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3. Case Report: Potential role of selective venous sampling for liquid biopsy in complex clinical settings: Three case presentations

Author

Tichà, V, Patelli, G, Basso, G, Prino, A, Repetti, E, Grugni, M, Damascelli, B, Tichà V., Patelli G., Basso G., Prino A., Repetti E., Grugni M., Damascelli B., Tichà, V, Patelli, G, Basso, G, Prino, A, Repetti, E, Grugni, M, Damascelli, B, Tichà V., Patelli G., Basso G., Prino A., Repetti E., Grugni M., and Damascelli B.

Abstract

Tumor mutation profiling from a blood sample, known as liquid biopsy, is a reality that has already been approved for some cancers. This molecular diagnostic method complements tissue biopsy but is less invasive and therefore more easily applied, especially during tumor evolution. Its use should allow detection of residual disease, evaluation of treatment response or resistance, and selection of targeted treatments. However, implementation of liquid biopsy in routine clinical practice is hindered by unsolved issues, one of which is the scarcity of circulating tumor DNA in blood samples drawn from peripheral veins. To address this problem, we propose minimally invasive selective venous sampling from the region of interest, as used for some hormonal studies and for mapping of endocrine tumors. Intuitively, selective sampling should improve the sensitivity of liquid biopsy by avoiding the dilution of tumor biomarkers that occurs in the peripheral circulation. We report three cases that illustrate the potential utility of selective liquid biopsy in complex clinical settings, providing implications for diagnosis and treatment as well as for monitoring over time, disease localization, identification of drug resistance, and differential diagnosis.

Published
2023

4. Chest CT opportunistic biomarkers for phenotyping high-risk COVID-19 patients: a retrospective multicentre study

Author

Palmisano, A, Gnasso, C, Cereda, A, Vignale, D, Leone, R, Nicoletti, V, Barbieri, S, Toselli, M, Giannini, F, Loffi, M, Patelli, G, Monello, A, Iannopollo, G, Ippolito, D, Mancini, E, Pontone, G, Vignali, L, Scarnecchia, E, Iannaccone, M, Baffoni, L, Spernadio, M, de Carlini, C, Sironi, S, Rapezzi, C, Esposito, A, Palmisano A., Gnasso C., Cereda A., Vignale D., Leone R., Nicoletti V., Barbieri S., Toselli M., Giannini F., Loffi M., Patelli G., Monello A., Iannopollo G., Ippolito D., Mancini E. M., Pontone G., Vignali L., Scarnecchia E., Iannaccone M., Baffoni L., Spernadio M., de Carlini C. C., Sironi S., Rapezzi C., Esposito A., Palmisano, A, Gnasso, C, Cereda, A, Vignale, D, Leone, R, Nicoletti, V, Barbieri, S, Toselli, M, Giannini, F, Loffi, M, Patelli, G, Monello, A, Iannopollo, G, Ippolito, D, Mancini, E, Pontone, G, Vignali, L, Scarnecchia, E, Iannaccone, M, Baffoni, L, Spernadio, M, de Carlini, C, Sironi, S, Rapezzi, C, Esposito, A, Palmisano A., Gnasso C., Cereda A., Vignale D., Leone R., Nicoletti V., Barbieri S., Toselli M., Giannini F., Loffi M., Patelli G., Monello A., Iannopollo G., Ippolito D., Mancini E. M., Pontone G., Vignali L., Scarnecchia E., Iannaccone M., Baffoni L., Spernadio M., de Carlini C. C., Sironi S., Rapezzi C., and Esposito A.

Abstract

Objective: To assess the value of opportunistic biomarkers derived from chest CT performed at hospital admission of COVID-19 patients for the phenotypization of high-risk patients. Methods: In this multicentre retrospective study, 1845 consecutive COVID-19 patients with chest CT performed within 72 h from hospital admission were analysed. Clinical and outcome data were collected by each center 30 and 80 days after hospital admission. Patients with unknown outcomes were excluded. Chest CT was analysed in a single core lab and behind pneumonia CT scores were extracted opportunistic data about atherosclerotic profile (calcium score according to Agatston method), liver steatosis (≤ 40 HU), myosteatosis (paraspinal muscle F < 31.3 HU, M < 37.5 HU), and osteoporosis (D12 bone attenuation < 134 HU). Differences according to treatment and outcome were assessed with ANOVA. Prediction models were obtained using multivariate binary logistic regression and their AUCs were compared with the DeLong test. Results: The final cohort included 1669 patients (age 67.5 [58.5–77.4] yo) mainly men 1105/1669, 66.2%) and with reduced oxygen saturation (92% [88–95%]). Pneumonia severity, high Agatston score, myosteatosis, liver steatosis, and osteoporosis derived from CT were more prevalent in patients with more aggressive treatment, access to ICU, and in-hospital death (always p < 0.05). A multivariable model including clinical and CT variables improved the capability to predict non-critical pneumonia compared to a model including only clinical variables (AUC 0.801 vs 0.789; p = 0.0198) to predict patient death (AUC 0.815 vs 0.800; p = 0.001). Conclusion: Opportunistic biomarkers derived from chest CT can improve the characterization of COVID-19 high-risk patients. Clinical relevance statement: In COVID-19 patients, opportunistic biomarkers of cardiometabolic risk extracted from chest CT improve patient risk stratification. Key Points: • In COVID-19 patients, several i

Published
2023

5. Case Report: Potential role of selective venous sampling for liquid biopsy in complex clinical settings: Three case presentations

Author

Tichà V., Patelli G., Basso G., Prino A., Repetti E., Grugni M., Damascelli B., Tichà, V, Patelli, G, Basso, G, Prino, A, Repetti, E, Grugni, M, and Damascelli, B

Subjects
Liquid biopsy, pancreatic cancer, glioblastoma, Genetics, Molecular Medicine, venous sampling, ctDNA, prostate cancer, Genetics (clinical)
Abstract

Tumor mutation profiling from a blood sample, known as liquid biopsy, is a reality that has already been approved for some cancers. This molecular diagnostic method complements tissue biopsy but is less invasive and therefore more easily applied, especially during tumor evolution. Its use should allow detection of residual disease, evaluation of treatment response or resistance, and selection of targeted treatments. However, implementation of liquid biopsy in routine clinical practice is hindered by unsolved issues, one of which is the scarcity of circulating tumor DNA in blood samples drawn from peripheral veins. To address this problem, we propose minimally invasive selective venous sampling from the region of interest, as used for some hormonal studies and for mapping of endocrine tumors. Intuitively, selective sampling should improve the sensitivity of liquid biopsy by avoiding the dilution of tumor biomarkers that occurs in the peripheral circulation. We report three cases that illustrate the potential utility of selective liquid biopsy in complex clinical settings, providing implications for diagnosis and treatment as well as for monitoring over time, disease localization, identification of drug resistance, and differential diagnosis.

Published
2023
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6. AI-SCoRE (artificial intelligence-SARS CoV2 risk evaluation): a fast, objective and fully automated platform to predict the outcome in COVID-19 patients

Author

Palmisano, A, Vignale, D, Boccia, E, Nonis, A, Gnasso, C, Leone, R, Montagna, M, Nicoletti, V, Bianchi, A, Brusamolino, S, Dorizza, A, Moraschini, M, Veettil, R, Cereda, A, Toselli, M, Giannini, F, Loffi, M, Patelli, G, Monello, A, Iannopollo, G, Ippolito, D, Mancini, E, Pontone, G, Vignali, L, Scarnecchia, E, Iannacone, M, Baffoni, L, Sperandio, M, de Carlini, C, Sironi, S, Rapezzi, C, Antiga, L, Jagher, V, Di Serio, C, Furlanello, C, Tacchetti, C, Esposito, A, Palmisano A., Vignale D., Boccia E., Nonis A., Gnasso C., Leone R., Montagna M., Nicoletti V., Bianchi A. G., Brusamolino S., Dorizza A., Moraschini M., Veettil R., Cereda A., Toselli M., Giannini F., Loffi M., Patelli G., Monello A., Iannopollo G., Ippolito D., Mancini E. M., Pontone G., Vignali L., Scarnecchia E., Iannacone M., Baffoni L., Sperandio M., de Carlini C. C., Sironi S., Rapezzi C., Antiga L., Jagher V., Di Serio C., Furlanello C., Tacchetti C., Esposito A., Palmisano, A, Vignale, D, Boccia, E, Nonis, A, Gnasso, C, Leone, R, Montagna, M, Nicoletti, V, Bianchi, A, Brusamolino, S, Dorizza, A, Moraschini, M, Veettil, R, Cereda, A, Toselli, M, Giannini, F, Loffi, M, Patelli, G, Monello, A, Iannopollo, G, Ippolito, D, Mancini, E, Pontone, G, Vignali, L, Scarnecchia, E, Iannacone, M, Baffoni, L, Sperandio, M, de Carlini, C, Sironi, S, Rapezzi, C, Antiga, L, Jagher, V, Di Serio, C, Furlanello, C, Tacchetti, C, Esposito, A, Palmisano A., Vignale D., Boccia E., Nonis A., Gnasso C., Leone R., Montagna M., Nicoletti V., Bianchi A. G., Brusamolino S., Dorizza A., Moraschini M., Veettil R., Cereda A., Toselli M., Giannini F., Loffi M., Patelli G., Monello A., Iannopollo G., Ippolito D., Mancini E. M., Pontone G., Vignali L., Scarnecchia E., Iannacone M., Baffoni L., Sperandio M., de Carlini C. C., Sironi S., Rapezzi C., Antiga L., Jagher V., Di Serio C., Furlanello C., Tacchetti C., and Esposito A.

Abstract

Purpose: To develop and validate an effective and user-friendly AI platform based on a few unbiased clinical variables integrated with advanced CT automatic analysis for COVID-19 patients’ risk stratification. Material and Methods: In total, 1575 consecutive COVID-19 adults admitted to 16 hospitals during wave 1 (February 16-April 29, 2020), submitted to chest CT within 72 h from admission, were retrospectively enrolled. In total, 107 variables were initially collected; 64 extracted from CT. The outcome was survival. A rigorous AI model selection framework was adopted for models selection and automatic CT data extraction. Model performances were compared in terms of AUC. A web–mobile interface was developed using Microsoft PowerApps environment. The platform was externally validated on 213 COVID-19 adults prospectively enrolled during wave 2 (October 14-December 31, 2020). Results: The final cohort included 1125 patients (292 non-survivors, 26%) and 24 variables. Logistic showed the best performance on the complete set of variables (AUC = 0.839 ± 0.009) as in models including a limited set of 13 and 5 variables (AUC = 0.840 ± 0.0093 and AUC = 0.834 ± 0.007). For non-inferior performance, the 5 variables model (age, sex, saturation, well-aerated lung parenchyma and cardiothoracic vascular calcium) was selected as the final model and the extraction of CT-derived parameters was fully automatized. The fully automatic model showed AUC = 0.842 (95% CI: 0.816–0.867) on wave 1 and was used to build a 0–100 scale risk score (AI-SCoRE). The predictive performance was confirmed on wave 2 (AUC 0.808; 95% CI: 0.7402–0.8766). Conclusions: AI-SCoRE is an effective and reliable platform for automatic risk stratification of COVID-19 patients based on a few unbiased clinical data and CT automatic analysis.

Published
2022

7. 72P Molecular characterization of advanced primary cardiac sarcomas

Author

Agostara, A.G., primary, Patelli, G., additional, Bencardino, K., additional, Lauricella, C., additional, Pierri, S., additional, Ciarlo, G., additional, Calvanese, G., additional, Gori, V., additional, Mariano, S., additional, Cipani, T., additional, Settepani, F., additional, Soriano, F., additional, Moreo, A., additional, Navarria, F., additional, Mascarin, M., additional, Caputo, V., additional, Veronese, S.M., additional, Russo, C.F., additional, Sartore Bianchi, A., additional, and Siena, S., additional

Published
2023
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8. The hidden interplay between sex and COVID-19 mortality: the role of cardiovascular calcification

Author

Cereda, A, Toselli, M, Palmisano, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Mangieri, A, Khokhar, A, Campo, G, Scoccia, A, Bertini, M, Loffi, M, Sergio, P, Andreini, D, Pontone, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Patelli, G, Besana, F, Vignali, L, Sverzellati, N, Iannaccone, M, Vaudano, P, Sangiorgi, G, Turchio, P, Monello, A, Tumminello, G, Maggioni, A, Rapezzi, C, Colombo, A, Giannini, F, Esposito, A, Cereda A., Toselli M., Palmisano A., Vignale D., Leone R., Nicoletti V., Gnasso C., Mangieri A., Khokhar A., Campo G., Scoccia A., Bertini M., Loffi M., Sergio P., Andreini D., Pontone G., Iannopollo G., Nannini T., Ippolito D., Bellani G., Patelli G., Besana F., Vignali L., Sverzellati N., Iannaccone M., Vaudano P. G., Sangiorgi G. M., Turchio P., Monello A., Tumminello G., Maggioni A. P., Rapezzi C., Colombo A., Giannini F., Esposito A., Cereda, A, Toselli, M, Palmisano, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Mangieri, A, Khokhar, A, Campo, G, Scoccia, A, Bertini, M, Loffi, M, Sergio, P, Andreini, D, Pontone, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Patelli, G, Besana, F, Vignali, L, Sverzellati, N, Iannaccone, M, Vaudano, P, Sangiorgi, G, Turchio, P, Monello, A, Tumminello, G, Maggioni, A, Rapezzi, C, Colombo, A, Giannini, F, Esposito, A, Cereda A., Toselli M., Palmisano A., Vignale D., Leone R., Nicoletti V., Gnasso C., Mangieri A., Khokhar A., Campo G., Scoccia A., Bertini M., Loffi M., Sergio P., Andreini D., Pontone G., Iannopollo G., Nannini T., Ippolito D., Bellani G., Patelli G., Besana F., Vignali L., Sverzellati N., Iannaccone M., Vaudano P. G., Sangiorgi G. M., Turchio P., Monello A., Tumminello G., Maggioni A. P., Rapezzi C., Colombo A., Giannini F., and Esposito A.

Abstract

Recent clinical and demographical studies on COVID-19 patients have demonstrated that men experience worse outcomes than women. However, in most cases, the data were not stratified according to gender, limiting the understanding of the real impact of gender on outcomes. This study aimed to evaluate the disaggregated in-hospital outcomes and explore the possible interactions between gender and cardiovascular calcifications. Data was derived from the sCORE-COVID-19 registry, an Italian multicentre registry that enrolled COVID-19 patients who had undergone a chest computer tomography scan on admission. A total of 1683 hospitalized patients (mean age 67±14 years) were included. Men had a higher prevalence of cardiovascular comorbidities, a higher pneumonia extension, more coronary calcifications (63% vs.50.9%, p<0.001), and a higher coronary calcium score (391±847 vs. 171±479 mm3, p<0.001). Men experienced a significantly higher mortality rate (24.4% vs. 17%, p=0.001), but the death event tended to occur earlier in women (15±7 vs. 8±7 days, p= 0.07). Non-survivors had a higher coronary, thoracic aorta, and aortic valve calcium score. Female sex, a known independent predictor of a favorable outcome in SARS-CoV2 infection, was not protective in women with a coronary calcification volume greater than 100 mm3. There were significant differences in cardiovascular comorbidities and vascular calcifications between men and women with SARS-CoV2 pneumonia. The differences in outcomes can be at least partially explained by the different cardiovascular profiles. However, women with poor outcomes had the same coronary calcific burden as men. The presumed favorable female sex bias in COVID-19 must therefore be reviewed in the context of comorbidities, especially cardiovascular ones.

Published
2021

9. Impact of clinical and subclinical coronary artery disease as assessed by coronary artery calcium in COVID-19

Author

Scoccia, A, Gallone, G, Cereda, A, Palmisano, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Khokhar, A, Sticchi, A, Biagi, A, Tacchetti, C, Campo, G, Rapezzi, C, Ponticelli, F, Danzi, G, Loffi, M, Pontone, G, Andreini, D, Casella, G, Iannopollo, G, Ippolito, D, Bellani, G, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Iannaccone, M, Vaudano, P, Pacielli, A, De Carlini, C, Maggiolini, S, Bonaffini, P, Senni, M, Scarnecchia, E, Anastasio, F, Colombo, A, Ferrari, R, Esposito, A, Giannini, F, Toselli, M, Scoccia A., Gallone G., Cereda A., Palmisano A., Vignale D., Leone R., Nicoletti V., Gnasso C., Monello A., Khokhar A., Sticchi A., Biagi A., Tacchetti C., Campo G., Rapezzi C., Ponticelli F., Danzi G. B., Loffi M., Pontone G., Andreini D., Casella G., Iannopollo G., Ippolito D., Bellani G., Patelli G., Besana F., Costa C., Vignali L., Benatti G., Iannaccone M., Vaudano P. G., Pacielli A., De Carlini C. C., Maggiolini S., Bonaffini P. A., Senni M., Scarnecchia E., Anastasio F., Colombo A., Ferrari R., Esposito A., Giannini F., Toselli M., Scoccia, A, Gallone, G, Cereda, A, Palmisano, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Khokhar, A, Sticchi, A, Biagi, A, Tacchetti, C, Campo, G, Rapezzi, C, Ponticelli, F, Danzi, G, Loffi, M, Pontone, G, Andreini, D, Casella, G, Iannopollo, G, Ippolito, D, Bellani, G, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Iannaccone, M, Vaudano, P, Pacielli, A, De Carlini, C, Maggiolini, S, Bonaffini, P, Senni, M, Scarnecchia, E, Anastasio, F, Colombo, A, Ferrari, R, Esposito, A, Giannini, F, Toselli, M, Scoccia A., Gallone G., Cereda A., Palmisano A., Vignale D., Leone R., Nicoletti V., Gnasso C., Monello A., Khokhar A., Sticchi A., Biagi A., Tacchetti C., Campo G., Rapezzi C., Ponticelli F., Danzi G. B., Loffi M., Pontone G., Andreini D., Casella G., Iannopollo G., Ippolito D., Bellani G., Patelli G., Besana F., Costa C., Vignali L., Benatti G., Iannaccone M., Vaudano P. G., Pacielli A., De Carlini C. C., Maggiolini S., Bonaffini P. A., Senni M., Scarnecchia E., Anastasio F., Colombo A., Ferrari R., Esposito A., Giannini F., and Toselli M.

Abstract

Background and aims: The potential impact of coronary atherosclerosis, as detected by coronary artery calcium, on clinical outcomes in COVID-19 patients remains unsettled. We aimed to evaluate the prognostic impact of clinical and subclinical coronary artery disease (CAD), as assessed by coronary artery calcium score (CAC), in a large, unselected population of hospitalized COVID-19 patients undergoing non-gated chest computed tomography (CT) for clinical practice. Methods: SARS-CoV 2 positive patients from the multicenter (16 Italian hospitals), retrospective observational SCORE COVID-19 (calcium score for COVID-19 Risk Evaluation) registry were stratified in three groups: (a) “clinical CAD” (prior revascularization history), (b) “subclinical CAD” (CAC >0), (c) “No CAD” (CAC = 0). Primary endpoint was in-hospital mortality and the secondary endpoint was a composite of myocardial infarction and cerebrovascular accident (MI/CVA). Results: Amongst 1625 patients (male 67.2%, median age 69 [interquartile range 58–77] years), 31%, 57.8% and 11.1% had no, subclinical and clinical CAD, respectively. Increasing rates of in-hospital mortality (11.3% vs. 27.3% vs. 39.8%, p < 0.001) and MI/CVA events (2.3% vs. 3.8% vs. 11.9%, p < 0.001) were observed for patients with no CAD vs. subclinical CAD vs clinical CAD, respectively. The association with in-hospital mortality was independent of in-study outcome predictors (age, peripheral artery disease, active cancer, hemoglobin, C-reactive protein, LDH, aerated lung volume): subclinical CAD vs. No CAD: adjusted hazard ratio (adj-HR) 2.86 (95% confidence interval [CI] 1.14–7.17, p=0.025); clinical CAD vs. No CAD: adj-HR 3.74 (95% CI 1.21–11.60, p=0.022). Among patients with subclinical CAD, increasing CAC burden was associated with higher rates of in-hospital mortality (20.5% vs. 27.9% vs. 38.7% for patients with CAC score thresholds≤100, 101–400 and > 400, respectively, p < 0.001). The adj-HR per 50 points increase in C

Published
2021

11. 509O Total neoadjuvant treatment (TNT) with non-operative management (NOM) for proficient mismatch repair locally advanced rectal cancer (pMMR LARC): First results of NO-CUT trial

Author

Amatu, A., Zampino, M.G., Bergamo, F., Mosconi, S., Sibio, D., Gerardi, M., Prete, A.A., Filippone, F.R., Ferrari, G., Borin, S., Galuppo, S., Mariano, S., Tosi, F.M., Bonazzina, E.F., Patelli, G., Ghezzi, S., Lazzari, L., Bencardino, K., Bianchi, A. Sartore, and Siena, S.

Published
2024
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12. Drug-induced interstitial lung disease during cancer therapies: expert opinion on diagnosis and treatment

Author

Conte, P, Ascierto, P A, Patelli, G, Danesi, R, Vanzulli, A, Sandomenico, F, Tarsia, P, Cattelan, A, Comes, Alessia, De Laurentiis, M, Falcone, A, Regge, D, Richeldi, Luca, Siena, S, Comes, A (ORCID:0000-0002-4471-895X), Richeldi, L (ORCID:0000-0001-8594-1448), Conte, P, Ascierto, P A, Patelli, G, Danesi, R, Vanzulli, A, Sandomenico, F, Tarsia, P, Cattelan, A, Comes, Alessia, De Laurentiis, M, Falcone, A, Regge, D, Richeldi, Luca, Siena, S, Comes, A (ORCID:0000-0002-4471-895X), and Richeldi, L (ORCID:0000-0001-8594-1448)

Abstract

Background: Drug-induced interstitial lung disease (DIILD) is a form of interstitial lung disease resulting from exposure to drugs causing inflammation and possibly interstitial fibrosis. Antineoplastic drugs are the primary cause of DIILD, accounting for 23%-51% of cases, with bleomycin, everolimus, erlotinib, trastuzumab-deruxtecan and immune checkpoint inhibitors being the most common causative agents. DIILD can be difficult to identify and manage, and there are currently no specific guidelines on the diagnosis and treatment of DIILD caused by anticancer drugs.Objective: To develop recommendations for the diagnosis and management of DIILD in cancer patients.Methods: Based on the published literature and their clinical expertise, a multidisciplinary group of experts in Italy developed recommendations stratified by DIILD severity, based on the Common Terminology Criteria for Adverse Events.Results: The recommendations highlight the importance of multidisciplinary interaction in the diagnosis and management of DIILD. Important components of the diagnostic process are physical examination and careful patient history-taking, measurement of vital signs (particularly respiratory rate and arterial oxygen saturation), relevant laboratory tests, respiratory function testing with spirometry and diffusing capacity of the lung for carbon monoxide and computed tomography/imaging. Because the clinical and radiological signs of DIILD are often similar to those of pneumonias or interstitial lung diseases, differential diagnosis is important, including microbial and serological testing to exclude or confirm infectious causes. In most cases, management of DIILD requires the discontinuation of the antineoplastic agent and the administration of short-term steroids. Steroid tapering must be undertaken slowly to prevent reactivation of DIILD. Patients with severe and very severe (grade 3 and 4) DIILD will require hospitalisation and often need oxygen and non-invasive ventilation. Decis

Published
2022

13. Author Correction: Coronavirus disease 2019 (COVID-19) in Italy: features on chest computed tomography using a structured report system (Scientific Reports, (2020), 10, 1, (17236), 10.1038/s41598-020-73788-5)

Author

Grassi R., Fusco R., Belfiore M. P., Montanelli A., Patelli G., Urraro F., Petrillo A., Granata V., Sacco P., Mazzei M. A., Feragalli B., Reginelli A., Cappabianca S., Grassi, R., Fusco, R., Belfiore, M. P., Montanelli, A., Patelli, G., Urraro, F., Petrillo, A., Granata, V., Sacco, P., Mazzei, M. A., Feragalli, B., Reginelli, A., and Cappabianca, S.

Abstract

The original version of this Article contained errors in the spelling of the authors Roberto Grassi, Roberta Fusco, Maria Paola Belfiore, Alessandro Montanelli, Gianluigi Patelli, Fabrizio Urraro, Antonella Petrillo, Vincenza Granata, Palmino Sacco, Maria Antonietta Mazzei, Beatrice Feragalli, Alfonso Reginelli & Salvatore Cappabianca which were incorrectly given as Grassi Roberto, Fusco Roberta, Belfiore Maria Paola, Montanelli Alessandro, Patelli Gianluigi, Urraro Fabrizio, Petrillo Antonella, Granata Vincenza, Sacco Palmino, Mazzei Maria Antonietta, Feragalli Beatrice, Reginelli Alfonso & Cappabianca Salvatore. These errors have now been corrected in the PDF and HTML versions of the Article.

Published
2021

15. Detection of lung hypoperfusion in Covid-19 patients during recovery by digital imaging quantification

Author

Codazzi F, Besana F, Patelli G, Ronzoni M, Manini S, Andrea Remuzzi, and Paganoni S

Subjects
medicine.medical_specialty, Lung, Coronavirus disease 2019 (COVID-19), business.industry, medicine.disease, Pneumonia, medicine.anatomical_structure, Text mining, Radiological weapon, medicine, In patient, Lung volumes, Radiology, business, Perfusion
Abstract

SummaryPurposeA large number of patients affected by the SARS-Cov-2 virus worldwide undergo recovery of symptoms in about one month. Among these patients, the healing process is still under observation, with some patients in need of careful clinical monitoring. While the radiological findings have been shown to regress almost completely, little knowledge is available at the moment about other complications in the lung and in other organs. We then investigated the lung perfusion conditions in patients affected by COVID-19 during recovery.MethodWe retrospectively studied 20 patients, from 14 to 60 days after resolution of the COVID-19 symptoms, using chest CT. In a subgroup of 5 patients contrasted CT was used. Beside normal radiological evaluation of lung tissue, perfusion conditions were evaluated by digital image processing in the lung volume automatically segmented.ResultsPulmonary lung evaluation showed that COVID-19 pneumonia almost completely regressed, with mild focal areas affected by fibrous stripes. In patients that reported dyspnea, lung CT showed complete resolution of interstitial changes. Quantification of lung perfusion condition by contrasted CT, showed that dyspnea in 3 patients was associated with areas of hypoperfusion, while in 2 patients not reporting dyspnea perfusion conditions were comparable to normal controls.ConclusionsAlthough we obtained preliminary data, this is the first report on quantitative evaluation of hypoperfused lung tissue detected in recovering COVID-19 patients. These results suggest the need to further investigate these patients and to redefine the role of CT evaluation for diagnostic purposes as well as for evaluation of potential treatments.FundingThis was an academic study that received no direct funding.

Published
2020
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16. Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients

Author

Giannini, F, Toselli, M, Palmisano, A, Cereda, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Manfrini, M, Khokhar, A, Sticchi, A, Biagi, A, Turchio, P, Tacchetti, C, Landoni, G, Boccia, E, Campo, G, Scoccia, A, Ponticelli, F, Danzi, G, Loffi, M, Muri, M, Pontone, G, Andreini, D, Mancini, E, Casella, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Franzesi, C, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Sverzellati, N, Scarnecchia, E, Lombardo, F, Anastasio, F, Iannaccone, M, Vaudano, P, Pacielli, A, Baffoni, L, Gardi, I, Cesini, E, Sperandio, M, Micossi, C, De Carlini, C, Spreafico, C, Maggiolini, S, Bonaffini, P, Iacovoni, A, Sironi, S, Senni, M, Fominskiy, E, De Cobelli, F, Maggioni, A, Rapezzi, C, Ferrari, R, Colombo, A, Esposito, A, Giannini, Francesco, Toselli, Marco, Palmisano, Anna, Cereda, Alberto, Vignale, Davide, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Manfrini, Marco, Khokhar, Arif, Sticchi, Alessandro, Biagi, Andrea, Turchio, Piergiorgio, Tacchetti, Carlo, Landoni, Giovanni, Boccia, Edda, Campo, Gianluca, Scoccia, Alessandra, Ponticelli, Francesco, Danzi, Gian Battista, Loffi, Marco, Muri, Margherita, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Ippolito, Davide, Bellani, Giacomo, Franzesi, Camillo Talei, Patelli, Gianluigi, Besana, Francesca, Costa, Claudia, Vignali, Luigi, Benatti, Giorgio, Sverzellati, Nicola, Scarnecchia, Elisa, Lombardo, Francesco Paolo, Anastasio, Fabio, Iannaccone, Mario, Vaudano, Paolo Giacomo, Pacielli, Alberto, Baffoni, Lucio, Gardi, Iljia, Cesini, Elisabetta, Sperandio, Massimiliano, Micossi, Chiara, De Carlini, Caterina Chiara, Spreafico, Cristiano, Maggiolini, Stefano, Bonaffini, Pietro Andrea, Iacovoni, Attilio, Sironi, Sandro, Senni, Michele, Fominskiy, Evgeny, De Cobelli, Francesco, Maggioni, Aldo Pietro, Rapezzi, Claudio, Ferrari, Roberto, Colombo, Antonio, Esposito, Antonio, Giannini, F, Toselli, M, Palmisano, A, Cereda, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Manfrini, M, Khokhar, A, Sticchi, A, Biagi, A, Turchio, P, Tacchetti, C, Landoni, G, Boccia, E, Campo, G, Scoccia, A, Ponticelli, F, Danzi, G, Loffi, M, Muri, M, Pontone, G, Andreini, D, Mancini, E, Casella, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Franzesi, C, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Sverzellati, N, Scarnecchia, E, Lombardo, F, Anastasio, F, Iannaccone, M, Vaudano, P, Pacielli, A, Baffoni, L, Gardi, I, Cesini, E, Sperandio, M, Micossi, C, De Carlini, C, Spreafico, C, Maggiolini, S, Bonaffini, P, Iacovoni, A, Sironi, S, Senni, M, Fominskiy, E, De Cobelli, F, Maggioni, A, Rapezzi, C, Ferrari, R, Colombo, A, Esposito, A, Giannini, Francesco, Toselli, Marco, Palmisano, Anna, Cereda, Alberto, Vignale, Davide, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Manfrini, Marco, Khokhar, Arif, Sticchi, Alessandro, Biagi, Andrea, Turchio, Piergiorgio, Tacchetti, Carlo, Landoni, Giovanni, Boccia, Edda, Campo, Gianluca, Scoccia, Alessandra, Ponticelli, Francesco, Danzi, Gian Battista, Loffi, Marco, Muri, Margherita, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Ippolito, Davide, Bellani, Giacomo, Franzesi, Camillo Talei, Patelli, Gianluigi, Besana, Francesca, Costa, Claudia, Vignali, Luigi, Benatti, Giorgio, Sverzellati, Nicola, Scarnecchia, Elisa, Lombardo, Francesco Paolo, Anastasio, Fabio, Iannaccone, Mario, Vaudano, Paolo Giacomo, Pacielli, Alberto, Baffoni, Lucio, Gardi, Iljia, Cesini, Elisabetta, Sperandio, Massimiliano, Micossi, Chiara, De Carlini, Caterina Chiara, Spreafico, Cristiano, Maggiolini, Stefano, Bonaffini, Pietro Andrea, Iacovoni, Attilio, Sironi, Sandro, Senni, Michele, Fominskiy, Evgeny, De Cobelli, Francesco, Maggioni, Aldo Pietro, Rapezzi, Claudio, Ferrari, Roberto, Colombo, Antonio, and Esposito, Antonio

Abstract

Background: Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated. Objectives: The aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients. Methods: 1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients’ outcomes. Results: Non-survivors compared to survivors had higher coronary artery [Agatston (467.76 ​± ​570.92 vs 206.80 ​± ​424.13 ​mm2, p ​< ​0.001); Volume (487.79 ​± ​565.34 vs 207.77 ​± ​406.81, p ​< ​0.001)], aortic valve [Volume (322.45 ​± ​390.90 vs 98.27 ​± ​250.74 mm2, p ​< ​0.001; Agatston 337.38 ​± ​414.97 vs 111.70 ​± ​282.15, p ​< ​0.001)] and thoracic aorta [Volume (3786.71 ​± ​4225.57 vs 1487.63 ​± ​2973.19 mm2, p ​< ​0.001); Agatston (4688.82 ​± ​5363.72 vs 1834.90 ​± ​3761.25, p ​< ​0.001)] calcium values. Coronary artery calcium (HR 1.308; 95% CI, 1.046–1.637, p ​= ​0.019) and total thoracic calcium (HR 1.975; 95% CI, 1.200–3.251, p ​= ​0.007) resulted to be independent predictors of in-hospital mortality. Conclusion: Coronary, aortic valve and thoracic aortic calcium assessment on admission non-gated CT permits to stratify the COVID-19 patients in-hospital mortality risk.

Published
2021

17. Chest CT-derived pulmonary artery enlargement at the admission predicts overall survival in COVID-19 patients: insight from 1461 consecutive patients in Italy

Author

Esposito, A, Palmisano, A, Toselli, M, Vignale, D, Cereda, A, Rancoita, P, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Biagi, A, Turchio, P, Landoni, G, Gallone, G, Monti, G, Casella, G, Iannopollo, G, Nannini, T, Patelli, G, Di Mare, L, Loffi, M, Sergio, P, Ippolito, D, Sironi, S, Pontone, G, Andreini, D, Mancini, E, Di Serio, C, De Cobelli, F, Ciceri, F, Zangrillo, A, Colombo, A, Tacchetti, C, Giannini, F, Esposito, Antonio, Palmisano, Anna, Toselli, Marco, Vignale, Davide, Cereda, Alberto, Rancoita, Paola Maria Vittoria, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Biagi, Andrea, Turchio, Piergiorgio, Landoni, Giovanni, Gallone, Guglielmo, Monti, Giacomo, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Patelli, Gianluigi, Di Mare, Luisa, Loffi, Marco, Sergio, Pietro, Ippolito, Davide, Sironi, Sandro, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Di Serio, Clelia, De Cobelli, Francesco, Ciceri, Fabio, Zangrillo, Alberto, Colombo, Antonio, Tacchetti, Carlo, Giannini, Francesco, Esposito, A, Palmisano, A, Toselli, M, Vignale, D, Cereda, A, Rancoita, P, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Biagi, A, Turchio, P, Landoni, G, Gallone, G, Monti, G, Casella, G, Iannopollo, G, Nannini, T, Patelli, G, Di Mare, L, Loffi, M, Sergio, P, Ippolito, D, Sironi, S, Pontone, G, Andreini, D, Mancini, E, Di Serio, C, De Cobelli, F, Ciceri, F, Zangrillo, A, Colombo, A, Tacchetti, C, Giannini, F, Esposito, Antonio, Palmisano, Anna, Toselli, Marco, Vignale, Davide, Cereda, Alberto, Rancoita, Paola Maria Vittoria, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Biagi, Andrea, Turchio, Piergiorgio, Landoni, Giovanni, Gallone, Guglielmo, Monti, Giacomo, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Patelli, Gianluigi, Di Mare, Luisa, Loffi, Marco, Sergio, Pietro, Ippolito, Davide, Sironi, Sandro, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Di Serio, Clelia, De Cobelli, Francesco, Ciceri, Fabio, Zangrillo, Alberto, Colombo, Antonio, Tacchetti, Carlo, and Giannini, Francesco

Abstract

Objectives Enlarged main pulmonary artery diameter (MPAD) resulted to be associated with pulmonary hypertension and mortality in a non-COVID-19 setting. The aim was to investigate and validate the association between MPAD enlargement and overall survival in COVID-19 patients. Methods This is a cohort study on 1469 consecutive COVID-19 patients submitted to chest CT within 72 h from admission in seven tertiary level hospitals in Northern Italy, between March 1 and April 20, 2020. Derivation cohort (n = 761) included patients from the first three participating hospitals; validation cohort (n = 633) included patients from the remaining hospitals. CT images were centrally analyzed in a core-lab blinded to clinical data. The prognostic value of MPAD on overall survival was evaluated at adjusted and multivariable Cox's regression analysis on the derivation cohort. The final multivariable model was tested on the validation cohort. Results In the derivation cohort, the median age was 69 (IQR, 58-77) years and 537 (70.6%) were males. In the validation cohort, the median age was 69 (IQR, 59-77) years with 421 (66.5%) males. Enlarged MPAD (>= 31 mm) was a predictor of mortality at adjusted (hazard ratio, HR [95%CI]: 1.741 [1.253-2.418], p < 0.001) and multivariable regression analysis (HR [95%CI]: 1.592 [1.154-2.196], p = 0.005), together with male gender, old age, high creatinine, low well-aerated lung volume, and high pneumonia extension (c-index [95%CI] = 0.826 [0.796-0.851]). Model discrimination was confirmed on the validation cohort (c-index [95%CI] = 0.789 [0.758-0.823]), also using CT measurements from a second reader (c-index [95%CI] = 0.790 [0.753;0.825]). Conclusion Enlarged MPAD (>= 31 mm) at admitting chest CT is an independent predictor of mortality in COVID-19.

Published
2021

19. Ulipristal Acetate Efficacy in a Patient with Symptomatic Fibroid and Concomitant Pulmonary Embolism

Author

von Wunster, S., D’Oria, P., Colonna, L., and Patelli, G.

Subjects
Article Subject, female genital diseases and pregnancy complications
Abstract

Ulipristal acetate (UPA) is an effective drug for the treatment of symptomatic uterine fibroids. The drug is highly effective in controlling bleeding control and in the recovery of anemia. Here, we report the case of a woman with severe menorrhagia due to a uterine fibroid and with concomitant pulmonary embolism, a serious life-threatening condition. UPA was shown to be effective in reducing fibroid volume and controlling symptoms, without worsening the underlying embolic disease. No adverse events were observed, and the patient has completely recovered.

Published
2020
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22. Building capacity to provide innovative interventions for early psychosis in mental health professionals.

Author

Poli, S., Ruggeri, M., Bonetto, C., De Santi, K., Miglietta, E., Petterlini, S., Alpi, A., Bislenghi, L., Bolis, T., Fascendini, S., Patelli, G., Cristofalo, D., Albasini, F., and Meneghelli, A.

Subjects
MENTAL health personnel, COMMUNITY mental health services, MENTAL health services, BEHAVIOR therapy, PSYCHOSES
Abstract

Despite international guidelines, cognitive behavioural therapy for early psychosis (CBTep) is still under-used in daily clinical practice, mainly due to the lack of specific skills among mental health professionals. The aim of the study was to evaluate the feasibility and efficacy of a CBTep training course and to investigate the impact of trainees' variables on the level of skills acquisition. An intensive and graded CBTep training programme consisting of 112 hours of plenary lectures, 30 hours of group supervision and 3 months of practical training was offered to mental health professionals of 65 Italian community Mental Health Centers (CMHCs). CBT expert psychologists were used as the comparison group. Participants underwent pre-planned exams to test the level of skills acquisition and were requested to complete a satisfaction survey. The vast majority of participants (93%) completed the training with medium–high evaluation scores and reported to be highly satisfied with the course. CMHCs staff members achieved high scores in the examinations and no major differences between them and CBT expert psychologists were found in most of the final exam scores. Our results support the feasibility and the efficacy of the training to build specific CBTep capacity in a large cohort of professionals working in Italian Generalist Mental Health Services. Key learning aims: (1) To understand the capacity building of a short training programme in CBT for early psychosis dedicated to community mental health professionals. (2) To consider the optimal characteristics of a CBT training programme for early psychosis. (3) To reflect on the feasibility of a CBT training programme for early psychosis in the context of Italian Community Mental Health Services. [ABSTRACT FROM AUTHOR]

Published
2020
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23. Recommendations for the quantification of serum monoclonal components

Author

Vernocchi, A, Dolci, A, Ceriotti, F, Lippi, Giuseppe, Merlini, G, Graziani, Ms, Caldini, A, Mussap, M, Natali, P, Patelli, G, Maoggi, S, Righetti, G, and Lalli, A.

Subjects
myeloma, Monoclonal component, immunoglobulins, Monoclonal component, myeloma, immunoglobulins
Published
2015

24. Intraarterial chemotherapy with polyoxyethylated castor oil free paclitaxel, incorporated in albumin nanoparticles (ABI-007): Phase I study of patients with squamous cell carcinoma of the head and neck and anal canal: preliminary evidence of clinical activity

Author

Damascelli, B, Cantù, G, Mattavelli, F, Tamplenizza, P, Bidoli, P, Leo, E, Dosio, F, Cerrotta, A, Di Tolla, G, Frigerio, L, Garbagnati, F, Lanocita, R, Marchianò, A, Patelli, G, Spreafico, C, Tichà, V, Vespro, V, Zunino, F, Damascelli B, Cantù G, Mattavelli F, Tamplenizza P, Bidoli P, Leo E, Dosio F, Cerrotta AM, Di Tolla G, Frigerio LF, Garbagnati F, Lanocita R, Marchianò A, Patelli G, Spreafico C, Tichà V, Vespro V, Zunino F, Damascelli, B, Cantù, G, Mattavelli, F, Tamplenizza, P, Bidoli, P, Leo, E, Dosio, F, Cerrotta, A, Di Tolla, G, Frigerio, L, Garbagnati, F, Lanocita, R, Marchianò, A, Patelli, G, Spreafico, C, Tichà, V, Vespro, V, Zunino, F, Damascelli B, Cantù G, Mattavelli F, Tamplenizza P, Bidoli P, Leo E, Dosio F, Cerrotta AM, Di Tolla G, Frigerio LF, Garbagnati F, Lanocita R, Marchianò A, Patelli G, Spreafico C, Tichà V, Vespro V, and Zunino F

Abstract

BACKGROUND. This study was designed to determine the feasibility, maximum tolerated dose, and toxicities of intraarterial administration of paclitaxel-albumin nanoparticles in patients with advanced head and neck and recurrent anal canal squamous cell carcinoma. Antitumor activity also was assessed. METHODS. Forty-three patients (31 with advanced head and neck and 12 with recurrent anal canal squamous cell carcinoma) were treated intraarterially with ABI-007 every 4 weeks for 3 cycles. In total, 120 treatment cycles were completed, 86 in patients with head and neck carcinoma (median, 3 cycles; range, 1-4) and 34 in patients with anal canal carcinoma (median, 3 cycles; range, 1-4). ABI-007 was compared preliminarily with Taxol® for in vitro cytostatic activity. Increasing dose levels from 120 to 300 mg/m2 were studied in 18 patients. Pharmacokinetic profiles after intraarterial administration were obtained in a restricted number of patients. RESULTS. The dose-limiting toxicity of ABI-007 was myelosuppression consisting of Grade 4 neutropenia in 3 patients. Nonhematologic toxicities included total alopecia (30 patients), gastrointestinal toxicity (3 patients, Grade 2), skin toxicity (5 patients, Grade 2), neurologic toxicity (4 patients, Grade 2) ocular toxicity (1 patient, Grade 2), flu-like syndrome (7 patients, Grade 2; 1 patient, Grade 3). In total, 120 transfemoral, percutaneous catheterization procedure-related complications occurred only during catheterization of the neck vessels in 3 patients (2 TIA, 1 hemiparesis) and resolved spontaneously. CONCLUSIONS. Intraarterial administration of ABI-007 by percutaneous catheterization does not require premedication, is easy and reproducible, and has acceptable toxicity. The maximum tolerated dose in a single administration was 270 mg/m2. Most dose levels showed considerable antitumor activity (42 assessable patients with 80.9% complete response and partial response). The recommended Phase II dose is 230 mg/m2 every 3 w

Published
2001

25. A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Author

Ruggeri, Mirella, Bonetto, Chiara, Lasalvia, Antonio, Girolamo, De, G, Fioritti, A, Rucci, P, Santonastaso, P, Neri, G, Pileggi, F, Ghigi, D, Miceli, M, Scarone, S, Cocchi, A, Torresani, S, Faravelli, C, Zimmermann, Christa, Meneghelli, A, Cremonese, C, Scocco, P, Leuci, E, Mazzi, F, Gennarelli, M, Brambilla, P, Bissoli, S, Bertani, Me, Tosato, Sarah, DE SANTI, Katia, Poli, Sara, Cristofalo, Doriana, Tansella, Michele, Get, Up, Group, Ruggeri, M, Mirella, Me, Bonetto, C, Cristofalo, D, De Santi, K, Lasalvia, A, Lunardi, S, Negretto, V, Poli, S, Tosato, S, Zamboni, Mg, Ballarin, M, Bocchio, Chiavetto, L, Scasselatti, C, Zanardini, R, Bellani, Marcella, Bertoldo, A, Marinelli, Veronica, Perlini, Cinzia, Rambaldelli, Gianluca, Bertani, M, Lazzarotto, L, Bardella, S, Gardellin, F, Lamonaca, D, Lunardon, M, Magnabosco, R, Martucci, M, Nicolau, S, Nifosì, F, Pavanati, M, Rossi, M, Piazza, C, Piccione, G, Sala, A, Sale, A, Stefan, B, Zotos, S, Balbo, M, Boggian, I, Ceccato, E, Dall'Agnola, R, Girotto, B, Goss, Claudia, Leoni, R, Mai, A, Pasqualini, A, Roccato, S, Rossi, A, Strizzolo, S, Urbani, A, Ald, F, Bianchi, B, Cappellari, P, Conti, R, Battisti, De, Lazzarin, E, Merlin, S, Migliorini, G, Pozzan, T, Sarto, L, Visonà, S, Brazzoli, A, Campi, A, Carmagnani, R, Giambelli, S, Gianella, A, Lunardi, L, Madaghiele, D, Maestrelli, P, Paiola, L, Posteri, E, Viola, L, Zamberlan, V, Zenari, M, Zanoni, M, Bonadonna, G, Bonomo, M, Veronese, A, Anderle, P, Angelozz, A, Amalric, I, Baron, G, Candeago, Eb, Castelli, F, Chieco, M, Costanzo, Di, E, Derossi, M, Doriguzzi, M, Galvano, O, Lattanz, M, Lezzi, R, Marcato, M, Marcolin, A, Marini, F, Matranga, M, Scalabrin, D, Zucchetto, M, Zadro, F, Austoni, G, Bianco, M, Bordino, F, Dario, F, Risio, De, A, Gatto, A, Granà, S, Favero, E, Franceschin, A, Friederici, S, Marangon, V, Pascolo, M, Ramon, L, Zambolin, S, Riolo, R, Buffon, A, Bortolo, Di, Fortin, S, Matarrese, F, Mogni, S, Codemo, N, Russi, A, Silvestro, A, Turella, E, Viel, P, Dominoni, A, Andreose, L, Boemio, M, Bressan, L, Cabbia, A, Canesso, E, Cian, R, Dal, Piccol, Dalla, C, Pasqua, Mm, Prisco, Di, Mantellato, L, Luison, M, Morgante, S, Santi, M, Sacillotto, M, Scabbio, M, Sponga, P, Sguotto, Ml, Stach, F, Vettorato, Mg, Martinello, G, Dassiè, F, Marino, S, Cibiniel, L, Masetto, I, Cabianca, O, Valente, A, Caberlotto, L, Passoni, A, Flumian, P, Daniel, L, Gion, M, Stanziale, S, Alborino, F, Bortolozzo, V, Bacelle, L, Bicciato, L, Basso, D, Navaglia, F, Manoni, F, Ercolin, M, Giubilini, F, Imbesi, M, Semrov, E, Giovanni, Cs, Taro, E, Ceno, V, Ovest, P, Anelli, S, Amore, M, Bigi, L, Britta, W, Anna, Gb, Bonatti, U, Borziani, M, Crosato, I, Galluccio, R, Galeotti, M, Gozzi, M, Greco, V, Guagnini, E, Pagani, S, Maccherozzi, M, Marchi, F, Melato, E, Mazzucchi, E, Marzullo, F, Pellegrini, P, Petrolini, N, Volta, P, Bonara, F, Brusamonti, E, Croci, R, Flamia, I, Fontana, F, Losi, R, Marchioro, R, Raffaini, L, Ruju, L, Saginario, A, Tondelli, Mg, Marrama, D, Bernardelli, L, Bonacini, F, Florindo, A, Merli, M, Nappo, P, Sola, L, Tondelli, O, Tonna, M, Torre, Mt, Tosatti, M, Venturelli, G, Zampolla, D, Bernardi, A, Cavalli, C, Cigala, L, Ciraudo, C, Bari, Di, Ferri, L, Gombi, F, Leurini, S, Mandatelli, E, Maccaferri, S, Oroboncoide, M, Pisa, B, Ricci, C, Poggi, E, Zurlini, C, Malpeli, M, Colla, R, Teodori, E, Vecchia, L, D'Andrea, R, Trenti, T, Paolini, P, Carpeggiani, P, Gagliostro, M, Pratelli, M, Lazzaro, S, Antonelli, A, Battistini, L, Bellini, F, Bonini, E, Capelli, Cb, Didomizio, C, Drei, C, Fucci, G, Gualandi, A, Grazia, Mr, Losi, Am, Mazzoni, Fm, Marangoni, D, Monna, G, Morselli, M, Oggioni, A, Oprandi, S, Paganelli, W, Passerini, M, Piscitelli, M, Reggiani, G, Rossi, G, Salvatori, F, Trasforini, S, Uslenghi, C, Veggetti, S, Bartolucci, G, Baruffa, R, Bertelli, R, Borghi, L, Ciavarella, P, Paltrinieri, E, Rizzardi, F, Serra, P, Suzzi, D, Carlo, U, Arienti, P, Aureli, F, Avanzi, R, Callegari, V, Corsino, A, Host, P, Michetti, R, Rizzo, F, Simoncelli, P, Soldati, E, Succi, E, Bertozzi, M, Canetti, E, Cavicchioli, L, Ceccarelli, E, Cenni, S, Marzola, G, Gallina, V, Leoni, C, Olivieri, A, Piccolo, E, Ravagli, S, Russo, R, Tedeschini, D, Verenini, M, Abram, W, Granata, V, Curcio, A, Guerra, G, Granini, S, Natali, L, Montanari, E, Pasi, F, Ventura, U, Valenti, S, Francesca, M, Farneti, R, Ravagli, P, Floris, R, Maroncelli, O, Volpones, G, Casali, D, Bencini, A, Cellini, M, Biase, De, Barbara, L, Charles, L, Pratesi, C, Tanini, A, Loparrino, R, Ulivelli, C, Cussoto, C, Dei, N, Fumanti, E, Pantani, M, Zeloni, G, Bellini, R, Cellesi, R, Dorigo, N, Gullì, P, Ialeggio, L, Pisanu, M, Rinaldi, G, Konze, A, Modignani, L, Frova, M, Monzani, E, Zanobio, A, Malagoli, M, Pagani, R, Barbera, S, Morganti, C, Amadè, Es, Brambilla, V, Montanari, A, Caterina, G, Lopez, C, Marocchi, A, Moletta, A, Sberna, M, Cascio, Mt, Manzone, Ml, Barbara, B, Mari, L, Razzini, E, Bianchi, Y, Pellizzer, Mr, Verdecchia, A, Sferrazza, Mg, Pismataro, R, D'Eril, Gv, Barassi, A, Pacciolla, R, Faraci, G, Rosmini, B, Carpi, F, Soelva, M, Anderlan, M, Francesco, De, M, Duregger, E, Vettori, C, Doimo, S, Kompatscher, E, Forer, M, Kerschbaumer, H, Gampe, A, Nicoletti, M, Acerbi, C, Aquilino, D, Azzali, S, Bensi, L, Cappellari, D, Casana, E, Campagnola, N, Dal, Corso, Di, E, Micco, E, Gobbi, E, Mairaghi, L, Malak, S, Mesiano, L, Paterlini, F, Perini, M, Puliti, Em, Rispoli, R, Rizzo, E, Sergenti, C, Soave, M, Alpi, A, Bislenghi, L, Bolis, T, Colnaghi, F, Fascendini, S, Grignani, S, Patelli, G, Casale, S, Zimmermann, C, Deledda, G, Goss, C, Mazzi, Maria Angela, Rimondini, Michela, Scassellati, C, Bonvicini, C, Longo, S, Ventriglia, M, Squitti, R, Frisoni, G, Pievani, M, Balestrieri, M, Perlini, C, Marinelli, V, Bellani, M, Rambaldelli, G, Atzori, M, Beltramello, A, Alessandrini, F, Pizzini, Francesca, Zoccatelli, G, Politi, P, Emanuele, E, Brondino, N, Martino, G, Bergami, A, Zarbo, R, Riva, Ma, Fumagalli, F, Molteni, R, Calabrese, F, Guidotti, G, Luoni, A, Macchi, F, Artioli, S, Baldetti, M, Bizzocchi, M, Bolzon, D, Bonello, E, Cacciari, G, Carraresi, C, Caselli, G, Furlato, K, Garlassi, S, Gavarini, A, Macchetti, F, Marteddu, V, Plebiscita, G, Totaro, S, Bebbington, P, Birchwood, M, Dazzan, P, Kuipers, E, Thornicroft, G, Pariante, C, Lawrie, S, Soares, J. C., Ruggeri, M., Bonetto, C., Lasalvia, A., De Girolamo, G., Bertani, M., Rucci, P., Santonastaso, P., Neri, G., Pileggi, F., Ghigi, D., Miceli, M., Scarone, S., Cocchi, A., Torresani, S., Faravelli, C., Zimmermann, C., Meneghelli, A., Cremonese, C., Scocco, P., Leuci, E., Mazzi, F., Gennarelli, Massimo, Brambilla, P., Bissoli, S., Lazzarotto, L., Bardella, S., Gardellin, F., Lamonaca, D., Lunardon, M., Magnabosco, R., Martucci, M., Nicolau, S., Nifosì, F., Bertani, M. E., Tosato, S., De Santi, K., Poli, S., Cristofalo, D., Tansella, Michele, Lunardi, S., Negretto, V., Zamboni, M. G., Ballarin, M., Chiavetto, Luisella Bocchio, Scasselatti, C., Zanardini, R., Bellani, M., Bertoldo, A., Marinelli, Valentina, Perlini, C., Rambaldelli, G., Pasqualini, A., Pavanati, M., Rossi, M., Piazza, C., Piccione, G., Sala, A., Roccato, S., Rossi-, A., Sale, A., Stefan, B., Strizzolo, S., Zotos, S., Balbo, M., Boggian, I., Ceccato, E., Dall’Agnola, R., Girotto, B., Leoni, R., Mai, A., Urbani, Alessandro, Ald, F., Bianchi, Benedetta, Cappellari, P., Conti, R., De Battisti, L., Lazzarin, E., Merlin, S., Migliorini, G., Pozzan, T., Sarto, L., Visonà, S., Brazzoli, A., Campi, A., Carmagnani, R., Giambelli, S., Gianella, A., Lunardi-, L., Madaghiele, D., Maestrelli, P., Paiola, L., Posteri, E., Viola, L., Zamberlan, V., Zenari, M., Zanoni, M., Bonadonna, G., Bonomo, M., Veronese, A., Anderle, P., Angelozz, A., Amalric, I., Baron, G., Candeago, E. B., Castelli, F., Chieco, M., Di Costanzo, E., Derossi, M., Doriguzzi, M., Galvano, O., Lattanz, M., Lezzi, R., Marcato, M., Marcolin, A., Marini, F., Matranga, M., Scalabrin, D., Zucchetto, M., Zadro, F., Austoni, G., Bianco, M., Bordino, F., Dario, F., DE RISIO, Alfredo, Gatto, A., Granà, S., Favero, E., Franceschin, A., Friederici, S., Marangon, V., Pascolo, M., Ramon, L., Zambolin, S., Riolo, R., Buffon, A., Di Bortolo, E., Fortin, S., Matarrese, F., Mogni, S., Codemo, N., Russi, A., Silvestro, Antonina, Turella, E., Viel, P., Dominoni, A., Andreose, L., Boemio, M., Bressan, L., Cabbia, A., Canesso, E., Cian, R., Dal Piccol, C., Dalla Pasqua, M. M., Di Prisco, A., Mantellato, L., Luison, M., Morgante, S., Santi, M., Sacillotto, M., Scabbio, M., Sponga, P., Sguotto, M. L., Stach, F., Vettorato, M. G., Martinello, G., Dassiè, F., DI MARINO, Simone, Cibiniel, L., Masetto, I., Cabianca, O., Valente, MADDALENA AGNESE, Caberlotto, L., Passoni, A., Flumian, P., Daniel, L., Gion, M., Stanziale, S., Alborino, F., Bortolozzo, V., Bacelle, L., Bicciato, L., Basso, D., Navaglia, F., Manoni, F., Ercolin, M., Giubilini, F., Imbesi, M., Semrov, E., Giovanni, C. S., Taro e Ceno, V., Ovest, P., Anelli, S., Amore, M., Bigi, L., Britta, W., Anna, G. B., Bonatti, U., Borziani, M., Crosato, I., Galluccio, R., Galeotti, M., Gozzi, M., Greco, V., Guagnini, E., Pagani, S., Maccherozzi, M., Marchi, F., Melato, E., Mazzucchi, E., Marzullo, F., Pellegrini, Pietro Carlo, Petrolini, N., Volta, P., Bonara, F., Brusamonti, E., Croci, R., Flamia, I., Fontana, F., Losi, R., Marchioro, R., Raffaini, L., Ruju, L., Saginario, A., Tondelli, M. G., Marrama, D., Bernardelli, L., Bonacini, F., Florindo, A., Merli, M., Nappo, P., Sola, L., Tondelli-, O., Tonna, M., Torre, M. T., Tosatti, M., Venturelli, G., Zampolla, D., Bernardi, A., Cavalli, Chiara, Cigala, L., Ciraudo, C., Di Bari, A., Ferri, L., Gombi, F., Leurini, S., Mandatelli, E., Maccaferri, S., Oroboncoide, M., Pisa, B., Ricci, Carmine, Poggi, E., Zurlini, C., Malpeli, M., Colla, R., Teodori, E., Vecchia, L., D’Andrea, R., Trenti, T., Paolini, P., Carpeggiani, P., Gagliostro, M., Pratelli, M., Lazzaro, S., Antonelli, A., Battistini, Luca, Bellini, Fiorella, Bonini, E., Capelli, C. B., Didomizio, C., Drei, C., Fucci, G., Gualandi, A., Grazia, M. R., Losi-, A. M., Mazzoni, F. M., Marangoni, D., Monna, G., Morselli, M., Oggioni, A., Oprandi, S., Paganelli, W., Passerini, M., Piscitelli, M., Reggiani, G., Rossi-, G., Salvatori, Franco, Trasforini, S., Uslenghi, C., Veggetti, S., Bartolucci, Giuliana, Baruffa, R., Bertelli, R., Borghi, L., Ciavarella, P., Paltrinieri, E., Rizzardi, F., Serra, P., Suzzi, D., Carlo, U., Arienti, P., Aureli, F., Avanzi, R., Callegari, V., Corsino, A., Host, P., Michetti, R., Rizzo, F., Simoncelli, P., Soldati, E., Succi, E., Bertozzi, M., Canetti, E., Cavicchioli, L., Ceccarelli, E., Cenni, S., Marzola, G., Gallina, V., Leoni, C., Olivieri, A., Piccolo, Elisa, Ravagli, S., Russo, R., Tedeschini, D., Verenini, M., Abram, W., Granata, V., Curcio, A., Guerra, G., Granini, S., Natali, L., Montanari, Eleonora, Pasi, F., Ventura, U., Valenti, S., Francesca, M., Farneti, R., Ravagli-, P., Floris, R., Maroncelli, O., Volpones, G., Casali, D., Bencini, A., Cellini, M., De Biase, L., Barbara, L., Charles, L., Pratesi, C., Tanini, A., Loparrino, R., Ulivelli, C., Cussoto, C., Dei, N., Fumanti, E., Pantani, M., Zeloni, G., Bellini-, R., Cellesi, R., Dorigo, N., Gullì, P., Ialeggio, L., Pisanu, M., Rinaldi, G., Konze, A., Modignani, L., Frova, M., Monzani, E., Amadè, E. S., Zanobio, A., Malagoli, M., Pagani-, R., Barbera, S., Morganti, C., Brambilla-, V., Montanari-, A., Caterina, G., LOPEZ CORTES, Carlo, Marocchi, A., Moletta, A., Sberna, M., Cascio, M. T., Manzone, M. L., Barbara-, B., Mari, L., Razzini, E., Bianchi-, Y., Pellizzer, M. R., Verdecchia, A., Sferrazza, M. G., Pismataro, R., D’Eril, G. V., Barassi, A., Pacciolla, R., Faraci, G., Rosmini, B., Carpi, F., Soelva, M., Anderlan, M., De Francesco, M., Duregger, E., Vettori, C., Doimo, S., Kompatscher, E., Forer, M., Kerschbaumer, H., Gampe, A., Nicoletti, M., Acerbi, C., Aquilino, D., Azzali, S., Bensi, L., Cappellari-, D., Casana, E., Campagnola, N., Dal Corso, E., Di Micco, E., Gobbi, E., Mairaghi, L., Malak, S., Mesiano, L., Paterlini, F., Perini, Matteo, Puliti, E. M., Rispoli, R., Rizzo-, E., Sergenti, C., Soave, M., Alpi, A., Bislenghi, L., Bolis, T., Colnaghi, F., Fascendini, S., Grignani, S., Patelli, G., Casale, S., Deledda, G., Goss, C., Mazzi-, M., Rimondini, M., Scassellati, C., Bonvicini, C., Longo, Salvatore, Bocchio Chiavetto, L., Ventriglia, M., Squitti, R., Frisoni, G., Pievani, M., Balestrieri, M., Atzori, M., Beltramello, A., Alessandrini, F., Pizzini, F., Zoccatelli, G., Politi, P., Emanuele, E., Brondino, N., Martino, G., Bergami, A., Zarbo, R., Riva, M. A., Fumagalli, F., Molteni, R., Calabrese, F., Guidotti, Giovanni, Luoni, Alessia, Macchi, F., Artioli, S., Baldetti, M., Bizzocchi, M., Bolzon, D., Bonello, E., Cacciari, G., Carraresi, C., Caselli, G., Furlato, K., Garlassi, S., Gavarini, A., Macchetti, F., Marteddu, V., Plebiscita, G., Totaro, S., Bebbington, P., Birchwood, M., Dazzan, P., Kuipers, E., Thornicroft, G., Pariante, C., Lawrie, S., Soares, J. C., Mirella Ruggeri, Chiara Bonetto, Antonio Lasalvia, Giovanni De Girolamo, Angelo Fioritti, Paola Rucci, Paolo Santonastaso, Giovanni Neri, Francesca Pileggi, Daniela Ghigi, Maurizio Miceli, Silvio Scarone, Angelo Cocchi, Stefano Torresani, Carlo Faravelli, Christa Zimmermann, Anna Meneghelli, Carla Cremonese, Paolo Scocco, Emanuela Leuci, Fausto Mazzi, Massimo Gennarelli, Paolo Brambilla, Sarah Bissoli, Maria Elena Bertani, Sarah Tosato, Katia De Santi, Sara Poli, Doriana Cristofalo, Michele Tansella, and and THE GET UP GROUP

Subjects
Research design, Time Factors, early psychosis, psychosocial interventions, cluster randomized triales, medicine.medical_treatment, Psychological intervention, Medicine (miscellaneous), Assertive community treatment, Severity of Illness Index, law.invention, Study Protocol, Randomized controlled trial, law, Recurrence, Early psychosi, Cluster Analysis, Pharmacology (medical), lcsh:R5-920, Family Relation, Community Mental Health Service, First-episode psychosis, Community Mental Health Center, Community Mental Health Services, Cognitive behavioral therapy, Treatment Outcome, Cognitive Therapy, Italy, Research Design, First-episode psychosisEarly psychosisCognitive behavioral therapyPsychosocial interventionAssertive community treatment, Family Relations, lcsh:Medicine (General), Psychosocial, Human, pragmatic trial, Early psychosis, Family intervention, Psychosocial intervention, Community Mental Health Centers, Humans, Patient Selection, Psychotic Disorders, Sample Size, Case Management, Cognitive Behavioral Therapy, medicine.medical_specialty, psychosocial interventions, Time Factor, cluster randomized triales, Psychotic Disorder, First-episode psychosi, medicine, Psychiatry, Cluster Analysi, business.industry, Mental health, Cognitive therapy, business
Abstract

Background Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in ‘real-world’ services. Methods/Design The Psychosis early Intervention and Assessment of Needs and Outcome (PIANO) trial is part of a larger research program (Genetics, Endophenotypes and Treatment: Understanding early Psychosis - GET UP) which aims to compare, at 9 months, the effectiveness of a multi-component psychosocial intervention versus treatment as usual (TAU) in a large epidemiologically based cohort of patients with FEP and their family members recruited from all public community mental health centers (CMHCs) located in two entire regions of Italy (Veneto and Emilia Romagna), and in the cities of Florence, Milan and Bolzano. The GET UP PIANO trial has a pragmatic cluster randomized controlled design. The randomized units (clusters) are the CMHCs, and the units of observation are the centers’ patients and their family members. Patients in the experimental group will receive TAU plus: 1) cognitive behavioral therapy sessions, 2) psycho-educational sessions for family members, and 3) case management. Patient enrolment will take place over a 1-year period. Several psychopathological, psychological, functioning, and service use variables will be assessed at baseline and follow-up. The primary outcomes are: 1) change from baseline to follow-up in positive and negative symptoms’ severity and subjective appraisal; 2) relapse occurrences between baseline and follow-up, that is, episodes resulting in admission and/or any case-note records of re-emergence of positive psychotic symptoms. The expected number of recruited patients is about 400, and that of relatives about 300. Owing to the implementation of the intervention at the CMHC level, the blinding of patients, clinicians, and raters is not possible, but every effort will be made to preserve the independency of the raters. We expect that this study will generate evidence on the best treatments for FEP, and will identify barriers that may hinder its feasibility in ‘real-world’ clinical settings, patient/family conditions that may render this intervention ineffective or inappropriate, and clinical, psychological, environmental, and service organization predictors of treatment effectiveness, compliance, and service satisfaction. Trial registration ClinicalTrials.gov Identifier NCT01436331

Published
2012

31. Evoluzione delle tecniche di controllo di getti di grandi dimensioni con metodo UT phased array.

Author

Gilardoni, C., Patelli, G., and Rocchi, C.

Subjects
*METAL castings, *ENGINEERING inspection, *TRANSDUCERS, *OPTICAL phased arrays, *INDUSTRIAL radiography
Abstract

This paper describes the new inspection methods of castings for oil and nuclear industry using phased array technique and dedicated probes. The phased array technique allows to considerably reduce the time of UT control thanks to a complete and exhaustive graphical representation of the analysis and thanks also to the use of a smaller number of transducers due to the versatility of the same. The time reduction joins a certain increase of the intrinsic quality of the PA technique, the ability to record the obtained results and the possibility of storage / display the performed exams. The PA technique is exactly at the halfway between the traditional ultrasonic inspection and the radiographic testing (often difficult to apply in service). It is possible to assume that, in the future, industrial radiography could be replaced by the phased array technique. [ABSTRACT FROM AUTHOR]

Published
2015

36. First clinical experience with a high-capacity implantable infusion pump for continuous intravenous chemotherapy.

Author

Damascelli, Bruno, Patelli, Gianluigi, Frigerio, Laura F., Lanocita, Rodolfo, Di Tolla, Giuseppe, Marchianò, Alfonso, Spreafico, Carlo, Garbagnati, Francesco, Bonalumi, Maria G., Monfardini, Lorenzo, Tichà, Vladimira, Prino, Aurelio, Damascelli, B, Patelli, G, Frigerio, L F, Lanocita, R, Di Tolla, G, Marchianò, A, Spreafico, C, and Garbagnati, F

Abstract

Purpose: To evaluate the efficiency of a new high-capacity pump for systemic venous chemotherapy and to verify the quality of implantation by interventional radiology staff.Methods: A total of 47 infusion pumps with a 60-ml reservoir and variable flow rates (2, 6, 8, or 12 ml/24 hr) were implanted by radiologists in 46 patients with solid tumor metastases requiring treatment with a single, continuously infused cytostatic agent. The reservoir was refilled transcutaneously, usually once weekly. The flow accuracy of the pump was assessed from actual drug delivery recorded on 34 patients over a minimum observation period of 180 days.Results: No early complications occurred in any of the 47 implants in 46 patients. A total of 12 (25.53%) complications occurred between 3 and 24 months after implantation. Seven (14.90%) of these were due to the external design of the pump, while five (10.63%) were related to the central venous catheter. In the 34 patients available for pump evaluation (follow-up of at least 180 days), the system was used for a total of 14,191 days (range 180-911 days, mean 417.38 days), giving an overall complication rate of 0.84 per 1000 days of operation. The mean flow rate accuracy was 90.26%.Conclusion: The new implantable pump showed good flow rate accuracy and reliable operation. The pump-related complications were related to its external design and have now been corrected by appropriate modifications. From a radiologic and surgical viewpoint, the venous implantation procedure is identical to that of conventional vascular access devices and can be performed by radiologists familiar with these techniques. The current limitations lie in the high cost of the pump and, for certain drugs, the short time between refills. [ABSTRACT FROM AUTHOR]

Published
1999
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42. Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients

Author

Giovanni Landoni, Andrea Biagi, Nicola Sverzellati, Roberto Ferrari, Fabio Anastasio, Gianluigi Patelli, Claudia Costa, Piergiorgio Turchio, Arif A. Khokhar, Alessandra Scoccia, Pietro Andrea Bonaffini, Cristiano Spreafico, Camillo Talei Franzesi, Gianni Casella, Edda Boccia, Antonio Esposito, Marco Toselli, Aldo P. Maggioni, Elisabetta Mancini, Chiara Gnasso, Luigi Vignali, Alessandro Sticchi, Elisa Scarnecchia, Antonio Colombo, Giacomo Bellani, Gianluca Pontone, Alberto Cereda, Caterina Chiara De Carlini, Marco Manfrini, Francesco Ponticelli, Stefano Maggiolini, Anna Palmisano, Claudio Rapezzi, Marco Loffi, Alberto Pacielli, Francesca Besana, Michele Senni, Lucio Baffoni, Sandro Sironi, Evgeny Fominskiy, Gianmarco Iannopollo, Francesco De Cobelli, Daniele Andreini, Giorgio Benatti, Paolo Giacomo Vaudano, Francesco Giannini, Gian Battista Danzi, Chiara Micossi, Alberto Monello, Tommaso Nannini, Massimiliano Sperandio, Carlo Tacchetti, Mario Iannaccone, Davide Vignale, Attilio Iacovoni, Riccardo Leone, Davide Ippolito, Gianluca Campo, Francesco Paolo Lombardo, Elisabetta Cesini, Valeria Nicoletti, Margherita Muri, Iljia Gardi, Giannini, F., Toselli, M., Palmisano, A., Cereda, A., Vignale, D., Leone, R., Nicoletti, V., Gnasso, C., Monello, A., Manfrini, M., Khokhar, A., Sticchi, A., Biagi, A., Turchio, P., Tacchetti, C., Landoni, G., Boccia, E., Campo, G., Scoccia, A., Ponticelli, F., Danzi, G. B., Loffi, M., Muri, M., Pontone, G., Andreini, D., Mancini, E. M., Casella, G., Iannopollo, G., Nannini, T., Ippolito, D., Bellani, G., Franzesi, C. T., Patelli, G., Besana, F., Costa, C., Vignali, L., Benatti, G., Sverzellati, N., Scarnecchia, E., Lombardo, F. P., Anastasio, F., Iannaccone, M., Vaudano, P. G., Pacielli, A., Baffoni, L., Gardi, I., Cesini, E., Sperandio, M., Micossi, C., De Carlini, C. C., Spreafico, C., Maggiolini, S., Bonaffini, P. A., Iacovoni, A., Sironi, S., Senni, M., Fominskiy, E., De Cobelli, F., Maggioni, A. P., Rapezzi, C., Ferrari, R., Colombo, A., Esposito, A., Giannini, F, Toselli, M, Palmisano, A, Cereda, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Manfrini, M, Khokhar, A, Sticchi, A, Biagi, A, Turchio, P, Tacchetti, C, Landoni, G, Boccia, E, Campo, G, Scoccia, A, Ponticelli, F, Danzi, G, Loffi, M, Muri, M, Pontone, G, Andreini, D, Mancini, E, Casella, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Franzesi, C, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Sverzellati, N, Scarnecchia, E, Lombardo, F, Anastasio, F, Iannaccone, M, Vaudano, P, Pacielli, A, Baffoni, L, Gardi, I, Cesini, E, Sperandio, M, Micossi, C, De Carlini, C, Spreafico, C, Maggiolini, S, Bonaffini, P, Iacovoni, A, Sironi, S, Senni, M, Fominskiy, E, De Cobelli, F, Maggioni, A, Rapezzi, C, Ferrari, R, Colombo, A, and Esposito, A

Subjects
Aortic valve, Male, Computed Tomography Angiography, Aorta, Thoracic, 030204 cardiovascular system & hematology, Severity of Illness Index, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Thoracic aorta, Aged, 80 and over, Middle Aged, Coronary Vessels, Pathophysiology, Calcium score, In-hospital mortality, medicine.anatomical_structure, Italy, Aortic Valve, Cardiology, Aortic valve, Calcification, Calcium score, Coronary artery, COVID-19, Thoracic aorta, In-hospital mortality, Female, Cardiology and Cardiovascular Medicine, Artery, Research Paper, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Aortic Diseases, chemistry.chemical_element, Calcium, Coronary artery, NO, Calcification, 03 medical and health sciences, Predictive Value of Tests, medicine.artery, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Vascular Calcification, Aged, Retrospective Studies, business.industry, SARS-CoV-2, COVID-19, medicine.disease, Pneumonia, chemistry, business
Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated. OBJECTIVES: The aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients. METHODS: 1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients' outcomes. RESULTS: Non-survivors compared to survivors had higher coronary artery [Agatston (467.76 ​± ​570.92 vs 206.80 ​± ​424.13 ​mm2, p ​

Published
2021

43. Impact of clinical and subclinical coronary artery disease as assessed by coronary artery calcium in COVID-19

Author

Arif A. Khokhar, Alberto Pacielli, Francesco Ponticelli, Marco Toselli, Gianmarco Iannopollo, Alberto Monello, Davide Ippolito, Antonio Colombo, Alessandro Sticchi, Antonio Esposito, Anna Palmisano, Luigi Vignali, Gianluca Campo, Pietro Andrea Bonaffini, Valeria Nicoletti, Caterina Chiara De Carlini, Daniele Andreini, Claudia Costa, Riccardo Leone, Giorgio Benatti, Giacomo Bellani, Marco Loffi, Andrea Biagi, Carlo Tacchetti, Fabio Anastasio, Elisa Scarnecchia, Chiara Gnasso, Alessandra Scoccia, Stefano Maggiolini, Gian Battista Danzi, Roberto Ferrari, Francesca Besana, Gianluigi Patelli, Claudio Rapezzi, Mario Iannaccone, Davide Vignale, Michele Senni, Gianluca Pontone, Guglielmo Gallone, Francesco Giannini, Gianni Casella, Alberto Cereda, Paolo Giacomo Vaudano, Scoccia, A, Gallone, G, Cereda, A, Palmisano, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Khokhar, A, Sticchi, A, Biagi, A, Tacchetti, C, Campo, G, Rapezzi, C, Ponticelli, F, Danzi, G, Loffi, M, Pontone, G, Andreini, D, Casella, G, Iannopollo, G, Ippolito, D, Bellani, G, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Iannaccone, M, Vaudano, P, Pacielli, A, De Carlini, C, Maggiolini, S, Bonaffini, P, Senni, M, Scarnecchia, E, Anastasio, F, Colombo, A, Ferrari, R, Esposito, A, Giannini, F, Toselli, M, Scoccia, A., Gallone, G., Cereda, A., Palmisano, A., Vignale, D., Leone, R., Nicoletti, V., Gnasso, C., Monello, A., Khokhar, A., Sticchi, A., Biagi, A., Tacchetti, C., Campo, G., Rapezzi, C., Ponticelli, F., Danzi, G. B., Loffi, M., Pontone, G., Andreini, D., Casella, G., Iannopollo, G., Ippolito, D., Bellani, G., Patelli, G., Besana, F., Costa, C., Vignali, L., Benatti, G., Iannaccone, M., Vaudano, P. G., Pacielli, A., De Carlini, C. C., Maggiolini, S., Bonaffini, P. A., Senni, M., Scarnecchia, E., Anastasio, F., Colombo, A., Ferrari, R., Esposito, A., Giannini, F., and Toselli, M.

Subjects
0301 basic medicine, Male, medicine.medical_specialty, coronary artery calcifications, Coronary Artery Disease, Coronary artery calcification, 030204 cardiovascular system & hematology, Coronary Angiography, Agatston score, Coronary artery disease, Article, NO, COVID-19, Coronary artery disease, Atherosclerosis, Agatston score, Coronary artery calcifications, Calcium score, In-hospital mortality, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Risk Factors, Internal medicine, Coronary artery calcifications, Clinical endpoint, Medicine, Humans, Myocardial infarction, cardiovascular diseases, Coronary atherosclerosis, Subclinical infection, Aged, Retrospective Studies, business.industry, SARS-CoV-2, Hazard ratio, COVID-19, Middle Aged, medicine.disease, Atherosclerosis, Coronary Vessels, Calcium score, In-hospital mortality, 030104 developmental biology, Atherosclerosi, Cardiology, Calcium, atherosclerosis, Cardiology and Cardiovascular Medicine, business
Abstract

Background and aims The potential impact of coronary atherosclerosis, as detected by coronary artery calcium, on clinical outcomes in COVID-19 patients remains unsettled. We aimed to evaluate the prognostic impact of clinical and subclinical coronary artery disease (CAD), as assessed by coronary artery calcium score (CAC), in a large, unselected population of hospitalized COVID-19 patients undergoing non-gated chest computed tomography (CT) for clinical practice. Methods SARS-CoV 2 positive patients from the multicenter (16 Italian hospitals), retrospective observational SCORE COVID-19 (calcium score for COVID-19 Risk Evaluation) registry were stratified in three groups: (a) “clinical CAD” (prior revascularization history), (b) “subclinical CAD” (CAC >0), (c) “No CAD” (CAC=0). Primary endpoint was in-hospital mortality and the secondary endpoint was a composite of myocardial infarction and cerebrovascular accident (MI/CVA). Results Amongst 1625 patients (male 67.2%, median age 69 [interquartile range 58-77] years), 31%, 57.8% and 11.1% had no, subclinical and clinical CAD, respectively. Increasing rates of in-hospital mortality (11.3% vs. 27.3% vs. 39.8%, p400, respectively, p, Graphical abstract Image 1

Published
2021

44. Chest CT–derived pulmonary artery enlargement at the admission predicts overall survival in COVID-19 patients: insight from 1461 consecutive patients in Italy

Author

Alberto Monello, Gianluigi Patelli, Tommaso Nannini, Gianmarco Iannopollo, Antonio Esposito, Francesco De Cobelli, Anna Palmisano, Piergiorgio Turchio, Giovanni Landoni, Chiara Gnasso, Gianluca Pontone, Luisa Di Mare, Carlo Tacchetti, Clelia Di Serio, Antonio Colombo, Sandro Sironi, Marco Loffi, Fabio Ciceri, Andrea Biagi, Elisabetta Mancini, Daniele Andreini, Riccardo Leone, Pietro Sergio, Alberto Zangrillo, Giacomo Monti, Gianni Casella, Paola M.V. Rancoita, Alberto Cereda, Davide Vignale, Guglielmo Gallone, Francesco Giannini, Valeria Nicoletti, Davide Ippolito, Marco Toselli, Esposito, A, Palmisano, A, Toselli, M, Vignale, D, Cereda, A, Rancoita, P, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Biagi, A, Turchio, P, Landoni, G, Gallone, G, Monti, G, Casella, G, Iannopollo, G, Nannini, T, Patelli, G, Di Mare, L, Loffi, M, Sergio, P, Ippolito, D, Sironi, S, Pontone, G, Andreini, D, Mancini, E, Di Serio, C, De Cobelli, F, Ciceri, F, Zangrillo, A, Colombo, A, Tacchetti, C, Giannini, F, Esposito, Antonio, Palmisano, Anna, Toselli, Marco, Vignale, Davide, Cereda, Alberto, Rancoita, Paola Maria Vittoria, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Biagi, Andrea, Turchio, Piergiorgio, Landoni, Giovanni, Gallone, Guglielmo, Monti, Giacomo, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Patelli, Gianluigi, Di Mare, Luisa, Loffi, Marco, Sergio, Pietro, Ippolito, Davide, Sironi, Sandro, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Di Serio, Clelia, De Cobelli, Francesco, Ciceri, Fabio, Zangrillo, Alberto, Colombo, Antonio, Tacchetti, Carlo, and Giannini, Francesco

Subjects
Male, Thorax, medicine.medical_specialty, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine.artery, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Lung volumes, Aged, Retrospective Studies, medicine.diagnostic_test, SARS-CoV-2, business.industry, Tomography, X-ray computed, Hazard ratio, COVID-19, Interventional radiology, General Medicine, medicine.disease, Pulmonary hypertension, Pulmonary artery, Pneumonia, Italy, Hypertension, pulmonary, Radiology Nuclear Medicine and imaging, Chest, Female, Radiology, business, Cohort study
Abstract

Objectives Enlarged main pulmonary artery diameter (MPAD) resulted to be associated with pulmonary hypertension and mortality in a non-COVID-19 setting. The aim was to investigate and validate the association between MPAD enlargement and overall survival in COVID-19 patients. Methods This is a cohort study on 1469 consecutive COVID-19 patients submitted to chest CT within 72 h from admission in seven tertiary level hospitals in Northern Italy, between March 1 and April 20, 2020. Derivation cohort (n = 761) included patients from the first three participating hospitals; validation cohort (n = 633) included patients from the remaining hospitals. CT images were centrally analyzed in a core-lab blinded to clinical data. The prognostic value of MPAD on overall survival was evaluated at adjusted and multivariable Cox’s regression analysis on the derivation cohort. The final multivariable model was tested on the validation cohort. Results In the derivation cohort, the median age was 69 (IQR, 58–77) years and 537 (70.6%) were males. In the validation cohort, the median age was 69 (IQR, 59–77) years with 421 (66.5%) males. Enlarged MPAD (≥ 31 mm) was a predictor of mortality at adjusted (hazard ratio, HR [95%CI]: 1.741 [1.253–2.418], p p = 0.005), together with male gender, old age, high creatinine, low well-aerated lung volume, and high pneumonia extension (c-index [95%CI] = 0.826 [0.796–0.851]). Model discrimination was confirmed on the validation cohort (c-index [95%CI] = 0.789 [0.758–0.823]), also using CT measurements from a second reader (c-index [95%CI] = 0.790 [0.753;0.825]). Conclusion Enlarged MPAD (≥ 31 mm) at admitting chest CT is an independent predictor of mortality in COVID-19. Key Points •Enlargement of main pulmonary artery diameter at chest CT performed within 72 h from the admission was associated with a higher rate of in-hospital mortality in COVID-19 patients. •Enlargement of main pulmonary artery diameter (≥ 31 mm) was an independent predictor of death in COVID-19 patients at adjusted and multivariable regression analysis. •The combined evaluation of clinical findings, lung CT features, and main pulmonary artery diameter may be useful for risk stratification in COVID-19 patients.

Published
2020
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45. COVID-19 pneumonia: computer-aided quantification of healthy lung parenchyma, emphysema, ground glass and consolidation on chest computed tomography (CT)

Author

Palmino Sacco, Salvatore Cappabianca, Roberta Fusco, Gianluigi Patelli, Beatrice Feragalli, Maria Antonietta Mazzei, Vincenza Granata, Antonella Petrillo, Alfonso Reginelli, Alessandro Montanelli, Fabrizio Urraro, Giuliana Giacobbe, Maria Paola Belfiore, Roberto Grassi, Grassi, R., Belfiore, M. P., Montanelli, A., Patelli, G., Urraro, F., Giacobbe, G., Fusco, R., Granata, V., Petrillo, A., Sacco, P., Mazzei, M. A., Feragalli, B., Reginelli, A., and Cappabianca, S.

Subjects
Adult, Male, Computer tool, Chest Radiology, X-ray computed, Ground-glass opacity, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Parenchyma, medicine, Humans, Radiology, Nuclear Medicine and imaging, Lung, Tomography, Aged, Volume quantification, Neuroradiology, Aged, 80 and over, SARS-CoV-2, business.industry, Ultrasound, COVID-19, General Medicine, Middle Aged, medicine.disease, Pneumonia, medicine.anatomical_structure, Pulmonary Emphysema, Radiology Nuclear Medicine and imaging, COVID-19 Nucleic Acid Testing, 030220 oncology & carcinogenesis, Viral pneumonia, Radiographic Image Interpretation, Computer-Assisted, Female, medicine.symptom, Tomography, X-Ray Computed, business, Nuclear medicine, Software
Abstract

Objective: To calculate by means of a computer-aided tool the volumes of healthy residual lung parenchyma, of emphysema, of ground glass opacity (GGO) and of consolidation on chest computed tomography (CT) in patients with suspected viral pneumonia by COVID-19. Materials and methods: This study included 116 patients that for suspected COVID-19 infection were subjected to the reverse transcription real-time fluorescence polymerase chain reaction (RT-PCR) test. A computer-aided tool was used to calculate on chest CT images healthy residual lung parenchyma, emphysema, GGO and consolidation volumes for both right and left lung. Expert radiologists, in consensus, assessed the CT images using a structured report and attributed a radiological severity score at the disease pulmonary involvement using a scale of five levels. Nonparametric test was performed to assess differences statistically significant among groups. Results: GGO was the most represented feature in suspected CT by COVID-19 infection; it is present in 102/109 (93.6%) patients with a volume percentage value of 19.50% and a median value of 0.64 L, while the emphysema and consolidation volumes were low (0.01 L and 0.03 L, respectively). Among quantified volume, only GGO volume had a difference statistically significant between the group of patients with suspected versus non-suspected CT for COVID-19 (p < < 0.01). There were differences statistically significant among the groups based on radiological severity score in terms of healthy residual parenchyma volume, of GGO volume and of consolidations volume (p < < 0.001). Conclusion: We demonstrated that, using a computer-aided tool, the COVID-19 pneumonia was mirrored with a percentage median value of GGO of 19.50% and that only GGO volume had a difference significant between the patients with suspected or non-suspected CT for COVID-19 infection.

Published
2020
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46. The hidden interplay between sex and COVID-19 mortality: the role of cardiovascular calcification

Author

Matteo Bertini, Alberto Monello, Marco Toselli, Francesco Giannini, Mario Iannaccone, Davide Vignale, Alessandra Scoccia, Tommaso Nannini, Francesca Besana, Gianluca Campo, Luigi Vignali, Anna Palmisano, Antonio Esposito, Giuseppe Sangiorgi, Chiara Gnasso, Davide Ippolito, Daniele Andreini, Riccardo Leone, Pietro Sergio, Piergiorgio Turchio, Antonio Mangieri, Arif A Khokhar, Valeria Nicoletti, Gianluigi Patelli, Paolo Giacomo Vaudano, Antonio Colombo, Alberto Cereda, G Pontone, Claudio Rapezzi, Aldo P. Maggioni, Gianmarco Iannopollo, Nicola Sverzellati, Marco Loffi, Giacomo Bellani, Gabriele Tumminello, Cereda, A, Toselli, M, Palmisano, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Mangieri, A, Khokhar, A, Campo, G, Scoccia, A, Bertini, M, Loffi, M, Sergio, P, Andreini, D, Pontone, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Patelli, G, Besana, F, Vignali, L, Sverzellati, N, Iannaccone, M, Vaudano, P, Sangiorgi, G, Turchio, P, Monello, A, Tumminello, G, Maggioni, A, Rapezzi, C, Colombo, A, Giannini, F, and Esposito, A

Subjects
Cardiovascular calcifications, Male, Aging, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Context (language use), Aorta, Thoracic, 030204 cardiovascular system & hematology, Sex bia, Sars-CoV2, NO, Settore MED/11, 03 medical and health sciences, 0302 clinical medicine, Cardiovascular calcification, Internal medicine, medicine.artery, Lung CT, Medicine, Thoracic aorta, Humans, 030212 general & internal medicine, Vascular Calcification, Aged, Aged, 80 and over, Sex bias, business.industry, SARS-CoV-2, Mortality rate, COVID-19, medicine.disease, Sex bias, Sars-CoV2, Lung CT, Cardiovascular calcifcations, COVID-19, Coronary Calcium Score, Pneumonia, Coronary artery calcification, RNA, Viral, Cardiovascular calcifcations, Female, Original Article, Geriatrics and Gerontology, business
Abstract

Recent clinical and demographical studies on COVID-19 patients have demonstrated that men experience worse outcomes than women. However, in most cases, the data were not stratified according to gender, limiting the understanding of the real impact of gender on outcomes. This study aimed to evaluate the disaggregated in-hospital outcomes and explore the possible interactions between gender and cardiovascular calcifications. Data was derived from the sCORE-COVID-19 registry, an Italian multicentre registry that enrolled COVID-19 patients who had undergone a chest computer tomography scan on admission. A total of 1683 hospitalized patients (mean age 67±14 years) were included. Men had a higher prevalence of cardiovascular comorbidities, a higher pneumonia extension, more coronary calcifications (63% vs.50.9%, p3, pp=0.001), but the death event tended to occur earlier in women (15±7 vs. 8±7 days, p= 0.07). Non-survivors had a higher coronary, thoracic aorta, and aortic valve calcium score. Female sex, a known independent predictor of a favorable outcome in SARS-CoV2 infection, was not protective in women with a coronary calcification volume greater than 100 mm3. There were significant differences in cardiovascular comorbidities and vascular calcifications between men and women with SARS-CoV2 pneumonia. The differences in outcomes can be at least partially explained by the different cardiovascular profiles. However, women with poor outcomes had the same coronary calcific burden as men. The presumed favorable female sex bias in COVID-19 must therefore be reviewed in the context of comorbidities, especially cardiovascular ones.

Published
2021

47. Coronavirus Disease 2019 (COVID-19) in Italy: Double Reading of Chest CT Examination

Author

Maria Paola Belfiore, Gaetano Maria Russo, Roberta Grassi, Salvatore Cappabianca, Palmino Sacco, Roberta Fusco, Gianluigi Patelli, Giuliana Giacobbe, Antonella Petrillo, Roberto Grassi, Vincenza Granata, Alessandro Montanelli, Fabrizio Urraro, Michelearcangelo La Porta, Alfonso Reginelli, Beatrice Feragalli, Reginelli, A., Grassi, R., Feragalli, B., Belfiore, M. P., Montanelli, A., Patelli, G., La Porta, M., Urraro, F., Fusco, R., Granata, V., Petrillo, A., Giacobbe, G., Russo, G. M., Sacco, P., and Cappabianca, S.

Subjects
radiological signs, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Concordance, Chest ct, chest CT, Biology, Article, Radiological sign, General Biochemistry, Genetics and Molecular Biology, double reading, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Structured reporting, medicine, 030212 general & internal medicine, lcsh:QH301-705.5, General Immunology and Microbiology, Double reading, COVID-19, Retrospective cohort study, medicine.disease, structured report, lcsh:Biology (General), Viral pneumonia, Radiological weapon, Radiology, General Agricultural and Biological Sciences
Abstract

To assess the performance of the second reading of chest compute tomography (CT) examinations by expert radiologists in patients with discordance between the reverse transcription real-time fluorescence polymerase chain reaction (RT-PCR) test for COVID-19 viral pneumonia and the CT report. Three hundred and seventy-eight patients were included in this retrospective study (121 women and 257 men, 71 years median age, with a range of 29&ndash, 93 years) and subjected to RT-PCR tests for suspicious COVID-19 infection. All patients were subjected to CT examination in order to evaluate the pulmonary disease involvement by COVID-19. CT images were reviewed first by two radiologists who identified COVID-19 typical CT patterns and then reanalyzed by another two radiologists using a CT structured report for COVID-19 diagnosis. Weighted k values were used to evaluate the inter-reader agreement. The median temporal window between RT-PCRs execution and CT scan was zero days with a range of (&minus, 9, 11) days. The RT-PCR test was positive in 328/378 (86.8%). Discordance between RT-PCR and CT findings for viral pneumonia was revealed in 60 cases. The second reading changed the CT diagnosis in 16/60 (26.7%) cases contributing to an increase the concordance with the RT-PCR. Among these 60 cases, eight were false negative with positive RT-PCR, and 36 were false positive with negative RT-PCR. Sensitivity, specificity, positive predictive value and negative predictive value of CT were respectively of 97.3%, 53.8%, 89.0%, and 88.4%. Double reading of CT scans and expert second readers could increase the diagnostic confidence of radiological interpretation in COVID-19 patients.

Published
2021

48. Chest CT Computerized Aided Quantification of PNEUMONIA Lesions in COVID-19 Infection: A Comparison among Three Commercial Software

Author

Cesare Paura, Alessandro Montanelli, Fabrizio Urraro, Vincenza Granata, Gianluigi Patelli, Simona Magliocchetti, Giuliana Giacobbe, Roberta Fusco, Diletta Cozzi, Assunta Grillo, Giuliano Gagliardi, Roberta Grassi, Alfredo Clemente, Beatrice Feragalli, Roberto Grassi, Vittorio Miele, Maria Paola Belfiore, Gaetano Maria Russo, Salvatore Cappabianca, Angela De Lisio, Grassi, R., Cappabianca, S., Urraro, F., Feragalli, B., Montanelli, A., Patelli, G., Granata, V., Giacobbe, G., Russo, G. M., Grillo, A., De Lisio, A., Paura, C., Clemente, A., Gagliardi, G., Magliocchetti, S., Cozzi, D., Fusco, R., Belfiore, M. P., and Miele, V.

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Health, Toxicology and Mutagenesis, Pneumonia, Viral, lcsh:Medicine, Spearman's rank correlation coefficient, Severity of Illness Index, Article, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Software, Retrospective Studie, Severity of illness, medicine, Humans, Diagnosis, Computer-Assisted, Pandemics, Retrospective Studies, Commercial software, Pandemic, business.industry, Coronavirus Infection, lcsh:R, Public Health, Environmental and Occupational Health, COVID-19, Retrospective cohort study, computed tomography, computer-aided quantification, medicine.disease, Feasibility Studie, Pneumonia, 030220 oncology & carcinogenesis, Radiological weapon, Feasibility Studies, Radiology, business, Coronavirus Infections, Tomography, X-Ray Computed, Human
Abstract

Purpose: To compare different commercial software in the quantification of Pneumonia Lesions in COVID-19 infection and to stratify the patients based on the disease severity using on chest computed tomography (CT) images. Materials and methods: We retrospectively examined 162 patients with confirmed COVID-19 infection by reverse transcriptase-polymerase chain reaction (RT-PCR) test. All cases were evaluated separately by radiologists (visually) and by using three computer software programs: (1) Thoracic VCAR software, GE Healthcare, United States, (2) Myrian, Intrasense, France, (3) InferRead, InferVision Europe, Wiesbaden, Germany. The degree of lesions was visually scored by the radiologist using a score on 5 levels (none, mild, moderate, severe, and critic). The parameters obtained using the computer tools included healthy residual lung parenchyma, ground-glass opacity area, and consolidation volume. Intraclass coefficient (ICC), Spearman correlation analysis, and non-parametric tests were performed. Results: Thoracic VCAR software was not able to perform volumes segmentation in 26/162 (16.0%) cases, Myrian software in 12/162 (7.4%) patients while InferRead software in 61/162 (37.7%) patients. A great variability (ICC ranged for 0.17 to 0.51) was detected among the quantitative measurements of the residual healthy lung parenchyma volume, GGO, and consolidations volumes calculated by different computer tools. The overall radiological severity score was moderately correlated with the residual healthy lung parenchyma volume obtained by ThoracicVCAR or Myrian software, with the GGO area obtained by the ThoracicVCAR tool and with consolidation volume obtained by Myrian software. Quantified volumes by InferRead software had a low correlation with the overall radiological severity score. Conclusions: Computer-aided pneumonia quantification could be an easy and feasible way to stratify COVID-19 cases according to severity, however, a great variability among quantitative measurements provided by computer tools should be considered.

Published
2020
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49. Intraarterial chemotherapy with polyoxyethylated castor oil free paclitaxel, incorporated in albumin nanoparticles (ABI-007): Phase I study of patients with squamous cell carcinoma of the head and neck and anal canal: preliminary evidence of clinical activity

Author

B, Damascelli, G, Cantù, F, Mattavelli, P, Tamplenizza, P, Bidoli, E, Leo, F, Dosio, A M, Cerrotta, G, Di Tolla, L F, Frigerio, F, Garbagnati, R, Lanocita, A, Marchianò, G, Patelli, C, Spreafico, V, Tichà, V, Vespro, F, Zunino, Damascelli, B, Cantù, G, Mattavelli, F, Tamplenizza, P, Bidoli, P, Leo, E, Dosio, F, Cerrotta, A, Di Tolla, G, Frigerio, L, Garbagnati, F, Lanocita, R, Marchianò, A, Patelli, G, Spreafico, C, Tichà, V, Vespro, V, and Zunino, F

Subjects
Adult, Male, squamous cell carcinoma, Castor Oil, Neutropenia, taxanes, paclitaxel, intraarterial chemotherapy, nanoparticles, Chemistry, Pharmaceutical, Middle Aged, Anus Neoplasms, Antineoplastic Agents, Phytogenic, Surface-Active Agents, Treatment Outcome, Head and Neck Neoplasms, Albumins, paclitaxel-albumin nanoparticles, Carcinoma, Squamous Cell, Humans, Infusions, Intra-Arterial, Female, Particle Size, Aged
Abstract

BACKGROUND. This study was designed to determine the feasibility, maximum tolerated dose, and toxicities of intraarterial administration of paclitaxel-albumin nanoparticles in patients with advanced head and neck and recurrent anal canal squamous cell carcinoma. Antitumor activity also was assessed. METHODS. Forty-three patients (31 with advanced head and neck and 12 with recurrent anal canal squamous cell carcinoma) were treated intraarterially with ABI-007 every 4 weeks for 3 cycles. In total, 120 treatment cycles were completed, 86 in patients with head and neck carcinoma (median, 3 cycles; range, 1-4) and 34 in patients with anal canal carcinoma (median, 3 cycles; range, 1-4). ABI-007 was compared preliminarily with Taxol® for in vitro cytostatic activity. Increasing dose levels from 120 to 300 mg/m2 were studied in 18 patients. Pharmacokinetic profiles after intraarterial administration were obtained in a restricted number of patients. RESULTS. The dose-limiting toxicity of ABI-007 was myelosuppression consisting of Grade 4 neutropenia in 3 patients. Nonhematologic toxicities included total alopecia (30 patients), gastrointestinal toxicity (3 patients, Grade 2), skin toxicity (5 patients, Grade 2), neurologic toxicity (4 patients, Grade 2) ocular toxicity (1 patient, Grade 2), flu-like syndrome (7 patients, Grade 2; 1 patient, Grade 3). In total, 120 transfemoral, percutaneous catheterization procedure-related complications occurred only during catheterization of the neck vessels in 3 patients (2 TIA, 1 hemiparesis) and resolved spontaneously. CONCLUSIONS. Intraarterial administration of ABI-007 by percutaneous catheterization does not require premedication, is easy and reproducible, and has acceptable toxicity. The maximum tolerated dose in a single administration was 270 mg/m2. Most dose levels showed considerable antitumor activity (42 assessable patients with 80.9% complete response and partial response). The recommended Phase II dose is 230 mg/m2 every 3 weeks

Published
2001

50. Clinicopathological characterisation of MTAP alterations in gastrointestinal cancers.

Author

Mauri G, Patelli G, Roazzi L, Valtorta E, Amatu A, Marrapese G, Bonazzina E, Tosi F, Bencardino K, Ciarlo G, Mariella E, Marsoni S, Bardelli A, Bonoldi E, Sartore-Bianchi A, and Siena S

Subjects
Humans, Female, Male, Middle Aged, Aged, Case-Control Studies, Cyclin-Dependent Kinase Inhibitor p16 metabolism, Cyclin-Dependent Kinase Inhibitor p16 genetics, Prognosis, Immunohistochemistry, Cyclin-Dependent Kinase Inhibitor p15 genetics, Adult, Aged, 80 and over, Mutation, High-Throughput Nucleotide Sequencing, Microsatellite Instability, Purine-Nucleoside Phosphorylase genetics, Gastrointestinal Neoplasms pathology, Gastrointestinal Neoplasms genetics, Biomarkers, Tumor genetics, Biomarkers, Tumor analysis
Abstract

Background: Methylthioadenosine phosphorylase (MTAP) is an essential metabolic enzyme in the purine and methionine salvage pathway. In cancer, MTAP gene copy number loss ( MTAP loss) confers a selective dependency on the related protein arginine methyltransferase 5. The impact of MTAP alterations in gastrointestinal (GI) cancers remains unknown although hypothetically druggable. Here, we aim to investigate the prevalence, clinicopathological features and prognosis of MTAP loss GI cancers., Methods: Cases with MTAP alterations were retrieved from The Cancer Genome Atlas (TCGA) and a real-world cohort of GI cancers profiled by next-generation sequencing. If MTAP alterations other than loss were found, immunohistochemistry was performed. Finally, we set a case-control study to assess MTAP loss prognostic impact., Results: Findings across the TCGA dataset (N=1363 patients) and our cohort (N=508) were consistent. Gene loss was the most common MTAP alteration (9.4%), mostly co-occurring with CDKN2A/B loss (97.7%). Biliopancreatic and gastro-oesophageal cancers had the highest prevalence of MTAP loss (20.5% and 12.7%, respectively), being mostly microsatellite stable (99.2%). In colorectal cancer, MTAP loss was rare (1.1%), while most MTAP alterations were mutations (5/7, 71.4%); among the latter, only MTAP-CDKN2B truncation led to protein loss, thus potentially actionable. MTAP loss did not confer worse prognosis., Conclusions: MTAP alterations are found in 5%-10% of GI cancers, most frequently biliopancreatic and gastro-oesophageal. MTAP loss is the most common alteration, identified almost exclusively in MSS, CDKN2A/B loss, upper-GI cancers. Other MTAP alterations were found in colorectal cancer, but unlikely to cause protein loss and drug susceptibility., Competing Interests: Competing interests: AB reports personal fees from Guardant Health and Inivata during the conduct of the study as well as grants from AstraZeneca, Boehringer-Ingelheim and Neophore outside the submitted work; in addition, AB is a shareholder of Neophore and Kither. SS is an advisory board member for Agenus, AstraZeneca, Bayer, BMS, CheckmAb, Daiichi-Sankyo, Guardant Health,Merck, Novartis, Roche-Genentech and Seagen. AS-B reports personal fees from Amgen, Bayer, Servier, Guardant Health and Novartis during the conduct of the study. GMauri and GP received honoraria from COR2ED., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.)

Published
2025
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