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Article ; Online: Trends of thrombo-inflammation biomarkers after Tocilizumab predict treatment failure better than scores in patients with severe SARS-CoV2 related respiratory failure.

Masotti, Luca / Cioni, Elisa / Grifoni, Elisa / Cei, Francesco / Tarquini, Roberto

2022 Volume 103, Page(s) 111–112

MeSH term(s)	Antibodies, Monoclonal, Humanized ; Biomarkers ; Humans ; Inflammation ; RNA, Viral ; Respiratory Insufficiency ; SARS-CoV-2 ; Treatment Failure ; COVID-19 Drug Treatment
Chemical Substances	Antibodies, Monoclonal, Humanized ; Biomarkers ; RNA, Viral ; tocilizumab (I031V2H011)
Language	English
Publishing date	2022-06-06
Publishing country	Netherlands
Document type	Letter ; Comment
ZDB-ID	1038679-8
ISSN	1879-0828 ; 0953-6205
ISSN (online)	1879-0828
ISSN	0953-6205
DOI	10.1016/j.ejim.2022.06.004
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Article ; Online: Validation of Empoli Embolic Stroke of Undetermined Source Atrial Fibrillation (E 2 AF) Score for Detecting Atrial Fibrillation in Patients With Embolic Stroke of Undetermined Source.

Masotti, Luca / Grifoni, Elisa / Baglini, Alessia / Sivieri, Irene / Mannini, Marianna / Iandoli, Gina / Madonia, Elisa Maria / Cosentino, Eleonora / Micheletti, Irene / Signorini, Ira / Cioni, Elisa / Sansone, Teresa / Pelagalli, Giulia / Baldini, Mariella / Giannoni, Sara / Bertini, Elisabetta / Di Donato, Ilaria

The neurologist

2023 Volume 28, Issue 6, Page(s) 426–428

MeSH term(s)	Humans ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Embolic Stroke ; Heart Atria ; Stroke/complications ; Stroke/diagnosis ; Risk Factors
Language	English
Publishing date	2023-11-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1361380-7
ISSN	2331-2637 ; 1074-7931
ISSN (online)	2331-2637
ISSN	1074-7931
DOI	10.1097/NRL.0000000000000497
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Article ; Online: Dural Metastasis without Subdural Hematoma or Subdural Fluid Collection in a Patient with Signet Ring Cell Gastric Adenocarcinoma.

Cioni, Elisa / Marchiani, Costanza / Gagliano, Manfredi / Bandini, Giulia / Palagano, Nicolas / Ciuti, Gabriele / Moggi Pignone, Alberto

The American journal of case reports

2020 Volume 21, Page(s) e925599

Abstract: BACKGROUND Signet ring cell (SRC) gastric adenocarcinoma is an aggressive histotype associated with poor prognosis, especially in advanced gastric cancer. Dural metastasis is rarely described in the literature, and clinical manifestations are generally ... ...

Abstract	BACKGROUND Signet ring cell (SRC) gastric adenocarcinoma is an aggressive histotype associated with poor prognosis, especially in advanced gastric cancer. Dural metastasis is rarely described in the literature, and clinical manifestations are generally related to subdural hematoma. Here we present a case of advanced SRC gastric cancer with dural neoplastic involvement in the absence of subdural hematoma or subdural fluid collection. CASE REPORT A 39-year-old woman presented with multiple episodes of confusion and headache. She had a history of SRC gastric adenocarcinoma that had been treated with neoadjuvant chemotherapy and total gastrectomy without evidence of disease relapse at follow-up. During hospitalization, she experienced persistent drowsiness and frequent generalized seizures that were nonresponsive to antiepileptic drugs. Brain computed tomography showed a dural right parafalcine nodular lesion suggestive of metastasis, and an SRC presence was detected in a cerebrospinal fluid sample. Cerebral magnetic resonance imaging showed isolated diffuse dural neoplastic involvement without evidence of subdural hematoma or subdural fluid collection. We considered palliative treatment with intrathecal chemotherapy, but it was not carried out because of clinical worsening and subsequent death. CONCLUSIONS In the very few case reports in the literature, dural metastasis in advanced gastric cancer is mainly associated with subdural hematoma. In our case, the absence of any subdural effusion, which is an even rarer condition, along with an unusual clinical presentation dominated by generalized seizures represented a diagnostic challenge. Given the aggressive course of the disease, a rapid diagnosis could allow a faster specific treatment to relieve a patient's symptoms.
MeSH term(s)	Adenocarcinoma ; Adult ; Carcinoma, Signet Ring Cell ; Dura Mater ; Female ; Hematoma, Subdural/etiology ; Humans ; Meningeal Neoplasms ; Stomach Neoplasms
Language	English
Publishing date	2020-10-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2517183-5
ISSN	1941-5923 ; 1941-5923
ISSN (online)	1941-5923
ISSN	1941-5923
DOI	10.12659/AJCR.925599
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Article ; Online: A rare case of Candida glabrata spondylodiscitis: case report and literature review.

Gagliano, Manfredi / Marchiani, Costanza / Bandini, Giulia / Bernardi, Paolo / Palagano, Nicolas / Cioni, Elisa / Finocchi, Martina / Bellando Randone, Silvia / Moggi Pignone, Alberto

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

2018 Volume 68, Page(s) 31–35

Abstract: Background: Spondylodiscitis is an infection of the vertebral column, the incidence of which is increasing due to an increase in the susceptible population and improved ascertainment. This disease has been associated with a wide range of microorganisms. ...

Abstract	Background: Spondylodiscitis is an infection of the vertebral column, the incidence of which is increasing due to an increase in the susceptible population and improved ascertainment. This disease has been associated with a wide range of microorganisms. Fungal spondylodiscitis is uncommon (0.5-1.6%) and strongly associated with immunosuppression and diabetes (Gouliouris et al., 2010). A rare case of Candida glabrata spondylodiscitis in a non-neutropenic diabetic patient is reported herein, along with a review of the literature. Case report: A case of C. glabrata spondylodiscitis of L3-L4 metameres was diagnosed. The diagnosis was obtained through open biopsy of an abscess and culture examination. The patient was treated with anidulafungin and surgical debridement of the lesion. Conclusions: The diagnosis of spondylodiscitis is often delayed or missed. Physicians should consider this entity in the differential diagnosis of lumbar pain in order to initiate an appropriate therapy to prevent spinal cord lesions and disability. This is particularly relevant in the case of a fungal aetiology, as there is a recognized global shift towards invasive candidiasis due to non-albicans Candida species, in particular C. glabrata, which has variable susceptibility to antifungal drugs.
MeSH term(s)	Abscess/diagnosis ; Abscess/microbiology ; Aged ; Anidulafungin ; Antifungal Agents/therapeutic use ; Candida glabrata/isolation & purification ; Candidiasis/diagnosis ; Candidiasis/drug therapy ; Debridement ; Discitis/diagnosis ; Discitis/drug therapy ; Discitis/microbiology ; Drug Resistance, Fungal ; Echinocandins/therapeutic use ; Humans ; Immunosuppression ; Lumbar Vertebrae/microbiology ; Male
Chemical Substances	Antifungal Agents ; Echinocandins ; Anidulafungin (9HLM53094I)
Language	English
Publishing date	2018-01-12
Publishing country	Canada
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1331197-9
ISSN	1878-3511 ; 1201-9712
ISSN (online)	1878-3511
ISSN	1201-9712
DOI	10.1016/j.ijid.2018.01.003
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Article ; Online: Prognostic role of Interleukin-6/lymphocytes ratio in SARS-CoV2 related pneumonia.

International immunopharmacology

2021 Volume 103, Page(s) 108435

Abstract: Introduction and aim: Interleukin-6 to lymphocyte (IL-6/Lym) ratio has been identified as a potential prognostic tool in patients with SARS-CoV2 related pneumonia. The aim of our study was to compare the prognostic power of IL-6/Lym ratio with other ... ...

Abstract	Introduction and aim: Interleukin-6 to lymphocyte (IL-6/Lym) ratio has been identified as a potential prognostic tool in patients with SARS-CoV2 related pneumonia. The aim of our study was to compare the prognostic power of IL-6/Lym ratio with other biomarkers in patients initially admitted in a non intensive unit and suffering for respiratory failure associated with SARS-CoV2 related pneumonia. Materials and methods: IL-6/Lym ratio, IL-6, D-Dimer, D-Dimer/fibrinogen ratio, fibrinogen, C-reactive protein (CRP), lymphocytes count and neutrophil/lymphocyte (N/L) ratio collected at hospital admission were tested as prognosticators of negative outcome, defined as combined endpoint in-hospital mortality and/or Intensive Care Unit (ICU) admission requiring oro-tracheal intubation (OTI). Results: Study population encompassed two hundreds and twenty-three patients (46% females) with mean age ± DS 69.4 ± 13.3 years. Eighty-nine patients (39.9%) suffered for severe respiratory failure and required non invasive ventilation, helmets and/or high flow nasal cannula. Fourty-one patients (18.3%) died during hospital stay and/or required OTI. In these patients mean values of IL-6/Lym ratio, IL-6, CRP and N/L were significantly higher and lymphocytes count was significantly lower compared with patients discharged alive and/or not requiring OTI, while no difference was found in mean values of D-Dimer, D-Dimer/Fibrinogen ratio and fibrinogen. AUC (0.797, 95% CI: 0.738-0.848) of IL-6/Lym ratio was the highest compared with those of all the other analyzed biomarkers and the difference was significant with the exception of IL-6. At multivariate logistic regression IL-6/Lym ratio > 66.5 resulted the only independent biomarker associated with mortality and/or OTI (OR 5.65; 95% 1.63-19.54). Conclusion: IL-6/Lym ratio seems to be an optimal prognosticator in SARS-CoV2 related pneumonia. Its routinary use in COVID-19 patients could be warranted.
MeSH term(s)	Aged ; Aged, 80 and over ; Biomarkers/metabolism ; COVID-19/metabolism ; COVID-19/mortality ; COVID-19/pathology ; Female ; Humans ; Interleukin-6/metabolism ; Lymphocytes/physiology ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Regression Analysis ; Respiratory Insufficiency ; Retrospective Studies ; SARS-CoV-2
Chemical Substances	Biomarkers ; IL6 protein, human ; Interleukin-6
Language	English
Publishing date	2021-12-10
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2043785-7
ISSN	1878-1705 ; 1567-5769
ISSN (online)	1878-1705
ISSN	1567-5769
DOI	10.1016/j.intimp.2021.108435
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Article ; Online: Early reduction of estimated Glomerular Filtration Rate (eGFR) predicts poor outcome in acutely ill hospitalized COVID-19 patients firstly admitted to medical regular wards (eGFR-COV19 study).

Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie

2022 Volume 153, Page(s) 113454

Abstract: Background: Analysis of autopsy tissues obtained from patients who died from COVID-19 showed kidney tropism for SARS-COV-2, with COVID-19-related renal dysfunction representing an overlooked problem even in patients lacking previous history of chronic ... ...

Abstract	Background: Analysis of autopsy tissues obtained from patients who died from COVID-19 showed kidney tropism for SARS-COV-2, with COVID-19-related renal dysfunction representing an overlooked problem even in patients lacking previous history of chronic kidney disease. This study aimed to corroborate in a substantial sample of consecutive acutely ill COVID-19 hospitalized patients the efficacy of estimated GFR (eGFR), assessed at hospital admission, to identify acute renal function derangement and the predictive role of its association with in-hospital death and need for mechanical ventilation and admission to intensive care unit (ICU). Methods: We retrospectively analyzed charts of 764 patients firstly admitted to regular medical wards (Division of Internal Medicine) for symptomatic COVID-19 between March 6th and May 30th, 2020 and between October 1st, 2020 and March 15th, 2021. eGFR values were calculated with the 2021 CKD-EPI formula and assessed at hospital admission and discharge. Baseline creatinine and GFR values were assessed by chart review of patients' medical records from hospital admittance data in the previous year. The primary outcome was in-hospital mortality, while ARDS development and need for non-invasive ventilation (NIV) and invasive mechanical ventilation (IMV) were the secondary outcomes. Results: SARS-COV-2 infection was diagnosed in 764 patients admitted with COVID-19 symptoms. A total of 682 patients (age range 23-100 years) were considered for statistical analysis, 310 needed mechanical ventilation and 137 died. An eGFR value <60 mL/min/1.73 m Conclusions: eGFR calculated at hospital admission correlated well with COVID-19-related kidney injury and eGFR values < 60 mL/min/1,73 m
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/therapy ; Adult ; Aged ; Aged, 80 and over ; COVID-19/therapy ; Glomerular Filtration Rate ; Hospital Mortality ; Hospitals ; Humans ; Middle Aged ; Respiratory Distress Syndrome ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Young Adult
Language	English
Publishing date	2022-07-21
Publishing country	France
Document type	Journal Article
ZDB-ID	392415-4
ISSN	1950-6007 ; 0753-3322 ; 0300-0893
ISSN (online)	1950-6007
ISSN	0753-3322 ; 0300-0893
DOI	10.1016/j.biopha.2022.113454
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Article ; Online: Predictive Factors for Hemorrhagic Transformation in Acute Ischemic Stroke in the REAL-World Clinical Practice.

Grifoni, Elisa / Bini, Chiara / Signorini, Ira / Cosentino, Eleonora / Micheletti, Irene / Dei, Alessandro / Pinto, Gabriele / Madonia, Elisa Maria / Sivieri, Irene / Mannini, Marianna / Baldini, Mariella / Bertini, Elisabetta / Giannoni, Sara / Bartolozzi, Maria Letizia / Guidi, Leonello / Bartalucci, Paola / Vanni, Simone / Segneri, Antonio / Pratesi, Alessandra /

Giordano, Antonio / Dainelli, Francesca / Maggi, Francesca / Romagnoli, Mario / Cioni, Elisa / Cioffi, Elisa / Pelagalli, Giulia / Mattaliano, Chiara / Schipani, Elena / Murgida, Giuseppe Salvatore / Di Martino, Stefania / Sisti, Eleonora / Cozzi, Andrea / Francolini, Valentina / Masotti, Luca

The neurologist

2023 Volume 28, Issue 3, Page(s) 150–156

Abstract: Background: Few data exists on predictive factors of hemorrhagic transformation (HT) in real-world acute ischemic stroke patients. The aims of this study were: (i) to identify predictive variables of HT (ii) to develop a score for predicting HT.: ... ...

Abstract	Background: Few data exists on predictive factors of hemorrhagic transformation (HT) in real-world acute ischemic stroke patients. The aims of this study were: (i) to identify predictive variables of HT (ii) to develop a score for predicting HT. Methods: We retrospectively analyzed the clinical, radiographic, and laboratory data of patients with acute ischemic stroke consecutively admitted to our Stroke Unit along two years. Patients with HT were compared with those without HT. A multivariate logistic regression analysis was performed to identify independent predictors of HT on CT scan at 24 hours to develop a practical score. Results: The study population consisted of 564 patients with mean age 77.5±11.8 years. Fifty-two patients (9.2%) showed HT on brain CT at 24 hours (4.9% symptomatic). NIHSS score ≥8 at Stroke Unit admission (3 points), cardioembolic etiology (2 points), acute revascularization by systemic thrombolysis and/or mechanical thrombectomy (1 point), history of previous TIA/stroke (1 point), and major vessel occlusion (1 point) were found independent risk factors of HT and were included in the score (Hemorrhagic Transformation Empoli score (HTE)). The predictive power of HTE score was good with an AUC of 0.785 (95% CI: 0.749-0.818). Compared with 5 HT predictive scores proposed in the literature (THRIVE, SPAN-100, MSS, GRASPS, SITS-SIC), the HTE score significantly better predicted HT. Conclusions: NIHSS score ≥8 at Stroke Unit admission, cardioembolism, urgent revascularization, previous TIA/stroke, and major vessel occlusion were independent predictors of HT. The HTE score has a good predictive power for HT. Prospective studies are warranted.
MeSH term(s)	Humans ; Aged ; Aged, 80 and over ; Brain Ischemia/complications ; Brain Ischemia/diagnostic imaging ; Ischemic Stroke/complications ; Ischemic Stroke/diagnostic imaging ; Retrospective Studies ; Ischemic Attack, Transient ; Stroke/complications ; Stroke/diagnostic imaging ; Risk Factors
Language	English
Publishing date	2023-05-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1361380-7
ISSN	2331-2637 ; 1074-7931
ISSN (online)	2331-2637
ISSN	1074-7931
DOI	10.1097/NRL.0000000000000462
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Article ; Online: Predictors of poor outcome in tocilizumab treated patients with Sars-CoV-2 related severe respiratory failure: A multicentre real world study.

Masotti, Luca / Landini, Giancarlo / Panigada, Grazia / Grifoni, Elisa / Tarquini, Roberto / Cei, Francesco / Cimolato, Barbara Maria Angela / Vannucchi, Vieri / Di Pietro, Massimo / Piani, Fiorella / Fortini, Alberto / Faraone, Antonio / Nenci, Gabriele / Cipollini, Franco / Blanc, Pierluigi / Lotti, Pamela / Di Natale, Massimo / Risaliti, Filippo / Aquilini, Donatella /

Seravalle, Cristiana / Bribani, Andrea / Farsi, Alessandro / Micheletti, Irene / Cioni, Elisa / Pelagalli, Giulia / Mattaliano, Chiara / Pinto, Gabriele / Madonia, Elisa Maria / Sivieri, Irene / Mannini, Marianna / Valoriani, Alice / Brancati, Simona / Rosselli, Matteo / Pavone, Eleonora / Burla, Maria Chiara / Sergi, Alessandro

International immunopharmacology

2022 Volume 107, Page(s) 108709

Abstract: Introduction: Despite Tocilizumab is now recognized as a concrete therapeutic option in patients with severe SARS-CoV-2 related respiratory failure, literature lacks about factors influencing the response to it in this context. Therefore, the aim of our ...

Abstract	Introduction: Despite Tocilizumab is now recognized as a concrete therapeutic option in patients with severe SARS-CoV-2 related respiratory failure, literature lacks about factors influencing the response to it in this context. Therefore, the aim of our study was to provide evidence about predictors of poor outcome in Tocilizumab treated patients in the real-world practice. Materials and methods: We retrospectively analyzed clinical, laboratory and chest computer tomography (CCT) data of patients firstly admitted in non Intensive Care Units (ICU) and suffering from severe respiratory failure, who were treated with the IL-6 antagonist Tocilizumab. We compared patients who died and/or required admission to ICU with oro-tracheal intubation (OTI) with those who did not. Results: Two hundreds and eighty-seven patients (29.9% females) with mean age ± SD 64.1 ± 12.6 years were the study population. In-hospital mortality was 18.8%, while the composite endpoint in-hospital mortality and/or ICU admission with OTI occurred in 23.7%. At univariate analysis, patients who died and/or were admitted to ICU with OTI were significantly older and co-morbid, had significantly higher values of creatinine, C-reactive protein (CRP) and procalcitonin and lower lymphocytes count, PaO2/FiO2 ratio (P/F) and room air pulsossimetry oxygen saturation (RAO Conclusion: Tocilizumab has shown to improve outcome in patients with severe respiratory failure associated to SARS-CoV-2 related pneumonia. In our multicentre study focusing on Tocilizumab treated severe COVID-19 patients, age ≥ 65 years, procalcitonin ≥ 0.14 ng/mL, RAO
MeSH term(s)	Aged ; Antibodies, Monoclonal, Humanized ; COVID-19/drug therapy ; Female ; Humans ; Male ; Procalcitonin ; Respiratory Insufficiency/drug therapy ; Retrospective Studies ; SARS-CoV-2
Chemical Substances	Antibodies, Monoclonal, Humanized ; Procalcitonin ; tocilizumab (I031V2H011)
Language	English
Publishing date	2022-03-18
Publishing country	Netherlands
Document type	Journal Article ; Multicenter Study
ZDB-ID	2043785-7
ISSN	1878-1705 ; 1567-5769
ISSN (online)	1878-1705
ISSN	1567-5769
DOI	10.1016/j.intimp.2022.108709
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