Publications by authors named "Pascale R"
Introduction: Infections significantly impact morbidity and mortality in lung transplant (LuTx) recipients. This survey focused on documenting current practices regarding the prevention and management of infections in LuTx in Italy.
Methods: A 52-question survey was administered online in the period from December 1, 2023, to January 31, 2024, assessing center characteristics, Tx team organization, microbiological investigations, infection prevention, and management.
Cardiac implantable electronic devices infections (CIEDI) are associated with poor survival despite the improvement in transvenous lead extraction (TLE). Aetiology and systemic involvement are driving factors of clinical outcomes. The aim of this study was to explore their contribute on overall mortality.
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- Intrahepatic cholangiocarcinoma (iCCA) is a highly aggressive liver cancer with poor treatment options, prompting research into new therapies targeting the Heat Shock Factor 1 (HSF1) transcription factor.
- Studies showed that HSF1 levels are significantly elevated in various stages of iCCA and correlate with worse patient outcomes, while inhibiting HSF1 delayed tumor development in mouse models.
- The HSF1 inhibitor KRIBB-11 was effective in slowing iCCA cell growth, inducing cell death, and reducing key metabolic functions in cancer cells, highlighting its potential as a therapeutic avenue.
Article Synopsis
- The study investigates the impact of adequate empirical combination therapy (AECT) on 30-day mortality rates in septic shock patients infected with Pseudomonas aeruginosa.
- Of 98 patients analyzed, those receiving AECT had a significantly lower mortality rate (25%) compared to those on adequate empirical monotherapy (AEMT) (56.8%), indicating AECT may enhance survival.
- The findings suggest transitioning to a single effective antibiotic after confirming susceptibility is safe, highlighting the need for further research to validate these results.
Article Synopsis
- A study on perioperative antibiotic prophylaxis (PAP) in lung transplant recipients over a 20-year period revealed significant variation in practices among different centers.
- The research enrolled 111 lung transplant recipients, finding that most received combination therapy, while the median duration for PAP was 10 days.
- However, the study concluded that there was no significant difference in preventing early post-operative infections (EPOIs) between combination and single-agent therapies, and duration of PAP also did not impact EPOI rates.
Background: The benefits of mitral repair versus replacement for endocarditis are inconclusive. This study compares outcomes of patients with infective endocarditis undergoing mitral valve repair versus replacement and investigates the impact of microbial etiology.
Methods: All 251 patients undergoing mitral valve surgery for active endocarditis between 2010 and 2023 were enrolled, 180 (71.
Aberrant upregulation of fatty acid synthase (FASN), catalyzing de novo synthesis of fatty acids, occurs in various tumor types, including human hepatocellular carcinoma (HCC). Although FASN oncogenic activity seems to reside in its pro-lipogenic function, cumulating evidence suggests that FASN's tumor-supporting role might also be metabolic-independent. : In the present study, we show that FASN inactivation by specific small interfering RNA (siRNA) promoted the downregulation of the S-phase kinase associated-protein kinase 2 (SKP2) and the consequent induction of p27 in HCC cell lines.
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- Meropenem-vaborbactam is a new treatment option for infections caused by KPC-producing Klebsiella pneumoniae, particularly those resistant to ceftazidime-avibactam.
- A study of 342 patients across 19 hospitals in Italy evaluated the outcomes of those treated with meropenem-vaborbactam, finding a 30-day mortality rate of 31.6%.
- The research identified risk factors for higher mortality, including septic shock, significant comorbidities, and delayed treatment, while the administration of the drug within 48 hours of infection onset was linked to better outcomes.
Background & Aims: The aim of this study was to investigate gut microbiome (GM) dynamics in relation to carbapenem-resistant Enterobacterales (CRE) colonization, CRE infection, and non-CRE infection development within 2 months after liver transplant (LT).
Methods: A single-center, prospective study was performed in patients undergoing LT from November 2018 to January 2020. The GM was profiled through 16S rRNA amplicon sequencing of a rectal swab taken on the day of transplantation, and fecal samples were collected weekly until 1 month after LT.
(1) Objectives: To assess the impact of optimal joint pharmacokinetic/pharmacodynamic (PK/PD) target attainment of continuous infusion (CI) piperacillin-tazobactam monotherapy on the microbiological outcome of documented ESBL-producing secondary bloodstream infections (BSIs). (2) Methods: Patients hospitalized in the period January 2022-October 2023, having a documented secondary BSI caused by ESBL-producing , and being eligible for definitive targeted CI piperacillin-tazobactam monotherapy according to specific pre-defined inclusion criteria (i.e.
View Article and Find Full Text PDFCeftobiprole is a fifth-generation cephalosporin used for different Gram-positive bacterial infections. A population pharmacokinetic analysis was conducted in real-life clinical patients to assess the adequacy of current dosages. Population pharmacokinetics was conducted using non-linear mixed effect modeling.
View Article and Find Full Text PDFSternal wound complications following cardiac surgery, including sternal dehiscence, mediastinitis, and osteomyelitis, pose significant challenges in terms of management and patient outcomes. We present a case report highlighting the complex management of a patient who underwent open heart surgery for severe aortic valve stenosis, followed by sternal wound dehiscence and sternum osteomyelitis due to extended spectrum beta lactamase (ESBL) producing . A multiple myeloma diagnosis was also suspected at the positron emission tomography (PET) scan and confirmed with bone marrow biopsy.
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- The study examined the effectiveness of three antiviral treatments for early COVID-19 (nirmatrelvir/ritonavir, molnupiravir, and remdesivir) among a large group of outpatient patients.
- 1,342 patients were analyzed, with high clinical recovery rates (96.9%) and a low hospitalization rate (2.6%), showing no significant differences in outcomes between the antiviral treatments.
- Vaccination status was important, as vaccinated patients had a lower risk of hospitalization or death compared to unvaccinated individuals.
Patients with heart transplantation (HT) have an increased risk of COVID-19 disease and the efficacy of vaccines on antibody induction is lower, even after three or four doses. The aim of our study was to assess the efficacy of four doses on infections and their interplay with immunosuppression. We included in this retrospective study all adult HT patients (12/21-11/22) without prior infection receiving a third or fourth dose of mRNA vaccine.
View Article and Find Full Text PDFBackground: The clinical usefulness of follow-up blood cultures (FUBCs) in gram-negative bloodstream infections (GN-BSIs) represents a debated issue.
Objective: To assess the impact on the clinical outcome of FUBCs in patients with GN-BSI and to predict risk factors for persistent bacteraemia.
Data Sources: PubMed-MEDLINE, Scopus, and the Cochrane Library Database were independently searched until 24 June, 2022.
Objective: There is evidence of a bidirectional association between COVID-19 disease and psychiatric disorders. We aimed to assess whether exposure to psychotropic medications prior to hospitalization was associated with mortality or discharge within 30 days after hospital admission.
Methods: In this prospective study, we included all individuals with a laboratory-confirmed COVID-19 infection who were admitted to the Bologna University Hospital between 1st March 2020 and 31st January 2021.
Article Synopsis
- Infections of cardiovascular implantable electronic devices (CIED) are primarily caused by Gram-positive bacteria, but this study focuses on the less common Gram-negative bacteria (GNB) infections, aiming to understand their risk factors, clinical features, and outcomes.
- The study analyzed data from 236 patients across 17 European centers, comparing 59 patients with GNB-CIED infections to controls with Gram-positive infections and those without infections, finding no major differences in clinical presentation but notable trends in diagnostic imaging.
- Key risk factors for GNB infections included obesity, a high comorbidity index, specific pacemaker settings, and the right subclavian vein site for device implantation; these infections were also linked to higher mortality rates, suggesting
Liver preneoplastic and neoplastic lesions of the genetically susceptible F344 and resistant BN rats cluster, respectively, with human HCC with better (HCCB) and poorer prognosis (HCCP); therefore, they represent a valid model to study the molecular alterations determining the genetic predisposition to HCC and the response to therapy. The ubiquitin-mediated proteolysis of ERK-inhibitor DUSP1, which characterizes HCC progression, favors the unrestrained ERK activity. DUSP1 represents a valuable prognostic marker, and ERK, CKS1, or SKP2 are potential therapeutic targets for human HCC.
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- SOT recipients vaccinated against SARS-CoV-2 generally show a poorer antibody response compared to non-SOT patients, and the effect of this on breakthrough infections is being studied.
- A study tracked 614 SOT recipients over a year, finding that 75.4% developed sufficient antibody responses, but 18.4% experienced breakthrough infections, with heart transplant patients exhibiting the poorest outcomes.
- Higher risks of breakthrough infections were linked to lower antibody response levels, younger ages, and shorter times since transplantation, particularly among heart transplant recipients.
A descriptive pharmacokinetic/pharmacodynamic analysis of continuous infusion ceftazidime-avibactam in a case series of critically ill renal patients treated for documented carbapenem-resistant Gram-negative bloodstream infections and/or ventilator-associated pneumonia.
Int J Antimicrob Agents
January 2023
Objectives: To describe the pharmacokinetic/pharmacodynamic (PK/PD) behaviour of continuous infusion (CI) ceftazidime-avibactam and the microbiological outcome in a case series of critically ill renal patients treated for documented carbapenem-resistant Gram-negative (CR-GN) bloodstream infections (BSI) and/or ventilator-associated pneumonia (VAP).
Methods: Critically ill patients with different degrees of renal function who were treated with CI ceftazidime-avibactam for documented CR-GN infections, and who underwent therapeutic drug monitoring from April 2021 to March 2022, were retrospectively assessed. Ceftazidime and avibactam concentrations were determined at steady-state, and the free fraction (fC) was calculated.
L-Dopa (LD), a substance used medically in the treatment of Parkinson's disease, is found in several natural products, such as L., also known as broad beans. Due to its low chemical stability, LD analysis in plant matrices requires an appropriate optimization of the chosen analytical method to obtain reliable results.
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