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Comparison of 2D and 4D Flow MRI Measurements for Hemodynamic Evaluation of the Fontan Palliation

Congenital Heart Disease 2023年第6期18卷 627-638页

作者： Elisa Listo nicola martini Stefano Salvadori Elisa Valenti nicola Stagnaro Gianluca Trocchio Chiara Marrone Alberto Clemente Francesca Raimondi Pierluigi Festa Lamia Ait Ali Department of Radiology IRCCS Istituto Giannina GasliniGenovaItaly U.O.C.Bioingegneria Gabriele Monasterio CNR-Tuscany FoundationPisaItaly Institute of Clinical Physiology CNR PisaItaly Cardiology Unit IRCCS Istituto Giannina GasliniGenovaItaly Pediatric Cardiology and GUCH Unit Massa Gabriele Monasterio CNR-Tuscany FoundationMassaItaly Gabriele Monasterio CNR-Tuscany Foundation PisaItaly Department of Cardiology Azienda Ospedaliero-Universitaria MeyerFlorenceItaly Institute of Clinical Physiology CNR MassaItaly

Background:The assessment of Fontan circuit’sﬂow is traditionally evaluated by multiple through-plane phase-contrast MRI acquisitions(2Dﬂow),while recently,a single volumetric 4D-ﬂow MRI acquisition is emerging as a comprehensive tool for the hemodynamic evaluation in congenital heart ***:To compare 2D and 4D-ﬂow MRI measurements in patients after Fontan palliation and to evaluate parameters affecting potential ***:39 patients after Fontan palliation(23 males,age 22±11 years)who underwent cardiac MRI with 2D and 4D-ﬂow MRI acquisition were included in the *** all patients,bloodﬂow quantiﬁcation in the Fontan circuit and aorta by 2Dﬂow and by 4Dﬂow MRI acquisition blinding to the 2D results was *** agreement between 2D and 4D-ﬂow MRI was calculated as the intraclass correlation coefﬁcient(ICC).The mean absolute differences between 4D and 2Dﬂows were analyzed using linear regression ***:4D-ﬂow MRI acquisition time was slightly lower than 2D(7.6±1.8 min vs.9.4±3.3 min,p=0.03).Flow was slightly predominant in the right pulmonary artery(58%of total pulmonaryﬂow).Conduit/tunnel-pul-monary arteriesﬂow accounted for 60%of the Fontan *** between 2D and 4D was overall good-to-excellent from ICC:0.81795%CI:0.637–0.907 to 0.93295%CI:0.866–*** was no signiﬁcant inﬂu-ence of evaluated parameters on the agreement on 4D and 2Dﬂ***:4D-ﬂow MRI represents a valid tool in Fontan’sﬂow quantiﬁ*** larger studies are needed to conﬁrm our results and to evaluate the impact of advanced 4D-ﬂow MRI parameters on the prognostic stratiﬁcation in patients after Fontan palliation.

关键词： Fontan palliation fontanﬂows 4Dﬂow MRI 2Dﬂow MRI cardiac magnetic resonance

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Reactivation of hepatitis B virus infection in patients with hemolymphoproliferative diseases, and its prevention

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World Journal of Gastroenterology 2019年第26期25卷 3299-3312页

作者： Caterina Sagnelli Mariantonietta Pisaturo Federica Calò Salvatore martini Evangelista Sagnelli nicola Coppola Department of Mental Health and Public Medicine Section of Infectious Diseases University of Campania Luigi Vanvitelli

Reactivation of hepatitis B virus(HBV)replication is characterized by increased HBV-DNA serum values of about 1 log or by HBV DNA turning positive if previously undetectable in serum,possibly associated with liver damage and seldom *** to HBV reactivation,hepatitis B surface antigen(HBsAg)-negative/anti-HBc-positive subjects may revert to *** patients with hemo-lymphoproliferative disease,the frequency of HBV reactivation depends on the type of lymphoproliferative disorder,the individual's HBV serological status and the potency and duration of *** particular,it occurs in 10%-50%of the HBsAg-positive and in 2%-25%of the HBsAg-negative/anti-HBc-positive,the highest incidences being registered in patients receiving rituximab-based *** reactivation can be prevented by accurate screening of patients at risk and by a pharmacological prophylaxis with anti-HBV nucleo(t)sides starting 2-3 wk before the beginning of immunosuppressive treatment and covering the entire period of administration of immunosuppressive drugs and a long subsequent period,the duration of which depends substantially on the degree of immunodepression *** with significant HBV replication before immunosuppressive therapy should receive anti-HBV nucleo(t)sides as a long-term(may be life-long)*** review article is mainly directed to doctors engaged every day in the treatment of patients with onco-lymphoproliferative diseases,so that they can broaden their knowledge on HBV infection and on its reactivation induced by the drugs with high immunosuppressive potential that they use in the care of their patients.

关键词： Hepatitis B virus reactivation Hepatitis B virus infection Hemolymphoproliferative diseases Immunosuppressive therapy Hepatitis B virus therapy Hepatitis B virus prophylasis

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Clinical impact of occult hepatitis B virus infection in immunosuppressed patients

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World Journal of Hepatology 2014年第6期6卷 384-393页

作者： Evangelista Sagnelli Mariantonietta Pisaturo Salvatore martini Pietro Filippini Caterina Sagnelli nicola Coppola Department of Mental Health and Public Medicine Section of Infectious DiseasesSecond University of Naples Department of Clinical and Experimental Medicine and Surgery "F.Magrassi e A.Lanzara" Second University of Naples

Occult hepatitis B infection(OBI), is characterized by low level hepatitis B virus(HBV) DNA in circulating blood and/or liver tissue. In clinical practice the presence of antibody to hepatitis B core antigen in hepatitis B surface antigen(HBsAg)-/anti-HBs-negative subjects is considered indicative of OBI. OBI is mostly observed in the window period of acute HBV infection in blood donors and in recipients of blood and blood products, in hepatitis C virus chronic carriers, in patients under pharmacological immunosuppression, and in those with immunodepression due to HIV infection or cancer. Reactivation of OBI mostly occurs in anti-HIV-positive subjects, in patients treated with immunosuppressive therapy in onco-hematological settings, in patients who undergo hematopoietic stem cell transplantation, in those treated with anti-CD20 or anti-CD52 monoclonal antibody, or anti-tumor necrosis factors antibody for rheumatological diseases, or chemotherapy for solid tumors. Under these conditions the mortality rate for hepatic failure or progression of the underlying disease due to discontinuation of specific treatment can reach 20%. For patients with OBI, prophylaxis with nucleot(s)ide analogues should be based on the HBV serological markers, the underlying diseases and the type of immunosuppressive treatment. Lamivudine prophylaxis is indicated in hemopoietic stem cell transplantation and in onco-hematological diseases when high dose corticosteroids and rituximab are used; monitoring may be indicated when rituximab-sparing schedules are used, but early treatment should be applied as soon as HBsAg becomes detectable. This review article presents an up-to-date evaluation of the current knowledge on OBI.

关键词： Occult hepatitis B virus infection Silent hepatitis B virus infection Hepatitis C virus infection Liver fibrosis

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Treatment of chronic hepatitis C in patients with HIV/HCV coinfection

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World Journal of Virology 2015年第1期4卷 1-12页

作者： nicola Coppola Salvatore martini Mariantonietta Pisaturo Caterina Sagnelli Pietro Filippini Evangelista Sagnelli Department of Mental Health and Public Medicine Section of Infectious DiseasesSecond University of Naples Division of Infectious Diseases AORN Sant’Anna e San Sebastiano di Caserta Department of Clinical and Experimental Medicine and Surgery "F.Magrassi e A.Lanzara" Second University of Naples

Hepatitis C virus(HCV) infection is one of the mostfrequent causes of comorbidity and mortality in the human immunodeficiency virus(HIV) population, and liver-related mortality is now the second highest cause of death in HIV-positive patients, so HCV infection should be countered with adequate antiviral therapy. In 2011 began the era of directly acting antivirals(DAAs) and the HCV NS3/4A protease inhibitors telaprevir and boceprevir were approved to treat HCV-genotype-1 infection, each one in combination with pegylated interferon alfa(Peg-IFN) + ribavirin(RBV). The addition of the first generation DAAs, strongly improved the efficacy of antiviral therapy in patients with HCVgenotype 1, both for the HCV-monoinfected and HIV/HCV coinfected, and the poor response to Peg-IFN + RBV in HCV/HIV coinfection was enhanced. These treatments showed higher rates of sustained virological response than Peg-IFN + RBV but reduced tolerability and adherence due to the high pill burden and the several pharmacokinetic interactions between HCV NS3/4A protease inhibitors and antiretroviral drugs. Then in 2013 a new wave of DAAs arrived, characterized by high efficacy, good tolerability, a low pill burden and shortened treatment duration. The second and third generation DAAs also comprised IFN-free regimens, which in small recent trials on HIV-positive patients have shown comforting preliminary results in terms of efficacy, tolerability and adherence.

关键词： Hepatitis C virus infection Human immunodeficiency virus infection Anti-hepatitis C virus treatment Directly acting antivirals HIV/HCV coinfection Chronic hepatitis C

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Role of occult hepatitis B virus infection in chronic hepatitis C

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World Journal of Gastroenterology 2015年第42期21卷 11931-11940页

作者： nicola Coppola Lorenzo Onorato Mariantonietta Pisaturo Margherita Macera Caterina Sagnelli Salvatore martini Evangelista Sagnelli Department of Mental Health and Public Medicine Section of Infectious Diseases Second University of Naples Division of Infectious Diseases AORN Sant’Anna e San Sebastiano di Caserta Department of Clinical and Experimental Medicine and Surgery "F. Magrassi e A. Lanzara" Second University of Naples

The development of sensitive assays to detect small amounts of hepatitis B virus(HBV) DNA has favored the identification of occult hepatitis B infection(OBI), a virological condition characterized by a low level of HBV replication with detectable levels of HBV DNA in liver tissue but an absence of detectable surface antigen of HBV(HBs Ag) in serum. The gold standard to diagnose OBI is the detection of HBV DNA in the hepatocytes by highly sensitive and specific techniques, a diagnostic procedure requiring liver tissue to be tested and the use of non-standardized non-commercially available techniques. Consequently, in everyday clinical practice, the detection of anti-hepatitis B core antibody(antiHBc) in serum of HBs Ag-negative subjects is used as a surrogate marker to identify patients with OBI. In patients with chronic hepatitis C(CHC), OBI has been identified in nearly one-third of these cases. Considerable data suggest that OBI favors the increase of liver damage and the development of hepatocellular carcinoma(HCC) in patients with CHC. The data from other studies, however, indicate no influence of OBI on the natural history of CHC, particularly regarding the risk of developing HCC.

关键词： Occult hepatitis B virus infection Silent hepatiti

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Coronary artery calcium score on low-dose computed tomography for lung cancer screening

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World Journal of Radiology 2014年第6期6卷 381-387页

作者： Teresa Arcadi Erica Maffei nicola Sverzellati Cesare Mantini Andrea I Guaricci Carlo Tedeschi Chiara martini Ludovico La Grutta Filippo Cademartiri Department of Radiology SDN Foundation IRCCS 80131 Naples Italy Cardio-vascular Imaging Unit Department of Radiology Giovanni XXIII Clinic Monas-tier di Treviso 31050 Treviso Italy Department of Radiology Erasmus Medical Center University Rotterdam 3015 CE Ro-tterdam The Netherlands Department of Radiology Azienda Ospeda-liero-Universitaria 43100 Parma Italy Department of Radiology Università di Chieti 66100 Chieti Italy Department of Cardiology Università di Foggia 71121 Foggia Italy Department of Cardiology San Gennaro Hospi-tal Naples 80136 Napoli Italy Department of Radiology University of Palermo Italy

AIM: To evaluate the feasibility of coronary artery calcium score(CACS) on low-dose non-gated chest CT(ngCCT).METHODS: Sixty consecutive individuals(30 males; 73 ± 7 years) scheduled for risk stratification by means of unenhanced ECG-triggered cardiac computed to-mography(gCCT) underwent additional unenhanced ngCCT. All CT scans were performed on a 64-slice CT scanner(Somatom Sensation 64 Cardiac, Siemens, Germany). CACS was calculated using conventional methods/scores(Volume, Mass, Agatston) as previ-ously described in literature. The CACS value obtained were compared. The Mayo Clinic classification was used to stratify cardiovascular risk based on Agatston CACS. Differences and correlations between the two methods were compared. A P-value 0 in the ngCCT. Of the 3 patients with 1-10 Agatston score on gCCT, 1(33%) showed an Agatston score of 0 in the ngCCT. Overall, 23(38%) patients were reclassified in a different car-diovascular risk category, mostly(18/23; 78%) shifting to a lower risk in the ngCCT. The estimated radiation dose was significantly higher for gCCT(DLP 115.8 ± 50.7 vs 83.8 ± 16.3; Effective dose 1.6 ± 0.7 mSv vs 1.2 ± 0.2 mSv; P < 0.01).CONCLUSION: CACS assessment is feasible on ngCCT; the variability of CACS values and the associated re-stratification of patients in cardiovascular risk groups should be taken into account.

关键词： Coronary artery calcium score Lung cancer screening High-resolution computed tomography unenhanced chest computed tomography Cardiovascular risk stratification

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Liver fibrosis in human immunodeficiency virus/hepatitis C virus coinfection: Diagnostic methods and clinical impact

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World Journal of Hepatology 2015年第24期7卷 2510-2521页

作者： Caterina Sagnelli Salvatore martini Mariantonietta Pisaturo Giuseppe Pasquale Margherita Macera Rosa Zampino nicola Coppola Evangelista Sagnelli Department of Clinical and Experimental Medicine and Surgery "F.Magrassi e A.Lanzara Second University of Naples Department of Mental Health and Public Medicine Section of Infectious DiseasesSecond University of Naples Division of Infectious Diseases AORN Sant’ Anna e San Sebastiano di Caserta Azienda Ospedaliera Universitaria Second University of Naples Department of Medical SurgicalNeurologicalMetabolic and Geriatric SciencesSecond University of Naples

Several non-invasive surrogate methods have recently challenged the main role of liver biopsy in assessing liver fibrosis in hepatitis C virus(HCV)-monoinfected and human immunodeficiency virus(HIV)/HCV-coinfected patients, applied to avoid the well-known side effects of liver puncture. Serological tests involve the determination of biochemical markers of synthesis or degradation of fibrosis, tests not readily available in clinical practice, or combinations of routine tests used in chronic hepatitis and HIV/HCV coinfection. Several radiologic techniques have also been proposed, some of which commonly used in clinical practice. The studies performed to compare the prognostic value of noninvasive surrogate methods with that of the degree of liver fibrosis assessed on liver tissue have not as yet provided conclusive results. Each surrogate technique has shown some limitations, including the risk of over- or under-estimating the extent of liver fibrosis. The current knowledge on liver fibrosis in HIV/HCVcoinfected patients will be summarized in this review article, which is addressed in particular to physicians involved in this setting in their clinical practice.

关键词： Human immunodeficiency virus/hepatitis C virus coi

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Comparison of survival outcomes between laparoscopic versus open radical nephroureterectomy in upper tract urothelial cancer patients:Experiences of a tertiary care single center

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Current Urology 2023年第4期17卷 292-298页

作者： Benedikt Hoeh Marina Kosiba Mike Wenzel nicola Meister Felix Preisser Shahrokh F.Shariat Jan Lukas Hohenhorst Andreas Becker Philipp Mandel Severine Banek Frederik Roos Pierre I.Karakiewicz Felix K.H.Chun Luis A.Kluth Department of Urology University Hospital FrankfurtGoethe University Frankfurt am MainFrankfurt am Main60590Germany Cancer Prognostics and Health Outcomes Unit Division of UrologyUniversity of Montreal Health CenterMontrealQuebecCanada Department of Urology Comprehensive Cancer CenterMedical University of ViennaViennaAustria Department of Urology Weill Cornell Medical CollegeNew YorkNYUSA Department of Urology University of Texas SouthwesternDallasTXUSA Department of Urology Second Faculty of MedicineCharles UniversityPragueCzech Republic Institute for Urology and Reproductive Health I.M.Sechenov First Moscow State Medical UniversityMoscowRussia Division of Urology Department of Special SurgeryJordan University HospitalThe University of JordanAmmanJordan martini-Klinik Prostate Cancer Center University Hospital Hamburg-EppendorfHamburgGermany

Objectives:To test for differences in overall and recurrence-free survival between laparoscopic and open surgical approaches in patients undergoing radical nephroureterectomy(RNU)for upper tract urothelial carcinoma(UTUC).Materials and methods:We retrospectively identified patients treated for UTUC from 2010 to 2020 from our institutional *** undergoing laparoscopic or open RNU with no suspicion of metastasis(cM0)were for the current study *** with suspected metastases at diagnosis(cM1)or those undergoing other surgical treatments were *** was performed according to the laparoscopic versus open surgical ***-Meier plots were used to test for differences in overall and recurrence-free survival with regard to the surgical ***,separate Kaplan-Meier plots were used to test the effect of preoperative ureterorenoscopy on overall and recurrence-free survival within the overall study ***:Of the 59 patients who underwent nephroureterectomy,29%(n=17)underwent laparoscopic nephroureterectomy,whereas 71%(n=42)underwent open *** and tumor characteristics were comparable between groups(p≥0.2).The median overall survival was 93 and 73 months in the laparoscopic nephroureterectomy group compared to the open nephroureterectomy group(p=0.5),*** median recurrence-free survival did not differ between open and laparoscopic nephroureterectomies(73 months for both groups;p=0.9).Furthermore,the median overall and recurrence-free survival rates did not differ between patients treated with and without preoperative ***:The results of this retrospective,single-center institution showed that overall and recurrence-free survival rates did not differ between patients with UTUC treated with laparoscopic and open ***,preoperative ureterorenoscopy before RNU was not associated with higher overall or recurrence-free survival rates.

关键词： Upper tract urothelial carcinoma Laparoscopic radical nephroureterectomy Open radical nephroureterectomy Overall survival

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