26 results on '"Frattari, Antonella"'
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2. Inadvertent intrathecal drug injection while treating low back pain: a case report and review of the literature
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Ferrieri, Alessandro, Bosco, Donatella, Polilli, Ennio, Ciulli, Raffaella, Visocchi, Lina, Mincione, Lucrezia, Iacoe, Rosa, Zocaro, Rosamaria, and Frattari, Antonella
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- 2023
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3. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study
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Abrough, Fekri, Acharya, Subhash P, Amin, Pravin, Arabi, Yaseen, Aragao, Irene, Bauer, Philippe, Beduneau, Gaëtan, Beitler, Jeremy, Berkius, Johan, Bugedo, Guillermo, Camporota, Luigi, Cerny, Vladimir, Cho, Young-Jae, Clarkson, Kevin, Estenssoro, Elisa, Goligher, Ewan, Grasselli, Giacomo, Gritsan, Alexey, Hashemian, Seyed Mohammadreza, Hermans, Greet, Heunks, Leo M, Jovanovic, Bojan, Kurahashi, Kiyoyasu, Laake, Jon Henrik, Matamis, Dimitrios, Moerer, Onnen, Molnar, Zsolt, Ozyilmaz, Ezgi, Panka, Bernardo, Papali, Alfred, Peñuelas, Óscar, Perbet, Sébastien, Piquilloud, Lise, Qiu, Haibo, Razek, Assem Abdel, Rittayamai, Nuttapol, Roldan, Rollin, Serpa Neto, Ary, Szuldrzynski, Konstanty, Talmor, Daniel, Tomescu, Dana, Van Haren, Frank, Villagomez, Asisclo, Zeggwagh, Amine Ali, Abe, Toshikazu, Aboshady, Abdelrhman, Acampo-de Jong, Melanie, Acharya, Subhash, Adderley, Jane, Adiguzel, Nalan, Agrawal, Vijay Kumar, Aguilar, Gerardo, Aguirre, Gaston, Aguirre-Bermeo, Hernan, Ahlström, Björn, 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Irene, Fernandez, Borja, Fernandez-Rodriguez, Maria Lorena, Ferrando, Carlos, Ferreira da Silva, Maria João, Ferreruela, Mireia, Ferrier, Janet, Flamm Zamorano, Matias Jesús, Flood, Laura, Floris, Leda, Fluckiger, Martin, Forteza, Catalina, Fortunato, Antonella, Frans, Eric, Frattari, Antonella, Fredes, Sebastian, Frenzel, Tim, Fumagalli, Roberto, Furche, Mariano Andres, Fusari, Maurizio, Fysh, Edward, Galeas-Lopez, Juan Luis, Galerneau, Louis-Marie, Garcia, Analía, Garcia, María Fernanda, Garcia, Elisabet, Garcia Olivares, Pablo, Garlicki, Jaroslaw, Garnero, Aude, Garofalo, Eugenio, Gautam, Prabha, Gazenkampf, Andrey, Gelinotte, Stéphanie, Gelormini, Domenico, Ghrenassia, Etienne, Giacomucci, Angelo, Giannoni, Robert, Gigante, Andrea, Glober, Nancy, Gnesin, Paolo, Gollo, Yari, Gomaa, Dina, Gomero Paredes, Rosita, Gomes, Rui, Gomez, Raúl Alejandro, Gomez, Oscar, Gomez, Aroa, Gondim, Louise, Gonzalez, Manuel, Gonzalez, Isabel, Gonzalez-Castro, Alejandro, Gordillo Romero, Orlando, Gordo, 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Smiechowicz, Jakub, Smischney, Nathan, Smith, Paul, Smith, Tim, Smith, Mark, Snape, Sarah, Snyman, Lindi, Soetens, Filiep, Sook Hong, Kyung, Sosa Medellin, Miguel Ángel, Soto, Giovanna, Souloy, Xavier, Sousa, Elsa, Sovatzis, Stefania, Sozutek, Didem, Spadaro, Savino, Spagnoli, Marco, Spångfors, Martin, Spittle, Nick, Spivey, Mike, Stapleton, Andrew, Stefanovic, Branislava, Stephenson, Lorraine, Stevenson, Elizabeth, Strand, Kristian, Strano, Maria Teresa, Straus, Slavenka, Sun, Chenliang, Sun, Rongqing, Sundaram, Venkat, SunPark, Tai, Surlemont, Elisabeth, Sutherasan, Yuda, Szabo, Zsuzsanna, Tainter, Christopher, Takaba, Akihiro, Tallott, Mandy, Tamasato, Tamasato, Tang, Zhanhong, Tangsujaritvijit, Viratch, Taniguchi, Leandro, Taniguchi, Daisuke, Tarantino, Fabio, Teerapuncharoen, Krittika, Temprano, Susana, Terragni, Pierpaolo, Terzi, Nicolas, Thakur, Anand, Theerawit, Pongdhep, Thille, Arnaud W, Thomas, Matt, Thungtitigul, Poungrat, Thyrault, Martial, Tilouch, Nejla, Timenetsky, Karina, Tirapu, Juna, Todeschini, Manuel, Tomas, Roser, Tomaszewski, Christian, Tonetti, Tommaso, Tonnelier, Alexandre, Trinder, John, Trongtrakul, Konlawij, Truwit, Jonathon, Tsuei, Betty, Tulaimat, Aiman, Turan, Sema, Turkoglu, Melda, Tyagi, Sanjeev, Ubeda, Alejandro, Vagginelli, Federica, Valenti, María Florencia, Vallverdu, Imma, Van Axel, Alisha, van den Hul, Ingrid, van der Hoeven, Hans, Van Der Meer, Nardo, Vanhoof, Marc, Vargas-Ordoñez, Mónica, Vaschetto, Rosanna, Vascotto, Ettore, Vatsik, Maria, Vaz, Ana, Vazquez-Sanchez, Antonia, Ventura, Sara, Vermeijden, Jan Wytze, Vidal, Anxela, Vieira, Jocyelle, Vilela Costa Pinto, Bruno, Villagra, Ana, Villegas Succar, Cristina, Vinorum, Ole Georg, Vitale, Giovanni, Vj, Ramesh, Vochin, Ana, Voiriot, Guillaume, Volta, Carlo Alberto, von Seth, Magnus, Wajdi, Maazouzi, Walsh, Don, Wang, Shouhong, Wardi, Gabriel, Ween-Velken, Nils Christian, Wei, Bi-Lin, Weller, Dolf, Welsh, Deborah, Welters, Ingeborg, Wert, Michael, Whiteley, Simon, Wilby, Elizabeth, Williams, Erin, Williams, Karen, Wilson, Antoinette, Wojtas, Jadwiga, Won Huh, Jin, Wrathall, David, Wright, Christopher, Wu, Jian-Feng, Xi, Guo, Xing, Zheng-Jiang, Xu, Hongyang, Yamamoto, Kotaro, Yan, Jie, Yáñez, Julio, Yang, Xiaobo, Yates, Elliot, Yazicioglu Mocin, Ozlem, Ye, Zhenglong, Yildirim, Fatma, Yoshida, Norifumi, Yoshido, Hector Higo Leon, Young Lee, Bo, Yu, Rongguo, Yu, Gong, Yu, Tao, Yuan, Boyun, Yuangtrakul, Nadwipa, Yumoto, Tetsuya, Yun, Xie, Zakalik, Graciela, Zaki, Ahmad, Zalba-Etayo, Begoña, Zambon, Massimo, Zang, Bin, Zani, Gianluca, Zarka, Jonathan, Zerbi, Simone Maria, Zerman, Avsar, Zetterquist, Harald, Zhang, Jiuzhi, Zhang, Hongwen, Zhang, Wei, Zhang, Guoxiu, Zhang, Weixin, Zhao, Hongsheng, Zheng, Jia, Zhu, Bin, Zumaran, Ronald, Pham, Tài, Madotto, Fabiana, Goligher, Ewan C, Mancebo, Jordi, Peñuelas, Oscar, Pesenti, Antonio, Wunsch, Hannah, van Haren, Frank, and Laffey, John G
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- 2023
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4. Incidence of hospital-acquired infections due to carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa in critically ill patients in Italy: a multicentre prospective cohort study.
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De Pascale, Gennaro, Cortegiani, Andrea, Rinaldi, Matteo, Antonelli, Massimo, Cattaneo, Sergio, Cecconi, Maurizio, Cuffaro, Raffaele, Dalfino, Lidia, Di Biase, Filomena, Donati, Abele, Fasano, Francesca Romana, Fasciana, Teresa, Foti, Giuseppe, Frattari, Antonella, Fumagalli, Roberto, Girardis, Massimo, Gottin, Leonardo, Mattei, Alessia, Milazzo, Marta, and Montrucchio, Giorgia
- Abstract
Background: Carbapenem-Resistant Gram-Negative Bacteria, including Carbapenem-Resistant Enterobacterales (CRE) and Carbapenem-Resistant Pseudomonas aeruginosa (CRPA), are common causes of infections in intensive care units (ICUs) in Italy. Objective: This prospective observational study evaluated the epidemiology, management, microbiological characterization, and outcomes of hospital-acquired CRE or CRPA infections treated in selected ICUs in Italy. Methods: The study included patients with hospital-acquired infections due to CRE and CRPA treated in 20 ICUs from June 2021 to February 2023. The primary endpoint was the 1-year incidence of CRE/CRPA infections. Secondary endpoints included the rate of CRE/CRPA infections, mortality in ICU, infection outcome, and microbiological characterization. Results: Among 13,088 patients admitted over the 12-month study period across each of the 20 ICUs, 283 had CRE infections, and 138 had CRPA infections. The incidence of CRE and CRPA infections was 3.57 per 1000 patient days and 1.74 per 1000 patient days, respectively. The proportion of CRE and CRPA infections over the total number of infections due to Enterobacterales and Pseudomonas aeruginosa was 19.2% and 26.8%, respectively. Among 158 patients included in the full analysis, 98 (62%) had CRE infections and 60 (38%) had CRPA infections. Ventilator-associated pneumonia and bloodstream infections were the most common infections, occurring in 53.8 and 34.2% of cases. Empirical therapy targeting gram-negative pathogens resulted inappropriate in 59.2% of analysed patients (77/130). The overall crude mortality in ICU rate was 30.4%, with a higher rate in CRE patients (36.7%) than in CRPA patients (20.0%). Clinical success, including microbiological eradication, was achieved in 50.6% of cases. Klebsiella pneumoniae was observed as the predominant CRE species, and all CRE isolates, including metallo-β-lactamases-producing CRE (MBL-CRE), were susceptible to Aztreonam-Avibactam. Conclusions: These results highlight the high prevalence of CRE/CRPA infections in Italian ICUs and emphasize the need for enhanced prevention and surveillance strategies. [ABSTRACT FROM AUTHOR]
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- 2025
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5. Reliability of predictive models to support early decision making in the emergency department for patients with confirmed diagnosis of COVID-19: the Pescara Covid Hospital score
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Polilli, Ennio, Frattari, Antonella, Esposito, Jessica Elisabetta, D’Amato, Milena, Rapacchiale, Giorgia, D’Intino, Angela, Albani, Alberto, Di Iorio, Giancarlo, Carinci, Fabrizio, and Parruti, Giustino
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- 2022
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6. SOX-1 antibodies in a patient with Crohn’s disease: a case report
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Polilli, Ennio, Frattari, Antonella, Esposito, Jessica Elisabetta, Angelini, Gilda, Di Risio, Annalisa, Mazzotta, Elena, Coladonato, Simona, Di Iorio, Giancarlo, Parruti, Giustino, and Tocco, Pierluigi
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- 2022
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7. Monitoring Immune Dysfunction in Critically Ill Patients with Carbapenem-Resistant Acinetobacter baumannii Sepsis Treated with Regimens Including Cefiderocol: A Pilot Study to Identify Accessible Biomarkers to Stratify Patients' Prognosis.
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Frattari, Antonella, Polilli, Ennio, Timelli, Laura, Spagnuolo, Francesca, Fazii, Paolo, and Parruti, Giustino
- Subjects
SOFT tissue infections ,LYMPHOCYTE subsets ,CARBAPENEM-resistant bacteria ,ACINETOBACTER infections ,ACINETOBACTER baumannii - Abstract
Background: Multidrug-resistant Acinetobacter baumannii (CRAB) infections are a serious problem in critical care. This study aims to develop an early prognostic score for immune paralysis, using practical and cost-effective parameters, to predict ICU mortality in patients with CRAB infections being treated with Cefiderocol. Methods: We carried out an observational pilot study on consecutive patients hospitalized in the ICU with ensuing septic Acinetobacter baumannii infections treated with Cefiderocol monotherapy or Cefiderocol including combinations. We investigated the predictive power of lymphocyte counts, lymphocyte subpopulations, serum cholinesterase levels, and reactivation of herpes viruses. Results: Overall, 36 of 39 patients entered in our analysis: 20 survivors and 16 deceased. A total of 12 patients developed bacteremia, 19 patients had HAP/VAP, and 5 patients had a soft tissue infection. Univariate analyses of factors associated with unfavorable outcome revealed a significant association for age (OR: 1.5, CI: 1.11–2.02), SAPS II (OR: 1.05, CI: 1.01–1.1), SOFA score (OR: 1.37, CI: 1.06–1.76), lymphocytopenia (OR: 32.5, CI: 3.45–306.4), viral reactivation (OR: 9.75, CI: 1.72–55.4), and cholinesterase drop <1600 U/L (OR: 39.7, CI: 5.8–271.6). At variance, monotherapy or associations with Cefiderocol were not associated. In the final multivariable model, the only independent predictors of death were age (OR: 1.42, CI: 0.98–2.05), lymphocytopenia (OR: 18.2, CI: 0.87–371), and cholinesterase drop to below 1600 U/L (OR: 9.7, CI: 0.77–123.7). Conclusions: Age, lymphocytopenia, and serum cholinesterase drops, which were nearly significantly associated with an unfavorable outcome, may help pinpoint patients with acute immune paralysis during sepsis. Knowledge of such an immune state may in turn directly influence patients' care. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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8. Circulating lymphocyte subsets as promising biomarkers to identify septic patients at higher risk of unfavorable outcome
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Polilli, Ennio, Esposito, Jessica Elisabetta, Frattari, Antonella, Trave, Francesca, Sozio, Federica, Ferrandu, Giovanna, Di Iorio, Giancarlo, and Parruti, Giustino
- Published
- 2021
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9. Control of Gram-negative multi-drug resistant microorganisms in an Italian ICU: Rapid decline as a result of a multifaceted intervention, including conservative use of antibiotics
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Frattari, Antonella, Savini, Vincenzo, Polilli, Ennio, Di Marco, Graziano, Lucisano, Giuseppe, Corridoni, Serena, Spina, Tullio, Costantini, Alberto, Nicolucci, Antonio, Fazii, Paolo, Viale, Pierluigi, and Parruti, Giustino
- Published
- 2019
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10. Cure of recurring Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae septic shock episodes due to complicated soft tissue infection using a ceftazidime and avibactam-based regimen: a case report
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Parruti, Giustino, Frattari, Antonella, Polilli, Ennio, Savini, Vincenzo, Sciacca, Antonina, Consorte, Augusta, Cibelli, Donatella Concetta, Agostinone, Adriana, Di Masi, Francesco, Pieri, Alessandro, Cacciatore, Pierluigi, Di Iorio, Giancarlo, Fazii, Paolo, and Spina, Tullio
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- 2019
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11. Whole-Genome Sequencing of ST2 A. baumannii Causing Bloodstream Infections in COVID-19 Patients.
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Cherubini, Sabrina, Perilli, Mariagrazia, Segatore, Bernardetta, Fazii, Paolo, Parruti, Giustino, Frattari, Antonella, Amicosante, Gianfranco, and Piccirilli, Alessandra
- Subjects
ACINETOBACTER baumannii ,SARS-CoV-2 ,COVID-19 ,NUCLEOTIDE sequencing ,MICROBIAL sensitivity tests ,BETA lactamases - Abstract
A total of 43 A. baumannii strains, isolated from 43 patients affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and by bacterial sepsis, were analyzed by antimicrobial susceptibility testing. All strains were resistant to almost three different classes of antibiotics, including carbapenems and colistin. The whole-genome sequencing (WGS) of eight selected A. baumannii isolates showed the presence of different insertion sequences (ISs), such as ISAba13, ISAba26, IS26, ISVsa3, ISEc29, IS6100 and IS17, giving to A. baumannii a high ability to capture and mobilize antibiotic resistance genes. Resistance to carbapenems is mainly mediated by the presence of OXA-23, OXA-66 and OXA-82 oxacillinases belonging to OXA-51-like enzymes. The presence of AmpC cephalosporinase, ADC-25, was identified in all A. baumannii. The pathogenicity of A. baumannii was exacerbated by the presence of several virulence factors. The multi-locus sequence typing (MLST) analysis showed that all strains belong to sequence type 2 (ST) international clone. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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12. A PATIENT WITH COVID-19 PNEUMONIA, PULMONARY EMBOLISM, AND OSA
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SPACONE, ANTONELLA, ESPOSITO, ANTONIETTA, ZUCCARINI, GIACOMO, PROSPERI, PIERPAOLO, RAPACCHIALE, GIORGIA, PATRIZIO, GIORGIA, FRATTARI, ANTONELLA, and PARRUTI, GIUSTINO
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- 2022
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13. Monocyte distribution width (MDW) as a new tool for the prediction of sepsis in critically ill patients: a preliminary investigation in an intensive care unit.
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Polilli, Ennio, Frattari, Antonella, Esposito, Jessica Elisabetta, Stanziale, Andrea, Giurdanella, Giuliana, Di Iorio, Giancarlo, Carinci, Fabrizio, and Parruti, Giustino
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- *
INTENSIVE care units , *SEPSIS , *CRITICALLY ill , *INTENSIVE care patients - Abstract
Background: Monocyte Distribution Width (MDW), a simple proxy marker of innate monocyte activation, can be used for the early recognition of sepsis along with Procalcitonin. This study explored the added value of MDW as an early predictor of ensuing sepsis in patients hospitalised in an Intensive Care Unit.Methods: We performed an observational prospective monocentric study to estimate the analytical performance of MDW in detecting ensuing sepsis in a sample of consecutive patients assisted in an Intensive Care Unit for > 48 h for any reason. Demographic and clinical characteristics, past medical history and other laboratory measurements were included as potential predictors of confirmed sepsis in multivariate logistic regression.Results: A total of 211 patients were observed, 129 of whom were included in the final sample due to the suspect of ensuing sepsis; of these, 74 (57%) had a confirmed diagnosis of sepsis, which was best predicted with the combination of MDW > 23.0 and PCT > 0.5 ng/mL (Positive Predictive Value, PPV: 92.6, 95% CI: 82.1-97.9). The best MDW cut-off to rule out sepsis was ≤20.0 (Negative Predictive Value, NPV: 86.4, 95% CI: 65.1-97.1). Multivariate analyses using both MDW and PCT found a significant association for MDW > 23 only (OR:17.64, 95% CI: 5.53-67.91).Conclusion: We found that values of MDW > 23 were associated with a high PPV for sepsis, whereas values of MDW ≤ 20 were associated with a high NPV. Our findings suggest that MDW may help clinicians to monitor ICU patients at risk of sepsis, with minimal additional efforts over standard of care. [ABSTRACT FROM AUTHOR]- Published
- 2021
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14. Ceftolozane-tazobactam and Fosfomycin for rescue treatment of otogenous meningitis caused by XDR Pseudomonas aeruginosa: Case report and review of the literature
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Frattari, Antonella, Savini, Vincenzo, Polilli, Ennio, Cibelli, Donatella, Talamazzi, Silvia, Bosco, Donatella, Consorte, Augusta, Fazii, Paolo, and Parruti, Giustino
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- 2018
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15. Impact of Covid‐19 epidemic on the activities of a blood centre, transfusion support for infected patients and clinical outcomes.
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Quaglietta, Anna, Nicolucci, Antonio, Posata, Raffaella, Frattari, Antonella, Parruti, Giustino, and Accorsi, Patrizia
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COVID-19 pandemic ,COVID-19 ,TREATMENT effectiveness ,BLOOD banks ,SARS-CoV-2 ,DIRECTED blood donations - Abstract
Objectives: We evaluated how the Severe Acute Respiratory disease from Coronavirus 2 (SARS‐CoV‐2) epidemic impacted transfusion services, transfusion support required by Covid‐19 patients and their clinical outcome. Background: In Italy, the first confirmed case of SARS‐CoV‐2 infection was registered on 21 February 2020. As of 20 April, about 250 000 cases were registered, 1143 of which were in the province of Pescara. Methods: We compared transfusion services provided by the blood centre of Pescara between 1 March and 20 April 2019 and between 1 March and 20 April 2020. We assessed the number and type of blood components donated, those transfused in the various hospital departments and those transfused to Covid‐19 patients. Results: Compared to 2019, we documented a decrease of 32% in the number of donations. The number of transfusions increased by 139% in the infectious diseases department (IDD), dedicated to Covid‐19 patients, and by 76% in the intensive care unit (ICU), whereas it markedly decreased in the other departments. Of 299 patients with Covid‐19, 60 were transfused (20.1%). Transfused patients in the ICU were significantly younger than those in IDD and had a lower number of lymphocytes, lower post‐transfusion increment of haemoglobin levels and higher D‐dimer and C reactive protein values. Mortality rate was 60.7% among transfused patients in the ICU and 39.0% among those in the IDD (p = 0.02). Conclusion: The Covid‐19 epidemic had a profound impact on transfusion activities. The important blood demand for Covid‐19 patients was satisfied because of the reduction in activities in other hospital wards. Covid‐19‐positive transfused patients showed a very poor prognosis. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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16. THE UTILITY OF EARLY HIGH FLOW NASAL OXYGEN THERAPY (FROM ER TO DISCHARGE AND HOME) IN PATIENT WITH SEVERE COVID-19 PNEUMONIA
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SPACONE, ANTONELLA, ESPOSITO, ANTONIETTA, ZUCCARINI, GIACOMO, PROSPERI, PIERPAOLO, RAPACCHIALE, GIORGIA, DI LORITO, ALESSANDRA, ZARA, BENEDETTA, D'APOLITO, ALESSANDRO, BARONE, ADRIANO, RAMPINO, ILARIA, DE PALMA, ANTONIO, DI FABIO, NATASHA, MARIA DI FLAMMINIO, FILIPPO, BASILISCO, MATTEO, BONDANESE, MARTINA, FRATTARI, ANTONELLA, and PARRUTI, GIUSTINO
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- 2021
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17. Operative Gynecological Laparoscopy Under Conscious Sedation.
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Rosati, Maurizio, Bramante, Silvia, Cont, Fiorella, Frattari, Antonella, Rizzi, Maria, and Roman, Robert A.
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- 2020
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18. Comparison of Monocyte Distribution Width (MDW) and Procalcitonin for early recognition of sepsis.
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Polilli, Ennio, Sozio, Federica, Frattari, Antonella, Persichitti, Laura, Sensi, Marina, Posata, Raffaella, Di Gregorio, Marco, Sciacca, Antonina, Flacco, Maria Elena, Manzoli, Lamberto, Di Iorio, Giancarlo, and Parruti, Giustino
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CALCITONIN ,SEPSIS ,NOSOCOMIAL infections ,BACTERIAL diseases ,COMMUNICABLE diseases ,NEONATAL sepsis - Abstract
We carried out a prospective observational study to evaluate whether Monocyte Distribution Width (MDW) may play a role in identifying patients with sepsis in comparison with Procalcitonin (PCT). We prospectively enrolled all consecutive patients hospitalized at the Infectious Diseases Unit of Pescara General Hospital for bacterial infection or sepsis. MDW values were collected for all patients. Clinical characteristics, demographic data, past and present medical history, microbiological results, PCT, as well as neutrophil and monocytes indices at entry were compared in the 2 groups. Two-hundred-sixty patients were enrolled, 63.5% males, aged 59.1±19.5 years. Sepsis was diagnosed in 105 (40.4%); in 60 (57.1%) at least 1 microorganism was isolated from blood cultures. In multivariate models, MDW as a continuous variable (OR:1.57 for each unit increase; 95%CI: 1.31–1.87, p<0.001) and PCT˃1 ng/mL (OR: 48.5; 95%CI: 14.7–160.1, p<0.001) were independently associated with sepsis. Statistical best cut points associated with sepsis were 22.0 for MDW and 1.0 ng/mL for PCT whereas MDW values<20 were invariably associated with negative blood cultures. At ROC curve analysis, the AUC of MDW (0.87) was nearly overlapping that of PCT (0.88). Our data suggest that incorporating MDW within current routine WBC counts and indices may be of remarkable use for detection of sepsis. Further research is warranted. [ABSTRACT FROM AUTHOR]
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- 2020
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19. Response to: 'Rational use of tocilizumab in COVID-19' by Jain and Sharma.
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Potere, Nicola, Di Nisio, Marcello, Cibelli, Donatella, Scurti, Rosa, Frattari, Antonella, Porreca, Ettore, Abbate, Antonio, and Parruti, Giustino
- Published
- 2022
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20. Response to: 'Correspondence on 'Interleukin-6 blockade with subcutaneous tocilizumab in severe COVID-19 pneumonia and hyperinflammation: a case-control study'.
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Potere, Nicola, Di Nisio, Marcello, Cibelli, Donatella, Scurti, Rosa, Frattari, Antonella, Porreca, Ettore, Abbate, Antonio, and Parruti, Giustino
- Published
- 2022
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21. Recurring septic shock in a patient with blunt abdominal and pelvic trauma: how mandatory is source control surgery?: a case report.
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Frattari, Antonella, Parruti, Giustino, Erasmo, Rocco, Guerra, Luigi, Polilli, Ennio, Zocaro, Rosamaria, Iervese, Giuliano, Fazii, Paolo, and Spina, Tullio
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- *
PELVIC fractures , *DEBRIDEMENT , *KLEBSIELLA pneumoniae , *COLISTIN , *DRUG resistance in bacteria , *THERAPEUTICS - Abstract
Background: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control.Case Presentation: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock. Two weeks later, an abdominal computed tomography scan revealed suprapubic and ischiatic abscesses at surgical sites, as well as dilated bowel. Debridement of both surgical sites, performed with vacuum-assisted closure therapy, yielded isolates of carbapenem and colistin-resistant Klebsiella pneumoniae. Antibiotic treatment was de-escalated after 21 days; 4 days later fever, leukocytosis, hypotension and acute renal failure relapsed. Blood purification techniques were started, for the removal of endotoxin and inflammatory mediators, with sequential hemodialysis. Clinical improvement ensued; blood cultures yielded Candida albicans and multidrug-resistant Acinetobacter baumannii; panresistant carbapenemase-producing Klebsiella pneumoniae grew from wound swabs. In spite of shock reversal, our patient remained febrile, with diarrhea. Control blood cultures yielded Candida albicans, Acinetobacter baumannii and carbapenem-resistant Klebsiella pneumoniae. His abdominal pain increased, paralleled by a right flank palpable mass. Colonoscopy revealed patchy serpiginous ulcers. At exploratory laparotomy, an inflammatory post-traumatic pseudotumor of his right colon was removed. Blood cultures turned negative after surgery. Septic shock, however, relapsed 4 days later. A blood purification cycle was repeated and combination antimicrobial therapy continued. Surgical wounds and blood cultures were persistently positive for carbapenem-resistant Klebsiella pneumoniae. Removal of pelvic synthesis media was therefore anticipated. Three weeks later, clinical, microbiological, and biochemical evidence of infection resolved.Conclusions: High quality intensive assistance for sepsis episodes needs a clear plan of cure, aimed to complete infection source control, in a complex multidisciplinary interplay of specialists and intensive care physicians. [ABSTRACT FROM AUTHOR]- Published
- 2017
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22. Laparoscopic Salpingo-oophorectomy in Conscious Sedation.
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Rosati, Maurizio, Bramante, Silvia, Conti, Fiorella, Rizzi, Maria, Frattari, Antonella, and Spina, Tullio
- Published
- 2015
- Full Text
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23. Interleukin-6 receptor blockade with subcutaneous tocilizumab in severe COVID-19 pneumonia and hyperinflammation: a case-control study.
- Author
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Potere, Nicola, Di Nisio, Marcello, Cibelli, Donatella, Scurti, Rosa, Frattari, Antonella, Porreca, Ettore, Abbate, Antonio, and Parruti, Giustino
- Published
- 2021
- Full Text
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24. Analysis of peripheral blood lymphocyte subsets in critical patients at ICU admission: A preliminary investigation of their role in the prediction of sepsis during ICU stay.
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Frattari, Antonella, Polilli, Ennio, Primiterra, Vanessa, Savini, Vincenzo, Ursini, Tamara, Di Iorio, Giancarlo, and Parruti, Giustino
- Published
- 2018
- Full Text
- View/download PDF
25. Operative Gynecological Laparoscopy Under Conscious Sedation.
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Rosati M, Bramante S, Conti F, Frattari A, Rizzi M, and Roman RA
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- Adult, Aged, Anesthesia, Obstetrical, Female, Humans, Middle Aged, Retrospective Studies, Conscious Sedation methods, Gynecologic Surgical Procedures methods, Laparoscopy methods
- Abstract
Background and Objectives: Operative laparoscopy is generally performed under general anesthesia. Local anesthesia and conscious sedation may be useful in select short procedures. In the present study, we evaluated safety and efficacy of operative laparoscopy under conscious sedation., Methods: Retrospective observational study evaluating patients undergoing gynecologic laparoscopy. Laparoscopy under conscious sedation was performed for each patient with umbilical direct insertion of a 12-mm port, followed by 2 ancillary ports at 1 cm medially to the anterior superior iliac spine. Conversion to conventional laparoscopy or laparotomy was recorded. Conscious sedation was obtained using Remifentanil and Propofol, administered by an infusion system based on pharmacokinetic and pharmacodynamic models. Local anesthesia was administered at port insertion sites and for paracervical block. Pain intensity was evaluated with the Visual Analog Scale (VAS). Adverse events and drug concentrations throughout the procedure were retrieved., Results: Our study population included 166 patients. They underwent laparoscopic unilateral versus bilateral salpingo-oophorectomy, ovarian cystectomy, bilateral salpingo-oophorectomy and omentectomy for a borderline ovarian tumor, myomectomy; or underwent surgery for unexplained infertility evaluation, pelvic pain, staging of ovarian cancer. Mean duration of pneumoperitoneum was 22.3 ± 7.2 min. Rate of conversion to laparoscopy under general anesthesia was 17/166 (10.2%) and there were only 3 cases of patients with low tolerability to the procedure. No severe adverse events occurred. Hospital discharge occurred in all unconverted cases after 6 to 18 h., Conclusions: Operative laparoscopy under conscious sedation and local anesthesia appears to be a feasible technique in gynecologic surgery with no adverse patient outcomes., Competing Interests: Conflicts of interest: None., (© 2020 by JSLS, Journal of the Society of Laparoscopic & Robotic Surgeons.)
- Published
- 2020
- Full Text
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26. Laparoscopic Salpingo-oophorectomy in Conscious Sedation.
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Rosati M, Bramante S, Conti F, Rizzi M, Frattari A, and Spina T
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- Adult, Aged, Female, Humans, Middle Aged, Patient Satisfaction, Conscious Sedation methods, Laparoscopy methods, Ovarian Neoplasms surgery, Ovariectomy methods
- Abstract
Introduction: Conscious sedation has traditionally been used for laparoscopic tubal ligation. General anesthesia with endotracheal intubation may be associated with side effects, such as nausea, vomiting, cough, and dizziness, whereas sedation offers the advantage of having the patient awake and breathing spontaneously. Until now, only diagnostic laparoscopy and minor surgical procedures have been performed in patients under conscious sedation., Case Description: Our report describes 5 cases of laparoscopic salpingo-oophorectomy successfully performed with the aid of conventional-diameter multifunctional instruments in patients under local anesthesia. Totally intravenous sedation was provided by the continuous infusion of propofol and remifentanil, administered through a workstation that uses pharmacokinetic-pharmacodynamic models to titrate each drug, as well as monitoring tools for levels of conscious sedation and local anesthesia. We have labelled our current procedure with the acronym OLICS (Operative Laparoscopy in Conscious Sedation). Four of the patients had mono- or bilateral ovarian cysts and 1 patient, with the BRCA1 gene mutation and a family history of ovarian cancer, had normal ovaries. Insufflation time ranged from 19 to 25 minutes. All patients maintained spontaneous breathing throughout the surgical procedure, and no episodes of hypotension or bradycardia occurred. Optimal pain control was obtained in all cases. During the hospital stay, the patients did not need further analgesic drugs. All the women reported high or very high satisfaction and were discharged within 18 hours of the procedure., Discussion and Conclusion: Salpingo-oophorectomy in conscious sedation is safe and feasible and avoids the complications of general anesthesia. It can be offered to well-motivated patients without a history of pelvic surgery and low to normal body mass index.
- Published
- 2015
- Full Text
- View/download PDF
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