Paola Gnerre - Academia.edu (original) (raw)

Papers by Paola Gnerre

Research paper thumbnail of COVID-19 after 2 Years from Hospital Discharge: A Pulmonary Function and Chest Computed Tomography Follow-Up Study

Research paper thumbnail of A FADOI survey on the quality of discharge summary in internal medicine wards

Internal and Emergency Medicine, May 28, 2022

Research paper thumbnail of Dalle evidenze alla pratica clinica: emorragia del tratto digestivo superiore, pancreatite acuta, sepsi ed osteoporosi. Il contributo dei giovani internisti FADOI

Italian Journal of Medicine, Nov 30, 2016

Dalle evidenze alla pratica clinica: emorragia del tratto digestivo superiore, pancreatite acuta,... more Dalle evidenze alla pratica clinica: emorragia del tratto digestivo superiore, pancreatite acuta, sepsi ed osteoporosi. Il contributo dei giovani internisti FADOI

Research paper thumbnail of Liver diseases and pregnancy

Italian Journal of Medicine, Sep 11, 2017

The pregnant woman experiences physiological changes to support fetal growth and development. The... more The pregnant woman experiences physiological changes to support fetal growth and development. The levels of estrogens (estradiol) and progesterone increase progressively during pregnancy. These sex hormones have effects on hepatic metabolic, synthesis, and excretory functions. The phenomenon of hemodilution secondary to the increase in plasma volume and the increases in cardiac output, decreases the serum protein concentrations. 1 Liver, in course of pregnancy, reveals no specific structural changes. In spite of this, several changes in values of liver function tests occur during normal pregnancy. Blood flow to the liver remains unchanged, but the percentage of cardiac output to the liver is reduced, which may impair clearance of substances requiring extensive hepatic metabolism. 1 Moreover, in pregnancy, gallbladder motility is also decreased for several causes: gallbladder enlargement and incomplete evacuation of bile, increased gallbladder volume during fasting is due to a combination of decreased water absorption by the gallbladder mucosa, enhanced of secretion of cholecystokinin in the response to food intake. All these phenomena can originate to from the high concentration of progesterone. 2 In this paper, we review the liver-related clinical and pathology changes that occur during pregnancy, subdividing these conditions into: i) conditions associated with pregnant status; ii) conditions complicating the pregnancy; iii) liver conditions present at the beginning of pregnancy. Conditions associated with pregnant status Intrahepatic cholestasis Intrahepatic cholestasis of pregnancy (ICP) usually occurs during the last trimester and has a rapid postnatal resolution. 3 It is characterized by severe pruritus, associated with increase in serum bile acid and aminotransferases (Table 1). The symptoms and biochemical abnormalities resolve rapidly after delivery but may recur in subsequent pregnancies and with the use of hormonal contraception. 4 Genetic variations may implicate heterozygous or homozygous mutations located in different positions of the genes. All the association studies with these candidate genes stress the complex variability of genotypes, the different

Research paper thumbnail of The management of the patient with acute pancreatitis: from evidence to clinical practice

Italian Journal of Medicine, Sep 11, 2017

Acute pancreatitis is an inflammatory disorder of the pancreas characterized by abdominal pain an... more Acute pancreatitis is an inflammatory disorder of the pancreas characterized by abdominal pain and elevation of pancreatic enzymes in the blood. The pathogenesis is complex and partly unknown and the evolution is often unpredictable. Many efforts have been made to define this disease and its complications and to classify different grades of severity in order to formulate prognostic scores that could guide the physician in choosing the optimal therapeutic setting and procedures. The management of the patient with pancreatitis is not always optimal and differs among internist, gastroenterologist or surgeon. We think that a patient with clinical suspicion of acute pancreatitis is admitted to medical or surgical department depending on the availability of beds and not according to evidence-based medicine. The aim of this monograph is to identify the optimal management of patients with acute pancreatitis admitted to hospital.

Research paper thumbnail of Italian good practice recommendations on management of persons with Long-COVID

Frontiers in Public Health, Apr 20, 2023

A significant number of people, following acute SARS-CoV-2 infection, report persistent symptoms ... more A significant number of people, following acute SARS-CoV-2 infection, report persistent symptoms or new symptoms that are sustained over time, often affecting different body systems. This condition, commonly referred to as Long-COVID, requires a complex clinical management. In Italy new health facilities specifically dedicated to the diagnosis and care of Long-COVID were implemented. However, the activity of these clinical centers is highly heterogeneous, with wide variation in the type of services provided, specialistic expertise and, ultimately, in the clinical care provided. Recommendations for a uniform management of Long-COVID were therefore needed. Professionals from different disciplines (including general practitioners, specialists in respiratory diseases, infectious diseases, internal medicine, geriatrics, cardiology, neurology, pediatrics, and odontostomatology) were invited to participate, together with a patient representative, in a multidisciplinary Panel appointed to draft Good Practices on clinical management of Long-COVID. The Panel, after extensive literature review, issued

Research paper thumbnail of Management of stable coronary artery disease: from evidence to clinical practice

Italian Journal of Medicine, Jun 14, 2017

Ischemic heart disease, the leading cause of death, is extremely diffuse among patients hospitali... more Ischemic heart disease, the leading cause of death, is extremely diffuse among patients hospitalized in Internal Medicine ward so that Internist should be able to manage correctly this disease. The following review revises the most recent literature and offers a practical clinical guide to be confident on this topic. After having emphasized that clinical overview remains essential, it briefly mentions advantages and limits of different investigations, reminds readers of possible alternative etiopathogeneses of ischemic heart disease (cardiac syndrome X), reports the most appropriate medical therapy, and gives the opportunity to understand appropriateness of specialist strategies such as coronary artery bypass grafting and percutaneous coronary intervention. Finally, it illustrates a rational and evidence-based follow-up of these patients, considering that only a small part of them should be followed by a Cardiologist. The aim of a correct management of ischemic heart disease remains to reduce mortality and improve the quality of life.

Research paper thumbnail of Metodologia clinica oggi nel paziente internistico complesso

Italian Journal of Medicine, 2020

Introduzione alla letturaA. Fontanella, P. Gnerre Il metodo clinico classico della tradizione ita... more Introduzione alla letturaA. Fontanella, P. Gnerre Il metodo clinico classico della tradizione italianaI. Portioli Modelli di ragionamento clinico e strumenti utilizzati nella pratica clinica in ambito internistico ai fini decisionaliP. Gnerre, R. Nardi I difetti del ragionamento clinico come causa di errori diagnosticiM. La Regina, F. Orlandini Metodologia clinica e EBM: vantaggi e limiti nel mondo reale dei pazienti complessi - Il mondo realeT.M. Attardo Metodologia clinica e EBM: vantaggi e limiti nel mondo reale dei pazienti complessi - Trappole e possibili biasM. Cavalleri Significatività statistica e rilevanza clinicaD. Tirotta Dalla medicina personalizzata alla medicina di precisioneG. Gensini, N. Scarpa Una possibile alternativa alle decisioni: il metodo Clinical Multi-criteria Decision Assessment (CMDA)O. Para Il metodo clinico in condizioni di incertezza: errori, vincoli, esperienza, buon senso e le opinioni del pazienteM.L. Cipollini, E. Romboli Meta-cognizione e capacità ...

Research paper thumbnail of FADOI e la medicina di genere

Research paper thumbnail of La figura dell’Hospitalist in Italia

Italian Journal of Medicine, Apr 27, 2018

Articolo pubblicato secondo la Creative Commons Attribution NonCommercial 4.0 License (CC BY-NC 4... more Articolo pubblicato secondo la Creative Commons Attribution NonCommercial 4.0 License (CC BY-NC 4.0).

Research paper thumbnail of L'internista naviga nel mare salato che è in noi

Italian Journal of Medicine, 2018

Il mare vivo che è in noiF. Sgambato, S. Prozzo, E. SgambatoMeccanismi fisiologici del ricambio d... more Il mare vivo che è in noiF. Sgambato, S. Prozzo, E. SgambatoMeccanismi fisiologici del ricambio di sodio ed acquaM. RenisLe alterazioni del bilancio del sodio e dell’acquaM. RenisApproccio clinico-pratico ai disturbi dell’equilibrio acido-baseA. Casola, L. Bianchi, S. Detrenis, S. Pioli, M. del Mar Jordana-Sanchez, T. Pasquariello, D. Fasano, M. Saccò, A. Magnano, F. Spagnoli, M. MeschiApproccio clinico-diagnostico e strumentale alle iposodiemie ipotoniche e non ipotonicheI. AmbrosinoApproccio clinico-diagnostico e strumentale alle ipersodiemieA. IlardiLa sindrome da inappropriata antidiuresiG. Tenconi, G. Secondo, L. MortaraApproccio clinico-diagnostico e strumentale alle ipopotassiemieT.M. AttardoApproccio diagnostico e strumentale alle iperpotassiemieM. GambacortaIpocalcemia: condizione comune a diverse patologieA. Montagnani, M. Alessandri, M. MiglioriniApproccio clinico-diagnostico e strumentale alle ipercalcemieP. Gnerre, M. Grandi, A. PercivaleApproccio clinico-diagnostico e ...

Research paper thumbnail of Management del paziente con cefalea, vertigine e sincope: dalle evidenze alla pratica clinica

Italian Journal of Medicine, 2016

Management del paziente con cefalea, vertigine e sincope: dalle evidenze alla pratica clinica

Research paper thumbnail of Real-world use of remdesivir for the treatment of patients admitted to Italian hospitals with COVID-19: the nationwide retrospective FADOI-RECOVER study

BMC Infectious Diseases

Background Remdesivir is widely used for treatment of SARS-CoV-2 pneumonia. The aim of this study... more Background Remdesivir is widely used for treatment of SARS-CoV-2 pneumonia. The aim of this study was to evaluate the characteristics of patients with moderate-to-severe COVID-19 treated with remdesivir, and their outcomes during hospitalization. Methods This retrospective observational multicenter study included consecutive patients, hospitalized for moderate-to-severe COVID-19 (September 2020—September 2021), who were treated with remdesivir. Results One thousand four patients were enrolled, all with onset of symptoms occurring less than 10 days before starting remdesivir; 17% of patients had 4 or more concomitant diseases. Remdesivir was well tolerated, adverse drug reactions (ADRs) being reported in 2.3% of patients. In-hospital death occurred in 80 patients (8.0%). The median timing of the first remdesivir dose was 5 days after symptom onset. The following endpoints did not differ according to the time span from the onset of symptoms to the first dose: length of hospitalization...

Research paper thumbnail of Outcomes of patients with COVID-19 hospitalized during the fourth pandemic wave in relation to their clinical features and vaccination status

Italian Journal of Medicine

This study aims to observe the clinical characteristics and outcomes of recovered patients from C... more This study aims to observe the clinical characteristics and outcomes of recovered patients from Coronavirus Disease (COVID-19) related to the vaccination status. We examined results of 205 COVID-19-recovered patients from 15 December 2021 to 1 March 2022 in two hospitals of Local Health Authority of Alessandria (Italy) during the fourth pandemic wave. 77% of patients were hospitalized for acute respiratory failure (ARF) with radiological pneumonia pattern (recovered for COVID), 23% for other causes with occasional positivity finding (recovered with COVID). 32% of patients were not vaccinated for Sars-COV-2, 37% had three doses, 25% two doses, 5% only one dose. All patients without vaccination were hospitalized for ARF and they had a 7 times higher risk of hospitalization than the vaccinated. 60% of all patients had >3 comorbidities, of these 50% was vaccinated with three doses. In the fourth pandemic wave compared to the other not all patients were hospitalized for ARF and pneumo...

Research paper thumbnail of MATERIALE PROTETTO DA COPYRIGHT NON FOTOCOPIARE O DISTRIBUIRE ELETTRONICAMENTE SENZA L'AUTORIZZAZIONE SCRITTA DELL'EDITORE Non sono sempre tutte neoplasie

Research paper thumbnail of An update on methods for sarcopenia diagnosis: from bench to bedside

Italian Journal of Medicine, 2018

Sarcopenia has been recognized as an age-related syndrome characterized by low muscle mass, low m... more Sarcopenia has been recognized as an age-related syndrome characterized by low muscle mass, low muscle strength, and low physical performance that is associated with increased likelihood of adverse outcomes including falls, fractures, hospitalization, frailty and mortality. Therefore, it is necessary to identify the condition early for applying intervention and prevention of the disastrous consequences of sarcopenia if left untreated. Clinical definition and diagnostic criteria for sarcopenia have been developed in the last years and different tools have been proposed for screening subjects with sarcopenia, evaluating the muscle mass, the muscle strength and the physical performance. In this review we analyzed the diagnostic criteria of sarcopenia and examined the current assessment tools used for the diagnosis and screening of sarcopenia.

Research paper thumbnail of COVID-19 6 months after hospital discharge: pulmonary function impairment and its heterogeneity

ERJ Open Research, 2021

Until now, reports about pulmonary function in previously hospitalized subjects for COVID-19 are ... more Until now, reports about pulmonary function in previously hospitalized subjects for COVID-19 are at discharge (1) or at 3-4 months (2-4). The first study at 6 months is that of Huang et al. (5), enrolling 1733 discharged subjects, 349 of them underwent a pulmonary function study. We consecutively enrolled from 15 March to 15 June 2020, during the first pandemic wave in Italy, 135 discharged COVID-19 patients, aged ≤80 yrs, in a follow-up study (Assessment of Cardiac and pulmonary consequences in patients recOvered from coviD-19 infection, the ACOD study) approved by the regional ethics committee (CER Liguria), aiming to collect data at 6 and 12 months after discharge from Hospitals (Santa Corona, Santa Maria di Misericordia, San Paolo) serving an area of 280.000 habitants. The present research letter reports timely preliminary data on respiratory function at 6 months from discharge. Written informed consent was collected from any subject. Spirometry and pulmonary diffusion capacity test were performed following the American Thoracic Society/European Respiratory Society statements (6-7) with a Vyntus Body Plethysmograph (Vyaire Medical GmbH, Hoechberg, Germany). To minimise cross-infections, diffusing capacity of the lung for carbon monoxide (D LCO) was measured by the single-breath method with Diffusion SB RT Module for Body Vyntus (Vyaire Medical, GmbH, Hoechberg, Germany). Abnormal data were that with a Z score >2SD (<LLN, Lower Limit of Normality or >ULN, Upper Limit of Normality) by applying The Global Lung Function Initiative Network (GLI) reference values (8-9). Appropriate correction to D LCO for haemoglobin was considered (7). Descriptive statistics are reported as mean (± standard deviation). Differences between two groups were analysed for statistical significance by Student's t-test (unpaired) and between more than two groups by ANOVA, Kruskal-Wallis, or χ 2 where appropriate. A two-sided p<0.05 was considered for all comparisons.

Research paper thumbnail of COVID-19 pandemic and Internal Medicine Units in Italy: a precious effort on the front line

Internal and Emergency Medicine, 2020

Research paper thumbnail of Nephrotoxicity induced by TZP in a healthy male

Clinical Nephrology, 2019

Research paper thumbnail of Variant of plasmablastic microlymphoma in Castleman disease: a case report and review of the literature

Italian Journal of Medicine, 2018

Castleman disease (CD) is a rare lymphoproliferative disorder also known as angiofollicular lymph... more Castleman disease (CD) is a rare lymphoproliferative disorder also known as angiofollicular lymph node hyperplasia or giant lymph node hyperplasia. CD can be unicentric CD (UCD) or multicentric CD (MCD). MCD affects more than one group of lymph nodes and/or lymphoid tissues and it is frequently associated with HIV and human herpes virus 8 (HHV-8) infections and, in contrast with UCD, it often results in systemic symptoms, such as fever, fatigue, anemia, inflammatory syndrome. HHV- 8-associated MCD recognizes HHV-8 as an etiopathogenetic agent and occurs generally in HIV-positive subjects. Our report describes an HHV-8 positive Castleman disease with plasmablastic microlymphoma occurring in a 51-year-old HIV seronegative woman, with a previous history of HBV infection and Kaposi’s sarcoma, who presented elevated procalcitonin levels during the acute phase of CD.

Research paper thumbnail of COVID-19 after 2 Years from Hospital Discharge: A Pulmonary Function and Chest Computed Tomography Follow-Up Study

Research paper thumbnail of A FADOI survey on the quality of discharge summary in internal medicine wards

Internal and Emergency Medicine, May 28, 2022

Research paper thumbnail of Dalle evidenze alla pratica clinica: emorragia del tratto digestivo superiore, pancreatite acuta, sepsi ed osteoporosi. Il contributo dei giovani internisti FADOI

Italian Journal of Medicine, Nov 30, 2016

Dalle evidenze alla pratica clinica: emorragia del tratto digestivo superiore, pancreatite acuta,... more Dalle evidenze alla pratica clinica: emorragia del tratto digestivo superiore, pancreatite acuta, sepsi ed osteoporosi. Il contributo dei giovani internisti FADOI

Research paper thumbnail of Liver diseases and pregnancy

Italian Journal of Medicine, Sep 11, 2017

The pregnant woman experiences physiological changes to support fetal growth and development. The... more The pregnant woman experiences physiological changes to support fetal growth and development. The levels of estrogens (estradiol) and progesterone increase progressively during pregnancy. These sex hormones have effects on hepatic metabolic, synthesis, and excretory functions. The phenomenon of hemodilution secondary to the increase in plasma volume and the increases in cardiac output, decreases the serum protein concentrations. 1 Liver, in course of pregnancy, reveals no specific structural changes. In spite of this, several changes in values of liver function tests occur during normal pregnancy. Blood flow to the liver remains unchanged, but the percentage of cardiac output to the liver is reduced, which may impair clearance of substances requiring extensive hepatic metabolism. 1 Moreover, in pregnancy, gallbladder motility is also decreased for several causes: gallbladder enlargement and incomplete evacuation of bile, increased gallbladder volume during fasting is due to a combination of decreased water absorption by the gallbladder mucosa, enhanced of secretion of cholecystokinin in the response to food intake. All these phenomena can originate to from the high concentration of progesterone. 2 In this paper, we review the liver-related clinical and pathology changes that occur during pregnancy, subdividing these conditions into: i) conditions associated with pregnant status; ii) conditions complicating the pregnancy; iii) liver conditions present at the beginning of pregnancy. Conditions associated with pregnant status Intrahepatic cholestasis Intrahepatic cholestasis of pregnancy (ICP) usually occurs during the last trimester and has a rapid postnatal resolution. 3 It is characterized by severe pruritus, associated with increase in serum bile acid and aminotransferases (Table 1). The symptoms and biochemical abnormalities resolve rapidly after delivery but may recur in subsequent pregnancies and with the use of hormonal contraception. 4 Genetic variations may implicate heterozygous or homozygous mutations located in different positions of the genes. All the association studies with these candidate genes stress the complex variability of genotypes, the different

Research paper thumbnail of The management of the patient with acute pancreatitis: from evidence to clinical practice

Italian Journal of Medicine, Sep 11, 2017

Acute pancreatitis is an inflammatory disorder of the pancreas characterized by abdominal pain an... more Acute pancreatitis is an inflammatory disorder of the pancreas characterized by abdominal pain and elevation of pancreatic enzymes in the blood. The pathogenesis is complex and partly unknown and the evolution is often unpredictable. Many efforts have been made to define this disease and its complications and to classify different grades of severity in order to formulate prognostic scores that could guide the physician in choosing the optimal therapeutic setting and procedures. The management of the patient with pancreatitis is not always optimal and differs among internist, gastroenterologist or surgeon. We think that a patient with clinical suspicion of acute pancreatitis is admitted to medical or surgical department depending on the availability of beds and not according to evidence-based medicine. The aim of this monograph is to identify the optimal management of patients with acute pancreatitis admitted to hospital.

Research paper thumbnail of Italian good practice recommendations on management of persons with Long-COVID

Frontiers in Public Health, Apr 20, 2023

A significant number of people, following acute SARS-CoV-2 infection, report persistent symptoms ... more A significant number of people, following acute SARS-CoV-2 infection, report persistent symptoms or new symptoms that are sustained over time, often affecting different body systems. This condition, commonly referred to as Long-COVID, requires a complex clinical management. In Italy new health facilities specifically dedicated to the diagnosis and care of Long-COVID were implemented. However, the activity of these clinical centers is highly heterogeneous, with wide variation in the type of services provided, specialistic expertise and, ultimately, in the clinical care provided. Recommendations for a uniform management of Long-COVID were therefore needed. Professionals from different disciplines (including general practitioners, specialists in respiratory diseases, infectious diseases, internal medicine, geriatrics, cardiology, neurology, pediatrics, and odontostomatology) were invited to participate, together with a patient representative, in a multidisciplinary Panel appointed to draft Good Practices on clinical management of Long-COVID. The Panel, after extensive literature review, issued

Research paper thumbnail of Management of stable coronary artery disease: from evidence to clinical practice

Italian Journal of Medicine, Jun 14, 2017

Ischemic heart disease, the leading cause of death, is extremely diffuse among patients hospitali... more Ischemic heart disease, the leading cause of death, is extremely diffuse among patients hospitalized in Internal Medicine ward so that Internist should be able to manage correctly this disease. The following review revises the most recent literature and offers a practical clinical guide to be confident on this topic. After having emphasized that clinical overview remains essential, it briefly mentions advantages and limits of different investigations, reminds readers of possible alternative etiopathogeneses of ischemic heart disease (cardiac syndrome X), reports the most appropriate medical therapy, and gives the opportunity to understand appropriateness of specialist strategies such as coronary artery bypass grafting and percutaneous coronary intervention. Finally, it illustrates a rational and evidence-based follow-up of these patients, considering that only a small part of them should be followed by a Cardiologist. The aim of a correct management of ischemic heart disease remains to reduce mortality and improve the quality of life.

Research paper thumbnail of Metodologia clinica oggi nel paziente internistico complesso

Italian Journal of Medicine, 2020

Introduzione alla letturaA. Fontanella, P. Gnerre Il metodo clinico classico della tradizione ita... more Introduzione alla letturaA. Fontanella, P. Gnerre Il metodo clinico classico della tradizione italianaI. Portioli Modelli di ragionamento clinico e strumenti utilizzati nella pratica clinica in ambito internistico ai fini decisionaliP. Gnerre, R. Nardi I difetti del ragionamento clinico come causa di errori diagnosticiM. La Regina, F. Orlandini Metodologia clinica e EBM: vantaggi e limiti nel mondo reale dei pazienti complessi - Il mondo realeT.M. Attardo Metodologia clinica e EBM: vantaggi e limiti nel mondo reale dei pazienti complessi - Trappole e possibili biasM. Cavalleri Significatività statistica e rilevanza clinicaD. Tirotta Dalla medicina personalizzata alla medicina di precisioneG. Gensini, N. Scarpa Una possibile alternativa alle decisioni: il metodo Clinical Multi-criteria Decision Assessment (CMDA)O. Para Il metodo clinico in condizioni di incertezza: errori, vincoli, esperienza, buon senso e le opinioni del pazienteM.L. Cipollini, E. Romboli Meta-cognizione e capacità ...

Research paper thumbnail of FADOI e la medicina di genere

Research paper thumbnail of La figura dell’Hospitalist in Italia

Italian Journal of Medicine, Apr 27, 2018

Articolo pubblicato secondo la Creative Commons Attribution NonCommercial 4.0 License (CC BY-NC 4... more Articolo pubblicato secondo la Creative Commons Attribution NonCommercial 4.0 License (CC BY-NC 4.0).

Research paper thumbnail of L'internista naviga nel mare salato che è in noi

Italian Journal of Medicine, 2018

Il mare vivo che è in noiF. Sgambato, S. Prozzo, E. SgambatoMeccanismi fisiologici del ricambio d... more Il mare vivo che è in noiF. Sgambato, S. Prozzo, E. SgambatoMeccanismi fisiologici del ricambio di sodio ed acquaM. RenisLe alterazioni del bilancio del sodio e dell’acquaM. RenisApproccio clinico-pratico ai disturbi dell’equilibrio acido-baseA. Casola, L. Bianchi, S. Detrenis, S. Pioli, M. del Mar Jordana-Sanchez, T. Pasquariello, D. Fasano, M. Saccò, A. Magnano, F. Spagnoli, M. MeschiApproccio clinico-diagnostico e strumentale alle iposodiemie ipotoniche e non ipotonicheI. AmbrosinoApproccio clinico-diagnostico e strumentale alle ipersodiemieA. IlardiLa sindrome da inappropriata antidiuresiG. Tenconi, G. Secondo, L. MortaraApproccio clinico-diagnostico e strumentale alle ipopotassiemieT.M. AttardoApproccio diagnostico e strumentale alle iperpotassiemieM. GambacortaIpocalcemia: condizione comune a diverse patologieA. Montagnani, M. Alessandri, M. MiglioriniApproccio clinico-diagnostico e strumentale alle ipercalcemieP. Gnerre, M. Grandi, A. PercivaleApproccio clinico-diagnostico e ...

Research paper thumbnail of Management del paziente con cefalea, vertigine e sincope: dalle evidenze alla pratica clinica

Italian Journal of Medicine, 2016

Management del paziente con cefalea, vertigine e sincope: dalle evidenze alla pratica clinica

Research paper thumbnail of Real-world use of remdesivir for the treatment of patients admitted to Italian hospitals with COVID-19: the nationwide retrospective FADOI-RECOVER study

BMC Infectious Diseases

Background Remdesivir is widely used for treatment of SARS-CoV-2 pneumonia. The aim of this study... more Background Remdesivir is widely used for treatment of SARS-CoV-2 pneumonia. The aim of this study was to evaluate the characteristics of patients with moderate-to-severe COVID-19 treated with remdesivir, and their outcomes during hospitalization. Methods This retrospective observational multicenter study included consecutive patients, hospitalized for moderate-to-severe COVID-19 (September 2020—September 2021), who were treated with remdesivir. Results One thousand four patients were enrolled, all with onset of symptoms occurring less than 10 days before starting remdesivir; 17% of patients had 4 or more concomitant diseases. Remdesivir was well tolerated, adverse drug reactions (ADRs) being reported in 2.3% of patients. In-hospital death occurred in 80 patients (8.0%). The median timing of the first remdesivir dose was 5 days after symptom onset. The following endpoints did not differ according to the time span from the onset of symptoms to the first dose: length of hospitalization...

Research paper thumbnail of Outcomes of patients with COVID-19 hospitalized during the fourth pandemic wave in relation to their clinical features and vaccination status

Italian Journal of Medicine

This study aims to observe the clinical characteristics and outcomes of recovered patients from C... more This study aims to observe the clinical characteristics and outcomes of recovered patients from Coronavirus Disease (COVID-19) related to the vaccination status. We examined results of 205 COVID-19-recovered patients from 15 December 2021 to 1 March 2022 in two hospitals of Local Health Authority of Alessandria (Italy) during the fourth pandemic wave. 77% of patients were hospitalized for acute respiratory failure (ARF) with radiological pneumonia pattern (recovered for COVID), 23% for other causes with occasional positivity finding (recovered with COVID). 32% of patients were not vaccinated for Sars-COV-2, 37% had three doses, 25% two doses, 5% only one dose. All patients without vaccination were hospitalized for ARF and they had a 7 times higher risk of hospitalization than the vaccinated. 60% of all patients had >3 comorbidities, of these 50% was vaccinated with three doses. In the fourth pandemic wave compared to the other not all patients were hospitalized for ARF and pneumo...

Research paper thumbnail of MATERIALE PROTETTO DA COPYRIGHT NON FOTOCOPIARE O DISTRIBUIRE ELETTRONICAMENTE SENZA L'AUTORIZZAZIONE SCRITTA DELL'EDITORE Non sono sempre tutte neoplasie

Research paper thumbnail of An update on methods for sarcopenia diagnosis: from bench to bedside

Italian Journal of Medicine, 2018

Sarcopenia has been recognized as an age-related syndrome characterized by low muscle mass, low m... more Sarcopenia has been recognized as an age-related syndrome characterized by low muscle mass, low muscle strength, and low physical performance that is associated with increased likelihood of adverse outcomes including falls, fractures, hospitalization, frailty and mortality. Therefore, it is necessary to identify the condition early for applying intervention and prevention of the disastrous consequences of sarcopenia if left untreated. Clinical definition and diagnostic criteria for sarcopenia have been developed in the last years and different tools have been proposed for screening subjects with sarcopenia, evaluating the muscle mass, the muscle strength and the physical performance. In this review we analyzed the diagnostic criteria of sarcopenia and examined the current assessment tools used for the diagnosis and screening of sarcopenia.

Research paper thumbnail of COVID-19 6 months after hospital discharge: pulmonary function impairment and its heterogeneity

ERJ Open Research, 2021

Until now, reports about pulmonary function in previously hospitalized subjects for COVID-19 are ... more Until now, reports about pulmonary function in previously hospitalized subjects for COVID-19 are at discharge (1) or at 3-4 months (2-4). The first study at 6 months is that of Huang et al. (5), enrolling 1733 discharged subjects, 349 of them underwent a pulmonary function study. We consecutively enrolled from 15 March to 15 June 2020, during the first pandemic wave in Italy, 135 discharged COVID-19 patients, aged ≤80 yrs, in a follow-up study (Assessment of Cardiac and pulmonary consequences in patients recOvered from coviD-19 infection, the ACOD study) approved by the regional ethics committee (CER Liguria), aiming to collect data at 6 and 12 months after discharge from Hospitals (Santa Corona, Santa Maria di Misericordia, San Paolo) serving an area of 280.000 habitants. The present research letter reports timely preliminary data on respiratory function at 6 months from discharge. Written informed consent was collected from any subject. Spirometry and pulmonary diffusion capacity test were performed following the American Thoracic Society/European Respiratory Society statements (6-7) with a Vyntus Body Plethysmograph (Vyaire Medical GmbH, Hoechberg, Germany). To minimise cross-infections, diffusing capacity of the lung for carbon monoxide (D LCO) was measured by the single-breath method with Diffusion SB RT Module for Body Vyntus (Vyaire Medical, GmbH, Hoechberg, Germany). Abnormal data were that with a Z score >2SD (<LLN, Lower Limit of Normality or >ULN, Upper Limit of Normality) by applying The Global Lung Function Initiative Network (GLI) reference values (8-9). Appropriate correction to D LCO for haemoglobin was considered (7). Descriptive statistics are reported as mean (± standard deviation). Differences between two groups were analysed for statistical significance by Student's t-test (unpaired) and between more than two groups by ANOVA, Kruskal-Wallis, or χ 2 where appropriate. A two-sided p<0.05 was considered for all comparisons.

Research paper thumbnail of COVID-19 pandemic and Internal Medicine Units in Italy: a precious effort on the front line

Internal and Emergency Medicine, 2020

Research paper thumbnail of Nephrotoxicity induced by TZP in a healthy male

Clinical Nephrology, 2019

Research paper thumbnail of Variant of plasmablastic microlymphoma in Castleman disease: a case report and review of the literature

Italian Journal of Medicine, 2018

Castleman disease (CD) is a rare lymphoproliferative disorder also known as angiofollicular lymph... more Castleman disease (CD) is a rare lymphoproliferative disorder also known as angiofollicular lymph node hyperplasia or giant lymph node hyperplasia. CD can be unicentric CD (UCD) or multicentric CD (MCD). MCD affects more than one group of lymph nodes and/or lymphoid tissues and it is frequently associated with HIV and human herpes virus 8 (HHV-8) infections and, in contrast with UCD, it often results in systemic symptoms, such as fever, fatigue, anemia, inflammatory syndrome. HHV- 8-associated MCD recognizes HHV-8 as an etiopathogenetic agent and occurs generally in HIV-positive subjects. Our report describes an HHV-8 positive Castleman disease with plasmablastic microlymphoma occurring in a 51-year-old HIV seronegative woman, with a previous history of HBV infection and Kaposi’s sarcoma, who presented elevated procalcitonin levels during the acute phase of CD.