1
|
Iannattone S, Mignemi G, Pivetta E, Gatta M, Sica C, Cardi V, Canale N, Spoto A, Bottesi G. Are anxiety, depression, and stress distinguishable in Italian adolescents? an examination through the Depression Anxiety Stress Scales-21. PLoS One 2024; 19:e0299229. [PMID: 38412147 PMCID: PMC10898757 DOI: 10.1371/journal.pone.0299229] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/05/2024] [Indexed: 02/29/2024] Open
Abstract
The adolescents' ability to discriminate between different negative emotional states is still under debate. The Depression Anxiety Stress Scales-21 (DASS-21) serves as a useful tool to unravel this issue, yet the literature on its structural validity in young people is ambiguous. Therefore, this study aimed to expand knowledge on the emotional experience of youth by investigating the factor structure and psychometric properties of the DASS-21 in Italian adolescents. Six hundred fifty-five students (60.6% girls) aged 14-18 (M = 16.3 ± 1.29) completed an online survey containing the DASS-21 and Positive and Negative Affect Schedule (PANAS). To evaluate the factor structure of the DASS-21, several alternative models were tested, also adopting an Exploratory Structural Equation Modeling (ESEM) procedure. Measurement invariance, reliability, validity, and latent means differences were addressed. The ESEM model with three correlated factors of Depression, Anxiety, and Stress yielded the best fit to the data, supporting a hierarchical structure of the DASS-21. In addition, this model was invariant across sex and age groups. The Anxiety scale predicted both positive and negative affect, while Depression predicted positive affect only. Finally, girls scored higher than boys on Anxiety and Depression, but no age differences emerged. Overall, our results indicate that anxiety, depression, and stress are distinguishable in Italian adolescents but, simultaneously, share an underlying condition of general distress, which may explain the comorbidity between internalizing problems. Such findings are discussed in terms of clinical and preventive implications for the adolescent population.
Collapse
Affiliation(s)
- Sara Iannattone
- Department of General Psychology, University of Padova, Padova, Italy
| | - Giuseppe Mignemi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Erika Pivetta
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Michela Gatta
- Woman and Child's Health Department, Padova University Hospital, Padova, Italy
| | - Claudio Sica
- Department of Health Sciences, University of Firenze, Firenze, Italy
| | - Valentina Cardi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Natale Canale
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Andrea Spoto
- Department of General Psychology, University of Padova, Padova, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padova, Padova, Italy
| |
Collapse
|
2
|
Angelini F, Pivetta E, Marino C, Canale N, Spada MM, Vieno A. Social norms and problematic gaming among adolescents: The role of Internet use coping motives. Addict Behav 2024; 148:107865. [PMID: 37804747 DOI: 10.1016/j.addbeh.2023.107865] [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: 06/08/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION Problematic gaming (PG) is a public health issue among adolescents worldwide. Although several studies have documented that peer influences constitute a relevant risk factor for adolescent problematic behaviors, little research is currently available on PG. The aim of this study was to examine the contribution of social norms and perceived friends' gaming frequency on participants' own gaming frequency and PG, by testing potential differences among groups with low vs. high motive to use the Internet (e.g., online gaming) as a coping strategy. METHOD A survey was administered to 470 adolescent gamers (mean age = 15.49 years; SD = 1.05 years; 77.9 % males). A theoretical model was tested through path analysis and multi-group comparisons were performed. RESULTS Path analysis revealed that social norms and perceived friends' gaming frequency were positively associated to participants' gaming behaviors and PG. Additionally, different patterns between groups emerged. CONCLUSION Our findings confirmed the relative importance of peer influences on adolescents' gaming behaviors and PG and showed that adolescents who rely more on online gaming to cope with negative affect may be more vulnerable to social influence processes than other peers. These findings may provide useful indications for prevention programs targeting adolescent PG.
Collapse
Affiliation(s)
- Federica Angelini
- Department of Developmental and Social Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy.
| | - Erika Pivetta
- Department of Developmental and Social Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy.
| | - Claudia Marino
- Department of Developmental and Social Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy; Division of Psychology, School of Applied Sciences, London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom.
| | - Natale Canale
- Department of Developmental and Social Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy.
| | - Marcantonio M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom.
| | - Alessio Vieno
- Department of Developmental and Social Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy.
| |
Collapse
|
3
|
Chiappero C, Misseri G, Mattei A, Ippolito M, Albera C, Pivetta E, Cortegiani A, Gregoretti C. Effectiveness and safety of a new helmet CPAP configuration allowing tidal volume monitoring in patients with COVID-19. Pulmonology 2023; 29 Suppl 4:S9-S17. [PMID: 34326019 PMCID: PMC8266523 DOI: 10.1016/j.pulmoe.2021.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND High generated tidal volumes (Vt) have been correlated with higher risk of self-induced lung injury and worse clinical outcome. This study aimed to evaluate the effectiveness and safety of a new helmet continuous positive airway pressure delivered (h-CPAP) configuration allowing Vt monitoring in patients affected by COVID-19. METHODS This prospective observational study was performed in the respiratory intermediate care unit of University Hospital in Turin, Italy, between March 24th, and June 15th, 2020. Included patients were treated with CPAP via a single-limb intentional leak configuration by a turbine-driven ventilator, provided with a dedicated patch. Effectiveness and safety of the configuration and healthcare workers safety were the outcomes of the study. MAIN FINDINGS Thirty-five patients were included in this study. Median age was 67 years (IQR 57-76 years), and 30 patients (85.7%) were men. Median value of overall leaks (intentional plus unintentional) was 68 L/min (IQR 63-75). Reliability of Vt measurements was 100%. An out of scale of Vt (above 50% compared to the previous values) was never recorded. Six patients (17.1%) needed more than two helmet replacements, due to leak test >10 l/min. Arm oedema and skin breakdowns were reported in sixteen (45.7%) and seven (20%) patients respectively. Among the 63 healthcare workers involved in the care of COVID-19 patients during the study only one was positive at RT-PCR nasopharyngeal swab testing. CONCLUSIONS The use of h-CPAP for treating COVID-19 in this configuration allowed for reliable Vt monitoring. Further studies evaluating this configuration in larger patients' cohorts are needed.
Collapse
Affiliation(s)
- C Chiappero
- Pneumology, Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino - Molinette hospital, Turin, Italy
| | | | - A Mattei
- Pneumology, Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino - Molinette hospital, Turin, Italy
| | - M Ippolito
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.). University of Palermo, Italy
| | - C Albera
- Pneumology, Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino - Molinette hospital, Turin, Italy; University of Turin, School of Medicine, Department of Medical Sciences, Italy
| | - E Pivetta
- Division of Emergency Medicine and High Dependency Unit, Department of General and Specialized Medicine, AOU Città della Salute e della Scienza di Torino - Molinette hospital, Turin, Italy
| | - A Cortegiani
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.). University of Palermo, Italy; Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy.
| | - C Gregoretti
- Fondazione "Giglio", Cefalù, Italy; Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.). University of Palermo, Italy
| |
Collapse
|
4
|
Pivetta E, Costa S, Antonietti JP, Marino C, Billieux J, Canale N. Adolescent problematic gaming and its association with maternal behaviors: A dyadic study focusing on the relational-emotional correlates. Addict Behav 2023; 140:107602. [PMID: 36621044 DOI: 10.1016/j.addbeh.2022.107602] [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: 09/13/2022] [Revised: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Associations between Problematic Gaming (PG) and the relational-emotional correlates of parenting have been reported in the literature. Previous research mostly collected information from adolescents, however, and suggested that little is known about the perceptions of parents and whether these are shared among parent-adolescent dyads. Therefore, this study aimed to (a) examine multiple informants' reports of adolescent PG and maternal behaviors (i.e., warmth and indifference) and (b) disentangle the associations between the behaviors shared by mothers and adolescents from those unique to each member. METHOD Data were collected by using self-administered online questionnaires from 137 Italian mother-adolescent dyads in Italy. The mean age of adolescents (n = 92 males, n = 42 females, n = 3 nonbinary) was 14.68 (±1.25) years and that of mothers 47.48 (±4.69) years. Descriptive statistics and common fate model (CFM) analyses were conducted. RESULTS Mothers reported higher scores of their offspring's PG. Within-reporter interclass correlations revealed positive associations between maternal indifference and adolescent PG for both informants. CFM indicated that correlations between maternal behaviors and adolescent PG based on shared perceptions did not reach statistical significance, whereas correlations based on unique mothers' perceptions were statistically significant for all the observed relationships. CONCLUSIONS In the context of adolescent PG, mothers may have a heightened motivation to perceive their parenting as crucial. The multi-informant approach allows a more accurate examination of the associations between adolescent PG and maternal behaviors and underscores the need to consider discordant assessment of the same phenomenon between mothers and adolescents.
Collapse
Affiliation(s)
- Erika Pivetta
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy.
| | - Sebastiano Costa
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | | | - Claudia Marino
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Center for Excessive Gambling, Addiction Medicine, Lausanne University, Hospitals (CHUV), Lausanne, Switzerland
| | - Natale Canale
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| |
Collapse
|
5
|
Marino C, Melodia F, Pivetta E, Mansueto G, Palmieri S, Caselli G, Canale N, Vieno A, Conti F, Spada MM. Desire thinking and craving as predictors of problematic Internet pornography use in women and men. Addict Behav 2023; 136:107469. [PMID: 36055058 DOI: 10.1016/j.addbeh.2022.107469] [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: 04/22/2022] [Revised: 08/06/2022] [Accepted: 08/19/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION According to the recent adaptation of the I-PACE model, desire thinking and craving might be closely related to problematic Internet pornography use. The overall aim of the present study was to investigate the role of two components of desire thinking (imaginal prefiguration and verbal perseveration) and craving in problematic Internet pornography use. Furthermore, we examined gender differences in the underlying mechanism linking desire thinking to problematic Internet pornography use. METHOD A total of 414 Italian adults (mean age = 27.55 years, SD = 6.13; age range = 18-58; 53.6 % men) participated in this study. Participants completed an online survey to assess problematic Internet pornography use, pornography craving, desire thinking and problematic Internet use. Path analyses and a multi-group approach were used to test the relationships among variables and to explore gender differences. RESULTS Imaginal prefiguration was associated to pornography craving which, in turn, was associated to verbal perseveration as proximal antecedent of problematic Internet pornography use, above and beyond the effect of age, relationship status, and problematic Internet use. Two paths significantly differed between men and women: the path between verbal perseveration and problematic Internet pornography, which for women was weaker and did not reach significance; and the path between problematic Internet use and problematic Internet pornography use that was not significant for women. CONCLUSIONS In line with the I-PACE model, the present study provided support for the potential role of desire thinking in problematic Internet pornography use as a specific Internet-use disorder and expanded the literature in the field by testing unexplored gender differences. Preventive and clinical implications are discussed.
Collapse
Affiliation(s)
- Claudia Marino
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy; Division of Psychology, School of Applied Sciences, London South Bank University, London, UK.
| | - Fiordalisa Melodia
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy.
| | - Erika Pivetta
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy.
| | - Giovanni Mansueto
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy; Department of Psychology, Sigmund Freud University, Milan, Italy; Department of Health Sciences, University of Florence, Florence, Italy.
| | - Sara Palmieri
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK; Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy; Department of Psychology, Sigmund Freud University, Milan, Italy.
| | - Gabriele Caselli
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy; Department of Psychology, Sigmund Freud University, Milan, Italy.
| | - Natale Canale
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy.
| | - Alessio Vieno
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy.
| | - Francesca Conti
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy.
| | - Marcantonio M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK.
| |
Collapse
|
6
|
Colasante E, Pivetta E, Canale N, Vieno A, Marino C, Lenzi M, Benedetti E, King DL, Molinaro S. Problematic gaming risk among European adolescents: a cross-national evaluation of individual and socio-economic factors. Addiction 2022; 117:2273-2282. [PMID: 35165980 PMCID: PMC9544763 DOI: 10.1111/add.15843] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 01/31/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Previous research has identified numerous risk and protective factors of adolescent problematic gaming (PG) at the individual and social levels; however, the influence of socio-economic indicators on PG is less known. This study aimed to measure the contribution of individual and socio-economic factors involved in PG risk among adolescents from 30 European countries. DESIGN Multi-level logistic regression analysis of survey data from the 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional study using self-administered anonymous questionnaires. SETTING Thirty European countries. PARTICIPANTS A representative cohort of 15-16-year-old students (n = 88 998 students; males = 49.2%). MEASUREMENTS The primary outcome measure was adolescents' (low and high) risk of PG. Individual key predictors included self-report assessments of socio-demographic characteristics, time spent gaming and family variables (parental regulation and monitoring, family support). Main country-level predictors comprised Gini coefficient for economic inequalities and benefits for families and children (% gross domestic product), retrieved from international public data sets and national thematic reports. The data analysis plan involved multi-level logistic regression. FINDINGS Participants who reported stronger parental regulation [odds ratio (OR) = 0.81, 95% confidence interval (CI) = 0.79-0.83] and higher family support (OR = 0.93, 95% CI = 0.91-0.95) reported lower risk of PG. At the country-level, economic inequalities (OR = 1.05, 95% CI = 1.03-1.07) were positively associated with the risk of PG, while benefits for families and children (OR = 0.78, 95% CI = 0.70-0.89) were negatively correlated with the risk of PG. CONCLUSIONS Supportive family environments, lower country-level economic inequalities and higher government expenditures on benefits for families and children appear to be associated with a lower risk of problematic gaming among European adolescents.
Collapse
Affiliation(s)
- Emanuela Colasante
- Epidemiology and Health Research LaboratoryInstitute of Clinical Physiology, National Research Council of ItalyPisaItaly
| | - Erika Pivetta
- Department of Developmental and Social PsychologyUniversity of PadovaPadovaItaly
| | - Natale Canale
- Department of Developmental and Social PsychologyUniversity of PadovaPadovaItaly
| | - Alessio Vieno
- Department of Developmental and Social PsychologyUniversity of PadovaPadovaItaly
| | - Claudia Marino
- Department of Developmental and Social PsychologyUniversity of PadovaPadovaItaly
| | - Michela Lenzi
- Department of Developmental and Social PsychologyUniversity of PadovaPadovaItaly
| | - Elisa Benedetti
- Epidemiology and Health Research LaboratoryInstitute of Clinical Physiology, National Research Council of ItalyPisaItaly
| | - Daniel L. King
- College of Education, Psychology, and Social WorkFlinders UniversityBedford ParkAustralia
| | - Sabrina Molinaro
- Epidemiology and Health Research LaboratoryInstitute of Clinical Physiology, National Research Council of ItalyPisaItaly
| |
Collapse
|
7
|
Imazio M, Pivetta E, Andreis A, Serra C, Ottino M, Brucato A, Giustetto C, Rinaldi M, Lupia E, De Ferrari GM, Adler Y. Incessant pericarditis as a risk factor for complicated pericarditis and hospital admission. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1826] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Incessant pericarditis is defined as pericarditis with persistent symptoms without a symptom-free interval of 4 to 6 weeks despite therapy. On the contrary, recurrent pericarditis is characterized by recurring symptoms after a symptom-free interval of at least 4 to 6 weeks, allowing the completion of therapy.
Aims
The aim of this study is to assess the risk of complicated pericarditis and related hospitalizations according to the clinical pattern of incessant or recurrent pericarditis.
Methods
From January 2017 to December 2018, all consecutive patients admitted to AOU Città della Salute (Turin, IT) for pericarditis were included in a prospective cohort study with a clinical and echocardiographic follow-up at 1, 3, and 6 months, and then every 6 months.
Results
We included 147 patients (median age, 50.9 years [IQR, 28.5]; 49.7% women, 89% had idiopathic aetiology, 11% had pericarditis related to systemic inflammatory disease/postcardiac injury syndrome, 80% had pericardial effusion, and 62% had elevated C-reactive protein >5 mg/L). Patients were treated according to ESC guidelines. After a median follow-up of 14 months (IQR, 9 months), adverse events were recorded in 54/147 patients (36.7%): nonidiopathic/viral aetiology in 16 of 147 cases (10.9%), recurrent pericarditis/persistent symptoms in 53 of 147 cases (36.1%), cardiac tamponade in 4/147 cases (2.7%), persistent CP in 4/147 cases (2.7%), and hospitalization related to pericarditis in 38/147 cases (25.9%). An incessant course was reported in 18 of 147 cases (12%). The risk of complications was higher in patients with incessant pericarditis (Figure) – especially CP – compared to nonincessant course (22.2% versus 0%, respectively; P<0.001). Patients with incessant pericarditis more commonly had echocardiographic evidence of CP (77.8% vs. 9.3%; P<0.001) and thickened pericardium on multimodality imaging (66.7% vs. 4.7%; P<0.001). These findings were reversible with medical therapy with the use of anakinra (100 mg/d) and colchicine in all but 4 cases that progressed to persistent CP, which were referred for pericardiectomy. An analysis of risk factors for complicated pericarditis and hospitalization using Cox proportional hazards regression analysis identified the following risk factors: large pericardial effusion (hazard ratio, 7.63 [95% CI, 3.09–18.83]), elevated C-reactive protein >5 mg/L (hazard ratio, 5.55 [95% CI, 1.87–16.44]), and incessant course (HR, 17.10 [95% CI, 7.63–38.33]).
Conclusions
This study highlights that an incessant course of pericarditis is a possible new risk factor for complications and especially for developing constriction. In clinical practice, the detection of an incessant course, as well as imaging findings of constriction and pericardial thickening, should prompt more diagnostic testing, a close follow-up, and more aggressive therapy to prevent complications and persistent constriction.
Funding Acknowledgement
Type of funding sources: None. Figure 1
Collapse
Affiliation(s)
- M Imazio
- University Hospital Santa Maria della Misericordia, Cardiology, Cardiothoracic Department, Udine, Italy
| | - E Pivetta
- A.O.U. Citta della Salute e della Scienza di Torino, Emergency Medicine Department, Turin, Italy
| | - A Andreis
- AOU Città della Salute e della Scienza di Torino, University Cardiology, Torino, Italy
| | - C Serra
- AOU Città della Salute e della Scienza di Torino, University Cardiology, Torino, Italy
| | - M Ottino
- A.O.U. Citta della Salute e della Scienza di Torino, Emergency Medicine Department, Turin, Italy
| | - A Brucato
- Fatebenefratelli Hospital, Dipartimento Scienze Biomediche e Cliniche, Milan, Italy
| | - C Giustetto
- AOU Città della Salute e della Scienza di Torino, University Cardiology, Torino, Italy
| | - M Rinaldi
- A.O.U. Citta della Salute e della Scienza di Torino, University Cardiac Surgery, Cardiovascular Department, Turin, Italy
| | - E Lupia
- A.O.U. Citta della Salute e della Scienza di Torino, Emergency Medicine Department, Turin, Italy
| | - G M De Ferrari
- AOU Città della Salute e della Scienza di Torino, University Cardiology, Torino, Italy
| | - Y Adler
- Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv, Israel
| |
Collapse
|
8
|
|
9
|
Pivetta E, Moretto F, Bianchi G, Masellis S, Bovaro F, Manasievska M, Maule MM, Lupia E. P5672Diagnostic accuracy and clinical utility of point-of-care ultrasound among syncope patients in the emergency department. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0614] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Syncope is still a challenge for risk stratification in the Emergency Department (ED), and the indication to discharge is not well established for all patients.
Purpose
To evaluate diagnostic accuracy and clinical utility of integration of clinical assessment and point-of-care ultrasound (POCUS) in evaluating non high-risk syncopes in the ED.
Methods
This observational prospective cohort study enrolled patients between February 2016 and January 2019.
All adult patients presenting in the ED for a non-high risk syncope were eligible (defined according to the 2015 ESC consensus on management of syncope in the ED). Subject for whom event etiology was identified right after the clinical assessment (i.e. history, physical exam, and EKG) or showing a clinical high risk for short term serious outcomes or refuse to participate in the study were excluded.
After the initial clinical assessment, the physician responsible for patient care was asked to categorize the syncope as low or neither high nor low risk. Immediately after, the same physician performed POCUS, and a new risk assessment, based on the results of both clinical and sonographic findings, was recorded. Thirty days after the ED evaluation, all participants were telephonically followed up by the investigators in order to assess the risk of short-term outcomes as defined in the San Francisco Syncope Rule cohorts. Both diagnostic accuracy, defined as sensitivity (SE) and specificity (SPE), and clinical utility, evaluated as net reclassification index (NRI) and net benefit were evaluated for clinical and POCUS-integrated assessment.
Results
A total of 415 patients with a syncope were eligible. Of these, 194 were enrolled (107 women - 55.2%). Median age was 63 years (interquartile range, IQR, 30 years). During the follow up, 21 patients experienced 28 events.
SE and SPE of the clinical evaluation were 33.3% (95% confidence interval, CI, 14.6–57%) and 79.5% (95% CI 72.7–85.3%), and they were 42.9% (95% CI 21.8–66%), and 92.4% (95% CI 87.4–95.9) for the POCUS-integrated evaluation (p<0.01 for SE and 0.05 for SPE).
NRI for events and non-events during follow up was 9.5% and 12.7%, respectively.
Using the prevalence of events in our cohort (10.8%) as the threshold probability, the use of the POCUS-integrated approach would reduce the diagnostic error of the clinical evaluation by 4.6 cases/100 patients.
The median time between clinical and POCUS-integrated evaluation was 15 minutes (iqr 20 minutes).
Conclusion
The results of our study suggest that the integration of the clinical evaluation with POCUS for patients presenting to the ED for non high-risk syncope might be able to increase the diagnostic accuracy and the utility of the clinical assessment alone.
Collapse
Affiliation(s)
- E Pivetta
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | | | - G Bianchi
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | | | - F Bovaro
- University of Turin, Turin, Italy
| | | | | | - E Lupia
- University of Turin, Turin, Italy
| |
Collapse
|
10
|
Cannizzaro R, Magris R, Fornasarig M, Pivetta E, Maiero S, Mongiat M, De Re V, Canzonieri V, De Paoli A, Turriziani V, Guarnieri G, Buonadonna A, Belluco C, Serraino D, Spessotto P. Evaluation of neoangiogenesis in locally advanced gastric cancer before and after neoadjuvant radiochemotherapy by probe confocal laser endomicroscopy (PCLE). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.292] [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
|
11
|
Pivetta E, Tizzani M, Porrino G, Ferreri E, Volpicelli G, Balzaretti P, Banderali A, Iacobucci A, Locatelli S, Merletti F, Baldi I, Casoli G, Lupia E, Cibinel GA. Lung Ultrasound for diagnosis of acute cardiogenic dyspnea in the Emergency Department – a simeu multicenter study. Crit Ultrasound J 2014. [PMCID: PMC4147846 DOI: 10.1186/2036-7902-6-s2-a5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
12
|
Kinnaman K, Rempell J, Kimberly H, Pivetta E, Platz E, Hiroshima E, Chudgar A, Adduci A, Stone M. Accuracy of Suprasternal Notch View Using Focused Cardiac Ultrasound to Evaluate Aortic Arch Measurements. Ann Emerg Med 2013. [DOI: 10.1016/j.annemergmed.2013.07.042] [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: 10/26/2022]
|
13
|
Pivetta E, Lupia E, Locatelli S, Casoli G, Tizzani M, Porrino G, Ferreri E, Volpicelli E, Cibinel GA, Goffi A. Acute decompensated heart failure: a diagnostic help from lung ultrasound. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
14
|
Civita M, Mana E, Sfasciamuro C, Odetto C, Laurita E, Cosola A, Esposito P, Voi V, Masoero C, Zanello P, Pivetta E, Cibinel G. A new training course for triage. The experience of Triage Education Group in Pinerolo. Emerg Care J 2012. [DOI: 10.4081/ecj.2012.2.23] [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
|
15
|
Piovano E, Pivetta E, Modaffari P, Martra F, Baima Poma C, Perotto S, Tripodi E, Zanfagnin V, Zola P, Ferrero A. A Search for Predictive Factors for Hypersensitivity Reactions to Paclitaxel and Platinum Salts in Chemotherapy for Gynecologic Pelvic Neoplasms. Gynecol Obstet Invest 2012; 74:21-7. [DOI: 10.1159/000336772] [Citation(s) in RCA: 8] [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: 04/06/2011] [Accepted: 01/24/2012] [Indexed: 11/19/2022]
|
16
|
Lai J, Adriano D, Fragassi S, Pivetta E, Fabbri M, Baldi U, Decastelli L. DETECTION OF ALLERGENS IN MEAT PRODUCTS: MONITORING DURING THE YEAR 2007. Ital J Food Saf 2008. [DOI: 10.4081/ijfs.2008.2.41] [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
|
17
|
Baussano I, Pivetta E, Vizzini L, Abbona F, Bugiani M. Predicting tuberculosis treatment outcome in a low-incidence area. Int J Tuberc Lung Dis 2008; 12:1441-1448. [PMID: 19017455] [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: 05/27/2023] Open
Abstract
SETTING Based on the cohort of pulmonary tuberculosis (PTB) cases resident between 2001 and 2005 in the Piedmont region of Italy, this study estimated the effect of selected determinants on the success of standardised short-course chemotherapy (SSCC). OBJECTIVE To identify predictors of unsuccessful treatment of PTB and to generate a nomogram to assist treating physicians and public health authorities with the identification of cases needing close follow-up. RESULTS Overall, 1564 cases were identified. Among new cases, predictors of successful treatment outcome were sex (women vs. men, aOR 0.48, 95%CI 0.37-0.63), geographic origin (EU vs. non-EU countries, aOR 0.43, 95%CI 0.31-0.60) and treatment setting (out-patient vs. in-patient services and unknown setting, aOR 0.2, 95%CI 0.16-0.26). Predictors of unsuccessful outcome were long-term residency status (homeless vs. residential, aOR 9.91, 95%CI 4.38-22.38) and age (for each year, aOR 1.02, 95%CI 1.01-1.03). CONCLUSION Using a limited number of predictors, the authors designed a nomogram predicting the individual probability of unfavourable SSCC. In principle, this approach is generalisable to other settings and the nomogram can be calibrated on local data to ensure appropriate case management and support targeted treatment follow-up.
Collapse
Affiliation(s)
- I Baussano
- Division of Epidemiology, Public Health and Primary Care, Imperial College, London, UK.
| | | | | | | | | |
Collapse
|
18
|
Gjuracic K, Pivetta E, Bruschi CV. Targeted DNA integration within different functional gene domains in yeast reveals ORF sequences as recombinational cold-spots. Mol Genet Genomics 2004; 271:437-46. [PMID: 15048565 DOI: 10.1007/s00438-004-0994-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2003] [Accepted: 02/19/2004] [Indexed: 10/26/2022]
Abstract
The efficiency of gene targeting within different segments of genes in yeast was estimated by transforming yeast cells with double-stranded integrative plasmids, bearing functional gene domains [promoter (P), ORF (O) and terminator (T)] derived from the common genetic markers HIS3, LEU2, TRP1 and URA3. Transformation experiments with circular plasmids carrying a single gene domain demonstrated that the 5' and 3' flanking DNA regions (P and T) of the HIS3 and URA3 genes are preferred as sites for plasmid integration by several fold over the corresponding ORFs. Moreover, when plasmids bearing combinations of two or three regions were linearized to target them to a specific site of integration, three of the ORFs were found to be less preferred as sites for plasmid integration than their corresponding flanking regions. Surprisingly, in up to 50% of the transformants obtained with plasmids that had been linearized within coding sequences, the DNA actually integrated into neighbouring regions. Almost the same frequencies of ORF mis-targeting were obtained with plasmid vectors containing only two functional domains ("PO" or "OT") of the gene URA3, demonstrating that this event is not the consequence of competition between homologous DNA regions distal to the ORF. Therefore, we suggest that coding sequences could be considered to be "cold spots" for plasmid integration in yeast.
Collapse
Affiliation(s)
- K Gjuracic
- Microbiology Group, ICGEB, Area Science Park, Padriciano 99, 34012 Trieste, Italy
| | | | | |
Collapse
|
19
|
Tedeschi R, Bidoli E, Zanussi S, Bortolin M, Pratesi C, Pivetta E, D’Andrea M, Ros M, Averna P, Varaschin P, Crepaldi C, Costanzo C, De Paoli P. BIOBANKING: L’ESPERIENZA DELLA MICROBIOLOGIA DEL CRO DI AVIANO. Microbiol Med 2003. [DOI: 10.4081/mm.2003.4221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
20
|
Zanirato G, Pivetta E. [Clinical use of GIC: indications and limits]. Dent Cadmos 1989; 57:79-83. [PMID: 2699875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Due to high cariostatic activity, glass ionomer are irreplaceable component in restorative armamentarium. Clinician needs to stock several types of material since characteristics (film thickness, radiopacity, viscosity, colors, ecc.) are adapted for specific uses.
Collapse
|
21
|
Pivetta G, Pivetta E. [Total amalgam reconstruction. Clinical evaluation after three years]. Dent Cadmos 1989; 57:78-82, 85-9. [PMID: 2636172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This study reports the results of the evaluation after three years of total amalgam restorations, made on molars and premolars vital and devitalized. The clinical parameters examinated were: 1) anatomic form and axial contour 2) marginal integrity 3) recurrent caries 4) occlusal contacts 5) interproximal contacts 6) pulpar or periodontal complication. To each of these parameters was given a degree of judgement expressed by Alpha, Bravo, Charlie, Delta. Alpha is the best evaluation, Bravo expresses a lower degree but clinically acceptable, Charlie and Delta are worse. Considering for each parameter the sum of the evaluations Alpha + Bravo, the clinically acceptable rate per cent of results has been quite good.
Collapse
|
22
|
Pivetta E, Pedretti S, Pivetta G. [Matrices: the Biaggi ring]. Attual Dent 1989; 5:14-7. [PMID: 2635039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
23
|
Fregonese D, Ciarmiello G, Rabassini A, Pivetta E, Caldato C. [Cytodiagnosis using ultrasound-guided transcutaneous aspiration with fine needle of focal liver masses]. Pathologica 1988; 80:573-6. [PMID: 2854622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
|
24
|
di Natale I, Padoan L, Sartori CA, Patelli G, Dal Pos R, Sorato R, Pivetta E. [Recent traumatic rupture of the diaphragm in patients with multiple injuries]. Chir Ital 1987; 39:402-9. [PMID: 3690778] [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: 01/07/2023]
Abstract
The authors report on 16 cases of recent traumatic diaphragmatic lesions in polytraumatized patients referred to them over the period 1979-86. After examining the diagnostic problems relating to this type of lesion, the authors describe the anatomico-topographical, clinical and therapeutic aspects. They conclude by stressing the need to explore the diaphragmatic cupulae systematically in the course of surgery for blunt abdominal trauma.
Collapse
Affiliation(s)
- I di Natale
- U.L.S.S. N. 10-Treviso, Presidio Ospedaliero Multizonale, IV DivisioneChirurgica
| | | | | | | | | | | | | |
Collapse
|
25
|
Colognato A, Gastaldon A, Pivetta E, Calabrò F, Sartori F, Roviaro GC, Bionetti PR. [Cystic lymphangioma of the mediastinum. (presentation of 5 personal cases) (author's transl)]. Chir Ital 1980; 32:937-45. [PMID: 7249191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
168 mediastinal masses, 4 of which were cystic lymphangiomas, were operated in the Thoracic Surgery Department of 1st Surgical Special Pathology. After an analysis of the frequently and the pathogenetic theories of this rare disease, the Authors, with the aid of clinical cases, illustrate the clinical procedures and instrumental semeiotics which may sometimes lead to suspicion of this pathology, with particular regard to Computerised Axial Tomography (C.A.T.).
Collapse
|