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Search Results: 1 - 10 of 189795 matches for " Pelaia G "
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Update on optimal use of omalizumab in management of asthma
Pelaia G,Gallelli L,Renda T,Romeo P
Journal of Asthma and Allergy , 2011,
Abstract: Girolamo Pelaia1, Luca Gallelli1, Teresa Renda1, Pasquale Romeo1, Maria Teresa Busceti1, Rosa Daniela Grembiale1, Rosario Maselli1, Serafino Antonio Marsico2, Alessandro Vatrella31Department of Experimental and Clinical Medicine, University Magna Gr cia of Catanzaro, Catanzaro; 2Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Naples; 3Department of Respiratory Medicine, University of Salerno, Salerno, ItalyAbstract: Omalizumab is a humanized monoclonal anti-IgE antibody recently approved for the treatment of severe allergic asthma. This drug inhibits allergic responses by binding to serum IgE, thus preventing interaction with cellular IgE receptors. Omalizumab is also capable of downregulating the expression of high affinity IgE receptors on inflammatory cells, as well as the numbers of eosinophils in both blood and induced sputum. The clinical effects of omalizumab include improvements in respiratory symptoms and quality of life, paralleled by a reduction of asthma exacerbations, emergency room visits, and use of systemic corticosteroids and rescue bronchodilators. Omalizumab is relatively well-tolerated, and only rarely induces anaphylactic reactions. Therefore, this drug represents a valid option as add-on therapy for patients with severe persistent allergic asthma inadequately controlled by high doses of standard inhaled treatments.Keywords: omalizumab, anti-IgE, severe asthma
Preload assessment in septic shock
A Donati, G Conti, S Loggi, S Falcetta, E Adrario, P Pelaia, P Pietropaoli
Critical Care , 2000, DOI: 10.1186/cc738
Abstract: 15 patients suffering from septic shock were studied. Admission criterion was septic shock refractory to standard therapy with cathecolamines. All patients were monitored with a Swan-Ganz catheter and Cold system (Pulsion, Münich) and received a bolus of methylene blue (MB) at the rate of 3 mg/Kg. Hemodynamic and oxyphoretic data were measured before MB infusion, and 20 min, 1 h and 2 h after the end of MB infusion, so that 4 sets of data for each patient were obtained to give a total of 60 data points.There is a significant correlation between ITBV and stroke volume (SV) and between ITBV and cardiac index (CI). There is also a correlation between ITBV and EVLW. No correlation was found between WP and SV and CI. Then we plotted WP vs the PaO2/FiO2 ratio and found that when the PaO2/FiO2 ratio was <200 there was no difference in EVLW between patients with WP ≤16 mmHg and patients with WP >16 mmHg. On the contrary, plotting ITBV vs PaO2/FiO2, with PaO2/FiO2 ratio>200, EVLW was very significantly higher (P<0.001) if ITBV was >1100 ml/mq, than if it was ≤1100 ml/mq.In septic patients, when a respiratory failure happens, ITBV can be normal or high (>1100 ml/mq). A high ITBV is related to a high EVLW, while a high EVLW with a normal ITBV means a normal preload. In this case, it is not useful to decrease preload to increase the PaO2/FiO2 ratio. ITBV together with PaO2/FiO2 ratio is useful to optimize hemodynamic therapy during respiratory failure in septic patients and allows us to identify the patients that need diuretic therapy.
Update on optimal use of omalizumab in management of asthma
Pelaia G, Gallelli L, Renda T, Romeo P, Busceti MT, Grembiale RD, Maselli R, Marsico SA, Vatrella A
Journal of Asthma and Allergy , 2011, DOI: http://dx.doi.org/10.2147/JAA.S14520
Abstract: ate on optimal use of omalizumab in management of asthma Review (6160) Total Article Views Authors: Pelaia G, Gallelli L, Renda T, Romeo P, Busceti MT, Grembiale RD, Maselli R, Marsico SA, Vatrella A Published Date June 2011 Volume 2011:4 Pages 49 - 59 DOI: http://dx.doi.org/10.2147/JAA.S14520 Girolamo Pelaia1, Luca Gallelli1, Teresa Renda1, Pasquale Romeo1, Maria Teresa Busceti1, Rosa Daniela Grembiale1, Rosario Maselli1, Serafino Antonio Marsico2, Alessandro Vatrella3 1Department of Experimental and Clinical Medicine, University Magna Gr cia of Catanzaro, Catanzaro; 2Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Naples; 3Department of Respiratory Medicine, University of Salerno, Salerno, Italy Abstract: Omalizumab is a humanized monoclonal anti-IgE antibody recently approved for the treatment of severe allergic asthma. This drug inhibits allergic responses by binding to serum IgE, thus preventing interaction with cellular IgE receptors. Omalizumab is also capable of downregulating the expression of high affinity IgE receptors on inflammatory cells, as well as the numbers of eosinophils in both blood and induced sputum. The clinical effects of omalizumab include improvements in respiratory symptoms and quality of life, paralleled by a reduction of asthma exacerbations, emergency room visits, and use of systemic corticosteroids and rescue bronchodilators. Omalizumab is relatively well-tolerated, and only rarely induces anaphylactic reactions. Therefore, this drug represents a valid option as add-on therapy for patients with severe persistent allergic asthma inadequately controlled by high doses of standard inhaled treatments.
Simvastatin Action Is Not Related to HDAC2 Expression in Non-Small Cell Lung Cancer (NSCLC)  [PDF]
Gallelli Luca, Falcone Daniela, Perri Mariarita, Erika Cione, Pelaia Girolamo, Mesuraca Maria, Terracciano Rosa, Spaziano Giuseppe, D’Agostino Bruno, Navarra Michele, Savino Rocco
Journal of Cancer Therapy (JCT) , 2016, DOI: 10.4236/jct.2016.712091
Abstract: In this study, we lowered the expression of HDAC2 protein, to evaluate the effects of simvastatin on the biochemical pathways involved in inflammatory and metastatic response. The model used is the non-small cell lung cancer line (GLC-82). Trypan blue staining for assessing vital cell number to be seed and MTT assay was used as cell proliferation test. Lentivus for HDAC2 was used to silence its mRNA. Western blotting analysis was used for protein extracts, and ELISA was done on culture media for cytokines (IL-6, IL-8 and TNF-alpha) release. Hydrogen peroxide (H2O2) was used to induce oxidative stress. Our results have shown that Lentivirus containing the shHDAC2 in GLC-82 cells was able to reduce protein expression of HDAC2. In the GLCshHDAC2 cell line obtained, H2O2 induced a significant increase in cytokines release and ERK1/2 phosphorylation (P < 0.01); a significant decrease of RECK activation (P < 0.01); a significant increased activation (P < 0.01) of both MMP-2 and MMP-9 and an increased
From Macrohemodynamic to the Microcirculation
Abele Donati,Roberta Domizi,Elisa Damiani,Erica Adrario,Paolo Pelaia,Can Ince
Critical Care Research and Practice , 2013, DOI: 10.1155/2013/892710
Abstract: ICU patients need a prompt normalization of macrohemodynamic parameters. Unfortunately, this optimization sometimes does not protect patients from organ failure development. Prevention or treatment of organ failure needs another target to be pursued: the microcirculatory restoration. Microcirculation is the ensemble of vessels of maximum 100? m in diameter. Nowadays the Sidestream Dark Field (SDF) imaging technique allows its bedside investigation and a recent round-table conference established the criteria for its evaluation. First, microcirculatory derangements have been studied in sepsis: they are mainly characterized by a reduction of vessel density, an alteration of flow, and a heterogeneous distribution of perfusion. Endothelial malfunction and glycocalyx rupture were proved to be the main reasons for the observed microthrombi, capillary leakage, leukocyte rolling, and rouleaux phenomenon, even if further studies are necessary for a better explanation. Therapeutic approaches targeting microcirculation are under investigation. Microcirculatory alterations have been recently demonstrated in other diseases such as hypovolemia and cardiac failure but this issue still needs to be explored. The aim of this paper is to gather the already known information, focus the reader’s attention on the importance of microvascular physiopathology in critical illness, and prompt him to actively participate to achieve a more comprehensive understanding of the issue. 1. Introduction The introduction in clinical practice of pulmonary artery catheter (PAC) about 40 years ago [1] allowed clinicians to measure the cardiac output (CO) at the bedside with the thermodilution technique [2]. Moreover, with an arterial and mixed venous gas analysis, arterial (CaO2) and mixed venous oxygen content (CvO2) could be easily calculated and oxygen availability (DO2) and consumption (VO2) consequently obtained by applying the following simple formulas: and . Old well-known physiologic data were available at the bedside as well as clinical parameters but their interpretation and utilization as a therapeutic target was and remains controversial to date. Shoemaker was the first clinician to try to interpret and utilize these new hemodynamic data. He was a surgeon and monitored the high risk surgical patients with PAC before, during, and after the operations [3]. He observed that patients could be divided into three groups on the basis of outcome: survived, survived with complications, and died. From the analysis of the hemodynamic data, patients with better outcome resulted to have CO,
Recombinant activated protein C treatment improves tissue perfusion and oxygenation in septic patients measured by near-infrared spectroscopy
Abele Donati, Michela Romanelli, Laura Botticelli, Agnese Valentini, Vincenzo Gabbanelli, Simonetta Nataloni, Tiziana Principi, Paolo Pelaia, Rick Bezemer, Can Ince
Critical Care , 2009, DOI: 10.1186/cc8010
Abstract: Patients were sedated, intubated, mechanically ventilated, and hemodynamically monitored with the PiCCO system. Tissue oxygen saturation (StO2) was measured using near-infrared spectroscopy (NIRS) during the vascular occlusion test (VOT). Baseline StO2 (StO2 baseline), rate of decrease in StO2 during VOT (StO2 downslope), and rate of increase in StO2 during the reperfusion phase were (StO2 upslope) determined. Data were collected before (T0), during (24 hours (T1a), 48 hours (T1b), 72 hours (T1c) and 96 hours (T1d)) and 6 hours after stopping rh-aPC treatment (T2) and at the same times in the controls. At every assessment, hemodynamic and metabolic parameters were registered and the SOFA score calculated.The mean ± standard deviation Acute Physiology and Chronic Health Evaluation II score was 26.3 ± 6.6 and 28.6 ± 5.3 in rh-aPC and control groups, respectively. There were no significant differences in macrohemodynamic parameters between the groups at all the time points. In the rh-aPC group, base excess was corrected (P < 0.01) from T1a until T2, and blood lactate was significantly decreased at T1d and T2 (2.8 ± 1.3 vs. 1.9 ± 0.7 mmol/l; P < 0.05). In the control group, base excess was significantly corrected at T1a, T1b, T1c, and T2 (P < 0.05). The SOFA score was significantly lower in the rh-aPC group compared with the controls at T2 (7.9 ± 2.2 vs. 12.2 ± 3.2; P < 0.05). There were no differences between groups in StO2 baseline. StO2 downslope in the rh-aPC group decreased significantly at all the time points, and at T1b and T2 (-16.5 ± 11.8 vs. -8.1 ± 2.4%/minute) was significantly steeper than in the control group. StO2 upslope increased and was higher than in the control group at T1c, T1d and T2 (101.1 ± 62.1 vs. 54.5 ± 23.8%/minute) (P < 0.05).Treatment with rh-aPC may improve muscle oxygenation (StO2 baseline) and reperfusion (StO2 upslope) and, furthermore, rh-aPC treatment may increase tissue metabolism (StO2 downslope). NIRS is a simple, real-time, non-inv
Fluid balance and urine volume are independent predictors of mortality in acute kidney injury
Catarina Teixeira, Francesco Garzotto, Pasquale Piccinni, Nicola Brienza, Michele Iannuzzi, Silvia Gramaticopolo, Francesco Forfori, Paolo Pelaia, Monica Rocco, Claudio Ronco, Clara Anello, Tiziana Bove, Mauro Carlini, Vincenzo Michetti, Dinna N Cruz, for the NEFROlogia e Cura INTensiva (NEFROINT) investigators
Critical Care , 2013, DOI: 10.1186/cc12484
Abstract: We performed a secondary analysis of data from a multicenter, prospective cohort study in 10 Italian ICUs. AKI was defined by renal SOFA score (creatinine>3.5mg/dL or urine output (UO) <500mL/d). Oliguria was defined as a UO <500mL/d. Mean fluid balance (MFB) and mean urine volume (MUV) were calculated as the arithmetic mean of all daily values. Use of diuretics was noted daily. To assess the impact of MFB and MUV on mortality of AKI patients, multivariable analysis was performed by Cox regression.Of the 601 included patients, 132 had AKI during ICU stay and the mortality in this group was 50%. Non-surviving AKI patients presented higher MFB (1.31 +/- 1.24 versus 0.17 +/- 0.72 L/day; P<0.001) and lower MUV (1.28 +/- 0.90 versus 2.35 +/- 0.98 L/day; P<0.001) as compared to survivors. In the multivariate analysis, MFB (adjusted hazard ratio (HR) 1.67 per L/day, 95%CI 1.33-2.09; <0.001) and MUV (adjusted HR 0.47 per L/day, 95%CI 0.33-0.67; <0.001) remained independent risk factors for 28-day mortality after adjustment for age, gender, diabetes, hypertension, diuretic use, non-renal SOFA and sepsis. Diuretic use was associated with better survival in this population (adjusted HR 0.25, 95%CI 0.12-0.52; <0.001).In this multicenter ICU study, a higher fluid balance and a lower urine volume were both important factors associated with 28-day mortality of AKI patients.
Levosimendan for resuscitating the microcirculation in patients with septic shock: a randomized controlled study
Andrea Morelli, Abele Donati, Christian Ertmer, Sebastian Rehberg, Matthias Lange, Alessandra Orecchioni, Valeria Cecchini, Giovanni Landoni, Paolo Pelaia, Paolo Pietropaoli, Hugo Van Aken, Jean-Louis Teboul, Can Ince, Martin Westphal
Critical Care , 2010, DOI: 10.1186/cc9387
Abstract: The study was designed as a prospective, randomized, double-blind clinical trial and performed in a multidisciplinary intensive care unit. After achieving normovolemia and a mean arterial pressure of at least 65 mmHg, 40 septic shock patients were randomized to receive either levosimendan 0.2 μg·kg-1·min-1 (n = 20) or an active comparator (dobutamine 5 μg·kg-1·min-1; control; n = 20) for 24 hours. Sublingual microcirculatory blood flow of small and medium vessels was assessed by sidestream dark-field imaging. Microcirculatory variables and data from right heart catheterization were obtained at baseline and 24 hours after randomization. Baseline and demographic data were compared by means of Mann-Whitney rank sum test or chi-square test, as appropriate. Microvascular and hemodynamic variables were analyzed using the Mann-Whitney rank sum test.Microcirculatory flow indices of small and medium vessels increased over time and were significantly higher in the levosimendan group as compared to the control group (24 hrs: MFIm 3.0 (3.0; 3.0) vs. 2.9 (2.8; 3.0); P = .02; MFIs 2.9 (2.9; 3.0) vs. 2.7 (2.3; 2.8); P < .001). The relative increase of perfused vessel density vs. baseline was significantly higher in the levosimendan group than in the control group (dMFIm 10 (3; 23)% vs. 0 (-1; 9)%; P = .007; dMFIs 47 (26; 83)% vs. 10 (-3; 27); P < .001). In addition, the heterogeneity index decreased only in the levosimendan group (dHI -93 (-100; -84)% vs. 0 (-78; 57)%; P < .001). There was no statistically significant correlation between systemic and microcirculatory flow variables within each group (each P > .05).Compared to a standard dose of 5 μg·kg-1·min-1 of dobutamine, levosimendan at 0.2 μg·kg-1·min-1 improved sublingual microcirculatory blood flow in patients with septic shock, as reflected by changes in microcirculatory flow indices of small and medium vessels.NCT00800306.Microvascular dysfunction plays a pivotal role in the pathophysiology of septic shock and may occur e
A Characterization of the Members of a Subfamily of Power Series Distributions  [PDF]
G. Nanjundan
Applied Mathematics (AM) , 2011, DOI: 10.4236/am.2011.26099
Abstract: This paper discusses a characterization of the members of a subfamily of power series distributions when their probability generating functions satisfy the functional equation where a, b and c are constants and is the derivative of f.
Double Negative Left-Handed Metamaterials for Miniaturization of Rectangular Microstrip Antenna  [PDF]
G. Singh
Journal of Electromagnetic Analysis and Applications (JEMAA) , 2010, DOI: 10.4236/jemaa.2010.26044
Abstract: In this paper, I have explored a significant concept for the miniaturization of microstrip patch antenna configuration by using the double negative (DNG) left-handed Metamaterials, which have dielectric permittivity and magnetic permeability both negative, simultaneously. It is achieved through the concept of phase-compensation by thin slab consist of the double positive (DPS) material, which have dielectric permittivity and magnetic permeability both positive, simultaneously and DNG metamaterials as a substrate of the microstrip patch antenna. By combining the DNG metamaterial slab with the slab made of DPS materials form a cavity resonator whose dispersion relation is independent of the sum of thickness of the slabs filling this cavity but it depends on the ratio of their thicknesses. This cavity constitutes by DPS and DNG material is used as substrate of the microstrip antennas and the DNG material slab is behave as phase compensator.
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