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1. Minimal Clinically Important Difference in Barthel Index Dyspnea in Patients with COPD

Author

Vitacca M, Malovini A, Balbi B, Aliani M, Cirio S, Spanevello A, Fracchia C, Maniscalco M, Corica G, Ambrosino N, and Paneroni M

Subjects
activities of daily life, breathlessness, dyspnea, chronic respiratory failure, exercise training, health related quality of life, rehabilitation, Diseases of the respiratory system, RC705-779
Abstract

Michele Vitacca,1 Alberto Malovini,2 Bruno Balbi,3 Maria Aliani,4 Serena Cirio,5 Antonio Spanevello,6,7 Claudio Fracchia,8 Mauro Maniscalco,9 Giacomo Corica,10 Nicolino Ambrosino,8 Mara Paneroni1 1Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Lumezzane, Brescia, Italy; 2Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Informatics and Systems Engineering for Clinical Research of the Institute of Pavia, Pavia, Italy; 3Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Veruno, Novara, Italy; 4Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Cassano Delle Murge, Bari, Italy; 5Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Pavia, Pavia, Italy; 6Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Tradate, Varese, Italy; 7University of Insubria, MACRO, Varese, Italy; 8Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Montescano, Pavia, Italy; 9Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Telese, Benevento, Italy; 10Istituti Clinici Scientifici Maugeri IRCCS, Health Directorate of the Institute of Lumezzane, Brescia, ItalyCorrespondence: Michele VitaccaIstituti Clinici Scientifici Maugeri IRCCS, Via Salvatore Maugeri, 4, Pavia 27100, ItalyEmail michele.vitacca@icsmaugeri.itBackground: The Barthel Index dyspnea (BId) is responsive to physiological changes and pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). However, the minimum clinically important difference (MCID) has not been established yet.Aim: To identify the MCID of BId in patients with COPD stratified according to the presence of chronic respiratory failure (CRF) or not.Materials and Methods: Using the Medical Research Council (MRC) score as an anchor, receiver operating characteristic curves and quantile regression were retrospectively evaluated before and after pulmonary rehabilitation in 2327 patients with COPD (1151 of them with CRF).Results: The median post-rehabilitation changes in BId for all patients were − 10 (interquartile range = − 17 to − 3, p< 0.001), correlating significantly with changes in MRC (r = 0.57, 95% CI = 0.53 to 0.59, p< 0.001). Comparing different methods of assessment, the MCID ranged from − 6.5 to − 9 points for patients without and − 7.5 to − 12 points for patients with CRF.Conclusion: The most conservative estimate of the MCID is − 9 points in patients with COPD, without and − 12 in those with CRF. This estimate may be useful in the clinical interpretation of data, particularly in response to intervention studies.Keywords: activities of daily life, breathlessness, dyspnea, chronic respiratory failure, exercise training, health related quality of life, rehabilitation

Published
2020

2. Antitumoral Activity of Cecropia Pachystachya Leaves Extract in Vitro and in Vivo Model of Rat Glioma: Brain and Blood Effects

Author

Bona, Natália Pontes, Pedra, Nathalia Stark, Spohr, Luiza, da Silva dos Santos, Francieli, Saraiva, Juliane Torchelsen, Carvalho, Fabiano Barbosa, da Cruz Fernandes, Marilda, Fernandes, Ana Sofia, Saraiva, Nuno, Martins, Marta Filipa, Tavares, Rejane Giacomelli, Spanevello, Roselia Maria, Aguiar, Mayara Sandrielly Soares de, and Stefanello, Francieli Moro

Published
2024
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3. Treatment with Blackberry Extract and Metformin in Sporadic Alzheimer’s Disease Model: Impact on Memory, Inflammation, Redox Status, Phosphorylated Tau Protein and Insulin Signaling

Author

de Mello, Julia Eisenhardt, Teixeira, Fernanda Cardoso, dos Santos, Alessandra, Luduvico, Karina, Soares de Aguiar, Mayara Sandrielly, Domingues, William Borges, Campos, Vinicius Farias, Tavares, Rejane Giacomelli, Schneider, Augusto, Stefanello, Francieli Moro, and Spanevello, Roselia Maria

Published
2024
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4. Antitumoral Activity of Electrospray-Nanoencapsulated Tannic Acid on C6 and U87MG Glioblastoma Cell Lines

Author

Simões, William Sanabria, Piccoli, Raphaela Cassol, dos Santos, Francieli da Silva, Saraiva, Juliane Torchelsen, Pedra, Nathalia Stark, da Silva, Giulia Bueno de Oliveira, Goularte, Kelen Cristiane Machado, Luduvico, Karina Pereira, Radünz, Marjana, Zavareze, Elessandra da Rosa, Spanevello, Roselia Maria, Bona, Natália Pontes, and Stefanello, Francieli Moro

Published
2024
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8. Development of a Barthel Index based on dyspnea for patients with respiratory diseases

Author

Vitacca M, Paneroni M, Baiardi P, De Carolis V, Zampogna E, Belli S, Carone M, Spanevello A, Balbi B, and Bertolotti G

Subjects
ADLs, psychometric tests, COPD, pulmonary rehabilitation, Diseases of the respiratory system, RC705-779
Abstract

Michele Vitacca,1 Mara Paneroni,1 Paola Baiardi,2 Vito De Carolis,3 Elisabetta Zampogna,4 Stefano Belli,5 Mauro Carone,3 Antonio Spanevello,4,6 Bruno Balbi,5 Giorgio Bertolotti7 1Respiratory Rehabilitation Division, Salvatore Maugeri Foundation, IRCCS, Institute of Lumezzane, Brescia, 2Scientific Direction, Salvatore Maugeri Foundation, IRCCS, Institute of Pavia, Pavia, 3Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Cassano delle Murge, Bari, 4Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Tradate, Varese, 5Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Veruno, Novara, 6Respiratory Diseases Unit, University of Insubria, Varese, 7Psychology Unit, Salvatore Maugeri Foundation, IRCCS, Institute of Tradate, Varese, Italy Background: As Barthel Index (BI) quantifies motor impairment but not breathlessness, the use of only this index could underestimate disability in chronic respiratory disease (CRD). To our knowledge, no study evaluates both motor and respiratory disability in CRD during activities of daily living (ADLs) simultaneously and with a unique tool. The objective of this study was to propose for patients with CRD an additional tool for dyspnea assessment during ADLs based on BI items named Barthel Index dyspnea.Methods: Comprehensibility, reliability, internal consistency, validity, responsiveness, and ability to differentiate between disease groups were assessed on 219 subjects through an observational study performed in an in-hospital rehabilitation setting.Results: Good comprehensibility, high reliability (interrater intraclass correlation coefficient was 0.93 [95% confidence interval 0.892–0.964] and test–retest intraclass correlation coefficient was 0.99 [95% confidence interval 0.983–0.994]), good internal consistency (Cronbach’s alpha 0.89), strong concurrent validity with 6 minute walking distance (Pearson r=–0.538, P

Published
2016

9. The Barthel index-dyspnea a tool for respiratory rehabilitation: reply to the letter by Chuang [Letter of clarification]

Author

Carone M, Vitacca M, Paneroni M, Baiardi P, Spanevello A, and Bertolotti G

Subjects
Barthel, COPD, Respiratory Rehabilitation, Diseases of the respiratory system, RC705-779
Abstract

Mauro Carone,1 Michele Vitacca,2 Mara Paneroni,2 Paola Baiardi,3 Antonio Spanevello,4,5 Giorgio Bertolotti6 1Respiratory Division, ICS MAUGERI SPA SB, Institute of Cassano Murge (BA) IRCCS, Italy; 2Respiratory Rehabilitation Division, ICS MAUGERI SPA SB, Institute of Lumezzane (BS) IRCCS, Italy; 3Scientific Direction, ICS MAUGERI SPA SB, Institute of Pavia, IRCCS, Italy; 4Respiratory Rehabilitation Division, ICS MAUGERI SPA SB, Institute of Tradate (VA) IRCCS, Italy; 5Respiratory Diseases Unit, University of Insubria, Varese; 6Psychology Unit, ICS MAUGERI SPA SB, Institute of Tradate (VA) IRCCS, Italy We read the remarkable letter by Chuang.1 We thank him for his valid suggestions on our paper. Interestingly, he focused on the two dimensions of the Barthel index-dyspnea (BI-d), which was exactly our goal. As rehabilitators, our goal is to provide patients with physical therapy depending on their health status and to improve their respiratory function. We need to verify and demonstrate the efficacy and the outcomes of respiratory rehabilitation, supported by physical therapy. For these reasons, we need an assessment device that measures respiratory improvement during daily motor activities that should be monitored.The modified Barthel index2 is a well-consolidated and widely used instrument to assess the performance of a person in a predetermined and fixed set of activities of daily living (ADLs). By proposing BI-d,3 we aimed to develop a scale to measure how dyspnea precludes or reduces the same ADLs, with the ultimate goal of globally assessing the effectiveness of rehabilitation. Hence, an assessment method that measures the impact of dyspnea on activities monitored by a rehabilitation program is of utmost importance for rehabilitators. Large part of Chuang’s letter is based on the Chronic Respiratory Questionnaire-dyspnea (CRQ-d). The CRQ-d is a health-related quality of life (health status) questionnaire, with a dyspnea “domain”.4 However, for our purposes, the CRQ-d is too individualized as each subject selects five activity items – “the most important” – out of 26 listed activities. Therefore, each subject may choose different items from other subjects in the same study group. Due to this significant methodology, CRQ was standardized recently into a version that contains a total of only five items with a dyspnea domain, all of which have to be responded.5 View the original paper by Vitacca et alView the original letter by Chuang

Published
2017

10. The one repetition maximum test and the sit-to-stand test in the assessment of a specific pulmonary rehabilitation program on peripheral muscle strength in COPD patients

Author

Zanini A, Aiello M, Cherubino F, Zampogna E, Azzola A, Chetta A, and Spanevello A

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Andrea Zanini,1,2 Marina Aiello,3 Francesca Cherubino,1 Elisabetta Zampogna,1 Andrea Azzola,4 Alfredo Chetta,3 Antonio Spanevello1,5 1Division of Pneumology, IRCCS Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation, Tradate, Italy; 2Division of Internal and Respiratory Medicine, Malcantonese Hospital, Giuseppe Rossi Foundation, Castelrotto, Switzerland; 3Respiratory Disease and Lung Function Unit, Department of Clinical and Experimental Medicine, University of Parma, Padiglione Rasori, Parma, Italy; 4Division of Pneumology, Department of Internal Medicine, Ospedale Civico, Lugano, Switzerland; 5Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy Background: Individuals with COPD may present reduced peripheral muscle strength, leading to impaired mobility. Comprehensive pulmonary rehabilitation (PR) should include strength training, in particular to lower limbs. Furthermore, simple tools for the assessment of peripheral muscle performance are required.Objectives: To assess the peripheral muscle performance of COPD patients by the sit-to-stand test (STST), as compared to the one-repetition maximum (1-RM), considered as the gold standard for assessing muscle strength in non-laboratory situations, and to evaluate the responsiveness of STST to a PR program.Methods: Sixty moderate-to-severe COPD inpatients were randomly included into either the specific strength training group or into the usual PR program group. Patients were assessed on a 30-second STST and 1-minute STST, 1-RM, and 6-minute walking test (6MWT), before and after PR. Bland–Altman plots were used to evaluate the agreement between 1-RM and STST. Results: The two groups were not different at baseline. In all patients, 1-RM was significantly related to the 30-second STST (r=0.48, P

Published
2015

11. Small airway dysfunction and flow and volume bronchodilator responsiveness in patients with chronic obstructive pulmonary disease

Author

Pisi R, Aiello M, Zanini A, Tzani P, Paleari D, Marangio E, Spanevello A, Nicolini G, and Chetta A

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Roberta Pisi,1 Marina Aiello,1 Andrea Zanini,2 Panagiota Tzani,1 Davide Paleari,3 Emilio Marangio,1 Antonio Spanevello,2,4 Gabriele Nicolini,5 Alfredo Chetta1 1Department of Clinical and Experimental Medicine, University of Parma, Parma, 2Division of Pneumology, IRCCS Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation, Tradate, 3Medical Department, Chiesi Farmaceutici SpA, Parma, 4Department of Clinical and Experimental Medicine, University of Insubria, Varese, 5Corporate Clinical Development, Chiesi Farmaceutici SpA, Parma, Italy Background: We investigated whether a relationship between small airways dysfunction and bronchodilator responsiveness exists in patients with chronic obstructive pulmonary disease (COPD).Methods: We studied 100 (20 female; mean age: 68±10 years) patients with COPD (forced expiratory volume in 1 second [FEV1]: 55% pred ±21%; FEV1/forced vital capacity [FVC]: 53%±10%) by impulse oscillometry system. Resistance at 5 Hz and 20 Hz (R5 and R20, in kPa·s·L-1) and the fall in resistance from 5 Hz to 20 Hz (R5 – R20) were used as indices of total, proximal, and peripheral airway resistance; reactance at 5 Hz (X5, in kPa·s·L-1) was also measured. Significant response to bronchodilator (salbutamol 400 µg) was expressed as absolute (≥0.2 L) and percentage (≥12%) change relative to the prebronchodilator value of FEV1 (flow responders, FRs) and FVC (volume responders, VRs).Results: Eighty out of 100 participants had R5 – R20 >0.03 kPa·s·L-1 (> upper normal limit) and, compared to patients with R5 – R20 ≤0.030 kPa·s·L-1, showed a poorer health status, lower values of FEV1, FVC, FEV1/FVC, and X5, along with higher values of residual volume/total lung capacity and R5 (P

Published
2015

12. Bronchial hyperresponsiveness, airway inflammation, and reversibility in patients with chronic obstructive pulmonary disease

Author

Zanini A, Cherubino F, Zampogna E, Croce S, Pignatti P, and Spanevello A

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Andrea Zanini,1 Francesca Cherubino,1 Elisabetta Zampogna,1 Stefania Croce,2 Patrizia Pignatti,2 Antonio Spanevello3 1Division of Pneumology, IRCCS Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation (IRCCS), Tradate, Italy; 2Allergy and Immunology Unit, Salvatore Maugeri Foundation (IRCCS), Pavia, Italy; 3Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy Background: Bronchial hyperresponsiveness (BHR), sputum eosinophilia, and bronchial reversibility are often thought to be a hallmark of asthma, yet it has been shown to occur in COPD as well.Objectives: To evaluate the relationship between BHR, lung function, and airway inflammation in COPD patients.Methods: Thirty-one, steroid-free patients with stable, mild and moderate COPD were studied. The following tests were carried out: baseline lung function, reversibility, provocative dose of methacholine causing a 20% fall in forced expiratory volume in 1 second, a COPD symptom score, and sputum induction.Results: Twenty-nine patients completed the procedures. About 41.4% had BHR, 31.0% had increased sputum eosinophils, and 37.9% had bronchial reversibility. Some of the patients had only one of these characteristics while others had two or the three of them. Patients with BHR had higher sputum eosinophils than patients without BHR (P=0.046) and those with sputum eosinophils ≥3% had more exacerbations in the previous year and a higher COPD symptom score than patients with sputum eosinophils

Published
2015

13. Antitumor Effect of Butia odorata Hydroalcoholic Extract on C6 and U87MG Glioma Cell Lines: Impact on Redox Status and Inflammation Signaling

Author

Saraiva, Juliane Torchelsen, dos Santos, Francieli da Silva, Bona, Natália Pontes, da Silveira, Larissa Menezes, Simões, William Sanabria, da Silva, Giulia Bueno de Oliveira, da Silva, Júlia Araújo, Domingues, William Borges, Nascimento, Mariana Cavalcanti, Campos, Vinicius Farias, Spanevello, Roselia Maria, Pedra, Nathalia Stark, and Stefanello, Francieli Moro

Published
2025
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14. Italian Cultural Institutions Across and Beyond Covid-19: Designing Digital Cultural Experiences in Extra-Ordinary Times

Author

Bollati, Ilaria, Morea, Valeria, Antonucci, Federica, Spanevello, Marta, Tosi, Francesca, Editor-in-Chief, Germak, Claudio, Series Editor, Zurlo, Francesco, Series Editor, Jinyi, Zhi, Series Editor, Pozzatti Amadori, Marilaine, Series Editor, Caon, Maurizio, Series Editor, Zanella, Francesca, editor, Bosoni, Giampiero, editor, Di Stefano, Elisabetta, editor, Iannilli, Gioia Laura, editor, Matteucci, Giovanni, editor, Messori, Rita, editor, and Trocchianesi, Raffaella, editor

Published
2024
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15. Biologics as well as inhaled anti-asthmatic therapy achieve clinical remission: Evidence from the Severe Asthma Network in Italy (SANI)

Author

Calabrese, Cecilia, Camiciottoli, Gianna, Carpagnano, Giovanna Elisiana, Centanni, Stefano, Corsico, Angelo Guido, Costantino, Maria Teresa, Crimi, Claudia, D'Adda, Alice, D’Alò, Simona, D'Amato, Maria, D'Andria, Corrado, Del Giacco, Stefano, Di Marco, Fabiano, Facciolongo, Nicola Cosimo, Farsi, Alessandro, Latorre, Manuela, Milanese, Manlio, Nettis, Eustachio, Nucera, Eleonora, Passalacqua, Giovanni, Pelaia, Girolamo, Pini, Laura, Ricciardi, Luisa, Massimo Ricciardolo, Fabio Luigi, Richeldi, Luca, Ridolo, Erminia, Santus, Pierachille, Scichilone, Nicola, Senna, Gianenrico, Spadaro, Giuseppe, Spanevello, Antonio, Tarsia, Paolo, Canonica, Giorgio Walter, Blasi, Francesco, Paggiaro, Pierluigi, Heffler, Enrico, Braido, Fulvio, Brussino, Luisa, Scioscia, Giulia, Cardini, Cristina, Oriecuia, Chiara, Sala, Isabella, and Bagnardi, Vincenzo

Published
2025
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16. Tranexamic acid versus placebo to prevent bleeding in patients with haematological malignancies and severe thrombocytopenia (TREATT): a randomised, double-blind, parallel, phase 3 superiority trial

Author

Estcourt, Lise J, McQuilten, Zoe K, Bardy, Peter, Cole-Sinclair, Merrole, Collins, Graham P., Crispin, Philip J., Curnow, Elinor, Curnow, Jennifer, Degelia, Amber, Dyer, Claire, Friebe, Adam, Floro, Lajos, Grand, Effie, Hudson, Cara, Jones, Gail, Joseph, Joanne, Kallmeyer, Charlotte, Karakantza, Marina, Kerr, Paul, Last, Sara, Lobo-Clarke, Maria, Lumley, Matthew, McMullin, Mary F, Medd, Patrick G., Morton, Suzy M., Mumford, Andrew D., Mushkbar, Maria, Parsons, Joseph, Powter, Gillian, Sekhar, Mallika, Smith, Laura, Soutar, Richard, Stevenson, William S., Subramoniapillai, Elango, Szer, Jeff, Thomas, Helen, Waters, Neil A., Wei, Andrew H., Westerman, David A., Wexler, Sarah A., Wood, Erica M., Stanworth, Simon J., Abioye, Adrienne, Afghan, Rabia, Ai, Sylvia Ai, Akanni, Magbor, Alajangi, Rajesh, Alam, Usmaan, Al-Bubseeree, Bahaa, Alderson, Sophie, Alderson, Craig, Ali, Sayed, Ali, Kabir, Alighan, Rookmeen, Allam, Rebecca Allam, Allen, Tania, Al-Sakkaf, Wesam, Ames, Kate, Anderson, Jacqueline, Andrews, Colin, Angel, Ann-Marie, Anlya, Manuela Anlya, Ansari, Farah, Appleby, Rowan, Arnold, Claire, Asbjornsdottir, Hulda, Asfaw, Biruk, Atkins, Elissa, Atkinson, Leela, Aubrey, Clare, Ayesha, Noor, Babbola, Lola, Badcock, David, Badcock, Samuel, Baggio, Diva, Bailiff, Ben, Baines, Kizzy, Baker, Holly, Baker, Victoria, Ball, Lindsay, Ball, Martin, Balquin, Irwin, Banks, Emma, Banos, George, Barnett, Jaytee, Barrie, Claire, Barron, Claire, Barton, Rebecca, Bason, Nina, Batta, Bindu, Bautista, Dianne, Bayley, Angela, Bayly, Emma, Baynes, Fionnuala, Bazargan, Ali, Bazeley, Rachel, Beadle, Yvonne, Beardsmore, Claire, Beattie, Kate, Bedford, Caroline, Behal, Rachna, Behan, Daniel, Bejan, Lilihna, Bell, Sarah, Bell, Karen, Bell, Louise, Bell, Kaitlyn, Benjamin, Reuben, Bennett, Sam, Benson, Gary, Benson, Warwick, Bent, Cameron, Bergin, Krystal, Berry, Alex, Besenyei, Stephanie, Besley, Caroline, Betteridge, Scott, Beveridge, Leigh, Bhattacharyya, Abir, Billen, Annelies, Bilmon, Ian, Binns, Emma, Birt, Mark, Bishop, David, Blanco, Andrea, Bleby, Lisa, Blemnerhet, Richard, Blombery, Piers, Blyth, Emily, Blythe, Nicola, Boal, Lauren, Boden, Ali, Bokhari, Syed W.I., Bongetti, Elisa, Booth, Stephen, Borley, Jayne, Bowen, David, Bowers, Dawn, Boyd, Stephen, Bradley, Sarah, Bradman, Helen, Bretag, Peta, Brillante, Maria, Brockbank, Rachel, Brough, Yasmin, Brown, Ellen, Brown, Jo, Brown, Eleanor, Brown, Claire, Brown, Jenny, Brown, Susan, Browning, Joe, Brownsdon, Alex, Bruce, David, Brydon-Hill, Ruth, Buckwell, Andrea, Burgess, Dannielle, Burke, Glenda, Burley, Kate, Burney, Claire, Burns, David, Burrows, Samuel, burton, Kieran, Butler, Jason, Cambalova, Lenka, Camozzi, Maria C., Campbell, Philip, Campfield, Karen, Campion, Victoria, Cargo, Catherine, Carmona, Julia, Carney, Dennis, Casan, Joshua, Cashman, Helen, Catt, Lorraine, Cattell, Michael, Cavill, Megan, Chadbone, Rachel, Chaganti, Sridhar, Chai, Yee, Chai, Khai Li, Chang, Joshua, Chapman, Judith, Chapman, Oliver G., Chapter, Tamika, Charlton, Andrew, Chau, Celina, Chauhan, Saleena, Chavda, Nikesh, Chen, Frederick, Chen, Melody, Chen, Meng Xi, Chen, Melanie, Chen, Melissa, Cheok, Kathleen, Cheung, Mai, Chidgey, Luke, Chmielokliec, Karolina, Choi, Philip, Choi, Jae, Chok, Anne, Chopra, Ruchika, Christopherson, Louise, Chu, Vicky, Chua, Chong Chyn, Chudakou, Pavel, Chugh, Vidushi, Chung, Chi, Clark, Erin, Clarke, Peter, Clarke, Kathleen, Clay, Jennifer, Clayton, Laura, Clements, Mitch, Clemmens, Jonathan, Clifford, Ruth, Collett, Dave, Collins, Maia, Collyer, Emily, Connolly, Maureen, Cook, Mark, Coombs, Sarah, Coppell, Jason, Cornwell, Sophie, Corrigan, Claire, Coughlin, Elizabeth, Couling, Jennifer, Cousins, Tony, Cowan, Catriona, Cox, Christine, Cox, Catherine, Coyle, Luke, Craig, Emily, Creasey, Thomas, Croan, Laura, Croft, Jane, Crosbie, Nicola, Crowe, Josephine, Crowther, Helen, Crozier, Jane, Culleton, Naomi, Cullis, Jonathan, Cumming, Anita, Cummins, Michelle, Cunningham, Adam, Curley, Cameron, Curtis, Samantha, Cuthbert, Robert, Cuthill, Kirsty, Dahahayake, Dinusha A, Dang, Amy, Davies, Marc, Davies, Ceri, Dawson, Emily, Day, Tom, De Abrew, Kanchana, De Lavallade, Hugues, De Silva, Neelaskshi, Dean, Georgina, Deane, Christopher, Demosthenous, Lisa, Desai, Amisha, Desborough, Michael, Devanny, Ian, Dhanapal, Jay, Dhani, Sundip, Di Martino, Vicky, Dickens, Emmy, DiCorleto, Carmen, Dinnett, Louise, Dirisan, Divya, Dixon, Karen, Dixon, Kiri, Doal, Inderjit, Dobivh, J, Docanto, Maria, Doecke, Helve, Donaldson, David, Donaldson, Kylee, Donohoe, Carrie, Douglas, Ashley, Doung, Stephen, Downer, Susan, D'Rozario, James, Drummond, Malcolm, Drummond, Mark, Drummond, Samantha, Drysdale, Elizabeth, D'Souza, Ross, D'Souza, Eugene, Dunn, Alex, Dutton, David, Dyson, Martin, Ediriwicurena, Kushani, Edleston, Sharon, Edwards, Dawn, Edwards, Morgan, Edwards, Anita, Eise, Nicole, Ellis, Steven, Ellis, Hayley, Elmonley, Shareef, Enstone, Rosemarie, Eordogh, Agnes, Erb, Sharon, Evans, Shannon, Evans, Megan, Ewing, Joanne, Eyre, Toby, Facey, Adam, Fammy, Mina, Farman, Jon, Farnell, Rachel, Favero, Laura, Fay, Keith, Ferguson, Karen, Fernon, Laura, Filshie, Robin, Finnegan, Damian, Fisher, Lisa, Flanagan, Asia, Fleck, Emma, Fletcher, Simon, Flora, Harpreet, Flower, Catherine, Fodor, Ioana, Foley, Heather, Folland, Emma, Folorunso, Comfort, Forbes, Molly, Fordwor, Katrina, Foster, Polly, Fox, Vanessa, Fox, Thomas, Francis, Olesya, Fryearson, Louise, Fuery, Madonna, Fung, Jiin, Furtado, Michelle, Galloway-Browne, Leanne, Gamble, Louise, Gamgee, Jeanette, Ganapathy, Arundathi, Gardner, Hayley, Gardner, Clare, Gasmelsheed, Noha, Gately, Amy, Gaynor, Lynda, Gebreid, Alex, Geffens, Ruth, George, Rachel, Gertner, Aniko, Ghebeh, Manar, Ghirardini, Emanuela, Giddings, Melainie, Gillett, Sandra, Gillett, Karen, Giri, Pratyush, Glass, Chris, Glewis, Sarah, Gooding, Sarah, Gordon, Olivia, Gordon, Joanne, Gottlieb, David, Gowda, Koushik, Gower, Elysie, Gray, Nicola, Grayer, Jo, Greaves, Elaine, Greenaway, Sally Anne, Greenfield, Graeme, Greenwood, Matthew, Gregory, Gareth, Griffin, James, Griffith, Julia, Griffith, James, Griffiths, Lindsey, Grzegrzolka, Paulina, Gu, Yisu, Guest, Jo, Guinai, Rosanna, Gullapalli, Veena, Gunolr, A., Guo, Lina, H, Wayne, Hagua, Sophia, Haile, Senait, Hall, Richard, Hamdollah-Zadeh, Maryam, Hanif, Zahra, Hanlon, Kathleen, Hann, Nicholas, Hanna, Ramez, Hannah, Guy, Hapuarachchi, Sameera, Hardman, Jacinta, Hardy, Alison, Harris, Anthony, Harris, Kylie, Harrison, Beth, Harrison, Simon, Harrison, Lea-Anne, Harrop, Sean, Harvey, Caroline, Hatcliffe, Faye, Hawking, Jo, Hawkins, Matthew, Hayden, Janet, Hayman, Michelle, Haynes, Elizabeth, Heaney, Nicholas, Hebbard, Andrew, Hempton, Jenny, Hendunneti, Sasanka, Henry, Maeve, Heywood, Jonathan, Hildyard, Catherine, Hill, Lydia, Hilldrith, Annette, Hitev, Petar, Hiwase, Smita, Hiwase, Devendra, Hoare, Chris, Hodge, Renate, Holloway, Amy, Holt, Chloe, Holton, Kelly, Homer, Lauren, Horne, Gillian, Horvath, Noemi, Hotong, Linda, Houdyk, Kristen, Houseman, Katy, Hoxhallari, Ilda, Hsu, Hannah, Hsu, Nina, Huang, Gillian, Hudson, Kerryn, Hufton, Melanie, Hughes, Timothy, Hughes, Siobhan, Hurley, Kate, Huxley, Rosie, Ibitoye, Temitope, Ibrouf, Abubaken, Inam, Farha, Indran, Tishya, Ingham, Karen, Innes, Calum, Irvine, David, Jaafar, Sarah, Jain, Manish, Jameson, Laura, Janjua, Pardeep, Jarvis, Rebecca, Jatheendran, Abirami, Javed, Abbie, Jen, Sheila, Jobanpura, Shailesh, Jobson, Irene, John, Deborah, Johns, Sophie, Johnston, Amanda, Jones, Hollie, Jones, Francesca, Joniak, Karolina, Jovanovic, Michael, Jovic, Anita, Joyce, Lauren, Judd, Andrew, Kakarlamudi, Sudhakar, Kakaroubas, Nick, Kalita, Maggie, Kam, Shirly, Kan, Julie, Kandle, P, Kanellopoulos, Alex, Kao, Chien, Kaparou, Maria, Kartsios, Charamlampos, Katsioulas, Vicki, Kaye, Russell, Keen, Katie, Kelly, Richard, Kelly, Pauline, Kelly, Donna, Kelly, Melanie, Kennedy, Glen, Kennedy, Nola, Kenny, Angela, Kenworthy, Zoe, Kerridge, Ian, Kesavan, Murali, Khafizi, Angelika, Khakwani, Muhammad, Khalid, Amna, Khamly, Kate, Khan, Anjum, Khan, Dalia, Khan, Mojid, Khan, Lubna, Khoo, Mona, Khwaja, Asim, Kim, Grace, King, Andrew, King, Vicky, King, Donna, Kinsella, Francesca, Kipp, David, Kirandeep, Pachoo, Kirui, Laura C., Kishore, Bhuvan, Knectlhi, Christopher, Knot, Amy, Knot, Armit, Ko, Cathy, Kolaric, Caitlin, Koo, Ray, Kotadia, Mary, Kothari, Jaimal, Kottaridis, Panagiotis D., Kuiluinathan, Gajan, Kulasekararaj, Austin, Kwan, John, Kwok, Marwan, Kwok, Phillip, Kwok, Fiona, Laane, Kristiina, Lad, Deena, Laird, Jennifer, Lam, Ada, Lane, Mary, Lanenco, Monica, Lang, Susan, Langridge, Alex, Langton, Catherine, Lannon, Michelle, Latif, Annie, Latimer, Maya, Latter, Ruth, Lau, I-Jun, Lawless, Sarah, Lawless, Theresa, Leach, Mike, Leaney, Sarah, Leary, Heather, Leavy, James, LeBlanc, Abbey, Lee, Vivienne, Lee, Edwin, Lee, Jenny, Lee, Tamara, Leischkie, Marian, Leitinger, Emma, Leon, Christopher, Leonard, Jayne, Lewis, David, Lewis, Ian, Lewis, Tania, Lim, Daniel, Littlewood, Kelly, Liu, Dara, Loh, Joanna, Lokare, Anand, Lomas, Oliver, Lovell, Richard, Lowe, Theresa, Lowry, Lisa, Lubowiecki, Marcin, Lumb, Rebecca, Lynch, Gail, Macaulay, Amanda, MacDonald, Lyndsey, MacDonald-Burn, Jill, Macmillan, Margaret, Maddock, Karen, Mahaliyana, Tomas, Mahon, Cassandra, Maidment, Alison, Maier, Susie, Mairos, Michelle, Majid, Mahseeman, Mak, Ka L, Mak, Anne, Malendrayogau, Arunthrthy, Malham, Hana, Malyon, Felicity, Mandadapu, Vineela, Mandel, Laura, Mant, Sarah, Manton, Ruth, Maouche, Nadjoua, Maqbool, Muhammad G., Marchant, Gregory, Marinho, Mariana, Marks, David, Marner, Mike, Marr, Helen, Marshall, Gillian, Martin, Siobhan, Martin, Abigail, Marzolini, Maria, Mason, Kiara, Massie, Jonathan, Masson, Rebecca, Mathavan, Vidya, Mathew, Siju, Mathie, Judith, Mattocks, Lehenta, Maybury, Bernard, Mayer, Georgina, McAlister, Chyrelle, McAllister, Jo, McConnell, Stewart, McCracken, James, McCullagh, Liz, McCulloch, Rory, Mcdermott, Christopher, Mcdonald, Kerian, McGinniss, Laura, McGurk, Fiona, McIlwain, Jessica, McIver, Kirsten, Mckay, Pam, McKenna, Lorraine, Mclornan, Donal, McMahon, Coalon, McNeice, Linda, McNeill, Susan, McNickle, Molly, McQueen, Fiona, McRae, Simon, McTaggart, Bobby, Mehew, Jenny, Mehra, Varnn, Melly, Michelle, Menichelli, Tara, Micklethwatte, Ken, Mihailescue, Loredana, Mijovic, Aleksander, Millband, Hannah, Miller, Lucy, Millien, Samuel T., Milnthorpe, James, Minson, Adrian, Molnar, Eva, Monsour, Marc, Moody, Mary, Moon, Rebecca, Moore, Sally, Moore, Katy, Morgan, Kelly, Morralley, Rebecca, Morris, Denise, Morris, Kirk, Morrison, Nicole, Moss, Merinda, Mughal, Muhammad, Muir, Paul, Mukkath, David, Mulla, Aasiyu, Mulligan, Stephen, Mullings, Joanne, Mulqueen, Angela, Muluey, Caitlin, Murdoch, Sarah, Murrani, Sura, Murthy, Vidhya, Musngi, Jimmy, Mustafa, Nadreen, Mynes, Tracey, Nalpantidis, Anastasios, Nandurkar, Harshal, Nardone, Linda, Nasari, Latifa, Nash, Monica, Naylor, Georgina, Ngu, Loretta, Nguethina, Melissa, Nguyen, John, Nguyen, Joseph, Nichol, Wendy, Nicholls, Emma, Nicole, Catherine S., Nicolson, Phillip, Nielson, David, Nikolousis, Emmanouil, Nix, Georgina, Njoku, Rita, Norman, Jane, Norman, Amy, Norris, Phoebe, North, Daniel, Norwood, Megan, Notcheva, Gaynor, Novitzky-Basso, Igor, Nyaboko, Joseph, Nygren, Maria, Obu, Ingrid, O'Connell, Siobhan, O'Connor, Jody, O'Kelly, Deanna, O'Niell, Aideen, Ony, Jeremy, Oo, Kathy, Oo, April, Oppermann, Anne, Orr, Ruth, O'Sullivan, Mary, Page, Jennifer, Palfreyman, Emma, Paneesha, Shankaranarayana, Panicker, Shyam, Parbutt, Catherine, Parigi, Elesha, Paris, Gemma, Parker, Tracey, Parnell, Caroline, Parrish, Christopher, Parsons, Alex, Pasat, Mioara, Patel, Natasha, Patel, Vijay, Patel, Pooja, Patel, Chaya, Pati, Nalini, Patterson, Andrea, Paul, Lauren, Payet, Danielle, Payne, Elspeth, Peachey, Victoria, Pearson, Amanda, Peniket, Andy, Percy, Laura, Pereyra, Millicent, Pervaiz, Omer, Phalod, Gunjan D, Pham, Anh, Pho, Jason, Pickard, Keir, Pidcock, Michael, Piggin, Anna, Pishyar, Yalda, Pocock, Abigail, Pol, Ranjendres, Polzella, Paolo, Poolan, Sonia, Portingale, Vicki, Posnett, Claire, Potluri, Sandeep, Potter, Victoria, Pratt, Guy, Prodger, Catherine, Pueblo, Andres, Puliyayil, Anish, Puvanakumar, Pratheepan, Qadri, Abdul, Quach, Hang, Quinn, Michael, Rafferty, Mark, Rahman, Marzia, Raj, Kavita, Raj, Sonia, Rajendran, Ramina, Ramanan, Radha, Ramasamy, Karthik, Rampotas, Alexandros, Ranchhod, Natasha, Rashid, Sabia, Ratanjee, Sunita, Rathore, Gurpreet, Ratnasingam, Sumita, Rayat, Manjit, Rayner, Michael, Reddell-Denton, Rebecca, Redding, Nicola, Reddy, Udaya, Rehman, Atique, Rice, Carol, Riches, Iwona, Rider, Thomas, Riley, John, Rinaldi, Ciro, Roberts, Kayleigh, Roberts, Andrew, Robertson, Bryony, Robertson, Peter, Robinson, Dan, Robinson, Rebecca, Robjohns, Emma, Robledo, Laura, Rodrigues, Ana, Rofe, Chris, Roff, Bridie, Rogers, Rachel, Rolt, Jill, Rooney, Carmela, Rose, Kathy, Rose, Hannah, Ross, David, Rouf, Shahara, Rourke, Claire, Routledge, David, Ruggiero, Janet, Rule, Simon, Rumsey, Richard, Sagge, Cherry, Saldhana, Helen, Salisbury, Richard, Salisbury, Sarah, Salvaris, Ross, Sanders, Kay, Sangombe, Mirriam, Sanigorska, Anna, Santos, Kristine, Sarkis, Taylah, Sarma, Anita, Saunders, Natalie, Schmidt, Kara, Schmidtmann, Anja, Schumacher, Ann, Scorer, Tom Scorer, Scott, Asleigh, Seath, Ingrid, Sejman, Frances, Selim, Adrian, Shamim, Nadia, Shan, Jocelyn, Shanmuganathan, Naranie, Shanmugaranjan, Shaminie, Sharpe, Michelle, Sharpley, Faye, Shaw, Emma, Sheath, Cara, Sheehy, Oonagh, Shen, Vivian, Sherbide, Solomon, Sheridan, Mathew, Sheridan, Jane, Sheridon, Matthew, Shields, Tracy, Sim, Hau V, Sim, Shirlene, Sims, Matt, Singaraveloo, Lydia, Singh, Gurcharan, Singh, Jasmine, Sladesal, Shree, Sloan, Andrew, Slobodian, Peter, Smith, Sophie, Smith, Sarit, Smith, Claire, Smith, Alastair, Smith, Neil, Snowden, Katherine, Solis, Joel, Somios, Denise, Soo, Jade, Spanevello, Michelle, Spaulding, Madeleie, Spence, Laura, Spillane, Liz, Spiteri, Alisha, Sprigg, Naomi, Springett, Sally, Stafford, Lynn, Stainthorp, Katherine, Stark, Kate, Steeden, Louise, Stephen, Ella, Stephenson, Aisling, Stewart, Andrew, Stewart, Orla, Stobie, Emma, Stokes, Chelsea, Streater, Jacqui, Suddens, Charlie-Marie, Suntharalingam, Surenthini, Surana, Narinder, Sutherland, Robyn, Sutherland, Antony, Sutton, David, Sweeney, Connor, Sweet, Reilly, Szucs, Aniko P, Taheri, Leila E., Tailor, Hinesh, Tam, Constantine, Tambakis, George, Tamplin, Mary, Tan, Chee, Tan, Sui, Tan, Joanne, Tan, Zhi, Taran, Tatiana, Tarpey, Fiona, Taseka, Angela, Tasker, Suzy, Tatarczuch, Maciej, Tayabali, Sarrah, Taylor, Hannah, Taylor, Robert, Taylor, Melaine, Taylor-Moore, Ella, Teasdale, Lesley, Tebbet, Elizabeth, Tedjasepstra, Aditya, Tedjaseputra, Aditya, Tepkumkun, Oummy, Terpstra, Andrew, Thomas, Wayne, Thomas, Shanice, Thompson, Rachel, Thornton, Thomas, Thorp, Bronwyn, Thrift, Moi Yap, Thwaites, Phillipa, Timbres, Jasmine, Tindall, Lauren, Tiong, Ing Soo, Tippler, Nicole, Todd, Tony, Todd, Shirley, Toghill, Neil, Tomlinson, Eve, Tooth, Jacinta, Topp, M., Trail, Nicola, Tran, Nguyen, Tran, Elizabeth, Tran, Vi, Treder, Bona, Tribbeck, Michelle, Trochowski, Siobhan, Truslove, Maria, Tse, Tsun, Tseu, Bing, Tucker, David, Turner, Kelly, Turner, Dianne, Turner, Herleen, Turner, Gillian, Twohig, Julie, Tylee, Thomas, Uhe, Micheleine, Underhill, Lauren, V, Joanne, Van der Vliet, Georgina, Van Tonder, Tina, VanderWeyden, Carrie, Varghese, Jerry, Vaughan, Lachlan, Veale, David, Vickaryyous, Nicky, Vince, Kathryn, Von Welligh, Jacoba, Vora, Sona, Wadehra, Karan, Walker, Rebecca, Walker, Stephen, Wallace, Roslyn, Wallniosve, Stephanie, Wallwork, S., Walmsley, Zoe, Walters, Fiona, Wang, Joyce, Wang, Angela, Wang, Chen, Wanyika, Mercy, Warcel, Dana, Wardrobe, Katrina, Warnes, Kristian, Waterhouse, Christopher, Waterworth, Adam, Watson, Caroline, Watson, Edmund, Watts, Emily, Weaver, Emma, Weber, Nicholas, Webley, Kaytie, Welford, Anna, Wells, Matt, Westbury, Sarah, Westcott, Jackie, Western, Robyn, Weston, Julia, White, Jessica, White, Phillipa, Whitehead, Anna, Whitehouse, James, Wieringa, Samantha, Willan, John, Williams, Sandra, Williams, Bethany, Williamson, Stephanie, Willoughby, Brett, Wilmot, Gail, Wilmott, Rosalind, Wilson, Joanna, Wilson, Emma, Wilson, Suzy, Wilson, Heather, Wilson, Caroline, Wilson, Tanya, Wilton, Margaret, Wiltshire, Paula, Wincup, Joanne, Wolf, Julia, Wong, Henna, Wong, Cyndi, Wong, Daniel, Wong, Jonathan, Wong, Shi Qin, Wood, Sarah, Wood, Henry, Wooding, Jackie, Woolley, Kelly, Wright, Myles, Wynn-Williams, Roland, Yannakou, Costas, Yeoh, Zhi Han, Yeung, David, Young, Agnes, Yuen, Flora, Yuen, Agnes, Zaja, Oliver, Zhang, Xiao-Yin, and Zhang, Mei

Published
2025
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17. Asthma and hypertension: the role of airway inflammation

Author

Dina Visca, Francesco Ardesi, Martina Zappa, Patrizia Pignatti, Sarah Grossi, Marco Vanetti, Giovanni Battista Migliori, Rosella Centis, Fabio Angeli, and Antonio Spanevello

Subjects
asthma, chronic diseases, comorbidities, arterial hypertension, airway inflammation, induced sputum, Medicine (General), R5-920
Abstract

IntroductionAsthma is a chronic inflammatory respiratory disease often associated with comorbidities. Among cardiovascular comorbidities, arterial hypertension seems to create an additional health burden in asthmatics. However, evidence on this relationship is lacking.ObjectiveOur study aims to evaluate the characteristics of hypertensive asthmatics, focusing on the role of inflammation as a possible link between these diseases.MethodsWe conducted a monocentric retrospective analysis consecutively including asthmatics who underwent induced sputum (IS) at our asthma referral center. Patients were divided in two groups according to presence or absence of history of hypertension. Clinical, functional, and inflammatory (airway and systemic) data were collected.ResultsData on two hundred and sixty asthmatic patients were analyzed. Seventy-nine (30.4%) of them had a diagnosis of hypertension requiring a specific pharmacological treatment. Asthmatics with hypertension were more frequently male (p = 0.047), older (p 0.05); distribution of comorbidities and lung function impairment (forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC); all p

Published
2024
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18. Mycobacterium chimaera: a case report from Italy

Author

Martina Maria Seminara, Dina Visca, Alice Claudia Repossi, and Antonio Spanevello

Subjects
Non-tuberculous Mycobacterium, Mycobacterium chimaera, coronary bypass, heater-cooler units, pulmonary rehabilitation, Medicine
Abstract

Mycobacterium chimaera is an environmental non-tuberculous mycobacterium belonging to Mycobacterium avium complex (MAC). It has been widely known to be associated with disseminated infection after cardiac surgery, related to heater-cooler units used during these procedures. Although M. chimaera seems to be a less virulent species compared to M. avium and M. intracellulare among MAC, several cases of M. Chimaera lung infections have been reported in settings of chronic obstructive pulmonary disease (COPD), cystic fibrosis, bronchiectasis, malignancy, or immunosuppression. Here, we present an Italian case report in association with newly diagnosed COPD.

Published
2024
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19. Profiling severe asthma: Any relevance for age? An analysis from Severe Asthma Network Italy (SANI) cohort

Author

Marco Caminati, MD, Alessandro Marcon, PhD, Rachele Vaia, MD, Gianenrico Senna, MD, Matteo Maule, MD, Pierpaolo Marchetti, MD, Jessica Miotti, MD, Giuseppe Argentino, MD, Francesco Blasi, MD, PhD, Giorgio W. Canonica, MD, Enrico M. Heffler, MD, PhD, Pierluigi Paggiaro, MD, Andrea Vianello, MD, PhD, Gabriella Guarnieri, MD, Luisa Brussino, MD PhD, S.S.D.D.U, Cecilia Calabrese, MD PhD, Gianna Camiciottoli, MD, Giovanna E. Carpagnano, MD PhD, Stefano Centanni, MD PhD, Angelo G. Corsico, MD PhD, Maria T. Costantino, MD, Claudia Crimi, MD PhD, Alice D'adda, MD, Simona D'alo, MD, Maria D'amato, MD PhD, Stefano Del Giacco, MD, Fabiano Di Marco, MD PhD, Nicola C. Facciolongo, MD, Manuela Latorre, MD PhD, Eustachio Nettis, MD, Eleonora Nucera, MD, Giovanni Passalacqua, MD, Girolamo Pelaia, MD, Laura Pini, MD PhD, Luisa Ricciardi, MD, Luca Richeldi, MD, Erminia Ridolo, MD PhD, Pierachille Santus, MD PhD, Nicola Scichilone, MD, Giulia Scioscia, MD PhD, Giuseppe Spadaro, MD, Antonio Spanevello, MD PhD, and Paolo Tarsia, MD PhD

Subjects
Severe asthma, Aging, Comorbidities, Lung function, Asthma control, Immunologic diseases. Allergy, RC581-607
Abstract

Background: Aging implies changes in terms of lung function, immune system, and respiratory and extra-respiratory comorbidities. Few studies have specifically addressed the relevance of age on severe asthma burden and control. We aimed to evaluate whether age acts as an independent determinant of asthma severity, in terms of clinical, functional, and inflammatory profile, and to explore potential cofactors that contribute to a more difficult disease control in different age groups. Methods: Patients from Severe Asthma Network Italy (SANI) registry were retrospectively divided in subgroups according to their age. Cutoffs for age were established according to quartiles in order to obtain a comparable number of patients for each group, and then rounded for the sake of simplicity. Results: Overall, 1805 severe asthma patients were analyzed. Lung function represented the most important age-related variable. On the opposite the level of asthma control was not differently distributed among age ranges. In young people the presence of atopy-related comorbidities (allergic rhinitis, atopic dermatitis) predominated, whilst systemic-metabolic and degenerative comorbidities such as diabetes, cardiovascular diseases, anxious-depressive syndrome, and osteoporosis prevailed in elderly. Bronchiectasis and sleep disturbances were significantly associated with age. Conclusions: Despite that it cannot be considered a treatable trait, our study suggests that age should be evaluated within a personalized approach to severe asthma patients, in order to provide a better clinical profiling and a more tailored treatment strategy.

Published
2024
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21. Tannic acid: A possible therapeutic agent for hypermethioninemia-induced neurochemical changes in young rats

Author

Meine, Bernardo de Moraes, de Mello, Julia Eisenhardt, Custódio, Solange Vega, da Silveira, Larissa Menezes, Simões, William Sanabria, Bona, Natália Pontes, Garcia, Driele Neske, Schneider, Augusto, de Souza, Lucas Petitemberte, Domingues, William Borges, Campos, Vinicius Farias, Spanevello, Roselia Maria, de Aguiar, Mayara Sandrielly Soares, and Stefanello, Francieli Moro

Published
2024
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23. Clinical characteristics and outcomes of vaccinated patients hospitalised with SARS-CoV-2 breakthrough infection: Multi-IPV, a multicentre study in Northern Italy

Author

Andrea Lombardi, Simone Villa, Marta Colaneri, Giovanni Scaglione, Francesca Bai, Benedetta Varisco, Valeria Bono, Antonio Vena, Chiara Dentone, Chiara Russo, Mauro Tettamanti, Giulia Renisi, Giulia Viero, Cecilia Azzarà, Marco Mantero, Flora Peyvandi, Matteo Bassetti, Giulia Marchetti, Antonio Muscatello, Alessandro Nobili, Andrea Gori, Alessandra Bandera, Silvano Bosari, Luigia Scudeller, Giuliana Fusetti, Laura Rusconi, Silvia Dell’Orto, Daniele Prati, Luca Valenti, Silvia Giovannelli, Maria Manunta, Giuseppe Lamorte, Francesca Ferarri, Andrea Gori., Davide Mangioni, Laura Alagna, Giorgio Bozzi, Andrea Lombardi., Riccardo Ungaro, Giuseppe Ancona, Marco Mussa, Bianca Veronica Mariani, Matteo Bolis, Nathalie Iannotti, Serena Ludovisi, Agnese Comelli, Simona Biscarini, Valeria Castelli, Emanuele Palomba, Marco Fava, Carlo Alberto Peri, Paola Saltini, Teresa Itri, Valentina Ferroni, Valeria Pastore, Roberta Massafra, Arianna Liparoti, Toussaint Muheberimana, Alessandro Giommi, Rosaria Bianco, Grazia Eliana Chitani, Chiara Bobbio, Irene De Matteis, Angelo Bianchi Bonomi, Roberta Gualtierotti, Barbara Ferrari, Raffaella Rossio, Nadia Boasi, Erica Pagliaro, Costanza Massimo, Michele De Caro, Andrea Giachi, Nicola Montano, Barbara Vigone, Chiara Bellocchi, Angelica Carandina, Elisa Fiorelli, Valerie Melli, Eleonora Tobaldini, Francesco Blasi, Stefano Aliberti, Maura Spotti, Leonardo Terranova, Sofia Misuraca, Alice D’Adda, Silvia Della Fiore, Marta Di Pasquale, Marco Mantero., Martina Contarini, Margherita Ori, Letizia Morlacchi, Valeria Rossetti, Andrea Gramegna, Maria Pappalettera, Mirta Cavallini, Agata Buscemi, Marco Vicenzi, Irena Rota, Giorgio Costantino, Monica Solbiati, Ludovico Furlan, Marta Mancarella, Giulia Colombo, Giorgio Colombo, Alice Fanin, Mariele Passarella, Valter Monzani, Ciro Canetta, Angelo Rovellini, Laura Barbetta, Filippo Billi, Christian Folli, Silvia Accordino, Diletta Maira, Cinzia Maria Hu, Irene Motta, Natalia Scaramellini, Anna Ludovica Fracanzani, Rosa Lombardi, Annalisa Cespiati, Matteo Cesari, Tiziano Lucchi, Marco Proietti, Laura Calcaterra, Clara Mandelli, Carlotta Coppola, Arturo Cerizza, Antonio Maria Pesenti, Giacomo Grasselli, Alessandro Galazzi, Alessandro Nobili., Igor Monti, Alessia Antonella Galbussera, Ernesto Crisafulli, Domenico Girelli, Alessio Maroccia, Daniele Gabbiani, Fabiana Busti, Alice Vianello, Marta Biondan, Filippo Sartori, Paola Faverio, Alberto Pesci, Stefano Zucchetti, Paolo Bonfanti, Marianna Rossi, Ilaria Beretta, Anna Spolti, Sergio Harari, Davide Elia, Roberto Cassandro, Antonella Caminati, Francesco Cipollone, Maria Teresa Guagnano, Damiano D’Ardes, Ilaria Rossi, Francesca Vezzani, Antonio Spanevello, Francesca Cherubino, Dina Visca, Marco Contoli, Alberto Papi, Luca Morandi, Nicholas Battistini, Guido Luigi Moreo, Pasqualina Iannuzzi, Daniele Fumagalla, and Sara Leone

Subjects
Vaccination, Breakthrough infection, SARS-COV-2, Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
Abstract

Background: Despite the well-known efficacy of anti-COVID-19 vaccines in preventing morbidity and mortality, several vaccinated individuals are diagnosed with SARS-CoV-2 breakthrough infection, which might require hospitalisation. This multicentre, observational, and retrospective study aimed to investigate the clinical characteristics and outcomes of vaccinated vs. non-vaccinated patients, both hospitalised with SARS-CoV-2 infection in 3 major hospitals in Northern Italy. Methods: Data collection was retrospective, and paper and electronic medical records of adult patients with a diagnosed SARS-CoV-2 infection were pseudo-anonymised and analysed. Vaccinated and non-vaccinated individuals were manually paired, using a predetermined matching criterion (similar age, gender, and date of hospitalisation). Demographic, clinical, treatment, and outcome data were compared between groups differing by vaccination status using Pearson’s Chi-square and Mann-Whitney tests. Moreover, multiple logistic regression analyses were performed to assess the impact of vaccination status on ICU admission or intra-hospital mortality. Results: Data from 360 patients were collected. Vaccinated patients presented with a higher prevalence of relevant comorbidities, like kidney replacement therapy or haematological malignancy, despite a milder clinical presentation at the first evaluation. Non-vaccinated patients required intensive care more often than their vaccinated counterparts (8.8% vs. 1.7%, p = 0.002). Contrariwise, no difference in intra-hospital mortality was observed between the two groups (19% vs. 20%, p = 0.853). These results were confirmed by multivariable logistic regressions, which showed that vaccination was significantly associated with decreased risk of ICU admission (aOR=0.172, 95%CI: 0.039–0.542, p = 0.007), but not of intra-hospital mortality (aOR=0.996, 95%CI: 0.582–1.703, p = 0.987). Conclusions: This study provides real-world data on vaccinated patients hospitalised with COVID-19 in Northern Italy. Our results suggest that COVID-19 vaccination has a protective role in individuals with higher risk profiles, especially regarding the need for ICU admission. These findings contribute to our understanding of SARS-CoV-2 infection outcomes among vaccinated individuals and emphasise the importance of vaccination in preventing severe disease, particularly in those countries with lower first-booster uptake rates.

Published
2024
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25. Long-term inhaled corticosteroid treatment in patients with chronic obstructive pulmonary disease, cardiovascular disease, and a recent hospitalised exacerbation: The ICSLIFE pragmatic, randomised controlled study

Author

Schipani, Giuseppina, Incalzi, Raffaele Antonello, Rogliani, Paola, Ceriana, Piero, Spanevello, Antonio, Balbi, Bruno, Foschino, Maria Pia, Scichilone, Nicola, Para, Ombretta, Nozzoli, Carlo, Dentali, Francesco, Beghè, Bianca, Milanese, Manlio, Monaco, Eugenia, Corsico, Angelo Guido, Facciolongo, Nicola, Barbetta, Carlo, Bonifazi, Martina, Romagnoli, Micaela, Pelaia, Corrado, di Marco, Fabiano, Bianco, Andrea, Papi, Alberto, Maniscalco, Mauro, Bargagli, Elena, Crimi, Claudia, Santus, Pierachille, Tazzari, Enea, Ronzoni, Luca, Santoli, Federica, Molino, Antonio, Marvisi, Maurizio, Patella, Vincenzo, Aliani, Maria, Forini, Giacomo, Bandiera, Valeria, Baraldi, Federico, D'Anna, Silvestro Ennio, Carone, Mauro, Scioscia, Giulia, and Fabbri, Leonardo M

Published
2024
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31. Clinical standards for the assessment, management and rehabilitation of post-TB lung disease

Author

Migliori, GB, Marx, FM, Ambrosino, N, Zampogna, E, Schaaf, HS, van der Zalm, MM, Allwood, B, Byrne, AL, Mortimer, K, Wallis, RS, Fox, GJ, Leung, CC, Chakaya, JM, Seaworth, B, Rachow, A, Marais, BJ, Furin, J, Akkerman, OW, Al Yaquobi, F, Amaral, AFS, Borisov, S, Caminero, JA, Carvalho, ACC, Chesov, D, Codecasa, LR, Teixeira, RC, Dalcolmo, MP, Datta, S, Dinh-Xuan, A-T, Duarte, R, Evans, CA, García-García, J-M, Günther, G, Hoddinott, G, Huddart, S, Ivanova, O, Laniado-Laborín, R, Manga, S, Manika, K, Mariandyshev, A, Mello, FCQ, Mpagama, SG, Muñoz-Torrico, M, Nahid, P, Ong, CWM, Palmero, DJ, Piubello, A, Pontali, E, Silva, DR, Singla, R, Spanevello, A, Tiberi, S, Udwadia, ZF, Vitacca, M, Centis, R, D Ambrosio, L, Sotgiu, G, Lange, C, and Visca, D

Subjects
Lung, Clinical Research, 7.3 Management and decision making, Management of diseases and conditions, Good Health and Well Being, Humans, Consensus, Lung Diseases, Quality of Life, Tuberculosis, tuberculosis, post-TB lung disease, se-quelae, pulmonary rehabilitation, clinical standards, Cardiorespiratory Medicine and Haematology, Microbiology
Abstract

BACKGROUND: Increasing evidence suggests that post-TB lung disease (PTLD) causes significant morbidity and mortality. The aim of these clinical standards is to provide guidance on the assessment and management of PTLD and the implementation of pulmonary rehabilitation (PR).METHODS: A panel of global experts in the field of TB care and PR was identified; 62 participated in a Delphi process. A 5-point Likert scale was used to score the initial ideas for standards and after several rounds of revision the document was approved (with 100% agreement).RESULTS: Five clinical standards were defined: Standard 1, to assess patients at the end of TB treatment for PTLD (with adaptation for children and specific settings/situations); Standard 2, to identify patients with PTLD for PR; Standard 3, tailoring the PR programme to patient needs and the local setting; Standard 4, to evaluate the effectiveness of PR; and Standard 5, to conduct education and counselling. Standard 6 addresses public health aspects of PTLD and outcomes due to PR.CONCLUSION: This is the first consensus-based set of Clinical Standards for PTLD. Our aim is to improve patient care and quality of life by guiding clinicians, programme managers and public health officers in planning and implementing adequate measures to assess and manage PTLD.

Published
2021

33. Protective action of Cecropia pachystachya extract and enriched flavonoid fraction against memory deficits, inflammation and oxidative damage in lipopolysaccharide challenged mice

Author

Bona, Natália Pontes, Soares de Aguiar, Mayara Sandrielly, Spohr, Luiza, Pedra, Nathalia Stark, dos Santos, Francieli da Silva, Saraiva, Juliane Torchelsen, Alvez, Fernando Lopez, de Moraes Meine, Bernardo, Recart, Vânia, Farias, Ingrid Vicente, Ortmann, Caroline Flach, Spanevello, Roselia Maria, Reginatto, Flavio Henrique, and Stefanello, Francieli Moro

Published
2024
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36. The role of the bronchial microvasculature in the airway remodelling in asthma and COPD

Author

Spanevello Antonio, Imperatori Andrea S, Chetta Alfredo, Zanini Andrea, and Olivieri Dario

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Abstract In recent years, there has been increased interest in the vascular component of airway remodelling in chronic bronchial inflammation, such as asthma and COPD, and in its role in the progression of disease. In particular, the bronchial mucosa in asthmatics is more vascularised, showing a higher number and dimension of vessels and vascular area. Recently, insight has been obtained regarding the pivotal role of vascular endothelial growth factor (VEGF) in promoting vascular remodelling and angiogenesis. Many studies, conducted on biopsies, induced sputum or BAL, have shown the involvement of VEGF and its receptors in the vascular remodelling processes. Presumably, the vascular component of airway remodelling is a complex multi-step phenomenon involving several mediators. Among the common asthma and COPD medications, only inhaled corticosteroids have demonstrated a real ability to reverse all aspects of vascular remodelling. The aim of this review was to analyze the morphological aspects of the vascular component of airway remodelling and the possible mechanisms involved in asthma and COPD. We also focused on the functional and therapeutic implications of the bronchial microvascular changes in asthma and COPD.

Published
2010
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37. EUFOREA pocket guide on the diagnosis and management of asthma: An educational and practical tool for general practitioners, non-respiratory physicians, paramedics and patients

Author

Diamant, Zuzana, Jesenak, Milos, Hanania, Nicola A., Heaney, Liam G., Djukanovic, Ratko, Ryan, Dermot, Quirce, Santiago, Backer, Vibeke, Gaga, Mina, Pavord, Ian, Antolín-Amérigo, Darío, Assaf, Sara, Bakakos, Petros, Bobcakova, Anna, Busse, William, Kappen, Jasper, Loukides, Stelios, van Maaren, Maurits, Panzner, Petr, Pite, Helena, Spanevello, Antonio, Stenberg, Henning, Striz, Ilja, Thio, Boony, Vasakova, Martina Koziar, Conti, Diego, Fokkens, Wytske, Lau, Susanne, Scadding, Glenis K., Van Staeyen, Elizabeth, Hellings, Peter W., and Bjermer, Leif

Published
2023
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38. Exhaled and arterial levels of endothelin-1 are increased and correlate with pulmonary systolic pressure in COPD with pulmonary hypertension

Author

Dragonieri Silvano, Cardone Rosa, Gadaleta Felice, Di Gioia Giuseppe, Seccia Teresa, Maniscalco Mauro, Scoditti Cristina, Carratu Pierluigi, Pierucci Paola, Spanevello Antonio, and Resta Onofrio

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Abstract Background Endothelin-1 (ET-1) and Nitric Oxide (NO) are crucial mediators for establishing pulmonary artery hypertension (PAH). We tested the hypothesis that their imbalance might also occur in COPD patients with PAH. Methods The aims of the study were to measure exhaled breath condensate (EBC) and circulating levels of ET-1, as well as exhaled NO (FENO) levels by, respectively, a specific enzyme immunoassay kit, and by chemiluminescence analysis in 3 groups of subjects: COPD with PAH (12), COPD only (36), and healthy individuals (15). In order to evaluate pulmonary-artery systolic pressure (PaPs), all COPD patients underwent Echo-Doppler assessment. Results Significantly increased exhaled and circulating levels of ET-1 were found in COPD with PAH compared to both COPD (p < 0.0001) only, and healthy controls (p < 0.0001). In COPD with PAH, linear regression analysis showed good correlation between ET-1 in EBC and PaPs (r = 0.621; p = 0.031), and between arterial levels of ET-1 and PaPs (r = 0.648; p = 0.022), while arterial levels of ET-1 inversely correlated with FEV1%, (r = -0.59, p = 0.043), and PaPs negatively correlated to PaO2 (r = -0.618; p = 0.032). Significantly reduced levels of FENO were found in COPD associated with PAH, compared to COPD only (22.92 ± 11.38 vs.35.07 ± 17.53 ppb; p = 0.03). Thus, we observed an imbalanced output in the breath between ET-1 and NO, as expression of pulmonary endothelium and epithelium impairment, in COPD with PAH compared to COPD only. Whether this imbalance is an early cause or result of PAH due to COPD is still unknown and deserves further investigations.

Published
2008
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40. Blueberry Extract Modulates Brain Enzymes Activities and Reduces Neuroinflammation: Promising Effect on Lipopolysaccharide-Induced Depressive-Like Behavior

Author

Spohr, Luiza, de Aguiar, Mayara Sandrielly Soares, Bona, Natália Pontes, Luduvico, Karina Pereira, Alves, Amália Gonçalves, Domingues, William Borges, Blödorn, Eduardo Bierhals, Bortolatto, Cristiani Folharini, Brüning, César Augusto, Campos, Vinicius Farias, Stefanello, Francieli Moro, and Spanevello, Roselia Maria

Published
2023
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48. ENCEFALITE POR EPSTEIN-BARR VÍRUS EM UM PACIENTE ADULTO VIVENDO COM HIV

Author

Paulo Cesar Landim Filho, Roberta Lestch da Silveira, Jerusa Marquardt Corazza, Fernanda Caldeira Veloso dos Santos, and Thami Ellen Busanello Spanevello

Subjects
Epstein-Barr Encefalite HIV, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

O Epstein-Barr Vírus (EBV) é um herpesvírus humano que participa da etiologia de muitas doenças autoimunes e cânceres. A apresentação de infecção no sistema nervoso central pode variar de formas assintomáticas a fatais. As encefalites virais são um desafio na prática médica, sendo por muitas vezes subdiagnosticadas. Dificilmente vê-se EBV causando esse tipo de doença em adultos com HIV. Portanto, são de grande importância relatos de casos dessa enfermidade para fornecer maior embasamento literário para auxílio no reconhecimento e tratamento de pacientes acometidos. Paciente de 54 anos, homossexual masculino, PVHIV/SIDA com história de má adesão ao tratamento, porém, com boa adesão recente. Em uso de terapia antirretroviral guiada por genotipagem, com carga viral não detectada e contagem de CD4+ de 269 células/microL em 2020. Deu entrada no Hospital Universitário de Santa Maria em novembro de 2021 devido à confusão mental, lapsos de memória e alteração na marcha, com declínio progressivo há 2 meses, culminando com fala desconexa e ebriosa, disfagia e quedas. Apresentava-se sonolento, desorientado, com marcha atáxica, reflexos profundos hiper-reativos, reflexo cutâneo plantar em flexão bilateral e parestesia em membros inferiores. Como marco do início dos sintomas foi mencionado um quadro gripal apresentado pelo paciente 4 meses antes. Realizaram-se tomografias de crânio e tórax e exames laboratoriais sem alterações. Também foi feita coleta de líquido cerebrospinal com discreto aumento de proteínas e de celularidade com predomínio de linfócitos, sem outras alterações. Diante do exposto, estabeleceu-se o diagnóstico sindrômico de encefalite e foi iniciado tratamento para os germes mais prováveis (Herpesvírus e Listeria monocytogenes) com aciclovir e ampicilina. Realizada ressonância nuclear magnética de crânio com achados característicos de encefalite viral, sugestivos de infecção por EBV. Coletou-se sorologia para EBV com resultado reagente para anticorpos IgG e IgM. Optado por manter tratamento com aciclovir por 21 dias. O paciente permaneceu em reabilitação clínica por sequelas motoras graves, foi transferido para uma instituição de cuidados continuados e, após 2 meses, evoluiu para óbito por causas desconhecidas. Esse relato é o primeiro no Brasil a evidenciar encefalite por EBV através de soroconversão de IgM durante internação hospitalar e fase sintomática da doença em um paciente adulto vivendo com HIV.

Published
2023
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49. HISTOPLASMOSE CUTÂNEA EXTENSA ASSOCIADA À PÊNFIGO VULGAR EM PACIENTE IMUNOCOMPETENTE

Author

Roberta Lestch da Silveira, Jerusa Marquardt Corazza, Fernanda Caldeira Veloso dos Santos, Thami Ellen Busanello Spanevello, and Adriane Schio Pagliarini

Subjects
Histoplasmose, Pênfigo, Doenças endêmicas, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

A histoplasmose, causada pelo fungo Histoplasma capsulatum, é uma micose endêmica que eventualmente pode resultar em doença grave. A maioria dos pacientes que desenvolve histoplasmose severa é imunodeprimida ou está em extremos de idade. Pode apresentar-se clinicamente com sintomas constitucionais, linfadenopatia, hepatoesplenomegalia, lesões de pele e mucosas. O diagnóstico é feito através de suspeita clínica associada à visualização direta/cultura do fungo em tecidos e/ou exame histopatológico. Anticorpos anti Histoplasma e antígeno urinário podem auxiliar na investigação. Paciente masculino, 55 anos, agricultor, encaminhado da atenção primária por perda de peso e placa eritematosa e dolorosa em bordo de língua iniciados há 5 meses. Realizada biópsia da lesão, sem identificação de microrganismos em exames diretos e culturas. Após 4 meses evoluiu com disfonia e lesões de pele bolhosas, frágeis, pruriginosas, com ulcerações, crostas e outras alterações tróficas crônicas, com saída de secreção serosa. As lesões iniciaram em membros superiores e apresentaram disseminação para todo o corpo. Foi submetido à biópsia de pele com evidência de Histoplasma capsulatum em exame micológico direto. Realizada, então, internação hospitalar para tratamento intravenoso com anfotericina B devido à grande extensão das lesões. Foi realizada ampla investigação de imunodeficiências, sem evidência de neoplasias e outras doenças. Sorologias para HIV, hepatites e sífilis não reagentes, VHS elevado, demais exames sem alterações. Durante o tratamento antifúngico as lesões apresentaram importante melhora, com evolução para crostas e redução progressiva da saída de secreção até interrupção completa. O paciente recebeu alta com itraconazol 400 mg/dia após uso de 10 dias de anfotericina B complexo lipídico. Em consulta ambulatorial de retorno mantinha lesões crostosas muito pruriginosas, com algumas lesões bolhosas. Foi obtido o resultado do exame anatomopatológico de língua e pele com diagnóstico de pênfigo vulgar, prescrita corticoterapia com prednisona 1 mg/kg/dia (dose reduzida posteriormente) e mantido itraconazol. Com o tratamento antifúngico para histoplasmose cutânea associado à corticoterapia para tratamento de pênfigo vulgar o paciente evoluiu com cicatrização completa das lesões de pele e mucosa. Devido à sua endemicidade, infecções fúngicas devem ser investigadas em pacientes com lesões de pele e sintomas constitucionais, mesmo na ausência de imunodeficiências conhecidas.

Published
2023
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50. MENINGITE CRÔNICA POR CRYPTOCOCCUS GATTII EM PACIENTE IMUNOCOMPETENTE

Author

Bruno Pereira Conte, Jerusa Marquardt Corazza, Roberta Lestch da Silveira, Thami Ellen Busanello Spanevello, and Fernanda Caldeira Veloso dos Santos

Subjects
Meningite crônica, Imunocompetente, Cryptococcus gattii, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

Meningite crônica cursa com inflamação no Líquido Cerebroespinal (LCE) e afeta várias regiões do sistema nervoso. Os sintomas mais comuns são cefaleia, náuseas, vômitos e polirradiculopatia. As possíveis etiologias são neoplásicas, autoimunes e infecciosas. Paciente masculino, 56 anos, morador da zona rural, diabético, etilista em abstinência, foi encaminhado a hospital de referência para investigação de cefaleia pulsátil associada a náuseas, vômitos, vertigem, perda ponderal e sudorese noturna eventual iniciados há cerca de 6 meses. Possuía histórico de internação hospitalar no ano anterior por sintomas neurológicos semelhantes, com hiperproteinorraquia e celularidade aumentada no LCE, com culturas negativas. Na ocasião, o paciente recebeu tratamento empírico para encefalite com ampicilina e teve alta após melhora sintomática. Cerca de 6 meses após a alta voltou a ficar sintomático e foi hospitalizado. Foram solicitados exames laboratoriais para pesquisa de doenças autoimunes, marcadores tumorais e sorologias, todos sem alterações. Análise de LCE demonstrou pleocitose (75% de linfócitos) e hiperproteinorraquia (503 mg/dL), com culturas e exames diretos negativos. O paciente foi submetido a ressonância de neuroeixo, sem alterações, e foi investigado para presença de neoplasias com resultados negativos. A tomografia de tórax evidenciou conglomerados de linfonodos em região hilar e opacidades micronodulares com preenchimento brônquico. Foram feitos lavado broncoalveolar, biópsia de lesão endobrônquica e de linfonodo mediastinal. As amostras tiveram cultura positiva para Cryptococcus gattii. Assim, definiu-se o diagnóstico de meningite crônica por etiologia fúngica com base nas alterações do LCE, apesar do micológico cultural negativo. Foi realizado tratamento de indução com anfotericina B lipossomal e fluconazol por 14 dias. O paciente evoluiu com melhora sintomática, recebeu alta com fluconazol para tratamento de consolidação e manteve-se assintomático desde então. Meningoencefalite criptocócica é uma causa extremamente rara de doença de sistema nervoso central em pacientes imunocompetentes. Acredita-se que o mecanismo se deve à alta exposição à cepa criptocócica com alta patogenicidade ou a algum déficit imunológico não detectado. Nesse sentido, álcool e diabetes podem fazer com que o hospedeiro se torne imunossuprimido temporariamente.

Published
2023
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