romano, A, Venosa, A, Nunzia Olivieri, A, Bianco, A, La Manna, A, Cerbone, Am, Spasiano, A, Agnese Stanziola, A, Colao, A, De Bellis, A, Gambale, A, Toriello, A, Tufano, A, Ciampa, A, Maria Risitano, A, Pisani, A, Russo, A, Volpe, A, De Martino, B, Amato, B, De Fusco, C, Piscopo, C, Selleri, C, Tucci, C, Pignata, C, Cioffi, D, Melis, D, Pasquali, D, De Brasi, D, Spitaleri, D, Russo, D, Martellotta, D, De Michele, E, Varricchio, E, Miraglia Del Giudice, E, Coscioni, E, Cimino, E, Pane, F, Tranfa, F, Pollio, F, Lonardo, F, Nuzzi, F, Simonelli, F, Trojsi, F, Habetswallner, F, Valentini, G, Cerbone, G, Parenti, G, Tedeschi, G, Capasso, G, Battista Rossi, G, Gaglione, G, Sarnelli, G, Argenziano, G, Bellastella, G, De Michele, G, Fiorentino, G, Spadaro, G, Scala, I, Santoro, L, Zeppa, L, Auricchio, L, Elio Adinolfi, L, Alessio, M, Amitrano, M, Savanelli, Mc, Russo, Mg, Ferrucci, Mg, Carbone, Mt, Pellecchia, Mt, Salerno, M, Melone, M, Del Donno, M, Vitale, M, Triggiani, M, Della Monica, M, Lo Presti, M, Tenuta, M, Mignogna, Md, Schiavulli, M, Zacchia, M, Brunetti-Pierri, N, Iovino, P, Moscato, P, Iandoli, R, Scarpa, R, Russo, R, Troisi, S, Sbordone, S, Perrotta, S, Fecarotta, S, Sampaolo, S, and Cicalese, V.

Subjects
Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Home therapy, rare diseases, 030204 cardiovascular system & hematology, Campania region, Covid-19, Italy, patient registry, Disease Outbreaks, 03 medical and health sciences, COVID-19 Testing, 0302 clinical medicine, Pandemic, Health care, medicine, Retrospective analysis, Humans, AcademicSubjects/MED00860, Registries, 030212 general & internal medicine, Medical diagnosis, Pandemics, Retrospective Studies, business.industry, Public Health, Environmental and Occupational Health, Outbreak, General Medicine, Original Article, business, Delivery of Health Care, Rare disease
Abstract

Background The aims of this study were: to investigate the capacity of the rare disease healthcare network in Campania to diagnose patients with rare diseases during the outbreak of Covid-19; and to shed light on problematic diagnoses during this period. Methods To describe the impact of the Covid-19 pandemic on the diagnosis of patients with rare diseases, a retrospective analysis of the Campania Region Rare Disease Registry was performed. A tailored questionnaire was sent to rare disease experts to investigate major issues during the emergency period. Results Prevalence of new diagnoses of rare disease in March and April 2020 was significantly lower than in 2019 (117 versus 317, P Conclusions This study describes the effects of the Covid-19 outbreak on the diagnosis of rare disease in a single Italian region and investigates potential issues of diagnosis and management during this period.

Published
2021
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46. A new DLK1 defect in a family with idiopathic central precocious puberty: elucidation of the male phenotype

Author

Palumbo, S., primary, Cirillo, G., additional, Sanchez, G., additional, Aiello, F., additional, Fachin, A., additional, Baldo, F., additional, Pellegrin, M. C., additional, Cassio, A., additional, Salerno, M., additional, Maghnie, M., additional, Faienza, M. F., additional, Wasniewska, M., additional, Fintini, D., additional, Giacomozzi, C., additional, Ciccone, S., additional, Miraglia del Giudice, E., additional, Tornese, G., additional, and Grandone, A., additional

Published
2022
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49. Impact of COVID-19 on the imaging diagnosis of cardiac disease in Europe

Author

Williams, M, Shaw, L, Hirschfeld, C, Maurovich-Horvat, P, Norgaard, B, Pontone, G, Jimenez-Heffernan, A, Sinitsyn, V, Sergienko, V, Ansheles, A, Bax, J, Buechel, R, Milan, E, Slart, R, Nicol, E, Bucciarelli-Ducci, C, Pynda, Y, Better, N, Cerci, R, Dorbala, S, Raggi, P, Villines, T, Vitola, J, Malkovskiy, E, Goebel, B, Cohen, Y, Randazzo, M, Pascual, T, Dondi, M, Paez, D, Einstein, A, Nasery, M, Goda, A, Shirka, E, Benlabgaa, R, Bouyoucef, S, Medjahedi, A, Nailli, Q, Agolti, M, Aguero, R, Del Carmen Alak, M, Alberguina, L, Arronada, G, Astesiano, A, Norton, C, Benteo, P, Blanco, J, Bonelli, J, Bustos, J, Cabrejas, R, Cachero, J, Campisi, R, Canderoli, A, Carames, S, Carrascosa, P, Castro, R, Cendoya, O, Cognigni, L, Collaud, C, Cortes, C, Courtis, J, Cragnolino, D, Daicz, M, De La Vega, A, De Maria, S, Del Riego, H, Dettori, F, Deviggiano, A, Dragonetti, L, Embon, M, Enriquez, R, Ensinas, J, Faccio, F, Facello, A, Garofalo, D, Geronazzo, R, Gonza, N, Gutierrez, L, Guzzo, M, Hasbani, V, Huerin, M, Jager, V, Lewkowicz, J, De Munain, M, Lotti, J, Marquez, A, Masoli, O, Mastrovito, E, Mayoraz, M, Melado, G, Mele, A, Merani, M, Meretta, A, Molteni, S, Montecinos, M, Noguera, E, Novoa, C, Sueldo, C, Ascani, S, Pollono, P, Pujol, M, Radzinschi, A, Raimondi, G, Redruello, M, Rodriguez, M, Romero, R, Acuna, A, Rovaletti, F, Miguel, L, Solari, L, Strada, B, Traverso, S, Traverzo, S, Del Huerto Velazquez Espeche, M, Weihmuller, J, Wolcan, J, Zeffiro, S, Sakanyan, M, Beuzeville, S, Boktor, R, Butler, P, Calcott, J, Carr, L, Chan, V, Chao, C, Chong, W, Dobson, M, Downie, D, Dwivedi, G, Elison, B, Engela, J, Francis, R, Gaikwad, A, Basavaraj, A, Goodwin, B, Greenough, R, Hamilton-Craig, C, Hsieh, V, Joshi, S, Lederer, K, Lee, K, Lee, J, Magnussen, J, Mai, N, Mander, G, Murton, F, Nandurkar, D, Neill, J, O'Rourke, E, O'Sullivan, P, Pandos, G, Pathmaraj, K, Pitman, A, Poulter, R, Premaratne, M, Prior, D, Ridley, L, Rutherford, N, Salehi, H, Saunders, C, Scarlett, L, Seneviratne, S, Shetty, D, Shrestha, G, Shulman, J, Solanki, V, Stanton, T, Stuart, M, Stubbs, M, Swainson, I, Taubman, K, Taylor, A, Thomas, P, Unger, S, Upton, A, Vamadevan, S, Van Gaal, W, Verjans, J, Voutnis, D, Wayne, V, Wilson, P, Wong, D, Wong, K, Younger, J, Feuchtner, G, Mirzaei, S, Weiss, K, Maroz-Vadalazhskaya, N, Gheysens, O, Homans, F, Moreno-Reyes, R, Pasquet, A, Roelants, V, Van De Heyning, C, Rios, R, Soldat-Stankovic, V, Stankovic, S, Siqueira, M, Almeida, A, Togni, P, Andrade, J, Andrade, L, Anselmi, C, Araujo, R, Azevedo, G, Bezerra, S, Biancardi, R, Grossman, G, Brandao, S, Pianta, D, Carreira, L, Castro, B, Chang, T, Cunali, F, Cury, R, Dantas, R, De Amorim Fernandes, F, De Lorenzo, A, De MacEdo Filho, R, Erthal, F, Fernandes, F, Fernandes, J, De Souza, T, Alves, W, Ghini, B, Goncalves, L, Gottlieb, I, Hadlich, M, Kameoka, V, Lima, R, Lima, A, Lopes, R, E Silva, R, Magalhaes, T, Silva, F, Mastrocola, L, Medeiros, F, Meneghetti, J, Naue, V, Naves, D, Nolasco, R, Nomura, C, Oliveira, J, Paixao, E, De Carvalho, F, Pinto, I, Possetti, P, Quinta, M, Ramos, R, Rocha, R, Rodrigues, A, Rodrigues, C, Romantini, L, Sanches, A, Santana, S, Da Silva, L, Schvartzman, P, Matushita, C, Senra, T, Shiozaki, A, De Siqueira, M, Siqueira, C, Smanio, P, Soares, C, Soares, J, Bittencourt, M, Spiro, B, Mesquita, C, Torreao, J, Torres, R, Uellendahl, M, Monte, G, Verissimo, O, Cabeda, E, Pedras, F, Waltrick, R, Zapparoli, M, Naseer, H, Garcheva-Tsacheva, M, Kostadinova, I, Theng, Y, Abikhzer, G, Barette, R, Chow, B, Dabreo, D, Friedrich, M, Garg, R, Hafez, M, Johnson, C, Kiess, M, Leipsic, J, Leung, E, Miller, R, Oikonomou, A, Probst, S, Roifman, I, Small, G, Tandon, V, Trivedi, A, White, J, Zukotynski, K, Canessa, J, Munoz, G, Concha, C, Hidalgo, P, Lovera, C, Massardo, T, Vargas, L, Abad, P, Arturo, H, Ayala, S, Benitez, L, Cadena, A, Caicedo, C, Moncayo, A, Gomez, S, Villamil, C, Jaimes, C, Londono, J, Blair, J, Pabon, L, Pineda, M, Rojas, J, Ruiz, D, Escobar, M, Vasquez, A, Vergel, D, Zuluaga, A, Gamboa, I, Castro, G, Gonzalez, U, Baric, A, Batinic, T, Franceschi, M, Hrabak, M, Jukic, M, Medakovic, P, Persic, V, Prpic, M, Punda, A, Batista, J, Lauchy, J, Gutierrez, Y, Menendez, R, Peix, A, Rochela, L, Panagidis, C, Petrou, I, Engelmann, V, Kaminek, M, Kincl, V, Lang, O, Simanek, M, Abdulla, J, Bottcher, M, Christensen, M, Gormsen, L, Hasbak, P, Hess, S, Holdgaard, P, Johansen, A, Kyhl, K, Ovrehus, K, Sand, N, Steffensen, R, Thomassen, A, Zerahn, B, Perez, A, Velez, G, Velez, M, Aziz, I, Abougabal, M, Ahmed, T, Allam, A, Asfour, A, Hassan, M, Hassan, A, Ibrahim, A, Kaffas, S, Kandeel, A, Ali, M, Mansy, A, Maurice, H, Nabil, S, Shaaban, M, Flores, A, Poksi, A, Knuuti, J, Kokkonen, V, Larikka, M, Uusitalo, V, Bailly, M, Burg, S, Deux, J, Habouzit, V, Hyafil, F, Lairez, O, Proffit, F, Regaieg, H, Sarda-Mantel, L, Tacher, V, Schneider, R, Ayetey, H, Angelidis, G, Archontaki, A, Chatziioannou, S, Datseris, I, Fragkaki, C, Georgoulias, P, Koukouraki, S, Koutelou, M, Kyrozi, E, Repasos, E, Stavrou, P, Valsamaki, P, Gonzalez, C, Gutierrez, G, Maldonado, A, Buga, K, Garai, I, Schmidt, E, Szilveszter, B, Varady, E, Banthia, N, Bhagat, J, Bhargava, R, Bhat, V, Bhatia, M, Choudhury, P, Chowdekar, V, Irodi, A, Jain, S, Joseph, E, Kumar, S, Mahapatra, G, Mitra, D, Mittal, B, Ozair, A, Patel, C, Patel, T, Patel, R, Patel, S, Saxena, S, Sengupta, S, Singh, S, Singh, B, Sood, A, Verma, A, Affandi, E, Alam, P, Edison, E, Gunawan, G, Hapkido, H, Hidayat, B, Huda, A, Mukti, A, Prawiro, D, Soeriadi, E, Syawaluddin, H, Albadr, A, Assadi, M, Emami, F, Houshmand, G, Maleki, M, Rostami, M, Zakavi, S, Zaid, E, Agranovich, S, Arnson, Y, Bar-Shalom, R, Frenkel, A, Knafo, G, Lugassi, R, Moalem, I, Mor, M, Muskal, N, Ranser, S, Shalev, A, Albano, D, Alongi, P, Arnone, G, Bagatin, E, Baldari, S, Bauckneht, M, Bertelli, P, Bianco, F, Bonfiglioli, R, Boni, R, Bruno, A, Bruno, I, Busnardo, E, Califaretti, E, Camoni, L, Carnevale, A, Casoni, R, Cavallo, A, Cavenaghi, G, Chierichetti, F, Chiocchi, M, Cittanti, C, Colletta, M, Conti, U, Cossu, A, Cuocolo, A, Cuzzocrea, M, De Rimini, M, De Vincentis, G, Del Giudice, E, Del Torto, A, Della Tommasina, V, Durmo, R, Erba, P, Evangelista, L, Faletti, R, Faragasso, E, Farsad, M, Ferro, P, Florimonte, L, Frantellizzi, V, Fringuelli, F, Gatti, M, Gaudiano, A, Gimelli, A, Giubbini, R, Giuffrida, F, Ialuna, S, Laudicella, R, Leccisotti, L, Leva, L, Liga, R, Liguori, C, Longo, G, Maffione, M, Mancini, M, Marcassa, C, Nardi, B, Pacella, S, Pepe, G, Pulizzi, S, Quartuccio, N, Rampin, L, Ricci, F, Rossini, P, Rubini, G, Russo, V, Sacchetti, G, Sambuceti, G, Scarano, M, Sciagra, R, Sperandio, M, Stefanelli, A, Ventroni, G, Zoboli, S, Baugh, D, Chambers, D, Madu, E, Nunura, F, Asano, H, Chimura, C, Fujimoto, S, Fujisue, K, Fukunaga, T, Fukushima, Y, Fukuyama, K, Hashimoto, J, Ichikawa, Y, Iguchi, N, Imai, M, Inaki, A, Ishimura, H, Isobe, S, Kadokami, T, Kato, T, Kudo, T, Kumita, S, Maruno, H, Mataki, H, Miyagawa, M, Morimoto, R, Moroi, M, Nagamachi, S, Nakajima, K, Nakata, T, Nakazato, R, Nanasato, M, Naya, M, Norikane, T, Ohta, Y, Okayama, S, Okizaki, A, Otomi, Y, Otsuka, H, Saito, M, Sakata, S, Sarai, M, Sato, D, Shiraishi, S, Suwa, Y, Takanami, K, Takehana, K, Taki, J, Tamaki, N, Taniguchi, Y, Teragawa, H, Tomizawa, N, Tsujita, K, Umeji, K, Wakabayashi, Y, Yamada, S, Yamazaki, S, Yoneyama, T, Rawashdeh, M, Batyrkhanov, D, Dautov, T, Makhdomi, K, Ombati, K, Alkandari, F, Garashi, M, Coie, T, Rajvong, S, Kalinin, A, Kalnina, M, Haidar, M, Komiagiene, R, Kviecinskiene, G, Mataciunas, M, Vajauskas, D, Picard, C, Karim, N, Reichmuth, L, Samuel, A, Allarakha, M, Naojee, A, Alexanderson-Rosas, E, Barragan, E, Becerril, A, Gonzalez-Montecinos, Cabada, M, Rodriguez, D, Carvajal-Juarez, I, Cortes, V, Cortes, F, De La Pena, E, Gama-Moreno, M, Gonzalez, L, Ramirez, N, Jimenez-Santos, M, Matos, L, Monroy, E, Morelos, M, Ornelas, M, Ramirez, J, Preciado-Anaya, A, Preciado-Gutierrez, O, Barragan, 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J., Kaplan M., Khushica P., Lakhi H., Louw L., Malan N., Milos K., Modiselle M., More S., Naidoo M., Scholtz L., Vangu M., Aguade-Bruix S., Blanco I., Cabrera A., Camarero A., Casans-Tormo I., Cuellar-Calabria H., Flotats A., Canamero M. E. F., Garcia M. E., Leta R., Diaz J. L., Lumbreras L., Marquez-Cabeza J. J., Martin F., De Alegria A. M., Medina F., Canal M. P., Peiro V., Pubul-Nunez V., Madrid J. I. R., Rey C. R., Perez R. R., Ruiz J., Hernandez G. S., Sevilla A., Zeidan N., Nanayakkara D., Udugama C., Simonsson M., Alkadhi H., Buechel R. R., Burger P., Ceriani L., De Boeck B., Grani C., De Saint Lager Lucas A. J., Kamani C. H., Kawel-Boehm N., Manka R., Prior J. O., Rominger A., Vallee J. -P., Khiewvan B., Premprabha T., Thientunyakit T., Sellem A., Kir K. M., Sayman H., Sebikali M. J., Muyinda Z., Kmetyuk Y., Korol P., Mykhalchenko O., Pliatsek V., Satyr M., Albalooshi B., Hassan M. I. A., Anderson J., Bedi P., Biggans T., Bularga A., Bull R., Burgul R., Carpenter J. -P., Coles D., Cusack D., Deshpande A., Dougan J., Fairbairn T., Farrugia A., Gopalan D., Gummow A., Ramkumar P. G., Hamilton M., Harbinson M., Hartley T., Hudson B., Joshi N., Kay M., Kelion A., Khokhar A., Kitt J., Low C., Mak S. M., Marousa N., Martin J., McAlindon E., Menezes L., Morgan-Hughes G., Moss A., Murray A., Patel D., Peebles C., Pugliese F., Rodrigues J. C. L., Rofe C., Sabharwal N., Schofield R., Semple T., Sharma N., Strouhal P., Subedi D., Topping W., Tweed K., Weir-Mccall J., Abbara S., Abbasi T., Abbott B., Abohashem S., Abramson S., Al-Abboud T., Al-Mallah M., Almousalli O., Ananthasubramaniam K., Kumar M. A., Askew J., Attanasio L., Balmer-Swain M., Bayer R. R., Bernheim A., Bhatti S., Bieging E., Blankstein R., Bloom S., Blue S., Bluemke D., Borges A., Branch K., Bravo P., Brothers J., Budoff M., Bullock-Palmer R., Burandt A., Burke F. 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E., McKenna M., McRae T., Mendoza F., Merhige M., Min D., Moffitt C., Moncher K., Moore W., Morayati S., Morris M., Mossa-Basha M., Mrsic Z., Murthy V., Nagpal P., Napier K., Narula J., Nelson K., Nijjar P., Osman M., Parwani P., Passen E., Patel A., Patil P., Paul R., Phillips L., Polsani V., Poludasu R., Pomerantz B., Porter T., Prentice R., Pursnani A., Rabbat M., Ramamurti S., Rich F., Luna H. R., Robinson A., Robles K., Rodriguez C., Rorie M., Rumberger J., Russell R., Sabra P., Sadler D., Schemmer M., Schoepf U. J., Shah S., Shah N., Shanbhag S., Sharma G., Shayani S., Shirani J., Shivaram P., Sigman S., Simon M., Slim A., Smith D., Smith A., Soman P., Srichai-Parsia M. B., Streeter J., Albert T., Tawakol A., Thomas D., Thompson R., Torbet T., Trinidad D., Ullery S., Unzek S., Uretsky S., Vallurupalli S., Verma V., Waller A., Wang E., Ward P., Weissman G., Wesbey G., White K., Winchester D., Wolinsky D., Yost S., Zgaljardic M., Alonso O., Beretta M., Ferrando R., Kapitan M., Mut F., Djuraev O., Rozikhodjaeva G., Ngoc H. L., Mai S. H., and Nguyen X. C.

Abstract

Objectives We aimed to explore the impact of the COVID-19 pandemic on cardiac diagnostic testing and practice and to assess its impact in different regions in Europe. Methods The online survey organised by the International Atomic Energy Agency Division of Human Health collected information on changes in cardiac imaging procedural volumes between March 2019 and March/April 2020. Data were collected from 909 centres in 108 countries. Results Centres in Northern and Southern Europe were more likely to cancel all outpatient activities compared with Western and Eastern Europe. There was a greater reduction in total procedure volumes in Europe compared with the rest of the world in March 2020 (45% vs 41%, p=0.003), with a more marked reduction in Southern Europe (58%), but by April 2020 this was similar in Europe and the rest of the world (69% vs 63%, p=0.261). Regional variations were apparent between imaging modalities, but the largest reductions were in Southern Europe for nearly all modalities. In March 2020, location in Southern Europe was the only independent predictor of the reduction in procedure volume. However, in April 2020, lower gross domestic product and higher COVID-19 deaths were the only independent predictors. Conclusion The first wave of the COVID-19 pandemic had a significant impact on care of patients with cardiac disease, with substantial regional variations in Europe. This has potential long-term implications for patients and plans are required to enable the diagnosis of non-COVID- 19 conditions during the ongoing pandemic.

Published
2021

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