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Cascini F, Franzini M, Andreoli A, Manzotti A, Cadeddu C, Quaranta G, Gentili A, Ricciardi W. Use of oxygen-ozone therapy to improve the effectiveness of antibiotic treatment on infected arthroplasty: protocol for a superiority, open-label, multicentre, randomised, parallel trial. BMJ Open 2024; 14:e076739. [PMID: 38176866 PMCID: PMC10773369 DOI: 10.1136/bmjopen-2023-076739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/20/2023] [Indexed: 01/06/2024] Open
Abstract
INTRODUCTION Surgical site infections still remain a major public health challenge and have become an increasing universal risk, especially for the implantation of orthopaedic devices.Unfortunately, the discovery and increasingly widespread use (especially the misuse) of antibiotics have led to the rapid appearance of antibiotic-resistant strains today; more and more infections are caused by microorganisms that fail to respond to conventional treatments.Oxygen-ozone therapy has been extensively used and studied for decades across various potential medical applications and has provided consistent effects with minimal side effects.This study aims to determine the superiority of oxygen-ozone therapy in combination with oral antibiotic therapy in patients with wound infections after an orthopaedic device implantation when compared with antibiotic therapy alone. METHODS AND ANALYSIS This is an open-label, multicentre, randomised, parallel-group study that aims to assess the efficacy and safety of oxygen-ozone therapy in combination with oral antibiotic therapy to treat infections in patients (male or female aged ≥18 years) having undergone surgery for the implant of an orthopaedic device. Patients must have at least one (but no more than three) postoperative wounds in the site of surgery (ulcers, eschars and sores) and at least one symptom (pain, burning, redness and malodour) and at least one sign (erythema, local warmth, swelling and purulent secretion) of infection of at least moderate intensity (score ≥2) in the target lesion at the screening visit (patients with wounds without signs of localised infection or with undermining wounds will be excluded).Patients (n=186) will be recruited from five Italian hospitals and studied for 7 weeks. All will be assigned to one of the two treatment groups according to a web-based, centralised randomisation procedure and placed into either the (1) intervention: oxygen-ozone therapy 2-3 times a week for 6 weeks (for a maximum of 15 sessions) simultaneously with an appropriate oral antibiotic therapy prescribed at baseline or (2) control: oral antibiotic therapy prescribed at baseline.The primary outcome is the efficacy and superiority of the treatment (ozone and oral antibiotic therapies); secondary outcomes include the resolution of signs and symptoms, modifications in lesion size and the treatment's safety and tolerability. ETHICS AND DISSEMINATION This study has been reviewed and approved by the responsible Independent Ethics Committee (IEC) of COMITATO ETICO CAMPANIA NORD, located at 'Azienda Ospedaliera San Giuseppe Moscati di Avellino'.After completion of the study, the project coordinator will prepare a draft manuscript containing the final results of the study on the basis of the statistical analysis. The manuscript will be derived by the co-authors for comments, and after revision, it will be sent to a major scientific journal. Findings will be disseminated via online and print media, events and peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04787575.
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Affiliation(s)
- Fidelia Cascini
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marianno Franzini
- Società Italiana di Ossigeno-Ozono Terapia (SIOOT), Gorle (BG), Italy
| | | | | | - Chiara Cadeddu
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluigi Quaranta
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Andrea Gentili
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Walter Ricciardi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Gentili A. Lung-protective strategy during one-lung ventilation: current and future approaches to quantify the role of positive end-expiratory pressure. Minerva Anestesiol 2024; 90:3-5. [PMID: 38088091 DOI: 10.23736/s0375-9393.23.17841-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Affiliation(s)
- Andrea Gentili
- Department of Anesthesia and Intensive Care, Villa Laura Hospital, Bologna, Italy -
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Cascini F, Gentili A, Melnyk A, Beccia F, Causio FA, Solimene V, Battilomo S, Paone S, Borghini A, Bartolo M, Chiarolla E, Ricciardi W. A new digital model for the Italian Integrated Home Care: strengths, barriers, and future implications. Front Public Health 2023; 11:1292442. [PMID: 38035284 PMCID: PMC10682786 DOI: 10.3389/fpubh.2023.1292442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Affiliation(s)
- Fidelia Cascini
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- General Directorate of Health Information System and Statistics, Ministero della Salute, Rome, Italy
| | - Andrea Gentili
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andriy Melnyk
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Flavia Beccia
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Andrea Causio
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Solimene
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Serena Battilomo
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simona Paone
- Italian National Agency for Regional Healthcare Services (Agenas), Rome, Italy
| | - Alice Borghini
- Italian National Agency for Regional Healthcare Services (Agenas), Rome, Italy
| | | | - Emilio Chiarolla
- General Directorate of Health Information System and Statistics, Ministero della Salute, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Luigi M, Donati L, Sciarroni R, Gentili A, Taglienti A, Tiberini A, Faggioli F, Ferretti L. Carlavirus Species Infecting Hop Plants in Italy: Molecular Identification and Phylogenetic Analyses of the Detected Isolates. Plants (Basel) 2023; 12:3514. [PMID: 37836254 PMCID: PMC10574973 DOI: 10.3390/plants12193514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/27/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023]
Abstract
Hop (Humulus lupulus L.) is a minor ingredient in the beer production but has a strong influence on the beer quality due to the high chemical complexity of the cones used in brewing. One of the major factors that can severely affect the chemical composition of the hop cones and their marketability is the presence of viral infections in the plant. Amongst the five major hop viruses, three belong to the Carlavirus genus: hop mosaic virus (HpMV), hop latent virus (HpLV), and American hop latent virus (AHLV). The occurrence of carlaviruses on hop germplasm in Italy was firstly recorded in 2017 but, in that context, a generic detection was only performed and no information on the infecting Carlavirus species was provided. To fill this gap, 51 hop samples previously found infected by carlaviruses were analysed by RT-PCR employing primer pairs specific for the coat protein (CP) of HpMV, HpLV and AHLV, respectively. HpLV resulted largely prevalent as it was detected in 96.1% of tested samples whereas for HpMV and AHLV an infection rate of 5.9% and 3.9% was recorded, respectively. CP nucleotide sequences from 13 selected virus isolates were obtained and analysed; moreover, the complete genome sequence of 7 isolates was obtained by using high throughput sequencing (HTS). Phylogenetic analysis showed close relationships among isolates from different geographical origin, including European and non-European countries, according to the worldwide movement of hop germplasm due to global trade. This is the first report of HpMV, HpLV and AHLV on hop germplasm in Italy.
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Affiliation(s)
| | | | | | | | | | | | | | - Luca Ferretti
- Council for Agricultural Research and Economics (CREA), Research Centre for Plant protection and Certification, Via C.G. Bertero, 22, 00156 Rome, Italy; (M.L.); (L.D.); (R.S.); (A.G.); (A.T.); (A.T.); (F.F.)
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Cascini F, Gentili A. National Recovery and Resilience Plan and Health: qualitative analysis on the sustainability of the interventions on healthcare. Ann Ig 2023; 35:602-610. [PMID: 36866601 DOI: 10.7416/ai.2023.2561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Background Sars-CoV2 epidemic was the cause of death of more than 180,000 Italian citizens. The sever-ity of this disease showed to policymakers how easily Italian health services, and particularly hospitals, could be overwhelmed by requests and needs from patients and the general population. As a consequence of the clogging of health services, the government decided to allocate a consistent investment to the com-munity and proximity assistance with a specific section (Mission 6) of the so called "National Recovery and Resilience Plan". Objective The aim of this study is to analyse the economic and social impact of the Mission 6 of the National Recovery and Resilience Plan, with particular regard to the most relevant interventions (Community Homes, Community Hospitals, Integrated Home Care), in order to understand its future sustainability. Material and methods A qualitative research methodology was chosen. Documents containing all the relevant information regarding the sustainability of the plan (called in short "Sustainability Plan") were taken into consideration. In case of missing data regarding the potential costs or expenditure of the afore-mentioned structures, estimates will be made reviewing literature for similar healthcare services, already implemented and active in Italy. Direct content analysis was chosen as the methodology for data analysis and final reporting of results. Results The National Recovery and Resilience Plan states that it will create savings of up to €1.18 bil-lion thanks to the re-organization of healthcare facilities, the reduction of hospitalizations, the reduction of inappropriate access to the emergency room, and the containment of pharmaceutical expenditure. This amount will be used to cover the salaries for the healthcare professionals employed in the newly planned healthcare structures. The analysis of this study has taken into account the number of healthcare profes-sionals that will be needed to operationalize the new facilities, as described in the plan and compared them with the reference salaries for each category (doctors, nurses, other healthcare workers). The annual cost for healthcare professionals has been stratified for each structure, with the following results: € 540 million for the personnel of the Community Hospitals ("Ospedali di Comunità"); € 1.1 billion for the personnel of Integrated Home Care Assistance ("Assistenza Domiciliare Integrata"); and € 540 million for the personnel of Community Homes ("Case della Comunità"). Discussion The expected € 1.18 billion expenditure is implausible to be sufficient to cover the cost for salaries of all the healthcare professionals needed, which is expected to be around € 2 billion. The National Agency for the Regional Healthcare Services ("Agenzia nazionale per i servizi sanitari regionali") calculated that in Emilia-Romagna (the only region in Italy to have already implemented a healthcare structure based on the one described in the National Recovery and Resilience Plan), the activation of Community Hospitals and Community Homes reduced the rate of inappropriate access to emergency rooms by 26% (while in the National Recovery and Resilience Plan expectation is a reduction of at least by 90% for "white codes", the identified code for stable and not urgent patients). Moreover, the hypothesis for the daily cost of stay in the Community Hospital is roughly € 106, while the average current cost in the active Community Hospitals in Italy is € 132 (much higher than the National Recovery and Resilience Plan estimate). Conclusion The underlying principle of the National Recovery and Resilience Plan is highly valuable since it strives to enhance the quality and the quantity of the healthcare services in the country that are too often left out of national investments and programs. Nevertheless, the National Recovery and Resilience Plan has critical issues due to the superficial prevision of cost. The success of the reform appears to be established by decision makers and by their long-term prospective, oriented to overcome the resistance to change.
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Affiliation(s)
- F Cascini
- Department of Life Sciences and Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
| | - A Gentili
- Department of Life Sciences and Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
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Cascini F, Gentili A, Causio FA, Altamura G, Melnyk A, Beccia F, Pappalardo C, Lontano A, Ricciardi W. Strengthening and promoting digital health practice: results from a Global Digital Health Partnership's survey. Front Public Health 2023; 11:1147210. [PMID: 37404277 PMCID: PMC10315462 DOI: 10.3389/fpubh.2023.1147210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/22/2023] [Indexed: 07/06/2023] Open
Abstract
Background and objective The capacity to promote and disseminate the best evidence-based practices in terms of digital health innovations and technologies represents an important goal for countries and governments. To support the digital health maturity across countries the Global Digital Health Partnership (GDHP) was established in 2019. The mission of the GDHP is to facilitate global collaboration and knowledge-sharing in the design of digital health services, through the administration of surveys and white papers. Objective The scope of this study is to critically analyze and discuss results from the Evidence and Evaluation GDHP Work Stream's survey, understand how governments and countries intend to address main obstacles to the digital health implementation, identify their strategies for a communication of effective digital health services, and promote the sharing of international based best practices on digital health. Methods This survey followed a cross-sectional study approach. A multiple-choice questionnaire was designed to gather data. Choices were extracted from research publications retrieved through a rapid review. Results Out of 29 countries receiving the survey, 10 returned it. On a scale from 1 to 5, eHealth systems/platforms (mean = 3.56) were indicated as the most important tool for centralized infrastructure to collect information on digital health, while primary care (mean = 4.0) represented the most voted item for healthcare services to collect information on digital health. Seven Countries out of 10 identified lack of organization, skepticism of clinicians, and accessibility of the population as a barriers to adopt digital health implementation, resulting to be the most voted items. Finally, the most endorsed priorities in digital health for Countries were the adoption of data-driven approaches (6 Countries), and telehealth (5 Countries). Conclusion This survey highlighted the main tools and obstacles for countries to promote the implementation of evidence-based digital health innovations. Identifying strategies that would communicate the value of health care information technology to healthcare professionals are particularly imperative. Effective communication programs for clinicians and the general population in addition to improved digital health literacy (both for clinicians and citizens) will be the key for the real implementation of future digital health technologies.
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Boiko A, Gaiduk M, Scherz WD, Gentili A, Conti M, Orcioni S, Martínez Madrid N, Seepold R. Monitoring of Cardiorespiratory Parameters during Sleep Using a Special Holder for the Accelerometer Sensor. Sensors (Basel) 2023; 23:s23115351. [PMID: 37300078 DOI: 10.3390/s23115351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
Sleep is extremely important for physical and mental health. Although polysomnography is an established approach in sleep analysis, it is quite intrusive and expensive. Consequently, developing a non-invasive and non-intrusive home sleep monitoring system with minimal influence on patients, that can reliably and accurately measure cardiorespiratory parameters, is of great interest. The aim of this study is to validate a non-invasive and unobtrusive cardiorespiratory parameter monitoring system based on an accelerometer sensor. This system includes a special holder to install the system under the bed mattress. The additional aim is to determine the optimum relative system position (in relation to the subject) at which the most accurate and precise values of measured parameters could be achieved. The data were collected from 23 subjects (13 males and 10 females). The obtained ballistocardiogram signal was sequentially processed using a sixth-order Butterworth bandpass filter and a moving average filter. As a result, an average error (compared to reference values) of 2.24 beats per minute for heart rate and 1.52 breaths per minute for respiratory rate was achieved, regardless of the subject's sleep position. For males and females, the errors were 2.28 bpm and 2.19 bpm for heart rate and 1.41 rpm and 1.30 rpm for respiratory rate. We determined that placing the sensor and system at chest level is the preferred configuration for cardiorespiratory measurement. Further studies of the system's performance in larger groups of subjects are required, despite the promising results of the current tests in healthy subjects.
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Affiliation(s)
- Andrei Boiko
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
| | - Maksym Gaiduk
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
| | - Wilhelm Daniel Scherz
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
| | - Andrea Gentili
- Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Massimo Conti
- Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Simone Orcioni
- Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, 60131 Ancona, Italy
| | | | - Ralf Seepold
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
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Valentini E, Compagnucci F, Gallegati M, Gentili A. Robotization, employment, and income: regional asymmetries and long-run policies in the Euro area. J Evol Econ 2023:1-35. [PMID: 37362351 PMCID: PMC10111330 DOI: 10.1007/s00191-023-00819-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 06/28/2023]
Abstract
This work correlates the impact of robotization on employment and households' income at the regional scale with the level of investment in R&D and education policies. This kind of policy, by raising the qualitative and quantitative levels of human capital, contributes to improving the complementarity effect between humans and robots, thus mitigating the substitution effect. To this end, we compute the Adjusted Penetration of Robots (APR) (a metric used to measure the extent to which robots are being used in a particular industry or sector) at the sectoral level, combining the International Federation of Robotics database for the stock of robots, EUROSTAT Regional database, and the STructural ANalysis database on 150 NUTS-2 regions of the Euro area. We then perform a spatial stacked-panel analysis on the investment in R&D and education level. Results supports the idea that regions that invest more in R&D and have higher levels of human capital can turn the risk of robotization into an increase in both income and "quantity of work," by enhancing complementarity between robots and the labor force. On the contrary, regions investing less in R&D and having lower levels of human capital may suffer a reduction in households' disposable income.
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Affiliation(s)
- Enzo Valentini
- Department of Political Science, Communication and International Relations, University of Macerata, Via Don Minzoni, 22, 62100 Macerata, Italy
| | - Fabiano Compagnucci
- Social Sciences, Gran Sasso Science Institute (GSSI), Via Michele Iacobucci, 2, 67100 L’Aquila, Italy
| | - Mauro Gallegati
- Department of Management, Università Politecnica delle Marche, Piazzale Martelli, 8, 60129 Ancona, Italy
| | - Andrea Gentili
- Faculty of Economics, Università degli Studi Internazionali di Roma, Via Cristoforo Colombo, 200, 00147 Roma, Italy
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Taglienti A, Donati L, Dragone I, Ferretti L, Gentili A, Araniti F, Sapienza F, Astolfi R, Fiorentino S, Vecchiarelli V, Papalini C, Ragno R, Bertin S. In Vivo Antiphytoviral and Aphid Repellency Activity of Essential Oils and Hydrosols from Mentha suaveolens and Foeniculum vulgare to Control Zucchini Yellow Mosaic Virus and Its Vector Aphis gossypii. Plants (Basel) 2023; 12:1078. [PMID: 36903936 PMCID: PMC10005592 DOI: 10.3390/plants12051078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
In recent years, natural compounds have gained attention in many fields due to their wide-range biological activity. In particular, essential oils and their associated hydrosols are being screened to control plant pests, exerting antiviral, antimycotic and antiparasitic actions. They are more quickly and cheaply produced and are generally considered safer for the environment and non-target organisms than conventional pesticides. In this study, we report the evaluation of the biological activity of two essential oils and their corresponding hydrosols obtained from Mentha suaveolens and Foeniculum vulgare in the control of zucchini yellow mosaic virus and its vector, Aphis gossypii, in Cucurbita pepo plants. The control of the virus was ascertained with treatments applied either concurrently with or after virus infection; choice tests were performed to verify repellency activity against the aphid vector. The results indicated that treatments could decrease virus titer as measured using real-time RT-PCR, while the experiments on the vector showed that the compounds effectively repelled aphids. The extracts were also chemically characterized using gas chromatography-mass spectrometry. Mentha suaveolens and Foeniculum vulgare hydrosol extracts mainly comprised fenchone and decanenitrile, respectively, while essential oils analysis returned a more complex composition, as expected.
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Affiliation(s)
- Anna Taglienti
- Research Centre for Plant Protection and Certification, Council for Agricultural Research and Economics, 00156 Rome, Italy
| | - Livia Donati
- Research Centre for Plant Protection and Certification, Council for Agricultural Research and Economics, 00156 Rome, Italy
| | - Immacolata Dragone
- Research Centre for Plant Protection and Certification, Council for Agricultural Research and Economics, 00156 Rome, Italy
| | - Luca Ferretti
- Research Centre for Plant Protection and Certification, Council for Agricultural Research and Economics, 00156 Rome, Italy
| | - Andrea Gentili
- Research Centre for Plant Protection and Certification, Council for Agricultural Research and Economics, 00156 Rome, Italy
| | - Fabrizio Araniti
- Department of Agricultural and Environmental Science, University of Milan, 20122 Milan, Italy
| | - Filippo Sapienza
- Rome Center for Molecular Design, Department of Drug Chemistry and Technology, Sapienza University of Rome, 00185 Rome, Italy
| | - Roberta Astolfi
- Rome Center for Molecular Design, Department of Drug Chemistry and Technology, Sapienza University of Rome, 00185 Rome, Italy
| | - Simona Fiorentino
- Centro Appenninico del Terminillo “Carlo Jucci”, Perugia University, 02100 Rieti, Italy
| | - Valerio Vecchiarelli
- Centro Appenninico del Terminillo “Carlo Jucci”, Perugia University, 02100 Rieti, Italy
| | - Claudia Papalini
- ARSIAL Regional Agency for the Development and Innovation of Agriculture of Lazio, 00162 Rome, Italy
| | - Rino Ragno
- Rome Center for Molecular Design, Department of Drug Chemistry and Technology, Sapienza University of Rome, 00185 Rome, Italy
| | - Sabrina Bertin
- Research Centre for Plant Protection and Certification, Council for Agricultural Research and Economics, 00156 Rome, Italy
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Cascini F, Altamura G, Failla G, Gentili A, Puleo V, Melnyk A, Causio F, Ricciardi W. Approaches to priority identification in digital health in ten countries of the Global Digital Health Partnership. Front Digit Health 2022; 4:968953. [PMID: 36339514 PMCID: PMC9632991 DOI: 10.3389/fdgth.2022.968953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/22/2022] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND To promote shared digital health best practices in a global context, as agreed within the Global Digital Health Partnership (GDHP), one of the most important topics to evaluate is the ability to detect what participating countries believe to be priorities suitable to improve their healthcare systems. No previously published scientific papers investigated these aspects as a cross-country comparison. OBJECTIVE The aim of this paper is to present results concerning the priorities identification section of the Evidence and Evaluation survey addressed to GDHP members in 2021, comparing countries' initiatives and perspectives for the future of digital health based on internationally agreed developments. METHODS This survey followed a cross-sectional study approach. An online survey was addressed to the stakeholders of 29 major countries. RESULTS Ten out of 29 countries answered the survey. The mean global score of 3.54 out of 5, calculated on the whole data set, demonstrates how the global attention to a digital evolution in health is shared by most of the evaluated countries. CONCLUSION The resulting insights on the differences between digital health priority identification among different GDHP countries serves as a starting point to coordinate further progress on digital health worldwide and foster evidence-based collaboration.
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Affiliation(s)
| | - Gerardo Altamura
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
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Gentili A, Failla G, Melnyk A, Puleo V, Tanna GLD, Ricciardi W, Cascini F. The cost-effectiveness of digital health interventions: A systematic review of the literature. Front Public Health 2022; 10:787135. [PMID: 36033812 PMCID: PMC9403754 DOI: 10.3389/fpubh.2022.787135] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 07/21/2022] [Indexed: 01/21/2023] Open
Abstract
Background Digital health interventions have significant potential to improve safety, efficacy, and quality of care, reducing waste in healthcare costs. Despite these premises, the evidence regarding cost and effectiveness of digital tools in health is scarce and limited. Objectives The aim of this systematic review is to summarize the evidence on the cost-effectiveness of digital health interventions and to assess whether the studies meet the established quality criteria. Methods We queried PubMed, Scopus and Web of Science databases for articles in English published from January 1, 2016 to December 31, 2020 that performed economic evaluations of digital health technologies. The methodological rigorousness of studies was assessed with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2009 checklist. Results Search identified 1,476 results, 552 of which were selected for abstract and 35 were included in this review. The studies were heterogeneous by country (mostly conducted in upper and upper-middle income countries), type of eHealth intervention, method of implementation, and reporting perspectives. The qualitative analysis identified the economic and effectiveness evaluation of six different types of interventions: (1) seventeen studies on new video-monitoring service systems; (2) five studies on text messaging interventions; (3) five studies on web platforms and digital health portals; (4) two studies on telephone support; (5) three studies on new mobile phone-based systems and applications; and (6) three studies on digital technologies and innovations. Conclusion Findings on cost-effectiveness of digital interventions showed a growing body of evidence and suggested a generally favorable effect in terms of costs and health outcomes. However, due to the heterogeneity across study methods, the comparison between interventions still remains difficult. Further research based on a standardized approach is needed in order to methodically analyze incremental cost-effectiveness ratios, costs, and health benefits.
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Affiliation(s)
- Andrea Gentili
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy,*Correspondence: Andrea Gentili
| | - Giovanna Failla
- Department of Public Health, University of Verona, Verona, Italy
| | - Andriy Melnyk
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Valeria Puleo
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Gian Luca Di Tanna
- Statistics Division, The George Institute for Global Health, University of New South Wales, Newtown, NSW, Australia
| | - Walter Ricciardi
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Fidelia Cascini
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
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Bellomarini L, Bencivelli L, Biancotti C, Blasi L, Conteduca FP, Gentili A, Laurendi R, Magnanimi D, Zangrandi MS, Tonelli F, Ceri S, Benedetto D, Nissl M, Sallinger E. Reasoning on company takeovers: From tactic to strategy. DATA KNOWL ENG 2022. [DOI: 10.1016/j.datak.2022.102073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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13
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Gentili A, Donati L, Bertin S, Manglli A, Ferretti L. First Report of ' Candidatus Phytoplasma fragariae' Infecting Hazelnut in Italy. Plant Dis 2022; 106:PDIS11212566PDN. [PMID: 35306852 DOI: 10.1094/pdis-11-21-2566-pdn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- A Gentili
- CREA - Research Centre for Plant Protection and Certification, 00156 Rome, Italy
| | - L Donati
- CREA - Research Centre for Plant Protection and Certification, 00156 Rome, Italy
| | - S Bertin
- CREA - Research Centre for Plant Protection and Certification, 00156 Rome, Italy
| | - A Manglli
- CREA - Research Centre for Plant Protection and Certification, 00156 Rome, Italy
| | - L Ferretti
- CREA - Research Centre for Plant Protection and Certification, 00156 Rome, Italy
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14
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Montonati C, Pergola V, Dellino C, Continisio S, Mattesi G, Zolin A, Scarpa F, Storer V, Gentili A, Cabrelle G, Cattarin S, Motta R, De Conti G, Iliceto S, Mele D. C47 CORO–CT PLAQUE ANALYSIS IN ASSESSMENT OF CARDIOVASCULAR RISK. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Computed tomographic (CT) coronary angiography represents a non–invasive approach to assess plaque characteristics that provides information to change treatment of coronary artery disease (CAD) and to asses risk stratification.
Purpose
Analyze the differences in plaque composition between patients with different plaque features: soft unstable plaques, hard stable plaques and no plaques; identify whether there is a relationship between the plaque density and the pericoronary fat attenuation index (pFAI). Materials and methods: 372 patients retrospectively analyzed who underwent CTCA for exclusion of CAD. They were divided into three groups: 37 (10%) patients with high attenuated plaques (> 60HU), 137 (37%)with low attenuated plaques (<29 HU and a volume of at least 15 mm3 and/or 30–59 HU with a volume greater than 52 mm3) and 198 (53%) patients without significant CAD. For each patients we collected clinical, radiological and follow–up data.
Results and Discussion
Low–attenuated plaques are significantly associated with older age, male sex, dyslipidemia and diabetes mellitus (p < 0.001). Higher values of pFAI were more present in patients with soft plaques than in those with stable plaques and without plaques (p = 0.005). It was also found that soft plaques were present in more CA segments compared to stable plaques. Overall volume of soft plaque appears greater than hard plaques and mainly localized in the anterior descendant coronary artery with higher stenosis values (p < 0.001). Presence of plaques with soft or high–risk features predisposes significantly and independently (p < 0.001) to a composite outcome (death, in–hospital admissions for percutaneous angioplasty or by–pass procedures) at the follow up.
Conclusions
Coronary plaque analysis showed a good correlation between high–risk plaques and pFAI, supporting the hypothesis that the presence of high–risk plaques can be correlated to inflammatory burden. Furthermore, the presence of high risk plaques predispose to death or hospitalization for coronary intervention.
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Luigi M, Manglli A, Dragone I, Antonelli MG, Contarini M, Speranza S, Bertin S, Tiberini A, Gentili A, Varvaro L, Tomassoli L, Faggioli F. Effects of Biochar on the Growth and Development of Tomato Seedlings and on the Response of Tomato Plants to the Infection of Systemic Viral Agents. Front Microbiol 2022; 13:862075. [PMID: 35615512 PMCID: PMC9125222 DOI: 10.3389/fmicb.2022.862075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
Biochar is a rich carbon product obtained by pyrolysis of biomass under a limited supply of oxygen. It is composed mainly of aromatic molecules, but its agronomic value is hard to evaluate and difficult to predict due to its great variable characteristics depending on the type of starting biomass and the conditions of pyrolysis. Anyway, it could be used as soil amendment because it increases the soil fertility of acidic soils, increases the agricultural productivity, and seems to provide protection against some foliar and soilborne diseases. In this study, the effects of biochar, obtained from olive pruning, have been evaluated on tomato seedlings growth and on their response to systemic agents' infection alone or added with beneficial microorganisms (Bacillus spp. and Trichoderma spp.). First, experimental data showed that biochar seems to promote the development of the tomato seedlings, especially at concentrations ranging from 1 to 20% (w/w with peat) without showing any antimicrobial effects on the beneficial soil bacteria at the tomato rhizosphere level and even improving their growth. Thus, those concentrations were used in growing tomato plants experimentally infected with tomato spotted wilt virus (TSWV) and potato spindle tuber viroid (PSTVd). The biochar effect was estimated by evaluating three parameters, namely, symptom expression, number of infected plants, and pathogen quantification, using RT-qPCR technique and −ΔΔCt analysis. Biochar at 10–15% and when added with Trichoderma spp. showed that it reduces the replication of PSTVd and the expression of symptoms even if it was not able to block the start of infection. The results obtained on TSWV-infected plants suggested that biochar could contribute to reducing both infection rate and virus replication. For systemic viral agents, such as PSTVd and TSWV, there are no curative control methods, and therefore, the use of prevention means, as can be assumed the use biochar, for example, in the nursery specialized in horticultural crops, can be of great help. These results can be an encouraging starting point to introduce complex biochar formulates among the sustainable managing strategies of plant systemic diseases.
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Affiliation(s)
- Marta Luigi
- Council for Agricultural Research and Economics-Research Centre for Plant Protection and Certification (CREA-DC), Rome, Italy
| | - Ariana Manglli
- Council for Agricultural Research and Economics-Research Centre for Plant Protection and Certification (CREA-DC), Rome, Italy
| | - Immacolata Dragone
- Council for Agricultural Research and Economics-Research Centre for Plant Protection and Certification (CREA-DC), Rome, Italy
| | | | - Mario Contarini
- Department of Agriculture and Forest Sciences, University of Tuscia, Viterbo, Italy
| | - Stefano Speranza
- Department of Agriculture and Forest Sciences, University of Tuscia, Viterbo, Italy
| | - Sabrina Bertin
- Council for Agricultural Research and Economics-Research Centre for Plant Protection and Certification (CREA-DC), Rome, Italy
| | - Antonio Tiberini
- Council for Agricultural Research and Economics-Research Centre for Plant Protection and Certification (CREA-DC), Rome, Italy
| | - Andrea Gentili
- Council for Agricultural Research and Economics-Research Centre for Plant Protection and Certification (CREA-DC), Rome, Italy
| | - Leonardo Varvaro
- Department of Agriculture and Forest Sciences, University of Tuscia, Viterbo, Italy
| | - Laura Tomassoli
- Council for Agricultural Research and Economics-Research Centre for Plant Protection and Certification (CREA-DC), Rome, Italy
| | - Francesco Faggioli
- Council for Agricultural Research and Economics-Research Centre for Plant Protection and Certification (CREA-DC), Rome, Italy
- *Correspondence: Francesco Faggioli
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16
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Gentili A. Answering the great automation question. Sci Robot 2022; 7:eabo7210. [PMID: 35417203 DOI: 10.1126/scirobotics.abo7210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Modeling an automation risk index for job profiles provides insights into worker reallocation and informs retraining policy.
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Affiliation(s)
- Andrea Gentili
- University eCampus, Faculty of Economics, Via Isimbardi, 10 - 22060 Novedrate (CO), Italia
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17
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Donati L, Bertin S, Gentili A, Luigi M, Taglienti A, Manglli A, Tiberini A, Brasili E, Sciubba F, Pasqua G, Ferretti L. Effects of Organic Biostimulants Added with Zeolite on Zucchini Squash Plants Infected by Tomato Leaf Curl New Delhi Virus. Viruses 2022; 14:v14030607. [PMID: 35337014 PMCID: PMC8952782 DOI: 10.3390/v14030607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Abstract
The use of organic substances in integrated pest management can contribute to human- and environment-safe crop production. In the present work, a combination of organic biostimulants (Fullcrhum Alert and BioVeg 500) and an inorganic corroborant (Clinogold, zeolite) was tested for the effects on the plant response to the quarantine pest tomato leaf curl New Delhi virus (ToLCNDV). Biostimulants were applied to healthy and infected greenhouse-grown zucchini plants, and the vegetative parameters and viral titer were evaluated. Although no antiviral effects were observed in terms of both virus replication and symptom expression, these biostimulants were shown to influence plant fitness. A significant increase in biomass and in leaf, flower, and fruit production was induced in both healthy and infected plants. Biostimulants also enhanced the production of metabolites commonly involved in plant response to virus infection, such as carbohydrates, phenylpropanoids and free amino acids. These results encourage new field trials to evaluate the actual productivity of infected plants after treatments and the possible application of organic biostimulants in agriculture.
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Affiliation(s)
- Livia Donati
- Council for Agricultural Research and Economics–Research Centre for Plant Protection and Certification, 00156 Rome, Italy; (S.B.); (A.G.); (M.L.); (A.T.); (A.M.); (A.T.); (L.F.)
- Correspondence:
| | - Sabrina Bertin
- Council for Agricultural Research and Economics–Research Centre for Plant Protection and Certification, 00156 Rome, Italy; (S.B.); (A.G.); (M.L.); (A.T.); (A.M.); (A.T.); (L.F.)
| | - Andrea Gentili
- Council for Agricultural Research and Economics–Research Centre for Plant Protection and Certification, 00156 Rome, Italy; (S.B.); (A.G.); (M.L.); (A.T.); (A.M.); (A.T.); (L.F.)
| | - Marta Luigi
- Council for Agricultural Research and Economics–Research Centre for Plant Protection and Certification, 00156 Rome, Italy; (S.B.); (A.G.); (M.L.); (A.T.); (A.M.); (A.T.); (L.F.)
| | - Anna Taglienti
- Council for Agricultural Research and Economics–Research Centre for Plant Protection and Certification, 00156 Rome, Italy; (S.B.); (A.G.); (M.L.); (A.T.); (A.M.); (A.T.); (L.F.)
| | - Ariana Manglli
- Council for Agricultural Research and Economics–Research Centre for Plant Protection and Certification, 00156 Rome, Italy; (S.B.); (A.G.); (M.L.); (A.T.); (A.M.); (A.T.); (L.F.)
| | - Antonio Tiberini
- Council for Agricultural Research and Economics–Research Centre for Plant Protection and Certification, 00156 Rome, Italy; (S.B.); (A.G.); (M.L.); (A.T.); (A.M.); (A.T.); (L.F.)
| | - Elisa Brasili
- Department of Environmental Biology, Sapienza University of Rome, 00185 Rome, Italy; (E.B.); (F.S.); (G.P.)
- NMR-based Metabolomics Laboratory (NMLab), Sapienza University of Rome, 00185 Rome, Italy
| | - Fabio Sciubba
- Department of Environmental Biology, Sapienza University of Rome, 00185 Rome, Italy; (E.B.); (F.S.); (G.P.)
- NMR-based Metabolomics Laboratory (NMLab), Sapienza University of Rome, 00185 Rome, Italy
| | - Gabriella Pasqua
- Department of Environmental Biology, Sapienza University of Rome, 00185 Rome, Italy; (E.B.); (F.S.); (G.P.)
- NMR-based Metabolomics Laboratory (NMLab), Sapienza University of Rome, 00185 Rome, Italy
| | - Luca Ferretti
- Council for Agricultural Research and Economics–Research Centre for Plant Protection and Certification, 00156 Rome, Italy; (S.B.); (A.G.); (M.L.); (A.T.); (A.M.); (A.T.); (L.F.)
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18
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Tiberini A, Manglli A, Taglienti A, Vučurović A, Brodarič J, Ferretti L, Luigi M, Gentili A, Mehle N. Development and Validation of a One-Step Reverse Transcription Real-Time PCR Assay for Simultaneous Detection and Identification of Tomato Mottle Mosaic Virus and Tomato Brown Rugose Fruit Virus. Plants 2022; 11:plants11040489. [PMID: 35214821 PMCID: PMC8878898 DOI: 10.3390/plants11040489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/31/2022] [Accepted: 02/09/2022] [Indexed: 11/16/2022]
Abstract
Tobamovirus species represent a threat to solanaceous crops worldwide, due to their extreme stability and because they are seed borne. In particular, recent outbreaks of tomato brown rugose fruit virus in tomato and pepper crops led to the establishment of prompt control measures, and the need for reliable diagnosis was urged. Another member of the genus, tomato mottle mosaic virus, has recently gained attention due to reports in different continents and its common features with tomato brown rugose fruit virus. In this study, a new real-time RT-PCR detection system was developed for tomato brown rugose fruit virus and tomato mottle mosaic virus on tomato leaves and seeds using TaqMan chemistry. This test was designed to detect tomato mottle mosaic virus by amplifying the movement protein gene in a duplex assay with the tomato brown rugose fruit virus target on the CP-3’NTR region, which was previously validated as a single assay. The performance of this test was evaluated, displaying analytical sensitivity 10−5–10−6-fold dilution for seeds and leaves, respectively, and good analytical specificity, repeatability, and reproducibility. Using the newly developed and validated test, tomato brown rugose fruit virus detection was 100% concordant with previously performed analyses on 106 official samples collected in 2021 from different continents.
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Affiliation(s)
- Antonio Tiberini
- CREA—Research Centre for Plant Protection and Certification, Via C.G. Bertero 22, 00156 Roma, Italy; (A.M.); (A.T.); (L.F.); (M.L.); (A.G.)
- Correspondence:
| | - Ariana Manglli
- CREA—Research Centre for Plant Protection and Certification, Via C.G. Bertero 22, 00156 Roma, Italy; (A.M.); (A.T.); (L.F.); (M.L.); (A.G.)
| | - Anna Taglienti
- CREA—Research Centre for Plant Protection and Certification, Via C.G. Bertero 22, 00156 Roma, Italy; (A.M.); (A.T.); (L.F.); (M.L.); (A.G.)
| | - Ana Vučurović
- Department of Biotechnology and Systems Biology, National Institute of Biology, Večna pot 111, SI-1000 Ljubljana, Slovenia; (A.V.); (J.B.); (N.M.)
| | - Jakob Brodarič
- Department of Biotechnology and Systems Biology, National Institute of Biology, Večna pot 111, SI-1000 Ljubljana, Slovenia; (A.V.); (J.B.); (N.M.)
| | - Luca Ferretti
- CREA—Research Centre for Plant Protection and Certification, Via C.G. Bertero 22, 00156 Roma, Italy; (A.M.); (A.T.); (L.F.); (M.L.); (A.G.)
| | - Marta Luigi
- CREA—Research Centre for Plant Protection and Certification, Via C.G. Bertero 22, 00156 Roma, Italy; (A.M.); (A.T.); (L.F.); (M.L.); (A.G.)
| | - Andrea Gentili
- CREA—Research Centre for Plant Protection and Certification, Via C.G. Bertero 22, 00156 Roma, Italy; (A.M.); (A.T.); (L.F.); (M.L.); (A.G.)
| | - Nataša Mehle
- Department of Biotechnology and Systems Biology, National Institute of Biology, Večna pot 111, SI-1000 Ljubljana, Slovenia; (A.V.); (J.B.); (N.M.)
- School for Viticulture and Enology, University of Nova Gorica, Dvorec Lanthieri, Glavni trg 8, SI-5271 Vipava, Slovenia
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Cascini F, Beccia F, Causio FA, Gentili A, Melnyk A, Boccia S, Ricciardi W. Is blockchain the breakthrough we are looking for to facilitate genomic data sharing? The European Union perspective. Digit Health 2022; 8:20552076221114225. [PMID: 35860615 PMCID: PMC9290163 DOI: 10.1177/20552076221114225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022] Open
Abstract
The recent progress of genomics research is providing unprecedented insight into human genetic variance, susceptibility to disease and risk stratification. Current trends predict that a massive amount of genomic data will be produced in the upcoming years which, when coupled with the fast-paced development of the field, will create new social, ethical, and legal challenges. In the complex legislative environment of the European Union, genomic data sharing policies will have to weigh the benefits of scientific discovery against the ethical risks posed by the act of sharing sensitive data. In this complex, interconnected environment, blockchain provides a unique and novel solution to accountability, traceability, and transparency issues regarding genomic data sharing. Implementing a distributed ledger technology-based database could empower both patients and citizens to responsibly use genomic data pertaining to them because it allows for a higher degree of control over the recipients of their data and their uses. The blockchain technology will engage both data owners and policymakers to address the multiple issues of genomic data sharing and allow us to redefine the way we look at genomics.
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Affiliation(s)
- Fidelia Cascini
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Flavia Beccia
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesco A Causio
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Andrea Gentili
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Andriy Melnyk
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Stefania Boccia
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
- Department of Woman and Child Health and Public Health-Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
- Istituti Clinici Scientifici Maugeri, Pavia, Italy
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20
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Puleo V, Gentili A, Failla G, Melnyk A, Di Tanna G, Ricciardi W, Cascini F. Digital health technologies: a systematic review of their cost-effectiveness. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Digital health interventions have a potential to improve safety, efficacy and quality of care, reducing waste in healthcare costs. Despite premises, the evidence regarding cost and effectiveness of digital tools in health is scarce and limited.
Objectives: The aim of this systematic review is to summarize the evidence on cost-effectiveness of digital health interventions and to assess whether the studies meet the established quality criteria.
Methods
We queried PubMed, Scopus and Web of Science databases for articles in English published from 1 January 2016 to 31 December 2020 that performed economic evaluations of digital health technologies. The methodological rigorousness of studies was assessed with a well-established checklist (CHEERS). The incremental cost-effectiveness ratio (ICER)was calculated when the reviewed study reported related data but did not express the ICER.
Results
Searches identified 1476 results, 552 of which were selected for abstract and 35 were included in this review. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The qualitative analysis identified the economic and effectiveness evaluation of seven different types of interventions: fourteen studies on a new telemedicine service; five on telecounseling; five on teletherapy; two on telemonitoring; five on new mobile applications; two on m-health programs; one on digital platforms and one on electronic health records.
Conclusions
Findings on cost-effectiveness of digital interventions showed a growing body of evidence and suggested a generally favorable effect in terms of costs and health outcomes. However, due to the heterogeneity across study methods, the comparison between interventions still remains difficult. Further research based on a standardized approach is needed in order to methodically analyze incremental cost-effectiveness ratios, costs, and health benefits.
Key messages
Digital interventions suggested a favorable effect in terms of costs and health outcomes. Digital health interventions have a potential to improve safety, efficacy and quality of care.
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Affiliation(s)
- V Puleo
- Department of Life Sciences and Public Health, Section of Hygiene and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - A Gentili
- Department of Life Sciences and Public Health, Section of Hygiene and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - G Failla
- Department of Public Health, University of Verona, Verona, Italy
| | - A Melnyk
- Department of Life Sciences and Public Health, Section of Hygiene and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - G Di Tanna
- Statistics Division, University of New South Wales, Sydney, Australia
| | - W Ricciardi
- Department of Life Sciences and Public Health, Section of Hygiene and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - F Cascini
- Department of Life Sciences and Public Health, Section of Hygiene and Public Health, Catholic University of Sacred Heart, Rome, Italy
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21
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Carini E, Villani L, Pezzullo AM, Gentili A, Barbara A, Ricciardi W, Boccia S. The Impact of Digital Patient Portals on Health Outcomes, System Efficiency, and Patient Attitudes: Updated Systematic Literature Review. J Med Internet Res 2021; 23:e26189. [PMID: 34494966 PMCID: PMC8459217 DOI: 10.2196/26189] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/24/2021] [Accepted: 05/24/2021] [Indexed: 01/02/2023] Open
Abstract
Background Patient portals are becoming increasingly popular worldwide even though their impact on individual health and health system efficiency is still unclear. Objective The aim of this systematic review was to summarize evidence on the impact of patient portals on health outcomes and health care efficiency, and to examine user characteristics, attitudes, and satisfaction. Methods We searched the PubMed and Web of Science databases for articles published from January 1, 2013, to October 31, 2019. Eligible studies were primary studies reporting on the impact of patient portal adoption in relation to health outcomes, health care efficiency, and patient attitudes and satisfaction. We excluded studies where portals were not accessible for patients and pilot studies, with the exception of articles evaluating patient attitudes. Results Overall, 3456 records were screened, and 47 articles were included. Among them, 11 studies addressed health outcomes reporting positive results, such as better monitoring of health status, improved patient-doctor interaction, and improved quality of care. Fifteen studies evaluated the impact of digital patient portals on the utilization of health services with mixed results. Patient characteristics were described in 32 studies, and it was reported that the utilization rate usually increases with age and female gender. Finally, 30 studies described attitudes and defined the main barriers (concerns about privacy and data security, and lack of time) and facilitators (access to clinical data and laboratory results) to the use of a portal. Conclusions Evidence regarding health outcomes is generally favorable, and patient portals have the potential to enhance the doctor-patient relationship, improve health status awareness, and increase adherence to therapy. It is still unclear whether the use of patient portals improves health service utilization and efficiency.
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Affiliation(s)
- Elettra Carini
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Maria Pezzullo
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Gentili
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Barbara
- Hygiene and Public Health Service, ASL Roma 1, Rome, Italy.,Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Women, Children and Public Health Sciences - Public Health Area, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
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22
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Di Pietro ML, Zaçe D, Sisti LG, Frisicale EM, Corsaro A, Gentili A, Giraldi L, Bruno S, Boccia S. Development and validation of a questionnaire to assess Unaccompanied Migrant Minors' needs (AEGIS-Q). Eur J Public Health 2021; 31:313-320. [PMID: 33176357 DOI: 10.1093/eurpub/ckaa184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While many studies focus on specific aspects of Unaccompanied Migrant Minors' (UMMs) health, especially mental well-being, there is a lack of tools comprehensively assessing their needs. To fill this gap, we developed and validated a questionnaire to thoroughly assess unAccompaniEd miGrant mInorS' physical, psychological, legal, spiritual, social and educational needs (AEGIS-Q). METHODS This work consisted of three stages. The first one involved an extensive literature review. Given the results of the review, a first draft of the questionnaire was developed and submitted to a panel of experts for validation (Delphi method-second stage). During the third stage, the final version of the questionnaire was pilot-tested in a sample of 18 UMMs. RESULTS The questionnaire, drafted based on the results of the review, consisted of sections covering personal data, migration profile, physical health needs and access to healthcare, psychological needs, legal needs, spiritual needs and educational and social needs of UMMs. After two Delphi rounds, the final version of the questionnaire, consisting of 83 questions, was structured. The pilot study had a response rate of 89-100%. We found substantial reliability for most of the sections in the questionnaire, including physical health (α=0.652), legal (α=0.781), and educational and social (α=0.614) needs. The questions regarding psychological needs had very high reliability (α=0.860). CONCLUSIONS The questionnaire offers a useful sharable tool to assess and monitor UMMs' needs, helping the reception system to better know and meet their needs and implement the taking in charge.
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Affiliation(s)
- Maria Luisa Di Pietro
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Drieda Zaçe
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Leuconoe Grazia Sisti
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Emanuela Maria Frisicale
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia.,Azienda Sanitaria Locale (ASL), Roma, Italia
| | | | - Andrea Gentili
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Luca Giraldi
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Stefania Bruno
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia.,Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Stefania Boccia
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia.,Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
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Affiliation(s)
- Andrea Gentili
- Department of Anesthesia and Intensive Care, Villa Laura Hospital, Bologna, Italy -
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Cascini F, Santaroni F, Lanzetti R, Failla G, Gentili A, Ricciardi W. Developing a Data-Driven Approach in Order to Improve the Safety and Quality of Patient Care. Front Public Health 2021; 9:667819. [PMID: 34095071 PMCID: PMC8175645 DOI: 10.3389/fpubh.2021.667819] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 04/26/2021] [Indexed: 01/25/2023] Open
Abstract
Objective: To improve the safety and quality of patient care in hospitals by shaping clinical pathways throughout the patient journey. Study Setting: A risk model designed for healthcare organizations in the context of the challenges arising from comorbidity and other treatment-related complexities. Study Design: The core of the model is the patient and his intra-hospital journey, which is analyzed using a data-driven approach. The structure of a predictive model to support organizational and clinical decision-making activities is explained. Data relating to each step of the intra-hospital journey (from hospital admission to discharge) are extracted from clinical records. Principal Findings: The proposed approach is feasible and can be used effectively to improve safety and quality. It enables the evaluation of clinical risks at each step of the patient journey. Conclusion: Based on data from real cases, the model can record and calculate, over time, variables and behaviors that affect the safety and quality of healthcare organizations. This provides a greater understanding of healthcare processes and their complexity which can, in turn, advance research relating to clinical pathways and improve strategies adopted by organizations.
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Affiliation(s)
- Fidelia Cascini
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Federico Santaroni
- Department of Statistical Sciences, Sapienza Università di Roma, Roma, Italy
| | - Riccardo Lanzetti
- Orthopaedics and Traumatology Unit, Department Emergency and Acceptance, San Camillo - Forlanini Hospital, Roma, Italy
| | - Giovanna Failla
- Department of Public Health, University of Verona, Verona, Italy
| | - Andrea Gentili
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Walter Ricciardi
- Section of Hygiene and Public Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
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Pumpo MD, Barbara A, La Milia DI, Tamburrano A, Vallone D, Gentili A, Cavalieri S, Viora C, Berloco F, Laurenti P. Flu vaccination coverage in a large Italian teaching hospital: the example of the leaders. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Annual flu vaccination among healthcare workers (HCWs) is recommended to prevent influenza and to avoid its transmission especially to frail patients. In our teaching hospital, flu vaccination rate among HCWs has been growing during last 3 years. The aim of this study was therefore to describe the flu vaccination coverage across the past 3 years and to analyze which factors lead to such increase. We performed a cross-sectional study on all HCWs of Fondazione Policlinico Universitario “A. Gemelli” (FPG) hospital of Rome (Italy) to determine the flu vaccination coverage. Socio-demographic and occupational data were collected from hospital personnel records and included age, gender, previous flu vaccination, profession and workplace unit. On site vaccination plus academic detailing involving leaders have been the main strategies adopted in this last 3 years that have already proved to be effective in increasing vaccination coverage among HCWs. During the 2018-2019 season, we analyzed how the flu vaccination coverage among leaders (nurse coordinators and head physicians) could affect all HCWs coverage rate. Flu vaccination rate increased from 9.57% in the 2016-17 to 14.24% in the 2017-18 and to 22.38% in 2018-2019. A total of 4035 HCWs employed in the FPG were included in 2018-19. Concerning the role played by vaccination of leaders in increasing general vaccination coverage during the 2018-2019, the group of HCWs with a vaccinated leader showed a higher coverage rate (28.65%) than the group with a non-vaccinated leader (16.22%) (p < 0.0001). The results are preliminary. Flu vaccination coverage of HCWs in our hospital during the last 3 years has been increasingly higher. Vaccination of the leaders, in addition to previously implemented effective strategies, resulted to be a key factor in increasing flu vaccination coverage among all HCWs. Socio-demographic and occupational variables can significantly influence the coverage rate as well.
Key messages
Annual flu vaccination among healthcare workers (HCWs) is recommended to prevent influenza and to avoid its transmission especially to frail patients. This study shows the growing flu vaccination coverage rate in our teaching hospital and the effectiveness of the example given by the vaccinated leaders in increasing the coverage among all HCWs.
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Affiliation(s)
- M Di Pumpo
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Barbara
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - D I La Milia
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A Tamburrano
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - D Vallone
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Gentili
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Cavalieri
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Viora
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Berloco
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - P Laurenti
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Gentili A, La Milia DI, Vallone D, Di Pumpo M, Vangi G, Berloco F, Cambieri A, Damiani G, Laurenti P, Ricciardi W. A six-years point prevalence survey of healthcare-associated infections in an Italian hospital. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Healthcare-Associated Infections (HAIs) are among the most serious public health problems in Europe representing the most frequent adverse event during care delivery. Despite their limitations, point prevalence surveys of HAIs are often preferred to prospective surveillance, since they provide a feasible estimate when resources are limited.
The aim of this study was to analyze the results of a six-years point prevalence survey of HAIs in a teaching acute care hospital in Italy and to investigate the main risk factors of HAIs in the acute-care hospital. A point prevalence survey to detect HAIs was carried out in Gemelli Hospital during the last 6 years, from 2013 to 2018. Inpatients of any age in Gemelli Hospital were eligible for inclusion. Patients in outpatient areas were excluded. HAIs were identified according to diagnosis guideline from ECDC in 2011. Statistically significant differences were tested through t-test and Chi-square test. Multi-variate analysis was performed to evaluate the impact of regressor factors for predict HAI’s prevalence. The statistical significance level was set at p < 0.05. The point prevalence ranged from 3,16% in 2017 to 6,64% in 2013. Pneumonia and surgical site infections (SSI) were the most frequent HAIs during the 6 years, with a rate of 27,31% and 26,20% respectively of all HAIs. The multiple logistic regression showed that length of stay at the moment of detection, urinary catheter, CVC and antibiotic therapy are useful to meaningfully predict HAI prevalence, with a regression coefficient (adjusted R2) of 0.2780.
Thanks to proper hospital policies, the point prevalence of HAIs does not seem to increase through the years, even though it is still too early to draw any conclusions. Pneumonia and SSI represented each one more than a quarter of all the HAIs, as reported also in literature. There is a strong association between length of stay at the moment of detection and HAIs but it is hard to understand which one is the cause of the other.
Key messages
Point prevalence from 2013 to 2018 seems to be stable. An accurate incidence survey is needed in order to identify the main risk factors of HAI and to realize more specific hospital programmes. Length of stay at the moment of detection is useful to meaningfully predict HAIs prevalence although the cause-and-effect relationship is still not clear.
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Affiliation(s)
- A Gentili
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - D I La Milia
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - D Vallone
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Di Pumpo
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Vangi
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - F Berloco
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - A Cambieri
- Medical Management, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - G Damiani
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - P Laurenti
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - W Ricciardi
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
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Vallone D, Di Pumpo M, Gentili A, Tamburrano A, Berloco F, Corbo MI, Cambieri A, Damiani G, Ricciardi W, Laurenti P. Incidence study of surgical site infections in a large University Hospital in Rome, first results. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Surgical Site Infections (SSI) represent about a quarter of healthcare associated infections (HAI), increase the risk of mortality and hospital stay and extend healthcare costs. The aim of this work is to evaluate the incidence of SSI in patients undergoing surgical procedures of Hospital Units in the Fondazione Policlinico A. Gemelli IRCCS (FPG).
Methods
This descriptive observational monocentric study has a 30-months duration: the first phase was conducted between July 2018 and March 2019. Patients undergoing abdominal surgery procedures were enrolled. Active infection surveillance was performed, according to the ECDC, during the hospital stay and the surgical outpatient visits. We also performed a post-discharge surveillance (PDS) at 30 days (or 90 days if an implant has been inserted), through a telephone interview, made by a medical doctor resident in Public Health.
Results
During the first phase were enrolled 431 procedures in 2 Hospital Units, about emergency and hepatobiliary surgery. There were 53 cases of surgical site infection (SSI) highlighted in these procedures. Therefore, SSI’s were reported in 12.09% of the procedures. In particular, in 6.28% of cases, SSIs were diagnosed during the hospital stay. The results of this study showed statistically significant differences (p < 0.005) in incidence rate of emergency (10,70%) and hepatobiliary tract (13,17%) procedures. The average hospital stay was significant higher (p < 0.001) in patients who developed an SSI (17.27 days) than in patients without SSI (4.89 days).
Conclusions
These preliminary results show that the incidence rate of SSI for gastrointestinal procedures is similar to other European Countries (9.6%). The Hospital Health Management of FPG take care to the surveillance of hospital infections and monitor the correct application of the procedures, in line with the standards defined by Joint Commission International for guarantee high level in patients’ care.
Key messages
Performing a survey to measure the incidence of surgical site infections for surgery procedures is very important to define it and to improve surveillance systems of hospital infections in FPG. Active surveillance of surgical site infections may allow to enhance appropriate preventive measures.
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Affiliation(s)
- D Vallone
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Di Pumpo
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Gentili
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Tamburrano
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Berloco
- Hospital Health Management, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - M I Corbo
- Hospital Health Management, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A Cambieri
- Hospital Health Management, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - G Damiani
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
- Hospital Health Management, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - W Ricciardi
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
- Hospital Health Management, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - P Laurenti
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
- Hospital Health Management, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Villani L, Frisicale EM, Parente P, Cacciatore P, Carini E, Gentili A, Grossi A, Pezzullo AM, Favaretti C, Ricciardi W. 1st European Academy for Healthcare Leaders: high training on leadership to manage health systems. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Nowadays having leadership skills is critical to manage healthcare systems. The World Health Organization Collaborating Centre on Health Policy, Governance and Leadership organized the 1st European Academy for Healthcare Leaders in Rome from 15th to 17th November 2018. Senior officials of the Ministries of Health of 16 Members Countries of the WHO European Region attended and actively participated to the event, led by experienced Italian and European experts. The Academy could be considered a moment of high training on leadership and governance of health systems.
Objectives
The event was aimed at creating effective networks among participants to share ideas and strategies to improve leadership skills, providing practical tools to be applied in healthcare systems and to develop a common and transferrable leadership framework in Europe. Frontal lectures and interactive workshops covered three main areas: leadership skills, current challenges of health systems and sustainability of health systems today.
Results
The 3-days event gave the opportunity to discuss the main issues in Public Health highlighting how to be an effective leader in healthcare. Leadership should enable the translation of knowledge into productive action pathways, providing health equity and improving population’s health. At the end of the event, participants filled a survey and the results showed high satisfaction about contents (100% out of 16 participants).
Conclusions
Health systems need to change in order to face the formidable challenges of our times. This event empowered the participants in order to support the creation of strategies and to develop leadership tools to apply at country level. The experiences, ideas and good practices shared during this event strengthened a collaborative network and have been useful to identify common goals and solutions.
Key messages
These kinds of events are fundamental to improve knowledge about leadership in healthcare. Leadership should have a major role to play in healthcare worldwide.
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Affiliation(s)
- L Villani
- WHO Collaborating Centre for Health Policy, Governance and Leadership in Europe, Rome, Italy
- Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
| | - E M Frisicale
- WHO Collaborating Centre for Health Policy, Governance and Leadership in Europe, Rome, Italy
- Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
- Local Health Authority, ASL Roma 1, Rome, Italy
| | - P Parente
- WHO Collaborating Centre for Health Policy, Governance and Leadership in Europe, Rome, Italy
- Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
- Local Health Authority, ASL Roma 1, Rome, Italy
| | - P Cacciatore
- WHO Collaborating Centre for Health Policy, Governance and Leadership in Europe, Rome, Italy
- Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
| | - E Carini
- WHO Collaborating Centre for Health Policy, Governance and Leadership in Europe, Rome, Italy
- Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Gentili
- WHO Collaborating Centre for Health Policy, Governance and Leadership in Europe, Rome, Italy
- Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Grossi
- WHO Collaborating Centre for Health Policy, Governance and Leadership in Europe, Rome, Italy
- Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A M Pezzullo
- WHO Collaborating Centre for Health Policy, Governance and Leadership in Europe, Rome, Italy
- Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Favaretti
- WHO Collaborating Centre for Health Policy, Governance and Leadership in Europe, Rome, Italy
- Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
| | - W Ricciardi
- WHO Collaborating Centre for Health Policy, Governance and Leadership in Europe, Rome, Italy
- Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
- Women’s and Children’s Health Sciences and Public Health, Fondazione Policlinico A. Gemelli, Rome, Italy
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Gentili A. Pregabalin: A Drug Useful in the Management of Pain after Craniotomy? J Neurosci Rural Pract 2019; 10:646-647. [PMID: 31831984 PMCID: PMC6906100 DOI: 10.1055/s-0039-1697240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Andrea Gentili
- Department of Anaesthesia and Intensive Care, Villa Laura Hospital, Bologna, Italy
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Gentili A, Arrighi L, Spisni R, Arieti S, Baccarini E. December 27th, 1899-2019: the first spinal anesthesia in Italy is 120 years old. Minerva Anestesiol 2019; 85:1373-1374. [PMID: 31486627 DOI: 10.23736/s0375-9393.19.13977-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Andrea Gentili
- Department of Anesthesia and Intensive Care, Villa Laura Hospital, Bologna, Italy -
| | | | | | - Stefano Arieti
- Section of History of Medicine, Department of Specialist, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
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Affiliation(s)
- Andrea Gentili
- Department of Anesthesia and Intensive Care, Villa Laura Hospital, Bologna, Italy -
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Rega ML, Santitoro AA, Laurenti P, Gentili A, Damiani G. [Vaccination, attitudes and perception of parents. Study in the ASL of Salerno]. Prof Inferm 2019; 72:193-202. [PMID: 31883571 DOI: 10.7429/pi.2019.723193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Despite the many advances obtained thanks to vaccination, in recent years it has been a marked drop in vaccination coverage. In fact, data show the failure in reaching the 95% of coverage, equal to the safety threshold for almost all vaccinations. This is due to the phenomenon of vaccine hesitancy. Aim of this study is to describe knowledge, attitudes and perceptions respect to childhood vaccinations in a sample of parents of patients of a Free Choice Pediatrician (PLS) in the territory of Salerno Local Healthcare Service, (ASL) to assess what might be the educational needs of parents to decrease the hesitation. METHODS A quantitative observational descriptive and phenomenological study was conducted, recruiting parents belonging to a PLS in ASL Salerno, through a questionnaire constructed ad hoc. RESULTS Parents are not always favorable to vaccination and for some vaccine they fear a bond with a pharmaceutical business. All have vaccinated their children but not for all available vaccinations. DISCUSSION AND CONCLUSIONS . Through the educational means of the PLS doubts about vaccinations are minor and the sample of children is vaccinated, although parents appear not totally supportive and considers vaccinations as a warranty by the ASL. The sample has shown a discrepancy between the health workers about the need to vaccinate or not. Hence the need to train the health care professional before and make him responsible and then inform, through a dedicated path, who should receive the vaccine.
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Affiliation(s)
- Maria Luisa Rega
- PhD, MSN, Fondazione Policlinico Universitario A. Gemelli IRCCS,Roma,Italia Università Cattolica Sacro Cuore, Roma, Italia. Corresponding Author:
| | - Angiola Anna Santitoro
- MSN, RN, nfermiera presso dipartimento materno infantile:Terapia Intensiva Neonatale-terapia Intensiva Pediatrica AOUS di Siena, Siena - Italia
| | - Patrizia Laurenti
- Professore Associato, Istituto di Sanità Pubblica Sezione di Igiene, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia Università Cattolica del Sacro Cuore, Roma, Italia
| | - Andrea Gentili
- MD, Medico specializzando in Igiene e Medicina Preventiva,Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia. Università Cattolica Sacro Cuore, Roma, Italia
| | - Gianfranco Damiani
- Professore Associato Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia. Università Cattolica del Sacro Cuore, Roma, Italia
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Sisti LG, Frisicale EM, Corsaro A, Zace D, Gentili A, Giraldi L, Bruno S, Boccia S, Di Pietro ML, Ricciardi W. Unaccompanied migrant minors (UMMs) needs assessment: is there a shared needs assessment tool? Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- LG Sisti
- Department of Public Health, Section of Hygiene, Catholic University of Sacred Heart, Rome, Italy
| | - EM Frisicale
- Department of Public Health, Section of Hygiene, Catholic University of Sacred Heart, Rome, Italy
| | - A Corsaro
- Department of Public Health, Section of Hygiene, Catholic University of Sacred Heart, Rome, Italy
| | - D Zace
- Department of Public Health, Section of Hygiene, Catholic University of Sacred Heart, Rome, Italy
| | - A Gentili
- Department of Public Health, Section of Hygiene, Catholic University of Sacred Heart, Rome, Italy
| | - L Giraldi
- Department of Public Health, Section of Hygiene, Catholic University of Sacred Heart, Rome, Italy
| | - S Bruno
- Department of Public Health, Section of Hygiene, Catholic University of Sacred Heart, Rome, Italy
| | - S Boccia
- Department of Public Health, Section of Hygiene, Catholic University of Sacred Heart, Rome, Italy
| | - ML Di Pietro
- Center for Global Health Research and Studies, Department of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
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Gentili A, Barbara A, Tamburrano A, Berloco F, La Milia D, Zega M, Sguera A, Damiani G, Ricciardi W, Laurenti P. The use of Academic Detailing to promote influenza vaccination among healthcare workers in hospital. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky218.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Gentili
- Catholic University of the Sacred Heart, Rome, Italy
| | - A Barbara
- Catholic University of the Sacred Heart, Rome, Italy
| | - A Tamburrano
- Catholic University of the Sacred Heart, Rome, Italy
| | - F Berloco
- Agostino Gemelli Teaching Hospital, Rome, Italy
| | - D La Milia
- Agostino Gemelli Teaching Hospital, Rome, Italy
| | - M Zega
- Agostino Gemelli Teaching Hospital, Rome, Italy
| | - A Sguera
- Agostino Gemelli Teaching Hospital, Rome, Italy
| | - G Damiani
- Catholic University of the Sacred Heart, Rome, Italy
| | - W Ricciardi
- Catholic University of the Sacred Heart, Rome, Italy
| | - P Laurenti
- Catholic University of the Sacred Heart, Rome, Italy
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Owens M, Coogle C, Gentili A, Marrs S, Slattum P, Parsons P, Waters L, Ansello E. EVIDENCE-BASED FALLS PREVENTION TRAINING AT A REGIONAL MEDICAL CENTER. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Owens
- Virginia Commonwealth University
| | - C Coogle
- Virginia Commonwealth University
| | | | - S Marrs
- Virginia Commonwealth University
| | - P Slattum
- School of Pharmacy, Virginia Commonwealth University
| | | | - L Waters
- Virginia Commonwealth University
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Tamburrano A, Barbara A, Gentili A, Laurenti P. [Control of antimicrobial resistance in the food chain: a narrative review]. Ig Sanita Pubbl 2018; 74:565-587. [PMID: 31030214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A poor environmental management and the deterioration of health and hygiene conditions (lack of awareness and attention to hygienic standards, to measures for preventing transmission of infection, and to appropriate use of antimicrobial therapies) facilitate the selection, release and diffusion of resistant pathogens in the environment, which can very easily contaminate the food chain. Antimicrobial resistance is a major problem worldwide, involving many sectors: medicine, veterinary medicine, breeding, agriculture, economy and commerce. In addition, the expanding globalization and increasing movements of both goods and people across countries and continents have drastically exacerbated the situation. In this difficult context, professionals of both the food and health sectors have an important role to play and their active participation is essential, together with that of citizens and patients themselves. For this very reason, national programs to combat antimicrobial resistance are needed, with a special focus on surveillance, antimicrobial stewardship, training of professionals and citizens, all the while assuring the availability of economic resources to achieve these goals. The "One Health" initiative is intended to strengthen the link between different scientific disciplines, such as human and veterinary medicine, since the phenomenon of antimicrobial resistance may be further aggravated by microbial transmission from animals to humans, directly or indirectly through the consumption of food. The aim of this narrative review is to give an overview of what is known about antimicrobial resistance related to food chain, to illustrate its extent and epidemiology in Italy, in Europe and globally, and to discuss the measures required to fight antimicrobial resistance including good practices on the use of antibiotics.
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Barbara A, Gentili A, Tognetto A, Tamburrano A, La Milia DI, de Waure C, Zega M, Berloco F, Piccoli B, Damiani G, Ricciardi W, Laurenti P. Factors influencing flu vaccination in a large Italian teaching hospital. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Barbara
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Gentili
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Tognetto
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Tamburrano
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - DI La Milia
- Hospital Hygiene Unit, Fondazione Policlinico Universitario “Agostino Gemelli”, Rome, Italy
| | - C de Waure
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - M Zega
- Servizio Infermieristico Tecnico e Riabilitazione Aziendale (S.I.T.R.A.), Fondazione Policlinico Universitario “Agostino Gemelli”, Rome, Italy
| | - F Berloco
- Hospital Hygiene Unit, Fondazione Policlinico Universitario “Agostino Gemelli”, Rome, Italy
| | - B Piccoli
- Section of Occupational Medicine, Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario “Agostino Gemelli”, Rome, Italy
| | - G Damiani
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - W Ricciardi
- Italian National Institute of Health, Rome, Italy
| | - P Laurenti
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Mengarelli A, Gentili A, Strazza A, Burattini L, Fioretti S, Di Nardo F. Co-activation patterns of gastrocnemius and quadriceps femoris in controlling the knee joint during walking. J Electromyogr Kinesiol 2018; 42:117-122. [PMID: 30025300 DOI: 10.1016/j.jelekin.2018.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 07/03/2018] [Accepted: 07/12/2018] [Indexed: 10/28/2022] Open
Abstract
Muscular co-activation is a well-known mechanism for lower limb joint stabilization in both healthy and pathological individuals. This muscular feature appears particularly important for the knee joint, not only during challenging motor tasks such as cutting and landing but also during walking, due to knee cyclic loading. Gastrocnemius acts on the knee joint with a flexor activity and co-activations with quadriceps muscles lead to greater knee ligament strain with respect to an isolated burst of either muscle. Thus, this study aimed to assess possible co-activations between gastrocnemius and quadriceps muscles during walking. Five co-activation periods were assessed: during early stance (identified in 5.7 ± 5.1% of total strides), early and late foot-contact (88.9 ± 8.9% and 8.9 ± 8.2%), push-off (23.9 ± 12.2%) and late swing (29.0 ± 16.1%). Outcomes showed that late foot-contact and swing co-activations could deserve particular attention: in both cases the knee joint was close to the full extension (around 3.5° and 6°, respectively) and thus, considering also the anterior tibia translation due to the quadriceps activity, the simultaneous gastrocnemius burst could lead to an enhanced knee ligaments elongation. Findings of this study represent the first attempt to provide a reference knee joint co-activation framework, useful also for further evaluation in cohorts with knee failures.
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Affiliation(s)
- Alessandro Mengarelli
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Andrea Gentili
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Annachiara Strazza
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Laura Burattini
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Sandro Fioretti
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Francesco Di Nardo
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy.
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Gentili A. Perioperative intravenous pediatric fluid: is there still a gap between theory and practice? Paediatr Anaesth 2018; 28:476-477. [PMID: 29870131 DOI: 10.1111/pan.13358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Andrea Gentili
- Department of Pediatric Anesthesia and Intensive Care, S.Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
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De Vuono S, Ricci MA, Siepi D, Boni M, Gentili A, Scavizzi M, Daviddi G, Labate P, Roscini AR, Lupattelli G. Laparoscopic sleeve gastrectomy modifies cholesterol synthesis but not cholesterol absorption. Obes Res Clin Pract 2017; 11:118-122. [PMID: 28057416 DOI: 10.1016/j.orcp.2016.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/22/2016] [Accepted: 12/10/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Each bariatric surgery procedure impacts differently on cholesterol synthesis and absorption. Although a restrictive procedure, sleeve gastrectomy resolves diabetes mellitus and, like mixed-type procedures, induces early changes in gastrointestinal hormones. To our knowledge the present study is the first to assess the effects of sleeve gastrectomy on cholesterol synthesis and absorption. METHODS AND RESULTS 42 consecutive subjects with obesity and sleeve gastrectomy candidates were included in the study together with a control group of 20 subjects without obesity. Before sleeve gastrectomy and 10 months afterwards, all subjects underwent a clinical examination, blood tests, ultrasound visceral fat area estimation and determination of plasma lathosterol, campesterol and sitosterol concentrations. After sleeve gastrectomy, significant decreases were observed in BMI, waist circumference, visceral and subcutaneous fat, blood pressure, triglycerides, insulin and glucose levels, lathosterol and HOMA-IR. HDL-C and apolipoprotein AI levels increased significantly. No significant differences emerged in LDL-C, apolipoprotein B levels or cholesterol absorption markers. Lathosterol levels correlated significantly with BMI, visceral fat area and HOMA-IR. Differences in cholesterol intake after surgery were not significantly associated with differences in lathosterol, campesterol and sitosterol concentrations. CONCLUSIONS Sleeve gastrectomy reduced the markers of cholesterol synthesis but did not modify cholesterol absorption. Changes in cholesterol synthesis and absorption were independent of variations in cholesterol intake, suggesting a specific sleeve gastrectomy-related effect.
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Affiliation(s)
- S De Vuono
- Internal Medicine, Department of Medicine, University of Perugia, Italy.
| | - M A Ricci
- Internal Medicine, Department of Medicine, University of Perugia, Italy.
| | - D Siepi
- Internal Medicine, Department of Medicine, University of Perugia, Italy.
| | - M Boni
- Surgery Department, San Giovanni Battista Hospital, Foligno, Italy.
| | - A Gentili
- Internal Medicine, Department of Medicine, University of Perugia, Italy.
| | - M Scavizzi
- Internal Medicine, Department of Medicine, University of Perugia, Italy.
| | - G Daviddi
- Internal Medicine, Department of Medicine, University of Perugia, Italy.
| | - P Labate
- Internal Medicine, Department of Medicine, University of Perugia, Italy.
| | - A R Roscini
- Internal Medicine, Department of Medicine, University of Perugia, Italy.
| | - G Lupattelli
- Internal Medicine, Department of Medicine, University of Perugia, Italy.
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Gentili A, Zaibi MS, Alomar SY, De Vuono S, Ricci MA, Alaeddin A, Siepi D, Boni M, Vaudo G, Trayhurn P, Lupattelli G. Circulating Levels of the Adipokines Monocyte Chemotactic Protein-4 (MCP-4), Macrophage Inflammatory Protein-1β (MIP-1β), and Eotaxin-3 in Severe Obesity and Following Bariatric Surgery. Horm Metab Res 2016; 48:847-853. [PMID: 27300476 DOI: 10.1055/s-0042-108731] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of the study was to investigate the involvement of the adipokines eotaxin-3, MIP-1β, and MCP-4 in obesity and related comorbidities and the modification of their circulating levels after bariatric surgery. Eighty severely obese subjects and 20 normal-weight controls were included in the study. Circulating levels of MCP-4, MIP-1β, and eotaxin-3, and the main clinical, biochemical, and instrumental parameters for the evaluation of cardiovascular and metabolic profile were determined in controls and in obese subjects at baseline and 10 months after surgery. Within the obese group at baseline, eotaxin-3 levels were higher in males than females and in smokers than non-smokers and showed a positive correlation with LDL-cholesterol, apolipoprotein B, and leptin. MIP-1β showed a positive correlation with age and leptin and a negative correlation with adiponectin and was an independent predictor of increased carotid artery intima-media thickness. MCP-4 levels were higher in obese subjects than controls and showed a positive correlation with body mass index, eotaxin-3, and MIP-1β. Bariatric surgery induced a marked decrease in all the 3 adipokines. MCP-4 is a novel biomarker of severe obesity and could have an indirect role in favoring sub-clinical atherosclerosis in obese patients by influencing the circulating levels of eotaxin-3 and MIP-1β, which are directly related to the main atherosclerosis markers and risk factors. The reduction of circulating levels of MCP-4, eotaxin-3, and MIP-1β could be one of the mechanisms by which bariatric surgery contributes to the reduction of cardiovascular risk in these patients.
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Affiliation(s)
- A Gentili
- Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy
| | - M S Zaibi
- Clore Laboratory, Buckingham Institute for Translational Medicine, University of Buckingham, Buckingham, UK
| | - S Y Alomar
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - S De Vuono
- Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy
| | - M A Ricci
- Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy
| | - A Alaeddin
- Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy
| | - D Siepi
- Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy
| | - M Boni
- Department of Surgery, "San Giovanni Battista" Hospital, Foligno, Perugia, Italy
| | - G Vaudo
- Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy
| | - P Trayhurn
- Clore Laboratory, Buckingham Institute for Translational Medicine, University of Buckingham, Buckingham, UK
| | - G Lupattelli
- Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, "Santa Maria della Misericordia" Hospital, University of Perugia, Italy
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Gentili A, Trayhurn P, Alomar S, Zaibi M, De Vuono S, Ricci M, Alaeddin A, Siepi D, Boni M, Vaudo G, Lupattelli G. Role of new adipokines in the pathogenesis of atherosclerosis in morbidly obese subjects. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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De Monte C, Carradori S, Gentili A, Mollica A, Trisciuoglio D, Supuran CT. Dual Cyclooxygenase and Carbonic Anhydrase Inhibition by Nonsteroidal Anti-Inflammatory Drugs for the Treatment of Cancer. Curr Med Chem 2016; 22:2812-8. [PMID: 26180003 DOI: 10.2174/0929867322666150716113501] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/03/2015] [Accepted: 07/13/2015] [Indexed: 11/22/2022]
Abstract
Among the class of nonsteroidal anti-inflammatory drugs (NSAIDs), COX-2 inhibitors or "coxibs" selectively inhibit the activity of the inducible isoform of cyclooxygenase. Moreover, there is emerging evidence that the sulfonamide-type coxibs, but not the methylsulfones, display an inhibitory activity also against several isoforms of human carbonic anhydrase (CA, EC 4.2.1.1). In this regard, celecoxib and valdecoxib, possessing a primary sulfonamide that binds to the zinc ion at the active site of the enzyme, are nanomolar inhibitors of the cancer-related hCA IX isoform. Also meloxicam and lornoxicam, NSAIDs belonging to the class of "oxicams", that contain a cyclic tertiary sulfonamide moiety, inhibit this isoform at low micromolar concentrations. The multiple pharmacological effects of the sulfonamide anti-inflammatory agents could be ascribed to the dual inhibition of CA and COX enzymes, supporting the evidence that inflammation and hypoxia pathways are involved in cancer onset and progression and suggesting that the antitumoral activity of these compounds should be further explored for their possible use in the polypharmacology of cancer prevention and therapy.
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Affiliation(s)
- Celeste De Monte
- Sapienza University of Rome, Department of Drug Chemistry and Technologies, 00185 - Rome, Italy.
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Moretti R, Leger PL, Besson VC, Csaba Z, Pansiot J, Di Criscio L, Gentili A, Titomanlio L, Bonnin P, Baud O, Charriaut-Marlangue C. Sildenafil, a cyclic GMP phosphodiesterase inhibitor, induces microglial modulation after focal ischemia in the neonatal mouse brain. J Neuroinflammation 2016; 13:95. [PMID: 27126393 PMCID: PMC4850658 DOI: 10.1186/s12974-016-0560-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/24/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Perinatal ischemic stroke is the most frequent form of cerebral infarction in neonates; however, evidence-based treatments are currently lacking. We have previously demonstrated a beneficial effect of sildenafil citrate, a PDE-5 inhibitor, on stroke lesion size in neonatal rat pups. The present study investigated the effects of sildenafil in a neonatal mouse stroke model on (1) hemodynamic changes and (2) regulation of astrocyte/microglia-mediated neuroinflammation. METHODS Ischemia was induced in C57Bl/6 mice on postnatal (P) day 9 by permanent middle cerebral artery occlusion (pMCAo), and followed by either PBS or sildenafil intraperitoneal (i.p.) injections. Blood flow (BF) velocities were measured by ultrasound imaging with sequential Doppler recordings and laser speckle contrast imaging. Animals were euthanized, and brain tissues were obtained at 72 h or 8 days after pMCAo. Expression of M1- and M2-like microglia/macrophage markers were analyzed. RESULTS Although sildenafil (10 mg/kg) treatment potently increased cGMP concentrations, it did not influence early collateral recruitment nor did it reduce mean infarct volumes 72 h after pMCAo. Nevertheless, it provided a significant dose-dependent reduction of mean lesion extent 8 days after pMCAo. Suggesting a mechanism involving modulation of the inflammatory response, sildenafil significantly decreased microglial density at 72 h and 8 days after pMCAo. Gene expression profiles indicated that sildenafil treatment also modulates M1- (ptgs2, CD32 and CD86) and M2-like (CD206, Arg-1 and Lgals3) microglia/macrophages in the late phase after pMCAo. Accordingly, the number of COX-2(+) microglia/macrophages significantly increased in the penumbra at 72 h after pMCAo but was significantly decreased 8 days after ischemia in sildenafil-treated animals. CONCLUSIONS Our findings argue that anti-inflammatory effects of sildenafil may provide protection against lesion extension in the late phase after pMCAo in neonatal mice. We propose that sildenafil treatment could represent a potential strategy for neonatal ischemic stroke treatment/recovery.
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Affiliation(s)
- Raffaella Moretti
- University Paris Diderot, Sorbonne Paris Cité, INSERM, UMR 1141, 75019, Paris, France.,University degli Studi di Udine, Udine, Italy
| | - Pierre-Louis Leger
- University Paris Diderot, Sorbonne Paris Cité, INSERM, UMR 1141, 75019, Paris, France.,UPMC-Paris6, AP-HP, Hôpital Armand Trousseau, Réanimation Néonatale et Pédiatrique, 75012, Paris, France
| | - Valérie C Besson
- University Paris Diderot, Sorbonne Paris Cité, INSERM, UMR 1141, 75019, Paris, France.,Pharmacologie de la Circulation Cérébrale - EA4475, Faculté des Sciences Pharmaceutiques et Biologiques, University of Paris Descartes, Paris, France
| | - Zsolt Csaba
- University Paris Diderot, Sorbonne Paris Cité, INSERM, UMR 1141, 75019, Paris, France
| | - Julien Pansiot
- University Paris Diderot, Sorbonne Paris Cité, INSERM, UMR 1141, 75019, Paris, France
| | - Lorena Di Criscio
- University Paris Diderot, Sorbonne Paris Cité, INSERM, UMR 1141, 75019, Paris, France
| | - Andrea Gentili
- University Paris Diderot, Sorbonne Paris Cité, INSERM, UMR 1141, 75019, Paris, France
| | - Luigi Titomanlio
- University Paris Diderot, Sorbonne Paris Cité, INSERM, UMR 1141, 75019, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, AP-HP, Hôpital Robert Debré, Urgences Pédiatriques, 75019, Paris, France
| | - Philippe Bonnin
- University Paris Diderot, Sorbonne Paris Cité, AP-HP, Hôpital Lariboisière, Physiologie Clinique, Explorations-Fonctionnelles, 75010, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, INSERM, U965, 75010, Paris, France
| | - Olivier Baud
- University Paris Diderot, Sorbonne Paris Cité, INSERM, UMR 1141, 75019, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, AP-HP, Hôpital Robert Debré, Réanimation Néonatale, 75019, Paris, France
| | - Christiane Charriaut-Marlangue
- University Paris Diderot, Sorbonne Paris Cité, INSERM, UMR 1141, 75019, Paris, France. .,INSERM UMR 1141, Hopital Robert Debré, 48 bd Serurier, 75019, Paris, France.
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Pérez-Fernández V, Gentili A, Martinelli A, Caretti F, Curini R. Evaluation of oxidized buckypaper as material for the solid phase extraction of cobalamins from milk: Its efficacy as individual and support sorbent of a hydrophilic–lipophilic balance copolymer. J Chromatogr A 2016; 1428:255-66. [DOI: 10.1016/j.chroma.2015.07.109] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/17/2015] [Accepted: 07/31/2015] [Indexed: 10/23/2022]
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Gentili A, Pasini L, Iannella E, Landuzzi V, Lima M, Bacchi Reggiani ML, Baroncini S. Predictive outcome indexes in neonatal Congenital Diaphragmatic Hernia. J Matern Fetal Neonatal Med 2014; 28:1602-7. [PMID: 25234103 DOI: 10.3109/14767058.2014.963043] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE We examined the reliability of the main prenatal and postnatal prognosis-related indexes that can be used to evaluate congenital diaphragmatic hernia (CDH) outcome. METHODS Seventy-seven neonates with CDH were analyzed according to CDH prognosis-related factors, divided into prenatal findings, postnatal clinical values and postnatal predictive outcome scores applied at birth and within the first 12-24 h. The data are compared between two groups: survivors and non-survivors. RESULTS During prenatal age, major associated anomalies, intrathoracic stomach, diagnosis prior to 25 weeks of gestational age and lung-to-head ratio < 0.6 were statistically significant, demonstrating their greater incidence in non-survivors. The majority of postnatal values at PICU admission were found to be reliable in identifying the CDH outcome: paO2/FiO2, oxygenation index, alveolar-arterial-O2 gradient, arterial-alveolar-O2 tension ratio, pH, mean blood pressure, body temperature. All the postnatal predictive outcome scores (Apgar 1' and 5', CDH-Study-Group equation, Score for Neonatal-Acute-Physiology II, SNAP-Perinatal-Extension II, Pediatric Risk of Mortality III and Wilford-Hall/Santa-Rosa formula) were statistically significant with more favorable values for prognosis in the survivors group. CONCLUSION The chances of predicting CDH outcome are fairly high. During prenatal age, only a few findings may be obtained. Conversely, many postnatal indexes and scores can reliably predict such outcome.
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Affiliation(s)
- A Gentili
- a Department of Paediatric Anaesthesia and Intensive Care
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Cordelli DM, Masetti R, Ricci E, Toni F, Zama D, Maffei M, Gentili A, Parmeggiani A, Pession A, Franzoni E. Life-threatening complications of posterior reversible encephalopathy syndrome in children. Eur J Paediatr Neurol 2014; 18:632-40. [PMID: 24814477 DOI: 10.1016/j.ejpn.2014.04.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 04/06/2014] [Accepted: 04/11/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although the posterior reversible encephalopathy syndrome (PRES) is considered to have a benign clinical outcome, the presentation of PRES can be associated with life-threatening complications such as severe cerebral hemorrhage, cerebellar herniation and refractory status epilepticus (SE). The aim of this paper is to report incidence, clinical features and outcome of life-threatening complications related to PRES in children. METHODS Patients who suffered from life-threatening complications were retrospectively identified from a group composed by 27 consecutive children diagnosed with PRES in our hospital between 2000 and 2012. The clinical, radiological and EEG features and the outcome of these patients were evaluated and compared to the characteristics of patients with no complications. RESULTS Five patients (18%) presented life-threatening complications: 2 cerebral hemorrhages with mass effect and midline shift (1 massive intraparenchymal hemorrhage and 1 subdural hemorrhage and intraparenchymal hemorrhage), 2 transforaminal cerebellar herniations and 1 refractory SE. Two children died because of complications and 2 children required urgent neurosurgical intervention. The infratentorial involvement at onset of PRES and the observation of focal neurological deficits other than visual disturbances were significantly more frequent in children with life-threatening complications (p < 0.01). CONCLUSIONS PRES is associated with a non-negligible incidence of life-threatening complications. A careful clinical, neuroradiological and EEG monitoring is necessary in order to improve the outcome especially in the case of focal neurological deficits and infratentorial involvement.
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Affiliation(s)
- Duccio M Cordelli
- Child Neurology Unit, University of Bologna, S. Orsola Malpighi Hospital, Via Massarenti 11, Bologna, Italy.
| | - Riccardo Masetti
- Pediatric Oncology and Hematology Unit "Lalla Seràgnoli", University of Bologna, S. Orsola Malpighi Hospital, Via Massarenti 11, Bologna, Italy
| | - Emilia Ricci
- Child Neurology Unit, University of Bologna, S. Orsola Malpighi Hospital, Via Massarenti 11, Bologna, Italy
| | - Francesco Toni
- Neuroradiology Department, IRCCS Institute of Neurological Sciences, Bellaria Hospital, Bologna, Italy
| | - Daniele Zama
- Pediatric Oncology and Hematology Unit "Lalla Seràgnoli", University of Bologna, S. Orsola Malpighi Hospital, Via Massarenti 11, Bologna, Italy
| | - Monica Maffei
- Neuroradiology Department, IRCCS Institute of Neurological Sciences, Bellaria Hospital, Bologna, Italy
| | - Andrea Gentili
- Pediatric Intensive Care Unit, University of Bologna, S. Orsola Malpighi Hospital, Via Massarenti 11, Bologna, Italy
| | - Antonia Parmeggiani
- Child Neurology Unit, University of Bologna, S. Orsola Malpighi Hospital, Via Massarenti 11, Bologna, Italy
| | - Andrea Pession
- Pediatric Oncology and Hematology Unit "Lalla Seràgnoli", University of Bologna, S. Orsola Malpighi Hospital, Via Massarenti 11, Bologna, Italy
| | - Emilio Franzoni
- Child Neurology Unit, University of Bologna, S. Orsola Malpighi Hospital, Via Massarenti 11, Bologna, Italy
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Gentili A, Carfagnini F, Mondardini MC, Tani G, Cazzato S, Baroncini S. Pneumorrachis in child with pectus excavatum during acute status asthmaticus. Minerva Anestesiol 2014; 80:508-509. [PMID: 24257151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- A Gentili
- Department of Pediatric Anesthesia and Intensive Care, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy -
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Serafini G, Ingelmo PM, Astuto M, Baroncini S, Borrometi F, Bortone L, Ceschin C, Gentili A, Lampugnani E, Mangia G, Meneghini L, Minardi C, Montobbio G, Pinzoni F, Rosina B, Rossi C, Sahillioğlu E, Sammartino M, Sonzogni R, Sonzogni V, Tesoro S, Tognon C, Zadra N. Preoperative evaluation in infants and children: recommendations of the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI). Minerva Anestesiol 2014; 80:461-469. [PMID: 24193177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The preoperative assessment involves the process of evaluating the patient's clinical condition, which is intended to define the physical status classification, eligibility for anesthesia and the risks associated with it, thus providing elements to select the most appropriate and individualized anesthetic plan. The aim of this recommendation was provide a framework reference for the preoperative evaluation assessment of pediatric patients undergoing elective surgery or diagnostic/therapeutic procedures. METHODS We obtained evidence concerning pediatric preoperative evaluation from a systematic search of the electronic databases MEDLINE and Embase between January 1998 and February 2012. We used the format developed by the Italian Center for Evaluation of the Effectiveness of Health Care's scoring system for assessing the level of evidence and strength of recommendations. RESULTS We produce a set of consensus guidelines on the preoperative assessment and on the request for preoperative tests. A review of the existing literature supporting these recommendations is provided. In reaching consensus, emphasis was placed on the level of evidence, clinical relevance and the risk/benefit ratio. CONCLUSION Preoperative evaluation is mandatory before any diagnostic or therapeutic procedure that requires the use of anesthesia or sedation. The systematic prescription of complementary tests in children should be abandoned, and replaced by a selective and rational prescription, based on the patient history and clinical examination performed during the preoperative evaluation.
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Affiliation(s)
- G Serafini
- Dipartimento di Anestesia e Rianimazione 1, Fondazione IRCCS Policlinico S. Matteo, Università di Pavia, Pavia, Italy -
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