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1. Landscape of alcohol-related hepatocellular carcinoma in the last 15 years highlights the need to expand surveillance programs

Author

Nicola Reggidori, Laura Bucci, Valentina Santi, Benedetta Stefanini, Lorenzo Lani, Davide Rampoldi, Giorgia Ghittoni, Fabio Farinati, Alberto Masotto, Bernardo Stefanini, Andrea Mega, Elisabetta Biasini, Francesco Giuseppe Foschi, Gianluca Svegliati-Baroni, Angelo Sangiovanni, Claudia Campani, Giovanni Raimondo, Gianpaolo Vidili, Antonio Gasbarrini, Ciro Celsa, Mariella Di Marco, Edoardo G. Giannini, Rodolfo Sacco, Maurizia Rossana Brunetto, Francesco Azzaroli, Donatella Magalotti, Filomena Morisco, Gian Ludovico Rapaccini, Gerardo Nardone, Alessandro Vitale, Franco Trevisani, Maurizio Biselli, Paolo Caraceni, Annagiulia Gramenzi, Francesca Benevento, Alessandro Granito, Luca Muratori, Fabio Piscaglia, Francesco Tovoli, Gloria Allegrini, Calogero Cammà, Giuseppe Cabibbo, Carmelo Marco Giacchetto, Paolo Giuffrida, Maria Vittoria Grassini, Mauro Grova, Gabriele Rancatore, Caterina Stornello, Valentina Adotti, Tancredi Li Cavoli, Fabio Marra, Martina Rosi, Vittoria Bevilacqua, Alberto Borghi, Lucia Napoli, Fabio Conti, G.L. Frassineti, Maria Teresa Migliano, Nicoletta de Matthaeis, Francesca Romana Ponziani, Gabriele Missale, Andrea Olivani, Mario Capasso, Valentina Cossiga, Maria Guarino, Ester Marina Cela, Antonio Facciorusso, Camilla Graziosi, Valentina Lauria, Giorgio Pelecca, Marta Schirripa, Fabrizio Chegai, Armando Raso, Alessio Bozzi, Maria Stella Franzè, Carlo Saitta, Assunta Sauchella, Elton Dajti, Federico Ravaioli, Maria Corina Plaz Torres, Giulia Pieri, Filippo Oliveri, Gabriele Ricco, Veronica Romagnoli, Alessandro Inno, Fabiana Marchetti, Pietro Coccoli, Antonio Malerba, Alberta Cappelli, Rita Golfieri, Cristina Mosconi, and Matteo Renzulli

Subjects
Hepatocellular carcinoma, Alcohol abuse, ITA.LI.CA staging system, Metabolic dysfunction-associated fatty liver disease, Surveillance programs, Oesophageal varices, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background & Aims: Alcohol abuse and metabolic disorders are leading causes of hepatocellular carcinoma (HCC) worldwide. Alcohol-related aetiology is associated with a worse prognosis compared with viral agents, because of the lower percentage of patients diagnosed with HCC under routine surveillance and a higher burden of comorbidity in alcohol abusers. This study aimed to describe the evolving clinical scenario of alcohol-related HCC over 15 years (2006–2020) in Italy. Methods: Data from the Italian Liver Cancer (ITA.LI.CA) registry were used: 1,391 patients were allocated to three groups based on the year of HCC diagnosis (2006–2010; 2011–2015; 2016–2020). Patient characteristics, HCC treatment, and overall survival were compared among groups. Survival predictors were also investigated. Results: Approximately 80% of alcohol-related HCCs were classified as cases of metabolic dysfunction-associated fatty liver disease. Throughout the quinquennia,

Published
2023
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3. Assessing the impact of COVID-19 on liver cancer management (CERO-19)

Author

Sergio Muñoz-Martínez, Victor Sapena, Alejandro Forner, Jean-Charles Nault, Gonzalo Sapisochin, Lorenza Rimassa, Bruno Sangro, Jordi Bruix, Marco Sanduzzi-Zamparelli, Wacław Hołówko, Mohamed El Kassas, Tudor Mocan, Mohamed Bouattour, Philippe Merle, Frederik J.H. Hoogwater, Saleh A. Alqahtani, Helen L. Reeves, David J. Pinato, Emmanouil Giorgakis, Tim Meyer, Gerda Elisabeth Villadsen, Henning Wege, Massimiliano Salati, Beatriz Mínguez, Giovan Giuseppe Di Costanzo, Christoph Roderburg, Frank Tacke, María Varela, Peter R. Galle, Mario Reis Alvares-da-Silva, Jörg Trojan, John Bridgewater, Giuseppe Cabibbo, Christian Toso, Anja Lachenmayer, Andrea Casadei-Gardini, Hidenori Toyoda, Tom Lüdde, Rosanna Villani, Ana María Matilla Peña, Cassia Regina Guedes Leal, Monica Ronzoni, Manuel Delgado, Christie Perelló, Sonia Pascual, José Luis Lledó, Josepmaria Argemi, Bristi Basu, Leonardo da Fonseca, Juan Acevedo, Alexander R. Siebenhüner, Chiara Braconi, Brandon M. Meyers, Alessandro Granito, Margarita Sala, Carlos Rodríguez-Lope, Lorraine Blaise, Manuel Romero-Gómez, Federico Piñero, Dhanny Gomez, Vivianne Mello, Rogerio Camargo Pinheiro Alves, Alex França, Fernanda Branco, Giovanni Brandi, Gustavo Pereira, Susanna Coll, Maria Guarino, Carlos Benítez, Maria Margarita Anders, Juan C. Bandi, Mercedes Vergara, Mariona Calvo, Markus Peck-Radosavljevic, Ignacio García-Juárez, Vincenzo Cardinale, Mar Lozano, Martina Gambato, Stefano Okolicsanyi, Dalia Morales-Arraez, Alessandra Elvevi, Alberto E. Muñoz, Alberto Lué, Massimo Iavarone, and Maria Reig

Subjects
COVID-19, Hepatocellular carcinoma, Cholangiocarcinoma, Liver cancer, Management, Clinical trials, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background & Aims: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic. Methods: An international survey evaluated the impact of the COVID-19 pandemic on clinical practice and clinical trials from March 2020 to June 2020, as the first phase of a multicentre, international, and observational project. The focus was on patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma, cared for around the world during the first COVID-19 pandemic wave. Results: Ninety-one centres expressed interest to participate and 76 were included in the analysis, from Europe, South America, North America, Asia, and Africa (73.7%, 17.1%, 5.3%, 2.6%, and 1.3% per continent, respectively). Eighty-seven percent of the centres modified their clinical practice: 40.8% the diagnostic procedures, 80.9% the screening programme, 50% cancelled curative and/or palliative treatments for LC, and 41.7% modified the liver transplantation programme. Forty-five out of 69 (65.2%) centres in which clinical trials were running modified their treatments in that setting, but 58.1% were able to recruit new patients. The phone call service was modified in 51.4% of centres which had this service before the COVID-19 pandemic (n = 19/37). Conclusions: The first wave of the COVID-19 pandemic had a tremendous impact on the routine care of patients with liver cancer. Modifications in screening, diagnostic, and treatment algorithms may have significantly impaired the outcome of patients. Ongoing data collection and future analyses will report the benefits and disadvantages of the strategies implemented, aiding future decision-making. Lay summary: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems globally. Herein, we assessed the impact of the first wave pandemic on patients with liver cancer and found that routine care for these patients has been majorly disrupted, which could have a significant impact on outcomes.

Published
2021
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4. Viral Outcome in Patients with Occult HBV Infection or HCV-Ab Positivity Treated for Lymphoma

Author

Maria Guarino, Marco Picardi, Anna Vitiello, Novella Pugliese, Matilde Rea, Valentina Cossiga, Fabrizio Pane, Nicola Caporaso, and Filomena Morisco

Subjects
Rituximab, Chemotherapy, Occult HBV infection, HCV infection, Specialties of internal medicine, RC581-951
Abstract

HBV and HCV reactivation has been widely reported in patients undergoing immunosuppressive therapy for oncohaematological diseases. We aimed to evaluate the HBV and HCV reactivation events in patients with non-Hodgkin lymphoma (NHL) or Hodgkin lym-phoma (HL) underwent cytotoxic chemotherapy containing or not rituximab. This is a retrospective observational study, including all patients with NHL and HL attending an Italian tertiary referral hospital, the University of Naples “Federico II”. A total of 322 patients were enrolled. We evaluated serum HBV and HCV markers. A total of 47 (38%) patients with occult HBV infection were enrolled. Seven/47 were treated with therapeutic cytotoxic schedule containing rituximab. Of them, 6/7 received prophylaxis with lamivudine. HBV reactivation was observed in two patients treated with rituximab. A reactivation was observed in the only patient (HBcAb+/HB-sAb+) not receiving lamivudine prophylaxis, and the other one was observed in 1 patient with isolated HBcAb positivity during lami-vudine prophylaxis. Moreover, 8 patients with HCV-Ab positivity were enrolled. No viral reactivation was observed in these patients. In conclusion, patients with occult HBV infection receiving chemotherapy containing rituximab for lymphoma without antiviral prophylaxis are at risk of viral reactivation. On the contrary, there is no risk of reactivation in patients undergoing rituximab-free schedule. Our findings suggest that there is also very low risk of HCV reactivation. This preliminary report underlines the concept that HBV reactivation is strongly related to the type of immunosuppressive therapy administered and that antiviral prophylaxis needs to be tailored.

Published
2017
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5. Accuracy of MR markers for differentiating Progressive Supranuclear Palsy from Parkinson's disease

Author

Stefano Zanigni, Giovanna Calandra-Buonaura, David Neil Manners, Claudia Testa, Dino Gibertoni, Stefania Evangelisti, Luisa Sambati, Maria Guarino, Patrizia De Massis, Laura Ludovica Gramegna, Claudio Bianchini, Paola Rucci, Pietro Cortelli, Raffaele Lodi, and Caterina Tonon

Subjects
Progressive Supranuclear Palsy, Parkinson's disease, MRI, Morphometry, DTI, Computer applications to medicine. Medical informatics, R858-859.7, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background: Advanced brain MR techniques are useful tools for differentiating Progressive Supranuclear Palsy from Parkinson's disease, although time-consuming and unlikely to be used all together in routine clinical work. We aimed to compare the diagnostic accuracy of quantitative morphometric, volumetric and DTI metrics for differentiating Progressive Supranuclear Palsy-Richardson's Syndrome from Parkinson's disease. Methods: 23 Progressive Supranuclear Palsy-Richardson's Syndrome and 42 Parkinson's disease patients underwent a standardized 1.5T brain MR protocol comprising high-resolution T1W1 and DTI sequences. Brainstem and cerebellar peduncles morphometry, automated volumetric analysis of brain deep gray matter and DTI metric analyses of specific brain structures were carried out. We determined diagnostic accuracy, sensitivity and specificity of MR-markers with respect to the clinical diagnosis by using univariate receiver operating characteristics curve analyses. Age-adjusted multivariate receiver operating characteristics analyses were then conducted including only MR-markers with a sensitivity and specificity exceeding 80%. Results: Morphometric markers (midbrain area, pons to midbrain area ratio and MR Parkinsonism Index), DTI parameters (infratentorial structures) and volumetric analysis (thalamus, putamen and pallidus nuclei) presented moderate to high diagnostic accuracy in discriminating Progressive Supranuclear Palsy-Richardson's Syndrome from Parkinson's disease, with midbrain area showing the highest diagnostic accuracy (99%) (mean ± standard deviation: 75.87 ± 16.95 mm2 vs 132.45 ± 20.94 mm2, respectively; p

Published
2016
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6. Assessing the impact of COVID-19 on liver cancer management (CERO-19)

Author

Manuel Delgado, Mar Lozano, Alejandro Forner, Bruno Sangro, Alessandro Granito, Margarita Sala, Monica Ronzoni, Giuseppe Cabibbo, Frederik J H Hoogwater, José Luis Lledó, Rosanna Villani, Alessandra Elvevi, Lorenza Rimassa, Juan Acevedo, Mariona Calvo, Mercedes Vergara, Sergio Muñoz-Martínez, Jean-Charles Nault, Juan C. Bandi, Markus Peck-Radosavljevic, Brandon M. Meyers, Marco Sanduzzi-Zamparelli, Rogerio Alves, Saleh A. Alqahtani, Alberto E. Muñoz, Sonia Pascual, Alberto Lué, Josepmaria Argemi, Beatriz Minguez, Henning Wege, Giovan Giuseppe Di Costanzo, David J. Pinato, Victor Sapena, Maria Guarino, Stefano Okolicsanyi, Vivianne Mello, Martina Gambato, Susanna Coll, Carlos Benítez, Dhanny Gomez, Christoph Roderburg, Peter R. Galle, Bristi Basu, Federico Piñero, Cassia Leal, Frank Tacke, Christie Perelló, Tudor Mocan, Massimiliano Salati, Helen L. Reeves, Jörg Trojan, Vincenzo Cardinale, Mohamed El Kassas, Tom Lüdde, John Bridgewater, Mário Reis Álvares-da-Silva, Anja Lachenmayer, Giovanni Brandi, Alex Vianey Callado França, Mohamed Bouattour, Tim Meyer, Gerda Elisabeth Villadsen, M. Varela, Jordi Bruix, Dalia Morales-Arraez, Carlos Rodríguez-Lope, Christian Toso, Wacław Hołówko, Philippe Merle, Manuel Romero-Gómez, Ignacio García-Juárez, Fernanda Branco, Gonzalo Sapisochin, Chiara Braconi, Emmanouil Giorgakis, Hidenori Toyoda, Lorraine Blaise, Ana María Matilla Peña, Andrea Casadei-Gardini, Leonardo G Da Fonseca, Alexander Siebenhüner, Maria Reig, Gustavo Pereira, Massimo Iavarone, Maria Margarita Anders, Munoz-Martinez S., Sapena V., Forner A., Nault J.-C., Sapisochin G., Rimassa L., Sangro B., Bruix J., Sanduzzi-Zamparelli M., Holowko W., El Kassas M., Mocan T., Bouattour M., Merle P., Hoogwater F.J.H., Alqahtani S.A., Reeves H.L., Pinato D.J., Giorgakis E., Meyer T., Villadsen G.E., Wege H., Salati M., Minguez B., Di Costanzo G.G., Roderburg C., Tacke F., Varela M., Galle P.R., Alvares-da-Silva M.R., Trojan J., Bridgewater J., Cabibbo G., Toso C., Lachenmayer A., Casadei-Gardini A., Toyoda H., Ludde T., Villani R., Matilla Pena A.M., Guedes Leal C.R., Ronzoni M., Delgado M., Perello C., Pascual S., Lledo J.L., Argemi J., Basu B., da Fonseca L., Acevedo J., Siebenhuner A.R., Braconi C., Meyers B.M., Granito A., Sala M., Rodriguez-Lope C., Blaise L., Romero-Gomez M., Pinero F., Gomez D., Mello V., Pinheiro Alves R.C., Franca A., Branco F., Brandi G., Pereira G., Coll S., Guarino M., Benitez C., Anders M.M., Bandi J.C., Vergara M., Calvo M., Peck-Radosavljevic M., Garcia-Juarez I., Cardinale V., Lozano M., Gambato M., Okolicsanyi S., Morales-Arraez D., Elvevi A., Munoz A.E., Lue A., Iavarone M., Reig M., Basu, Bristi [0000-0002-3562-2868], Apollo - University of Cambridge Repository, Institut Català de la Salut, [Muñoz-Martínez S, Sapena V, Forner A] BCLC group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain. [Nault JC] Service d’hépatologie, Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bobigny, France. Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris Nord, Paris, France. Centre de Recherche des Cordeliers, Inserm, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors Laboratory, Paris, France. [Sapisochin G] Abdominal Transplant & HPB Surgical Oncology, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Canada. [Rimassa L] Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy. Department of Biomedical Sciences, Humanitas University, Milan, Italy. [Mínguez B] Unitat del Fetge, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Recerca en Malalties hepàtiques, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Hepatocellular carcinoma, LC, medicine.medical_treatment, diagnóstico::toma de decisiones clínicas [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Nurses, RC799-869, Liver transplantation, Cholangiocarcinoma, Clinical trials, ENS-CCA, Interquartile range, Decisió, Presa de, Pandemic, Other subheadings::/diagnosis [Other subheadings], virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], CERO-19, Pandèmia de COVID-19, 2020, Immunology and Allergy, iCCA, intrahepatic cholangiocarcinoma, COVID-19, coronavirus disease 2019, Liver Cancer Outcome in the COVID-19-pandemic Project, Settore MED/12 - Gastroenterologia, ddc:617, IQR, Gastroenterology, BCLC, Barcelona Clinic Liver Cancer, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias hepáticas [ENFERMEDADES], Diseases of the digestive system. Gastroenterology, Management, Clinical Practice, Clinical trial, European Network for the Study of Cholangiocarcinoma, Diagnosis::Clinical Decision-Making [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Fetge - Malalties - Diagnòstic, Liver cancer, PROGRESSION-FREE SURVIVAL, Liver Cancer, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Otros calificadores::/diagnóstico [Otros calificadores], 610 Medicine & health, Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Liver Neoplasms [DISEASES], LT, liver transplantation, Article, Barcelona Clinic Liver Cancer, Internal Medicine, medicine, ENS-CCA, European Network for the Study of Cholangiocarcinoma, Hepatology, business.industry, CERO-19, Liver Cancer Outcome in the COVID-19-pandemic Project, COVID-19, IQR, Interquartile range, medicine.disease, BCLC, Emergency medicine, Observational study, 610 Medizin und Gesundheit, business, HCC, hepatocellular carcinoma, LC, liver cancer, SARS-CoV-2, severe acute respiratory syndrome coronavirus-2
Abstract

[Background & Aims] The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic., [Methods] An international survey evaluated the impact of the COVID-19 pandemic on clinical practice and clinical trials from March 2020 to June 2020, as the first phase of a multicentre, international, and observational project. The focus was on patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma, cared for around the world during the first COVID-19 pandemic wave., [Results] Ninety-one centres expressed interest to participate and 76 were included in the analysis, from Europe, South America, North America, Asia, and Africa (73.7%, 17.1%, 5.3%, 2.6%, and 1.3% per continent, respectively). Eighty-seven percent of the centres modified their clinical practice: 40.8% the diagnostic procedures, 80.9% the screening programme, 50% cancelled curative and/or palliative treatments for LC, and 41.7% modified the liver transplantation programme. Forty-five out of 69 (65.2%) centres in which clinical trials were running modified their treatments in that setting, but 58.1% were able to recruit new patients. The phone call service was modified in 51.4% of centres which had this service before the COVID-19 pandemic (n = 19/37)., [Conclusions] The first wave of the COVID-19 pandemic had a tremendous impact on the routine care of patients with liver cancer. Modifications in screening, diagnostic, and treatment algorithms may have significantly impaired the outcome of patients. Ongoing data collection and future analyses will report the benefits and disadvantages of the strategies implemented, aiding future decision-making., [Lay summary] The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems globally. Herein, we assessed the impact of the first wave pandemic on patients with liver cancer and found that routine care for these patients has been majorly disrupted, which could have a significant impact on outcomes.

Published
2021

7. Karyological and bioinformatic data on the common chameleon Chamaeleo chamaeleon

Author

Khaled Said, Agnese Petraccioli, Marcello Mezzasalma, Orfeo Picariello, Gaetano Odierna, Fabio Maria Guarino, Noureddine Chatti, Marwa Sidhom, Sidhom, M., Said, K., Chatti, N., Guarino, F. M., Odierna, G., Petraccioli, A., Picariello, O., and Mezzasalma, M.

Subjects
Chameleons, Karyotype, lcsh:Computer applications to medicine. Medical informatics, C-banding, Homologous Sequences, DNA sequencing, 03 medical and health sciences, 0302 clinical medicine, Data sequences, Agricultural and Biological Science, biology.animal, Chameleon, lcsh:Science (General), Chamaeleo chamaeleon, Nucleic Acid Databases, Chamaeleonidae, 030304 developmental biology, 0303 health sciences, Multidisciplinary, biology, Reptiles, DNA, biology.organism_classification, Short read, Evolutionary biology, lcsh:R858-859.7, 030217 neurology & neurosurgery, lcsh:Q1-390
Abstract

The data presented in this paper stand as supplementary information of the associated article “Karyological characterization of the common chameleon (Chamaeleo chamaeleon) provides insights on the evolution and diversification of sex chromosomes in Chamaeleonidae” [1] . This work provides (i) raw experimental data on the karyology of the common chameleon Chamaeleo chamaeleon and (ii) the results of bioinformatic analysis on sex-specific and repeated DNA sequences found in the same species. The karyological information here presented includes traditional staining method (Giemsa staining) and sequential C-banding + fluorochromes performed on Tunisian samples of the species. The sequence data include the alignments of the isolated DNA sequences with homologous sequences found in squamate Short Read Archives (SRAs) and the results of searches in public nucleic acid databases.

Published
2020

8. Cognitive and affective disorders in critical SARS-CoV-2 patients and caregivers

Author

Rossella Santoro, Tommaso Tonetti, Maria Guarino, Lucia Cretella, M. Della Giovampaola, L Mascia, P. Bottausci, Luisa Sambati, Katia Mattarozzi, Pietro Cortelli, and L. Romano

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Neuropsychology, Cognition, Intensive care unit, Article, law.invention, Neurology, Quality of life, law, medicine, Verbal fluency test, Anxiety, Neurology (clinical), medicine.symptom, business, Depression (differential diagnoses)
Abstract

Background and aims: We investigated cognitive and affective disorders in patients with SARS-CoV-2 hospitalized in Intensive Care Unit (ICU). Care givers quality of life, psychological distress and satisfaction with the information received by health-care professionals were assessed. Methods: From March 1 to April 30, 2020, 22 consecutive patients with SARS-CoV-2 infection, confirmed by PCR on oronasopharyngeal swab, requiring ICU admission were recruited together with a caregiver. Patients with previous cognitive disorders were excluded. Three months after ICU discharge, patients underwent a comprehensive neuropsychological evaluation and filled out validated questionnaires. Results: Seven of 22 resulted mildly cognitively impaired. Memory was the most impaired domain, followed by attention and verbal fluency. Three out of 22 patients reported an average high level of anxiety but no depression. Quality of life was mild impaired for 19 patients. Lower performances at MoCA were related to higher APACHE score at T0 (r = −.44;p −.48;ps −.53;ps −.53;ps

Published
2021

9. Waiting time prioritisation for specialist services in Italy: The homogeneous waiting time groups approach

Author

Pierpaolo Bertoli, Giuliano Mariotti, Pierpaolo Faronato, Mariangela Galante, Carlo Liva, Maria Gentilini, Salvatore Brugaletta, Luigi Siciliani, Pierluigi Camboa, Alessio Gioffredi, Giorgio Benea, Enrico Pofi, Vincenzo Rebba, Lorenzo Bistolfi, Rita Fellini, Paola Casucci, Dino Dessi, and Teresa Maria Guarino

Subjects
Waiting time, Time Factors, Primary care, Health Services Accessibility, medicine, Ambulatory Care, Humans, Outpatient services, Waiting lists, Prioritisation, Diffusion of innovation, Operations management, Specialist care, Inpatient care, business.industry, Health Priorities, Health Policy, Referral process, Diagnostic test, medicine.disease, Italy, Homogeneous, Medical emergency, business, Specialization
Abstract

The demand for referrals and diagnostic procedures in Italy has been rising constantly in recent years, making access to diagnostic services increasingly difficult with significant waiting times. A number of Health Authorities (known as Local Health Units) have responded by implementing formalised waiting-time prioritisation tools, giving rise to what are known as Homogeneous Waiting Groups (HWGs). The study describes the implementation of the HWG approach in Italy. This represents a promising tool for improving the prioritisation of patients waiting to see a specialist or to receive a diagnostic test. The study of the Italian HWG experience provides useful insights to improve the outpatient referral process for those countries where the demand prioritisation policies have focused more on inpatient care than outpatient specialist care and diagnostic services.

Published
2014

10. Neurologic complications of intestinal transplantation

Author

Andrea Stracciari and Maria Guarino

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Incidence (epidemiology), Immunosuppression, Intestine transplant, Transplantation, Parenteral nutrition, Neurologic problems, medicine, Etiology, In patient, Intensive care medicine, business
Abstract

Intestinal transplantation has become a life-saving therapy in patients with irreversible loss of intestinal function and complications of total parenteral nutrition, but it entails a high incidence of neurologic complications, which occur more frequently than in other solid organ transplantations. Neurologic complications may be surgery-related or occur postoperatively, often within the first month. The etiology is various, often multifactorial, immunosuppression being one of the leading causes as intestine transplant recipients usually need potent immunosuppressive regimens. Neurologic problems after intestinal transplantation may present with a wide clinical spectrum, mainly mild to severe central nervous system disorders. Awareness of these complications is crucial for patients’ survival, since it will assist clinicians in prevention, prompt diagnosis, and treatment. This survey tackles the most common neurologic disorders and presents practice points of management which can help in the daily clinical care of intestinal transplant recipients.

Published
2014

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