المؤلفون: Sara Del Tufo, Umberto Atripaldi, Antonella Nicastro, Iacopo Panarese, Davide Ciardiello, Valerio Nardone, Francesco Selvaggi, Roberto Grassi, Salvatore Cappabianca, Erika Martinelli, Alfonso Reginelli

المصدر: Radiology Case Reports, Vol 19, Iss 9, Pp 3626-3630 (2024)

مصطلحات موضوعية: Rectal cancer, Biomarkers, Perineural invasion, MRI, Staging, Medical physics. Medical radiology. Nuclear medicine, R895-920

الوصف: Treatment of rectal cancer has improved over the years thanks to a multidisciplinary approach. A correct staging has a fundamental role for risk stratification and to define the best treatment for each patient. Unfortunately, approximately 30% of patients with locally advanced rectal cancers will experience tumor recurrence. Thus, the identification of novel clinical-pathological and radiological prognostic factors represents an urgent unmet clinical need. Here we report the case of a patient with radically resected localized rectal cancer who developed an impressive early pelvic recurrence. To better understand the clinical scenario, we have studied the possible factors related to the aggressiveness of the disease. The only poor prognosticfactor that was evidenced at histological report was perineural invasion. Therefore, we questioned whether we could evaluate perineural invasion with imaging, similar to head and neck tumors. Learning from this clinical case, we believe that improving the risk stratification and radiology reporting is necessary to provide the best care for the patient and allow for a better prognosis prediction. Of course, our data should be considered as hypothesis generating and should be further investigated and validated in larger and prospective studies.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S193004332400428XTest; https://doaj.org/toc/1930-0433Test

الوصول الحر: https://doaj.org/article/eec5cbb29fdd4342a5a6cb660c4ec7b4Test

المؤلفون: Maria Paola Belfiore, Gaetano Maria Russo, Luigi Gallo, Umberto Atripaldi, Stefania Tamburrini, Valentina Caliendo, Luigi Impieri, Maria Teresa Del Canto, Giovanni Ciani, Pasquale Parrella, Maria Luisa Mangoni di Santo Stefano, Antonio Alessandro Heliot Salvia, Fabrizio Urraro, Valerio Nardone, Nicola Coppola, Alfonso Reginelli, Salvatore Cappabianca

المصدر: Tomography, Vol 8, Iss 4, Pp 1836-1850 (2022)

مصطلحات موضوعية: COVID-19, complications, SARS-CoV-2, Computer applications to medicine. Medical informatics, R858-859.7

الوصف: Introduction. Coronavirus SARS-CoV-2, the causative agent of COVID-19, primarily causes a respiratory tract infection that is not limited to respiratory distress syndrome, but it is also implicated in other body systems. Systemic complications were reported due to an exaggerated inflammatory response, which involves severe alveolar damage in the lungs and exacerbates the hypercoagulation that leads to venous thrombosis, ischemic attack, vascular dysfunction and infarction of visceral abdominal organs. Some complications are related to anticoagulant drugs that are administrated to stabilize hypercoagulability, but increase the risk of bleeding, hematoma and hemorrhage. The aim of this study is to report the diagnostic role of CT in the early diagnosis and management of patients with severe COVID-19 complications through the most interesting cases in our experience. Material and Methods. The retrospective analysis of patients studied for COVID-19 in our institution and hospitals, which are part of the university training network, was performed. Cases. Pneumomediastinum, cortical kidney necrosis, splenic infarction, cerebral ischemic stroke, thrombosis of the lower limb and hematomas are the most major complications that are reviewed in this study. Conclusions. Since the onset of the COVID-19 pandemic, the CT imaging modality with its high sensitivity and specificity remains the preferred imaging choice to diagnose early the different complications associated with COVID-19, such as thrombosis, ischemic stroke, infarction and pneumomediastinum, and their management, which significantly improved the outcomes.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2379-139X/8/4/154Test; https://doaj.org/toc/2379-1381Test; https://doaj.org/toc/2379-139XTest

الوصول الحر: https://doaj.org/article/be405e47e9c24509a60f868541c86d62Test

المؤلفون: Raffaella Capasso, Antonio Pinto, Nicola Serra, Umberto Atripaldi, Adele Corcione, Giorgio Bocchini, Salvatore Guarino, Roberta Lieto, Gaetano Rea, Giacomo Sica, Tullio Valente

المصدر: Tomography, Vol 8, Iss 3, Pp 1534-1543 (2022)

مصطلحات موضوعية: Acinetobacter pneumonia, multidrug resistance, chest X-ray, chest tomography, ground-glass, consolidation, Computer applications to medicine. Medical informatics, R858-859.7

الوصف: Acinetobacter baumannii (Ab) is an opportunistic Gram-negative pathogen intrinsically resistant to many antimicrobials. The aim of this retrospective study was to describe the imaging features on chest X-ray (CXR) and computed tomography (CT) scans in hospitalized patients with multidrug-resistant (MDR) Ab pneumonia. CXR and CT findings were graded on a three-point scale: 1 represents normal attenuation, 2 represents ground-glass attenuation, and 3 represents consolidation. For each lung zone, with a total of six lung zones in each patient, the extent of disease was graded using a five-point scale: 0, no involvement; 1, involving 25% of the zone; 2, 25–50%; 3, 50–75%; and 4, involving >75% of the zone. Points from all zones were added for a final total cumulative score ranging from 0 to 72. Among 94 patients who tested positive for MDR Ab and underwent CXR (males 52.9%, females 47.1%; mean age 64.2 years; range 1–90 years), 68 patients underwent both CXR and chest CT examinations. The percentage of patients with a positive CT score was significantly higher than that obtained on CXR (67.65% > 35.94%, p-value = 0.00258). CT score (21.88 ± 15.77) was significantly (p-value = 0.0014) higher than CXR score (15.06 ± 18.29). CXR and CT revealed prevalent bilateral abnormal findings mainly located in the inferior and middle zones of the lungs. They primarily consisted of peripheral ground-glass opacities and consolidations which predominated on CXR and CT, respectively.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2379-139X/8/3/126Test; https://doaj.org/toc/2379-1381Test; https://doaj.org/toc/2379-139XTest

الوصول الحر: https://doaj.org/article/76393de436734bc3b8018b871eb5d87aTest

المؤلفون: Alfonso Reginelli, Vittorio Patanè, Fabrizio Urraro, Anna Russo, Marco De Chiara, Alfredo Clemente, Umberto Atripaldi, Giovanni Balestrucci, Mauro Buono, Emma D’ippolito, Roberta Grassi, Ida D’onofrio, Stefania Napolitano, Teresa Troiani, Ferdinando De Vita, Fortunato Ciardiello, Valerio Nardone, Salvatore Cappabianca

المصدر: Diagnostics, Vol 13, Iss 14, p 2334 (2023)

مصطلحات موضوعية: magnetic resonance, oncologic, radiotherapy, oncologic diagnostics, bone metastases, lung cancer, Medicine (General), R5-920

الوصف: Metastasis to bone is a common occurrence among epithelial tumors, with a high incidence rate in the Western world. As a result, bone lesions are a significant burden on the healthcare system, with a high morbidity index. These injuries are often symptomatic and can lead to functional limitations, which in turn cause reduced mobility in patients. Additionally, they can lead to secondary complications such as pathological fractures, spinal cord compression, hypercalcemia, or bone marrow suppression. The treatment of bone metastases requires collaboration between multiple healthcare professionals, including oncologists, orthopedists, neurosurgeons, physiatrists, and radiotherapists. The primary objective of this study is to evaluate the correlation between two methods used to assess local control. Specifically, the study aims to determine if a reduction in the volume of bone lesions corresponds to better symptomatic control in the clinical management of patients, and vice versa. To achieve this objective, the study evaluates morphological criteria by comparing pre- and post-radiotherapy treatment imaging using MRI and RECIST 1.1 criteria. MRI without contrast is the preferred diagnostic imaging method, due to its excellent tolerance by patients, the absence of exposure to ionizing radiation, and the avoidance of paramagnetic contrast media side effects. This imaging modality allows for accurate assessment of bone lesions. One of the secondary objectives of this study is to identify potentially useful parameters that can distinguish patients into two classes: “good” and “poor” responders to treatment, as reported by previous studies in the literature. These parameters can be evaluated from the imaging examinations by analyzing morphological changes and radiomic features on different sequences, such as T1, STIR (short tau inversion recovery), and DWI-MRI (diffusion-weighted).

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2075-4418/13/14/2334Test; https://doaj.org/toc/2075-4418Test

الوصول الحر: https://doaj.org/article/d330a329429b4c0c801a9508c0779d5fTest

المؤلفون: Flavia Fusco, Giancarlo Scognamiglio, Assunta Merola, Anna Selvaggia Roma, Carmine Nicastro, Micaela Spatarella, Maurizio D'Abbraccio, Gabriella Di Mauro, Umberto Atripaldi, Lidia Atripaldi, Anna Correra, Michela Palma, Rosaria Barracano, Nunzia Borrelli, Annalisa Capuano, Berardo Sarubbi

المصدر: International Journal of Cardiology Congenital Heart Disease, Vol 6, Iss , Pp 100266- (2021)

مصطلحات موضوعية: Adult congenital heart disease, COVID-19, Vaccination, Antibody response, IgG antispike, ACHD, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Background: real-world data on COVID-19 vaccine safety, immunogenicity and acceptance in adults with congenital heart disease (ACHD) are lacking. Methods: ACHD patients who were offered COVID-19 vaccination from January to June 2021 were included. Data on adverse events, on patients’ attitude towards vaccination and antispike IgG titre were retrospectively collected. A group of healthy individuals with similar age and sex undergoing vaccination was included for comparison. Results: 208 patients followed in a single ACHD tertiary centre (33.3 [26–45] years, 54% male) received COVID-19 vaccine, 65% vaccinated at our institution: 199 (96%) received Pfizer–BioNTech BNT162b2 vaccine, 4 (2%) Moderna-1273 and 5 (2%) AstraZeneca–ChAdOx1. Median follow-up after vaccination was 79 [57–96] days. No major adverse event was reported and the incidence of minor events was not different between ACHD patients and the control group. One patient was diagnosed with acute pericarditis. There were two deaths unrelated to the vaccine during follow-up. Three (1.5%) vaccinated patients tested positive for COVID-19. Antispike IgG titre, available in 159 (76%) patients, was 1334 [600–3401] BAU/ml, not significantly different from the control group (p=0.2). One patient with Fontan failure was seronegative. Advanced physiological stage was associated with lower antibody response, independently from previous viral exposure (p

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2666668521001907Test; https://doaj.org/toc/2666-6685Test

الوصول الحر: https://doaj.org/article/1c1cf7fc4f6c4a89b9ba096a98c776d2Test

المؤلفون: Pietro Cappabianca, Gaetano Maria Russo, Umberto Atripaldi, Luigi Gallo, Maria Paola Rocco, Giovanni Pasceri, Michele A. A. Karaboue, Silvia Angioi, Salvatore Cappabianca, Alfonso Reginelli

المصدر: Medical Sciences, Vol 9, Iss 4, p 61 (2021)

مصطلحات موضوعية: diagnostic imaging, installed CT fleet, radiology, UHC, Medicine

الوصف: Universal Health Coverage (UHC) is a set of principles adopted by the World Health Organization (WHO) aimed to guarantee access to primary care for the entire world population through a range of essential health services without neglecting the diagnostic aspect. Italy is one of the signatory states, which means that diagnostic services should be appropriated and exigible throughout the national territory equally. Our research analyzed and identified the main criticalities in terms of age, territorial distribution, and technological and health appropriateness of installed Computed Tomography (CT) needed to meet the principles of UHC. Data analyzed in our study were published by Assobiomedica at the end of 2016 and by COCIR, which included and investigated the installed fleet of diagnostic equipment in the Italian sanitary system and in various European countries. The 6th point of the Alma Ata Declaration defines the concept of “primary health care”, which includes the importance of the diagnostic phase in the Italian health care system to provide Essential Levels of Assistance (LEA). It is clear from our studies that the technology at the national level is not adequate to satisfy the UHC principles or the European criteria, with negative effects on the diagnostic standards and on advanced screenings. This study conducted on the installed CTs in Italy at the end of 2016 confirms the persistence of progressive aging that has been recorded for several years in the health facilities of the country and suggests incentive policies for the replacement of obsolete equipment, which represent a form of investment rather than a cost, due to the nature of the expenditure itself, one-off and amortizable over time.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2076-3271/9/4/61Test; https://doaj.org/toc/2076-3271Test

الوصول الحر: https://doaj.org/article/7889ea9f330741caa60011c119748cbfTest

المؤلفون: Gabriele Madonna, Silvia Sale, Mariaelena Capone, Chiara De Falco, Valentina Santocchio, Tiziana Di Matola, Giuseppe Fiorentino, Caterina Pirozzi, Anna D’Antonio, Rocco Sabatino, Lidia Atripaldi, Umberto Atripaldi, Marcello Raffone, Marcello Curvietto, Antonio Maria Grimaldi, Vito Vanella, Lucia Festino, Luigi Scarpato, Marco Palla, Michela Spatarella, Francesco Perna, Pellegrino Cerino, Gerardo Botti, Roberto Parrella, Vincenzo Montesarchio, Paolo Antonio Ascierto, Luigi Atripaldi

المصدر: Biology, Vol 10, Iss 8, p 735 (2021)

مصطلحات موضوعية: COVID-19, iTNF-α, SARS-CoV-2, monocytes, neutrophils, eosinophils, Biology (General), QH301-705.5

الوصف: In December 2019, a novel coronavirus, “SARS-CoV-2”, was recognized as the cause of coronavirus disease 2019 (COVID-19). Several studies have explored the changes and the role of inflammatory cells and cytokines in the immunopathogenesis of the disease, but until today, the results have been controversial. Based on these premises, we conducted a retrospective assessment of monocyte intracellular TNF-α expression (iTNF-α) and on the frequencies of lymphocyte sub-populations in twenty-five patients with moderate/severe COVID-19. We found lymphopenia in all COVID-19 infected subjects compared to healthy subjects. On initial observation, in patients with favorable outcomes, we detected a high absolute eosinophil count and a high CD4+/CD8+ T lymphocytes ratio, while in the Exitus Group, we observed high neutrophil and CD8+ T lymphocyte counts. During infection, in patients with favorable outcomes, we observed a rise in the lymphocyte count, in the monocyte and in Treg lymphocyte counts, and in the CD4+ and in CD8+ T lymphocytes count but a reduction in the CD4+/CD8+ T lymphocyte ratio. Instead, in the Exitus Group, we observed a reduction in the Treg lymphocyte counts and a decrease in iTNF-α expression. Our preliminary findings point to a modulation of the different cellular mediators of the immune system, which probably play a key role in the outcomes of COVID-19.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2079-7737/10/8/735Test; https://doaj.org/toc/2079-7737Test

الوصول الحر: https://doaj.org/article/e343bdff7d1d4b32b0340e0b82d59d55Test

المؤلفون: Roberto Grassi, Salvatore Cappabianca, Fabrizio Urraro, Vincenza Granata, Giuliana Giacobbe, Simona Magliocchetti, Diletta Cozzi, Roberta Fusco, Roberta Galdiero, Carmine Picone, Maria Paola Belfiore, Alfonso Reginelli, Umberto Atripaldi, Ornella Picascia, Michele Coppola, Elio Bignardi, Roberta Grassi, Vittorio Miele

المصدر: Journal of Personalized Medicine, Vol 11, Iss 7, p 641 (2021)

مصطلحات موضوعية: COVID-19, computed tomography, computer aided quantification, Medicine

الوصف: Purpose: the purpose of this study was to assess the evolution of computed tomography (CT) findings and lung residue in patients with COVID-19 pneumonia, via quantified evaluation of the disease, using a computer aided tool. Materials and methods: we retrospectively evaluated 341 CT examinations of 140 patients (68 years of median age) infected with COVID-19 (confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR)), who were hospitalized, and who received clinical and CT examinations. All CTs were evaluated by two expert radiologists, in consensus, at the same reading session, using a computer-aided tool for quantification of the pulmonary disease. The parameters obtained using the computer tool included the healthy residual parenchyma, ground glass opacity, consolidation, and total lung volume. Results: statistically significant differences (p value ≤ 0.05) were found among quantified volumes of healthy residual parenchyma, ground glass opacity (GGO), consolidation, and total lung volume, considering different clinical conditions (stable, improved, and worsened). Statistically significant differences were found among quantified volumes for healthy residual parenchyma, GGO, and consolidation (p value ≤ 0.05) between dead patients and discharged patients. CT was not performed on cadavers; the death was an outcome, which was retrospectively included to differentiate findings of patients who survived vs. patients who died during hospitalization. Among discharged patients, complete disease resolutions on CT scans were observed in 62/129 patients with lung disease involvement ≤5%; lung disease involvement from 5% to 15% was found in 40/129 patients, while 27/129 patients had lung disease involvement between 16 and 30%. Moreover, 8–21 days (after hospital admission) was an “advanced period” with the most severe lung disease involvement. After the extent of involvement started to decrease—particularly after 21 days—the absorption was more obvious. Conclusions: a complete disease resolution on chest CT scans was observed in 48.1% of discharged patients using a computer-aided tool to quantify the GGO and consolidation volumes; after 16 days of hospital admission, the abnormalities identified by chest CT began to improve; in particular, the absorption was more obvious after 21 days.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2075-4426/11/7/641Test; https://doaj.org/toc/2075-4426Test

الوصول الحر: https://doaj.org/article/803aa78ad1bf44d38ccab170ad7c582fTest

المؤلفون: Veronica Bordoni, Bruno Brando, Pierluca Piselli, Olindo Forini, Federico Enrico Perna, Umberto Atripaldi, Sara Carputo, Federica Garziano, Elisabetta Trento, Giovanna D'Agosto, Alessandra Latini, Manuela Colafigli, Antonio Cristaudo, Alessandra Sacchi, Massimo Andreoni, Gabriella De Carli, Nicoletta Orchi, Sandro Grelli, Arianna Gatti, Carlotta Cerva, Antonella Minutolo, Marina Potestà, Maria Luisa Di Martino, Francesco Ortu, Paola Selva, Laura Del Pup, Irene Guarnori, Patrizia Lorenzini, Giusy Capuano, Andrea Antinori, Chiara Agrati

المصدر: PLoS ONE, Vol 14, Iss 12, p e0225415 (2019)

مصطلحات موضوعية: Medicine, Science

الوصف: A significant proportion of HIV-infected patients experiencing a late diagnosis highlights the need to define immunological protocols able to help the clinicians in identifying patients at higher risk for immunological failure. The aim of the study was to evaluate the feasibility of easy cytometric tests in defining the effect of antiretroviral treatment (cART) on immunological homeostasis and in identifying predictive markers of early immune recovery. Chronic HIV infected patients (n = 202) were enrolled in a prospective multicentric study, and their immunological profile was studied before (w0) and after 24 weeks (w24) of antiretroviral treatment (cART) using a standardized flow cytometric panel. Based on CD4 T cell count before treatment, patients were divided in late (LP: CD4 500/mmc) presenters. In all groups, cART introduction increased CD4 and CD4/CD8 T cell ratio, naïve T cell (CD4 and CD8) and CD127-expressing CD4 T cells. In parallel, cART significantly reduced effector memory T cells (CD4 and CD8) and T cell activation (CD38+CD8 and CD95+CD4 T cells). Moreover, the frequency of Naïve and Effector CD4 T cells before treatment correlated with several immune parameters key associated with the pathogenesis of HIV, thus mirroring the health of immune system. Interestingly, we identified the Naïve/Effector CD4 T cell ratio (N/EM) at w0 as a marker able to predict early immune recovery. Specifically, in LP, N/EM ratio was significantly higher in immunological responder patients (CD4>500/mmc at w24) when compared to immunological non responder (CD4 T cells

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1932-6203Test

الوصول الحر: https://doaj.org/article/adce99d7ce5248f88f66723568009ee0Test

المؤلفون: Annalisa Capuano, Berardo Sarubbi, Maurizio D'Abbraccio, Anna Selvaggia Roma, Flavia Fusco, Rosaria Barracano, Gabriella di Mauro, Carmine Nicastro, Anna Correra, Lidia Atripaldi, Michela Palma, Micaela Spatarella, Giancarlo Scognamiglio, Nunzia Borrelli, Umberto Atripaldi, Assunta Merola

المصدر: International Journal of Cardiology Congenital Heart Disease
International Journal of Cardiology Congenital Heart Disease, Vol 6, Iss, Pp 100266-(2021)

مصطلحات موضوعية: Pediatrics, medicine.medical_specialty, Heart disease, Coronavirus disease 2019 (COVID-19), business.industry, Immunogenicity, Incidence (epidemiology), Vaccination, COVID-19, medicine.disease, IgG antispike, Article, Acute pericarditis, RC666-701, Antibody response, medicine, ACHD, Diseases of the circulatory (Cardiovascular) system, Adult congenital heart disease, Stage (cooking), Adverse effect, business

الوصف: Background real-world data on COVID-19 vaccine safety, immunogenicity and acceptance in adults with congenital heart disease (ACHD) are lacking. Methods ACHD patients who were offered COVID-19 vaccination from January to June 2021 were included. Data on adverse events, on patients’ attitude towards vaccination and antispike IgG titre were retrospectively collected. A group of healthy individuals with similar age and sex undergoing vaccination was included for comparison. Results 208 patients followed in a single ACHD tertiary centre (33.3 [26–45]years,54%male) received COVID-19 vaccine, 65% vaccinated at our institution: 199 (96%)received Pfizer–BioNTech BNT162b2 vaccine, 4 (2%)Moderna-1273 and 5 (2%)AstraZeneca–ChAdOx1. Median follow-up after vaccination was 79 [57–96]days. No major adverse event was reported and there was no difference in the in adverse events incidence between ACHD patients and the control group. One patient was diagnosed with acute pericarditis. There were two unrelated deaths during follow-up. Three (1.5%)vaccinated patients tested positive for COVID-19. Antispike IgG titre, available in 159 (76%)patients, was 1334 [600–3401]BAU/ml, not significantly different from the control group (p = 0.2). One patient with Fontan failure was seronegative. Advanced physiological stage was related to lower antibody response, independently from previous viral exposure (p
Graphical abstract Image 1

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f7ebcbcc075f473c5f4cd7afb5642e5eTest
http://europepmc.org/articles/PMC8552781Test