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Fabbro E, Kyrdoda Y, Dore S, Marzi G, Borruso G, Battino S, Piani GC, Vianelli D. Is entrepreneurship a key factor in the development of European countries? A proposal for an innovation readiness environment (IRE) index. Open Res Eur 2024; 4:12. [PMID: 38638592 PMCID: PMC11024594 DOI: 10.12688/openreseurope.16813.1] [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: 12/13/2023] [Indexed: 04/20/2024]
Abstract
This study investigates the complex interplay among innovation, research and development (R&D), and entrepreneurship within the context of European nations. The focus of the study is also on the contributory role of tertiary educational institutions in nurturing entrepreneurial activities. To deepen the understanding of these multifaceted relationships and their subsequent impact on regional economies, the research introduces a novel metric termed the Innovation Readiness Environment (IRE) index. This index combines various indicators such as R&D expenditure, patenting rates, firm size, and educational levels, thereby providing a framework for evaluating the innovative capabilities and entrepreneurial success of firms in a given region. Utilization of this index offers policymakers and stakeholders a nuanced understanding of the regional innovation ecosystem, facilitating the identification of both strengths and deficiencies. This, in turn, enables the formulation of targeted policy interventions to enhance both innovation and entrepreneurship. One salient conclusion drawn from this study is the pivotal role of tertiary education in catalysing entrepreneurial ventures. The findings posit that higher levels of entrepreneurial education significantly supplement an individual's likelihood of entrepreneurial success by imparting the requisite skills and knowledge indispensable in a competitive business milieu. Higher education institutions, by fostering an environment conducive to innovation, emerge as critical agents in the cultivation of entrepreneurial acumen and the stimulation of economic expansion. The study further incorporates a spatial analytical framework to elucidate the regional specificities of innovation at the pan-European scale.
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Affiliation(s)
- Elisa Fabbro
- Internationalization Staff Unit, Institutional Services Area, University of Trieste, Trieste, Friuli-Venezia Giulia, Italy
| | - Yuliia Kyrdoda
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Friuli-Venezia Giulia, Italy
| | - Salvatore Dore
- Technology Transfer Office, University of Trieste, Trieste, Friuli-Venezia Giulia, Italy
| | - Giacomo Marzi
- IMT School for Advanced Studies Lucca, Lucca, Tuscany, Italy
| | - Giuseppe Borruso
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Friuli-Venezia Giulia, Italy
| | - Silvia Battino
- Department of Economics and Business, University of Sassari, Sassari, Sardinia, Italy
| | - Giovanni Cristiano Piani
- Communication and External Relations, University of Trieste, Trieste, Friuli-Venezia Giulia, Italy
| | - Donata Vianelli
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Friuli-Venezia Giulia, Italy
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Busani L, Creti R, Fabbro E, Prestinaci F, Pantosti A, Marella AM, Brusaferro S, Sabbatucci M. Fighting Antimicrobial Resistance and Healthcare-Associated Infections in EU-JAMRAI: The One-Health Response from Italy. Chemotherapy 2023; 69:56-64. [PMID: 37673044 DOI: 10.1159/000531684] [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] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/13/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Antimicrobial resistance (AMR) is a serious health threat, and it has high priority among the European public health agenda. The development and implementation of the National Action Plans (NAPs) with a One-Health perspective to fight AMR was supported in 2017 by the European Union (EU) through a Joint Action on Antimicrobial Resistance and Healthcare Associated Infections (EU-JAMRAI). The Italian National Institute of Health (Istituto Superiore di Sanità), supported by the University of Udine, and the University of Foggia were among the 44 partners involved. This paper describes the results of EU-JAMRAI relevant to Italy and its impact on national policies. METHODS The activities involved national and international experts who worked in groups, either in virtual or face-to-face meetings. Country-to-country visits were organized to assess and compare the national strategies to counteract AMR and to exchange best practices. In addition, qualitative research methods, particularly focus groups (FGs) and structured interviews, were carried out to collect information and opinions from the experts. RESULTS The Italian team of experts from the Ministry of Health and the University of Foggia visited the Netherlands and hosted the Polish expert team in Italy. In two FG, stakeholders' opinions from different organizations were collected and analyzed to identify critical areas and provide recommendations to ensure implementation of the NAP and effective One-Health integration. In addition, attitudes of medical professionals toward antimicrobial stewardship were evaluated in a medium/large Italian hospital. Strengths were identified in the multidisciplinary approach and the hospital management's proactive involvement. As for the veterinary sector, Italy was among the 10 EU countries that did not have any national AMR surveillance in place for animal bacterial pathogens. Consequently, a European surveillance system was proposed with the adhesion of Italy. Regarding research and innovation to fight AMR and healthcare-associated infection, Italy worked with the other European partners to identify national research gaps and opportunities. As a result, recommendations were issued to the authorities to promote research and innovation with a One-Health approach. CONCLUSIONS The Italian participation in the EU JAMRAI provided experience and examples to the Italian government for implementing the NAP and planning the roadmap to fight AMR and helped point out the system's criticalities. It also supported the promotion of the One-Health integrated vision that was included in the updated NAP.
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Affiliation(s)
- Luca Busani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
- Centre for Gender Specific-medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Roberta Creti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Elisa Fabbro
- Department of Medicine, University of Udine, Udine, Italy,
- Internationalisation Staff Unit, University of Trieste, Trieste, Italy,
| | - Francesca Prestinaci
- Centre for Control and Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy
| | - Annalisa Pantosti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Anna Maria Marella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Silvio Brusaferro
- Department of Medicine, University of Udine, Udine, Italy
- Presidency, Istituto Superiore di Sanità, Rome, Italy
| | - Michela Sabbatucci
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
- Directorate General for health prevention, Ministry of Health, Rome, Italy
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Sana S, Fabbro E, Zovi A, Vitiello A, Ola-Ajayi T, Zahoui Z, Salami B, Sabbatucci M. Scoping Review on Barriers and Challenges to Pediatric Immunization Uptake among Migrants: Health Inequalities in Italy, 2003 to Mid-2023. Vaccines (Basel) 2023; 11:1417. [PMID: 37766094 PMCID: PMC10537267 DOI: 10.3390/vaccines11091417] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
In the aftermath of the COVID-19 pandemic, asylum seekers, refugees, and foreign-born migrants are more likely to suffer from physical, mental, and socioeconomic consequences owing to their existing vulnerabilities and worsening conditions in refugee camps around the world. In this scenario, the education of migrants and newcomers about immunization is critical to achieving health equity worldwide. Globally, it is unclear whether government vaccination policies are prioritizing the health information needs of migrants. We searched for studies investigating the vaccination uptake of migrant children settled in Italy that were published between January 2003 and 25 June 2023. Following Arksey and O'Malley's five-stage method for scoping reviews, all potentially relevant literature published in English was retrieved from SciSearch, Medline, and Embase. This search resulted in 88 research articles, 25 of which met our inclusion criteria. Our findings indicate unequal access to vaccination due to a lack of available information in the native language of the immigrants' country of origin, vaccine safety concerns or lack of awareness, logistical difficulties, and fear of legal consequences. The findings strongly encourage further government and political discourse to ensure migrants have fair, equitable, ethical, and timely access to essential medicines.
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Affiliation(s)
- Samina Sana
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada; (S.S.); (T.O.-A.); (Z.Z.); (B.S.)
| | - Elisa Fabbro
- Internationalization Staff Unit, Institutional Services Area, University of Trieste, Piazzale Europa, 1, 34127 Trieste, Italy
- Area Science Park, Padriciano, 99, 34149 Trieste, Italy
| | - Andrea Zovi
- Directorate General for Hygiene, Food Safety and Nutrition, Ministry of Health, Viale Giorgio Ribotta 5, 00144 Rome, Italy; (A.Z.)
| | - Antonio Vitiello
- Directorate General for Hygiene, Food Safety and Nutrition, Ministry of Health, Viale Giorgio Ribotta 5, 00144 Rome, Italy; (A.Z.)
| | - Toluwani Ola-Ajayi
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada; (S.S.); (T.O.-A.); (Z.Z.); (B.S.)
| | - Ziad Zahoui
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada; (S.S.); (T.O.-A.); (Z.Z.); (B.S.)
| | - Bukola Salami
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada; (S.S.); (T.O.-A.); (Z.Z.); (B.S.)
- Directorate General for Health Prevention, Ministry of Health, Viale Giorgio Ribotta 5, 00144 Rome, Italy
| | - Michela Sabbatucci
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, Calgary, AB T6G 1C9, Canada
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Sirrs S, Fabbro E, Sechi A. Training competencies in adult metabolic medicine: A survey of working adult metabolic medicine physicians. JIMD Rep 2022; 63:468-474. [PMID: 36101815 PMCID: PMC9458608 DOI: 10.1002/jmd2.12312] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/18/2022] [Accepted: 06/14/2022] [Indexed: 12/15/2022] Open
Abstract
The rapid expansion of the number of adult patients with inherited metabolic diseases (IMDs) has created demand for physicians with expertise in the field of adult metabolic medicine (AMM). Unfortunately, existing accredited training programs in this field are rare, and training programs in pediatric metabolic medicine cannot fully meet the needs of AMM physicians as the types of patients and the problems they face are different in the adult setting. We surveyed a group of working practitioners in AMM for input on what medical expert competencies they feel should be included as part of training programs in AMM. Through a modified Delphi process, 66 physicians from six continents reached consensus on a comprehensive list of training competencies in AMM. This list includes competencies from the fields of adult internal medicine, neurology, medical genetics, and pediatric metabolic medicine but also includes competencies not found in any of those programs, leading to the conclusion that the training needs for specialists in AMM cannot be met from any of these existing programs. We propose that AMM be considered a subspecialty separate from pediatric metabolic medicine and that accredited training programs in AMM be created using these medical expert competencies as part of a broader program design.
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Affiliation(s)
- Sandra Sirrs
- Division of Endocrinology, Department of Medicine University of British Columbia Vancouver British Columbia Canada
| | - Elisa Fabbro
- Research and Third Mission Unit University of Trieste Trieste Italy
| | - Annalisa Sechi
- Regional Coordinating Center for Rare Diseases University Hospital of Udine Udine Italy
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Sechi A, Fabbro E, Sirrs S. The right tool for the job-Fit for purpose training programs in adult metabolic medicine. J Inherit Metab Dis 2022; 45:864-865. [PMID: 35513340 DOI: 10.1002/jimd.12511] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Annalisa Sechi
- Regional Coordinating Center for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Elisa Fabbro
- Research and Third Mission Unit, University of Trieste, Trieste, Italy
| | - Sandra Sirrs
- Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Fabbro E, Arnau Sánchez J, Del Pilar López Acuña M, Hukelová H, Alcaraz Quiñonero M, Pantosti A, Busani L. Where we are in the fight against Antimicrobial Resistance and Healthcare-Associated Infections. The opinion of the stakeholders of the European Joint Action on Antimicrobial Resistance and Healthcare-Associated Infections (EU-JAMRAI). Ann Ist Super Sanita 2022; 58:204-212. [PMID: 36128970 DOI: 10.4415/ann_22_03_10] [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: 06/15/2023]
Abstract
During the second European Joint Action on Antimicrobial Resistance (AMR) and Healthcare-Associated Infections (HCI) (EU-JAMRAI) annual meeting, the Evaluation Team elicited stakeholders' opinions regarding the implementation of the National Strategies and Action Plans to fight AMR and HCI, the One Health integration and the EU-JAMRAI support to the national and EU authorities in two Focus Groups. This qualitative exercise contributed to identify criticalities and possible improvements in aspects such as political priorities, legislation/legal requirements, human and financial resources, and supervision in many health sectors to ensure effective implementation of the action plans. Stakeholders pointed out at the different speed of EU member states, in particular concerning the One Health integration in the plans. Finally, the Stakeholders strongly asked the EU-JAMRAI to reinforce the integration and dissemination of the best practices and results, to help policymakers at national and European levels in defining and implementing harmonized policies and actions against AMR and HCI.
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Affiliation(s)
- Elisa Fabbro
- Università degli Studi di Trieste, Trieste, Italy
| | | | | | - Hana Hukelová
- Instituto Murciano de Investigación Biosanitaria, El Palmar, Murcia, Spain
| | | | - Annalisa Pantosti
- Formerly, Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Luca Busani
- Centro di Riferimento per la Medicina di Genere, Istituto Superiore di Sanità, Rome, Italy
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Sidoli C, Zambon A, Tassistro E, Rossi E, Mossello E, Inzitari M, Cherubini A, Marengoni A, Morandi A, Bellelli G, Tarasconi A, Sella M, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Porcella L, Nardiello I, Chimenti E, Zeni M, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, Pietrogrande L, Mosca M, Corazzin I, Rossi P, Nunziata V, D’Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell’Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Borghi C, Bianchetti A, Crucitti A, DiFrancesco V, Fontana G, Geriatria A, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cassadonte F, Vatrano M, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Seneci F, Fimognari F, Bambar V, Saitta A, Corica F, Braga M, Servi, Ettorre E, Camellini Bellelli CG, Annoni G, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Formilan M, Patrizia G, Santuar L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl’Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Alessandro M, Calogero P, Corvalli G, Di F, Pezzoni D, Platto C, D’Ambrosio V, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Bonetto M, Grasso M, Troisi E, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Faraci B, Bertoletti E, Vannucci M, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D’Amico F, Grippa A, Mazzone A, Cottino M, Vezzadini G, Avanzi S, Brambilla C, Orini S, Sgrilli F, Mello A, Lombardi Muti LE, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D’Amico F, D’Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Cortegiani A, Pistidda L, D’Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study. Aging Clin Exp Res 2022; 34:1827-1835. [PMID: 35396698 DOI: 10.1007/s40520-022-02099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. AIM We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the "Delirium Day project". METHODS We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the "Delirium Day project" (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. RESULTS Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17-1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08-2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62-2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10-1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02-1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68-3.36, p value < 0.0001). CONCLUSION This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.
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Zucchelli A, Manzoni F, Morandi A, Di Santo S, Rossi E, Valsecchi MG, Inzitari M, Cherubini A, Bo M, Mossello E, Marengoni A, Bellelli G, Tarasconi A, Sella M, Auriemma S, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Margola A, Porcella L, Nardiello I, Chimenti E, Zeni M, Giani A, Famularo S, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Ballestrero A, Minaglia C, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, De F, Pietrogrande L, De B, Mosca M, Corazzin I, Rossi P, Nunziata V, D‘Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell‘Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Bianchetti A, Crucitti A, Di Francesco V, Fontana G, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cannistrà U, Cassadonte F, Vatrano M, Cassandonte F, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Fimognari F, Bambara V, Saitta A, Corica F, Braga M, Ettorre E, Camellini C, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Patrizia G, Santuari L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl‘Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Calogero P, Corvalli G, Pezzoni D, Gentile S, Morandi A, Platto C, D‘Ambrosio V, Faraci B, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Confente S, Bonetto M, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Bertoletti E, Vannucci M, Tesi F, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D‘Amico F, Grippa A, Mazzone A, Riva E, Dell‘Acqua D, Cottino M, Vezzadini G, Avanzi S, Orini S, Sgrilli F, Mello A, Lombardi L, Muti E, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, De F, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D‘Amico F, D‘Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Scapigliati A, Cortegiani A, Vitale F, Pistidda L, D‘Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017. Aging Clin Exp Res 2022; 34:349-357. [PMID: 34417734 PMCID: PMC8847195 DOI: 10.1007/s40520-021-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/31/2021] [Indexed: 01/22/2023]
Abstract
Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric
syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01950-8.
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Bolatov AK, Seisembekov TZ, Askarova AZ, Baikanova RK, Smailova DS, Fabbro E. Online-Learning due to COVID-19 Improved Mental Health Among Medical Students. Med Sci Educ 2021; 31:183-192. [PMID: 33230424 PMCID: PMC7673686 DOI: 10.1007/s40670-020-01165-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/08/2020] [Indexed: 05/12/2023]
Abstract
In reference to the announcement of the pandemic of the new coronavirus 2019-(nCoV), all educational institutions in the Republic of Kazakhstan have switched to online learning (OL). The purpose of this study was to investigate the mental state of the medical students switching to OL in comparison with the mental state of the students who had traditional learning (TL). A repeated questionnaire-based cross-sectional study was conducted among medical students ranging from 1st year to 5th year at Astana Medical University in the 2019-2020 academic year. The first study was conducted during the TL (October-November 2019, N = 619), and the second study was conducted during the OL period (April 2020, N = 798). Burnout syndrome, depression, anxiety, somatic symptoms, and satisfaction with academic performance have been studied. The findings revealed that prevalence of the burnout syndrome, depression, anxiety, and somatic symptoms decreased after transitioning from TL to OL. However, during the OL period, the prevalence of colleague-related burnout increased, which tells us about the negative impact of OL on students' communication and interpersonal relationships. The most common depression and anxiety symptoms, dissatisfaction with academic performance were among students who indicated a decrease in academic performance during OL. Students who lived alone during the quarantine were more prone to depression during OL. In conclusion, during the quarantine period after the transition from TL to OL, the mental health state of medical students improved, despite the severe conditions of the pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-020-01165-y.
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Affiliation(s)
- Aidos K. Bolatov
- Astana Medical University, Beybitshilik St. 49A, Nur-Sultan, Kazakhstan Z10K9D9
| | | | | | | | - Dariga S. Smailova
- Semey Medical University, Abay Kunanbayev St. 103, Semey, Kazakhstan F17G0D3
| | - Elisa Fabbro
- University of Udine, Via Colugna 50, 33100 Udine, Italy
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Sechi A, Fabbro E, Langeveld M, Tullio A, Lachmann R, Mochel F. Education and training in adult metabolic medicine: Results of an international survey. JIMD Rep 2019; 49:63-69. [PMID: 31497483 PMCID: PMC6718119 DOI: 10.1002/jmd2.12044] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 12/12/2022] Open
Abstract
Adult metabolic medicine (AMM) is an expanding medical subspecialty, due to the increasing number of adult patients with inherited metabolic diseases (IMD). However, a formal training and postgraduate education in this field is not available in the majority of countries. Existing adult metabolic specialists (AMS) come from many different backgrounds. The aim of this survey was to assess the state of play as regards education and training in AMM worldwide. Members of the Society for the Study of Inborn Error of Metabolism adult metabolic group (n = 89) were asked to take part in this survey. Forty-two AMS (47.2%) from 18 different countries completed the questionnaire. The most common specialties were internal medicine (38.1%), endocrinology (26.2%), genetics (21.4%), and neurology (21.4%). Ninety-five percent of respondents considered that practical clinical experience had contributed importantly for their professional development, while only 27% felt the same for formal academic education. The current state of available education and training was judged as generally poor or fair (73% of the respondents). The most suggested ways of improving education and training in AMM were: to facilitate international internships; to implement courses on adult-IMD; and to create a formal academic education. The skills considered most important for AMS were: recognition of signs and symptoms of diseases, knowledge of the available treatments, and ability to perform a correct follow up. In conclusion, worldwide, current available education and training in AMM is considered inadequate. This survey emphasizes the need for development of new, formal training opportunities to improve knowledge, and competence in this rapidly expanding field.
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Affiliation(s)
- Annalisa Sechi
- Regional Coordinator Centre for Rare DiseasesAcademic Hospital of UdineUdineItaly
| | - Elisa Fabbro
- Department of MedicineUniversity of UdineUdineItaly
| | - Mirjam Langeveld
- Academic Medical CentreUniversity of AmsterdamAmsterdamThe Netherlands
| | - Annarita Tullio
- Institute of Hygiene and Clinical EpidemiologyAcademic Hospital of UdineUdineItaly
| | | | - Fanny Mochel
- Reference Center for Neurometabolic DiseasesLa Pitié‐Salpêtriere University HospitalParisFrance
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Battistella C, Quattrin R, Celotto D, d'Angelo M, Fabbro E, Brusaferro S, Agodi A, Astengo M, Baldo V, Baldovin T, Bert F, Biancone L, Calò LA, Canale A, Castellino P, Carli A, Icardi G, Lopalco PL, Righi A, Siliquini R, Tardivo S, Tassinari F, Veroux M. Factors predicting influenza vaccination adherence among patients in dialysis: an Italian survey. Hum Vaccin Immunother 2019; 15:2434-2439. [PMID: 30852938 DOI: 10.1080/21645515.2019.1588005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 10/27/2022] Open
Abstract
Introduction: The aim of this study was to investigate knowledge and practices about influenza among patients on dialysis services of Italian hospitals at risk of severe influenza infection and vaccine and to identify predictive factors to vaccination adherence. Methods: A cross-sectional observational study was carried out from January 2017 to July 2017 after the 2016/2017 influenza vaccination campaign. The questionnaire was administered to all patients treated in seven large Italian dialysis services. It consisted of influenza vaccination coverage, knowledge about influenza and its vaccination, perceived risk of influenza complications, recommendations on influenza uptake received by general practitioner (GP) and nephrologist. Results: Response rate was 90% (703/781). Patients' knowledge about influenza infection and vaccine were detected by nine closed questions: 35.6% of responders answered correctly to ≥ 6 sentences, 47.5% of them reported that "influenza vaccine can cause influenza" and 45.7% believed that "antibiotics are a correct strategy to treat influenza". Levels of perceived risks of hospitalisation and death were low in 39.3% and 16.5% of patients respectively. The adherence to the last seasonal influenza vaccination was 57.5%. The multivariate predictors of influenza vaccination uptake resulted: age ≥65, male, consulting TV/radio, asking information to GP and/or nephrologist. Conclusions: The study reveals the low adherence to influenza vaccination and the subotpimal level of knowledge in dialysis patients. Different strategies, including a greater alliance among nephrologists and GPs to prevent influenza should be encouraged to improve the adherence to influenza vaccination in this at risk group.
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Affiliation(s)
| | - Rosanna Quattrin
- Department of Organisation of Hospital Services, Azienda Sanitaria Universitaria Integrata di Udine , Udine , Italy
| | | | | | - Elisa Fabbro
- Department of Medicine, University of Udine , Udine , Italy
| | | | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania , Catania , Italy
| | - Matteo Astengo
- Dipartimento Scienze della Salute, University of Genova , Genova , Italy
| | - Vincenzo Baldo
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padova , Padova , Italy
| | - Tatjana Baldovin
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padova , Padova , Italy
| | - Fabrizio Bert
- Dipartimento Scienze della Sanita' Pubblica, University of Turin , Torino , Italy.,Citta' della Salute e della Scienza Torino , Torino , Piemonte , Italy
| | - Luigi Biancone
- Citta' della Salute e della Scienza Torino , Torino , Piemonte , Italy.,Dipartimento Scienze Mediche, University of Turin , Torino , Italy
| | - Lorenzo A Calò
- Department of Medicine (DIMED), Nephrology, University of Padova , Padova , Italy
| | - Alice Canale
- Department of Translational Research and New Technologies in Medicine and Surgery, Hygiene and Epidemiology Section, University of Pisa , Pisa , Italy
| | - Pietro Castellino
- Department of Clinical and Experimental Medicine, Internal Medicine, University of Catania , Catania , Italy
| | - Alberto Carli
- Department of Diagnostic and Public Health, University of Verona , Verona , Italy
| | - Giancarlo Icardi
- Dipartimento Scienze della Salute, University of Genova , Genova , Italy
| | - Pietro Luigi Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, Hygiene and Epidemiology Section, University of Pisa , Pisa , Italy
| | - Anna Righi
- Department of Translational Research and New Technologies in Medicine and Surgery, Hygiene and Epidemiology Section, University of Pisa , Pisa , Italy
| | - Roberta Siliquini
- Dipartimento Scienze della Sanita' Pubblica, University of Turin , Torino , Italy.,Citta' della Salute e della Scienza Torino , Torino , Piemonte , Italy
| | - Stefano Tardivo
- Department of Diagnostic and Public Health, University of Verona , Verona , Italy
| | - Federico Tassinari
- Dipartimento Scienze della Salute, University of Genova , Genova , Italy
| | - Massimiliano Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies, Vascular Surgery and Organ Transplant Unit, University Hospital of Catania , Catania , Italy
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Cattani G, Madia A, Arnoldo L, Valent F, Lavia B, Celotto D, Grillone L, Fabbro E, Basaglia G, Brusaferro S. Positive impact of a regional Antimicrobial Stewardship Program: Friuli Venezia Giulia's experience. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.398] [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)
- G Cattani
- Alto Friuli – Collinare – Medio Friuli Healthcare Trust, Directorate of Friuli Venezia Giulia Regional Health System, Codroipo, Italy
| | - A Madia
- Department of Medicine, University of Udine, Udine, Italy
| | - L Arnoldo
- Udine Healthcare and University Integrated Trust, Directorate of Friuli Venezia Giulia Regional Health System, Udine, Italy
| | - F Valent
- Udine Healthcare and University Integrated Trust, Udine, Italy
| | - B Lavia
- Directorate of Friuli Venezia Giulia Regional Health System, Udine, Italy
| | - D Celotto
- Department of Medicine, University of Udine, Udine, Italy
| | - L Grillone
- Department of Medicine, University of Udine, Udine, Italy
| | - E Fabbro
- Department of Medicine, University of Udine, Udine, Italy
| | - G Basaglia
- Friuli Occidentale Healthcare Trust, Pordenone, Italy
| | - S Brusaferro
- Department of Medicine, University of Udine, Udine, Italy
- Udine Healthcare and University Integrated Trust, Directorate of Friuli Venezia Giulia Regional Health System, Udine, Italy
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Moccia A, Quattrin R, Battistella C, Fabbro E, Brusaferro S. An easy, prompt and reproducible methodology to manage an unexpected increase of incident reports in surgery theatres. BMJ Open Qual 2018; 6:e000147. [PMID: 29435508 PMCID: PMC5717955 DOI: 10.1136/bmjoq-2017-000147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 06/28/2017] [Revised: 10/07/2017] [Accepted: 10/09/2017] [Indexed: 11/03/2022] Open
Abstract
Objectives Surgery is a high-risk hospital area for adverse events (AEs) occurrence. This study aims to develop an effectiveness and reactive methodology to manage an unexpected increase of AEs in the operating rooms (ORs) of a large Academic Hospital providing about 30 000 surgeries per year. Methods The study included three phases: 1. analysis of the AEs collected through the hospital incident reporting system from 2014 to 2015; 2. development of a programme to improve the surgical patient's safety and 3. application and evaluation of the programme effectiveness. Results In 2014, all hospital AEs were 825 (10.3% in ORs), while in the first 5 months of 2015, they were 645 (17.7% in ORs) [relative risk (RR) 2015 vs 2014=1.7; 95% CI=1.3 to 2.2; p<0.0001] with two sentinel events. Due to this increase, 177 real-time observations were planned in 12 ORs with external staff (n.25) during 1 week in June, July and November 2015 using a checklist with 14 items related to the patient's pathway (surgical site, time-out, medical records and sponges count). After the observations, the AEs decreased from 11.4×1000 surgeries (January-June 2015) to 8.6×1000 (July-December 2015) (RR=0.7, 95% CI=0.6 to 0.9, p<0.05). Compliance to the correct procedures applied by ORs staff has improved during the year for all items. Conclusions The methodology of this study has been revealed effective to control an unexpected increase in AEs and to improve the healthcare workers' adherence to correct procedures and it could be translated in other patients' safety settings.
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Affiliation(s)
- Adriana Moccia
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Rosanna Quattrin
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | | | - Elisa Fabbro
- Department of Medicine, Università degli Studi di Udine, Udine, Italy
| | - Silvio Brusaferro
- Department of Medicine, Università degli Studi di Udine, Udine, Italy
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Madia A, Arnoldo L, Cattani G, Lavia B, Fabbro E, Brusaferro S. Four years of a Regional Antimicrobial Stewardship project: analysis of antibiotic consumption. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.205] [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)
- A Madia
- Department of Medicine, Udine, Italy
| | - L Arnoldo
- Department of Medicine, Udine, Italy
| | - G Cattani
- Alto Friuli-Collinare-Medio Friuli Healthcare Trust, Codroipo, Italy
| | - B Lavia
- Directorate of Friuli Venezia Giulia Regional Health System, Udine, Italy
| | - E Fabbro
- Department of Medicine, Udine, Italy
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Palese A, Fabbro E, Casetta A, Mansutti I. First or Second Drop of Blood in Capillary Glucose Monitoring: Findings from a Quantitative Study. J Emerg Nurs 2016; 42:420-6. [PMID: 27181194 DOI: 10.1016/j.jen.2016.03.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/18/2014] [Revised: 03/09/2016] [Accepted: 03/11/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED For clinical nurses, especially those working in emergency departments, it is crucial to measure blood glucose (BG) in an accurate, timely, and safe manner. Many differences in practice exist with regard to use of the first or second drop of blood for testing, and no consistent guidelines are available for capillary BG testing at home or in ED settings. The purpose of this study is to evaluate the BG differences between the first and second drop of capillary blood collected from the same site in patients with type 1 diabetes. METHODS A consecutive sample of 195 persons with type 1 diabetes who had washed their hands and were not suspected of having hypoglycemia were included in the study. Descriptive and inferential statistical analysis for non-normal distributed variables was performed. RESULTS A strong correlation emerged between the BG reported in the first and the second drops (Spearman's rho test [rs] 0.979, P < .001; Pearson r 0.978, P < .001). The average BG values obtained from the first and second drops were 184.30 mg/dL (median, 166) and 187.6 mg/dL (median, 172), respectively, and thus the second drop showed higher glucose values compared with the first drop. However, BG values of the second drop were not higher in all occasions: whereas some evaluations reported higher BG values in the second drop capillary sample (n = 123), others reported higher values in the first drop (n = 65), and still others reported identical measurements in the first and second drops (n = 7). Five outliers were present with a BG difference from -39 to -53 mg/dL in the first drop compared with the second drop, and 3 outliers were present with a BG difference from +46 to +57 mg/dL in the first drop compared with the second drop. However, the differences that emerged were not affected by glucose concentration (P = .221). DISCUSSION Using the first drop of blood in a patient with clean hands allows emergency nurses to perform the test more quickly, resulting in immediate information. Findings indicate that the first drop of blood is adequate for clinical decision making, but the clinician should use judgment if using protocols in which small values (eg, 6 mg/dL) are important, because the first drop is more likely to have a slightly lower value.
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Spanghero M, Zanfi C, Fabbro E, Scicutella N, Camellini C. Effect of milk replacers added with microencapsulated organic acids or essential oils on the performance of weaning calves. Italian Journal of Animal Science 2016. [DOI: 10.4081/ijas.2007.1s.366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- M. Spanghero
- Dipartimento di Scienze Animali, Università di Udine, Italy
| | - C. Zanfi
- Dipartimento di Scienze Animali, Università di Udine, Italy
| | - E. Fabbro
- Dipartimento di Scienze Animali, Università di Udine, Italy
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Brusaferro S, Arnoldo L, Cattani G, Fabbro E, Cookson B, Gallagher R, Hartemann P, Holt J, Kalenic S, Popp W, Privitera G, Prikazsky V, Velasco C, Suetens C, Varela Santos C. Harmonizing and supporting infection control training in Europe. J Hosp Infect 2015; 89:351-6. [PMID: 25777079 DOI: 10.1016/j.jhin.2014.12.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 12/16/2014] [Indexed: 11/18/2022]
Abstract
Healthcare-associated infection (HCAI), patient safety, and the harmonization of related policies and programmes are the focus of increasing attention and activity in Europe. Infection control training for healthcare workers (HCWs) is a cornerstone of all patient safety and HCAI prevention and control programmes. In 2009 the European Centre for Disease Prevention and Control (ECDC) commissioned an assessment of needs for training in infection control in Europe (TRICE), which showed a substantial increase in commitment to HCAI prevention. On the other hand, it also identified obstacles to the harmonization and promotion of training in infection control and hospital hygiene (IC/HH), mostly due to differences between countries in: (i) the required qualifications of HCWs, particularly nurses; (ii) the available resources; and (iii) the sustainability of IC/HH programmes. In 2013, ECDC published core competencies for infection control and hospital hygiene professionals in the European Union and a new project was launched ['Implementation of a training strategy for infection control in the European Union' (TRICE-IS)] that aimed to: define an agreed methodology and standards for the evaluation of IC/HH courses and training programmes; develop a flexible IC/HH taxonomy; and implement an easily accessible web tool in 'Wiki' format for IC/HH professionals. This paper reviews several aspects of the TRICE and the TRICE-IS projects.
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Affiliation(s)
- S Brusaferro
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
| | - L Arnoldo
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - G Cattani
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - E Fabbro
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - B Cookson
- Division of Infection and Immunity, University College London, London, UK
| | - R Gallagher
- Infection Prevention and Control, Royal College of Nursing, London, UK
| | - P Hartemann
- Service d'Hygiène Hospitalière, C.H.U. de Nancy & DESP-SERES, Faculté de Médicine, Vandoeuvre‒Nancy, France
| | - J Holt
- National Center for Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - S Kalenic
- Department of Medical Microbiology, University of Zagreb, Zagreb, Croatia
| | - W Popp
- Hospital Hygiene, University Clinics Essen, Essen, Germany
| | - G Privitera
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, University of Pisa, Pisa, Italy
| | - V Prikazsky
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - C Velasco
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - C Suetens
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - C Varela Santos
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Brusaferro S, Cookson B, Kalenic S, Cooper T, Fabry J, Gallagher R, Hartemann P, Mannerquist K, Popp W, Privitera G, Ruef C, Viale P, Coiz F, Fabbro E, Suetens C, Varela Santos C. Training infection control and hospital hygiene professionals in Europe, 2010: agreed core competencies among 33 European countries. ACTA ACUST UNITED AC 2014; 19. [PMID: 25523973 DOI: 10.2807/1560-7917.es2014.19.49.20985] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The harmonisation of training programmes for infection control and hospital hygiene (IC/HH) professionals in Europe is a requirement of the Council recommendation on patient safety. The European Centre for Disease Prevention and Control commissioned the 'Training Infection Control in Europe' project to develop a consensus on core competencies for IC/HH professionals in the European Union (EU). Core competencies were drafted on the basis of the Improving Patient Safety in Europe (IPSE) project's core curriculum (CC), evaluated by questionnaire and approved by National Representatives (NRs) for IC/HH training. NRs also re-assessed the status of IC/HH training in European countries in 2010 in comparison with the situation before the IPSE CC in 2006. The IPSE CC had been used to develop or update 28 of 51 IC/HH courses. Only 10 of 33 countries offered training and qualification for IC/HH doctors and nurses. The proposed core competencies are structured in four areas and 16 professional tasks at junior and senior level. They form a reference for standardisation of IC/HH professional competencies and support recognition of training initiatives.
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Affiliation(s)
- S Brusaferro
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
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Brusaferro S, Cookson B, Gallagher R, Hartemann P, Holt J, Kalenic S, Popp W, Privitera G, Arnoldo L, Cattani G, Fabbro E, Varela Santos C, Suetens C. A model for validation of European Professional Infection Control/Hospital Hygiene training courses. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku161.139] [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: 11/12/2022] Open
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Cosso C, Barbieri F, Franconeri A, Piccazzo R, Fabbro E, Seriolo B, Garlaschi G, Cutolo M, Cimmino M. SAT0504 Mri Bone Marrow Oedema is A Frequent Feature in Patients with Gout. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4380] [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: 11/03/2022]
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Brusaferro S, Cookson B, Gallagher R, Hartemann P, Holt J, Kalenic S, Popp W, Privitera G, Varela Santos C, Suetens C, Arnoldo L, Cattani G, Fabbro E. Promoting european infection control / hospital hygiene core competencies: a need for training professionals in Europe. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt123.122] [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: 11/14/2022] Open
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22
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Brusaferro S, Cookson BD, Gallagher R, Hartemann P, Holte J, Kalenic S, Popp W, Privitera GP, Santos CV, Suetens C, Arnoldo L, Cattani G, Fabbro E. P171: Promoting European infection control / hospital hygiene core competencies (EIC/HHCC): a comparative analysis with related disciplines. Antimicrob Resist Infect Control 2013. [PMCID: PMC3688218 DOI: 10.1186/2047-2994-2-s1-p171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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23
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Barbieri F, Tomatis V, Zampogna G, Fabbro E, Piccazzo R, Ferrero G, Cimmino MA. FRI0498 An mri study of bone erosions healing in the wrist and metacarpophalangeal joints of patients with rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1625] [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: 11/04/2022]
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Orlandi D, Fabbro E, Ferrero G, Martini C, Lacelli F, Serafini G, Silvestri E, Sconfienza LM. High-resolution ultrasound of the extrinsic carpal ligaments. J Ultrasound 2012; 15:267-72. [PMID: 23730393 DOI: 10.1016/j.jus.2012.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 11/15/2022] Open
Abstract
Thanks to its intrinsic high spatial resolution, ultrasound is an ideal imaging modality for examining very thin, superficial structures, and this makes it very helpful in the evaluation of extrinsic carpal ligaments. These structures, which arise from the radius and ulna and insert on the carpal bones, are extremely important for wrist stability. Previous studies have assessed the use of ultrasound to study the extrinsic carpal ligaments in cadavers, healthy asymptomatic subjects, and patients with rheumatoid arthritis. In the present report, we review the normal anatomy, biomechanics, and ultrasound appearance of these ligaments.
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Affiliation(s)
- D Orlandi
- Scuola di Specializzazione in Radiodiagnostica, Dipartimento di Medicina Interna, Università degli Studi di Genova, Italy
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Paparo F, Fabbro E, Piccazzo R, Revelli M, Ferrero G, Muda A, Cimmino MA, Garlaschi G. Multimodality imaging of intraosseous ganglia of the wrist and their differential diagnosis. Radiol Med 2012; 117:1355-73. [DOI: 10.1007/s11547-012-0875-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 09/30/2011] [Indexed: 02/06/2023]
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Orlandi D, Sconfienza LM, Fabbro E, Ferrero G, Martini C, Lacelli F, Serafini G, Silvestri E. Preliminary ultrasound evaluation of the rotator cable in asymptomatic volunteers(). J Ultrasound 2012; 15:16-9. [PMID: 23396940 DOI: 10.1016/j.jus.2012.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To characterize the rotator cable high-resolution ultrasound appearance in asymptomatic shoulders of volunteers of different age. MATERIALS AND METHODS IRB approval and volunteers' written consent was obtained. Excluding subjects with known shoulder affections, we screened 24 asymptomatic volunteers. Supraspinatus and infraspinatus tendons high-resolution ultrasound evaluation was performed according to standard scan protocols, further excluding shoulders with partial/full-thickness cuff tears. Thus, we studied 24 shoulders in 12 young volunteers (age range 21-39 years, mean age 33 ± 8 years) and 21 shoulders in 11 elderly volunteers (age range 62-83 years, mean age 75 ± 45 years). For each shoulder, we noted rotator cable visibility and its thickness and width. Fisher's and U Mann-Whitney statistics were used. RESULTS Rotator cable was less frequently detected in young than in elderly volunteers (5/24 vs. 11/21 shoulders; P = 0.034). When detected, rotator cable was significantly thicker in young (range 1.2-1.5 mm, mean thickness 1.3 ± 0.1 mm) than in elderly (range 0.9-1.4 mm, mean thickness 1.2 ± 0.1 mm) volunteers (P = 0.025), while its width was not significantly different in young (range 4.5-7.1 mm, mean 5.6 ± 1.1 mm) compared to elderly (range 2.5-7.1 mm, mean 4.2 ± 1.4 mm) volunteers (P = 0.074) although a tendency can be highlighted. CONCLUSIONS Ultrasound demonstrated the different consistency of rotator cable in young and elderly asymptomatic patients, with high interobserver reproducibility.
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Affiliation(s)
- D Orlandi
- Scuola di Specializzazione in Radiodiagnostica, Genova University, Italy
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27
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Paparo F, Fabbro E, Ferrero G, Piccazzo R, Revelli M, Camellino D, Garlaschi G, Cimmino MA. Imaging studies of crystalline arthritides. Reumatismo 2012; 63:263-75. [PMID: 22303533 DOI: 10.4081/reumatismo.2011.263] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 01/19/2012] [Indexed: 11/23/2022] Open
Abstract
Gout, calcium pyrophosphate dihydrate (CPPD) deposition disease, and calcium hydroxyapatite deposition disease (HADD) are the three most common crystal-induced arthropathies. Multimodality imaging may help in their diagnosis, and is useful for a precise and comprehensive assessment and grading of the related osteoarticular damage. Plain film radiography, due to its low cost and wide availability, is the first imaging technique to be used in crystal deposition diseases, providing well-known and specific findings for CPPD deposition disease and HADD, while it may undergrade the early osteoarticular lesions in gouty patients. Ultrasonography (US) is a radiation-free approach that accurately depicts crystal deposits in cartilage, peri- and intra-articular soft tissues, but it does not give a panoramic view of the affected joints. Cross-sectional imaging techniques can examine crystal deposits in the spine and axial joints. CT has the potential to distinguish monosodium urate (MSU) crystals from calcium containing crystals, due to their different attenuation values. MRI may demonstrate synovitis, erosions and bone marrow edema in gouty patients and it may differentiate tophi from other soft tissue nodules due to its high contrast resolution and power of tissue characterization.
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Affiliation(s)
- F Paparo
- Department of Radiology, E.O. Ospedali Galliera, Genoa, Italy.
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Paparo F, Zampogna G, Fabbro E, Parodi M, Andracco R, Ferrero G, Garlaschi G, Cimmino MA. Imaging of tophi with an extremity-dedicated MRI system. Clin Exp Rheumatol 2011; 29:519-526. [PMID: 21722500] [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] [Received: 09/02/2010] [Accepted: 02/11/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To describe the MRI features of gout tophi in the soft-tissues or joints of the limbs by low-field extremity-dedicated MRI. METHODS Nine consecutive patients, 8M/1W, affected by chronic tophaceous gout were studied. Mean patients' age was 71.3±11.5 years, mean disease duration 98.1±44.9 months, and mean serum uric acid concentration 9.2±2.8 mg/L. Diagnosis was based on the ACR classification criteria for gout, and by identification of MSU crystals in the tophi and synovial fluid. Conventional radiograms and MRI with an extremity-dedicated system were obtained of the joint areas involved by tophi. RESULTS At T1 weighted MRI images, all tophi showed a homogeneous intermediate signal intensity, similar to that of muscle. Conversely, in T2 weighted images, a wide spectrum of signal intensity patterns was observed. The pattern of contrast enhancement was variable from intense homogeneous to peripheral and heterogeneous. Capsulo-ligamentous structures were often thickened and degenerated and, on occasion, could be recognised as inhomogeneous, hypointense ribbon-shaped elements in the context of the tophus. In only two cases, tendons were infiltrated by tophaceous matter. Bone marrow oedema (BME) and erosions were seen in 8 out of 10 bones adjacent to tophi. CONCLUSIONS The MRI appearance of gout tophi using an extremity-dedicated machine is similar to that described in the literature using whole body machines. BME adjacent to the tophus was a frequent finding. This technique may occasionally help in the differential diagnosis of nodules and in the follow-up of the disease. It also represents a useful tool to investigate the pathogenesis of gout and to better understand its clinical progression.
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Affiliation(s)
- F Paparo
- Sezione di Diagnostica per Immagini, Dipartimento di Medicina Interna, Università di Genova, Italy
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29
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Spanghero M, Robinson P, Zanfi C, Fabbro E. Effect of increasing doses of a microencapsulated blend of essential oils on performance of lactating primiparous dairy cows. Anim Feed Sci Technol 2009. [DOI: 10.1016/j.anifeedsci.2009.06.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Spanghero M, Zanfi C, Fabbro E, Scicutella N, Camellini C. Effects of a blend of essential oils on some end products of in vitro rumen fermentation. Anim Feed Sci Technol 2008. [DOI: 10.1016/j.anifeedsci.2007.05.048] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Fabbro E, Rubert L, Quaglia S, Ferrara F, Kiren V, Ventura A, Not T. Uselessness of anti-actin antibody in celiac disease screening. Clin Chim Acta 2008; 390:134-7. [DOI: 10.1016/j.cca.2008.01.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2007] [Revised: 01/15/2008] [Accepted: 01/15/2008] [Indexed: 10/22/2022]
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Granzotto M, Fabbro E, Maschio M, Martelossi S, Quaglia S, Tommasini A, Presani G, Ventura A. Heterozygous nucleotide-binding oligomerization domain-2 mutations affect monocyte maturation in Crohn’s disease. World J Gastroenterol 2007; 13:6191-6. [PMID: 18069758 PMCID: PMC4171228 DOI: 10.3748/wjg.v13.i46.6191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the function of monocytes in Crohn’s disease (CD) patients and to correlate this with disease-associated nucleotide-binding oligomerization domain-2 (NOD2) gene variants.
METHODS: Monocytes from 47 consecutively referred CD patients and 9 healthy blood donors were cultured with interleukin (IL)-4 and granulocyte-macrophage colony-stimulating factor (GM-CSF), and stimulated with lipopolysaccharide (LPS) or muramyldipeptide (MDP), the putative ligand of NOD2.
RESULTS: We found that monocytes from CD patients differentiated in vitro to mature dendritic cells (DCs), as determined by immunophenotype and morphology. NOD2 genotype was assessed in all subjects, and we observed high CD86 expression on immature and LPS-stimulated DCs in NOD2 mutated CD patients, as compared with wtNOD2 CD patients and controls. By contrast, CD86 expression levels of DCs induced to maturity with MDP derived from NOD2-mutated subjects were comparable to those of normal subjects. The amount of IL-12p70 in patient-cell cultures was larger than in controls after LPS treatment, but not after treatment with MDP.
CONCLUSION: Our results suggest that DCs obtained from patients with mutations in the NOD2 gene display an activated phenotype characterized by high CD86 expression, but have a diminished response to MDP when compared to the terminal differentiation phase. We speculate that the altered differentiation of monocytes might lead to an imbalance between inflammation and the killing ability of monocytes, and may be relevant to the pathogenesis of CD.
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Arzese A, Beltrame A, Piazza M, Fabbro E, Rorato G, Negri C, Zamparini E, Viale P. MALARIA DA IMPORTAZIONE NEL NORD-EST: PRESENTAZIONE DI CASISTICA TRIENNALE. Microbiol Med 2007. [DOI: 10.4081/mm.2007.2772] [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: 11/22/2022] Open
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Arzese A, Beltrame A, Fabbro E, Romano K, Zamparini E, Viale P. PREVALENZA DI INFEZIONI DA DIENTAMOEBA FRAGILIS IN POPOLAZIONE SINTOMATICA. Microbiol Med 2006. [DOI: 10.4081/mm.2006.3192] [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: 11/22/2022] Open
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35
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Arzese A, Beltrame A, Cristini F, Rorato G, Fabbro E, Negri C, Crapis M, Viale P. DIAGNOSI DI DISTOMATOSI EPATICA: PRESENTAZIONE DI UN CASO CLINICO. Microbiol Med 2006. [DOI: 10.4081/mm.2006.3185] [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: 11/23/2022] Open
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36
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Arzese A, Beltrame A, Scudeller L, Tavio M, Cadeo B, Fabbro E, Londero A, Viale P. DIAGNOSI OCCASIONALE DI INFESTAZIONE ENTERICA DA DIPHYLLOBOTHRIUM spp. Microbiol Med 2006. [DOI: 10.4081/mm.2006.3184] [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: 11/23/2022] Open
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Piolanti M, Fabbro E, Pascali E, Rossi C, Caputo M, Varotti G, Papa S, Grazi G, Gavelli G. [CT angiography for the evaluation of adult orthotopic liver transplantation arterial complications]. Radiol Med 2001; 102:348-56. [PMID: 11779982] [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: 02/23/2023]
Abstract
PURPOSE In this study we compared duplex Doppler sonography, conventional angiography and CT angiography for the evaluation of hepatic arterial complications following orthotopic liver transplantation (OLT). MATERIAL AND METHODS CT angiography, with Maximum Intensity Projection (MIP) and Volume Rendering reconstructions, was performed in 11 patients with well-grounded suspect of hepatic artery stenosis or thrombosis after routine duplex Doppler examination. Eight patients underwent conventional angiography. RESULTS CT detected three out of four duplex doppler false positives and confirmed the diagnostic suspect in four cases. In two cases it showed a shift of the blood flow towards the splenic artery with hepatic hypoperfusion. In one case a wrong delay rendered the study unuseful. In seven out of eight patients conventional angiography confirmed CT angiography findings. DISCUSSION. The follow up of OLT arterial complications is now performed with duplex doppler sonography; this technique has a satisfactory sensitivity and specificity, but far from 100%. Therefore in some patients the diagnosis of arterial obstruction might be delayed, with the risk of serious complications; in other cases with ultrasonographic false positive findings, useless angiographic examinations are performed. In our experience CT angiography proved to be a precious tool, which might be included in the diagnostic algorithm of arterial complications after OLT. Particularly CT angiography seems to be suitable for the cases of discordance between clinical and duplex doppler findings, to improve the overall diagnostic accuracy. CONCLUSION In our experience CT-angiography proved to be accurate and satisfactory as a second step examination after duplex-doppler in the diagnostic algorythm of adult OLT arterial complications.
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Affiliation(s)
- M Piolanti
- Radiologia III, Policlinico S. Orsola-Malpighi, Università degli Studi, Bologna, Italy.
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Caputo M, Piolanti M, Riccioli LA, Pazienza L, Fabbro E, Gruppioni F, Grazi G, Gavelli G. [Nonobstructive residual mucocele of the cystic duct. Reassessment of complications in our 13 years' experience with liver transplantation]. Radiol Med 2000; 100:354-6. [PMID: 11213414] [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: 02/19/2023]
Abstract
PURPOSE We reassessed the incidence of mucocele of the residual cystic duct in our series of orthotopic liver transplantation (OLT) patients. MATERIAL AND METHODS We examined a series of 283 liver transplants with end-to-end choledocho-choledocal anastomosis (263 patients, 163 men and 80 women, 24-65 years old), performed at the II Surgical Department of the University of Bologna from May 1986 to April 1999 and subsequently followed-up in our Institute. All patients were examined with gray-scale and color Doppler US and some also underwent CT and CT cholangiography. RESULTS An anechoic ovoidal structure just before the portal vein and in proximity of the main bile duct was found in 13 patients. US and CT findings, the latter when available, led us to make a diagnosis of nonobstructive mucocele of the cystic duct. The radiological diagnosis was eventually confirmed by clinical and surgical findings. DISCUSSION AND CONCLUSIONS In our series the incidence of this complication was 4.5%, a slightly higher value than those reported in the literature. Cystic duct mucocele cannot be considered an uncommon complication and should thus be more carefully searched for by operators. In our experience this complication never required reoperation for cholestasis.
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Affiliation(s)
- M Caputo
- Dipartimento Clinico di Scienze Radiologiche ed Istopatologiche, Radiodiagnostica III, Policlinico S. Orsola, Malpighi, Bologna
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Dueker SR, Lin Y, Jones AD, Mercer R, Fabbro E, Miller JW, Green R, Clifford AJ. Determination of blood folate using acid extraction and internally standardized gas chromatography-mass spectrometry detection. Anal Biochem 2000; 283:266-75. [PMID: 10906248 DOI: 10.1006/abio.2000.4660] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Whole blood folate level is a superior indicator of folate nutritional status than serum/plasma level. Problems with and lack of confidence in results of current whole blood folate assays have limited its popularity for assessing folate nutritional status. Here, an acid extraction GCMS detection method that measures total folate whole blood is presented. Folates are released from the matrix of whole blood and cleaved to para-aminobenzoic acid (pABA) by acid hydrolysis in the presence of [(13)C(6)]pABA as internal standard (IS). The hydrolysate is passed over a C18 resin to remove heme. The pABA isotopomers are ethyl esterified, isolated on C18 resin, and trifluoroacetylated. Following normal-phase HPLC separation, the isotopomers are silylated to their tBDMS derivatives. The abundance of these derivatives are measured at m/z 324 for [(13)C(6)]pABA as IS and m/z 318 for pABA from whole blood folate. Our method uses readily available chemicals and our results agree well with those using Lactobacillus casei, the current gold standard reference assay. The presence of folate analogs (methotrexate) or antibacterials (sulfonamines) does not affect our method. This feature makes it useful in monitoring folate status of patients undergoing chemotherapy. Before using our method, pABA supplements must be discontinued for a few days.
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Affiliation(s)
- S R Dueker
- Department of Nutrition, University of California, Davis, California 95616, USA
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