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  1. Article ; Online: Exploring post-SEPSIS and post-COVID-19 syndromes

    Darcy Holmes / Marta Colaneri / Emanuele Palomba / Andrea Gori

    Frontiers in Medicine, Vol

    crossovers from pathophysiology to therapeutic approach

    2024  Volume 10

    Abstract: Sepsis, driven by several infections, including COVID-19, can lead to post-sepsis syndrome (PSS) and post-acute sequelae of COVID-19 (PASC). Both these conditions share clinical and pathophysiological similarities, as survivors face persistent multi- ... ...

    Abstract Sepsis, driven by several infections, including COVID-19, can lead to post-sepsis syndrome (PSS) and post-acute sequelae of COVID-19 (PASC). Both these conditions share clinical and pathophysiological similarities, as survivors face persistent multi-organ dysfunctions, including respiratory, cardiovascular, renal, and neurological issues. Moreover, dysregulated immune responses, immunosuppression, and hyperinflammation contribute to these conditions. The lack of clear definitions and diagnostic criteria hampers comprehensive treatment strategies, and a unified therapeutic approach is significantly needed. One potential target might be the renin-angiotensin system (RAS), which plays a significant role in immune modulation. In fact, RAS imbalance can exacerbate these responses. Potential interventions involving RAS include ACE inhibitors, ACE receptor blockers, and recombinant human ACE2 (rhACE2). To address the complexities of PSS and PASC, a multifaceted approach is required, considering shared immunological mechanisms and the role of RAS. Standardization, research funding, and clinical trials are essential for advancing treatment strategies for these conditions.
    Keywords post-sepsis syndrome (PSS) ; post-acute sequelae of COVID-19 (PASC) ; immune dysfunction ; renin-angiotensin system (RAS) ; angiotensin-converting enzyme 2 (ACE2) ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2024-01-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Nocardia Infections in the Immunocompromised Host

    Emanuele Palomba / Arianna Liparoti / Anna Tonizzo / Valeria Castelli / Laura Alagna / Giorgio Bozzi / Riccardo Ungaro / Antonio Muscatello / Andrea Gori / Alessandra Bandera

    Microorganisms, Vol 10, Iss 1120, p

    A Case Series and Literature Review

    2022  Volume 1120

    Abstract: Nocardia is primarily considered an opportunistic pathogen and affects patients with impaired immune systems, solid-organ transplant recipients (SOTRs), and patients with haematologic malignancies. We present the cases of six patients diagnosed with ... ...

    Abstract Nocardia is primarily considered an opportunistic pathogen and affects patients with impaired immune systems, solid-organ transplant recipients (SOTRs), and patients with haematologic malignancies. We present the cases of six patients diagnosed with nocardiosis at our center in the last two years, describing the various predisposing conditions alongside the clinical manifestation, the diagnostic workup, and the treatment course. Moreover, we propose a brief literature review on Nocardia infections in the immunocompromised host, focusing on SOTRs and haematopoietic stem cell transplantation recipients and highlighting risk factors, clinical presentations, the diagnostic tools available, and current treatment and prophylaxis guidelines.
    Keywords nocardia ; nocardiosis ; immunocompromised ; transplant ; haematologic malignancies ; SOT ; Biology (General) ; QH301-705.5
    Language English
    Publishing date 2022-05-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Immune Checkpoint Inhibitors in People Living with HIV/AIDS

    Valeria Castelli / Andrea Lombardi / Emanuele Palomba / Giorgio Bozzi / Riccardo Ungaro / Laura Alagna / Davide Mangioni / Antonio Muscatello / Alessandra Bandera / Andrea Gori

    Cells, Vol 10, Iss 2227, p

    Facts and Controversies

    2021  Volume 2227

    Abstract: Immune checkpoint inhibitors (ICIs) are reshaping the landscape of cancer treatment, redefining the prognosis of several tumors. They act by restoring the cytotoxic activity of tumor-specific T lymphocytes that are in a condition of immune exhaustion. ... ...

    Abstract Immune checkpoint inhibitors (ICIs) are reshaping the landscape of cancer treatment, redefining the prognosis of several tumors. They act by restoring the cytotoxic activity of tumor-specific T lymphocytes that are in a condition of immune exhaustion. The same condition has been widely described in chronic HIV infection. In this review, we dissect the role of ICIs in people living with HIV/AIDS (PLWHIV). First, we provide an overview of the immunologic scenario. Second, we discuss the possible use of ICIs as adjuvant treatment of HIV to achieve elimination of the viral reservoir. Third, we examine the influence of HIV infection on ICI safety and effectiveness. Finally, we describe how the administration of ICIs impacts opportunistic infections.
    Keywords immune checkpoint inhibitors ; HIV ; immune exhaustion ; Biology (General) ; QH301-705.5
    Language English
    Publishing date 2021-08-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Congenital Hepatic Fibrosis as a Cause of Recurrent Cholangitis

    Emanuele Palomba / Marco Maggioni / Giulia Viero / Davide Mangioni / Rosa Lombardi / Barbara Antonelli / Daniele Dondossola / Massimo Iavarone / Anna Ludovica Fracanzani / Alessandra Bandera / Andrea Gori / Andrea Lombardi

    Livers, Vol 1, Iss 12, Pp 132-

    A Case Report and Review of the Literature

    2021  Volume 137

    Abstract: Rare liver diseases caused by ductal plate malformation, such as congenital hepatic fibrosis (CHF), Caroli syndrome, and polycystic liver disease, can have clinical manifestations such as recurrent cholangitis—frequently involving multidrug-resistant ... ...

    Abstract Rare liver diseases caused by ductal plate malformation, such as congenital hepatic fibrosis (CHF), Caroli syndrome, and polycystic liver disease, can have clinical manifestations such as recurrent cholangitis—frequently involving multidrug-resistant microorganisms—leading to difficulties in selecting the optimal antimicrobial treatment. Without prompt recognition, these infections severely hamper the patient’s quality of life and can develop into life-threatening complications. We report here the case of a 50-year-old woman with a history of recurring cholangitis with occasional systemic involvement leading to bloodstream infection, who ultimately received a diagnosis of CHF and was put on chronic suppressive antibiotic therapy while on the waiting list for a liver transplant. We also reviewed the literature collecting cases of recurrent infections occurring in patients with ductal plate malformation.
    Keywords congenital hepatic fibrosis ; cholangitis ; liver transplantation ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2021-08-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Mucormycosis in CAPA, a Possible Fungal Super-Infection

    Paola Saltini / Emanuele Palomba / Valeria Castelli / Marco Fava / Laura Alagna / Simona Biscarini / Marco Mantero / Francesco Blasi / Anna Grancini / Alessandra Bandera / Andrea Gori / Antonio Muscatello / Andrea Lombardi

    Journal of Fungi, Vol 7, Iss 708, p

    2021  Volume 708

    Abstract: The occurrence of pulmonary fungal superinfection due to Aspergillus spp. in patients with COVID-19 is a well-described complication associated with significant morbidity and mortality. This can be related to a directed effect of the virus and to the ... ...

    Abstract The occurrence of pulmonary fungal superinfection due to Aspergillus spp. in patients with COVID-19 is a well-described complication associated with significant morbidity and mortality. This can be related to a directed effect of the virus and to the immunosuppressive role of the therapies administered for the disease. Here, we describe the first case of pulmonary infection due to Mucorales occurring in a patient with a concomitant diagnosis of COVID-19-associated pulmonary aspergillosis.
    Keywords mucormycosis ; CAPA ; COVID-19 ; Biology (General) ; QH301-705.5
    Language English
    Publishing date 2021-08-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Preliminary Evidence of Good Safety Profile and Outcomes of Early Treatment with Tixagevimab/Cilgavimab Compared to Previously Employed Monoclonal Antibodies for COVID-19 in Immunocompromised Patients

    Andrea Lombardi / Giulia Viero / Simone Villa / Simona Biscarini / Emanuele Palomba / Cecilia Azzarà / Nathalie Iannotti / Bianca Mariani / Camilla Genovese / Mara Tomasello / Anna Tonizzo / Marco Fava / Antonia Grazia Valzano / Letizia Corinna Morlacchi / Maria Francesca Donato / Giuseppe Castellano / Ramona Cassin / Maria Carrabba / Antonio Muscatello /
    Andrea Gori / Alessandra Bandera

    Biomedicines, Vol 11, Iss 1540, p

    2023  Volume 1540

    Abstract: Objectives: Monoclonal antibodies (mAbs) have proven to be a valuable tool against COVID-19, mostly among subjects with risk factors for progression to severe illness. Tixagevimab/cilgavimab (TIX/CIL), a combination of two Fc-modified human monoclonal ... ...

    Abstract Objectives: Monoclonal antibodies (mAbs) have proven to be a valuable tool against COVID-19, mostly among subjects with risk factors for progression to severe illness. Tixagevimab/cilgavimab (TIX/CIL), a combination of two Fc-modified human monoclonal antibodies, has been recently approved to be employed as early treatment. Methods: Two groups of immunocompromised patients exposed to different early treatments (i.e., TIX/CIL vs. other mAbs [casirivimab/imdevimab, bamlanivimab/etesevimab, sotrovimab]) were compared in terms of clinical outcomes (hospitalisation and mortality within 14 days from administration) and time to the negativity of nasal swabs. We used either Pearson’s chi-square or Fisher’s exact test for categorical variables, whereas the Wilcoxon rank–sum test was employed for continuous ones. Kaplan–Meier curves were produced to compare the time to nasopharyngeal swab negativity. Results: Early treatment with TIX/CIL was administered to 19 immunocompromised patients, while 89 patients received other mAbs. Most of them were solid organ transplant recipients or suffering from hematologic or solid malignancies. Overall, no significant difference was observed between the two groups regarding clinical outcomes. In the TIX/CIL group, one patient (1/19, 5.3%), who was admitted to the emergency room within the first 14 days from treatment and was hospitalised due to COVID-19 progression, died. Regarding the time to nasal swab negativity, no significant difference ( p = 0.088) emerged. Conclusions: Early treatment of SARS-CoV-2 infection with TIX/CIL showed favourable outcomes in a small group of immunocompromised patients, reporting no significant difference compared to similar patients treated with other mAbs.
    Keywords monoclonal antibodies ; tixagevimab/cilgavimab ; immunocompromised ; Biology (General) ; QH301-705.5
    Subject code 616
    Language English
    Publishing date 2023-05-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Multidrug-Resistant Bacterial Colonization and Infections in Large Retrospective Cohort of Mechanically Ventilated COVID-19 Patients

    Davide Mangioni / Liliane Chatenoud / Jacopo Colombo / Emanuele Palomba / Fernando A. Guerrero / Matteo Bolis / Nicola Bottino / Giuseppe Breda / Maria V. Chiaruttini / Gabriele Fior / Manuela Marotta / Giovanni Massobrio / Caterina Matinato / Antonio Muscatello / Paola Previtali / Sara Santambrogio / Francesca Tardini / Gianluca Zuglian / Giacomo Grasselli /
    Roberto Fumagalli / Andrea Gori / Nino Stocchetti / Gianpaola Monti / Alessandra Bandera

    Emerging Infectious Diseases, Vol 29, Iss 8, Pp 1598-

    2023  Volume 1607

    Abstract: Few data are available on incidence of multidrug-resistant organism (MDRO) colonization and infections in mechanically ventilated patients, particularly during the COVID-19 pandemic. We retrospectively evaluated all patients admitted to the COVID-19 ... ...

    Abstract Few data are available on incidence of multidrug-resistant organism (MDRO) colonization and infections in mechanically ventilated patients, particularly during the COVID-19 pandemic. We retrospectively evaluated all patients admitted to the COVID-19 intensive care unit (ICU) of Hub Hospital in Milan, Italy, during October 2020‒May 2021. Microbiologic surveillance was standardized with active screening at admission and weekly during ICU stay. Of 435 patients, 88 (20.2%) had MDROs isolated ≤48 h after admission. Of the remaining patients, MDRO colonization was diagnosed in 173 (51.2%), MDRO infections in 95 (28.1%), and non-MDRO infections in 212 (62.7%). Non-MDRO infections occurred earlier than MDRO infections (6 days vs. 10 days; p<0.001). Previous exposure to antimicrobial drugs within the ICU was higher in MDRO patients than in non-MDRO patients (116/197 [58.9%] vs. 18/140 [12.9%]; p<0.001). Our findings might serve as warnings for future respiratory viral pandemics and call for increased measures of antimicrobial stewardship and infection control.
    Keywords antimicrobial resistance ; multidrug resistant ; MDR ; multidrug-resistant bacteria ; bacteria ; multidrug-resistant organism ; Medicine ; R ; Infectious and parasitic diseases ; RC109-216
    Subject code 610
    Language English
    Publishing date 2023-08-01T00:00:00Z
    Publisher Centers for Disease Control and Prevention
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Multidrug-Resistant Gram-Negative Bacteria Decolonization in Immunocompromised Patients

    Laura Alagna / Emanuele Palomba / Davide Mangioni / Giorgio Bozzi / Andrea Lombardi / Riccardo Ungaro / Valeria Castelli / Daniele Prati / Maurizio Vecchi / Antonio Muscatello / Alessandra Bandera / Andrea Gori

    International Journal of Molecular Sciences, Vol 21, Iss 5619, p

    A Focus on Fecal Microbiota Transplantation

    2020  Volume 5619

    Abstract: Antimicrobial resistance is an important issue for global health; in immunocompromised patients, such as solid organ and hematological transplant recipients, it poses an even bigger threat. Colonization by multidrug-resistant (MDR) bacteria was ... ...

    Abstract Antimicrobial resistance is an important issue for global health; in immunocompromised patients, such as solid organ and hematological transplant recipients, it poses an even bigger threat. Colonization by multidrug-resistant (MDR) bacteria was acknowledged as a strong risk factor to subsequent infections, especially in individuals with a compromised immune system. A growing pile of studies has linked the imbalance caused by the dominance of certain taxa populating the gut, also known as intestinal microbiota dysbiosis, to an increased risk of MDR bacteria colonization. Several attempts were proposed to modulate the gut microbiota. Particularly, fecal microbiota transplantation (FMT) was successfully applied to treat conditions like Clostridioides difficile infection and other diseases linked to gut microbiota dysbiosis. In this review we aimed to provide a look at the data gathered so far on FMT, focusing on its possible role in treating MDR colonization in the setting of immunocompromised patients and analyzing its efficacy and safety.
    Keywords gut colonization ; decolonization ; fecal microbiota transplantation ; antimicrobial resistance ; multidrug-resistant ; immunocompromised ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
    Subject code 610
    Language English
    Publishing date 2020-08-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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