Search

Your search keyword '"stronati, M"' showing total 118 results
Start Over Author "stronati, M" Search Limiters Full Text
118 results on '"stronati, M"'

1. Segmental Thoracic Spinal Anesthesia for Laparoscopic Cholecystectomy with the “Hypobaric” Technique: A Case Series

Author

Vincenzi P, Stronati M, Garelli P, Gaudenzi D, Boccoli G, and Starnari R

Subjects
thoracic spinal anesthesia, laparoscopic cholecystectomy, hypobaric ropivacaine, intratechal midazolam, intratechal ketamine, Anesthesiology, RD78.3-87.3
Abstract

Paolo Vincenzi,1 Massimo Stronati,2 Paolo Garelli,3 Diletta Gaudenzi,4 Gianfranco Boccoli,3 Roberto Starnari2 1Department of General Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy; 2Department of Anesthesiology, IRCSS-INRCA, Ancona, Italy; 3Department of General Surgery, IRCSS-INRCA, Ancona, Italy; 4Department of Perioperative Services, AOU “Ospedali Riuniti di Ancona”, Ancona, ItalyCorrespondence: Paolo Vincenzi, Department of General Surgery, Ospedali Riuniti Marche Nord, Piazzale Cinelli n 1, Pesaro, 61121, Italy, Tel +39 3394578495, Email paolo.vincenzi1981@gmail.comPurpose: Several studies have applied lumbar spinal anesthesia (SA) with isobaric/hyperbaric bupivacaine and opioids in elective laparoscopic cholecystectomy (LC), documenting a superiority of the methodic over general anesthesia (GA) in terms of perioperative pain, nausea, and vomiting, though with a notable incidence of intraoperative right shoulder pain, potentially responsible for conversion to GA. This case series presents an opioid-free scheme of segmental thoracic spinal anesthesia (STSA) with hypobaric ropivacaine, reporting its benefits mainly in terms of shoulder pain occurrence.Patients and Methods: Hypobaric STSA was performed in nine patients undergoing elective LC between May 1 and September 1, 2022. The level of the needle insertion was included between T8 and T9, via a median or a paramedian approach. Midazolam (0.03 mg/kg) and Ketamine (0.3 mg/kg) were used as adjuvants for intrathecal sedation, followed by the administration of hypobaric ropivacaine 0.25% at a dose of 5 mg and then isobaric ropivacaine at a dose of 10 mg. Patients were placed in anti-Trendelenburg position for the entire duration of surgery. LC was conducted through the standard 3 or 4 ports technique with pneumoperitoneum maintained at a pressure of 8– 10 mmHg.Results: Mean patient age was 75.7 (± 17.5) years, with a mean ASA score and Charlson comorbidity index (CCI) of 2.7 (± 0.7) and 4.9 (± 2.7), respectively. STSA was completed without complications in all patients, with no need for conversion to GA. Mean operative time and SA duration were 37.5 (± 8.7) and 145.2 (± 21.8) min, respectively. Intraoperatively, no shoulder or abdominal pain and nausea were reported, with only four and two patients requiring vasopressor and sedative intravenous drugs, respectively. Postoperatively, overall mean VAS pain score and within the first 12 hafter surgery were 3 (± 2) and 4 (± 2), respectively. Median length of stay was 2 (range = 1– 3) days.Conclusion: Hypobaric opioid-free STSA appears to be a promising approach for laparoscopic surgeries, with minimal to null occurrence of shoulder pain. Larger prospective studies are required to validate these findings.Keywords: thoracic spinal anesthesia, laparoscopic cholecystectomy, hypobaric ropivacaine, intrathecal midazolam, intrathecal ketamine

Published
2023

2. Opioid-Free Segmental Thoracic Spinal Anesthesia with Intrathecal Sedation for Breast and Axillary Surgery: Report of Four Cases

Author

Vincenzi P, Stronati M, Isidori P, Iuorio S, Gaudenzi D, Boccoli G, and Starnari R

Subjects
spinal anesthesia, breast cancer surgery, axillary surgery, intrathecal midazolam, intrathecal ketamine, Anesthesiology, RD78.3-87.3
Abstract

Paolo Vincenzi,1 Massimo Stronati,2 Paolo Isidori,1 Salvatore Iuorio,2 Diletta Gaudenzi,3 Gianfranco Boccoli,1 Roberto Starnari2 1Department of General Surgery, IRCSS-INRCA, Ancona, Italy; 2Department of Anaesthesiology, IRCSS-INRCA, Ancona, Italy; 3Department of Perioperative Services, AOU “Ospedali Riuniti di Ancona”, Ancona, ItalyCorrespondence: Paolo Vincenzi, Department of General Surgery, IRCSS-INRCA, Via della Montagnola n 81, Ancona, 60127, Italy, Tel + 39 3394578495, Email paolo.vincenzi1981@gmail.comPurpose: Few studies have described segmental thoracic spinal anesthesia (STSA) as primary anesthesiologic method in breast and axillary surgery, documenting the association of intrathecal local anesthetics and opioids. This case series reports an opioid-free scheme of STSA in four elderly patients undergoing major breast and axillary oncological surgery.Patients and Methods: STSA was performed in three female patients undergoing unilateral mastectomy ± axillary lymph node dissection (ALND) or sentinel lymph node biopsy for invasive ductal carcinoma and in one male patient undergoing ALND for melanoma metastases. The level of needle insertion was included between T6-8, via a median or paramedian approach. Midazolam (2 mg) and ketamine (20 mg) were used as adjuvants for intrathecal sedation, followed by the administration of hypobaric ropivacaine 0.25% at a dose of 8 mg. The level of sensory blockade achieved was comprised between C2-3 and T11-12. Postoperative analgesia was maintained through continuous intravenous administration of Ketorolac by an elastomeric pump (90 mg over 24 hrs.).Results: Spinal anesthesia was completed without complications in all patients. Conversion to general anesthesia (GA) and perioperative intravenous sedation were not required. No major postoperative complications and no episodes of postoperative nausea and vomiting (PONV) were reported. No rescue analgesic was administered. All patients were discharged in postoperative day 2 and are alive at 30, 29, 27 and 13 months after surgery, respectively. High grade of satisfaction on the anesthesiologic method was expressed by all cases.Conclusion: STSA with local anesthetic plus midazolam and ketamine might be considered a safe and effective alternative to GA, even in surgeries involving the breast and axillary region, particularly in elderly and frail patients. Larger prospective studies are required to validate these findings.Keywords: spinal anesthesia, breast cancer surgery, axillary surgery, intrathecal midazolam, intrathecal ketamine

Published
2022

5. Strategies for preventing group B streptococcal infections in newborns: A nation-wide survey of Italian policies

Author

Tzialla, C, berardi, A, farina, C, clerici, P, borghesi, A, viora, E, scollo, P, stronati, M, Task Force for group B streptococcal infections for the Italian Society of Neonatology including Stival, G, barbaglia, Ma, guala, A, giunta, E, parola, L, grossignani, Mr, perri, P, tubaldi, L, alletto, G, daidone, S, flacco, V, dani, C, sterpa, A, rapisardi, G, elicio, Mr, faldella, G, capretti, Mg, messner, H, bandiera, M, achille, C, azzali, A, montrasio, G, mariani, S, galvagno, G, giacosa, E, de Angelis, F, spandrio, M, serra, A, garofalo, F, perona, A, porcelli, F, ferrero, F, De Franco, S, paollilo, P, picone, S, besana, R, varisco, T, farina, M, memo, L, nicolini, G, lietti, D, Di Chiara, G, rottoli, A, Bonabitacola, T, Cortis, E, Neri, E, Martinelli, S, Ilardi, L, Rondanini, Gf, Calzi, P, Gatta, A, Quntadamo, Pa, Ivaldi, M, Terenzani, L, Di Lascio, N, Travaglio, Md, Vetrano, G, Furcolo, G, Vitacco, V, Intini, C, Frigerio, M, Stroppiana, P, Policicchio, G, Mesirca, P, Gianino, P, Audenio, E, Paludetto, R, Raimondi, F, Pugliese, A, Valentino, L, Nosari, N, Marchesano, G, Chirico, G, Bellù, R, Menchini, M, Poletti, A, E T, Vacchiano, Pinto, L, E D, Perri, Coppola, R, Perini, R, Vetrella, A, De Luca, G, Lista, G, Cavigioli, F, Bettinelli, A, Massironi, E, Franco, C, Bernardo, L, Poli, S, Palladini, M, Tota, V, Spadavecchia, F, Zuccotti, Gv, Pogliani, L, Bracaglia, G, Mancini, Al, Zocco, F, Iozzia, G, Auriemma, A, Teani, M, Mangilli, G, Tempra, Am, Di Terlizi, L, Bottino, R, Salvi, C, Fortunato, V, Musaico, R, Gargantini, G, Carrera, G, Magaldi, R, Taurino, L, D'Onofrio, Am, Buffone, E, Tempera, A, Agosti, M, Garzia, P, Mosca, F, Pugni, L, Tagliabue, P, Colombo, C, Demi, M, Picco, G, Carlucci, A, Zorzi, G, Padula, D, Cardone, Ml, Buonocore, G, Muraca, Mc, Boldrini, A, Ciantelli, M, Lanari, M, Serra, L, Felici, L, Banderalli, G, Brambilla, C, Dall'Agnola, A, Viviani, E, Zonca, Mc, Licardi, G, Chiara, A, Ancora, G, Papa, I, Gancia, P, Pomero, G, Deloglu, A, Villani, P, Mussini, P, Canidio, E, Migliavacca, D, Di Fabio, S, Cipollone, I, Biasucci, G, Rubbi, P, Piepoli, M, Guastaferro, N, Infriccioli, F, Bertino, E, Perathoner, C, Parmigiani, S, Suriano, G, Ianniello, C, Biasini, A, Azzalli, M, Timpani, G, Barresi, S, Caoci, G, Ciccotti, R, De Curtis, M, Natale, F, Finocchi, M, Haass, C, Milillo, F, Lucieri, S, Guercio, E, Canepa, Sa, Scozia, G, Antonucci, R, Limongelli, O, Macciò, S, Mongelli, F, Colonna, F, Dragovic, D, Calipa, Mt, Cohen, A, Moresco, L, Italian Society of Obstetricians and Gynecologists including La Spina, R, Ruggeri, R, Luehwink, A, Brattoli, M, Fedi, A, Lacchi, L, Ettore, G, Pappalardo, E, Conoscenti, G, Zeni, B, Spellecchia, D, Favretti, L, Spagna, L, Zaglio, S, Bresciani, D, Bandini, A, Mancini, R, Mustoni, P, Dodero, D, Grimaldi, M, Di Mario, M, Migliorini, P, Kemeny, A, Anastasio, Ps, Riccardi, T, Maggino, T, Cerri, G, Puggina, P, Marconi, Am, Morgia, S, Bellia, G, D'Anna, Mr, Catania, M, Bacchi Modena, A, Franchi, L, Calonaci, N, Schettini, S, Paradiso, R, Saccucci, P, Ioppi, M, Zorzi, M, Stellin, G, Patacchiola, F, Carrata, L, Bassini, D, San Marco, L, Todros, T, Tibadi, C, Liborio, M, Italian Association of Clinical Microbiologists including Laricchia, R, Tauro, L, Ferrara, F, Nuara, C, Ghiraldi, E, Molinari, F, Comessatti, A, Rocchetti, A, Di Matteo, L, Miconi, V, Calvi, P, Pernigotti, A, Fabozzi, F, Micca, G, Monticone, G, Sarti, M, Da Rin, G, Zoppelletto, M, Modolo, E, Landini, Mp, Furlini, G, Galluppi, E, Pagani, E, Aschbacher, R, Innocenti, P, Bresolin, N, Raggi, Me, Bonfanti, C, De Francesco, M, Santer, P, Griessmaier, A, De Francesco, D, Pirali, A, Prasciolu, C, Usai, F, Cuzzone, G, Scutellà, M, Tramacere, P, Fossati, D, Piaserico, G, Bordignon, G, Sciacca, A, Di Vincenzo, F, Imbriani, A, Melotti, D, Catanoso, G, Rivetti, I, Neri, G, Bruno, R, Bacelle, L, Sartore, P, Giana, G, Sala, E, Giraldi, C, Cavalcanti, P, Perugini, M, Perugini, A, Ginardi, C, Maritano, D, Ferrini, A, Bonettini, A, Avanzini, A, Gasperoni, S, Pieretti, B, Montanari, E, Carillo, C, Rossi, Mr, Laureti, A, Baldoni, Ml, Serra, D, Melioli, G, Bandettini, R, Oneto, F, Colla, R, Storchi Incerti, S, Lanzini, F, Pauri, P, Tili, E, Leone, Ra, Verdastro, G, Megha, M, Luzzaro, F, Conti, A, Busulini, L, Mirri, P, Diodati, R, Vettori, C, Pittalis, S, Anesi, A, Fiore, A, Goglia, L, Vitullo, E, Sinno, A, Platzgummer, S, Spitaler, C, Trabucchi, Mc, Besozzi, M, Cesana, E, Inghilleri, G, Grosso, S, D'Angelo, R, Fogato, E, Lavarda, F, Ortisi, G, Clementi, M, Cichero, P, Rumpianesi, F, Venturelli, C, Mortillaro, F, Daffara, S, Catania, Mr, Iula, D, Andreoni, S, Politi, A, Agostinelli, C, Paparella, C, Capozzi, D, Notaris, P, Bistoni, F, Mencacci, A, Valentini, M, Filippetti, A, Confalonieri, M, Novarese, O, Bonini, F, Salamone, D, Camporese, A, De Rosa, R, Casprini, P, Degl'Innocenti, R, Giordano, R, Allù, Mt, Zanella, D, Malandrino, M, Tronci, M, Valmarin, M, Leonetti, G, Falco, S, Meledandri, M, Ballardini, M, Spanò, A, Cava, Mc, Mascellino, Mt, Schinella, M, Gualdi, P, Casari, E, Scattolo, N, Motta, C, Perfetti, C, Bassano, M, Cera, G, Iafisco, P, Mura, I, Palmieri, A, Migliardi, M, Ferlini, M, Grandi, G, Giardini, F, Albano, F, Latino, M, Ferrero, Mp, Bellizia, L, Russolo, M, Russolo, S, Pesenti, A, Fasano, Ma, Previato, S, Radillo, O, Busetti, M, Ferrari, P, Siderini, V, Puzzolante, L, Scarparo, C, Arzese, A, Cappuccia, N, Lodolo, L, Delledonne, L, Gramoni, A, Maiolo, V, Gheller, A, Spadaro, S, Balzaretti, M, Tzialla, C., Berardi, A., Farina, C., Clerici, P., Borghesi, A., Viora, E., Scollo, P., Stronati, M., Stival, G., Barbaglia, M. A., Guala, A., Giunta, E., Parola, L., Grossignani, M. R., Perri, P., Tubaldi, L., Alletto, G., Daidone, S., Flacco, V., Dani, C., Sterpa, A., Rapisardi, G., Elicio, M. R., Faldella, G., Capretti, M. G., Messner, H., Bandiera, M., Achille, C., Azzali, A., Montrasio, G., Mariani, S., Galvagno, G., Giacosa, E., de Angelis, F., Spandrio, M., Serra, A., Garofalo, F., Perona, A., Porcelli, F., Ferrero, F., De Franco, S., Paollilo, P., Picone, S., Besana, R., Varisco, T., Farina, M., Memo, L., Nicolini, G., Lietti, D., Di Chiara, G., Rottoli, A., Bonabitacola, T., Cortis, E., Neri, E., Martinelli, S., Ilardi, L., Rondanini, G. F., Calzi, P., Gatta, A., Quntadamo, P. A., Ivaldi, M., Terenzani, L., Di Lascio, N., Travaglio, M. D., Vetrano, G., Furcolo, G., Vitacco, V., Intini, C., Frigerio, M., Stroppiana, P., Policicchio, G., Mesirca, P., Gianino, P., Audenio, E., Paludetto, R., Raimondi, F., Pugliese, A., Valentino, L., Nosari, N., Marchesano, G., Chirico, G., Bell(`u), R., Menchini, M., Poletti, A., Vacchiano, T., Pinto, L., Perri, D., Coppola, R., Perini, R., Vetrella, A., De Luca, G., Lista, G., Cavigioli, F., Bettinelli, A., Massironi, E., Franco, C., Bernardo, L., Poli, S., Palladini, M., Tota, V., Spadavecchia, F., Zuccotti, G. V., Pogliani, L., Bracaglia, G., Mancini, A. L., Zocco, F., Iozzia, G., Auriemma, A., Teani, M., Mangilli, G., Tempra, A. M., Di Terlizi, L., Bottino, R., Salvi, C., Fortunato, V., Musaico, R., Gargantini, G., Carrera, G., Magaldi, R., Taurino, L., D?onofrio, A. M., Buffone, E., Tempera, A., Agosti, M., Garzia, P., Mosca, F., Pugni, L., Tagliabue, P., Colombo, C., Demi, M., Picco, G., Carlucci, A., Zorzi, G., Padula, D., Cardone, M. L., Buonocore, G., Muraca, M. C., Boldrini, A., Ciantelli, M., Lanari, M., Serra, L., Felici, L., Banderalli, G., Brambilla, C., Dall?agnola, A., Viviani, E., Zonca, M. C., Licardi, G., Chiara, A., Ancora, G., Papa, I., Gancia, P., Pomero, G., Deloglu, A., Villani, P., Mussini, P., Canidio, E., Migliavacca, D., Di Fabio, S., Cipollone, I., Biasucci, G., Rubbi, P., Piepoli, M., Guastaferro, N., Infriccioli, F., Bertino, E., Perathoner, C., Parmigiani, S., Suriano, G., Ianniello, C., Biasini, A., Azzalli, M., Timpani, G., Barresi, S., Caoci, G., Ciccotti, R., De Curtis, M., Natale, F., Finocchi, M., Haass, C., Milillo, F., Lucieri, S., Guercio, E., Canepa, S. A., Scozia, G., Antonucci, R., Limongelli, O., Macci(`o), S., Mongelli, F., Colonna, F., Dragovic, D., Calipa, M. T., Cohen, A., Moresco, L., La Spina, R., Ruggeri, R., Luehwink, A., Brattoli, M., Fedi, A., Lacchi, L., Ettore, G., Pappalardo, E., Conoscenti, G., Zeni, B., Spellecchia, D., Favretti, L., Spagna, L., Zaglio, S., Bresciani, D., Bandini, A., Mancini, R., Mustoni, P., Dodero, D., Grimaldi, M., Di Mario, M., Migliorini, P., Kemeny, A., Anastasio, P. S., Riccardi, T., Maggino, T., Cerri, G., Puggina, P., Marconi, A. M., Morgia, S., Bellia, G., D?anna, M. R., Catania, M., Bacchi Modena, A., Franchi, L., Calonaci, N., Schettini, S., Paradiso, R., Saccucci, P., Ioppi, M., Zorzi, M., Stellin, G., Patacchiola, F., Carrata, L., Bassini, D., San Marco, L., Todros, T., Tibadi, C., Liborio, M., Laricchia, R., Tauro, L., Ferrara, F., Nuara, C., Ghiraldi, E., Molinari, F., Comessatti, A., Rocchetti, A., Di Matteo, L., Miconi, V., Calvi, P., Pernigotti, A., Fabozzi, F., Micca, G., Monticone, G., Sarti, M., Da Rin, G., Zoppelletto, M., Modolo, E., Landini, M. P., Furlini, G., Galluppi, E., Pagani, E., Aschbacher, R., Innocenti, P., Bresolin, N., Raggi, M. E., Bonfanti, C., De Francesco, M., Santer, P., Griessmaier, A., De Francesco, D., Pirali, A., Prasciolu, C., Usai, F., Cuzzone, G., Scutell(`a), M., Tramacere, P., Fossati, D., Piaserico, G., Bordignon, G., Sciacca, A., Di Vincenzo, F., Imbriani, A., Melotti, D., Catanoso, G., Rivetti, I., Neri, G., Bruno, R., Bacelle, L., Sartore, P., Giana, G., Sala, E., Giraldi, C., Cavalcanti, P., Perugini, M., Perugini, A., Ginardi, C., Maritano, D., Ferrini, A., Bonettini, A., Avanzini, A., Gasperoni, S., Pieretti, B., Montanari, E., Carillo, C., Rossi, M. R., Laureti, A., Baldoni, M. L., Serra, D., Melioli, G., Bandettini, R., Oneto, F., Colla, R., Storchi Incerti, S., Lanzini, F., Pauri, P., Tili, E., Leone, R. A., Verdastro, G., Megha, M., Luzzaro, F., Conti, A., Busulini, L., Mirri, P., Diodati, R., Vettori, C., Pittalis, S., Anesi, A., Fiore, A., Goglia, L., Vitullo, E., Sinno, A., Platzgummer, S., Spitaler, C., Trabucchi, M. C., Besozzi, M., Cesana, E., Inghilleri, G., Grosso, S., D?angelo, R., Fogato, E., Lavarda, F., Ortisi, G., Clementi, M., Cichero, P., Rumpianesi, F., Venturelli, C., Mortillaro, F., Daffara, S., Catania, M. R., Iula, D., Andreoni, S., Politi, A., Agostinelli, C., Paparella, C., Capozzi, D., Notaris, P., Bistoni, F., Mencacci, A., Valentini, M., Filippetti, A., Confalonieri, M., Novarese, O., Bonini, F., Salamone, D., Camporese, A., De Rosa, R., Casprini, P., Degl?innocenti, R., Giordano, R., All(`u), M. T., Zanella, D., Malandrino, M., Tronci, M., Valmarin, M., Leonetti, G., Falco, S., Meledandri, M., Ballardini, M., Span(`o), A., Cava, M. C., Mascellino, M. T., Schinella, M., Gualdi, P., Casari, E., Scattolo, N., Motta, C., Perfetti, C., Bassano, M., Cera, G., Iafisco, P., Mura, I., Palmieri, A., Migliardi, M., Ferlini, M., Grandi, G., Giardini, F., Albano, F., Latino, M., Ferrero, M. P., Bellizia, L., Russolo, M., Russolo, S., Pesenti, A., Fasano, M. A., Previato, S., Radillo, O., Busetti, M., Ferrari, P., Siderini, V., Puzzolante, L., Scarparo, C., Arzese, A., Cappuccia, N., Lodolo, L., Delledonne, L., Gramoni, A., Maiolo, V., Gheller, A., Spadaro, S., Balzaretti, M., Tzialla, Chryssoula, Berardi, Alberto, Farina, Claudio, Clerici, Pierangelo, Borghesi, Alessandro, Viora, Elsa, Scollo, Paolo, Stronati, Mauro, [.., Lanari, Marcello, Faldella, Giacomo, and ]

Subjects
Male, Pediatrics, Group B, 0302 clinical medicine, Neonate, Pregnancy, Surveys and Questionnaires, Prevalence, Mass Screening, Blood culture, 030212 general & internal medicine, Antibiotic prophylaxis, Survey, GBS, Group B streptococcus, Infection, Newborn infant, Adult, Antibiotic Prophylaxis, Female, Health Surveys, Humans, Infant, Newborn, Italy, Neonatal Screening, Pregnancy Complications, Infectious, Prenatal Care, Primary Prevention, Risk Assessment, Streptococcal Infections, Streptococcus agalactiae, reproductive and urinary physiology, Group B streptococcu, medicine.diagnostic_test, lcsh:RJ1-570, Infectious, Perinatology and Child Health, Pediatrics, Perinatology and Child Health, medicine.medical_specialty, Antibiotic sensitivity, Group B Streptococcal Infection, Prenatal care, 03 medical and health sciences, 030225 pediatrics, medicine, Intensive care medicine, Mass screening, business.industry, Public health, Infant, lcsh:Pediatrics, Newborn, Pregnancy Complications, business
Abstract

Background There are no Italian data regarding the strategies for preventing neonatal group B streptococcal (GBS) infection. We conducted a national survey in order to explore obstetrical, neonatal and microbiological practices for the GBS prevention. Methods Three distinct questionnaires were sent to obstetricians, neonatologists and microbiologists. Questionnaires included data on prenatal GBS screening, maternal risk factors, intrapartum antibiotic prophylaxis, microbiological information concerning specimen processing and GBS antimicrobial susceptibility. Results All respondent obstetrical units used the culture-based screening approach to identify women who should receive intrapartum antibiotic prophylaxis, and more than half of the microbiological laboratories (58%) reported using specimen processing consistent with CDC guidelines. Most neonatal units (89 out of 107, 82%) reported using protocols for preventing GBS early-onset sepsis consistent with CDC guidelines. Conclusions The screening-based strategy is largely prevalent in Italy, and most protocols for preventing GBS early-onset sepsis are consistent with CDC guidelines. However, we found discrepancies in practices among centers that may reflect the lack of Italian guidelines issued by public health organizations.

Published
2017

6. Intersociety policy statement on the use of whole-exome sequencing in the critically ill newborn infant

Author

Borghesi, A, Mencarelli, Ma, Memo, L, Ferrero, Gb, Bartuli, A, Genuardi, M, Stronati, M, Villani, A, Renieri, A, Corsello, G, Their Respective Scientific Societies, Agostiniani, R, Staiano, A, Del Vecchio, A, Banderali, G, Peroni, D, Piazzolla, R, Turra, R, Bozzola, E, Vecchio, D, Rosati, Gv, Macrì, F, Romagnoli, C, De Curtis, M, Orfeo, L, Mangili, G, Mosca, F, Fanos, V, Paolillo, P, Raimondi, F, Rizzo, A, Chirico, G, Corvaglia, Lt, Cacace, Concetta, Poggiani, C, Zuppa, Aa, Pisano, D, Melis, D, Giuffrè, M, Carbone, Mt, Macchiaiolo, M, Tarani, L, Selicorni, A, Andria, G, Coviello, D, Gentile, M, Ghiorzo, P, Novelli, A, Ragusa, A, Scarano, G, Giardino, D., Borghesi A, Mencarelli MA, Memo L, Ferrero GB, Bartuli A, Genuardi M, Stronati M, Villani A, Renieri A, Corsello G, Borghesi, Alessandro, Mencarelli, Maria Antonietta, Memo, Luigi, Ferrero, Giovanni Battista, Bartuli, Andrea, Genuardi, Maurizio, Stronati, Mauro, Villani, Alberto, Renieri, Alessandra, Corsello, Giovanni, and Agostiniani R, Staiano A, Del Vecchio A, Banderali G, Peroni D, Piazzolla R, Turra R, Bozzola E, Vecchio D, Rosati GV, Macrì F, Romagnoli C, De Curtis M, Orfeo L, Mangili G, Mosca F, Fanos V, Paolillo P, Raimondi F, Rizzo A, Chirico G, Corvaglia LT, Cacace C, Poggiani C, Zuppa AA, Pisano D, Melis D, Giuffrè M, Carbone MT, Macchiaiolo M, Tarani L, Selicorni A, Andria G, Coviello D, Gentile M, Ghiorzo P, Novelli A, Ragusa A, Scarano G, Giardino D.

Subjects
0301 basic medicine, Male, Neonatal intensive care unit, Disease, Review, 030105 genetics & heredity, Pediatrics, Whole Exome Sequencing, Neonate, Neonatal, Outcome Assessment, Health Care, Diagnosis, Policy Making, Exome sequencing, Sanger sequencing, Genome, lcsh:RJ1-570, Perinatology and Child Health, Settore MED/38, Intensive Care Units, Italy, Whole-exome sequencing, Practice Guidelines as Topic, symbols, WES, Female, Human, Diagnosi, NICU, medicine.medical_specialty, Mendelian, 03 medical and health sciences, symbols.namesake, Outcome Assessment (Health Care), Neonatal Screening, Genetic, Intensive Care Units, Neonatal, Exome Sequencing, medicine, WGS, Pediatrics, Perinatology and Child Health, Humans, Genetic Testing, Intensive care medicine, Settore MED/06 - ONCOLOGIA MEDICA, Genetic heterogeneity, Critically ill, business.industry, Genome, Human, Infant, Newborn, Infant, lcsh:Pediatrics, Newborn, Infant newborn, 030104 developmental biology, Differential diagnosis, business
Abstract

The rapid advancement of next-generation sequencing (NGS) technology and the decrease in costs for whole-exome sequencing (WES) and whole-genome sequening (WGS), has prompted its clinical application in several fields of medicine. Currently, there are no specific guidelines for the use of NGS in the field of neonatal medicine and in the diagnosis of genetic diseases in critically ill newborn infants. As a consequence, NGS may be underused with reduced diagnostic success rate, or overused, with increased costs for the healthcare system. Most genetic diseases may be already expressed during the neonatal age, but their identification may be complicated by nonspecific presentation, especially in the setting of critical clinical conditions. The differential diagnosis process in the neonatal intensive care unit (NICU) may be time-consuming, uncomfortable for the patient due to repeated sampling, and ineffective in reaching a molecular diagnosis during NICU stay. Serial gene sequencing (Sanger sequencing) may be successful only for conditions for which the clinical phenotype strongly suggests a diagnostic hypothesis and for genetically homogeneous diseases. Newborn screenings with Guthrie cards, which vary from country to country, are designed to only test for a few dozen genetic diseases out of the more than 6000 diseases for which a genetic characterization is available. The use of WES in selected cases in the NICU may overcome these issues. We present an intersociety document that aims to define the best indications for the use of WES in different clinical scenarios in the NICU. We propose that WES is used in the NICU for critically ill newborn infants when an early diagnosis is desirable to guide the clinical management during NICU stay, when a strong hypothesis cannot be formulated based on the clinical phenotype or the disease is genetically heterogeneous, and when specific non-genetic laboratory tests are not available. The use of WES may reduce the time for diagnosis in infants during NICU stay and may eventually result in cost-effectiveness.

Published
2017

7. Enteral Nutrition Tolerance and REspiratory Support (ENTARES) Study in preterm infants: Study protocol for a randomized controlled trial

Author

Cresi, F., Maggiora, E., Borgione, S. M., Spada, E., Coscia, Emanuele, Bertino, E., Meneghin, F., Corvaglia, L. T., Ventura, M. L., Lista, G., Mosca, F., Orsi, A., Mercadante, D., Martinelli, S., Ilardi, L., Proto, A., Gatto, S., Aceti, A., Sandri, F., Chakrokh, R., Laforgia, N., Di Mauro, A., Baldassarre, M. E., Del Vecchio, A., Petrillo, F., Spalierno, M. P., Raimondi, F., Capasso, L., Palma, M., Farina, D., Campagnoli, M. F., Boetti, T., Logrippo, F., Agosti, M., Morlacchi, L., Perniciaro, S., Dani, C., Elia, S., Vento, Giovanni, Maggio, Luca, Stronati, M., Civardi, E., Lidia, G., Angela, B., Coscia A., Vento G. (ORCID:0000-0002-8132-5127), Maggio L. (ORCID:0000-0001-6358-7775), Cresi, F., Maggiora, E., Borgione, S. M., Spada, E., Coscia, Emanuele, Bertino, E., Meneghin, F., Corvaglia, L. T., Ventura, M. L., Lista, G., Mosca, F., Orsi, A., Mercadante, D., Martinelli, S., Ilardi, L., Proto, A., Gatto, S., Aceti, A., Sandri, F., Chakrokh, R., Laforgia, N., Di Mauro, A., Baldassarre, M. E., Del Vecchio, A., Petrillo, F., Spalierno, M. P., Raimondi, F., Capasso, L., Palma, M., Farina, D., Campagnoli, M. F., Boetti, T., Logrippo, F., Agosti, M., Morlacchi, L., Perniciaro, S., Dani, C., Elia, S., Vento, Giovanni, Maggio, Luca, Stronati, M., Civardi, E., Lidia, G., Angela, B., Coscia A., Vento G. (ORCID:0000-0002-8132-5127), and Maggio L. (ORCID:0000-0001-6358-7775)

Abstract

Background: Respiratory distress syndrome (RDS) and feeding intolerance are common conditions in preterm infants and among the major causes of neonatal mortality and morbidity. For many years, preterm infants with RDS have been treated with mechanical ventilation, increasing risks of acute lung injury and bronchopulmonary dysplasia. In recent years non-invasive ventilation techniques have been developed. Showing similar efficacy and risk of bronchopulmonary dysplasia, nasal continuous positive airway pressure (NCPAP) and heated humidified high-flow nasal cannula (HHHFNC) have become the most widespread techniques in neonatal intensive care units. However, their impact on nutrition, particularly on feeding tolerance and risk of complications, is still unknown in preterm infants. The aim of the study is to evaluate the impact of NCPAP vs HHHFNC on enteral feeding and to identify the most suitable technique for preterm infants with RDS. Methods: A multicenter randomized single-blind controlled trial was designed. All preterm infants with a gestational age of 25-29 weeks treated with NCPAP or HHHFNC for RDS and demonstrating stability for at least 48 h along with the compliance with inclusion criteria (age less than 7 days, need for non-invasive respiratory support, suitability to start enteral feeding) will be enrolled in the study and randomized to the NCPAP or HHHFNC arm. All patients will be monitored until discharge, and data will be analyzed according to an intention-to-treat model. The primary outcome is the time to reach full enteral feeding, while parameters of respiratory support, feeding tolerance, and overall health status will be evaluated as secondary outcomes. The sample size was calculated at 141 patients per arm. Discussion: The identification of the most suitable technique (NCPAP vs HHHFNC) for preterm infants with feeding intolerance could reduce gastrointestinal complications, improve growth, and reduce hospital length of stay, thus improving clinica

Published
2019

8. Combined antiretroviral therapy reduces hyperimmunoglobulinemia in HIV-1 infected children

Author

Chiappini, E, Galli, L, Tovo, PA, Gabiano, C, de Martino, M, Osimani, P, Cordiali, R, De Mattia, D, Manzioma, M, DI BARI, DANIELA COLOMBA, Ruggeri, M, Masi, M, Miniaci, A, Specchia, F, Ciccia, M, Lanari, M, Baldi, F, Battisti, L, Schumacher, R, Duse, M, Fiorino, C, Dessi, C, Pintor, C, Dedoni, M, Fenu, ML, CAVALLINI, RAFFAELLA, D'ANASTASIO, ELISABETTA, Merolla, F, Sticca, M, Pomero, G, Bezzi, T, Fiumana, E, Paganelli, S, Vierucci, A, Vitucci, P, CECCHI, MARIA TERESA, Cosso, D, Timitilli, A, Stronati, M, Plebani, A, PINZANI, ROBERTO, VIGANO', ALDO, Giacomet, V, Bianchi, R, SALVINI, FRANCESCO, Zuccotti, GV, Giovannini, M, Ferraris, G, Lipreri, R, Moretti, C, Cellini, M, Cano, MC, Palazzi, G, Guarino, A, Bruzzese, E, DE MARCO, GIUSEPPINA, Tarallo, L, TANCREDI, FERNANDO ANTONIO, Giaquinto, C, D'Elia, R, Rampon, O, Nogare, EDR, SANFILIPPO, ALESSIA, Romano, A, Saitta, M, Dodi, I, Barone, A, Maccabruni, A, Consolini, R, Legitimo, A, Magnani, C, Falconieri, P, Fundaro, C, Genovese, O, Salvucci, S, Casadei, AM, Gattinara, GC, Bernardi, S, PALMA, PASQUALE, Anzidei, G, Anzidei, M, Cerilli, S, Catania, S, Ajassa, C, Ganau, A, Cristiano, L, Mazza, A, Di Palma, A, Garetto, S, Riva, C, Scolfaro, C, Portelli, V, Rabusin, M, Pellegatta, A, Molesini, M, Chiappini, E, Galli, L, Tovo, PA, Gabiano, C, de Martino, M, Osimani, P, Cordiali, R, De Mattia, D, Manzioma, M, Di Bari, C, Ruggeri, M, Masi, M, Miniaci, A, Specchia, F, Ciccia, M, Lanari, M, Baldi, F, Battisti, L, Schumacher, R, Duse, M, Fiorino, C, Dessi, C, Pintor, C, Dedoni, M, Fenu, ML, Cavallini, R, Anastasio, E, Merolla, F, Sticca, M, Pomero, G, Bezzi, T, Fiumana, E, Paganelli, S, Vierucci, A, Vitucci, P, Cecchi, MT, Cosso, D, Timitilli, A, Stronati, M, Plebani, A, Pinzani, R, Vigano, A, Giacomet, V, Bianchi, R, Salvini, F, Zuccotti, GV, Giovannini, M, Ferraris, G, Lipreri, R, Moretti, C, Cellini, M, Cano, MC, Palazzi, G, Guarino, A, Bruzzese, E, De Marco, G, Tarallo, L, Tancredi, F, Giaquinto, C, D'Elia, R, Rampon, O, Nogare, EDR, Sanfilippo, A, Romano, A, Saitta, M, Dodi, I, Barone, A, Maccabruni, A, Consolini, R, Legitimo, A, Magnani, C, Falconieri, P, Fundaro, C, Genovese, O, Salvucci, S, Casadei, AM, Gattinara, GC, Bernardi, S, Palma, P, Anzidei, G, Anzidei, M, Cerilli, S, Catania, S, Ajassa, C, Ganau, A, Cristiano, L, Mazza, A, Di Palma, A, Garetto, S, Riva, C, Scolfaro, C, Portelli, V, Rabusin, M, Pellegatta, A, and Molesini, M

Subjects
Adult, medicine.medical_specialty, Adolescent, immunogiobulins, Immunology, immunoglobulins, combined antiretroviral therapy, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Gastroenterology, children, Hypergammaglobulinemia, Internal medicine, medicine, Humans, Immunology and Allergy, Child, Therapeutic regimen, biology, business.industry, Immunoglobulins, Intravenous, Infant, Normal population, hiv-1 infection, Settore MED/38, Antiretroviral therapy, HIV Reverse Transcriptase, Infectious Diseases, Child, Preschool, Intravenous IG, HIV-1, biology.protein, HIV-1 infection, Drug Evaluation, Reverse Transcriptase Inhibitors, Drug Therapy, Combination, Antibody, business, Viral load
Abstract

Objective: To evaluate the effect of combined antiretroviral therapy on serum immunoglobulin (Ig) levels in HIV-1 perinatally infected children.Methods: Data from 1250 children recorded by the Italian Register for HIV Infection in Children from 1985 to 2002 were analysed. Since Ig levels physiologically vary with age, differences at different age periods were evaluated as differences in z-scores calculated using means and standard deviations of normal population for each age period. Combined antiretroviral therapy has become widespread in Italy since 1996, thus differences in Ig z-scores between the periods 1985-1995 and 1996-2002 were analysed. Data according to type of therapeutic regimen were also analysed.Results: Between the two periods 1985-1995 and 1996-2002, significant (P < 0.0001) decreases in IgG (6.29 +/- 4.72 versus 4.44 +/- 4.33), IgM (9.25 +/- 13.32 versus 5.61 +/- 7.93), and IgA (10.25 +/- 15.68 versus 6.48 +/- 11.56) z-scores, together with a parallel significant (P < 0.0001) increase in CD4 T-lymphocyte percentages, were found. These decreases were confirmed regardless of whether the children were receiving intravenous Ig or not. Ig z-scores were significantly higher in children receiving mono-therapy than in those receiving double-combined therapy (IgG, P < 0.0001; IgM, P = 0.003; IgA, P = 0.031) and in the latter children than in those receiving three or more drugs (P < 0.0001 for all z-scores). Ig z-scores correlated inversely with CD4 T lymphocyte percentages and, directly, with viral loads.Conclusions: Our data show that in HIV-1 infected children combined antiretroviral therapy leads to reduction of hyperimmunoglobulinemia which parallels restoration of CD4 T-lymphocyte percentage and viral load decrease, which it turn probably reflects improved B-lymphocyte functions.(C) 2004 Lippincott Williams Wilkins.

Published
2004
Full Text
View/download PDF

9. Robust Hyperproperty Preservation for Secure Compilation (Extended Abstract)

Author

Garg, D., Hritcu, C., Patrignani, M., Stronati, M., and Swasey, D.

Abstract

We map the space of soundness criteria for secure compilation based on the preservation of hyperproperties in arbitrary adversarial contexts, which we call robust hyperproperty preservation. For this, we study the preservation of several classes of hyperproperties and for each class we propose an equivalent "property-free" characterization of secure compilation that is generally better tailored for proofs. Even the strongest of our soundness criteria, the robust preservation of all hyperproperties, seems achievable for simple transformations and provable using context back-translation techniques previously developed for showing fully abstract compilation. While proving the robust preservation of hyperproperties that are not safety requires such powerful context back-translation techniques, for preserving safety hyperproperties robustly, translating each finite trace prefix back to a source context seems to suffice.

Published
2017

10. Congenital syphilis in Italy: a multicentre study

Author

Tridapalli, E., Capretti, M. G., Reggiani, M. L. B., Stronati, M., Faldella, G., Auriti, C., Balata, A., Barera, G., Bennato, E., Berardi, A., Bolognesi, S., Bonomi, A., Boulos, F., Brambilla, C., Branchi, M., Cabiati, G., Caddia, V., Calzetti, G., Campanile, A., Cataldo, P., Cavagna, R., Chiarolini, A., Ciccia, M., Ciccotti, R., Ciofalo, A., Contiero, R., Corona, G., Corso, G., Costa, L., Coviello, C., Cristofori, G., Crivellaro, C., Cucchi, G., Danese, G., Da Riol, R., Decembrino, L., Delogu, A., Del Vecchio, A., De Sanctis, L., Di Chiara, G., Di Comite, A., Di Grande, E. C., D'Onofrio, A. M., Faccia, P., Ferrari, D., Fortunati, P., Gabriella, T. L., Galimberti, D., Garzia, P., Giorgino, M., Gragnani, S., Gurrido, R., Lacaita, G., Leone, G., Lipari, A., Lorenzini, C., Lo Sciotto, P., Malagutti, L., Maschio, F., Matteucci, L., Migliozzi, L., Mileti, F., Murgia, M. R., Navone, M., Nosari, N., Notarmuzi, M. L., Pagliani, L., Paino, D., Papa, I., Papili, F., Parisi, G., Perocchi, F., Perona, A., Pirrami, R., Pitassi, I., Priore, Raponi, S., Rizzo, V., Robieux, I., Rossi, A., Ruffini, E., Russo, R., Salvi, G., Serra, L., Sferlazzo, S., Solimano, T., Spadaro, V., Stramare, D., Stroppiana, P., Tarquini, E., Taurino, L., Tedoldi, S., Tessariol, D., Travaglio, M. D., Vagnarelli, F., Valente, A., Valentini, P., Volta, A., Zaffaroni, M., Tridapalli E, Capretti MG, Reggiani ML, Stronati M, Faldella G, and Italian Neonatal Task Force of Congenital Syphilis for The Italian Society of Neonatology – Collaborative Group.

Subjects
medicine.medical_specialty, Pediatrics, Adolescent, Reproductive medicine, Infant, Premature, Diseases, Prenatal care, Young Adult, Foreign born, Pregnancy, Risk Factors, Seroepidemiologic Studies, Age Factors, Birth Weight, Female, Humans, Infant, Newborn, Infant, Premature, Italy, Maternal Age, Pregnancy Complications, Infectious, Prenatal Care, Prospective Studies, Syphilis, Syphilis, Congenital, medicine, CONGENITAL SYPHILIS, Seroprevalence, Reproductive health, business.industry, Obstetrics and Gynecology, General Medicine, medicine.disease, Congenital syphilis, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Pediatrics, Perinatology and Child Health, MULTICENTER STUDY, business
Abstract

OBJECTIVE: To study the prevalence of congenital syphilis and its risk factors in Italy. STUDY DESIGN: Prospective study from 1 July 2006 to 30 June 2007. Data on mother-child pairs were collected for every syphilis seropositive mother. RESULTS: Maternal syphilis seroprevalence at delivery was 0.17%. 207 infants were born to 203 syphilis seropositive mothers. In 25 newborns it was possible to diagnose congenital syphilis (20/100,000 live births). Maternal risk factors included age

Published
2010
Full Text
View/download PDF

11. Canonical Transient Receptor Potential 3 channel triggers VEGF-induced intracellular Ca2+ oscillations in endothelial progenitor cells isolated from umbilical cord blood

Author

Dragoni, S, Laforenza, U, Bonetti, E, Lodola, F, Bottino, C, Guerra, G, Borghesi, A, Stronati, M, Rosti, V, Tanzi, F, Moccia, F, Dragoni S, Laforenza U, Bonetti E, Lodola F, Bottino C, Guerra G, Borghesi A, Stronati M, Rosti V, Tanzi F, Moccia F, Dragoni, S, Laforenza, U, Bonetti, E, Lodola, F, Bottino, C, Guerra, G, Borghesi, A, Stronati, M, Rosti, V, Tanzi, F, Moccia, F, Dragoni S, Laforenza U, Bonetti E, Lodola F, Bottino C, Guerra G, Borghesi A, Stronati M, Rosti V, Tanzi F, and Moccia F

Abstract

Endothelial colony-forming cells (ECFCs) are the only endothelial progenitor cells (EPCs) that are capable of acquiring a mature endothelial phenotype. ECFCs are mainly mobilized from bone marrow to promote vascularization and represent a promising tool for cell-based therapy of severe ischemic diseases. Vascular endothelial growth factor (VEGF) stimulates the proliferation of peripheral blood-derived ECFCs (PB-ECFCs) through oscillations in intracellular Ca2+ concentration ([Ca2+]i). VEGF-induced Ca2+ spikes are driven by the interplay between inositol-1,4,5-trisphosphate (InsP3)-dependent Ca2+ release and store-operated Ca2+ entry (SOCE). The therapeutic potential of umbilical cord blood-derived ECFCs (UCB-ECFCs) has also been shown in recent studies. However, VEGF-induced proliferation of UCB-ECFCs is faster compared with their peripheral counterpart. Unlike PB-ECFCs, UCB-ECFCs express canonical transient receptor potential channel 3 (TRPC3) that mediates diacylglycerol-dependent Ca2+ entry. The present study aimed at investigating whether the higher proliferative potential of UCB-ECFCs was associated to any difference in the molecular underpinnings of their Ca 2+ response to VEGF. We found that VEGF induces oscillations in [Ca2+]i that are patterned by the interaction between InsP3-dependent Ca2+ release and SOCE. Unlike PB-ECFCs, VEGF-evoked Ca2+ oscillations do not arise in the absence of extracellular Ca2+ entry and after pharmacological (with Pyr3 and flufenamic acid) and genetic (by employing selective small interference RNA) suppression of TRPC3. VEGF-induced UCB-ECFC proliferation is abrogated on inhibition of the intracellular Ca2+ spikes. Therefore, the Ca 2+ response to VEGF in UCB-ECFCs is shaped by a different Ca 2+ machinery as compared with PB-ECFCs, and TRPC3 stands out as a promising target in EPC-based treatment of ischemic pathologies.

Published
2013

12. Patient-reported outcomes measure for children born preterm: validation of the SOLE VLBWI Questionnaire, a new quality of life self-assessment tool

Author

Olivieri, I., M Bova, S., Fazzi, E., Ricci, Daniela, Tinelli, F., Montomoli, C., Rezzani, C., Balottin, U., Orcesi, S., Ariaudo, G., Capone, L., Spairani, S., Stronati, M., Figar, T., Mastrangelo, Marica, Krachmalnicoff, A., Lista, G., Accorsi, P., Martelli, P., Rossi, A., Micheletti, S., Zaccagnino, M., Chirico, G., Mallardi, M., Quintiliani, Michela, Romeo, Domenico Marco, Gallini, Francesca, Battini, Roberta, and Comparini, A.

Subjects
Self-assessment, Male, Self-Assessment, Psychometrics, Neurology (clinical), Pediatrics, Perinatology and Child Health, Developmental Neuroscience, Pediatrics, Developmental psychology, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Cronbach's alpha, 030225 pediatrics, Surveys and Questionnaires, Humans, Infant, Very Low Birth Weight, Medical history, Patient Reported Outcome Measures, Child, Measure (data warehouse), Alpha Value, Very Low Birth Weight, Infant, Reproducibility of Results, Perinatology and Child Health, Focus group, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Quality of Life, Female, Psychology, 030217 neurology & neurosurgery, Clinical psychology
Abstract

Aim This study was conducted to develop and validate a new self-report questionnaire for measuring quality of life (QoL), at school age, in children with a very low birthweight (VLBW). Method Through a focus group approach, children were involved directly in defining the questionnaire items, which were presented as illustrations rather than written questions. This preliminary validation of the questionnaire was conducted in 152 participants with VLBW (aged 7–11y) randomly selected from the five participating Italian centres. The questionnaire was completed by children and parents separately; data on children's demographic and medical history, and intellectual, adaptive, and behavioural functioning were collected using standardized scales. All the children also completed the Paediatric Quality of Life Inventory (PedsQL), another Italian-language measure of QoL in children. Results Our questionnaire was readily accepted and understood, and quick to complete. The Cronbach's alpha value showed it to be a reliable instrument. The child-compiled version correlated well with the PedsQL, whereas no correlations emerged with the other scales used, IQ, or degree of impairment. Conversely, these variables correlated significantly with the parent-compiled version. Children's and parents’ answers were divergent on practically all the items. Interpretation The results confirm the validity of the new instrument and highlight a poor overlap between parents’ and children's perspectives.

Published
2016

13. [Update for the standard procedures of diagnosis and therapy in cases of congenital rubella]

Author

BUFFOLANO, WILMA, Filia A, Agnese M, Stronati M, Dicostanzo P., Buffolano, Wilma, Filia, A, Agnese, M, Stronati, M, and Dicostanzo, P.

Subjects
Incidence, Rubella Syndrome, Congenital, Vaccination, Diagnosis, Differential, Early Diagnosis, Immunoglobulin M, Italy, Pregnancy, Immunoglobulin G, Practice Guidelines as Topic, Humans, Immunologic Factors, Female, Rubella Vaccine, Pregnancy Complications, Infectious, Child, Biomarkers
Abstract

Congenital Rubella is the dramatic consequence of rubella during gestation. A combined strategy of Measles and Rubella universal vaccination on children and selective vaccination of susceptible women has been shown effective in the elimination of congenital rubella requiring an incidence of1 case of CRS per 100,000 live births. Verification processes of rubella elimination require that physicians early and appropriately diagnose all cases of congenital rubella, including those unpatent at birth. The paper highlights clinical and laboratory aspects channeling diagnosis of congenital rubella infection or syndrome even after the first year of life, and the short- and long-term management criteria.

Published
2013

14. Recommendations for pediatric tuberculosis vaccination in Italy

Author

Montagnani, C, Esposito, S, Galli, L, Chiappini, E, Principi, N, de Martino, M, Bosis, S, Tagliabue, C, Senatore, L, Ascolese, B, Villani, A, Lancella, L, Cursi, L, Grandin, A, Marabotto, C, Ciofi, D, Festini, F, Anziati, M, Becciani, S, Remaschi, G, Sollai, S, Tersigni, C, Venturini, E, Guarino, A, Lo Vecchio, A, Scotto, R, Gabiano, C, Garazzino, S, Le Serre, D, Raffaldi, I, Bernardi, F, Bertazzoni, E, Blasi, F, Bocchino, M, Assante, L, Castagnola, E, Losurdo, G, Codecasa, L, Di Mauro, G, Faccini, M, Marseglia, G, Mascolo, A, Di Comite, A, Stronati, M, Matteelli, A, Migliori, Gb, D’Ambrosio, L, Centis, R, Pasinato, Cirillo, Tortoli, Russo, Scaglione, F, Scala, E, and Tomà, P

Subjects
Pediatrics, medicine.medical_specialty, Tuberculosis, Immunology, Breastfeeding, Tuberculin, Reviews, Disease, Tuberculous meningitis, 03 medical and health sciences, 0302 clinical medicine, children, prevention, BCG, tuberculosis, vaccination, vaccine, 030225 pediatrics, medicine, Immunology and Allergy, Humans, 030212 general & internal medicine, Immunization Schedule, Pharmacology, business.industry, medicine.disease, Settore MED/38, Pediatric tuberculosis, Vaccination, Italy, BCG Vaccine, business, BCG vaccine
Abstract

Bacillus Calmette-Guerin (BCG) vaccine is still the only vaccine approved for the prevention of tuberculosis (TB), and is widely used in highly endemic countries, where all newborns receive a single intradermal dose immediately after birth; however, the recommendations concerning its use in Europe vary widely from country to country. This document describes the recommendations of a group of Italian scientific societies concerning its pediatric use in Italy, the persistence of the protection it provides, its safety, its interference with tuberculin skin test (TST) responses, and the children who should be vaccinated. The experts conclude that BCG vaccination provides a good level of protection against tuberculous meningitis and disseminated forms, and a fair level of protection against pulmonary disease; the protective effective lasts at least 10 years, and revaccination offers no advantages over a single administration. The vaccine is safe in immunocompetent subjects, and affects the response to a TST for at least 6 y On the basis of these observations, we recommend its use in Italy in all TST-negative immunocompetent newborns and breastfeeding infants aged

Published
2015

15. Lactoferrin and prevention of late-onset sepsis in the pre-term neonates

Author

Manzoni, P, Decembrino, L, Stolfi, I, Pugni, L, Rinaldi, M, Cattani, Sara, Romeo, Mg, Messner, H, Laforgia, N, Vagnarelli, F, Memo, L, Bordignon, L, Saia, Os, Maule, MILENA MARIA, Gallo, E, Mostert, Michael Martin, Magnani, Silvia Carla, Quercia, M, Bollani, Luigi, Pedicino, R, Renzullo, L, Betta, P, Ferrari, F, Magaldi, R, Mosca, F, Stronati, M, Farina, Davide, Italian, Task Force for the Study, Prevention of Neonatal Fungal Infections, and Italian Society of, Neonatology

Subjects
Infant, Premature, Diseases, Sepsis, chemistry.chemical_compound, Anti-Infective Agents, Lactoferricin, Intensive care, medicine, Animals, Humans, Age of Onset, biology, Lactoferrin, business.industry, Infant, Newborn, Obstetrics and Gynecology, medicine.disease, Antimicrobial, Lactoferrin and prevention of late-onset sepsis, Low birth weight, chemistry, Pediatrics, Perinatology and Child Health, Immunology, biology.protein, Premature Birth, Colostrum, Cattle, medicine.symptom, business, Infant, Premature, Fluconazole, medicine.drug
Abstract

Late-onset sepsis (LOS) affects a large proportion of pre-term neonates in neonatal intensive care units (NICUs) worldwide, with high morbidity and related mortality, and frequent occurrence of severe late neurodevelopmental impairment. Due to the frequency, severity and difficulties in early diagnosis and prompt therapy, prevention is crucial for decreasing the burden of infection-related complications in NICUs. It is well known that feeding with fresh maternal milk, hygiene measures and the cautious use of H2-blockers are related with a decreased risk of developing sepsis. However, evidence from randomised clinical trials exists only for fluconazole in the prevention of fungal infections in the NICU. Lactoferrin is the main whey protein in mammalian milk, and is involved in innate immune host defences. Notably, human lactoferrin can be found at increased concentrations in colostrum and in milk from mothers of premature neonates. Human (hLF) and bovine lactoferrin (bLF) share a high (77%) amino-acid homology, and the same N-terminal peptide responsible for antimicrobial activity, called lactoferricin. In vitro, bLF shows potent direct antimicrobial activity against all types of pathogens, which occurs via anti-cell wall actions and leads to disintegration of the micro-organism's membranes. bLF is also synergistic with many antimicrobials and antifungals, and promotes growth and differentiation of the immature gut. Based on this background data, a randomised clinical trial was recently conducted in very low birth weight pre-term neonates given bLF alone or with the probiotic Lactobacillus GG. The aim of the trial was to assess the ability of bLF to prevent late-onset sepsis of any origin in the studied infants during their stay in the NICU. This article discusses the preliminary data from this study, along with the proposed mechanisms of action of bLF in pre-term infants.

Published
2010
Full Text
View/download PDF

17. Development and validation of an enzyme linked immunosorbent assay for palivizumab serum determination

Author

Iommiello, Livia Visai, Michela Montagna, Maria Antonietta Avanzini, Ragazzi M, Nora Bloise, Stronati M, and Di Comite A

Subjects
Palivizumab, medicine.drug_class, Immunology, Population, Enzyme-Linked Immunosorbent Assay, medicine.disease_cause, Monoclonal antibody, Antibodies, Monoclonal, Humanized, Antiviral Agents, Injections, Intramuscular, Sensitivity and Specificity, Epitope, Virus, Antigen, Limit of Detection, medicine, Immunology and Allergy, Humans, education, Pharmacology, Observer Variation, education.field_of_study, biology, business.industry, Infant, Reproducibility of Results, Reference Standards, Virology, Respiratory syncytial virus (RSV), Polyclonal antibodies, Calibration, biology.protein, Linear Models, Drug Monitoring, business, medicine.drug
Abstract

Palivizumab (Synagis®) is a humanized monoclonal antibody (IgG1K) composed of 95% human and 5% murine sequences. It is directed to an epitope in the A antigenic site of the F protein of respiratory syncytial virus (RSV). Palivizumab is used for prevention of serious lower respiratory tract disease caused by RSV in pediatric patients who are at increased risk of severe disease and is administered intramuscularly (IM) for a total of 5 monthly doses. Herein, we report on the development and validation of a very sensitive enzyme-linked immunosorbent assay (ELISA) to measure serum concentrations of palivizumab by a rabbit polyclonal antibody specifically produced against the murine sequence. The method was developed and validated according to the guidelines “Guidance for Industry” (1998) and has proved suitable for the determination of palivizumab serum levels in the target infant population. The ELISA assay was successfully applied to test the serum samples in an infant population who received palivizumab intramuscularly; thus, the assay could be used to determine serum levels in palivizumab-treated infants to optimize dosing and scheduling and to study the relationship between dose and clinical response.

Published
2013

19. Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial

Author

Manzoni, P, Rinaldi, M, Cattani, S, Pugni, L, Romeo, Mg, Messner, H, Stolfi, I, Decembrino, L, Laforgia, N, Vagnarelli, F, Memo, L, Bordignon, L, Saia, Os, Maule, M, Gallo, E, Mostert, M, Magnani, C, Quercia, M, Bollani, L, Pedicino, R, Renzullo, L, Betta, P, Mosca, F, Ferrari, Fabrizio, Magaldi, R, Stronati, M, Farina, D, Italian Task Force for the Study, and Prevention of Neonatal Fungal Infections Italian Society of Neonatology

Subjects
bovine lactoferrin
Published
2009

20. Cancer rates after year 2000 significantly decrease in children with perinatal HIV infection: A study by the Italian Register for HIV Infection in Children

Author

Chiappini, E, Galli, L, Tovo, Pa, Gabiano, C, Lisi, C, Giaquinto, C, Rampon, O, Gattinara, Gc, De Marco, G, Osimani, P, Manzionna, M, Miniaci, A, Pintor, C, Rosso, R, Esposito, S, Viganò, A, Dodi, I, Maccabruni, A, Fundarò, C, de Martino, M, Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., Molesini, M., Chiappini, Elena, Galli, Luisa, Tovo, Pier-Angelo, Gabiano, Clara, Lisi, Catiuscia, Giaquinto, Carlo, Rampon, Osvalda, Gattinara, Guido Castelli, De Marco, Giulio, Osimani, Patrizia, Manzionna, Mariano, Miniaci, Angela, Pintor, Carlo, Rosso, Raffaella, Esposito, Susanna, Viganò, Alessandra, Dodi, Icilio, Maccabruni, Anna, Fundarò, Carlo, De Martino, Maurizio, Italian Register for HIV Infection in, Children, and Lanari, M.

Subjects
Registrie, Pediatrics, Cancer Research, Time Factors, HIV Infections, Antiretroviral Therapy, Highly Active, Neoplasms, HIV Infection, Registries, Sida, Child, biology, Incidence (epidemiology), Medicine (all), Incidence, Child, Preschool, Disease Progression, Humans, Infant, Infant, Newborn, Italy, Treatment Outcome, Oncology, symbols, Population study, Viral disease, Human, medicine.medical_specialty, cancer rates, HIV infection, children, Time Factor, Antiretroviral Therapy, symbols.namesake, Acquired immunodeficiency syndrome (AIDS), medicine, cancer, Highly Active, Poisson regression, Preschool, Settore MED/38 - Pediatria Generale e Specialistica, Perinatal HIV infection, business.industry, Cancer, Newborn, medicine.disease, biology.organism_classification, Italian Register for HIV infection in children, El Niño, Neoplasm, business
Abstract

Purpose To evaluate the impact of highly active antiretroviral therapy (HAART) on cancer incidence in HIV-infected children throughout a 20-year period. Patients and Methods An observational population study was conducted on 1,190 perinatally HIV-infected children enrolled onto the Italian Register for HIV Infection in Children from 1985 to 2004 and never lost to follow-up (total observation time, 10,037.66 years). Cancer rates were calculated in the pre-HAART (1985 to 1995), early HAART (1996 to 1999), and late HAART (2000 to 2004) periods and compared using Poisson regression adjusted for age. The proportion of HAART-treated children increased from 4.1% in 1996 to 60.4% in 1999 and to 81.5% in 2004. In the same time frame, the proportion of children receiving HAART for at least 2 years increased from 3.1% to 77.0%. Results Overall, 35 cancers occurred. Cancer rates were 4.49 (95% CI, 2.37 to 6.64), 4.09 (95% CI, 1.68 to 6.50), and 0.76 (95% CI, 0.00 to 1.80) per 1,000 children per year in 1985 to 1995, 1996 to 1999, and 2000 to 2004, respectively. Notably, there was no significant difference comparing the periods from 1985 to 1995 and 1996 to 1999 (P = .081). By contrast, cancer rates were significantly lower in the period from 2000 to 2004 than in 1996 to 1999 (P < .0001). Results were confirmed by separately analyzing data from children observed from birth (P = .418 for 1985 to 1995 v 1996 to 1999; P = .001 for 1996 to 1999 v 2000 to 2004). Conclusion Dramatically reduced cancer rates were observed only in the late HAART period in parallel to the increasing proportion of children receiving HAART therapy.

Published
2007

21. Virologic, immunologic, and clinical benefits from early combined antiretroviral therapy in infants with perinatal HIV-1 infection

Author

Chiappini, E., Galli, L., Atovo, P. i. e. r., Gabiano, C., Castelli Gattinara, G., Guarino, A., Baddato, R., Giaquinto, C., Lisi, C., de Martino, M., Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., Molesini, M., Chiappini, E, Galli, L, Tovo, Pa, Gabiano, C, Gattinara, Gc, Guarino, Alfredo, Baddato, R, Giaquinto, C, Lisi, C, and DE MARTINO, M.

Subjects
medicine.medical_specialty, Pediatrics, Anti-HIV Agents, medicine.medical_treatment, Immunology, combined antiretroviral therapy, CD4-CD8 Ratio, HIV Infections, HIV-1 infection, Asymptomatic, Drug Administration Schedule, Acquired immunodeficiency syndrome (AIDS), Immunopathology, Antiretroviral Therapy, Highly Active, Medicine, Immunology and Allergy, Humans, Sida, ART, infants, Chemotherapy, biology, business.industry, Age Factors, Infant, Viral Load, biology.organism_classification, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, CD4 Lymphocyte Count, Infectious Diseases, Treatment Outcome, Child, Preschool, Lentivirus, Disease Progression, HIV-1, Viral disease, medicine.symptom, business, Epidemiologic Methods, Viral load
Abstract

Objective: To investigate the impact of early versus deferred combined antiretroviral treatment (ART) in asymptomatic or moderately symptomatic [Centers for Disease Control and Prevention (CDC) category N, A or B] infants with perinatal HIV-1 infection. Methods: A multi-centre nationwide case-control study was conducted. Data from 30 infants treated with combined ART with three or more drugs before 6 months of age were compared with data from 103 infants starting ART with three or more drugs after 6 months of age. The median follow-up time was 4.1 years (range, 1.0-6.5 years). Results: No difference was evident in the first available viral load and CD4 T-lymphocyte percentage between the two groups of children. Early-treated infants showed significantly lower viral loads than infants receiving deferred treatment at all the follow-up periods. A higher proportion of early-treated infants than infants receiving deferred treatment (73.3% versus 30.1%; P < 0.0001) reached an undetectable viral load. Higher CD4 T-lymphocyte percentages were found in early-treated infants at 13-24 (P < 0.0001), 25-36 (P < 0.0001), and 37-48 (P = 0.003) months of age. No early-treated infant versus 20 of 103 (19.4%) infants receiving deferred ART (P=0.02) showed a CD4 T-lymphocyte percentage of less than 15% at one time point during follow-up. No CDC category A, B or C clinical event occurred in early-treated infants over the follow-up period while 44 of 103 (42.7%) infants receiving deferred treatment presented a decline in the CDC category. Kaplan-Meier analyses revealed significant differences in CDC category A (P = 0.0002), B (P = 0.0003), and C (P = 0.0018) event-free survivals. Conclusion: The data suggest virologic, immunologic, and clinical benefits from early administration of ART.

Published
2006

22. Persistently high IgA serum levels are a marker of immunological or virological failure of combined antiretroviral therapy in children with perinatal HIV-1 infection

Author

Chiappini, E., Galli, L., Tovo, P. A., Gabiano, C., de Martino, M., Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., Molesini, M., Chiappini E., Galli L., Tovo PA., Gabiano C., de Martino M., Osimani P, Masi M., Specchia F., Molesini M., and The Italian Register for HIV Infection in Children

Subjects
Adolescent, Anti-HIV Agents, Immunology, HIV Infections, HIV-1 infection, Perinatal hiv, Antiretroviral Therapy, Highly Active, Clinical Studies, Immunology and Allergy, Medicine, Humans, Treatment Failure, Child, viremia, business.industry, combinedantiretroviral therapy, hyper-IgA, Infant, Newborn, Normal population, Infant, Viral Load, Antiretroviral therapy, Virological failure, Infectious Disease Transmission, Vertical, CD4 Lymphocyte Count, Immunoglobulin A, Child, Preschool, HIV-1, Drug Monitoring, business, Viral load, Biomarkers, Follow-Up Studies
Abstract

Summary Non-expensive and low-complexity surrogate markers for monitoring the response to combined antiretroviral therapy (combined-ART) are needed in poor-resource settings where routine assessment of CD4+ T-lymphocyte count and viral load can not be afforded. We longitudinally evaluated Ig serum levels in 234 HIV-1 infected children receiving combined-ART with ≥ 3 drugs. Since Ig levels physiologically vary with age, differences at different age periods were evaluated as differences in z-scores calculated using the mean and standard deviation of the normal population for each age period. Data from 17 (7·3%) children with immunological failure and from 54 (23·1%) children with virological failure of combined-ART were compared with data from not-failed children. At baseline children with immunological failure showed higher IgM z-scores (P = 0·042) than children without. After 3–12 months of therapy immunologically failed children displayed higher viral loads (P < 0·0001) and IgA (P = 0·043) z-scores than not-failed children. Similarly, at the same follow-up time, children with virological failure showed lower CD4+ T-lymphocyte percentages (P = 0·005) and higher IgA z-scores (P < 0·0001) than not-failed children. No difference in IgG or IgM z-scores was evidenced between failed and not-failed children after 3–12 months of therapy. In conclusion, IgA serum level is a cheap and low-complexity marker of immunological or virological failure of combined-ART which might be adopted in poor-resource settings.

Published
2005

23. “Congenital syphilis in Italy: multicentre study”.

Author

Tridapalli, E, Capretti, Mg, Bacchi Reggiani, Ml, Stronati, M, Faldella, G, Valentini, Piero, Et, Al, Valentini, Piero (ORCID:0000-0001-6095-9510), Tridapalli, E, Capretti, Mg, Bacchi Reggiani, Ml, Stronati, M, Faldella, G, Valentini, Piero, Et, Al, and Valentini, Piero (ORCID:0000-0001-6095-9510)

Abstract

Objective To study the prevalence of congenital syphilis and its risk factors in Italy. Study design Prospective study from 1 July 2006 to 30 June 2007. Data on mother–child pairs were collected for every syphilis seropositive mother. Results Maternal syphilis seroprevalence at delivery was 0.17%. 207 infants were born to 203 syphilis seropositive mothers. In 25 newborns it was possible to diagnose congenital syphilis (20/100 000 live births). Maternal risk factors included age <20 years, no antenatal care and no adequate treatment. The infected babies were more often preterm or weighed <2000 g at birth. Discussion Many syphilis seropositive mothers were foreign born but the risk of an infected newborn was not higher in foreign-born than in Italian seropositive women. The significant factors were lack of antenatal screening and inadequate maternal treatment. Conclusion Syphilis is a re-emerging infection in Italy. Prevention strategies should include antenatal serological tests for all pregnant women and treatment for infected mothers.

Published
2012

24. Congenital syphilis in Italy: a multicentre study

Author

Tridapalli, E, Capretti, Mg, Reggiani, Mlb, Stronati, M, Faldella, G, Valentini, Piero, Italian Neonatal Task Force For The Italian Society Of, Neonatology, Valentini, Piero (ORCID:0000-0001-6095-9510), Tridapalli, E, Capretti, Mg, Reggiani, Mlb, Stronati, M, Faldella, G, Valentini, Piero, Italian Neonatal Task Force For The Italian Society Of, Neonatology, and Valentini, Piero (ORCID:0000-0001-6095-9510)

Abstract

OBJECTIVE: To study the prevalence of congenital syphilis and its risk factors in Italy. STUDY DESIGN: Prospective study from 1 July 2006 to 30 June 2007. Data on mother-child pairs were collected for every syphilis seropositive mother. RESULTS: Maternal syphilis seroprevalence at delivery was 0.17%. 207 infants were born to 203 syphilis seropositive mothers. In 25 newborns it was possible to diagnose congenital syphilis (20/100,000 live births). Maternal risk factors included age <20 years, no antenatal care and no adequate treatment. The infected babies were more often preterm or weighed <2000 g at birth. DISCUSSION: Many syphilis seropositive mothers were foreign born but the risk of an infected newborn was not higher in foreign-born than in Italian seropositive women. The significant factors were lack of antenatal screening and inadequate maternal treatment. CONCLUSION: Syphilis is a re-emerging infection in Italy. Prevention strategies should include antenatal serological tests for all pregnant women and treatment for infected mothers.

Published
2010

37. Spiramycin Treatment of Toxoplasma gondiiInfection in Pregnant Women Impairs the Production and the Avidity Maturation of T. gondii-Specific Immunoglobulin G Antibodies

Author

Meroni, V., Genco, F., Tinelli, C., Lanzarini, P., Bollani, L., Stronati, M., and Petersen, E.

Abstract

ABSTRACTThe aim of the study was to evaluate the influence of treatment with spiramycin on the increase of immunoglobulin G (IgG) titers and IgG avidity indexes (AI) in pregnant women with seroconversion from the beginning of therapy until delivery and after delivery. This group was compared with adult patients with recently acquired untreated toxoplasmosis. One hundred four samples from 32 pregnant women with seroconversion for toxoplasmosis and/or very low IgG AI were followed from the beginning of therapy with spiramycin until delivery. Twenty-nine women were further followed some months after delivery and interruption of therapy. Thirty-eight samples from 16 untreated, nonpregnant patients were evaluated as the control group. The Toxoplasma gondii-specific IgG antibody and the T. gondii-specific IgG AI were significantly delayed in pregnant women receiving therapy compared to nonpregnant, untreated controls, and the findings were consistent with the results of assays from two different manufacturers. The T. gondii-specific IgG AI increased in pregnant women after they gave birth. Avidity maturation is delayed during pregnancy and treatment, and low-avidity antibodies in pregnant women within 3 to 4 months cannot be taken as a sign of infection.

Published
2009
Full Text
View/download PDF

38. Survey of neonatal respiratory care and surfactant administration in very preterm infants in the Italian neonatal network

Author

Bellù R, Gagliardi L, Tagliabue P, Corchia C, Vendettuoli V, Mosca F, Zanini R, Condò M, Turoli D, Weissmann G, Vanzati M, De Nisi G, Villa E, Moro G, Guerrini P, Contiero R, Ellero S, Furlan R, Abbiati L, Borroni C, Prandi G, Fabris C, Vielmi F, Agosti M, Tandoi F, Guidali, De Curtis M, Tozzi C, Lucchini R, Battaglioli M, Lista GL, Introvini P, Ferrari F, Gallo C, Cervello P, Bellante E, Bottura C, Pasquali F, Boccacci S, Latini G, Giannuzzi R, Martinelli S, Brunelli A, Motta G, Di Nunzio ML, Vendemiati A, Zorzi C, Carli G, Alfiero, Romeo N, Mammoliti P, Mastretta E, Barberis L, Farina D, Gancia G, Dalmazzo C, Napolitano M, Messina F, Rinaldi G, Magaldi R, Rinaldi M, Litta R, Lago P, Zanardo V, Chiandetti L, Visentin S, Presta G, Cella D, Poggiani C, Ferrari D, Parati S, Lombardo F, Grigorio R, Barera G, Franco M, Poloniato A, Colombo A, Burgio G, Sala E, Barberi I, Tiralongo V, Arco A, Careggi F, Dani C, Pratesi S, Mignatti V, Ancora G, Faldella G, Grandi S, Stronati M, Perotti G, Chirico G, Migliori C, De Marini S, Forleo V, Mansi G, Bona G, Stucchi I, Savastio, Ferrero F, Parola A, Padovani EM, Viviani E, Pecoraro L, Tiberina FI, Agostino R, Gizzi C, Massenzi L, Messner H, Staffier A, Salvia G, Esposito L, Forziati V, Latorre G, Sandri F, Alati S, Demaria F, Lombardi O, Costabile CD, Scarpelli G, Cavalli C, Volante E, Proietti D, Ganguzza O, Spinella B, Pietro RS, Haass C, Scapillati E, Consigli C, Gatta A, Quitadamo P, Boldrini A, Vuerich M, Sigali E, Ghirri P, Fiorini P, Petrucci L, Moroni M, Braghetti P, Casucci P, Minelli L, Mezzetti D, Orfeo L, De Luca MG, Laforgia N, Grassi A, Gesu RB, Dotta A, Savignoni F, Bagnoli F, De Felice C, Badii S, Biasini A, Belluzzi A, Stella M, Romagnoli C, Zecca E, Barone G, Colleselli P, Vecchiato L, Nicolussi D, Monaldi N, Giliberti P, Chello G, Rojo S, Giovanettoni C, Colnaghi CA, Verucci E, Placidi G, Belloni C, Carrera G, Zambetti C, Biban P, Serra A, Carnielli V, Pedini A, Vetrano G, Furcolo G, Pasquariello B, Falco L, Ausanio G, Bernardo I, Marchesano G, Nosari N, Sarnelli P, Maccabruni M, Merazzi D, Gazzolo D, Sabatini FT, Colivicchi M, Del Vecchio A, Tarantino M, Gargano G, Pedori S, Bellettato M, Pesavento R, Cesaro A, Nicolò A, Mondello I, Pugliese A, Iervolino C, Corsello G, Giuffré M, Betta M, Romeo MG, Saporito A, D'Incecco C, Perrone B, Rodonò MG, Serra G, Franceschi A, Risso FM, Carpentieri M, Cigliano MP, Casilino R, Paolillo P, Picone S, Marra A, Rossetti D, Testa T, Del Cuore F., PALUDETTO, ROBERTO, CAPASSO, LETIZIA, RAIMONDI, FRANCESCO, Bellù, R, Gagliardi, L, Tagliabue, P, Corchia, C, Vendettuoli, V, Mosca, F, Zanini, R, Corsello, G, Giuffrè, M, Italian Neonatal Network., Condò, M, Turoli, D, Weissmann, G, Vanzati, M, De Nisi, G, Villa, E, Moro, G, Guerrini, P, Contiero, R, Ellero, S, Furlan, R, Abbiati, L, Borroni, C, Prandi, G, Fabris, C, Vielmi, F, Agosti, M, Tandoi, F, Guidali, De Curtis, M, Tozzi, C, Lucchini, R, Battaglioli, M, Lista, Gl, Introvini, P, Ferrari, F, Gallo, C, Cervello, P, Bellante, E, Bottura, C, Pasquali, F, Boccacci, S, Latini, G, Giannuzzi, R, Martinelli, S, Brunelli, A, Motta, G, Di Nunzio, Ml, Vendemiati, A, Zorzi, C, Carli, G, Alfiero, Romeo, N, Mammoliti, P, Mastretta, E, Barberis, L, Farina, D, Gancia, G, Dalmazzo, C, Napolitano, M, Messina, F, Rinaldi, G, Magaldi, R, Rinaldi, M, Litta, R, Lago, P, Zanardo, V, Chiandetti, L, Visentin, S, Presta, G, Cella, D, Poggiani, C, Ferrari, D, Parati, S, Lombardo, F, Grigorio, R, Barera, G, Franco, M, Poloniato, A, Colombo, A, Burgio, G, Sala, E, Barberi, I, Tiralongo, V, Arco, A, Careggi, F, Dani, C, Pratesi, S, Mignatti, V, Ancora, G, Faldella, G, Grandi, S, Stronati, M, Perotti, G, Chirico, G, Migliori, C, De Marini, S, Forleo, V, Paludetto, Roberto, Capasso, Letizia, Mansi, G, Raimondi, Francesco, Bona, G, Stucchi, I, Savastio, Ferrero, F, Parola, A, Padovani, Em, Viviani, E, Pecoraro, L, Tiberina, Fi, Agostino, R, Gizzi, C, Massenzi, L, Messner, H, Staffier, A, Salvia, G, Esposito, L, Forziati, V, Latorre, G, Sandri, F, Alati, S, Demaria, F, Lombardi, O, Costabile, Cd, Scarpelli, G, Cavalli, C, Volante, E, Proietti, D, Ganguzza, O, Spinella, B, Pietro, R, Haass, C, Scapillati, E, Consigli, C, Gatta, A, Quitadamo, P, Boldrini, A, Vuerich, M, Sigali, E, Ghirri, P, Fiorini, P, Petrucci, L, Moroni, M, Braghetti, P, Casucci, P, Minelli, L, Mezzetti, D, Orfeo, L, De Luca, Mg, Laforgia, N, Grassi, A, Gesu, Rb, Dotta, A, Savignoni, F, Bagnoli, F, De Felice, C, Badii, S, Biasini, A, Belluzzi, A, Stella, M, Romagnoli, C, Zecca, E, Barone, G, Colleselli, P, Vecchiato, L, Nicolussi, D, Monaldi, N, Giliberti, P, Chello, G, Rojo, S, Giovanettoni, C, Colnaghi, Ca, Verucci, E, Placidi, G, Belloni, C, Carrera, G, Zambetti, C, Biban, P, Serra, A, Carnielli, V, Pedini, A, Vetrano, G, Furcolo, G, Pasquariello, B, Falco, L, Ausanio, G, Bernardo, I, Marchesano, G, Nosari, N, Sarnelli, P, Maccabruni, M, Merazzi, D, Gazzolo, D, Sabatini, Ft, Colivicchi, M, Del Vecchio, A, Tarantino, M, Gargano, G, Pedori, S, Bellettato, M, Pesavento, R, Cesaro, A, Nicolò, A, Mondello, I, Pugliese, A, Iervolino, C, Giuffré, M, Betta, M, Romeo, Mg, Saporito, A, D'Incecco, C, Perrone, B, Rodonò, Mg, Serra, G, Franceschi, A, Risso, Fm, Carpentieri, M, Cigliano, Mp, Casilino, R, Paolillo, P, Picone, S, Marra, A, Rossetti, D, Testa, T, and Del Cuore, F.

Subjects
Preterm infants, Ventilation, Ventilatory support, Medicine (all), Drug Utilization, Humans, Infant Mortality, Infant, Newborn, Infant, Very Low Birth Weight, Intubation, Intratracheal, Italy, Oxygen Inhalation Therapy, Pulmonary Surfactants, Respiration, Artificial, Infant, Premature, Settore MED/38 - Pediatria Generale E Specialistica, Premature, Very Low Birth Weight, Respiration, Infant, Newborn, national survay, Intratracheal, Very preterm infant, national survay, neonatal respiratory care, Very preterm infant, Artificial, Preterm infant, neonatal respiratory care, Intubation
Abstract

INTRODUCTION: Variation of respiratory care is described between centers around the world. The Italian Neonatal Network (INN), as a national group of the Vermont-Oxford Network (VON) allows to perform a wide analysis of respiratory care in very low birth weight infants. METHODS: We analyzed the dataset of infants enrolled in the INN in 2009 and 2010 and, for surfactant administration only, from 2006 to 2010 from 83 participating centers. All definitions are those of the (VON). A questionnaire analysis was also performed with a questionnaire on centers practices. RESULTS: We report data for 8297 infants. Data on ventilator practices and outcomes are outlined. Variation for both practices and outcome is found. Trend in surfactant administration is also analyzed. CONCLUSIONS. The great variation across hospitals in all the surveyed techniques points to the possibility of implementing potentially better practices with the aim of reducing unwanted variation. These data also show the power of large neonatal networks in identifying areas for potential improvement.

39. Post-discharge nutrition of the very low-birthweight infant: Interim results of the multicentric GAMMA study

Author

Agosti, M., Vegni, C., Calciolari, G., Marini, A., Mautone, A., Cosmo, L., Ladisa, G., Alessandroni, R., Capretti, A., Chiappe, S., Palmas, G., Polizzi, B., Angrì, F., Catalano, L., Sabatino, G., Domizio, S., Rinaldi, G., Popolo, G., Spennati, G. F., Persia, R., Zanini, R., roberto bellu', Stronati, M., Mussini, P., Ferrari, F., Ferrari, P., Paino, G., Napolitano, M., Spinella, B., Pomo, R., Rondini, G., Polito, E., Lungarotti, S., Soldani, C., Dore, A., Oggiano, R., Mussa, G. C., Farinasso, D., Agosta, G., Saia, S., Battajon, N., Macagno, F., Chiandotto, V., and Leva, L.

Subjects
Male, Pediatrics, medicine.medical_specialty, Post discharge, Group B, Corrected Age, Interim, Humans, Infant, Very Low Birth Weight, Medicine, Prospective Studies, Infant Nutritional Physiological Phenomena, Interim report, Psychomotor learning, business.industry, Infant, Newborn, General Medicine, medicine.disease, Infant Formula, Patient Discharge, Head circumference, Pediatrics, Perinatology and Child Health, Small for gestational age, Female, business, very low birth wieight, Psychomotor Performance
Abstract

This report presents the interim results up to 12 mo corrected age (c.a.) of a multicentric, prospective, controlled study on very low-birthweight infants, randomized at 40 wk post-conception in two different groups of formula feeding: 80 Kcal/dL (group A) vs 70 Kcal/dL (group B) up to 55 wk of postconceptional age. Subsequently, all the babies were fed with a follow-on formula, with the introduction of solid foods at 6 mo c.a. Weight, length, head circumference and neurological conditions with psychomotor development (evaluated by the Griffiths' Developmental Scale) were measured at regular intervals and all of these parameters were satisfactory in both groups. For growth, in group A there was a greater increase in weight in boys at 55 wk and at 6 mo c.a., and small for gestational age (SGA) babies had a greater increase in length at 1 y of age, while head circumference caught up on growth from week 40 to week 55. Measured by the Griffiths' Developmental Scale, the SGA group fed 80 Kcal/dL had a better score at 6 mo; similarly boys fed 80 Kcal/dL had a better score at 6 and at 9 mo. Conclusion: Nutrition of very low birthweight infants post-discharge could have an influence on physical growth and on neurodevelopmental outcome. This interim report needs to be confirmed at the end of the study.

47. Continuous thoracic spinal anesthesia with local anesthetic plus midazolam and ketamine is superior to local anesthetic plus fentanyl in major abdominal surgery

Author

Roberto Bucchianeri, Paolo Vincenzi, Alfredo Venezia, Roberto Starnari, Roberto Montalti, Gianfranco Boccoli, Leonardo Chiodi, Lesley De Pietri, Massimo Stronati, Marina Giampieri, Riccardo Grifoni, Diletta Gaudenzi, Lucia Faloia, Vincenzi, P., Starnari, R., Faloia, L., Grifoni, R., Bucchianeri, R., Chiodi, L., Venezia, A., Stronati, M., Giampieri, M., Montalti, R., Gaudenzi, D., De Pietri, L., and Boccoli, G.

Subjects
Bupivacaine, Local anesthetic, medicine.drug_class, business.industry, Sedation, lcsh:Surgery, Perioperative, lcsh:RD1-811, Article, Fentanyl, Anesthesia, medicine, Midazolam, Ketamine, medicine.symptom, business, Abdominal surgery, medicine.drug
Abstract

Background Limited studies have applied thoracic continuous spinal anesthesia in abdominal surgery, relying exclusively on opioids. This retrospective study analyzes 2 different schemes of thoracic continuous spinal anesthesia and postoperative analgesia in elderly patients undergoing major abdominal surgery. Methods A total of 98 patients aged ≥ 75 years were divided into 2 groups. The control group (60 patients) received bupivacaine plus fentanyl, whereas the study group (38 patients) received bupivacaine plus ketamine and midazolam. Both received analogous postoperative continuous intrathecal analgesia. Several perioperative variables were evaluated. Results Spinal anesthesia was performed without complications in all patients. Doses of noradrenaline administered, incidence of respiratory depression, need for intraoperative sedation, and time to first flatus were significantly reduced in the bupivacaine plus ketamine and midazolam group. Conclusion In a population of frail, elderly patients, thoracic continuous spinal anesthesia with local anesthetic plus midazolam and ketamine was superior to local anesthetic plus fentanyl. In the group receiving local anesthetic plus midazolam and ketamine, the incidence of respiratory depression was reduced, and doses of norepinephrine and intraoperative sedating medications were lower. Intraoperative anesthesia and postoperative analgesia were similar in both groups.

Published
2020

48. incidence and risk factors of bacterial sepsis and invasive fungal infection in neonates and infants requiring major surgery: an Italian multicentre prospective study

Author

C, Auriti, D U, De Rose, A, Santisi, L, Martini, M P, Ronchetti, L, Ravà, V, Antenucci, P, Bernaschi, L, Serafini, S, Catarzi, P, Fiorini, P, Betta, M G, Scuderi, V, Di Benedetto, S, Ferrari, M, Maino, F, Cavigioli, I, Cocchi, M, Giuffré, E, Bonanno, C, Tzialla, J, Bua, L, Pugni, B, Della Torre, G, Nardella, D, Mazzeo, P, Manzoni, I, Capolupo, M, Ciofi Degli Atti, A, Dotta, M, Stronati, M, Raponi, F, Mosca, P, Bagolan, Auriti C., De Rose D.U., Santisi A., Martini L., Ronchetti M.P., Rava L., Antenucci V., Bernaschi P., Serafini L., Catarzi S., Fiorini P., Betta P., Scuderi M.G., Di Benedetto V., Ferrari S., Maino M., Cavigioli F., Cocchi I., Giuffre M., Bonanno E., Tzialla C., Bua J., Pugni L., Della Torre B., Nardella G., Mazzeo D., Manzoni P., Capolupo I., Ciofi degli Atti M., Dotta A., Stronati M., Raponi M., Mosca F., and Bagolan P.

Subjects
Microbiology (medical), Settore MED/38 - Pediatria Generale e Specialistica, Fungal infection, Antifungal Agents, Incidence, Infant, Newborn, Infant, General Medicine, Candida, Fungal colonization, Neonatal sepsis, Surgery, Infectious Diseases, Mycoses, Risk Factors, Sepsis, Humans, Prospective Studies, Neonatal sepsi, fungal infection Fungal colonization Neonatal sepsis Surgery Candida, Invasive Fungal Infections
Abstract

Background: Limited data are currently available on the incidence rates and risk factors for bacterial sepsis and invasive fungal infections (IFIs) among neonates and infants undergoing major surgery. Aim: To assess the incidence of bacterial sepsis and IFI, fungal colonization, risk factors for sepsis, and mortality in neonates and infants aged

Published
2022

49. Probiotics’ efficacy in paediatric diseases: which is the evidence? A critical review on behalf of the Italian Society of Pediatrics

Author

Andrea Lo Vecchio, Alberto Villani, Irene Viola, Massimo Martinelli, Marisa Bobbio, Mauro Stronati, Annamaria Staiano, Giuseppe Banderali, Mattia Olivero, Claudio Romano, Elisa Civardi, Sofia D’Elios, Renato Turra, Alberto Chiara, Diego Peroni, Martinelli, M., Banderali, G., Bobbio, M., Civardi, E., Chiara, A., D'Elios, S., Lo Vecchio, A., Olivero, M., Peroni, D., Romano, C., Stronati, M., Turra, R., Viola, I., Staiano, A., and Villani, A.

Subjects
medicine.medical_specialty, Allergy, Functional gastrointestinal disorders, MEDLINE, Review, Cochrane Library, 03 medical and health sciences, 0302 clinical medicine, Functional gastrointestinal disorder, Necrotizing enterocolitis, 030225 pediatrics, Medicine, Necrotizing enterocoliti, Acute infectious diarrhoea, Allergy, Functional gastrointestinal disorders, Necrotizing enterocolitis, Paediatrics, Probiotics, 030212 general & internal medicine, Intensive care medicine, Acute infectious diarrhoea, Paediatrics, Probiotics, Health professionals, Maternal and child health, business.industry, Clinical study design, lcsh:RJ1-570, Small sample, lcsh:Pediatrics, medicine.disease, Settore MED/38, Paediatric, business, Infectious diarrhoea
Abstract

During the last decade several paediatric studies have been published with different possible indications for probiotics, leading to a global increase of probiotics’ market. Nevertheless, different study designs, multiple single/combined strains and small sample size still leave many uncertainties regarding their efficacy. In addition, different regulatory and quality control issues make still very difficult the interpretation of the clinical data. The objective of this review is to critically summarise the current evidence on probiotics’ efficacy and safety on a different number of pathologies, including necrotizing enterocolitis, acute infectious diarrhoea, allergic diseases and functional gastrointestinal disorders in order to guide paediatric healthcare professionals on using evidence-based probiotics’ strains. To identify relevant data, literature searches were performed including Medline-PubMed, the Cochrane Library and EMBASE databases. Considering probiotics strain-specific effects, the main focus was on individual probiotic strains and not on probiotics in general.

Published
2020

50. Monitoring neonatal fungal infection with metabolomics

Author

Vassilios Fanos, Marco Zaffanello, Angelica Dessì, Mario Giuffrè, Mauro Stronati, Antonio Noto, Pierluigi Caboni, Giovanni Corsello, Francesca Serraino, Barbara Liori, Dessì, A, Liori, B, Caboni, P, Corsello, G, Giuffrè, M, Noto, A, Serraino, F, Stronati, M, Zaffanello, M, and Fanos, V

Subjects
Fungal infection, medicine.medical_specialty, Urine, Infant, Newborn, Diseases, sepsis, Sepsis, Settore MED/38 - Pediatria Generale E Specialistica, Metabolomics, Intensive Care Units, Neonatal, medicine, Humans, Intensive care medicine, Principal Component Analysis, Patient affected, business.industry, Infant, Newborn, Obstetrics and Gynecology, medicine.disease, Italy, Mycoses, fungal infections, Pediatrics, Perinatology and Child Health, Metabolome, Population study, Metabolomic, Prematurity, Fungal sepsis, Clinical case, neonate, business, Biomarkers, Metabolic profile, metabolomic
Abstract

The objective of our study was to evaluate the capability of the metabolomics approach to identify the variations of urine metabolites over time related to the neonatal fungal septic condition. The study population included a clinical case of a preterm neonate with invasive fungal infection and 13 healthy preterm controls. This study showed a unique urine metabolic profile of the patient affected by fungal sepsis compared to urine of controls and it was also possible to evaluate the efficacy of therapy in improving patient health.

Published
2014
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results