Annalisa di Coste - Academia.edu (original) (raw)
Papers by Annalisa di Coste
PubMed, Aug 1, 2013
Background: Sublingual-specific immunotherapy (SLIT) is considered as a valid treatment of respir... more Background: Sublingual-specific immunotherapy (SLIT) is considered as a valid treatment of respiratory allergies. Aim: We performed a case-control study to evaluate the effect of SLIT in children with allergic asthma and rhinitis. Patients and methods: The study plan included 140 patients (age 6-14 yr, 43% girls and 57% boys) presenting allergic rhinitis and/or asthma, 70 treated with SLIT actively for three years and 70 controls never treated with specific immunotherapy (only symptomatic drugs). Rhinitis Symptom Score (RSS), Asthma Symptom Score (ASS) and Medication Score (MS) were evaluated at beginning and during the 3 years of immunotherapy. results: There was a significant improvement of RSS (mean ± SD) in the SLIT group: baseline 5.31 ± 2.01, third year 1.38 ± 1.06 (p < 0.0001 vs baseline). Control group: baseline 5.00 ± 1.08, third year 4.68 ± 1.152 (P ¼ NS). ASS (mean ± SD) in the SLIT group: baseline 4.09 ± 2.21, third year 1.23 ± 1.4 (p < 0.0001 vs baseline). Control group: baseline 4.04 ± 2.46, third year 3.62 ± 2.26 (p ¼ NS). MS (mean ± SD) in the SLIT group: baseline 3.30 ± 1.4, third year 0.88 ± 1.26 (p < 0.0001 vs baseline). Control group: baseline 3.19 ± 1.23, third year 3.39 ± 1.12 (p ¼ NS). There are no statistically significant differences among monosensitized/polysensitized patients and at different age ranges. None of the patients included reported severe systemic reactions or anaphylaxis. Conclusions: During the treatment, the active group showed sustained reductions in mean asthma and rhinitis symptom scores when compared with controls to confirm the efficacy and safety of sublingual immunotherapy.
Early Human Development, Oct 1, 2013
This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/authorsrights
Allergologia et immunopathologia, Sep 1, 2017
Please cite this article in press as: di Coste A, et al. Predictivity of clinical efficacy of sub... more Please cite this article in press as: di Coste A, et al. Predictivity of clinical efficacy of sublingual immunotherapy (SLIT) based on sensitisation pattern to molecular allergens in children with allergic rhinoconjunctivitis. Allergol Immunopathol (Madr). 2017.
European Respiratory Journal, Sep 1, 2012
International Ophthalmology, Oct 20, 2021
Objectives To describe the ophthalmological characteristics in a Juvenile idiopathic arthritis (J... more Objectives To describe the ophthalmological characteristics in a Juvenile idiopathic arthritis (JIA) cohort and to evaluate how therapeutic advances have changed the course of the uveitis. Methods Analysis of a retrospective cohort study of consecutive JIA pediatric patients including JIAassociated uveitis (JIA-U) and comparison with a previous study in the same uveitis center assessed before the widespread of biological therapy. Results The total of 49 JIA patients were analyzed, of whom 18 JIA-U, compared with a JIA-U past cohort of 66 patients. Systemic corticosteroids were used significantly less in the current JIA-U group (p = 0.008) than in the past one. JIA-U present cohort was on therapy more frequently with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) than the past group (p = 0.039), mostly treated with methotrexate (93.3%). Furthermore, a larger use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) was described in the current JIA-U group (p = 0.005) also associated with csDMARDs (p = 0.003). Adalimumab was used more (72.7%) in the present JIA-U cohort compared to a larger treatment with infliximab (61.5%) in the past (p = 0.005). Higher number of uveitis recurrences was observed in the previous cohort compared to the current one (p = 0.005). Fewer complications were described in this study than in the previous: posterior synechiae (p = 0.007), cataract (p \ 0.001), band keratopathy (p \ 0.001), and elevated intraocular pressure (IOP) (p = 0.047). Conclusion Current therapies reduced the uveitis recurrences and ocular complications including cataract due also to the lower use of corticosteroids. The new close collaboration with the pediatric rheumatologic center in the same University has contributed to the care improvement and decrease of uveitis complications.
Allergologia et immunopathologia, Jan 11, 2017
The diagnostic and therapeutic approach to grass pollen allergy is now possible by detecting spec... more The diagnostic and therapeutic approach to grass pollen allergy is now possible by detecting specific IgE (sIgE) to its allergenic components. To evaluate the correlation between the sensitisation to different molecular Phleum pratense (Phl p) allergens and clinical efficacy of SLIT. The pilot study included 36 patients affected by allergic rhinoconjunctivitis, all treated with SLIT actively. We performed serum analysis of sIgE to Phl p 1, 2, 4, 5, 6, 7, 11 and 12. The Average Rhinoconjunctivitis Total Symptom Score (ARTSS) and the Average Combined Score (ACS) were evaluated before and after one year of immunotherapy. Three different groups of sensitisation were defined based on the range of IgE reactivity to Phleum pratense allergens at baseline: group I (sIgE reactive to 1-3 allergens); group II (sIgE reactive to 4-5 allergens); and group III (sIgE reactive to 6-8 allergens). At T0 ACS was 1.79±0.18 in group I; 1.81±0.23 in group II; and 1.95±0.34 in group III. At T1 ACS was 0.85±...
International Journal of Immunopathology and Pharmacology, 2013
Diagnosis of CGD is made by demonstrating absent or markedly reduced oxidase activity in stimulat... more Diagnosis of CGD is made by demonstrating absent or markedly reduced oxidase activity in stimulated neutrophils. The screening test proposed is based upon the naked eye evaluation of the reduction of NBT on a solid surface. It seems to be a useful tool for rapid and inexpensive detection of CGD patients, especially for large-scale screening purposes. The test was carried out on forty-five subjects: two males affected by CGD, three female carriers and forty healthy donors. The test confirmed the results obtained with flow cytometric and NBT assays.
Objectives To describe the ophthalmological characteristics in a Juvenile idiopathic arthritis (J... more Objectives To describe the ophthalmological characteristics in a Juvenile idiopathic arthritis (JIA) cohort and to evaluate how therapeutic advances have changed the course of the uveitis. Methods Analysis of a retrospective cohort study of consecutive JIA pediatric patients including JIA-associated uveitis (JIA-U) and comparison with a previous study in the same uveitis center assessed before the wide-spread of biological therapy. Results 49 JIA patients analyzed, of whom 18 JIA-U, compared with a JIA-U past cohort of 66 patients. Systemic corticosteroids were used significantly less in the current JIA-U group (p = 0.008) than in the past one. JIA-U present cohort were on therapy more frequently with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), than the past group (p = 0.039), mostly treated with methotrexate (93.3%). Furthermore, a larger use of biologic disease-modifying antirheumatic drugs (bDMARDs) was described in the current JIA-U group (p = 0.005...
Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argomenti trattati ... more Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argomenti trattati nell'articolo. Abstract L'immunoterapia specifica (ITS) è riconosciuta come molto efficace nel trattamento di pazienti con rinite e/o asma allergica severa ed è raccomandata dalla World Health organization (WHo) nella gestione della malattia allergica. Lo scopo di questo lavoro è quello di esaminare le pubblicazioni del 2010-2011 sull'immunoterapia sublinguale in età pediatrica, in pazienti con rinocongiuntivite e/o asma allergica. Sono stati presi in considerazione lavori in cui erano arruolati soggetti di età compresa tra 0 e 18 anni, con IgE specifiche e prick test positivi per l'allergene responsabile dei sintomi. I principali outcome primari e secondari dei vari studi erano la va-lutazione della qualità della vita, la sicurezza e l'efficacia della terapia sia a livello clinico (valutazione di score dei sintomi e dei farmaci utilizzati), sia a livello immunologico...
12 Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argomenti tratta... more 12 Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argomenti trattati nell'articolo. Nell'aprile del 2015 la prestigiosa rivista Nature ha pubblicato un articolo dal titolo: "Personalized medicine: time for one-person trials" a firma di Nicholas J. Schork. La personalized medicine è da noi conosciuta anche come "precision medicine". L'autore stigmatizza il fatto che i dieci farmaci con il più alto fatturato negli Stati Uniti d'America funzionano nel migliore dei casi in 1 su 4 pazienti e nel peggiore dei casi 1 su 25, esponendo quindi il caso di una "medicina di imprecisione". Sono questi i farmaci definiti "blockbuster", la cui efficacia è dimostrata attraverso studi di popolazione che per raggiungere i grandi nu-meri indispensabili ai fini di una registrazione, necessariamente rinunciano alla precisa definizione del singolo paziente ma tengono insieme popolazioni selezionate solo per pochi parame...
allergologia 2 Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argo... more allergologia 2 Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argomenti trattati nell'articolo. Abstract L'immunoterapia allergene-specifica (AIT) è l'unica terapia etiologica delle allergopatie re-spiratorie e la sola che abbia un effetto disease-modifying. A differenza della farmacote-rapia, l'effetto dell'AIT persiste anche dopo la sospensione del trattamento. L'AIT riduce la probabilità di sviluppare asma nei soggetti con rinite allergica e riduce il rischio di nuove sensibilizzazioni. Le vie di somministrazione più spesso impiegate sono la via sottocutanea (SCIT) e la sublinguale (SLIT). L'AIT prodotta per il singolo paziente è detta NPP (Named Patient Product). La qualità degli estratti disponibili ha subìto negli anni un deciso e sostanziale miglioramento, anche se ogni azienda produttrice utilizza dei criteri di standardizzazione in-house, il che rende non confrontabili tra loro estratti di aziende diverse. Oggi sono...
International Journal of Environmental Research and Public Health, 2020
This work describes a methodology for the definition of indoor air quality monitoring plans in sc... more This work describes a methodology for the definition of indoor air quality monitoring plans in schools and above all to improve the knowledge and evaluation of the indoor concentration levels of some chemical pollutants. The aim is to guide interventions to improve the health of students and exposed staff connected with the activities carried out there. The proposed methodology is based on the simultaneous study of chemical (indoor/outdoor PM2.5, NO2, CO2) and physical (temperature, humidity) parameters by means of automatic analyzers coupled with gaseous compounds (benzene, toluene, ethylbenzene, xylenes, formaldehyde and NO2) sampled by denuders. The important novelty is that all the data were collected daily in two different situations, i.e., during school activities and no-school activities, allowing us to evaluate the exposure of each student or person. The different behaviors of all the measured pollutants during the two different situations are reported and commented on. Fina...
European Respiratory Journal, Sep 1, 2013
European Respiratory Journal, Sep 1, 2011
Background: Pulmonary function tests play an important role in the diagnosis, and management of r... more Background: Pulmonary function tests play an important role in the diagnosis, and management of respiratory diseases in children. The aim of our study was to evaluate the lung function by performing spirometry and airway resistance by the interrupter technique (Rint) in pre-school children in relation to their atopic status. Materials and methods: We studied 83 asymptomatic children (Males: 51 and Females: 32, mean age 5.15 years ± 0.72 SD). For each child has been collected the family history concerning: atopy, respiratory diseases, history of gestational and neonatal period. In all children, Skin Prick Test (SPT) to inhalant and food allergens were performed. Rint, by requiring minimal cooperation to be carried out, were performed in all subjects. Spirometry was also well tolerated by 56 subjects and was used to determine FEV 1 and FEV 0,5. Results: Twenty-two subjects (26.5%) had positive SPT. The following table shows the values of the main spirometric and Rint parameters of atopic (A) and not atopic subjects (NA). Conclusions: Despite our study assess the feasibility and repeatibility of both tests in preschool children, spirometric parameters were not statistically different between atopic and not atopic children, while mean values of Rint E were significant lower in non atopic compared to atopic children.
European Respiratory Journal, Sep 1, 2012
European Respiratory Journal, Sep 1, 2013
The clinical respiratory journal, 2013
Data from large population registries suggest an incidence of congenital lung cysts in the range ... more Data from large population registries suggest an incidence of congenital lung cysts in the range of 1 per 8300–35 000 live births (1). Congenital cystic adenomatoid malformation (CCAM) is a developmental, non-hereditary hamartomatous abnormality of the lung with adenomatoid cyst proliferation, firstly described in 1949 by Ch’in and Tang (2). It is believed to be the result of a bronchial atresia or maturation arrest in bronchopulmonary segments at/before the seventh gestational week, producing dysplastic lung growth beyond the atretic segments (3) and cystic distortion of the lung architecture. Most CCAMs are detected antenatally by ultrasound, presenting with respiratory distress in the neonatal period; infants with large lesions may have respiratory insufficiency. The malformation is usually unilateral and sublobar or lobar in size, but occasionally, it can be multilobar or even bilateral with no special predilection for any lobe (4, 5). Only 10% of primary diagnoses are made after the first year of life (5, 6), and rarely the presentation of CCAM is delayed until adulthood. Computed tomography (CT) scan is the investigation of choice with a good accuracy (66.7%) in characterising the various types of CCAM. CCAMs symptoms include frequent chest infections, bronchiectasis, lung abscess, haemoptysis, pneumothorax, air embolism, haemothorax, pyopneumothorax, steroid resistant bronchospasm or rarely bronchioloalveolar carcinoma, blastomas and rhabdomyosarcoma. The treatment is usually surgical, involving complete resection of the affected parenchyma. This prevents recurrent infections and development of neoplastic transformation. The CCAMs Stocker classification (7) was based on the clinical and histological features and originally divided into three types (1, 2 and 3). CCAMs Type 1 account for 70% of cases, and are characterised by single or multiple cysts more than 3 cm in diameter; the cyst wall contains elastic tissue, smooth muscle and fibrovascular connective tissue. CCAMs Type 2 (approximately the 20–25% of cases) are characterised by multiple small cysts, 2 cm in diameter (rarely larger); mucous cells and cartilage are absent, and striated muscle fibres may occasionally be seen. CCAMs Type 3 are rare (approximately the 8% of cases) and characterised by cysts not larger than 1.5 cm in diameter; mucous cells, cartilage and striated muscle fibres are absent. Usually, CCAMs Type 3 involve a lobe of lung and have a spongy-like appearance, constructed by bulk gland-like structures. Types 0 and 4 CCAMs were subsequently proposed (8), and the term congenital pulmonary airway malformation was proposed instead of CCAM. CCAMs Type 0 account <2% of cases, and are the less frequently observed among CCAM lesions and incompatible with life. Clinically, infants present cyanosis and severe respiratory distress at birth and survive only few hours unless treated with extracorporeal membrane oxygenation; they are unable to survive without this support. Microscopically, the tissue consists entirely of bronchial-like structures with muscle, glands, numerous cartilage plates and small cysts (<0.5 mm); more distal components, such as proximal bronchioles, are only rarely seen. CCAMs Type 4 account between 10% and 15% of cases, and consist of multiple large cysts (up to 15 cm) lined only with Type 1 and 2 alveolar cells. Children with this malformation vary in age at presentation from 1 day to 4 years and display various degrees of respiratory distress. It may involve more than one lobe in 20% of cases, and resection is usually curative even with bilateral involvement (9). We report a case of diffuse, bilateral CCAM associated with allergic bronchial asthma, discovered in an adolescent with few symptoms. A 13-year-old Caucasian boy, sensitised to dust mites and grass pollen with a clinical history of respiratory distress at birth, was resolved in the second day of life with oxygen therapy. In the first year of life, he showed recurrent episodes of cough and bronchospasm treated with bronchodilators. In the subsequent years, he was healthy and reported wheezing only after intense physical exercise; he practiced daily martial arts. The boy came to our department for the Pre-Competition Medical Assessment when he was 12 years old. Pulmonary function tests showed severe airflow obstruction [forced expiratory volume in 1 s (FEV1) 49.0%, FEV1/ forced vital capacity 70.0% and maximum expiratory flow 50 24.7% of the predicted values] reversible after inhalation of 400 mcg of salbutamol (FEV1 + 16.3%). For this reason, he started a daily antiasthmatic therapy The Clinical Respiratory Journal
PubMed, Aug 1, 2013
Background: Sublingual-specific immunotherapy (SLIT) is considered as a valid treatment of respir... more Background: Sublingual-specific immunotherapy (SLIT) is considered as a valid treatment of respiratory allergies. Aim: We performed a case-control study to evaluate the effect of SLIT in children with allergic asthma and rhinitis. Patients and methods: The study plan included 140 patients (age 6-14 yr, 43% girls and 57% boys) presenting allergic rhinitis and/or asthma, 70 treated with SLIT actively for three years and 70 controls never treated with specific immunotherapy (only symptomatic drugs). Rhinitis Symptom Score (RSS), Asthma Symptom Score (ASS) and Medication Score (MS) were evaluated at beginning and during the 3 years of immunotherapy. results: There was a significant improvement of RSS (mean ± SD) in the SLIT group: baseline 5.31 ± 2.01, third year 1.38 ± 1.06 (p < 0.0001 vs baseline). Control group: baseline 5.00 ± 1.08, third year 4.68 ± 1.152 (P ¼ NS). ASS (mean ± SD) in the SLIT group: baseline 4.09 ± 2.21, third year 1.23 ± 1.4 (p < 0.0001 vs baseline). Control group: baseline 4.04 ± 2.46, third year 3.62 ± 2.26 (p ¼ NS). MS (mean ± SD) in the SLIT group: baseline 3.30 ± 1.4, third year 0.88 ± 1.26 (p < 0.0001 vs baseline). Control group: baseline 3.19 ± 1.23, third year 3.39 ± 1.12 (p ¼ NS). There are no statistically significant differences among monosensitized/polysensitized patients and at different age ranges. None of the patients included reported severe systemic reactions or anaphylaxis. Conclusions: During the treatment, the active group showed sustained reductions in mean asthma and rhinitis symptom scores when compared with controls to confirm the efficacy and safety of sublingual immunotherapy.
Early Human Development, Oct 1, 2013
This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/authorsrights
Allergologia et immunopathologia, Sep 1, 2017
Please cite this article in press as: di Coste A, et al. Predictivity of clinical efficacy of sub... more Please cite this article in press as: di Coste A, et al. Predictivity of clinical efficacy of sublingual immunotherapy (SLIT) based on sensitisation pattern to molecular allergens in children with allergic rhinoconjunctivitis. Allergol Immunopathol (Madr). 2017.
European Respiratory Journal, Sep 1, 2012
International Ophthalmology, Oct 20, 2021
Objectives To describe the ophthalmological characteristics in a Juvenile idiopathic arthritis (J... more Objectives To describe the ophthalmological characteristics in a Juvenile idiopathic arthritis (JIA) cohort and to evaluate how therapeutic advances have changed the course of the uveitis. Methods Analysis of a retrospective cohort study of consecutive JIA pediatric patients including JIAassociated uveitis (JIA-U) and comparison with a previous study in the same uveitis center assessed before the widespread of biological therapy. Results The total of 49 JIA patients were analyzed, of whom 18 JIA-U, compared with a JIA-U past cohort of 66 patients. Systemic corticosteroids were used significantly less in the current JIA-U group (p = 0.008) than in the past one. JIA-U present cohort was on therapy more frequently with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) than the past group (p = 0.039), mostly treated with methotrexate (93.3%). Furthermore, a larger use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) was described in the current JIA-U group (p = 0.005) also associated with csDMARDs (p = 0.003). Adalimumab was used more (72.7%) in the present JIA-U cohort compared to a larger treatment with infliximab (61.5%) in the past (p = 0.005). Higher number of uveitis recurrences was observed in the previous cohort compared to the current one (p = 0.005). Fewer complications were described in this study than in the previous: posterior synechiae (p = 0.007), cataract (p \ 0.001), band keratopathy (p \ 0.001), and elevated intraocular pressure (IOP) (p = 0.047). Conclusion Current therapies reduced the uveitis recurrences and ocular complications including cataract due also to the lower use of corticosteroids. The new close collaboration with the pediatric rheumatologic center in the same University has contributed to the care improvement and decrease of uveitis complications.
Allergologia et immunopathologia, Jan 11, 2017
The diagnostic and therapeutic approach to grass pollen allergy is now possible by detecting spec... more The diagnostic and therapeutic approach to grass pollen allergy is now possible by detecting specific IgE (sIgE) to its allergenic components. To evaluate the correlation between the sensitisation to different molecular Phleum pratense (Phl p) allergens and clinical efficacy of SLIT. The pilot study included 36 patients affected by allergic rhinoconjunctivitis, all treated with SLIT actively. We performed serum analysis of sIgE to Phl p 1, 2, 4, 5, 6, 7, 11 and 12. The Average Rhinoconjunctivitis Total Symptom Score (ARTSS) and the Average Combined Score (ACS) were evaluated before and after one year of immunotherapy. Three different groups of sensitisation were defined based on the range of IgE reactivity to Phleum pratense allergens at baseline: group I (sIgE reactive to 1-3 allergens); group II (sIgE reactive to 4-5 allergens); and group III (sIgE reactive to 6-8 allergens). At T0 ACS was 1.79±0.18 in group I; 1.81±0.23 in group II; and 1.95±0.34 in group III. At T1 ACS was 0.85±...
International Journal of Immunopathology and Pharmacology, 2013
Diagnosis of CGD is made by demonstrating absent or markedly reduced oxidase activity in stimulat... more Diagnosis of CGD is made by demonstrating absent or markedly reduced oxidase activity in stimulated neutrophils. The screening test proposed is based upon the naked eye evaluation of the reduction of NBT on a solid surface. It seems to be a useful tool for rapid and inexpensive detection of CGD patients, especially for large-scale screening purposes. The test was carried out on forty-five subjects: two males affected by CGD, three female carriers and forty healthy donors. The test confirmed the results obtained with flow cytometric and NBT assays.
Objectives To describe the ophthalmological characteristics in a Juvenile idiopathic arthritis (J... more Objectives To describe the ophthalmological characteristics in a Juvenile idiopathic arthritis (JIA) cohort and to evaluate how therapeutic advances have changed the course of the uveitis. Methods Analysis of a retrospective cohort study of consecutive JIA pediatric patients including JIA-associated uveitis (JIA-U) and comparison with a previous study in the same uveitis center assessed before the wide-spread of biological therapy. Results 49 JIA patients analyzed, of whom 18 JIA-U, compared with a JIA-U past cohort of 66 patients. Systemic corticosteroids were used significantly less in the current JIA-U group (p = 0.008) than in the past one. JIA-U present cohort were on therapy more frequently with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), than the past group (p = 0.039), mostly treated with methotrexate (93.3%). Furthermore, a larger use of biologic disease-modifying antirheumatic drugs (bDMARDs) was described in the current JIA-U group (p = 0.005...
Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argomenti trattati ... more Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argomenti trattati nell'articolo. Abstract L'immunoterapia specifica (ITS) è riconosciuta come molto efficace nel trattamento di pazienti con rinite e/o asma allergica severa ed è raccomandata dalla World Health organization (WHo) nella gestione della malattia allergica. Lo scopo di questo lavoro è quello di esaminare le pubblicazioni del 2010-2011 sull'immunoterapia sublinguale in età pediatrica, in pazienti con rinocongiuntivite e/o asma allergica. Sono stati presi in considerazione lavori in cui erano arruolati soggetti di età compresa tra 0 e 18 anni, con IgE specifiche e prick test positivi per l'allergene responsabile dei sintomi. I principali outcome primari e secondari dei vari studi erano la va-lutazione della qualità della vita, la sicurezza e l'efficacia della terapia sia a livello clinico (valutazione di score dei sintomi e dei farmaci utilizzati), sia a livello immunologico...
12 Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argomenti tratta... more 12 Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argomenti trattati nell'articolo. Nell'aprile del 2015 la prestigiosa rivista Nature ha pubblicato un articolo dal titolo: "Personalized medicine: time for one-person trials" a firma di Nicholas J. Schork. La personalized medicine è da noi conosciuta anche come "precision medicine". L'autore stigmatizza il fatto che i dieci farmaci con il più alto fatturato negli Stati Uniti d'America funzionano nel migliore dei casi in 1 su 4 pazienti e nel peggiore dei casi 1 su 25, esponendo quindi il caso di una "medicina di imprecisione". Sono questi i farmaci definiti "blockbuster", la cui efficacia è dimostrata attraverso studi di popolazione che per raggiungere i grandi nu-meri indispensabili ai fini di una registrazione, necessariamente rinunciano alla precisa definizione del singolo paziente ma tengono insieme popolazioni selezionate solo per pochi parame...
allergologia 2 Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argo... more allergologia 2 Gli Autori dichiarano di non avere alcun conflitto di interesse rispetto agli argomenti trattati nell'articolo. Abstract L'immunoterapia allergene-specifica (AIT) è l'unica terapia etiologica delle allergopatie re-spiratorie e la sola che abbia un effetto disease-modifying. A differenza della farmacote-rapia, l'effetto dell'AIT persiste anche dopo la sospensione del trattamento. L'AIT riduce la probabilità di sviluppare asma nei soggetti con rinite allergica e riduce il rischio di nuove sensibilizzazioni. Le vie di somministrazione più spesso impiegate sono la via sottocutanea (SCIT) e la sublinguale (SLIT). L'AIT prodotta per il singolo paziente è detta NPP (Named Patient Product). La qualità degli estratti disponibili ha subìto negli anni un deciso e sostanziale miglioramento, anche se ogni azienda produttrice utilizza dei criteri di standardizzazione in-house, il che rende non confrontabili tra loro estratti di aziende diverse. Oggi sono...
International Journal of Environmental Research and Public Health, 2020
This work describes a methodology for the definition of indoor air quality monitoring plans in sc... more This work describes a methodology for the definition of indoor air quality monitoring plans in schools and above all to improve the knowledge and evaluation of the indoor concentration levels of some chemical pollutants. The aim is to guide interventions to improve the health of students and exposed staff connected with the activities carried out there. The proposed methodology is based on the simultaneous study of chemical (indoor/outdoor PM2.5, NO2, CO2) and physical (temperature, humidity) parameters by means of automatic analyzers coupled with gaseous compounds (benzene, toluene, ethylbenzene, xylenes, formaldehyde and NO2) sampled by denuders. The important novelty is that all the data were collected daily in two different situations, i.e., during school activities and no-school activities, allowing us to evaluate the exposure of each student or person. The different behaviors of all the measured pollutants during the two different situations are reported and commented on. Fina...
European Respiratory Journal, Sep 1, 2013
European Respiratory Journal, Sep 1, 2011
Background: Pulmonary function tests play an important role in the diagnosis, and management of r... more Background: Pulmonary function tests play an important role in the diagnosis, and management of respiratory diseases in children. The aim of our study was to evaluate the lung function by performing spirometry and airway resistance by the interrupter technique (Rint) in pre-school children in relation to their atopic status. Materials and methods: We studied 83 asymptomatic children (Males: 51 and Females: 32, mean age 5.15 years ± 0.72 SD). For each child has been collected the family history concerning: atopy, respiratory diseases, history of gestational and neonatal period. In all children, Skin Prick Test (SPT) to inhalant and food allergens were performed. Rint, by requiring minimal cooperation to be carried out, were performed in all subjects. Spirometry was also well tolerated by 56 subjects and was used to determine FEV 1 and FEV 0,5. Results: Twenty-two subjects (26.5%) had positive SPT. The following table shows the values of the main spirometric and Rint parameters of atopic (A) and not atopic subjects (NA). Conclusions: Despite our study assess the feasibility and repeatibility of both tests in preschool children, spirometric parameters were not statistically different between atopic and not atopic children, while mean values of Rint E were significant lower in non atopic compared to atopic children.
European Respiratory Journal, Sep 1, 2012
European Respiratory Journal, Sep 1, 2013
The clinical respiratory journal, 2013
Data from large population registries suggest an incidence of congenital lung cysts in the range ... more Data from large population registries suggest an incidence of congenital lung cysts in the range of 1 per 8300–35 000 live births (1). Congenital cystic adenomatoid malformation (CCAM) is a developmental, non-hereditary hamartomatous abnormality of the lung with adenomatoid cyst proliferation, firstly described in 1949 by Ch’in and Tang (2). It is believed to be the result of a bronchial atresia or maturation arrest in bronchopulmonary segments at/before the seventh gestational week, producing dysplastic lung growth beyond the atretic segments (3) and cystic distortion of the lung architecture. Most CCAMs are detected antenatally by ultrasound, presenting with respiratory distress in the neonatal period; infants with large lesions may have respiratory insufficiency. The malformation is usually unilateral and sublobar or lobar in size, but occasionally, it can be multilobar or even bilateral with no special predilection for any lobe (4, 5). Only 10% of primary diagnoses are made after the first year of life (5, 6), and rarely the presentation of CCAM is delayed until adulthood. Computed tomography (CT) scan is the investigation of choice with a good accuracy (66.7%) in characterising the various types of CCAM. CCAMs symptoms include frequent chest infections, bronchiectasis, lung abscess, haemoptysis, pneumothorax, air embolism, haemothorax, pyopneumothorax, steroid resistant bronchospasm or rarely bronchioloalveolar carcinoma, blastomas and rhabdomyosarcoma. The treatment is usually surgical, involving complete resection of the affected parenchyma. This prevents recurrent infections and development of neoplastic transformation. The CCAMs Stocker classification (7) was based on the clinical and histological features and originally divided into three types (1, 2 and 3). CCAMs Type 1 account for 70% of cases, and are characterised by single or multiple cysts more than 3 cm in diameter; the cyst wall contains elastic tissue, smooth muscle and fibrovascular connective tissue. CCAMs Type 2 (approximately the 20–25% of cases) are characterised by multiple small cysts, 2 cm in diameter (rarely larger); mucous cells and cartilage are absent, and striated muscle fibres may occasionally be seen. CCAMs Type 3 are rare (approximately the 8% of cases) and characterised by cysts not larger than 1.5 cm in diameter; mucous cells, cartilage and striated muscle fibres are absent. Usually, CCAMs Type 3 involve a lobe of lung and have a spongy-like appearance, constructed by bulk gland-like structures. Types 0 and 4 CCAMs were subsequently proposed (8), and the term congenital pulmonary airway malformation was proposed instead of CCAM. CCAMs Type 0 account <2% of cases, and are the less frequently observed among CCAM lesions and incompatible with life. Clinically, infants present cyanosis and severe respiratory distress at birth and survive only few hours unless treated with extracorporeal membrane oxygenation; they are unable to survive without this support. Microscopically, the tissue consists entirely of bronchial-like structures with muscle, glands, numerous cartilage plates and small cysts (<0.5 mm); more distal components, such as proximal bronchioles, are only rarely seen. CCAMs Type 4 account between 10% and 15% of cases, and consist of multiple large cysts (up to 15 cm) lined only with Type 1 and 2 alveolar cells. Children with this malformation vary in age at presentation from 1 day to 4 years and display various degrees of respiratory distress. It may involve more than one lobe in 20% of cases, and resection is usually curative even with bilateral involvement (9). We report a case of diffuse, bilateral CCAM associated with allergic bronchial asthma, discovered in an adolescent with few symptoms. A 13-year-old Caucasian boy, sensitised to dust mites and grass pollen with a clinical history of respiratory distress at birth, was resolved in the second day of life with oxygen therapy. In the first year of life, he showed recurrent episodes of cough and bronchospasm treated with bronchodilators. In the subsequent years, he was healthy and reported wheezing only after intense physical exercise; he practiced daily martial arts. The boy came to our department for the Pre-Competition Medical Assessment when he was 12 years old. Pulmonary function tests showed severe airflow obstruction [forced expiratory volume in 1 s (FEV1) 49.0%, FEV1/ forced vital capacity 70.0% and maximum expiratory flow 50 24.7% of the predicted values] reversible after inhalation of 400 mcg of salbutamol (FEV1 + 16.3%). For this reason, he started a daily antiasthmatic therapy The Clinical Respiratory Journal