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5. Risk factors and action thresholds for the novel coronavirus pandemic. Insights from the Italian Society of Nephrology COVID-19 Survey

Author

Nordio, M., Reboldi, G., Di Napoli, A., Quintaliani, G., Alberici, F., Postorino, M., Aucella, F., Messa, P., Brunori, G., Bosco, M., Malberti, F., Mandreoli, M., Mazzaferro, S., Movilli, E., Ravera, M., Salomone, M., Santoro, D., Postorinolimido, M. A., Bonomini, M., Stingone, A., Maccarone, M., Di Loreto, E., Stacchiotti, L., Malandra, R., Chiarella, S., D'Agostino, F., Fuiano, G., Nicodemo, L., Bonofiglio, R., Greco, S., Mallamaci, F., Barreca, E., Caserta, C., Bruzzese, V., Galati, D., Tramontana, D., Viscione, M., Chiuchiolo, L., Tuccillo, S., Sepe, M., Vitale, F., Ciriana, E., Martignetti, V., Caserta, D., Stizzo, A., Romano, A., Iulianiello, G., Cascone, E., Minicone, P., Chiricone, D., Delgado, G., Barbato, A., Celentano, S., Molfino, I., Coppola, S., Raiola, I., Abategiovanni, M., Borrelli, S., Margherita, C., Bruno, F., Ida, M., Aliperti, E., Potito, D., Cuomo, G., De Luca, M., Merola, M., Botta, C., Garofalo, G., Alinei, P., Paglionico, C., Roano, M., Vitale, S., Ierardi, R., Fimiani, V., Conte, G., Di Natale, G., Romano, M., Di Marino, V., Scafarto, A., Meccariello, S., Pecoraro, C., Di Stazio, E., Di Meglio, E., Cuomo, A., Maresca, B., Rotaia, E., Capasso, G., Auricchio, M., Pluvio, C., Maddalena, L., De Maio, A., Palladino, G., Buono, F., Gigliotti, G., Mancini, E., La Manna, G., Storari, A., Mosconi, G., Cappelli, G., Scarpioni, R., Gregorini, M., Rigotti, A., Mancini, W., Bianco, F., Boscutti, G., Amici, G., Tosto, M., Fini, R., Pace, G., Cioffi, A., Boccia, E., Di Lullo, L., Di Zazzo, G., Simonelli, R., Bondatti, F., Miglio, L., Rifici, N., Treglia, A., Muci, M., Baldinelli, G., Rizzi, E., Lonzi, M., De Cicco, C., Forte, F., De Paolis, P., Grandaliano, Giuseppe, Cuzziol, C., Torre, V. M., Sfregola, P., Rossi, V., Fabio, G., Flammini, A., Filippini, A., Onorato, L., Vendola, F., Di Daniela, N., Alfarone, C., Scabbia, L., Ferrazzano, M., Grotta, B. D., Gamberini, M., Fazzari, L., Mene, P., Morgia, A., Catucci, A., Palumbo, R., Puliti, M., Marinelli, R., Polito, P., Marrocco, F., Morabito, S., Rocca, R., Nazzaro, L., Lavini, R., Iamundo, V., Chiappini, M., Casarci, M., Morosetti, M., Hassan, S., Firmi, G., Galliani, M., Serraiocco, M., Feriozzi, S., Valentini, W., Sacco, P., Garibotto, G., Cappelli, V., Saffioti, C., Repetto, M., Rolla, D., Lorenz, M., Pedrini, L., Polonioli, D., Galli, E., Ruggenenti, P., Scolari, F., Bove, S., Costantino, E., Bracchi, M., Mangano, S., Depetri, G., La Milia, V., Farina, M., Zecchini, S., Savino, R., Melandri, M., Guastoni, C., Paparella, M., Gallieni, M., Minetti, E., Bisegna, S., Righetti, M., Badalamenti, S., Alberghini, E., Bertoli, S., Fabbrini, P., Albrizio, P., Rampino, T., Colturi, C., Rombola, G., Lucatello, A., Guerrini, E., Ranghino, A., Lenci, F., Fanciulli, E., Santarelli, S., Damiani, C., Garofalo, D., Sopranzi, F., Santoferrara, A., Di Luca, M., Galiotta, P., Brigante, M., Manganaro, M., Maffei, S., Berto, I., Besso, L., Viglino, G., Cusinato, S., Chiarinottichiappero, D. F., Tognarelli, G., Gianoglio, B., Forneris, G., Biancone, L., Savoldi, S., Vitale, C., Boero, R., Filiberti, O., Borzumati, M., Gesualdo, L., Lomonte, C., Gernone, G., Pallotta, G., Di Paolo, S., Vernaglione, L., Specchio, A., Stallone, G., Dell'Aquila, R., Sandri, G., Russo, F., Napoli, M., Marangi, A., Morrone, L., Di Stratis, C., Fresu, A., Cicu, F., Murtas, S., Manca, O., Pani, A., Pilloni, M., Pistis, R., Cadoni, M., Contu, B., Logias, F., Ivaldi, R., Fancello, S., Cossu, M., Lepori, G., Vittoria, S., Battiati, E., Arnone, M., Rome, M., Barbera, A., Granata, A., Collura, G., Dico, C. L., Pugliese, G., Di Natale, E., Rizzari, G., Cottone, L., Longo, N., Battaglia, G., Marcantoni, C., Giannetto, G., Tumino, G., Randazzo, F., Bellissimo, L., Faro, F. L., Grippaldi, F., Urso, S., Quattrone, G., Todaro, I., Vincenzo, D., Murgo, A., Masuzzo, M., Pisacane, A., Monardo, P., Pontorierro, M., Quari, C., Bauro, A., Chimenz, R. R., Alfio, D., Girasole, F., Cascio, A. L., Caviglia, A., Tornese, F., Sirna, F., Altieri, C., Cusumano, R., Saveriano, V., La Corte, A., Locascio, G., Rotolo, U., Musso, S., Risuglia, L., Blanco, G., Minardo, G., Castellino, S., Zappulla, Z., Randone, S., Di Francesca, M., Cassetti, C. C., Oddo, G., Buscaino, G., Mucaria, F., Barraco, V. I., Di Martino, A., Rallo, D., Dani, L., Campolo, G., Manescalchi, F., Biagini, M., Agate, M., Panichi, V., Casani, A., Traversari, L., Garosi, G., Tabbi, M., Selvi, A., Cencioni, L., Fagugli, R., Timio, F., Leveque, A., Manes, M., Mennella, G., Calo, L., Fiorini, F., Abaterusso, C., Calzavara, P., Meneghel, G., Bonesso, C., Gambaro, G., Gammaro, L., Rugiu, C., Ronco, C., Nordio M., Reboldi G., Di Napoli A., Quintaliani G., Alberici F., Postorino M., Aucella F., Messa P., Brunori G., Bosco M., Malberti F., Mandreoli M., Mazzaferro S., Movilli E., Ravera M., Salomone M., Santoro D., PostorinoLimido M.A., Bonomini M., Stingone A., Maccarone M., Di Loreto E., Stacchiotti L., Malandra R., Chiarella S., D'Agostino F., Fuiano G., Nicodemo L., Bonofiglio R., Greco S., Mallamaci F., Barreca E., Caserta C., Bruzzese V., Galati D., Tramontana D., Viscione M., Chiuchiolo L., Tuccillo S., Sepe M., Vitale F., Ciriana E., Martignetti V., Caserta D., Stizzo A., Romano A., Iulianiello G., Cascone E., Minicone P., Chiricone D., Delgado G., Barbato A., Celentano S., Molfino I., Coppola S., Raiola I., Abategiovanni M., Borrelli S., Margherita C., Bruno F., Ida M., Aliperti E., Potito D., Cuomo G., De Luca M., Merola M., Botta C., Garofalo G., Alinei P., Paglionico C., Roano M., Vitale S., Ierardi R., Fimiani V., Conte G., Di Natale G., Romano M., Di Marino V., Scafarto A., Meccariello S., Pecoraro C., Di Stazio E., Di Meglio E., Cuomo A., Maresca B., Rotaia E., Capasso G., Auricchio M., Pluvio C., Maddalena L., De Maio A., Palladino G., Buono F., Gigliotti G., Mancini E., La Manna G., Storari A., Mosconi G., Cappelli G., Scarpioni R., Gregorini M., Rigotti A., Mancini W., Bianco F., Boscutti G., Amici G., Tosto M., Fini R., Pace G., Cioffi A., Boccia E., Di Lullo L., Di Zazzo G., Simonelli R., Bondatti F., Miglio L., Rifici N., Treglia A., Muci M., Baldinelli G., Rizzi E., Lonzi M., De Cicco C., Forte F., De Paolis P., Grandaliano G., Cuzziol C., Torre V.M., Sfregola P., Rossi V., Fabio G., Flammini A., Filippini A., Onorato L., Vendola F., Di Daniela N., Alfarone C., Scabbia L., Ferrazzano M., Grotta B.D., Gamberini M., Fazzari L., Mene P., Morgia A., Catucci A., Palumbo R., Puliti M., Marinelli R., Polito P., Marrocco F., Morabito S., Rocca R., Nazzaro L., Lavini R., Iamundo V., Chiappini M., Casarci M., Morosetti M., Hassan S., Firmi G., Galliani M., Serraiocco M., Feriozzi S., Valentini W., Sacco P., Garibotto G., Cappelli V., Saffioti C., Repetto M., Rolla D., Lorenz M., Pedrini L., Polonioli D., Galli E., Ruggenenti P., Scolari F., Bove S., Costantino E., Bracchi M., Mangano S., Depetri G., La Milia V., Farina M., Zecchini S., Savino R., Melandri M., Guastoni C., Paparella M., Gallieni M., Minetti E., Bisegna S., Righetti M., Badalamenti S., Alberghini E., Bertoli S., Fabbrini P., Albrizio P., Rampino T., Colturi C., Rombola G., Lucatello A., Guerrini E., Ranghino A., Lenci F., Fanciulli E., Santarelli S., Damiani C., Garofalo D., Sopranzi F., Santoferrara A., Di Luca M., Galiotta P., Brigante M., Manganaro M., Maffei S., Berto I., Besso L., Viglino G., Cusinato S., ChiarinottiChiappero D.F., Tognarelli G., Gianoglio B., Forneris G., Biancone L., Savoldi S., Vitale C., Boero R., Filiberti O., Borzumati M., Gesualdo L., Lomonte C., Gernone G., Pallotta G., Di Paolo S., Vernaglione L., Specchio A., Stallone G., Dell'Aquila R., Sandri G., Russo F., Napoli M., Marangi A., Morrone L., Di Stratis C., Fresu A., Cicu F., Murtas S., Manca O., Pani A., Pilloni M., Pistis R., Cadoni M., Contu B., Logias F., Ivaldi R., Fancello S., Cossu M., Lepori G., Vittoria S., Battiati E., Arnone M., Rome M., Barbera A., Granata A., Collura G., Dico C.L., Pugliese G., Di Natale E., Rizzari G., Cottone L., Longo N., Battaglia G., Marcantoni C., Giannetto G., Tumino G., Randazzo F., Bellissimo L., Faro F.L., Grippaldi F., Urso S., Quattrone G., Todaro I., Vincenzo D., Murgo A., Masuzzo M., Pisacane A., Monardo P., Pontorierro M., Quari C., Bauro A., Chimenz R.R., Alfio D., Girasole F., Cascio A.L., Caviglia A., Tornese F., Sirna F., Altieri C., Cusumano R., Saveriano V., La Corte A., Locascio G., Rotolo U., Musso S., Risuglia L., Blanco G., Minardo G., Castellino S., Zappulla Z., Randone S., Di Francesca M., Cassetti C.C., Oddo G., Buscaino G., Mucaria F., Barraco V.I., Di Martino A., Rallo D., Dani L., Campolo G., Manescalchi F., Biagini M., Agate M., Panichi V., Casani A., Traversari L., Garosi G., Tabbi M., Selvi A., Cencioni L., Fagugli R., Timio F., Leveque A., Manes M., Mennella G., Calo L., Fiorini F., Abaterusso C., Calzavara P., Meneghel G., Bonesso C., Gambaro G., Gammaro L., Rugiu C., and Ronco C.

Subjects
Male, Contextual analysis, medicine.medical_treatment, Population, 030232 urology & nephrology, Recursive partitioning, 030204 cardiovascular system & hematology, Rate ratio, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Classification tree, COVID-19, Renal replacement therapy, Risk Factors, Medical, Surveys and Questionnaires, Health care, medicine, Settore MED/14 - NEFROLOGIA, Humans, education, Pandemics, Societies, Medical, Female, Italy, Nephrology, education.field_of_study, business.industry, Multilevel model, Decision rule, Confidence interval, Original Article, Hemodialysis, business, Contextual analysi, Societies, Demography
Abstract

Background and aim: Over 80% (365/454) of the nation’s centers participated in the Italian Society of Nephrology COVID-19 Survey. Out of 60,441 surveyed patients, 1368 were infected as of April 23rd, 2020. However, center-specific proportions showed substantial heterogeneity. We therefore undertook new analyses to identify explanatory factors, contextual effects, and decision rules for infection containment. Methods: We investigated fixed factors and contextual effects by multilevel modeling. Classification and Regression Tree (CART) analysis was used to develop decision rules. Results: Increased positivity among hemodialysis patients was predicted by center location [incidence rate ratio (IRR) 1.34, 95% confidence interval (CI) 1.20–1.51], positive healthcare workers (IRR 1.09, 95% CI 1.02–1.17), test-all policy (IRR 5.94, 95% CI 3.36–10.45), and infected proportion in the general population (IRR 1.002, 95% CI 1.001–1.003) (all p < 0.01). Conversely, lockdown duration exerted a protective effect (IRR 0.95, 95% CI 0.94–0.98) (p < 0.01). The province-contextual effects accounted for 10% of the total variability. Predictive factors for peritoneal dialysis and transplant cases were center location and infected proportion in the general population. Using recursive partitioning, we identified decision thresholds at general population incidence ≥ 229 per 100,000 and at ≥ 3 positive healthcare workers. Conclusions: Beyond fixed risk factors, shared with the general population, the increased and heterogeneous proportion of positive patients is related to the center’s testing policy, the number of positive patients and healthcare workers, and to contextual effects at the province level. Nephrology centers may adopt simple decision rules to strengthen containment measures timely.

Published
2021

12. Standard protocol compared to a novel protocol for 68Ga-PSMA-PET/CT in patients with recurrent prostate cancer - which one is superior?

Author

Dijkstra, Lotte, Haupt, Fabian, Viscione, M., Fech, Viktor, Krause, Thomas Michael, Rominger, Axel Oliver, and Afshar Oromieh, Ali

Subjects
610 Medicine & health
Abstract

Purpose / Introduction: Since the clinical introduction of PET-imaging with 68Ga-PSMA-11, this diagnostic tool has spread worldwide and is regarded as a breakthrough in the diagnosis of recurrent prostate cancer (PC). According to its first described clinical set-up, 68Ga-PSMA-11 PET/CT is conducted at 1h post injection (p.i.). However, further publications demonstrated that later imaging (e.g. at 3h p.i.) show the majority of PC lesions with higher contrast. In 2017, we conducted scans at 1h p.i.. However, in 2018, we changed our protocol to later imaging timing. The aim of this evaluation was to compare the standard protocol of 68Ga-PSMA-11 PET/CT with a novel protocol described below. Subjects & Methods: We retrospectively compared two patient cohorts scanned with 68Ga-PSMA-11 PET/CT in 2017 (n=94 patients) and 2018 (n=75 patients). In 2017, the scanning protocol was as follows: acquisition at 1h p.i. (targeted activity: 200 MBq) with 2 min per bed position, neither hydration nor forced diuresis. In 2018, the scans were conducted at 1.5h p.i. (also 2min per bed position and targeted activity of 200 MBq). In addition, the patients started to drink 1L of water at 0.5h p.i. and were injected with 20mg of furosemide at 1h p.i.. Rates of pathologic scans, maximum standardized uptake values (SUVmax) of tumor lesions (n=164 in 2017 and n=127 in 2018), average standardized uptake values (SUVmean) of urinary bladder as well as tumor contrast (SUVmax-tumor/SUVmean gluteal musculature) were measured in all patients. Results: Average tumor contrast was significantly (p=0.0451) higher in 2018 compared to 2017 (59.0 vs. 46.1). Average SUVmean of the urinary bladder was significantly (p

Published
2018

15. Corrigendum to 'Brain and cognitive functions in two groups of naïve HIV patients selected for a different plan of antiretroviral therapy: A qEEG study' [Clin. Neurophysiol. 127 (2016) 3455–3469]((S1388245716305089)(10.1016/j.clinph.2016.09.001))

Author

Babiloni, C, Pennica, A, Capotosto, P, Onorati, P, Muratori, C, Ferracuti, S, Roma, P, Correr, V, Piccinni, E, Noce, G, Del Percio, C, Cordone, S, Limatola, C, Soricelli, A, Di Campli, F, Gianserra, L, Ciullini, L, Aceti, A, Viscione, M, Teti, E, Sarmati, L, and Andreoni, M

Subjects
Settore MED/17 - Malattie Infettive
Published
2017

16. Corrigendum to 'Abnormal cortical sources of resting state electroencephalographic rhythms in single treatment-naïve HIV individuals: A statistical z-score index' [Clin. Neurophysiol. 127 (2016) 1803–1812] (S138824571501559X) (10.1016/j.clinph.2015.12.007))

Author

Babiloni, C, Pennica, A, Del Percio, C, Noce, G, Cordone, S, Muratori, C, Ferracuti, S, Donato, N, Di Campli, F, Gianserra, L, Teti, E, Aceti, A, Soricelli, A, Viscione, M, Limatola, C, Andreoni, M, and Onorati, P

Subjects
Settore MED/17 - Malattie Infettive
Published
2017

17. Cambiamenti ambientali indotti dalle variazioni climatiche oloceniche e dall’uomo nell’area dell’Abitato antico di Pontecagnano (SA –Italia meridionale)

Author

Amato V., Aiello G., Aurino P., Bailo Modesti G., Basile F., Cerchiai L., Di Pasquale L., Mancusi M., Rossi A., Pellegrino C., Schiano Di Cola C., Viscione M., BARRA, DIANA, DI PASQUALE, GAETANO, RUSSO ERMOLLI, ELDA, Amato, V., Aiello, G., Aurino, P., Bailo Modesti, G., Barra, Diana, Basile, F., Cerchiai, L., DI PASQUALE, Gaetano, Di Pasquale, L., Mancusi, M., Rossi, A., RUSSO ERMOLLI, Elda, Pellegrino, C., Schiano Di Cola, C., and Viscione, M.

Subjects
paleoambienti, geoarcheologia, cambiamenti climatici
Abstract

L’abitato antico di Pontecagnano (VII-III a.C.), sorge su un alto morfologico di natura travertinosa, che in antico emergeva di pochi metri dal settore NO della pianura alluvionale costiera del Fiume Sele. I lavori per l’ampliamento dell’autostrada A3 SA-RC hanno intercettato livelli archeologici rappresentativi di ampie porzioni del territorio urbano e periurbano dell’abitato antico e messo in evidenza un record archeostratigrafico che va dal Pleistocene Superiore ad oggi. Lo studio geomorfologico ed archeo-tephro-stratigrafico di dettaglio, corredato da analisi paleoambientali, ha consentito di delineare gli aspetti salienti dell’evoluzione del paesaggio e degli ambienti nel corso dell’Olocene. Le modifiche dell’ambiente e del paesaggio sono state prevalentemente indotte da condizionamenti antropici sul sistema idraulico e forestale e sull’organizzazione del territorio soprattutto per il periodo di vita dell’abitato, dove si coglie un importante bonifica. Nei periodi precedenti e successivi alla vita dell’abitato i cambiamenti ambientali sono stati indotti da variazioni climatiche e dai prodotti delle eruzioni dei vulcani napoletani.

Published
2009

18. Antiretroviral therapy effects on sources of cortical rhythms in HIV subjects: responders vs. mild responders

Author

Babiloni, C, Pennica, A, Vecchio, F, Onorati, P, Muratori, C, Ferracuti, S, Roma, P, Donato, N, Noce, G, Del Percio, C, Bonacci, C, Di Campli, F, Gianserra, L, Teti, E, Aceti, A, Soricelli, A, Viscione, M, Rossini, Paolo Maria, Andreoni, M., Rossini, Paolo Maria (ORCID:0000-0003-2665-534X), Babiloni, C, Pennica, A, Vecchio, F, Onorati, P, Muratori, C, Ferracuti, S, Roma, P, Donato, N, Noce, G, Del Percio, C, Bonacci, C, Di Campli, F, Gianserra, L, Teti, E, Aceti, A, Soricelli, A, Viscione, M, Rossini, Paolo Maria, Andreoni, M., and Rossini, Paolo Maria (ORCID:0000-0003-2665-534X)

Abstract

We tested the hypothesis that 5months of combined anti-retroviral therapy (cART) affect cortical sources of resting state cortical electroencephalographic (EEG) rhythms in naïve HIV subjects.

Published
2015

23. Nevirapine use, prolonged antiretroviral therapy and high CD4 nadir values are strongly correlated with undetectable HIV-DNA and -RNA levels and CD4 cell gain

Author

Sarmati, L., primary, Parisi, S. G., additional, Montano, M., additional, Andreis, S., additional, Scaggiante, R., additional, Galgani, A., additional, Viscione, M., additional, Maffongelli, G., additional, Ricciardi, A., additional, Andreoni, C., additional, Boros, S., additional, Palu, G., additional, and Andreoni, M., additional

Published
2012
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24. Hemodiafiltration: single or double hemofilter?

Author

MEMOLI B., GAZZOTTI R. M., MAZZONE P, LOMBARDI F., VISCIONE M., FUIANO G., CONTE G., ANDREUCCI V. E., DELLO RUSSO, ANTONIO, Memoli, B., Gazzotti, R. M., Mazzone, P, Lombardi, F., Viscione, M., Fuiano, G., DELLO RUSSO, Antonio, Conte, G., and Andreucci, V. E.

Published
1989

28. Treatment of Recurrent Hepatocellular Carcinoma with Sorafenib in a HIV/HCV Co-Infected patient in HAART: A Case Report

Author

De Nardo Pasquale, Viscione Magdalena, Corpolongo Angela, Bellagamba Rita, Vennarecci Giovanni, Ettorre Giuseppe, Gentilotti Elisa, Tommasi Chiara, and Nicastri Emanuele

Subjects
HAART, Sorafenib, Fosamprenavir, TDM, Hepatocarcinoma, HIV/HCV co-infection, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Liver disease is the second cause of death among HIV patients receiving highly active antiretroviral therapy (HAART) in Europe. HIV patients have a high prevalence of chronic HBV (6–10%) and HCV (33%) co-infection, and accelerated progression of viral hepatitis. Furthermore, the long duration of both HIV and HCV diseases in the HAART era increases the risk of hepatocellular carcinoma. Findings We report the case of a 49 year -old HIV/HCV co-infected male patient who developed hepatocellular carcinoma. The patient underwent a partial hepatectomy, and a few months later was treated with transcatheter arterial chemoembolisation due to hepatocarcinoma recurrence. Two months later, advanced hepatocellular carcinoma was diagnosed and sorafenib therapy was initiated. The patient achieved partial response of the main lesions, complete regression of the smallest lesions and did not experience clinical progression during the 20-month follow-up period. During therapy with sorafenib, the patient was treated with HAART with good viral and immunological responses. We used the therapeutic drug monitoring to assess antiretroviral concentrations during co-administration of sorafenib. Fosamprenavir Ctrough was found under the minimum level recommended by international guidelines. No grade 3 or 4 toxicities were observed. At month 20 of treatment, new liver lesions with portal vein thrombosis were diagnosed. After 28 months of sorafenib therapy, the patient deceased for severe liver insufficiency. Conclusions Sorafenib monotherapy demonstrated a marked delay in HCC disease progression in an HIV/HCV co-infected patient. Fosamprenavir Ctrough was found under the minimum level recommended by international guidelines, suggesting a possible interaction.

Published
2012
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30. Effectiveness of Single Daily Intraperitoneal Administration of Aztreonam and Cefuroxime in the Treatment of Peritonitis in Continuous Ambulatory Peritoneal Dialysis (CAPD)

Author

G. Fuiano, E Nani, G. Conte, M. Viscione, V Sepe, Fuiano, G, Sepe, V, Viscione, M, Nani, E, and Conte, Giuseppe

Subjects
medicine.medical_specialty, medicine.medical_treatment, 030232 urology & nephrology, Peritonitis, Aztreonam, medicine.disease_cause, Drug Administration Schedule, Peritoneal dialysis, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Pharmacotherapy, Peritoneal Dialysis, Continuous Ambulatory, medicine, Humans, Infusions, Parenteral, 030212 general & internal medicine, Intensive care medicine, Citrobacter, Cefuroxime, biology, Streptococcus, business.industry, Continuous ambulatory peritoneal dialysis, General Medicine, Middle Aged, Staphylococcal Infections, medicine.disease, biology.organism_classification, chemistry, Evaluation Studies as Topic, Nephrology, Anesthesia, Kidney Failure, Chronic, Drug Therapy, Combination, business, medicine.drug
Abstract

To discover if the management of peritonitis in continuous ambulatory peritoneal dialysis (CAPD) may be effectively simplified by single daily i.p. administration of aztreonam (A) and cefuroxime (C), 10 adult CAPD patients (pts) with peritonitis were trained to start the following treatment procedure: a) sterile collection of dialysate effluent for cultures; b) 4 rapid in-and-out exchanges with antibiotic free dialysate; c) addition of 2 g C and 2 g A to a 2-L exchange for 6-h dwell time (the same dosage was repeated once a day in the overnight exchange); d) routine CAPD exchanges. Concentrations of C and A were measured in dialysate and serum of the patients 2, 12, 18, and 21–23 h after the i.p. administration: C remained within therapeutic range in all samples, while serum and dialysate A levels fell below such range 16 h after the i.p. administration. Seventeen peritonitis episodes occurred during the observation period (12 months): initial dialysate cultures grew Staph. aureus in 6 episodes, Staph epidermidis in 6, Pseudomonas aer. in 2, Streptococcus faecalis in 1, Citrobacter in 1, and Candida in 1. All patients but 1 (with Candida-positive culture) responded to this treatment with no relapse in 2 months. We conclude that once a day i.p. administration of 2 g aztreonam plus 2 g of cefuroxime is an effective and simple way of treating CAPD pts with gram-positive and gram-negative peritonitis.

Published
1989
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31. A deep learning method for the recovery of standard-dose imaging quality from ultra-low-dose PET on wavelet domain.

Author

Xue S, Liu F, Wang H, Zhu H, Sari H, Viscione M, Sznitman R, Rominger A, Guo R, Li B, and Shi K

Abstract

Purpose: Recent development in positron emission tomography (PET) dramatically increased the effective sensitivity by increasing the geometric coverage leading to total-body PET imaging. This encouraging breakthrough brings the hope of ultra-low dose PET imaging equivalent to transatlantic flight with the assistance of deep learning (DL)-based methods. However, conventional DL approaches face limitations in addressing the heterogeneous domain of PET imaging. This study aims to develop a wavelet-based DL method capable of restoring high-quality imaging from ultra-low-dose PET scans., Materials and Methods: In contrast to conventional DL techniques that denoise images in the spatial domain, we introduce WaveNet, a novel approach that inputs wavelet-decomposed frequency components of PET imaging to perform denoising in the frequency domain. A dataset comprising total-body 18 F -FDG PET images of 1447, acquired using total-body PET scanners including Biograph Vision Quadra (Siemens Healthineers) and uEXPLORER (United Imaging) in Bern and Shanghai, was utilized for developing and testing the proposed method. The quality of enhanced images was assessed using a customized scoring system, which incorporated weighted global physical metrics and local indices., Results: Our proposed WaveNet consistently outperforms the baseline UNet model across all levels of dose reduction factors (DRF), with greater improvements observed as image quality decreases. Statistical analysis (p < 0.05) and visual inspection validated the superiority of WaveNet. Moreover, WaveNet demonstrated superior generalizability when applied to two cross-scanner datasets (p < 0.05)., Conclusion: WaveNet developed with total-body PET scanners may offer a computational-friendly and robust approach to recover image quality from ultra-low-dose PET imaging. Its adoption may enhance the reliability and clinical acceptance of DL-based dose reduction techniques., Competing Interests: Declarations. Competing interests: H.S. is a full-time employee of Siemens Healthineers AG in Switzerland. K.S. and A.R. have received research grants from Siemens Healthineers AG and Novartis AG. Authors A.R., B.L. and K.S. are editors in Eur J Nucl Med Mol Imaging. The remaining authors declare no competing interests. Ethics approval: This retrospective study complies with all relevant ethical regulations of the respective local ethics committees in Switzerland (Waiver from Cantonal Ethics Committee of Bern, Switzerland) and China (Approval from Ruijin Hospital Ethics Committee Shanghai Jiao Tong University School of Medicine). Consent to participate: Informed consent was obtained from all patients included in this study. Consent to publish: All authors have reviewed the final version of the manuscript and approved it for submission to your journal., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2024
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32. Internal dosimetry study of [ 82 Rb]Cl using a long axial field-of-view PET/CT.

Author

Mercolli L, Bregenzer C, Diemling M, Mingels C, Rominger A, Sari H, Seibel S, Sohlberg A, Viscione M, and Caobelli F

Subjects
Humans, Middle Aged, Adult, Male, Radiation Dosage, Female, Positron Emission Tomography Computed Tomography methods, Radiometry methods, Rubidium Radioisotopes
Abstract

Purpose: Long axial field-of-view (LAFOV) positron emission tomography (PET) systems allow to image all major organs with one bed position, which is particularly useful for acquiring whole-body dynamic data using short-lived radioisotopes like 82 Rb., Methods: We determined the absorbed dose in target organs of three subjects (29, 40, and 57 years old) using two different methods, i.e., MIRD and voxel dosimetry. The subjects were injected with 407.0 to 419.61 MBq of [ 82 Rb]Cl and were scanned dynamically for 7 min with a LAFOV PET/CT scanner., Results: Using the MIRD formalism and voxel dosimetry, the absorbed dose ranged from 1.84 to 2.78 μGy/MBq (1.57 to 3.92 μGy/MBq for voxel dosimetry) for the heart wall, 2.76 to 5.73 μGy/MBq (3.22 to 5.37 μGy/MBq for voxel dosimetry) for the kidneys, and 0.94 to 1.88 μGy/MBq (0.98 to 1.92 μGy/MBq for voxel dosimetry) for the lungs. The total body effective dose lied between 0.50 and 0.76 μSv/MBq., Conclusion: Our study suggests that the radiation dose associated with [ 82 Rb]Cl PET/CT can be assessed by means of dynamic LAFOV PET and that it is lower compared to literature values., (© 2024. The Author(s).)

Published
2024
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33. Investigating the influence of long-axial versus short-axial field of view PET/CT on stage migration in lymphoma and non-small cell lung cancer.

Author

Alberts I, Seibel S, Xue S, Viscione M, Mingels C, Sari H, Afshar-Oromieh A, Limacher A, and Rominger A

Abstract

Objectives: The objective of this study was to evaluate the influence of a long-axial field-of-view (LAFOV) on stage migration using a large single-centre retrospective cohort in lymphoma and non-small cell lung cancer (NSCLC)., Methods: A retrospective study is performed for patients undergoing PET/computed tomography (CT) on either a short-axial field-of-view (SAFOV) or LAFOV PET/CT system for the staging of known or suspected NSCLC or for therapeutic response in lymphoma. The primary endpoint was the Deauville therapy response score for patients with lymphoma for the two systems. Secondary endpoints were the American Joint Committee on Cancer stage for NSCLC, the frequency of cN3 and cM1 findings, the probability for a positive nodal staging (cN1-3) for NSCLC and the diagnostic accuracy for nodal staging in NSCLC., Results: One thousand two hundred eighteen records were screened and 597 patients were included for analysis ( N  = 367 for lymphoma and N  = 291 for NSCLC). For lymphoma, no significant differences were found in the proportion of patients with complete metabolic response versus non-complete metabolic response Deauville response scores ( P  = 0.66). For NSCLC no significant differences were observed between the two scanners for the frequency of cN3 and cM1 findings, for positive nodal staging, neither the sensitivity nor the specificity., Conclusions: In this study use of a LAFOV system was neither associated with upstaging in lymphoma nor NSCLC compared to a digital SAFOV system. Diagnostic accuracy was comparable between the two systems in NSCLC despite shorter acquisition times for LAFOV., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Published
2023
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35. An encoder-decoder network for direct image reconstruction on sinograms of a long axial field of view PET.

Author

Ma R, Hu J, Sari H, Xue S, Mingels C, Viscione M, Kandarpa VSS, Li WB, Visvikis D, Qiu R, Rominger A, Li J, and Shi K

Subjects
Humans, Positron-Emission Tomography methods, Signal-To-Noise Ratio, Image Processing, Computer-Assisted methods, Positron Emission Tomography Computed Tomography
Abstract

Purpose: Deep learning is an emerging reconstruction method for positron emission tomography (PET), which can tackle complex PET corrections in an integrated procedure. This paper optimizes the direct PET reconstruction from sinogram on a long axial field of view (LAFOV) PET., Methods: This paper proposes a novel deep learning architecture to reduce the biases during direct reconstruction from sinograms to images. This architecture is based on an encoder-decoder network, where the perceptual loss is used with pre-trained convolutional layers. It is trained and tested on data of 80 patients acquired from recent Siemens Biograph Vision Quadra long axial FOV (LAFOV) PET/CT. The patients are randomly split into a training dataset of 60 patients, a validation dataset of 10 patients, and a test dataset of 10 patients. The 3D sinograms are converted into 2D sinogram slices and used as input to the network. In addition, the vendor reconstructed images are considered as ground truths. Finally, the proposed method is compared with DeepPET, a benchmark deep learning method for PET reconstruction., Results: Compared with DeepPET, the proposed network significantly reduces the root-mean-squared error (NRMSE) from 0.63 to 0.6 (p &lt; 0.01) and increases the structural similarity index (SSIM) and peak signal-to-noise ratio (PSNR) from 0.93 to 0.95 (p &lt; 0.01) and from 82.02 to 82.36 (p &lt; 0.01), respectively. The reconstruction time is approximately 10 s per patient, which is shortened by 23 times compared with the conventional method. The errors of mean standardized uptake values (SUVmean) for lesions between ground truth and the predicted result are reduced from 33.5 to 18.7% (p = 0.03). In addition, the error of max SUV is reduced from 32.7 to 21.8% (p = 0.02)., Conclusion: The results demonstrate the feasibility of using deep learning to reconstruct images with acceptable image quality and short reconstruction time. It is shown that the proposed method can improve the quality of deep learning-based reconstructed images without additional CT images for attenuation and scattering corrections. This study demonstrated the feasibility of deep learning to rapidly reconstruct images without additional CT images for complex corrections from actual clinical measurements on LAFOV PET. Despite improving the current development, AI-based reconstruction does not work appropriately for untrained scenarios due to limited extrapolation capability and cannot completely replace conventional reconstruction currently., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2022
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36. Using domain knowledge for robust and generalizable deep learning-based CT-free PET attenuation and scatter correction.

Author

Guo R, Xue S, Hu J, Sari H, Mingels C, Zeimpekis K, Prenosil G, Wang Y, Zhang Y, Viscione M, Sznitman R, Rominger A, Li B, and Shi K

Subjects
Magnetic Resonance Imaging, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography methods, Deep Learning, Image Processing, Computer-Assisted methods
Abstract

Despite the potential of deep learning (DL)-based methods in substituting CT-based PET attenuation and scatter correction for CT-free PET imaging, a critical bottleneck is their limited capability in handling large heterogeneity of tracers and scanners of PET imaging. This study employs a simple way to integrate domain knowledge in DL for CT-free PET imaging. In contrast to conventional direct DL methods, we simplify the complex problem by a domain decomposition so that the learning of anatomy-dependent attenuation correction can be achieved robustly in a low-frequency domain while the original anatomy-independent high-frequency texture can be preserved during the processing. Even with the training from one tracer on one scanner, the effectiveness and robustness of our proposed approach are confirmed in tests of various external imaging tracers on different scanners. The robust, generalizable, and transparent DL development may enhance the potential of clinical translation., (© 2022. The Author(s).)

Published
2022
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37. A cross-scanner and cross-tracer deep learning method for the recovery of standard-dose imaging quality from low-dose PET.

Author

Xue S, Guo R, Bohn KP, Matzke J, Viscione M, Alberts I, Meng H, Sun C, Zhang M, Zhang M, Sznitman R, El Fakhri G, Rominger A, Li B, and Shi K

Subjects
Artificial Intelligence, Brain diagnostic imaging, Humans, Image Processing, Computer-Assisted, Positron-Emission Tomography methods, Deep Learning, Fluorodeoxyglucose F18
Abstract

Purpose: A critical bottleneck for the credibility of artificial intelligence (AI) is replicating the results in the diversity of clinical practice. We aimed to develop an AI that can be independently applied to recover high-quality imaging from low-dose scans on different scanners and tracers., Methods: Brain [ 18 F]FDG PET imaging of 237 patients scanned with one scanner was used for the development of AI technology. The developed algorithm was then tested on [ 18 F]FDG PET images of 45 patients scanned with three different scanners, [ 18 F]FET PET images of 18 patients scanned with two different scanners, as well as [ 18 F]Florbetapir images of 10 patients. A conditional generative adversarial network (GAN) was customized for cross-scanner and cross-tracer optimization. Three nuclear medicine physicians independently assessed the utility of the results in a clinical setting., Results: The improvement achieved by AI recovery significantly correlated with the baseline image quality indicated by structural similarity index measurement (SSIM) (r = -0.71, p < 0.05) and normalized dose acquisition (r = -0.60, p < 0.05). Our cross-scanner and cross-tracer AI methodology showed utility based on both physical and clinical image assessment (p < 0.05)., Conclusion: The deep learning development for extensible application on unknown scanners and tracers may improve the trustworthiness and clinical acceptability of AI-based dose reduction., (© 2021. The Author(s).)

Published
2022
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38. Feasibility of late acquisition [68Ga]Ga-PSMA-11 PET/CT using a long axial field-of-view PET/CT scanner for the diagnosis of recurrent prostate cancer-first clinical experiences.

Author

Alberts I, Prenosil G, Mingels C, Bohn KP, Viscione M, Sari H, Rominger A, and Afshar-Oromieh A

Subjects
Edetic Acid, Feasibility Studies, Humans, Male, Neoplasm Recurrence, Local, Retrospective Studies, Positron Emission Tomography Computed Tomography, Prostatic Neoplasms diagnostic imaging
Abstract

Purpose: While acquisition of images in [ 68  Ga]Ga-PSMA-11 following longer uptake times can improve lesion uptake and contrast, resultant imaging quality and count statistics are limited by the isotope's half-life (68 min). Here, we present a series of cases demonstrating that when performed using a long axial field-of-view (LAFOV) PET/CT system, late imaging is feasible and can even provide improved image quality compared to regular acquisitions., Methods: In this retrospective case series, we report our initial experiences with 10 patients who underwent standard imaging at 1 h p.i. following administration of 192 ± 36 MBq [ 68  Ga]Ga-PSMA-11 with additional late imaging performed at 4 h p.i. Images were acquired in a single bed position for 6 min at 1 h p.i. and 16 min p.i. at 4 h p.i. using a LAFOV scanner (106 cm axial FOV). Two experienced nuclear medicine physicians reviewed all scans in consensus and evaluated overall image quality (5-point Likert scale), lesion uptake in terms of standardised uptake values (SUV), tumour to background ratio (TBR) and target-lesion signal to background noise (SNR)., Results: Subjective image quality as rated on a 5-point Likert scale was only modestly lower for late acquisitions (4.2/5 at 4 h p.i.; 5/5 1 h p.i.), TBR was significantly improved (4 h: 3.41 vs 1 h: 1.93, p < 0.001) and SNR was improved with borderline significance (4 h: 33.02 vs 1 h: 24.80, p = 0.062) at later imaging. Images were obtained with total acquisition times comparable to routine examinations on standard axial FOV scanners., Conclusion: Late acquisition in tandem with a LAFOV PET/CT resulted in improvements in TBR and SNR and was associated with only modest impairment in subjective visual imaging quality. These data show that later acquisition times for [ 68  Ga]Ga-PSMA-11 may be preferable when performed on LAFOV systems., (© 2021. The Author(s).)

Published
2021
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39. Development of a deep learning method for CT-free correction for an ultra-long axial field of view PET scanner.

Author

Xue S, Bohn KP, Guo R, Sari H, Viscione M, Rominger A, Li B, and Shi K

Subjects
Artificial Intelligence, China, Humans, Image Processing, Computer-Assisted, Positron-Emission Tomography, Tomography, X-Ray Computed, Deep Learning
Abstract

Introduction: The possibility of low-dose positron emission tomography (PET) imaging using high sensitivity long axial field of view (FOV) PET/computed tomography (CT) scanners makes CT a critical radiation burden in clinical applications. Artificial intelligence has shown the potential to generate PET images from non-corrected PET images. Our aim in this work is to develop a CT-free correction for a long axial FOV PET scanner., Methods: Whole body PET images of 165 patients scanned with a digital regular FOV PET scanner (Biograph Vision 600 (Siemens Healthineers) in Shanghai and Bern) was included for the development and testing of the deep learning methods. Furthermore, the developed algorithm was tested on data of 7 patients scanned with a long axial FOV scanner (Biograph Vision Quadra, Siemens Healthineers). A 2D generative adversarial network (GAN) was developed featuring a residual dense block, which enables the model to fully exploit hierarchical features from all network layers. The normalized root mean squared error (NRMSE) and peak signal-to-noise ratio (PSNR), were calculated to evaluate the results generated by deep learning., Results: The preliminary results showed that, the developed deep learning method achieved an average NRMSE of 0.4±0.3% and PSNR of 51.4±6.4 for the test on Biograph Vision, and an average NRMSE of 0.5±0.4% and PSNR of 47.9±9.4 for the validation on Biograph Vision Quadra, after applied transfer learning., Conclusion: The developed deep learning method shows the potential for CT-free AI-correction for a long axial FOV PET scanner. Work in progress includes clinical assessment of PET images by independent nuclear medicine physicians. Training and fine-tuning with more datasets will be performed to further consolidate the development.

Published
2021
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40. Clinical performance of long axial field of view PET/CT: a head-to-head intra-individual comparison of the Biograph Vision Quadra with the Biograph Vision PET/CT.

Author

Alberts I, Hünermund JN, Prenosil G, Mingels C, Bohn KP, Viscione M, Sari H, Vollnberg B, Shi K, Afshar-Oromieh A, and Rominger A

Subjects
Humans, Medical Oncology, Motion, Positron-Emission Tomography, Radiopharmaceuticals, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography
Abstract

Purpose: To investigate the performance of the new long axial field-of-view (LAFOV) Biograph Vision Quadra PET/CT and a standard axial field-of-view (SAFOV) Biograph Vision 600 PET/CT (both: Siemens Healthineers) system using an intra-patient comparison., Methods: Forty-four patients undergoing routine oncological PET/CT were prospectively included and underwent a same-day dual-scanning protocol following a single administration of either 18 F-FDG (n = 20), 18 F-PSMA-1007 (n = 16) or 68 Ga-DOTA-TOC (n = 8). Half the patients first received a clinically routine examination on the SAFOV (FOV axial 26.3 cm) in continuous bed motion and then immediately afterwards on the LAFOV system (10-min acquisition in list mode, FOV axial 106 cm); the second half underwent scanning in the reverse order. Comparisons between the LAFOV at different emulated scan times (by rebinning list mode data) and the SAFOV were made for target lesion integral activity, signal to noise (SNR), target lesion to background ratio (TBR) and visual image quality., Results: Equivalent target lesion integral activity to the SAFOV acquisitions (16-min duration for a 106 cm FOV) were obtained on the LAFOV in 1.63 ± 0.19 min (mean ± standard error). Equivalent SNR was obtained by 1.82 ± 1.00 min LAFOV acquisitions. No statistically significant differences (p > 0.05) in TBR were observed even for 0.5 min LAFOV examinations. Subjective image quality rated by two physicians confirmed the 10 min LAFOV to be of the highest quality, with equivalence between the LAFOV and the SAFOV at 1.8 ± 0.85 min. By analogy, if the LAFOV scans were maintained at 10 min, proportional reductions in applied radiopharmaceutical could obtain equivalent lesion integral activity for activities under 40 MBq and equivalent doses for the PET component of <1 mSv., Conclusion: Improved image quality, lesion quantification and SNR resulting from higher sensitivity were demonstrated for an LAFOV system in a head-to-head comparison under clinical conditions. The LAFOV system could deliver images of comparable quality and lesion quantification in under 2 min, compared to routine SAFOV acquisition (16 min for equivalent FOV coverage). Alternatively, the LAFOV system could allow for low-dose examination protocols. Shorter LAFOV acquisitions (0.5 min), while of lower visual quality and SNR, were of adequate quality with respect to target lesion identification, suggesting that ultra-fast or low-dose acquisitions can be acceptable in selected settings.

Published
2021
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41. Digital PET/CT allows for shorter acquisition protocols or reduced radiopharmaceutical dose in [ 18 F]-FDG PET/CT.

Author

Alberts I, Sachpekidis C, Prenosil G, Viscione M, Bohn KP, Mingels C, Shi K, Ashar-Oromieh A, and Rominger A

Subjects
Body Weight, Humans, Image Processing, Computer-Assisted, Retrospective Studies, Sensitivity and Specificity, Signal-To-Noise Ratio, Fluorodeoxyglucose F18 chemistry, Neoplasms diagnostic imaging, Positron Emission Tomography Computed Tomography methods, Radiopharmaceuticals chemistry
Abstract

Purpose: To establish the feasibility of shorter acquisition times (and by analogy, applied activity) on tumour detection and lesion contrast in digital PET/CT., Methods: Twenty-one randomly selected patients who underwent oncological [ 18 F]-FDG PET/CT on a digital PET/CT were retrospectively evaluated. Scan data were anonymously obtained and reconstructed in list-mode acquisition for a standard 2 min/bed position (bp), 1 min/bp and 30 s/bp (100%, 50% and 25% time or applied activity, respectively). Scans were randomized and read by two nuclear medicine physicians in a consensus read. Readers were blind to clinical details. Scans were evaluated for the number of pathological lesions detected. Measured uptake for lesions was evaluated by maximum and mean standardized uptake value (SUVmax and SUVmean, respectively) and tumour-to-backround ratio (TBR) were compared. Agreement between the three acquisitions was compared by Krippendorf's alpha., Results: Overall n = 100 lesions were identified in the 2 min and 1 min/bp acquisitions and n = 98 lesions in the 30 s/bp acquisitions. Agreement between the three acquisitions with respect to lesion number and tumour-to-background ratio showed almost perfect agreement (K's α = 0.999). SUVmax, SUVmean and TBR likewise showed > 98% agreement, with longer acquisitions being associated with slightly higher mean TBR (2 min/bp 7.94 ± 4.41 versus 30 s/bp 7.84 ± 4.22, p < 0.05)., Conclusion: Shorter acquisition times have traditionally been associated with reduced lesion detectability or the requirement for larger amounts of radiotracer activity. These data confirm that this is not the case for new-generation digital PET scanners, where the known higher sensitivity results in clinically adequate images for shorter acquisitions. Only a small variation in the semi-quantitative parameters SUVmax, SUVmean and TBR was seen, confirming that either reduction of acquisition time or (by analogy) applied activity can be reduced as much as 75% in digital PET/CT without apparent clinical detriment.

Published
2021
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42. [Gross Hematuria after kidney biopsy. A case report].

Author

Manganelli R, Iannaccone S, Lombardi G, De Siero M, Lago L, Desiderio G, De Simone E, Viscione M, and Tirri C

Subjects
Adult, Biopsy adverse effects, Female, Humans, Arteriovenous Fistula complications, Arteriovenous Fistula etiology, Hematuria etiology, Kidney pathology, Postoperative Complications etiology, Renal Artery, Renal Veins
Abstract

We describe the clinical case of a patient experiencing severe gross hematuria causing clotting in the renal pelvis, after undergoing a kidney biopsy.The ecocolordopper and CT angiography performed did not reveal the cause of hematuria.The kidney arteriography allowed the diagnosis, revealing an arteriovenous fistula responsible for bleeding together with a small false aneurysm in the lower pole of the biopsied kidney. Both lesions were successfully treated with superselective embolization with microcoils. We discuss about the diagnostic and therapeutic approach of these rare post-biopsy complications briefly focusing on the technical aspects and on possible risks that the transcatheter embolotherapy may result., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

Published
2017

44. Corrigendum to "Brain and cognitive functions in two groups of naïve HIV patients selected for a different plan of antiretroviral therapy: A qEEG study" [Clin. Neurophysiol. 127 (2016) 3455-3469].

Author

Babiloni C, Pennica A, Capotosto P, Onorati P, Muratori C, Ferracuti S, Roma P, Correr V, Piccinni E, Noce G, Del Percio C, Cordone S, Limatola C, Soricelli A, Di Campli F, Gianserra L, Ciullini L, Aceti A, Viscione M, Teti E, Sarmati L, and Andreoni M

Published
2017
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45. Brain and cognitive functions in two groups of naïve HIV patients selected for a different plan of antiretroviral therapy: A qEEG study.

Author

Babiloni C, Pennica A, Capotosto P, Onorati P, Muratori C, Ferracuti S, Roma P, Correr V, Piccinni E, Noce G, Del Percio C, Cordone S, Limatola C, Soricelli A, Di Campli F, Gianserra L, Ciullini L, Aceti A, Viscione M, Teti E, Sarmati L, and Andreoni M

Subjects
Adult, Anti-Retroviral Agents administration & dosage, Brain drug effects, Electroencephalography drug effects, Female, Follow-Up Studies, HIV Infections diagnosis, Humans, Male, Antiretroviral Therapy, Highly Active methods, Brain physiopathology, Cognition physiology, Electroencephalography methods, HIV Infections drug therapy, HIV Infections physiopathology
Abstract

Objective: Cortical sources of electroencephalographic (EEG) rhythms were investigated in two sub-populations of naïve HIV subjects, grouped based on clinical criteria to receive different combination anti-retroviral therapies (cARTs). These EEG sources were hypothesized to reflect beneficial effects of both regimes., Methods: Eyes-closed resting state EEG data were collected in 19 (Group A) and 39 (Group B) naïve HIV subjects at baseline (i.e. pre-treatment; T0) and after 5months of cART (T5). Compared with the Group A, the Group B was characterized by slightly worse serological parameters and higher cardiovascular risk. At T0, mean viral load (VL) and CD4 count were 87,694copies/ml and 435cells/μl in the Group A and 187,370copies/ml and 331cells/μl in the Group B. The EEG data were also collected in 50 matched control HIV-negative subjects. Cortical EEG sources were assessed by LORETA software., Results: Compared to the Control Group, the HIV Groups showed lower alpha (8-12Hz) source activity at T0 while the Group B also exhibited higher delta source activity. The treatment partially normalized alpha and delta source activity in the Group A and B, respectively, in association with improved VL, CD4, and cognitive functions., Conclusions: Different cART regimens induced diverse beneficial effects in delta or alpha source activity in the two naïve HIV Groups., Significance: These sources might unveil different neurophysiological effects of diverse cART on brain function in naïve HIV Groups as a function of clinical status and/or therapeutic compounds., (Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

Published
2016
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46. Antiretroviral therapy affects the z-score index of deviant cortical EEG rhythms in naïve HIV individuals.

Author

Babiloni C, Pennica A, Del Percio C, Noce G, Cordone S, Lopez S, Berry K, Muratori C, Ferracuti S, Roma P, Correr V, Di Campli F, Gianserra L, Ciullini L, Aceti A, Soricelli A, Teti E, Viscione M, Limatola C, Onorati P, Capotosto P, and Andreoni M

Subjects
Adult, Alpha Rhythm drug effects, Beta Rhythm drug effects, Delta Rhythm drug effects, Electroencephalography, Humans, Male, Antiretroviral Therapy, Highly Active, Brain Waves drug effects, Cerebral Cortex drug effects, Cerebral Cortex physiopathology, HIV Infections drug therapy, HIV Infections physiopathology
Abstract

Objective: Here we tested the effect of combined antiretroviral therapy (cART) on deviant electroencephalographic (EEG) source activity in treatment-naïve HIV individuals., Methods: Resting state eyes-closed EEG data were recorded before and after 5 months of cART in 48 male HIV subjects, who were naïve at the study start. The EEG data were also recorded in 59 age- and sex-matched healthy subjects as a control group. Frequency bands of interest included delta, theta, alpha1, alpha2 and alpha3, based on alpha frequency peak specific to each individual. They also included beta1 (13-20 Hz) and beta2 (20-30 Hz). Low-resolution brain electromagnetic tomography (LORETA) estimated EEG cortical source activity in frontal, central, temporal, parietal, and occipital regions., Results: Before the therapy, the HIV group showed greater parietal delta source activity and lower spatially diffuse alpha source activity compared to the control group. Thus, the ratio of parietal delta and alpha3 source activity served as an EEG marker. The z-score showed a statistically deviant EEG marker (EEG +) in 50% of the HIV individuals before therapy (p < 0.05). After 5 months of cART, delta source activity decreased, and alpha3 source activity increased in the HIV subjects with EEG + (about 50% of them showed a normalized EEG marker)., Conclusions: This procedure detected a deviant EEG marker before therapy and its post-therapy normalization in naïve HIV single individuals., Significance: The parietal delta/alpha3 EEG marker may be used to monitor cART effects on brain function in such individuals.

Published
2016
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47. Abnormal cortical sources of resting state electroencephalographic rhythms in single treatment-naïve HIV individuals: A statistical z-score index.

Author

Babiloni C, Pennica A, Del Percio C, Noce G, Cordone S, Muratori C, Ferracuti S, Donato N, Di Campli F, Gianserra L, Teti E, Aceti A, Soricelli A, Viscione M, Limatola C, Andreoni M, and Onorati P

Subjects
Adult, Humans, Male, Pilot Projects, Viral Load methods, Cerebral Cortex physiopathology, Electroencephalography methods, Electroencephalography statistics & numerical data, HIV Infections diagnosis, HIV Infections physiopathology, Rest physiology
Abstract

Objective: This study tested a simple statistical procedure to recognize single treatment-naïve HIV individuals having abnormal cortical sources of resting state delta (<4 Hz) and alpha (8-13 Hz) electroencephalographic (EEG) rhythms with reference to a control group of sex-, age-, and education-matched healthy individuals. Compared to the HIV individuals with a statistically normal EEG marker, those with abnormal values were expected to show worse cognitive status., Methods: Resting state eyes-closed EEG data were recorded in 82 treatment-naïve HIV (39.8 ys.±1.2 standard error mean, SE) and 59 age-matched cognitively healthy subjects (39 ys.±2.2 SE). Low-resolution brain electromagnetic tomography (LORETA) estimated delta and alpha sources in frontal, central, temporal, parietal, and occipital cortical regions., Results: Ratio of the activity of parietal delta and high-frequency alpha sources (EEG marker) showed the maximum difference between the healthy and the treatment-naïve HIV group. Z-score of the EEG marker was statistically abnormal in 47.6% of treatment-naïve HIV individuals with reference to the healthy group (p<0.05). Compared to the HIV individuals with a statistically normal EEG marker, those with abnormal values exhibited lower mini mental state evaluation (MMSE) score, higher CD4 count, and lower viral load (p<0.05)., Conclusions: This statistical procedure permitted for the first time to identify single treatment-naïve HIV individuals having abnormal EEG activity., Significance: This procedure might enrich the detection and monitoring of effects of HIV on brain function in single treatment-naïve HIV individuals., (Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

Published
2016
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48. Antiretroviral therapy effects on sources of cortical rhythms in HIV subjects: responders vs. mild responders.

Author

Babiloni C, Pennica A, Vecchio F, Onorati P, Muratori C, Ferracuti S, Roma P, Donato N, Noce G, Del Percio C, Bonacci C, Di Campli F, Gianserra L, Teti E, Aceti A, Soricelli A, Viscione M, Rossini PM, and Andreoni M

Subjects
Adult, Anti-Retroviral Agents therapeutic use, Cerebral Cortex physiopathology, Electroencephalography drug effects, Electroencephalography methods, Female, HIV Infections physiopathology, Humans, Longitudinal Studies, Male, Alpha Rhythm drug effects, Anti-Retroviral Agents pharmacology, Brain Mapping methods, Cerebral Cortex drug effects, Delta Rhythm drug effects, HIV Infections drug therapy
Abstract

Objective: We tested the hypothesis that 5months of combined anti-retroviral therapy (cART) affect cortical sources of resting state cortical electroencephalographic (EEG) rhythms in naïve HIV subjects., Methods: Eyes-closed resting state EEG data were recorded at baseline (i.e. pre-treatment; T0), T1 (after 4weeks of cART), T2 (after 8weeks of cART), and T5 (after 5months of cART) in 38 naïve HIV subjects. EEG data were also recorded in 40 age-matched cognitively normal subjects for control purposes. EEG rhythms of interest were delta (2-4Hz), theta (4-8Hz), alpha 1 (8-10.5Hz), alpha 2 (10.5-13Hz), beta 1 (13-20Hz), and beta 2 (20-30Hz). Cortical EEG sources were estimated by LORETA software., Results: Compared to the control group, the HIV group at T0 showed greater delta sources and lower widespread alpha sources. cART induced a global improvement of biological (viral load, CD4 count) and EEG (delta, alpha) markers, remarkable even after 4weeks. Compared to HIV Responders (>100cells/μl at 5-month follow up), the HIV Mild Responders (<100cells/μl) showed greater parietal delta sources at baseline and lower occipital alpha sources at 5-month follow up., Conclusions: In naïve HIV subjects, 5months of successful cART affect brain synchronization mechanisms at the basis of the generation of delta and alpha rhythms., Significance: The present EEG markers may be useful secondary neurophysiological end points for pharmacological clinical trials in naïve HIV subjects., (Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

Published
2015
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49. Cortical sources of resting-state EEG rhythms in "experienced" HIV subjects under antiretroviral therapy.

Author

Babiloni C, Buffo P, Vecchio F, Onorati P, Muratori C, Ferracuti S, Roma P, Battuello M, Donato N, Noce G, Di Campli F, Gianserra L, Teti E, Aceti A, Soricelli A, Viscione M, Andreoni M, Rossini PM, and Pennica A

Subjects
Adult, CD4 Lymphocyte Count, Cerebral Cortex physiopathology, Cross-Sectional Studies, Female, HIV Infections immunology, Humans, Male, Middle Aged, Neuropsychological Tests, Tomography, Viral Load, Antiretroviral Therapy, Highly Active, Electroencephalography, HIV Infections drug therapy, HIV Infections physiopathology
Abstract

Objective: Treatment-naïve patients with human immunodeficiency virus (HIV) are characterized by diffuse abnormalities of resting-state cortical electroencephalographic (EEG) rhythms (Babiloni et al., 2012a). Here, we tested the hypothesis that these EEG rhythms vary as a function of the systemic immune activity and antiretroviral therapy (ART) in HIV patients., Methods: Resting-state eyes-closed EEG data were recorded in 68 ART-HIV patients (mini mental state evaluation (MMSE) of 27.5 ± 0.3 SEM), in 60 treatment-naïve HIV subjects (MMSE of 27.5 ± 0.4 SEM) and in 75 age-matched cognitively normal subjects (MMSE of 29.3 ± 0.1 SEM). Based on the CD4 lymphocytes' count, we divided ART-HIV subjects into two subgroups: those with CD4>500 cells/μl (ART-HIV+) and those with CD4<500 cells/μl (ART-HIV-). EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-12 Hz), beta 1 (13-20 Hz), and beta 2 (20-30 Hz). Cortical EEG sources were estimated by LORETA software., Results: Widespread theta, alpha, and beta sources were lower in ART-HIV subjects than in control subjects. Furthermore, occipital and temporal alpha 1 sources were lower in treatment-naïve HIV than in ART-HIV subjects. Moreover, the opposite was true for widespread pathological delta sources. Finally, parietal, occipital, and temporal alpha 1 sources were lower in ART-HIV- than in ART-HIV+ subjects., Conclusions: In ART-HIV subjects, cortical sources of resting-state alpha rhythms are related to systemic immune activity and cART., Significance: This EEG procedure may produce biomarkers of treatment response in patients' brain compartments for longitudinal clinical studies., (Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

Published
2014
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50. Antiretroviral therapeutic drug monitoring in HIV-infected pregnant women: maternal immunovirological outcome at delivery and during the 18 month follow-up period.

Author

Nicastri E, Ivanovic J, Signore F, Tempestilli M, Bellagamba R, Viscione M, Pisani G, Vallone C, Tommasi C, Gallo AL, De Nardo P, Pucillo PL, and Narciso P

Subjects
Adult, CD4 Lymphocyte Count, Female, Follow-Up Studies, HIV Seropositivity drug therapy, HIV-1 drug effects, Humans, Infant, Infant, Newborn, Longitudinal Studies, Male, Pregnancy, Pregnancy Complications, Infectious drug therapy, Pregnancy Outcome, Prospective Studies, Treatment Outcome, Viral Load, Anti-HIV Agents pharmacology, Antiretroviral Therapy, Highly Active, Drug Monitoring, HIV Seropositivity immunology, HIV-1 immunology, Pregnancy Complications, Infectious immunology, Pregnancy Complications, Infectious virology
Abstract

No data are available on the long-term immunovirological outcome of HIV-positive pregnant women experiencing sub-therapeutic antiretroviral drug (ARV) concentrations during pregnancy. The objective of our study was to assess the long-term virological outcome in pregnant women treated with HAART. A prospective, multi-center study enrolled 60 HIV-infected pregnant women stratified into 3 groups according to the response to HAART. Group A, women successfully treated with HAART; Group B, women with confirmed virological failure during HAART; Group C, women successfully treated with HAART during pregnancy for prevention of vertical transmission only. Smoking, alcohol use, low adherence to therapy, and increased viral load at delivery were significantly associated to virological failure at univariate analysis. At multivariate regression analysis, only adherence to therapy was reported as an independent variable related to the virological response (p < 0.001). Virological failure during follow-up was reported in 2 (25.0%) of the 8 women with sub therapeutic Ctrough and in 4 of the 33 (12.1%) women with therapeutic Ctrough (p=0.33). In group C, the viro-immunological set points during follow-up did not differ from those observed before HAART initiation. No significantly increased rate of virological failure after delivery was reported in women with sub-therapeutic ARV concentrations during pregnancy and long-term follow-up. The long-term virological outcome was independently associated to reduced adherence to therapy. Evaluation of the clinical impact of the low plasma ARV concentrations during pregnancy on the long-term virological outcome deserves further larger studies.

Published
2012
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