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Martelli E, Sotgiu G, Saderi L, Federici M, Sangiorgi G, Zamboni M, Martelli AR, Accarino G, Bianco G, Bonanno F, Bracale UM, Cappello E, Cioffi G, Colacchio G, Crinisio A, De Vivo S, Dionisi CP, Flora L, Impedovo G, Intrieri F, Iorio L, Maritati G, Modugno P, Monaco M, Natalicchio G, Palazzo V, Petrosino F, Pompeo F, Pulli R, Razzano D, Ruggieri MR, Ruotolo C, Sangiuolo P, Vigliotti G, Volpe P, Biello A, Boggia P, Boschetti M, Centritto EM, Condò F, Cucciolillo L, D’Amodio AS, De Laurentis M, Desantis C, Di Lella D, Di Nardo G, Disabato A, Ficarelli I, Gasparre A, Giordano AN, Luongo A, Massara M, Molinari V, Padricelli A, Panagrosso M, Petrone A, Pisanello S, Prunella R, Tedesco M, Settembrini AM. How the First Year of the COVID-19 Pandemic Impacted Patients' Hospital Admission and Care in the Vascular Surgery Divisions of the Southern Regions of the Italian Peninsula. J Pers Med 2022; 12:jpm12071170. [PMID: 35887667 PMCID: PMC9316551 DOI: 10.3390/jpm12071170] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/29/2022] Open
Abstract
Background: To investigate the effects of the COVID-19 lockdowns on the vasculopathic population. Methods: The Divisions of Vascular Surgery of the southern Italian peninsula joined this multicenter retrospective study. Each received a 13-point questionnaire investigating the hospitalization rate of vascular patients in the first 11 months of the COVID-19 pandemic and in the preceding 11 months. Results: 27 out of 29 Centers were enrolled. April-December 2020 (7092 patients) vs. 2019 (9161 patients): post-EVAR surveillance, hospitalization for Rutherford category 3 peripheral arterial disease, and asymptomatic carotid stenosis revascularization significantly decreased (1484 (16.2%) vs. 1014 (14.3%), p = 0.0009; 1401 (15.29%) vs. 959 (13.52%), p = 0.0006; and 1558 (17.01%) vs. 934 (13.17%), p < 0.0001, respectively), while admissions for revascularization or major amputations for chronic limb-threatening ischemia and urgent revascularization for symptomatic carotid stenosis significantly increased (1204 (16.98%) vs. 1245 (13.59%), p < 0.0001; 355 (5.01%) vs. 358 (3.91%), p = 0.0007; and 153 (2.16%) vs. 140 (1.53%), p = 0.0009, respectively). Conclusions: The suspension of elective procedures during the COVID-19 pandemic caused a significant reduction in post-EVAR surveillance, and in the hospitalization of asymptomatic carotid stenosis revascularization and Rutherford 3 peripheral arterial disease. Consequentially, we observed a significant increase in admissions for urgent revascularization for symptomatic carotid stenosis, as well as for revascularization or major amputations for chronic limb-threatening ischemia.
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Affiliation(s)
- Eugenio Martelli
- Department of General and Specialist Surgery, Sapienza University of Rome, 155 Viale del Policlinico, 00161 Rome, Italy
- Saint Camillus International University of Health Sciences, 8 Via di Sant’Alessandro, 00131 Rome, Italy
- Division of Vascular Surgery, S. Anna and S. Sebastiano Hospital, Via F. Palasciano, 81100 Caserta, Italy;
- Correspondence: (M.Z.); (E.M.); Tel.: +39-3490611365 (M.Z.); +39-3294003220 (E.M.)
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro, 07100 Sassari, Italy; (G.S.); (L.S.)
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro, 07100 Sassari, Italy; (G.S.); (L.S.)
| | - Massimo Federici
- Department of Systems Medicine, University of Rome Tor Vergata, 1 Viale Montpellier, 00133 Rome, Italy;
| | - Giuseppe Sangiorgi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 1 Viale Montpellier, 00133 Rome, Italy;
| | - Matilde Zamboni
- Division of Vascular Surgery, Saint Martin Hospital, 22 Viale Europa, 32100 Belluno, Italy
- Correspondence: (M.Z.); (E.M.); Tel.: +39-3490611365 (M.Z.); +39-3294003220 (E.M.)
| | - Allegra R. Martelli
- Medicine and Surgery School of Medicine, Campus Bio-Medico University of Rome, 21 Via À. del Portillo, 00128 Rome, Italy;
| | - Giancarlo Accarino
- San Giovanni Di Dio e Ruggi d’Aragona Hospital, Via San Leonardo s.n.c., 84125 Salerno, Italy;
| | - Giuseppe Bianco
- San Giovanni Bosco Hospital, 225 Via F. M. Briganti, 80144 Naples, Italy; (G.B.); (M.B.)
| | - Francesco Bonanno
- Madonna delle Grazie Hospital, Via Montescaglioso s.n.c., 75100 Matera, Italy;
| | - Umberto M. Bracale
- Federico II Polyclinic, Department of Public Health and Residency Program in Vascular Surgery, University of Naples Federico II, 5 Via S. Pansini, 80131 Naples, Italy; (U.M.B.); (F.C.); (M.P.); (A.P.)
| | - Enrico Cappello
- Mediterranean Neurological Institute NEUROMED, 18 Via Atinense, 80122 Naples, Italy; (E.C.); (F.P.)
| | - Giovanni Cioffi
- Pellegrini Hospital, 41 Via Portamedina alla Pignasecca, 80134 Naples, Italy; (G.C.); (S.D.V.); (A.S.D.)
| | - Giovanni Colacchio
- F. Miulli Hospital, Km. 4100 Strada Provinciale 127 Acquaviva-Santeramo, 70021 Acquaviva delle Fonti, Italy; (G.C.); (A.G.)
| | - Adolfo Crinisio
- Salus Clinic, 4 Via F. Confalonieri, 84091 Battipaglia, Italy; (A.C.); (G.D.N.)
| | - Salvatore De Vivo
- Pellegrini Hospital, 41 Via Portamedina alla Pignasecca, 80134 Naples, Italy; (G.C.); (S.D.V.); (A.S.D.)
| | | | - Loris Flora
- San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy;
| | - Giovanni Impedovo
- SS. Annunziata Hospital, 1 Via F. Bruno, 74121 Taranto, Italy; (G.I.); (S.P.); (R.P.)
| | - Francesco Intrieri
- Annunziata Hospital, 1 Via Migliori, 87100 Cosenza, Italy; (F.I.); (V.M.)
| | - Luca Iorio
- Cardarelli Hospital, 1 Via U. Petrella, 86100 Campobasso, Italy; (L.I.); (L.C.)
| | - Gabriele Maritati
- A. Perrino Hospital, Strada Statale 7 per Mesagne, 72100 Brindisi, Italy; (G.M.); (P.B.)
| | - Piero Modugno
- Gemelli Molise Hospital, Catholic University of the Sacred Heart, 1 Largo A. Gemelli, 86100 Campobasso, Italy; (P.M.); (E.M.C.)
| | - Mario Monaco
- Pineta Grande Hospital, Km. 30 Via Domitiana, 81030 Castelvolturno, Italy;
| | | | - Vincenzo Palazzo
- Casa Sollievo della Sofferenza Hospital, Viale Cappuccini s.n.c., 71013 San Giovanni Rotondo, Italy; (V.P.); (A.N.G.)
| | - Fernando Petrosino
- San Luca Hospital, 1 Via F. Cammarota, 84078 Vallo della Lucania, Italy; (F.P.); (A.L.)
| | - Francesco Pompeo
- Mediterranean Neurological Institute NEUROMED, 18 Via Atinense, 80122 Naples, Italy; (E.C.); (F.P.)
| | - Raffaele Pulli
- Polyclinic of Bari, Department of Emergency and Organs Transplantation, Aldo Moro University of Bari, 11 Piazza Giulio Cesare, 70124 Bari, Italy; (R.P.); (C.D.)
| | - Davide Razzano
- San Pio Hospital, 1 Via dell’angelo, 82100 Benevento, Italy;
| | | | - Carlo Ruotolo
- Cardarelli Hospital, 9 Via A. Cardarelli, 80131 Naples, Italy; (C.R.); (I.F.)
| | - Paolo Sangiuolo
- Monaldi Hospital, Via L. Bianchi s.n.c., 84100 Naples, Italy; (P.S.); (M.D.L.)
| | - Gennaro Vigliotti
- Del Mare Hospital, 11 Via E. Russo, 80147 Naples, Italy; (G.V.); (D.D.L.)
| | - Pietro Volpe
- Bianchi-Melacrino-Morelli Hospital, 21 Via G. Melacrino, 89124 Reggio di Calabria, Italy; (P.V.); (M.M.)
| | - Antonella Biello
- Venere Hospital, 1 Via Ospedale di Venere, 70131 Bari, Italy; (G.N.); (A.B.)
| | - Pietro Boggia
- A. Perrino Hospital, Strada Statale 7 per Mesagne, 72100 Brindisi, Italy; (G.M.); (P.B.)
| | - Michelangelo Boschetti
- San Giovanni Bosco Hospital, 225 Via F. M. Briganti, 80144 Naples, Italy; (G.B.); (M.B.)
| | - Enrico M. Centritto
- Gemelli Molise Hospital, Catholic University of the Sacred Heart, 1 Largo A. Gemelli, 86100 Campobasso, Italy; (P.M.); (E.M.C.)
| | - Flavia Condò
- Federico II Polyclinic, Department of Public Health and Residency Program in Vascular Surgery, University of Naples Federico II, 5 Via S. Pansini, 80131 Naples, Italy; (U.M.B.); (F.C.); (M.P.); (A.P.)
- San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy;
| | - Lucia Cucciolillo
- Cardarelli Hospital, 1 Via U. Petrella, 86100 Campobasso, Italy; (L.I.); (L.C.)
| | - Amodio S. D’Amodio
- Pellegrini Hospital, 41 Via Portamedina alla Pignasecca, 80134 Naples, Italy; (G.C.); (S.D.V.); (A.S.D.)
| | - Mario De Laurentis
- Monaldi Hospital, Via L. Bianchi s.n.c., 84100 Naples, Italy; (P.S.); (M.D.L.)
| | - Claudio Desantis
- Polyclinic of Bari, Department of Emergency and Organs Transplantation, Aldo Moro University of Bari, 11 Piazza Giulio Cesare, 70124 Bari, Italy; (R.P.); (C.D.)
| | - Daniela Di Lella
- Del Mare Hospital, 11 Via E. Russo, 80147 Naples, Italy; (G.V.); (D.D.L.)
| | - Giovanni Di Nardo
- Salus Clinic, 4 Via F. Confalonieri, 84091 Battipaglia, Italy; (A.C.); (G.D.N.)
| | - Angelo Disabato
- Cardinal Panico Hospital, 4 Via San Pio X, 73039 Tricase, Italy; (C.P.D.); (A.D.)
| | - Ilaria Ficarelli
- Cardarelli Hospital, 9 Via A. Cardarelli, 80131 Naples, Italy; (C.R.); (I.F.)
| | - Angelo Gasparre
- F. Miulli Hospital, Km. 4100 Strada Provinciale 127 Acquaviva-Santeramo, 70021 Acquaviva delle Fonti, Italy; (G.C.); (A.G.)
| | - Antonio N. Giordano
- Casa Sollievo della Sofferenza Hospital, Viale Cappuccini s.n.c., 71013 San Giovanni Rotondo, Italy; (V.P.); (A.N.G.)
| | - Alessandro Luongo
- San Luca Hospital, 1 Via F. Cammarota, 84078 Vallo della Lucania, Italy; (F.P.); (A.L.)
| | - Mafalda Massara
- Bianchi-Melacrino-Morelli Hospital, 21 Via G. Melacrino, 89124 Reggio di Calabria, Italy; (P.V.); (M.M.)
| | - Vincenzo Molinari
- Annunziata Hospital, 1 Via Migliori, 87100 Cosenza, Italy; (F.I.); (V.M.)
| | - Andrea Padricelli
- Division of Vascular Surgery, S. Anna and S. Sebastiano Hospital, Via F. Palasciano, 81100 Caserta, Italy;
| | - Marco Panagrosso
- Federico II Polyclinic, Department of Public Health and Residency Program in Vascular Surgery, University of Naples Federico II, 5 Via S. Pansini, 80131 Naples, Italy; (U.M.B.); (F.C.); (M.P.); (A.P.)
| | - Anna Petrone
- Federico II Polyclinic, Department of Public Health and Residency Program in Vascular Surgery, University of Naples Federico II, 5 Via S. Pansini, 80131 Naples, Italy; (U.M.B.); (F.C.); (M.P.); (A.P.)
- Del Mare Hospital, 11 Via E. Russo, 80147 Naples, Italy; (G.V.); (D.D.L.)
| | - Serena Pisanello
- SS. Annunziata Hospital, 1 Via F. Bruno, 74121 Taranto, Italy; (G.I.); (S.P.); (R.P.)
| | - Roberto Prunella
- SS. Annunziata Hospital, 1 Via F. Bruno, 74121 Taranto, Italy; (G.I.); (S.P.); (R.P.)
| | - Michele Tedesco
- Riuniti Polyclinic, 1 Viale L. Pinto, 71122 Foggia, Italy; (M.R.R.); (M.T.)
| | - Alberto M. Settembrini
- Division of Vascular Surgery, Maggiore Polyclinic Hospital Ca’ Granda IRCCS and Foundation, 28 Via F. Sforza, 20122 Milan, Italy;
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Stabile E, Piccolo R, Franzese M, Accarino G, Bracale UM, Cappello E, Cioffi G, Cioppa A, Crinisio A, Flora L, Landino P, Martelli E, Mancusi R, Niola R, Petrosino F, Razzano D, Ruotolo C, Salemme L, Sangiuolo P, Santini G, Soreca E, Vigliotti G, Villari B, Amabile G, Ammollo RP, Barbarisi D, Corbisiero AM, D’angelo A, Cangiano G, De Gregorio C, De Laurentis M, Laurenzano E, Ficarelli I, Luongo A, Molino C, Sarti G, Viola D, Esposito G. A cross-sectional study evaluating hospitalization rates for chronic limb-threatening ischemia during the COVID-19 outbreak in Campania, Italy. Vasc Med 2021; 26:174-179. [PMID: 33332228 PMCID: PMC8033437 DOI: 10.1177/1358863x20977678] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The expansion of coronavirus disease 2019 (COVID-19) prompted measures of disease containment by the Italian government with a national lockdown on March 9, 2020. The purpose of this study is to evaluate the rate of hospitalization and mode of in-hospital treatment of patients with chronic limb-threatening ischemia (CLTI) before and during lockdown in the Campania region of Italy. The study population includes all patients with CLTI hospitalized in Campania over a 10-week period: 5 weeks before and 5 weeks during lockdown (n = 453). Patients were treated medically and/or underwent urgent revascularization and/or major amputation of the lower extremities. Mean age was 69.2 ± 10.6 years and 27.6% of the patients were women. During hospitalization, 21.9% of patients were treated medically, 78.1% underwent revascularization, and 17.4% required amputations. In the weeks during the lockdown, a reduced rate of hospitalization for CLTI was observed compared with the weeks before lockdown (25 vs 74/100,000 inhabitants/year; incidence rate ratio: 0.34, 95% CI 0.32-0.37). This effect persisted to the end of the study period. An increased amputation rate in the weeks during lockdown was observed (29.3% vs 13.4%; p < 0.001). This study reports a reduced rate of CLTI-related hospitalization and an increased in-hospital amputation rate during lockdown in Campania. Ensuring appropriate treatment for patients with CLTI should be prioritized, even during disease containment measures due to the COVID-19 pandemic or other similar conditions.
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Affiliation(s)
- Eugenio Stabile
- Department of Advanced Biomedical
Sciences, Division of Cardiology, University of Naples Federico II, Naples,
Italy
| | - Raffaele Piccolo
- Department of Advanced Biomedical
Sciences, Division of Cardiology, University of Naples Federico II, Naples,
Italy
| | - Michele Franzese
- Department of Advanced Biomedical
Sciences, Division of Cardiology, University of Naples Federico II, Naples,
Italy
| | - Giancarlo Accarino
- Department of Vascular and Endovascular
Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Umberto Marcello Bracale
- Department of Public Health, Division of
Vascular Surgery, University of Naples Federico II, Naples, Italy
| | - Enrico Cappello
- Division of Vascular and Endovascular
Surgery, Mediterranea Centro Cuore, Naples, Italy
| | - Giovanni Cioffi
- Division of Vascular Surgery, Ospedale
Pellegrini, Naples, Italy
| | - Angelo Cioppa
- Division of Invasive Cardiology, Clinica
Montevergine, Mercogliano, Italy
| | - Adolfo Crinisio
- Division of Vascular and Endovascular
Surgery, Clinica Salus, Battipaglia, Italy
| | - Loris Flora
- Division of Vascular Surgery, AORN San
Giuseppe Moscati, Avellino, Italy
| | - Pietro Landino
- Department of Cardiology and Cardiac
Surgery, Casa di Cura S. Michele, Maddaloni, Italy
| | - Eugenio Martelli
- Division of Vascular and Endovascular
Surgery, AORN Sant’Anna e San Sebastiano, Caserta, Italy
| | - Rosario Mancusi
- Division of Vascular and Endovascular
Surgery, Villa dei Fiori Hospital, Acerra, Italy
| | - Raffaella Niola
- Division of Vascular and
Interventional Radiology, AORN Cardarelli, Naples, Italy
| | - Fernando Petrosino
- Division of Vascular Surgery, Presidio
Ospedaliero ‘San Luca’, Vallo della Lucania, Italy
| | - Davide Razzano
- Division of Vascular Surgery, AO San
Pio, Benevento, Italy
| | - Carlo Ruotolo
- Division of Vascular Surgery, AORN
Cardarelli, Naples, Italy
| | - Luigi Salemme
- Division of Invasive Cardiology, Clinica
Montevergine, Mercogliano, Italy
| | - Paolo Sangiuolo
- Division of Vascular Surgery, AORN
Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | | | - Emilio Soreca
- Department of Radiology, AO San Pio,
Benevento, Italy
| | | | - Bruno Villari
- Division of Cardiology, Ospedale Sacro
Cuore di Gesù, Benevento, Italy
| | - Giampaolo Amabile
- Division of Vascular and
Interventional Radiology, AORN Cardarelli, Naples, Italy
| | - Raffaele Pio Ammollo
- Department of Public Health, Division of
Vascular Surgery, University of Naples Federico II, Naples, Italy
| | - Danilo Barbarisi
- Division of Vascular Surgery, AORN San
Giuseppe Moscati, Avellino, Italy
| | | | - Antonio D’angelo
- Department of Vascular and Endovascular
Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Gianluca Cangiano
- Division of Vascular and
Interventional Radiology, AORN Cardarelli, Naples, Italy
| | - Claudia De Gregorio
- Division of Vascular and Endovascular
Surgery, Villa dei Fiori Hospital, Acerra, Italy
| | - Mario De Laurentis
- Division of Vascular Surgery, AORN
Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | | | | | - Alessandro Luongo
- Division of Vascular Surgery, Presidio
Ospedaliero ‘San Luca’, Vallo della Lucania, Italy
| | - Claudio Molino
- Division of Vascular and Endovascular
Surgery, Clinica Salus, Battipaglia, Italy
| | - Giuseppe Sarti
- Department of Radiology, Ospedale del
Mare, Naples, Italy
| | - Daniela Viola
- Division of Vascular Surgery, Ospedale
del Mare, Naples, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical
Sciences, Division of Cardiology, University of Naples Federico II, Naples,
Italy
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Curcio S, Petrosino F, Morrone M, De Luca G. Interactions between Proteins and the Membrane Surface in Multiscale Modeling of Organic Fouling. J Chem Inf Model 2018; 58:1815-1827. [PMID: 30133272 DOI: 10.1021/acs.jcim.8b00298] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the present paper, an improved multiscale modeling aimed at describing membrane fouling in the UltraFiltration (UF) process was proposed. Some of the authors of this work previously published a multiscale approach to simulate ultrafiltration of Bovine Serum Albumin (BSA) aqueous solutions. However, the noncovalent interactions between proteins and the membrane surface were not taken into account in the previous formulation. Herein, the proteins-surface interactions were accurately computed by first-principle-based calculations considering also the effect of pH. Both the effective surface of polysulfone (PSU) and the first layer of proteins adsorbed on the membrane surface were accurately modeled. Different from the previous work, the equilibrium distance between proteins was calculated and imposed as lower bound to the protein-protein distances in the compact deposit accumulated on the membrane surface. The computed BSA surface charges were used to estimate the protein potential and the charge density, both necessary to formulate a forces balance at microscopic scale. The protein surface potential was compared with Z-potential measurements of BSA aqueous solution, and a remarkable agreement was found. Finally, the overall additional resistance, as due to both the compact and loose layers of the deposit, was computed, thus allowing the final transition to a macroscopic scale, where an unsteady-state mass transfer model was formulated to describe the behavior of a typical dead-end UF process. A good agreement between simulated and experimental permeate flux decays was observed.
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Affiliation(s)
- S Curcio
- Department of Computer Engineering, Modeling, Electronics and Systems (D.I.M.E.S.), Laboratory of Transport Phenomena and Biotechnology , University of Calabria , Ponte P. Bucci, cubo 39/c , 87036 Rende , Cosenza , Italy
| | - F Petrosino
- Department of Computer Engineering, Modeling, Electronics and Systems (D.I.M.E.S.), Laboratory of Transport Phenomena and Biotechnology , University of Calabria , Ponte P. Bucci, cubo 39/c , 87036 Rende , Cosenza , Italy
| | - M Morrone
- Institute on Membrane Technology , ITM-CNR , Ponte P. Bucci, cubo 17/c , 87036 Rende , Cosenza , Italy
| | - G De Luca
- Institute on Membrane Technology , ITM-CNR , Ponte P. Bucci, cubo 17/c , 87036 Rende , Cosenza , Italy
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