Raffaele Landolfi

@unicatt.it

Dipartimento Scienze Cardiovascolari
Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Raffaele Landolfi


            Download Compact PDF  
https://researchid.co/0000-0002-7913-8576

RESEARCH INTERESTS

Thrombosis, Coagulation, Vascular disease
281

Scopus Publications

Scopus Publications

  • Why medical fiction privileges certain disease manifestations
    Raffaele Landolfi
    Bleeding Thrombosis and Vascular Biology, 2026
    Medical fictions - across novels, television series, and cinema - have become a powerful cultural lens through which the public understands diseases, physicians, hospitals, and the practice of medicine. The prominence of visually striking illnesses in these narratives stems from a convergence of aesthetic necessity, psychological impact, and cultural habit. In particular, skin manifestations - especially those linked to thrombo-hemorrhagic or inflammatory processes - provide an immediate and compelling visual language, enabling writers to portray the body’s internal disorder and the inherent fragility of life. By contrast, invisible diseases - hypertension, insomnia, chronic fatigue, neurochemical imbalances - remain more complex and less thrilling to represent. Our future challenge, as clinicians and science communicators, will be to develop ways to render the invisible suffering - mental, metabolic, immunologic - as narratively and visually comprehensible as the classic rash or bruise.
  • A case of thrombotic thrombocytopenic purpura presented in a popular TV series
    Raffaele Landolfi
    Bleeding Thrombosis and Vascular Biology, 2025
    This report outlines how a factitious case of thrombotic thrombocytopenic purpura is narrated in a popular series broadcasted by the Italian main television channel. Personal and medical stories of a young patient grasp the attention of a doctor who has just decided to enter a new professional life.
  • Mapping and ranking outcomes for the evaluation of seasonal influenza vaccine efficacy and effectiveness: a delphi study
    Chiara de Waure, Elisabetta Alti, Vincenzo Baldo, Paolo Bonanni, Michele Conversano, et al.
    Expert Review of Vaccines, 2024
    BACKGROUND Protection provided by seasonal influenza vaccination (SIV) may be measured against numerous outcomes and their heterogeneity may hamper decision-making. The aim of this study was to explore outcomes used for estimation of SIV efficacy/effectiveness (VE) and obtain expert consensus on their importance. RESEARCH DESIGN AND METHODS An umbrella review was first conducted to collect and map outcomes considered in systematic reviews of SIV VE. A Delphi study was then performed to reach expert convergence on the importance of single outcomes, measured on a 9-point Likert scale, in principal target groups, namely children, working-age adults, older adults, subjects with co-morbidities and pregnant women. RESULTS Literature review identified 489 outcomes. Following data reduction, 20 outcomes were selected for the Delphi process. After two Delphi rounds and a final consensus meeting, convergence was reached. All 20 outcomes were judged important or critically important. More severe outcomes, such as influenza-related hospital encounters and mortality with or without laboratory confirmation, were generally top-ranked across all target groups (median scores ≥ 8 out of 9). CONCLUSIONS Rather than focusing on laboratory-confirmed infection per se, experimental and observational VE studies should include more severe influenza-related outcomes because they are expected to exercise a greater impact on decision-making.
  • Neuropsychiatric symptoms, oral pigmentation and fever as revealing hints of autoimmune Addison’s disease
    Raffaele MANNA, Antonio BIANCHI, Laura GERARDINO, Clelia CIPOLLA, Donato RIGANTE, et al.
    Minerva Endocrinology, 2023
  • A real-time integrated framework to support clinical decision making for covid-19 patients
    Rita Murri, Carlotta Masciocchi, Jacopo Lenkowicz, Massimo Fantoni, Andrea Damiani, et al.
    Computer Methods and Programs in Biomedicine, 2022
  • Project R. Evolution for improving clinical research in Italy: challenges and strategies
    Francesca Arizio, Alessio Bonardi, Diego Cortinovis, Antonio Costanzo, Adriano Cristinziano, et al.
    Current Medical Research and Opinion, 2022
    OBJECTIVE The R.Evolution project aimed to reach a consensus on the main challenges of conducting clinical research in Italy and possible strategies and approaches to address them and optimize clinical research management. METHODS A scientific board of experts initially discussed potentially critical areas in clinical research conduct and further explored them through an online national survey. The survey results were further examined by a group of 35 panelists representing different clinical research stakeholders. A Nominal Group Technique and a Delphi approach (two rounds) were used to generate a consensus on critical factors, tools and strategies in clinical research. RESULTS Four main critical areas were identified: study feasibility, authorization procedures, operational aspects and patient management. The main issues are scarce awareness of the value of clinical research, lack of trained workforce and excessive complexity of protocols and administrative procedures. The Delphi panel identified six intervention areas: culture and patient involvement; procedures; staff, contracts, training and incentives; organization and infrastructure; administrative procedures; and ethics committee. CONCLUSION According to the R-Evolution project, possible strategies to improve clinical research management in Italy include a deeper understanding of the value of clinical research, the creation of long-term plans for hiring, training, organizing and motivating clinical trial staff, the simplification and harmonization of administrative procedures, as well as protocol design, and the development of stronger networks of centers and stakeholders.
  • Scurvy: A Disease not to be Forgotten
    Massimo Montalto, Enrica Porceddu, Erika Pero, Andrea Lupascu, Antonella Gallo, et al.
    Nutrition in Clinical Practice, 2021
    An 18-year-old man presented to our hospital with muscular pain, diffuse petechiae, spontaneous thigh ecchymosis, edema and pain of the right knee, bilateral pretibial subcutaneous nodules, and gingival hypertrophy and hemorrhage. His history was positive for a mixed anxiety-depressive disorder and a restrictive diet caused by self-diagnosed food allergies. Skin lesions appeared like hyperkeratotic papules with coiled hairs and perifollicular hemorrhages. A diagnosis of scurvy was made upon demonstration of low serum levels of ascorbic acid. An allergy evaluation found cross-reactivity between pollens and food, related to the presence of panallergens. Moreover, we found that our patient was also affected by celiac disease. In conclusion, scurvy should be considered in the differential diagnosis of patients with petechiae and ecchymosis, especially when food restriction, malabsorption, or psychiatric disorders are present.
  • Prevalence and characteristics of myocardial injury during COVID-19 pandemic: A new role for high-sensitive troponin
    Alessandro Maino, Enrico Di Stasio, Maria Chiara Grimaldi, Luigi Cappannoli, Erica Rocco, et al.
    International Journal of Cardiology, 2021
    Background Coronavirus disease 2019 (COVID-19) is a pandemic disease that is causing a public health emergency. Characteristics and clinical significance of myocardial injury remain unclear. Methods This retrospective single-center study analyzed analyzed 189 patients who received a COVID-19 diagnosis out of all 758 subjects with a high sensitive troponin I (Hs-TnI) measurement within the first 24 h of admission at the Policlinico A.Gemelli (Rome, Italy) between February 20th 2020 to April 09th 2020. Results The prevalence of myocardial injury in our COVID-19 population is of 16%. The patients with cardiac injury were older, had a greater number of cardiovascular comorbidities and higher values of acute phase and inflammatory markers and leucocytes. They required more frequently hospitalization in Intensive Care Unit (10 [32.3%] vs 18 [11.4%]; p = .003) and the mortality rate was significantly higher (17 [54.8%] vs. 15 [9.5%], p < .001). Among patients in ICU, the subjects with myocardial injury showed an increase need of endotracheal intubation (8 out of 9 [88%] vs 7 out of 19[37%], p = .042). Multivariate analyses showed that hs-TnI can significantly predict the degree of COVID-19 disease, the intubation need and in-hospital mortality. Conclusions In this study we demonstrate that hs-Tn can significantly predict disease severity, intubation need and in-hospital death. Therefore, it may be reasonable to use Hs-Tn as a clinical tool in COVID-19 population in order to triage them into different risk groups and can play a pivotal role in the detection of subjects at high risk of cardiac impairment during both the early and recovery stage.
  • Hyperglycemia at admission, comorbidities, and in-hospital mortality in elderly patients hospitalized in internal medicine wards: data from the RePoSI Registry
    Salvatore Corrao, Alessandro Nobili, Giuseppe Natoli, Pier Mannuccio Mannucci, Francesco Perticone, et al.
    Acta Diabetologica, 2021
    Aims The association between hyperglycemia at hospital admission and relevant short- and long-term outcomes in elderly population is known. We assessed the effects on mortality of hyperglycemia, disability, and multimorbidity at admission in internal medicine ward in patients aged ≥ 65 years. Methods Data were collected from an active register of 102 internal medicine and geriatric wards in Italy (RePoSi project). Patients were recruited during four index weeks of a year. Socio-demographic data, reason for hospitalization, diagnoses, treatment, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), renal function, functional (Barthel Index), and cognitive status (Short Blessed Test) and mood disorders (Geriatric Depression Scale) were recorded. Mortality rates were assessed in hospital 3 and 12 months after discharge. Results Of the 4714 elderly patients hospitalized, 361 had a glycemia level ≥ 250 mg/dL at admission. Compared to subjects with lower glycemia level, patients with glycemia ≥ 250 mg/dL showed higher rates of male sex, smoke and class III obesity. These patients had a significantly lower Barthel Index (p = 0.0249), higher CIRS-SI and CIRS-CI scores (p = 0.0025 and p = 0.0013, respectively), and took more drugs. In-hospital mortality rate was 9.2% and 5.1% in subjects with glycemia ≥ 250 and &lt; 250 mg/dL, respectively (p = 0.0010). Regression analysis showed a strong association between in-hospital death and glycemia ≥ 250 mg/dL (OR 2.07; [95% CI 1.34–3.19]), Barthel Index ≤ 40 (3.28[2.44–4.42]), CIRS-SI (1.87[1.27–2.77]), and male sex (1.54[1.16–2.03]). Conclusions The stronger predictors of in-hospital mortality for older patients admitted in general wards were glycemia level ≥ 250 mg/dL, Barthel Index ≤ 40, CIRS-SI, and male sex.
  • Low-dose Aspirin prevents hypertension and cardiac fibrosis when thromboxane A2 is unrestrained
    Ilaria D'Agostino, Stefania Tacconelli, Annalisa Bruno, Annalisa Contursi, Luciana Mucci, et al.
    Pharmacological Research, 2021
    Enhanced platelet activation has been reported in patients with essential hypertension and heart failure. The possible contribution of platelet-derived thromboxane (TX)A2 in their pathophysiology remains unclear. We investigated the systemic TXA2 biosynthesis in vivo and gene expression of its receptor TP in 22 essential hypertension patients and a mouse model of salt-sensitive hypertension. The contribution of platelet TXA2 biosynthesis on enhanced blood pressure (BP) and overload-induced cardiac fibrosis was explored in mice by treating with low-dose Aspirin, resulting in selective inhibition of platelet cyclooxygenase (COX)-1-dependent TXA2 generation. In essential hypertensive patients, systemic biosynthesis of TXA2 [assessed by measuring its urinary metabolites (TXM) reflecting predominant platelet source] was enhanced together with higher gene expression of circulating leukocyte TP and TGF-β, vs. normotensive controls. Similarly, in hypertensive mice with prostacyclin (PGI2) receptor (IP) deletion (IPKO) fed with a high-salt diet, enhanced urinary TXM, and left ventricular TP overexpression were detected vs. normotensive wildtype (WT) mice. Increased cardiac collagen deposition and profibrotic gene expression (including TGF-β) was found. Low-dose Aspirin administration caused a selective inhibition of platelet TXA2 biosynthesis and mitigated enhanced blood pressure, cardiac fibrosis, and left ventricular profibrotic gene expression in IPKO but not WT mice. Moreover, the number of myofibroblasts and extravasated platelets in the heart was reduced. In cocultures of human platelets and myofibroblasts, platelet TXA2 induced profibrotic gene expression, including TGF-β1. In conclusion, our results support tailoring low-dose Aspirin treatment in hypertensive patients with unconstrained TXA2/TP pathway to reduce blood pressure and prevent early cardiac fibrosis.
  • Nonalcoholic fatty liver disease (NAFLD) severity is associated to a nonhemostatic contribution and proinflammatory phenotype of platelets
    Luca Miele, Maria Adele Alberelli, Maurizio Martini, Antonio Liguori, Giuseppe Marrone, et al.
    Translational Research, 2021
  • The multifaceted spectrum of liver cirrhosis in older hospitalised patients: Analysis of the REPOSI registry
    Antonio De Vincentis, Umberto Vespasiani-Gentilucci, Luisa Costanzo, Alessio Novella, Laura Cortesi, et al.
    Age and Ageing, 2021
  • Pattern of comorbidities and 1-year mortality in elderly patients with COPD hospitalized in internal medicine wards: data from the RePoSI Registry
    Christiano Argano, Nicola Scichilone, Giuseppe Natoli, Alessandro Nobili, Gino Roberto Corazza, et al.
    Internal and Emergency Medicine, 2021
  • Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register)
    Jessica Pepe, Pasquale Agosti, Cristiana Cipriani, Mauro Tettamanti, Alessandro Nobili, et al.
    Endocrine, 2021
  • What changed in the Italian internal medicine and geriatric wards during the lockdown
    Barbara D'Avanzo, Alessandro Nobili, Mauro Tettamanti, Luca Pasina, Pier Mannuccio Mannucci
    European Journal of Internal Medicine, 2021
  • Gemelli decision tree Algorithm to Predict the need for home monitoring or hospitalization of confirmed and unconfirmed COVID-19 patients (GAP-Covid19): Preliminary results from a retrospective cohort study
    G. Vetrugno, P. Laurenti, F. Franceschi, F. Foti, F. D'Ambrosio, et al.
    European Review for Medical and Pharmacological Sciences, 2021
  • “Early transfusion of convalescent plasma in older patients with COVID-19 to prevent disease progression: A structured summary of a study protocol for a randomised controlled trial”
    Luciana Teofili, Raffaele Landolfi, Antonella Cingolani, Andrea Antinori, Jacopo Vecchiet, et al.
    Trials, 2020
  • Pain and Frailty in Hospitalized Older Adults
    Ilaria Ardoino, Carlotta Franchi, Alessandro Nobili, Pier Mannuccio Mannucci, Oscar Corli, et al.
    Pain and Therapy, 2020
  • Cardiovascular disease and SARS-CoV-2: The role of host immune response versus direct viral injury
    Federico Biscetti, Maria Margherita Rando, Elisabetta Nardella, Andrea Leonardo Cecchini, Piergiorgio Bruno, et al.
    International Journal of Molecular Sciences, 2020
  • COVID-19 and intestinal inflammation: Role of fecal calprotectin
    Veronica Ojetti, Angela Saviano, Marcello Covino, Nicola Acampora, Eliana Troiani, et al.
    Digestive and Liver Disease, 2020
  • Assessment of neurological manifestations in hospitalized patients with COVID-19
    M. Luigetti, R. Iorio, A. R. Bentivoglio, L. Tricoli, V. Riso, et al.
    European Journal of Neurology, 2020
  • Association between omentin-1 and major cardiovascular events after lower extremity endovascular revascularization in diabetic patients: A prospective cohort study
    Federico Biscetti, Elisabetta Nardella, Maria Margherita Rando, Andrea Leonardo Cecchini, Flavia Angelini, et al.
    Cardiovascular Diabetology, 2020
  • Sarilumab use in severe SARS-CoV-2 pneumonia
    Elisa Gremese, Antonella Cingolani, Silvia Laura Bosello, Stefano Alivernini, Barbara Tolusso, et al.
    Eclinicalmedicine, 2020
  • Sortilin levels correlate with major cardiovascular events of diabetic patients with peripheral artery disease following revascularization: A prospective study
    Federico Biscetti, Elisabetta Nardella, Maria Margherita Rando, Andrea Leonardo Cecchini, Nicola Bonadia, et al.
    Cardiovascular Diabetology, 2020
  • Letter: prevalence and patterns of gastrointestinal symptoms in a large Western cohort of patients with COVID-19
    Gianluca Ianiro, Serena Porcari, Carlo Romano Settanni, Stefano Bibbò, Francesca Romana Ponziani, et al.
    Alimentary Pharmacology and Therapeutics, 2020