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  1. Article ; Online: Long-Term GeneXpert Positivity after Treatment for Pulmonary Tuberculosis

    Luisa Costantini / Marco Marando / Pietro Gianella

    European Journal of Case Reports in Internal Medicine (2020)

    2020  

    Abstract: Tuberculosis (TB) is a cause of ill health and death worldwide. Since 2010, the diagnostic process has strongly relied on GeneXpert assays on biological specimens. Xpert MTB/RIF is an automated nucleic acid amplification test (NAAT) for Mycobacterium ... ...

    Abstract Tuberculosis (TB) is a cause of ill health and death worldwide. Since 2010, the diagnostic process has strongly relied on GeneXpert assays on biological specimens. Xpert MTB/RIF is an automated nucleic acid amplification test (NAAT) for Mycobacterium tuberculosis and rifampicin resistance, endorsed by the World Health Organization and the US Food and Drug Administration. Xpert is used in many countries as the initial diagnostic test for tuberculosis. Nevertheless, the reliability of GeneXpert positive tests in patients with a history of TB is largely unknown, due to possible false-positive results (i.e., GeneXpert-positive but culture-negative patients). We present a case report of a patient with a history of pulmonary TB, who was GeneXpert positive but culture negative on bronchoalveolar lavage 22 months after completion of appropriate antitubercular therapy.
    Keywords tuberculosis ; tb ; genexpert ; retested patients ; false positives ; Medicine ; R
    Language English
    Publishing date 2020-07-01T00:00:00Z
    Publisher SMC MEDIA SRL
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: False-Negative Nasopharyngeal Swab RT-PCR Assays in Typical COVID-19

    Marco Marando / Adriana Tamburello / Pietro Gianella

    European Journal of Case Reports in Internal Medicine (2020)

    Role of Ultra-low-dose Chest CT and Bronchoscopy in Diagnosis

    2020  

    Abstract: On 11 March 2020, the WHO declared COVID-19 a pandemic and global health emergency. We describe the clinical features and role of ultra-low-dose chest computed tomography (CT) and bronchoscopy in the diagnosis of coronavirus disease (COVID-19). In our ... ...

    Abstract On 11 March 2020, the WHO declared COVID-19 a pandemic and global health emergency. We describe the clinical features and role of ultra-low-dose chest computed tomography (CT) and bronchoscopy in the diagnosis of coronavirus disease (COVID-19). In our patient, who was highly suggestive clinically and radiologically for COVID-19, we had two false-negative results for nasopharyngeal and oral swab reverse-transcriptase polymerase chain reaction (RT-PCR) assays for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Eventually, we confirmed the diagnosis using bronchoscopy and bronchoalveolar lavage (BAL).
    Keywords coronavirus ; covid-19 ; rt-pcr ; ultra-low-dose chest ct ; bronchoscopy ; Medicine ; R ; covid19
    Language English
    Publishing date 2020-04-01T00:00:00Z
    Publisher SMC MEDIA SRL
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Diagnostic sensitivity of RT-PCR assays on nasopharyngeal specimens for detection of SARS-CoV-2 infection

    Marco Marando / Adriana Tamburello / Pietro Gianella / Rebecca Taylor / Enos Bernasconi / Tanja Fusi-Schmidhauser

    Caspian Journal of Internal Medicine, Vol 13, Iss Covid 19 Supplement 2, Pp 139-

    A Systematic Review and Meta-Analysis

    2022  Volume 147

    Abstract: Background: Reverse transcription polymerase chain reaction (RT-PCR) is the current standard of reference in the diagnosis of SARS-CoV-2 infection. In outpatient clinical practice, nasopharyngeal swab RT-PCR testing is still the most common procedure. ... ...

    Abstract Background: Reverse transcription polymerase chain reaction (RT-PCR) is the current standard of reference in the diagnosis of SARS-CoV-2 infection. In outpatient clinical practice, nasopharyngeal swab RT-PCR testing is still the most common procedure. The purpose of this systematic review and meta-analysis was to evaluate the sensitivity of RT-PCR nasopharyngeal assays. Methods: We searched three databases, including PubMed/MEDLINE, EMBASE, and Cochrane Library, using a comprehensive strategy. Studies investigating the sensitivity of SARS-CoV-2 RT-PCR nasopharyngeal assays in adults were included. Two reviewers extracted data and assessed trial quality independently. Pooled sensitivity and its confidence interval were computed using the meta package in R. Results: Thirteen studies were found eligible for the inclusion in the systematic review. Out of these, 25 different sub-studies were identified and included in the meta-analysis, which reported the sensitivities of 25 different nasopharyngeal RT-PCR assays. Finally, the overall pooled sensitivity resulted 89% (95% CI, 85.4 to 91.8%). Conclusion: Our study suggests that RT-PCR assays on nasopharyngeal specimens have a substantial sensitivity for diagnosing SARS-CoV-2 infection.
    Keywords nasopharyngeal swabs ; sars-cov-2 ; rt-pcr assay ; diagnostic yield ; Internal medicine ; RC31-1245
    Subject code 610
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher Babol University of Medical Sciences
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: The Dark Purple Side of Ceftriaxone

    Elia Rigamonti / Francesca Bedussi / Jerome Blanc / Pietro Gianella / Gianluca Vanini

    European Journal of Case Reports in Internal Medicine (2020)

    A Case Report on Leucocytoclastic Vasculitis

    2020  

    Abstract: We present a case of an 85-year-old woman diagnosed with uncomplicated pyelonephritis, who was treated with intravenous ceftriaxone. Her chronic medications were phenprocoumon, diltiazem and bisoprolol. During the infectious phase, the patient presented ... ...

    Abstract We present a case of an 85-year-old woman diagnosed with uncomplicated pyelonephritis, who was treated with intravenous ceftriaxone. Her chronic medications were phenprocoumon, diltiazem and bisoprolol. During the infectious phase, the patient presented tachycardia – despite high-dose beta-blocker treatment – and developed left acute heart failure, with acute renal failure (pre-renal origin). After introduction of furosemide diuretic therapy, clinical conditions improved and better control of the volemic status and heart rate was achieved. Several days after ceftriaxone and digoxin therapy initiation, worsening multiple non-blanching palpable purpuric lesions with bullae and papules, limited to the lower extremities, were noted. Skin biopsy was performed and a diagnosis of leucocytoclastic vasculitis, with associated panniculitis, was made. Ceftriaxone was discontinued and systemic corticosteroids were introduced, with a clear improvement in the cutaneous condition.
    Keywords vasculitis ; ceftriaxone ; dermatology ; Medicine ; R
    Language English
    Publishing date 2020-03-01T00:00:00Z
    Publisher SMC MEDIA SRL
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Differential diagnoses in COVID-19 pandemic

    Elia Rigamonti / Tanja Fusi-Schmidhauser / Gianluca Argentieri / Pietro Gianella

    Italian Journal of Medicine, Iss AOP (2020)

    a retrospective descriptive study

    2020  

    Abstract: Since 02.2020, SARS-CoV-2 infection rapidly spread across Southern Switzerland. The available literature on differential diagnoses of COVID-19 is scarce. Our study aims to review differential diagnoses of SARS-CoV-2 infections in public hospitals in ... ...

    Abstract Since 02.2020, SARS-CoV-2 infection rapidly spread across Southern Switzerland. The available literature on differential diagnoses of COVID-19 is scarce. Our study aims to review differential diagnoses of SARS-CoV-2 infections in public hospitals in Southern Switzerland and to describe patients’ related outcome. Between 01.03.2020 and 15.04.2020, 344 patients had a chest CT-scan at admission, 210 of them were pathological. 172 patients had a positive nasopharyngeal swab for SARSCoV- 2 and 38 patients needed an additional diagnostic work-up and were included in this study. Among the selected patients,8 patients underwent 2 PCR for SARS-CoV2, 18 of them 3 PCR. We observed 29 infective cases, 3 due to cardiovascular aetiologies, 2 due to COPD exacerbation, 1 due to cryptogenic organizing pneumonia, 3 not related to respiratory diseases. Our results highlight the importance of differential diagnosis in times of widespread occurrence of COVID-19, considering the similarity of symptoms and imaging appearance with other respiratory conditions.
    Keywords Interstitial bilateral pneumonia ; differential diagnoses ; COVID-19 ; SARS-CoV-2 infection ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2020-12-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Contemporary adequacy of thromboprophylaxis in acutely ill medical patients in Switzerland

    Marco Marando / Katherine Blondon / Pauline Darbellay Farhoumand / Mathieu Nendaz / Damien Grauser / Alain Sallet / Adriana Tamburello / Marco Pons / Marc Righini / Pietro Gianella / Marc Blondon

    Swiss Medical Weekly, Vol 153, Iss

    a bi-centric prospective cohort

    2023  Volume 11

    Abstract: BACKGROUND: Venous thromboembolism is a dreaded complication of hospitalised patients, with associated morbidity, mortality and increased healthcare costs. Previous studies have shown that pharmacological thromboprophylaxis, though effective, is ... ...

    Abstract BACKGROUND: Venous thromboembolism is a dreaded complication of hospitalised patients, with associated morbidity, mortality and increased healthcare costs. Previous studies have shown that pharmacological thromboprophylaxis, though effective, is inadequately administered in a large proportion of medical inpatients. STUDY AIMS: Our primary aim was to evaluate the contemporary adequacy of thromboprophylaxis in medical inpatients admitted to two Swiss hospitals (a university hospital and a regional hospital). The secondary aim was to estimate the 90-day incidence of relevant thrombotic and bleeding events. METHODS: In this prospective cohort, patients were recruited at the University Hospital of Geneva and the Regional Hospital of Lugano between September 2020 and February 2021 and followed for 90 days for venous thromboembolism and bleeding events. The adequacy of thromboprophylaxis (pharmacological and/or mechanical) at 24h after hospital admission was evaluated according to the simplified Geneva risk score for hospital-associated venous thromboembolism. RESULTS: Among 200 participants (100 at each site, mean age of 65 years), 57.5% were deemed at high risk of venous thromboembolism at admission. Thromboprophylaxis was adequate in 59.5% (95% CI 52.3–66.4%). Among high-risk and low-risk inpatients, thromboprophylaxis was adequate in 71.3% and 43.5%, respectively, with differences between sites. At 90 days, risks of adjudicated venous thromboembolism, major bleeding and mortality were 1.5%, 1.5% and 6.0%, respectively. CONCLUSION: Despite the extensive literature on thromboprophylaxis, the adequacy of thromboprophylaxis has not improved and remains insufficient among medical inpatients. Implementation and evaluation of clinical decision support systems are critically needed in this field. clinicaltrials.gov number: NCT05306821
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-11-01T00:00:00Z
    Publisher SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: The effect of the COVID-19 pandemic on severe asthma care in Europe

    Katrien Eger / Dora Paroczai / Alison Bacon / Florence Schleich / Svetlana Sergejeva / Arnaud Bourdin / Isabelle Vachier / Eleftherios Zervas / Konstantinos Katsoulis / Dimosthenis Papapetrou / Konstantinos Kostikas / Zsuzsanna Csoma / Enrico Heffler / Giorgio Walter Canonica / Ineta Grisle / Kristina Bieksiene / Jolita Palacionyte / Anneke ten Brinke / Simone Hashimoto /
    Frank W.J.M. Smeenk / Gert-Jan Braunstahl / Simone van der Sar / Florin Mihălţan / Natalia Nenasheva / Marina Peredelskaya / Biljana Zvezdin / Ivan Čekerevac / Sanja Hromiš / Vojislav Ćupurdija / Zorica Lazic / Branislava Milenkovic / Sanja Dimic-Janjic / Valentyna Yasinska / Barbro Dahlén / Apostolos Bossios / Nikolaos Lazarinis / David Aronsson / Arne Egesten / Abul Kashem Mohammad Munir / Lars Ahlbeck / Christer Janson / Sabina Škrgat / Natalija Edelbaher / Joerg Leuppi / Fabienne Jaun / Jochen Rüdiger / Nikolay Pavlov / Pietro Gianella / Reta Fischer / Florian Charbonnier / Rekha Chaudhuri / Steven James Smith / Simon Doe / Michelle Fawdon / Matthew Masoli / Liam Heaney / Hans Michael Haitchi / Ramesh Kurukulaaratchy / Olivia Fulton / Betty Frankemölle / Toni Gibson / Karen Needham / Peter Howarth / Ratko Djukanovic / Elisabeth Bel / Michael Hyland

    ERJ Open Research, Vol 8, Iss

    will care change for good?

    2022  Volume 2

    Abstract: Background The coronavirus disease 2019 (COVID-19) pandemic has put pressure on healthcare services, forcing the reorganisation of traditional care pathways. We investigated how physicians taking care of severe asthma patients in Europe reorganised care, ...

    Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has put pressure on healthcare services, forcing the reorganisation of traditional care pathways. We investigated how physicians taking care of severe asthma patients in Europe reorganised care, and how these changes affected patient satisfaction, asthma control and future care. Methods In this European-wide cross-sectional study, patient surveys were sent to patients with a physician-diagnosis of severe asthma, and physician surveys to severe asthma specialists between November 2020 and May 2021. Results 1101 patients and 268 physicians from 16 European countries contributed to the study. Common physician-reported changes in severe asthma care included use of video/phone consultations (46%), reduced availability of physicians (43%) and change to home-administered biologics (38%). Change to phone/video consultations was reported in 45% of patients, of whom 79% were satisfied or very satisfied with this change. Of 709 patients on biologics, 24% experienced changes in biologic care, of whom 92% were changed to home-administered biologics and of these 62% were satisfied or very satisfied with this change. Only 2% reported worsening asthma symptoms associated with changes in biologic care. Many physicians expect continued implementation of video/phone consultations (41%) and home administration of biologics (52%). Conclusions Change to video/phone consultations and home administration of biologics was common in severe asthma care during the COVID-19 pandemic and was associated with high satisfaction levels in most but not all cases. Many physicians expect these changes to continue in future severe asthma care, though satisfaction levels may change after the pandemic.
    Keywords Medicine ; R
    Subject code 360
    Language English
    Publishing date 2022-05-01T00:00:00Z
    Publisher European Respiratory Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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