Publications by authors named "Squeri A"

Article Synopsis
  • Tethering is a common issue in mitral valve problems, often seen in patients with serious regurgitation, but its true effects on treatment outcomes are not well understood.
  • A study involving over 2,200 patients found that while those with tethering had higher initial rates of cardiac death and rehospitalization, after adjusting for other factors, tethering did not significantly impact long-term outcomes.
  • Consequently, the study suggests that having tethering should not prevent suitable patients from undergoing transcatheter edge-to-edge repair (TEER) for mitral valve issues.
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Aims: While factors associated with adverse events are well elucidated in setting of isolated left ventricular dysfunction, clinical and imaging-based prognosticators of adverse outcomes are lacking in context of biventricular dysfunction. The purpose of this study was to establish role of clinical variables in prognosis of biventricular heart failure (HF), as assessed by cardiac magnetic resonance imaging.

Methods: Study cohort consisted of 840 patients enrolled in DERIVATE registry with coexisting CMR-derived right ventricular (RV) and left ventricular (LV) dysfunction, as defined by RV and LV ejection fractions ≤45 % and ≤ 50 %, respectively.

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Takotsubo syndrome (TTS) is a clinical syndrome characterized by a transient left ventricular dysfunction whose diagnosis can be challenging due to its resemblance to acute myocardial infarction (AMI). Despite the growing recognition of TTS, acute complications and long-term mortality rates are comparable to those observed in AMI patients. In this context, a systematic diagnostic approach is imperative for an accurate patient assessment, with due consideration of the distinctive characteristics and optimal timing of each imaging modality.

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: We aimed to compare the procedural efficacy and long-term clinical results of a totally contrast-free Transcatheter Aortic Valve Implantation (TAVI) procedure (i.e., contrast dye was not used for either the pre-procedural assessment or during the procedure) to those of standard practice in patients with severe renal dysfunction.

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Article Synopsis
  • Transcatheter mitral edge-to-edge repair (TEER) is a minimally invasive option for treating severe mitral regurgitation in patients with high surgical risk, but there are concerns regarding the risk of cerebrovascular accidents (CVAs) after the procedure.
  • In a study of 2,238 patients, the incidence of CVAs was found to be low at 1.47%, with the majority occurring after hospital discharge and linked to preexisting conditions like atrial fibrillation and renal dysfunction.
  • While CVAs did not significantly increase the risk of long-term or cardiac death, the study suggests the need for proactive antithrombotic therapy for patients at higher risk before and after TEER.
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Purpose To use unsupervised machine learning to identify phenotypic clusters with increased risk of arrhythmic mitral valve prolapse (MVP). Materials and Methods This retrospective study included patients with MVP without hemodynamically significant mitral regurgitation or left ventricular (LV) dysfunction undergoing late gadolinium enhancement (LGE) cardiac MRI between October 2007 and June 2020 in 15 European tertiary centers. The study end point was a composite of sustained ventricular tachycardia, (aborted) sudden cardiac death, or unexplained syncope.

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Article Synopsis
  • Minimally invasive mitral valve repair using the MitraClip device shows beneficial outcomes in patients with significant mitral regurgitation, including those who have had prior valve repairs.
  • A study involving 2,238 patients highlighted that while device and procedural success rates are slightly lower for those with previous valve procedures, overall outcomes such as death and rehospitalization rates remain similar across groups.
  • The findings suggest that transcatheter edge-to-edge repair is a viable option for carefully selected patients even after previous mitral valve interventions.
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Human immunodeficiency virus (HIV) infection has historically been related to the development of specific cancers, some of which are so closely linked to the infection, such as Kaposi's Sarcoma (KS), that they have earned the name Acquired Immuno-Deficiency Syndrome (AIDS)-defining cancers (ADCs). While the development of antiretroviral therapy (ART) has decreased the incidence of AIDS-defining cancers, the resulting aging of people living with HIV (PLWH) highlighted an increased occurrence of other forms of cancer. At the "Gaetano Martino" hospital in Messina, we developed a multidisciplinary approach by creating a bridge between the Oncology Unit and the Infectious Diseases Unit to carry out screening and a more rapid diagnostic and therapeutic journey for cancers in PLWH.

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Article Synopsis
  • Transcatheter edge-to-edge repair (TEER) is an effective, minimally invasive method for treating significant mitral regurgitation and has seen advancements in device technology, specifically the NT, NTr, and XTr MitraClip devices.
  • A study analyzed data from a large patient registry to compare these devices, focusing on patient outcomes after the procedure, specifically looking at complications and hospital discharge.
  • Results showed that while the NT group faced worse outcomes initially, adjusted analyses indicated no significant differences in long-term results among the devices, suggesting that newer MitraClip devices provide better outcomes even when used on patients with more complex cases.
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Immune checkpoints inhibitors (ICIs) have markedly improved the therapeutic management of advanced NSCLC and, more recently, they have demonstrated efficacy also in the early-stage disease. Despite better survival outcomes with ICIs compared to standard chemotherapy, a large proportion of patients can derive limited clinical benefit from these agents. So far, few predictive biomarkers, including the programmed death-ligand 1 (PD-L1), have been introduced in clinical practice.

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The current surgical guidelines recommend an optimal margin width of 2 mm for the management of patients diagnosed with ductal carcinoma in situ (DCIS). However, there are still many controversies regarding re-excision when the optimal margin criteria are not met in the first resection. The purpose of this study is to understand the importance of surgical margin width, re-excision, and treatments to avoid additional surgery on locoregional recurrence (LRR).

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As the need for higher volumetric productivity in biomanufacturing grows, biopharmaceutical companies are increasingly investing in a perfusion cell culture process, most commonly one that uses a hollow fiber filter as the cell retention device. A current challenge with using hollow fiber filters is fouling of the membrane, which reduces product sieving and can increase transmembrane pressure (TMP) past process limitations. In this work, the impact of hollow fiber filter geometries on product sieving and hydraulic membrane resistance profiles is evaluated in a tangential flow filtration (TFF) perfusion system.

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Speckle tracking echocardiography (STE) is a reliable imaging technique of recognized clinical value in several settings. This method uses the motion of ultrasound backscatter speckles within echocardiographic images to derive myocardial velocities and deformation parameters, providing crucial insights on several cardiac pathological and physiological processes. Its feasibility, reproducibility, and accuracy have been widely demonstrated, being myocardial strain of the various chambers inserted in diagnostic algorithms and guidelines for various pathologies.

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Background And Objective: Brain metastases (BMs) are present in approximately 55% of patients with HER2-positive breast cancer (HER2+ BC). The introduction of anti-HER2 agents has radically changed the prognosis of these patients by prolonging overall survival.

Methods: In this review, we describe the biology of central nervous system (CNS) spreading in patients with HER2+ BC.

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In Italy, cervical cancer represents the fifth most prevalent cancer in women under 50 years of age and is one of the most commonly detected lesions globally. Given the developing burden of the disease and the availability of both primary and secondary prevention measures, their accurate surveillance is of paramount importance. The aim of this study was to evaluate the trends in cervical cancer screening adherence in the period between 2020 and 2022, as well as to evaluate positive tests, identifying the most frequently associated genotypes and the vaccination coverage.

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In recent years, we have seen the development and approval for clinical use of an increasing number of therapeutic agents against actionable oncogenic drivers in metastatic non-small cell lung cancer (NSCLC). Among them, selective inhibitors, including tyrosine kinase inhibitors (TKIs) and monoclonal antibodies targeting the mesenchymal-epithelial transition (MET) receptor, have been studied in patients with advanced NSCLC with deregulation, primarily due to exon 14 skipping mutations or amplification. Some MET TKIs, including capmatinib and tepotinib, have proven to be highly effective in this molecularly defined subgroup of patients and are already approved for clinical use.

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Background: Implantable cardioverter-defibrillator (ICD) therapy is the most effective prophylactic strategy against sudden cardiac death (SCD) in patients with ischemic cardiomyopathy (ICM) and left ventricle ejection fraction (LVEF) ≤35% as detected by transthoracic echocardiograpgy (TTE). This approach has been recently questioned because of the low rate of ICD interventions in patients who received implantation and the not-negligible percentage of patients who experienced SCD despite not fulfilling criteria for implantation.

Objectives: The DERIVATE-ICM registry (CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy; NCT03352648) is an international, multicenter, and multivendor study to assess the net reclassification improvement (NRI) for the indication of ICD implantation by the use of cardiac magnetic resonance (CMR) as compared to TTE in patients with ICM.

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Lung cancer is the leading cause of cancer deaths in the world. Surgery is the most potentially curative therapeutic option for patients with early-stage non-small cell lung cancer (NSCLC). The five-year survival for these patients remains poor and variable, depending on the stage of disease at diagnosis, and the risk of recurrence following tumor resection is high.

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Article Synopsis
  • Cancer patients have a higher risk of vaccine-preventable diseases due to weakened immune systems and cancer treatments, yet vaccination rates remain low.
  • The Italian Association of Medical Oncology (AIOM) has been promoting vaccination awareness since 2014 and provides recommendations for vaccines like flu, pneumococcal, and SARS-CoV-2 for patients with solid tumors.
  • AIOM emphasizes the importance of education, a multidisciplinary care approach, and ongoing research to enhance vaccination coverage and manage the health of cancer patients effectively.
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Background And Objective: Non-small cell lung cancer (NSCLC) with Kirsten rat sarcoma viral oncogene homolog () driver alterations harbors a poor prognosis with standard therapies, including chemotherapy and/or immunotherapy with anti-programmed cell death protein 1 (anti-PD-1) or anti-programmed death ligand-1 (anti-PD-L1) antibodies. Selective KRAS G12C inhibitors have been shown to provide significant clinical benefit in pretreated NSCLC patients with G12C mutation.

Methods: In this review, we describe KRAS and the biology of -mutant tumors and review data from preclinical studies and clinical trials on KRAS-targeted therapies in NSCLC patients with KRAS G12C mutation.

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Metastatic urothelial bladder cancer is associated with high mortality rates. The advent of immunocheckpoint inhibitors (ICIs), with the approval of pembrolizumab in second line treatment, has changed the treatment landscape and improved clinical outcomes of patients. Until recently, subsequent lines of therapy have been limited to single-agents chemotherapy, poor efficacy and relevant toxicities.

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To the best of our knowledge, this is the first report of simultaneous grasping of the 3 leaflets during TriClip (Abbott Cardiovascular) implantation. The final valve configuration with a triple orifice resembled the result of the clover surgical technique. This technique should be considered in selected cases of challenging grasping.

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On 11 June 2021, the Italian Ministry of Health authorized the heterologous vaccination schedule. The goals of our retrospective study were to (a) evaluate the undesirable effects after the administration of Vaxzevria and Comirnaty vaccines; (b) evaluate the antibody response after 28 days from the administration of the second dose; and (c) compare the antibody responses after the homologous and heterologous vaccination regimens. The undesirable effects were collected using a survey; IgG Spike was quantified using the electrochemiluminescence method; the comparison between the antibody responses was carried out using the sample of a homologous vaccine schedule previously analyzed.

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Objective: On March 11, 2020, the World Health Organization (WHO) has declared the novel coronavirus (COVID-19) outbreak as a global pandemic. COVID-19 pandemic has impacted health services, including immunization programs, with a consequent reduction in vaccination coverage in those categories for which the prevention of vaccine-preventable diseases is strongly recommended.

Subjects And Methods: We conducted a retrospective cross-sectional study on the general population and on PLWHs, comparing anti-human papillomavirus (HPV) vaccination coverage data in 2019, before COVID-19 pandemic, and the 2020 data, after the announcement of the pandemic state and the lockdown and the implementation of restrictive measures to contain the contagion.

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