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Article ; Online: Clinical practice and outcome of S-ICD replacement: Results from the multicenter RHYTHM DETECT registry.

Bianchi, Valter / Francia, Pietro / Ricciardi, Giuseppe / Viani, Stefano / Nigro, Gerardo / Biffi, Mauro / De Filippo, Paolo / Ottaviano, Luca / Migliore, Federico / Vicentini, Alessandro / Lovecchio, Mariolina / Valsecchi, Sergio / D'Onofrio, Antonio / Palmisano, Pietro

Heart rhythm

2024

Language	English
Publishing date	2024-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2229357-7
ISSN	1556-3871 ; 1547-5271
ISSN (online)	1556-3871
ISSN	1547-5271
DOI	10.1016/j.hrthm.2024.04.039
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Article ; Online: Improving predictive accuracy in primary biliary cholangitis: A new genetic risk score.

Gerussi, Alessio / Cappadona, Claudio / Bernasconi, Davide Paolo / Cristoferi, Laura / Valsecchi, Maria Grazia / Carbone, Marco / Invernizzi, Pietro / Asselta, Rosanna

Liver international : official journal of the International Association for the Study of the Liver

2024

Abstract: Background and aims: Genetic variants influence primary biliary cholangitis (PBC) risk. We established and tested an accurate polygenic risk score (PRS) using these variants.: Methods: Data from two Italian cohorts (OldIT 444 cases, 901 controls; ... ...

Abstract	Background and aims: Genetic variants influence primary biliary cholangitis (PBC) risk. We established and tested an accurate polygenic risk score (PRS) using these variants. Methods: Data from two Italian cohorts (OldIT 444 cases, 901 controls; NewIT 255 cases, 579 controls) were analysed. The latest international genome-wide meta-analysis provided effect size estimates. The PRS, together with human leukocyte antigen (HLA) status and sex, was included in an integrated risk model. Results: Starting from 46 non-HLA genes, 22 variants were selected. PBC patients in the OldIT cohort showed a higher risk score than controls: -.014 (interquartile range, IQR, -.023, .005) versus -.022 (IQR -.030, -.013) (p < 2.2 × 10 Conclusion: The combination of sex and a novel PRS accurately discriminated between PBC cases and controls. The model identified a subset of individuals at increased risk of PBC who might benefit from tailored monitoring.
Language	English
Publishing date	2024-04-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2102783-3
ISSN	1478-3231 ; 1478-3223
ISSN (online)	1478-3231
ISSN	1478-3223
DOI	10.1111/liv.15916
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Zs.A 1632: Show issues

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Article ; Online: Optimizing Antibiotic Therapy for Intravenous Drug Users: A Narrative Review Unraveling Pharmacokinetics/Pharmacodynamics Challenges.

Colaneri, Marta / Genovese, Camilla / Valsecchi, Pietro / Calia, Matteo / Cattaneo, Dario / Gori, Andrea / Bruno, Raffaele / Seminari, Elena

European journal of drug metabolism and pharmacokinetics

2024 Volume 49, Issue 2, Page(s) 123–129

Abstract: Intravenous drug users (IVDUs) face heightened susceptibility to life-threatening gram-positive bacterial infections, particularly methicillin-resistant Staphylococcus aureus (MRSA). While the standard antibiotic dosing strategies for special patients, ... ...

Abstract	Intravenous drug users (IVDUs) face heightened susceptibility to life-threatening gram-positive bacterial infections, particularly methicillin-resistant Staphylococcus aureus (MRSA). While the standard antibiotic dosing strategies for special patients, such as obese or critically ill individuals, are known to be inadequate, raising concerns about treatment efficacy, a similar sort of understanding has not been assessed for IVDUs yet. With this in mind, this review examines the pharmacokinetic/pharmacodynamic characteristics of antibiotics commonly used against gram-positive bacteria in IVDUs. Focusing on daptomycin, vancomycin, teicoplanin, aminoglycosides, and the novel lipoglycopeptide dalbavancin, the study reveals significant pharmacokinetic variations in IVDUs, suggesting the need for personalized dosing. Concomitant opioid substitution therapy and other factors, such as malnutrition, contribute to altered pharmacokinetics/pharmacodynamics, emphasizing the importance of targeted therapeutic drug monitoring. Overall, our study calls for increased awareness among clinicians regarding the unique pharmacokinetic/pharmacodynamic challenges in IVDUs and advocates for tailored antibiotic dosing strategies to enhance treatment outcomes in this marginalized population.
MeSH term(s)	Humans ; Drug Users ; Methicillin-Resistant Staphylococcus aureus ; Substance Abuse, Intravenous/drug therapy ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Vancomycin
Chemical Substances	Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU)
Language	English
Publishing date	2024-02-08
Publishing country	France
Document type	Review ; Journal Article
ZDB-ID	196729-0
ISSN	2107-0180 ; 0398-7639 ; 0378-7966
ISSN (online)	2107-0180
ISSN	0398-7639 ; 0378-7966
DOI	10.1007/s13318-024-00882-8
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Zs.A 1236: Show issues

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Article ; Online: The possible role of serum bactericidal titres in long-term suppressive antibiotic treatment for infective endocarditis: report of three cases.

Valsecchi, Pietro / Calia, Matteo / Marvulli, Lea Nadia / Bono, Enrica / Monzillo, Vincenzina / Bruno, Raffaele / Seminari, Elena

Infectious diseases (London, England)

2023 Volume 55, Issue 7, Page(s) 514–518

Abstract: Introduction: long term suppressive antibiotic treatment may be the only feasible option for patients with infective endocarditis (IE) not suitable for surgery.: Case reports: we present three cases of prosthetic valve endocarditis (PVE) caused by !## ...

Abstract	Introduction: long term suppressive antibiotic treatment may be the only feasible option for patients with infective endocarditis (IE) not suitable for surgery. Case reports: we present three cases of prosthetic valve endocarditis (PVE) caused by Conclusions: long term oral amoxicillin was effective and well-tolerated. SBTs after switch to oral therapy were quite heterogeneous, in some cases not reaching the conventionally established titre to assess bactericidal effect (1:8).Key pointsendovascular infection in non-suitable-for-surgery patients can be managed with long-term oral suppressive therapy.serum bactericidal assay confirmed high effectiveness of parenteral antibiotic therapy.serum bactericidal assay showed highly variable titres during oral therapy.
MeSH term(s)	Humans ; Endocarditis, Bacterial/drug therapy ; Anti-Bacterial Agents/therapeutic use ; Heart Valve Prosthesis ; Tomography, X-Ray Computed ; Endocarditis/drug therapy ; Anti-Infective Agents ; Amoxicillin/therapeutic use
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents ; Amoxicillin (804826J2HU)
Language	English
Publishing date	2023-06-02
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2839775-7
ISSN	2374-4243 ; 2374-4235
ISSN (online)	2374-4243
ISSN	2374-4235
DOI	10.1080/23744235.2023.2216271
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Article ; Online: Procedure, management, and outcome of subcutaneous implantable cardioverter-defibrillator extraction in clinical practice.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

2023 Volume 25, Issue 6

Abstract: Aims: Subcutaneous implantable cardioverter-defibrillator (S-ICD) therapy is expanding rapidly. However, there are few data on the S-ICD extraction procedure and subsequent patient management. The aim of this analysis was to describe the procedure, ... ...

Abstract	Aims: Subcutaneous implantable cardioverter-defibrillator (S-ICD) therapy is expanding rapidly. However, there are few data on the S-ICD extraction procedure and subsequent patient management. The aim of this analysis was to describe the procedure, management, and outcome of S-ICD extractions in clinical practice. Methods and results: We enrolled consecutive patients who required complete S-ICD extraction at 66 Italian centres. From 2013 to 2022, 2718 patients undergoing de novo implantation of an S-ICD were enrolled. Of these, 71 required complete S-ICD system extraction (17 owing to infection). The S-ICD system was successfully extracted in all patients, and no complications were reported; the median procedure duration was 40 (25th-75th percentile: 20-55) min. Simple manual traction was sufficient to remove the lead in 59 (84%) patients, in whom lead-dwelling time was shorter [20 (9-32) months vs. 30 (22-41) months; P = 0.032]. Hospitalization time was short in the case of both non-infectious [2 (1-2) days] and infectious indications [3 (1-6) days]. In the case of infection, no patients required post-extraction intravenous antibiotics, the median duration of any antibiotic therapy was 10 (10-14) days, and the re-implantation was performed during the same procedure in 29% of cases. No complications arose over a median of 21 months. Conclusion: The S-ICD extraction was safe and easy to perform, with no complications. Simple traction of the lead was successful in most patients, but specific tools could be needed for systems implanted for a longer time. The peri- and post-procedural management of S-ICD extraction was free from complications and not burdensome for patients and healthcare system. Clinical trial registration: URL: http://clinicaltrials.gov/Identifier: NCT02275637.
MeSH term(s)	Humans ; Administration, Intravenous ; Anti-Bacterial Agents ; Defibrillators, Implantable ; Hospitalization ; Treatment Outcome
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-06-22
Publishing country	England
Document type	Clinical Study ; Journal Article
ZDB-ID	1449879-0
ISSN	1532-2092 ; 1099-5129
ISSN (online)	1532-2092
ISSN	1099-5129
DOI	10.1093/europace/euad158
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Zs.A 5434: Show issues

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Article ; Online: Safety of Omitting Defibrillation Efficacy Testing With Subcutaneous Defibrillators: A Propensity-Matched Case-Control Study.

Circulation. Arrhythmia and electrophysiology

2021 Volume 14, Issue 12, Page(s) e010381

MeSH term(s)	Arrhythmias, Cardiac/diagnosis ; Arrhythmias, Cardiac/mortality ; Arrhythmias, Cardiac/physiopathology ; Arrhythmias, Cardiac/therapy ; Case-Control Studies ; Defibrillators, Implantable ; Electric Countershock/adverse effects ; Electric Countershock/instrumentation ; Electric Countershock/mortality ; Equipment Safety ; Female ; Humans ; Italy ; Male ; Materials Testing ; Patient Safety ; Propensity Score ; Prosthesis Design ; Prosthesis Failure ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Failure
Language	English
Publishing date	2021-12-02
Publishing country	United States
Document type	Comparative Study ; Letter ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2426129-4
ISSN	1941-3084 ; 1941-3149
ISSN (online)	1941-3084
ISSN	1941-3149
DOI	10.1161/CIRCEP.121.010381
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Zs.A 6667: Show issues

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Article ; Online: Meningiomas in Gynecology and Reproduction: an Updated Overview for Clinical Practice.

Girardelli, Serena / Albano, Luigi / Mangili, Giorgia / Valsecchi, Luca / Rabaiotti, Emanuela / Cavoretto, Paolo Ivo / Mortini, Pietro / Candiani, Massimo

Reproductive sciences (Thousand Oaks, Calif.)

2021 Volume 29, Issue 9, Page(s) 2452–2464

Abstract: There is various evidence to suggest a relationship between female hormones and meningiomas; as clinicians, we often come to face challenging situations involving female patients diagnosed with meningiomas during the post-pubertal phases of their life. ... ...

Abstract	There is various evidence to suggest a relationship between female hormones and meningiomas; as clinicians, we often come to face challenging situations involving female patients diagnosed with meningiomas during the post-pubertal phases of their life. We aimed to review the specific circumstances (pregnancy, postpartum, hormonal contraception and hormone replacement therapy, gender-affirming hormonal treatment) clinicians might come to face during their daily clinical practice, given the absence of available guidelines. We therefore conducted a narrative review on articles found in PubMed and Embase databases using appropriate keywords. Ninety-six relevant articles were included. The available evidence on managing meningiomas in post-pubertal women often implies personal strategies, highlighting the lack of a unified approach. The knowledge of the biological links between female hormones and meningiomas is fundamental to correctly counsel patients in various life phases. Prospective randomized studies are required to improve available guidelines on how to best manage meningiomas in female post-pubertal patients.
MeSH term(s)	Female ; Gynecology ; Hormones ; Humans ; Meningeal Neoplasms/therapy ; Meningioma/therapy ; Pregnancy ; Prospective Studies ; Reproduction
Chemical Substances	Hormones
Language	English
Publishing date	2021-05-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2276411-2
ISSN	1933-7205 ; 1933-7191
ISSN (online)	1933-7205
ISSN	1933-7191
DOI	10.1007/s43032-021-00606-2
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Article ; Online: Reduction in inappropriate therapies through device programming in subcutaneous implantable defibrillator patients: data from clinical practice.

2023 Volume 25, Issue 5

Abstract: Aims: In subcutaneous implantable cardioverter defibrillator (S-ICD) recipients, the UNTOUCHED study demonstrated a very low inappropriate shock rate on programming a conditional zone between 200 and 250 bpm and a shock zone for arrhythmias >250 bpm. ... ...

Abstract	Aims: In subcutaneous implantable cardioverter defibrillator (S-ICD) recipients, the UNTOUCHED study demonstrated a very low inappropriate shock rate on programming a conditional zone between 200 and 250 bpm and a shock zone for arrhythmias >250 bpm. The extent to which this programming approach is adopted in clinical practice is still unknown, as is its impact on the rates of inappropriate and appropriate therapies. Methods and results: We assessed ICD programming on implantation and during follow-up in a cohort of 1468 consecutive S-ICD recipients in 56 Italian centres. We also measured the occurrence of inappropriate and appropriate shocks during follow-up. On implantation, the median programmed conditional zone cut-off was set to 200 bpm (IQR: 200-220) and the shock zone cut-off was 230 bpm (IQR: 210-250). During follow-up, the conditional zone cut-off rate was not significantly changed, while the shock zone cut-off was changed in 622 (42%) patients and the median value increased to 250 bpm (IQR: 230-250) (P < 0.001). UNTOUCHED-like programming of detection cut-offs was adopted in 426 (29%) patients immediately after device implantation, and in 714 (49%, P < 0.001) at the last follow-up. UNTOUCHED-like programming was independently associated with fewer inappropriate shocks (hazard ratio 0.50, 95%CI 0.25-0.98, P = 0.044), and had no impact on appropriate and ineffective shocks. Conclusions: In recent years, S-ICD implanting centres have increasingly programmed high arrhythmia detection cut-off rates, at the time of implantation in the case of new S-ICD recipients, and during follow-up in the case of pre-existing implants. This has contributed significantly to reducing the incidence of inappropriate shocks in clinical practice. Rordorf: Programming of the S-ICD. Clinical trial registration: URL: http://clinicaltrials.gov/Identifier: NCT02275637.
MeSH term(s)	Humans ; Defibrillators, Implantable/adverse effects ; Tachycardia, Ventricular/diagnosis ; Follow-Up Studies ; Prospective Studies ; Electric Countershock ; Arrhythmias, Cardiac/diagnosis ; Arrhythmias, Cardiac/therapy
Language	English
Publishing date	2023-03-16
Publishing country	England
Document type	Journal Article
ZDB-ID	1449879-0
ISSN	1532-2092 ; 1099-5129
ISSN (online)	1532-2092
ISSN	1099-5129
DOI	10.1093/europace/euac234
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Zs.A 5434: Show issues

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Article ; Online: Modern subcutaneous implantable defibrillator therapy in patients with cardiomyopathies and channelopathies: data from a large multicentre registry.

2023 Volume 25, Issue 9

Abstract: Aims: Patients with cardiomyopathies and channelopathies are usually younger and have a predominantly arrhythmia-related prognosis; they have nearly normal life expectancy thanks to the protection against sudden cardiac death provided by the implantable ...

Abstract	Aims: Patients with cardiomyopathies and channelopathies are usually younger and have a predominantly arrhythmia-related prognosis; they have nearly normal life expectancy thanks to the protection against sudden cardiac death provided by the implantable cardioverter defibrillator (ICD). The subcutaneous ICD (S-ICD) is an effective alternative to the transvenous ICD and has evolved over the years. This study aimed to evaluate the rate of inappropriate shocks (IS), appropriate therapies, and device-related complications in patients with cardiomyopathies and channelopathies who underwent modern S-ICD implantation. Methods and results: We enrolled consecutive patients with cardiomyopathies and channelopathies who had undergone implantation of a modern S-ICD from January 2016 to December 2020 and who were followed up until December 2022. A total of 1338 S-ICD implantations were performed within the observation period. Of these patients, 628 had cardiomyopathies or channelopathies. The rate of IS at 12 months was 4.6% [95% confidence interval (CI): 2.8-6.9] in patients with cardiomyopathies and 1.1% (95% CI: 0.1-3.8) in patients with channelopathies (P = 0.032). No significant differences were noted over a median follow-up of 43 months [hazard ratio (HR): 0.76; 95% CI: 0.45-1.31; P = 0.351]. The rate of appropriate shocks at 12 months was 2.3% (95% CI: 1.1-4.1) in patients with cardiomyopathies and 2.1% (95% CI: 0.6-5.3) in patients with channelopathies (P = 1.0). The rate of device-related complications was 0.9% (95% CI: 0.3-2.3) and 3.2% (95% CI: 1.2-6.8), respectively (P = 0.074). No significant differences were noted over the entire follow-up. The need for pacing was low, occurring in 0.8% of patients. Conclusion: Modern S-ICDs may be a valuable alternative to transvenous ICDs in patients with cardiomyopathies and channelopathies. Our findings suggest that modern S-ICD therapy carries a low rate of IS. Clinical trial registration: URL: http://clinicaltrials.gov/Identifier: NCT02275637.
MeSH term(s)	Humans ; Defibrillators, Implantable/adverse effects ; Channelopathies/complications ; Channelopathies/therapy ; Treatment Outcome ; Death, Sudden, Cardiac/etiology ; Death, Sudden, Cardiac/prevention & control ; Cardiomyopathies/complications ; Cardiomyopathies/therapy ; Registries
Language	English
Publishing date	2023-08-01
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	1449879-0
ISSN	1532-2092 ; 1099-5129
ISSN (online)	1532-2092
ISSN	1099-5129
DOI	10.1093/europace/euad239
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Article ; Online: What prompts clinicians to start antibiotic treatment in COVID-19 patients? An Italian web survey helps us to understand where the doubts lie.

Colaneri, Marta / Valsecchi, Pietro / Vecchia, Marco / Di Filippo, Alessandro / Zuccaro, Valentina / Seminari, Elena / Sacchi, Paolo / Maiocchi, Laura / Fabbiani, Massimiliano / Ricciardi, Alessandra / Muzzi, Alba / Bruno, Raffaele

Journal of global antimicrobial resistance

2021 Volume 26, Page(s) 74–76

MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Antimicrobial Stewardship ; COVID-19 ; Humans ; Italy ; SARS-CoV-2
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2021-06-09
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2710046-7
ISSN	2213-7173 ; 2213-7165
ISSN (online)	2213-7173
ISSN	2213-7165
DOI	10.1016/j.jgar.2021.05.014
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