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4 results on '"Gabriele Zelent"'

1. Septic Shock, Tubular Necrosis, and Central Diabetes Insipidus: A Challenging Syndrome

Author

Gabriele Melegari, Antonio Manenti, Federica Arturi, Eugenia Gualdi, Sonia Filoni, Gabriele Zelent, and Alberto Barbieri

Subjects
Central diabetes insipidus, Campylobacter Upsaliensis, Septic shock, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9, Medicine
Abstract

Abstract Background The association between septic shock, acute tubular necrosis, and central diabetes insipidus is infrequent: our recent clinical observation invited us to deepen its pathophysiological features. Methods We reported an unusual case report of a young, healthy man with a septic shock, severe dehydration with a hematocrit of 70.6% caused by gastrointestinal infection and refractory renal failure, and persistent polyuria. Results The patient presented severe dehydration, hypovolemic shock with a hematocrit of 70.6%, and acute renal failure. The subsequent laboratory exams demonstrated a gastrointestinal infection of Campylobacter Upsaliensis and Helicobacter pylori. The persistent renal failure and polyuria later 20 days made it mandatory for further investigations. A Magnetic brain Resonance excluded encephalic lesions but demonstrated a posterior pituitary lobe hypointense. Conclusions This cascade of pathological events seems originated from a septic shock: the consequent increase in hematocrit and blood viscosity, estimated double the normal, with severe hypotensive shock correlated, decelerated the microcirculatory blood flow, until a proper blood stasis in the venous system. These factors caused hypoxia and possible venous thromboses, electively affecting the pituitary hypothalamic nuclei and their axons in the post-hypophysis and its portal system.

Published
2024
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2. Intracranial stenosis treated with stenting in patient with suspected cerebral vasculitis: two case reports.

Author

Gabriele Vandelli, Laura Giacobazzi, Ludovico Ciolli, Maria Luisa Dell'Acqua, Laura Vandelli, Livio Picchetto, Francesca Rosafio, Giuseppe Maria Borzì, Riccardo Ricceri, Stefano Meletti, Stefano Vallone, Carlo Salvarani, Marco Sebastiani, Federico Sacchetti, Luca Verganti, Stefano Merolla, Gabriele Zelent, and Guido Bigliardi

Subjects
Neurology. Diseases of the nervous system, RC346-429
Abstract

Central nervous system vasculitis (CNSV) is an uncommon and poorly understood form of vasculitis. Early recognition is important because medical treatment might improve the outcome. However, randomized clinical trials on CNSV treatment do not exist. Endovascular treatment has been reported in few cases, but no data exist for intracranial stenting. We report two cases of patients with suspected CNSV and recurrent clinical episodes, treated with intracranial stenting. A 48-year-old man had relapsing episodes of right hemiparesis. Neuroradiological exams showed severe left carotid terminus stenosis. Despite immunosuppressive therapy, neuroradiological follow-up exams showed a worsening of the aforementioned stenosis with many transient episodes of weakness in the right limbs and aphasia. A 64-year-old woman had a sudden onset of dysarthria and transient aphasia. Neuroradiological exams showed a severe arterial stenosis involving the origin of left ACA and MCA. Despite dual antiplatel therapy she presented an acute onset of severe aphasia, due to an occlusion of the left carotid terminus and proximal MCA. In both cases endovascular procedure and intracranial stenting was performed, with marked improvement of cerebral blood flow. No more clinical episodes were reported. Intracranial stenting may be a valid therapeutic option in selected patients with CNSV and involvement of medium or large size vessels with clinical worsening despite best medical treatment.

Published
2023
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3. Qualitative versus automatic evaluation of CT perfusion parameters in acute posterior circulation ischaemic stroke

Author

Luca Verganti, Nicola Serra, Ferdinando Caranci, Federico Sacchetti, Guido Bigliardi, Livio Picchetto, Andrea Zini, Stefano Vallone, Gabriele Zelent, Raffaella Capasso, Capasso, Raffaella, Vallone, Stefano, Serra, Nicola, Zelent, Gabriele, Verganti, Luca, Sacchetti, Federico, Bigliardi, Guido, Picchetto, Livio, Caranci, Ferdinando, and Zini, Andrea

Subjects
Automatic, Perfusion scanning, 030218 nuclear medicine & medical imaging, Brain Ischemia, Quantitative perfusion, 03 medical and health sciences, Perfusion map, 0302 clinical medicine, Qualitative analysis, Ischaemic stroke, medicine, Humans, Radiology, Nuclear Medicine and imaging, Symptom onset, Stroke, Neuroradiology, Diagnostic Neuroradiology, Ischemic Stroke, Retrospective Studies, RAPID, business.industry, Reproducibility of Results, Perfusion maps, medicine.disease, Perfusion, Cerebrovascular Circulation, CT perfusion, Neurology (clinical), Posterior ischaemic stroke, Cardiology and Cardiovascular Medicine, Nuclear medicine, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery
Abstract

Purpose To compare the diagnostic accuracy (ACC) in the detection of acute posterior circulation strokes between qualitative evaluation of software-generated colour maps and automatic assessment of CT perfusion (CTP) parameters. Methods Were retrospectively collected 50 patients suspected of acute posterior circulation stroke who underwent to CTP (GE “Lightspeed”, 64 slices) within 24 h after symptom onset between January 2016 and December 2018. The Posterior circulation-Acute Stroke Prognosis Early CT Score (pc-ASPECTS) was used for quantifying the extent of ischaemic areas on non-contrast (NC)CT and colour-coded maps generated by CTP4 (GE) and RAPID (iSchemia View) software. Final pc-ASPECTS was calculated on follow-up NCCT and/or MRI (Philips Intera 3.0 T or Philips Achieva Ingenia 1.5 T). RAPID software also elaborated automatic quantitative mismatch maps. Results By qualitative evaluation of colour-coded maps, MTT-CTP4D and Tmax-RAPID showed the highest sensitivity (SE) (88.6% and 90.9%, respectively) and ACC (84% and 88%, respectively) compared with the other perfusion parameters (CBV, CBF). Baseline NCCT and CBF provided by RAPID quantitative perfusion mismatch maps had the lowest SE (29.6% and 6.8%, respectively) and ACC (38% and 18%, respectively). CBF and Tmax assessment provided by quantitative RAPID perfusion mismatch maps showed significant lower SE and ACC than qualitative evaluation. No significant differences were found between the pc-ASPECTSs assessed on colour-coded MTT and Tmax maps neither between the scores assessed on colour-coded CBV-CTP4D and CBF-RAPID maps. Conclusion Qualitative analysis of colour-coded maps resulted more sensitive and accurate in the detection of ischaemic changes than automatic quantitative analysis.

Published
2021

4. High serum levels of silica nanoparticles in systemic sclerosis patients with occupational exposure: Possible pathogenetic role in disease phenotypes

Author

Gabriele Zelent, Dilia Giuggioli, Gianluca Sighinolfi, Fabrizio Luppi, Michele Colaci, Erica Artoni, Clodoveo Ferri, Ferri, C, Artoni, E, Sighinolfi, G, Luppi, F, Zelent, G, Colaci, M, and Giuggioli, D

Subjects
Lung Diseases, Male, 0301 basic medicine, Systemic disease, Gastroenterology, Scleroderma, Systemic sclerosi, 0302 clinical medicine, Nanoparticle, Risk Factors, Etiopathogenesis, Inhalation, Silica, Middle Aged, Occupational exposure, Silicon Dioxide, Microparticle, Systemic sclerosis, Female, Interstitial lung fibrosi, Adult, medicine.medical_specialty, Interstitial lung fibrosis, Microparticles, Nanoparticles, Aged, Case-Control Studies, Humans, Lung Diseases, Interstitial, Occupational Exposure, Scleroderma, Systemic, Silica nanoparticles, 03 medical and health sciences, Rheumatology, Internal medicine, medicine, Etiopathogenesi, 030203 arthritis & rheumatology, business.industry, Systemic, High serum, Case-control study, medicine.disease, Anesthesiology and Pain Medicine, 030104 developmental biology, Interstitial, business
Abstract

Background: Systemic sclerosis (SSc) is an autoimmune systemic disease characterized by diffuse fibrosis of skin and visceral organs due to different genetic, infectious, and/or environmental/occupational causative factors, including the inhalation of silica dust. Objectives: To investigate serum trace elements including silicon (s-Si) levels in SSc patients living in a restricted geographical area with high density of worksites with silica exposure hazard. Methods: This case-control study included 80 SSc patients (M:F 10:70; aged 58.4 ± 11.9SD years, mean disease duration 10.1 ± 7.8SD) and 50 age-/sex-matched healthy control subjects consecutively investigated at our University-based Rheumatology Unit. Patients and controls were evaluated for environmental/occupational exposure categories (structured questionnaire), morphological characterization of serum micro-/nanoparticles (Environmental Scanning Electron Microscopy and Energy Dispersive X-ray Spectroscopy microanalysis), and quantitative assessment of trace elements (inductively coupled plasma atomic emission spectroscopy). Results: Among various categories, only occupational exposure to silica dust was recorded in a significant proportion of SSc patients compared to controls (55% vs. 11%; p

Published
2018

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