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Article: Advances in Diagnostics and Management of Respiratory System Diseases.

Confalonieri, Paola / Salton, Francesco / Confalonieri, Marco / Pozzan, Riccardo / Ruaro, Barbara

2023 Volume 14, Issue 1

Abstract: Recently, significant innovations in the diagnosis and management of respiratory diseases have been developed [ ... ]. ...

Abstract	Recently, significant innovations in the diagnosis and management of respiratory diseases have been developed [...].
Language	English
Publishing date	2023-12-21
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics14010020
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Editorial: Evolution in respiratory pharmacology.

Ruaro, Barbara / Pozzan, Riccardo / Andrisano, Alessia Giovanna / Confalonieri, Marco / Ambhore, Nilesh Sudhakar

Frontiers in pharmacology

2023 Volume 14, Page(s) 1329811

Language	English
Publishing date	2023-11-17
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2587355-6
ISSN	1663-9812
ISSN	1663-9812
DOI	10.3389/fphar.2023.1329811
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Functional Progression after Dose Suspension or Discontinuation of Nintedanib in Idiopathic Pulmonary Fibrosis: A Real-Life Multicentre Study.

Ruaro, Barbara / Salotti, Andrea / Reccardini, Nicolò / Kette, Stefano / Da Re, Beatrice / Nicolosi, Salvatore / Zuccon, Umberto / Confalonieri, Marco / Mondini, Lucrezia / Pozzan, Riccardo / Hughes, Michael / Confalonieri, Paola / Salton, Francesco

Pharmaceuticals (Basel, Switzerland)

2024 Volume 17, Issue 1

Abstract: Background: Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial lung disease with rapidly progressive evolution and an unfavorable outcome. Nintedanib (NTD) is an antifibrotic drug that has been shown to be effective in slowing down the ... ...

Abstract	Background: Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial lung disease with rapidly progressive evolution and an unfavorable outcome. Nintedanib (NTD) is an antifibrotic drug that has been shown to be effective in slowing down the progression of the disease. The aim of our study was to examine the efficacy, especially in terms of the functional decline, and the safety profile of NTD in patients treated with the recommended dose and subjects who reduced or suspended the therapy due to the occurrence of adverse reactions. Methods: We conducted a real-life retrospective study based on the experience of NTD use in two centers between 2015 and 2022. Clinical data were evaluated at baseline, at 6 and 12 months after the NTD introduction in the whole population and in subgroups of patients who continued the full-dose treatment, at a reduced dosage, and at the discontinuation of treatment. The following data were recorded: the demographic features, IPF clinical features, NTD therapeutic dosage, tolerability and adverse events, pulmonary function tests (PFTs), the duration of treatment upon discontinuation, and the causes of interruption. Results: There were 54 IPF patients who were included (29.6% females, with a median (IQR) age at baseline of 75 (69.0-79.0) years). Twelve months after the introduction of the NTD therapy, 20 (37%) patients were still taking the full dose, 11 (20.4%) had reduced it to 200 mg daily, and 15 (27.8%) had stopped treatment. Gastrointestinal intolerance predominantly led to the dose reduction (13.0%) and treatment cessation (20.4%). There were two deaths within the initial 6 months (3.7%) and seven (13.0%) within 12 months. Compared to the baseline, the results of the PFTs remained stable at 6 and 12 months for the entire NTD-treated population, except for a significant decline in the DLCO (% predicted value) at both 6 (38.0 ± 17.8 vs. 43.0 ± 26.0; Conclusions: This study highlights the functional decline of the FVC at 12 months after the NTD initiation among patients discontinuing therapy but not among those reducing their dosage.
Language	English
Publishing date	2024-01-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2193542-7
ISSN	1424-8247
ISSN	1424-8247
DOI	10.3390/ph17010119
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Transbronchial lung cryobiopsy and pulmonary fibrosis: A never-ending story?

Ruaro, Barbara / Tavano, Stefano / Confalonieri, Paola / Pozzan, Riccardo / Hughes, Michael / Braga, Luca / Volpe, Maria Concetta / Ligresti, Giovanni / Andrisano, Alessia Giovanna / Lerda, Selene / Geri, Pietro / Biolo, Marco / Baratella, Elisa / Confalonieri, Marco / Salton, Francesco

Heliyon. 2023 Apr., v. 9, no. 4 p.e14768-

2023

Abstract: The diagnostic process of pulmonary fibrosis (PF) is often challenging, requires a collaborative effort of several experts, and often requires bioptic material, which can be difficult to obtain, both in terms of quality and technique. The main procedures ...

Abstract	The diagnostic process of pulmonary fibrosis (PF) is often challenging, requires a collaborative effort of several experts, and often requires bioptic material, which can be difficult to obtain, both in terms of quality and technique. The main procedures available to obtain such samples are transbronchial lung cryobiopsy (TBLC) and surgical lung biopsy (SLB). The purpose of this paper is to review the evidence for the role of TBLC in the diagnostic-therapeutic process of PF. A comprehensive review was performed to identify articles to date that addressed the role of TBLC in the diagnostic-therapeutic process of PF using the PubMed® database. The reasoned search identified 206 papers, including 21 manuscripts (three reviews, one systematic review, two guidelines, two prospective studies, three retrospective studies, one cross-sectional study, one original article, three editorials, three clinical trials, and two unclassifiable studies), which were included in the final review. TBLC is gaining increasing efficacy and improving safety profile; however, there are currently no clear data demonstrating its superiority over SLB. Therefore, the two techniques should be considered with careful rationalization on a case-by-case basis. Further research is needed to further optimize and standardize the procedure and to thoroughly study the histological and molecular characteristics of PF.
Keywords	biopsy ; cross-sectional studies ; databases ; histology ; lungs ; pulmonary fibrosis ; systematic review ; Pulmonary fibrosis (PF) ; Idiopathic pulmonary fibrosis (IPF) ; Interstitial lung disease (ILD) ; Transbronchial lung cryobiopsy (TBLC) ; Surgical lung biopsy (SLB) ; Bronchoscopy
Language	English
Dates of publication	2023-04
Publishing place	Elsevier Ltd
Document type	Article ; Online
Note	Use and reproduction
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2023.e14768
Database	NAL-Catalogue (AGRICOLA)

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Article: Nintedanib in Idiopathic Pulmonary Fibrosis: Tolerability and Safety in a Real Life Experience in a Single Centre in Patients also Treated with Oral Anticoagulant Therapy.

Ruaro, Barbara / Gandin, Ilaria / Pozzan, Riccardo / Tavano, Stefano / Bozzi, Chiara / Hughes, Michael / Kodric, Metka / Cifaldi, Rossella / Lerda, Selene / Confalonieri, Marco / Baratella, Elisa / Confalonieri, Paola / Salton, Francesco

Pharmaceuticals (Basel, Switzerland)

2023 Volume 16, Issue 2

Abstract: Idiopathic pulmonary fibrosis (IPF) is a rare and severe disease with a median survival of ~3 years. Nintedanib (NTD) has been shown to be useful in controlling interstitial lung disease (ILD) in IPF. Here we describe the experience of NTD use in IPF in ... ...

Abstract	Idiopathic pulmonary fibrosis (IPF) is a rare and severe disease with a median survival of ~3 years. Nintedanib (NTD) has been shown to be useful in controlling interstitial lung disease (ILD) in IPF. Here we describe the experience of NTD use in IPF in a real-life setting. Objective. Our objective was to examine the safety profile and efficacy of nintedanib even in subjects treated with anticoagulants. Clinical data of patients with IPF treated with NTD at our center were retrospectively evaluated at baseline and at 6 and 12 months after the introduction of NTD. The following parameters were recorded: IPF clinical features, NTD tolerability, and pulmonary function tests (PFT) (i.e., Forced Vital Capacity (FVC) and carbon monoxide diffusing capacity (DLCO)). In total, 56 IPF patients (34% female and 66% male, mean onset age: 71 ± 11 years, mean age at baseline: 74 ± 9 years) treated with NTD were identified. At enrollment, HRCT showed an UIP pattern in 45 (80%) and a NSIP in 11 (20%) patients. For FVC and FEV1 we found no significant change between baseline and 6 months, but for DLCO we observed a decrease (
Language	English
Publishing date	2023-02-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2193542-7
ISSN	1424-8247
ISSN	1424-8247
DOI	10.3390/ph16020307
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Microvascular Alteration in COVID-19 Documented by Nailfold Capillaroscopy.

Mondini, Lucrezia / Confalonieri, Paola / Pozzan, Riccardo / Ruggero, Luca / Trotta, Liliana / Lerda, Selene / Hughes, Michael / Bellan, Mattia / Confalonieri, Marco / Ruaro, Barbara / Salton, Francesco / Tavano, Stefano

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 11

Abstract: COVID-19 is a multisystemic disease that mainly affects and causes dysregulation of the endothelium, causing systemic manifestations. A nailfold video capillaroscopy is a safe, easy, and noninvasive method to evaluate microcirculation alteration. In this ...

Abstract	COVID-19 is a multisystemic disease that mainly affects and causes dysregulation of the endothelium, causing systemic manifestations. A nailfold video capillaroscopy is a safe, easy, and noninvasive method to evaluate microcirculation alteration. In this review, we analyzed the literature available to date regarding the object of nailfold video capillaroscopy (NVC) use in patients with a SARS-CoV-2 infection, both in the acute phase and after discharge. The scientific evidence pointed out the main alterations in capillary circulation shown by NVC, so reviewing the findings of each article allowed us to define and analyze the future prospects and needs for possibly including NVC within the management of patients with COVID-19, both during and after the acute phase.
Language	English
Publishing date	2023-05-29
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13111905
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Transbronchial lung cryobiopsy and pulmonary fibrosis: A never-ending story?

Heliyon

2023 Volume 9, Issue 4, Page(s) e14768

Abstract: Background: The diagnostic process of pulmonary fibrosis (PF) is often challenging, requires a collaborative effort of several experts, and often requires bioptic material, which can be difficult to obtain, both in terms of quality and technique. The ... ...

Abstract	Background: The diagnostic process of pulmonary fibrosis (PF) is often challenging, requires a collaborative effort of several experts, and often requires bioptic material, which can be difficult to obtain, both in terms of quality and technique. The main procedures available to obtain such samples are transbronchial lung cryobiopsy (TBLC) and surgical lung biopsy (SLB). Objective: The purpose of this paper is to review the evidence for the role of TBLC in the diagnostic-therapeutic process of PF. Methods: A comprehensive review was performed to identify articles to date that addressed the role of TBLC in the diagnostic-therapeutic process of PF using the PubMed® database. Results: The reasoned search identified 206 papers, including 21 manuscripts (three reviews, one systematic review, two guidelines, two prospective studies, three retrospective studies, one cross-sectional study, one original article, three editorials, three clinical trials, and two unclassifiable studies), which were included in the final review. Conclusions: TBLC is gaining increasing efficacy and improving safety profile; however, there are currently no clear data demonstrating its superiority over SLB. Therefore, the two techniques should be considered with careful rationalization on a case-by-case basis. Further research is needed to further optimize and standardize the procedure and to thoroughly study the histological and molecular characteristics of PF.
Language	English
Publishing date	2023-03-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2023.e14768
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Theory and Practice of Glucocorticoids in COVID-19: Getting to the Heart of the Matter-A Critical Review and Viewpoints.

Salton, Francesco / Confalonieri, Paola / Meduri, Gianfranco Umberto / Mondini, Lucrezia / Trotta, Liliana / Barbieri, Mariangela / Bozzi, Chiara / Torregiani, Chiara / Lerda, Selene / Bellan, Mattia / Confalonieri, Marco / Ruaro, Barbara / Tavano, Stefano / Pozzan, Riccardo

Pharmaceuticals (Basel, Switzerland)

2023 Volume 16, Issue 7

Abstract: Prolonged, low-dose glucocorticoids (GCs) have shown the highest efficacy among pharmacological and non-pharmacological treatments for COVID-19. Despite the World Health Organization's recommendation against their use at the beginning of the pandemic, ... ...

Abstract	Prolonged, low-dose glucocorticoids (GCs) have shown the highest efficacy among pharmacological and non-pharmacological treatments for COVID-19. Despite the World Health Organization's recommendation against their use at the beginning of the pandemic, GCs at a dose equivalent to dexamethasone 6 mg/day for 10 days are now indicated in all COVID-19 cases who require respiratory support. However, the efficacy of the intervention depends on the timing of initiation, the dose, and other individual factors. Indeed, patients treated with similar GC protocols often experience different outcomes, which do not always correlate with the presence of comorbidities or with the severity of respiratory involvement at baseline. This prompted us to critically review the literature on the rationale, pharmacological principles, and clinical evidence that should guide GC treatment. Based on these data, the best treatment protocol probably involves an initial bolus dose to saturate the glucocorticoid receptors, followed by a continuous infusion to maintain constant plasma levels, and eventually a slow tapering to interruption. Methylprednisolone has shown the highest efficacy among different GC molecules, most likely thanks to its higher ability to penetrate the lung. Decreased tissue sensitivity to glucocorticoids is thought to be the main mechanism accounting for the lower response to the treatment in some individuals. We do not have a readily available test to identify GC resistance; therefore, to address inter-individual variability, future research should aim at investigating clinical, physiological, and laboratory markers to guide a personalized GC treatment approach.
Language	English
Publishing date	2023-06-25
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2193542-7
ISSN	1424-8247
ISSN	1424-8247
DOI	10.3390/ph16070924
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Host-Based Treatments for Severe COVID-19.

Mondini, Lucrezia / Salton, Francesco / Trotta, Liliana / Bozzi, Chiara / Pozzan, Riccardo / Barbieri, Mariangela / Tavano, Stefano / Lerda, Selene / Hughes, Michael / Confalonieri, Marco / Confalonieri, Paola / Ruaro, Barbara

Current issues in molecular biology

2023 Volume 45, Issue 4, Page(s) 3102–3121

Abstract: COVID-19 has been a global health problem since 2020. There are different spectrums of manifestation of this disease, ranging from asymptomatic to extremely severe forms requiring admission to intensive care units and life-support therapies, mainly due ... ...

Abstract	COVID-19 has been a global health problem since 2020. There are different spectrums of manifestation of this disease, ranging from asymptomatic to extremely severe forms requiring admission to intensive care units and life-support therapies, mainly due to severe pneumonia. The progressive understanding of this disease has allowed researchers and clinicians to implement different therapeutic alternatives, depending on both the severity of clinical involvement and the causative molecular mechanism that has been progressively explored. In this review, we analysed the main therapeutic options available to date based on modulating the host inflammatory response to SARS-CoV-2 infection in patients with severe and critical illness. Although current guidelines are moving toward a personalised treatment approach titrated on the timing of presentation, disease severity, and laboratory parameters, future research is needed to identify additional biomarkers that can anticipate the disease course and guide targeted interventions on an individual basis.
Language	English
Publishing date	2023-04-05
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2000024-8
ISSN	1467-3045 ; 1467-3037
ISSN (online)	1467-3045
ISSN	1467-3037
DOI	10.3390/cimb45040203
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Correlation between Microvascular Damage and Internal Organ Involvement in Scleroderma

Mario D’Oria / Ilaria Gandin / Pozzan Riccardo / Michael Hughes / Sandro Lepidi / Francesco Salton / Paola Confalonieri / Marco Confalonieri / Stefano Tavano / Barbara Ruaro

Diagnostics, Vol 13, Iss 1, p

Focus on Lung Damage and Endothelial Dysfunction

2022 Volume 55

Abstract: Background. Systemic sclerosis (SSc) is an incurable connective tissue disease characterized by decreased peripheral blood perfusion due to microvascular damage and skin thickening/hardening. The microcirculation deficit is typically secondary to ... ...

Abstract	Background. Systemic sclerosis (SSc) is an incurable connective tissue disease characterized by decreased peripheral blood perfusion due to microvascular damage and skin thickening/hardening. The microcirculation deficit is typically secondary to structural vessel damage, which can be assessed morphologically and functionally in a variety of ways, exploiting different technologies. Objective. This paper focuses on reviewing new studies regarding the correlation between microvascular damage, endothelial dysfunction, and internal organ involvement, particularly pulmonary changes in SSc. Methods. We critically reviewed the most recent literature on the correlation between blood perfusion and organ involvement. Results. Many papers have demonstrated the link between structural microcirculatory damage and pulmonary involvement; however, studies that have investigated correlations between microvascular functional impairment and internal organ damage are scarce. Overall, the literature supports the correlation between organ involvement and functional microcirculatory impairment in SSc patients. Conclusions. Morphological and functional techniques appear to be emerging biomarkers in SSc, but obviously need further investigation.
Keywords	systemic sclerosis (SSc) ; peripheral blood perfusion (PBP) ; dermal thickness (DT) ; lung impairments ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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