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Article: Personalized Medicine and Machine Learning: A Roadmap for the Future.

Sebastiani, Marco / Vacchi, Caterina / Manfredi, Andreina / Cassone, Giulia

2022 Volume 11, Issue 14

Abstract: In the last ten years, many advances have been made in the treatment and diagnosis of immune-mediated diseases [ ... ]. ...

Abstract	In the last ten years, many advances have been made in the treatment and diagnosis of immune-mediated diseases [...].
Language	English
Publishing date	2022-07-15
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11144110
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Article: Diagnosis, Clinical Features and Management of Interstitial Lung Diseases in Rheumatic Disorders: Still a Long Journey.

Sebastiani, Marco / Vacchi, Caterina / Cassone, Giulia / Manfredi, Andreina

Journal of clinical medicine

2022 Volume 11, Issue 2

Abstract: Interstitial lung disease (ILD) is one of the most frequent pulmonary complications of autoimmune rheumatic diseases (ARDs), and it is mainly associated with connective tissue diseases (CTDs) and rheumatoid arthritis (RA) [ ... ]. ...

Abstract	Interstitial lung disease (ILD) is one of the most frequent pulmonary complications of autoimmune rheumatic diseases (ARDs), and it is mainly associated with connective tissue diseases (CTDs) and rheumatoid arthritis (RA) [...].
Language	English
Publishing date	2022-01-14
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11020410
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Article ; Online: Diagnosis, Clinical Features and Management of Interstitial Lung Diseases in Rheumatic Disorders

Marco Sebastiani / Caterina Vacchi / Giulia Cassone / Andreina Manfredi

Journal of Clinical Medicine, Vol 11, Iss 410, p

Still a Long Journey

2022 Volume 410

Abstract	Interstitial lung disease (ILD) is one of the most frequent pulmonary complications of autoimmune rheumatic diseases (ARDs), and it is mainly associated with connective tissue diseases (CTDs) and rheumatoid arthritis (RA) [.]
Keywords	n/a ; Medicine ; R
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Reply to the comment on: Hypereosinophilic bronchiolitis in ANCA-associated vasculitis: where does it stand? by Bilgin et al.

Sebastiani, Marco / Manfredi, Andreina / Cassone, Giulia / Salvarani, Carlo / Luppi, Fabrizio

Clinical and experimental rheumatology

2021 Volume 39 Suppl 129, Issue 2, Page(s) 197

MeSH term(s)	Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy ; Antibodies, Antineutrophil Cytoplasmic ; Bronchiolitis ; Eosinophilia ; Humans
Chemical Substances	Antibodies, Antineutrophil Cytoplasmic
Language	English
Publishing date	2021-03-25
Publishing country	Italy
Document type	Letter ; Comment
ZDB-ID	605886-3
ISSN	1593-098X ; 0392-856X
ISSN (online)	1593-098X
ISSN	0392-856X
DOI	10.55563/clinexprheumatol/onslav
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Article ; Online: Classification of pulmonary sounds through deep learning for the diagnosis of interstitial lung diseases secondary to connective tissue diseases.

Dianat, Behnood / La Torraca, Paolo / Manfredi, Andreina / Cassone, Giulia / Vacchi, Caterina / Sebastiani, Marco / Pancaldi, Fabrizio

Computers in biology and medicine

2023 Volume 160, Page(s) 106928

Abstract: Early diagnosis of interstitial lung diseases secondary to connective tissue diseases is critical for the treatment and survival of patients. The symptoms, like dry cough and dyspnea, appear late in the clinical history and are not specific, moreover, ... ...

Abstract	Early diagnosis of interstitial lung diseases secondary to connective tissue diseases is critical for the treatment and survival of patients. The symptoms, like dry cough and dyspnea, appear late in the clinical history and are not specific, moreover, the current approach to confirm the diagnosis of interstitial lung disease is based on high resolution computer tomography. However, computer tomography involves x-ray exposure for patients and high costs for the Health System, therefore preventing its use for a massive screening campaign in elder people. In this work we investigate the use of deep learning techniques for the classification of pulmonary sounds acquired from patients affected by connective tissue diseases. The novelty of the work consists of a suitably developed pre-processing pipeline for de-noising and data augmentation. The proposed approach is combined with a clinical study where the ground truth is represented by high resolution computer tomography. Various convolutional neural networks have provided an overall accuracy as high as 91% in the classification of lung sounds and have led to an overwhelming diagnostic accuracy in the range 91%-93%. Modern high performance hardware for edge computing can easily support our algorithms. This solution paves the way for a vast screening campaign of interstitial lung diseases in elder people on the basis of a non-invasive and cheap thoracic auscultation.
MeSH term(s)	Humans ; Aged ; Deep Learning ; Lung Diseases, Interstitial/diagnostic imaging ; Lung/diagnostic imaging ; Connective Tissue Diseases/diagnosis ; Connective Tissue Diseases/diagnostic imaging ; Tomography, X-Ray Computed/methods ; Respiratory Sounds/diagnosis
Language	English
Publishing date	2023-04-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	127557-4
ISSN	1879-0534 ; 0010-4825
ISSN (online)	1879-0534
ISSN	0010-4825
DOI	10.1016/j.compbiomed.2023.106928
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Zs.A 653: Show issues

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Article: Radiomics to predict the mortality of patients with rheumatoid arthritis-associated interstitial lung disease: A proof-of-concept study.

Venerito, Vincenzo / Manfredi, Andreina / Lopalco, Giuseppe / Lavista, Marlea / Cassone, Giulia / Scardapane, Arnaldo / Sebastiani, Marco / Iannone, Florenzo

Frontiers in medicine

2023 Volume 9, Page(s) 1069486

Abstract: Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In oncology, radiomics ... ...

Abstract	Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In oncology, radiomics allows the quantification of tumour phenotype by analysing the characteristics of medical images. Using specific software, it is possible to segment organs on high-resolution computed tomography (HRCT) images and extract many features that may uncover disease characteristics that are not detected by the naked eye. We aimed to investigate whether features from whole lung radiomic analysis of HRCT may alone predict mortality in RA-ILD patients. Methods: High-resolution computed tomographies of RA patients from January 2012 to March 2022 were analyzed. The time between the first available HRCT and the last follow-up visit or ILD-related death was recorded. We performed a volumetric analysis in 3D Slicer, automatically segmenting the whole lungs and trachea Results: We retrieved the HRCTs of 30 RA-ILD patients. The median survival time (interquartile range) was 48 months (36-120 months). Thirteen out of 30 (43.33%) patients died during the observation period. Whole line segmentation was fast and reliable. The model included either the median grey level intensity within the whole lung segmentation [high-resolution (HR) 9.35, 95% CI 1.56-55.86] as a positive predictor of death and the 10th percentile of the number of included voxels (HR 0.20, 95% CI 0.05-0.84), the voxel-based pre-processing information (HR 0.23, 95% CI 0.06-0.82) and the flatness (HR 0.42, 95% CI 0.18-0.98), negatively correlating to mortality. The correlation of grey level values to their respective voxels (HR 1.52 95% CI 0.82-2.83) was also retained as a confounder. Conclusion: Radiomic analysis may predict RA-ILD patients' mortality and may promote HRCT as a digital biomarker regardless of the clinical characteristics of the disease.
Language	English
Publishing date	2023-01-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.1069486
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Article ; Online: Treatment of giant cell arteritis with ultra-short glucocorticoids and tocilizumab: the role of imaging in a prospective observational study.

Muratore, Francesco / Marvisi, Chiara / Cassone, Giulia / Boiardi, Luigi / Mancuso, Pamela / Besutti, Giulia / Spaggiari, Lucia / Casali, Massimiliano / Croci, Stefania / Versari, Annibale / Giorgi Rossi, Paolo / Catanoso, Mariagrazia / Costantini, Massimo / Galli, Elena / Salvarani, Carlo

Rheumatology (Oxford, England)

2023 Volume 63, Issue 1, Page(s) 64–71

Abstract: Objectives: To assess the impact of tocilizumab (TCZ) monotherapy after ultra-short-pulse glucocorticoids (GCs) on clinical manifestations, and vessel inflammation and damage in large vessel-GCA (LV-GCA).: Methods: In this prospective observational ... ...

Abstract	Objectives: To assess the impact of tocilizumab (TCZ) monotherapy after ultra-short-pulse glucocorticoids (GCs) on clinical manifestations, and vessel inflammation and damage in large vessel-GCA (LV-GCA). Methods: In this prospective observational study, we enrolled patients with active LV-GCA. All patients received 500 mg per day i.v. methylprednisolone for three consecutive days and weekly s.c. TCZ injections from day 4 until week 52. PET/CT was performed on all patients at baseline and at weeks 24 and 52. The primary end points were the reduction in the PET vascular activity score (PETVAS) at weeks 24 and 52 compared with baseline, and the proportion of patients with relapse-free remission at weeks 24 and 52. The secondary end point was the proportion of patients with new aortic dilation at weeks 24 and 52. Results: A total of 18 patients were included (72% female, mean age 68.5 years). Compared with the baseline value, a significant reduction in the PETVAS was observed at weeks 24 and 52, mean (95% CI) reductions -8.6 (-11.5 to -5.7) and -10.4 (-13.6 to -7.2), P = 0.001 and 0.002, respectively. The proportion of patients with relapse-free remission at weeks 24 and 52 was 10/18 (56%, 95% CI 31-78) and 8/17 (47%, 95% CI 23-72), respectively. At weeks 24 and 52, no patient had shown new aortic dilation. However, 4 patients who had shown aortic dilation at baseline showed a significant increase in aortic diameter (≥5 mm) at week 52. Conclusion: TCZ monotherapy after ultra-short-pulse GCs controlled the clinical symptoms of GCA and reduced vascular inflammation. Trial registration: ClinicalTrials.gov, https://clinicaltrials.gov, NCT05394909.
MeSH term(s)	Humans ; Female ; Aged ; Male ; Glucocorticoids/therapeutic use ; Giant Cell Arteritis/diagnostic imaging ; Giant Cell Arteritis/drug therapy ; Positron Emission Tomography Computed Tomography ; Treatment Outcome ; Inflammation
Chemical Substances	Glucocorticoids ; tocilizumab (I031V2H011)
Language	English
Publishing date	2023-05-15
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/kead215
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Zs.B 240: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 497: Show issues

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Article ; Online: Tocilizumab or glucocorticoids treatment for patients with SARS-CoV-2 pneumonia: An observational study.

Dolci, Giovanni / Cassone, Giulia / Besutti, Giulia / Corsini, Romina / Sampaolesi, Fabio / Iotti, Valentina / Galli, Elena / Palermo, Adalgisa / Fontana, Matteo / Mancuso, Pamela

The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases

2021 Volume 26, Issue 1, Page(s) 101702

Abstract: Objective: To estimate the effect of tocilizumab or glucocorticoids in preventing death and intubation in patients hospitalized with SARS-CoV-2 pneumonia.: Methods: This was a retrospective cohort study enrolling all consecutive patients hospitalized ...

Abstract	Objective: To estimate the effect of tocilizumab or glucocorticoids in preventing death and intubation in patients hospitalized with SARS-CoV-2 pneumonia. Methods: This was a retrospective cohort study enrolling all consecutive patients hospitalized at Reggio Emilia AUSL between February the 11 Results and conclusion: Therapy with tocilizumab alone was associated with a reduction of deaths (OR 0.49, 95% CI 0.21-1.17) and of the composite outcome death/intubation (OR 0.35, 95% CI 0.13-0.90) compared to glucocorticoids alone. Nevertheless, this result should be cautiously interpreted due to a potential prescription bias.
MeSH term(s)	Antibodies, Monoclonal, Humanized ; COVID-19/drug therapy ; Glucocorticoids/therapeutic use ; Humans ; Retrospective Studies ; SARS-CoV-2 ; Treatment Outcome
Chemical Substances	Antibodies, Monoclonal, Humanized ; Glucocorticoids ; tocilizumab (I031V2H011)
Language	English
Publishing date	2021-12-21
Publishing country	Brazil
Document type	Journal Article ; Observational Study
ZDB-ID	2041400-6
ISSN	1678-4391 ; 1413-8670
ISSN (online)	1678-4391
ISSN	1413-8670
DOI	10.1016/j.bjid.2021.101702
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Zs.A 5633: Show issues

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Article: Efficacy and safety of rituximab in the treatment of connective tissue disease-related interstitial lung disease.

Vacchi, Caterina / Manfredi, Andreina / Cassone, Giulia / Erre, Gian Luca / Salvarani, Carlo / Sebastiani, Marco

Drugs in context

2021 Volume 10

Abstract: Interstitial lung disease (ILD) represents a severe pulmonary complication of connective tissue diseases, rheumatoid arthritis (RA), and antineutrophil cytoplasmic antibody-associated vasculitis. Treatment of ILD, mainly based on immunosuppression, ... ...

Abstract	Interstitial lung disease (ILD) represents a severe pulmonary complication of connective tissue diseases, rheumatoid arthritis (RA), and antineutrophil cytoplasmic antibody-associated vasculitis. Treatment of ILD, mainly based on immunosuppression, remains challenging. Rituximab (RTX), a monoclonal antibody binding to CD20, is considered a valuable therapeutic choice in cases of refractory ILD. Here, we review the available efficacy and safety data on the use of RTX in the treatment of rheumatic disease-related ILD. Despite controversial efficacy data, RTX seems to be able to stabilize or improve ILD related to RA and antisynthetase syndrome and in established and severe ILD complicating systemic sclerosis. Fewer data are available regarding ILD related to Sjögren syndrome, systemic lupus erythematosus, and antineutrophil cytoplasmic antibody-associated vasculitis. To date, few prospective studies are available and randomized trials are still ongoing with the purpose of exploring the role of RTX in this condition, including the supposed relationship between efficacy and ILD radiologic patterns and safety data, up to now derived mainly from RA studies. Despite an overall acceptable safety profile, concerns remain regarding an increased infectious disease risk in patients with ILD as well as possible lung toxicity and the increased rate of immune-mediated reactions in patients with connective tissue diseases. In conclusion, RTX is a relevant therapeutic option for rheumatic disease-related ILD despite the existing uncertainties; ongoing trials are expected to clarify its use.
Language	English
Publishing date	2021-01-15
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2719560-0
ISSN	1740-4398 ; 1745-1981
ISSN (online)	1740-4398
ISSN	1745-1981
DOI	10.7573/dic.2020-8-7
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Article: Efficacy and safety of mycophenolate mofetil in the treatment of rheumatic disease-related interstitial lung disease: a narrative review.

Cassone, Giulia / Sebastiani, Marco / Vacchi, Caterina / Erre, Gian Luca / Salvarani, Carlo / Manfredi, Andreina

Drugs in context

2021 Volume 10

Abstract: Mycophenolate mofetil (MMF) is an antimetabolite with a potent inhibitory effect on proliferation of T and B lymphocytes used since the early 1990s for the prevention of acute allograft rejection after organ transplant. MMF is also widely used for the ... ...

Abstract	Mycophenolate mofetil (MMF) is an antimetabolite with a potent inhibitory effect on proliferation of T and B lymphocytes used since the early 1990s for the prevention of acute allograft rejection after organ transplant. MMF is also widely used for the treatment of a variety of rheumatic diseases (RDs) and their pulmonary involvement. Interstitial lung disease (ILD) is a heterogeneous group of progressive fibrotic diseases of the lung, which is often secondary to RD and represents a major cause of morbidity and mortality. MMF is considered the main alternative to cyclophosphamide as a first-line agent to treat RD-related ILD or as possible maintenance therapy after cyclophosphamide, with a lower rate of side-effects. However, as for other immunosuppressive agents, the use of MMF in RD-ILD is supported by poor scientific evidence. In this narrative review, we describe the available data and recent advances on the effectiveness and safety of MMF for the treatment of ILD related to RD, including rheumatoid arthritis, systemic sclerosis, primary Sjögren syndrome, systemic lupus erythematosus, idiopathic inflammatory myopathies, undifferentiated connective tissue disease, interstitial pneumonia with autoimmune features and antineutrophil cytoplasmic antibody-associated vasculitis.
Language	English
Publishing date	2021-01-15
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2719560-0
ISSN	1740-4398 ; 1745-1981
ISSN (online)	1740-4398
ISSN	1745-1981
DOI	10.7573/dic.2020-8-8
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