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1. Long-term outcome of COVID-19 patients treated with helmet noninvasive ventilation vs. high-flow nasal oxygen: a randomized trial

Author

Michi, Teresa, Mattana, Chiara, Menga, Luca Salvatore, Bocci, Maria Grazia, Cesarano, Melania, Rosà, Tommaso, Gualano, Maria Rosaria, Montomoli, Jonathan, Spadaro, Savino, Tosato, Matteo, Rota, Elisabetta, Landi, Francesco, Cutuli, Salvatore Lucio, Tanzarella, Eloisa S., Pintaudi, Gabriele, Piervincenzi, Edoardo, Bello, Giuseppe, Tonetti, Tommaso, Rucci, Paola, De Pascale, Gennaro, Maggiore, Salvatore M., Grieco, Domenico Luca, Conti, Giorgio, Antonelli, Massimo, Maviglia, Riccardo, Mercurio, Giovanna, De Santis, Paolo, Pennisi, Mariano Alberto, Anzellotti, Gian Marco, Torrini, Flavia, Rubino, Carlotta, Morena, Tony Christian, Gennenzi, Veronica, Postorino, Stefania, Vargas, Joel, Filetici, Nicoletta, Settanni, Donatella, Durante, Miriana, Cascarano, Laura, Di Muro, Mariangela, Scarascia, Roberta, Bitondo, Maria Maddalena, Murdolo, Martina, Mele, Alessandro, Silva, Serena, Zaccone, Carmelina, Pozzana, Francesca, Maccaglia, Alessio, Savino, Martina, Potalivo, Antonella, Ceccaroni, Francesca, Scavone, Angela, Lombardi, Gianmarco, Montini, Luca, Dell'Anna, Antonio Maria, Volta, Carlo Alberto, Ranieri, Vito M., Falò, Giulia, Carelli, Simone, Natalini, Daniele, Berardi, Cecilia, Delle Cese, Luca, Vetrugno, Luigi, Balzani, Eleonora, Null, Null, Menga, Luca S., Landi, Francesco (ORCID:0000-0002-3472-1389), Cutuli, Salvatore L., Bello, Giuseppe (ORCID:0000-0003-2648-7235), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Grieco, Domenico Luca (ORCID:0000-0002-4557-6308), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Pennisi, Mariano Alberto (ORCID:0000-0001-8761-5144), Morena, Tony C., Montini, Luca (ORCID:0000-0003-4602-5134), Dell’Anna, Antonio Maria, Michi, Teresa, Mattana, Chiara, Menga, Luca Salvatore, Bocci, Maria Grazia, Cesarano, Melania, Rosà, Tommaso, Gualano, Maria Rosaria, Montomoli, Jonathan, Spadaro, Savino, Tosato, Matteo, Rota, Elisabetta, Landi, Francesco, Cutuli, Salvatore Lucio, Tanzarella, Eloisa S., Pintaudi, Gabriele, Piervincenzi, Edoardo, Bello, Giuseppe, Tonetti, Tommaso, Rucci, Paola, De Pascale, Gennaro, Maggiore, Salvatore M., Grieco, Domenico Luca, Conti, Giorgio, Antonelli, Massimo, Maviglia, Riccardo, Mercurio, Giovanna, De Santis, Paolo, Pennisi, Mariano Alberto, Anzellotti, Gian Marco, Torrini, Flavia, Rubino, Carlotta, Morena, Tony Christian, Gennenzi, Veronica, Postorino, Stefania, Vargas, Joel, Filetici, Nicoletta, Settanni, Donatella, Durante, Miriana, Cascarano, Laura, Di Muro, Mariangela, Scarascia, Roberta, Bitondo, Maria Maddalena, Murdolo, Martina, Mele, Alessandro, Silva, Serena, Zaccone, Carmelina, Pozzana, Francesca, Maccaglia, Alessio, Savino, Martina, Potalivo, Antonella, Ceccaroni, Francesca, Scavone, Angela, Lombardi, Gianmarco, Montini, Luca, Dell'Anna, Antonio Maria, Volta, Carlo Alberto, Ranieri, Vito M., Falò, Giulia, Carelli, Simone, Natalini, Daniele, Berardi, Cecilia, Delle Cese, Luca, Vetrugno, Luigi, Balzani, Eleonora, Null, Null, Menga, Luca S., Landi, Francesco (ORCID:0000-0002-3472-1389), Cutuli, Salvatore L., Bello, Giuseppe (ORCID:0000-0003-2648-7235), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Grieco, Domenico Luca (ORCID:0000-0002-4557-6308), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Pennisi, Mariano Alberto (ORCID:0000-0001-8761-5144), Morena, Tony C., Montini, Luca (ORCID:0000-0003-4602-5134), and Dell’Anna, Antonio Maria

Abstract

BackgroundLong-term outcomes of patients treated with helmet noninvasive ventilation (NIV) are unknown: safety concerns regarding the risk of patient self-inflicted lung injury and delayed intubation exist when NIV is applied in hypoxemic patients. We assessed the 6-month outcome of patients who received helmet NIV or high-flow nasal oxygen for COVID-19 hypoxemic respiratory failure.MethodsIn this prespecified analysis of a randomized trial of helmet NIV versus high-flow nasal oxygen (HENIVOT), clinical status, physical performance (6-min-walking-test and 30-s chair stand test), respiratory function and quality of life (EuroQoL five dimensions five levels questionnaire, EuroQoL VAS, SF36 and Post-Traumatic Stress Disorder Checklist for the DSM) were evaluated 6 months after the enrollment.ResultsAmong 80 patients who were alive, 71 (89%) completed the follow-up: 35 had received helmet NIV, 36 high-flow oxygen. There was no inter-group difference in any item concerning vital signs (N = 4), physical performance (N = 18), respiratory function (N = 27), quality of life (N = 21) and laboratory tests (N = 15). Arthralgia was significantly lower in the helmet group (16% vs. 55%, p = 0.002). Fifty-two percent of patients in helmet group vs. 63% of patients in high-flow group had diffusing capacity of the lungs for carbon monoxide < 80% of predicted (p = 0.44); 13% vs. 22% had forced vital capacity < 80% of predicted (p = 0.51). Both groups reported similar degree of pain (p = 0.81) and anxiety (p = 0.81) at the EQ-5D-5L test; the EQ-VAS score was similar in the two groups (p = 0.27). Compared to patients who successfully avoided invasive mechanical ventilation (54/71, 76%), intubated patients (17/71, 24%) had significantly worse pulmonary function (median diffusing capacity of the lungs for carbon monoxide 66% [Interquartile range: 47-77] of predicted vs. 80% [71-88], p = 0.005) and decreased quality of life (EQ-VAS: 70 [53-70] vs. 80 [70-83], p = 0.01).ConclusionsIn

Published
2023

2. Predicting Factors for Seizures after Cerebral Venous Thrombosis: A Retrospective Single Center Cohort Study

Author

Colò, Francesca, Brunetti, Valerio, Di Muro, Mariangela, Rossi, Elena, Bartolomei, Francesca, Alexandre, Andrea Maria, Bellavia, Simone, Scala, Irene, Słomka, Artur, Pilato, Fabio, Frisullo, Giovanni, Broccolini, Aldobrando, Della Marca, Giacomo, Rossi, Elena (ORCID:0000-0002-7572-9379), Pilato, Fabio (ORCID:0000-0002-7248-3916), Broccolini, Aldobrando (ORCID:0000-0001-8295-9271), Della Marca, Giacomo (ORCID:0000-0001-6914-799X), Colò, Francesca, Brunetti, Valerio, Di Muro, Mariangela, Rossi, Elena, Bartolomei, Francesca, Alexandre, Andrea Maria, Bellavia, Simone, Scala, Irene, Słomka, Artur, Pilato, Fabio, Frisullo, Giovanni, Broccolini, Aldobrando, Della Marca, Giacomo, Rossi, Elena (ORCID:0000-0002-7572-9379), Pilato, Fabio (ORCID:0000-0002-7248-3916), Broccolini, Aldobrando (ORCID:0000-0001-8295-9271), and Della Marca, Giacomo (ORCID:0000-0001-6914-799X)

Abstract

Background: Seizures are a common complication of cerebral venous thrombosis. In this study, we intended to define clinical and neuroradiological factors associated with early and late seizures and predictors for seizure recurrence. Methods: The database of our high-volume tertiary stroke center was screened for patients diagnosed with cerebral venous thrombosis between April 2006 and July 2021. Demographics, clinical, imaging, and instrumental data were collected. Results: Out of a total of 80 patients, 30 had seizures, either within the first week after onset (22 patients) or after (8 patients). Speech impairment and intracerebral bleeding were statistically associated with seizures in univariate analysis, but in a logistic regression model, only brain damage with hemorrhagic infarct and/or presence of brain hematoma [OR 6.051; 95% CI 1.881-19.468] (p = 0.003) were predicting factors for seizures. Late seizures were significantly more frequent in younger age [OR 0.864; 95% CI 0.763-0.978] (p = 0.020). Early seizures resulted as protective factors for recurrence; an altered state of consciousness at baseline and late seizures resulted as predictive factors for relapses (0.0% vs. 81.0%, p = 0.005, and 100.0% vs. 19.0%, p < 0.005, respectively). Conclusions: Our study confirms brain bleeding as the strongest risk factor for seizures after cerebral venous thrombosis. Recurrence is unusual after early seizures, while the presence of late seizures seems to raise the risk of recurrence.

Published
2022

3. Predicting Factors for Seizures after Cerebral Venous Thrombosis: A Retrospective Single Center Cohort Study

Author

Colò, Francesca, Brunetti, Valerio, Di Muro, Mariangela, Rossi, Elena, Bartolomei, Francesca, Alexandre, Andrea Maria, Bellavia, Simone, Scala, Irene, Słomka, Artur, Pilato, Fabio, Frisullo, Giovanni, Broccolini, Aldobrando, Della Marca, Giacomo, Rossi, Elena (ORCID:0000-0002-7572-9379), Pilato, Fabio (ORCID:0000-0002-7248-3916), Broccolini, Aldobrando (ORCID:0000-0001-8295-9271), Della Marca, Giacomo (ORCID:0000-0001-6914-799X), Colò, Francesca, Brunetti, Valerio, Di Muro, Mariangela, Rossi, Elena, Bartolomei, Francesca, Alexandre, Andrea Maria, Bellavia, Simone, Scala, Irene, Słomka, Artur, Pilato, Fabio, Frisullo, Giovanni, Broccolini, Aldobrando, Della Marca, Giacomo, Rossi, Elena (ORCID:0000-0002-7572-9379), Pilato, Fabio (ORCID:0000-0002-7248-3916), Broccolini, Aldobrando (ORCID:0000-0001-8295-9271), and Della Marca, Giacomo (ORCID:0000-0001-6914-799X)

Abstract

Background: Seizures are a common complication of cerebral venous thrombosis. In this study, we intended to define clinical and neuroradiological factors associated with early and late seizures and predictors for seizure recurrence. Methods: The database of our high-volume tertiary stroke center was screened for patients diagnosed with cerebral venous thrombosis between April 2006 and July 2021. Demographics, clinical, imaging, and instrumental data were collected. Results: Out of a total of 80 patients, 30 had seizures, either within the first week after onset (22 patients) or after (8 patients). Speech impairment and intracerebral bleeding were statistically associated with seizures in univariate analysis, but in a logistic regression model, only brain damage with hemorrhagic infarct and/or presence of brain hematoma [OR 6.051; 95% CI 1.881-19.468] (p = 0.003) were predicting factors for seizures. Late seizures were significantly more frequent in younger age [OR 0.864; 95% CI 0.763-0.978] (p = 0.020). Early seizures resulted as protective factors for recurrence; an altered state of consciousness at baseline and late seizures resulted as predictive factors for relapses (0.0% vs. 81.0%, p = 0.005, and 100.0% vs. 19.0%, p < 0.005, respectively). Conclusions: Our study confirms brain bleeding as the strongest risk factor for seizures after cerebral venous thrombosis. Recurrence is unusual after early seizures, while the presence of late seizures seems to raise the risk of recurrence.

Published
2022

4. Sublingual sufentanil nanotab patient-controlled analgesia system/15 mcg in a multimodal analgesic regimen after vertebral surgery: a case-series analysis.

Author

Vergari, Alessandro, Di Muro, Mariangela, De Angelis, A, Nestorini, R, Meluzio, Mc, Frassanito, Luciano, Tamburrelli, Francesco Ciro, Rossi, Marco, Vergari A (ORCID:0000-0002-4909-3098), Di Muro M, Frassanito L, Tamburrelli FC (ORCID:0000-0002-3140-5700), Rossi M. (ORCID:0000-0002-4539-5670), Vergari, Alessandro, Di Muro, Mariangela, De Angelis, A, Nestorini, R, Meluzio, Mc, Frassanito, Luciano, Tamburrelli, Francesco Ciro, Rossi, Marco, Vergari A (ORCID:0000-0002-4909-3098), Di Muro M, Frassanito L, Tamburrelli FC (ORCID:0000-0002-3140-5700), and Rossi M. (ORCID:0000-0002-4539-5670)

Abstract

Questo studio ha l’obiettivo di valutare l’efficacia, la sicurezza e la comodità d’uso di Zalviso nella gestione del dolore post-operatorio in seguito ad interventi di artrodesi vertebrale posteriore per spondilolistesi degenerativa, nell’ambito di un protocollo analgesico multimodale.

Published
2019

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