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Russo R, Cozzani E, D'Agostino F, Guadagno A, Parodi A. A Solitary Pinkish Nodule on the Abdomen: A Quiz. Acta Derm Venereol 2024; 104:adv18458. [PMID: 38567912 PMCID: PMC11005173 DOI: 10.2340/actadv.v104.18458] [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: 08/22/2023] [Accepted: 12/12/2023] [Indexed: 04/05/2024] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- Roberto Russo
- Department of Health Sciences, University of Genoa, Genoa, Italy; Dermatology Unit, San Martino Polyclinic Hospital, Genoa, Italy
| | - Emanuele Cozzani
- Department of Health Sciences, University of Genoa, Genoa, Italy; Dermatology Unit, San Martino Polyclinic Hospital, Genoa, Italy.
| | - Federica D'Agostino
- Department of Health Sciences, University of Genoa, Genoa, Italy; Dermatology Unit, San Martino Polyclinic Hospital, Genoa, Italy
| | | | - Aurora Parodi
- Department of Health Sciences, University of Genoa, Genoa, Italy; Dermatology Unit, San Martino Polyclinic Hospital, Genoa, Italy
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2
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D'Agostino F, Gasparini G, Riva SF, Guadagno A, Parodi A. Annular Pigmented Macules on the Upper Trunk: A Quiz. Acta Derm Venereol 2024; 104:adv35278. [PMID: 38470166 PMCID: PMC10949078 DOI: 10.2340/actadv.v104.35278] [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: 12/24/2023] [Accepted: 01/30/2024] [Indexed: 03/13/2024] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- Federica D'Agostino
- Department of Health Sciences (DISSAL), Section of Dermatology, University of Genoa, Genoa, Italy; Department of Dermatology, Ospedale Policlinico San Martino IRCCS, Genoa, Italy.
| | - Giulia Gasparini
- Department of Health Sciences (DISSAL), Section of Dermatology, University of Genoa, Genoa, Italy; Department of Dermatology, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Silvia Francesca Riva
- Department of Health Sciences (DISSAL), Section of Dermatology, University of Genoa, Genoa, Italy; Department of Dermatology, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Antonio Guadagno
- Department of Health Sciences (DISSAL), Section of Dermatology, University of Genoa, Genoa, Italy; Department of Dermatology, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Aurora Parodi
- Department of Health Sciences (DISSAL), Section of Dermatology, University of Genoa, Genoa, Italy; Department of Dermatology, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
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3
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Sallustio F, Mascolo AP, Marrama F, Lacidogna G, D'Agostino F, Rocco A, Gandini R, Morosetti D, Da Ros V, Nezzo M, Argirò R, Plocco M, Alemseged F, Diomedi M. Comparison between different referral strategies for acute ischemic stroke patients in a hub-spoke emergency stroke network: a real-world experience in south-east Lazio. Neurol Sci 2024; 45:203-211. [PMID: 37507617 DOI: 10.1007/s10072-023-06966-8] [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: 04/11/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023]
Abstract
AIM To describe different referral strategies for acute ischemic stroke (AIS) patients in a Hub-Spoke emergency stroke network with their incidence, time metrics and related outcomes. METHODS Referral paradigms were defined as follows: primary transfer to the comprehensive stroke center (CSC) from a remote region, called mothership (MS); secondary transfer to the CSC from a primary stroke center where intravenous thrombolysis was available, called drip and ship (DS); secondary transfer to the CSC from a community hospital where no reperfusion therapy was available, called ship and drip (SD); primary transfer to the CSC from its catchment area, called direct CSC (dCSC). RESULTS Among 517 anterior circulation AIS patients treated with mechanical thrombectomy between 2015 and 2020, 16.6% of them were SD, in addition to the well-known referral paradigms of MS (21.8%) and DS (18.1%). This rate grew to 30% when only patients whose place of onset was outside the CSC catchment area were considered. In the SD group, onset to CSC and onset to groin were significantly longer (178±80 min vs. 102±60 min, p<0.001, and 277±77 min vs. 211±61 min, p<0.001, respectively), and the risk of any intracranial hemorrhage (ICH) was significantly higher (OR: 2.514; 95%CI: 1.18-5.35, p=0.017) compared to MS. CONCLUSION In this hub-spoke stroke network, a high proportion of SD paradigm was found, which was associated with longer times to treatment and higher rates of any ICH. A closer cooperation between hospital stroke physicians, national health system staff, and paramedics is warranted to identify the most appropriate referral strategy for each patient.
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Affiliation(s)
- F Sallustio
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy.
| | - A P Mascolo
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy
| | - F Marrama
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy
| | - G Lacidogna
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy
| | - F D'Agostino
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy
| | - A Rocco
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy
| | - R Gandini
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - D Morosetti
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - V Da Ros
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - M Nezzo
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - R Argirò
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - M Plocco
- Neurovascular Therapy Unit, F. Spaziani Hospital, Rome, Frosinone, Italy
| | - F Alemseged
- Department of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - M Diomedi
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Rome, Italy
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Trave I, Donadoni R, Cozzani E, D'Agostino F, Herzum A, Parodi A. Acne fulminans and its multiple associated factors: a systematic review. Eur J Dermatol 2023; 33:624-634. [PMID: 38465543 DOI: 10.1684/ejd.2023.4629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Acne fulminans (AF) is a severe form of acne that presents with an outburst of haemorrhagic pustules and ulcerations, which may or may not be associated with systemic symptoms and laboratory abnormalities. In the latest classification, four variants of AF are considered, but this does not include AF associated with systemic therapies and inherited genetic syndromes. To systematically review disease features and evaluate differences among AF. Related articles were searched using the terms "acne fulminans", "acne conglobata with septicaemia", "acute febrile ulcerative acne" and "pseudo acne fulminans". We searched Medline and Google Scholar from inception to 1977 to identify case reports, case series, commentaries and reviews reporting new AF cases. A total of 98 articles met our inclusion criteria. AF induced by higher levels of androgens more frequently presented nodules and cysts than erosions, crusted and haemorrhagic lesions and necrosis. In contrast, patients affected by AF without any apparent cause (referred to here as "miscellaneous AF") more frequently presented with ulcerations and erosions, and patients with AF associated with systemic treatment showed a similar frequency of lesions. Notably, AF in patients with high levels of androgens and AF induced by antibiotics rarely showed comedones. In addition, aseptic osteolytic lesions were more common in miscellaneous AF than other AF. AF may present with differences in clinical and laboratory features and associated systemic illnesses, which should be evaluated for the planning of a personalized therapeutic scheme. We propose a classification of AF, according to its association with certain factors.
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Carannante F, Mazzotta E, Miacci V, Bianco G, Mascianà G, D'Agostino F, Caricato M, Capolupo GT. Identification and management of subvesical bile duct leakage after laparoscopic cholecystectomy: A systematic review. Asian J Surg 2023; 46:4161-4168. [PMID: 37127504 DOI: 10.1016/j.asjsur.2023.04.031] [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: 09/28/2022] [Revised: 12/10/2022] [Accepted: 04/12/2023] [Indexed: 05/03/2023] Open
Abstract
Bile leak is a rare complication after Laparoscopic Cholecystectomy. Subvesical bile duct (SVBD) injury is the second cause of minor bile leak, following the unsuccessful clipping of the cystic duct stump. The aim of this study is to pool available data on this type of biliary tree anatomical variation to summarize incidence of injury, methods used to diagnose and treat SVBD leaks after LC. Articles published between 1985 and 2021 describing SVBD evidence in patients operated on LC for gallstone disease, were included. Data were divided into two groups based on the intra or post-operative evidence of bile leak from SVBD after surgery. This systematic report includes 68 articles for a total of 231 patients. A total of 195 patients with symptomatic postoperative bile leak are included in Group 1, while Group 2 includes 36 patients describing SVBD visualized and managed during LC. Outcomes of interest were diagnosis, clinical presentation, treatment, and outcomes. The management of minor bile leak is controversial. In most of cases diagnosed postoperatevely, Endoscopic Retrograde Cholangio-Pancreatography (ERCP) is the best way to treat this complication. Surgery should be considered when endoscopic or radiological approaches are not resolutive.
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Affiliation(s)
- F Carannante
- Colorectal Surgery Clinic and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy.
| | - E Mazzotta
- Colorectal Surgery Clinic and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - V Miacci
- Colorectal Surgery Clinic and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - G Bianco
- Colorectal Surgery Clinic and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - G Mascianà
- Colorectal Surgery Clinic and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - F D'Agostino
- Department of Anaesthesia, Intensive Care and Pain Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - M Caricato
- Colorectal Surgery Clinic and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - G T Capolupo
- Colorectal Surgery Clinic and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy
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6
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Sallustio F, Mascolo AP, Marrama F, D'Agostino F, Proietti M, Greco L, Di Giuliano F, Alemseged F, Gandini R, Martorana A, Diomedi M, Koch G. Temporal lobe atrophy as a potential predictor of functional outcome in older adults with acute ischemic stroke. Acta Neurol Belg 2023:10.1007/s13760-022-02167-w. [PMID: 36637792 DOI: 10.1007/s13760-022-02167-w] [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: 08/19/2022] [Accepted: 12/15/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND To explore whether temporal lobe atrophy predicts 3-month functional outcome in a population of patients with anterior circulation acute ischemic stroke (AIS) treated with mechanical thrombectomy (MT). METHODS We retrospectively selected patients > 65 years from our prospective endovascular stroke registry between June 2013 and August 2018. According to 3-month modified Rankin Scale (mRS), patients were divided in two groups, named good (mRS ≤ 2) and poor (mRS > 2) outcome. Measures of temporal lobe atrophy (i.e., interuncal distance [IUD], medial temporal lobe thickness [mTLT] and radial width of temporal horn [rWTH]) were assessed on pre-treatment CT scan. Cutoff values for good outcome were obtained for IUD, mTLT and rWTH by means of non-parametric ROC curve analysis. Multivariate analysis was performed to identify predictors of outcome. Ordinal shift analysis based on cutoff values was built to evaluate differences in 3-month mRS. RESULTS Among 340 patients, 130 (38.2%) had good and 210 (61.8%) had poor outcome. We found the following cutoff values for good outcome: < 25 mm for IUD, > 15 mm for mTLT and < 4 mm for rWTH. Lower IUD (OR 0.71; 95% CI 0.63-0.80; p < 0.0001) and rWTH (OR 0.73; 95% CI 0.61-0.87; p < 0.0001) and higher mTLT (OR 1.30; 95% CI 1.14-1.49; p < 0.0001) were independently associated with good outcome. Ordinal shift analysis based on cutoff values revealed significant differences in the rate of good outcome for rWTH (49 vs 27%; p < 0.0001), mTLT (52 vs 21%; p < 0.0001) and IUD (57 vs 17%; p < 0.0001). CONCLUSIONS Assessment of temporal lobe atrophy may predict functional outcome in patients with AIS treated with MT.
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Affiliation(s)
- Fabrizio Sallustio
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. .,Department of Clinical and Behavioural Neurology, Santa Lucia Foundation IRCCS, 0039, Rome, Italy.
| | - Alfredo Paolo Mascolo
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Federico Marrama
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Federica D'Agostino
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Marco Proietti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Greco
- Diagnostic Neuroradiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Francesca Di Giuliano
- Diagnostic Neuroradiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Fana Alemseged
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Roberto Gandini
- Diagnostic Neuroradiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Alessandro Martorana
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Marina Diomedi
- Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Giacomo Koch
- Department of Clinical and Behavioural Neurology, Santa Lucia Foundation IRCCS, 0039, Rome, Italy.,Department of Psychology, eCampus University, Novedrate, Italy
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Vanalli M, Cesare M, Cocchieri A, D'Agostino F. Natural language processing and String Metric-assisted Assessment of Semantic Heterogeneity method for capturing and standardizing unstructured nursing activities in a hospital setting: a retrospective study. Ann Ig 2023; 35:3-20. [PMID: 35403664 DOI: 10.7416/ai.2022.2517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Nurses record data in electronic health records (EHRs) using different terminologies and coding systems. The purpose of this study was to identify unstructured free-text nursing activities recorded by nurses in EHRs with natural language processing (NLP) techniques and to map these nursing activities into standard nursing activities using the SMASH method. STUDY DESIGN A retrospective study using NLP techniques with a unidirectional mapping strategy called SMASH. METHODS The unstructured free-text nursing activities recorded in the Medicine, Neurology and Gastroenterology inpatient units of the Agostino Gemelli IRCCS University Hospital Foundation, Rome, Italy were collected for 6 months in 2018. Data were analyzed by three phases: a) text summarization component with NLP techniques, b) a consensus analysis by four experts to detect the category of word stems, and c) cross-mapping with SMASH. The SMASH method calculated the string comparison, similarity and distance of words through the Levenshtein distance (LD), Jaro-Winker distance and the cross-mapping's cut-offs: map [0.80-1.00] with < 13 LD, partial-map [0.50-0.79] with <13 LD and no map [0.0-0.49] with >13 LD. RESULTS During the study period, 491 patient records were assessed. 548 different unstructured free-text nursing activities were recorded by nurses. 451 unstructured free-text nursing activities (82.3%) were mapped to standard PAI nursing activities, 47 (8.7%) were partial mapped, while 50 (9.0%) were not mapped. This automated mapping yielded recall of 0.95%, precision of 0.94%, accuracy of 0.91%, F-measure of 0.96. The F-measure indicates good reliability of this automated procedure in cross-mapping. CONCLUSIONS Lexical similarities between unstructured free-text nursing activities and standard nursing activities were found, NLP with the SMASH method is a feasible approach to extract data related to nursing concepts that are not recorded through structured data entry.
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Affiliation(s)
- M Vanalli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - M Cesare
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - A Cocchieri
- Fondazione Policlinico Universitario A. Gemelli IRCCS, University of Catholic Sacred Heart, Rome, Italy
| | - F D'Agostino
- Unicamillus, Saint Camillus International University of Health Sciences, Rome, Italy
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Cusano F, Sampogna F, Brunasso Vernetti AMG, Stisi S, Sandri G, Malara G, Naldi L, Pellegrino M, Tripepi GL, Di Luzio Paparatti U, Agnusdei CP, Bonifati C, Celano A, Corazza V, D'Agostino F, De Pasquale R, Filippucci E, Foti R, Galdo G, Gai F, Ganzetti G, Graceffa D, Maccarone M, Mazzotta A, Melchionda G, Molinaro F, Paoletti F, Tonolo S, Vercellone A, Vitetta R, Massone C, Sebastiani GD. A consensus-based approach on the management of patients with both psoriasis and psoriatic arthritis in the dermatological and rheumatological settings in Italy: The ADOI PSO-Amore Project. Dermatol Reports 2022; 14:9541. [PMID: 36199897 PMCID: PMC9527681 DOI: 10.4081/dr.2022.9541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 07/20/2022] [Indexed: 11/23/2022] Open
Abstract
Psoriasis is a complex disease often needing a multidisciplinary approach. In particular, the collaboration between dermatologist and rheumatologist is crucial for the management of patients suffering from both psoriasis (PSO) and psoriatic arthritis (PsA). Here we report a series of recommendations from a group of experts, as a result of a Consensus Conference, defining the circumstances in which it is preferable or even mandatory, depending on the available settings, to rely on the opinion of the two specialists, jointly or in a deferred manner. Indications are given on how to organize a 3rd level joint Dermatology- Rheumatology care unit, in connection with 1st and 2nd level clinicians of both specialties, GPs, and other specialists involved in the management of psoriasis. A potential patient journey is suggested, that can be used as a basis for future design and validation of national and/or local diagnostic therapeutic and assistance pathways.
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9
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Sallustio F, Pracucci G, Cappellari M, Saia V, Mascolo AP, Marrama F, Gandini R, Koch G, Diomedi M, D'Agostino F, Rocco A, Da Ros V, Wlderk A, Nezzo M, Argirò R, Morosetti D, Renieri L, Nencini P, Vallone S, Zini A, Bigliardi G, Pitrone A, Grillo F, Bracco S, Tassi R, Bergui M, Naldi A, Carità G, Casetta I, Gasparotti R, Magoni M, Simonetti L, Haznedari N, Paolucci M, Mavilio N, Malfatto L, Menozzi R, Genovese A, Cosottini M, Orlandi G, Comai A, Franchini E, Pedicelli A, Frisullo G, Puglielli E, Casalena A, Cester G, Baracchini C, Castellano D, Di Liberto A, Ricciardi GK, Chiumarulo L, Petruzzellis M, Lafe E, Persico A, Cavasin N, Critelli A, Semeraro V, Tinelli A, Giorgianni A, Carimati F, Auteri W, Rizzuto S, Biraschi F, Nicolini E, Ferrari A, Melis M, Calia S, Tassinari T, Nuzzi NP, Corato M, Sacco S, Squassina G, Invernizzi P, Gallesio I, Ruiz L, Dui G, Carboni N, Amistà P, Russo M, Maiore M, Zanda B, Craparo G, Mannino M, Inzitari D, Toni D, Mangiafico S. Carotid artery stenting during endovascular thrombectomy for acute ischemic stroke with tandem occlusion: the Italian Registry of Endovascular Treatment in Acute Stroke. Acta Neurol Belg 2022; 123:475-485. [PMID: 36056270 DOI: 10.1007/s13760-022-02067-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/11/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE The management of tandem extracranial internal carotid artery and intracranial large vessel occlusion during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) has been under-investigated. We sought to investigate outcomes of AIS patients with tandem occlusion (TO) treated with carotid artery stenting (CAS) compared to those not treated with CAS (no-CAS) during EVT. METHODS We performed a cohort study using data from AIS patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. Outcomes were 3 months' mortality, functional outcome, complete and successful recanalization, any intracranial hemorrhage, parenchymal hematoma and symptomatic intracerebral hemorrhage. RESULTS Among 466 AIS patients with TO, CAS patients were 122 and no-CAS patients were 226 (118 excluded). After adjustment for unbalanced variables, CAS was associated with a lower rate of 3 months' mortality (OR 0.407, 95% CI 0.171-0.969, p = 0.042). After adjustment for pre-defined variables, CAS was associated with a lower rate of 3 months' mortality (aOR 0.430, 95% CI 0.187-0.989, p = 0.047) and a higher rate of complete recanalization (aOR 1.986, 95% CI 1.121-3.518, p = 0.019), successful recanalization (aOR 2.433, 95% CI 1.263-4.686, p = 0.008) and parenchymal hematoma (aOR 2.876, 95% CI 1.173-7.050, p = 0.021). CAS was associated with lower 3 months mortality (OR 0.373, 95% CI 0.141-0.982, p = 0.046) and higher rates of successful recanalization (OR 2.082, 95% CI 1.099-3.942, p = 0.024) after adjustment for variables associated with 3 months' mortality and successful recanalization, respectively. CONCLUSIONS Among AIS patients with TO, CAS during EVT was associated with a higher rate of successful reperfusion and a lower rate of 3 months' mortality.
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Affiliation(s)
- Fabrizio Sallustio
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. .,Department of Clinical and Behavioural Neurology, Santa Lucia Foundation IRCCS, Rome, Italy.
| | | | - Manuel Cappellari
- Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Valentina Saia
- Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure, Italy
| | - Alfredo Paolo Mascolo
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Federico Marrama
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Roberto Gandini
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Giacomo Koch
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Clinical and Behavioural Neurology, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Marina Diomedi
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Federica D'Agostino
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Alessandro Rocco
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Valerio Da Ros
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Andrea Wlderk
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Marco Nezzo
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Renato Argirò
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Daniele Morosetti
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Leonardo Renieri
- Interventional Neuroradiology Unit, Ospedale Careggi-University Hospital, Florence, Italy
| | - Patrizia Nencini
- Stroke Unit, Ospedale Careggi-University Hospital, Florence, Italy
| | - Stefano Vallone
- Neuroradiology Unit, Ospedale Civile S. Agostino-Estense University Hospital, Modena, Italy
| | - Andrea Zini
- Department of Neurology and Stroke Center, Maggiore Hospital, Bologna, Italy
| | - Guido Bigliardi
- Neurology Unit, Ospedale Civile S. Agostino-Estense University Hospital, Modena, Italy
| | - Antonio Pitrone
- Neuroradiology Unit, Azienda Ospedaliera Universitaria Policlinico Messina, Messina, Italy
| | - Francesco Grillo
- Stroke Unit, Azienda Ospedaliera Universitaria Policlinico Messina, Messina, Italy
| | - Sandra Bracco
- Interventional Neuroradiology Unit, Ospedale S. Maria Delle Scotte-University Hospital, Siena, Italy
| | - Rossana Tassi
- Stroke Unit, Ospedale S. Maria Delle Scotte-University Hospital, Siena, Italy
| | - Mauro Bergui
- Interventional Neuroradiology Unit, Città della Salute e della Scienza-Molinette, Turin, Italy
| | - Andrea Naldi
- Stroke Unit, Città della Salute e della Scienza-Molinette, Turin, Italy
| | - Giuseppe Carità
- Interventional Neuroradiology Unit, Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | - Ilaria Casetta
- Neurology Division, Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | | | | | - Luigi Simonetti
- Neuroradiology Unit, IRCCS Istituto Delle Scienze Neurologiche, Bellaria Hospital, Bologna, Italy
| | - Nicolò Haznedari
- Interventional Neuroradiology Unit, AUSL Romagna Cesena, Cesena, Italy
| | - Matteo Paolucci
- Neurology and Stroke Unit, AUSL Romagna Cesena, Cesena, Italy
| | - Nicola Mavilio
- Interventional Neuroradiology Unit, IRCCS San Martino-IST, Genoa, Italy
| | | | - Roberto Menozzi
- Interventional Neuroradiology Unit, Ospedale Universitario, Parma, Italy
| | | | - Mirco Cosottini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giovanni Orlandi
- Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | | | | | | | | | - Edoardo Puglielli
- Interventional Radiology Unit, Ospedale Civile Mazzini, Teramo, Italy
| | | | - Giacomo Cester
- Neuroradiology Unit, Azienda Ospedaliero-Universitaria, Padua, Italy
| | | | - Davide Castellano
- Interventional Neuroradiology Unit, Ospedale San Giovanni Bosco, Turin, Italy
| | | | | | - Luigi Chiumarulo
- Interventional Neuroradiology Unit, AOU Consorziale Policlinico, Bari, Italy
| | | | - Elvis Lafe
- Diagnostic Radiology and Interventional Neuroradiology, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessandra Persico
- Cerebrovascular Disease and Stroke Unit, IRCCS Fondazione Mondino, Pavia, Italy
| | - Nicola Cavasin
- Neuroradiology Unit, Ospedale dell'Angelo, USSL3 Serenissima, Mestre, Italy
| | - Adriana Critelli
- Neurology Unit, Ospedale dell'Angelo, USSL3 Serenissima, Mestre, Italy
| | | | | | - Andrea Giorgianni
- Neuroradiology Department, Ospedale di Circolo di Varese, ASST-Sette Laghi, Varese, Italy
| | - Federico Carimati
- Neurology and Stroke Unit, Ospedale di Circolo di Varese, ASST-Sette Laghi, Varese, Italy
| | - William Auteri
- Neuroradiology Unit, Azienda Ospedaliera Cosenza, Cosenza, Italy
| | | | - Francesco Biraschi
- Interventional Neuroradiology Unit, University of Rome La Sapienza, Rome, Italy
| | | | - Antonio Ferrari
- Interventional Neuroradiology, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Maurizio Melis
- Neuroscience Department, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Stefano Calia
- Neuroradiology Unit, Santa Corona Hospital, Pietra Ligure, Italy
| | - Tiziana Tassinari
- Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure, Italy
| | | | - Manuel Corato
- Stroke Unit, IRCCS Humanitas Rozzano, Rozzano, Milano, Italy
| | - Simona Sacco
- Department of Clinical Sciences and Biotechnology, Avezzano, L'Aquila, Italy
| | - Guido Squassina
- Neuroradiology Unit, Fondazione Poliambulanza, Brescia, Italy
| | | | - Ivan Gallesio
- Neuroradiology Unit, Azienda Ospedaliera "SS Antonio e Biagio e C. Arrigo", Alessandria, Italy
| | - Luigi Ruiz
- Neurology Department, Azienda Ospedaliera "SS Antonio e Biagio e C. Arrigo", Alessandria, Italy
| | - Giovanni Dui
- Interventional Radiology, Ospedale San Francesco, Nuoro, Italy
| | - Nicola Carboni
- Neurology and Stroke Unit, Ospedale San Francesco, Nuoro, Italy
| | - Pietro Amistà
- Neuroradiology Unit, Ospedale S. Maria Misericordia, Rovigo, Italy
| | - Monia Russo
- Stroke Unit, Ospedale S. Maria Misericordia, Rovigo, Italy
| | - Mario Maiore
- Neuroradiology Unit, Azienda Ospedaliera Universitaria SS Annunziata, Sassari, Italy
| | - Bastianina Zanda
- Stroke Unit, Azienda Ospedaliera Universitaria SS Annunziata, Sassari, Italy
| | - Giuseppe Craparo
- Interventional Radiology, Ospedale Civico e Benfratelli, Palermo, Italy
| | - Marina Mannino
- Neurology Unit, Ospedale Civico e Benfratelli, Palermo, Italy
| | | | - Danilo Toni
- Stroke Unit, University of Rome La Sapienza, Rome, Italy
| | - Salvatore Mangiafico
- Interventional Neuroradiology Unit, Ospedale Careggi-University Hospital, Florence, Italy
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Onorato L, Sarnelli B, D'Agostino F, Signoriello G, Trama U, D'Argenzio A, Montemurro MV, Coppola N. Epidemiological, Clinical and Microbiological Characteristics of Patients with Bloodstream Infections Due to Carbapenem-Resistant K. Pneumoniae in Southern Italy: A Multicentre Study. Antibiotics (Basel) 2022; 11:antibiotics11050633. [PMID: 35625277 PMCID: PMC9137758 DOI: 10.3390/antibiotics11050633] [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] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 12/04/2022] Open
Abstract
Background: In the present study, our aim was to evaluate the clinical and microbiological characteristics of a cohort of patients with bloodstream infections (BSI) due to Carbapenem-Resistant Enterobacteriaceae (CRE) and investigate the independent predictors of mortality. Methods: All episodes of carbapenem-resistant E. coli (CREc) or K. pneumoniae (CRKp) BSI that were subject to a mandatory notification from January to December 2020 in all acute care hospitals and long-term care facilities of the Campania region in southern Italy were enrolled. All carbapenem-resistant strains were assessed through molecular tests for the presence of five carbapenemase gene families, i.e., K. pneumoniae Carbapenemase (KPC), oxacillinase-48 (OXA-48), New Delhi Metallo-β-lactamase (NDM), Verona integron encoded metallo-β-lactamase (VIM) and Imipenemase (IMP). Results: During the study period, a total of 154 consecutive non-repeated CRE BSI, all due to CRKp, were reported. The most frequently identified genes were KPC in 108 cases (70.1%), followed by metallo-betalactamases (MBL) (16.2%), and OXA-48 (2.6%); in 17 isolates (11%) no carbapenemase was detected. The overall mortality at 90 days was 41.9%. Using a log-rank test, patients without risk factors for CRE infections showed a significantly lower cumulative mortality (p = 0.001). After multivariate logistic regression analysis, the presence of at least one risk factor was the only predictor of mortality (OR: 1.7, 95% CI 1.2–6.1, p = 0.015). Conclusions. The study reported a non-negligible prevalence of MBL-producing organisms among CRKp isolated from blood cultures in our region. This data highlights the importance of molecular characterization of all clinical isolates of carbapenem-resistant organisms.
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Affiliation(s)
- Lorenzo Onorato
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", 80131 Napoli, Italy
| | - Bruno Sarnelli
- Direzione Generale Tutela della Salute e Coordinamento del Sistema Sanitario Regionale della Campania, 80143 Napoli, Italy
| | - Federica D'Agostino
- UOSD Programmazione, Progettazione, Valutazione Strategica e Gestione della Performance-Azienda Ospedaliera "San Pio"-Benevento, 82100 Benevento, Italy
| | - Giuseppe Signoriello
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Ugo Trama
- UOSD Politica del Farmaco e Dispositivi, Regione Campania, 80143 Napoli, Italy
| | - Angelo D'Argenzio
- Direzione Generale Tutela della Salute e Coordinamento del Sistema Sanitario Regionale della Campania, 80143 Napoli, Italy
| | | | - Nicola Coppola
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", 80131 Napoli, Italy
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11
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Bertolino L, Patauner F, Gagliardi M, D'Amico F, Crivaro V, Bernardo M, Scherillo I, Bellitti F, Cusano C, Greco R, Panetta V, Durante A, Di Caterino A, Frieri A, Cioffi G, Nappo M, Corrado M, Lanzieri M, Sabatini P, Bettelli R, Dello Russo R, Taddeo ML, Petrone R, Di Sevo MG, Iannuzzo M, Iervolino M, Buonocore R, D'Agostino F, Gambardella M, De Martino A, Spagnuolo S, Savarese M, Sole S, Russo C, Agozzino E, Galdiero M, Martino R, Calemma R, Sciambra A, Aprea C, Colaccio D, Di Guida P, Venditti M, Montella E, Guerriero F, Perrotta R, Di Filippo U, Pizza A, Di Fronzo A, Lombardi A, Capuano L, De Stefano A, Mastropietro A, Mastro M, Loffreda R, Maccarone L, Di Tora A, Oto S, Tammaro C, Mondelli AC, Ruocco M, Ferraro B, Petrosino A, Presta SSA, Durante Mangoni E. Diagnostic and infection control strategies for Clostridioides difficile infections in a setting of high antimicrobial resistance prevalence. Infez Med 2021; 29:70-78. [PMID: 33664175] [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: 06/12/2023]
Abstract
Clostridioides difficile (CD) is a major nosocomial pathogen and the leading cause of antibiotic-associated diarrhoea. In light of the strong association between antimicrobial use and CD infections (CDI), it may be hypothesised that areas at higher prevalence of antimicrobial resistance, like the region of Campania in southern Italy, could also have a higher rate of CDI. In this multicentre, region-based, prospective study, we analysed such issues, exploiting CDI incidence data collected from local hospitals. In 2016, the Italian National Centre for Disease Control supported a project involving three Italian regions: Friuli Venezia Giulia, Lazio and Campania. In Campania, a network of 49 hospitals willing to participate in the project was created. The project consisted of two phases: a survey on practice patterns concerning CDI and an epidemiological surveillance study. We identified a stringent need to improve awareness about CDI among the regional health-care community, as a widespread lack of surveillance programmes for CDI control was observed (existing in only 40% of participating facilities). Moreover, almost half of the participating hospitals (n=16, 43%) had no standardised procedures or protocols to control and prevent CDI. In the second phase of the study, we collected data of CDI cases during a six-month surveillance programme. In all, 87 CDI cases were observed, for a total of 903,334 patient bed-days and 122,988 admissions. According to the above data, CDI incidence was 0.96 cases/10000 patient bed-days, much lower than expected based on prior studies conducted elsewhere. The results of our study suggest CDI remains a rather neglected clinical issue in Campania. Despite a high burden of antimicrobial resistance and antimicrobial use in our geographic setting, we observed a very low incidence of CDI. Such a low incidence could be explained by underdiagnosis, but could also be related to actual diet, the lower patient age or the specific genetic background. However, further studies are warranted to either confirm or rebut the above hypotheses.
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Affiliation(s)
- Lorenzo Bertolino
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Fabian Patauner
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Massimo Gagliardi
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Fabiana D'Amico
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | | | | | | | | | | | - Rita Greco
- A.O.U. "Sant'Anna e San Sebastiano", Caserta, Italy
| | | | | | | | - Angelo Frieri
- "Sant'Angelo dei Lombardi" Hospital, Avellino, Italy
| | - Grazia Cioffi
- A.O.U.S. Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Maria Nappo
- A.O.U.S. Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Mariano Corrado
- "Umberto I" Hospital, Nocera, and DEA Nocera-Pagani-Scafati, Italy
| | - Michele Lanzieri
- "Umberto I" Hospital, Nocera, and DEA Nocera-Pagani-Scafati, Italy
| | - Paola Sabatini
- "Umberto I" Hospital, Nocera, and DEA Nocera-Pagani-Scafati, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Erminia Agozzino
- Dipartimento di Medicina Sperimentale, Università della Campania "L. Vanvitelli", AOU della Campania "L. Vanvitelli", Naples, Italy
| | - Massimiliano Galdiero
- Dipartimento di Medicina Sperimentale, Università della Campania "L. Vanvitelli", AOU della Campania "L. Vanvitelli", Naples, Italy
| | - Rosa Martino
- Istituto NazionaleTumori-IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Rosa Calemma
- Istituto NazionaleTumori-IRCCS "Fondazione G. Pascale", Naples, Italy
| | | | | | - Diego Colaccio
- "S. Giuseppe Melorio" Hospital, S. Maria Capua Vetere, Italy
| | | | | | | | | | | | | | | | | | - Anna Lombardi
- "S. Giovanni di Dio" Hospital, Frattamaggiore, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Emanuele Durante Mangoni
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy; Unit of Infectious and Transplant Medicine, AORN Ospedali dei Colli - Monaldi Hospital, Naples, Italy
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12
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Sallustio F, Saia V, Marrama F, Pracucci G, Gandini R, Koch G, Mascolo AP, D'Agostino F, Rocco A, Argiro' R, Nezzo M, Morosetti D, Wlderk A, Da Ros V, Diomedi M, Renieri L, Nencini P, Vallone S, Zini A, Bigliardi G, Caragliano A, Francalanza I, Bracco S, Tassi R, Bergui M, Naldi A, Saletti A, De Vito A, Gasparotti R, Magoni M, Cirillo L, Commodaro C, Biguzzi S, Castellan L, Malfatto L, Menozzi R, Grisendi I, Cosottini M, Orlandi G, Comai A, Franchini E, D'Argento F, Frisullo G, Puglielli E, Casalena A, Causin F, Baracchini C, Boghi A, Chianale G, Augelli R, Cappellari M, Chiumarulo L, Petruzzellis M, Sgreccia A, Tosi P, Cavasin N, Critelli A, Semeraro V, Boero G, Vizzari F, Cariddi LP, Di Benedetto O, Pugliese P, Iacobucci M, De Michele M, Fusaro F, Moller J, Allegretti L, Tassinari T, Nuzzi NP, Marcheselli S, Sacco S, Pavia M, Invernizzi P, Gallesio I, Ruiz L, Zedda S, Rossi R, Amistà P, Russo M, Pintus F, Sanna A, Craparo G, Mannino M, Inzitari D, Mangiafico S, Toni D. Mechanical Thrombectomy for Acute Intracranial Carotid Occlusion with Patent Intracranial Arteries : The Italian Registry of Endovascular Treatment in Acute Stroke. Clin Neuroradiol 2020; 31:21-29. [PMID: 33301052 DOI: 10.1007/s00062-020-00980-5] [Citation(s) in RCA: 2] [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] [Received: 09/14/2020] [Accepted: 11/12/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE Intracranial carotid artery occlusion represents an underinvestigated cause of acute ischemic stroke as well as an indication for mechanical thrombectomy. We investigated baseline and procedural characteristics, outcomes and predictors of outcome in patients with acute ischemic stroke secondary to intracranial carotid artery occlusion. METHODS A retrospective analysis of the Italian Registry of Endovascular Treatment in Acute Stroke was performed. Patients with intracranial carotid artery occlusion (infraclinoid and supraclinoid) with or without cervical artery occlusion but with patent intracranial arteries were included. The 3‑month functional independence, mortality, successful reperfusion and symptomatic intracranial hemorrhage were evaluated. RESULTS Intracranial carotid artery occlusion with patent intracranial arteries was diagnosed in 387 out of 4940 (7.8%) patients. The median age was 74 years and median baseline National Institute of Health Stroke Scale (NIHSS) was 18. Functional independence was achieved in 130 (34%) patients, successful reperfusion in 289 (75%) and symptomatic intracranial hemorrhage in 33 (9%), whereas mortality occurred in 111 (29%) patients. In univariate analysis functional independence was associated with lower age, lower NIHSS at presentation, higher rate of successful reperfusion and lower rate of symptomatic intracranial hemorrhage. Multivariable regression analysis found age (odds ratio, OR:1.03; P = 0.006), NIHSS at presentation (OR: 1.07; P < 0.001), diabetes (OR: 2.60; P = 0.002), successful reperfusion (OR:0.20; P < 0.001) and symptomatic intracranial hemorrhage (OR: 4.17; P < 0.001) as the best independent predictors of outcome. CONCLUSION Our study showed a not negligible rate of intracranial carotid artery occlusion with patent intracranial arteries, presenting mostly as severe stroke, with an acceptable rate of 3‑month functional independence. Age, NIHSS at presentation and successful reperfusion were the best independent predictors of outcome.
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Affiliation(s)
- Fabrizio Sallustio
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. .,Department of Clinical and Behavioural Neurology, Santa Lucia Foundation IRCCS, Rome, Italy.
| | - Valentina Saia
- Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure, Italy
| | - Federico Marrama
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | | | - Roberto Gandini
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Giacomo Koch
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Clinical and Behavioural Neurology, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Alfredo Paolo Mascolo
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Federica D'Agostino
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Alessandro Rocco
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Renato Argiro'
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Marco Nezzo
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Daniele Morosetti
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Andrea Wlderk
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Valerio Da Ros
- Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Marina Diomedi
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Leonardo Renieri
- Interventional Neuroradiology Unit, Ospedale Careggi-University Hospital, Firenze, Italy
| | - Patrizia Nencini
- Stroke Unit, Ospedale Careggi-University Hospital, Firenze, Italy
| | - Stefano Vallone
- Neuroradiology Unit, Ospedale Civile S. Agostino-Estense University Hospital, Modena, Italy
| | - Andrea Zini
- IRCCS Istituto di Scienze Neurologiche di Bologna, Department of Neurology and Stroke Center, Maggiore Hospital, Bologna, Italy
| | - Guido Bigliardi
- Neuroradiology Unit, Ospedale Civile S. Agostino-Estense University Hospital, Modena, Italy
| | - Antonio Caragliano
- Interventional Neuroradiology Unit, Policlinico G. Martino, Messina, Italy
| | | | - Sandra Bracco
- Interventional Neuroradiology Unit, Ospedale S. Maria delle Scotte-University Hospital, Siena, Italy
| | - Rossana Tassi
- Stroke Unit, Ospedale S. Maria delle Scotte-University Hospital, Siena, Italy
| | - Mauro Bergui
- Interventional Neuroradiology Unit, Città della Salute e della Scienza-Molinette, Torino, Italy
| | - Andrea Naldi
- Stroke Unit, Città della Salute e della Scienza-Molinette, Torino, Italy
| | - Andrea Saletti
- Interventional Neuroradiology Unit, Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | - Alessandro De Vito
- Neurology Division and Stroke Unit, Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | | | | | - Luigi Cirillo
- IRCCS Istituto di Scienze Neurologiche di Bologna, Neuroradiology Unit, Ospedale Bellaria, Bologna University-DIMES, Bologna, Italy
| | | | - Sara Biguzzi
- Neurology and Stroke Unit, AUSL Romagna Cesena, Cesena, Italy
| | - Lucio Castellan
- Interventional Neuroradiology Unit, IRCCS San Martino-IST, Genova, Italy
| | | | - Roberto Menozzi
- Interventional Neuroradiology Unit, Ospedale Universitario, Parma, Italy
| | | | - Mirco Cosottini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giovanni Orlandi
- Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | | | | | | | | | - Edoardo Puglielli
- Interventional Radiology Unit, Ospedale Civile Mazzini, Teramo, Italy
| | | | - Francesco Causin
- Neuroradiology Unit, Azienda Ospedaliero-Universitaria, Padova, Italy
| | | | - Andrea Boghi
- Interventional Neuroradiology Unit, Ospedale San Giovanni Bosco, Torino, Italy
| | | | - Raffaele Augelli
- Neuroradiology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Manuel Cappellari
- Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Luigi Chiumarulo
- Interventional Neuroradiology Unit, AOU Consorziale Policlinico, Bari, Italy
| | | | - Alessandro Sgreccia
- Diagnostic Radiology and Interventional Neuroradiology, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Piera Tosi
- Cerebrovascular Disease and Stroke Unit, IRCCS Fondazione Mondino, Pavia, Italy
| | - Nicola Cavasin
- Neuroradiology Unit, Ospedale dell'Angelo, USSL3 Serenissima, Mestre, Italy
| | - Adriana Critelli
- Neurology Unit, Ospedale dell'Angelo, USSL3 Serenissima, Mestre, Italy
| | | | - Giovanni Boero
- Neurology Unit, Osp. "SS. Annunziata"-ASL TA, Taranto, Italy
| | - Francesco Vizzari
- Neuroradiology Department, Ospedale di Circolo di Varese, ASST-Sette Laghi, Varese, Italy
| | | | | | | | - Marta Iacobucci
- Interventional Neuroradiology Unit, University of Rome La Sapienza, Roma, Italy
| | | | - Federico Fusaro
- Interventional Neuroradiology, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Jessica Moller
- Stroke Unit, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Luca Allegretti
- Neuroradiology Unit, Santa Corona Hospital, Pietra Ligure, Italy
| | - Tiziana Tassinari
- Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure, Italy
| | | | | | - Simona Sacco
- Department of Clinical Sciences and Biotechnology, University of L'Aquila, Avezzano, L'Aquila, Italy
| | - Marco Pavia
- Neuroradiology Unit, Fondazione Poliambulanza, Brescia, Italy
| | | | - Ivan Gallesio
- Neuroradiology Unit, Azienda Ospedaliera "SS Antonio e Biagio e C. Arrigo", Alessandria, Italy
| | - Luigi Ruiz
- Neurology Department, Azienda Ospedaliera "SS Antonio e Biagio e C. Arrigo", Alessandria, Italy
| | - Sandro Zedda
- Interventional Radiology, Ospedale San Francesco, Nuoro, Italy
| | - Rosario Rossi
- Neurology and Stroke Unit, Ospedale San Francesco, Nuoro, Italy
| | - Pietro Amistà
- Neuroradiology Unit, Ospedale S. Maria Misericordia, Rovigo, Italy
| | - Monia Russo
- Stroke Unit, Ospedale S. Maria Misericordia, Rovigo, Italy
| | | | | | - Giuseppe Craparo
- Interventional Radiology, Ospedale Civico e Benfratelli, Palermo, Italy
| | - Marina Mannino
- Neurology Unit, Ospedale Civico e Benfratelli, Palermo, Italy
| | | | - Salvatore Mangiafico
- Interventional Neuroradiology Unit, Ospedale Careggi-University Hospital, Firenze, Italy
| | - Danilo Toni
- Stroke Unit, University of Rome La Sapienza, Roma, Italy
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Quarato CMI, De Cosmo S, D'Agostino F, Gaudiuso G, Sperandeo M. Commentary: Ultrasound-Guided Biopsy of Pleural-Based Pulmonary Lesions by Injection of Contrast-Enhancing Drugs. Front Pharmacol 2020; 11:365. [PMID: 32346365 PMCID: PMC7171447 DOI: 10.3389/fphar.2020.00365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 03/10/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
- Carla Maria Irene Quarato
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, University of Foggia, Foggia, Italy
| | - Salvatore De Cosmo
- Department of Internal Medicine, IRCCS Fondazione "Casa Sollievo Della Sofferenza", Foggia, Italy
| | - Federica D'Agostino
- Department of Internal Medicine, IRCCS Fondazione "Casa Sollievo Della Sofferenza", Foggia, Italy
| | - Giulia Gaudiuso
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, University of Bari, Bary, Italy
| | - Marco Sperandeo
- Department of Internal Medicine, Unit of Interventional and Diagnostic Ultrasound, IRCCS Fondazione "Casa Sollievo Della Sofferenza", Foggia, Italy
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Cipriani C, D'Agostino F, Rea G. Diagnosis of pneumothorax in major trauma: fast or accuracy? J Ultrasound 2020; 23:223-224. [PMID: 32144683 DOI: 10.1007/s40477-020-00444-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/22/2020] [Indexed: 12/26/2022] Open
Affiliation(s)
- Cristiana Cipriani
- Department of Clinical, Internal Medicine, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
| | | | - Gaetano Rea
- Department of Radiology, "Vincenzo Monaldi" Hospital-AORN Ospedale Dei Colli, Naples, Italy
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Poggi C, Pecoraro Y, Carillo C, Anile M, Amore D, Mantovani S, Naldi G, Pagini A, Bassi M, Cagnetti S, Mottola E, D'Agostino F, Vannucci J, Pernazza A, Cimino G, Savi D, Gomellini S, Pugliese F, De Giacomo T, Rendina EA, Venuta F, Diso D. Inflammatory Myofibroblastic Tumor After Lung Transplant-A Rare and Aggressive Complication: A Case Report. Transplant Proc 2019; 51:2991-2994. [PMID: 31611127 DOI: 10.1016/j.transproceed.2019.08.011] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Malignant diseases are well-known complications after lung transplantation (LT). Among these, inflammatory myofibroblastic tumor (IMT) is a rare neoplasm with a not well-known and often aggressive biological behavior. MATERIAL AND METHODS We hereby describe 2 cases of cystic fibrosis patients who underwent bilateral sequential LT (BSLT) complicated by IMT. RESULTS A 26-year-old man presented a right endobronchial lesion 6 months after BSLT. Two consecutive fiber bronchoscopic biopsies showed granulation tissue. For the persistent lesion growth, the patient underwent a transthoracic biopsy showing histologic diagnosis of IMT. Therefore, he underwent to right pneumonectomy that was unfortunately complicated after 6 months with a late bronchopleural fistula and empyema with exitus 6 months later. A 31-year-old woman 1 year after BSLT presented with a left voluminous pleural-parenchymal lesion; the histologic examination after biopsy revealed an IMT. She underwent a removal of the lesion with a macroscopic R0 resection. Histologic, immunophenotypic, and cytogenetic examinations showed a strong overexpression of anaplastic lymphoma kinase requiring biological adjuvant therapies; however, the patient refused it. Four years later, she presented a recurrence treated with debulking procedure and adjuvant radiotherapy. At last follow-up, the patient was alive with stable disease and optimal graft function. CONCLUSIONS Although IMT is a rare complication after lung transplant, to obtain a careful diagnosis, an early and aggressive treatment is mandatory.
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Affiliation(s)
- Camilla Poggi
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I.
| | - Ylenia Pecoraro
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Carolina Carillo
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Marco Anile
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Davide Amore
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Sara Mantovani
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Giuseppe Naldi
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Andreina Pagini
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Massimiliano Bassi
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Sara Cagnetti
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Emilia Mottola
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Federica D'Agostino
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Jacopo Vannucci
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Angelina Pernazza
- Division of Pathology, Sapienza University of Rome, Policlinico Umberto I
| | - Giuseppe Cimino
- Division of Adult Cystic Fibrosis Centre, Department of Public Health and Infectious Diseases, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Daniela Savi
- Division of Adult Cystic Fibrosis Centre, Department of Public Health and Infectious Diseases, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Sara Gomellini
- Division of Oncologic Radiotherapy, AO S. Giovanni Addolorata, Rome
| | - Francesco Pugliese
- Division of Anesthesiology and Intensive Care Unit for Organ's Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Tiziano De Giacomo
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | | | - Federico Venuta
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
| | - Daniele Diso
- Division of Advanced Thoracic Surgery and Lung Transplant, Sapienza University of Rome, AOU Policlinico Umberto I
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16
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Bravetti C, Cocchieri A, D'Agostino F, Vellone E, Alvaro R, Zega M. A nursing clinical information system for the assessment of the complexity of care. Ann Ig 2018; 30:410-420. [PMID: 30062369 DOI: 10.7416/ai.2018.2241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND The complexity of care can be described through a clinical nursing information system, in particular through the Professional Assessment Instrument -PAI-, encoding each health care activity in time units and analysing the relationship of observed time to patient characteristics in relation to the functional models of care needs. DESIGNS Observational study. METHODS Data were collected for 11 months in 2016-17 in four inpatient units of an Italian hospital using the Professional Assessment Instrument, and a survey grid to measure the time of the nursing activities delivered. All activities with a frequency of 20 or more have been included. The Work Sampling technique was used for time-tracking. RESULTS The sample included 2765 nursing activities. The mean times for each care activity were compared showing significant differences. A statistically significant correlation (Sperman's correlation coefficient) was observed both between the observed time and the level of illness severity and between time and functional models. CONCLUSIONS Patient complexity, both in terms of illness severity and level of dependence, can be coded through a clinical nursing information system. This facilitates the classification and measurement of nursing care delivered, which includes the entire care process.
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Affiliation(s)
- C Bravetti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - A Cocchieri
- Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - F D'Agostino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - E Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - R Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - M Zega
- Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
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17
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Pennini A, Cittadini N, Basilici Zannetti E, Cervoni C, Vellone E, D'Agostino F, Alvaro R. An experience of field work learning for healthcare providers: new perspectives between disadvantages and critical issues. Ann Ig 2017; 28:252-62. [PMID: 27479761 DOI: 10.7416/ai.2016.2104] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The learning models used in traditional education are not very effective for the continuing education of healthcare providers. Fieldwork learning is an active learning method that is feasible in the workplace and is also suitable for professionals who possess a style of experiential learning. Guardian Angel 2.0® is a fieldwork learning project designed to promote educational skills in nurses to improve the self-care and quality of life in women affected by osteoporosis. The purpose of this article is to present the Guardian Angel 2.0® project and its results. METHODS The Guardian Angel 2.0® effort lasted nine months and involved 212 nurses in the north, centre and south of Italy. A socio-demographic questionnaire, an evaluation scale of the learning process and a participants' satisfaction questionnaire were used to evaluate and monitor the fieldwork learning project. RESULTS Out of the 212 nurses who participated in the project, 119 (70%) completed it. The mean age of these participants was 48 years (± 7.98), and 83.5% were female. About half of the participants (52.0%, 55.4% and 45.0%, respectively) were good (a) at respecting deadlines, (b) at using the methodological instruments and (c) the information tools properly. Almost all nurses considered the project to be very relevant (96.4%). In regards to the project's quality, the nurses perceived it as excellent (51.0%) and very good (48.5%). Finally, the project was considered very useful or useful by 100% of nurses. CONCLUSIONS The general satisfaction of nurses was high. The fieldwork learning was relevant and useful for developing educational skills in nurses. It would therefore be appropriate to use fieldwork learning in clinical settings to improve the existing experience of healthcare providers and thereby reduce the difficulties of transforming the knowledge from a theoretical to a practical level and to promote the development of new behaviours when the existing ones become obsolete or inefficient.
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Affiliation(s)
- A Pennini
- PhD candidate in Nursing Sciences, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - N Cittadini
- PhD candidate in Nursing Sciences, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - E Basilici Zannetti
- PhD candidate in Nursing Sciences, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - C Cervoni
- RN, MSN, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - E Vellone
- RN, PhD, Assistant Professor, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - F D'Agostino
- RN, PhD, Research Fellow, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - R Alvaro
- RN, MSN, Associate Professor, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
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18
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Paturzo M, Petruzzo A, D'Agostino F, Barbaranelli C, Alvaro R, Vellone E. 1253The Caregiver Preparedness Scale is valid and reliable to measure preparedness in caregivers of heart failure patients. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.1253] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Bravetti C, Cocchieri A, D'Agostino F, Alvaro R, Zega M. The assessment of the complexity of care through the clinical nursing information system in clinical practice: a study protocol. Ann Ig 2017; 29:273-280. [PMID: 28569337 DOI: 10.7416/ai.2017.2155] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The costs of nursing staff amounts to approximately 50% of the total budget of the health workforce and accounts for 20% to 30% of the total costs incurred by the health care companies. The goal of the study, by analyzing the complexity of care, is to provide a quantification of the assistance delivered, through the assessment of the technical aspects of the welfare activities according to the variable of time. Data from these activities flow into the clinical nursing information system Professional Assessment Instrument - PAI - which is used at the health facility involved in this study. This instrument allows nurses to document the nursing process in electronic format by using a standardized nursing language (nursing diagnoses, nursing interventions and nursing outcomes). METHODS The design of the study is observational. The participants will be patients that are hospitalized in the cardiology departments, the intensive care units for cardiac and thoracic surgery, pulmonary medicine and medical oncology of the "A.Gemelli" hospital in Rome, Italy. The observers who will carry out the surveys will be students of the nursing degree course and the coordinators of the respective wards. The times recorded for each health care activity will be correlated with variables that are defined in the literature as the indicators of the complexity of care. The research protocol was approved by the Ethics Committee of the "A. Gemelli" Hospital in June 2015. RESULTS In terms of results, this study aims to verify the reliability of the Professional Assessment Instrument tool as a system for the classification and measurement of nursing care which includes the entire care process, taking into account all of the variables deemed crucial to the nursing care effort. CONCLUSIONS This study will provide a tool for the assessment of the complexity of care, with the goal of improving the quality of care for the patients and of interacting with the health administration system for the management of resources.
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Affiliation(s)
- C Bravetti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - A Cocchieri
- Department of Nursing Professions, Catholic University, Rome, Italy
| | - F D'Agostino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - R Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - M Zega
- Agostino Gemelli University Polyclinic, Rome, Italy
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20
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D'Agostino F, Zega M, Rocco G, Luzzi L, Vellone E, Alvaro R. Impact of a nursing information system in clinical practice: a longitudinal study project. Ann Ig 2013; 25:329-41. [PMID: 23703307 DOI: 10.7416/ai.2013.1935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The implementation of adequate clinical information systems helps to deal with the immense flow of health data to ensure the continuity of care and access to a safe and high-quality healthcare system. Currently there is an increasing awareness of the importance of evaluating and measuring the impact of such systems in clinical practice. Implementations often fail, due to inadequate interaction between technology and human elements. METHODS This article describes a research project aimed at evaluating the impact of a clinical nursing information system (CNIS), called Professional Assessment Instrument (PAI), in clinical practice. The study will evaluate PAI Quality, Nurses Satisfaction, PAI Use, Nurses and Environment Characteristics, Net Benefits and Nurses' Experiences related to the PAI use. A theoretical model developed for this research will guide the study. A quali-quantitative longitudinal design will be performed involving two hospitals over a 9-month period. To measure different dimensions that affect the success/failure of CNIS we will use different tools/ methods of data collection (questionnaires, psychometric tools, surveys and focus groups). EXPECTED RESULTS This study will evaluate the impact of a CNIS in hospitals providing an overview of the factors which can help and hinder the implementation of an information system. CONCLUSIONS The results of the study will support interventions to improve and implement clinical information systems designed to computerize nursing data, with positive effects on public health and research in general, providing further evidence for health policy.
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Affiliation(s)
- F D'Agostino
- School of Nursing, University Tor Vergata Rome, Italy.
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21
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Del Vescovo R, Pisanti F, Russo V, Battisti S, Cazzato RL, D'Agostino F, Giurazza F, Quattrocchi CC, Faiella E, Setola R, Giulianelli R, Grasso RF, Beomonte Zobel B. Dynamic contrast-enhanced MR evaluation of prostate cancer before and after endorectal high-intensity focused ultrasound. Radiol Med 2012; 118:851-62. [PMID: 22986696 DOI: 10.1007/s11547-012-0876-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2011] [Accepted: 12/04/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE The authors sought to determine the diagnostic performance of dynamic contrast-enhanced magnetic resonance (DCE-MR) imaging in the evaluation of prostate cancer before and after transrectal high-intensity focused ultrasound (HIFU) treatment. MATERIALS AND METHODS We analysed 25 patients with prostate cancer. The prostate-specific antigen (PSA) value was evaluated 1, 4 and 6 months after treatment. DCE-MR imaging was performed the day prior to and 1, 4 and 6 months after HIFU treatment. Transrectal prostate biopsies were obtained at the time of diagnosis and 6 months after treatment. RESULTS Before treatment, intraglandular lesions were considered to be potential sites of neoplasm and subsequently confirmed as sites of prostate adenocarcinoma in all 25 patients based on prostatespecific antigen (PSA) values and histological examinations (rho=1; p<0.001). Using histology as the gold standard, DCE-MR imaging displayed 100% sensitivity, 100% specificity, 100% positive predictive value and 100% negative predictive value before treatment. After HIFU treatment, DCE-MR imaging showed 100% sensitivity and 96% specificity. CONCLUSIONS DCE-MR imaging can be used to visualise prostate adenocarcinoma. Several morphological and postgadolinium modifications in the follow-up DCE-MR images after HIFU treatment were also observed.
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Affiliation(s)
- R Del Vescovo
- Department of Radiology, Campus Bio-Medico, University of Rome, Rome, Italy.
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22
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Occhicone F, Quattrocchi CC, Napoli N, Dell'Aia P, D'Agostino F, Pozzilli P, Beomonte Zobel B. Incidence of new fractures in women with osteoporosis-induced vertebral fractures detected on routine lateral chest radiographs. Radiol Med 2010; 115:815-25. [PMID: 20577909 DOI: 10.1007/s11547-010-0564-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Accepted: 11/20/2009] [Indexed: 11/28/2022]
Abstract
PURPOSE Vertebral fractures represent one of the major complications of osteopororis. Diagnosis is followed by a pharmacological, interventional or surgical treatment. Up to day there are non practice guidelines for a screening evaluation of bone fractures in elderly and most of the fractures remain undiagnosed. We prospectively evaluated the prevalence of vertebral fractures on chest X-rays to determine the diagnostic and prognostic roles of chest X-ray in predicting new bone fractures 2 years after the initial radiogram. MATERIALS AND METHODS Between March 2004 and October 2005, 4,045 women underwent chest X-ray in our radiology department for any indication. We identified 166 women with the presence of at least one vertebral fracture. A questionnaire was administered to these women to collect information about diagnosis of osteoporosis, history of malignancy, systemic diseases, osteoporosis-inducing drugs and pharmacological, radiological or surgical treatment received. RESULTS Out of the 166 women (age 73+/-10.5 years) with vertebral fractures, we interviewed 101 women; 13 had died and 52 were not found. Most of the patients were on menopause (97.1%, 98/101) with an average age of menopause of 48,2 years (+/-6 years). Among the patients on menopause, 15,8% (16/101) had undergone hysterectomy. All patients received a diagnosis of osteoporosis, which was reached with a chest X-ray report in 23.7% (24/101) of cases. A new skeletal fracture occurred in 20.5% (5/27) of patients receiving treatment against a frequency of 20.8% (16/74) in patients without treatment. No statistical difference was found between the groups (p = 0.374). CONCLUSIONS Inadequate treatment may explain the lack of a substantial difference in new fracture risk between treated and untreated patients. For these reason we discuss about the evaluation of an adeguate therapeutic approaches in prevention of osteoporosis-induced fractures.
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Affiliation(s)
- F Occhicone
- Department of Radiology, Interdisciplinary Center for Biomedical Research, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy.
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D'Agostino F, Goglia C, Pasquariello A, Mottola A, Mottola R, Antonicelli R, Rossi M, Lanzetta R, Racca A, Ferro P. [Critical aspects of the direct distribution of medicines to patients upon discharge at the G. Rummo hospital in Benevento (Italy)]. Ig Sanita Pubbl 2009; 65:377-385. [PMID: 20010984] [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: 05/28/2023]
Abstract
Delivering prescription drugs directly to patients at the moment of discharge from the hospital is a useful tool for ensuring continuity in patient drug use, improving prescriptive appropriateness, limiting pharmaceutical expenditure and analyzing pharmacoepidemiological data. A project was therefore conducted from April 2005 to January 2007, at the G. Rumino hospital in Benevento (Italy), to encourage the direct delivery of drugs to patients upon discharge. The project consisted of various phases. Firstly, the medical records of all patients discharged from the hospital during April 2005 were analysed, mainly to collect information regarding discharge prescriptions, verify whether copies of the discharge form and prescription records were present in the chart, the type of drugs prescribed and whether these were available in the hospital pharmacy list of available drugs and had been dispensed to the patient. The percentage of drugs not available and of patients who did not pick up the prescribed drugs was calculated, critical aspects of the prescription process were analysed, and corrective measures implemented. A second evaluation of medical records was then performed for patients discharged in January 2007, to evaluate the effectiveness of the corrective measures applied. Results show that most discharged patients continue not to take advantage of the direct distribution of drugs in hospital and more information and communication to physicians and patients regarding this opportunity is required.
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Procaccini DA, Angelini P, Aucella F, Avanzi C, Brusasco S, Carta G, Cataldi G, Cogoni G, D'Agostino F, d'Elia F, Del Mastro G, Dell'aquila R, De Min AM, Feliciangeli G, Freddi P, Gallucci M, Giannico G, Gigante B, Infante B, Ktena M, Manno C, Marseglia CD, Navarra A, Pappani A, Pompa G, Querques M, Russo D, Sacchetti A, Sechi MA, Specchio A, Stallone C, Virgilio M. [Health-related quality of life in patients with chronic kidney disease]. G Ital Nefrol 2008; 25:694-701. [PMID: 19048570] [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: 05/27/2023]
Abstract
Assessment of quality of life in patients with different degrees of chronic kidney disease is an important issue because of its impact on clinical decisions and financial resource management in the health-care system. The aim of this study was to assess whether a generic instrument like the SF-36 questionnaire is able to discriminate three different populations of patients with different degrees of renal disease (pre-ESRD, ESRD, TxR). Five hundred sixty-three patients from 12 Italian nephrology units completed the SF-36 scales by themselves. The results from these samples were compared with those from the general population. Univariate analysis and multivariate regression were used. The generic SF-36 questionnaire proved to be a powerful instrument to discriminate populations with different degrees of chronic renal failure. The quality of life of patients on dialysis is significantly worse than that of the normal population and other patients with less severe renal function impairment.
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Affiliation(s)
- D A Procaccini
- Struttura di Nefrologia e Dialisi, Azienda Ospedaliero-Universitaria OO.RR., Foggia, Italy. procaccininefro@ospedaliriunitifoggia@it
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25
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Pansini F, Gargano L, Sambati M, Dambrosio N, D'Altri C, Giannoccaro G, Boccia E, Cecilia A, Di Toro Mammarella R, Flammini A, La Rosa S, Fici M, Sabella V, Falco M, Montalto G, Rindone F, Murgo AM, Greco V, Giannetto M, D'Agostino F, Pellegrini F, Invernizzi C, Strippoli GFM, Manno C. [Patient satisfaction in hemodialysis: a pilot cross-sectional analysis and a review]. G Ital Nefrol 2007; 24:584-594. [PMID: 18278762] [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: 05/25/2023]
Abstract
BACKGROUND Assessment of patient satisfaction is not performed routinely in many healthcare institutions. In this review, we discuss methodological aspects of assessment of patient satisfaction in hemodialysis. We also present a pilot study conducted in the Gambro Healthcare Italy dialysis clinics network. METHODS Patient satisfaction was assessed in a network of hemodialysis units by using an internally validated Italian translation of the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) questionnaire. A cross-sectional analytic study design was used and data analysed with univariate and multivariate hierarchical logistic regression to explore correlates of the risk of being unsatisfied with dialysis treatment. Covariates which were considered include a series of over 20 clinical, demographic, organizational and structural aspects. In addition, unexplained inter-centre residual variability due to 'case-mix' was explored and plotted. RESULTS Seventeen dialysis units participated in this cross-sectional analysis and 758/1001 (75.7%) provided answers to the questionnaires. There was a statistically significant association on multivariate hierarchical analysis between the risk of being unsatisfied with dialysis treatment and interdialysis body weight gain (unit of increase: 1 kg, p=0.004). On the contrary, the risk of unsatisfaction with dialysis treatment was significantly lower in patients with higher dry weight (unit of increase: 1 kg, p=0.002). Our multivariate hierarchical analysis identified some residual variability between dialysis units (n=6 outliers) which may not be explained by any of over 20 potential confounding covariates which were explored. CONCLUSIONS Assessment of ''customer satisfaction'' is standard practice in private for profit product companies in general but needs to be increasingly recognized as a standard in both public and private providers of healthcare services. Social research methods, which are used for this type of analysis, need to be fine tuned and actively implemented in order to better understand how we may influence the quality of service we provide to our patients and the level at which they rate it.
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Affiliation(s)
- F Pansini
- Dipartimento dell'Emergenza e Trapianti d'Organo (DETO), Università degli Studi, Bari, Italy
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Agozzino E, Attena F, D'Agostino F. [Sexually transmitted diseases: a public health issue]. Ig Sanita Pubbl 2004; 60:373-90. [PMID: 17206213] [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: 05/13/2023]
Abstract
Sexually Transmitted Diseases (STDs) are a main problem in the public health policy. The importance of these diseases is not only limited to their high incidence but also to the complications they may cause and to their role in the HIV transmission. Control of STDs represents one of the main aims of the World Health Organization. For many years STDs were thought to have been almost completely eliminated; instead, recently the rates of STDs are increasing. This has prompted the search for control strategies, that, however, have shown to be difficult to implement. For this reason, prevention programs based on promotion of responsible sexual behaviour, early diagnosis and treatment, and reduction of infectiousness, have been implemented in many countries.
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Affiliation(s)
- Erminia Agozzino
- Dipartimento di Medicina Pubblica, Clinica e Preventiva Sezione di Igiene, II Università degli Studi di Napoli.
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Attena F, D'Agostino F, Oriente P, Chignoli V, De Paola A. [New procedures for improving case sheets editing]. Ig Sanita Pubbl 2003; 59:157-66. [PMID: 14576862] [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: 04/27/2023]
Abstract
Case sheets are very important instruments for improving health care quality in hospitals. Despite their importance, they are very seldom used and filled in the right way. The study is based on an attempt to optimise case sheets editing; it implies multiple steps: 1. Project development; implementation of a pattern for assessing markers (thoroughness, clearness, reliability and record tracking); 2. Delivery of personal research protocols; 3. Early analysis, assessment of results; detection of severity; 4. Correctional interventions; 5. Secondary analysis; assessment of interventions. Although most indicators have shown an improvement, outcomes remain unsatisfactory, given the extent of shortfalls before intervention.
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Affiliation(s)
- Francesco Attena
- Scuola di Specializzazione in Igiene e Medicina Preventiva, Dipartimento di Medicina Pubblica, Clinica e Preventiva ,Seconda Università degli Studi di Napoli.
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Battino M, Bompadre S, Leone L, Devecchi E, Degiuli A, D'Agostino F, Cambiè G, D'Agostino M, Faggi L, Colturani G, Gorini A, Villa RF. Coenzyme Q, Vitamin E and Apo-E alleles in Alzheimer Disease. Biofactors 2003; 18:277-81. [PMID: 14695944 DOI: 10.1002/biof.5520180231] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Neurodegenerative Diseases represent the most common cause of Dementia, about 5-10% of the population aged above 65 years and about 30% above 80 years. A study about Apo-E alleles, Coenzyme Q and Vitamins E as biological indicators was performed in plasma samples of patients aged from 30 to 85 years, affected by Neurodegenerative Diseases. The results were compared with control subjects of approximately the same ages as the reference group. A frequency of 21.7% of epsilon4 allele in control group was estimated, against 15.8% observed in patients. The frequency of epsilon2 and epsilon3 alleles was 13.0% and 65.2% in the control group against 10.5% and 73.7% in patients. No significant differences were observed between the frequency of epsilon3/epsilon3 genotype and epsilon3/epsilon4 genotype in the control group compared to patients' group. The frequencies observed in epsilon2/epsilon3 genotype groups were 8.7% vs 15.8% and of e2/e4 genotype 17.4% vs 5.3%. The epsilon2/epsilon2 and epsilon4/epsilon4 genotypes were not identified in any groups. Plasma CoQ10 concentrations were similar in patient and control groups and no differences were found even taking into account the distribution of male and female subjects in the two groups. Also, vitamin E did not provide evidence of any differences between groups and the analysis among sexes revealed that again vitamin E concentrations were similar in between subgroups.
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Affiliation(s)
- M Battino
- Institute of Biochemistry, Università Politecnica delle Marche, Faculty of Medicine, Ancona, Italy.
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29
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D'Agostino F. [Medical deontology and medical ethics]. Med Secoli 2001; 10:19-29. [PMID: 11620160] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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30
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Pelizzo G, Lembo MA, Franchella A, Giombi A, D'Agostino F, Sala S. Gastric volvulus associated with congenital diaphragmatic hernia, wandering spleen, and intrathoracic left kidney: CT findings. Abdom Imaging 2001; 26:306-8. [PMID: 11429960 DOI: 10.1007/s002610000171] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We present an unusual case of gastric volvulus associated with wandering spleen, a delayed manifestation of congenital diaphragmatic hernia and left intrathoracic kidney. Gastric volvulus should be considered in any infant with unexplained vomiting and left diaphragmatic anomaly: in these patients, developmental disorders of the peritoneal visceral attachments of the left upper abdomen may coexist. The absence of ligamentous connections between the stomach, posterior abdominal wall, and spleen result in wandering spleen. We emphasize prompt surgical therapy to avoid gastric and splenic necrosis. Radiologic findings and the appearance of this complex congenital malformation are reported.
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Affiliation(s)
- G Pelizzo
- Department of Pediatric Surgery, Arcispedale S. Anna, Corso Giovecca 203, 44100 Ferrara, Italy
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31
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Di Vito M, Lenti L, Knijn A, Iorio E, D'Agostino F, Molinari A, Calcabrini A, Stringaro A, Meschini S, Arancia G, Bozzi A, Strom R, Podo F. 1H NMR-visible mobile lipid domains correlate with cytoplasmic lipid bodies in apoptotic T-lymphoblastoid cells. Biochim Biophys Acta 2001; 1530:47-66. [PMID: 11341958 DOI: 10.1016/s1388-1981(00)00165-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The presence of nuclear magnetic resonance (NMR)-visible mobile lipid (ML) domains in apoptotic lymphoblasts suggests alterations in neutral lipid metabolism and compartmentation during programmed cell death. The detection of similar ML signals in activated lymphocytes raises questions about common mechanisms of ML formation during apoptosis and upon lymphoblast stimulation. Structure and subcellular localization of ML domains were therefore investigated by NMR, fluorescence and electron microscopy in Jurkat T-lymphoblasts either induced to apoptosis (by anthracyclines or dexamethasone or by serum deprivation) or activated by phorbol myristate acetate (PMA) plus ionomycin. ML contents in drug-treated cells correlated linearly with apoptosis, irrespective of the specific inducer and cell cycle arrest phase (r = 0.993, P < 0.001). Similar ML levels were measured in drug-induced apoptotic cells (A approximately 30-40%) and in non-apoptotic PMA/ionomycin-treated lymphoblasts (72 h). Lower ML contents were instead formed in serum-deprived apoptotic cells, with respect to controls. Increases in ML signals were associated, in either apoptotic or activated cells, with the accumulation of cytoplasmic, osmophilic lipid bodies (diameter < or = 1.0 microm), surrounded by own membrane, possessing intramembrane particles. The results support the hypothesis that ML are formed in the cytoplasm of drug-induced apoptotic cells during an early, 'biochemically active' phase of programmed cell death.
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Affiliation(s)
- M Di Vito
- Laboratory of Cell Biology, Istituto Superiore di Sanità, Rome, Italy
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32
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Gallieni M, Brancaccio D, Antonucci F, Bellinghieri G, Carpani P, Cozzolino M, D'Agostino F, Del Mastro G, Mallamace A, Memoli B. Twice versus thrice weekly administration of intravenous calcitriol in dialysis patients: a randomized prospective trial. Gruppo Italiano di Studio dell'Osteodistrofia Renale. Clin Nephrol 2000; 53:188-93. [PMID: 10749297] [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: 02/16/2023] Open
Abstract
BACKGROUND Administration of intravenous (i.v.) calcitriol three times weekly effectively controls the synthesis and secretion of PTH in most uremic patients. Administration of a single dose of 1.25(OH)2D3 reduces synthesis of PTH-mRNA for 6 days in rats. Moreover, it can lower PTH levels for up to 4 days in chronic hemodialysis patients. Therefore, a good response to the administration of i.v. calcitriol two times weekly can be expected. We studied - in a multicenter randomized study in patients with moderate to severe secondary hyperparathyroidism - the effects of the same doses of intravenous calcitriol, administered two or three times weekly. METHODS Twenty-two hemodialysis patients were randomized into two frequencies of treatment groups: two times (G-2/w) and three times weekly (G-3/w). Both groups were treated with increasing doses of intravenous calcitriol for 3 months (first month 3 microg, second month 4 microg, third month 6 microg weekly). RESULTS After 12 weeks of therapy with intravenous calcitriol the G-2/w group showed a significant reduction in serum PTH levels (from 821 +/- 392 to 350 +/- 246 pg/ml; mean reduction = 57.4%) comparable to the decrease observed in the G-3/w group (from 632 +/- 116 to 246 +/- 190 pg/ml; mean reduction = 61.2%). Ionized calcium (G-2/w from 1.13 +/-0.10 to 1.14 +/- 0.08 and G-3/w 1.21 +/- 0.13 to 1.26 +/- 0.18 mmol/l) and phosphate levels (G-2/w from 4.99 +/- 1.01 to 5.99 +/- 1.78 and G-3/w 5.31 +/- 0.73 to 5.81 +/- 1.18 mg/dl) did not change significantly and phosphate binders were not modified during the study. CONCLUSION This study confirms that intravenous calcitriol is an effective therapy for moderate to severe secondary hyperparathyroidism. The administration of two doses per week of intravenous calcitriol is as efficacious as three doses per week in suppressing PTH secretion.
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33
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Coppola V, Verrengia D, Gatta G, Alfinito M, Alfano L, D'Agostino F. Small bowel enteroclysis in surgically treated obesity. Radiol Med 1998; 96:466-9. [PMID: 10051870] [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: 02/11/2023]
Abstract
PURPOSE To define the indications, technical limitations and diagnostic yeld of small bowel transbuccal enema in the follow-up of surgical jejunoileal shunting in patients with complicated severe essential obesity. MATERIAL AND METHODS Three patients were submitted to surgical diversion: two of them underwent an intestinal bypass after Payne-De Wind (isoperistaltic end-to-side jejunoileostomy) and the other after Scott (end-to-end jejunoileostomy). The latter refers to intestinal recanalization and antiperistaltic lower end-to-side gastroenteric restoration. RESULTS Radiologic studies are the only means to depict the surgical small bowel. Radiographic follow-up needs barium sulfate administration and therefore cannot be performed any sooner than 30 days postoperatively. In the last three years the classic transbuccal enema has been performed with a Rollandi tube (with a terminal opening and a balloon). Both the anastomosis and the blind loop are difficult to demonstrate. CONCLUSIONS Jejunoileal bypass can be used to treat severe obsity uncontrollable otherwise, to reduce food absorption. Different severe complications may result and small bowel studies may permit to show late local complications. Small bowel enema is also indispensable in bypass reversal. There are no alternatives to this radiologic examination which is however very difficult to perform, because of the changes made by previous operation(s), and to interpret because the anastomosis, the sutured loop and wall changes are often poorly demonstrated.
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Affiliation(s)
- V Coppola
- Istituto di Scienze Radiologiche Università Federico II, Napoli
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34
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Abstract
Ethical thinking about social science research is dominated by a biomedical model whose salient features are the assumption that only potential harms to subjects of research are relevant in the ethical evaluation of that research, and in the emphasis on securing informed consent in order to establish ethical proxy. A number of counter-examples are considered to the assumption, a number of defences against these counter-examples are examined, and an alternative model is proposed for the ethical evaluation of social science research: a model which can cope with the systemic harms (harms other than those to participants as participants) which have been identified. This model is based on John Rawls's idea of original position reasoning and treats social science research as an institutional feature of the basic structure of society.
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Affiliation(s)
- F D'Agostino
- Department of Philosophy, University of New England, Armidale, NSW 2351, Australia
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35
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Ferroni P, Lenti L, Guadagni F, Martini F, D'Agostino F, Spila A, Pontieri GM, Gazzaniga PP. Possible involvement of tumour cell membrane gangliosides in platelet-tumour cell interactions. Eur J Cancer 1995; 31A:79-84. [PMID: 7695984 DOI: 10.1016/0959-8049(94)00436-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The possible correlation(s) between platelet proaggregating activity, and sialic acid content and ganglioside expression of six human colorectal tumour cell lines (CBS, GEO, HT-29, WiDr, MIP and DLD-1) was evaluated. The three cell lines (HT-29, WiDr and DLD-1) capable of inducing remarkable in vitro platelet aggregation, had significantly higher amounts of lipid-bound sialic acid than those cell lines characterised by a lower platelet proaggregating activity (GEO, CBS and MIP). High performance thin-layer chromatography demonstrated the presence of one band comigrating with GM3 in all cell lines, while GD1a and GT1b comigrating gangliosides were present only in HT-29, WiDr and DLD-1 cells. Finally, an increased platelet pro-aggregating activity of GEO and CBS cell lines was observed after the incorporation of exogenous gangliosides. The present data support the hypothesis that lipid-bound sialic acid may be involved in platelet-tumour cell interactions.
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Affiliation(s)
- P Ferroni
- Department of Experimental Medicine, University of Rome La Sapienza, Italy
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36
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Hess G, Avillez F, Lourenco MH, D'Agostino F, Cambie G, Piot P, Vercauteren G, Michl U, Melchior W, Bayer H. Diagnosis of human immunodeficiency virus (HIV) infection: multicenter evaluation of a newly developed anti-HIV 1 and 2 enzyme immunoassay. J Clin Microbiol 1994; 32:403-6. [PMID: 8150950 PMCID: PMC263044 DOI: 10.1128/jcm.32.2.403-406.1994] [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] [Indexed: 01/29/2023] Open
Abstract
A new anti-human immunodeficiency virus type 1 and 2 (anti-HIV 1 and 2) test is described. It uses recombinant p24 and peptides covering gp32, gp41, and gp120 to identify HIV-1 and HIV-2 infections. This test has been shown to be specific (99.5%) and sensitive (99.8%). In this respect, the assay was equal or superior to anti-HIV 1 and 2 tests run as references. The test was able to discriminate sera from patients with HIV infections from those from uninfected individuals with excellence; it also exerted high intra- and interassay precisions. The "modular" concept of the test allows the use of single components (gp32 or gp41) to separate between HIV-2 and HIV-1 infections, respectively.
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Affiliation(s)
- G Hess
- Medizinische Klinik und Poliklinik, Klinikum der Johannes-Gutenberg-Universität, Mainz, Germany
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37
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Sbalzarini G, D'Agostino F, Mercantini F, Girami M, Labadini A, Pandolfi C. [Carcinoembryonic antigen (CEA) and mucinous-like tumor associated antigen (MAC). Statistic correlation in advanced breast carcinoma]. Minerva Med 1991; 82:811-3. [PMID: 1780086] [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: 12/28/2022]
Abstract
In this study we have determined the plasmatic values of carcinoembryonic antigen (CEA) and mucinous like tumor associated antigen (MCA) in 20 women with metastatic breast cancer. CEA and MCA were determined by enzyme immunoassay technique. The results were analyzed by test r for the statement of statistical correlation. Since r was inferior to p 5% (r = 0.3255; p = 0.4438) the 2 parameters are not correlated and their biological expression must be considered independent.
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Affiliation(s)
- G Sbalzarini
- I Divisione Medica, USSL n. 56, Ospedale Maggiore, Lodi, Milano
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38
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Crocchiolo PR, Lizioli A, Arcidiacono I, Cantaluppi P, Filippi C, Sobatti D, Bedarida G, D'Agostino F, Cambie G, Nardella ML. Behaviour of different clinical, immunological and serological parameters observed in a group of HIV positive patients during a 12 month treatment period with zidovudine. Boll Ist Sieroter Milan 1990; 69:423-30. [PMID: 1983798] [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: 12/29/2022]
Abstract
During a 12 month open clinical trial, 14 patients (6 with AIDS, 2 with ARC and 6 with PGL) were continuously administered a daily 1200 mg dose of Zidovudine. Clinical course was correlated with a number of serological (HIV p24 antigen, p17 and p24 antibodies) and immunological (CD4 cell counts, serum neopterin and beta 2-microglobulin levels) parameters. All patients survived until the end of the trial: none developed major opportunistic infections, but 5 required an average of 7 blood transfusions each. Disappearance of p24 Ag was observed in 4 out of 7 patients, although with a subsequent reappearance in 3; moreover, changes of p24 Ag and HIV core Ab profiles were generally paralleled by neopterin and, to a lesser extent, by CD4/neopterin ratio variations. In the long run, significant differences between baseline and end-point results were shown by neopterin, but not by CD4 cell counts and beta 2-microglobulin levels. Efficacy of Zidovudine therapy seemed to be mainly related to clinical, but even more so, to immunological and serological status at baseline; in fact, severe clinical deterioration was observed in 2 patients who had an already low CD4/neopterin ratio from the beginning, coupled with a p24 Ag positivity and a negativity of both anti-p17 and -p24. Conversely, a stable clinical condition was observed in those patients in whom the reverse was true.
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Affiliation(s)
- P R Crocchiolo
- Infectious Diseases Department, Ospedale Maggiore, Lodi, Italy
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39
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Crocchiolo PR, Lizioli A, Cantaluppi P, Filippi C, D'Agostino F, Cambié G, Panzeri MP, Nardella ML. CD4+:neopterin ratio correlates with p24 antigenaemia in HIV infected patients. J Clin Lab Immunol 1990; 31:55-7. [PMID: 1983767] [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: 12/29/2022]
Abstract
In an effort to improve the Walter Reed Staging System (WR), which mainly relies on immune depletion parameters, by introducing viral replication and T-cell activation markers, we examined by p24 antigenaemia and serum neopterin levels (SNL) 72 HIV positive PGL, ARC and AIDS patients (11 of whom classified as WR 2, 21 as WR 3, 16 as WR 5 and 24 as WR 6). While CD4 cell counts, already weakly correlating with the WR itself, did not significantly differ between p24 antigen (p24 AG) positive and negative patients, striking differences between the two groups, especially in PGL patients (p less than 0.0001), were found as far as SNL was concerned. In fact, SNL values, fluctuating around 10 and 30 nmol/l, respectively, in p24 Ag positive and negative patients regardless of their WR allocation, seemed rather to reflect, as global means of any given class, prevalence rate of p24 Ag positivity. We suggest, therefore, to use CD4/SNL ratio (R) for HIV infection and disease staging, as it not only may represent a compromise index between cellular immune depletion and T-cell activation, but also seems to take into account the viral replication component, already shown to be an important predictive marker of disease progression.
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Affiliation(s)
- P R Crocchiolo
- Infectious Diseases Department, Ospedale Maggiore, Lodi, Italy
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40
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Bedarida G, Panzeri MP, Lizioli A, D'Agostino F, Cambié G, Nardella ML, Berto E, Crocchiolo P. Detection of HIV antibodies in seronegative subjects at risk of HIV infection. AIDS 1989; 3:613-4. [PMID: 2506907] [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: 01/01/2023]
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41
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Bedarida G, Crocchiolo P, Cambié G, D'Agostino F, Uberti Foppa C, Berto E, Grisi ME, Arcidiacono I, Ronsivalle MG, Pasquali M. HIV-IgM serology. Infection 1988; 16:301-2. [PMID: 3215691 DOI: 10.1007/bf01645079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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42
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D'Agostino F. [Iatrogenic arrhythmia]. Clin Ter 1988; 124:387-95. [PMID: 2974350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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43
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D'Agostino F. [The role of calcium in striated cardiac and vascular smooth muscle cells]. Clin Ter 1988; 124:303-13. [PMID: 2849522] [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: 01/02/2023]
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44
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45
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46
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Rizzo SC, Grignani G, Gamba G, Bedarida G, D'Agostino F. Intravenous gammaglobulin therapy for chronic idiopathic thrombocytopenic purpura in adults. Haematologica 1985; 70:337-40. [PMID: 3935533] [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: 01/08/2023] Open
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47
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Melillo G, D'Amato G, Liccardi G, D'Agostino F, Schiano M. Allergy to Olea europaea pollen: relationship between skin prick tests, RAST, ELISA and bronchial provocations tests. Allergol Immunopathol (Madr) 1985; 13:229-34. [PMID: 3898790] [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: 01/07/2023]
Abstract
Olea Europaea is the most important allergenic tree in Southern Italy and in the Naples area. Its pollination period lasts from the middle of April to the end of June. In our pollinosis patients we observed frequency of sensitization of 13.05% to Olea pollen. That means that this pollen follows Parietaria (47.80%) and Gramineae (34.70%) regarding the frequency of allergic sensitization. In an attempt to evaluate the degree of allergic sensitization to Olea pollen and the concordance of various tests, we studied 24 asthmatic patients with skin positivity to only this pollen using commercially available allergen extracts and reagents. The patients were examined by SPT, RAST, ELISA and BPT with allergen. Our study has shown that there is no relationship between the results of SPT and Phadebas RAST; a slight relationship between SPT and Phadezym RAST, and a very good relationship between Phadebas and Phadezym RAST. Bronchial challenge with Olea extract was positive in all patients. These results may be interpreted considering the low degree of purification of Olea pollen extracts available commercially.
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48
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Bedarida G, Cambiè G, D'Agostino F, Sterza G. [Currently available means for the prevention of post-transfusion hepatitis and criteria for their application]. Ric Clin Lab 1984; 14 Suppl 1:37-60. [PMID: 6429830] [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: 05/21/2023]
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49
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Tullio D, Valerio A, D'Agostino F. [Calcium antagonists in cardiology]. Clin Ter 1983; 104:27-51. [PMID: 6337771] [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: 01/19/2023]
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50
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Bedarida G, D'Agostino F, Bianchi M, Susani G, Sangalli F, Fattorini A, Sterza G. Unexpected lower prevalence of HBsAg in diabetics than in controls. (A study on 2,465 patients). Ric Clin Lab 1982; 12:409-15. [PMID: 7111984 DOI: 10.1007/bf02909426] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Serum samples from 2,465 diabetics were examined by radioimmunoassay for HBsAg, anti-HBs and anti-HBc at the Centro Antidiabetico of the Ospedale Maggiore di Lodi; during the same period, the same tests were carried out on serum samples from 2,176 control subjects, who had been admitted to the surgical, casualty and obstetrical departments for reasons that had nothing whatsoever to do with any form of liver disease. The ages of the two groups ranged from 6 to 90 years. The diabetics were divided into three groups; insulin-dependent, non-insulin-dependent and diabetics treated with insulin for diabetic complications. The overall frequency of HBsAg in the various groups of diabetics was 3.5%, while in the controls it was 6.1% (p less than 0.001). In the group of young insulin-dependent diabetics, the frequency was 1.7%, as compared to 6.9% for the controls in the same age group (p less than 0.05). In the group of patients treated with insulin for diabetic complications, the frequency increased to 11.5%, while for the controls in the same age group it was 5.5%. The levels of HBsAg were practically the same in the diabetics and in the controls, whereas the level of anti-HBc was higher in the diabetics: 55.6% compared to 50% (p less than 0.005). This last result indicates that the chances of hepatitis B virus infection were greater for the diabetics than for the controls. Diabetics, and especially those insulin-dependent are, therefore, believed to possess a greater capacity of resistance through their T cell-mediated immune response to the hepatitis B virus.
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