88 results on '"Guffanti, E"'
Search Results
2. Circadian rhythm of COPD symptoms in clinically based phenotypes. Results from the STORICO Italian observational study
- Author
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Scichilone, N, Antonelli Incalzi, R, Blasi, F, Schino, P, Cuttitta, G, Zullo, A, Ori, A, Canonica, G, Foschino, M, Prediletto, R, Tranfa, C, Zappa, M, Patriciello, P, Labate, L, Mariotta, S, Nava, S, Vatrella, A, Mastroberardino, M, Sarzani, R, Iuliano, A, Maggi, L, Zedda, A, Pesci, A, Sera, G, Nicolini, A, Salvatore Walter, D, Forte, S, Mario, D, Rivolta, F, Ferliga, M, Raco, A, Luigi, D, Cabibbo, G, Maselli, R, Gulotta, C, Nardini, S, Guffanti, E, Castellani, W, Triolo, L, Passalacqua, G, Beghe, B, Salvatore, L, Faccini, E, Atzeni, E, Tazza, R, Giamesio, P, Scichilone N., Antonelli Incalzi R., Blasi F., Schino P., Cuttitta G., Zullo A., Ori A., Canonica G., Foschino M. P., Prediletto R., Tranfa C. M. E., Zappa M. C., Patriciello P., Labate L., Mariotta S., Nava S., Vatrella A., Mastroberardino M., Sarzani R., Iuliano A., Maggi L., Zedda A., Pesci A., Sera G., Nicolini A., Salvatore Walter D. D., Forte S., Mario D. D., Rivolta F., Ferliga M., Raco A. F., Luigi D. R., Cabibbo G., Maselli R., Gulotta C., Nardini S., Guffanti E. E., Castellani W., Triolo L., Passalacqua G., Beghe B., Salvatore L. C., Faccini E., Atzeni E., Tazza R., Giamesio P., Scichilone, N, Antonelli Incalzi, R, Blasi, F, Schino, P, Cuttitta, G, Zullo, A, Ori, A, Canonica, G, Foschino, M, Prediletto, R, Tranfa, C, Zappa, M, Patriciello, P, Labate, L, Mariotta, S, Nava, S, Vatrella, A, Mastroberardino, M, Sarzani, R, Iuliano, A, Maggi, L, Zedda, A, Pesci, A, Sera, G, Nicolini, A, Salvatore Walter, D, Forte, S, Mario, D, Rivolta, F, Ferliga, M, Raco, A, Luigi, D, Cabibbo, G, Maselli, R, Gulotta, C, Nardini, S, Guffanti, E, Castellani, W, Triolo, L, Passalacqua, G, Beghe, B, Salvatore, L, Faccini, E, Atzeni, E, Tazza, R, Giamesio, P, Scichilone N., Antonelli Incalzi R., Blasi F., Schino P., Cuttitta G., Zullo A., Ori A., Canonica G., Foschino M. P., Prediletto R., Tranfa C. M. E., Zappa M. C., Patriciello P., Labate L., Mariotta S., Nava S., Vatrella A., Mastroberardino M., Sarzani R., Iuliano A., Maggi L., Zedda A., Pesci A., Sera G., Nicolini A., Salvatore Walter D. D., Forte S., Mario D. D., Rivolta F., Ferliga M., Raco A. F., Luigi D. R., Cabibbo G., Maselli R., Gulotta C., Nardini S., Guffanti E. E., Castellani W., Triolo L., Passalacqua G., Beghe B., Salvatore L. C., Faccini E., Atzeni E., Tazza R., and Giamesio P.
- Abstract
Background: Chronic Obstructive Pulmonary Disease (COPD) encompasses various phenotypes that severely limit the applicability of precision respiratory medicine. The present investigation is aimed to assess the circadian rhythm of symptoms in pre-defined clinical COPD phenotypes and its association with health-related quality of life (HR-QoL), the quality of sleep and the level of depression/anxiety in each clinical phenotype. Methods: The STORICO (NCT03105999) Italian observational prospective cohort study enrolled COPD subjects. A clinical diagnosis of either chronic bronchitis (CB), emphysema (EM) or mixed COPD-asthma (MCA) phenotype was made by clinicians at enrollment. Baseline early-morning, day-time and nocturnal symptoms (gathered via the Night-time, Morning and Day-time Symptoms of COPD questionnaire), HR-QoL (via the St. George's Respiratory Questionnaire), anxiety and depression levels (via the Hospital Anxiety and Depression Scale), quality of sleep (via COPD and Asthma Sleep Impact Scale), physical activity (via the International Physical Activity Questionnaire) as well as lung function were recorded. Results: 606 COPD subjects (age 71.4 ± 8.2 years, male 75.1%) were studied. 57.9, 35.5 5.3 and 1.3% of the sample belonged to the CB, EM, MCA and EM + CB phenotypes respectively. The vast majority of subjects reported early-morning and day-time symptoms (79.5 and 79.2% in the CB and 75.8 and 77.7% in the EM groups); the proportion suffering from night-time symptoms was higher in the CB than in the EM group (53.6% vs. 39.5%, p = 0.0016). In both CB and EM, indiscriminately, the presence of symptoms during the 24-h day was associated with poorer HR-QoL, worse quality of sleep and higher levels of anxiety/depression. Conclusions: The findings highlight the primary classificatory role of nocturnal symptoms in COPD. Trial registration: Trial registration number: NCT03105999, date of registration: 10th April 2017.
- Published
- 2019
3. Ceftazidime-avibactam use for KPC-Kp infections: a retrospective observational multicenter study
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Tumbarello, M, Raffaelli, F, Giannella, M, Mantengoli, E, Mularoni, A, Venditti, M, De Rosa, F, Sarmati, L, Bassetti, M, Brindicci, G, Rossi, M, Luzzati, R, Grossi, P, Corona, A, Capone, A, Falcone, M, Mussini, C, Trecarichi, E, Cascio, A, Guffanti, E, Russo, A, De Pascale, G, Tascini, C, Gentile, I, Losito, A, Bussini, L, Conti, G, Ceccarelli, G, Corcione, S, Compagno, M, Giacobbe, D, Saracino, A, Fantoni, M, Antinori, S, Peghin, M, Bonfanti, P, Oliva, A, De Gasperi, A, Tiseo, G, Rovelli, C, Meschiari, M, Shbaklo, N, Spanu, T, Cauda, R, Viale, P, Tumbarello, Mario, Raffaelli, Francesca, Giannella, Maddalena, Mantengoli, Elisabetta, Mularoni, Alessandra, Venditti, Mario, De Rosa, Francesco Giuseppe, Sarmati, Loredana, Bassetti, Matteo, Brindicci, Gaetano, Rossi, Marianna, Luzzati, Roberto, Grossi, Paolo Antonio, Corona, Alberto, Capone, Alessandro, Falcone, Marco, Mussini, Cristina, Trecarichi, Enrico Maria, Cascio, Antonio, Guffanti, Elena, Russo, Alessandro, De Pascale, Gennaro, Tascini, Carlo, Gentile, Ivan, Losito, Angela Raffaella, Bussini, Linda, Conti, Giampaolo, Ceccarelli, Giancarlo, Corcione, Silvia, Compagno, Mirko, Giacobbe, Daniele Roberto, Saracino, Annalisa, Fantoni, Massimo, Antinori, Spinello, Peghin, Maddalena, Bonfanti, Paolo, Oliva, Alessandra, De Gasperi, Andrea, Tiseo, Giusy, Rovelli, Cristina, Meschiari, Marianna, Shbaklo, Nour, Spanu, Teresa, Cauda, Roberto, Viale, Pierluigi, Tumbarello, M, Raffaelli, F, Giannella, M, Mantengoli, E, Mularoni, A, Venditti, M, De Rosa, F, Sarmati, L, Bassetti, M, Brindicci, G, Rossi, M, Luzzati, R, Grossi, P, Corona, A, Capone, A, Falcone, M, Mussini, C, Trecarichi, E, Cascio, A, Guffanti, E, Russo, A, De Pascale, G, Tascini, C, Gentile, I, Losito, A, Bussini, L, Conti, G, Ceccarelli, G, Corcione, S, Compagno, M, Giacobbe, D, Saracino, A, Fantoni, M, Antinori, S, Peghin, M, Bonfanti, P, Oliva, A, De Gasperi, A, Tiseo, G, Rovelli, C, Meschiari, M, Shbaklo, N, Spanu, T, Cauda, R, Viale, P, Tumbarello, Mario, Raffaelli, Francesca, Giannella, Maddalena, Mantengoli, Elisabetta, Mularoni, Alessandra, Venditti, Mario, De Rosa, Francesco Giuseppe, Sarmati, Loredana, Bassetti, Matteo, Brindicci, Gaetano, Rossi, Marianna, Luzzati, Roberto, Grossi, Paolo Antonio, Corona, Alberto, Capone, Alessandro, Falcone, Marco, Mussini, Cristina, Trecarichi, Enrico Maria, Cascio, Antonio, Guffanti, Elena, Russo, Alessandro, De Pascale, Gennaro, Tascini, Carlo, Gentile, Ivan, Losito, Angela Raffaella, Bussini, Linda, Conti, Giampaolo, Ceccarelli, Giancarlo, Corcione, Silvia, Compagno, Mirko, Giacobbe, Daniele Roberto, Saracino, Annalisa, Fantoni, Massimo, Antinori, Spinello, Peghin, Maddalena, Bonfanti, Paolo, Oliva, Alessandra, De Gasperi, Andrea, Tiseo, Giusy, Rovelli, Cristina, Meschiari, Marianna, Shbaklo, Nour, Spanu, Teresa, Cauda, Roberto, and Viale, Pierluigi
- Abstract
Background: A growing body of observational evidence supports the value of ceftazidime-avibactam (CAZ-AVI) in managing infections caused by carbapenem-resistant Enterobacteriaceae. Methods: We retrospectively analyzed observational data on use and outcomes of CAZ-AVI therapy for infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) strains. Multivariate regression analysis was used to identify variables independently associated with 30-day mortality. Results were adjusted for propensity score for receipt of CAZ-AVI combination regimens versus CAZ-AVI monotherapy. Results: The cohort comprised 577 adults with bloodstream infections (n = 391) or nonbacteremic infections involving mainly the urinary tract, lower respiratory tract, and intra-abdominal structures. All received treatment with CAZ-AVI alone (n = 165) or with ≥1 other active antimicrobials (n = 412). The all-cause mortality rate 30 days after infection onset was 25% (146/577). There was no significant difference in mortality between patients managed with CAZ-AVI alone and those treated with combination regimens (26.1% vs 25.0%, P =. 79). In multivariate analysis, mortality was positively associated with presence at infection onset of septic shock (P =. 002), neutropenia (P <. 001), or an INCREMENT score ≥8 (P =. 01); with lower respiratory tract infection (LRTI) (P =. 04); and with CAZ-AVI dose adjustment for renal function (P =. 01). Mortality was negatively associated with CAZ-AVI administration by prolonged infusion (P =. 006). All associations remained significant after propensity score adjustment. Conclusions: CAZ-AVI is an important option for treating serious KPC-Kp infections, even when used alone. Further study is needed to explore the drug's seemingly more limited efficacy in LRTIs and potential survival benefits of prolonging CAZ-AVI infusions to ≥3 hours.
- Published
- 2021
4. Can healthcare utilization data reliably capture cases of chronic respiratory diseases? A cross-sectional investigation in Italy
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Biffi, A., Comoretto, R., Arfe, A., Scotti, L., Merlino, L., Vaghi, A., Pesci, A., de Marco, R., Corrao, G., Brignoli, O., Cerveri, I., Guffanti, E., Villa, M., Biffi, A, Comoretto, R, Arfè, A, Scotti, L, Merlino, L, Vaghi, A, Pesci, A, DE MARCO, R, Corrao, G, Brignoli, O, Cerveri, I, Guffanti, E, and Villa, M
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,Healthcare utilization database ,medicine.medical_specialty ,Adolescent ,Databases, Factual ,Cross-sectional study ,Sensitivity and Specificity ,03 medical and health sciences ,Pulmonary Disease, Chronic Obstructive ,Young Adult ,0302 clinical medicine ,Prevalence ,Medicine ,Humans ,030212 general & internal medicine ,Young adult ,Intensive care medicine ,Child ,Asthma ,Aged ,Estimation ,Aged, 80 and over ,COPD ,business.industry ,Algorithms ,Chronic obstructive pulmonary disease ,External validation ,Infant, Newborn ,Uncertainty ,Infant ,Middle Aged ,medicine.disease ,respiratory tract diseases ,Algorithm ,Chronic disease ,Cross-Sectional Studies ,030228 respiratory system ,Healthcare utilization ,Italy ,Child, Preschool ,Emergency medicine ,Chronic Disease ,Female ,business ,Research Article - Abstract
Background Healthcare utilization data are increasingly used for chronic disease surveillance. Nevertheless, no standard criteria for estimating prevalence of high-impact diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, are available. In this study an algorithm for recognizing COPD/asthma cases from HCU data is developed and implemented in the HCU databases of the Italian Lombardy Region (about 10 million residents). The impact of diagnostic misclassification for reliably estimating prevalence was also assessed. Methods Disease-specificdrug codes, hospital discharges together with co-payment exemptions when available, and a combination of them according with patient’s age, were used to create the proposed algorithm. Identified cases were considered for prevalence estimation. An external validation study was also performed in order to evaluate systematic uncertainty of prevalence estimates. Results Raw prevalence of COPD and asthma in 2010 was 3.6 and 3.3% respectively. According to external validation, sensitivity values were 53% for COPD and 39% for asthma. Adjusted prevalence estimates were respectively 6.8 and 8.5% for COPD (among person aged 40 years or older) and asthma (among person aged 40 years or younger). Conclusions COPD and asthma prevalence may be estimated from HCU data, albeit with high systematic uncertainty. Validation is recommended in this setting. Electronic supplementary material The online version of this article (doi:10.1186/s12890-016-0362-6) contains supplementary material, which is available to authorized users.
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- 2017
5. Can healthcare utilization data reliably capture cases of chronic respiratory diseases? A cross-sectional investigation in Italy
- Author
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Biffi, A, Comoretto, R, Arfè, A, Scotti, L, Merlino, L, Vaghi, A, Pesci, A, DE MARCO, R, Corrao, G, Brignoli, O, Cerveri, I, Guffanti, E, Villa, M, BIFFI, ANNALISA, COMORETTO, ROSANNA IRENE, SCOTTI, LORENZA, PESCI, ALBERTO, DE MARCO, ROBERTO, CORRAO, GIOVANNI, Villa, M., Biffi, A, Comoretto, R, Arfè, A, Scotti, L, Merlino, L, Vaghi, A, Pesci, A, DE MARCO, R, Corrao, G, Brignoli, O, Cerveri, I, Guffanti, E, Villa, M, BIFFI, ANNALISA, COMORETTO, ROSANNA IRENE, SCOTTI, LORENZA, PESCI, ALBERTO, DE MARCO, ROBERTO, CORRAO, GIOVANNI, and Villa, M.
- Abstract
Background: Healthcare utilization data are increasingly used for chronic disease surveillance. Nevertheless, no standard criteria for estimating prevalence of high-impact diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, are available. In this study an algorithm for recognizing COPD/asthma cases from HCU data is developed and implemented in the HCU databases of the Italian Lombardy Region (about 10 million residents). The impact of diagnostic misclassification for reliably estimating prevalence was also assessed. Methods: Disease-specificdrug codes, hospital discharges together with co-payment exemptions when available, and a combination of them according with patient's age, were used to create the proposed algorithm. Identified cases were considered for prevalence estimation. An external validation study was also performed in order to evaluate systematic uncertainty of prevalence estimates. Results: Raw prevalence of COPD and asthma in 2010 was 3.6 and 3.3% respectively. According to external validation, sensitivity values were 53% for COPD and 39% for asthma. Adjusted prevalence estimates were respectively 6.8 and 8.5% for COPD (among person aged 40 years or older) and asthma (among person aged 40 years or younger). Conclusions: COPD and asthma prevalence may be estimated from HCU data, albeit with high systematic uncertainty. Validation is recommended in this setting.
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- 2017
6. Long-term azithromycin use in patients with chronic obstructive pulmonary disease and tracheostomy
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Blasi, F, Bonardi, D, Aliberti, S, Tarsia, P, Confalonieri, M, Amir, O, Carone, M, Di Marco, F, Centanni, S, Guffanti, E, ALIBERTI, STEFANO, Guffanti, E., Blasi, F, Bonardi, D, Aliberti, S, Tarsia, P, Confalonieri, M, Amir, O, Carone, M, Di Marco, F, Centanni, S, Guffanti, E, ALIBERTI, STEFANO, and Guffanti, E.
- Abstract
Patients with Chronic Obstructive Pulmonary Disease (COPD) and tracheostomy are at high risk for exacerbations and hospitalizations. Macrolide treatment has shown to reduce exacerbations in moderate-to-severe COPD. To evaluate the safety and the efficacy of long-term azithromycin use in outpatients with severe COPD and tracheostomy. A multicenter, randomized, uncontrolled, pilot trial evaluating the safety and the efficacy of azithromycin 500 mg three day-a-week for 6 months (AZI) vs. standard of care (SC) in severe COPD outpatients with tracheostomy. Patients were monitored for six months of treatment plus six months of follow up. The primary outcome was the reduction in the number of exacerbations and hospitalizations. A total of 22 patients was randomized (11 to SC and 11 to AZI). Patients in AZI had a significant lower cumulative number of exacerbations after the first 3 months of treatment when compared to patients in SC (p = 0.001), as well as hospitalizations (p = 0.02). Kaplan-Meier survival curves for time to first exacerbation showed a significant reduction in AZI of the rates of first exacerbation when compared to SC (log rank test = 12.14, p < 0.001), as well as to first hospitalization (log-rank = 4.09, p = 0.04). Azithromycin significantly improved the quality of life in comparison to SC. No serious adverse events in the AZI group were reported. Long-term azithromycin treatment seems to be safe and effective in severe COPD outpatients with tracheostomy in reducing exacerbations, hospitalizations, as well as in improving quality of life. © 2009 Elsevier Ltd. All rights reserved.
- Published
- 2010
7. Long-term azithromycin use in patients with chronic obstrctive pulmonary disease and tracheostomy
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Blasi Francesco, Bonardi Daniela, Aliberti Stefano, Tarsia stefano, Confalonieri Marco, Amir O, Carone Mauro, Di Marco Fabiano, Centanni Stefano, Guffanti E, Blasi, Francesco, Bonardi, Daniela, Aliberti, Stefano, Tarsia, Stefano, Confalonieri, Marco, Amir, O, Carone, Mauro, Di Marco, Fabiano, Centanni, Stefano, and Guffanti, E
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Macrolide COPD Acute exacerbation of chronic bronchitis Tracheostomy - Abstract
Patients with Chronic Obstructive Pulmonary Disease (COPD) and tracheostomy are at high risk for exacerbations and hospitalizations. Macrolide treatment has shown to reduce exacerbations in moderate-to-severe COPD. To evaluate the safety and the efficacy of long-term azithromycin use in outpatients with severe COPD and tracheostomy. A multicenter, randomized, uncontrolled, pilot trial evaluating the safety and the efficacy of azithromycin 500 mg three day-a-week for 6 months (AZI) vs. standard of care (SC) in severe COPD outpatients with tracheostomy. Patients were monitored for six months of treatment plus six months of follow up. The primary outcome was the reduction in the number of exacerbations and hospitalizations. A total of 22 patients was randomized (11 to SC and 11 to AZI). Patients in AZI had a significant lower cumulative number of exacerbations after the first 3 months of treatment when compared to patients in SC (p ¼ 0.001), as well as hospitalizations (p¼ 0.02). Kaplan–Meier survival curves for time to first exacerbation showed a significant reduction in AZI of the rates of first exacerbation when compared to SC (log rank test¼ 12.14, p < 0.001), as well as to first hospitalization (log-rank ¼ 4.09, p ¼ 0.04). Azithromycin significantly improved the quality of life in comparison to SC. No serious adverse events in the AZI group were reported. Long-term azithromycin treatment seems to be safe and effective in severe COPD outpatients with tracheostomy in reducing exacerbations, hospitalizations, as well as in improving quality of life.
- Published
- 2010
8. Home mechanical ventilation patients: a retrospective survey to identify level of burden in real life
- Author
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Vitacca, M., primary, Escarrabill, J., additional, Galavotti, G., additional, Vianello, A., additional, Prats, E., additional, Scala, R., additional, Peratoner, A., additional, Guffanti, E., additional, Maggi, L., additional, Barbano, L., additional, and Balbi, B., additional
- Published
- 2016
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9. Comparison of the antihypertensive effect of urapidil and metoprolol in hypertension
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Leonetti, G., Mazzola, C., Boni, S., Guffanti, E., Meani, A., and Zanchetti, A.
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- 1986
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10. Ibopamine versus hydrochlorothiazide/amiloride in patients with mild congestive heart failure
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Riva, Elisabetta, Abbondati, G., Cavalli, A., Fuccella, L. M., Schleman, M., Tournadre, P., Blanchot, P., Demange, J., Germaine, R., Kayanakis, J., Lahitton, B., Sellier, P., Tadei, A., De Weerd, P., Klazen, C., Penn, H., Rehorst, D., Basso, F., Floris, B., Guffanti, E., Mazzola, C., Mereu, D., Pisano, G., Rossi, P., Sonaglioni, G., Beissel, J., Delagardelle, Ch., Ferres, M., Friederici, R., and SK & F Ibopamine Working Group
- Published
- 1989
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11. Coronary stenting and surgery: Perioperative management of antiplatelet therapy in patients undergoing surgery after coronary stent implantation [Stent coronarico e chirurgia: La gestione perioperatoria della terapia antiaggregante nel paziente portatore di stent coronarico candidato a intervento chirurgico]
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Rossini, R., Bramucci, E., Castiglioni, B., DE SERVI, S., Lettieri, C., Lettino, M., Masumeci, G., Visconti, L., Piccaluga, E., Savonitto, S., Trabattoni, D., Buffoli, F., Angiolillo, D., Bovenzi, F., Cremonesi, A., Scherillo, M., Guagliumi, G., Valdatta, Luigi, Boni, Luigi, Dionigi, G., Guffanti, E., Gerometta, P., Parolari, A., Biglioli, F., Beltramini, G., Devalle, L., Droghetti, A., Bozzani, A., Ravelli, P., Crescini, C., Staurenghi, G., Gaini, S., Scarone, P., Francetti, L., Corbella, S., Comel, A., Gadda, F., Salvi, L., Castelli, A., Menozzi, E., and D'Angelo, Fabio
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Surgical Procedures ,Aspirin ,Clopidogrel ,Coronary heart disease ,Stent ,Surgery ,Coronary Disease ,Humans ,Platelet Aggregation Inhibitors ,Postoperative Hemorrhage ,Risk Assessment ,Risk Factors ,Stents ,Surgical Procedures, Operative ,Cardiology and Cardiovascular Medicine ,Operative - Published
- 2012
12. Nuclear pore complex proteins mark the implantation window in human endometrium
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Meier, U. T., Kuokkanen, S. M., Kittur, N., Heller, D. S., Brodt, Z. N., Guffanti, E., Santoro, N., Young, S. L., and Polotsky, A. J.
- Abstract
Nucleolar channel systems (NCSs) are membranous organelles appearing transiently in the epithelial cell nuclei of postovulatory human endometrium. Their characterization and use as markers for a healthy receptive endometrium have been limited because they are only identifiable by electron microscopy. Here we describe the light microscopic detection of NCSs using immunofluorescence. Specifically, the monoclonal nuclear pore complex antibody 414 shows that NCSs are present in about half of all human endometrial epithelial cells but not in any other cell type, tissue or species. Most nuclei contain only a single NCS of uniform 1 μm diameter indicating a tightly controlled organelle. The composition of NCSs is as unique as their structure; they contain only a subset each of the proteins of nuclear pore complexes, inner nuclear membrane, nuclear lamina and endoplasmic reticulum. Validation of our robust NCS detection method on 95 endometrial biopsies defines a 6-day window, days 19-24 (±1) of an idealized 28 day cycle, wherein NCSs occur. Therefore, NCSs precede and overlap with the implantation window and serve as potential markers of uterine receptivity. The immunodetection assay, combined with the hitherto underappreciated prevalence of NCSs, now enables simple screening and further molecular and functional dissection.
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- 2008
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13. Effect of noninvasive mechanicalventilation in elderly patients with hypercapnic acute-on-chronic respiratoryfailure and a do-not-intubate order
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Scarpazza, P, Incorvaia, C, di Franco, G, Raschi, S, Usai, P, Bernareggi, M, Bonacina, C, Melacini, C, Vanni, S, Bencini, S, Pravettoni, C, DI CARA, Giuseppe, Yacoub, Mr, Riario Sforza GG, Guffanti, E, and Casali, W.
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chronic respiratory failure ,non-invasive ventilation - Published
- 2008
14. Any chance to evaluate in vivo field methods using standard protocols?
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Confalonieri, R., primary, Francone, C., additional, Chiodini, M.E., additional, Cantaluppi, E., additional, Caravati, L., additional, Colombi, V., additional, Fantini, D., additional, Ghiglieno, I., additional, Gilardelli, C., additional, Guffanti, E., additional, Inversini, M., additional, Paleari, L., additional, Pochettino, G.G., additional, Bocchi, S., additional, Bregaglio, S., additional, Cappelli, G., additional, Dominoni, P., additional, Frasso, N., additional, Stella, T., additional, and Acutis, M., additional
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- 2014
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15. Body composition markers in older persons with COPD
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Abbatecola, A. M., primary, Fumagalli, A., additional, Spazzafumo, L., additional, Betti, V., additional, Misuraca, C., additional, Corsonello, A., additional, Cherubini, A., additional, Guffanti, E. E., additional, and Lattanzio, F., additional
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- 2013
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16. Feasibility and Effectiveness of an Educational Program in Italian COPD Patients Undergoing Rehabilitation
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Paneroni, M., primary, Clini, E., additional, Crisafulli, E., additional, Guffanti, E., additional, Fumagalli, A., additional, Bernasconi, A., additional, Cabiaglia, A., additional, Nicolini, A., additional, Brogi, S., additional, Ambrosino, N., additional, Peroni, R., additional, Bianchi, L., additional, and Vitacca, M., additional
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- 2013
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17. La telemedicina nei pazienti in ossigenoterapia domiciliare.
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Negro, R. W., Goldberg, A. I., Guffanti, E. E., Colombo, D., Fumagalli, A., Misuraca, C., and Viganò, A.
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- 2006
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18. Solitary rectal ulcer syndrome (SRUS) and rectal prolapse: More than bad luck
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Velio, P., primary, Bertoglio, C., additional, Conte, D., additional, Cermesoni, L., additional, and Guffanti, E., additional
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- 1995
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19. Development and Validation of the HOPE Prognostic Index on 24-Month Posthospital Mortality and Rehospitalization: Italian National Research Center on Aging (INRCA)
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Abbatecola AM, Spazzafumo L, Corsonello A, Sirolla C, Bustacchini S, and Guffanti E
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- 2011
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20. Ibopamine in the Treatment of Mild Chronic Heart Failure in Elderly Patients
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Azzolinï, A., primary, Guffanti, E., additional, Ronzitti, M., additional, Tantalo, L., additional, Colantoni, A., additional, and Pizzorni, C., additional
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- 1990
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21. Haemodynamic effects of diltiazem at rest and during exercise in patients with previous myocardial infarction.
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COBELLI, F., OPASICH, C., RICCARDI, G., ROSSETTI, S., GUFFANTi, E., and SPECCHIA, G.
- Abstract
A single blind study between placebo and diltiazem (25 mg i.v. single dose) was carried out on 20 male patients with previous myocardial infarction and without exertional ischaemia. Patients, 50 ±6.1 (mean±SD) years of age, underwent a right heart catheterization with Seldinger's percutaneous approach and brachial or radial artery percutaneous catheterization. Haemodynamic variables were recorded in the supine position after catheterization in baseline conditions at rest, after a warming-up period of 6 min, before and after a first and second exercise test with stepwise increments of 25 W per 3 min. Before the second exercise test, either placebo or diltiazem (25 mg) was injected intravenously in 3 min. In comparison with placebo, diltiazern significantly reduced resting blood pressure (P<0.001) and systemic vascular resistance (P<0001) and increased cardiac index (P<0.01); during exercise it also reduced the mean pulmonary arterial pressure (P<005), pulmonary wedge pressure (P<0.05), total pulmonary resistance (P<0.02), and increased the stroke volume (P<005). The present study demonstrated that intravenous diltiazem did not induce a significant rise in cardiac index but reduced the afterload and slightly reduced the preload. Diltiazem also reduced myocardial oxygen consumption and decreased blood pressure, mean right atrial pressure and slightly decreased the heart rate. [ABSTRACT FROM PUBLISHER]
- Published
- 1987
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22. The effect of long-term treatment with erdosteine on chronic obstructive pulmonary disease: The equalife study
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Moretti, M., Bottrighi, P., Dallari, R., Da Porto, R., Dolcetti, A., Grandi, P., Giancarlo Garuti, Guffanti, E., Roversi, P., Gugliemo, M., and Potena, A.
23. Rejection and survival after total orthotopic liver-small bowel allotransplantation in pigs immunosuppressed with FK 506
- Author
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Velio, P., Tarantino, C., Bertoglio, C., Guffanti, E., Bardella, M. T., Biffi, R., Andreoni, B., Rossi, G., Stefano Gatti, Piazzini, A., Fassati, L. R., and Galmarini, D.
24. Comparative Evaluation of Two Calcium Antagonists, Nicardipine and Nifedipine, in Patients with Mild to Moderate Chronic Heart Failure.
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MAZZOLA, C., primary, GUFFANTI, E. E., additional, VACCARELLA, A., additional, TURRI, D., additional, NAZZARI, M., additional, and FIORELLA, G., additional
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- 1988
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25. Long-term azithromycin use in patients with chronic obstructive pulmonary disease and tracheostomy
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Francesco Blasi, Enrico Guffanti, Stefano Aliberti, Paolo Tarsia, Mauro Carone, Daniela Bonardi, Stefano Centanni, Marco Confalonieri, Omar Amir, Fabiano Di Marco, Blasi, F, Bonardi, D, Aliberti, S, Tarsia, P, Confalonieri, M, Amir, O, Carone, M, Di Marco, F, Centanni, S, Guffanti, E, Blasi, F., Bonardi, D., Aliberti, S., Tarsia, P., Confalonieri, M., Amir, O., Carone, M., Di Marco, F., Centanni, S., and Guffanti, E.
- Subjects
Male ,Exacerbation ,Pilot Projects ,Kaplan-Meier Estimate ,Azithromycin ,Severity of Illness Index ,Body Mass Index ,law.invention ,Pulmonary Disease, Chronic Obstructive ,Tracheostomy ,Randomized controlled trial ,law ,80 and over ,Pharmacology (medical) ,Aged, 80 and over ,COPD ,Smoking ,Middle Aged ,Hospitalization ,Female ,Acute exacerbation of chronic bronchiti ,Macrolides ,Macrolide ,Human ,medicine.drug ,Pulmonary and Respiratory Medicine ,Chronic Obstructive ,medicine.medical_specialty ,Pulmonary Disease ,Internal medicine ,Severity of illness ,medicine ,Humans ,Pilot Project ,Adverse effect ,Aged ,MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO ,Acute exacerbation of chronic bronchitis ,business.industry ,Biochemistry (medical) ,medicine.disease ,Surgery ,Clinical trial ,Log-rank test ,Quality of Life ,business - Abstract
Patients with Chronic Obstructive Pulmonary Disease (COPD) and tracheostomy are at high risk for exacerbations and hospitalizations. Macrolide treatment has shown to reduce exacerbations in moderate-to-severe COPD. To evaluate the safety and the efficacy of long-term azithromycin use in outpatients with severe COPD and tracheostomy. A multicenter, randomized, uncontrolled, pilot trial evaluating the safety and the efficacy of azithromycin 500 mg three day-a-week for 6 months (AZI) vs. standard of care (SC) in severe COPD outpatients with tracheostomy. Patients were monitored for six months of treatment plus six months of follow up. The primary outcome was the reduction in the number of exacerbations and hospitalizations. A total of 22 patients was randomized (11 to SC and 11 to AZI). Patients in AZI had a significant lower cumulative number of exacerbations after the first 3 months of treatment when compared to patients in SC (p = 0.001), as well as hospitalizations (p = 0.02). Kaplan-Meier survival curves for time to first exacerbation showed a significant reduction in AZI of the rates of first exacerbation when compared to SC (log rank test = 12.14, p < 0.001), as well as to first hospitalization (log-rank = 4.09, p = 0.04). Azithromycin significantly improved the quality of life in comparison to SC. No serious adverse events in the AZI group were reported. Long-term azithromycin treatment seems to be safe and effective in severe COPD outpatients with tracheostomy in reducing exacerbations, hospitalizations, as well as in improving quality of life. © 2009 Elsevier Ltd. All rights reserved.
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- 2010
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26. Ceftazidime-avibactam use for KPC-Kp infections: a retrospective observational multicenter study
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Tumbarello, Mario, Raffaelli, Francesca, Giannella, Maddalena, Mantengoli, Elisabetta, Mularoni, Alessandra, Venditti, Mario, De Rosa, Francesco Giuseppe, Sarmati, Loredana, Bassetti, Matteo, Brindicci, Gaetano, Rossi, Marianna, Luzzati, Roberto, Grossi, Paolo Antonio, Corona, Alberto, Capone, Alessandro, Falcone, Marco, Mussini, Cristina, Trecarichi, Enrico Maria, Cascio, Antonio, Guffanti, Elena, Russo, Alessandro, De Pascale, Gennaro, Tascini, Carlo, Gentile, Ivan, Losito, Angela Raffaella, Bussini, Linda, Conti, Giampaolo, Ceccarelli, Giancarlo, Corcione, Silvia, Compagno, Mirko, Giacobbe, Daniele Roberto, Saracino, Annalisa, Fantoni, Massimo, Antinori, Spinello, Peghin, Maddalena, Bonfanti, Paolo, Oliva, Alessandra, De Gasperi, Andrea, Tiseo, Giusy, Rovelli, Cristina, Meschiari, Marianna, Shbaklo, Nour, Spanu, Teresa, Cauda, Roberto, Viale, Pierluigi, Tumbarello, M, Raffaelli, F, Giannella, M, Mantengoli, E, Mularoni, A, Venditti, M, De Rosa, F, Sarmati, L, Bassetti, M, Brindicci, G, Rossi, M, Luzzati, R, Grossi, P, Corona, A, Capone, A, Falcone, M, Mussini, C, Trecarichi, E, Cascio, A, Guffanti, E, Russo, A, De Pascale, G, Tascini, C, Gentile, I, Losito, A, Bussini, L, Conti, G, Ceccarelli, G, Corcione, S, Compagno, M, Giacobbe, D, Saracino, A, Fantoni, M, Antinori, S, Peghin, M, Bonfanti, P, Oliva, A, De Gasperi, A, Tiseo, G, Rovelli, C, Meschiari, M, Shbaklo, N, Spanu, T, Cauda, R, and Viale, P
- Subjects
Carbapenemase ,carbapenemases ,Ceftazidime-avibactam ,ceftazidime-avibactam ,KPC-producing Klebsiella pneumoniae - Abstract
Background: A growing body of observational evidence supports the value of ceftazidime-avibactam (CAZ-AVI) in managing infections caused by carbapenem-resistant Enterobacteriaceae. Methods: We retrospectively analyzed observational data on use and outcomes of CAZ-AVI therapy for infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) strains. Multivariate regression analysis was used to identify variables independently associated with 30-day mortality. Results were adjusted for propensity score for receipt of CAZ-AVI combination regimens versus CAZ-AVI monotherapy. Results: The cohort comprised 577 adults with bloodstream infections (n = 391) or nonbacteremic infections involving mainly the urinary tract, lower respiratory tract, and intra-abdominal structures. All received treatment with CAZ-AVI alone (n = 165) or with ≥1 other active antimicrobials (n = 412). The all-cause mortality rate 30 days after infection onset was 25% (146/577). There was no significant difference in mortality between patients managed with CAZ-AVI alone and those treated with combination regimens (26.1% vs 25.0%, P =. 79). In multivariate analysis, mortality was positively associated with presence at infection onset of septic shock (P =. 002), neutropenia (P
- Published
- 2021
27. Ceftazidime-avibactam use for klebsiella pneumoniae carbapenemase-producing k. pneumoniae infections: A retrospective observational multicenter study
- Author
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Mirko Compagno, Giampaolo Corti, Maddalena Peghin, Francesca Raffaelli, Annalisa Saracino, Cristina Mussini, Spinello Antinori, Maddalena Giannella, Roberto Cauda, Marianna Rossi, Gennaro De Pascale, Elena Guffanti, Enrico Maria Trecarichi, Giancarlo Ceccarelli, Teresa Spanu, Elisabetta Mantengoli, Antonio Cascio, Mario Venditti, Loredana Sarmati, Carlo Tascini, Silvia Corcione, Daniele Roberto Giacobbe, Massimo Fantoni, Linda Bussini, Paolo Bonfanti, Alessandra Mularoni, Marianna Meschiari, Nour Shbaklo, Giusy Tiseo, Mario Tumbarello, Roberto Luzzati, Angela Raffaella Losito, Alessandra Oliva, Pierluigi Viale, Alessandro Russo, Francesco Giuseppe De Rosa, Gaetano Brindicci, Ivan Gentile, Alberto Corona, Andrea De Gasperi, Paolo Grossi, Marco Falcone, Alessandro Capone, Cristina Rovelli, Matteo Bassetti, Tumbarello M., Raffaelli F., Giannella M., Mantengoli E., Mularoni A., Venditti M., De Rosa F.G., Sarmati L., Bassetti M., Brindicci G., Rossi M., Luzzati R., Grossi P.A., Corona A., Capone A., Falcone M., Mussini C., Trecarichi E.M., Cascio A., Guffanti E., Russo A., De Pascale G., Tascini C., Gentile I., Losito A.R., Bussini L., Corti G., Ceccarelli G., Corcione S., Compagno M., Giacobbe D.R., Saracino A., Fantoni M., Antinori S., Peghin M., Bonfanti P., Oliva A., De Gasperi A., Tiseo G., Rovelli C., Meschiari M., Shbaklo N., Spanu T., Cauda R., Viale P., Tumbarello, Mario, Raffaelli, Francesca, Giannella, Maddalena, Mantengoli, Elisabetta, Mularoni, Alessandra, Venditti, Mario, De Rosa, Francesco Giuseppe, Sarmati, Loredana, Bassetti, Matteo, Brindicci, Gaetano, Rossi, Marianna, Luzzati, Roberto, Grossi, Paolo Antonio, Corona, Alberto, Capone, Alessandro, Falcone, Marco, Mussini, Cristina, Trecarichi, Enrico Maria, Cascio, Antonio, Guffanti, Elena, Russo, Alessandro, De Pascale, Gennaro, Tascini, Carlo, Gentile, Ivan, Losito, Angela Raffaella, Bussini, Linda, Conti, Giampaolo, Ceccarelli, Giancarlo, Corcione, Silvia, Compagno, Mirko, Giacobbe, Daniele Roberto, Saracino, Annalisa, Fantoni, Massimo, Antinori, Spinello, Peghin, Maddalena, Bonfanti, Paolo, Oliva, Alessandra, De Gasperi, Andrea, Tiseo, Giusy, Rovelli, Cristina, Meschiari, Marianna, Shbaklo, Nour, Spanu, Teresa, Cauda, Roberto, and Viale, Pierluigi
- Subjects
Microbiology (medical) ,Adult ,medicine.medical_specialty ,Azabicyclo Compound ,carbapenemases ,Bacterial Protein ,Microbial Sensitivity Tests ,Neutropenia ,Ceftazidime ,beta-Lactamases ,beta-Lactamase ,Carbapenemase ,carbapenemase ,Bacterial Proteins ,Retrospective Studie ,Lower respiratory tract infection ,Internal medicine ,Drug Combination ,Anti-Bacterial Agent ,medicine ,Humans ,KPC-producing Klebsiella pneumoniae ,Retrospective Studies ,Septic shock ,business.industry ,Ceftazidime-avibactam ,Microbial Sensitivity Test ,ceftazidime-avibactam ,Mortality rate ,Carbapenemases ,Anti-Bacterial Agents ,Azabicyclo Compounds ,Drug Combinations ,Klebsiella Infections ,Klebsiella pneumoniae ,medicine.disease ,Ceftazidime/avibactam ,Settore MED/17 ,Infectious Diseases ,Cohort ,Propensity score matching ,Observational study ,business ,medicine.drug ,Human ,Klebsiella Infection - Abstract
Background A growing body of observational evidence supports the value of ceftazidime-avibactam (CAZ-AVI) in managing infections caused by carbapenem-resistant Enterobacteriaceae. Methods We retrospectively analyzed observational data on use and outcomes of CAZ-AVI therapy for infections caused by Klebsiella pneumoniae carbapenemase–producing K. pneumoniae (KPC-Kp) strains. Multivariate regression analysis was used to identify variables independently associated with 30-day mortality. Results were adjusted for propensity score for receipt of CAZ-AVI combination regimens versus CAZ-AVI monotherapy. Results The cohort comprised 577 adults with bloodstream infections (n = 391) or nonbacteremic infections involving mainly the urinary tract, lower respiratory tract, and intra-abdominal structures. All received treatment with CAZ-AVI alone (n = 165) or with ≥1 other active antimicrobials (n = 412). The all-cause mortality rate 30 days after infection onset was 25% (146/577). There was no significant difference in mortality between patients managed with CAZ-AVI alone and those treated with combination regimens (26.1% vs 25.0%, P = .79). In multivariate analysis, mortality was positively associated with presence at infection onset of septic shock (P = .002), neutropenia (P < .001), or an INCREMENT score ≥8 (P = .01); with lower respiratory tract infection (LRTI) (P = .04); and with CAZ-AVI dose adjustment for renal function (P = .01). Mortality was negatively associated with CAZ-AVI administration by prolonged infusion (P = .006). All associations remained significant after propensity score adjustment. Conclusions CAZ-AVI is an important option for treating serious KPC-Kp infections, even when used alone. Further study is needed to explore the drug’s seemingly more limited efficacy in LRTIs and potential survival benefits of prolonging CAZ-AVI infusions to ≥3 hours.
- Published
- 2021
28. Circadian rhythm of COPD symptoms in clinically based phenotypes. Results from the STORICO Italian observational study
- Author
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Scichilone, Nicola, Antonelli Incalzi, Raffaele, Blasi, Francesco, Schino, Pietro, Cuttitta, Giuseppina, Zullo, Alessandro, Ori, Alessandra, Canonica, Giorgio Walter, Schino P, Cuttitta G, Foschino MP, Prediletto R, Tranfa C, Zappa MC, Patriciello P, Labate L, Mariotta S, Nava S, Vatrella A, Mastroberardino M, Sarzani R, Iuliano A, Maggi L, Zedda A, Pesci A, Sera G, Nicolini A, Salvatore Walter DD, Forte S, Mario DD, Rivolta F, Ferliga M, Raco AF, Luigi DR, Cabibbo G, Maselli R, Gulotta C, Nardini S, Guffanti EE, Castellani W, Triolo L, Passalacqua G, Beghè B, Salvatore LC, Faccini E, Atzeni E, Tazza R, Giamesio P., Scichilone N., Antonelli Incalzi R., Blasi F., Schino P., Cuttitta G., Zullo A., Ori A., Canonica G., Foschino M.P., Prediletto R., Tranfa C.M.E., Zappa M.C., Patriciello P., Labate L., Mariotta S., Nava S., Vatrella A., Mastroberardino M., Sarzani R., Iuliano A., Maggi L., Zedda A., Pesci A., Sera G., Nicolini A., Salvatore Walter D.D., Forte S., Mario D.D., Rivolta F., Ferliga M., Raco A.F., Luigi D.R., Cabibbo G., Maselli R., Gulotta C., Nardini S., Guffanti E.E., Castellani W., Triolo L., Passalacqua G., Beghe B., Salvatore L.C., Faccini E., Atzeni E., Tazza R., Giamesio P., Scichilone, N, Antonelli Incalzi, R, Blasi, F, Schino, P, Cuttitta, G, Zullo, A, Ori, A, Canonica, G, Foschino, M, Prediletto, R, Tranfa, C, Zappa, M, Patriciello, P, Labate, L, Mariotta, S, Nava, S, Vatrella, A, Mastroberardino, M, Sarzani, R, Iuliano, A, Maggi, L, Zedda, A, Pesci, A, Sera, G, Nicolini, A, Salvatore Walter, D, Forte, S, Mario, D, Rivolta, F, Ferliga, M, Raco, A, Luigi, D, Cabibbo, G, Maselli, R, Gulotta, C, Nardini, S, Guffanti, E, Castellani, W, Triolo, L, Passalacqua, G, Beghe, B, Salvatore, L, Faccini, E, Atzeni, E, Tazza, R, Giamesio, P, Scichilone, Nicola, Antonelli Incalzi, Raffaele, Blasi, Francesco, Schino, Pietro, Cuttitta, Giuseppina, Zullo, Alessandro, Ori, Alessandra, Canonica, Giorgio, Walter, Foschino, Mp, Zappa, Mc, Salvatore Walter, Dd, Mario, Dd, Raco, Af, Luigi, Dr, Guffanti, Ee, Beghè, B, Salvatore, Lc, and Giamesio, P.
- Subjects
Male ,Chronic bronchitis ,Time Factors ,Health Status ,Anxiety ,Hospital Anxiety and Depression Scale ,Severity of Illness Index ,Health Statu ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Surveys and Questionnaires ,Forced Expiratory Volume ,Clinical phenotype ,Medicine ,Surveys and Questionnaire ,Respiratory function ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Lung ,Depression (differential diagnoses) ,COPD ,Depression ,Middle Aged ,Circadian Rhythm ,Phenotype ,Italy ,Female ,medicine.symptom ,24-hour symptoms, Clinical phenotype, Real-world, Respiratory function ,Research Article ,Human ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Chronic Obstructive ,Time Factor ,Settore MED/10 - Malattie Dell'Apparato Respiratorio ,Pulmonary Disease ,03 medical and health sciences ,Internal medicine ,Humans ,Asthma ,24-hour symptoms ,Real-world ,Aged ,Sleep ,Quality of Life ,lcsh:RC705-779 ,business.industry ,Correction ,lcsh:Diseases of the respiratory system ,medicine.disease ,24-hour symptom ,Prospective Studie ,030228 respiratory system ,business - Abstract
Background Chronic Obstructive Pulmonary Disease (COPD) encompasses various phenotypes that severely limit the applicability of precision respiratory medicine. The present investigation is aimed to assess the circadian rhythm of symptoms in pre-defined clinical COPD phenotypes and its association with health-related quality of life (HR-QoL), the quality of sleep and the level of depression/anxiety in each clinical phenotype. Methods The STORICO (NCT03105999) Italian observational prospective cohort study enrolled COPD subjects. A clinical diagnosis of either chronic bronchitis (CB), emphysema (EM) or mixed COPD-asthma (MCA) phenotype was made by clinicians at enrollment. Baseline early-morning, day-time and nocturnal symptoms (gathered via the Night-time, Morning and Day-time Symptoms of COPD questionnaire), HR-QoL (via the St. George’s Respiratory Questionnaire), anxiety and depression levels (via the Hospital Anxiety and Depression Scale), quality of sleep (via COPD and Asthma Sleep Impact Scale), physical activity (via the International Physical Activity Questionnaire) as well as lung function were recorded. Results 606 COPD subjects (age 71.4 ± 8.2 years, male 75.1%) were studied. 57.9, 35.5 5.3 and 1.3% of the sample belonged to the CB, EM, MCA and EM + CB phenotypes respectively. The vast majority of subjects reported early-morning and day-time symptoms (79.5 and 79.2% in the CB and 75.8 and 77.7% in the EM groups); the proportion suffering from night-time symptoms was higher in the CB than in the EM group (53.6% vs. 39.5%, p = 0.0016). In both CB and EM, indiscriminately, the presence of symptoms during the 24-h day was associated with poorer HR-QoL, worse quality of sleep and higher levels of anxiety/depression. Conclusions The findings highlight the primary classificatory role of nocturnal symptoms in COPD. Trial registration Trial registration number: NCT03105999, date of registration: 10th April 2017.
- Published
- 2019
29. Characterization of Grape (Vitis vinifera L.) Berry Sunburn Symptoms by Reflectance
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Letizia Rocchi, Laura Rustioni, Gabriele Cola, Osvaldo Failla, Eugenio Guffanti, Rustioni, L., Rocchi, L., Guffanti, E., Cola, G., and Failla, O.
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0106 biological sciences ,Reflectance spectroscopy ,Berry ,01 natural sciences ,browning symptom ,sun exposure ,03 medical and health sciences ,chemistry.chemical_compound ,Botany ,Browning ,medicine ,Sunburn ,Vitis vinifera ,030304 developmental biology ,Sunlight ,0303 health sciences ,General Chemistry ,medicine.disease ,Reflectivity ,white grapes ,melanin-like pigment ,Horticulture ,chemistry ,Chlorophyll ,General Agricultural and Biological Sciences ,010606 plant biology & botany - Abstract
Sunburn can affect grape quality both for chemical modifications and by visual impact of the browning. Optical properties of 17 white grape accessions were investigated in the visible region using a noninvasive instrument. Reflectance spectra were obtained using a Jaz System spectrometer. Browning was induced by exposing grape bunches to direct sunlight at 12:30 p.m. for 5 h. During the experiment, the global solar radiation ranged from 2.6 to 2.7 MJ m–2 h–1 and the air temperature from 24.3 to 29.2 °C; the exposed berries reached a temperature of 34.2 °C in comparison to the 30.4 °C of the shaded ones. Differences between the spectra of controlled and exposed berries mainly emphasized the loss in chlorophyll and the formation of brown compounds. A positive correlation between the chlorophyll concentration and berry browning was proposed. Developing rapid, noninvasive, and low-cost methods based on reflectance spectroscopy could support grapevine variety characterization with respect to sunburn susceptibi...
- Published
- 2014
30. Major liver resections, perioperative issues and posthepatectomy liver failure: A comprehensive update for the anesthesiologist.
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De Gasperi A, Petrò L, Amici O, Scaffidi I, Molinari P, Barbaglio C, Cibelli E, Penzo B, Roselli E, Brunetti A, Neganov M, Giacomoni A, Aseni P, and Guffanti E
- Abstract
Significant advances in surgical techniques and relevant medium- and long-term outcomes over the past two decades have led to a substantial expansion in the indications for major liver resections. To support these outstanding results and to reduce perioperative complications, anesthesiologists must address and master key perioperative issues (preoperative assessment, proactive intraoperative anesthesia strategies, and implementation of the Enhanced Recovery After Surgery approach). Intensive care unit monitoring immediately following liver surgery remains a subject of active and often unresolved debate. Among postoperative complications, posthepatectomy liver failure (PHLF) occurs in different grades of severity (A-C) and frequency (9%-30%), and it is the main cause of 90-d postoperative mortality. PHLF, recently redefined with pragmatic clinical criteria and perioperative scores, can be predicted, prevented, or anticipated. This review highlights: (1) The systemic consequences of surgical manipulations anesthesiologists must respond to or prevent, to positively impact PHLF (a proactive approach); and (2) the maximal intensive treatment of PHLF, including artificial options, mainly based, so far, on Acute Liver Failure treatment(s), to buy time waiting for the recovery of the native liver or, when appropriate and in very selected cases, toward liver transplant. Such a clinical context requires a strong commitment to surgeons, anesthesiologists, and intensivists to work together, for a fruitful collaboration in a mandatory clinical continuum., Competing Interests: Conflict-of-interest statement: All the authors declare that they have no conflict of interest., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
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- 2024
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31. Analysis of Massaciuccoli Peat after Maturation in Sodium Chloride Water of Undulna Thermae.
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Di Pasqua LG, Berardo C, Raffo L, Ferrigno A, Guffanti E, and Vairetti M
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- Humic Substances analysis, Water analysis, Wetlands, Sodium Chloride, Soil
- Abstract
In Italy, peat extracted from the peat bogs of Lake Massaciuccoli is the only peat used for therapeutic purposes. Massaciuccoli peat (M-peat) soaked in the salty bromine-iodine water of Undulna Thermae has given positive results in various pathological situations, mainly in dermatological, rheumatological, and traumatological conditions. Morphological and biochemical analysis were performed using base M-peat samples matured in the salty bromine-iodine water of the Undulna Thermae for different times, to evaluate whether maturation time modifies peat chemico-physical properties. The maturation process induced particle aggregation, with an increase in the fractions with larger particle size. The presence of a high number of proteins derived from organic degradation was observed; after 6 months of maturation, a significant increase in proteins was found, suggesting that salty bromine-iodine water plays a role in the clinical action of the peat. The presence of lipids in M-peat was also confirmed, allowing us to draw important considerations on its therapeutic properties possibly deriving from the relevant interactions between lipids and humic acids. Finally, from our observations, it could be reasonably argued that longer periods of maturation do not result in additional advantages regarding clinical activity.
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- 2022
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32. Ceftazidime-Avibactam Use for Klebsiella pneumoniae Carbapenemase-Producing K. pneumoniae Infections: A Retrospective Observational Multicenter Study.
- Author
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Tumbarello M, Raffaelli F, Giannella M, Mantengoli E, Mularoni A, Venditti M, De Rosa FG, Sarmati L, Bassetti M, Brindicci G, Rossi M, Luzzati R, Grossi PA, Corona A, Capone A, Falcone M, Mussini C, Trecarichi EM, Cascio A, Guffanti E, Russo A, De Pascale G, Tascini C, Gentile I, Losito AR, Bussini L, Corti G, Ceccarelli G, Corcione S, Compagno M, Giacobbe DR, Saracino A, Fantoni M, Antinori S, Peghin M, Bonfanti P, Oliva A, De Gasperi A, Tiseo G, Rovelli C, Meschiari M, Shbaklo N, Spanu T, Cauda R, and Viale P
- Subjects
- Adult, Anti-Bacterial Agents therapeutic use, Azabicyclo Compounds therapeutic use, Bacterial Proteins, Ceftazidime therapeutic use, Drug Combinations, Humans, Microbial Sensitivity Tests, Retrospective Studies, beta-Lactamases, Klebsiella Infections drug therapy, Klebsiella pneumoniae
- Abstract
Background: A growing body of observational evidence supports the value of ceftazidime-avibactam (CAZ-AVI) in managing infections caused by carbapenem-resistant Enterobacteriaceae., Methods: We retrospectively analyzed observational data on use and outcomes of CAZ-AVI therapy for infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) strains. Multivariate regression analysis was used to identify variables independently associated with 30-day mortality. Results were adjusted for propensity score for receipt of CAZ-AVI combination regimens versus CAZ-AVI monotherapy., Results: The cohort comprised 577 adults with bloodstream infections (n = 391) or nonbacteremic infections involving mainly the urinary tract, lower respiratory tract, and intra-abdominal structures. All received treatment with CAZ-AVI alone (n = 165) or with ≥1 other active antimicrobials (n = 412). The all-cause mortality rate 30 days after infection onset was 25% (146/577). There was no significant difference in mortality between patients managed with CAZ-AVI alone and those treated with combination regimens (26.1% vs 25.0%, P = .79). In multivariate analysis, mortality was positively associated with presence at infection onset of septic shock (P = .002), neutropenia (P < .001), or an INCREMENT score ≥8 (P = .01); with lower respiratory tract infection (LRTI) (P = .04); and with CAZ-AVI dose adjustment for renal function (P = .01). Mortality was negatively associated with CAZ-AVI administration by prolonged infusion (P = .006). All associations remained significant after propensity score adjustment., Conclusions: CAZ-AVI is an important option for treating serious KPC-Kp infections, even when used alone. Further study is needed to explore the drug's seemingly more limited efficacy in LRTIs and potential survival benefits of prolonging CAZ-AVI infusions to ≥3 hours., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
- Published
- 2021
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33. Italian suggestions for pulmonary rehabilitation in COVID-19 patients recovering from acute respiratory failure: results of a Delphi process.
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Vitacca M, Lazzeri M, Guffanti E, Frigerio P, D'Abrosca F, Gianola S, Carone M, Paneroni M, Ceriana P, Pasqua F, Banfi P, Gigliotti F, Simonelli C, Cirio S, Rossi V, Beccaluva CG, Retucci M, Santambrogio M, Lanza A, Gallo F, Fumagalli A, Mantero M, Castellini G, Calabrese M, Castellana G, Volpato E, Ciriello M, Garofano M, Clini E, and Ambrosino N
- Subjects
- Ambulatory Care, Betacoronavirus, COVID-19, Coronavirus Infections complications, Coronavirus Infections physiopathology, Delphi Technique, Exercise Test, Humans, Intensive Care Units, Italy, Nutritional Status, Pandemics, Personal Protective Equipment, Pneumonia, Viral complications, Pneumonia, Viral physiopathology, Quality of Life, Respiratory Function Tests, Respiratory Insufficiency etiology, Respiratory Insufficiency physiopathology, SARS-CoV-2, Stress Disorders, Post-Traumatic, Coronavirus Infections rehabilitation, Physical Therapy Modalities, Pneumonia, Viral rehabilitation, Respiratory Insufficiency rehabilitation, Respiratory Therapy methods
- Abstract
There is a need of consensus about the pulmonary rehabilitation (PR) in patients with COVID-19 after discharge from acute care. To facilitate the knowledge of the evidence and its translation into practice, we developed suggestions based on experts' opinion. A steering committee identified areas and questions sent to experts. Other international experts participated to a RAND Delphi method in reaching consensus and proposing further suggestions. Strong agreement in suggestions was defined when the mean agreement was >7 (1 = no agreement and 9 = maximal agreement). Panelists response rate was >95%. Twenty-three questions from 4 areas: Personnel protection equipment, phenotypes, assessments, interventions, were identified and experts answered with 121 suggestions, 119 of which received high level of concordance. The evidence-based suggestions provide the clinicians with current evidence and clinical experts opinion. This framework can be used to facilitate clinical decision making within the context of the individual patient. Further studies will evaluate the clinical usefulness of these suggestions.
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- 2020
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34. Joint Statement on the Role of Respiratory Rehabilitation in the COVID-19 Crisis: The Italian Position Paper.
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Vitacca M, Carone M, Clini EM, Paneroni M, Lazzeri M, Lanza A, Privitera E, Pasqua F, Gigliotti F, Castellana G, Banfi P, Guffanti E, Santus P, and Ambrosino N
- Subjects
- COVID-19, Coronavirus Infections epidemiology, Humans, Italy, Pandemics, Patient Acuity, Pneumonia, Viral epidemiology, Respiratory Distress Syndrome etiology, Respiratory Distress Syndrome rehabilitation, Respiratory Insufficiency etiology, SARS-CoV-2, Betacoronavirus, Coronavirus Infections complications, Physical Therapy Modalities, Pneumonia, Viral complications, Respiratory Insufficiency rehabilitation
- Abstract
Due to the exponential growth of the number of subjects affected by coronavirus disease 2019 (COVID-19), the entire Italian health care system had to respond promptly and in a very short time with the need of semi-intensive and intensive care units. Moreover, trained dedicated COVID-19 teams consisting of physicians were coming from different specialties (intensivists or pneumologists and infectiologists), while respiratory therapists and nurses have been recruited to work on and on without rest. However, due to still limited and evolving knowledge of COVID-19, there are few recommendations concerning the need in respiratory rehabilitation and physiotherapy interventions. The presentation of this paper is the result of a consensus promoted by the Italian societies of respiratory health care professionals who contacted pulmonologists directly involved in the treatment and rehabilitation of COVID-19. The aim was to formulate the more proper and common suggestions to be applied in different hospital settings in offering rehabilitative programs and physiotherapy workforce planning for COVID-19 patients. Two main areas of intervention were identified: organization and treatment, which are described in this paper to face the emergency., (© 2020 S. Karger AG, Basel.)
- Published
- 2020
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35. Prevalence and variability of use of home mechanical ventilators, positive airway pressure and oxygen devices in the Lombardy region, Italy.
- Author
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Vitacca M, Barbano L, Colombo D, Leoni O, and Guffanti E
- Subjects
- Continuous Positive Airway Pressure instrumentation, Continuous Positive Airway Pressure statistics & numerical data, Humans, Hyperbaric Oxygenation instrumentation, Hyperbaric Oxygenation statistics & numerical data, Italy epidemiology, Observational Studies as Topic, Patient-Centered Care, Prevalence, Respiration, Artificial instrumentation, Respiration, Artificial trends, Health Services Accessibility standards, Respiration, Artificial statistics & numerical data, Ventilators, Mechanical supply & distribution
- Abstract
Few studies have analyzed the prevalence and accessibility of home mechanical ventilation (HMV) in Italy. We aimed to investigate the prevalence and prescription variability of HMV as well as of long-term oxygen therapy (LTOT) and continuous positive airway pressure (CPAP), in the Lombardy Region. Prescribing rates of HMV (both noninvasive and tracheostomies), CPAP (auto-CPAP, CPAP/other sleep machines) and LTOT (liquid-O2, O2-gas, concentrators) in the 15 Local Healthcare districts of Lombardy were gathered from billing data for 2012 and compared. Crude rates (per 100,000 population) and rates for the different healthcare districts were calculated. In 2012, 6325 patients were on HMV (crude prescription rate: 63/100,000) with a high variation across districts (8/100,000 in Milano 1 vs 150/100,000 in Pavia). There were 14,237 patients on CPAP (crude prescription rate: 142/100,000; CPAP/other sleep machines 95.3% vs auto-CPAP 4.7%) with also high intra-regional variation (56/100,000 in Mantova vs. 260/100,000 in Pavia). There were 21,826 patients on LTOT (prescription rate: 217/100,000 rate; liquid-O2 94%, O2-gas 2.08%, O2-concentrators 3.8%), with again high intra-regional variation (100/100,000 in Bergamo vs 410/100,000 in Valle Camonica). The crude rate of HMV prescriptions in Lombardy is very high, with a high intra-regional variability in prescribing HMV, LTOT and CPAP which is partly explainable by the accessibility to specialist centers with HMV/sleep-study facilities. Analysis of administrative data and variability mapping can help identify areas of reduced access for an improved standardization of services. An audit among Health Payer and prescribers to interpret the described huge variability could be welcomed.
- Published
- 2018
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36. COPD management as a model for all chronic respiratory conditions: report of the 4 th Consensus Conference in Respiratory Medicine.
- Author
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Nardini S, De Benedetto F, Sanguinetti CM, Bellofiore S, Carlone S, Privitera S, Sagliocca L, Tupputi E, Baccarani C, Caiffa G, Calabrese MC, Capuozzo A, Cauchi S, Conio V, Coratella G, Crismancich F, Dal Negro RW, Dellarole F, Delucchi M, Favaretti C, Forte S, Gallo FM, Giuliano R, Grandi M, Grillo A, Gualano MR, Guffanti E, Locicero S, Lombardo FP, Mantero M, Marasso R, Martino L, Mastroberardino M, Mereu C, Messina R, Neri M, Novelletto BF, Parente P, Pasquinucci S, Pistolesi M, Polverino M, Posca A, Richeldi L, Roccia F, Giustini ES, Salemi M, Santacroce S, Schisano M, Schisano M, Selvi E, Silenzi A, Soverina P, Taranto C, Ugolini M, Visaggi P, and Zanasi A
- Abstract
Background: Non-communicable diseases (NCDs) kill 40 million people each year. The management of chronic respiratory NCDs such as chronic obstructive pulmonary disease (COPD) is particularly critical in Italy, where they are widespread and represent a heavy burden on healthcare resources. It is thus important to redefine the role and responsibility of respiratory specialists and their scientific societies, together with that of the whole healthcare system, in order to create a sustainable management of COPD, which could become a model for other chronic respiratory conditions., Methods: These issues were divided into four main topics (Training, Organization, Responsibilities, and Sustainability) and discussed at a Consensus Conference promoted by the Research Center of the Italian Respiratory Society held in Rome, Italy, 3-4 November 2016., Results and Conclusions: Regarding training, important inadequacies emerged regarding specialist training - both the duration of practical training courses and teaching about chronic diseases like COPD. A better integration between university and teaching hospitals would improve the quality of specialization. A better organizational integration between hospital and specialists/general practitioners (GPs) in the local community is essential to improve the diagnostic and therapeutic pathways for chronic respiratory patients. Improving the care pathways is the joint responsibility of respiratory specialists, GPs, patients and their caregivers, and the healthcare system. The sustainability of the entire system depends on a better organization of the diagnostic-therapeutic pathways, in which also other stakeholders such as pharmacists and pharmaceutical companies can play an important role.
- Published
- 2017
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37. Characterization of Grape (Vitis vinifera L.) Berry Sunburn Symptoms by Reflectance.
- Author
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Rustioni L, Rocchi L, Guffanti E, Cola G, and Failla O
- Abstract
Sunburn can affect grape quality both for chemical modifications and by visual impact of the browning. Optical properties of 17 white grape accessions were investigated in the visible region using a noninvasive instrument. Reflectance spectra were obtained using a Jaz System spectrometer. Browning was induced by exposing grape bunches to direct sunlight at 12:30 p.m. for 5 h. During the experiment, the global solar radiation ranged from 2.6 to 2.7 MJ m
-2 h-1 and the air temperature from 24.3 to 29.2 °C; the exposed berries reached a temperature of 34.2 °C in comparison to the 30.4 °C of the shaded ones. Differences between the spectra of controlled and exposed berries mainly emphasized the loss in chlorophyll and the formation of brown compounds. A positive correlation between the chlorophyll concentration and berry browning was proposed. Developing rapid, noninvasive, and low-cost methods based on reflectance spectroscopy could support grapevine variety characterization with respect to sunburn susceptibility as well as study of the physiological processes involved in the symptoms' appearance.- Published
- 2014
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38. Role of histone modifications and early termination in pervasive transcription and antisense-mediated gene silencing in yeast.
- Author
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Castelnuovo M, Zaugg JB, Guffanti E, Maffioletti A, Camblong J, Xu Z, Clauder-Münster S, Steinmetz LM, Luscombe NM, and Stutz F
- Subjects
- Histone-Lysine N-Methyltransferase physiology, Proton-Phosphate Symporters genetics, RNA, Antisense biosynthesis, RNA-Binding Proteins metabolism, Saccharomyces cerevisiae metabolism, Saccharomyces cerevisiae Proteins genetics, Saccharomyces cerevisiae Proteins metabolism, Saccharomyces cerevisiae Proteins physiology, Gene Expression Regulation, Fungal, Gene Silencing, Histones metabolism, RNA, Antisense metabolism, Saccharomyces cerevisiae genetics, Transcription Termination, Genetic
- Abstract
Most genomes, including yeast Saccharomyces cerevisiae, are pervasively transcribed producing numerous non-coding RNAs, many of which are unstable and eliminated by nuclear or cytoplasmic surveillance pathways. We previously showed that accumulation of PHO84 antisense RNA (asRNA), in cells lacking the nuclear exosome component Rrp6, is paralleled by repression of sense transcription in a process dependent on the Hda1 histone deacetylase (HDAC) and the H3K4 histone methyl transferase Set1. Here we investigate this process genome-wide and measure the whole transcriptome of various histone modification mutants in a Δrrp6 strain using tiling arrays. We confirm widespread occurrence of potentially antisense-dependent gene regulation and identify three functionally distinct classes of genes that accumulate asRNAs in the absence of Rrp6. These classes differ in whether the genes are silenced by the asRNA and whether the silencing is HDACs and histone methyl transferase-dependent. Among the distinguishing features of asRNAs with regulatory potential, we identify weak early termination by Nrd1/Nab3/Sen1, extension of the asRNA into the open reading frame promoter and dependence of the silencing capacity on Set1 and the HDACs Hda1 and Rpd3 particularly at promoters undergoing extensive chromatin remodelling. Finally, depending on the efficiency of Nrd1/Nab3/Sen1 early termination, asRNA levels are modulated and their capability of silencing is changed.
- Published
- 2014
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39. Laparoscopic repair of ventral hernia in a laparoscopic experienced surgical center: low recurrence rate, morbidity, and chronic pain are achievable.
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Cocozza E, Berselli M, Latham L, Livraghi L, Farassino L, Bianchi V, Mangano A, and Guffanti E
- Subjects
- Adult, Aged, Aged, 80 and over, Chronic Pain etiology, Follow-Up Studies, Hernia, Ventral prevention & control, Humans, Intraoperative Complications, Male, Middle Aged, Postoperative Complications, Recurrence, Retrospective Studies, Treatment Outcome, Videotape Recording, Hernia, Ventral surgery, Laparoscopy
- Abstract
Purpose: Recurrence rate and the perioperative outcome evaluation through laparoscopic approach for ventral (primary and incisional) hernia repair., Materials and Methods: A retrospective evaluation of a series of patients treated through a minimally invasive approach for ventral hernia was performed. A standardized surgical technique was adopted. All the patients were evaluated through a clinical follow-up., Results: From July 2004 to June 2011, 150 videolaparoscopic ventral hernia repairs were performed. The median follow-up was 40 months. One hernia recurrence (0.7%) was detected after 55 months. The intraoperative and postoperative complication rate was 2.6% (1 conversion to open surgery) and 5.3%, respectively. Chronic pain nonresponsive to drug was registered in 2 patients (1.3%)., Conclusions: The videolaparoscopic approach to ventral hernia repair is a safe technique that can guarantee a low recurrence rate; moreover, if it is performed in an experienced laparoscopic surgical center, it can be a valid alternative to the traditional open approach.
- Published
- 2014
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40. Bimodal expression of PHO84 is modulated by early termination of antisense transcription.
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Castelnuovo M, Rahman S, Guffanti E, Infantino V, Stutz F, and Zenklusen D
- Subjects
- DNA Helicases physiology, Exosome Multienzyme Ribonuclease Complex physiology, Histone Deacetylases physiology, Histone-Lysine N-Methyltransferase physiology, In Situ Hybridization, Fluorescence, Metalloendopeptidases physiology, Models, Genetic, Multiprotein Complexes, Nuclear Proteins physiology, Polyadenylation, Polynucleotide Adenylyltransferase physiology, Promoter Regions, Genetic genetics, Proton-Phosphate Symporters biosynthesis, RNA Helicases physiology, RNA, Antisense metabolism, RNA, Fungal metabolism, RNA, Messenger biosynthesis, RNA, Messenger metabolism, RNA-Binding Proteins physiology, Saccharomyces cerevisiae Proteins biosynthesis, Saccharomyces cerevisiae Proteins physiology, Gene Expression Regulation, Fungal, Proton-Phosphate Symporters genetics, RNA, Antisense genetics, RNA, Fungal genetics, Saccharomyces cerevisiae genetics, Saccharomyces cerevisiae Proteins genetics, Transcription, Genetic
- Abstract
Many Saccharomyces cerevisiae genes encode antisense transcripts, some of which are unstable and degraded by the exosome component Rrp6. Loss of Rrp6 results in the accumulation of long PHO84 antisense (AS) RNAs and repression of sense transcription through PHO84 promoter deacetylation. We used single-molecule resolution fluorescent in situ hybridization (smFISH) to investigate antisense-mediated transcription regulation. We show that PHO84 AS RNA acts as a bimodal switch, in which continuous, low-frequency antisense transcription represses sense expression within individual cells. Surprisingly, antisense RNAs do not accumulate at the PHO84 gene but are exported to the cytoplasm. Furthermore, rather than stabilizing PHO84 AS RNA, the loss of Rrp6 favors its elongation by reducing early transcription termination by Nrd1-Nab3-Sen1. These observations suggest that PHO84 silencing results from antisense transcription through the promoter rather than the static accumulation of antisense RNAs at the repressed gene.
- Published
- 2013
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41. Long-term azithromycin use in patients with chronic obstructive pulmonary disease and tracheostomy.
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Blasi F, Bonardi D, Aliberti S, Tarsia P, Confalonieri M, Amir O, Carone M, Di Marco F, Centanni S, and Guffanti E
- Subjects
- Aged, Aged, 80 and over, Azithromycin adverse effects, Body Mass Index, Female, Hospitalization statistics & numerical data, Humans, Kaplan-Meier Estimate, Macrolides adverse effects, Male, Middle Aged, Pilot Projects, Pulmonary Disease, Chronic Obstructive mortality, Quality of Life, Severity of Illness Index, Smoking, Azithromycin therapeutic use, Macrolides therapeutic use, Pulmonary Disease, Chronic Obstructive drug therapy, Tracheostomy
- Abstract
Patients with Chronic Obstructive Pulmonary Disease (COPD) and tracheostomy are at high risk for exacerbations and hospitalizations. Macrolide treatment has shown to reduce exacerbations in moderate-to-severe COPD. To evaluate the safety and the efficacy of long-term azithromycin use in outpatients with severe COPD and tracheostomy. A multicenter, randomized, uncontrolled, pilot trial evaluating the safety and the efficacy of azithromycin 500 mg three day-a-week for 6 months (AZI) vs. standard of care (SC) in severe COPD outpatients with tracheostomy. Patients were monitored for six months of treatment plus six months of follow up. The primary outcome was the reduction in the number of exacerbations and hospitalizations. A total of 22 patients was randomized (11 to SC and 11 to AZI). Patients in AZI had a significant lower cumulative number of exacerbations after the first 3 months of treatment when compared to patients in SC (p = 0.001), as well as hospitalizations (p = 0.02). Kaplan-Meier survival curves for time to first exacerbation showed a significant reduction in AZI of the rates of first exacerbation when compared to SC (log rank test = 12.14, p < 0.001), as well as to first hospitalization (log-rank = 4.09, p = 0.04). Azithromycin significantly improved the quality of life in comparison to SC. No serious adverse events in the AZI group were reported. Long-term azithromycin treatment seems to be safe and effective in severe COPD outpatients with tracheostomy in reducing exacerbations, hospitalizations, as well as in improving quality of life., (Copyright 2009 Elsevier Ltd. All rights reserved.)
- Published
- 2010
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42. Trans-acting antisense RNAs mediate transcriptional gene cosuppression in S. cerevisiae.
- Author
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Camblong J, Beyrouthy N, Guffanti E, Schlaepfer G, Steinmetz LM, and Stutz F
- Subjects
- DNA-Binding Proteins metabolism, Gene Dosage genetics, Gene Silencing, Histone Deacetylases metabolism, Histone-Lysine N-Methyltransferase, Proton-Phosphate Symporters genetics, Saccharomyces cerevisiae Proteins genetics, Saccharomyces cerevisiae Proteins metabolism, Trans-Activators metabolism, Transcription Factors metabolism, Gene Expression Regulation, Fungal, RNA, Antisense metabolism, Saccharomyces cerevisiae genetics, Saccharomyces cerevisiae metabolism, Suppression, Genetic genetics
- Abstract
Homology-dependent gene silencing, a phenomenon described as cosuppression in plants, depends on siRNAs. We provide evidence that in Saccharomyces cerevisiae, which is missing the RNAi machinery, protein coding gene cosuppression exists. Indeed, introduction of an additional copy of PHO84 on a plasmid or within the genome results in the cosilencing of both the transgene and the endogenous gene. This repression is transcriptional and position-independent and requires trans-acting antisense RNAs. Antisense RNAs induce transcriptional gene silencing both in cis and in trans, and the two pathways differ by the implication of the Hda1/2/3 complex. We also show that trans-silencing is influenced by the Set1 histone methyltransferase, which promotes antisense RNA production. Finally we show that although antisense-mediated cis-silencing occurs in other genes, trans-silencing so far depends on features specific to PHO84. All together our data highlight the importance of noncoding RNAs in mediating RNAi-independent transcriptional gene silencing.
- Published
- 2009
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43. Bidirectional promoters generate pervasive transcription in yeast.
- Author
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Xu Z, Wei W, Gagneur J, Perocchi F, Clauder-Münster S, Camblong J, Guffanti E, Stutz F, Huber W, and Steinmetz LM
- Subjects
- Gene Expression Profiling, Genes, Fungal genetics, Genes, Overlapping genetics, Genome, Fungal genetics, Models, Genetic, Nucleosomes, RNA Stability genetics, RNA, Untranslated genetics, Saccharomyces cerevisiae classification, Saccharomyces cerevisiae Proteins genetics, Gene Expression Regulation, Fungal genetics, Promoter Regions, Genetic genetics, RNA, Fungal genetics, Saccharomyces cerevisiae genetics, Transcription, Genetic genetics
- Abstract
Genome-wide pervasive transcription has been reported in many eukaryotic organisms, revealing a highly interleaved transcriptome organization that involves hundreds of previously unknown non-coding RNAs. These recently identified transcripts either exist stably in cells (stable unannotated transcripts, SUTs) or are rapidly degraded by the RNA surveillance pathway (cryptic unstable transcripts, CUTs). One characteristic of pervasive transcription is the extensive overlap of SUTs and CUTs with previously annotated features, which prompts questions regarding how these transcripts are generated, and whether they exert function. Single-gene studies have shown that transcription of SUTs and CUTs can be functional, through mechanisms involving the generated RNAs or their generation itself. So far, a complete transcriptome architecture including SUTs and CUTs has not been described in any organism. Knowledge about the position and genome-wide arrangement of these transcripts will be instrumental in understanding their function. Here we provide a comprehensive analysis of these transcripts in the context of multiple conditions, a mutant of the exosome machinery and different strain backgrounds of Saccharomyces cerevisiae. We show that both SUTs and CUTs display distinct patterns of distribution at specific locations. Most of the newly identified transcripts initiate from nucleosome-free regions (NFRs) associated with the promoters of other transcripts (mostly protein-coding genes), or from NFRs at the 3' ends of protein-coding genes. Likewise, about half of all coding transcripts initiate from NFRs associated with promoters of other transcripts. These data change our view of how a genome is transcribed, indicating that bidirectionality is an inherent feature of promoters. Such an arrangement of divergent and overlapping transcripts may provide a mechanism for local spreading of regulatory signals-that is, coupling the transcriptional regulation of neighbouring genes by means of transcriptional interference or histone modification.
- Published
- 2009
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44. Nuclear pore complex proteins mark the implantation window in human endometrium.
- Author
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Guffanti E, Kittur N, Brodt ZN, Polotsky AJ, Kuokkanen SM, Heller DS, Young SL, Santoro N, and Meier UT
- Subjects
- Animals, Antibodies, Monoclonal, Biomarkers, Diagnostic Techniques, Obstetrical and Gynecological, Endometrium ultrastructure, Female, Fluorescent Antibody Technique, Humans, Nuclear Pore physiology, Papio, Pregnancy, Sensitivity and Specificity, Time Factors, Embryo Implantation physiology, Endometrium physiology, Luteal Phase physiology, Nuclear Pore ultrastructure
- Abstract
Nucleolar channel systems (NCSs) are membranous organelles appearing transiently in the epithelial cell nuclei of postovulatory human endometrium. Their characterization and use as markers for a healthy receptive endometrium have been limited because they are only identifiable by electron microscopy. Here we describe the light microscopic detection of NCSs using immunofluorescence. Specifically, the monoclonal nuclear pore complex antibody 414 shows that NCSs are present in about half of all human endometrial epithelial cells but not in any other cell type, tissue or species. Most nuclei contain only a single NCS of uniform 1 microm diameter indicating a tightly controlled organelle. The composition of NCSs is as unique as their structure; they contain only a subset each of the proteins of nuclear pore complexes, inner nuclear membrane, nuclear lamina and endoplasmic reticulum. Validation of our robust NCS detection method on 95 endometrial biopsies defines a 6-day window, days 19-24 (+/-1) of an idealized 28 day cycle, wherein NCSs occur. Therefore, NCSs precede and overlap with the implantation window and serve as potential markers of uterine receptivity. The immunodetection assay, combined with the hitherto underappreciated prevalence of NCSs, now enables simple screening and further molecular and functional dissection.
- Published
- 2008
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45. Effect of noninvasive mechanical ventilation in elderly patients with hypercapnic acute-on-chronic respiratory failure and a do-not-intubate order.
- Author
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Scarpazza P, Incorvaia C, di Franco G, Raschi S, Usai P, Bernareggi M, Bonacina C, Melacini C, Vanni S, Bencini S, Pravettoni C, Di Cara G, Yacoub MR, Riario-Sforza GG, Guffanti E, and Casali W
- Subjects
- APACHE, Acute Disease, Age Factors, Aged, Aged, 80 and over, Carbon Dioxide blood, Chronic Disease, Female, Glasgow Coma Scale, Humans, Hydrogen-Ion Concentration, Hypercapnia blood, Hypercapnia etiology, Hypercapnia mortality, Male, Respiratory Insufficiency blood, Respiratory Insufficiency etiology, Respiratory Insufficiency mortality, Risk Assessment, Risk Factors, Time Factors, Treatment Failure, Hypercapnia therapy, Intubation, Intratracheal, Respiration, Artificial mortality, Respiratory Insufficiency therapy, Resuscitation Orders
- Abstract
Noninvasive mechanical ventilation (NIMV) is effective in the treatment of patients with acute respiratory failure (ARF). It proved to reduce the need of endotracheal intubation (ETI), the incidence of ETI-associated pneumonia, and mortality compared to nonventilated patients. A particular aspect concerns the outcome of NIMV in patients referring to an emergency room (ER) for ARF, and with a do-not-intubate (DNI) status due to advanced age or critical conditions. The aim of our study is to assess the outcome of NIMV in a group of elderly patients with acute hypercapnic ARF who had a DNI status. An overall number of 62 subjects (30 males, 32 females, mean age 81 +/- 4.8 years, range 79-91 years) referred to our semi-intensive respiratory department were enrolled in the study. The underlying diseases were severe chronic obstructive pulmonary disease (COPD) in 50/62 subjects, restrictive thoracic disorders in 7/62 subjects, and multiorgan failure in 5/62 subjects. Fifty-four/62 patients were successfully treated with NIMV while 2/62 did not respond to NIMV and were therefore submitted to ETI (one survived). Among NIMV-treated patients, death occurred in 6 patients after a mean of 9.9 days; the overall rate of NIMV failure was 12.9%. Negative prognostic factors for NIMV response proved to be: an older age, a low Glasgow Coma Score, a high APACHE score at admission, a high PaCO2 after 12 hours and a low pH both after 1 and 12 hours of NIMV. We conclude that elderly patients with acute hypercapnic ARF with a DNI status can be successfully treated by NIMV.
- Published
- 2008
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46. Home mechanical ventilation patients: a retrospective survey to identify level of burden in real life.
- Author
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Vitacca M, Escarrabill J, Galavotti G, Vianello A, Prats E, Scala R, Peratoner A, Guffanti E, Maggi L, Barbano L, and Balbi B
- Subjects
- Aged, Female, Health Surveys, Humans, Male, Middle Aged, Retrospective Studies, Cost of Illness, Home Care Services, Neuromuscular Diseases therapy, Pulmonary Disease, Chronic Obstructive therapy, Respiration, Artificial, Thoracic Diseases therapy
- Abstract
Background and Aim: Home care for patients under home mechanical ventilation (HMV) may cause dramatic physical and economic burden in addition to the burden of time on family/caregivers and health care service (HCS) with difficult resource allocation decision-making. Our aims were: 1. To identify conditions causing major care burden in managing HMV patients according to family and payer's perspectives related to characteristics of the disease, dependency and accessibility; and 2. To find, if any, differences among diseases., Methods: A questionnaire was sent to eight pulmonary centres to identify factors connected with the greater care burden. Retrospective data of 792 patients still alive and in HMV was reviewed., Results: Compared to neuromuscular disorders (NM) and chest wall deformities, the COPD group have presented a statistically greater number of hospitalisations/yr (1.37 +/- 0.77), greater length of stay (13 +/- 10 days), higher number of outpatient visits/yr (2.55 +/- 1.73) or emergency room accesses/yr (0.74 +/- 1.08). Patients with NM diseases need more home care. The prevalence of one, two and three among five selected burden criteria (needs of MV > 12 hrs/day, tracheotomy, high dependency, distance from hospital, frequent hospitalisations) was respectively 19%, 30% and 33% of the cases; the NM was the group most represented., Conclusions: In HMV patients: 1. underlying disease, level of their dependency, hours spent under MV, presence of tracheotomy, home distance from hospital, hospital accesses are the causes of major care burden; and 2. as a novelty we have demonstrated that more than fifty percent of them present two or three contemporaneous criteria selected as care burden, being NM and COPD patients the most representative group necessitating of family's and HCS's care respectively.
- Published
- 2007
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47. Assembly into snoRNP controls 5'-end maturation of a box C/D snoRNA in Saccharomyces cerevisiae.
- Author
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Preti M, Guffanti E, Valitutto E, and Dieci G
- Subjects
- 3' Flanking Region, 5' Flanking Region, Base Sequence, Cell Nucleolus genetics, Cell Nucleolus metabolism, Molecular Sequence Data, Mutation, Nuclear Proteins genetics, Nuclear Proteins metabolism, RNA Polymerase III genetics, RNA Polymerase III metabolism, RNA, Small Nucleolar metabolism, Ribonucleoproteins, Small Nucleolar metabolism, Saccharomyces cerevisiae metabolism, Saccharomyces cerevisiae Proteins genetics, Saccharomyces cerevisiae Proteins metabolism, RNA, Small Nucleolar genetics, Ribonucleoproteins, Small Nucleolar genetics, Saccharomyces cerevisiae genetics
- Abstract
The SNR52 gene, coding for a box C/D snoRNA, is the only snoRNA gene transcribed by RNA polymerase (Pol) III in Saccharomyces cerevisiae. Pol III transcription generates a precisely terminated primary transcript that undergoes extensive 5'-end processing. Here, we show that mutations of the box C/D core motif required for snoRNP assembly compromise 5'-end maturation of the SNR52 snoRNA. Upstream processing was also impaired by specific depletion of either Nop1p or Nop58p snoRNP proteins. We further show that the nuclear exosome is required for 3'-end maturation of SNR52 snoRNA, at variance with all the other known Pol III transcripts. Our data suggest a functional coupling between snoRNP assembly and 5'-end maturation of independently transcribed box C/D snoRNAs.
- Published
- 2006
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48. Nucleosome depletion activates poised RNA polymerase III at unconventional transcription sites in Saccharomyces cerevisiae.
- Author
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Guffanti E, Percudani R, Harismendy O, Soutourina J, Werner M, Iacovella MG, Negri R, and Dieci G
- Subjects
- Base Sequence, Chromatin chemistry, DNA metabolism, Genome, Fungal, Micrococcal Nuclease metabolism, Molecular Sequence Data, Open Reading Frames, Promoter Regions, Genetic, Protein Conformation, RNA Polymerase III metabolism, Sequence Homology, Nucleic Acid, Nucleosomes metabolism, RNA Polymerase III chemistry, Saccharomyces cerevisiae metabolism, Transcription, Genetic
- Abstract
RNA polymerase (pol) III, assisted by the transcription factors TFIIIC and TFIIIB, transcribes small untranslated RNAs, such as tRNAs. In addition to known pol III-transcribed genes, the Saccharomyces cerevisiae genome contains loci (ZOD1, ETC1-8) associated to incomplete pol III transcription complexes (Moqtaderi, Z., and Struhl, K. (2004) Mol. Cell. Biol. 24, 4118-4127). We show that a short segment of the ZOD1 locus, containing box A and box B promoter elements and a termination signal between them, directs the pol III-dependent production of a small RNA both in vitro and in vivo. In yeast cells, the levels of both ZOD1- and ETC5-specific transcripts were dramatically enhanced upon nucleosome depletion. Remarkably, transcription factor and pol III occupancy at the corresponding loci did not change significantly upon derepression, thus suggesting that chromatin opening activates poised pol III to transcription. Comparative genomic analysis revealed that the ZOD1 promoter is the only surviving portion of a tDNA(Ile) ancestor, whose transcription capacity has been preserved throughout evolution independently from the encoded RNA product. Similarly, another TFIIIC/TFIIIB-associated locus, close to the YGR033c open reading frame, was found to be the strictly conserved remnant of an ancient tDNA(Arg). The maintenance, by eukaryotic genomes, of chromatin-repressed, non-coding transcription units has implications for both genome expression and organization.
- Published
- 2006
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49. Distinct modes of TATA box utilization by the RNA polymerase III transcription machineries from budding yeast and higher plants.
- Author
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Dieci G, Yukawa Y, Alzapiedi M, Guffanti E, Ferrari R, Sugiura M, and Ottonello S
- Subjects
- Arabidopsis enzymology, Arabidopsis metabolism, Base Sequence, DNA, Plant genetics, DNA, Plant metabolism, Genes, Plant, Molecular Sequence Data, RNA Polymerase III genetics, RNA, Transfer genetics, RNA, Transfer metabolism, Saccharomyces cerevisiae enzymology, Saccharomyces cerevisiae metabolism, TATA-Box Binding Protein genetics, TATA-Box Binding Protein metabolism, Transcription Factor TFIIIB genetics, Transcription Factor TFIIIB metabolism, Transcription Initiation Site, Arabidopsis genetics, RNA Polymerase III metabolism, Saccharomyces cerevisiae genetics, TATA Box, Transcription, Genetic
- Abstract
The TATA box is a key upstream control element for basal tRNA gene transcription by RNA polymerase III in some eukaryotes, such as the fission yeast (Schizosaccharomyces pombe) and higher plants, but not in others such as the budding yeast (Saccharomyces cerevisiae). To gain information on this differential TATA box requirement, we examined side-by-side the in vitro transcription properties of TATA-containing and TATA-mutated plant and S. cerevisiae tDNAs in homologous in vitro transcription systems from both organisms and in a hybrid system in which yeast TBP was replaced by its plant homologue. The data support the general conclusion that specific features of the plant transcription machinery, rather than upstream region architecture per se, are responsible for the much stronger TATA box dependence of the plant system. In both systems, however, a strong influence of the TATA box on transcription start site selection was observed. This was particularly striking in the case of plant tDNAs, where TATA-rich upstream regions were found to favour the use of alternative initiation sites. Replacement of yeast TBP with its plant counterpart did not confer any general TATA box responsiveness to the yeast transcription machinery. Interactions involving components other than TBP are thus responsible for the strong TATA box requirement of plant tDNA transcription.
- Published
- 2006
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50. A minimal promoter for TFIIIC-dependent in vitro transcription of snoRNA and tRNA genes by RNA polymerase III.
- Author
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Guffanti E, Ferrari R, Preti M, Forloni M, Harismendy O, Lefebvre O, and Dieci G
- Subjects
- 5' Untranslated Regions metabolism, Base Sequence, Binding Sites genetics, DNA Mutational Analysis, Molecular Sequence Data, RNA Polymerase III chemistry, RNA Polymerase III metabolism, RNA, Fungal genetics, RNA, Fungal metabolism, Recombinant Proteins chemistry, Recombinant Proteins genetics, Recombinant Proteins metabolism, Saccharomyces cerevisiae enzymology, Saccharomyces cerevisiae genetics, Transcription Factors, TFIII chemistry, Transcription Factors, TFIII metabolism, Promoter Regions, Genetic, RNA Polymerase III physiology, RNA, Small Nucleolar genetics, RNA, Transfer genetics, Transcription Factors, TFIII genetics, Transcription, Genetic
- Abstract
The Saccharomyces cerevisiae SNR52 gene is unique among the snoRNA coding genes in being transcribed by RNA polymerase III. The primary transcript of SNR52 is a 250-nucleotide precursor RNA from which a long leader sequence is cleaved to generate the mature snR52 RNA. We found that the box A and box B sequence elements in the leader region are both required for the in vivo accumulation of the snoRNA. As expected box B, but not box A, was absolutely required for stable TFIIIC, yet in vitro. Surprisingly, however, the box B was found to be largely dispensable for in vitro transcription of SNR52, whereas the box A-mutated template effectively recruited TFIIIB; yet it was transcriptionally inactive. Even in the complete absence of box B and both upstream TATA-like and T-rich elements, the box A still directed efficient, TFIIIC-dependent transcription. Box B-independent transcription was also observed for two members of the tRNA(Asn)(GTT) gene family, but not for two tRNA(Pro)(AGG) gene copies. Fully recombinant TFIIIC supported box B-independent transcription of both SNR52 and tRNA(Asn) genes, but only in the presence of TFIIIB reconstituted with a crude B'' fraction. Non-TFIIIB component(s) in this fraction were also required for transcription of wild-type SNR52. Transcription of the box B-less tRNA(Asn) genes was strongly influenced by their 5'-flanking regions, and it was stimulated by TBP and Brf1 proteins synergistically. The box A can thus be viewed as a core TFIIIC-interacting element that, assisted by upstream TFIIIB-DNA contacts, is sufficient to promote class III gene transcription.
- Published
- 2006
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