Publications by authors named "M Sansone"

310 Publications

Severe multisystem inflammatory syndrome (MIS-C/A) after confirmed SARS-CoV-2 infection: a report of four adult cases.

Infect Dis (Lond) 2022 Jan 16:1-6. Epub 2022 Jan 16.

Department of Infectious Diseases, Region Vastra Gotaland, Sahlgrenska University Hospital, Gothenburg, Sweden.

Background: Multisystem inflammatory syndrome (MIS) triggered by a recent SARS-Cov-2 infection has been recognised worldwide. Although predominantly affecting children (MIS-C), similar presentations have been reported among adults (MIS-A).

Method: A retrospective case series describing four critically ill patients with MIS-C/A diagnosed between January and April 2021 at Sahlgrenska University Hospital, Gothenburg, Sweden. Clinical presentation, laboratory and radiological findings, treatment and outcome are reported.

Results: Cases occurred in previously healthy patients with a history of laboratory-confirmed mild SARS-CoV-2 infection four to seven weeks earlier. The median age was 24 years (range 19-43) and 3/4 were male. All fulfilled suggested MIS-C/A criteria according to the US Centre for Disease Control and all required care at an intensive care unit. Treatment was initiated with intravenous immunoglobulin, interleukin-1-receptor antagonists, and pulse steroids in 3/4 cases which resulted in rapid clinical improvement. No severe complications were noticed in any case during a three-month follow-up period.

Conclusion: MIS-C/A should be considered, irrespective of age, in patients with fever, hyperinflammation and multiple organ system involvements emerging weeks after COVID-19. Previously suggested treatment regimens for MIS-C seem to be applicable also for MIS-A.
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http://dx.doi.org/10.1080/23744235.2021.2025422DOI Listing
January 2022

Minimal prevalence of HPV vaccination and common occurrence of high-risk HPV types in pregnant women with HIV: data from a national study in Italy.

Eur J Clin Microbiol Infect Dis 2022 Jan 9. Epub 2022 Jan 9.

Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy.

Among 733 pregnant women with HIV followed between 2013 and 2021, only 8 (1.1%) had prior HPV vaccination. One had low-grade squamous intraepithelial lesions [LSIL], and none had HPV type information. Among the 725 non-vaccinated women, 578 (79.7%) had information on cervical cytology. Rate of cytologic abnormalities in this group was 20.6% (0.2% atypical glandular cells of undetermined significance [AGC], 1.7% atypical squamous cells of undetermined significance [ASC-US], 11.1% LSIL, and 7.6% high-grade squamous intraepithelial lesions [HSIL]). Among 56 women with HPV type information, 75.0% carried high risk types, with similar occurrence in women with and without cytologic abnormalities, 30.4% had multiple high-risk types, and 75.9% carried at least one of the types included in the currently recommended 9-valent vaccine.
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http://dx.doi.org/10.1007/s10096-021-04393-1DOI Listing
January 2022

A Pipelined Tracer-Aware Approach for Lesion Segmentation in Breast DCE-MRI.

J Imaging 2021 Dec 14;7(12). Epub 2021 Dec 14.

Department of Electrical Engineering and Information Technology (DIETI), University of Naples Federico II, Via Claudio 21, 80125 Naples, Italy.

The recent spread of Deep Learning (DL) in medical imaging is pushing researchers to explore its suitability for lesion segmentation in Dynamic Contrast-Enhanced Magnetic-Resonance Imaging (DCE-MRI), a complementary imaging procedure increasingly used in breast-cancer analysis. Despite some promising proposed solutions, we argue that a "naive" use of DL may have limited effectiveness as the presence of a contrast agent results in the acquisition of multimodal 4D images requiring thorough processing before training a DL model. We thus propose a pipelined approach where each stage is intended to deal with or to leverage a peculiar characteristic of breast DCE-MRI data: the use of a breast-masking pre-processing to remove non-breast tissues; the use of Three-Time-Points (3TP) slices to effectively highlight contrast agent time course; the application of a motion-correction technique to deal with patient involuntary movements; the leverage of a modified U-Net architecture tailored on the problem; and the introduction of a new "Eras/Epochs" training strategy to handle the unbalanced dataset while performing a strong data augmentation. We compared our pipelined solution against some literature works. The results show that our approach outperforms the competitors by a large margin (+9.13% over our previous solution) while also showing a higher generalization ability.
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http://dx.doi.org/10.3390/jimaging7120276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8703956PMC
December 2021

ART Innovations: Fostering Women's Psychophysical Health between Bioethics Precepts and Human Rights.

Healthcare (Basel) 2021 Nov 1;9(11). Epub 2021 Nov 1.

Department of Anatomical, Histological, Medicolegal and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.

Infertility is a highly relevant global issue affecting the reproductive health of at least 15% of reproductive-aged couples worldwide. The scope and severity of the infertility problem is even more prevalent in developing countries, mostly due to untreated reproductive tract infections (RTIs). Infertility, however, goes beyond the mere inability to procreate, but brings about profound psychological, social, and ethical implications of enormous magnitude. In vitro fertilization (IVF) and other assisted reproduction technologies (ARTs) have gradually become widespread therapeutic options. After all, the implementation of medically assisted reproductive procedures in order to overcome infertility is in keeping with the tenets of the reproductive rights agenda laid out at the International Conference on Population and Development (ICPD) in Cairo in 1994. Nonetheless, concerns still linger about how to implement and regulate such interventions in an ethically tenable fashion. The unremitting pace at which such techniques develop have upset the very notion of sexuality relating to reproduction as well as the concept of family itself. That rift risks causing a crisis in terms of bioethics sustainability and enforcement, which is bound to happen when science and innovation outpace the bioethical precepts on which we rely for essential guidance in medical practice. The authors argue in favor of an approach to regulation and policy-making that puts on the forefront a thorough assessment as to potential risks that such interventions might entail for foundational bioethics principles and inalienable human rights.
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http://dx.doi.org/10.3390/healthcare9111486DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8623993PMC
November 2021

Cytokine signature and COVID-19 prediction models in the two waves of pandemics.

Sci Rep 2021 10 21;11(1):20793. Epub 2021 Oct 21.

Department of Translational Medicine, Federico II University of Naples, Naples, Italy.

In Europe, multiple waves of infections with SARS-CoV-2 (COVID-19) have been observed. Here, we have investigated whether common patterns of cytokines could be detected in individuals with mild and severe forms of COVID-19 in two pandemic waves, and whether machine learning approach could be useful to identify the best predictors. An increasing trend of multiple cytokines was observed in patients with mild or severe/critical symptoms of COVID-19, compared with healthy volunteers. Linear Discriminant Analysis (LDA) clearly recognized the three groups based on cytokine patterns. Classification and Regression Tree (CART) further indicated that IL-6 discriminated controls and COVID-19 patients, whilst IL-8 defined disease severity. During the second wave of pandemics, a less intense cytokine storm was observed, as compared with the first. IL-6 was the most robust predictor of infection and discriminated moderate COVID-19 patients from healthy controls, regardless of epidemic peak curve. Thus, serum cytokine patterns provide biomarkers useful for COVID-19 diagnosis and prognosis. Further definition of individual cytokines may allow to envision novel therapeutic options and pave the way to set up innovative diagnostic tools.
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http://dx.doi.org/10.1038/s41598-021-00190-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8531346PMC
October 2021
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