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Dive into the research topics where Gian Michele Magnano is active.

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Featured researches published by Gian Michele Magnano.


Annals of the Rheumatic Diseases | 2014

Whole-body MRI in the assessment of disease activity in juvenile dermatomyositis

Clara Malattia; Maria Beatrice Damasio; Annalisa Madeo; Angela Pistorio; Anna Providenti; Silvia Pederzoli; Stefania Viola; Antonella Buoncompagni; Chiara Mattiuz; Agnese Beltramo; Alessandro Consolaro; Angelo Ravelli; Nicolino Ruperto; Paolo Picco; Gian Michele Magnano; Alberto Martini

Objective To compare whole-body MRI (WB-MRI) with clinical examination in the assessment of disease activity in juvenile dermatomyositis (JDM). Methods WB-MR images were obtained from 41 JDM patients and 41 controls using a 1.5 T MRI scanner and short τ inversion recovery sequences. 18 patients had follow-up WB-MRI. Muscle, subcutaneous tissue and myofascial signal abnormalities were scored in 36 muscular groups and on proximal and distal extremities. WB-MRI and clinical assessments were performed concurrently and results compared. Validation procedures included analysis of feasibility, reliability, construct validity, discriminative ability and responsiveness. Results WB-MRI revealed distal legs (26/41 patients) and forearm (19/41 patients) muscle inflammation undetected during clinical examination and allowed an accurate assessment of subcutaneous (23/41 patients) and myofascial involvement (13/41 patients). 27 patients showed a patchy distribution of muscle inflammation while in seven the abnormal hyperintense areas tended to be homogeneously distributed. The inter-reader agreement for muscular, subcutaneous and myofascial WB-MRI scores was excellent. Correlations between WB-MRI muscle score and disease activity measures were excellent (Manual Muscle Test: rs=−0.84, Childhood Myositis Assessment Scale: rs=−0.81). WB-MRI score was higher in JDM active patients when compared with the control group (pB<0.0001) and the inactive patients (pB=0.004), and showed an excellent responsiveness (standardised response mean=1.65). Follow-up WB-MRI showed resolution of inflammation in nine patients whereas clinical criteria for remission were satisfied in five. Conclusions WB-MRI provides additional information to clinical evaluation and represents a promising tool to estimate total inflammatory burden, tailor treatment and monitor its efficacy.


Annals of the Rheumatic Diseases | 2011

Development and preliminary validation of a paediatric-targeted MRI scoring system for the assessment of disease activity and damage in juvenile idiopathic arthritis

Clara Malattia; Maria Beatrice Damasio; Angela Pistorio; Maka Ioseliani; Iris Vilca; Maura Valle; Nicolino Ruperto; Stefania Viola; Antonella Buoncompagni; Gian Michele Magnano; Angelo Ravelli; Paolo Tomà; Alberto Martini

Objectives To develop and validate a paediatric-targeted MRI scoring system for the assessment of disease activity and damage in juvenile idiopathic arthritis (JIA). To compare the paediatric MRI score with the adult-designed. Outcome Measures in Rheumatology Clinical Trials—Rheumatoid Arthritis MRI Score (RAMRIS), whose suitability for assessing growing joints was tested. Methods In 66 patients with JIA the clinically more affected wrist was studied. Thirty-nine patients had a 1-year MRI follow-up. Two readers independently assigned the paediatric score and the RAMRIS to all studies. Validation procedures included analysis of reliability, construct validity and responsiveness to change. A reduced version of the bone erosion score was also developed and tested. Results The paediatric score showed an excellent reproducibility (interclass correlation coefficient >0.9). The interobserver agreement of RAMRIS was moderate for bone erosions and excellent for bone marrow oedema (BMO). The paediatric score and RAMRIS provided similar results for construct validity. The responsiveness to change of the paediatric score was moderate for synovitis and bone erosion, and poor for BMO and did not improve when RAMRIS was applied. The reduced version of the bone erosion was valuable for the assessment of joint damage, and provided time-saving advantages. Conclusion The results demonstrate that the paediatric MRI score is a reliable and valid method for assessing disease activity and damage in JIA. Unexpectedly, the RAMRIS provides acceptable suitability for use in the paediatric age group. Further work, especially in a longitudinal setting, is required before defining the most suitable MRI scale for assessing growing joints.


Pediatric Transplantation | 2011

HHV-8-related visceral Kaposi’s sarcoma following allogeneic HSCT: Report of a pediatric case and literature review

Ilaria Sala; Maura Faraci; Gian Michele Magnano; Angela Rita Sementa; Eddi Di Marco; Alberto Garaventa; Concetta Micalizzi; Edoardo Lanino; Giuseppe Morreale; Cristina Moroni; Elio Castagnola

Sala I, Faraci M, Magnano GM, Sementa A, di Marco E, Garaventa A, Micalizzi C, Lanino E, Morreale G, Moroni C, Castagnola E. HHV‐8‐related visceral Kaposi’s sarcoma following allogeneic HSCT: Report of a pediatric case and literature review.
Pediatr Transplantation 2011: 15:E8–E11.


Pediatric Infectious Disease Journal | 2014

Role of management strategies in reducing mortality from invasive fungal disease in children with cancer or receiving hemopoietic stem cell transplant: a single center 30-year experience.

Elio Castagnola; Francesca Bagnasco; Loredana Amoroso; Ilaria Caviglia; Silvia Caruso; Maura Faraci; Michaela Calvillo; Cristina Moroni; Roberto Bandettini; Giuliana Cangemi; Gian Michele Magnano; Piero Buffa; Andrea Moscatelli; Riccardo Haupt

Background: In the last decades, several diagnostic and therapeutic strategies have been implemented for management of invasive fungal diseases (IFD) in patients with cancer or receiving allogeneic hemopoietic stem cell transplant. Few data are available on their impact on mortality in children. Methods: All IFD episodes diagnosed at tertiary care center during a 30-year period between 1983 and 2012 were analyzed for 90-day mortality and risk factors. Diagnoses were coded according to international (European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group) criteria. Four treatment eras (1983–1990, 1991–1999, 2000–2005 and 2006–2012) were defined according to availability of diagnostic technologies, new antifungal drugs and use of a diagnostic-driven approach without empiric antifungal therapy. Results: A total of 198 IFD were diagnosed in 191 patients; 71.2% were proven/probable infections; 39.9% were caused by yeasts and 31.3% by molds. Within 90 days from IFD diagnosis, 58 (30.4%) patients died for a 28.3% cumulative probability of death. A multivariable analysis showed that the highest risk of death was associated with alternative donor-hemopoietic stem cell transplant [hazard ratio (HR): 3.96] and mold etiology (HR: 1.34). The risk of death significantly decreased across the treatment eras, with almost a 3-fold reduced risk for patients diagnosed during the 2006–2012 period (HR: 0.24). Also if the variable year of diagnosis was considered as continuous, the hazard of death significantly decreased by 5% per year (HR: 0.95). Conclusions: New management strategies resulted in a better prognosis of IFD in children with cancer or hemopoietic stem cell transplant. A diagnostic-driven approach was not associated with an increase in mortality.


Arthritis Care and Research | 2016

Delineating the Application of Ultrasound in Detecting Synovial Abnormalities of the Subtalar Joint in Juvenile Idiopathic Arthritis

Stefano Lanni; Francesca Bovis; Angelo Ravelli; Stefania Viola; Francesca Magnaguagno; Angela Pistorio; Gian Michele Magnano; Alberto Martini; Clara Malattia

To investigate the frequency of ultrasound (US)–detectable involvement of the subtalar joint (STJ), to compare clinical versus US assessment of the STJ, and to compare different scanning approaches to the STJ in juvenile idiopathic arthritis (JIA).


Pediatric Radiology | 1998

Pancreatitis caused by duodenal duplication

Gian Michele Magnano; Mauro Occhi; Girolamo Mattioli; Ferdinando Pesce; V. Jasonni; Paolo Tomà

Abstract Two cases of recurrent pancreatitis, due to duodenal duplication, are reported. The aim of this paper is to emphasise the role of endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) in the detection of associated pancreaticobiliary anomalies and in the planning of the correct surgical approach. The order of imaging in a child with recurrent pancreatitis should be US, barium meal and PTC. ERCP is often difficult to perform in children.


Pediatric Pulmonology | 2016

Mild tracheal compression by aberrant innominate artery and chronic dry cough in children

Michele Ghezzi; Michela Silvestri; Oliviero Sacco; Serena Panigada; Donata Girosi; Gian Michele Magnano; Giovanni A. Rossi

Background: In children with aberrant innominate artery (AIA) one of the most prevalent respiratory symptom is dry cough. How frequently this mediastinal vessels anomaly, that can induce tracheal compression (TC) of different degree, may be detected in children with chronic dry cough is not known. Methods: In a 3‐year retrospective study, the occurrence of mediastinal vessels abnormalities and the presence and degree of TC was evaluated in children with recurrent/chronic dry cough. Results: Vascular anomalies were detected in 68 out of the 209 children evaluated. A significant TC was detected in 54 children with AIA, in eight with right aortic arch, in four with double aortic arch but not in two with aberrant right subclavian artery. In AIA patients, TC evaluated on computed tomography scans, was mild in 47, moderate in six and severe in one. During bronchoscopy TC increased in expiration or during cough, but this finding was more pronounced in children with right aortic arch and double aortic arch in which a concomitant tracheomalacia was more evident. Comorbidities were detected in 21 AIA patients, including atopy, reversible bronchial obstruction and gastroesophageal reflux. Aortopexy was performed in eight AIA patients, while the remaining AIA patients were managed medically and showed progressive improvement with time. Conclusion: Mild TC induced by AIA can be detected in a sizeable proportion of children with recurrent/chronic dry cough. The identification of this anomaly, that may at least partially explain the origin of their symptom, may avoid further unnecessary diagnostic examinations and ineffective chronic treatments. Pediatr Pulmonol. 2016;51:286–294.


Pediatric Pulmonology | 2016

Short-length ligamentum arteriosum as a cause of congenital narrowing of the left main stem bronchus

Oliviero Sacco; Francesco Santoro; Elena Ribera; Gian Michele Magnano; Giovanni A. Rossi

An entity that has received little attention as cause or recurrent respiratory disorder is the narrowing of the left main stem bronchus. When not associated with congenital heart disorders, this condition has been ascribed to primary localized malacia of the bronchial cartilages or to the anterior displacement of the descending aorta in front to the adjacent vertebral bodies. Four girls were evaluated for recurrent/chronic respiratory symptoms. A pulsatile extrinsic compression on the posterior bronchial wall of the left main stem bronchus was detected, pressed between the descending aorta, posteriorly, and the left pulmonary artery, anteriorly. The two arteries were closely linked together by a short‐length ligamentum that was resected, allowing the mobilization of the aorta with posterior aortopexy, stabilizing the space created between the pulmonary artery and the descending aorta. The reduced compression on the left main bronchus resulted in the enlargement of its caliber and in a marked improvement of the respiratory symptoms. Pediatr Pulmonol. 2016;51:1356–1361.


Pediatric Pulmonology | 2014

Corticosteroids may favor proliferation of thoracic inflammatory myofibroblastic tumors

Serena Panigada; Oliviero Sacco; Donata Girosi; Gian Michele Magnano; Pietro Tuo; Vincenzo Tarantino; Claudio Gambini; Loredana Petecchia; Michela Silvestri; Giovanni A. Rossi

Inflammatory myofibroblastic tumor (IMT) was thought to represent a benign post‐infectious or post‐inflammatory process cured by surgical resection. However, reports of cases with an aggressive clinical course suggest the need for caution about the prognosis. The treatment of choice is a complete surgical resection, while medical treatment options are limited. Corticosteroid therapy has been used with some success in unresectable lesion. However, rapid progression of lung IMT after prednisone treatment has been reported, raising the hypothesis that corticosteroids may favor a tumultuous proliferation of this lesion, possibly through immunosuppression. We here report a similar observation and suggest that other mechanisms may be involved. A 5‐year and 6‐month‐old boy presented with a 72 hr history of breathlessness, initially responsive to albuterol and prednisone. He represented 15 days later with increasing symptoms despite further prednisone treatment. CT chest scan showed a mass lesion in the tracheal lumen, which on biopsy was found to be an IMT. The possibility that prednisone may have an enhancing effect on IMT cell proliferation is demonstrated through IMT cell culture and discussed. Pediatr Pulmonol. 2014; 49:E109–E111.


The Journal of Rheumatology | 2018

Effect of the Inclusion of the Metacarpophalangeal Joints on the Wrist Magnetic Resonance Imaging Scoring System in Juvenile Idiopathic Arthritis

Eh Pieter van Dijkhuizen; Federica Vanoni; Gian Michele Magnano; Francesca Magnaguagno; Karen Rosendahl; Marion A. J. van Rossum; Alberto Martini; Clara Malattia

Objective. To extend the magnetic resonance imaging (MRI) score for assessment of wrist synovitis in juvenile idiopathic arthritis (JIA) by inclusion of the metacarpophalangeal (MCP) joints, and to compare the metric properties of the original and the extended score. Methods. Wrist MRI of 70 patients with JIA were scored by 3 independent readers according to (1) the wrist component of the rheumatoid arthritis MRI synovitis score (comprising distal radioulnar, radiocarpal, and combined midcarpal and carpometacarpal joints); and (2) an extended score including the MCP joints. Thirty-eight patients had a 1-year MRI followup. The concordance between the readers [intraclass correlation coefficient (ICC), 95% limits of agreement (LOA), and weighted Cohen’s κ], correlations with clinical variables (Spearman’s ϱ), and the sensitivity to change [standardized response mean (SRM)] were calculated for both scores. Results. The interreader agreement was moderate for the original score (ICC 0.77; 95% CI 0.68–0.84) and good for the extended score (ICC 0.86; 95% CI 0.80–0.91). Using 95% LOA, the aggregate score variability was less favorable with relatively wide LOA. Weighted Cohen’s κ of the individual joints indicated good agreement for the original score and good to excellent agreement for the extended score. Correlations with clinical variables reflecting disease activity improved for the extended score and its SRM was higher compared to that of the original score. Conclusion. The extended score showed better reliability, construct validity, and sensitivity to change than the original. Inclusion of the MCP joints should be considered for a more accurate assessment of disease activity and treatment efficacy in JIA.

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Paolo Tomà

Boston Children's Hospital

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Alberto Martini

Istituto Giannina Gaslini

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Angela Pistorio

Istituto Giannina Gaslini

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Clara Malattia

Istituto Giannina Gaslini

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Elio Castagnola

Istituto Giannina Gaslini

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Maura Faraci

Istituto Giannina Gaslini

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Oliviero Sacco

Istituto Giannina Gaslini

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