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Djuric O, Giorgi Rossi P, Ivanciu EC, Cardellicchio S, Cresci C, Carozzi L, Pistelli F, Bessi V, Gai P, Galli V, Lavacchini G, Bricci C, Gorini G, Bosi S, Paci E. Motivation, acceptability and attitudes toward lung cancer screening among persons who attend a tobacco cessation program: A multicenter survey in Italy. Prev Med Rep 2023; 35:102272. [PMID: 37384117 PMCID: PMC10293766 DOI: 10.1016/j.pmedr.2023.102272] [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: 12/05/2022] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/30/2023] Open
Abstract
This study aimed to evaluate smoking cessation (SC) motivation and the acceptability of a lung cancer screening (LCS) program with low-dose computed tomography (LDCT) among people who attend SC programs. A multicenter survey was conducted in the period January-December 2021 involving 197 people who attended group or individual SC courses in Reggio Emilia and Tuscany. Questionnaires, information sheets, and decision aids about the potential benefits and harms of LCS with LDCT were distributed at different time points during the course. The wish to protect own health (66%) was the most frequent reason given for quitting smoking, followed by cigarette dependence (40.6%) and current health problems (30.5%). Half of the participants (56%) considered periodic health checks including LDCT, as an advantageous activity. The great majority of participants were in favor of LCS (92%), with only 8% being indifferent, and no one was against these programs. Interestingly, those with sufficiently high smoking-related LC risk to be eligible for LCS and those attending the individual course were less in favor of LCS but also less concerned about the possible harms associated with LCS. The type of counseling was a significant predictor for both LCS acceptability and perceived harm of LCS. The favorable perception of LCS in people attending SC courses, despite the considerable preoccupation with potential harms, is an important finding of this study. Introducing a discussion on the benefits and harms of LCS in SC programs may prepare persons who smoke to make informed decisions on utilizing LCS.
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Affiliation(s)
- Olivera Djuric
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Biomedical, Metabolic and Neural Sciences, Centre for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), Public Health Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elena Camelia Ivanciu
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Chiara Cresci
- Antismoking Center, Florence-Careggi University Hospital, Florence, Italy
| | - Laura Carozzi
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Francesco Pistelli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Valentina Bessi
- Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Patrizia Gai
- Antismoking Center, Azienda Unità Sanitaria Locale Toscana Center, Italy
| | - Valentina Galli
- Antismoking Center, Prato, Azienda Unità Sanitaria Locale Toscana Center, Italy
| | - Giacomo Lavacchini
- Antismoking Center, Borgo San Lorenzo, Azienda Unità Sanitaria Locale Toscana Center, Italy
| | - Claudia Bricci
- Italian League against Cancer (LILT), Reggio Emilia, Italy
| | - Giuseppe Gorini
- Division of Epidemiology and Clinical Governance, Institute for Study, PRevention and netwoRk in Oncology (ISPRO), Florence, Italy
| | - Sandra Bosi
- Italian League against Cancer (LILT), Reggio Emilia, Italy
| | - Eugenio Paci
- Italian League against Cancer (LILT), Florence, Italy
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Gallus S, Cresci C, Rigamonti V, Lugo A, Bagnardi V, Fanucchi T, Cirone D, Ciaccheri A, Cardellicchio S. Self-efficacy in predicting smoking cessation: A prospective study in Italy. Tob Prev Cessat 2023; 9:15. [PMID: 37125003 PMCID: PMC10141785 DOI: 10.18332/tpc/162942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Predicting the success of smoking cessation might be crucial to guide towards the treatment of smoking dependence in a clinical setting. We analyzed the potential determinants of successful smoking cessation with a specific focus on self-efficacy in predicting quitting smoking. METHODS All consecutive smokers (n=478; 224 men and 254 women) attending the Careggi University Hospital Smoking Cessation Service in Florence (Italy) in 2018-2019 provided information on self-efficacy in predicting smoking cessation, using a 1-10 rating scale during their first visit. Patients were followed up for success in quitting smoking at 3, 6 and 12 months, validated through CO exhaled measurement. To evaluate the association between self-efficacy and the probability of success, we estimated multivariable relative risks (RRs) and corresponding 95% confidence intervals (CIs) through log-binomial models for longitudinal data. RESULTS Overall, 47.9% of smokers succeeded in their attempt to quit at 3 months, 40.2% at 6 months, and 33.9% at 12 months. Compared to low self-efficacy (rating scale 1-5), the RR of success in quitting smoking was 1.40 (95% CI: 1.06-1.85) for intermediate self-efficacy (scale 6-7) and 1.64 (95% CI: 1.28-2.12) for high self-efficacy (scale 8-10). CONCLUSIONS Self-efficacy is an independent determinant of smoking cessation. We recommend to systematically collect self-efficacy, together with other relevant variables, to predict successful smoking cessation. Moreover, strategies to develop and maintain high levels of self-efficacy are essential to increase quit success and improve treatment.
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Affiliation(s)
- Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Chiara Cresci
- Anti-smoking center, Careggi University Hospital, Florence, Italy
- SOD of Alcohology, Careggi University Hospital, Florence, Italy
- Tuscan Regional Alcoholic Center, Careggi University Hospital, Florence, Italy
| | - Vera Rigamonti
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | | | - Donatello Cirone
- Tuscan Regional Alcoholic Center, Careggi University Hospital, Florence, Italy
| | - Angela Ciaccheri
- Anti-smoking center, Careggi University Hospital, Florence, Italy
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Mansueto G, Carrozzino D, Sparle Christensen K, Cardellicchio S, Pezzuto A, Abrams K, Zvolensky M, Cosci F. Clinimetric properties of the Smoking Abstinence Expectancies Questionnaire. Addict Behav 2021; 123:107061. [PMID: 34359015 DOI: 10.1016/j.addbeh.2021.107061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/16/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
Smoking abstinence expectancies are beliefs about negative and positive short-term psychological and physiological consequences of not smoking. The Smoking Abstinence Expectancies Questionnaire (SAEQ) is a widely used Patient-Reported Outcome Measure (PROM) to assess smoking abstinence expectancies. It has four subscales: negative mood, somatic symptoms, harmful consequences, positive consequences. Although studied from a psychometric perspective, the SAEQ needs further evaluation. Clinimetrics, and its Clinimetric Criteria for Patient-Reported Outcome Measures (CLIPROM), offers a robust method to evaluate the SAEQ. We verified construct validity and sensitivity of the Italian version of the SAEQ applying CLIPROM criteria. A total of 293 adult Italian smokers were consecutively enrolled at two smoking cessation clinics and assessed via the SAEQ. Item Response Theory models (i.e., combining Rasch and Mokken analyses) were used to test construct validity and sensitivity. The total score of the SAEQ was not found to be unidimensional but each SAEQ subscale score was. PSI (0.90) indicated that the total score of the SAEQ could reliably discriminate between respondents with different levels of the trait under assessment, whereas SAEQ subscales on negative mood and harmful consequences could reliably distinguish between different groups but not between different subjects (PSI ranging from 0.77 and 0.78). Overall, the total score of the SAEQ is a sensitive screening PROM and can be used at smoking cessation clinics to discriminate between subjects with different levels of smoking abstinence expectancies. SAEQ subscales should be used to detect severity and subjective burden of a wide range of expected effects of nicotine abstinence.
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Cattaruzza MS, Gorini G, Bosetti C, Boffi R, Lugo A, Veronese C, Carreras G, Santucci C, Stival C, Pacifici R, Zagà V, Gallus S, Giulietti F, Sarzani R, Spannella F, Del Donno M, Tartaglione S, Marrazzo G, Pelaia G, D'Agosto V, Berti A, Voller F, Cardellicchio S, Cresci C, Foschino Barbaro MP, De Palma R, Negrini S, Sicbaldi V, Serafini A, Bisconti M, Refolo L, Landoni G, Rovere P, Veronesi G, Faverio P, Garavello W, Pesci A, Giacobbe R, Martucci P, Parrella R, Scarano F, Aiello M, Chetta A, Franco C, Mangia A, Carrozzi L, Maggi F, Monzani F, Pistelli F, Russo P, Sanna A, Barreca FM, Conti V, Rossi E, Ruli M, Ruli S, Eslami Varzaneh S, Principe R, Guerrini S, Sebastiani A, Galluccio G, Pezzuto A, Ricci A, Casali E, Mastroianni C, Pirina P, Polo F, Beatrice F, Romagnoli M, Baraldo M, Cojutti PG, Tascini C, Pecori D, Graziano E, Tinghino B. Covid-19 and the role of smoking: the protocol of the multicentric prospective study COSMO-IT (COvid19 and SMOking in ITaly). Acta Biomed 2020; 91:e2020062. [PMID: 32921714 PMCID: PMC7716969 DOI: 10.23750/abm.v91i3.10373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/02/2020] [Indexed: 01/08/2023]
Abstract
The emergency caused by Covid-19 pandemic raised interest in studying lifestyles and comorbidities as important determinants of poor Covid-19 prognosis. Data on tobacco smoking, alcohol consumption and obesity are still limited, while no data are available on the role of e-cigarettes and heated tobacco products (HTP). To clarify the role of tobacco smoking and other lifestyle habits on COVID-19 severity and progression, we designed a longitudinal observational study titled COvid19 and SMOking in ITaly (COSMO-IT). About 30 Italian hospitals in North, Centre and South of Italy joined the study. Its main aims are: 1) to quantify the role of tobacco smoking and smoking cessation on the severity and progression of COVID-19 in hospitalized patients; 2) to compare smoking prevalence and severity of the disease in relation to smoking in hospitalized COVID-19 patients versus patients treated at home; 3) to quantify the association between other lifestyle factors, such as e-cigarette and HTP use, alcohol and obesity and the risk of unfavourable COVID-19 outcomes. Socio-demographic, lifestyle and medical history information will be gathered for around 3000 hospitalized and 700-1000 home-isolated, laboratory-confirmed, COVID-19 patients. Given the current absence of a vaccine against SARS-COV-2 and the lack of a specific treatment for COVID-19, prevention strategies are of extreme importance. This project, designed to highly contribute to the international scientific debate on the role of avoidable lifestyle habits on COVID-19 severity, will provide valuable epidemiological data in order to support important recommendations to prevent COVID-19 incidence, progression and mortality.
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Affiliation(s)
| | - Giuseppe Gorini
- Oncologic network, prevention and research Institute (ISPRO), Florence, Italy .
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
| | - Roberto Boffi
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
| | | | - Giulia Carreras
- Oncologic network, prevention and research Institute (ISPRO), Florence, Italy .
| | - Claudia Santucci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
| | - Chiara Stival
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
| | - Roberta Pacifici
- National Observatory on Smoking, Alcohol and Drugs, National Institute of Health, Rome, Italy.
| | | | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
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- Ospedale San Jacopo Azienda USL Toscana Centro, Pistoia.
| | | | | | | | - Mei Ruli
- Ospedale di Stato, Repubblica di San Marino.
| | | | | | | | | | | | | | - Aldo Pezzuto
- Azienda Ospedaliero-Universitaria Sant'Andrea, Roma.
| | - Alberto Ricci
- Azienda Ospedaliero-Universitaria Sant'Andrea, Roma.
| | - Elena Casali
- Azienda Ospedaliero-Universitaria Policlinico Umberto I, Roma.
| | | | - Pietro Pirina
- Azienda Ospedaliero Universitaria di Sassari, Sassari.
| | | | - Fabio Beatrice
- Ospedale San Giovanni Bosco, ASL Città di Torino, Torino.
| | | | | | | | - Carlo Tascini
- Azienza Sanitaria Universitaria Friuli Centrale, Udine.
| | - Davide Pecori
- Azienza Sanitaria Universitaria Friuli Centrale, Udine.
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Cattaruzza M, Zagà V, Principe R, Cardellicchio S, Siracusano L, Zelano G, Tinghino B. The 40-day cytisine treatment for smoking cessation: the Italian experience. Tob Prev Cessat 2017. [DOI: 10.18332/tpc/70829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sardi I, Cardellicchio S, Iorio AL, da Ros M, la Marca G, Giunti L, Massimino M, Genitori L. P03.09 * PHARMACOLOGICAL MODULATION OF BLOOD-BRAIN BARRIER: FUTURE STRATEGY FOR TREATMENT OF BRAIN TUMORS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cardellicchio S, Farina S, Bresci C, Settimelli V, Chiaro S, Massimino M, Genitori L, Sardi I. P05.07 * A LOWER-DOSE CISPLATIN-ETOPOSIDE REGIMEN FOR CHILDREN WITH HYPOTHALAMIC/CHIASMATIC TUMOR AND DIENCEPHALIC CACHEXIA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nutini S, Carrozzi L, Melani A, Pistelli F, Aquilini F, De Bernardo T, Bracci LS, Cardellicchio S, Checcacci S, Scarselli G, Mello G, Baldi C, Migliacci MF, Alfano A. [Cigarette smoking in pregnancy: observational prospective study in three towns of Tuscany Region (Central Italy)]. Epidemiol Prev 2013; 37:145-152. [PMID: 23851244] [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: 06/02/2023]
Abstract
OBJECTIVE to assess the prevalence of smoking in pregnancy and its changes after childbirth, and the characteristics associated with a greater likelihood of smoking during pregnancy in a sample of women attending three university hospitals in Tuscany (Central Italy). DESIGN observational prospective multicentric study. SETTING AND PARTICIPANTS 1,036 women in ninth month of pregnancy were enrolled at the teaching hospitals of Careggi (Firenze), Pisa and Siena. Women filled a standardized, self-administered questionnaire at enrolment. A second questionnaire was administered by phone to the smoking, ex-smoking and abstinent-during-pregnancy women one year after the delivery. RESULTS 60.5% of women was never smoker, 17.4% was ex-smoker, 14% of women stopped smoking during pregnancy, and 8.4% were current smokers. Smoking in pregnancy was significantly associated with being younger than 31 years old (OR 1.75; 95%CI 1.01-1.84) and unmarried (OR 1.75; 95%CI 1.10- 2.78), having a low school degree (OR 2.31; 95%CI 1.58-3.36) and a smoking partner (OR 3.03; 95%CI 2.32-3.96). The absolute risk of smoking during pregnancy was 42%. One year after delivery, 44%of women who stopped smoking in pregnancy relapsed. CONCLUSIONS a not negligible percentage of women residents in Tuscany Region smokes during pregnancy. Relapses after delivery are high. Even if recently in Italy a smoke free legislation was implemented, the study shows a low attention toward passive smoking during pregnancy. Smoking cessation interventions specifically tailored for pregnant women and relapses prevention need to be implemented in Tuscany by all health care professionals who care for women during pregnancy and after delivery.
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Affiliation(s)
- Sandra Nutini
- Centro antifumo, SOD pneumologia 2, Dipartimento di specialità medico-chirurgiche, Azienda ospedaliero-universitaria Careggi, Firenze.
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Kim JH, Song HB, Kim DH, Park KD, Kim JH, Kim JH, Lee BJ, Kim DH, Kim JH, Khatua S, Kalkan E, Brown R, Pearlman M, Vats T, Abela L, Fiaschetti G, Shalaby T, Grunder E, Ma M, Grahlert J, Baumgartner M, Siler U, Nonoguchi N, Ohgaki H, Grotzer M, Adachi JI, Suzuki T, Fukuoka K, Yanagisawa T, Mishima K, Koga T, Matsutani M, Nishikawa R, Sardi I, Giunti L, Bresci C, Cardellicchio S, Da Ros M, Buccoliero AM, Farina S, Arico M, Genitori L, Massimino M, Filippi L, Erdreich-Epstein A, Zhou H, Ren X, Schur M, Davidson TB, Ji L, Sposto R, Asgharzadeh S, Tong Y, White E, Murugesan M, Nimmervoll B, Wang M, Marino D, Ellison D, Finkelstein D, Pounds S, Malkin D, Gilbertson R, Eden C, Ju B, Murugesan M, Phoenix T, Poppleton H, Lessman C, Taylor M, Gilbertson R, Sardi I, la Marca G, Cardellicchio S, Da Ros M, Malvagia S, Giunti L, Fratoni V, Farina S, Arico M, Genitori L, Massimino M, Giovannini MG, Giangaspero F, Badiali M, Gleize V, Paris S, Moi L, Elhouadani S, Arcella A, Morace R, Antonelli M, Buttarelli F, Mokhtari K, Sanson M, Smith S, Ward J, Wilson M, Rahman C, Rose F, Peet A, Macarthur D, Grundy R, Rahman R, Venkatraman S, Birks D, Balakrishnan I, Alimova I, Harris P, Patel P, Foreman N, Vibhakar R, Wu H, Zhou Q, Wang D, Wang G, Dang D, Pencreach E, Nguyen A, Guerin E, Lasthaus C, Guenot D, Entz-Werle N, Unland R, Schlosser S, Farwick N, Plagemann T, Richter G, Juergens H, Fruehwald M, Chien CL, Lee YH, Lin CI, Hsieh JY, Lin SC, Wong TT, Ho DMT, Wang HW, Lagah S, Tan IL, Malcolm S, Grundy R, Rahman R, Majani Y, Smith S, Grundy R, Rahman R, van Vuurden DG, Aronica E, Wedekind LE, Hulleman E, Biesmans D, Bugiani M, Vandertop WP, Kaspers GJL, Wurdinger T, Noske DP, Van der Stoop PM, van Vuurden DG, Shukla S, Wedekind LE, Kuipers GK, Hulleman E, Noske DP, Wurdinger T, Vandertop WP, Slotman BJ, Kaspers GJL, Cloos J, Sun T, Warrington N, Luo J, Ganzhorn S, Tabori U, Druley T, Gutmann D, Rubin J, Castelo-Branco P, Choufani S, Mack S, Galagher D, Zhang C, Lipman T, Zhukova N, Martin D, Merino D, Wasserman J, Samuel C, Alon N, Hitzler J, Wang JCY, Malkin D, Keller G, Dirks PB, Pfister S, Taylor MD, Weksberg R, Tabori U, Leblond P, Meignan S, Dewitte A, Le Tinier F, Wattez N, Lartigau E, Lansiaux A, Hanson R, Gordon I, Zhao S, Camphausen K, Warren K, Warrington NM, Sun T, Gutmann DH, Rubin JB, Nguyen A, Lasthaus C, Jaillet M, Pencreach E, Guerin E, Guenot D, Entz-Werle N, Kovacs Z, Martin-Fiori E, Shalaby T, Grotzer M, Bernasconi M, Werner B, Dyberg C, Baryawno N, Milosevic J, Wickstrom M, Northcott PA, Taylor MD, Kool M, Kogner P, Johnsen JI, Wilson M, Reynolds G, Davies N, Arvanitis T, Peet A, Zoghbi A, Meisterernst M, Fruehwald MC, Kerl K, Orr B, Haffner M, Nelson W, Yegnasubramanian S, Eberhart C, Fotovati A, Abu-Ali S, Wang PS, Deleyrolle L, Lee C, Triscott J, Chen J, Franciosi S, Nakamura Y, Sugita Y, Uchiumi T, Kuwano M, Leavitt B, Singh S, Jury A, Jones C, Wakimoto H, Reynolds B, Pallen C, Dunn S, Fletcher S, Levine J, Li M, Kagawa N, Hirayama R, Chiba Y, Kijima N, Arita H, Kinoshita M, Hashimoto N, Izumoto S, Maruno M, Yoshimine T. BIOLOGY. Neuro Oncol 2012; 14:i7-i15. [PMCID: PMC3483341 DOI: 10.1093/neuonc/nos095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
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Fontana GA, Cardellicchio S, Camiciottoli G, Panuccio P, Boddi V. Changes in transcutaneous oxygen partial pressure as an index of response to inhaled methacholine in asthmatic patients. Chest 1993; 103:1375-80. [PMID: 8486013 DOI: 10.1378/chest.103.5.1375] [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: 01/31/2023] Open
Abstract
Bronchoconstriction and hypoxemia have been reported to occur during airway challenges, but the correlation between changes in forced expiratory volume in 1 s (FEV1) and transcutaneous oxygen partial pressure (tcPO2) during methacholine provocation tests has not yet been established (to our knowledge). In 15 symptom-free atopic asthmatic patients and 5 normal subjects, variations in tcPO2 and FEV1 were simultaneously measured during inhalation of doubling methacholine concentrations; the drug concentrations causing a 20 percent decrease in control FEV1 and tcPO2 (PC20FEV1 and PC20tcPO2, respectively) were subsequently calculated. In patients, geometric mean PC20FEV1 and PC20TcPO2 were 1.31 (range, 0.16 to 5.19) and 1.26 (range, 0.29 to 5.82) mg/ml, respectively. In addition, in six patients, methacholine-induced fall in tcPO2 was accompanied by similar changes in arterial PO2. Methacholine inhalation caused no change in tcPO2 or FEV1 in normal subjects. The independent effects of deep breath tests and bronchoconstriction on PC20tcPO2 were studied in five patients challenged on two separate occasions, with and without FEV1 assessment; in these patients, PC20tcPO2 were similar on both the study days. The results indicate that, in asthmatic patients, methacholine-induced bronchoconstriction causes parallel decreases in FEV1 and tcPO2. The tcPO2 monitoring may serve as a tool in the assessment of airway hyperreactivity when active patient's cooperation is scarce.
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Affiliation(s)
- G A Fontana
- Dipartimento di Fisiopatologia Clinica, Università di Firenze, Italy
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11
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Bucciarelli G, Masi C, Seghi P, Benvenuti P, Giannini GM, Cardellicchio S, Pacifico G, Freschi G. [Pneumoperitoneum in preparation for surgery of large ventral hernia]. MINERVA CHIR 1993; 48:29-33. [PMID: 8464554] [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: 01/30/2023]
Abstract
Reparative surgery of ventral hernia may be relatively simple or, on the other hand, the surgeon may be confronted with a number of tactical and technical problems. Many of these are caused by the "loss of the right of domicile". In order to avoid this particular condition it is useful to resort to preoperative pneumoperitoneum. This method entails the gradual and progressive introduction of air into the peritoneal cavity. In this way abdominal capacity is increased and it is therefore possible to re-insert all the viscera into their natural cavities avoiding all the harmful consequences for respiratory and cardio-circulatory organs following forced replacement. Preoperative pneumo-peritoneum is a relatively well consolidated surgical technique in large scale eventration. The methods is simple to perform and has a low incidence of complications.
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Affiliation(s)
- G Bucciarelli
- Cattedra di Pathologia Speciale Chirurgica, Università degli Studi di Firenze
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Masi C, Benvenuti P, Cardellicchio S, Pacifico G, Seghi P. [Progressive pneumoperitoneum in the preparation for surgical intervention for voluminous ventral hernias]. MINERVA CHIR 1992; 47:1327-35. [PMID: 1436582] [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: 12/27/2022]
Abstract
The paper report three patients suffering from voluminous ventral hernias who were treated using progressive pneumoperitoneum as a preparative method prior to reparative surgery. On the basis of the results obtained, the authors sustain the rationality, safety and efficacy of the procedure, in particular given its ability to reestablish good respiratory and circulatory function in those cases where the latter were severely affected by hernia. Since this method needs a longer application time and therefore involves a greater economic burden, pneumoperitoneum should probably be reserved for selected cases, and alternative techniques should be used in patients where hernia is more easily resolved.
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Affiliation(s)
- C Masi
- Cattedra di Patologia Speciale Chirurgica e Propedeutica, Università degli Studi di Firenze
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Cardellicchio S, Ferrante E, Castellani W, Panuccio B, Comis G, Boddi V, Fontana GA. Influence of inspiratory flow rate on the bronchial response to ultrasonic mist of distilled water in asthmatic patients. Respiration 1989; 56:220-6. [PMID: 2635351 DOI: 10.1159/000195804] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [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: 01/01/2023] Open
Abstract
In an attempt to evaluate the influence of inspiratory flow rate on the sensitivity of the bronchial challenge with ultrasonic mist of distilled water (UMDW), we studied 8 symptom-free asthmatic patients who inhaled 60 liters of UMDW at a flow rate of either 0.35 or 1.2 1/s on two separate occasions. Tidal volume and the total duration of the respiratory cycle were kept constant during all inhalation tests. The bronchial response was assessed in terms of percent changes of baseline airway conductance. The results demonstrate that the mean bronchial response after 0.35 1/s UMDW inhalation was significantly greater than after 1.2 1/s inhalation of comparable doses of UMDW. Furthermore, 3 patients who developed a significant bronchoconstriction after 0.35 1/s UMDW inhalation showed only a mild, not significant bronchial response when the mist was inhaled at 1.2 1/s. We conclude that the sensitivity of the UMDW challenge is increased if the agent is inhaled during slow, tidal breathing.
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Affiliation(s)
- S Cardellicchio
- Dipartimento di Fisiopatologia Clinica, Università di Firenze, Italia
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Fontana GA, Hanson PJ, Cardellicchio S, Cresci F, Panuccio P. Effect of aminophylline aerosol on the bronchial response to ultrasonic mist of distilled water in asthmatic patients. Respiration 1988; 54:241-6. [PMID: 3249839 DOI: 10.1159/000195531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 01/04/2023] Open
Abstract
To ascertain whether inhaled aminophylline was effective in preventing the bronchial response induced by inhalating of an ultrasonic mist of distilled water (UMDW), we examined 8 asthmatic patients who had previously been shown to be reactive to this agent. Patients were given either 30 mg aminophylline or saline placebo aerosols followed by inhalation of 60 liters of UMDW; measurements of specific airway conductance (sGaw) were made before and after aminophylline or saline administration and after UMDW challenge. UMDW consistently induced a significant decrease in sGaw in all patients; however, in our subjects as a group, the degree of UMDW-induced bronchoconstriction was significantly less after premedication with aminophylline aerosol than after saline (p less than 0.01). Our results suggest that aminophylline is effective in preventing UMDW-induced bronchoconstriction; the possible relationships between bronchial response to UMDW and its modulation by inhaled aminophylline are discussed.
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Affiliation(s)
- G A Fontana
- Dipartimento di Fisiopatologia Clinica, Unità di Fisiopatologia Respiratoria, Firenze, Italia
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