Fondazione IRCCS San Matteo Hospital

Pavia, Italy

Fondazione IRCCS San Matteo Hospital

Pavia, Italy
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Falcone C.,University of Pavia | Falcone C.,Fondazione IRCCS San Matteo Hospital | Falcone C.,IRCCS San Donato Hospital | Buzzi M.P.,University of Pavia | And 8 more authors.
International Journal of Immunopathology and Pharmacology | Year: 2010

Low levels of the regulatory peptide apelin have been reported in patients with lone atrial fibrillation (AF). We evaluate the potential utility of assessing apelin plasma levels as a predictor of AF recurrence in individuals presenting for electrical cardioversion. Plasma levels of apelin, brain natriuretic peptide (BNP) and high-sensitivity C-reactive protein were measured in 93 patients, with persistent AF before successful external electrical cardioversion. Significantly lower apelin plasma levels were found in patients with AF recurrence as respect to population with persistence of sinus rhythm during a six months follow-up. The hazard increased with duration of AF, left atrial dimension, BNP concentrations. Subjects with apelin levels below the median had a hazard ratio of 3.1 of arrhythmia recurrence with respect to those with high apelin levels (p<0.05). A significant difference in BNP levels was found between patients with and without AF recurrence during the follow-up. After adjusting for potential confounders, both BNP and apelin retained their statistical significance as independent predictors of arrhythmia recurrence. Patients with both low apelin and elevated BNP had a worse prognosis compared with those with either low apelin or elevated BNP alone. Low plasma apelin levels before external electrical cardioversion are an independent prognostic factor for arrhythmia recurrence in patients with AF treated with antiarrhythmic drugs. Apelin may be of particular value for the identification of high-risk patients in addition to BNP. Copyright © by BIOLIFE, s.a.s.


D'Ercole L.,Fondazione IRCCS San Matteo Hospital | Thyrion F.Z.,Fondazione IRCCS San Matteo Hospital | Bocchiola M.,Fondazione IRCCS San Matteo Hospital | Mantovani L.,Fondazione IRCCS San Matteo Hospital | Klersy C.,Scientific Direction Fondazione IRCCS San Matteo Hospital
Physica Medica | Year: 2012

The aim of this study was to propose local diagnostic reference levels (DRL) for exposure to radiation during diagnostic procedures and neuroradiological interventions such as cerebral angiography and embolisation of cerebral aneurysms (intra-cranial aneurysms and arteriovenous malformations). Hospitals should adopt the national DRLs for use locally or establish their own DRLs based on local practice, if sufficient local data are available. For this purpose we studied a sample of 113 cerebral angiography procedures and 82 embolisations of cerebral aneurysms. The data recorded included the kerma-area product (KAP), the fluoroscopy time and the number of frames for each procedure: third quartiles from the total dosimetric databank were calculated and proposed as provisional local DRL. Since the complexity of a procedure must be taken into account when evaluating the radiation dose, in the case of embolisation of aneurysms (intra-cranial), in this initial phase we assessed whether the complexity of the embolisation procedure is related to the size of the aneurysm and/or its site. We, therefore, re-calculated the DRL for only intra-cranial aneurysms, leaving aside the arteriovenous malformations. Considering that the DRL calculated for all the therapeutic procedures are similar to those calculated considering only intra-cranial aneurysms, at the moment we propose, besides the DRL for cerebral angiography, a single DRL for all interventional procedures, even when the clinical pictures are very different. Local preliminary DRLs were proposed as follows: 180 Gy cm2, 12 min and 317 frames for cerebral angiography and 487 Gy cm2, 46 min and 717 frames for interventional procedures (intra-cranial aneurysms and arteriovenous malformations). © 2010 Associazione Italiana di Fisica Medica.


Canducci F.,University of Insubria | Debiaggi M.,University of Pavia | Ceresola E.R.,Vita-Salute San Raffaele University | Sampaolo M.,Vita-Salute San Raffaele University | And 4 more authors.
Clinical and Developmental Immunology | Year: 2013

In 54 adult stem cell transplant recipients, the presence and persistence of human rhinoviruses (including the novel lineage C) were evaluated by molecular detection and phylogenetic analysis, independently from respiratory symptoms. In the same group of patients, the presence of other coinfecting respiratory pathogens, including the novel enterovirus 109, was also evaluated. © 2013 Filippo Canducci et al.


D'Ercole L.,Fondazione IRCCS San Matteo Hospital | Azzaretti A.,Fondazione IRCCS San Matteo Hospital | Thyrion F.Z.,Fondazione IRCCS San Matteo Hospital | Bocchiola M.,Fondazione IRCCS San Matteo Hospital | Di Maria F.,Fondazione IRCCS San Matteo Hospital
Spine | Year: 2010

STUDY DESIGN. We studied the radiation doses to which patients were exposed during 17 vertebroplasty operations. OBJECTIVE. The radiation doses during vertebroplasty were measured to determine maximum skin dose (MSD), a measure of the likelihood of radiation-induced skin effects. SUMMARY OF BACKGROUND DATA. Vertebroplasty is performed with use of fluoroscopic guidance for needle placement and to monitor bone cement injection. This procedure requires relatively long duration of fluoroscopic guidance, and so, it demands dose measurements for patients. METHODS. From May 2006 to April 2008, 16 patients (7 men and 9 women; mean age 70.19 years, range 30-87 years) underwent a total of 17 vertebroplasty procedures. Total dose-area product (DAP), duration of fluoroscopy, and the parameters for anteroposterior (AP) and lateral (LAT) fluoroscopic and fluorography projections were recorded for each procedure. Gafchromic films were placed on the patients' skin to measure entrance surface dose and to evaluate the MSD. RESULTS. The MSD and DAP were higher in the LAT plane than in the AP plane. These results were expected because the fluoroscopy time was longer, and the number of fluorography runs was higher in the LAT plane than in the AP plane.The MSD values for the AP plane ranged between 0.184 Gy and 1.834 Gy, whereas those for the LAT plane ranged between 0.417 Gy and 2.362 Gy. The frequency distribution of values for both planes showed that most MSD values were in the range of 0 to 0.5 Gy and 0.5 to 1 Gy for the AP plane and 0.5 to 1 Gy and 1 to 1.5 Gy for the LAT plane. There was great variability in the MSD at each value for the parameters among individual instances. CONCLUSION. When evaluating the MSD to a patient, a distinction should be made between AP and LAT projections, because an overall mean MSD value underestimates the contribution of x-ray absorption on the LAT plane. The use of radiochromic films to estimate radiation damage to the skin has been shown to have the limitation of relying on DAP values only. © 2010, Lippincott Williams & Wilkins.


Fuardo M.,University of Pavia | Fuardo M.,Fondazione IRCCS San Matteo Hospital | Lemoine S.,University of Caen Lower Normandy | Lo Coco C.,Fondazione IRCCS San Matteo Hospital | And 2 more authors.
Experimental Biology and Medicine | Year: 2013

The aim of the study was to examine the cardioprotective effect of morphine and Delta 2 opioid D-Ala2-Leu5 enkephalin (DADLE) administered, at early reoxygenation, in isolated human myocardium exposed to hypoxia-reoxygenation. Then, we tested the involvement of mitochondrial permeability transition pore in morphine and DADLE-induced postconditioning. Human right atrial trabeculae were obtained during cardiac surgery (coronary artery bypass and aortic valve replacement). Isometrically contracting isolated human right atrial trabeculae were exposed to 30-min hypoxia and 60-min reoxygenation (control group). In treatment groups, morphine 0.5 mmol, DADLE 10 nmol, DADLE 50 nmol and DADLE 100 nmol were administered during the first 15 min of reoxygenation. In two additional groups, morphine and DADLE 100 nmol were administered in the presence of atractyloside 50 μmol, the mitochondrial permeability transition pore opener. The force of contraction at the end of 60-min reoxygenation period (FoC60 expressed as % of baseline) was compared (mean ± standard deviation) between the groups by an analysis of variance. Morphine (FoC60: 81 ± 9% of baseline), DADLE 50 nmol (FoC60: 76 ± 11% of baseline) and DADLE 100 nmol (FoC60: 81 ± 4% of baseline) increased significantly (P < 0.001) the FoC60 as compared with the control group (FoC60: 53 ± 3% of baseline). DADLE 10 nmol did not modify the FoC60 (50 ± 9% of baseline; P = 0.60 versus control group). The enhanced recovery of FoC60 induced by morphine and DADLE 100 nmol were abolished in the presence of atractyloside (FoC60: respectively 57 ± 6% and 44 ± 7% of baseline; P < 0.001). In conclusion, the administration of morphine and DADLE, in early reoxygenation period, protected human myocardium, in vitro, against hypoxia-reoxygenation injury, at least in part, by the inhibition of mitochondrial permeability transition pore opening. © 2013 by the Society for Experimental Biology and Medicine.


Libetta C.,Fondazione Irccs San Matteo Hospital | Libetta C.,University of Pavia | Sepe V.,Fondazione Irccs San Matteo Hospital | Canton A.D.,Fondazione Irccs San Matteo Hospital | Canton A.D.,University of Pavia
International Reviews of Immunology | Year: 2010

Long-term hemodialysis treatment results in chronic monocyte activation with cytokine release. It generates Treg induction with potential immune dysfunction and associated clinical complications. Recent immunological data and preliminary clinical evidence suggest that synthetic polymers and vitamin E coated membranes are associated with a significant improvement in hemodialysis tolerance when compared to cellulose membranes. The aim of this review is to update cytokine release, T-cell polarization, and its clinical impact in patients under extracorporeal hemodialysis comparing traditional cellulose to synthetic/vitamin E coated membranes. © 2010 Informa Healthcare USA, Inc.


Giordano C.,AUSL di Piacenza | D'Ercole L.,Fondazione IRCCS San Matteo Hospital | Gobbi R.,AUSL di Piacenza | Bocchiola M.,Fondazione IRCCS San Matteo Hospital | Passerini F.,AUSL di Piacenza
Physica Medica | Year: 2010

The aim of this study was to evaluate the maximum skin dose (MSD) in patients undergoing interventional cardiology procedures, obtaining local reference levels and comparing these with the reference levels proposed in the literature.The patients' MSD was measured using Gafchromic XR type R films. In order to evaluate reference levels, the number of images acquired, the fluoroscopy times and the KAP TOTAL were recorded for each procedure.For the evaluation of the MSD, 8 coronary angiography (CA) and 16 percutaneous transluminal coronary angioplasty (PTCA) procedures, carried out in the period from May to June 2008, were analyzed.For the CA procedures the MSD values were below 0.5 Gy.For the PTCA procedures, we found a fairly good correlation between fluoroscopy time and MSD (r = 0.80, p = 0.0002) and between MSD and WFP (r = 0.863, p < 0.0001); there was a strong correlation between KAP TOTAL and MSD (r = 0.904, p < 0.0001). Since the correlation between KAP TOTAL and MSD is more striking than that with fluoroscopic time and the WFP, KAP measurements are suitable for online skin dosimetry and may, therefore, be used to avoid radiation-induced skin injuries. A MSD greater than 3 Gy occurred in only one procedure.For calculus of the local reference levels, we extended the data-gathering to 30 procedure CA and to 40 PTCA: we compared local practice with that in other centers using the guidance levels proposed by Balter et al. Our median KAP values were below these proposed guidance levels; our mean KAP values were above these proposed action levels. From a first application of the proposed reference levels, it appears that, according to the recommendations of Balter et al. an investigation into local practice is not necessary. © 2010 Associazione Italiana di Fisica Medica.


PubMed | Fondazione IRCCS San Matteo Hospital
Type: Journal Article | Journal: Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) | Year: 2011

The aim of this study was to propose local diagnostic reference levels (DRL) for exposure to radiation during diagnostic procedures and neuroradiological interventions such as cerebral angiography and embolisation of cerebral aneurysms (intra-cranial aneurysms and arteriovenous malformations). Hospitals should adopt the national DRLs for use locally or establish their own DRLs based on local practice, if sufficient local data are available. For this purpose we studied a sample of 113 cerebral angiography procedures and 82 embolisations of cerebral aneurysms. The data recorded included the kerma-area product (KAP), the fluoroscopy time and the number of frames for each procedure: third quartiles from the total dosimetric databank were calculated and proposed as provisional local DRL. Since the complexity of a procedure must be taken into account when evaluating the radiation dose, in the case of embolisation of aneurysms (intra-cranial), in this initial phase we assessed whether the complexity of the embolisation procedure is related to the size of the aneurysm and/or its site. We, therefore, re-calculated the DRL for only intra-cranial aneurysms, leaving aside the arteriovenous malformations. Considering that the DRL calculated for all the therapeutic procedures are similar to those calculated considering only intra-cranial aneurysms, at the moment we propose, besides the DRL for cerebral angiography, a single DRL for all interventional procedures, even when the clinical pictures are very different. Local preliminary DRLs were proposed as follows: 180 Gy cm(2), 12 min and 317 frames for cerebral angiography and 487 Gy cm(2), 46 min and 717 frames for interventional procedures (intra-cranial aneurysms and arteriovenous malformations).

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