Matteo Gelardi | Università degli Studi di Bari (original) (raw)
Papers by Matteo Gelardi
International Archives of Allergy and Immunology, 2006
Access to full text and tables of contents, including tentative ones for forthcoming issues: www.... more Access to full text and tables of contents, including tentative ones for forthcoming issues: www.karger.com/iaa_issues
PubMed, Apr 1, 2018
Inflammatory rhinitis is a very common disorder. It includes allergic rhinitis (AR) and non-aller... more Inflammatory rhinitis is a very common disorder. It includes allergic rhinitis (AR) and non-allergic rhinitis (NAR). Nasal inflammation is shared by both disorders. So, anti-inflammatory treatment is indicated for both. Beclomethasone dipropionate (BDP) is a corticosteroid that is long time available both as intranasal spray and aerosol solution. BDP is a corticosteroid with proved efficacy in the treatment of rhinitis, both as spray and aerosol. Safety issue has been satisfactory explored, thus BDP is usually safe and well tolerated. Hyaluronic acid (HA) with high molecular weight has anti-inflammatory activity associated with wetting-lubricating effect. BDP may be usefully employed in acute forms, HA may be also used in chronic ones.
PubMed, Aug 3, 2023
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the nose a... more Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the nose and the paranasal sinuses characterized by the presence of nasal polyps and persistent symptoms of nasal obstruction, anterior or posterior rhinorrhea, facial pain or pressure, and reduction or loss of smell, lasting longer than 12 weeks. Several therapeutic strategies are nowadays available to treat CRSwNP as a function of disease severity. However, a standardized therapeutic algorithm has not yet been proposed. Since CRSwNP severity can be assessed by the Clinical-Cytological Grading (CCG) and the consequent reduction in patients' Quality of Life can be defined with the Sino Nasal Outcome Test-22 (SNOT-22), we aimed to propose a new diagnostic-therapeutic algorithm, that takes into consideration both the characteristics of the patients, including the CCG, nasal obstruction, and SNOT-22, and all the therapies available today.
Electronics, Jun 15, 2020
The qualitative and quantitative evaluation of nasal epithelial cells is interesting in chronic i... more The qualitative and quantitative evaluation of nasal epithelial cells is interesting in chronic infectious and inflammatory pathologies of the nose and sinuses. Among the cells of the population of the nasal mucosa, ciliated cells are particularly important. In fact, the observation of these cells is essential to investigate primary ciliary dyskinesia, a rare and severe disease associated with other serious diseases such as respiratory diseases, situs inversus, heart disease, and male infertility. Biopsy or brushing of the ciliary mucosa and assessment of ciliary function through measurements of the Ciliary Beating Frequency (CBF) are usually required to facilitate diagnosis. Therefore, low-cost and easy-to-use technologies devoted to measuring the ciliary beating frequency are desirable. We have considered related works in this field and noticed that up to date an actually usable system is not available to measure and monitor CBF. Moreover, performing this operation manually is practically unfeasible or demanding. For this reason, we designed BeatCilia, a low cost and easy-to-use system, based on image processing techniques, with the aim of automatically measuring CBF. This system performs cell Region of Interest (RoI) detection basing on dense optical flow computation of cell body masking, focusing on the cilia movement and taking advantage of the structural characteristics of the ciliated cell and CBF estimation by applying a fast Fourier transform to extract the frequency with the peak amplitude. The experimental results show that it offers a reliable and fast CBF estimation method and can efficiently run on a consumer-grade smartphone. It can support rhinocytologists during cell observation, significantly reducing their efforts.
World Allergy Organization Journal, Feb 1, 2012
Background: The airways and the upper digestive tract have a common embrional origin, and in sens... more Background: The airways and the upper digestive tract have a common embrional origin, and in sensitized subjects they can respond to allergens with an immediate reaction (asthma, rhinitis or oral allergy syndrome). We investigated the possible functional connection between respiratory tract and upper digestive tract by means of specific oral allergen challenges. Methods: Patients sensitized to birch and apple were subdivided in GROUP A (N ¼ 12; asthma and rhinitis due to birch and OAS due to apple) GROUP B (N ¼ 10; OAS due to apple without asthma/rhinitis); GROUP C (N ¼ 8; asthma and rhinitis due to birch without OAS). Healthy subjects represented the control group D (N ¼ 6). Oral provocation test with apple was performed out of the pollen season. Visual analog scale for eye, nose and mouth symptoms, spirometry, nasal eosinophil count and exhaled nitric oxide were assessed before and 6 hours after challenge. Results: There was no change in nasal and ocular symptoms before versus after challenge in all groups. On the contrary, in groups A and B the oral scores significantly increased after challenge (P , .001), whereas no change was seen in groups C and D. Exhaled nitric oxide and nasal eosinophils showed no change before versus after challenge in all groups. Nitric oxide was higher before and after challenge in groups A and C versus groups B and D. No change was een as well in forced vital capacity and forced expiratory volume in one second. Conclusions: In the case of birch-apple syndrome, eating apple does not functionally or clinically affect the respiratory tract.
Journal of Biological Regulators and Homeostatic Agents, Nov 1, 2020
American Journal of Rhinology, Sep 1, 2007
Background Interleukin (IL)-4 and IL-6, respectively, markers of neutrophilic and eosinophilic in... more Background Interleukin (IL)-4 and IL-6, respectively, markers of neutrophilic and eosinophilic inflammation, were analyzed in nasal and oral exhaled breath condensate to understand the inflammation of upper and lower airways in subjects with aspirin-induced asthma (AIA) syndrome, evaluating possible differences between AIA and the single pathological conditions included in AIA syndrome. Methods Twelve patients with AIA, 17 patients with mild asthma (MA), 12 patients with nasal polyposis (NP), 11 patients with mild asthma + nasal polyposis (MA + NP), and 10 healthy subjects (HSs) were enrolled. Nasal and oral exhaled IL-4 and IL-6 were measured by enzyme immunoassay kit. Results Higher levels of nasal and oral exhaled IL-4 and IL-6 were observed in AIA compared with MA, NP, MA + NP, and HSs. Moreover, a positive correlation was identified between nasal exhaled IL-4 and IL-6 and, respectively, the number of neutrophils and eosinophils and in nasal scraping. Conclusion The concentration of eosinophilic and neutrophilic markers in upper and lower airways of subjects with AIA syndrome is higher compared with HS and subjects with MA, NP, and MA + NP.
International Archives of Allergy and Immunology, 2018
Eosinophilic granulomatosis with polyangiitis (EGPA) is a necrotizing vasculitis that predominant... more Eosinophilic granulomatosis with polyangiitis (EGPA) is a necrotizing vasculitis that predominantly affects small- to medium-sized vessels. It is characterized by a wide spectrum of extrapulmonary symptoms, including sinonasal and paranasal sinus abnormalities. These are the most common features of this disease, constituting diagnostic criteria for EGPA. However, the actual clinical features, cellular mechanisms and impact on patients' quality of life (QoL) are still a matter of study. Thirty-nine EGPA patients underwent multidimensional rhinological evaluations, including rhinofibroscopy, nasal cytology, and QoL questionnaires. This was coupled with respiratory and rheumatological assessments. Twenty-eight patients were diagnosed with chronic rhinosinusitis (CRS). Of these, 18 had nasal polyposis (NP). Chronic rhinitis was diagnosed in 10 patients. Of these, 3 had allergic rhinitis (AR) and seven had non-AR (NAR). Overall, only 1 patient (2.6%) was normal. Nasal cytology showed that hypereosinophilia was present in 17/28 patients with CRS, 4/7 patients with NAR and all patients with AR. SNOT-22 and SF-36 showed a severe impact of nasal symptoms on QoL. No differences in asthma control or rheumatological patterns for EGPA were observed among patients with or without NP. Even when the rheumatological assessment scored EGPA "under control" according to the Birmingham Vasculitis Activity Score and Vasculitis Damage Index, sinonasal diseases and related nasal inflammatory processes were not controlled. Therefore, there is a need for clinical monitoring and targeted treatment to control the inflammatory processes and improve the QoL of EGPA patients.
Annals of Allergy Asthma & Immunology, Mar 1, 2012
Background: The constant increase in the elderly population worldwide has led to a greater intere... more Background: The constant increase in the elderly population worldwide has led to a greater interest in immunologic responses during aging. Thus, special attention to allergic diseases in elderly people has begun to emerge, but little is known about the effect and features of allergic rhinitis in elderly people. Objective: To evaluate the clinical and cytologic characteristics of respiratory allergy and its impact on the quality of life in elderly people. Methods: Elderly patients with rhinitis referred to our allergy unit during a 3-month period underwent clinical evaluation and responded to the Rhinasthma Questionnaire. All patients also underwent skin prick testing, measurement of total IgE level, and nasal cytologic analysis. The data were compared with a control group of young adults. Results: Fifty-four patients older than 65 years (mean age, 69.3 years) and 89 young adults (mean age, 26.3 years) with allergic rhinitis were studied. The elderly patients had a less positive family history of atopy (Pϭ.02) and had rhinitis plus conjunctivitis more frequently (Pϭ.002) than young adults, whereas the difference between groups in total IgE level was not statistically significant. On nasal cytologic analysis, the differential count of inflammatory cells did not differ between groups, but in the elderly patients the epithelial-goblet cell ratio was decreased. The quality of life in elderly people was more impaired than in young adults (Pϭ.01). Conclusion: In elderly people with allergic rhinitis, the clinical characteristics are different and quality of life is more heavily impaired compared with young adults.
Gazzetta medica italiana. Archivio per le scienze mediche, May 1, 2023
Annals of Allergy Asthma & Immunology, Nov 1, 2022
Monaldi archives for chest disease, Mar 5, 2021
An elegant study reported dysmorphic cells and syncytia in the deceased's lungs for COVID-19 [1].... more An elegant study reported dysmorphic cells and syncytia in the deceased's lungs for COVID-19 [1]. The authors reasonably considered that most of these syncytia-forming cells were pneumocytes, as identified by specific biomarkers. However, cellular dysmorphism and syncytia are pathological features common in other respiratory infections caused by different viruses, including the human respiratory syncytial virus (HRSV) and Epstein-Barr virus (EBV), as correctly documented [2,3]. On the other hand, a respiratory infection due to viruses, including rhinovirus, adenovirus, myxovirus, and coronavirus, usually results in ciliocytophthoria of nasal ciliated cells [4]. The term ciliocytophthoria identifies characteristic cytological alterations, including rarefaction/disappearance of ciliary apparatus, a confluence of cytoplasmatic vacuoles, "decapitation" of the apical portion of the ciliated cell. In this regard, a recent report demonstrated that nasal and bronchial epithelial cells, recovered from a patient with severe COVID-19, displayed only partial rarefaction of the cilia, the presence of some binucleated cells, and the reduction/disappearance of the hyperchromatic stria [5]. These mild cytopathic alterations were consistent with the nose and bronchi's mild involvement in asymptomatic or paucisymptomatic COVID-19 patients (Figure 1). The possible explanation of this gianic behavior does not depend on ACE-2 receptor expression, well represented along the whole respiratory tract. Instead, the composition of the epithelial lining seems to have a pathogenic role. Namely, the epithelium's height and complexity gradually decrease along the respiratory tract, from the tall pseudostratified ciliated columnar cells inter
Rhinosinusitis (RS) affects the nose and the paranasal sinus and is characterized by nasal and sy... more Rhinosinusitis (RS) affects the nose and the paranasal sinus and is characterized by nasal and systemic symptoms. It may be classified as acute or chronic, based on duration. Rhinosinusitis may be clinically suspected, but the diagnosis is usually based on the endoscopy. Antibiotic therapy is frequently used for RS patients in clinical practice. However, antibiotics often induce intestinal dysbiosis associated with some clinical problems and respiratory microbiota impairment. The current clinical experience was conducted in patients with pharyngotonsillitis and treated with antibiotics. A one-month course of a probiotic mixture (Abincol® containing Lactobacillus plantarum LP01 (1 billion of living cells), Lactobacillus lactis subspecies cremoris LLC02 (800 million living cells), and Lactobacillus delbrueckii LDD01 (200 million living cells), was prescribed in the Group A, and was compared with no addon treatment, such as the Group B. Patients were evaluated at baseline (T0), at the end of antibiotic treatment (T1), at the end of probiotic course (T2), and at the end of 3-month follow-up (T3).
2020 5th International Conference on Smart and Sustainable Technologies (SpliTech), Sep 23, 2020
Nasal cytology studies microscopic analysis of the cells contained in the nasal mucosa and repres... more Nasal cytology studies microscopic analysis of the cells contained in the nasal mucosa and represents a useful diagnostic methodology able to recognize and differentiate some nasal pathologies. The standard clinical protocol provides for the observation of at least fifty microscopic fields and cell counting to obtain cell population distribution. In this paper we show as well-known image processing algorithms can be implemented on a common smartphone to support cell counting, taking a photo of the observation fields directly from the microscope. The system designed, called RhinoSmart, processes the images acquired on the smartphone itself and extracts the cellular elements. These cropped images can be observed and counted directly by the specialists or, better can be sent to a server system that classifies cells and send back the report in a short time.
PubMed, Mar 19, 2020
To the Editor, we would like to thank Rafael Martínez-Girón, Hugo Cornelis van Woerden, and Crist... more To the Editor, we would like to thank Rafael Martínez-Girón, Hugo Cornelis van Woerden, and Cristina MartínezTorre, who confirmed post-viral, namely during rhinovirus infection, cytomorphological alterations loaded to nasal epithelial cells (1). The outcomes of that study were consistent with our research that described structural modification during viral infection (2,3). In this regard, the first evidence concerned vacuolar degeneration at the cytoplasmic level and further nuclear impairment, manly nuclear alterations, such as intranuclear halo (4). In particular, it has to note that the “halo” is inside the cellular membrane as confirmed by electronic microscopy (3). Analyzing the subjects investigated by the authors, it seems that some relevant details were lacking, mainly concerning the type of perennial rhinitis. In fact, as reported, all subjects were treated with oral H1 antagonists and intranasal corticosteroids. Both medications are commonly prescribed for allergic rhinitis. Besides, 2 patients had nasal polyps and one asthma. There is a reasonable suspicion that they suffered from allergic rhinitis. In conflict with this hypothesis, eosinophils were, however, very scarce. Remarkably, perennial rhinitis was not classified in their study. Consistently, we would underline the clinical relevance of nasal cytology in the workup of nasal disorders (5). Nasal cytology is a simple, easy, and repeatable technique that is very fruitful in clinical practice. Nasal cytology carefully defines the phenotype and endotype of rhinitis, so it is a classic example of Precision Medicine (6) and it is a point-ofcare test (7). Moreover, it has been recently standardized, thus the methodology has been rigorously validated (8). In the context of the topic, a close link exists between allergic rhinitis and rhinovirus. It was demonstrated that allergic patients have a mucosal inflammation that involves adhesion molecule machinery, mainly intercellular adhesion molecule 1 (ICAM-1), and is associated with functional impairment, such as nasal airflow limitation (9-11). Interestingly, ICAM-1 is also the main receptor for rhinovirus: this curious coincidence explains the increased susceptibility to infections in allergic patients (12). These concepts underline the importance of a precise and documented diagnosis of rhinitis that is the requisite for a tailored treatment: the so-called Personalized Medicine (13). In conclusion, nasal cytology could be envisaged as a mandatory test to identify the phenotype, and endotype to optimize the management of patients with perennial rhinitis.
European Archives of Oto-rhino-laryngology, Nov 14, 2022
The aim of this study was to report the use of extra-short and short implants in combination with... more The aim of this study was to report the use of extra-short and short implants in combination with Guided Bone Regeneration (GBR) to rehabilitate a case of severe mandibular reabsorption. A 55-yearold female patient asked for a fixed implant supported rehabilitation in 4.5 - 4.6 zone which showed severe atrophy. It was decided to use an extra-short 4 mm length and 4.1 mm Ø, Roxolid and SLActive implant (Straumann Standard Plus Regular Neck, Institut Straumann AG) in 4.5 position and a short 6 mm length and 4.8 mm Ø, Roxolid and SLActive implant (Straumann Standard Plus Wide Neck, Institut Straumann AG) in 4.6 position. The implants supported cemented fixed prosthesis. Examinations were performed at the day of the surgery and up to 7-years in function to evaluate implant stability and periapical radiography. One extra-short implant and one short implant were placed. After 7 years in function no biological or prosthetic complication were recorded. Within the limitation of this case report, the use of short and extra-short implants to support fixed prosthesis seem to be a feasible treatment alternative in severe mandibular atrophy.
PubMed, Mar 21, 2019
Inflammation is a common pathogenic mechanism involved in many otorhinolaryngological (ORL) disor... more Inflammation is a common pathogenic mechanism involved in many otorhinolaryngological (ORL) disorders. Broser® is an oral nutraceutical currently containing bromelain 100 mg, escin 30 mg, and selenium 42.5 mcg. It could exert a safe and effective anti-inflammatory activity by virtue of these components. Therefore, the aim of the current survey, conducted in clinical practice of 84 Italian ORL centers, was to evaluate its safety and efficacy in the treatment of patients.
PubMed, Oct 1, 2017
Objective: The aim of this study was to evaluate the reparative role of hyaluronic acid in acute ... more Objective: The aim of this study was to evaluate the reparative role of hyaluronic acid in acute rhinosinusitis (ARS). Patients and methods: 48 patients affected by ARS were submitted to nasal endoscopy, nasal cytology, mucociliary transport evaluation (MCTt) and visual analogue scale questionnaire (VAS) at T0, after 14-18 days (T1) and after 30-35 days (T2). The patients were randomized into two groups, A and B, and received Levofloxacin and Prednisone. Moreover, using a nebulizer ampoule for nasal douche, Group A received high molecular weight Sodium Hyaluronate (3%) plus saline solution (NaCl 0.9%) twice a day for 30 days; Group B received saline solution twice a day for 30 days. Results: At T0 only the VAS score showed differences regarding nasal discharge and post-nasal drip. At T1, in Group A MCTt and the number of bacteria were significantly lower than in Group B. The VAS score showed improvement in Group A. At T2 in Group A, MCTt and number of neutrophils were significantly lower than in Group B. The VAS score showed statistically significant differences between the two groups regarding nasal discharge. Conclusions: In ARS patients sodium hyaluronate plus saline solution significantly improved symptoms, MCT time and reduced neutrophil count on nasal cytology.
International Archives of Allergy and Immunology, 2006
Access to full text and tables of contents, including tentative ones for forthcoming issues: www.... more Access to full text and tables of contents, including tentative ones for forthcoming issues: www.karger.com/iaa_issues
PubMed, Apr 1, 2018
Inflammatory rhinitis is a very common disorder. It includes allergic rhinitis (AR) and non-aller... more Inflammatory rhinitis is a very common disorder. It includes allergic rhinitis (AR) and non-allergic rhinitis (NAR). Nasal inflammation is shared by both disorders. So, anti-inflammatory treatment is indicated for both. Beclomethasone dipropionate (BDP) is a corticosteroid that is long time available both as intranasal spray and aerosol solution. BDP is a corticosteroid with proved efficacy in the treatment of rhinitis, both as spray and aerosol. Safety issue has been satisfactory explored, thus BDP is usually safe and well tolerated. Hyaluronic acid (HA) with high molecular weight has anti-inflammatory activity associated with wetting-lubricating effect. BDP may be usefully employed in acute forms, HA may be also used in chronic ones.
PubMed, Aug 3, 2023
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the nose a... more Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the nose and the paranasal sinuses characterized by the presence of nasal polyps and persistent symptoms of nasal obstruction, anterior or posterior rhinorrhea, facial pain or pressure, and reduction or loss of smell, lasting longer than 12 weeks. Several therapeutic strategies are nowadays available to treat CRSwNP as a function of disease severity. However, a standardized therapeutic algorithm has not yet been proposed. Since CRSwNP severity can be assessed by the Clinical-Cytological Grading (CCG) and the consequent reduction in patients' Quality of Life can be defined with the Sino Nasal Outcome Test-22 (SNOT-22), we aimed to propose a new diagnostic-therapeutic algorithm, that takes into consideration both the characteristics of the patients, including the CCG, nasal obstruction, and SNOT-22, and all the therapies available today.
Electronics, Jun 15, 2020
The qualitative and quantitative evaluation of nasal epithelial cells is interesting in chronic i... more The qualitative and quantitative evaluation of nasal epithelial cells is interesting in chronic infectious and inflammatory pathologies of the nose and sinuses. Among the cells of the population of the nasal mucosa, ciliated cells are particularly important. In fact, the observation of these cells is essential to investigate primary ciliary dyskinesia, a rare and severe disease associated with other serious diseases such as respiratory diseases, situs inversus, heart disease, and male infertility. Biopsy or brushing of the ciliary mucosa and assessment of ciliary function through measurements of the Ciliary Beating Frequency (CBF) are usually required to facilitate diagnosis. Therefore, low-cost and easy-to-use technologies devoted to measuring the ciliary beating frequency are desirable. We have considered related works in this field and noticed that up to date an actually usable system is not available to measure and monitor CBF. Moreover, performing this operation manually is practically unfeasible or demanding. For this reason, we designed BeatCilia, a low cost and easy-to-use system, based on image processing techniques, with the aim of automatically measuring CBF. This system performs cell Region of Interest (RoI) detection basing on dense optical flow computation of cell body masking, focusing on the cilia movement and taking advantage of the structural characteristics of the ciliated cell and CBF estimation by applying a fast Fourier transform to extract the frequency with the peak amplitude. The experimental results show that it offers a reliable and fast CBF estimation method and can efficiently run on a consumer-grade smartphone. It can support rhinocytologists during cell observation, significantly reducing their efforts.
World Allergy Organization Journal, Feb 1, 2012
Background: The airways and the upper digestive tract have a common embrional origin, and in sens... more Background: The airways and the upper digestive tract have a common embrional origin, and in sensitized subjects they can respond to allergens with an immediate reaction (asthma, rhinitis or oral allergy syndrome). We investigated the possible functional connection between respiratory tract and upper digestive tract by means of specific oral allergen challenges. Methods: Patients sensitized to birch and apple were subdivided in GROUP A (N ¼ 12; asthma and rhinitis due to birch and OAS due to apple) GROUP B (N ¼ 10; OAS due to apple without asthma/rhinitis); GROUP C (N ¼ 8; asthma and rhinitis due to birch without OAS). Healthy subjects represented the control group D (N ¼ 6). Oral provocation test with apple was performed out of the pollen season. Visual analog scale for eye, nose and mouth symptoms, spirometry, nasal eosinophil count and exhaled nitric oxide were assessed before and 6 hours after challenge. Results: There was no change in nasal and ocular symptoms before versus after challenge in all groups. On the contrary, in groups A and B the oral scores significantly increased after challenge (P , .001), whereas no change was seen in groups C and D. Exhaled nitric oxide and nasal eosinophils showed no change before versus after challenge in all groups. Nitric oxide was higher before and after challenge in groups A and C versus groups B and D. No change was een as well in forced vital capacity and forced expiratory volume in one second. Conclusions: In the case of birch-apple syndrome, eating apple does not functionally or clinically affect the respiratory tract.
Journal of Biological Regulators and Homeostatic Agents, Nov 1, 2020
American Journal of Rhinology, Sep 1, 2007
Background Interleukin (IL)-4 and IL-6, respectively, markers of neutrophilic and eosinophilic in... more Background Interleukin (IL)-4 and IL-6, respectively, markers of neutrophilic and eosinophilic inflammation, were analyzed in nasal and oral exhaled breath condensate to understand the inflammation of upper and lower airways in subjects with aspirin-induced asthma (AIA) syndrome, evaluating possible differences between AIA and the single pathological conditions included in AIA syndrome. Methods Twelve patients with AIA, 17 patients with mild asthma (MA), 12 patients with nasal polyposis (NP), 11 patients with mild asthma + nasal polyposis (MA + NP), and 10 healthy subjects (HSs) were enrolled. Nasal and oral exhaled IL-4 and IL-6 were measured by enzyme immunoassay kit. Results Higher levels of nasal and oral exhaled IL-4 and IL-6 were observed in AIA compared with MA, NP, MA + NP, and HSs. Moreover, a positive correlation was identified between nasal exhaled IL-4 and IL-6 and, respectively, the number of neutrophils and eosinophils and in nasal scraping. Conclusion The concentration of eosinophilic and neutrophilic markers in upper and lower airways of subjects with AIA syndrome is higher compared with HS and subjects with MA, NP, and MA + NP.
International Archives of Allergy and Immunology, 2018
Eosinophilic granulomatosis with polyangiitis (EGPA) is a necrotizing vasculitis that predominant... more Eosinophilic granulomatosis with polyangiitis (EGPA) is a necrotizing vasculitis that predominantly affects small- to medium-sized vessels. It is characterized by a wide spectrum of extrapulmonary symptoms, including sinonasal and paranasal sinus abnormalities. These are the most common features of this disease, constituting diagnostic criteria for EGPA. However, the actual clinical features, cellular mechanisms and impact on patients' quality of life (QoL) are still a matter of study. Thirty-nine EGPA patients underwent multidimensional rhinological evaluations, including rhinofibroscopy, nasal cytology, and QoL questionnaires. This was coupled with respiratory and rheumatological assessments. Twenty-eight patients were diagnosed with chronic rhinosinusitis (CRS). Of these, 18 had nasal polyposis (NP). Chronic rhinitis was diagnosed in 10 patients. Of these, 3 had allergic rhinitis (AR) and seven had non-AR (NAR). Overall, only 1 patient (2.6%) was normal. Nasal cytology showed that hypereosinophilia was present in 17/28 patients with CRS, 4/7 patients with NAR and all patients with AR. SNOT-22 and SF-36 showed a severe impact of nasal symptoms on QoL. No differences in asthma control or rheumatological patterns for EGPA were observed among patients with or without NP. Even when the rheumatological assessment scored EGPA "under control" according to the Birmingham Vasculitis Activity Score and Vasculitis Damage Index, sinonasal diseases and related nasal inflammatory processes were not controlled. Therefore, there is a need for clinical monitoring and targeted treatment to control the inflammatory processes and improve the QoL of EGPA patients.
Annals of Allergy Asthma & Immunology, Mar 1, 2012
Background: The constant increase in the elderly population worldwide has led to a greater intere... more Background: The constant increase in the elderly population worldwide has led to a greater interest in immunologic responses during aging. Thus, special attention to allergic diseases in elderly people has begun to emerge, but little is known about the effect and features of allergic rhinitis in elderly people. Objective: To evaluate the clinical and cytologic characteristics of respiratory allergy and its impact on the quality of life in elderly people. Methods: Elderly patients with rhinitis referred to our allergy unit during a 3-month period underwent clinical evaluation and responded to the Rhinasthma Questionnaire. All patients also underwent skin prick testing, measurement of total IgE level, and nasal cytologic analysis. The data were compared with a control group of young adults. Results: Fifty-four patients older than 65 years (mean age, 69.3 years) and 89 young adults (mean age, 26.3 years) with allergic rhinitis were studied. The elderly patients had a less positive family history of atopy (Pϭ.02) and had rhinitis plus conjunctivitis more frequently (Pϭ.002) than young adults, whereas the difference between groups in total IgE level was not statistically significant. On nasal cytologic analysis, the differential count of inflammatory cells did not differ between groups, but in the elderly patients the epithelial-goblet cell ratio was decreased. The quality of life in elderly people was more impaired than in young adults (Pϭ.01). Conclusion: In elderly people with allergic rhinitis, the clinical characteristics are different and quality of life is more heavily impaired compared with young adults.
Gazzetta medica italiana. Archivio per le scienze mediche, May 1, 2023
Annals of Allergy Asthma & Immunology, Nov 1, 2022
Monaldi archives for chest disease, Mar 5, 2021
An elegant study reported dysmorphic cells and syncytia in the deceased's lungs for COVID-19 [1].... more An elegant study reported dysmorphic cells and syncytia in the deceased's lungs for COVID-19 [1]. The authors reasonably considered that most of these syncytia-forming cells were pneumocytes, as identified by specific biomarkers. However, cellular dysmorphism and syncytia are pathological features common in other respiratory infections caused by different viruses, including the human respiratory syncytial virus (HRSV) and Epstein-Barr virus (EBV), as correctly documented [2,3]. On the other hand, a respiratory infection due to viruses, including rhinovirus, adenovirus, myxovirus, and coronavirus, usually results in ciliocytophthoria of nasal ciliated cells [4]. The term ciliocytophthoria identifies characteristic cytological alterations, including rarefaction/disappearance of ciliary apparatus, a confluence of cytoplasmatic vacuoles, "decapitation" of the apical portion of the ciliated cell. In this regard, a recent report demonstrated that nasal and bronchial epithelial cells, recovered from a patient with severe COVID-19, displayed only partial rarefaction of the cilia, the presence of some binucleated cells, and the reduction/disappearance of the hyperchromatic stria [5]. These mild cytopathic alterations were consistent with the nose and bronchi's mild involvement in asymptomatic or paucisymptomatic COVID-19 patients (Figure 1). The possible explanation of this gianic behavior does not depend on ACE-2 receptor expression, well represented along the whole respiratory tract. Instead, the composition of the epithelial lining seems to have a pathogenic role. Namely, the epithelium's height and complexity gradually decrease along the respiratory tract, from the tall pseudostratified ciliated columnar cells inter
Rhinosinusitis (RS) affects the nose and the paranasal sinus and is characterized by nasal and sy... more Rhinosinusitis (RS) affects the nose and the paranasal sinus and is characterized by nasal and systemic symptoms. It may be classified as acute or chronic, based on duration. Rhinosinusitis may be clinically suspected, but the diagnosis is usually based on the endoscopy. Antibiotic therapy is frequently used for RS patients in clinical practice. However, antibiotics often induce intestinal dysbiosis associated with some clinical problems and respiratory microbiota impairment. The current clinical experience was conducted in patients with pharyngotonsillitis and treated with antibiotics. A one-month course of a probiotic mixture (Abincol® containing Lactobacillus plantarum LP01 (1 billion of living cells), Lactobacillus lactis subspecies cremoris LLC02 (800 million living cells), and Lactobacillus delbrueckii LDD01 (200 million living cells), was prescribed in the Group A, and was compared with no addon treatment, such as the Group B. Patients were evaluated at baseline (T0), at the end of antibiotic treatment (T1), at the end of probiotic course (T2), and at the end of 3-month follow-up (T3).
2020 5th International Conference on Smart and Sustainable Technologies (SpliTech), Sep 23, 2020
Nasal cytology studies microscopic analysis of the cells contained in the nasal mucosa and repres... more Nasal cytology studies microscopic analysis of the cells contained in the nasal mucosa and represents a useful diagnostic methodology able to recognize and differentiate some nasal pathologies. The standard clinical protocol provides for the observation of at least fifty microscopic fields and cell counting to obtain cell population distribution. In this paper we show as well-known image processing algorithms can be implemented on a common smartphone to support cell counting, taking a photo of the observation fields directly from the microscope. The system designed, called RhinoSmart, processes the images acquired on the smartphone itself and extracts the cellular elements. These cropped images can be observed and counted directly by the specialists or, better can be sent to a server system that classifies cells and send back the report in a short time.
PubMed, Mar 19, 2020
To the Editor, we would like to thank Rafael Martínez-Girón, Hugo Cornelis van Woerden, and Crist... more To the Editor, we would like to thank Rafael Martínez-Girón, Hugo Cornelis van Woerden, and Cristina MartínezTorre, who confirmed post-viral, namely during rhinovirus infection, cytomorphological alterations loaded to nasal epithelial cells (1). The outcomes of that study were consistent with our research that described structural modification during viral infection (2,3). In this regard, the first evidence concerned vacuolar degeneration at the cytoplasmic level and further nuclear impairment, manly nuclear alterations, such as intranuclear halo (4). In particular, it has to note that the “halo” is inside the cellular membrane as confirmed by electronic microscopy (3). Analyzing the subjects investigated by the authors, it seems that some relevant details were lacking, mainly concerning the type of perennial rhinitis. In fact, as reported, all subjects were treated with oral H1 antagonists and intranasal corticosteroids. Both medications are commonly prescribed for allergic rhinitis. Besides, 2 patients had nasal polyps and one asthma. There is a reasonable suspicion that they suffered from allergic rhinitis. In conflict with this hypothesis, eosinophils were, however, very scarce. Remarkably, perennial rhinitis was not classified in their study. Consistently, we would underline the clinical relevance of nasal cytology in the workup of nasal disorders (5). Nasal cytology is a simple, easy, and repeatable technique that is very fruitful in clinical practice. Nasal cytology carefully defines the phenotype and endotype of rhinitis, so it is a classic example of Precision Medicine (6) and it is a point-ofcare test (7). Moreover, it has been recently standardized, thus the methodology has been rigorously validated (8). In the context of the topic, a close link exists between allergic rhinitis and rhinovirus. It was demonstrated that allergic patients have a mucosal inflammation that involves adhesion molecule machinery, mainly intercellular adhesion molecule 1 (ICAM-1), and is associated with functional impairment, such as nasal airflow limitation (9-11). Interestingly, ICAM-1 is also the main receptor for rhinovirus: this curious coincidence explains the increased susceptibility to infections in allergic patients (12). These concepts underline the importance of a precise and documented diagnosis of rhinitis that is the requisite for a tailored treatment: the so-called Personalized Medicine (13). In conclusion, nasal cytology could be envisaged as a mandatory test to identify the phenotype, and endotype to optimize the management of patients with perennial rhinitis.
European Archives of Oto-rhino-laryngology, Nov 14, 2022
The aim of this study was to report the use of extra-short and short implants in combination with... more The aim of this study was to report the use of extra-short and short implants in combination with Guided Bone Regeneration (GBR) to rehabilitate a case of severe mandibular reabsorption. A 55-yearold female patient asked for a fixed implant supported rehabilitation in 4.5 - 4.6 zone which showed severe atrophy. It was decided to use an extra-short 4 mm length and 4.1 mm Ø, Roxolid and SLActive implant (Straumann Standard Plus Regular Neck, Institut Straumann AG) in 4.5 position and a short 6 mm length and 4.8 mm Ø, Roxolid and SLActive implant (Straumann Standard Plus Wide Neck, Institut Straumann AG) in 4.6 position. The implants supported cemented fixed prosthesis. Examinations were performed at the day of the surgery and up to 7-years in function to evaluate implant stability and periapical radiography. One extra-short implant and one short implant were placed. After 7 years in function no biological or prosthetic complication were recorded. Within the limitation of this case report, the use of short and extra-short implants to support fixed prosthesis seem to be a feasible treatment alternative in severe mandibular atrophy.
PubMed, Mar 21, 2019
Inflammation is a common pathogenic mechanism involved in many otorhinolaryngological (ORL) disor... more Inflammation is a common pathogenic mechanism involved in many otorhinolaryngological (ORL) disorders. Broser® is an oral nutraceutical currently containing bromelain 100 mg, escin 30 mg, and selenium 42.5 mcg. It could exert a safe and effective anti-inflammatory activity by virtue of these components. Therefore, the aim of the current survey, conducted in clinical practice of 84 Italian ORL centers, was to evaluate its safety and efficacy in the treatment of patients.
PubMed, Oct 1, 2017
Objective: The aim of this study was to evaluate the reparative role of hyaluronic acid in acute ... more Objective: The aim of this study was to evaluate the reparative role of hyaluronic acid in acute rhinosinusitis (ARS). Patients and methods: 48 patients affected by ARS were submitted to nasal endoscopy, nasal cytology, mucociliary transport evaluation (MCTt) and visual analogue scale questionnaire (VAS) at T0, after 14-18 days (T1) and after 30-35 days (T2). The patients were randomized into two groups, A and B, and received Levofloxacin and Prednisone. Moreover, using a nebulizer ampoule for nasal douche, Group A received high molecular weight Sodium Hyaluronate (3%) plus saline solution (NaCl 0.9%) twice a day for 30 days; Group B received saline solution twice a day for 30 days. Results: At T0 only the VAS score showed differences regarding nasal discharge and post-nasal drip. At T1, in Group A MCTt and the number of bacteria were significantly lower than in Group B. The VAS score showed improvement in Group A. At T2 in Group A, MCTt and number of neutrophils were significantly lower than in Group B. The VAS score showed statistically significant differences between the two groups regarding nasal discharge. Conclusions: In ARS patients sodium hyaluronate plus saline solution significantly improved symptoms, MCT time and reduced neutrophil count on nasal cytology.