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1. Short-term Evolution of Nutritional Status in Patients with Idiopathic Pulmonary Fibrosis

Author

Faverio, P, Fumagalli, A, Conti, S, Madotto, F, Bini, F, Harari, S, Mondoni, M, Oggionni, T, Barisione, E, Ceruti, P, Papetti, M, Bodini, B, Caminati, A, Valentino, A, Centanni, S, Lanzi, P, Della Zoppa, M, Crotti, S, Grosso, M, Sukkar, S, Modina, D, Andreoli, M, Nicali, R, Suigo, G, Busnelli, S, Paciocco, G, Lettieri, S, Mantovani, L, Cesana, G, Pesci, A, Luppi, F, Faverio, Paola, Fumagalli, Alessia, Conti, Sara, Madotto, Fabiana, Bini, Francesco, Harari, Sergio, Mondoni, Michele, Oggionni, Tiberio, Barisione, Emanuela, Ceruti, Paolo, Papetti, Maria Chiara, Bodini, Bruno Dino, Caminati, Antonella, Valentino, Angela, Centanni, Stefano, Lanzi, Paola, Della Zoppa, Matteo, Crotti, Silvia, Grosso, Marco, Sukkar, Samir Giuseppe, Modina, Denise, Andreoli, Marco, Nicali, Roberta, Suigo, Giulia, Busnelli, Sara, Paciocco, Giuseppe, Lettieri, Sara, Mantovani, Lorenzo Giovanni, Cesana, Giancarlo, Pesci, Alberto, Luppi, Fabrizio, Faverio, P, Fumagalli, A, Conti, S, Madotto, F, Bini, F, Harari, S, Mondoni, M, Oggionni, T, Barisione, E, Ceruti, P, Papetti, M, Bodini, B, Caminati, A, Valentino, A, Centanni, S, Lanzi, P, Della Zoppa, M, Crotti, S, Grosso, M, Sukkar, S, Modina, D, Andreoli, M, Nicali, R, Suigo, G, Busnelli, S, Paciocco, G, Lettieri, S, Mantovani, L, Cesana, G, Pesci, A, Luppi, F, Faverio, Paola, Fumagalli, Alessia, Conti, Sara, Madotto, Fabiana, Bini, Francesco, Harari, Sergio, Mondoni, Michele, Oggionni, Tiberio, Barisione, Emanuela, Ceruti, Paolo, Papetti, Maria Chiara, Bodini, Bruno Dino, Caminati, Antonella, Valentino, Angela, Centanni, Stefano, Lanzi, Paola, Della Zoppa, Matteo, Crotti, Silvia, Grosso, Marco, Sukkar, Samir Giuseppe, Modina, Denise, Andreoli, Marco, Nicali, Roberta, Suigo, Giulia, Busnelli, Sara, Paciocco, Giuseppe, Lettieri, Sara, Mantovani, Lorenzo Giovanni, Cesana, Giancarlo, Pesci, Alberto, and Luppi, Fabrizio

Published
2023

2. Sarcopenia in idiopathic pulmonary fibrosis: a prospective study exploring prevalence, associated factors and diagnostic approach

Author

Faverio, P, Fumagalli, A, Conti, S, Madotto, F, Bini, F, Harari, S, Mondoni, M, Oggionni, T, Barisione, E, Ceruti, P, Papetti, M, Bodini, B, Caminati, A, Valentino, A, Centanni, S, Lanzi, P, Della Zoppa, M, Crotti, S, Grosso, M, Sukkar, S, Modina, D, Andreoli, M, Nicali, R, Suigo, G, Busnelli, S, Paciocco, G, Lettieri, S, Mantovani, L, Cesana, G, Pesci, A, Luppi, F, Faverio, Paola, Fumagalli, Alessia, Conti, Sara, Madotto, Fabiana, Bini, Francesco, Harari, Sergio, Mondoni, Michele, Oggionni, Tiberio, Barisione, Emanuela, Ceruti, Paolo, Papetti, Maria Chiara, Bodini, Bruno Dino, Caminati, Antonella, Valentino, Angela, Centanni, Stefano, Lanzi, Paola, Della Zoppa, Matteo, Crotti, Silvia, Grosso, Marco, Sukkar, Samir Giuseppe, Modina, Denise, Andreoli, Marco, Nicali, Roberta, Suigo, Giulia, Busnelli, Sara, Paciocco, Giuseppe, Lettieri, Sara, Mantovani, Lorenzo Giovanni, Cesana, Giancarlo, Pesci, Alberto, Luppi, Fabrizio, Faverio, P, Fumagalli, A, Conti, S, Madotto, F, Bini, F, Harari, S, Mondoni, M, Oggionni, T, Barisione, E, Ceruti, P, Papetti, M, Bodini, B, Caminati, A, Valentino, A, Centanni, S, Lanzi, P, Della Zoppa, M, Crotti, S, Grosso, M, Sukkar, S, Modina, D, Andreoli, M, Nicali, R, Suigo, G, Busnelli, S, Paciocco, G, Lettieri, S, Mantovani, L, Cesana, G, Pesci, A, Luppi, F, Faverio, Paola, Fumagalli, Alessia, Conti, Sara, Madotto, Fabiana, Bini, Francesco, Harari, Sergio, Mondoni, Michele, Oggionni, Tiberio, Barisione, Emanuela, Ceruti, Paolo, Papetti, Maria Chiara, Bodini, Bruno Dino, Caminati, Antonella, Valentino, Angela, Centanni, Stefano, Lanzi, Paola, Della Zoppa, Matteo, Crotti, Silvia, Grosso, Marco, Sukkar, Samir Giuseppe, Modina, Denise, Andreoli, Marco, Nicali, Roberta, Suigo, Giulia, Busnelli, Sara, Paciocco, Giuseppe, Lettieri, Sara, Mantovani, Lorenzo Giovanni, Cesana, Giancarlo, Pesci, Alberto, and Luppi, Fabrizio

Abstract

Background: Sarcopenia gained importance in the evaluation of patients with chronic respiratory diseases, including idiopathic pulmonary fibrosis (IPF), since it may impact negatively on clinical outcomes. Aim: Aim of this study is to evaluate the prevalence and factors associated with sarcopenia, defined according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) 2019 definition, and to evaluate the prevalence of the single criteria that define the EWGSOP2 definition (muscle strength, muscle quantity and physical performance), in a cohort of consecutive patients with IPF prospectively followed up in 9 hospitals in Northern Italy between December 2018 and May 2021. Methods: Enrolled patients underwent an extensive pulmonary and nutritional assessment, including bioelectrical impedance analysis, dynamometry and 4-m gait speed test, both at IPF diagnosis and at 6-month follow-up. Results: Out of the 83 patients (81% males, mean age 72.5 years) with IPF at disease diagnosis enrolled in the study, 19 (22.9%) showed sarcopenia, including 2 (2.4%) with severe sarcopenia, 5 (6.0%) with confirmed sarcopenia and 12 (14.5%) with probable sarcopenia. Sarcopenia was associated with a significantly higher severity of the disease and sedentary lifestyle, while no differences were observed in regards to body mass index, history of weight loss and comorbidities between patients with and without sarcopenia. Out of the 64 patients without sarcopenia at baseline, 16 cases showed alteration of muscle quantity and/or physical performance. In the 51 patients with complete data at 6-month follow-up, there were no cases of severe sarcopenia, 1 case (2.0%) showed confirmed sarcopenia, while the prevalence of probable sarcopenia was 19.6% (10 cases). No differences in regards to antifibrotic treatment received and onset of gastrointestinal side effects were observed between patients with and without sarcopenia at follow-up. Conclusions: The prevalence of sarcopenia in p

Published
2022

3. Nutritional assessment in idiopathic pulmonary fibrosis: a prospective multicentre study

Author

Faverio, P, Fumagalli, A, Conti, S, Madotto, F, Bini, F, Harari, S, Mondoni, M, Oggionni, T, Barisione, E, Ceruti, P, Papetti, M, Bodini, B, Caminati, A, Valentino, A, Centanni, S, Noè, D, Della Zoppa, M, Crotti, S, Grosso, M, Sukkar, S, Modina, D, Andreoli, M, Nicali, R, Suigo, G, De Giacomi, F, Busnelli, S, Cattaneo, E, Mantovani, L, Cesana, G, Pesci, A, Luppi, F, Faverio, P, Fumagalli, A, Conti, S, Madotto, F, Bini, F, Harari, S, Mondoni, M, Oggionni, T, Barisione, E, Ceruti, P, Papetti, M, Bodini, B, Caminati, A, Valentino, A, Centanni, S, Noè, D, Della Zoppa, M, Crotti, S, Grosso, M, Sukkar, S, Modina, D, Andreoli, M, Nicali, R, Suigo, G, De Giacomi, F, Busnelli, S, Cattaneo, E, Mantovani, L, Cesana, G, Pesci, A, and Luppi, F

Abstract

Background. Nutritional status (NS) impacts on quality of life and prognosis of patients with respiratory diseases including idiopathic pulmonary fibrosis (IPF). However, there is a lack of studies performing an extensive nutritional assessment of IPF patients. This study aims to investigate the NS and to identify nutritional phenotypes in a cohort of IPF patients at diagnosis. Methods. Patients underwent a thorough pulmonary and nutritional evaluation including questionnaires on NS and physical activity, anthropometry, body impedence, dynamometry, 4- meter gait speed and blood tests. Results. 90 IPF patients (78.9% males, mean age 72.7 years) were enrolled. The majority of patients were classified as Gender-Age-Physiology Index stage 2 (47, 52.2%) with an inactive lifestyle according to International Physical Activity Questionnaire score (39, 43.3%) and had mean forced vital capacity and diffusing capacity for carbon monoxide 86.5% and 54.2%, respectively. In regards to nutritional phenotypes, the majority of patients were normally nourished (67.8%, 95% Confidence Interval (CI):58.6-77.7), followed by non-sarcopenic obese (25.3%, 95%CI:16.1-35.2), sarcopenic (4.6%, 95%CI:0.0-14.5) and sarcopenic obese (2.3%, 95%CI:0.0-12.2). Among normally nourished, 49.2% showed early signs of nutritional and physical performance alterations, including body mass index≥ 30 in 4.3%, history of weight loss≥ 5% in 11.9%, reduction of gait speed and hand grip strength in 11.9% and 35.6%, respectively. Low vitamin D values were observed in 56.3% of cases. Conclusions. IPF patients at diagnosis are mainly normally nourished and obese, but early signs of nutritional and physical performance impairment can already be identified at this stage.

Published
2021

5. A Tricky Fever of Unknown Origin after Tracheal Crash

Author

Izzo C, Lombi A, Balbo Pe, Nicali R, Campisi P, and Radin E

Subjects
medicine.medical_specialty, medicine.diagnostic_test, Septic shock, business.industry, medicine.medical_treatment, Stent, medicine.disease, Surgery, Respiratory failure, Bronchoscopy, Tracheobronchomalacia, medicine, Intubation, Chondritis, Medical emergency, Fever of unknown origin, business
Abstract

A healthy, smoker farmer had a serious accident with a tracheal rupture. After 1 year of subjective wellness, he developed a persistent fever, cough and dyspnea, partially solved by antibiotics and steroids. Several investigations were performed, but they were all negative. A treatment with steroids was administered with a good initial response but subsequent worsening up to respiratory failure two years later, that required intubation and VAM. A bronchoscopy demonstrated the presence of a severe tracheobronchomalacia, possibly caused by post-traumatic chondritis. A Dumon Y silicone stent was inserted but, due to dislodgement, was replaced with a metallic stent, nevertheless a malacic progression was observed, and the patient died in two weeks due to septic shock.

Published
2013

10. Short-term Evolution of Nutritional Status in Patients with Idiopathic Pulmonary Fibrosis

Author

Paola Faverio, Alessia Fumagalli, Sara Conti, Fabiana Madotto, Francesco Bini, Sergio Harari, Michele Mondoni, Tiberio Oggionni, Emanuela Barisione, Paolo Ceruti, Maria Chiara Papetti, Bruno Dino Bodini, Antonella Caminati, Angela Valentino, Stefano Centanni, Paola Lanzi, Matteo Della Zoppa, Silvia Crotti, Marco Grosso, Samir Giuseppe Sukkar, Denise Modina, Marco Andreoli, Roberta Nicali, Giulia Suigo, Sara Busnelli, Giuseppe Paciocco, Sara Lettieri, Lorenzo Giovanni Mantovani, Giancarlo Cesana, Alberto Pesci, Fabrizio Luppi, Faverio, P, Fumagalli, A, Conti, S, Madotto, F, Bini, F, Harari, S, Mondoni, M, Oggionni, T, Barisione, E, Ceruti, P, Papetti, M, Bodini, B, Caminati, A, Valentino, A, Centanni, S, Lanzi, P, Della Zoppa, M, Crotti, S, Grosso, M, Sukkar, S, Modina, D, Andreoli, M, Nicali, R, Suigo, G, Busnelli, S, Paciocco, G, Lettieri, S, Mantovani, L, Cesana, G, Pesci, A, and Luppi, F

Subjects
Pulmonary and Respiratory Medicine, Idiopathic pulmonary fibrosis, nutrition, prognosis
Published
2023

11. Sarcopenia in idiopathic pulmonary fibrosis: a prospective study exploring prevalence, associated factors and diagnostic approach

Author

Paola Faverio, Alessia Fumagalli, Sara Conti, Fabiana Madotto, Francesco Bini, Sergio Harari, Michele Mondoni, Tiberio Oggionni, Emanuela Barisione, Paolo Ceruti, Maria Chiara Papetti, Bruno Dino Bodini, Antonella Caminati, Angela Valentino, Stefano Centanni, Paola Lanzi, Matteo Della Zoppa, Silvia Crotti, Marco Grosso, Samir Giuseppe Sukkar, Denise Modina, Marco Andreoli, Roberta Nicali, Giulia Suigo, Sara Busnelli, Giuseppe Paciocco, Sara Lettieri, Lorenzo Giovanni Mantovani, Giancarlo Cesana, Alberto Pesci, Fabrizio Luppi, Faverio, P, Fumagalli, A, Conti, S, Madotto, F, Bini, F, Harari, S, Mondoni, M, Oggionni, T, Barisione, E, Ceruti, P, Papetti, M, Bodini, B, Caminati, A, Valentino, A, Centanni, S, Lanzi, P, Della Zoppa, M, Crotti, S, Grosso, M, Sukkar, S, Modina, D, Andreoli, M, Nicali, R, Suigo, G, Busnelli, S, Paciocco, G, Lettieri, S, Mantovani, L, Cesana, G, Pesci, A, and Luppi, F

Subjects
Male, Sarcopenia, Idiopathic pulmonary fibrosi, Hand Strength, Settore MED/10 - Malattie dell'Apparato Respiratorio, Bioimpedance analysis, Gait speed, Hand grip, Idiopathic pulmonary fibrosis, Aged, Female, Humans, Prevalence, Prospective Studies, Idiopathic Pulmonary Fibrosis, Bioimpedance analysi
Abstract

Background Sarcopenia gained importance in the evaluation of patients with chronic respiratory diseases, including idiopathic pulmonary fibrosis (IPF), since it may impact negatively on clinical outcomes. Aim Aim of this study is to evaluate the prevalence and factors associated with sarcopenia, defined according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) 2019 definition, and to evaluate the prevalence of the single criteria that define the EWGSOP2 definition (muscle strength, muscle quantity and physical performance), in a cohort of consecutive patients with IPF prospectively followed up in 9 hospitals in Northern Italy between December 2018 and May 2021. Methods Enrolled patients underwent an extensive pulmonary and nutritional assessment, including bioelectrical impedance analysis, dynamometry and 4-m gait speed test, both at IPF diagnosis and at 6-month follow-up. Results Out of the 83 patients (81% males, mean age 72.5 years) with IPF at disease diagnosis enrolled in the study, 19 (22.9%) showed sarcopenia, including 2 (2.4%) with severe sarcopenia, 5 (6.0%) with confirmed sarcopenia and 12 (14.5%) with probable sarcopenia. Sarcopenia was associated with a significantly higher severity of the disease and sedentary lifestyle, while no differences were observed in regards to body mass index, history of weight loss and comorbidities between patients with and without sarcopenia. Out of the 64 patients without sarcopenia at baseline, 16 cases showed alteration of muscle quantity and/or physical performance. In the 51 patients with complete data at 6-month follow-up, there were no cases of severe sarcopenia, 1 case (2.0%) showed confirmed sarcopenia, while the prevalence of probable sarcopenia was 19.6% (10 cases). No differences in regards to antifibrotic treatment received and onset of gastrointestinal side effects were observed between patients with and without sarcopenia at follow-up. Conclusions The prevalence of sarcopenia in patients with IPF both at diagnosis and at 6-month follow-up was low but not negligible and was associated with higher severity of the disease and sedentary lifestyle. In IPF patients, a comprehensive diagnostic work-up including all the criteria defining the EWGSOP2 definition might be more useful than a series testing for prompt recognition of nutritional and physical performance abnormalities.

Published
2022

12. Nutritional assessment in idiopathic pulmonary fibrosis: a prospective multicentre study

Author

Denise Modina, Antonella Caminati, Matteo Della Zoppa, Sara Busnelli, Marco Grosso, Elena Cattaneo, Samir Giuseppe Sukkar, Alberto Pesci, Bruno Dino Bodini, Marco Andreoli, Michele Mondoni, Fabrizio Luppi, Stefano Centanni, Paola Faverio, Angela Valentino, Silvia Crotti, Roberta Nicali, Federica De Giacomi, Lorenzo G. Mantovani, Alessia Fumagalli, Francesco Bini, Sara Conti, Sergio Harari, Giulia Suigo, Tiberio Oggionni, Giancarlo Cesana, Fabiana Madotto, Paolo Ceruti, Donatella Noè, Maria Chiara Papetti, Emanuela Barisione, Faverio, P, Fumagalli, A, Conti, S, Madotto, F, Bini, F, Harari, S, Mondoni, M, Oggionni, T, Barisione, E, Ceruti, P, Papetti, M, Bodini, B, Caminati, A, Valentino, A, Centanni, S, Noè, D, Della Zoppa, M, Crotti, S, Grosso, M, Sukkar, S, Modina, D, Andreoli, M, Nicali, R, Suigo, G, De Giacomi, F, Busnelli, S, Cattaneo, E, Mantovani, L, Cesana, G, Pesci, A, and Luppi, F

Subjects
Pulmonary and Respiratory Medicine, Vital capacity, medicine.medical_specialty, business.industry, Anthropometry, medicine.disease, Confidence interval, Idiopathic pulmonary fibrosis, Grip strength, nutrition, Quality of life, Internal medicine, Diffusing capacity, Cohort, medicine, business, Idiopathic pulimanory fibrosi
Abstract

BackgroundNutritional status impacts quality of life and prognosis of patients with respiratory diseases, including idiopathic pulmonary fibrosis (IPF). However, there is a lack of studies performing an extensive nutritional assessment of IPF patients. This study aimed to investigate the nutritional status and to identify nutritional phenotypes in a cohort of IPF patients at diagnosis.MethodsPatients underwent a thorough pulmonary and nutritional evaluation including questionnaires on nutritional status, and physical activity, anthropometry, body impedance, dynamometry, 4-m gait speed and blood tests.Results90 IPF patients (78.9% males, mean age 72.7 years) were enrolled. The majority of patients were classified as Gender-Age-Physiology Index stage 2 (47, 52.2%) with an inactive lifestyle according to International Physical Activity Questionnaire score (39, 43.3%), and had mean forced vital capacity and diffusing capacity for carbon monoxide 86.5% and 54.2%, respectively. In regards to nutritional phenotypes, the majority of patients were normally nourished (67.8%, 95% CI 58.6–77.7%), followed by non-sarcopenic obese (25.3%, 95% CI 16.1–35.2%), sarcopenic (4.6%, 95% CI 0.0–14.5%) and sarcopenic obese (2.3%, 95% CI 0.0–12.2%). Among the normally nourished, 49.2% showed early signs of nutritional and physical performance alterations, including body mass index ≥30 kg·m−2 in 4.3%, history of weight loss ≥5% in 11.9%, and reduction of gait speed and hand grip strength in 11.9% and 35.6%, respectively. Low vitamin D values were observed in 56.3% of cases.ConclusionsIPF patients at diagnosis are mainly normally nourished and obese, but early signs of nutritional and physical performance impairment can already be identified at this stage.

Published
2022

13. Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study

Author

Antonio Poerio, Andrea Castelli, Sara Piciucchi, Giulia Falò, Davide Allegri, Marco Verri, Andrea Marudi, Massimiliano Mazzolini, Michele Imbriani, Loredana Franchini, Carlo Coniglio, Mirco Leo, Antonella Potalivo, Luigi Lazzari Agli, Roberta Nicali, Marco Cavagnino, Guglielmo Consales, Marina Terzitta, Harri Sintonen, Raffaella Papa, Maria Teresa Minguzzi, Cristiana Laici, Paolo Orlandi, Federica Damiani, Carlo Alberto Mazzoli, Silvia Orlando, Vito Marco Ranieri, Iacopo Cappellini, Valentina Chiarini, Elisa Marinangeli, Stefano Oldani, Virginia Buldini, Marco Tartaglione, Gianluca Zani, Lorenzo Mellini, Carlo Alberto Volta, Irene Ottaviani, Silvia Candini, Filippo Becherucci, Emanuela Giampalma, Maria Concetta Lanza, Federica Ciccarese, Irene Cavalli, Annalisa Marchio, Bruno Balbi, Fabrizio Racca, Matteo Monari, Luca Morini, Anna Malfatto, Elisabetta Bertellini, Francesco Boni, Emanuele Russo, Lorenzo Viola, Michele Valli, Savino Spadaro, Martina Ferioli, Emanuele Matteo, Giovanni Gordini, Marco Contoli, Ilaria Valentini, Chiara Tartivita, Alessia Guzzo, Lorenzo Giuntoli, Gaetano Scaramuzzo, Davide Colombo, Jessica Maccieri, Luca Bissoni, Stefano Nava, Angela Bellocchio, Patrizio Goti, Laura Bernabé, Jonathan Montomoli, Stefano Maitan, Tommaso Meconi, Angelo Senzi, Lorenzo Gamberini, Silvia Pareschi, Stefania Taddei, Angelica Venni, Fabio Ferrari, Marco Miceli, Chiara Capozzi, Elisabetta Marangoni, Lorenzo Tutino, Giulia Felloni, Antonio Siniscalchi, Giacinto Pizzilli, Francesco Muratore, Giorgia Dalpiaz, Federico Moro, Daniele Fecarotti, Vanni Agnoletti, Gabriele Melegari, Rita Golfieri, Federico Domenico Baccarini, Francesca Facondini, Patrizia Pompa Cleta, Marianna Padovani, Eva Bernardi, Tommaso Tonetti, Angelina Adduci, Federico Daniele, Anna Filomena Ferravante, Maurizio Fusari, Igor Bacchilega, Claudia Ravaglia, Nicola Cilloni, Martina Mughetti, Vittorio Pavoni, Ersenad Neziri, Irene Prediletto, Aline Pagni, Gamberini L., Mazzoli C.A., Prediletto I., Sintonen H., Scaramuzzo G., Allegri D., Colombo D., Tonetti T., Zani G., Capozzi C., Dalpiaz G., Agnoletti V., Cappellini I., Melegari G., Damiani F., Fusari M., Gordini G., Laici C., Lanza M.C., Leo M., Marudi A., Papa R., Potalivo A., Montomoli J., Taddei S., Mazzolini M., Ferravante A.F., Nicali R., Ranieri V.M., Russo E., Volta C.A., Spadaro S., Tartaglione M., Chiarini V., Buldini V., Coniglio C., Moro F., Orlando S., Fecarotti D., Cilloni N., Giuntoli L., Bellocchio A., Matteo E., Pizzilli G., Siniscalchi A., Tartivita C., Cavalli I., Castelli A., Marchio A., Bacchilega I., Bernabe L., Facondini F., Morini L., Bissoni L., Viola L., Meconi T., Pavoni V., Venni A., Pagni A., Cleta P.P., Cavagnino M., Guzzo A., Malfatto A., Adduci A., Pareschi S., Bertellini E., Maccieri J., Marinangeli E., Racca F., Verri M., Falo G., Marangoni E., Ottaviani I., Boni F., Felloni G., Baccarini F.D., Terzitta M., Maitan S., Tutino L., Senzi A., Consales G., Becherucci F., Imbriani M., Orlandi P., Candini S., Golfieri R., Ciccarese F., Poerio A., Muratore F., Ferrari F., Mughetti M., Giampalma E., Franchini L., Neziri E., Miceli M., Minguzzi M.T., Mellini L., Piciucchi S., Monari M., Valli M., Daniele F., Ferioli M., Nava S., Lazzari Agli L.A., Valentini I., Bernardi E., Balbi B., Contoli M., Padovani M., Oldani S., Ravaglia C., and Goti P.

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Health-related quality of life, Population, Article, NO, Pulmonary function testing, 03 medical and health sciences, 0302 clinical medicine, Quality of life, DLCO, Acute respiratory distress syndrome, COVID-19, Dyspnea, Respiratory function tests, Internal medicine, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Survivors, education, Aged, Mechanical ventilation, Health related quality of life, education.field_of_study, Respiratory Distress Syndrome, business.industry, Middle Aged, Respiration, Artificial, Patient Discharge, humanities, 3. Good health, Intensive Care Units, 030228 respiratory system, Italy, Quality of Life, Female, business, Icu discharge, Follow-Up Studies
Abstract

Background Health-related quality of life (HRQoL) impairment is often reported among COVID-19 ICU survivors, and little is known about their long-term outcomes. We evaluated the HRQoL trajectories between 3 months and 1 year after ICU discharge, the factors influencing these trajectories and the presence of clusters of HRQoL profiles in a population of COVID-19 patients who underwent invasive mechanical ventilation (IMV). Moreover, pathophysiological correlations of residual dyspnea were tested. Methods We followed up 178 survivors from 16 Italian ICUs up to one year after ICU discharge. HRQoL was investigated through the 15D instrument. Available pulmonary function tests (PFTs) and chest CT scans at 1 year were also collected. A linear mixed-effects model was adopted to identify factors associated with different HRQoL trajectories and a two-step cluster analysis was performed to identify HRQoL clusters. Results We found that HRQoL increased during the study period, especially for the significant increase of the physical dimensions, while the mental dimensions and dyspnea remained substantially unchanged. Four main 15D profiles were identified: full recovery (47.2%), bad recovery (5.1%) and two partial recovery clusters with mostly physical (9.6%) or mental (38.2%) dimensions affected. Gender, duration of IMV and number of comorbidities significantly influenced HRQoL trajectories. Persistent dyspnea was reported in 58.4% of patients, and weakly, but significantly, correlated with both DLCO and length of IMV. Conclusions HRQoL impairment is frequent 1 year after ICU discharge, and the lowest recovery is found in the mental dimensions. Persistent dyspnea is often reported and weakly correlated with PFTs alterations. Trial registration NCT04411459.

Published
2021

14. Short-Term Evolution of Nutritional Status in Patients with Idiopathic Pulmonary Fibrosis.

Author

Faverio P, Fumagalli A, Conti S, Madotto F, Bini F, Harari S, Mondoni M, Oggionni T, Barisione E, Ceruti P, Papetti MC, Bodini BD, Caminati A, Valentino A, Centanni S, Lanzi P, Della Zoppa M, Crotti S, Grosso M, Sukkar SG, Modina D, Andreoli M, Nicali R, Suigo G, Busnelli S, Paciocco G, Lettieri S, Mantovani LG, Cesana G, Pesci A, and Luppi F

Subjects
Humans, Patients, Nutritional Status, Idiopathic Pulmonary Fibrosis
Published
2023
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15. Sarcopenia in idiopathic pulmonary fibrosis: a prospective study exploring prevalence, associated factors and diagnostic approach.

Author

Faverio P, Fumagalli A, Conti S, Madotto F, Bini F, Harari S, Mondoni M, Oggionni T, Barisione E, Ceruti P, Papetti MC, Bodini BD, Caminati A, Valentino A, Centanni S, Lanzi P, Della Zoppa M, Crotti S, Grosso M, Sukkar SG, Modina D, Andreoli M, Nicali R, Suigo G, Busnelli S, Paciocco G, Lettieri S, Mantovani LG, Cesana G, Pesci A, and Luppi F

Subjects
Aged, Female, Hand Strength physiology, Humans, Male, Prevalence, Prospective Studies, Idiopathic Pulmonary Fibrosis diagnosis, Idiopathic Pulmonary Fibrosis epidemiology, Sarcopenia diagnosis, Sarcopenia epidemiology
Abstract

Background: Sarcopenia gained importance in the evaluation of patients with chronic respiratory diseases, including idiopathic pulmonary fibrosis (IPF), since it may impact negatively on clinical outcomes., Aim: Aim of this study is to evaluate the prevalence and factors associated with sarcopenia, defined according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) 2019 definition, and to evaluate the prevalence of the single criteria that define the EWGSOP2 definition (muscle strength, muscle quantity and physical performance), in a cohort of consecutive patients with IPF prospectively followed up in 9 hospitals in Northern Italy between December 2018 and May 2021., Methods: Enrolled patients underwent an extensive pulmonary and nutritional assessment, including bioelectrical impedance analysis, dynamometry and 4-m gait speed test, both at IPF diagnosis and at 6-month follow-up., Results: Out of the 83 patients (81% males, mean age 72.5 years) with IPF at disease diagnosis enrolled in the study, 19 (22.9%) showed sarcopenia, including 2 (2.4%) with severe sarcopenia, 5 (6.0%) with confirmed sarcopenia and 12 (14.5%) with probable sarcopenia. Sarcopenia was associated with a significantly higher severity of the disease and sedentary lifestyle, while no differences were observed in regards to body mass index, history of weight loss and comorbidities between patients with and without sarcopenia. Out of the 64 patients without sarcopenia at baseline, 16 cases showed alteration of muscle quantity and/or physical performance. In the 51 patients with complete data at 6-month follow-up, there were no cases of severe sarcopenia, 1 case (2.0%) showed confirmed sarcopenia, while the prevalence of probable sarcopenia was 19.6% (10 cases). No differences in regards to antifibrotic treatment received and onset of gastrointestinal side effects were observed between patients with and without sarcopenia at follow-up., Conclusions: The prevalence of sarcopenia in patients with IPF both at diagnosis and at 6-month follow-up was low but not negligible and was associated with higher severity of the disease and sedentary lifestyle. In IPF patients, a comprehensive diagnostic work-up including all the criteria defining the EWGSOP2 definition might be more useful than a series testing for prompt recognition of nutritional and physical performance abnormalities., (© 2022. The Author(s).)

Published
2022
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16. Nutritional assessment in idiopathic pulmonary fibrosis: a prospective multicentre study.

Author

Faverio P, Fumagalli A, Conti S, Madotto F, Bini F, Harari S, Mondoni M, Oggionni T, Barisione E, Ceruti P, Papetti MC, Bodini BD, Caminati A, Valentino A, Centanni S, Noè D, Della Zoppa M, Crotti S, Grosso M, Sukkar SG, Modina D, Andreoli M, Nicali R, Suigo G, De Giacomi F, Busnelli S, Cattaneo E, Mantovani LG, Cesana G, Pesci A, and Luppi F

Abstract

Background: Nutritional status impacts quality of life and prognosis of patients with respiratory diseases, including idiopathic pulmonary fibrosis (IPF). However, there is a lack of studies performing an extensive nutritional assessment of IPF patients. This study aimed to investigate the nutritional status and to identify nutritional phenotypes in a cohort of IPF patients at diagnosis., Methods: Patients underwent a thorough pulmonary and nutritional evaluation including questionnaires on nutritional status, and physical activity, anthropometry, body impedance, dynamometry, 4-m gait speed and blood tests., Results: 90 IPF patients (78.9% males, mean age 72.7 years) were enrolled. The majority of patients were classified as Gender-Age-Physiology Index stage 2 (47, 52.2%) with an inactive lifestyle according to International Physical Activity Questionnaire score (39, 43.3%), and had mean forced vital capacity and diffusing capacity for carbon monoxide 86.5% and 54.2%, respectively. In regards to nutritional phenotypes, the majority of patients were normally nourished (67.8%, 95% CI 58.6-77.7%), followed by non-sarcopenic obese (25.3%, 95% CI 16.1-35.2%), sarcopenic (4.6%, 95% CI 0.0-14.5%) and sarcopenic obese (2.3%, 95% CI 0.0-12.2%). Among the normally nourished, 49.2% showed early signs of nutritional and physical performance alterations, including body mass index ≥30 kg·m -2 in 4.3%, history of weight loss ≥5% in 11.9%, and reduction of gait speed and hand grip strength in 11.9% and 35.6%, respectively. Low vitamin D values were observed in 56.3% of cases., Conclusions: IPF patients at diagnosis are mainly normally nourished and obese, but early signs of nutritional and physical performance impairment can already be identified at this stage., Competing Interests: Conflict of interest: P. Faverio reports personal fees from Boehringer Ingelheim and grants from Roche, outside the submitted work. Conflict of interest: A. Fumagalli has nothing to disclose. Conflict of interest: S. Conti has nothing to disclose. Conflict of interest: F. Madotto has nothing to disclose. Conflict of interest: F. Bini has nothing to disclose. Conflict of interest: S. Harari reports personal fees from Actelion, Roche and Boehringer Ingelheim, outside the submitted work. Conflict of interest: M. Mondoni has nothing to disclose. Conflict of interest: T. Oggionni has nothing to disclose. Conflict of interest: E. Barisione reports personal fees from Chiesi Farmaceutici, Boehringer Ingelheim and GlaxoSmithKline, outside the submitted work. Conflict of interest: P. Ceruti has nothing to disclose. Conflict of interest: M.C. Papetti has nothing to disclose. Conflict of interest: B.D. Bodini has nothing to disclose. Conflict of interest: A. Caminati reports personal fees from Roche and Boehringer Ingelheim, outside the submitted work. Conflict of interest: A. Valentino has nothing to disclose. Conflict of interest: S. Centanni has nothing to disclose. Conflict of interest: D. Noè has nothing to disclose. Conflict of interest: M. Della Zoppa has nothing to disclose. Conflict of interest: S. Crotti has nothing to disclose. Conflict of interest: M. Grosso reports personal fees from Chiesi Farmaceutici and Johnson & Johnson, outside the submitted work. Conflict of interest: S.G. Sukkar has nothing to disclose. Conflict of interest: D. Modina has nothing to disclose. Conflict of interest: M. Andreoli has nothing to disclose. Conflict of interest: R. Nicali has nothing to disclose. Conflict of interest: G. Suigo has nothing to disclose. Conflict of interest: F. De Giacomi has nothing to disclose. Conflict of interest: S. Busnelli has nothing to disclose. Conflict of interest: E. Cattaneo has nothing to disclose. Conflict of interest: L.G. Mantovani has nothing to disclose. Conflict of interest: G. Cesana has nothing to disclose. Conflict of interest: A. Pesci has nothing to disclose. Conflict of interest: F. Luppi reports lectures fee from Roche and from Boehringer Ingelheim., (Copyright ©The authors 2022.)

Published
2022
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17. Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study.

Author

Gamberini L, Mazzoli CA, Prediletto I, Sintonen H, Scaramuzzo G, Allegri D, Colombo D, Tonetti T, Zani G, Capozzi C, Dalpiaz G, Agnoletti V, Cappellini I, Melegari G, Damiani F, Fusari M, Gordini G, Laici C, Lanza MC, Leo M, Marudi A, Papa R, Potalivo A, Montomoli J, Taddei S, Mazzolini M, Ferravante AF, Nicali R, Ranieri VM, Russo E, Volta CA, and Spadaro S

Subjects
Aged, Dyspnea epidemiology, Female, Follow-Up Studies, Humans, Italy epidemiology, Male, Middle Aged, Patient Discharge, Prospective Studies, Respiratory Distress Syndrome epidemiology, Respiratory Distress Syndrome therapy, Survivors, COVID-19 epidemiology, Intensive Care Units, Quality of Life, Respiration, Artificial, Respiratory Function Tests
Abstract

Background: Health-related quality of life (HRQoL) impairment is often reported among COVID-19 ICU survivors, and little is known about their long-term outcomes. We evaluated the HRQoL trajectories between 3 months and 1 year after ICU discharge, the factors influencing these trajectories and the presence of clusters of HRQoL profiles in a population of COVID-19 patients who underwent invasive mechanical ventilation (IMV). Moreover, pathophysiological correlations of residual dyspnea were tested., Methods: We followed up 178 survivors from 16 Italian ICUs up to one year after ICU discharge. HRQoL was investigated through the 15D instrument. Available pulmonary function tests (PFTs) and chest CT scans at 1 year were also collected. A linear mixed-effects model was adopted to identify factors associated with different HRQoL trajectories and a two-step cluster analysis was performed to identify HRQoL clusters., Results: We found that HRQoL increased during the study period, especially for the significant increase of the physical dimensions, while the mental dimensions and dyspnea remained substantially unchanged. Four main 15D profiles were identified: full recovery (47.2%), bad recovery (5.1%) and two partial recovery clusters with mostly physical (9.6%) or mental (38.2%) dimensions affected. Gender, duration of IMV and number of comorbidities significantly influenced HRQoL trajectories. Persistent dyspnea was reported in 58.4% of patients, and weakly, but significantly, correlated with both DLCO and length of IMV., Conclusions: HRQoL impairment is frequent 1 year after ICU discharge, and the lowest recovery is found in the mental dimensions. Persistent dyspnea is often reported and weakly correlated with PFTs alterations., Trial Registration: NCT04411459., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Published
2021
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20. An atypical case of Stanford type-A chronic aortic dissection managed conservatively.

Author

Maffè S, Nicali R, Dellavesa P, Paffoni P, Bergamasco L, and Parravicini U

Subjects
Aged, Aortic Dissection diagnostic imaging, Aorta diagnostic imaging, Aortic Aneurysm, Thoracic diagnostic imaging, Chronic Disease, Echocardiography methods, Fatal Outcome, Humans, Male, Tomography, X-Ray Computed methods, Aortic Dissection complications, Aortic Dissection therapy, Aortic Aneurysm, Thoracic complications, Aortic Aneurysm, Thoracic therapy, Conservative Treatment methods, Pancreatic Neoplasms complications
Abstract

Stanford type-A aortic dissection is a clinical emergency; mortality is high, and surgery is urgently required in most cases. Chronic forms of type-A dissection are rare and have a poor prognosis if not treated surgically. We present an unusual case of chronic type-A aortic dissection, with silent onset, in an oncologic patient without risk factors, which was managed conservatively and remained substantially stable during follow-up., (© 2019 Wiley Periodicals, Inc.)

Published
2019
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21. Abdominal adenopathy found during a routine follow-up.

Author

Carmagnola S, Venezia L, Anderloni A, Nicali R, Patrucco F, and Balbo PE

Subjects
Abdomen, Humans, Lymphatic Diseases etiology, Male, Middle Aged, Sarcoidosis complications, Sarcoidosis drug therapy, Adenoma surgery, Duodenal Neoplasms surgery, Lymph Nodes pathology, Lymphatic Diseases pathology, Sarcoidosis diagnosis
Abstract

During routine follow-up of a 60-year-old man with an endoluminal lesion of the duodenum, we found a persistent reactive abdominal adenopathy of unknown origin, later diagnosed as an abdominal localization of sarcoidosis. This article focuses on the differential diagnosis of abdominal granulomatous lymphadenopathies, the management of abdominal adenopathy of unknown origin, and the difficult decision making about sampling lymph nodes with reactive and inflammatory echographic appearance.

Published
2015
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22. [Effects of pretreatment with amiodarone infusion in patients with persistent atrial fibrillation submitted to external electrical cardioversion: a single center experience].

Author

Maffè S, Paffoni P, Perucca A, Dellavesa P, Parravicini U, Nicali R, Bielli M, Paino AM, Signorotti F, Franchetti Pardo N, Zenone F, and Zanetta M

Subjects
Atrial Fibrillation drug therapy, Data Interpretation, Statistical, Female, Humans, Male, Middle Aged, Retrospective Studies, Secondary Prevention, Statistics, Nonparametric, Time Factors, Amiodarone administration & dosage, Anti-Arrhythmia Agents administration & dosage, Atrial Fibrillation therapy, Electric Countershock
Abstract

Background: Several studies demonstrated the efficacy of amiodarone pretreatment in achieving bet-ter outcomes after electrical cardioversion of atrial fibrillation. In the majority of cases, oral amiodarone for at least 1 month was administered, with the result of lengthening of pre-cardioversion time. Only one study in the literature reported high-dose amiodarone infusion, showing an increase in the incidence of slow arrhythmias. The aim of this study was to test the efficacy of pretreatment infusion of a single dose of amiodarone few hours before electrical cardioversion in restoring sinus rhythm and reducing the incidence of early arrhythmic recurrences., Methods: The study was retrospective. We analyzed a population of 155 patients with persistent atrial fibrillation, from May 2003 to November 2005. The first group of 86 patients was treated with amiodarone at the dose of 4 mg/kg in 30 min, few hours before electrical cardioversion; the second group of 69 patients was treated with electrical cardioversion without pharmacological pretreatment. The two groups were homogeneous for age, sex, coronary artery disease, duration of arrhythmia, atrial dimensions, left ventricular ejection fraction, and paddle position for electrical cardioversion., Results: There were no significant differences between the two groups in terms of efficacy of cardioversion (95.3 vs 91.3%, p = NS). Pretreatment with bolus of amiodarone significantly reduced the incidence of immediate recurrence (3.5 vs 17.4%, p < 0.05) and the mix of immediate and early recurrence (19.7 vs 33.3%, p < 0.05). There were no significant differences in the incidence of late recurrences (17.4 vs 13%, p = NS). There were no significant bradyarrhythmias in the two groups. Amiodarone pretreatment did not reduce energy delivery to obtain cardioversion., Conclusions: Amiodarone pretreatment with intravenous bolus few hours before electrical cardioversion reduces short-term recurrences of atrial fibrillation. It does not reduce energy delivery of electrical cardioversion and does not increase the incidence of slow arrhythmias. Randomized prospective studies are warranted to confirm these findings.

Published
2008

23. p53 expression in cultured blood human monocytes infected with mycobacterial strains.

Author

Galietti F, Bollo E, Cappia S, Dondo A, Pregel P, Nicali R, and Pozzi E

Subjects
Apoptosis, Cells, Cultured, Cyclin-Dependent Kinase Inhibitor p21, Cyclins metabolism, Humans, Monocytes pathology, Mycobacterium Infections pathology, Mycobacterium avium Complex pathogenicity, Mycobacterium bovis pathogenicity, Mycobacterium tuberculosis pathogenicity, Proto-Oncogene Proteins c-bcl-2 metabolism, Monocytes metabolism, Monocytes microbiology, Mycobacterium Infections metabolism, Tumor Suppressor Protein p53 metabolism
Abstract

Background: An upregulation of the cell-cycle associated proteins p53 and p21/Waf1/Cip1 induced by mycobacteria was previously reported. We aimed to evaluate the expression of such proteins in peripheral blood human monocyte cultures infected with strains of different mycobacterial pathogens., Methods: The study relied on the immunocytochemical determination of p53, p21/Waf1/Cipl, bcl-2 and on the Tunel detection of apoptosis in monocytes populations cultured on four-welled chamber slides (10(6) cells/well) infected with Mycobacterium tuberculosis, M. bovis and M. avium for four consecutive days (mycobacterium/monocyte ratio 10:1). The results were expressed as mean values and SD of the percentages of stainings recorded in five fields per slide., Results: The statistical analysis with Fischer test demostrated that at most sampling times the p53 and p21/Waf1/Cip1 expression and the apoptosis index were significantly higher in M. tuberculosis infected cultures than in controls (p<0.05). The M. bovis related picture diverged from the previous one for a lower p53 expression (p<0.05) at all sampling times. The M. avium infected culture values did not diverge significantly from the controls., Conclusions: The p53 and p21/Wafl/Cipl upregulation is compatible with both host defense strategies and pathogen strategies (safeguard of intracellular sanctuaries). The discrepancies among different cultures suggest a direct relationship between p53 activation and mycobacterial ability to enter host cells.

Published
2001

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